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ARIZONA HOUSE OF REPRESENTATIVES57th Legislature, 2nd Regular Session |
House: HHS DP 11-1-0-0 |
HB 2437: EMS reciprocity; compact
Sponsor: Representative Bliss, LD 1
Caucus & COW
Overview
Adopts the Emergency Medical Services (EMS) Personnel Licensure Interstate Compact (Compact) to allow EMS personnel to obtain the privilege to practice in other Compact states. Creates the Interstate Commission for EMS Personnel Practice (Commission) and outlines membership, responsibilities and duties.
History
The Compact functions as a contractual agreement among states. It establishes the legal framework for multistate practice and mutual recognition of EMS licensure. The Compact was introduced in 2014, with two states enacting it by 2015. By 2017, ten states had joined, meeting the activation threshold. Currently 25 states have passed the Compact: Alabama, Arkansas, Colorado, Georgia, Idaho, Indiana, Iowa, Kansas, Louisiana, Mississippi, Missouri, Montana, Nebraska, Nevada, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia and Wyoming (Compact).
Provisions
Home State Licensure
1. Deems any member state in which an individual holds a current license a home state for the purposes of the Compact. (Sec. 1)
2. Allows any member state to require an individual to obtain and retain a license to be authorized to practice in the member state under circumstances not authorized by the privilege to practice under the terms of the Compact. (Sec. 1)
3. Requires member states participating in the Compact to:
a. require the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing initial licenses at the EMT and paramedic levels;
b. have a mechanism in place for receiving and investigating complaints about individuals;
c. notify the Commission of any adverse action or significant investigatory information regarding the individual;
d. require a criminal background check for initial licensure within 5 years after activation of the Compact; and
e. comply with the rules of the Commission. (Sec. 1)
Compact Privilege to Practice
4. Requires member states to recognize the privilege to practice for individuals licensed in another member state that meets all applicable requirements. (Sec. 1)
5. Requires individuals exercising the privilege to practice to:
a. be at least 18 years of age;
b. possess a current unrestricted license in a member state as an emergency medical technician (EMT), advanced emergency medical technician (AEMT), paramedic or state recognized and licensed level with a scope of practice and authority between EMT and paramedic; and
c. practice under the supervision of a medical director. (Sec. 1)
6. Requires an individual providing patient care in a remote state under the privilege to practice to function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state as may be defined in Commission rules. (Sec. 1)
7. Subjects an individual participating in a remote state to the remote state's authority and laws. (Sec. 1)
8. Allows a remote state, in accordance with due process and that state's laws, to restrict, suspend or revoke an individual's privilege to practice in the remote state and may take any other necessary actions to protect the health and safety of its citizens. (Sec. 1)
9. Requires a remote state to promptly notify the home state and the Commission if it restricts, suspends or revokes an individual's privilege to practice. (Sec. 1)
10. Deems an individual ineligible to practice in a remote state if their privilege to practice is restricted or suspended by their home state until the individual's home state license is restored. (Sec. 1)
11. Deems an individual ineligible to practice in a remote state if their privilege to practice is restricted or suspended by any remote state until the individual's privilege to practice is restored. (Sec. 1)
12. Allows an individual to practice in a remote state under a privilege to practice only in the performance of the individuals EMS duties as assigned by an appropriate authority, Commission rules and under certain circumstances, as outlined. (Sec. 1)
Adverse Actions
13. Grants a home state exclusive power to impose adverse action against an individual's license. (Sec. 1)
14. Deems an individual ineligible to practice in a remote state if their privilege to practice is restricted or suspended by their home state until the individual's home state license is restored and the conditions are met, as outlined. (Sec. 1)
15. Requires a member state to report adverse actions and any occurrences that the individual's privilege to practice is restricted, suspended or revoked to the Commission in accordance with Commission rules. (Sec. 1)
16. Permits a remote state to take adverse action on an individual's privilege to practice within that state. (Sec. 1)
17. Allows remote states to take adverse action against an individual's privilege to practice in that state based on the factual findings of another member state so long as each state follows its own procedures for imposing such adverse action. (Sec. 1)
18. Requires a home state's EMS authority to investigate and take appropriate action with respect to reported conduct in a remote state as it would if such conduct had occurred within the remote state. (Sec. 1)
19. Requires the home state, in such cases, to control in determining the appropriate adverse action. (Sec. 1)
20. Clarifies the Compact does not override a member state's decision that participation in an alternative program may be used in lieu of adverse action and such participation remain nonpublic if required by the member state's laws. (Sec. 1)
21. Directs member states to require individuals who enter any alternative programs to agree not to practice in any other member state during the term of the alternative program without prior authorization from the other member state. (Sec. 1)
Additional Powers Invested in a Member State's EMS Authority
22. Grants a member state the authority to issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses and production of evidence. (Sec. 1)
23. Requires subpoenas issued by a member state's EMS authority for the attendance and testimony of witnesses or the production of evidence from another member state, or both, to be enforced in the remote state by any court of competent jurisdiction, according to the court's practice and procedure in considering subpoenas issued in its own proceedings. (Sec. 1)
24. Requires the issuing state's EMS authority to pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state where the witness or evidence, or both, are located. (Sec. 1)
25. Grants a member state the authority to issue cease and desist orders to restrict, suspend or revoke an individual's privilege to practice in the member state. (Sec. 1)
Interstate Commission for EMS Personnel Practice
26. Creates a joint agency known as the Commission. (Sec. 1)
27. Declares the Commission a body politic and an instrumentality of the Compact states. (Sec. 1)
28. Declares the Commission's venue proper and judicial proceedings by or against the Commission to be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. (Sec. 1)
29. Permits the Commission to waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. (Sec. 1)
30. Specifies that this Compact is not a waiver of sovereign immunity. (Sec. 1)
31. Outlines membership, voting and meeting procedures. (Sec. 1)
32. Requires all meetings to be open to the public. (Sec. 1)
33. Outlines the powers, duties and authorities of the Commission. (Sec. 1)
34. Establishes requirements for public Commission meetings. (Sec. 1)
35. Establishes procedures for closed Commission meetings. (Sec. 1)
36. Outlines topics that the Commission can discuss in a closed, nonpublic meeting or nonpublic part of a public meeting. (Sec. 1)
37. Requires the Commission to pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities. (Sec. 1)
38. Allows the Commission to accept any and all appropriate revenue sources, donations and grants of monies, equipment, supplies, materials and services. (Sec. 1)
39. Allows the Commission to levy and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. (Sec. 1)
40. Requires the annual assessment amount to be allocated based on a formula, as determined by the Commission, which must promulgate a rule binding on all member states. (Sec. 1)
41. Prohibits the Commission from incurring obligations of any kind before securing the monies adequate to meet the obligations. (Sec. 1)
42. Prohibits the Commission from pledging the credit of any member state, except by and with the authority of the member state. (Sec. 1)
43. Requires the Commission to keep accurate accounts of all receipts and disbursements. (Sec. 1)
44. Subjects all receipts and disbursements of the Commission to audit and accounting procedures established under Commission bylaws. (Sec. 1)
45. Requires all receipts and disbursements of monies be audited yearly by a certified or licensed public accountant and the audit report be included in and become part of the annual report of the Commission. (Sec. 1)
46. Contains provisions relating to qualified immunity, defense and indemnification. (Sec. 1)
Coordinated Database
47. Requires the Commission to provide for the development and maintenance of a coordinated database and reporting system containing licensure, adverse action and significant investigatory information on all licensed individuals in member states. (Sec. 1)
48. Requires member states to submit uniform data sets to the coordinated database on all individuals to whom the Compact applies too. (Sec. 1)
49. Requires the coordinated database to include:
a. identifying information;
b. licensure data;
c. significant investigatory information;
d. adverse actions against a licensee;
e. an indicator that a privilege to practice is restricted, suspended or revoked;
f. nonconfidential information related to alternative program participation;
g. Any denial of an application for licensure and the reasons for denial; and
h. other information that may facilitate the administration of this Compact, as determined by Commission rules. (Sec. 1)
50. Requires the coordinated database administrator to promptly notify all member states of any adverse action taken against, or significant investigative information on, any individual in a member state. (Sec. 1)
51. Allows a member state that contributes information to the coordinated database to designate information that may not be shared with the public without the express permission of that member state. (Sec. 1)
52. Requires any information submitted to the coordinated database that is subsequently required to be expunged by the laws of the member state contributing the information to be removed from the coordinated database. (Sec. 1)
Rulemaking
53. Requires the Commission to exercise its rulemaking powers and rules adopted thereunder. (Sec. 1)
54. Specifies that rules and amendments become binding as of the date specified in each rule or amendment. (Sec. 1)
55. Specifies that in a majority of legislatures of the participating states rejects a Commission rule by enacting a statute or resolution in the same manner used to adopt the Compact then that rule has no further force and effect in any member state. (Sec. 1)
56. Requires Commission rules be adopted at a regular or special meeting. (Sec. 1)
57. Requires the Commission to file a notice of proposed rulemaking at least 60 days before the meeting at which a proposed rule or rules will be considered and voted on. (Sec. 1)
58. Requires the notice of proposed rulemaking to be on the website of the Commission and each member state or publication in which each state would otherwise publish proposed rules. (Sec. 1)
59. Outlines what must be included in the notice of proposed rulemaking. (Sec. 1)
60. Requires the Commission to allow persons to submit written data, facts, opinions and arguments which must be made available to the public before adopting a proposed rule. (Sec. 1)
61. Establishes procedures for conducting hearings for notices of proposed rulemaking. (Sec. 1)
62. Clarifies that a separate hearing is not required for each rule. (Sec. 1)
63. Requires the Commission, by a majority vote of all delegates, to take final action on a proposed rule and determine the effective date of the rule based on the rulemaking record and full text of the rule, if adopted. (Sec. 1)
64. Contains conditions and procedures for the Commission to:
a. adopt emergency rules; and
b. revise previously adopted rules. (Sec. 1)
Oversight, Dispute Resolution and Enforcement
65. Directs the executive, legislative and judicial branches of state government in each participating state to enforce the Compact and take all actions necessary and appropriate to implement the Compact. (Sec. 1)
66. Requires all courts to take judicial notice of the Compact and its rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this Compact, which may affect the powers, responsibilities or actions of the Commission. (Sec. 1)
67. Entitles the Commission to receive service of process in any such proceeding and have standing to intervene in such a proceeding for all purposes. (Sec. 1)
68. Deems failure to provide service of process to the Commission renders a judgement or order void. (Sec. 1)
69. Contains procedures for when the Commission determines a participating state has defaulted in the performance of its obligations or responsibilities under the Commission or Commission rules. (Sec. 1)
70. Stipulates that a defaulting state may be terminated if a state in default fails to cure the default and on the affirmative vote of a majority of the delegates of the participating states. (Sec. 1)
71. Specifies that a cure of default does not relieve the offending state of obligations or liabilities incurred during the period of default. (Sec. 1)
72. Requires termination of participation in the Compact to be imposed only after all other means of securing compliance has been exhausted. (Sec. 1)
73. Requires notice of intent to suspend or terminate must be given to the Commission to the Governor, the majority and minority leaders of the defaulting state's legislature and each member state. (Sec. 1)
74. Deems a terminated member state responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. (Sec. 1)
75. Prohibits the Commission from bearing any costs related to a state that is found to be in default or terminated from the Compact, unless agreed on in writing between the Commission and defaulting state. (Sec. 1)
76. Allows a defaulting state to appeal the action of the Commission by petitioning the Unites States District Court for the District of Columbia or the federal district where the Commission has its principal offices. (Sec. 1)
77. Awards the prevailing party all costs of such litigation, including reasonable attorney fees. (Sec. 1)
78. Requires the Commission to attempt to resolve disputes related to the Compact that arise among participating states and between participating states and nonparticipating states, if requested by a member state. (Sec. 1)
79. Requires the Commission to promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate. (Sec. 1)
80. Allows the Commission, by majority vote, to 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 that is in default to enforce compliance with the Compact, the Commission bylaws and rules. (Sec. 1)
81. Permits the relief sought to include both injunctive relief and damages. (Sec. 1)
82. Allows the Commission to pursue any other remedies available under federal or state law. (Sec. 1)
Date of Implementation of the Commission and Associated Rules, Withdrawal and Amendment
83. Makes this Compact effective on the adoption of the tenth participating state. (Sec. 1)
84. Subjects any state that joins this Compact after the Commission's initial adoption to all rules as they exist on the date on which the Compact becomes law in that state. (Sec. 1)
85. Specifies that any rule that has been previously adopted by the Commission has the full force and effect of law on the day the Compact becomes law. (Sec. 1)
86. Allows any member state to withdraw from the Compact by enacting a statute repealing the same and the following apply:
a. a member state's withdrawal does not take effect until six months after enactment of the repealing statute; and
b. withdrawal does not affect the continuing requirement of the withdrawing state's EMS authority to comply with the investigative and adverse action reporting requirements before the effective date of withdrawal. (Sec. 1)
87. States that this Compact does not invalidate or prevent any EMS personnel licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of the Compact. (Sec 1)
88. Allows the Compact to be amended by the member states. (Sec. 1)
89. Specifies that this amendment does not become effective and binding on any member state until it is enacted into the laws of all member states. (sec. 1)
Miscellaneous
90. Declares on the declaration by a member state's Governor of a state of emergency or disaster that activates the Emergency Management Assistance Compact (EMAC), all relevant terms and provisions of EMAC apply and, to the extent any Compact terms or provisions conflict with EMAC, the EMAC prevails with respect to any individual practicing in the remote state in response to the declaration. (Sec. 1)
91. Requires member states to consider a veteran, activate military service member and member of the National Guard and Reserves separating from an active-duty tour, their spouses, who holds a current valid and unrestricted NREMT certification at or above the level of the state license as satisfying the minimum training and examination requirements. (Sec. 1)
92. Requires member states to expedite the processing of licensure applications submitted by veterans, active military service members and members of the National Guard and Reserves separating from an active duty, tour and their spouses. (Sec. 1)
93. Subjects all individuals functioning with a privilege to practice to adverse action regulations. (Sec. 1)
94. Asserts that the Compact be liberally construed to effectuate its purposes. (Sec. 1)
95. Specifies that if the Compact is held contrary to any state's Constitution, the Compact remains in full force and effect as to the remaining member states. (Sec. 1)
96. Clarifies the Compact does not supersede state law or rules related to licensure of EMS agencies. (Sec. 1)
97. Defines terms. (Sec. 1)
98. Outlines the purposes of the Compact. (Sec. 1)
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