                                 CODE OF VIRGINIA

PA LICENSURE COMPACT (§ 54.1-2953.1)

The General Assembly hereby enacts, and the Commonwealth of Virginia hereby
enters into, the PA Licensure Compact with any and all states legally joining
therein according to its terms, in the form substantially as follows:
		Pa licensure compact.
		Article 1. Purpose.
		In order to strengthen access to medical services, and in recognition of the
advances in the delivery of medical services, the participating states of the PA
Licensure Compact have allied in common purpose to develop a comprehensive
process that complements the existing authority of state licensing boards to
license and discipline PAs and seeks to enhance the portability of a license to
practice as a PA while safeguarding the safety of patients. This Compact allows
medical services to be provided by PAs, via the mutual recognition of the
licensee&#8217;s qualifying license by other compact participating states. This
Compact also adopts the prevailing standard for PA licensure and affirms that
the practice and delivery of medical services by the PA occurs where the patient
is located at the time of the patient encounter, and therefore requires the PA
to be under the jurisdiction of the state licensing board where the patient is
located. State licensing boards that participate in this Compact retain the
jurisdiction to impose adverse action against a compact privilege in that state
issued to a PA through the procedures of this Compact. The PA Licensure Compact
will alleviate burdens for military families by allowing active duty military
personnel and their spouses to obtain a compact privilege based on having an
unrestricted license in good standing from a participating state.
		Article 2. Definitions.
		As used in this Compact, unless the context requires otherwise, the following
definitions shall apply:
		&#8220;Adverse action&#8221; means any administrative, civil, equitable, or
criminal action permitted by a state&#8217;s laws that is imposed by a licensing
board or other authority against a PA license or license application or Compact
privilege such as license denial, censure, revocation, suspension, probation,
monitoring of the licensee, or restriction on the licensee&#8217;s practice.
		&#8220;Compact privilege&#8221; means the authorization granted by a remote
state to allow a licensee from another participating state to practice as a PA
to provide medical services and other licensed activity to a patient located in
the remote state under the remote state&#8217;s laws and regulations.
		&#8220;Conviction&#8221; means a finding by a court that an individual is
guilty of a felony or misdemeanor offense through adjudication or entry of a
plea of guilt or no contest to the charge by the offender.
		&#8220;Criminal background check&#8221; means the submission of fingerprints
or other biometric-based information for a license applicant for the purpose of
obtaining that applicant&#8217;s criminal history record information, as defined
in 28 C.F.R. § 20.3(d), from the state&#8217;s criminal history record
repository as defined in 28 C.F.R. § 20.3(f).
		&#8220;Data system&#8221; means the repository of information about licensees,
including but not limited to license status and adverse actions, that is created
and administered under the terms of this Compact.
		&#8220;Executive committee&#8221; means a group of directors and ex-officio
individuals elected or appointed pursuant to subdivision F 2 of Article 7.
		&#8220;Impaired practitioner&#8221; means a PA whose practice is adversely
affected by health-related condition(s) that impact their ability to practice.
		&#8220;Investigative information&#8221; means information, records, or
documents received or generated by a licensing board pursuant to an
investigation.
		&#8220;Jurisprudence requirement&#8221; means the assessment of an
individual&#8217;s knowledge of the laws and rules governing the practice of a
PA in a state.
		&#8220;License&#8221; means current authorization by a state, other than
authorization pursuant to a Compact privilege, for a PA to provide medical
services, which would be unlawful without current authorization.
		&#8220;Licensee&#8221; means an individual who holds a license from a state to
provide medical services as a PA.
		&#8220;Licensing board&#8221; means any state entity authorized to license and
otherwise regulate PAs.
		&#8220;Medical services&#8221; means health care services provided for the
diagnosis, prevention, treatment, cure, or relief of a health condition, injury,
or disease, as defined by a state&#8217;s laws and regulations.
		&#8220;Model compact&#8221; means the model for the PA Licensure Compact on
file with the Council of State Governments or other entity as designated by the
Commission.
		&#8220;Participating state&#8221; means a state that has enacted this Compact.
		&#8220;PA&#8221; means an individual who is licensed as a physician assistant
in a state. For purposes of this Compact, any other title or status adopted by a
state to replace the term &#8220;physician assistant&#8221; shall be deemed
synonymous with &#8220;physician assistant&#8221; and shall confer the same
rights and responsibilities to the licensee under the provisions of this Compact
at the time of its enactment.
		&#8220;PA Licensure Compact Commission,&#8221; &#8220;Compact
Commission,&#8221; or &#8220;Commission&#8221; mean the national administrative
body created pursuant to subsection A of Article 7.
		&#8220;Qualifying license&#8221; means an unrestricted license issued by a
participating state to provide medical services as a PA.
		&#8220;Remote state&#8221; means a participating state where a licensee who is
not licensed as a PA is exercising or seeking to exercise the compact privilege.
		&#8220;Rule&#8221; means a regulation promulgated by an entity that has the
force and effect of law.
		&#8220;Significant investigative information&#8221; means investigative
information that a licensing board, after an inquiry or investigation that
includes notification and an opportunity for the PA to respond if required by
state law, has reason to believe is not groundless and, if proven true, would
indicate more than a minor infraction.
		&#8220;State&#8221; means any state, commonwealth, district, or territory of
the United States.
		Article 3. State Participation in This Compact.

A. To participate in this Compact, a participating state shall:

   1. License PAs.

   2. Participate in the Compact Commission&#8217;s data system.

   3. Have a mechanism in place for receiving and investigating complaints
   against licensees and license applicants.

   4. Notify the Commission, in compliance with the terms of this Compact and
   Commission rules, of any adverse action against a licensee or license
   applicant and the existence of significant investigative information regarding
   a licensee or license applicant.

   5. Fully implement a criminal background check requirement, within a time
   frame established by Commission rule, by its licensing board receiving the
   results of a criminal background check and reporting to the Commission whether
   the license applicant has been granted a license.

   6. Comply with the rules of the Compact Commission.

   7. Utilize passage of a recognized national exam such as the NCCPA PANCE as a
   requirement for PA licensure.

   8. Grant the compact privilege to a holder of a qualifying license in a
   participating state.

B. Nothing in this Compact prohibits a participating state from charging a fee
for granting the compact privilege.
			Article 4. Compact Privilege.

A. To exercise the compact privilege, a licensee shall:

   1. Have graduated from a PA program accredited by the Accreditation Review
   Commission on Education for the Physician Assistant, Inc., or other programs
   authorized by Commission rule.

   2. Hold current NCCPA certification.

   3. Have no felony or misdemeanor conviction.

   4. Have never had a controlled substance license, permit, or registration
   suspended or revoked by a state or by the U.S. Drug Enforcement
   Administration.

   5. Have a unique identifier as determined by Commission rule.

   6. Hold a qualifying license.

   7. Have had no revocation of a license or limitation or restriction on any
   license currently held due to an adverse action.

   8. If a licensee has had a limitation or restriction on a license or compact
   privilege due to an adverse action, two years shall have elapsed from the date
   on which the license or compact privilege is no longer limited or restricted
   due to the adverse action.

   9. If a compact privilege has been revoked or is limited or restricted in a
   participating state for conduct that would not be a basis for disciplinary
   action in a participating state in which the licensee is practicing or
   applying to practice under a compact privilege, that participating state shall
   have the discretion not to consider such action as an adverse action requiring
   the denial or removal of a compact privilege in that state.

   10. Notify the Compact Commission that the licensee is seeking the compact
   privilege in a remote state.

   11. Meet any jurisprudence requirement of a remote state in which the licensee
   is seeking to practice under the compact privilege and pay any fees applicable
   to satisfying the jurisprudence requirement.

   12. Report to the Commission any adverse action taken by a nonparticipating
   state within 30 days after the action is taken.

B. The compact privilege is valid until the expiration or revocation of the
qualifying license unless terminated pursuant to an adverse action. The licensee
shall also comply with all of the requirements of subsection A to maintain the
compact privilege in a remote state. If the participating state takes adverse
action against a qualifying license, the licensee shall lose the compact
privilege in any remote state in which the licensee has a compact privilege
until all of the following occur:

   1. The license is no longer limited or restricted; and

   2. Two years have elapsed from the date on which the license is no longer
   limited or restricted due to the adverse action.

C. Once a restricted or limited license satisfies the requirements of
subdivisions B 1 and 2, the licensee shall meet the requirements of subsection A
to obtain a compact privilege in any remote state.

D. For each remote state in which a PA seeks authority to prescribe controlled
substances, the PA shall satisfy all requirements imposed by such state in
granting or renewing such authority.
			Article 5. Designation of the State from Which Licensee is Applying for a
Compact Privilege.
			Upon a licensee&#8217;s application for a compact privilege, the licensee
shall identify to the Commission the participating state from which the licensee
is applying, in accordance with applicable rules adopted by the Commission, and
subject to the following requirements:

   1. When applying for a compact privilege, the licensee shall provide the
   Commission with the address of the licensee&#8217;s primary residence and
   thereafter shall immediately report to the Commission any change in the
   address of the licensee&#8217;s primary residence.

   2. When applying for a compact privilege, the licensee is required to consent
   to accept service of process by mail at the licensee&#8217;s primary residence
   on file with the Commission with respect to any action brought against the
   licensee by the Commission or a participating state, including a subpoena,
   with respect to any action brought or investigation conducted by the
   Commission or a participating state.
   				Article 6. Adverse Actions.

A. A participating state in which a licensee is licensed shall have exclusive
power to impose adverse action against the qualifying license issued by that
participating state.

B. In addition to the other powers conferred by state law, a remote state shall
have the authority, in accordance with existing state due process law, to do all
of the following:

   1. Take adverse action against a PA&#8217;s compact privilege within that
   state to remove a licensee&#8217;s compact privilege or take other action
   necessary under applicable law to protect the health and safety of its
   citizens.

   2. Issue subpoenas for both hearings and investigations that require the
   attendance and testimony of witnesses as well as the production of evidence.
   Subpoenas issued by a licensing board in a participating state for the
   attendance and testimony of witnesses or the production of evidence from
   another participating state shall be enforced in the latter state by any court
   of competent jurisdiction, according to the practice and procedure of that
   court applicable to subpoenas issued in proceedings pending before it. The
   issuing authority shall pay any witness fees, travel expenses, mileage, and
   other fees required by the service statutes of the state in which the
   witnesses or evidence are located.

   3. Notwithstanding subdivision 2, subpoenas may not be issued by a
   participating state to gather evidence of conduct in another state that is
   lawful in that other state for the purpose of taking adverse action against a
   licensee&#8217;s compact privilege or application for a compact privilege in
   that participating state.

   4. Nothing in this Compact authorizes a participating state to impose
   discipline against a PA&#8217;s compact privilege or to deny an application
   for a compact privilege in that participating state for the individual&#8217;s
   otherwise lawful practice in another state.

C. For purposes of taking adverse action, the participating state that issued
the qualifying license shall give the same priority and effect to reported
conduct received from any other participating state as it would if the conduct
had occurred within the participating state that issued the qualifying license.
In so doing, that participating state shall apply its own state laws to
determine appropriate action.

D. A participating state, if otherwise permitted by state law, may recover from
the affected PA the costs of investigations and disposition of cases resulting
from any adverse action taken against that PA.

E. A participating state may take adverse action based on the factual findings
of a remote state, provided that the participating state follows its own
procedures for taking the adverse action.

F. Joint investigations.

   1. In addition to the authority granted to a participating state by its
   respective state PA laws and regulations or other applicable state law, any
   participating state may participate with other participating states in joint
   investigations of licensees.

   2. Participating states shall share any investigative, litigation, or
   compliance materials in furtherance of any joint or individual investigation
   initiated under this Compact.

G. If an adverse action is taken against a PA&#8217;s qualifying license, the
PA&#8217;s compact privilege in all remote states shall be deactivated until two
years have elapsed after all restrictions have been removed from the state
license. All disciplinary orders by the participating state that issued the
qualifying license that impose adverse action against a PA&#8217;s license shall
include a statement that the PA&#8217;s compact privilege is deactivated in all
participating states during the pendency of the order.

H. If any participating state takes adverse action, it promptly shall notify the
administrator of the data system.

   7. Article 7. Establishment of the PA Licensure Compact Commission.

A. The participating states hereby create and establish a joint government
agency and national administrative body known as the PA Licensure Compact
Commission. The Commission is an instrumentality of the compact states acting
jointly and not an instrumentality of any one state. The Commission shall come
into existence on or after the effective date of the Compact as set forth in
subsection A of Article 11.

B. Membership, voting, and meetings.

   1. Each participating state shall have and be limited to one delegate selected
   by that participating state&#8217;s licensing board or, if the state has more
   than one licensing board, selected collectively by the participating
   state&#8217;s licensing boards.

   2. The delegate shall be either:
   				a. A current PA, physician, or public member of a licensing board or PA
   council/committee; or
   				b. An administrator of a licensing board.

   3. Any delegate may be removed or suspended from office as provided by the
   laws of the state from which the delegate is appointed.

   4. The participating state licensing board shall fill any vacancy occurring in
   the Commission within 60 days.

   5. Each delegate shall be entitled to one vote on all matters voted on by the
   Commission and shall otherwise have an opportunity to participate in the
   business and affairs of the Commission. A delegate shall vote in person or by
   such other means as provided in the bylaws. The bylaws may provide for
   delegates&#8217; participation in meetings by telecommunications, video
   conference, or other means of communication.

   6. The Commission shall meet at least once during each calendar year.
   Additional meetings shall be held as set forth in this Compact and the bylaws.

   7. The Commission shall establish by rule a term of office for delegates.

C. The Commission shall have the following powers and duties:

   1. Establish a code of ethics for the Commission;

   2. Establish the fiscal year of the Commission;

   3. Establish fees;

   4. Establish bylaws;

   5. Maintain its financial records in accordance with the bylaws;

   6. Meet and take such actions as are consistent with the provisions of this
   Compact and the bylaws;

   7. Promulgate rules to facilitate and coordinate implementation and
   administration of this Compact. The rules shall have the force and effect of
   law and shall be binding in all participating states;

   8. Bring and prosecute legal proceedings or actions in the name of the
   Commission, provided that the standing of any state licensing board to sue or
   be sued under applicable law shall not be affected;

   9. Purchase and maintain insurance and bonds;

   10. Borrow, accept, or contract for services of personnel, including, but not
   limited to, employees of a participating state;

   11. Hire employees and engage contractors, elect or appoint officers, fix
   compensation, define duties, grant such individuals appropriate authority to
   carry out the purposes of this Compact, and establish the Commission&#8217;s
   personnel policies and programs relating to conflicts of interest,
   qualifications of personnel, and other related personnel matters;

   12. Accept any and all appropriate donations and grants of money, equipment,
   supplies, materials, and services, and receive, utilize, and dispose of the
   same; provided that at all times the Commission shall avoid any appearance of
   impropriety or conflict of interest;

   13. Lease, purchase, accept appropriate gifts or donations of, or otherwise
   own, hold, improve, or use, any property, real, personal, or mixed; provided
   that at all times the Commission shall avoid any appearance of impropriety;

   14. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise
   dispose of any property real, personal, or mixed;

   15. Establish a budget and make expenditures;

   16. Borrow money;

   17. Appoint committees, including standing committees composed of members,
   state regulators, state legislators or their representatives, and consumer
   representatives, and such other interested persons as may be designated in
   this Compact and the bylaws;

   18. Provide and receive information from, and cooperate with, law-enforcement
   agencies;

   19. Elect a chair, vice chair, secretary, and treasurer and such other
   officers of the Commission as provided in the Commission&#8217;s bylaws;

   20. Reserve for itself, in addition to those reserved exclusively to the
   Commission under the Compact, powers that the executive committee may not
   exercise;

   21. Approve or disapprove a state&#8217;s participation in the Compact based
   upon its determination as to whether the state&#8217;s compact legislation
   departs in a material manner from the model compact language;

   22. Prepare and provide to the participating states an annual report; and

   23. Perform such other functions as may be necessary or appropriate to achieve
   the purposes of this Compact consistent with the state regulation of PA
   licensure and practice.

D. Meetings of the Commission.

   1. All meetings of the Commission that are not closed pursuant to this
   subsection shall be open to the public. Notice of public meetings shall be
   posted on the Commission&#8217;s website at least 30 days prior to the public
   meeting.

   2. Notwithstanding subdivision 1, the Commission may convene a public meeting
   by providing at least 24 hours&#8217; prior notice on the Commission&#8217;s
   website, and any other means as provided in the Commission&#8217;s rules, for
   any of the reasons it may dispense with notice of proposed rulemaking under
   subsection L of Article 9.

   3. The Commission may convene in a closed, non-public meeting or non-public
   part of a public meeting to receive legal advice or to discuss:
   				a. Noncompliance of a participating state with its obligations under this
   Compact;
   				b. The employment, compensation, discipline or other matters, practices,
   or procedures related to specific employees, or other matters related to the
   Commission&#8217;s internal personnel practices and procedures;
   				c. Current, threatened, or reasonably anticipated litigation;
   				d. Negotiation of contracts for the purchase, lease, or sale of goods,
   services, or real estate;
   				e. Accusing any person of a crime or formally censuring any person;
   				f. Disclosure of trade secrets or commercial or financial information that
   is privileged or confidential;
   				g. Disclosure of information of a personal nature where disclosure would
   constitute a clearly unwarranted invasion of personal privacy;
   				h. Disclosure of investigative records compiled for law-enforcement
   purposes;
   				i. Disclosure of information related to any investigative reports prepared
   by or on behalf of or for use of the Commission or other committee charged
   with responsibility of investigation or determination of compliance issues
   pursuant to this Compact;
   				j. Legal advice; or
   				k. Matters specifically exempted from disclosure by federal or
   participating states&#8217; statutes.

   4. If a meeting, or portion of a meeting, is closed pursuant to this
   provision, the chair of the meeting or the chair&#8217;s designee shall
   certify that the meeting or portion of the meeting may be closed and shall
   reference each relevant exempting provision.

   5. The Commission shall keep minutes that fully and clearly describe all
   matters discussed in a meeting and shall provide a full and accurate summary
   of actions taken, including a description of the views expressed. All
   documents considered in connection with an action shall be identified in such
   minutes. All minutes and documents of a closed meeting shall remain under
   seal, subject to release by a majority vote of the Commission or order of a
   court of competent jurisdiction.

E. Financing of the Commission.

   1. The Commission shall pay, or provide for the payment of, the reasonable
   expenses of its establishment, organization, and ongoing activities.

   2. The Commission may accept any and all appropriate revenue sources,
   donations, and grants of money, equipment, supplies, materials, and services.

   3. The Commission may levy on and collect an annual assessment from each
   participating state and may impose compact privilege fees on licensees of
   participating states to whom a compact privilege is granted to cover the cost
   of the operations and activities of the Commission and its staff, which shall
   be in a total amount sufficient to cover its annual budget as approved by the
   Commission each year for which revenue is not provided by other sources. The
   aggregate annual assessment amount levied on participating states shall be
   allocated based upon a formula to be determined by Commission rule.
   				a. A compact privilege expires when the licensee&#8217;s qualifying
   license in the participating state from which the licensee applied for the
   compact privilege expires.
   				b. If the licensee terminates the qualifying license through which the
   licensee applied for the compact privilege before its scheduled expiration,
   and the licensee has a qualifying license in another participating state, the
   licensee shall inform the Commission that it is changing to that participating
   state the participating state through which it applies for a compact privilege
   and pay to the Commission any compact privilege fee required by Commission
   rule.

   4. The Commission shall not incur obligations of any kind prior to securing
   the funds adequate to meet the same; nor shall the Commission pledge the
   credit of any of the participating states, except by and with the authority of
   the participating state.

   5. The Commission shall keep accurate accounts of all receipts and
   disbursements. The receipts and disbursements of the Commission shall be
   subject to the financial review and accounting procedures established under
   its bylaws. All receipts and disbursements of funds handled by the Commission
   shall be subject to an annual financial review by a certified or licensed
   public accountant, and the report of the financial review shall be included in
   and become part of the annual report of the Commission.

F. The executive committee.

   1. The executive committee shall have the power to act on behalf of the
   Commission according to the terms of this Compact and Commission rules.

   2. The executive committee shall be composed of nine members:
   				a. Seven voting members who are elected by the Commission from the current
   membership of the Commission;
   				b. One ex-officio, nonvoting member from a recognized national PA
   professional association; and
   				c. One ex-officio, nonvoting member from a recognized national PA
   certification organization.

   3. The ex-officio members will be selected by their respective organizations.

   4. The Commission may remove any member of the executive committee as provided
   in its bylaws.

   5. The executive committee shall meet at least annually.

   6. The executive committee shall have the following duties and
   responsibilities:
   				a. Recommend to the Commission changes to the Commission&#8217;s rules or
   bylaws, changes to this Compact legislation, fees to be paid by compact
   participating states such as annual dues, and any Commission compact fee
   charged to licensees for the compact privilege;
   				b. Ensure Compact administration services are appropriately provided,
   contractual or otherwise;
   				c. Prepare and recommend the budget;
   				d. Maintain financial records on behalf of the Commission;
   				e. Monitor Compact compliance of participating states and provide
   compliance reports to the Commission;
   				f. Establish additional committees as necessary;
   				g. Exercise the powers and duties of the Commission during the interim
   between Commission meetings, except for issuing proposed rulemaking or
   adopting Commission rules or bylaws, or exercising any other powers and duties
   exclusively reserved to the Commission by the Commission&#8217;s rules; and
   				h. Perform other duties as provided in the Commission&#8217;s rules or
   bylaws.

   7. All meeting of the executive committee at which it votes or plans to vote
   on matters in exercising the powers and duties of the Commission shall be open
   to the public and public notice of such meetings shall be given as public
   meetings of the Commission are given.

   8. The executive committee may convene in a closed, non-public meeting for the
   same reasons that the Commission may convene in a non-public meeting as set
   forth in subdivision D 3 and shall announce the closed meeting as the
   Commission is required to under subdivision D 4 and keep minutes of the closed
   meeting as the Commission is required to under subdivision D 5.

G. Qualified immunity, defense, and indemnification.

   1. The members, officers, executive director, employees, and representatives
   of the Commission shall be immune from suit and liability, both personally and
   in their official capacity, for any claim for damage to or loss of property or
   personal injury or other civil liability caused by or arising out of any
   actual or alleged act, error, or omission that occurred, or that the person
   against whom the claim is made had a reasonable basis for believing occurred
   within the scope of Commission employment, duties, or responsibilities;
   provided that nothing in this subdivision shall be construed to protect any
   such person from suit or liability for any damage, loss, injury, or liability
   caused by the intentional or willful or wanton misconduct of that person. The
   procurement of insurance of any type by the Commission shall not in any way
   compromise or limit the immunity granted hereunder.

   2. The Commission shall defend any member, officer, executive director,
   employee, and representative of the Commission in any civil action seeking to
   impose liability arising out of any actual or alleged act, error, or omission
   that occurred within the scope of Commission employment, duties, or
   responsibilities, or as determined by the Commission that the person against
   whom the claim is made had a reasonable basis for believing occurred within
   the scope of Commission employment, duties, or responsibilities; provided that
   nothing herein shall be construed to prohibit that person from retaining their
   own counsel at their own expense; and provided further, that the actual or
   alleged act, error, or omission did not result from that person&#8217;s
   intentional or willful or wanton misconduct.

   3. The Commission shall indemnify and hold harmless any member, officer,
   executive director, employee, and representative of the Commission for the
   amount of any settlement or judgment obtained against that person arising out
   of any actual or alleged act, error, or omission that occurred within the
   scope of Commission employment, duties, or responsibilities, or that such
   person had a reasonable basis for believing occurred within the scope of
   Commission employment, duties, or responsibilities, provided that the actual
   or alleged act, error, or omission did not result from the intentional or
   willful or wanton misconduct of that person.

   4. Venue is proper and judicial proceedings by or against the Commission shall
   be brought solely and exclusively in a court of competent jurisdiction where
   the principal office of the Commission is located. The Commission may waive
   venue and jurisdictional defenses in any proceedings as authorized by
   Commission rules.

   5. Nothing herein shall be construed as a limitation on the liability of any
   licensee for professional malpractice or misconduct, which shall be governed
   solely by any other applicable state laws.

   6. Nothing herein shall be construed to designate the venue or jurisdiction to
   bring actions for alleged acts of malpractice, professional misconduct,
   negligence, or other such civil action pertaining to the practice of a PA. All
   such matters shall be determined exclusively by state law other than this
   Compact.

   7. Nothing in this Compact shall be interpreted to waive or otherwise abrogate
   a participating state&#8217;s state action immunity or state action
   affirmative defense with respect to antitrust claims under the Sherman Act,
   the Clayton Act, or any other state or federal antitrust or anticompetitive
   law or regulation.

   8. Nothing in this Compact shall be construed to be a waiver of sovereign
   immunity by the participating states or by the Commission.
   				Article 8. Data System.

A. The Commission shall provide for the development, maintenance, operation, and
utilization of a coordinated data and reporting system containing licensure,
adverse action, and the reporting of the existence of significant investigative
information on all licensed PAs and applicants denied a license in participating
states.

B. Notwithstanding any other state law to the contrary, a participating state
shall submit a uniform data set to the data system on all PAs to whom this
Compact is applicable (utilizing a unique identifier) as required by the rules
of the Commission, including:

   1. Identifying information;

   2. Licensure data;

   3. Adverse actions against a license or compact privilege;

   4. Any denial of application for licensure, and the reason(s) for such denial
   (excluding the reporting of any criminal history record information where
   prohibited by law);

   5. The existence of significant investigative information; and

   6. Other information that may facilitate the administration of this Compact,
   as determined by the rules of the Commission.

C. Significant investigative information pertaining to a licensee in any
participating state shall only be available to other participating states.

D. The Commission shall promptly notify all participating states of any adverse
action taken against a licensee or an individual applying for a license that has
been reported to it. This adverse action information shall be available to any
other participating state.

E. Participating states contributing information to the data system may, in
accordance with state or federal law, designate information that may not be
shared with the public without the express permission of the contributing state.
Notwithstanding any such designation, such information shall be reported to the
Commission through the data system.

F. Any information submitted to the data system that is subsequently expunged
pursuant to federal law or the laws of the participating state contributing the
information shall be removed from the data system upon reporting of such by the
participating state to the Commission.

G. The records and information provided to a participating state pursuant to
this Compact or through the data system, when certified by the Commission or an
agent thereof, shall constitute the authenticated business records of the
Commission, and shall be entitled to any associated hearsay exception in any
relevant judicial, quasi-judicial or administrative proceedings in a
participating state.
			Article 9. Rulemaking.

A. The Commission shall exercise its rulemaking powers pursuant to the criteria
set forth in this section and the rules adopted thereunder. Commission rules
shall become binding as of the date specified by the Commission for each rule.

B. The Commission shall promulgate reasonable rules in order to effectively and
efficiently implement and administer this Compact and achieve its purposes. A
Commission rule shall be invalid and have not force or effect only if a court of
competent jurisdiction holds that the rule is invalid because the Commission
exercised its rulemaking authority in a manner that is beyond the scope of the
purposes of this Compact, or the powers granted hereunder, or based upon another
applicable standard of review.

C. The rules of the Commission shall have the force of law in each participating
state, provided however that where the rules of the Commission conflict with the
laws of the participating state that establish the medical services a PA may
perform in the participating state, as held by a court of competent
jurisdiction, the rules of the Commission shall be ineffective in that state to
the extent of the conflict.

D. If a majority of the legislatures of the participating states rejects a
Commission rule, by enactment of a statute or resolution in the same manner used
to adopt this Compact within four years of the date of adoption of the rule,
then such rule shall have no further force and effect in any participating state
or to any state applying to participate in the Compact.

E. Commission rules shall be adopted at a regular or special meeting of the
Commission.

F. Prior to promulgation and adoption of a final rule or rules by the
Commission, and at least 30 days in advance of the meeting at which the rule
will be considered and voted upon, the Commission shall file a notice of
proposed rulemaking:

   1. On the website of the Commission or other publicly accessible platform; and

   2. To persons who have requested notice of the Commission&#8217;s notices of
   proposed rulemaking; and

   3. In such other way(s) as the Commission may by rule specify.

G. The notice of proposed rulemaking shall include:

   1. The time, date, and location of the public hearing on the proposed rule and
   the proposed time, date, and location of the meeting in which the proposed
   rule will be considered and voted upon;

   2. The text of the proposed rule and the reason for the proposed rule;

   3. A request for comments on the proposed rule from any interested person and
   the date by which written comments must be received; and

   4. The manner in which interested persons may submit notice to the Commission
   of their intention to attend the public hearing or provide any written
   comments.

H. Prior to adoption of a proposed rule, the Commission shall allow persons to
submit written data, facts, opinions, and arguments, which shall be made
available to the public.

I. If the hearing is to be held via electronic means, the Commission shall
publish the mechanism for access to the electronic hearing.

   1. All persons wishing to be heard at the hearing shall as directed in the
   notice of proposed rulemaking, not less than five business days before the
   scheduled date of the hearing, notify the Commission of their desire to appear
   and testify at the hearing.

   2. Hearings shall be conducted in a manner providing each person who wishes to
   comment a fair and reasonable opportunity to comment orally or in writing.

   3. All hearings shall be recorded. A copy of the recording and the written
   comments, data, facts, opinions, and arguments received in response to the
   proposed rulemaking shall be made available to a person upon request.

   4. Nothing in this section shall be construed as requiring a separate hearing
   on each proposed rule. Proposed rules may be grouped for the convenience of
   the Commission at hearings required by this section.

J. Following the public hearing, the Commission shall consider all written and
oral comments timely received.

K. The Commission shall, by majority vote of all delegates, take final action on
the proposed rule and shall determine the effective date of the rule, if
adopted, based on the rulemaking record and the full text of the rule.

   1. If adopted, the rule shall be posted on the Commission&#8217;s website.

   2. The Commission may adopt changes to the proposed rule provided the changes
   do not enlarge the original purpose of the proposed rule.

   3. The Commission shall provide on its website an explanation of the reasons
   for substantive changes made to the proposed rule as well as reasons for
   substantive changes not made that were recommended by commenters.

   4. The Commission shall determine a reasonable effective date for the rule.
   Except for an emergency as provided in subsection L, the effective date of the
   rule shall be no sooner than 30 days after the Commission issued the notice
   that it adopted the rule.

L. Upon determination that an emergency exists, the Commission may consider and
adopt an emergency rule with 24 hours prior notice, without the opportunity for
comment, or hearing, provided that the usual rulemaking procedures provided in
this Compact and in this section shall be retroactively applied to the rule as
soon as reasonably possible, in no event later than 90 days after the effective
date of the rule. for the purposes of this provision, an emergency rule is one
that must be adopted immediately by the Commission in order to:

   1. Meet an imminent threat to public health, safety, or welfare;

   2. Prevent a loss of Commission or participating state funds;

   3. Meet a deadline for the promulgation of a Commission rule that is
   established by federal law or rule; or

   4. Protect public health and safety.

M. The Commission or an authorized committee of the Commission may direct
revisions to a previously adopted Commission rule for purposes of correcting
typographical errors, errors in format, errors in consistency, or grammatical
errors. Public notice of any revisions shall be posted on the website of the
Commission. The revision shall be subject to challenge by any person for a
period of 30 days after posting. The revision may be challenged only on grounds
that the revision results in a material change to a rule. A challenge shall be
made as set forth in the notice of revisions and delivered to the Commission
prior to the end of the notice period. If no challenge is made, the revision
will take effect without further action. If the revision is challenged, the
revision may not take effect without the approval of the Commission.

N. No participating state&#8217;s rulemaking requirements shall apply under this
Compact.
			Article 10. Oversight, Dispute Resolution, and Enforcement.

A. Oversight.

   1. The executive and judicial branches of state government in each
   participating state shall enforce this Compact and take all actions necessary
   and appropriate to implement the Compact.

   2. Venue is proper and judicial proceedings by or against the Commission shall
   be brought solely and exclusively in a court of competent jurisdiction where
   the principal office of the Commission is located. The Commission may waive
   venue and jurisdictional defenses to the extent it adopts or consents to
   participate in alternative dispute resolution proceedings. Nothing herein
   shall affect or limit the selection or propriety of venue in any action
   against a licensee for professional malpractice, misconduct, or any such
   similar matter.

   3. The Commission shall be entitled to receive service of process in any
   proceeding regarding the enforcement or interpretation of the Compact or the
   Commission&#8217;s rules and shall have standing to intervene in such a
   proceeding for all purposes. Failure to provide the Commission with service of
   process shall render a judgment or order in such proceeding void as to the
   Commission, this Compact, or Commission rules.

B. Default, technical assistance, and termination.

   1. If the Commission determines that a participating state has defaulted in
   the performance of its obligations or responsibilities under this Compact or
   the Commission rules, the Commission shall provide written notice to the
   defaulting state and other participating states. The notice shall describe the
   default, the proposed means of curing the default, and any other action that
   the Commission may take and shall offer remedial training and specific
   technical assistance regarding the default.

   2. If a state in default fails to cure the default, the defaulting state may
   be terminated from this Compact upon an affirmative vote of a majority of the
   delegates of the participating states, and all rights, privileges, and
   benefits conferred by this Compact upon such state may be terminated on the
   effective date of termination. A cure of the default does not relieve the
   offending state of obligations or liabilities incurred during the period of
   default.

   3. Termination of participation in this Compact shall be imposed only after
   all other means of securing compliance have been exhausted. Notice of intent
   to suspend or terminate shall be given by the Commission to the governor, the
   majority and minority leaders of the defaulting state&#8217;s legislature, and
   to the licensing board(s) of each of the participating states.

   4. A state that has been terminated is responsible for all assessments,
   obligations, and liabilities incurred through the effective date of
   termination, including obligations that extend beyond the effective date of
   termination.

   5. The Commission shall not bear any costs related to a state that is found to
   be in default or that has been terminated from this Compact, unless agreed
   upon in writing between the Commission and the defaulting state.

   6. The defaulting state may appeal its termination from the Compact by the
   Commission by petitioning the United States District Court for the District of
   Columbia or the federal district where the Commission has its principal
   offices. The prevailing member shall be awarded all costs of such litigation,
   including reasonable attorney fees.

   7. Upon the termination of a state&#8217;s participation in the Compact, the
   State shall immediately provide notice to all licensees within that state of
   such termination:
   				a. Licensees who have been granted a compact privilege in that state shall
   retain the compact privilege for 180 days following the effective date of such
   termination.
   				b. Licensees who are licensed in that state who have been granted a
   compact privilege in a participating state shall retain the compact privilege
   for 180 days unless the licensee also has a qualifying license in a
   participating state or obtains a qualifying license in a participating state
   before the 180-day period ends, in which case the compact privilege shall
   continue.

C. Dispute resolution.

   1. Upon request by a participating state, the Commission shall attempt to
   resolve disputes related to this Compact that arise among participating states
   and between participating and nonparticipating states.

   2. The Commission shall promulgate a rule providing for both mediation and
   binding dispute resolution for disputes as appropriate.

D. Enforcement.

   1. The Commission, in the reasonable exercise of its discretion, shall enforce
   the provisions of this Compact and rules of the Commission.

   2. If compliance is not secured after all means to secure compliance have been
   exhausted, by majority vote, the Commission may initiate legal action in the
   United States District Court for the District of Columbia or the federal
   district where the Commission has its principal offices, against a
   participating state in default to enforce compliance with the provisions of
   this Compact and the Commission&#8217;s promulgated rules and bylaws. The
   relief sought may include both injunctive relief and damages. In the event
   judicial enforcement is necessary, the prevailing party shall be awarded all
   costs of such litigation, including reasonable attorney fees. The remedies
   herein shall not be the exclusive remedies of the Commission. The Commission
   may pursue any other remedies available under federal or state law.

E. Legal action against the Commission.

   1. A participating state may initiate legal action against the Commission in
   the United States District Court for the District of Columbia or the federal
   district where the Commission has its principal offices to enforce compliance
   with the provisions of the Compact and its rules. The relief sought may
   include both injunctive relief and damages. In the event judicial enforcement
   is necessary, the prevailing party shall be awarded all costs of such
   litigation, including reasonable attorney fees.

   2. No person other than a participating state shall enforce this Compact
   against the Commission.
   				Article 11.  Date of Implementation of the PA Licensure Compact
   Commission.

A. This Compact shall come into effect on the date on which this Compact statute
is enacted into law in the seventh participating state.

   1. On or after the effective date of the Compact, the Commission shall convene
   and review the enactment of each of the states that enacted the Compact prior
   to the Commission convening (&#8220;charter participating states&#8221;) to
   determine if the statute enacted by each such charter participating state is
   materially different than the model compact.
   				a. A charter participating state whose enactment is found to be materially
   different from the model compact shall be entitled to the default process set
   forth in subsection B of Article 10.
   				b. If any participating state later withdraws from the Compact or its
   participation is terminated, the Commission shall remain in existence and the
   Compact shall remain in effect even if the number of participating states
   should be less than seven. Participating states enacting the Compact
   subsequent to the Commission convening shall be subject to the process set
   forth in subdivision C 21 of Article 7 to determine if their enactments are
   materially different from the model compact and whether they qualify for
   participation in the Compact.

   2. Participating states enacting the Compact subsequent to the seven initial
   charter participating states shall be subject to the process set forth in
   subdivision C 21 of Article 7 to determine if their enactments are materially
   different from the model compact and whether they qualify for participation in
   the Compact.

   3. All actions taken for the benefit of the Commission or in furtherance of
   the purposes of the administration of the Compact prior to the effective date
   of the Compact or the Commission coming into existence shall be considered to
   be actions of the Commission unless specifically repudiated by the Commission.

B. Any state that joins this Compact shall be subject to the Commission&#8217;s
rules and bylaws as they exist on the date on which this Compact becomes law in
that state. Any rule that has been previously adopted by the Commission shall
have the full force and effect of law on the day this Compact becomes law in
that state.

C. Any participating state may withdraw from this Compact by enacting a statute
repealing the same.

   1. A participating state&#8217;s withdrawal shall not take effect until 180
   days after enactment of the repealing statute. During this 180-day period, all
   compact privileges that were in effect in the withdrawing state and were
   granted to licensees licensed in the withdrawing state shall remain in effect.
   If any licensee licensed in the withdrawing state is also licensed in another
   participating state or obtains a license in another participating state within
   the 180 days, the licensee&#8217;s compact privileges in other participating
   states shall not be affected by the passage of the 180 days.

   2. Withdrawal shall not affect the continuing requirement of the state
   licensing board(s) of the withdrawing state to comply with the investigative
   and adverse action reporting requirements of this Compact prior to the
   effective date of withdrawal.

   3. Upon the enactment of a statute withdrawing a state from this Compact, the
   state shall immediately provide notice of such withdrawal to all licensees
   within that state. Such withdrawing state shall continue to recognize all
   licenses granted pursuant to this Compact for a minimum of 180 days after the
   date of such notice of withdrawal.

D. Nothing contained in this Compact shall be construed to invalidate or prevent
any PA licensure agreement or other cooperative arrangement between
participating states and between a participating state and nonparticipating
state that does not conflict with the provisions of this Compact.

E. This Compact may be amended by the participating states. No amendment to this
Compact shall become effective and binding upon any participating state until it
is enacted materially in the same manner into the laws of all participating
states as determined by the Commission.
			Article 12. Construction and Severability.

A. This Compact and the Commission&#8217;s rulemaking authority shall be
liberally construed so as to effectuate the purposes and the implementation and
administration of the Compact. Provisions of the Compact expressly authorizing
or requiring the promulgation of rules shall not be construed to limit the
Commission&#8217;s rulemaking authority solely for those purposes.

B. The provisions of this Compact shall be severable and if any phrase, clause,
sentence, or provision of this Compact is held by a court of competent
jurisdiction to be contrary to the constitution of any participating state, a
state seeking participation in the Compact, or of the United States, or the
applicability thereof to any government, agency, person, or circumstance is held
to be unconstitutional by a court of competent jurisdiction, the validity of the
remainder of this Compact and the applicability thereof to any other government,
agency, person, or circumstance shall not be affected thereby.

C. Notwithstanding subsection B or this subsection, the Commission may deny a
state&#8217;s participation in the Compact or, in accordance with the
requirements of subsection B of Article 10, terminate a participating
state&#8217;s participation in the Compact, if it determines that a
constitutional requirement of a participating state is, or would be with respect
to a state seeking to participate in the Compact, a material departure from the
Compact. Otherwise, if this Compact shall be held to be contrary to the
constitution of any participating state, the Compact shall remain in full force
and effect as to the remaining participating states and in full force and effect
as to the participating state affected as to all severable matters.
			Article 13.  Binding Effect of Compact.

A. Nothing herein prevents the enforcement of any other law of a participating
state that is not inconsistent with this Compact.

B. Any laws in a participating state in conflict with this Compact are
superseded to the extent of the conflict.

C. All agreements between the Commission and the participating states are
binding in accordance with their terms.
