Compare versions
--- version:4990S.01P - Perfected+++ version:4990H.07C - House Committee Substitute@@ -1,210 +1,2931 @@-EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted-and is intended to be omitted in the law.SECOND REGULAR SESSION-[PERFECTED]-SENATE BILL NO. 1092-103RD GENERAL ASSEMBLY-INTRODUCED BY SENATOR LEWIS.-4990S.01P KRISTINA MARTIN, Secretary+HOUSE COMMITTEE SUBSTITUTE FOR+SENA TE BILL NO. 1092+103RD GENERAL ASSEMBL Y+4990H.07C JOSEPH ENGLER, Chief ClerkAN ACT-To repeal section 337.600, RSMo, and to enact in lieu thereof one new section relating to social-workers.-Be it enacted by the General Assembly of the State of Missouri, as follows:- Section A. Section 337.600, RSMo, is repealed and one new 1-section enacted in lieu thereof, to be known as section 337.600, 2-to read as follows:3- 337.600. As used in sections 337.600 to 337.689, the 1-following terms mean: 2- (1) "Advanced macro social worker", the applications 3-of social work theory, knowledge, methods, principles, 4-values, and ethics; and the professional use of self to 5-community and organizational systems, systemic and macrocosm 6-issues, and other indirect nonclinical services; specialized 7-knowledge and advanced practice skills in case management, 8-information and referral, nonclinical assessments, 9-counseling, outcome evaluation, mediation, nonclinical 10-supervision, nonclinical consultation, expert testimony, 11-education, outcome evaluation, research, advocacy, social 12-planning and policy development, community organization, and 13-the development, implementation and administration of 14-policies, programs, and activities. A licensed advanced 15-macro social worker may not treat mental or emotional 16- SB 1092 2-disorders or provide psychotherapy without the direct 17-supervision of a licensed clinical social worker, or 18-diagnose a mental disorder; 19- (2) "Clinical social work", the application of social 20-work theory, knowledge, values, methods, principles, and 21-techniques of case work, group work, client-centered 22-advocacy, community organization, administration, planning, 23-evaluation, consultation, research, psychotherapy and 24-counseling methods and techniques to persons, families and 25-groups in assessment, diagnosis, treatment, prevention and 26-amelioration of mental and emotional conditions; 27- (3) "Committee", the state committee for social 28-workers established in section 337.622; 29- (4) "Department", the Missouri department of commerce 30-and insurance; 31- (5) "Director", the director of the division of 32-professional registration; 33- (6) "Division", the division of professional 34-registration; 35- (7) "Independent practice", any practice of social 36-workers outside of an organized setting such as a social, 37-medical, or governmental agency in which a social worker 38-assumes responsibility and accountability for services 39-required; 40- (8) "Licensed advanced macro social worker", any 41-person who offers to render services to individuals, groups, 42-families, couples, organizations, institutions, communities, 43-government agencies, corporations, or the general public for 44-a fee, monetary or otherwise, implying that the person is 45-trained, experienced, and licensed as an advanced macro 46-social worker, and who holds a current valid license to 47-practice as an advanced macro social worker; 48- SB 1092 3- (9) "Licensed baccalaureate social worker", any person 49-who offers to render services to individuals, groups, 50-organizations, institutions, corporations, government 51-agencies, or the general public for a fee, monetary or 52-otherwise, implying that the person is trained, experienced, 53-and licensed as a baccalaureate social worker, and who holds 54-a current valid license to practice as a baccalaureate 55-social worker; 56- (10) "Licensed clinical social worker", any person who 57-offers to render services to individuals, groups, 58-organizations, institutions, corporations, government 59-agencies, or the general public for a fee, monetary or 60-otherwise, implying that the person is trained, experienced, 61-and licensed as a clinical social worker, and who holds a 62-current, valid license to practice as a clinical social 63-worker; 64- (11) "Licensed master social worker", any person who 65-offers to render services to individuals, groups, families, 66-couples, organizations, institutions, communities, 67-government agencies, corporations, or the general public for 68-a fee, monetary or otherwise, implying that the person is 69-trained, experienced, and licensed as a master social 70-worker, and who holds a current valid license to practice as 71-a master social worker. A licensed master social worker may 72-not treat mental or emotional disorders, provide 73-psychotherapy without the direct supervision of a licensed 74-clinical social worker, or diagnose a mental disorder; 75- (12) "Master social work", the application of social 76-work theory, knowledge, methods, and ethics and the 77-professional use of self to restore or enhance social, 78-psychosocial, or biopsychosocial functioning of individuals, 79-couples, families, groups, organizations, communities, 80- SB 1092 4-institutions, government agencies, or corporations. The 81-practice includes the applications of specialized knowledge 82-and advanced practice skills in the areas of assessment, 83-treatment planning, implementation and evaluation, case 84-management, mediation, information and referral, counseling, 85-client education, supervision, consultation, education, 86-research, advocacy, community organization and development, 87-planning, evaluation, implementation and administration of 88-policies, programs, and activities. Under supervision as 89-provided in this section, the practice of master social work 90-may include the practices reserved to clinical social 91-workers or advanced macro social workers for no more than 92-forty-eight consecutive calendar months for the purpose of 93-obtaining licensure under section 337.615 or 337.645; 94- (13) "Practice of advanced macro social work", 95-rendering, offering to render, or supervising those who 96-render to individuals, couples, families, groups, 97-organizations, institutions, corporations, government 98-agencies, communities, or the general public any service 99-involving the application of methods, principles, and 100-techniques of advanced practice macro social work; 101- (14) "Practice of baccalaureate social work", 102-rendering, offering to render, or supervising those who 103-render to individuals, families, groups, organizations, 104-institutions, corporations, or the general public any 105-service involving the application of methods, principles, 106-and techniques of baccalaureate social work; 107- (15) "Practice of clinical social work", rendering, 108-offering to render, or supervising those who render to 109-individuals, couples, groups, organizations, institutions, 110-corporations, or the general public any service involving 111- SB 1092 5-the application of methods, principles, and techniques of 112-clinical social work; 113- (16) "Practice of master social work", rendering, 114-offering to render, or supervising those who render to 115-individuals, couples, families, groups, organizations, 116-institutions, corporations, government agencies, 117-communities, or the general public any service involving the 118-application of methods, principles, and techniques of master 119-social work; 120- (17) "Qualified advanced macro supervisor", any 121-licensed social worker who meets the qualifications of a 122-qualified clinical supervisor or a licensed advanced macro 123-social worker who has: 124- (a) Practiced in the field of social work as a 125-licensed social worker for which he or she is supervising 126-the applicant for a minimum of [five] three years; 127- (b) Successfully completed a minimum of sixteen hours 128-of supervisory training from the Association of Social Work 129-Boards, the National Association of Social Workers, an 130-accredited university, or a program approved by the state 131-committee for social workers. All organizations providing 132-the supervisory training shall adhere to the basic content 133-and quality standards outlined by the state committee on 134-social work; and 135- (c) Met all the requirements of sections 337.600 to 136-337.689, and as defined by rule by the state committee for 137-social workers; 138- (18) "Qualified baccalaureate supervisor", any 139-licensed social worker who meets the qualifications of a 140-qualified clinical supervisor, qualified master supervisor, 141-qualified advanced macro supervisor, or a licensed 142-baccalaureate social worker who has: 143- SB 1092 6- (a) Practiced in the field of social work as a 144-licensed social worker for which he or she is supervising 145-the applicant for a minimum of [five] three years; 146- (b) Successfully completed a minimum of sixteen hours 147-of supervisory training from the Association of Social Work 148-Boards, the National Association of Social Workers, an 149-accredited university, or a program approved by the state 150-committee for social workers. All organizations providing 151-the supervisory training shall adhere to the basic content 152-and quality standards outlined by the state committee on 153-social workers; and 154- (c) Met all the requirements of sections 337.600 to 155-337.689, and as defined by rule by the state committee for 156-social workers; 157- (19) "Qualified clinical supervisor", any licensed 158-clinical social worker who has: 159- (a) Practiced in the field of social work as a 160-licensed social worker for which he or she is supervising 161-the applicant for a minimum of [five] three years; 162- (b) Successfully completed a minimum of sixteen hours 163-of supervisory training from the Association of Social Work 164-Boards, the National Association of Social Workers, an 165-accredited university, or a program approved by the state 166-committee for social workers. All organizations providing 167-the supervisory training shall adhere to the basic content 168-and quality standards outlined by the state committee on 169-social work; and 170- (c) Met all the requirements of sections 337.600 to 171-337.689, and as defined by rule by the state committee for 172-social workers; 173- (20) "Social worker", any individual that has: 174- SB 1092 7- (a) Received a baccalaureate degree in social work 175-from an accredited social work program approved by the 176-Council on Social Work Education; 177- (b) Received a master's degree in social work from a 178-social work program: 179- a. Accredited by the Council on Social Work Education; 180-or 181- b. Recognized and approved by the committee in 182-accordance with rules adopted by the committee under section 183-337.627 and in accordance with the procedure set forth in 184-section 337.628; 185- (c) Received a doctorate or Ph.D. in social work; or 186- (d) A current social worker license as set forth in 187-sections 337.600 to 337.689. 188-✓+T o repeal sections 324.009, 332.081, 337.600, and 345.050, RSMo, and to enact in lieu+thereof forty-six new sections relating to professional licensure.+Be it enacted by the General Assembly of the state of Missouri, as follows:+Section A. Sections 324.009, 332.081, 337.600, and 345.050, RSMo, are repealed+2 and forty-six new sections enacted in lieu thereof, to be known as sections 324.004, 324.009,+3 324.218, 324.1800, 324.1805, 324.1810, 324.1815, 324.1820, 324.1825, 324.1830, 324.1835,+4 324.1840, 324.1845, 324.1850, 324.1855, 324.1860, 324.1865, 332.081, 332.700, 332.705,+5 332.710, 332.715, 332.720, 332.725, 332.730, 332.735, 332.740, 332.745, 332.750, 332.755,+6 332.760, 334.1800, 334.1805, 334.1810, 334.1815, 334.1820, 334.1825, 334.1830, 334.1835,+7 334.1840, 334.1845, 334.1850, 334.1855, 334.1860, 337.600, and 345.050, to read as+8 follows:+324.004 . 1. Any person who has at least thr ee years of work experience in an+2 occupation or pro fession in another state, the District of Columbia, or any combination+3 of such jurisdictions, and whose work experience involved the practice of an occupation+4 or profes sion for which a license is not r equir ed in the jurisdiction or jurisdictions in+5 which the person worked but is r equir ed in this state, may submit an application for a+6 one-time nonr enewable two-year temporary license in this state in the occupation or+7 pr ofession, along with pr oof of at least thr ee years of work experience in the occupation+8 or pr ofession and a fee as set by regu lation of the oversight body , to the r elevant+9 oversight body in this state. The oversight body shall make a determination of+10 qualification within forty-five days of r eceiving a completed application.+11 2. The oversight body shall req uir e an applicant under this section to take and+12 pass the examination specific to the occupation or pr ofession which is re quir ed for+EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is+intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.+13 licensur e by those individuals applying pursuant to the pr ovisions of the oversight+14 body's statutory and regu latory authority . An oversight body that administers an+15 examination on the laws of this state as part of its licensing application requi rem ents+16 may requi re an applicant under this section to take and pass an examination specific to+17 the laws of this state.+18 3. The oversight body shall not issue a one-time nonr enewable temporary license+19 to any applicant described in subsection 1 of this section who has had any license in the+20 r elevant occupation or pr ofession r evoked by an oversight body outside of this state,+21 who is curr ently under investigation, who has a complaint pending, or who is curr ently+22 under disciplinary action.+23 4. (1) Except as pr ovided in subdivision (2) of this subsection, applicants for the+24 one-time temporary nonr enewable license under this section shall be citizens of the+25 United States or lawfully present noncitizens authorized to work in the United States+26 under federal law and shall submit legal pr oof of citizenship or employment+27 authorization that is acceptable for the employment eligibility verification under+28 federal law as part of the application. If the holder of a one-time nonr enewable+29 temporary license issued under this section loses lawful pr esence or federal work+30 authorization, the one-time nonr enewable temporary license shall automatically be+31 r evoked.+32 (2) Applicants for the one-time nonr enewable temporary license under this+33 section in an occupation reg ulated by the board of therapeutic massage shall be citizens+34 of the United States and shall submit legal pr oof of citizenship as part of the application.+35 5. If an applicant is not curr ently r esiding in this state, the oversight body shall+36 conditionally appr ove the application contingent upon rece ipt of pr oof of domicile in+37 this state within sixty days of the applicant r eceiving the temporary license. If the+38 applicant fails to pr ovide proo f within sixty days of receiv ing the temporary license, the+39 oversight body may terminate the temporary license and the applicant may reap ply for+40 a temporary license.+41 6. The pr ovisions of this section shall not apply to the following:+42 (1) Any occupation whose oversight body has enter ed into a licensing compact+43 with another state for the regul ation of practice under the oversight body's jurisdiction.+44 The pro visions of this section shall not be construed to alter the authority granted by , or+45 any r equirements pr omulgated pursuant to, any interjurisdictional or interstate+46 compacts adopted by this state or any rec iproci ty agr eements with other states, and+47 whenever possible the pr ovisions of this section shall be interpret ed so as to imply no+48 conflict between it and any compact or any r ecipro city agr eement with other states;+HCS SB 1092 2+49 (2) Any occupation set forth in subsection 6 of section 290.257 or any electrical+50 contractor licensed under sections 324.900 to 324.945;+51 (3) Any occupation whose r egulators or licensees are requ ired to comply with+52 specific federal statutory , regu latory , and administrative requ irem ents in order to+53 practice in this state; or+54 (4) Assistant physicians licensed under chapter 334.+55 7. The one-time nonr enewable temporary license shall expir e after two years.+56 Upon expiration, the individual shall be req uire d to apply for a permanent license in+57 accordance with the license r equir ements for the occupation for which he or she held the+58 temporary license.+59 8. Notwithstanding any other provi sion of law to the contrary , a license issued+60 under this section shall be valid only in this state and shall not make a licensee eligible to+61 be part of an interstate compact. An applicant who is licensed in another state pursuant+62 to an interstate compact shall not be eligible for licensur e by an oversight body under+63 the pro visions of this section.+64 9. Notwithstanding any other provi sion of law to the contrary , a license issued+65 under this section shall be valid only in this state and shall not make a licensee eligible to+66 obtain a license by reci proci ty in another state.+67 10. As used in this section, the term "oversight body" means any board,+68 department, agency , or office of a jurisdiction that issues occupational or profession al+69 licenses.+70 1 1. The division of profes sional r egistration may pro mulgate rules to implement+71 the pr ovisions of this section. Any rule or portion of a rule, as that term is defined in+72 section 536.010, that is crea ted under the authority delegated in this section shall+73 become effective only if it complies with and is subject to all of the provi sions of chapter+74 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable+75 and if any of the powers vested with the general assembly pursuant to chapter 536 to+76 r eview , to delay the effective date, or to disappr ove and annul a rule are subsequently+77 held unconstitutional, then the grant of rulemaking authority and any rule pr oposed or+78 adopted after August 28, 2026, shall be invalid and void.+324.009. 1. For purposes of this section, the following terms mean:+2 (1) "License", a license, certificate, registration, permit, accreditation, or military+3 occupational speciality that enables a person to legally practice an occupation or profession in+4 a particular jurisdiction;+5 (2) "Military", the Armed Forces of the United States including the Air Force, Army ,+6 Coast Guard, Marine Corps, Navy , Space Force, National Guard and any other military+7 branch that is designated by Congress as part of the Armed Forces of the United States, and+HCS SB 1092 3+8 all reserve components and auxiliaries. Such term also includes the military reserves and+9 militia of any United States territory or state;+10 (3) "Missouri law enforcement officer", any person employed by or otherwise serving+11 in a position for the state or a local governmental entity in the state of Missouri as a police+12 of ficer , peace of ficer certified under chapter 590, auxiliary police of ficer , sheriff, sheriff 's+13 deputy , member of the patrol as that term is defined in section 43.010, or in some like position+14 involving the enforcement of the law and protection of the public interest at the risk of that+15 person's life and who is a permanent resident of the state of Missouri or who is domiciled in+16 the state of Missouri;+17 (4) "Nonresident military or law enforcement spouse":+18 (a) A nonresident spouse of an active duty member of the Armed Forces of the United+19 States who has been transferred or is scheduled to be transferred to the state of Missouri, or+20 who has been transferred or is scheduled to be transferred to an adjacent state and is or will be+21 domiciled in the state of Missouri, or has moved to the state of Missouri on a permanent+22 change-of-station basis; or+23 (b) A nonresident spouse of a person residing outside the state of Missouri who has+24 accepted an offer of employment from and with the state or a local governmental entity in the+25 state of Missouri and who will become a Missouri law enforcement of ficer upon the+26 commencement of such employment;+27 (5) "Oversight body", any board, department, agency , or of fice of a jurisdiction that+28 issues licenses;+29 (6) "Resident military or law enforcement spouse", a spouse of an active duty+30 member of the Armed Forces of the United States who has been transferred or is scheduled to+31 be transferred to the state of Missouri or an adjacent state and who is a permanent resident of+32 the state of Missouri, who is domiciled in the state of Missouri, or who has Missouri as his or+33 her home of record, or a spouse of a Missouri law enforcement of ficer .+34 2. Any person who holds a valid current license issued by another state, a branch or+35 unit of the military , a territory of the United States, or the District of Columbia, and who has+36 been licensed for at least one year in such other jurisdiction, may submit an application for a+37 license in Missouri in the same occupation or profession, and at the same practice level, for+38 which he or she holds the current license, along with proof of current licensure and proof of+39 licensure for at least one year in the other jurisdiction, to the relevant oversight body in this+40 state.+41 3. The oversight body in this state shall:+42 (1) W ithin six months of receiving an application described in subsection 2 of this+43 section, waive any examination, educational, or experience requirements for licensure in this+44 state for the applicant if it determines that there were minimum education requirements and, if+HCS SB 1092 4+45 applicable, work experience and clinical supervision requirements in ef fect and the other+46 [ state ] jurisdiction verifies that the person met those requirements in order to be licensed or+47 certified in that [ state ] jurisdiction . An oversight body that administers an examination on+48 laws of this state as part of its licensing application requirement may require an applicant to+49 take and pass an examination specific to the laws of this state; or+50 (2) W ithin thirty days of receiving an application described in subsection 2 of this+51 section from a nonresident military or law enforcement spouse or a resident military or law+52 enforcement spouse, waive any examination, educational, or experience requirements for+53 licensure in this state for the applicant and issue such applicant a license under this section if+54 such applicant otherwise meets the requirements of this section.+55 4. (1) The oversight body shall not waive any examination, educational, or+56 experience requirements for any applicant who has had his or her license revoked by an+57 oversight body outside the state; who is currently under investigation, who has a complaint+58 pending, or who is currently under disciplinary action, except as provided in subdivision (2)+59 of this subsection, with an oversight body outside the state; who does not hold a license in+60 good standing with an oversight body outside the state; who has a criminal record that would+61 disqualify him or her for licensure in Missouri; or who does not hold a valid current license in+62 the other jurisdiction on the date the oversight body receives his or her application under this+63 section.+64 (2) If another jurisdiction has taken disciplinary action against an applicant, the+65 oversight body shall determine if the cause for the action was corrected and the matter+66 resolved. If the matter has not been resolved by that jurisdiction, the oversight body may+67 deny a license until the matter is resolved.+68 5. Nothing in this section shall prohibit the oversight body from denying a license to+69 an applicant under this section for any reason described in any section associated with the+70 occupation or profession for which the applicant seeks a license.+71 6. Any person who is licensed under the provisions of this section shall be subject to+72 the applicable oversight body's jurisdiction and all rules and regulations pertaining to the+73 practice of the licensed occupation or profession in this state. Any health care provi der+74 licensed under the pr ovisions of this section shall be deemed fully licensed to practice+75 within the pr ofession's scope of practice in this state and may pr ovide telehealth services+76 as described in section 191.1 145 to the same extent and in the same manner as a health+77 car e pr ovider who r eceived his or her license without a waiver of any requ irem ents.+78 7. This section shall not be construed to waive any requirement for an applicant to+79 pay any fees, post any bonds or surety bonds, or submit proof of insurance associated with the+80 license the applicant seeks.+HCS SB 1092 5+81 8. This section shall not apply to business, professional, or occupational licenses+82 issued or required by political subdivisions.+83 9. The provisions of this section shall not impede an oversight body's authority to+84 require an applicant to submit fingerprints as part of the application process.+85 10. The provisions of this section shall not be construed to alter the authority granted+86 by , or any requirements promulgated pursuant to, any interjurisdictional or interstate+87 compacts adopted by Missouri statute or any reciprocity agreements with other states in+88 ef fect, and whenever possible this section shall be interpreted so as to imply no conflict+89 between it and any compact, or any reciprocity agreements with other states in ef fect.+90 1 1. Notwithstanding any other provision of law , a license issued under this section+91 shall be valid only in this state and shall not make a licensee eligible to be part of an interstate+92 compact. An applicant who is licensed in another state pursuant to an interstate compact shall+93 not be eligible for licensure by an oversight body under the provisions of this section.+94 12. The provisions of this section shall not apply to any occupation set forth in+95 subsection 6 of section 290.257, or any electrical contractor licensed under sections 324.900+96 to 324.945.+324.218. 1. An applicant who has not pr eviously taken or passed an examination+2 r ecognized by the committee and who meets the qualifications of subsection 2 of section+3 324.210 may obtain without examination a nonr enewable temporary license by paying a+4 temporary-license fee and submitting to the committee an agre ement-to-supervise form+5 that is signed by a licensed dietitian who has agr eed to supervise the applicant. Such+6 temporary licensee may practice dietetics, but any such practice shall be under the+7 supervision of a dietitian licensed in this state.+8 2. (1) Any dietitian who has agr eed to supervise a temporary licensee shall hold+9 an unencumber ed license to practice dietetics in this state and shall prov ide the+10 committee pr oof of active dietetics practice in this state for a minimum of one year+11 befor e supervising the temporary licensee.+12 (2) The supervising dietitian shall not be an immediate family member of the+13 temporary licensee. The committee shall define the term "immediate family member"+14 for purposes of this subdivision and the scope of such supervision by rule.+15 3. (1) The dietitian who has agr eed to supervise the applicant for a temporary+16 license shall submit to the committee a signed and notarized form pr escribed by the+17 committee attesting that the applicant for a temporary license shall begin employment+18 at a location in this state within seven days of issuance of the temporary license.+19 (2) If the temporary licensee's employment described in subdivision (1) of this+20 subsection ceases, the supervising dietitian shall notify the committee within thr ee days+21 of such cessation.+HCS SB 1092 6+22 4. A licensed dietitian shall not supervise mor e than one temporary licensee at a+23 time.+24 5. The temporary license obtained by an applicant under this section shall expir e+25 the date the committee is notified by the supervising dietitian that the temporary+26 licensee's employment has ceased or within one hundred eighty days of its issuance,+27 whichever occurs first.+324.1800. 1. Sections 324.1800 to 324.1865 shall be known and may be cited as+2 the "Dietitian Licensur e Compact".+3 2. The purpose of this Compact is to facilitate interstate Practice of Dietetics+4 with the goal of impro ving public access to dietetics services. This Compact preserves+5 the regu latory authority of States to pr otect public health and safety thr ough the+6 curr ent system of State licensur e, while also pr oviding for licensur e portability thr ough+7 a Compact Privilege granted to qualifying pro fessionals.+8 3. This Compact is designed to achieve the following objectives:+9 (1) Increas e public access to dietetics services;+10 (2) Pr ovide opportunities for interstate practice by Licensed Dietitians who meet+11 uniform req uire ments;+12 (3) Eliminate the necessity for Licenses in multiple States;+13 (4) Reduce administrative burden on Member States and Licensees;+14 (5) Enhance the States' ability to pr otect the public's health and safety;+15 (6) Encourage the cooperation of Member States in regul ating multistate+16 practice of Licensed Dietitians;+17 (7) Support relo cating Active Military Members and their spouses;+18 (8) Enhance the exchange of licensure , investigative, and disciplinary+1 9 information among Member States; and+20 (9) V est all Member States with the authority to hold a Licensed Dietitian+21 accountable for meeting all State practice laws in the State in which the patient is+22 located at the time care is ren dered .+324.1805. As used in this Compact, and except as otherwise pr ovided, the+2 following definitions shall apply:+3 (1) "ACEND" means the Accred itation Council for Education in Nutrition and+4 Dietetics or its successor organization.+5 (2) "Active Military Member" means any individual with full-time duty status in+6 the active armed for ces of the United States, including members of the National Guard+7 and Reserve.+8 (3) "Adverse Action" means any administrative, civil, equitable or criminal+9 action permitted by a State's laws which is imposed by a Licensing Authority or other+HCS SB 1092 7+10 authority against a Licensee, including actions against an individual's License or+11 Compact Privilege such as revocation , suspension, pr obation, monitoring of the+12 Licensee, limitation on the Licensee's practice, or any other Encumbrance on licensur e+13 affecting a Licensee's authorization to practice, including issuance of a cease and desist+14 action.+15 (4) "Alternative Pr ogram" means a non-disciplinary monitoring or practice+16 r emediation pro cess appr oved by a Licensing Authority .+17 (5) "Charter Member State" means any Member State which enacted this+18 Compact by law before the Effective Date specified in section 324.1855.+19 (6) "Continuing Education" means a req uire ment, as a condition of License+20 r enewal, to pr ovide evidence of participation in, and completion of, educational and+21 pr ofessional activities releva nt to practice or ar ea of work.+22 (7) "CDR" means the Commission on Dietetic Registration or its successor+23 organization.+24 (8) "Compact Commission" means the government agency whose membership+25 consists of all States that have enacted this Compact, which is known as the Dietitian+26 Licensur e Compact Commission, as described in section 324.1835, and which shall+27 operate as an instrumentality of the Member States.+28 (9) "Compact Privilege" means a legal authorization, which is equivalent to a+29 License, permitting the Practice of Dietetics in a Remote State.+30 (10) "Current Significant Investigative Information" means:+31 (a) Investigative Information that a Licensing Authority , after a pr eliminary+32 inquiry that includes notification and an opportunity for the subject Licensee to+33 r espond, if requi red by State law , has rea son to believe is not gr oundless and, if prov ed+34 true, would indicate mor e than a minor infraction; or+35 (b) Investigative Information that indicates that the subject Licensee rep res ents+36 an immediate thr eat to public health and safety r egardless of whether the subject+37 Licensee has been notified and had an opportunity to res pond.+38 (1 1) "Data System" means a repo sitory of information about Licensees,+39 including, but not limited to, Continuing Education, examination, licensure ,+4 0 investigative, Compact Privilege and Adverse Action information.+41 (12) "Encumber ed License" means a License in which an Adverse Action+42 r estricts a Licensee's ability to practice dietetics.+43 (13) "Encumbrance" means a r evocation or suspension of, or any limitation on a+44 Licensee's full and unr estricted Practice of Dietetics by a Licensing Authority .+HCS SB 1092 8+45 (14) "Executive Committee" means a gr oup of delegates elected or appointed to+46 act on behalf of, and within the powers granted to them by , this Compact, and the+47 Compact Commission.+48 (15) "Home State" means the Member State that is the Licensee's primary State+49 of res idence or that has been designated pursuant to section 324.1825.+50 (16) "Investigative Information" means information, record s, and documents+51 r eceived or generated by a Licensing Authority pursuant to an investigation.+52 (17) "Jurisprudence Requirem ent" means an assessment of an individual's+53 knowledge of the State laws and r egulations governing the Practice of Dietetics in such+54 State.+55 (18) "License" means an authorization fr om a Member State to either:+56 (a) Engage in the Practice of Dietetics (including medical nutrition therapy); or+57 (b) Use the title "dietitian," "licensed dietitian," "licensed dietitian nutritionist,"+58 "certified dietitian," or other title describing a substantially similar practitioner as the+59 Compact Commission may further define by Rule.+60 (19) "Licensee" or "Licensed Dietitian" means an individual who curr ently+61 holds a License and who meets all of the requ irem ents outlined in section 324.1815.+62 (20) "Licensing Authority" means the board or agency of a State, or equivalent,+63 that is res ponsible for the licensing and r egulation of the Practice of Dietetics.+64 (21) "Member State" means a State that has enacted the Compact.+65 (22) "Practice of Dietetics" means the synthesis and application of dietetics as+66 defined by state law and regu lations, primarily for the pro vision of nutrition car e+67 services, including medical nutrition therapy , in person or via telehealth, to pr event,+68 manage, or tr eat diseases or medical conditions and pr omote wellness.+69 (23) "Registered Dietitian" means a person who:+70 (a) Has completed applicable education, experience, examination, and+7 1 r ecertification re quir ements appr oved by CDR;+72 (b) Is creden tialed by CDR as a r egistere d dietitian or a registe red dietitian+73 nutritionist; and+74 (c) Is legally authorized to use the title regi stered dietitian or reg istered dietitian+75 nutritionist and the corr esponding abbr eviations "RD" or "RDN."+76 (24) "Remote State" means a Member State other than the Home State, wher e a+77 Licensee is exer cising or seeking to exerci se a Compact Privilege.+78 (25) "Rule" means a regul ation pr omulgated by the Compact Commission that+79 has the for ce of law .+80 (26) "Single State License" means a License issued by a Member State within+81 the issuing State and does not include a Compact Privilege in any other Member State.+HCS SB 1092 9+82 (27) "State" means any state, commonwealth, district, or territory of the United+83 States of America.+84 (28) "Unencumber ed License" means a License that authorizes a Licensee to+85 engage in the full and unr estricted Practice of Dietetics.+324.1810. 1. T o participate in the Compact, a State must curre ntly:+2 (1) License and r egulate the Practice of Dietetics; and+3 (2) Have a mechanism in place for receivi ng and investigating complaints about+4 Licensees.+5 2. A Member State shall:+6 (1) Participate fully in the Compact Commission's Data System, including using+7 the unique identifier as defined in Rules;+8 (2) Notify the Compact Commission, in compliance with the terms of the+9 Compact and Rules, of any Adverse Action or the availability of Curren t Significant+10 Investigative Information regard ing a Licensee;+11 (3) Implement or utilize pr ocedur es for considering the criminal history reco rd+12 information of applicants for an initial Compact Privilege. These proced ures shall+13 include the submission of fingerprints or other biometric-based information by+14 applicants for the purpose of obtaining an applicant's criminal history re cord+15 information fr om the Federal Bureau of Investigation and the agency res ponsible for+16 r etaining that State's criminal reco rds;+17 (a) A Member State must fully implement a criminal history reco rd information+18 r equir ement, within a time frame established by Rule, which includes receivi ng the+19 r esults of the Federal Burea u of Investigation r ecord sear ch and shall use those r esults+20 in determining Compact Privilege eligibility .+21 (b) Communication between a Member State and the Compact Commission or+22 among Member States regard ing the verification of eligibility for a Compact Privilege+23 shall not include any information recei ved fr om the Federal Burea u of Investigation+24 r elating to a federal criminal history record information check performed by a Member+25 State;+26 (4) Comply with and enfor ce the Rules of the Compact Commission;+27 (5) Requir e an applicant for a Compact Privilege to obtain or ret ain a License in+28 the Licensee's Home State and meet the Home State's qualifications for licensur e or+29 r enewal of licensur e, as well as all other applicable State laws; and+30 (6) Recognize a Compact Privilege granted to a Licensee who meets all of the+31 r equir ements outlined in section 324.1815 in accordance with the terms of the Compact+32 and Rules.+33 3. Member States may set and collect a fee for granting a Compact Privilege.+HCS SB 1092 10+34 4. Individuals not r esiding in a Member State shall continue to be able to apply+35 for a Member State's Single State License as pr ovided under the laws of each Member+36 State. However , the Single State License granted to these individuals shall not be+37 r ecognized as granting a Compact Privilege to engage in the Practice of Dietetics in any+38 other Member State.+39 5. Nothing in this Compact shall affect the r equir ements established by a+40 Member State for the issuance of a Single State License.+41 6. At no point shall the Compact Commission have the power to define the+42 r equir ements for the issuance of a Single State License to practice dietetics. The+43 Member States shall ret ain sole jurisdiction over the pr ovision of these re quir ements.+324.1815. 1. T o exercise the Compact Privilege under the terms and pr ovisions+2 of the Compact, the Licensee shall:+3 (1) Satisfy one of the following:+4 (a) Hold a valid curr ent regi stration that gives the applicant the right to use the+5 term Register ed Dietitian; or+6 (b) Complete all of the following:+7 a. An education pr ogram which is either:+8 (i) A master's degree or doctoral degr ee that is progr ammatically accred ited by:+9 i. ACEND; or+10 ii. A dietetics accr editing agency recog nized by the United States Department of+11 Education, which the Compact Commission may by Rule determine, and fr om a college+12 or university accre dited at the time of graduation by the appr opriate region al+13 accr editing agency recogn ized by the Council on Higher Education Accr editation and+14 the United States Department of Education.+15 (ii) An academic degree fr om a college or university in a for eign country+16 equivalent to the degree described in item (i) that is pr ogrammatically accredi ted by:+17 i. ACEND; or+18 ii. A dietetics accr editing agency recog nized by the United States Department of+19 Education, which the Compact Commission may by Rule determine.+20 b. A planned, documented, supervised practice experience in dietetics that is+21 pr ogrammatically accr edited by:+22 (i) ACEND; or+23 (ii) A dietetics accred iting agency recog nized by the United States Department of+24 Education which the Compact Commission may by Rule determine and which involves+25 at least 1000 hours of practice experience under the supervision of a Register ed Dietitian+26 or a Licensed Dietitian.+27 c. Successful completion of either:+HCS SB 1092 1 1+28 (i) The Registration Examination for Dietitians administer ed by CDR; or+29 (ii) A national cr edentialing examination for dietitians appr oved by the Compact+30 Commission by Rule; such completion being no mor e than five years prior to the date of+31 the Licensee's application for initial licensur e and accompanied by a period of+32 continuous licensur e ther eafter , all of which may be further governed by the Rules of the+33 Compact Commission;+34 (2) Hold an Unencumbered License in the Home State;+35 (3) Notify the Compact Commission that the Licensee is seeking a Compact+36 Privilege within a Remote State or States;+37 (4) Pay any applicable fees, including any State fee, for the Compact Privilege;+38 (5) Meet any Jurisprudence Requirem ents established by the Remote State or+39 States in which the Licensee is seeking a Compact Privilege; and+40 (6) Report to the Compact Commission any Adverse Action, Encumbrance, or+41 r estriction on a License taken by any non-Member State within 30 days fr om the date+42 the action is taken.+43 2. The Compact Privilege is valid until the expiration date of the Home State+44 License. T o maintain a Compact Privilege, r enewal of the Compact Privilege shall be+45 congruent with the ren ewal of the Home State License as the Compact Commission may+46 define by Rule. The Licensee must comply with the req uiremen ts of subsection 1 of this+47 section to maintain the Compact Privilege in the Remote State or States.+48 3. A Licensee exerci sing a Compact Privilege shall adher e to the laws and+49 r egulations of the Remote State. Licensees shall be res ponsible for educating themselves+50 on, and complying with, any and all State laws relat ing to the Practice of Dietetics in+51 such Remote State.+52 4. Notwithstanding anything to the contrary pr ovided in this Compact or State+53 law , a Licensee exer cising a Compact Privilege shall not be r equir ed to complete+54 Continuing Education Requir ements r equir ed by a Remote State. A Licensee exerc ising+55 a Compact Privilege is only requi red to meet any Continuing Education Requireme nts+56 as requ ired by the Home State.+324.1820. 1. A Licensee may hold a Home State License, which allows for a+2 Compact Privilege in other Member States, in only one Member State at a time.+3 2. If a Licensee changes Home State by moving between two Member States:+4 (1) The Licensee shall file an application for obtaining a new Home State License+5 based on a Compact Privilege, pay all applicable fees, and notify the curr ent and new+6 Home State in accordance with the Rules of the Compact Commission.+7 (2) Upon r eceipt of an application for obtaining a new Home State License by+8 virtue of a Compact Privilege, the new Home State shall verify that the Licensee meets+HCS SB 1092 12+9 the criteria in section 324.1815 via the Data System, and requi re that the Licensee+10 complete the following:+11 (a) Federal Bureau of Investigation fingerprint based criminal history rec ord+12 information check;+13 (b) Any other criminal history record information r equir ed by the new Home+14 State; and+15 (c) Any Jurisprudence Requirem ents of the new Home State.+16 (3) The former Home State shall convert the former Home State License into a+17 Compact Privilege once the new Home State has activated the new Home State License+18 in accordance with applicable Rules adopted by the Compact Commission.+19 (4) Notwithstanding any other pr ovision of this Compact, if the Licensee cannot+20 meet the criteria in section 324.1815, the new Home State may apply its r equir ements+21 for issuing a new Single State License.+22 (5) The Licensee shall pay all applicable fees to the new Home State in order to+23 be issued a new Home State License.+24 3. If a Licensee changes their State of r esidence by moving fr om a Member State+25 to a non-Member State, or fr om a non-Member State to a Member State, the State+26 criteria shall apply for issuance of a Single State License in the new State.+27 4. Nothing in this Compact shall interfer e with a Licensee's ability to hold a+28 Single State License in multiple States; however , for the purposes of this Compact, a+29 Licensee shall have only one Home State License.+30 5. Nothing in this Compact shall affect the r equir ements established by a+31 Member State for the issuance of a Single State License.+324.1825. An Active Military Member , or their spouse, shall designate a Home+2 State wher e the individual has a curr ent License in good standing. The individual may+3 r etain the Home State designation during the period the service member is on active+4 duty .+324.1830. 1. In addition to the other powers conferred by State law , a Remote+2 State shall have the authority , in accordance with existing State due proce ss law , to:+3 (1) T ake Adverse Action against a Licensee's Compact Privilege within that+4 Member State; and+5 (2) Issue subpoenas for both hearings and investigations that requ ire the+6 attendance and testimony of witnesses as well as the prod uction of evidence. Subpoenas+7 issued by a Licensing Authority in a Member State for the attendance and testimony of+8 witnesses or the pr oduction of evidence from another Member State shall be enforced in+9 the latter State by any court of competent jurisdiction, according to the practice and+10 pr ocedur e applicable to subpoenas issued in pr oceedings pending before that court. The+HCS SB 1092 13+11 issuing authority shall pay any witness fees, travel expenses, mileage, and other fees+12 r equir ed by the service statutes of the State in which the witnesses or evidence are+13 located.+14 2. Only the Home State shall have the power to take Adverse Action against a+15 Licensee's Home State License.+16 3. For purposes of taking Adverse Action, the Home State shall give the same+17 priority and effect to reported conduct received fr om a Member State as it would if the+18 conduct had occurr ed within the Home State. In so doing, the Home State shall apply+19 its own State laws to determine appr opriate action.+20 4. The Home State shall complete any pending investigations of a Licensee who+21 changes Home States during the course of the investigations. The Home State shall also+22 have authority to take appr opriate action or actions and shall pr omptly r eport the+23 conclusions of the investigations to the administrator of the Data System. The+24 administrator of the Data System shall pr omptly notify the new Home State of any+25 Adverse Actions.+26 5. A Member State, if otherwise permitted by State law , may reco ver fr om the+27 affected Licensee the costs of investigations and dispositions of cases res ulting fr om any+28 Adverse Action taken against that Licensee.+29 6. A Member State may take Adverse Action based on the factual findings of+30 another Remote State, pro vided that the Member State follows its own proce dures for+31 taking the Adverse Action.+32 7. (1) In addition to the authority granted to a Member State by its res pective+33 State law , any Member State may participate with other Member States in joint+34 investigations of Licensees.+35 (2) Member States shall share any investigative, litigation, or compliance+36 materials in furtherance of any joint investigation initiated under the Compact.+37 8. If Adverse Action is taken by the Home State against a Licensee's Home State+38 License res ulting in an Encumbrance on the Home State License, the Licensee's+39 Compact Privilege or Privileges in all other Member States shall be revok ed until all+40 Encumbrances have been rem oved from the Home State License. All Home State+41 disciplinary orders that impose Adverse Action against a Licensee shall include a+42 statement that the Licensee's Compact Privileges ar e rev oked in all Member States+43 during the pendency of the order .+44 9. Once an Encumber ed License in the Home State is r estor ed to an+45 Unencumber ed License (as certified by the Home State's Licensing Authority), the+46 Licensee must meet the req uirements of subsection 1 of section 324.1815 and follow the+HCS SB 1092 14+47 administrative requ irem ents to reapp ly to obtain a Compact Privilege in any Remote+48 State.+49 10. If a Member State takes Adverse Action, it shall pr omptly notify the+50 administrator of the Data System. The administrator of the Data System shall pr omptly+51 notify the other Member States of any Adverse Actions.+52 1 1. Nothing in this Compact shall override a Member State's decision that+53 participation in an Alternative Pr ogram may be used in lieu of Adverse Action.+324.1835. 1. The Compact Member States her eby creat e and establish a joint+2 government agency whose membership consists of all Member States that have enacted+3 the Compact known as the Dietitian Licensur e Compact Commission. The Compact+4 Commission is an instrumentality of the Compact States acting jointly and not an+5 instrumentality of any one State. The Compact Commission shall come into existence+6 on or after the effective date of the Compact as set forth in section 324.1855.+7 2. (1) Each Member State shall have and be limited to one (1) delegate selected+8 by that Member State's Licensing Authority .+9 (2) The delegate shall be the primary administrator of the Licensing Authority+10 or their designee.+11 (3) The Compact Commission shall by Rule or bylaw establish a term of office+12 for delegates and may by Rule or bylaw establish term limits.+13 (4) The Compact Commission may recomm end rem oval or suspension of any+14 delegate fr om office.+15 (5) A Member State's Licensing Authority shall fill any vacancy of its delegate+16 occurring on the Compact Commission within 60 days of the vacancy .+17 (6) Each delegate shall be entitled to one vote on all matters before the Compact+18 Commission requ iring a vote by the delegates.+19 (7) Delegates shall meet and vote by such means as set forth in the bylaws. The+20 bylaws may pr ovide for delegates to meet and vote in-person or by telecommunication,+21 video conferenc e, or other means of communication.+22 (8) The Compact Commission shall meet at least once during each calendar year .+23 Additional meetings may be held as set forth in the bylaws. The Compact Commission+24 may meet in person or by telecommunication, video conferen ce, or other means of+25 communication.+26 3. The Compact Commission shall have the following powers:+27 (1) Establish the fiscal year of the Compact Commission;+28 (2) Establish code of conduct and conflict of interes t policies;+29 (3) Establish and amend Rules and bylaws;+30 (4) Maintain its financial r ecords in accordance with the bylaws;+HCS SB 1092 15+31 (5) Meet and take such actions as ar e consistent with the pr ovisions of this+32 Compact, the Compact Commission's Rules, and the bylaws;+33 (6) Initiate and conclude legal pr oceedings or actions in the name of the+34 Compact Commission, prov ided that the standing of any Licensing Authority to sue or+35 be sued under applicable law shall not be affected;+36 (7) Maintain and certify reco rds and information provi ded to a Member State as+37 the authenticated business records of the Compact Commission, and designate an agent+38 to do so on the Compact Commission's behalf;+39 (8) Purchase and maintain insurance and bonds;+40 (9) Borrow , accept, or contract for services of personnel, including, but not+41 limited to, employees of a Member State;+42 (10) Conduct an annual financial rev iew;+43 (1 1) Hir e employees, elect or appoint officers, fix compensation, define duties,+44 grant such individuals appr opriate authority to carry out the purposes of the Compact,+45 and establish the Compact Commission's personnel policies and pr ograms relat ing to+46 conflicts of interes t, qualifications of personnel, and other r elated personnel matters;+47 (12) Assess and collect fees;+48 (13) Accept any and all appr opriate donations, grants of money , other sources of+49 r evenue, equipment, supplies, materials, services, and gifts, and r eceive, utilize, and+50 dispose of the same; pr ovided that at all times the Compact Commission shall avoid any+51 actual or appearance of impr opriety or conflict of interes t;+52 (14) Lease, pur chase, ret ain, own, hold, impr ove, or use any pr operty , r eal,+53 personal, or mixed, or any undivided interes t ther ein;+54 (15) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise+55 dispose of any pr operty real, personal, or mixed;+56 (16) Establish a budget and make expenditur es;+57 (17) Borrow money;+58 (18) Appoint committees, including standing committees, composed of members,+59 State r egulators, State legislators or their re pr esentatives, and consumer+6 0 r epresent atives, and such other interes ted persons as may be designated in this+61 Compact or the bylaws;+62 (19) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent+63 agencies;+64 (20) Establish and elect an Executive Committee, including a chair and a vice+65 chair;+HCS SB 1092 16+66 (21) Determine whether a State's adopted language is materially differ ent fr om+67 the model compact language such that the State would not qualify for participation in+68 the Compact; and+69 (22) Perform such other functions as may be necessary or appr opriate to achieve+70 the purposes of this Compact.+71 4. (1) The Executive Committee shall have the power to act on behalf of the+72 Compact Commission according to the terms of this Compact. The powers, duties, and+73 r esponsibilities of the Executive Committee shall include:+74 (a) Oversee the day-to-day activities of the administration of the Compact+75 including enforcem ent and compliance with the pr ovisions of the Compact, its Rules and+76 bylaws, and other such duties as deemed necessary;+77 (b) Recommend to the Compact Commission changes to the Rules or bylaws,+78 changes to this Compact legislation, fees charged to Compact Member States, fees+79 charged to Licensees, and other fees;+80 (c) Ensur e Compact administration services ar e appr opriately pr ovided,+81 including by contract;+82 (d) Pr epare and rec ommend the budget;+83 (e) Maintain financial r ecords on behalf of the Compact Commission;+84 (f) Monitor Compact compliance of Member States and pro vide compliance+85 r eports to the Compact Commission;+86 (g) Establish additional committees as necessary;+87 (h) Exer cise the powers and duties of the Compact Commission during the+88 interim between Compact Commission meetings, except for adopting or amending+89 Rules, adopting or amending bylaws, and exerci sing any other powers and duties+90 expr essly r eserved to the Compact Commission by Rule or bylaw; and+91 (i) Other duties as prov ided in the Rules or bylaws of the Compact Commission.+92 (2) The Executive Committee shall be composed of nine members:+93 (a) The chair and vice chair of the Compact Commission shall be voting+94 members of the Executive Committee;+95 (b) Five voting members fr om the curren t membership of the Compact+96 Commission, elected by the Compact Commission;+97 (c) One ex-officio, nonvoting member fr om a r ecognized profession al association+98 r epresent ing dietitians; and+99 (d) One ex-officio, nonvoting member fr om a re cognized national cr edentialing+100 organization for dietitians.+101 (3) The Compact Commission may r emove any member of the Executive+102 Committee as pr ovided in the Compact Commission's bylaws.+HCS SB 1092 17+103 (4) (a) The Executive Committee shall meet at least annually .+104 (b) Executive Committee meetings shall be open to the public, except that the+105 Executive Committee may meet in a closed, non-public meeting as pr ovided in+106 subdivision (2) of subsection 6 of this section.+107 (c) The Executive Committee shall give 30 days' notice of its meetings, posted on+108 the website of the Compact Commission and as determined to pr ovide notice to persons+109 with an interes t in the business of the Compact Commission.+110 (d) The Executive Committee may hold a special meeting in accordance with+111 paragraph (c) of subdivision (1) of subsection 6 of this section.+112 5. The Compact Commission shall adopt and pro vide to the Member States an+113 annual r eport.+114 6. (1) (a) All meetings shall be open to the public, except that the Compact+115 Commission may meet in a closed, non-public meeting as pr ovided in subdivision (2) of+116 this subsection.+117 (b) Public notice for all meetings of the full Compact Commission shall be given+118 in the same manner as requi red under the rulemaking pr ovisions in section 324.1845,+119 except that the Compact Commission may hold a special meeting as prov ided in+120 paragraph (c) of this subdivision.+121 (c) The Compact Commission may hold a special meeting when it must meet to+122 conduct emergency business by giving 24 hours' notice to all Member States, on the+123 Compact Commission's website, and other means as pro vided in the Compact+124 Commission's Rules. The Compact Commission's legal counsel shall certify that the+125 Compact Commission's need to meet qualifies as an emergency .+126 (2) The Compact Commission or the Executive Committee or other committees+127 of the Compact Commission may convene in a closed, non-public meeting for the+128 Compact Commission or Executive Committee or other committees of the Compact+129 Commission to receiv e legal advice or to discuss:+130 (a) Non-compliance of a Member State with its obligations under the Compact;+131 (b) The employment, compensation, discipline, or other matters, practices, or+132 pr ocedur es r elated to specific employees;+133 (c) Curr ent or thr eatened discipline of a Licensee by the Compact Commission+134 or by a Member State's Licensing Authority;+135 (d) Curre nt, thr eatened, or reas onably anticipated litigation;+136 (e) Negotiation of contracts for the pur chase, lease, or sale of goods, services, or+137 r eal estate;+138 (f) Accusing any person of a crime or formally censuring any person;+HCS SB 1092 18+139 (g) T rade secr ets or commer cial or financial information that is privileged or+140 confidential;+141 (h) Information of a personal natur e wher e disclosure would constitute a clearly+142 unwarranted invasion of personal privacy;+143 (i) Investigative record s compiled for law enfor cement purposes;+144 (j) Information r elated to any investigative repo rts prepa red by or on behalf of+145 or for use of the Compact Commission or other committee charged with res ponsibility+146 of investigation or determination of compliance issues pursuant to the Compact;+147 (k) Matters specifically exempted fr om disclosur e by federal or Member State+148 law; or+149 (l) Other matters as specified in the Rules of the Compact Commission.+150 (3) If a meeting, or portion of a meeting, is closed, the pr esiding officer shall state+151 that the meeting will be closed and ref eren ce each relev ant exempting provi sion, and+152 such re feren ce shall be recor ded in the minutes.+153 (4) The Compact Commission shall keep minutes that fully and clearly describe+154 all matters discussed in a meeting and shall prov ide a full and accurate summary of+155 actions taken, and the reas ons ther efor , including a description of the views expr essed.+156 All documents consider ed in connection with an action shall be identified in such+157 minutes. All minutes and documents of a closed meeting shall r emain under seal,+158 subject to r elease only by a majority vote of the Compact Commission or order of a+159 court of competent jurisdiction.+160 7. (1) The Compact Commission shall pay , or provi de for the payment of, the+161 r easonable expenses of its establishment, organization, and ongoing activities.+162 (2) The Compact Commission may accept any and all appr opriate reven ue+163 sour ces as pr ovided in subdivision (13) of subsection 3 of this section.+164 (3) The Compact Commission may levy on and collect an annual assessment+165 fr om each Member State and impose fees on Licensees of Member States to whom it+166 grants a Compact Privilege to cover the cost of the operations and activities of the+167 Compact Commission and its staff, which must, in a total amount, be sufficient to cover+168 its annual budget as appr oved each year for which revenu e is not prov ided by other+169 sour ces. The aggr egate annual assessment amount for Member States shall be allocated+170 based upon a formula that the Compact Commission shall promul gate by Rule.+171 (4) The Compact Commission shall not incur obligations of any kind prior to+172 securing the funds adequate to meet the same; nor shall the Compact Commission+173 pledge the cr edit of any of the Member States, except by and with the authority of the+174 Member State.+HCS SB 1092 19+175 (5) The Compact Commission shall keep accurate accounts of all recei pts and+176 disbursements. The r eceipts and disbursements of the Compact Commission shall be+177 subject to the financial rev iew and accounting proce dures established under its bylaws.+178 However , all receip ts and disbursements of funds handled by the Compact Commission+179 shall be subject to an annual financial review by a certified or licensed public+180 accountant, and the r eport of the financial revi ew shall be included in and become part+181 of the annual repo rt of the Compact Commission.+182 8. (1) The members, officers, executive director , employees and repr esentatives+183 of the Compact Commission shall be immune fr om suit and liability , both personally+184 and in their official capacity , for any claim for damage to or loss of pro perty or personal+185 injury or other civil liability caused by or arising out of any actual or alleged act, error ,+186 or omission that occurr ed, or that the person against whom the claim is made had a+187 r easonable basis for believing occurr ed within the scope of Compact Commission+188 employment, duties, or r esponsibilities; pr ovided that nothing in this subdivision shall+189 be construed to protect any such person fr om suit or liability for any damage, loss,+190 injury , or liability caused by the intentional or willful or wanton misconduct of that+191 person. The pr ocure ment of insurance of any type by the Compact Commission shall+192 not in any way compromis e or limit the immunity granted her eunder .+193 (2) The Compact Commission shall defend any member , officer , executive+194 dir ector , employee, and r epresent ative of the Compact Commission in any civil action+195 seeking to impose liability arising out of any actual or alleged act, error , or omission that+196 occurr ed within the scope of Compact Commission employment, duties, or+1 9 7 r esponsibilities, or as determined by the Compact Commission that the person+198 against whom the claim is made had a rea sonable basis for believing occurr ed within the+199 scope of Compact Commission employment, duties, or r esponsibilities; pr ovided that+200 nothing her ein shall be construed to pro hibit that person fr om ret aining their own+201 counsel at their own expense; and pr ovided further , that the actual or alleged act, error ,+202 or omission did not res ult fr om that person's intentional or willful or wanton+203 misconduct.+204 (3) The Compact Commission shall indemnify and hold harmless any member ,+205 officer , executive dir ector , employee, and repr esentative of the Compact Commission for+206 the amount of any settlement or judgment obtained against that person arising out of+207 any actual or alleged act, erro r , or omission that occurr ed within the scope of Compact+208 Commission employment, duties, or r esponsibilities, or that such person had a+209 r easonable basis for believing occurr ed within the scope of Compact Commission+210 employment, duties, or r esponsibilities, pro vided that the actual or alleged act, error , or+HCS SB 1092 20+211 omission did not r esult fr om the intentional or willful or wanton misconduct of that+212 person.+213 (4) Nothing herei n shall be construed as a limitation on the liability of any+214 Licensee for profes sional malpractice or misconduct, which shall be governed solely by+215 any other applicable State laws.+216 (5) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate+217 a Member State's state action immunity or state action affirmative defense with res pect+218 to antitrust claims under the Sherman Act, Clayton Act, or any other State or federal+219 antitrust or anticompetitive law or regu lation.+220 (6) Nothing in this Compact shall be construed to be a waiver of soverei gn+221 immunity by the Member States or by the Compact Commission.+324.1840. 1. The Compact Commission shall prov ide for the development,+2 maintenance, operation, and utilization of a coordinated Data System.+3 2. The Compact Commission shall assign each applicant for a Compact Privilege+4 a unique identifier , as determined by the Rules.+5 3. Notwithstanding any other pro vision of State law to the contrary , a Member+6 State shall submit a uniform data set to the Data System on all individuals to whom this+7 Compact is applicable as r equir ed by the Rules of the Compact Commission, including:+8 (1) Identifying information;+9 (2) Licensure data;+10 (3) Adverse Actions against a License or Compact Privilege and information+11 r elated ther eto;+12 (4) Non-confidential information rel ated to Alternative Pr ogram participation,+13 the beginning and ending dates of such participation, and other information rel ated to+14 such participation not made confidential under Member State law;+15 (5) Any denial of application for licensur e, and the reas on or rea sons for such+16 denial;+17 (6) The pr esence of Curr ent Significant Investigative Information; and+18 (7) Other information that may facilitate the administration of this Compact or+19 the pro tection of the public, as determined by the Rules of the Compact Commission.+20 4. The r ecords and information pr ovided to a Member State pursuant to this+21 Compact or thr ough the Data System, when certified by the Compact Commission or an+22 agent ther eof, shall constitute the authenticated business rec ords of the Compact+23 Commission, and shall be entitled to any associated hearsay exception in any r elevant+24 judicial, quasi-judicial, or administrative proceed ings in a Member State.+25 5. Curren t Significant Investigative Information pertaining to a Licensee in any+26 Member State will only be available to other Member States.+HCS SB 1092 21+27 6. It is the res ponsibility of the Member States to re port any Adverse Action+28 against a Licensee and to monitor the Data System to determine whether any Adverse+29 Action has been taken against a Licensee. Adverse Action information pertaining to a+30 Licensee in any Member State will be available to any other Member State.+31 7. Member States contributing information to the Data System may designate+32 information that may not be shared with the public without the express permission of+33 the contributing State.+34 8. Any information submitted to the Data System that is subsequently expunged+35 pursuant to federal law or the laws of the Member State contributing the information+36 shall be re moved fr om the Data System.+324.1845. 1. The Compact Commission shall pr omulgate rea sonable Rules in+2 order to effectively and efficiently implement and administer the purposes and+3 pr ovisions of the Compact. A Rule shall be invalid and have no for ce or effect only if a+4 court of competent jurisdiction holds that the Rule is invalid because the Compact+5 Commission exercised its rulemaking authority in a manner that is beyond the scope+6 and purposes of the Compact, or the powers granted hereunder , or based upon another+7 applicable standard of revie w .+8 2. The Rules of the Compact Commission shall have the for ce of law in each+9 Member State, pr ovided however that where the Rules conflict with the laws or+10 r egulations of a Member State that relat e to the pr ocedur es, actions, and proce sses a+11 Licensed Dietitian is permitted to undertake in that State and the cir cumstances under+12 which they may do so, as held by a court of competent jurisdiction, the Rules of the+13 Compact Commission shall be ineffective in that State to the extent of the conflict.+14 3. The Compact Commission shall exercise its rulemaking powers pursuant to+15 the criteria set forth in this Section and the Rules adopted ther eunder . Rules shall+16 become binding on the day following adoption or as of the date specified in the Rule or+17 amendment, whichever is later .+18 4. If a majority of the legislatur es of the Member States rej ects a Rule or portion+19 of a Rule, by enactment of a statute or res olution in the same manner used to adopt the+20 Compact within four (4) years of the date of adoption of the Rule, then such Rule shall+21 have no further for ce and effect in any Member State.+22 5. Rules shall be adopted at a reg ular or special meeting of the Compact+23 Commission.+24 6. Prior to adoption of a pr oposed Rule, the Compact Commission shall hold a+25 public hearing and allow persons to prov ide oral and written comments, data, facts,+26 opinions, and arguments.+HCS SB 1092 22+27 7. Prior to adoption of a pr oposed Rule by the Compact Commission, and at+28 least thirty (30) days in advance of the meeting at which the Compact Commission will+29 hold a public hearing on the pr oposed Rule, the Compact Commission shall pro vide a+30 Notice of Pr oposed rulemaking:+31 (1) On the website of the Compact Commission or other publicly accessible+32 platform;+33 (2) T o persons who have req uested notice of the Compact Commission's notices+34 of prop osed rulemaking; and+35 (3) In such other way or ways as the Compact Commission may by Rule specify .+36 8. The Notice of Pr oposed rulemaking shall include:+37 (1) The time, date, and location of the public hearing at which the Compact+38 Commission will hear public comments on the pro posed Rule and, if differe nt, the time,+39 date, and location of the meeting wher e the Compact Commission will consider and vote+40 on the prop osed Rule;+41 (2) If the hearing is held via telecommunication, video conference, or other+42 means of communication, the Compact Commission shall include the mechanism for+43 access to the hearing in the Notice of Pr oposed rulemaking;+44 (3) The text of the pr oposed Rule and the reas on ther efor;+45 (4) A requ est for comments on the pr oposed Rule fr om any interes ted person;+46 and+47 (5) The manner in which interes ted persons may submit written comments.+48 9. All hearings will be r ecorded. A copy of the recor ding and all written+49 comments and documents receiv ed by the Compact Commission in res ponse to the+50 pr oposed Rule shall be available to the public.+51 10. Nothing in this Section shall be construed as r equiring a separate hearing on+52 each Rule. Rules may be gr ouped for the convenience of the Compact Commission at+53 hearings requ ired by this Section.+54 1 1. (1) The Compact Commission shall, by majority vote of all members, take+55 final action on the prop osed Rule based on the rulemaking r ecord and the full text of the+56 Rule.+57 (2) The Compact Commission may adopt changes to the pr oposed Rule pr ovided+58 the changes do not enlarge the original purpose of the pr oposed Rule.+59 (3) The Compact Commission shall prov ide an explanation of the reas ons for+60 substantive changes made to the prop osed Rule as well as reas ons for substantive+61 changes not made that were recommended by commenters.+62 (4) The Compact Commission shall determine a reas onable effective date for the+63 Rule. Except for an emergency as pro vided in subsection 12 of this section, the effective+HCS SB 1092 23+64 date of the Rule shall be no sooner than 30 days after issuing the notice that it adopted+65 or amended the Rule.+66 12. Upon determination that an emergency exists, the Compact Commission+67 may consider and adopt an emergency Rule with 24 hours' notice, with opportunity to+68 comment, pr ovided that the usual rulemaking pr ocedur es pro vided in the Compact and+69 in this Section shall be retr oactively applied to the Rule as soon as reas onably possible,+70 in no event later than ninety (90) days after the effective date of the Rule. For the+71 purposes of this pro vision, an emergency Rule is one that must be adopted immediately+72 in order to:+73 (1) Meet an imminent thr eat to public health, safety , or welfare;+74 (2) Pr event a loss of Compact Commission or Member State funds;+75 (3) Meet a deadline for the pr omulgation of a Rule that is established by federal+76 law or rule; or+77 (4) Pr otect public health and safety .+78 13. The Compact Commission or an authorized committee of the Compact+79 Commission may dir ect r evision to a pr eviously adopted Rule for purposes of corr ecting+80 typographical erro rs, err ors in format, erro rs in consistency , or grammatical errors.+81 Public notice of any revision shall be posted on the website of the Compact Commission.+82 The revision shall be subject to challenge by any person for a period of thirty (30) days+83 after posting. The revision may be challenged only on grou nds that the rev ision r esults+84 in a material change to a Rule. A challenge shall be made in writing and deliver ed to the+85 Compact Commission prior to the end of the notice period. If no challenge is made, the+86 r evision will take effect without further action. If the r evision is challenged, the rev ision+87 may not take effect without the appr oval of the Compact Commission.+88 14. No Member State's rulemaking requ irem ents shall apply under this+89 Compact.+324.1850. 1. (1) The executive and judicial branches of State government in+2 each Member State shall enforce this Compact and take all actions necessary and+3 appr opriate to implement this Compact.+4 (2) Except as otherwise pr ovided in this Compact, venue is pro per and judicial+5 pr oceedings by or against the Compact Commission shall be brou ght solely and+6 exclusively in a court of competent jurisdiction wher e the principal office of the+7 Compact Commission is located. The Compact Commission may waive venue and+8 jurisdictional defenses to the extent it adopts or consents to participate in alternative+9 dispute reso lution pr oceedings. Nothing herei n shall affect or limit the selection or+10 pr opriety of venue in any action against a Licensee for profes sional malpractice,+11 misconduct, or any such similar matter .+HCS SB 1092 24+12 (3) The Compact Commission shall be entitled to r eceive service of pro cess in+13 any proceed ing rega rding the enfor cement or interpr etation of the Compact and shall+14 have standing to intervene in such a pro ceeding for all purposes. Failur e to pr ovide the+15 Compact Commission service of pr ocess shall rend er a judgment or order void as to the+16 Compact Commission, this Compact, or promulg ated Rules.+17 2. (1) If the Compact Commission determines that a Member State has+18 defaulted in the performance of its obligations or res ponsibilities under this Compact or+19 the pro mulgated Rules, the Compact Commission shall pro vide written notice to the+20 defaulting State. The notice of default shall describe the default, the pr oposed means of+21 curing the default, and any other action that the Compact Commission may take and+22 shall offer training and specific technical assistance reg arding the default.+23 (2) The Compact Commission shall pr ovide a copy of the notice of default to the+24 other Member States.+25 3. If a State in default fails to cur e the default, the defaulting State may be+26 terminated fro m the Compact upon an affirmative vote of a majority of the delegates of+27 the Member States, and all rights, privileges, and benefits conferr ed on that State by+28 this Compact may be terminated on the effective date of termination. A cur e of the+29 default does not reliev e the offending State of obligations or liabilities incurr ed during+30 the period of default.+31 4. T ermination of membership in the Compact shall be imposed only after all+32 other means of securing compliance have been exhausted. Notice of intent to suspend or+33 terminate shall be given by the Compact Commission to the governor , the majority and+34 minority leaders of the defaulting State's legislature, the defaulting State's Licensing+35 Authority , and each of the Member States' Licensing Authority .+36 5. A State that has been terminated is res ponsible for all assessments,+37 obligations, and liabilities incurr ed thr ough the effective date of termination, including+38 obligations that extend beyond the effective date of termination.+39 6. Upon the termination of a State's membership fr om this Compact, that State+40 shall immediately pr ovide notice to all Licensees within that State of such termination.+41 The terminated State shall continue to recog nize all Compact Privileges granted+42 pursuant to this Compact for a minimum of six months after the date of said notice of+43 termination.+44 7. The Compact Commission shall not bear any costs r elated to a State that is+45 found to be in default or that has been terminated fr om the Compact, unless agr eed+46 upon in writing between the Compact Commission and the defaulting State.+47 8. The defaulting State may appeal the action of the Compact Commission by+48 petitioning the U.S. District Court for the District of Columbia or the federal district+HCS SB 1092 25+49 wher e the Compact Commission has its principal offices. The pr evailing party shall be+50 awarded all costs of such litigation, including reas onable attorney's fees.+51 9. (1) Upon requ est by a Member State, the Compact Commission shall attempt+52 to res olve disputes r elated to the Compact that arise among Member States and between+53 Member and non-Member States.+54 (2) The Compact Commission shall promulg ate a Rule pro viding for both+55 mediation and binding dispute r esolution for disputes as appr opriate.+56 10. (1) By supermajority vote, the Compact Commission may initiate legal+57 action against a Member State in default in the United States District Court for the+58 District of Columbia or the federal district wher e the Compact Commission has its+59 principal offices to enforce compliance with the pr ovisions of the Compact and its+60 pr omulgated Rules. The rel ief sought may include both injunctive re lief and damages.+61 In the event judicial enforcem ent is necessary , the pr evailing party shall be awarded all+62 costs of such litigation, including reas onable attorney's fees. The rem edies herei n shall+63 not be the exclusive rem edies of the Compact Commission. The Compact Commission+64 may pursue any other rem edies available under federal or the defaulting Member+65 State's law .+66 (2) A Member State may initiate legal action against the Compact Commission+67 in the U.S. District Court for the District of Columbia or the federal district where the+68 Compact Commission has its principal offices to enfor ce compliance with the pr ovisions+69 of the Compact and its pro mulgated Rules. The relie f sought may include both+70 injunctive reli ef and damages. In the event judicial enforcem ent is necessary , the+71 pr evailing party shall be awarded all costs of such litigation, including reas onable+72 attorney's fees.+73 (3) No party other than a Member State shall enfor ce this Compact against the+74 Compact Commission.+324.1855. 1. (1) The Compact shall come into effect on the date on which the+2 Compact statute is enacted into law in the seventh Member State.+3 (2) (a) On or after the effective date of the Compact, the Compact Commission+4 shall convene and review the enactment of each of the first seven Member States+5 ("Charter Member States") to determine if the statute enacted by each such Charter+6 Member State is materially differ ent than the model Compact statute.+7 (b) A Charter Member State whose enactment is found to be materially differ ent+8 fr om the model Compact statute shall be entitled to the default process set forth in+9 section 324.1850.+10 (c) If any Member State is later found to be in default, or is terminated, or+11 withdraws fr om the Compact, the Compact Commission shall r emain in existence and+HCS SB 1092 26+12 the Compact shall rem ain in effect even if the number of Member States should be less+13 than seven.+14 (3) Member States enacting the Compact subsequent to the seven initial Charter+15 Member States shall be subject to the pro cess set forth in subdivision (21) of subsection+16 3 of section 324.1835 to determine if their enactments are materially differ ent fr om the+17 model Compact statute and whether they qualify for participation in the Compact.+18 (4) All actions taken for the benefit of the Compact Commission or in+19 furtherance of the purposes of the administration of the Compact prior to the effective+20 date of the Compact or the Compact Commission coming into existence shall be+21 consider ed to be actions of the Compact Commission unless specifically rep udiated by+22 the Compact Commission.+23 (5) Any State that joins the Compact subsequent to the Compact Commission's+24 initial adoption of the Rules and bylaws shall be subject to the Rules and bylaws as they+25 exist on the date on which the Compact becomes law in that State. Any Rule that has+26 been pr eviously adopted by the Compact Commission shall have the full for ce and effect+27 of law on the day the Compact becomes law in that State.+28 2. (1) Any Member State may withdraw fr om this Compact by enacting a+29 statute repeal ing the same.+30 (2) A Member State's withdrawal shall not take effect until 180 days after+31 enactment of the rep ealing statute.+32 (3) Withdra wal shall not affect the continuing r equir ement of the withdrawing+33 State's Licensing Authority to comply with the investigative and Adverse Action+34 r eporting req uirements of this Compact prior to the effective date of withdrawal.+35 (4) Upon the enactment of a statute withdrawing fr om this Compact, a State+36 shall immediately provi de notice of such withdrawal to all Licensees within that State.+37 Notwithstanding any subsequent statutory enactment to the contrary , such withdrawing+38 State shall continue to recog nize all Compact Privileges granted pursuant to this+39 Compact for a minimum of 180 days after the date of such notice of withdrawal.+40 3. Nothing contained in this Compact shall be construed to invalidate or pr event+41 any licensur e agr eement or other cooperative arrangement between a Member State+42 and a non-Member State that does not conflict with the provi sions of this Compact.+43 4. This Compact may be amended by the Member States. No amendment to this+44 Compact shall become effective and binding upon any Member State until it is enacted+45 into the laws of all Member States.+324.1860. 1. This Compact and the Compact Commission's rulemaking+2 authority shall be liberally construed so as to effectuate the purposes and the+3 implementation and administration of the Compact. Pr ovisions of the Compact+HCS SB 1092 27+4 expr essly authorizing or req uiring the pr omulgation of Rules shall not be construed to+5 limit the Compact Commission's rulemaking authority solely for those purposes.+6 2. The pr ovisions of this Compact shall be severable and if any phrase, clause,+7 sentence, or prov ision of this Compact is held by a court of competent jurisdiction to be+8 contrary to the constitution of any Member State, a State seeking participation in the+9 Compact, or of the United States, or the applicability ther eof to any government,+10 agency , person, or cir cumstance is held to be unconstitutional by a court of competent+11 jurisdiction, the validity of the rem ainder of this Compact and the applicability ther eof+12 to any other government, agency , person, or circu mstance shall not be affected ther eby .+13 3. Notwithstanding subsection 2 of this section, the Compact Commission may+14 deny a State's participation in the Compact or , in accordance with the r equir ements of+15 subsection 2 of section 324.1850, terminate a Member State's participation in the+16 Compact, if it determines that a constitutional r equir ement of a Member State is a+17 material departure fro m the Compact. Otherwise, if this Compact shall be held to be+18 contrary to the constitution of any Member State, the Compact shall r emain in full for ce+19 and effect as to the r emaining Member States and in full for ce and effect as to the+20 Member State affected as to all severable matters.+324.1865. 1. Nothing herei n shall pr event or inhibit the enforcem ent of any+2 other law of a Member State that is not inconsistent with the Compact.+3 2. Any laws, statutes, r egulations, or other legal re quir ements in a Member State+4 in conflict with the Compact ar e superseded to the extent of the conflict.+5 3. All permissible agreements between the Compact Commission and the+6 Member States are binding in accordance with their terms.+332.081. 1. Notwithstanding any other provision of law to the contrary , hospitals+2 licensed under chapter 197 shall be authorized to employ any or all of the following oral+3 health providers:+4 (1) A dentist licensed under this chapter for the purpose of treating on hospital+5 premises those patients who present with a dental condition and such treatment is necessary to+6 ameliorate the condition for which they presented such as severe pain or tooth abscesses;+7 (2) An oral and maxillofacial surgeo n licensed under this chapter for the purpose of+8 treating oral conditions that need to be ameliorated as part of treating the underlying cause of+9 the patient's medical needs including, but not limited to, head and neck cancer , HIV or AIDS,+10 severe trauma resulting in admission to the hospital, or gan transplant, diabetes, or seizure+11 disorders. It shall be a condition of treatment that such patients are admitted to the hospital on+12 either an in- or out-patient basis; and+13 (3) A maxillofacial prosthodontist licensed under this chapter for the purpose of+14 treating and supporting patients of a head and neck cancer team or other complex care or+HCS SB 1092 28+15 sur gical team for the fabrication of appliances following ablative sur gery , surgery to correct+16 birth anomalies, extensive radiation treatment of the head or neck, or trauma-related sur gery .+17 2. No person or other entity shall practice dentistry in Missouri or provide dental+18 services as [ defined ] described in section 332.071 unless and until the board has issued to the+19 person a certificate certifying that the person has been duly registered as a dentist in Missouri+20 or the board has issued such certificate to an entity that has been duly registered to provide+21 dental services by licensed dentists and dental hygienists and unless and until the board has+22 issued to the person a license, to be renewed each period, as provided in this chapter , to+23 practice dentistry or as a dental hygienist, or has issued to the person or entity a permit, to be+24 renewed each period, to provide dental services in Missouri. Nothing in this chapter shall be+25 so construed as to make it unlawful for:+26 (1) A legally qualified physician or surge on, who does not practice dentistry as a+27 specialty , from extracting teeth;+28 (2) A dentist licensed in a state other than Missouri from making a clinical+29 demonstration before a meeting of dentists in Missouri;+30 (3) Dental students in any accredited dental school to practice dentistry under the+31 personal direction of instructors;+32 (4) Dental hygiene students in any accredited dental hygiene school to practice dental+33 hygiene under the personal direction of instructors;+34 (5) A duly registered and licensed dental hygienist in Missouri to practice dental+35 hygiene as defined in section 332.091;+36 (6) A dental assistant, certified dental assistant, or expanded functions dental assistant+37 to be delegated duties as defined in section 332.093;+38 (7) A duly registered dentist or dental hygienist to teach in an accredited dental or+39 dental hygiene school;+40 (8) A person who has been granted a dental faculty permit under section 332.183 to+41 practice dentistry in the scope of his or her employment at an accredited dental school,+42 college, or program in Missouri;+43 (9) A duly qualified anesthesiologist or nurse anesthetist to administer an anesthetic+44 in connection with dental services or dental surgery;+45 (10) A person to practice dentistry in or for:+46 (a) The United States Armed Forces;+47 (b) The United States Public Health Service;+48 (c) Migrant, community , or health care for the homeless health centers provided in+49 Section 330 of the Public Health Service Act (42 U.S.C. Section 254b);+50 (d) Federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section+51 1396d(l)) of the Social Security Act;+HCS SB 1092 29+52 (e) Governmental entities, including county health departments; or+53 (f) The United States V eterans Bureau; or+54 (1 1) A dentist licensed in a state other than Missouri to evaluate a patient or render an+55 oral, written, or otherwise documented dental opinion when providing testimony or records+56 for the purpose of a civil or criminal action before any judicial or administrative proceeding+57 of this state or other forum in this state.+58 3. No corporation shall practice dentistry as defined in section 332.071 unless that+59 corporation is or ganized under the provisions of chapter 355 or 356 provided that a+60 corporation org anized under the provisions of chapter 355 and qualifying as an or ganization+61 under 26 U.S.C. Section 501(c)(3) may only employ dentists and dental hygienists licensed in+62 this state to render dental services to Medicaid recipients, low-income individuals who have+63 available income below two hundred percent of the federal poverty level, and all participants+64 in the SCHIP program, unless such limitation is contrary to or inconsistent with federal or+65 state law or regulation. This subsection shall not apply to:+66 (1) A hospital licensed under chapter 197 that provides care and treatment only to+67 children under the age of eighteen at which a person regulated under this chapter provides+68 dental care within the scope of his or her license or registration;+69 (2) A federally qualified health center as defined in Section 1905(l) of the Social+70 Security Act (42 U.S.C. Section 1396d(l)), or a migrant, community , or health care for the+71 homeless health center provided for in Section 330 of the Public Health Services Act (42+72 U.S.C. Section 254b) at which a person regulated under this chapter provides dental care+73 within the scope of his or her license or registration;+74 (3) A city or county health department or ganized under chapter 192 or chapter 205 at+75 which a person regulated under this chapter provides dental care within the scope of his or her+76 license or registration;+77 (4) A social welfare board or ganized under section 205.770, a city health department+78 operating under a city charter , or a city-county health department at which a person regulated+79 under this chapter provides dental care within the scope of his or her license or registration;+80 (5) Any entity that has received a permit from the dental board and does not receive+81 compensation from the patient or from any third party on the patient's behalf at which a+82 person regulated under this chapter provides dental care within the scope of his or her license+83 or registration; or+84 (6) Any hospital nonprofit corporation exempt from taxation under Section 501(c)(3)+85 of the Internal Revenue Code, as amended, that engages in its operations and provides dental+86 services at facilities owned by a city , county , or other political subdivision of the state , or any+87 entity contracted with the state to pr ovide car e in a corr ectional center , as such term is+HCS SB 1092 30+88 defined in section 217.010, at which a person regulated under this chapter provides dental+89 care within the scope of his or her license or registration.+90+91 If any of the entities exempted from the requirements of this subsection are unable to provide+92 services to a patient due to the lack of a qualified provider and a referral to another entity is+93 made, the exemption shall extend to the person or entity that subsequently provides services+94 to the patient.+95 4. No unincorporated or ganization shall practice dentistry as defined in section+96 332.071 unless such org anization is exempt from federal taxation under Section 501(c)(3) of+97 the Internal Revenue Code of 1986, as amended, and provides dental treatment without+98 compensation from the patient or any third party on their behalf as a part of a broader+99 program of social services including food distribution. Nothing in this chapter shall prohibit+100 or ganizations under this subsection from employing any person regulated by this chapter .+101 5. A dentist shall not enter into a contract that allows a person who is not a dentist to+102 influence or interfere with the exercise of the dentist's independent professional judgment.+103 6. A not-for- profit corporation or ganized under the provisions of chapter 355 and+104 qualifying as an or ganization under 26 U.S.C. Section 501(c)(3), an unincorporated+105 or ganization operating pursuant to subsection 4 of this section, or any other person should not+106 direct or interfere or attempt to direct or interfere with a licensed dentist's professional+107 judgment and competent practice of dentistry . Nothing in this subsection shall be so+108 construed as to make it unlawful for not-for -profit or ganizations to enforce employment+109 contracts, corporate policy and procedure manuals, or quality improvement or assurance+110 requirements.+111 7. All entities defined in subsection 3 of this section and those exempted under+112 subsection 4 of this section shall apply for a permit to employ dentists and dental hygienists+113 licensed in this state to render dental services, and the entity shall apply for the permit in+114 writing on forms provided by the Missouri dental board. The board shall not char ge a fee of+115 any kind for the issuance or renewal of such permit. The provisions of this subsection shall+116 not apply to a federally qualified health center as defined in Section 1905(l) of the Social+117 Security Act (42 U.S.C. Section 1396d(l)).+118 8. Any entity that obtains a permit to render dental services in this state is subject to+119 discipline pursuant to section 332.321. If the board concludes that the person or entity has+120 committed an act or is engaging in a course of conduct that would be grounds for disciplinary+121 action, the board may file a complaint before the administrative hearing commission. The+122 board may refuse to issue or renew the permit of any entity for one or any combination of+123 causes stated in subsection 2 of section 332.321. The board shall notify the applicant in+HCS SB 1092 31+124 writing of the reasons for the refusal and shall advise the applicant of his or her right to file a+125 complaint with the administrative hearing commission as provided by chapter 621.+126 9. A federally qualified health center as defined in Section 1905(l) of the Social+127 Security Act (42 U.S.C. Section 1396d(l)) shall register with the board. The information+128 provided to the board as part of the registration shall include the name of the health center , the+129 nonprofit status of the health center , sites where dental services will be provided, and the+130 names of all persons employed by , or contracting with, the health center who are required to+131 hold a license pursuant to this chapter . The registration shall be renewed every twenty-four+132 months. The board shall not char ge a fee of any kind for the issuance or renewal of the+133 registration. The registration of the health center shall not be subject to discipline pursuant to+134 section 332.321. Nothing in this subsection shall prohibit disciplinary action against a+135 licensee of this chapter who is employed by , or contracts with, such health center for the+136 actions of the licensee in connection with such employment or contract.+137 10. The board may promulgate rules and regulations to ensure not-for -profit+138 corporations are rendering care to the patient populations as set forth herein, including+139 requirements for covered not-for -profit corporations to report patient census data to the board.+140 The provisions of this subsection shall not apply to a federally qualified health center as+141 defined in Section 1905(l) of the Social Security Act (42 U.S.C. Section 1396d(l)).+142 1 1. All not-for-p rofit corporations or ganized or operated pursuant to the provisions of+143 chapter 355 and qualifying as an or ganization under 26 U.S.C. Section 501(c)(3), or the+144 requirements relating to migrant, community , or health care for the homeless health centers+145 provided in Section 330 of the Public Health Service Act (42 U.S.C. Section 254b) and+146 federally qualified health centers as defined in Section 1905(l) (42 U.S.C. Section 1396d(l))+147 of the Social Security Act, that employ persons who practice dentistry or dental hygiene in+148 this state shall do so in accordance with the relevant laws of this state except to the extent that+149 such laws are contrary to, or inconsistent with, federal statute or regulation.+332.700. Sections 332.700 to 332.760 shall be known and cited as the Dentist and+2 Dental Hygienist Compact. The purposes of this Compact ar e to facilitate the interstate+3 practice of dentistry and dental hygiene and impro ve public access to dentistry and+4 dental hygiene services by pr oviding Dentists and Dental Hygienists licensed in a+5 Participating State the ability to practice in Participating States in which they ar e not+6 licensed. The Compact does this by establishing a pathway for Dentists and Dental+7 Hygienists licensed in a Participating State to obtain a Compact Privilege that+8 authorizes them to practice in another Participating State in which they are not licensed.+9 The Compact enables Participating States to pr otect the public health and safety with+10 r espect to the practice of such Dentists and Dental Hygienists, thr ough the State's+HCS SB 1092 32+11 authority to re gulate the practice of dentistry and dental hygiene in the State. The+12 Compact:+13 (1) Enables Dentists and Dental Hygienists who qualify for a Compact Privilege+14 to practice in other Participating States without satisfying burdensome and duplicative+15 r equir ements associated with securing a License to practice in those States;+16 (2) Pr omotes mobility and addresse s workfor ce shortages thr ough each+17 Participating State's acceptance of a Compact Privilege to practice in that State;+18 (3) Increas es public access to qualified, licensed Dentists and Dental Hygienists+19 by creat ing a res ponsible, str eamlined pathway for Licensees to practice in Participating+20 States;+21 (4) Enhances the ability of Participating States to protect the public's health and+22 safety;+23 (5) Does not interfer e with licensur e requ irem ents established by a Participating+24 State;+25 (6) Facilitates the sharing of licensur e and disciplinary information among+26 Participating States;+27 (7) Require s Dentists and Dental Hygienists who practice in a Participating State+28 pursuant to a Compact Privilege to practice within the Scope of Practice authorized in+29 that State;+30 (8) Extends the authority of a Participating State to regu late the practice of+31 dentistry and dental hygiene within its borders to Dentists and Dental Hygienists who+32 practice in the State thr ough a Compact Privilege;+33 (9) Pr omotes the cooperation of Participating States in regu lating the practice of+34 dentistry and dental hygiene within those States;+35 (10) Facilitates the reloc ation of military members and their spouses who are+36 licensed to practice dentistry or dental hygiene.+332.705. As used in this Compact, unless the context req uires otherwise, the+2 following definitions shall apply:+3 (1) "Active Military Member" means any person with full-time duty status in+4 the armed force s of the United States, including members of the National Guard and+5 Reserve.+6 (2) "Adverse Action" means disciplinary action or encumbrance imposed on a+7 License or Compact Privilege by a State Licensing Authority .+8 (3) "Alternative Pr ogram" means a non-disciplinary monitoring or practice+9 r emediation pr ocess applicable to a Dentist or Dental Hygienist appr oved by a State+10 Licensing Authority of a Participating State in which the Dentist or Dental Hygienist is+HCS SB 1092 33+11 licensed. This includes, but is not limited to, progr ams to which Licensees with+12 substance abuse or addiction issues are ref erred in lieu of Adverse Action.+13 (4) "Clinical Assessment" means examination or process , r equir ed for licensur e+14 as a Dentist or Dental Hygienist as applicable, that prov ides evidence of clinical+15 competence in dentistry or dental hygiene.+16 (5) "Commissioner" means the individual appointed by a Participating State to+17 serve as the member of the Commission for that Participating State.+18 (6) "Compact" means this Dentist and Dental Hygienist Compact.+19 (7) "Compact Privilege" means the authorization granted by a Remote State to+20 allow a Licensee fr om a Participating State to practice as a Dentist or Dental Hygienist+21 in a Remote State.+22 (8) "Continuing Pr ofessional Development" means a req uirement, as a condition+23 of License ren ewal to prov ide evidence of successful participation in educational or+24 pr ofessional activities releva nt to practice or ar ea of work.+25 (9) "Criminal Backgr ound Check" means the submission of fingerprints or+26 other biometric-based information for a License applicant for the purpose of obtaining+27 that applicant's criminal history reco rd information, as defined in 28 C.F .R. § 20.3(d)+28 fr om the Federal Burea u of Investigation and the State's criminal history rec ord+29 r epository as defined in 28 C.F .R. § 20.3(f).+30 (10) "Data System" means the Commission's r epository of information about+31 Licensees, including but not limited to examination, licensur e, investigative, Compact+32 Privilege, Adverse Action, and Alternative Pro gram.+33 (1 1) "Dental Hygienist" means an individual who is licensed by a State Licensing+34 Authority to practice dental hygiene.+35 (12) "Dentist" means an individual who is licensed by a State Licensing+36 Authority to practice dentistry .+37 (13) "Dentist and Dental Hygienist Compact Commission" or "Commission"+38 means a joint government agency established by this Compact comprised of each State+39 that has enacted the Compact and a national administrative body comprised of a+40 Commissioner fr om each State that has enacted the Compact.+41 (14) "Encumber ed License" means a License that a State Licensing Authority+42 has limited in any way other than thr ough an Alternative Pr ogram.+43 (15) "Executive Board" means the Chair , V ice Chair , Secr etary and T re asurer+44 and any other Commissioners as may be determined by Commission Rule or bylaw .+45 (16) "Jurisprudence Requireme nt" means the assessment of an individual's+46 knowledge of the laws and Rules governing the practice of dentistry or dental hygiene,+47 as applicable, in a State.+HCS SB 1092 34+48 (17) "License" means curren t authorization by a State, other than authorization+49 pursuant to a Compact Privilege, or other privilege, for an individual to practice as a+50 Dentist or Dental Hygienist in that State.+51 (18) "Licensee" means an individual who holds an unr estricted License fr om a+52 Participating State to practice as a Dentist or Dental Hygienist in that State.+53 (19) "Model Compact" means the model for the Dentist and Dental Hygienist+54 Compact on file with the Council of State Governments or other entity as designated by+55 the Commission.+56 (20) "Participating State" means a State that has enacted the Compact and been+57 admitted to the Commission in accordance with the pr ovisions her ein and Commission+58 Rules.+59 (21) "Qualifying License" means a License that is not an Encumbered License+60 issued by a Participating State to practice dentistry or dental hygiene.+61 (22) "Remote State" means a Participating State wher e a Licensee who is not+62 licensed as a Dentist or Dental Hygienist is exerc ising or seeking to exer cise the Compact+63 Privilege.+64 (23) "Rule" means a r egulation pr omulgated by an entity that has the for ce of+65 law .+66 (24) "Scope of Practice" means the proce dures, actions, and process es a Dentist+67 or Dental Hygienist licensed in a State is permitted to undertake in that State and the+68 cir cumstances under which the Licensee is permitted to undertake those proced ures,+69 actions and process es. Such proc edures, actions and pr ocesses and the cir cumstances+70 under which they may be undertaken may be established thr ough means, including, but+71 not limited to, statute, r egulations, case law , and other pr ocesses available to the State+72 Licensing Authority or other government agency .+73 (25) "Significant Investigative Information" means information, record s, and+74 documents r eceived or generated by a State Licensing Authority pursuant to an+75 investigation for which a determination has been made that ther e is pr obable cause to+76 believe that the Licensee has violated a statute or regul ation that is consider ed mor e+77 than a minor infraction for which the State Licensing Authority could pursue Adverse+78 Action against the Licensee.+79 (26) "State" means any state, commonwealth, district, or territory of the United+80 States of America that regu lates the practices of dentistry and dental hygiene.+81 (27) "State Licensing Authority" means an agency or other entity of a State that+82 is res ponsible for the licensing and r egulation of Dentists or Dental Hygienists.+332.710. 1. In order to join the Compact and ther eafter continue as a+2 Participating State, a State must:+HCS SB 1092 35+3 (1) Enact a compact that is not materially differ ent fro m the Model Compact as+4 determined in accordance with Commission Rules;+5 (2) Participate fully in the Commission's Data System;+6 (3) Have a mechanism in place for receivi ng and investigating complaints about+7 its Licensees and License applicants;+8 (4) Notify the Commission, in compliance with the terms of the Compact and+9 Commission Rules, of any Adverse Action or the availability of Significant Investigative+10 Information regard ing a Licensee and License applicant;+11 (5) Fully implement a Criminal Backgr ound Check req uire ment, within a time+12 frame established by Commission Rule, by receiv ing the r esults of a qualifying Criminal+13 Backgr ound Check;+14 (6) Comply with the Commission Rules applicable to a Participating State;+15 (7) Accept the National Board Examinations of the Joint Commission on+16 National Dental Examinations or another examination accepted by Commission Rule as+17 a licensur e examination;+18 (8) Accept for licensur e that applicants for a Dentist License graduate fro m a+19 pr edoctoral dental education pr ogram accred ited by the Commission on Dental+20 Accr editation, or another accr editing agency reco gnized by the United States+2 1 Department of Education for the accreditati on of dentistry and dental hygiene+22 education pro grams, leading to the Doctor of Dental Surgery (D.D.S.) or Doctor of+23 Dental Medicine (D.M.D.) degr ee;+24 (9) Accept for licensur e that applicants for a Dental Hygienist License graduate+25 fr om a dental hygiene education prog ram accredi ted by the Commission on Dental+26 Accr editation or another accr editing agency r ecognized by the United States+2 7 Department of Education for the accreditati on of dentistry and dental hygiene+28 education pro grams;+29 (10) Require for licensur e that applicants successfully complete a Clinical+30 Assessment;+31 (1 1) Have Continuing Pro fessional Development re quir ements as a condition for+32 License ren ewal; and+33 (12) Pay a participation fee to the Commission as established by Commission+34 Rule.+35 2. Pr oviding alternative pathways for an individual to obtain an unr estricted+36 License does not disqualify a State fr om participating in the Compact.+37 3. When conducting a Criminal Backgr ound Check the State Licensing+38 Authority shall:+39 (1) Consider that information in making a licensur e decision;+HCS SB 1092 36+40 (2) Maintain documentation of completion of the Criminal Backgr ound Check+41 and backgroun d check information to the extent allowed by State and federal law; and+42 (3) Report to the Commission whether it has completed the Criminal+43 Backgr ound Check and whether the individual was granted or denied a License.+44 4. A Licensee of a Participating State who has a Qualifying License in that State+45 and does not hold an Encumbered License in any other Participating State, shall be+46 issued a Compact Privilege in a Remote State in accordance with the terms of the+47 Compact and Commission Rules. If a Remote State has a Jurisprudence Requirem ent a+48 Compact Privilege will not be issued to the Licensee unless the Licensee has satisfied the+49 Jurisprudence Requirem ent.+332.715. 1. T o obtain and exer cise the Compact Privilege under the terms and+2 pr ovisions of the Compact, the Licensee shall:+3 (1) Have a Qualifying License as a Dentist or Dental Hygienist in a Participating+4 State;+5 (2) Be eligible for a Compact Privilege in any Remote State in accordance with+6 subsections 4, 7, and 8 of this section;+7 (3) Submit to an application pro cess whenever the Licensee is seeking a Compact+8 Privilege;+9 (4) Pay any applicable Commission and Remote State fees for a Compact+10 Privilege in the Remote State;+11 (5) Meet any Jurisprudence Requirem ent established by a Remote State in+12 which the Licensee is seeking a Compact Privilege;+13 (6) Have passed a National Board Examination of the Joint Commission on+14 National Dental Examinations or another examination accepted by Commission Rule;+15 (7) For a Dentist, have graduated fr om a pr edoctoral dental education pr ogram+16 accr edited by the Commission on Dental Accredi tation, or another accr editing agency+17 r ecognized by the United States Department of Education for the accre ditation of+18 dentistry and dental hygiene education pro grams, leading to the Doctor of Dental+19 Surgery (D.D.S.) or Doctor of Dental Medicine (D.M.D.) degre e;+20 (8) For a Dental Hygienist, have graduated fr om a dental hygiene education+21 pr ogram accr edited by the Commission on Dental Accr editation or another accred iting+22 agency recogni zed by the United States Department of Education for the accr editation+23 of dentistry and dental hygiene education pr ograms;+24 (9) Have successfully completed a Clinical Assessment for licensur e;+25 (10) Report to the Commission Adverse Action taken by any non-Participating+26 State when applying for a Compact Privilege and, otherwise, within thirty (30) days+27 fr om the date the Adverse Action is taken;+HCS SB 1092 37+28 (1 1) Report to the Commission when applying for a Compact Privilege the+29 addr ess of the Licensee's primary r esidence and ther eafter immediately r eport to the+30 Commission any change in the addr ess of the Licensee's primary res idence; and+31 (12) Consent to accept service of proc ess by mail at the Licensee's primary+32 r esidence on record with the Commission with respect to any action br ought against the+33 Licensee by the Commission or a Participating State, and consent to accept service of a+34 subpoena by mail at the Licensee's primary res idence on r ecord with the Commission+35 with respect to any action brou ght or investigation conducted by the Commission or a+36 Participating State.+37 2. The Licensee must comply with the r equir ements of subsection 1 of this+38 section to maintain the Compact Privilege in the Remote State. If those r equir ements+39 ar e met, the Compact Privilege will continue as long as the Licensee maintains a+40 Qualifying License in the State thr ough which the Licensee applied for the Compact+41 Privilege and pays any applicable Compact Privilege renewa l fees.+42 3. A Licensee pr oviding dentistry or dental hygiene in a Remote State under the+43 Compact Privilege shall function within the Scope of Practice authorized by the Remote+44 State for a Dentist or Dental Hygienist licensed in that State.+45 4. A Licensee pr oviding dentistry or dental hygiene pursuant to a Compact+46 Privilege in a Remote State is subject to that State's regula tory authority . A Remote+47 State may , in accordance with due pro cess and that State's laws, by Adverse Action+48 r evoke or r emove a Licensee's Compact Privilege in the Remote State for a specific+49 period of time and impose fines or take any other necessary actions to pro tect the health+50 and safety of its citizens. If a Remote State imposes an Adverse Action against a+51 Compact Privilege that limits the Compact Privilege, that Adverse Action applies to all+52 Compact Privileges in all Remote States. A Licensee whose Compact Privilege in a+53 Remote State is r emoved for a specified period of time is not eligible for a Compact+54 Privilege in any other Remote State until the specific time for rem oval of the Compact+55 Privilege has passed and all encumbrance requ irem ents are satisfied.+56 5. If a License in a Participating State is an Encumber ed License, the Licensee+57 shall lose the Compact Privilege in a Remote State and shall not be eligible for a+58 Compact Privilege in any Remote State until the License is no longer encumber ed.+59 6. Once an Encumbered License in a Participating State is r estored to good+60 standing, the Licensee must meet the requ irem ents of subsection 1 of this section to+61 obtain a Compact Privilege in a Remote State.+62 7. If a Licensee's Compact Privilege in a Remote State is rem oved by the Remote+63 State, the individual shall lose or be ineligible for the Compact Privilege in any Remote+64 State until the following occur:+HCS SB 1092 38+65 (1) The specific period of time for which the Compact Privilege was rem oved has+66 ended; and+67 (2) All conditions for rem oval of the Compact Privilege have been satisfied.+68 8. Once the req uirements of subsection 7 of this section have been met, the+69 Licensee must meet the r equir ements in subsection 1 of this section to obtain a Compact+70 Privilege in a Remote State.+332.720. An Active Military Member and their spouse shall not be requi red to+2 pay to the Commission for a Compact Privilege the fee otherwise charged by the+3 Commission. If a Remote State chooses to charge a fee for a Compact Privilege, it may+4 choose to charge a red uced fee or no fee to an Active Military Member and their spouse+5 for a Compact Privilege.+332.725. 1. A Participating State in which a Licensee is licensed shall have+2 exclusive authority to impose Adverse Action against the Qualifying License issued by+3 that Participating State.+4 2. A Participating State may take Adverse Action based on the Significant+5 Investigative Information of a Remote State, so long as the Participating State follows its+6 own proced ures for imposing Adverse Action.+7 3. Nothing in this Compact shall override a Participating State's decision that+8 participation in an Alternative Pr ogram may be used in lieu of Adverse Action and that+9 such participation shall rem ain non-public if req uire d by the Participating State's laws.+10 Participating States must r equir e Licensees who enter any Alternative Pr ogram in lieu+11 of discipline to agr ee not to practice pursuant to a Compact Privilege in any other+12 Participating State during the term of the Alternative Pr ogram without prior+13 authorization fr om such other Participating State.+14 4. Any Participating State in which a Licensee is applying to practice or is+15 practicing pursuant to a Compact Privilege may investigate actual or alleged violations+16 of the statutes and regul ations authorizing the practice of dentistry or dental hygiene in+17 any other Participating State in which the Dentist or Dental Hygienist holds a License or+18 Compact Privilege.+19 5. A Remote State shall have the authority to:+20 (1) T ake Adverse Actions as set forth in subsection 4 of section 332.715 against a+21 Licensee's Compact Privilege in the State;+22 (2) In furtherance of its rights and res ponsibilities under the Compact and the+23 Commission's Rules issue subpoenas for both hearings and investigations that requ ire+24 the attendance and testimony of witnesses, and the pr oduction of evidence. Subpoenas+25 issued by a State Licensing Authority in a Participating State for the attendance and+26 testimony of witnesses, or the pr oduction of evidence fro m another Participating State,+HCS SB 1092 39+27 shall be enforced in the latter State by any court of competent jurisdiction, according to+28 the practice and proc edure of that court applicable to subpoenas issued in proceed ings+29 pending before it. The issuing authority shall pay any witness fees, travel expenses,+30 mileage, and other fees requ ired by the service statutes of the State wher e the witnesses+31 or evidence are located; and+32 (3) If otherwise permitted by State law , recover fr om the Licensee the costs of+33 investigations and disposition of cases r esulting fr om any Adverse Action taken against+34 that Licensee.+35 6. (1) In addition to the authority granted to a Participating State by its Dentist+36 or Dental Hygienist licensur e act or other applicable State law , a Participating State+37 may jointly investigate Licensees with other Participating States.+38 (2) Participating States shall share any Significant Investigative Information,+39 litigation, or compliance materials in furtherance of any joint or individual investigation+40 initiated under the Compact.+41 7. (1) After a Licensee's Compact Privilege in a Remote State is terminated, the+42 Remote State may continue an investigation of the Licensee that began when the+43 Licensee had a Compact Privilege in that Remote State.+44 (2) If the investigation yields what would be Significant Investigative+4 5 Information had the Licensee continued to have a Compact Privilege in that Remote+46 State, the Remote State shall r eport the pr esence of such information to the Data System+47 as requ ired by subdivision (6) of subsection 2 of section 332.735 as if it was Significant+48 Investigative Information.+332.730. 1. The Compact Participating States hereb y cr eate and establish a joint+2 government agency whose membership consists of all Participating States that have+3 enacted the Compact. The Commission is an instrumentality of the Participating States+4 acting jointly and not an instrumentality of any one State. The Commission shall come+5 into existence on or after the effective date of the Compact as set forth in subsection 1 of+6 section 332.750.+7 2. (1) Each Participating State shall have and be limited to one (1)+8 Commissioner selected by that Participating State's State Licensing Authority or , if+9 the State has mor e than one State Licensing Authority , selected collectively by the State+10 Licensing Authorities.+11 (2) The Commissioner shall be a member or designee of such Authority or+12 Authorities.+13 (3) The Commission may by Rule or bylaw establish a term of office for+14 Commissioners and may by Rule or bylaw establish term limits.+HCS SB 1092 40+15 (4) The Commission may recomme nd to a State Licensing Authority or+16 Authorities, as applicable, rem oval or suspension of an individual as the State's+17 Commissioner .+18 (5) A Participating State's State Licensing Authority , or Authorities, as+19 applicable, shall fill any vacancy of its Commissioner on the Commission within sixty+20 (60) days of the vacancy .+21 (6) Each Commissioner shall be entitled to one vote on all matters that are voted+22 upon by the Commission.+23 (7) The Commission shall meet at least once during each calendar year .+24 Additional meetings may be held as set forth in the bylaws. The Commission may meet+25 by telecommunication, video conferenc e or other similar electr onic means.+26 3. The Commission shall have the following powers:+27 (1) Establish the fiscal year of the Commission;+28 (2) Establish a code of conduct and conflict of inter est policies;+29 (3) Adopt Rules and bylaws;+30 (4) Maintain its financial r ecords in accordance with the bylaws;+31 (5) Meet and take such actions as ar e consistent with the pr ovisions of this+32 Compact, the Commission's Rules, and the bylaws;+33 (6) Initiate and conclude legal pr oceedings or actions in the name of the+34 Commission, pr ovided that the standing of any State Licensing Authority to sue or be+35 sued under applicable law shall not be affected;+36 (7) Maintain and certify rec ords and information pr ovided to a Participating+37 State as the authenticated business records of the Commission, and designate a person+38 to do so on the Commission's behalf;+39 (8) Purchase and maintain insurance and bonds;+40 (9) Borrow , accept, or contract for services of personnel, including, but not+41 limited to, employees of a Participating State;+42 (10) Conduct an annual financial rev iew;+43 (1 1) Hir e employees, elect or appoint officers, fix compensation, define duties,+44 grant such individuals appr opriate authority to carry out the purposes of the Compact,+45 and establish the Commission's personnel policies and pr ograms r elating to conflicts of+46 inter est, qualifications of personnel, and other re lated personnel matters;+47 (12) As set forth in the Commission Rules, charge a fee to a Licensee for the+48 grant of a Compact Privilege in a Remote State and ther eafter , as may be established by+49 Commission Rule, charge the Licensee a Compact Privilege renewa l fee for each+50 r enewal period in which that Licensee exer cises or intends to exer cise the Compact+51 Privilege in that Remote State. Nothing her ein shall be construed to pr event a Remote+HCS SB 1092 41+52 State fr om charging a Licensee a fee for a Compact Privilege or ren ewals of a Compact+53 Privilege, or a fee for the Jurisprudence Requir ement if the Remote State imposes such+54 a req uire ment for the grant of a Compact Privilege;+55 (13) Accept any and all appr opriate gifts, donations, grants of money , other+56 sour ces of r evenue, equipment, supplies, materials, and services, and receive, utilize, and+57 dispose of the same; pr ovided that at all times the Commission shall avoid any+58 appearance of improp riety and/or conflict of inter est;+59 (14) Lease, pur chase, ret ain, own, hold, impr ove, or use any pr operty , r eal,+60 personal, or mixed, or any undivided interes t ther ein;+61 (15) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise+62 dispose of any pr operty real, personal, or mixed;+63 (16) Establish a budget and make expenditur es;+64 (17) Borrow money;+65 (18) Appoint committees, including standing committees, which may be+66 composed of members, State regu lators, State legislators or their repr esentatives, and+67 consumer r epresent atives, and such other interes ted persons as may be designated in+68 this Compact and the bylaws;+69 (19) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent+70 agencies;+71 (20) Elect a Chair , V ice Chair , Secr etary and T rea sur er and such other officers+72 of the Commission as pr ovided in the Commission's bylaws;+73 (21) Establish and elect an Executive Board;+74 (22) Adopt and prov ide to the Participating States an annual r eport;+75 (23) Determine whether a State's enacted compact is materially differ ent fr om+76 the Model Compact language such that the State would not qualify for participation in+77 the Compact; and+78 (24) Perform such other functions as may be necessary or appr opriate to achieve+79 the purposes of this Compact.+80 4. (1) All meetings of the Commission that are not closed pursuant to this+81 subsection shall be open to the public. Notice of public meetings shall be posted on the+82 Commission's website at least thirty (30) days prior to the public meeting.+83 (2) Notwithstanding subdivision (1) of this subsection, the Commission may+84 convene an emergency public meeting by pr oviding at least twenty-four (24) hours prior+85 notice on the Commission's website, and any other means as pr ovided in the+86 Commission's Rules, for any of the re asons it may dispense with notice of pro posed+87 rulemaking under subsection 13 of section 332.740. The Commission's legal counsel+HCS SB 1092 42+88 shall certify that one of the rea sons justifying an emergency public meeting has been+89 met.+90 (3) Notice of all Commission meetings shall prov ide the time, date, and location+91 of the meeting, and if the meeting is to be held or accessible via telecommunication,+92 video conference , or other electr onic means, the notice shall include the mechanism for+93 access to the meeting thr ough such means.+94 (4) The Commission may convene in a closed, non-public meeting for the+95 Commission to receiv e legal advice or to discuss:+96 (a) Non-compliance of a Participating State with its obligations under the+97 Compact;+98 (b) The employment, compensation, discipline or other matters, practices or+99 pr ocedur es rel ated to specific employees or other matters rela ted to the Commission's+100 internal personnel practices and proc edures;+101 (c) Curr ent or thr eatened discipline of a Licensee or Compact Privilege holder+102 by the Commission or by a Participating State's Licensing Authority;+103 (d) Curre nt, thr eatened, or reas onably anticipated litigation;+104 (e) Negotiation of contracts for the pur chase, lease, or sale of goods, services, or+105 r eal estate;+106 (f) Accusing any person of a crime or formally censuring any person;+107 (g) T rade secr ets or commer cial or financial information that is privileged or+108 confidential;+109 (h) Information of a personal natur e wher e disclosure would constitute a clearly+110 unwarranted invasion of personal privacy;+111 (i) Investigative record s compiled for law enfor cement purposes;+112 (j) Information r elated to any investigative repo rts prepa red by or on behalf of+113 or for use of the Commission or other committee charged with r esponsibility of+114 investigation or determination of compliance issues pursuant to the Compact;+115 (k) Legal advice;+116 (l) Matters specifically exempted fr om disclosur e to the public by federal or+117 Participating State law; and+118 (m) Other matters as pr omulgated by the Commission by Rule.+119 (5) If a meeting, or portion of a meeting, is closed, the pr esiding officer shall state+120 that the meeting will be closed and ref eren ce each relev ant exempting provi sion, and+121 such re feren ce shall be recor ded in the minutes.+122 (6) The Commission shall keep minutes that fully and clearly describe all+123 matters discussed in a meeting and shall pr ovide a full and accurate summary of actions+124 taken, and the reas ons ther efor , including a description of the views expr essed. All+HCS SB 1092 43+125 documents consider ed in connection with an action shall be identified in such minutes.+126 All minutes and documents of a closed meeting shall r emain under seal, subject to+127 r elease only by a majority vote of the Commission or order of a court of competent+128 jurisdiction.+129 5. (1) The Commission shall pay , or pr ovide for the payment of, the reas onable+130 expenses of its establishment, organization, and ongoing activities.+131 (2) The Commission may accept any and all appr opriate sources of reven ue,+132 donations, and grants of money , equipment, supplies, materials, and services.+133 (3) The Commission may levy on and collect an annual assessment fr om each+134 Participating State and impose fees on Licensees of Participating States when a+135 Compact Privilege is granted, to cover the cost of the operations and activities of the+136 Commission and its staff, which must be in a total amount sufficient to cover its annual+137 budget as appr oved each fiscal year for which sufficient revenu e is not pr ovided by+138 other source s. The aggr egate annual assessment amount for Participating States shall+139 be allocated based upon a formula that the Commission shall pr omulgate by Rule.+140 (4) The Commission shall not incur obligations of any kind prior to securing the+141 funds adequate to meet the same; nor shall the Commission pledge the credi t of any+142 Participating State, except by and with the authority of the Participating State.+143 (5) The Commission shall keep accurate accounts of all re ceipts and+1 4 4 disbursements. The r eceipts and disbursements of the Commission shall be subject+145 to the financial r eview and accounting pr ocedur es established under its bylaws. All+146 r eceipts and disbursements of funds handled by the Commission shall be subject to an+147 annual financial r eview by a certified or licensed public accountant, and the r eport of+148 the financial rev iew shall be included in and become part of the annual r eport of the+149 Commission.+150 6. (1) The Executive Board shall have the power to act on behalf of the+151 Commission according to the terms of this Compact. The powers, duties, and+152 r esponsibilities of the Executive Board shall include:+153 (a) Overseeing the day-to-day activities of the administration of the Compact+154 including compliance with the pr ovisions of the Compact and the Commission's Rules+155 and bylaws;+156 (b) Recommending to the Commission changes to the Rules or bylaws, changes+157 to this Compact legislation, fees charged to Compact Participating States, fees charged+158 to Licensees, and other fees;+159 (c) Ensuring Compact administration services ar e appr opriately pr ovided,+160 including by contract;+161 (d) Pr eparing and recommending the budget;+HCS SB 1092 44+162 (e) Maintaining financial reco rds on behalf of the Commission;+163 (f) Monitoring Compact compliance of Participating States and pr oviding+164 compliance rep orts to the Commission;+165 (g) Establishing additional committees as necessary;+166 (h) Exer cising the powers and duties of the Commission during the interim+167 between Commission meetings, except for adopting or amending Rules, adopting or+168 amending bylaws, and exer cising any other powers and duties expr essly res erved to the+169 Commission by Rule or bylaw; and+170 (i) Other duties as pr ovided in the Rules or bylaws of the Commission.+171 (2) The Executive Board shall be composed of up to seven (7) members:+172 (a) The Chair , V ice Chair , Secr etary and T rea sur er of the Commission and any+173 other members of the Commission who serve on the Executive Board shall be voting+174 members of the Executive Board; and+175 (b) Other than the Chair , V ice Chair , Secr etary , and T r easurer , the Commission+176 may elect up to thr ee (3) voting members fr om the curren t membership of the+177 Commission.+178 (3) The Commission may rem ove any member of the Executive Board as+179 pr ovided in the Commission's bylaws.+180 (4) The Executive Board shall meet at least annually .+181 (a) An Executive Board meeting at which it takes or intends to take formal+182 action on a matter shall be open to the public, except that the Executive Board may meet+183 in a closed, non-public session of a public meeting when dealing with any of the matters+184 cover ed under subdivision (4) of subsection 4 of this section.+185 (b) The Executive Board shall give five (5) business days' notice of its public+186 meetings, posted on its website and as it may otherwise determine to prov ide notice to+187 persons with an inter est in the public matters the Executive Board intends to addr ess at+188 those meetings.+189 (5) The Executive Board may hold an emergency meeting when acting for the+190 Commission to:+191 (a) Meet an imminent thr eat to public health, safety , or welfare;+192 (b) Pr event a loss of Commission or Participating State funds; or+193 (c) Pr otect public health and safety .+194 7. (1) The members, officers, executive director , employees and repr esentatives+195 of the Commission shall be immune fr om suit and liability , both personally and in their+196 official capacity , for any claim for damage to or loss of prop erty or personal injury or+197 other civil liability caused by or arising out of any actual or alleged act, error , or+198 omission that occurr ed, or that the person against whom the claim is made had a+HCS SB 1092 45+199 r easonable basis for believing occurr ed within the scope of Commission employment,+200 duties or r esponsibilities; prov ided that nothing in this subdivision shall be construed to+201 pr otect any such person fro m suit or liability for any damage, loss, injury , or liability+202 caused by the intentional or willful or wanton misconduct of that person. The+203 pr ocur ement of insurance of any type by the Commission shall not in any way+204 compr omise or limit the immunity granted hereu nder .+205 (2) The Commission shall defend any member , officer , executive direc tor ,+206 employee, and re present ative of the Commission in any civil action seeking to impose+207 liability arising out of any actual or alleged act, err or , or omission that occurred within+208 the scope of Commission employment, duties, or re sponsibilities, or as determined by+209 the Commission that the person against whom the claim is made had a rea sonable basis+210 for believing occurr ed within the scope of Commission employment, duties, or+211 r esponsibilities; pr ovided that nothing her ein shall be construed to pr ohibit that+212 person fro m ret aining their own counsel at their own expense; and pr ovided further ,+213 that the actual or alleged act, error , or omission did not res ult fr om that person's+214 intentional or willful or wanton misconduct.+215 (3) Notwithstanding subdivision (1) of this subsection, should any member ,+216 officer , executive dir ector , employee, or repr esentative of the Commission be held liable+217 for the amount of any settlement or judgment arising out of any actual or alleged act,+218 err or , or omission that occurr ed within the scope of that individual's employment,+219 duties, or responsibi lities for the Commission, or that the person to whom that+220 individual is liable had a r easonable basis for believing occurr ed within the scope of the+221 individual's employment, duties, or respon sibilities for the Commission, the+2 2 2 Commission shall indemnify and hold harmless such individual, prov ided that the+223 actual or alleged act, erro r , or omission did not result fr om the intentional or willful or+224 wanton misconduct of the individual.+225 (4) Nothing herei n shall be construed as a limitation on the liability of any+226 Licensee for profes sional malpractice or misconduct, which shall be governed solely by+227 any other applicable State laws.+228 (5) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate+229 a Participating State's state action immunity or state action affirmative defense with+230 r espect to antitrust claims under the Sherman Act, Clayton Act, or any other State or+231 federal antitrust or anticompetitive law or regul ation.+232 (6) Nothing in this Compact shall be construed to be a waiver of soverei gn+233 immunity by the Participating States or by the Commission.+332.735. 1. The Commission shall pr ovide for the development, maintenance,+2 operation, and utilization of a coordinated database and r eporting system containing+HCS SB 1092 46+3 licensur e, Adverse Action, and the pr esence of Significant Investigative Information on+4 all Licensees and applicants for a License in Participating States.+5 2. Notwithstanding any other pr ovision of State law to the contrary , a+6 Participating State shall submit a uniform data set to the Data System on all individuals+7 to whom this Compact is applicable as requi red by the Rules of the Commission,+8 including:+9 (1) Identifying information;+10 (2) Licensure data;+11 (3) Adverse Actions against a Licensee, License applicant or Compact Privilege+12 and information r elated ther eto;+13 (4) Non-confidential information rel ated to Alternative Pr ogram participation,+14 the beginning and ending dates of such participation, and other information rel ated to+15 such participation;+16 (5) Any denial of an application for licensur e, and the r eason or r easons for such+17 denial (excluding the re porting of any criminal history r ecord information wher e+18 pr ohibited by law);+19 (6) The pr esence of Significant Investigative Information; and+20 (7) Other information that may facilitate the administration of this Compact or+21 the pro tection of the public, as determined by the Rules of the Commission.+22 3. The rec ords and information pro vided to a Participating State pursuant to+23 this Compact or thr ough the Data System, when certified by the Commission or an+24 agent ther eof, shall constitute the authenticated business rec ords of the Commission,+25 and shall be entitled to any associated hearsay exception in any re levant judicial, quasi-+26 judicial or administrative pr oceedings in a Participating State.+27 4. Significant Investigative Information pertaining to a Licensee in any+28 Participating State will only be available to other Participating States.+29 5. It is the res ponsibility of the Participating States to monitor the database to+30 determine whether Adverse Action has been taken against a Licensee or License+31 applicant. Adverse Action information pertaining to a Licensee or License applicant in+32 any Participating State will be available to any other Participating State.+33 6. Participating States contributing information to the Data System may+34 designate information that may not be shar ed with the public without the expr ess+35 permission of the contributing State.+36 7. Any information submitted to the Data System that is subsequently expunged+37 pursuant to federal law or the laws of the Participating State contributing the+38 information shall be rem oved fr om the Data System.+HCS SB 1092 47+332.740. 1. The Commission shall promul gate r easonable Rules in order to+2 effectively and efficiently implement and administer the purposes and pro visions of the+3 Compact. A Commission Rule shall be invalid and have no for ce or effect only if a court+4 of competent jurisdiction holds that the Rule is invalid because the Commission+5 exer cised its rulemaking authority in a manner that is beyond the scope and purposes of+6 the Compact, or the powers granted her eunder , or based upon another applicable+7 standard of r eview .+8 2. The Commission shall pr omulgate Rules in accordance with the authority+9 granted under this Compact. All Commission Rules shall be consistent with the+10 Constitution of the United States and, to the extent applicable, the constitutions of+11 Participating States, and shall further the purposes and intent of this Compact. Any+12 Rule adopted by the Commission that exceeds the scope of the Commission's authority+13 or is otherwise inconsistent with this Compact or applicable constitutional r equir ements+14 shall be subject to challenge and determination in accordance with the dispute+15 r esolution and enforcem ent pr ovisions under section 332.745 of this Compact.+16 3. The Rules of the Commission shall have the for ce of law in each Participating+17 State, pro vided however that wher e the Rules of the Commission conflict with the laws+18 of the Participating State that establish the Participating State's Scope of Practice as+19 held by a court of competent jurisdiction, the Rules of the Commission shall be+20 ineffective in that State to the extent of the conflict.+21 4. The Commission shall exerci se its Rulemaking powers pursuant to the criteria+22 set forth in this section and the Rules adopted ther eunder . Rules shall become binding+23 as of the date specified by the Commission for each Rule.+24 5. If a majority of the legislatur es of the Participating States rej ects a+25 Commission Rule or portion of a Commission Rule, by enactment of a statute or+26 r esolution in the same manner used to adopt the Compact, within four (4) years of the+27 date of adoption of the Rule, then such Rule shall have no further for ce and effect in any+28 Participating State or to any State applying to participate in the Compact.+29 6. Rules shall be adopted at a reg ular or special meeting of the Commission.+30 7. Prior to adoption of a pr oposed Rule, the Commission shall hold a public+31 hearing and allow persons to pro vide oral and written comments, data, facts, opinions,+32 and arguments.+33 8. Prior to adoption of a pr oposed Rule by the Commission, and at least thirty+34 (30) days in advance of the meeting at which the Commission will hold a public hearing+35 on the pr oposed Rule, the Commission shall pr ovide a Notice of Pr oposed Rulemaking:+36 (1) On the website of the Commission or other publicly accessible platform;+HCS SB 1092 48+37 (2) T o persons who have requ ested notice of the Commission's notices of+38 pr oposed rulemaking; and+39 (3) In such other way or ways as the Commission may by Rule specify .+40 9. The Notice of Pr oposed Rulemaking shall include:+41 (1) The time, date, and location of the public hearing at which the Commission+42 will hear public comments on the pro posed Rule and, if differ ent, the time, date, and+43 location of the meeting wher e the Commission will consider and vote on the pro posed+44 Rule;+45 (2) If the hearing is held via telecommunication, video conference, or other+46 electr onic means, the Commission shall include the mechanism for access to the hearing+47 in the Notice of Pr oposed Rulemaking;+48 (3) The text of the pr oposed Rule and the reas on ther efor;+49 (4) A requ est for comments on the pr oposed Rule fr om any interes ted person;+50 and+51 (5) The manner in which interes ted persons may submit written comments.+52 10. All hearings will be record ed. A copy of the record ing and all written+53 comments and documents receiv ed by the Commission in res ponse to the prop osed Rule+54 shall be available to the public.+55 1 1. Nothing in this section shall be construed as requ iring a separate hearing on+56 each Commission Rule. Rules may be grou ped for the convenience of the Commission+57 at hearings req uired by this section.+58 12. The Commission shall, by majority vote of all Commissioners, take final+59 action on the prop osed Rule based on the rulemaking reco rd.+60 (1) The Commission may adopt changes to the pro posed Rule pro vided the+61 changes do not enlarge the original purpose of the pr oposed Rule.+62 (2) The Commission shall pro vide an explanation of the r easons for substantive+63 changes made to the pr oposed Rule as well as r easons for substantive changes not made+64 that wer e r ecommended by commenters.+65 (3) The Commission shall determine a reas onable effective date for the Rule.+66 Except for an emergency as pr ovided in subsection 13 of this section, the effective date+67 of the Rule shall be no sooner than thirty (30) days after the Commission issuing the+68 notice that it adopted or amended the Rule.+69 13. Upon determination that an emergency exists, the Commission may consider+70 and adopt an emergency Rule with 24 hours' notice, with opportunity to comment,+71 pr ovided that the usual rulemaking proced ures pr ovided in the Compact and in this+72 section shall be r etro actively applied to the Rule as soon as rea sonably possible, in no+HCS SB 1092 49+73 event later than ninety (90) days after the effective date of the Rule. For the purposes of+74 this prov ision, an emergency Rule is one that must be adopted immediately in order to:+75 (1) Meet an imminent thr eat to public health, safety , or welfare;+76 (2) Pr event a loss of Commission or Participating State funds;+77 (3) Meet a deadline for the pr omulgation of a Rule that is established by federal+78 law or rule; or+79 (4) Pr otect public health and safety .+80 14. The Commission or an authorized committee of the Commission may direct+81 r evisions to a pr eviously adopted Rule for purposes of corr ecting typographical errors,+82 err ors in format, err ors in consistency , or grammatical err ors. Public notice of any+83 r evisions shall be posted on the website of the Commission. The r evision shall be subject+84 to challenge by any person for a period of thirty (30) days after posting. The revi sion+85 may be challenged only on gr ounds that the r evision res ults in a material change to a+86 Rule. A challenge shall be made in writing and deliver ed to the Commission prior to the+87 end of the notice period. If no challenge is made, the r evision will take effect without+88 further action. If the r evision is challenged, the revi sion may not take effect without the+89 appr oval of the Commission.+90 15. No Participating State's rulemaking req uirements shall apply under this+91 Compact.+332.745. 1. (1) The executive and judicial branches of State government in each+2 Participating State shall enfor ce this Compact and take all actions necessary and+3 appr opriate to implement the Compact.+4 (2) V enue is prop er and judicial proc eedings by or against the Commission shall+5 be bro ught solely and exclusively in a court of competent jurisdiction wher e the+6 principal office of the Commission is located. The Commission may waive venue and+7 jurisdictional defenses to the extent it adopts or consents to participate in alternative+8 dispute reso lution pr oceedings. Nothing herei n shall affect or limit the selection or+9 pr opriety of venue in any action against a Licensee for profes sional malpractice,+10 misconduct or any such similar matter .+11 (3) The Commission shall be entitled to recei ve service of process in any+12 pr oceeding regard ing the enfor cement or interpr etation of the Compact or Commission+13 Rule and shall have standing to intervene in such a pr oceeding for all purposes. Failur e+14 to pro vide the Commission service of pro cess shall rend er a judgment or order void as+15 to the Commission, this Compact, or promulg ated Rules.+16 2. (1) If the Commission determines that a Participating State has defaulted in+17 the performance of its obligations or res ponsibilities under this Compact or the+18 pr omulgated Rules, the Commission shall pro vide written notice to the defaulting State.+HCS SB 1092 50+19 The notice of default shall describe the default, the prop osed means of curing the+20 default, and any other action that the Commission may take, and shall offer training+21 and specific technical assistance reg arding the default.+22 (2) The Commission shall pr ovide a copy of the notice of default to the other+23 Participating States.+24 3. If a State in default fails to cur e the default, the defaulting State may be+25 terminated fr om the Compact upon an affirmative vote of a majority of the+26 Commissioners, and all rights, privileges and benefits conferred on that State by this+27 Compact may be terminated on the effective date of termination. A cur e of the default+28 does not reli eve the offending State of obligations or liabilities incurr ed during the+29 period of default.+30 4. T ermination of participation in the Compact shall be imposed only after all+31 other means of securing compliance have been exhausted. Notice of intent to suspend or+32 terminate shall be given by the Commission to the governor , the majority and minority+33 leaders of the defaulting State's legislatur e, the defaulting State's State Licensing+34 Authority or Authorities, as applicable, and each of the Participating States' State+35 Licensing Authority or Authorities, as applicable.+36 5. A State that has been terminated is res ponsible for all assessments,+37 obligations, and liabilities incurr ed thr ough the effective date of termination, including+38 obligations that extend beyond the effective date of termination.+39 6. Upon the termination of a State's participation in this Compact, that State+40 shall immediately pr ovide notice to all Licensees of the State, including Licensees of+41 other Participating States issued a Compact Privilege to practice within that State, of+42 such termination. The terminated State shall continue to rec ognize all Compact+43 Privileges then in effect in that State for a minimum of one hundred eighty (180) days+44 after the date of said notice of termination.+45 7. The Commission shall not bear any costs r elated to a State that is found to be+46 in default or that has been terminated fr om the Compact, unless agr eed upon in writing+47 between the Commission and the defaulting State.+48 8. The defaulting State may appeal the action of the Commission by petitioning+49 the United States District Court for the District of Columbia or the federal district+50 wher e the Commission has its principal offices. The pr evailing party shall be awarded+51 all costs of such litigation, including r easonable attorney's fees.+52 9. (1) Upon req uest by a Participating State, the Commission shall attempt to+53 r esolve disputes r elated to the Compact that arise among Participating States and+54 between Participating States and non-Participating States.+HCS SB 1092 51+55 (2) The Commission shall pr omulgate a Rule prov iding for both mediation and+56 binding dispute r esolution for disputes as appr opriate.+57 10. (1) The Commission, in the reas onable exer cise of its discr etion, shall enforce+58 the pro visions of this Compact and the Commission's Rules.+59 (2) By majority vote, the Commission may initiate legal action against a+60 Participating State in default in the United States District Court for the District of+61 Columbia or the federal district where the Commission has its principal offices to+62 enfor ce compliance with the pr ovisions of the Compact and its pro mulgated Rules. The+63 r elief sought may include both injunctive relief and damages. In the event judicial+64 enfor cement is necessary , the pr evailing party shall be awarded all costs of such+65 litigation, including r easonable attorney's fees. The r emedies herei n shall not be the+66 exclusive r emedies of the Commission. The Commission may pursue any other+67 r emedies available under federal or the defaulting Participating State's law .+68 (3) A Participating State may initiate legal action against the Commission in the+69 United States District Court for the District of Columbia or the federal district wher e+70 the Commission has its principal offices to enforce compliance with the pr ovisions of the+71 Compact and its pr omulgated Rules. The reli ef sought may include both injunctive+72 r elief and damages. In the event judicial enforcem ent is necessary , the pr evailing party+73 shall be awarded all costs of such litigation, including reas onable attorney's fees.+74 (4) No individual or entity other than a Participating State may enfor ce this+75 Compact against the Commission.+332.750. 1. The Compact shall come into effect on the date on which the+2 Compact statute is enacted into law in the seventh Participating State.+3 (1) On or after the effective date of the Compact, the Commission shall convene+4 and rev iew the enactment of each of the States that enacted the Compact prior to the+5 Commission convening ("Charter Participating States") to determine if the statute+6 enacted by each such Charter Participating State is materially differe nt than the Model+7 Compact.+8 (a) A Charter Participating State whose enactment is found to be materially+9 differ ent fr om the Model Compact shall be entitled to the default pr ocess set forth in+10 section 332.745.+11 (b) If any Participating State is later found to be in default, or is terminated or+12 withdraws fr om the Compact, the Commission shall rem ain in existence and the+13 Compact shall rem ain in effect even if the number of Participating States should be less+14 than seven (7).+15 (2) Participating States enacting the Compact subsequent to the Charter+16 Participating States shall be subject to the pr ocess set forth in subdivision (23) of+HCS SB 1092 52+17 subsection 3 of section 332.730 to determine if their enactments ar e materially differ ent+18 fr om the Model Compact and whether they qualify for participation in the Compact.+19 (3) All actions taken for the benefit of the Commission or in furtherance of the+20 purposes of the administration of the Compact prior to the effective date of the Compact+21 or the Commission coming into existence shall be considere d to be actions of the+22 Commission unless specifically r epudiated by the Commission.+23 (4) Any State that joins the Compact subsequent to the Commission's initial+24 adoption of the Rules and bylaws shall be subject to the Commission's Rules and bylaws+25 as they exist on the date on which the Compact becomes law in that State. Any Rule+26 that has been pr eviously adopted by the Commission shall have the full for ce and effect+27 of law on the day the Compact becomes law in that State.+28 2. Any Participating State may withdraw fr om this Compact by enacting a+29 statute repeal ing that State's enactment of the Compact.+30 (1) A Participating State's withdrawal shall not take effect until one hundr ed+31 eighty (180) days after enactment of the r epealing statute.+32 (2) Withdra wal shall not affect the continuing r equir ement of the withdrawing+33 State's Licensing Authority or Authorities to comply with the investigative and Adverse+34 Action reporting r equir ements of this Compact prior to the effective date of withdrawal.+35 (3) Upon the enactment of a statute withdrawing fr om this Compact, the State+36 shall immediately provi de notice of such withdrawal to all Licensees within that State.+37 Notwithstanding any subsequent statutory enactment to the contrary , such withdrawing+38 State shall continue to recogn ize all Compact Privileges to practice within that State+39 granted pursuant to this Compact for a minimum of one hundred eighty (180) days after+40 the date of such notice of withdrawal.+41 3. Nothing contained in this Compact shall be construed to invalidate or pr event+42 any licensur e agr eement or other cooperative arrangement between a Participating+43 State and a non-Participating State that does not conflict with the prov isions of this+44 Compact.+45 4. This Compact may be amended by the Participating States. No amendment to+46 this Compact shall become effective and binding upon any Participating State until it is+47 enacted into the laws of all Participating States.+332.755. 1. This Compact and the Commission's rulemaking authority shall be+2 liberally construed so as to effectuate the purposes, and the implementation and+3 administration of the Compact. Pr ovisions of the Compact expr essly authorizing or+4 r equiring the promulg ation of Rules shall not be construed to limit the Commission's+5 rulemaking authority solely for those purposes.+HCS SB 1092 53+6 2. The pr ovisions of this Compact shall be severable and if any phrase, clause,+7 sentence or provi sion of this Compact is held by a court of competent jurisdiction to be+8 contrary to the constitution of any Participating State, a State seeking participation in+9 the Compact, or of the United States, or the applicability ther eof to any government,+10 agency , person or circ umstance is held to be unconstitutional by a court of competent+11 jurisdiction, the validity of the rem ainder of this Compact and the applicability ther eof+12 to any other government, agency , person or circu mstance shall not be affected ther eby .+13 3. Notwithstanding subsection 2 of this section, the Commission may deny a+14 State's participation in the Compact or , in accordance with the r equir ements of+15 subsection 2 of section 332.745, terminate a Participating State's participation in the+16 Compact, if it determines that a constitutional req uire ment of a Participating State is a+17 material departure fro m the Compact. Otherwise, if this Compact shall be held to be+18 contrary to the constitution of any Participating State, the Compact shall rem ain in full+19 for ce and effect as to the r emaining Participating States and in full for ce and effect as to+20 the Participating State affected as to all severable matters.+332.760. 1. Nothing herei n shall preven t or inhibit the enforcem ent of any other+2 law of a Participating State that is not inconsistent with the Compact.+3 2. Except as explicitly permitted her ein, nothing in this Compact, nor any Rule+4 of the Commission, shall be construed to limit, restrict, or in any way red uce the ability+5 of a Participating State to enact and enforce laws, regu lations, or other rules relat ed to+6 the practice of dentistry and dental hygiene within such Participating State, including+7 but not limited to standards of practice, Scope of Practice, office safety r equir ements,+8 patient care standards, and all other aspects of pr ofessional practice occurring within+9 such Participating State's borders.+10 3. Any laws, statutes, reg ulations, or other legal req uirements in a Participating+11 State in conflict with the Compact ar e superseded to the extent of the conflict.+12 4. All permissible agr eements between the Commission and the Participating+13 States ar e binding in accordance with their terms.+334.1800. 1. Sections 334.1800 to 334.1860 shall be known and may be cited as+2 the "Physician Assistant Licensure Compact".+3 2. In order to str engthen access to Medical Services, and in r ecognition of the+4 advances in the delivery of Medical Services, the Participating States of the P A+5 Licensur e Compact have allied in common purpose to develop a compr ehensive pro cess+6 that complements the existing authority of State Licensing Boards to license and+7 discipline physician assistants and seeks to enhance the portability of a License to+8 practice as a physician assistant while safeguarding the safety of patients. This+9 Compact allows Medical Services to be prov ided by physician assistants, via the mutual+HCS SB 1092 54+10 r ecognition of the Licensee's Qualifying License by other Compact Participating States.+11 This Compact also adopts the prevai ling standard for physician assistant licensur e and+12 affirms that the practice and delivery of Medical Services by the physician assistant+13 occurs wher e the patient is located at the time of the patient encounter , and ther efor e+14 r equir es the physician assistant to be under the jurisdiction of the State Licensing Board+15 wher e the patient is located. State Licensing Boards that participate in this Compact+16 r etain the jurisdiction to impose Adverse Action against a Compact Privilege in that+17 State issued to a physician assistant thr ough the pro cedur es of this Compact. The P A+18 Licensur e Compact will alleviate burdens for military families by allowing active duty+19 military personnel and their spouses to obtain a Compact Privilege based on having an+20 unr estricted License in good standing fr om a Participating State.+334.1805. In this Compact:+2 (1) "Adverse Action" means any administrative, civil, equitable, or criminal+3 action permitted by a State's laws which is imposed by a Licensing Board or other+4 authority against a physician assistant License or License application or Compact+5 Privilege such as License denial, censure, revo cation, suspension, pr obation, monitoring+6 of the Licensee, or r estriction on the Licensee's practice.+7 (2) "Compact Privilege" means the authorization granted by a Remote State to+8 allow a Licensee from another Participating State to practice as a physician assistant to+9 pr ovide Medical Services and other licensed activity to a patient located in the Remote+10 State under the Remote State's laws and regu lations.+11 (3) "Conviction" means a finding by a court that an individual is guilty of a+12 felony or misdemeanor offense thr ough adjudication or entry of a plea of guilt or no+13 contest to the charge by the offender .+14 (4) "Criminal Backgr ound Check" means the submission of fingerprints or+15 other biometric-based information for a License applicant for the purpose of obtaining+16 that applicant's criminal history record information, as defined in 28 C.F .R. § 20.3(d),+17 fr om the State's criminal history r ecord repo sitory as defined in 28 C.F .R. § 20.3(f).+18 (5) "Data System" means the r epository of information about Licensees,+19 including but not limited to License status and Adverse Actions, which is creat ed and+20 administer ed under the terms of this Compact.+21 (6) "Executive Committee" means a group of dir ectors and ex-officio individuals+22 elected or appointed pursuant to subdivision (2) of subsection 6 of section 334.1830.+23 (7) "Impair ed Practitioner" means a physician assistant whose practice is+24 adversely affected by health-re lated condition(s) that impact their ability to practice.+25 (8) "Investigative Information" means information, r ecords, or documents+26 r eceived or generated by a Licensing Board pursuant to an investigation.+HCS SB 1092 55+27 (9) "Jurisprudence Requirem ent" means the assessment of an individual's+28 knowledge of the laws and Rules governing the practice of a physician assistant in a+29 State.+30 (10) "License" means curren t authorization by a State, other than authorization+31 pursuant to a Compact Privilege, for a physician assistant to prov ide Medical Services,+32 which would be unlawful without curr ent authorization.+33 (1 1) "Licensee" means an individual who holds a License fr om a State to provi de+34 Medical Services as a physician assistant.+35 (12) "Licensing Board" means any State entity authorized to license and+36 otherwise reg ulate physician assistants.+37 (13) "Medical Services" means health care services pr ovided for the diagnosis,+38 pr evention, tr eatment, cur e or relief of a health condition, injury , or disease, as defined+39 by a State's laws and regu lations. The medical services pro vided by a physician+40 assistant to a patient located in Missouri are defined by Missouri's state laws and+41 r egulations.+42 (14) "Model Compact" means the model for the P A Licensure Compact on file+43 with The Council of State Governments or other entity as designated by the+44 Commission.+45 (15) "Participating State" means a State that has enacted this Compact.+46 (16) "P A" or "Physician Assistant" means an individual who is licensed as a+47 physician assistant in a State. For purposes of this Compact, any other title or status+48 adopted by a State to re place the term "physician assistant" shall be deemed+49 synonymous with "physician assistant" and shall confer the same rights and+5 0 r esponsibilities to the Licensee under the pr ovisions of this Compact at the time of its+51 enactment.+52 (17) "P A Licensur e Compact Commission," "Compact Commission," or+53 "Commission" mean the national administrative body cr eated pursuant to subsection+54 1 of section 334.1830 of this Compact.+55 (18) "Qualifying License" means an unrest ricted License issued by a+5 6 Participating State to provi de Medical Services as a physician assistant.+57 (19) "Remote State" means a Participating State wher e a Licensee who is not+58 licensed as a physician assistant is exercising or seeking to exerci se the Compact+59 Privilege.+60 (20) "Rule" means a r egulation pr omulgated by an entity that has the for ce and+61 effect of law .+62 (21) "Significant Investigative Information" means Investigative Information+63 that a Licensing Board, after an inquiry or investigation that includes notification and+HCS SB 1092 56+64 an opportunity for the physician assistant to r espond if requ ired by State law , has+65 r eason to believe is not groun dless and, if proven true, would indicate mor e than a+66 minor infraction.+67 (22) "State" means any state, commonwealth, district, or territory of the United+68 States.+334.1810. 1. T o participate in this Compact, a Participating State shall:+2 (1) License physician assistants.+3 (2) Participate in the Compact Commission's Data System.+4 (3) Have a mechanism in place for receivi ng and investigating complaints+5 against Licensees and License applicants.+6 (4) Notify the Commission, in compliance with the terms of this Compact and+7 Commission Rules, of any Adverse Action against a Licensee or License applicant and+8 the existence of Significant Investigative Information regard ing a Licensee or License+9 applicant.+10 (5) Fully implement a Criminal Backgr ound Check req uire ment, within a time+11 frame established by Commission Rule, by its Licensing Board r eceiving the results of a+12 Criminal Backgr ound Check and reporting to the Commission whether the License+13 applicant has been granted a License.+14 (6) Comply with the Rules of the Compact Commission.+15 (7) Utilize passage of a recog nized national exam such as the NCCP A P ANCE as+16 a req uire ment for physician assistant licensur e.+17 (8) Grant the Compact Privilege to a holder of a Qualifying License in a+18 Participating State.+19 2. Nothing in this Compact pr ohibits a Participating State fr om charging a fee+20 for granting the Compact Privilege.+334.1815. 1. T o exer cise the Compact Privilege, a Licensee must:+2 (1) Have graduated fr om a physician assistant progra m accr edited by the+3 Accr editation Review Commission on Education for the Physician Assistant, Inc. or+4 other pr ograms authorized by Commission Rule.+5 (2) Hold curr ent NCCP A certification.+6 (3) Have no felony or misdemeanor Conviction.+7 (4) Have never had a controlled substance license, permit, or regi stration+8 suspended or r evoked by a State or by the United States Drug Enfor cement+9 Administration.+10 (5) Have a unique identifier as determined by Commission Rule.+11 (6) Hold a Qualifying License.+HCS SB 1092 57+12 (7) Have had no rev ocation of a License or limitation or res triction on any+13 License curr ently held due to an adverse action.+14 (8) If a Licensee has had a limitation or res triction on a License or Compact+15 Privilege due to an Adverse Action, two years must have elapsed fr om the date on which+16 the License or Compact Privilege is no longer limited or res tricted due to the Adverse+17 Action.+18 (9) If a Compact Privilege has been r evoked or is limited or restricted in a+19 Participating State for conduct that would not be a basis for disciplinary action in a+20 Participating State in which the Licensee is practicing or applying to practice under a+21 Compact Privilege, that Participating State shall have the discret ion not to consider+22 such action as an Adverse Action req uiring the denial or rem oval of a Compact+23 Privilege in that State.+24 (10) Notify the Compact Commission that the Licensee is seeking the Compact+25 Privilege in a Remote State.+26 (1 1) Meet any Jurisprudence Requirem ent of a Remote State in which the+27 Licensee is seeking to practice under the Compact Privilege and pay any fees applicable+28 to satisfying the Jurisprudence Requirem ent.+29 (12) Report to the Commission any Adverse Action taken by a non-participating+30 State within thirty (30) days after the action is taken.+31 2. The Compact Privilege is valid until the expiration or r evocation of the+32 Qualifying License unless terminated pursuant to an Adverse Action. The Licensee+33 must also comply with all of the re quir ements of subsection 1 of this section to maintain+34 the Compact Privilege in a Remote State. If the Participating State takes Adverse+35 Action against a Qualifying License, the Licensee shall lose the Compact Privilege in any+36 Remote State in which the Licensee has a Compact Privilege until all of the following+37 occur:+38 (1) The License is no longer limited or restricted; and+39 (2) T wo (2) years have elapsed fr om the date on which the License is no longer+40 limited or res tricted due to the Adverse Action.+41 3. Once a res tricted or limited License satisfies the requ irem ents of subdivisions+42 (1) and (2) of subsection 2 of this section, the Licensee must meet the requ irem ents of+43 subsection 1 of this section to obtain a Compact Privilege in any Remote State.+44 4. For each Remote State in which a physician assistant seeks authority to+45 pr escribe control led substances, the physician assistant shall satisfy all r equir ements+46 imposed by such State in granting or renewi ng such authority .+334.1820. Upon a Licensee's application for a Compact Privilege, the Licensee+2 shall identify to the Commission the Participating State fr om which the Licensee is+HCS SB 1092 58+3 applying, in accordance with applicable Rules adopted by the Commission, and subject+4 to the following r equir ements:+5 (1) When applying for a Compact Privilege, the Licensee shall pr ovide the+6 Commission with the addr ess of the Licensee's primary res idence and ther eafter shall+7 immediately r eport to the Commission any change in the addr ess of the Licensee's+8 primary resi dence.+9 (2) When applying for a Compact Privilege, the Licensee is req uired to consent+10 to accept service of proc ess by mail at the Licensee's primary res idence on file with the+11 Commission with res pect to any action br ought against the Licensee by the Commission+12 or a Participating State, including a subpoena, with res pect to any action brou ght or+13 investigation conducted by the Commission or a Participating State.+334.1825. 1. A Participating State in which a Licensee is licensed shall have+2 exclusive power to impose Adverse Action against the Qualifying License issued by that+3 Participating State.+4 2. In addition to the other powers conferr ed by State law , a Remote State shall+5 have the authority , in accordance with existing State due process law , to do all of the+6 following:+7 (1) T ake Adverse Action against a physician assistant's Compact Privilege within+8 that State to rem ove a Licensee's Compact Privilege or take other action necessary+9 under applicable law to pr otect the health and safety of its citizens.+10 (2) Issue subpoenas for both hearings and investigations that requ ire the+11 attendance and testimony of witnesses as well as the prod uction of evidence. Subpoenas+12 issued by a Licensing Board in a Participating State for the attendance and testimony of+13 witnesses or the prod uction of evidence fro m another Participating State shall be+14 enfor ced in the latter State by any court of competent jurisdiction, according to the+15 practice and pr ocedur e of that court applicable to subpoenas issued in proceed ings+16 pending before it. The issuing authority shall pay any witness fees, travel expenses,+17 mileage and other fees req uired by the service statutes of the State in which the+18 witnesses or evidence are located.+19 (3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be+20 issued by a Participating State to gather evidence of conduct in another State that is+21 lawful in that other State for the purpose of taking Adverse Action against a Licensee's+22 Compact Privilege or application for a Compact Privilege in that Participating State.+23 (4) Nothing in this Compact authorizes a Participating State to impose discipline+24 against a physician assistant's Compact Privilege or to deny an application for a+25 Compact Privilege in that Participating State for the individual's otherwise lawful+26 practice in another State.+HCS SB 1092 59+27 3. For purposes of taking Adverse Action, the Participating State which issued+28 the Qualifying License shall give the same priority and effect to repo rted conduct+29 r eceived fr om any other Participating State as it would if the conduct had occurr ed+30 within the Participating State which issued the Qualifying License. In so doing, that+31 Participating State shall apply its own State laws to determine appr opriate action.+32 4. A Participating State, if otherwise permitted by State law , may recover fr om+33 the affected physician assistant the costs of investigations and disposition of cases+34 r esulting from any Adverse Action taken against that physician assistant.+35 5. A Participating State may take Adverse Action based on the factual findings+36 of a Remote State, pr ovided that the Participating State follows its own pr ocedur es for+37 taking the Adverse Action.+38 6. (1) In addition to the authority granted to a Participating State by its+39 r espective State physician assistant laws and reg ulations or other applicable State law ,+40 any Participating State may participate with other Participating States in joint+41 investigations of Licensees.+42 (2) Participating States shall share any investigative, litigation, or compliance+43 materials in furtherance of any joint or individual investigation initiated under this+44 Compact.+45 7. If an Adverse Action is taken against a physician assistant's Qualifying+46 License, the physician assistant's Compact Privilege in all Remote States shall be+47 deactivated until two (2) years have elapsed after all res trictions have been r emoved+48 fr om the State License. All disciplinary orders by the Participating State which issued+49 the Qualifying License that impose Adverse Action against a physician assistant's+50 License shall include a Statement that the physician assistant's Compact Privilege is+51 deactivated in all Participating States during the pendency of the order .+52 8. If any Participating State takes Adverse Action, it pr omptly shall notify the+53 administrator of the Data System.+334.1830. 1. The Participating States her eby creat e and establish a joint+2 government agency and national administrative body known as the P A Licensur e+3 Compact Commission. The Commission is an instrumentality of the Compact States+4 acting jointly and not an instrumentality of any one State. The Commission shall come+5 into existence on or after the effective date of the Compact as set forth in subsection 1 of+6 section 334.1850.+7 2. (1) Each Participating State shall have and be limited to one (1) delegate+8 selected by that Participating State's Licensing Board or , if the State has mor e than one+9 Licensing Board, selected collectively by the Participating State's Licensing Boards.+10 (2) The delegate shall be either:+HCS SB 1092 60+11 (a) A curr ent physician assistant, physician or public member of a Licensing+12 Board or physician assistant Council/Committee; or+13 (b) An administrator of a Licensing Board.+14 (3) Any delegate may be rem oved or suspended fr om office as pro vided by the+15 laws of the State from which the delegate is appointed.+16 (4) The Participating State Licensing Board shall fill any vacancy occurring in+17 the Commission within sixty (60) days.+18 (5) Each delegate shall be entitled to one (1) vote on all matters voted on by the+19 Commission and shall otherwise have an opportunity to participate in the business and+20 affairs of the Commission. A delegate shall vote in person or by such other means as+21 pr ovided in the bylaws. The bylaws may prov ide for delegates' participation in+22 meetings by telecommunications, video confer ence, or other means of communication.+23 (6) The Commission shall meet at least once during each calendar year .+24 Additional meetings shall be held as set forth in this Compact and the bylaws.+25 (7) The Commission shall establish by Rule a term of office for delegates.+26 3. The Commission shall have the following powers and duties:+27 (1) Establish a code of ethics for the Commission;+28 (2) Establish the fiscal year of the Commission;+29 (3) Establish fees;+30 (4) Establish bylaws;+31 (5) Maintain its financial r ecords in accordance with the bylaws;+32 (6) Meet and take such actions as ar e consistent with the pr ovisions of this+33 Compact and the bylaws;+34 (7) Pr omulgate Rules limited to the Commission's authority to facilitate and+35 coordinate implementation and administration of this Compact. The Rules authorized+36 by the Compact shall have the forc e and effect of law and shall be binding in all+37 Participating States;+38 (8) Bring and prosecute legal pr oceedings or actions in the name of the+39 Commission, pr ovided that the standing of any State Licensing Board to sue or be sued+40 under applicable law shall not be affected;+41 (9) Purchase and maintain insurance and bonds;+42 (10) Borrow , accept, or contract for services of personnel, including, but not+43 limited to, employees of a Participating State;+44 (1 1) Hir e employees and engage contractors, elect or appoint officers, fix+45 compensation, define duties, grant such individuals appr opriate authority to carry out+46 the purposes of this Compact, and establish the Commission's personnel policies and+HCS SB 1092 61+47 pr ograms relat ing to conflicts of intere st, qualifications of personnel, and other r elated+48 personnel matters;+49 (12) Accept any and all appr opriate donations and grants of money , equipment,+50 supplies, materials and services, and receiv e, utilize and dispose of the same; pr ovided+51 that at all times the Commission shall avoid any appearance of impropri ety or conflict+52 of interes t;+53 (13) Lease, pur chase, accept appr opriate gifts or donations of, or otherwise own,+54 hold, improv e or use, any pro perty , rea l, personal or mixed; pr ovided that at all times+55 the Commission shall avoid any appearance of impropri ety;+56 (14) Sell, convey , mortgage, pledge, lease, exchange, abandon, or otherwise+57 dispose of any pr operty real, personal, or mixed;+58 (15) Establish a budget and make expenditur es;+59 (16) Borrow money;+60 (17) Appoint committees, including standing committees composed of members,+61 State r egulators, State legislators or their re pr esentatives, and consumer+6 2 r epresent atives, and such other interes ted persons as may be designated in this+63 Compact and the bylaws;+64 (18) Pr ovide and r eceive information fr om, and cooperate with, law enforcem ent+65 agencies;+66 (19) Elect a Chair , V ice Chair , Secr etary and T rea sur er and such other officers+67 of the Commission as pr ovided in the Commission's bylaws;+68 (20) Reserve for itself, in addition to those rese rved exclusively to the+69 Commission under the Compact, powers that the Executive Committee may not+70 exer cise;+71 (21) Appr ove or disappr ove a State's participation in the Compact based upon+72 its determination as to whether the State's Compact legislation departs in a material+73 manner fr om the Model Compact language;+74 (22) Pr epare and pr ovide to the Participating States an annual repo rt; and+75 (23) Perform such other functions as may be necessary or appr opriate to achieve+76 the purposes of this Compact consistent with the State regu lation of physician assistant+77 licensur e and practice.+78 4. (1) All meetings of the Commission that are not closed pursuant to this+79 subsection shall be open to the public. Notice of public meetings shall be posted on the+80 Commission's website at least thirty (30) days prior to the public meeting.+81 (2) Notwithstanding subdivision (1) of this subsection, the Commission may+82 convene a public meeting by pr oviding at least twenty-four (24) hours prior notice on+83 the Commission's website, and any other means as pr ovided in the Commission's Rules,+HCS SB 1092 62+84 for any of the reas ons it may dispense with notice of pro posed rulemaking under+85 subsection 12 of section 334.1840.+86 (3) The Commission may convene in a closed, non-public meeting or non-public+87 part of a public meeting to recei ve legal advice or to discuss:+88 (a) Non-compliance of a Participating State with its obligations under this+89 Compact;+90 (b) The employment, compensation, discipline or other matters, practices or+91 pr ocedur es rel ated to specific employees or other matters rela ted to the Commission's+92 internal personnel practices and proc edures;+93 (c) Curr ent, thr eatened, or r easonably anticipated litigation;+94 (d) Negotiation of contracts for the purch ase, lease, or sale of goods, services, or+95 r eal estate;+96 (e) Accusing any person of a crime or formally censuring any person;+97 (f) Disclosure of trade secr ets or commer cial or financial information that is+98 privileged or confidential;+99 (g) Disclosur e of information of a personal natur e wher e disclosur e would+100 constitute a clearly unwarranted invasion of personal privacy;+101 (h) Disclosur e of investigative r ecords compiled for law enfor cement purposes;+102 (i) Disclosur e of information re lated to any investigative rep orts pr epar ed by or+103 on behalf of or for use of the Commission or other committee charged with+104 r esponsibility of investigation or determination of compliance issues pursuant to this+105 Compact;+106 (j) Legal advice; or+107 (k) Matters specifically exempted fr om disclosure by federal or Participating+108 States' statutes.+109 (4) If a meeting, or portion of a meeting, is closed pursuant to this pr ovision, the+110 chair of the meeting or the chair's designee shall certify that the meeting or portion of+111 the meeting may be closed and shall r efer ence each r elevant exempting pr ovision.+112 (5) The Commission shall keep minutes that fully and clearly describe all+113 matters discussed in a meeting and shall pr ovide a full and accurate summary of actions+114 taken, including a description of the views expr essed. All documents consider ed in+115 connection with an action shall be identified in such minutes. All minutes and+116 documents of a closed meeting shall r emain under seal, subject to relea se by a majority+117 vote of the Commission or order of a court of competent jurisdiction.+118 5. (1) The Commission shall pay , or pr ovide for the payment of, the reas onable+119 expenses of its establishment, organization, and ongoing activities.+HCS SB 1092 63+120 (2) The Commission may accept any and all appr opriate reven ue sources ,+121 donations, and grants of money , equipment, supplies, materials, and services.+122 (3) The Commission may levy on and collect an annual assessment fr om each+123 Participating State and may impose Compact Privilege fees on Licensees of+1 2 4 Participating States to whom a Compact Privilege is granted to cover the cost of the+125 operations and activities of the Commission and its staff, which must be in a total+126 amount sufficient to cover its annual budget as appr oved by the Commission each year+127 for which rev enue is not pr ovided by other sour ces. The aggreg ate annual assessment+128 amount levied on Participating States shall be allocated based upon a formula to be+129 determined by Commission Rule.+130 (a) A Compact Privilege expir es when the Licensee's Qualifying License in the+131 Participating State fr om which the Licensee applied for the Compact Privilege expir es.+132 (b) If the Licensee terminates the Qualifying License thr ough which the Licensee+133 applied for the Compact Privilege before its scheduled expiration, and the Licensee has+134 a Qualifying License in another Participating State, the Licensee shall inform the+135 Commission that it is changing to that Participating State the Participating State+136 thr ough which it applies for a Compact Privilege and pay to the Commission any+137 Compact Privilege fee r equir ed by Commission Rule.+138 (4) The Commission shall not incur obligations of any kind prior to securing the+139 funds adequate to meet the same; nor shall the Commission pledge the cred it of any of+140 the Participating States, except by and with the authority of the Participating State.+141 (5) The Commission shall keep accurate accounts of all re ceipts and+1 4 2 disbursements. The r eceipts and disbursements of the Commission shall be subject+143 to the financial r eview and accounting pr ocedur es established under its bylaws. All+144 r eceipts and disbursements of funds handled by the Commission shall be subject to an+145 annual financial r eview by a certified or licensed public accountant, and the r eport of+146 the financial rev iew shall be included in and become part of the annual r eport of the+147 Commission.+148 6. (1) The Executive Committee shall have the power to act on behalf of the+149 Commission according to the terms of this Compact and Commission Rules.+150 (2) The Executive Committee shall be composed of nine (9) members:+151 (a) Seven voting members who ar e elected by the Commission fr om the curr ent+152 membership of the Commission;+153 (b) One ex-officio, nonvoting member fr om a reco gnized national physician+154 assistant profes sional association; and+155 (c) One ex-officio, nonvoting member fr om a recogn ized national physician+156 assistant certification organization.+HCS SB 1092 64+157 (3) The ex-officio members will be selected by their res pective organizations.+158 (4) The Commission may rem ove any member of the Executive Committee as+159 pr ovided in its bylaws.+160 (5) The Executive Committee shall meet at least annually .+161 (6) The Executive Committee shall have the following duties and res ponsibilities:+162 (a) Recommend to the Commission changes to the Commission's Rules or+163 bylaws, changes to this Compact legislation, fees to be paid by Compact Participating+164 States such as annual dues, and any Commission Compact fee charged to Licensees for+165 the Compact Privilege;+166 (b) Ensur e Compact administration services are appr opriately provi ded,+167 contractual or otherwise;+168 (c) Pr epar e and recomm end the budget;+169 (d) Maintain financial record s on behalf of the Commission;+170 (e) Monitor Compact compliance of Participating States and pr ovide compliance+171 r eports to the Commission;+172 (f) Establish additional committees as necessary;+173 (g) Exercis e the powers and duties of the Commission during the interim+174 between Commission meetings, except for issuing pr oposed rulemaking or adopting+175 Commission Rules or bylaws, or exer cising any other powers and duties exclusively+176 r eserved to the Commission by the Commission's Rules; and+177 (h) Perform other duties as provi ded in the Commission's Rules or bylaws.+178 (7) All meetings of the Executive Committee at which it votes or plans to vote on+179 matters in exer cising the powers and duties of the Commission shall be open to the+180 public and public notice of such meetings shall be given as public meetings of the+181 Commission are given.+182 (8) The Executive Committee may convene in a closed, non-public meeting for+183 the same r easons that the Commission may convene in a non-public meeting as set forth+184 in subdivision (3) of subsection 4 of this section and shall announce the closed meeting as+185 the Commission is req uired to under subdivision (4) of subsection 4 of this section and+186 keep minutes of the closed meeting as the Commission is requi red to under subdivision+187 (5) of subsection 4 of this section.+188 7. (1) The members, officers, executive director , employees and repr esentatives+189 of the Commission shall be immune fr om suit and liability , both personally and in their+190 official capacity , for any claim for damage to or loss of prop erty or personal injury or+191 other civil liability caused by or arising out of any actual or alleged act, error , or+192 omission that occurr ed, or that the person against whom the claim is made had a+193 r easonable basis for believing occurr ed within the scope of Commission employment,+HCS SB 1092 65+194 duties or r esponsibilities; prov ided that nothing in this subdivision shall be construed to+195 pr otect any such person fro m suit or liability for any damage, loss, injury , or liability+196 caused by the intentional or willful or wanton misconduct of that person. The+197 pr ocur ement of insurance of any type by the Commission shall not in any way+198 compr omise or limit the immunity granted hereu nder .+199 (2) The Commission shall defend any member , officer , executive direc tor ,+200 employee, and re present ative of the Commission in any civil action seeking to impose+201 liability arising out of any actual or alleged act, err or , or omission that occurred within+202 the scope of Commission employment, duties, or re sponsibilities, or as determined by+203 the commission that the person against whom the claim is made had a r easonable basis+204 for believing occurr ed within the scope of Commission employment, duties, or+205 r esponsibilities; pr ovided that nothing her ein shall be construed to pr ohibit that+206 person fro m ret aining their own counsel at their own expense; and pr ovided further ,+207 that the actual or alleged act, error , or omission did not res ult fr om that person's+208 intentional or willful or wanton misconduct.+209 (3) The Commission shall indemnify and hold harmless any member , officer ,+210 executive dir ector , employee, and repr esentative of the Commission for the amount of+211 any settlement or judgment obtained against that person arising out of any actual or+212 alleged act, err or , or omission that occurre d within the scope of Commission+21 3 employment, duties, or res ponsibilities, or that such person had a r easonable basis+214 for believing occurr ed within the scope of Commission employment, duties, or+215 r esponsibilities, prov ided that the actual or alleged act, erro r , or omission did not+216 r esult fr om the intentional or willful or wanton misconduct of that person.+217 (4) V enue is prop er and judicial proc eedings by or against the Commission shall+218 be bro ught solely and exclusively in a court of competent jurisdiction wher e the+219 principal office of the Commission is located. The Commission may waive venue and+220 jurisdictional defenses in any proceed ings as authorized by Commission Rules.+221 (5) Nothing herei n shall be construed as a limitation on the liability of any+222 Licensee for profes sional malpractice or misconduct, which shall be governed solely by+223 any other applicable State laws.+224 (6) Nothing her ein shall be construed to designate the venue or jurisdiction to+225 bring actions for alleged acts of malpractice, pr ofessional misconduct, negligence, or+226 other such civil action pertaining to the practice of a physician assistant. All such+227 matters shall be determined exclusively by State law other than this Compact.+228 (7) Nothing in this Compact shall be interpr eted to waive or otherwise abr ogate+229 a Participating State's state action immunity or state action affirmative defense with+HCS SB 1092 66+230 r espect to antitrust claims under the Sherman Act, Clayton Act, or any other State or+231 federal antitrust or anticompetitive law or regul ation.+232 (8) Nothing in this Compact shall be construed to be a waiver of soverei gn+233 immunity by the Participating States or by the Commission.+334.1835. 1. The Commission shall prov ide for the development, maintenance,+2 operation, and utilization of a coordinated data and r eporting system containing+3 licensur e, Adverse Action, and the rep orting of the existence of Significant Investigative+4 Information on all licensed physician assistants and applicants denied a License in+5 Participating States.+6 2. Notwithstanding any other State law to the contrary , a Participating State+7 shall submit a uniform data set to the Data System on all physician assistants to whom+8 this Compact is applicable (utilizing a unique identifier) as requ ired by the Rules of the+9 Commission, including:+10 (1) Identifying information;+11 (2) Licensure data;+12 (3) Adverse Actions against a License or Compact Privilege;+13 (4) Any denial of application for licensur e, and the reas on or rea sons for such+14 denial (excluding the repo rting of any Criminal history record information wher e+15 pr ohibited by law);+16 (5) The existence of Significant Investigative Information; and+17 (6) Other information that may facilitate the administration of this Compact, as+18 determined by the Rules of the Commission.+19 3. Significant Investigative Information pertaining to a Licensee in any+20 Participating State shall only be available to other Participating States.+21 4. The Commission shall pr omptly notify all Participating States of any Adverse+22 Action taken against a Licensee or an individual applying for a License that has been+23 r eported to it. This Adverse Action information shall be available to any other+24 Participating State.+25 5. Participating States contributing information to the Data System may , in+26 accordance with State or federal law , designate information that may not be shar ed with+27 the public without the expr ess permission of the contributing State. Notwithstanding+28 any such designation, such information shall be rep orted to the Commission thr ough the+29 Data System.+30 6. Any information submitted to the Data System that is subsequently expunged+31 pursuant to federal law or the laws of the Participating State contributing the+32 information shall be r emoved fr om the Data System upon reporting of such by the+33 Participating State to the Commission.+HCS SB 1092 67+34 7. The rec ords and information pro vided to a Participating State pursuant to+35 this Compact or thr ough the Data System, when certified by the Commission or an+36 agent ther eof, shall constitute the authenticated business rec ords of the Commission,+37 and shall be entitled to any associated hearsay exception in any re levant judicial, quasi-+38 judicial or administrative pr oceedings in a Participating State.+334.1840. 1. The Commission shall exer cise its Rulemaking powers pursuant to+2 the criteria set forth in this Section and the Rules adopted ther eunder . Commission+3 Rules shall become binding as of the date specified by the Commission for each Rule.+4 2. The Commission shall promul gate reas onable Rules in order to effectively and+5 efficiently implement and administer this Compact and achieve its purposes. A+6 Commission Rule shall be invalid and have no for ce or effect only if a court of+7 competent jurisdiction holds that the Rule is invalid because the Commission exer cised+8 its rulemaking authority in a manner that is beyond the scope of the purposes of this+9 Compact, or the powers granted hereunder , or based upon another applicable standard+10 of review .+11 3. The Rules of the Commission shall have the for ce of law in each Participating+12 State, pro vided however that wher e the Rules of the Commission conflict with the laws+13 of the Participating State that establish the medical services a physician assistant may+14 perform in the Participating State, as held by a court of competent jurisdiction, the+15 Rules of the Commission shall be ineffective in that State to the extent of the conflict.+16 4. If a majority of the legislatur es of the Participating States rej ects a+17 Commission Rule, by enactment of a statute or res olution in the same manner used to+18 adopt this Compact within four (4) years of the date of adoption of the Rule, then such+19 Rule shall have no further for ce and effect in any Participating State or to any State+20 applying to participate in the Compact.+21 5. Commission Rules shall be adopted at a regu lar or special meeting of the+22 Commission.+23 6. Prior to pr omulgation and adoption of a final Rule or Rules by the+24 Commission, and at least thirty (30) days in advance of the meeting at which the Rule+25 will be consider ed and voted upon, the Commission shall file a Notice of Pr oposed+26 Rulemaking:+27 (1) On the website of the Commission or other publicly accessible platform; and+28 (2) T o persons who have requ ested notice of the Commission's notices of+29 pr oposed rulemaking; and+30 (3) In such other way(s) as the Commission may by Rule specify .+31 7. The Notice of Pr oposed Rulemaking shall include:+HCS SB 1092 68+32 (1) The time, date, and location of the public hearing on the prop osed Rule and+33 the pro posed time, date and location of the meeting in which the pr oposed Rule will be+34 consider ed and voted upon;+35 (2) The text of the pr oposed Rule and the reas on for the pr oposed Rule;+36 (3) A r equest for comments on the prop osed Rule fr om any interes ted person+37 and the date by which written comments must be receiv ed; and+38 (4) The manner in which interes ted persons may submit notice to the+39 Commission of their intention to attend the public hearing or pr ovide any written+40 comments.+41 8. Prior to adoption of a pro posed Rule, the Commission shall allow persons to+42 submit written data, facts, opinions, and arguments, which shall be made available to+43 the public.+44 9. If the hearing is to be held via electr onic means, the Commission shall publish+45 the mechanism for access to the electr onic hearing.+46 (1) All persons wishing to be heard at the hearing shall as direc ted in the Notice+47 of Pr oposed Rulemaking, not less than five (5) business days befor e the scheduled date+48 of the hearing, notify the Commission of their desire to appear and testify at the hearing.+49 (2) Hearings shall be conducted in a manner provi ding each person who wishes+50 to comment a fair and reas onable opportunity to comment orally or in writing.+51 (3) All hearings shall be r ecorded. A copy of the r ecording and the written+52 comments, data, facts, opinions, and arguments recei ved in res ponse to the pro posed+53 rulemaking shall be made available to a person upon requ est.+54 (4) Nothing in this section shall be construed as requi ring a separate hearing on+55 each pr oposed Rule. Pr oposed Rules may be gro uped for the convenience of the+56 Commission at hearings req uire d by this section.+57 10. Following the public hearing the Commission shall consider all written and+58 oral comments timely r eceived.+59 1 1. The Commission shall, by majority vote of all delegates, take final action on+60 the prop osed Rule and shall determine the effective date of the Rule, if adopted, based+61 on the Rulemaking record and the full text of the Rule.+62 (1) If adopted, the Rule shall be posted on the Commission's website.+63 (2) The Commission may adopt changes to the pro posed Rule pro vided the+64 changes do not enlarge the original purpose of the pr oposed Rule.+65 (3) The Commission shall prov ide on its website an explanation of the reas ons+66 for substantive changes made to the pr oposed Rule as well as reas ons for substantive+67 changes not made that were recommended by commenters.+HCS SB 1092 69+68 (4) The Commission shall determine a reas onable effective date for the Rule.+69 Except for an emergency as pr ovided in subsection 12 of this section, the effective date+70 of the Rule shall be no sooner than thirty (30) days after the Commission issued the+71 notice that it adopted the Rule.+72 12. Upon determination that an emergency exists, the Commission may consider+73 and adopt an emergency Rule with twenty-four (24) hours prior notice, without the+74 opportunity for comment, or hearing, provi ded that the usual rulemaking proce dures+75 pr ovided in this Compact and in this section shall be r etr oactively applied to the Rule as+76 soon as rea sonably possible, in no event later than ninety (90) days after the effective+77 date of the Rule. For the purposes of this pr ovision, an emergency Rule is one that must+78 be adopted immediately by the Commission in order to:+79 (1) Meet an imminent thr eat to public health, safety , or welfare;+80 (2) Pr event a loss of Commission or Participating State funds;+81 (3) Meet a deadline for the pro mulgation of a Commission Rule that is+82 established by federal law or Rule; or+83 (4) Pr otect public health and safety .+84 13. The Commission or an authorized committee of the Commission may direct+85 r evisions to a pr eviously adopted Commission Rule for purposes of corr ecting+86 typographical erro rs, err ors in format, erro rs in consistency , or grammatical errors.+87 Public notice of any revision s shall be posted on the website of the Commission. The+88 r evision shall be subject to challenge by any person for a period of thirty (30) days after+89 posting. The revision may be challenged only on gr ounds that the re vision r esults in a+90 material change to a Rule. A challenge shall be made as set forth in the notice of+91 r evisions and deliver ed to the Commission prior to the end of the notice period. If no+92 challenge is made, the revision will take effect without further action. If the r evision is+93 challenged, the rev ision may not take effect without the appr oval of the Commission.+94 14. No Participating State's rulemaking req uirements shall apply under this+95 Compact.+334.1845. 1. (1) The executive and judicial branches of State government in+2 each Participating State shall enfor ce this Compact and take all actions necessary and+3 appr opriate to implement the Compact.+4 (2) V enue is prop er and judicial proc eedings by or against the Commission shall+5 be bro ught solely and exclusively in a court of competent jurisdiction wher e the+6 principal office of the Commission is located. The Commission may waive venue and+7 jurisdictional defenses to the extent it adopts or consents to participate in alternative+8 dispute reso lution pr oceedings. Nothing herei n shall affect or limit the selection or+HCS SB 1092 70+9 pr opriety of venue in any action against a licensee for pr ofessional malpractice,+10 misconduct or any such similar matter .+11 (3) The Commission shall be entitled to recei ve service of process in any+12 pr oceeding r egarding the enforcem ent or interpr etation of the Compact or the+13 Commission's Rules and shall have standing to intervene in such a pr oceeding for all+14 purposes. Failur e to pr ovide the Commission with service of pr ocess shall rend er a+15 judgment or order in such proceed ing void as to the Commission, this Compact, or+16 Commission Rules.+17 2. (1) If the Commission determines that a Participating State has defaulted in+18 the performance of its obligations or res ponsibilities under this Compact or the+19 Commission Rules, the Commission shall pr ovide written notice to the defaulting State+20 and other Participating States. The notice shall describe the default, the pro posed+21 means of curing the default and any other action that the Commission may take and+22 shall offer rem edial training and specific technical assistance r egarding the default.+23 (2) If a State in default fails to cur e the default, the defaulting State may be+24 terminated fr om this Compact upon an affirmative vote of a majority of the delegates of+25 the Participating States, and all rights, privileges and benefits conferred by this+26 Compact upon such State may be terminated on the effective date of termination. A+27 cur e of the default does not reli eve the offending State of obligations or liabilities+28 incurr ed during the period of default.+29 (3) T ermination of participation in this Compact shall be imposed only after all+30 other means of securing compliance have been exhausted. Notice of intent to suspend or+31 terminate shall be given by the Commission to the governor , the majority and minority+32 leaders of the defaulting State's legislature, and to the Licensing Board(s) of each of the+33 Participating States.+34 (4) A State that has been terminated is res ponsible for all assessments,+35 obligations, and liabilities incurr ed thr ough the effective date of termination, including+36 obligations that extend beyond the effective date of termination.+37 (5) The Commission shall not bear any costs rela ted to a State that is found to be+38 in default or that has been terminated fr om this Compact, unless agre ed upon in writing+39 between the Commission and the defaulting State.+40 (6) The defaulting State may appeal its termination fro m the Compact by the+41 Commission by petitioning the United States District Court for the District of Columbia+42 or the federal district where the Commission has its principal offices. The pr evailing+43 member shall be awarded all costs of such litigation, including rea sonable attorney's+44 fees.+HCS SB 1092 71+45 (7) Upon the termination of a State's participation in the Compact, the State+46 shall immediately pr ovide notice to all Licensees within that State of such termination:+47 (a) Licensees who have been granted a Compact Privilege in that State shall+48 r etain the Compact Privilege for one hundred eighty (180) days following the effective+49 date of such termination.+50 (b) Licensees who are licensed in that State who have been granted a Compact+51 Privilege in a Participating State shall reta in the Compact Privilege for one hundr ed+52 eighty (180) days unless the Licensee also has a Qualifying License in a Participating+53 State or obtains a Qualifying License in a Participating State before the one hundr ed+54 eighty (180)-day period ends, in which case the Compact Privilege shall continue.+55 3. (1) Upon req uest by a Participating State, the Commission shall attempt to+56 r esolve disputes rela ted to this Compact that arise among Participating States and+57 between participating and non-Participating States.+58 (2) The Commission shall pr omulgate a Rule prov iding for both mediation and+59 binding dispute r esolution for disputes as appr opriate.+60 4. (1) The Commission, in the rea sonable exerc ise of its discr etion, shall enforce+61 the pro visions of this Compact and Rules of the Commission.+62 (2) If compliance is not secure d after all means to secure compliance have been+63 exhausted, by majority vote, the Commission may initiate legal action in the United+64 States District Court for the District of Columbia or the federal district wher e the+65 Commission has its principal offices, against a Participating State in default to enforce+66 compliance with the prov isions of this Compact and the Commission's pr omulgated+67 Rules and bylaws. The r elief sought may include both injunctive reli ef and damages. In+68 the event judicial enforcem ent is necessary , the prevai ling party shall be awarded all+69 costs of such litigation, including r easonable attorney's fees.+70 (3) The r emedies her ein shall not be the exclusive rem edies of the Commission.+71 The Commission may pursue any other rem edies available under federal or State law .+72 5. (1) A Participating State may initiate legal action against the Commission in+73 the United States District Court for the District of Columbia or the federal district+74 wher e the Commission has its principal offices to enforce compliance with the pr ovisions+75 of the Compact and its Rules. The r elief sought may include both injunctive r elief and+76 damages. In the event judicial enfor cement is necessary , the pr evailing party shall be+77 awarded all costs of such litigation, including reas onable attorney's fees.+78 (2) No person other than a Participating State shall enforce this Compact against+79 the Commission.+334.1850. 1. This Compact shall come into effect on the date on which this+2 Compact statute is enacted into law in the seventh Participating State.+HCS SB 1092 72+3 (1) On or after the effective date of the Compact, the Commission shall convene+4 and rev iew the enactment of each of the States that enacted the Compact prior to the+5 Commission convening ("Charter Participating States") to determine if the statute+6 enacted by each such Charter Participating State is materially differe nt than the Model+7 Compact.+8 (a) A Charter Participating State whose enactment is found to be materially+9 differ ent fr om the Model Compact shall be entitled to the default pr ocess set forth in+10 subsection 2 of section 334.1845.+11 (b) If any Participating State later withdraws fr om the Compact or its+12 participation is terminated, the Commission shall r emain in existence and the Compact+13 shall rem ain in effect even if the number of Participating States should be less than+14 seven. Participating States enacting the Compact subsequent to the Commission+15 convening shall be subject to the pr ocess set forth in subdivision (21) of subsection 3 of+16 section 334.1830 to determine if their enactments are materially differ ent from the+17 Model Compact and whether they qualify for participation in the Compact.+18 (2) Participating States enacting the Compact subsequent to the seven initial+19 Charter Participating States shall be subject to the pr ocess set forth in subdivision (21)+20 of subsection 3 of section 334.1830 to determine if their enactments ar e materially+21 differ ent fr om the Model Compact and whether they qualify for participation in the+22 Compact.+23 (3) All actions taken for the benefit of the Commission or in furtherance of the+24 purposes of the administration of the Compact prior to the effective date of the Compact+25 or the Commission coming into existence shall be considere d to be actions of the+26 Commission unless specifically r epudiated by the Commission.+27 2. Any State that joins this Compact shall be subject to the Commission's Rules+28 and bylaws as they exist on the date on which this Compact becomes law in that State.+29 Any Rule that has been pr eviously adopted by the Commission shall have the full for ce+30 and effect of law on the day this Compact becomes law in that State.+31 3. Any Participating State may withdraw fr om this Compact by enacting a+32 statute repeal ing the same.+33 (1) A Participating State's withdrawal shall not take effect until one hundr ed+34 eighty (180) days after enactment of the r epealing statute. During this one hundr ed+35 eighty (180) day-period, all Compact Privileges that wer e in effect in the withdrawing+36 State and wer e granted to Licensees licensed in the withdrawing State shall rem ain in+37 effect. If any Licensee licensed in the withdrawing State is also licensed in another+38 Participating State or obtains a license in another Participating State within the one+HCS SB 1092 73+39 hundr ed eighty (180) days, the Licensee's Compact Privileges in other Participating+40 States shall not be affected by the passage of the one hundred eighty (180) days.+41 (2) W ithdrawal shall not affect the continuing r equir ement of the State+42 Licensing Board(s) of the withdrawing State to comply with the investigative, and+43 Adverse Action rep orting req uirements of this Compact prior to the effective date of+44 withdrawal.+45 (3) Upon the enactment of a statute withdrawing a State fro m this Compact, the+46 State shall immediately provi de notice of such withdrawal to all Licensees within that+47 State. Such withdrawing State shall continue to reco gnize all licenses granted pursuant+48 to this Compact for a minimum of one hundr ed eighty (180) days after the date of such+49 notice of withdrawal.+50 4. Nothing contained in this Compact shall be construed to invalidate or pr event+51 any physician assistant licensur e agreement or other cooperative arrangement between+52 Participating States and between a Participating State and non-Participating State that+53 does not conflict with the pro visions of this Compact.+54 5. This Compact may be amended by the Participating States. No amendment to+55 this Compact shall become effective and binding upon any Participating State until it is+56 enacted materially in the same manner into the laws of all Participating States as+57 determined by the Commission.+334.1855. 1. This Compact and the Commission's rulemaking authority shall be+2 liberally construed so as to effectuate the purposes, and the implementation and+3 administration of the Compact. Pr ovisions of the Compact expr essly authorizing or+4 r equiring the promulg ation of Rules shall not be construed to limit the Commission's+5 rulemaking authority solely for those purposes.+6 2. The pr ovisions of this Compact shall be severable and if any phrase, clause,+7 sentence or provi sion of this Compact is held by a court of competent jurisdiction to be+8 contrary to the constitution of any Participating State, a State seeking participation in+9 the Compact, or of the United States, or the applicability ther eof to any government,+10 agency , person or circ umstance is held to be unconstitutional by a court of competent+11 jurisdiction, the validity of the rem ainder of this Compact and the applicability ther eof+12 to any other government, agency , person or circu mstance shall not be affected ther eby .+13 3. Notwithstanding subsection 2 of this section, the Commission may deny a+14 State's participation in the Compact or , in accordance with the r equir ements of+15 subsection 2 of section 334.1845, terminate a Participating State's participation in the+16 Compact, if it determines that a constitutional re quir ement of a Participating State is, or+17 would be with res pect to a State seeking to participate in the Compact, a material+18 departur e from the Compact. Otherwise, if this Compact shall be held to be contrary to+HCS SB 1092 74+19 the constitution of any Participating State, the Compact shall r emain in full for ce and+20 effect as to the rem aining Participating States and in full for ce and effect as to the+21 Participating State affected as to all severable matters.+334.1860. 1. Nothing her ein pr events the enfor cement of any other law of a+2 Participating State that is not inconsistent with this Compact.+3 2. Any laws in a Participating State in conflict with this Compact are superseded+4 to the extent of the conflict.+5 3. All agreements between the Commission and the Participating States are+6 binding in accordance with their terms.+337.600. As used in sections 337.600 to 337.689, the following terms mean:+2 (1) "Advanced macro social worker", the applications of social work theory ,+3 knowledge, methods, principles, values, and ethics; and the professional use of self to+4 community and or ganizational systems, systemic and macrocosm issues, and other indirect+5 nonclinical services; specialized knowledge and advanced practice skills in case management,+6 information and referral, nonclinical assessments, counseling, outcome evaluation, mediation,+7 nonclinical supervision, nonclinical consultation, expert testimony , education, outcome+8 evaluation, research, advocacy , social planning and policy development, community+9 or ganization, and the development, implementation and administration of policies,+1 0 programs, and activities. A licensed advanced macro social worker may not treat mental+11 or emotional disorders or provide psychotherapy without the direct supervision of a licensed+12 clinical social worker , or diagnose a mental disorder;+13 (2) "Clinical social work", the application of social work theory , knowledge, values,+14 methods, principles, and techniques of case work, group work, client-centered advocacy ,+15 community or ganization, administration, planning, evaluation, consultation, research,+16 psychotherapy and counseling methods and techniques to persons, families and groups in+17 assessment, diagnosis, treatment, prevention and amelioration of mental and emotional+18 conditions;+19 (3) "Committee", the state committee for social workers established in section+20 337.622;+21 (4) "Department", the Missouri department of commerce and insurance;+22 (5) "Director", the director of the division of professional registration;+23 (6) "Division", the division of professional registration;+24 (7) "Independent practice", any practice of social workers outside of an or ganized+25 setting such as a social, medical, or governmental agency in which a social worker assumes+26 responsibility and accountability for services required;+27 (8) "Licensed advanced macro social worker", any person who of fers to render+28 services to individuals, groups, families, couples, or ganizations, institutions, communities,+HCS SB 1092 75+29 government agencies, corporations, or the general public for a fee, monetary or otherwise,+30 implying that the person is trained, experienced, and licensed as an advanced macro social+31 worker , and who holds a current valid license to practice as an advanced macro social worker;+32 (9) "Licensed baccalaureate social worker", any person who of fers to render services+33 to individuals, groups, or ganizations, institutions, corporations, government agencies, or the+34 general public for a fee, monetary or otherwise, implying that the person is trained,+35 experienced, and licensed as a baccalaureate social worker , and who holds a current valid+36 license to practice as a baccalaureate social worker;+37 (10) "Licensed clinical social worker", any person who of fers to render services to+38 individuals, groups, or ganizations, institutions, corporations, government agencies, or the+39 general public for a fee, monetary or otherwise, implying that the person is trained,+40 experienced, and licensed as a clinical social worker , and who holds a current, valid license to+41 practice as a clinical social worker;+42 (1 1) "Licensed master social worker", any person who of fers to render services to+43 individuals, groups, families, couples, or ganizations, institutions, communities, government+44 agencies, corporations, or the general public for a fee, monetary or otherwise, implying that+45 the person is trained, experienced, and licensed as a master social worker , and who holds a+46 current valid license to practice as a master social worker . A licensed master social worker+47 may not treat mental or emotional disorders, provide psychotherapy without the direct+48 supervision of a licensed clinical social worker , or diagnose a mental disorder;+49 (12) "Master social work", the application of social work theory , knowledge,+50 methods, and ethics and the professional use of self to restore or enhance social, psychosocial,+51 or biopsychosocial functioning of individuals, couples, families, groups, or ganizations,+52 communities, institutions, government agencies, or corporations. The practice includes the+53 applications of specialized knowledge and advanced practice skills in the areas of assessment,+54 treatment planning, implementation and evaluation, case management, mediation,+5 5 information and referral, counseling, client education, supervision, consultation, education,+56 research, advocacy , community or ganization and development, planning, evaluation,+57 implementation and administration of policies, programs, and activities. Under supervision+58 as provided in this section, the practice of master social work may include the practices+59 reserved to clinical social workers or advanced macro social workers for no more than forty-+60 eight consecutive calendar months for the purpose of obtaining licensure under section+61 337.615 or 337.645;+62 (13) "Practice of advanced macro social work", rendering, of fering to render , or+63 supervising those who render to individuals, couples, families, groups, or ganizations,+64 institutions, corporations, government agencies, communities, or the general public any+HCS SB 1092 76+65 service involving the application of methods, principles, and techniques of advanced practice+66 macro social work;+67 (14) "Practice of baccalaureate social work", rendering, of fering to render , or+68 supervising those who render to individuals, families, groups, or ganizations, institutions,+69 corporations, or the general public any service involving the application of methods,+70 principles, and techniques of baccalaureate social work;+71 (15) "Practice of clinical social work", rendering, of fering to render , or supervising+72 those who render to individuals, couples, groups, or ganizations, institutions, corporations, or+73 the general public any service involving the application of methods, principles, and+74 techniques of clinical social work;+75 (16) "Practice of master social work", rendering, of fering to render , or supervising+76 those who render to individuals, couples, families, groups, or ganizations, institutions,+77 corporations, government agencies, communities, or the general public any service involving+78 the application of methods, principles, and techniques of master social work;+79 (17) "Qualified advanced macro supervisor", any licensed social worker who meets+80 the qualifications of a qualified clinical supervisor or a licensed advanced macro social+81 worker who has:+82 (a) Practiced in the field of social work as a licensed social worker for which he or+83 she is supervising the applicant for a minimum of [ five ] thr ee years;+84 (b) Successfully completed a minimum of sixteen hours of supervisory training from+85 the Association of Social W ork Boards, the National Association of Social W orkers, an+86 accredited university , or a program approved by the state committee for social workers. All+87 or ganizations providing the supervisory training shall adhere to the basic content and quality+88 standards outlined by the state committee on social work; and+89 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by+90 the state committee for social workers;+91 (18) "Qualified baccalaureate supervisor", any licensed social worker who meets the+92 qualifications of a qualified clinical supervisor , qualified master supervisor , qualified+93 advanced macro supervisor , or a licensed baccalaureate social worker who has:+94 (a) Practiced in the field of social work as a licensed social worker for which he or+95 she is supervising the applicant for a minimum of [ five ] thr ee years;+96 (b) Successfully completed a minimum of sixteen hours of supervisory training from+97 the Association of Social W ork Boards, the National Association of Social W orkers, an+98 accredited university , or a program approved by the state committee for social workers. All+99 or ganizations providing the supervisory training shall adhere to the basic content and quality+100 standards outlined by the state committee on social workers; and+HCS SB 1092 77+101 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by+102 the state committee for social workers;+103 (19) "Qualified clinical supervisor", any licensed clinical social worker who has:+104 (a) Practiced in the field of social work as a licensed social worker for which he or+105 she is supervising the applicant for a minimum of [ five ] thr ee years;+106 (b) Successfully completed a minimum of sixteen hours of supervisory training from+107 the Association of Social W ork Boards, the National Association of Social W orkers, an+108 accredited university , or a program approved by the state committee for social workers. All+109 or ganizations providing the supervisory training shall adhere to the basic content and quality+110 standards outlined by the state committee on social work; and+111 (c) Met all the requirements of sections 337.600 to 337.689, and as defined by rule by+112 the state committee for social workers;+113 (20) "Social worker", any individual that has:+114 (a) Received a baccalaureate degree in social work from an accredited social work+115 program approved by the Council on Social W ork Education;+116 (b) Received a master's degree in social work from a social work program:+117 a. Accredited by the Council on Social W ork Education; or+118 b. Recognized and approved by the committee in accordance with rules adopted by+119 the committee under section 337.627 and in accordance with the procedure set forth in section+120 337.628;+121 (c) Received a doctorate or Ph.D. in social work; or+122 (d) A current social worker license as set forth in sections 337.600 to 337.689.+345.050. T o be eligible for licensure by the board by examination, each applicant+2 shall submit the application fee and shall furnish evidence of such person's current+3 competence and shall:+4 (1) Hold a master's or a doctoral degree from a program that was awarded+5 "accreditation candidate" status or is accredited by the Council on Academic Accreditation of+6 the American Speech-Language-Hearing Association or other accrediting agency approved+7 by the board in the area in which licensure is sought;+8 (2) Submit official transcripts from one or more accredited colleges or universities+9 presenting evidence of the completion of course work and clinical practicum requirements+10 equivalent to that required by the Council on Academic Accreditation of the American+11 Speech-Language-Hearing Association or other accrediting agency approved by the board;+12 (3) Present written evidence of completion of a clinical fellowship from supervisors.+13 The experience required by this subdivision shall follow the completion of the requirements+14 of subdivisions (1) and (2) of this section. This period of employment shall be under the+15 direct supervision of a [ person who is ] licensed [ by the state of Missouri in the profession in+HCS SB 1092 78+16 which the applicant seeks to be licensed ] speech-language pathologist in good standing in+17 any state . Persons applying with an audiology clinical doctoral degree are exempt from this+18 provision; and+19 (4) Pass an examination promulgated or approved by the board. The board shall+20 determine the subject and scope of the examinations.+✔+HCS SB 1092 79
Diffs are computed deterministically from extracted bill text and show additions, deletions, and section moves. Scanned-PDF text extracted via OCR is flagged where confidence is low; see methodology.