1.1 	A bill for an act
1.2 	relating to health occupations; creating a physician assistant licensure compact;
1.3 	proposing coding for new law in Minnesota Statutes, chapter 148.
1.4 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.5 	Section 1. [148.675] PHYSICIAN ASSISTANT LICENSURE COMPACT.
1.6 	The physician assistant (PA) licensure compact is enacted into law and entered into with 
1.7 	all other jurisdictions legally joining in it in the form substantially specified in this section.
1.8 	ARTICLE I
1.9 	PURPOSE
1.10 	In order to strengthen access to medical services, and in recognition of the advances in 
1.11 	the delivery of medical services, the participating states of the PA licensure compact have 
1.12 	allied in common purpose to develop a comprehensive process that complements the existing 
1.13 	authority of state licensing boards to license and discipline PAs and seek to enhance the 
1.14 	portability of a license to practice as a PA while safeguarding the safety of patients. This 
1.15 	compact allows medical services to be provided by PAs via the mutual recognition of the 
1.16 	licensee's qualifying license by other compact participating states. This compact also adopts 
1.17 	the prevailing standard for PA licensure and affirms that the practice and delivery of medical 
1.18 	services by the PA occurs where the patient is located at the time of the patient encounter, 
1.19 	and therefore requires the PA to be under the jurisdiction of the state licensing board where 
1.20 	the patient is located. State licensing boards that participate in this compact retain the 
1.21 	jurisdiction to impose adverse actions against a compact privilege in that state issued to a 
1.22 	PA through the procedures of this compact. The PA licensure compact will alleviate burdens 
2.1 	for military families by allowing active duty military personnel and their spouses to obtain 
2.2 	a compact privilege based on having an unrestricted license in good standing from a 
2.3 	participating state.
2.4 	ARTICLE II
2.5 	DEFINITIONS
2.6 	As used in this compact, and except as otherwise provided, the following terms have 
2.7 	the meanings given them.
2.8 	(a) "Adverse action" means any administrative, civil, equitable, or criminal action 
2.9 	permitted by a state's laws that is imposed by a licensing board or other authority against a 
2.10 	PA license, license application, or compact privilege such as license denial, censure, 
2.11 	revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee's 
2.12 	practice.
2.13 	(b) "Charter participating states" means the states that enacted the compact prior to the 
2.14 	commission convening.
2.15 	(c) "Compact privilege" means the authorization granted by a remote state to allow a 
2.16 	licensee from another participating state to practice as a PA to provide medical services or 
2.17 	other licensed activities to a patient located in the remote state under the remote state's laws 
2.18 	and regulations.
2.19 	(d) "Conviction" means a finding by a court that an individual is guilty of a felony or 
2.20 	misdemeanor offense through adjudication or entry of a plea of guilt or no contest to the 
2.21 	charge by the offender.
2.22 	(e) "Criminal background check" means the submission of fingerprints or other 
2.23 	biometric-based information for a license applicant for the purpose of obtaining that 
2.24 	applicant's criminal history record information, as defined in Code of Federal Regulations, 
2.25 	title 28, part 20, subpart 20.3, clause (d), from the state's criminal history record repository, 
2.26 	as defined in Code of Federal Regulations, title 28, part 20, subpart 20.3, clause (f).
2.27 	(f) "Data system" means the repository of information about licensees, including but not 
2.28 	limited to license status and adverse action, that is created and administered under the terms 
2.29 	of this compact.
2.30 	(g) "Executive committee" means a group of directors and ex officio individuals elected 
2.31 	or appointed pursuant to article VII, paragraph (f), clause (2).
3.1 	(h) "Impaired practitioner" means a PA whose practice is adversely affected by a 
3.2 	health-related condition that impacts the PA's ability to practice.
3.3 	(i) "Investigative information" means information, records, and documents received or 
3.4 	generated by a licensing board pursuant to an investigation.
3.5 	(j) "Jurisprudence requirement" means the assessment of an individual's knowledge of 
3.6 	the laws and rules governing the practice of a PA in a state.
3.7 	(k) "License" means current authorization by a state, other than authorization pursuant 
3.8 	to a compact privilege, for a PA to provide medical services, which would be unlawful 
3.9 	without current authorization.
3.10 	(l) "Licensee" means an individual who holds a license from a state to provide medical 
3.11 	services as a PA.
3.12 	(m) "Licensing board" means any state entity authorized to license and otherwise regulate 
3.13 	PAs.
3.14 	(n) "Medical services" means health care services provided for the diagnosis, prevention, 
3.15 	treatment, cure, or relief of a health condition, injury, or disease, as defined by a state's laws 
3.16 	and regulations.
3.17 	(o) "Model compact" means the model for the PA licensure compact on file with the 
3.18 	Council of State Governments or other entity as designated by the commission.
3.19 	(p) "Participating state" means a state that has enacted this compact.
3.20 	(q) "PA" means an individual who is licensed as a physician assistant in a state. For 
3.21 	purposes of this compact, any other title or status adopted by a state to replace the term 
3.22 	"physician assistant" shall be deemed synonymous with "physician assistant" and shall 
3.23 	confer the same rights and responsibilities to the licensee under the provisions of this compact 
3.24 	at the time of its enactment.
3.25 	(r) "PA Licensure Compact Commission" or "compact commission" or "commission" 
3.26 	means the national administrative body created pursuant to article VII, paragraph (a).
3.27 	(s) "Qualifying license" means an unrestricted license issued by a participating state to 
3.28 	provide medical services as a PA.
3.29 	(t) "Remote state" means a participating state where a licensee who is not licensed as a 
3.30 	PA is exercising or seeking to exercise the compact privilege.
3.31 	(u) "Rule" means a regulation promulgated by an entity that has the force and effect of 
3.32 	law.
4.1 	(v) "Significant investigative information" means investigative information that a 
4.2 	licensing board, after an inquiry or investigation that includes notification and an opportunity 
4.3 	for the PA to respond if required by state law, has reason to believe is not groundless and, 
4.4 	if proven true, would indicate more than a minor infraction.
4.5 	(w) "State" means any state, commonwealth, district, or territory of the United States.
4.6 	ARTICLE III
4.7 	STATE PARTICIPATION IN THE COMPACT
4.8 	(a) To participate in this compact, a participating state must:
4.9 	(1) license PAs;
4.10 	(2) participate in the commission's data system;
4.11 	(3) have a mechanism in place for receiving and investigating complaints against licensees 
4.12 	and license applicants;
4.13 	(4) notify the commission, in compliance with the terms of this compact and commission 
4.14 	rules, of any adverse action against the licensee or license applicant and the existence of 
4.15 	significant investigative information regarding a licensee or license applicant;
4.16 	(5) fully implement a criminal background check requirement, within a time frame 
4.17 	established by commission rule, by its licensing board receiving the results of a criminal 
4.18 	background check and reporting to the commission whether the license applicant has been 
4.19 	granted a license;
4.20 	(6) fully comply with the rules of the compact commission;
4.21 	(7) utilize a recognized national examination such as the National Commission on 
4.22 	Certification of Physician Assistants (NCCPA) physician assistant national certifying 
4.23 	examination as a requirement for PA licensure; and
4.24 	(8) grant the compact privilege to a holder of a qualifying license in a participating state.
4.25 	(b) Nothing in this compact prohibits a participating state from charging a fee for granting 
4.26 	the compact privilege.
4.27 	ARTICLE IV
4.28 	COMPACT PRIVILEGE
4.29 	(a) To exercise the compact privilege, a licensee must:
5.1 	(1) have graduated from a PA program accredited by the Accreditation Review 
5.2 	Commission on Education for the Physician Assistant, Inc. or other programs authorized 
5.3 	by commission rule;
5.4 	(2) hold current NCCPA certification;
5.5 	(3) have no felony or misdemeanor convictions;
5.6 	(4) have never had a controlled substance license, permit, or registration suspended or 
5.7 	revoked by a state or by the United States Drug Enforcement Administration;
5.8 	(5) have a unique identifier as determined by commission rule;
5.9 	(6) hold a qualifying license;
5.10 	(7) have had no revocation of a license or limitation or restriction due to an adverse 
5.11 	action on any currently held license;
5.12 	(8) if a licensee has had a limitation or restriction on a license or compact privilege due 
5.13 	to an adverse action, two years must have elapsed from the date on which the license or 
5.14 	compact privilege is no longer limited or restricted due to the adverse action;
5.15 	(9) if a compact privilege has been revoked or is limited or restricted in a participating 
5.16 	state for conduct that would not be a basis for disciplinary action in a participating state in 
5.17 	which the licensee is practicing or applying to practice under a compact privilege, that 
5.18 	participating state shall have the discretion not to consider such action as an adverse action 
5.19 	requiring the denial or removal of a compact privilege in that state;
5.20 	(10) notify the compact commission that the licensee is seeking the compact privilege 
5.21 	in a remote state;
5.22 	(11) meet any jurisprudence requirement of a remote state in which the licensee is seeking 
5.23 	to practice under the compact privilege and pay any fees applicable to satisfying the 
5.24 	jurisprudence requirement; and
5.25 	(12) report to the commission any adverse action taken by any nonparticipating state 
5.26 	within 30 days after the date the action is taken.
5.27 	(b) The compact privilege is valid until the expiration or revocation of the qualifying 
5.28 	license unless terminated pursuant to an adverse action. The licensee must also comply with 
5.29 	all of the requirements of paragraph (a) to maintain the compact privilege in a remote state. 
5.30 	If the participating state takes adverse action against a qualifying license, the licensee shall 
5.31 	lose the compact privilege in any remote state in which the licensee has a compact privilege 
5.32 	until all of the following occur:
6.1 	(1) the license is no longer limited or restricted; and
6.2 	(2) two years have elapsed from the date on which the license is no longer limited or 
6.3 	restricted due to the adverse action.
6.4 	(c) Once a restricted or limited license satisfies the requirements of paragraph (b), the 
6.5 	licensee must meet the requirements of paragraph (a) to obtain a compact privilege in any 
6.6 	remote state.
6.7 	(d) For each remote state in which a PA seeks authority to prescribe controlled substances, 
6.8 	the PA shall satisfy all requirements imposed by such state in granting or renewing such 
6.9 	authority.
6.10 	ARTICLE V
6.11 	DESIGNATION OF THE STATE FROM WHICH LICENSEE IS APPLYING FOR 
6.12 	COMPACT PRIVILEGE.
6.13 	Upon a licensee's application for a compact privilege, the licensee must identify to the 
6.14 	commission the participating state from which the licensee is applying, in accordance with 
6.15 	applicable rules adopted by the commission, and subject to the following requirements:
6.16 	(1) the licensee must provide the commission with the address of the licensee's primary 
6.17 	residence and thereafter shall immediately report to the commission any change in the 
6.18 	address of the licensee's primary residence; and
6.19 	(2) the licensee must consent to accept service of process by mail at the licensee's primary 
6.20 	residence on file with the commission with respect to any action brought against the licensee 
6.21 	by the commission or a participating state, including a subpoena, with respect to any action 
6.22 	brought or investigation conducted by the commission or a participating state.
6.23 	ARTICLE VI
6.24 	ADVERSE ACTIONS
6.25 	(a) A participating state in which a licensee is licensed shall have exclusive power to 
6.26 	impose adverse action against the qualifying license issued by that participating state.
6.27 	(b) In addition to the other powers conferred by state law, a remote state shall have the 
6.28 	authority, in accordance with existing state due process law, to do the following:
6.29 	(1) take adverse action against a PA's compact privilege in the state to remove a licensee's 
6.30 	compact privilege or take other action necessary under applicable law to protect the health 
6.31 	and safety of its citizens; and
7.1 	(2) issue subpoenas for both hearings and investigations that require the attendance and 
7.2 	testimony of witnesses and the production of evidence. Subpoenas issued by a licensing 
7.3 	board in a participating state for the attendance and testimony of witnesses or the production 
7.4 	of evidence from another participating state shall be enforced in the latter state by any court 
7.5 	of competent jurisdiction, according to the practice and procedure of that court applicable 
7.6 	to subpoenas issued in proceedings pending before it. The issuing authority shall pay any 
7.7 	witness fees, travel expenses, mileage, and other fees required by the service statutes of the 
7.8 	state in which the witnesses or evidence are located.
7.9 	(c) Notwithstanding paragraph (b), clause (1), subpoenas may not be issued by a 
7.10 	participating state to gather evidence of conduct in another state that is lawful in that other 
7.11 	state, for the purpose of taking adverse action against a licensee's compact privilege or 
7.12 	application for a compact privilege in that participating state.
7.13 	(d) Nothing in this compact authorizes a participating state to impose discipline against 
7.14 	a PA's compact privilege or to deny an application for a compact privilege in that participating 
7.15 	state for the individual's otherwise lawful practice in another state.
7.16 	(e) For purposes of taking adverse action, the participating state which issued the 
7.17 	qualifying license shall give the same priority and effect to reported conduct received from 
7.18 	any other participating state as it would if the conduct had occurred within the participating 
7.19 	state which issued the qualifying license. In so doing, that participating state shall apply its 
7.20 	own state laws to determine appropriate action.
7.21 	(f) A participating state, if otherwise permitted by state law, may recover from the 
7.22 	affected PA the costs of investigations and disposition of cases resulting from any adverse 
7.23 	action taken against that PA.
7.24 	(g) A participating state may take adverse action based on the factual findings of a remote 
7.25 	state, provided that the participating state follows its own procedures for taking the adverse 
7.26 	action.
7.27 	(h) Joint investigations:
7.28 	(1) in addition to the authority granted to a participating state by its respective state PA 
7.29 	laws and regulations or other applicable state law, any participating state may participate 
7.30 	with other participating states in joint investigations of licensees; and
7.31 	(2) participating states shall share any investigative, litigation, or compliance materials 
7.32 	in furtherance of any joint or individual investigation initiated under this compact.
8.1 	(i) If an adverse action is taken against a PA's qualifying license, the PA's compact 
8.2 	privilege in all remote states shall be deactivated until two years have elapsed after all 
8.3 	restrictions have been removed from the state license. All disciplinary orders by the 
8.4 	participating state which issued the qualifying license that impose adverse action against a 
8.5 	PA's license shall include a statement that the PA's compact privilege is deactivated in all 
8.6 	participating states during the pendency of the order.
8.7 	(j) If any participating state takes adverse action, it promptly shall notify the administrator 
8.8 	of the data system.
8.9 	ARTICLE VII
8.10 	ESTABLISHMENT OF THE PA LICENSURE COMPACT COMMISSION
8.11 	(a) The participating states hereby create and establish a joint government agency and 
8.12 	national administrative body known as the PA Licensure Compact Commission. The 
8.13 	commission is an instrumentality of the compact states acting jointly, and is not an 
8.14 	instrumentality of any one state. The commission shall come into existence on or after the 
8.15 	effective date of the compact as set forth in article XI, paragraph (a).
8.16 	(b) Membership, voting, and meetings:
8.17 	(1) each participating state shall have and be limited to one delegate selected by that 
8.18 	participating state's licensing board or, if the state has more than one licensing board, selected 
8.19 	collectively by the participating state's licensing boards;
8.20 	(2) the delegate shall be:
8.21 	(i) a current PA, physician, or public member of a licensing board or PA council or 
8.22 	committee; or
8.23 	(ii) an administrator of a licensing board;
8.24 	(3) any delegate may be removed or suspended from office as provided by the laws of 
8.25 	the state from which the delegate is appointed;
8.26 	(4) the participating state board shall fill any vacancy occurring in the commission within 
8.27 	60 days;
8.28 	(5) each delegate shall be entitled to one vote on all matters voted on by the commission 
8.29 	and shall otherwise have an opportunity to participate in the business and affairs of the 
8.30 	commission;
9.1 	(6) a delegate shall vote in person or by such other means as provided in the bylaws. 
9.2 	The bylaws may provide for delegates' participation in meetings by telecommunications, 
9.3 	video conference, or other means of communication;
9.4 	(7) the commission shall meet at least once during each calendar year. Additional 
9.5 	meetings shall be held as set forth in this compact and the bylaws; and
9.6 	(8) the commission shall establish by rule a term of office for delegates.
9.7 	(c) The commission shall have the following powers and duties:
9.8 	(1) establish a code of ethics for the commission;
9.9 	(2) establish the fiscal year of the commission;
9.10 	(3) establish fees;
9.11 	(4) establish bylaws;
9.12 	(5) maintain its financial records in accordance with the bylaws;
9.13 	(6) meet and take such actions as are consistent with the provisions of this compact and 
9.14 	the bylaws;
9.15 	(7) promulgate rules to facilitate and coordinate implementation and administration of 
9.16 	this compact. The rules shall have the force and effect of law and shall be binding in all 
9.17 	participating states;
9.18 	(8) bring and prosecute legal proceedings or actions in the name of the commission, 
9.19 	provided that the standing of any state licensing board to sue or be sued under applicable 
9.20 	law shall not be affected;
9.21 	(9) purchase and maintain insurance and bonds;
9.22 	(10) borrow, accept, or contract for services of personnel, including but not limited to 
9.23 	employees of a participating state;
9.24 	(11) hire employees and engage contractors, elect or appoint officers, fix compensation, 
9.25 	define duties, grant such individuals appropriate authority to carry out the purposes of this 
9.26 	compact, and establish the commission's personnel policies and programs relating to conflicts 
9.27 	of interest, qualifications of personnel, and other related personnel matters;
9.28 	(12) accept any and all appropriate donations and grants of money, equipment, supplies, 
9.29 	materials, and services, and receive, utilize, and dispose of the same, provided that at all 
9.30 	times the commission shall avoid any appearance of impropriety or conflict of interest;
10.1 	(13) lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, 
10.2 	improve, or use, any property, real, personal, or mixed, provided that at all times the 
10.3 	commission shall avoid any appearance of impropriety;
10.4 	(14) sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of 
10.5 	any property real, personal, or mixed;
10.6 	(15) establish a budget and make expenditures;
10.7 	(16) borrow money;
10.8 	(17) appoint committees, including standing committees composed of members, state 
10.9 	regulators, state legislators or their representatives, and consumer representatives, and such 
10.10 	other interested persons as may be designated in this compact and the bylaws;
10.11 	(18) provide and receive information from, and cooperate with, law enforcement agencies;
10.12 	(19) elect a chair, vice chair, secretary, and treasurer and such other officers of the 
10.13 	commission as provided in the commission's bylaws;
10.14 	(20) reserve for itself, in addition to those reserved exclusively to the commission under 
10.15 	the compact, powers that the executive committee may not exercise;
10.16 	(21) approve or disapprove a state's participation in the compact based upon its 
10.17 	determination as to whether the state's compact legislation departs in a material manner 
10.18 	from the model compact language;
10.19 	(22) prepare and provide to the participating states an annual report; and
10.20 	(23) perform such other functions as may be necessary or appropriate to achieve the 
10.21 	purposes of this compact consistent with the state regulation of PA licensure and practice.
10.22 	(d) Meetings of the commission:
10.23 	(1) all meetings of the commission that are not closed pursuant to this paragraph shall 
10.24 	be open to the public. Notice of public meetings shall be posted on the commission's website 
10.25 	at least 30 days prior to the public meeting;
10.26 	(2) notwithstanding clause (1), the commission may convene a public meeting by 
10.27 	providing at least 24 hours' prior notice on the commission's website, and any other means 
10.28 	as provided in the commission's rules, for any of the reasons it may dispense with notice of 
10.29 	proposed rulemaking under article IX, paragraph (l);
10.30 	(3) the commission may convene in a closed, nonpublic meeting or nonpublic part of a 
10.31 	public meeting to receive legal advice or to discuss:
11.1 	(i) noncompliance of a participating state with its obligations under this compact;
11.2 	(ii) the employment, compensation, discipline, or other matters, practices, or procedures 
11.3 	related to specific employees, or other matters related to the commission's internal personnel 
11.4 	practices and procedures;
11.5 	(iii) current, threatened, or reasonably anticipated litigation;
11.6 	(iv) negotiation of contracts for the purchase, lease, or sale of goods, services, or real 
11.7 	estate;
11.8 	(v) accusing any person of a crime or formally censuring any person;
11.9 	(vi) disclosure of trade secrets or commercial or financial information that is privileged 
11.10 	or confidential;
11.11 	(vii) disclosure of information of a personal nature where disclosure would constitute a 
11.12 	clearly unwarranted invasion of personal privacy;
11.13 	(viii) disclosure of investigative records compiled for law enforcement purposes;
11.14 	(ix) disclosure of information related to any investigative reports prepared by or on 
11.15 	behalf of, or for use of, the commission or other committee charged with responsibility of 
11.16 	investigation or determination of compliance issues pursuant to this compact;
11.17 	(x) legal advice; or
11.18 	(xi) matters specifically exempted from disclosure by federal or participating states' 
11.19 	statutes;
11.20 	(4) if a meeting, or portion of a meeting, is closed pursuant to clause (3), the chair of 
11.21 	the meeting or the chair's designee shall certify that the meeting or portion of the meeting 
11.22 	may be closed and shall reference each relevant exempting provision; and
11.23 	(5) the commission shall keep minutes that fully and clearly describe all matters discussed 
11.24 	in a meeting and shall provide a full and accurate summary of actions taken, including a 
11.25 	description of the views expressed. All documents considered in connection with an action 
11.26 	shall be identified in such minutes. All minutes and documents of a closed meeting shall 
11.27 	remain under seal, subject to release by a majority vote of the commission or order of a 
11.28 	court of competent jurisdiction.
11.29 	(e) Financing of the commission:
11.30 	(1) the commission shall pay, or provide for the payment of, the reasonable expenses of 
11.31 	its establishment, organization, and ongoing activities;
12.1 	(2) the commission may accept any and all appropriate revenue sources, donations, and 
12.2 	grants of money, equipment, supplies, materials, and services;
12.3 	(3) the commission may levy on and collect an annual assessment from each participating 
12.4 	state and may impose compact privilege fees on licensees of participating states to whom 
12.5 	a compact privilege is granted, to cover the cost of the operations and activities of the 
12.6 	commission and its staff. The cost of the operations and activities of the commission and 
12.7 	its staff must be in a total amount sufficient to cover its annual budget as approved by the 
12.8 	commission each year for which revenue is not provided by other sources. The aggregate 
12.9 	annual assessment amount levied on participating states shall be allocated based upon a 
12.10 	formula to be determined by commission rule:
12.11 	(i) a compact privilege expires when the licensee's qualifying license in the participating 
12.12 	state from which the licensee applied for the compact privilege expires; and
12.13 	(ii) if the licensee terminates the qualifying license through which the licensee applied 
12.14 	for the compact privilege before its scheduled expiration, and the licensee has a qualifying 
12.15 	license in another participating state, the licensee shall inform the commission that it is 
12.16 	changing the participating state through which it applies for a compact privilege to the other 
12.17 	participating state and pay to the commission any compact privilege fee required by 
12.18 	commission rule;
12.19 	(4) the commission shall not incur obligations of any kind prior to securing the funds 
12.20 	adequate to meet the same, nor shall the commission pledge the credit of any of the 
12.21 	participating states, except by and with the authority of the participating state; and
12.22 	(5) the commission shall keep accurate accounts of all receipts and disbursements. The 
12.23 	receipts and disbursements of the commission shall be subject to the financial review and 
12.24 	accounting procedures established under its bylaws. All receipts and disbursements of funds 
12.25 	handled by the commission shall be subject to an annual financial review by a certified or 
12.26 	licensed public accountant, and the report of the financial review shall be included in and 
12.27 	become part of the annual report of the commission.
12.28 	(f) The executive committee:
12.29 	(1) the executive committee shall have the power to act on behalf of the commission 
12.30 	according to the terms of this compact and commission rules;
12.31 	(2) the executive committee shall be composed of nine members as follows:
12.32 	(i) seven voting members who are elected by the commission from the current 
12.33 	membership of the commission;
13.1 	(ii) one ex officio, nonvoting member from a recognized national PA professional 
13.2 	association; and
13.3 	(iii) one ex officio, nonvoting member from a recognized national PA certification 
13.4 	organization;
13.5 	(3) the ex officio members will be selected by their respective organizations;
13.6 	(4) the commission may remove any member of the executive committee as provided 
13.7 	in its bylaws;
13.8 	(5) the executive committee shall meet at least annually;
13.9 	(6) the executive committee shall have the following duties and responsibilities:
13.10 	(i) recommend to the entire commission changes to the commission's rules or bylaws, 
13.11 	changes to this compact legislation, fees paid by compact participating states such as annual 
13.12 	dues, and any commission compact fee charged to licensees for the compact privilege;
13.13 	(ii) ensure compact administration services are appropriately provided, contractual or 
13.14 	otherwise;
13.15 	(iii) prepare and recommend the budget;
13.16 	(iv) maintain financial records on behalf of the commission;
13.17 	(v) monitor compact compliance of participating states and provide compliance reports 
13.18 	to the commission;
13.19 	(vi) establish additional committees as necessary;
13.20 	(vii) exercise the powers and duties of the commission during the interim between 
13.21 	commission meetings, except for issuing proposed rulemaking or adopting commission 
13.22 	rules or bylaws, or exercising any other powers and duties exclusively reserved to the 
13.23 	commission by the commission's rules; and
13.24 	(viii) perform other duties as provided in commission's rules or bylaws;
13.25 	(7) all meetings of the executive committee at which it votes or plans to vote on matters 
13.26 	in exercising the powers and duties of the commission shall be open to the public, and public 
13.27 	notice of such meetings shall be given as public meetings of the commission are given; and
13.28 	(8) the executive committee may convene in a closed, nonpublic meeting for the same 
13.29 	reasons that the commission may convene in a nonpublic meeting as set forth in paragraph 
13.30 	(d), clause (3), and shall announce the closed meeting as the commission is required to 
14.1 	under paragraph (d), clause (4), and keep minutes of the closed meeting as the commission 
14.2 	is required to under paragraph (d), clause (5).
14.3 	(g) Qualified immunity, defense, and indemnification:
14.4 	(1) the members, officers, executive director, employees, and representatives of the 
14.5 	commission shall be immune from suit and liability, both personally and in their official 
14.6 	capacity, for any claim for damage to or loss of property or personal injury or other civil 
14.7 	liability caused by or arising out of any actual or alleged act, error, or omission that occurred, 
14.8 	or that the person against whom the claim is made had a reasonable basis for believing 
14.9 	occurred, within the scope of commission employment, duties, or responsibilities, provided 
14.10 	that nothing in this paragraph shall be construed to protect any such person from suit or 
14.11 	liability for any damage, loss, injury, or liability caused by the intentional or willful or 
14.12 	wanton misconduct of that person. The procurement of insurance of any type by the 
14.13 	commission shall not in any way compromise or limit the immunity granted hereunder;
14.14 	(2) the commission shall defend any member, officer, executive director, employee, or 
14.15 	representative of the commission in any civil action seeking to impose liability arising out 
14.16 	of any actual or alleged act, error, or omission that occurred within the scope of commission 
14.17 	employment, duties, or responsibilities, or that the person against whom the claim is made 
14.18 	had a reasonable basis for believing occurred within the scope of commission employment, 
14.19 	duties, or responsibilities, provided that nothing herein shall be construed to prohibit that 
14.20 	person from retaining their own counsel at their own expense, and provided further that the 
14.21 	actual or alleged act, error, or omission did not result from that person's intentional or willful 
14.22 	or wanton misconduct;
14.23 	(3) the commission shall indemnify and hold harmless any member, officer, executive 
14.24 	director, employee, or representative of the commission for the amount of any settlement 
14.25 	or judgment obtained against that person arising out of any actual or alleged act, error, or 
14.26 	omission that occurred within the scope of commission employment, duties, or 
14.27 	responsibilities, or that such person had a reasonable basis for believing occurred within 
14.28 	the scope of commission employment, duties, or responsibilities, provided that the actual 
14.29 	or alleged act, error, or omission did not result from the intentional or willful or wanton 
14.30 	misconduct of that person;
14.31 	(4) venue is proper and judicial proceedings by or against the commission shall be 
14.32 	brought solely and exclusively in a court of competent jurisdiction where the principal office 
14.33 	of the commission is located. The commission may waive venue and jurisdictional defenses 
14.34 	in any proceedings as authorized by commission rules;
15.1 	(5) nothing herein shall be construed as a limitation on the liability of any licensee for 
15.2 	professional malpractice or misconduct, which shall be governed solely by any other 
15.3 	applicable state laws;
15.4 	(6) nothing herein shall be construed to designate the venue or jurisdiction to bring 
15.5 	actions for alleged acts of malpractice, professional misconduct, negligence, or other such 
15.6 	civil action pertaining to the practice of a PA. All such matters shall be determined 
15.7 	exclusively by state law other than this compact;
15.8 	(7) nothing in this compact shall be interpreted to waive or otherwise abrogate a 
15.9 	participating state's state action immunity or state action affirmative defense with respect 
15.10 	to antitrust claims under the federal Sherman Act, Clayton Act, or any other state or federal 
15.11 	antitrust or anticompetitive law or regulation; and
15.12 	(8) nothing in this compact shall be construed to be a waiver of sovereign immunity by 
15.13 	the participating states or by the commission.
15.14 	ARTICLE VIII
15.15 	DATA SYSTEM
15.16 	(a) The commission shall provide for the development, maintenance, and utilization of 
15.17 	a coordinated database and reporting system containing licensure and adverse action 
15.18 	information, and the reporting of significant investigative information on all licensed PAs 
15.19 	and applicants denied a license in participating states.
15.20 	(b) Notwithstanding any other state law to the contrary, a participating state shall submit 
15.21 	a uniform data set to the data system on all PAs to whom this compact is applicable, using 
15.22 	a unique identifier, as required by the rules of the commission, including:
15.23 	(1) identifying information;
15.24 	(2) licensure data;
15.25 	(3) adverse actions against a license or compact privilege;
15.26 	(4) any denial of application for licensure and the reason or reasons for the denial, 
15.27 	excluding the reporting of any criminal history record information where prohibited by law;
15.28 	(5) the existence of significant investigative information; and
15.29 	(6) other information that may facilitate the administration of this compact, as determined 
15.30 	by the rules of the commission.
16.1 	(c) Significant investigative information pertaining to a licensee in any participating 
16.2 	state shall only be available to other participating states.
16.3 	(d) The commission shall promptly notify all participating states of any reports it receives 
16.4 	of any adverse action taken against a licensee or an individual applying for a license. This 
16.5 	adverse action information shall be available to any other participating state.
16.6 	(e) Participating states contributing information to the data system may, in accordance 
16.7 	with state or federal law, designate information that may not be shared with the public 
16.8 	without the express permission of the contributing state. Notwithstanding any such 
16.9 	designation, such information shall be reported to the commission through the data system.
16.10 	(f) Any information submitted to the data system that is subsequently expunged by 
16.11 	federal law or the laws of the participating state contributing the information shall be removed 
16.12 	from the data system upon reporting of such by the participating state to the commission.
16.13 	(g) The records and information provided to a participating state pursuant to this compact 
16.14 	or through the data system, when certified by the commission or an agent thereof, shall 
16.15 	constitute the authenticated business records of the commission and shall be entitled to any 
16.16 	associated hearsay exception in any relevant judicial, quasi-judicial, or administrative 
16.17 	proceedings in a participating state.
16.18 	ARTICLE IX
16.19 	RULEMAKING
16.20 	(a) The commission shall exercise its rulemaking powers pursuant to the criteria set 
16.21 	forth in this article and the rules adopted thereunder. Commission rules shall become binding 
16.22 	as of the date specified by the commission for each rule.
16.23 	(b) The commission shall promulgate reasonable rules in order to effectively and 
16.24 	efficiently implement and administer this compact and achieve its purposes. A commission 
16.25 	rule shall be invalid and have no force or effect only if a court of competent jurisdiction 
16.26 	holds that the rule is invalid because the commission exercised its rulemaking authority in 
16.27 	a manner that is beyond the scope of the purposes of this compact, or the powers granted 
16.28 	hereunder, or based upon another applicable standard of review.
16.29 	(c) The rules of the commission shall have the force of law in each participating state, 
16.30 	provided however that where the rules of the commission conflict with the laws of the 
16.31 	participating state that establish the medical services a PA may perform in the participating 
16.32 	state, as held by a court of competent jurisdiction, the rules of the commission shall be 
16.33 	ineffective in that state to the extent of the conflict.
17.1 	(d) If a majority of the legislatures of the participating states rejects a commission rule, 
17.2 	by enactment of a statute or resolution in the same manner used to adopt the compact within 
17.3 	four years of the date of adoption of the rule, then such rule shall have no further force and 
17.4 	effect in any participating state or in any state applying to participate in the compact.
17.5 	(e) Rules or amendments to the rules shall be adopted at a regular or special meeting of 
17.6 	the commission.
17.7 	(f) Prior to promulgation and adoption of a final rule or rules by the commission and at 
17.8 	least 30 days in advance of the meeting at which the rule will be considered and voted upon, 
17.9 	the commission shall file a notice of proposed rulemaking:
17.10 	(1) on the website of the commission or other publicly accessible platform;
17.11 	(2) to persons who have requested notice of the commission's notices of proposed 
17.12 	rulemaking; and
17.13 	(3) in such other ways as the commission may specify by rule.
17.14 	(g) The notice of proposed rulemaking shall include:
17.15 	(1) the time, date, and location of the public hearing on the proposed rule;
17.16 	(2) the time, date, and location of the public hearing in which the proposed rule will be 
17.17 	considered and voted upon;
17.18 	(3) the text of the proposed rule and the reason for the proposed rule;
17.19 	(4) a request for comments on the proposed rule from any interested person and the date 
17.20 	by which written comments must be received; and
17.21 	(5) the manner in which interested persons may submit notice to the commission of their 
17.22 	intention to attend the public hearing and any written comments.
17.23 	(h) Prior to adoption of a proposed rule, the commission shall allow persons to submit 
17.24 	written data, facts, opinions, and arguments, which shall be made available to the public.
17.25 	(i) If the hearing is held via electronic means, the commission shall publish the mechanism 
17.26 	for access to the electronic hearing:
17.27 	(1) all persons wishing to be heard at the hearing shall notify the commission of their 
17.28 	desire to appear and testify at the hearing, not less than five business days before the 
17.29 	scheduled date of the hearing, as directed in the notice of proposed rulemaking;
17.30 	(2) hearings shall be conducted in a manner providing each person who wishes to 
17.31 	comment a fair and reasonable opportunity to comment orally or in writing;
18.1 	(3) all hearings shall be recorded. A copy of the recording and the written comments, 
18.2 	data, facts, opinions, and arguments received in response to the proposed rulemaking shall 
18.3 	be made available to a person on request; and
18.4 	(4) nothing in this section shall be construed as requiring a separate hearing on each 
18.5 	rule. Proposed rules may be grouped for the convenience of the commission at hearings 
18.6 	required by this article.
18.7 	(j) Following the public hearing, the commission shall consider all written and oral 
18.8 	comments timely received.
18.9 	(k) The commission shall, by majority vote of all delegates, take final action on the 
18.10 	proposed rule and shall determine the effective date of the rule, if adopted, based on the 
18.11 	rulemaking record and the full text of the rule. The commission:
18.12 	(1) shall, if adopted, post the rule on the commission's website;
18.13 	(2) may adopt changes to the proposed rule provided the changes do not expand the 
18.14 	original purpose of the proposed rule;
18.15 	(3) shall provide on its website an explanation of the reasons for substantive changes 
18.16 	made to the proposed rule as well as reasons for substantive changes not made that were 
18.17 	recommended by commenters; and
18.18 	(4) shall determine a reasonable effective date for the rule. Except for an emergency as 
18.19 	provided in paragraph (l), the effective date of the rule shall be no sooner than 30 days after 
18.20 	the commission issued the notice that it adopted the rule.
18.21 	(l) Upon determination that an emergency exists, the commission may consider and 
18.22 	adopt an emergency rule with 24 hours' prior notice, without the opportunity for comment 
18.23 	or hearing, provided that the usual rulemaking procedures provided in the compact and in 
18.24 	this article shall be retroactively applied to the rule as soon as reasonably possible, in no 
18.25 	event later than 90 days after the effective date of the rule. For the purposes of this provision, 
18.26 	an emergency rule is one that must be adopted immediately by the commission in order to:
18.27 	(1) meet an imminent threat to public health, safety, or welfare;
18.28 	(2) prevent a loss of commission or participating state funds;
18.29 	(3) meet a deadline for the promulgation of a commission rule that is established by 
18.30 	federal law or rule; or
18.31 	(4) protect public health and safety.
19.1 	(m) The commission or an authorized committee of the commission may direct revisions 
19.2 	to a previously adopted commission rule for purposes of correcting typographical errors, 
19.3 	errors in format, errors in consistency, or grammatical errors. Public notice of any revisions 
19.4 	shall be posted on the website of the commission. The revision shall be subject to challenge 
19.5 	by any person for a period of 30 days after posting. The revision may be challenged only 
19.6 	on grounds that the revision results in a material change to a rule. A challenge shall be made 
19.7 	as set forth in the notice of revisions and delivered to the commission prior to the end of 
19.8 	the notice period. If no challenge is made, the revision will take effect without further action. 
19.9 	If the revision is challenged, the revision may not take effect without the approval of the 
19.10 	commission.
19.11 	(n) No participating state's rulemaking requirements shall apply under this compact.
19.12 	ARTICLE X
19.13 	OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
19.14 	(a) Oversight:
19.15 	(1) the executive and judicial branches of state government in each participating state 
19.16 	shall enforce this compact and take all actions necessary and appropriate to implement the 
19.17 	compact;
19.18 	(2) venue is proper and judicial proceedings by or against the commission shall be 
19.19 	brought solely and exclusively in a court of competent jurisdiction where the principal office 
19.20 	of the commission is located. The commission may waive venue and jurisdictional defenses 
19.21 	to the extent it adopts or consents to participate in alternative dispute resolution proceedings. 
19.22 	Nothing herein shall affect or limit the selection or propriety of venue in any action against 
19.23 	a licensee for professional malpractice, misconduct, or any such similar matter; and
19.24 	(3) the commission shall be entitled to receive service of process in any such proceeding 
19.25 	regarding the enforcement or interpretation of the compact or the commission's rules and 
19.26 	shall have standing to intervene in such a proceeding for all purposes. Failure to provide 
19.27 	service of process to the commission shall render a judgment or order void as to the 
19.28 	commission, this compact, or commission rules.
19.29 	(b) Default, technical assistance, and termination:
19.30 	(1) if the commission determines that a participating state has defaulted in the 
19.31 	performance of its obligations or responsibilities under this compact or the commission 
19.32 	rules, the commission shall:
20.1 	(i) provide written notice to the defaulting state and other participating states describing 
20.2 	the default, the proposed means of curing the default, or any other action that the commission 
20.3 	may take; and
20.4 	(ii) offer remedial training and specific technical assistance regarding the default;
20.5 	(2) if a state in default fails to cure the default, the defaulting state may be terminated 
20.6 	from this compact upon an affirmative vote of a majority of the delegates of the participating 
20.7 	states, and all rights, privileges, and benefits conferred by this compact may be terminated 
20.8 	on the effective date of termination. A cure of the default does not relieve the offending 
20.9 	state of obligations or liabilities incurred during the period of default;
20.10 	(3) termination of participation in this compact shall be imposed only after all other 
20.11 	means of securing compliance have been exhausted. Notice of intent to suspend or terminate 
20.12 	shall be given by the commission to the governor, the majority and minority leaders of the 
20.13 	defaulting state's legislature, and the licensing board or boards of each of the participating 
20.14 	states;
20.15 	(4) a state that has been terminated is responsible for all assessments, obligations, and 
20.16 	liabilities incurred through the effective date of termination, including obligations that 
20.17 	extend beyond the effective date of termination;
20.18 	(5) the commission shall not bear any costs related to a state that is found to be in default 
20.19 	or that has been terminated from this compact, unless agreed upon in writing between the 
20.20 	commission and the defaulting state;
20.21 	(6) the defaulting state may appeal its termination from the compact by the commission 
20.22 	by petitioning the United States District Court for the District of Columbia or the federal 
20.23 	district where the commission has its principal offices. The prevailing member shall be 
20.24 	awarded all costs of such litigation, including reasonable attorney's fees; and
20.25 	(7) upon the termination of a state's participation in the compact, the state shall 
20.26 	immediately provide notice to all licensees within that state of such termination:
20.27 	(i) licensees who have been granted a compact privilege in that state shall retain the 
20.28 	compact privilege for 180 days following the effective date of such termination; and
20.29 	(ii) licensees who are licensed in that state who have been granted a compact privilege 
20.30 	in a participating state shall retain the compact privilege for 180 days, unless the licensee 
20.31 	also has a qualifying license in a participating state or obtains a qualifying license in a 
20.32 	participating state before the 180-day period ends, in which case the compact privilege shall 
20.33 	continue.
21.1 	(c) Dispute resolution:
21.2 	(1) upon request by a participating state, the commission shall attempt to resolve disputes 
21.3 	related to this compact that arise among participating states and between participating and 
21.4 	nonparticipating states; and
21.5 	(2) the commission shall promulgate a rule providing for both mediation and binding 
21.6 	dispute resolution for disputes, as appropriate.
21.7 	(d) Enforcement:
21.8 	(1) the commission, in the reasonable exercise of its discretion, shall enforce the 
21.9 	provisions of this compact and rules of the commission;
21.10 	(2) if compliance is not secured after all means to secure compliance have been exhausted, 
21.11 	by majority vote, the commission may initiate legal action in the United States District 
21.12 	Court for the District of Columbia or the federal district where the commission has its 
21.13 	principal offices against a participating state in default, to enforce compliance with the 
21.14 	provisions of this compact and the commission's promulgated rules and bylaws. The relief 
21.15 	sought may include both injunctive relief and damages. In the event judicial enforcement 
21.16 	is necessary, the prevailing member shall be awarded all costs of such litigation, including 
21.17 	reasonable attorney's fees; and
21.18 	(3) the remedies herein shall not be the exclusive remedies of the commission. The 
21.19 	commission may pursue any other remedies available under federal or state law.
21.20 	(e) Legal action against the commission:
21.21 	(1) a participating state may initiate legal action against the commission in the United 
21.22 	States District Court for the District of Columbia or the federal district where the commission 
21.23 	has its principal offices to enforce compliance with the provisions of the compact and the 
21.24 	commission's rules. The relief sought may include both injunctive relief and damages. In 
21.25 	the event judicial enforcement is necessary, the prevailing party shall be awarded all costs 
21.26 	of such litigation, including reasonable attorney's fees; and
21.27 	(2) no person other than a participating state shall enforce this compact against the 
21.28 	commission.
21.29 	ARTICLE XI
21.30 	DATE OF IMPLEMENTATION OF THE PA LICENSURE COMPACT 
21.31 	COMMISSION
22.1 	(a) This compact shall come into effect on the date on which the compact statute is 
22.2 	enacted into law in the seventh participating state.
22.3 	(b) On or after the effective date of the compact, the commission shall convene and 
22.4 	review the enactment of each of the charter participating states to determine if the statute 
22.5 	enacted by each charter participating state is materially different than the model compact. 
22.6 	A charter participating state whose enactment is found to be materially different from the 
22.7 	model compact shall be entitled to the default process set forth in article X, paragraph (b).
22.8 	(c) If any participating state later withdraws from the compact or its participation is 
22.9 	terminated, the commission shall remain in existence and the compact shall remain in effect 
22.10 	even if the number of participating states should be less than seven. Participating states 
22.11 	enacting the compact subsequent to the commission convening shall be subject to the process 
22.12 	set forth in article VII, paragraph (c), clause (21), to determine if their enactments are 
22.13 	materially different from the model compact and whether they qualify for participation in 
22.14 	the compact.
22.15 	(d) Any participating state enacting the compact subsequent to the seven initial charter 
22.16 	participating states shall be subject to the process set forth in article VII, paragraph (c), 
22.17 	clause (21), to determine if the state's enactment is materially different from the model 
22.18 	compact and whether the state qualifies for participation in the compact.
22.19 	(e) All actions taken for the benefit of the commission or in furtherance of the purposes 
22.20 	of the administration of the compact prior to the effective date of the compact or the 
22.21 	commission coming into existence shall be considered to be actions of the commission 
22.22 	unless specifically repudiated by the commission.
22.23 	(f) Any state that joins this compact shall be subject to the commission's rules and bylaws 
22.24 	as they exist on the date on which this compact becomes law in that state. Any rule that has 
22.25 	been previously adopted by the commission shall have the full force and effect of law on 
22.26 	the day this compact becomes law in that state.
22.27 	(g) Any participating state may withdraw from this compact by enacting a statute 
22.28 	repealing the same:
22.29 	(1) a participating state's withdrawal shall not take effect until 180 days after enactment 
22.30 	of the repealing statute. During this 180-day period, all compact privileges that were in 
22.31 	effect in the withdrawing state and were granted to licensees licensed in the withdrawing 
22.32 	state shall remain in effect. If any licensee licensed in the withdrawing state is also licensed 
22.33 	in another participating state or obtains a license in another participating state within the 
23.1 	180 days, the licensee's compact privileges in other participating states shall not be affected 
23.2 	by the passage of the 180 days;
23.3 	(2) withdrawal shall not affect the continuing requirement of the state licensing board 
23.4 	or boards of the withdrawing state to comply with the investigative and adverse action 
23.5 	reporting requirements of this compact prior to the effective date of withdrawal; and
23.6 	(3) upon the enactment of a statute withdrawing a state from this compact, the state shall 
23.7 	immediately provide notice of such withdrawal to all licensees within that state. Such 
23.8 	withdrawing state shall continue to recognize all licenses granted pursuant to this compact 
23.9 	for a minimum of 180 days after the date of such notice of withdrawal.
23.10 	(h) Nothing contained in this compact shall be construed to invalidate or prevent any 
23.11 	PA licensure agreement or other cooperative arrangement between participating states or a 
23.12 	participating state and a nonparticipating state that does not conflict with the provisions of 
23.13 	this compact.
23.14 	(i) This compact may be amended by the participating states. No amendment to this 
23.15 	compact shall become effective and binding upon any participating state until it is enacted 
23.16 	materially in the same manner into the laws of all participating states, as determined by the 
23.17 	commission.
23.18 	ARTICLE XII
23.19 	CONSTRUCTION AND SEVERABILITY
23.20 	(a) This compact and the commission's rulemaking authority shall be liberally construed 
23.21 	so as to effectuate the purposes of the compact and its implementation and administration. 
23.22 	Provisions of the compact expressly authorizing or requiring the promulgation of rules shall 
23.23 	not be construed to limit the commission's rulemaking authority solely for those purposes.
23.24 	(b) The provisions of this compact shall be severable and if any phrase, clause, sentence, 
23.25 	or provision of this compact is held by a court of competent jurisdiction to be contrary to 
23.26 	the constitution of any participating state, of a state seeking participation in the compact, 
23.27 	or of the United States, or the applicability thereof to any government, agency, person, or 
23.28 	circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity 
23.29 	of the remainder of this compact and the applicability thereof to any government, agency, 
23.30 	person, or circumstance shall not be affected thereby.
23.31 	(c) Notwithstanding paragraph (b) or any provision of this article, the commission may 
23.32 	deny a state's participation in the compact or, in accordance with the requirements of article 
23.33 	X, paragraph (b), terminate a participating state's participation in the compact, if it determines 
24.1 	that a constitutional requirement of a participating state is, or would be with respect to a 
24.2 	state seeking to participate in the compact, a material departure from the compact. Otherwise, 
24.3 	if this compact shall be held to be contrary to the constitution of any participating state, the 
24.4 	compact shall remain in full force and effect as to the remaining participating states and in 
24.5 	full force and effect as to the participating state affected as to all severable matters.
24.6 	ARTICLE XIII
24.7 	BINDING EFFECT OF THE COMPACT
24.8 	(a) Nothing herein prevents the enforcement of any other law of a participating state 
24.9 	that is not inconsistent with this compact.
24.10 	(b) Any laws in a participating state in conflict with this compact are superseded to the 
24.11 	extent of the conflict.
24.12 	(c) All agreements between the commission and the participating states are binding in 
24.13 	accordance with their terms.

24.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

24.15 	Sec. 2. DIRECTION TO BOARD OF MEDICAL PRACTICE.
 24.16 	The Board of Medical Practice must publish the effective date of the compact in 
24.17 	Minnesota Statutes, section 148.675, in the State Register and on the board's website.