Purpose

• Create the Respiratory Care Interstate Compact to let respiratory therapists licensed in one member state practice in other member states, while preserving each state’s authority to protect public health and safety.
• Improve access to respiratory therapy services, reduce unnecessary red tape, support relocating military members and their spouses, and help address workforce shortages through shared regulation and cooperation.

Main Provisions

• Establishment and structure

  • Create a joint Respiratory Care Interstate Compact Commission made up of member states.
  • Each member state appoints one commissioner; commissioners vote on all commission matters.
  • The Commission can set bylaws, rules, a code of conduct, and policies; manage finances; enter contracts; and oversee enforcement and compliance.

• State participation requirements

  • Minnesota (through its statute) would enact a compact that is not materially different from the model compact.
  • States must participate in a centralized data system and have mechanisms to receive and investigate complaints.
  • States must notify the Commission of adverse actions against licensees or compact privilege holders and comply with Commission rules.
  • States must grant the compact privilege to eligible licensees and require initial criminal background checks.
  • States must require licensees to meet jurisprudence requirements in the remote state and report significant actions to the Commission.

• Compact privilege (how portability works)

  • To exercise the compact privilege, a licensee must:
  • Hold an active home-state license as a respiratory therapist.
  • Hold an active NBRC (National Board for Respiratory Care) credential or equivalent.
  • Have no adverse actions against their license in the previous two years.
  • Notify the Commission when seeking the compact privilege.
  • Pay applicable fees for the privilege (and renewals) and meet the remote state's jurisprudence requirements.
  • Report to the Commission any adverse action in any state within 30 days.
  • Provide the licensee’s domicile address and consent to service of process by mail.
  • The compact privilege remains valid until its home-state license expires or is revoked, as long as the licensee meets all requirements.
  • Practice in a remote state must stay within that state’s scope of practice for respiratory therapists.
  • If a home-state license becomes encumbered, the compact privilege is suspended or terminated in remote states until the issue is resolved and certain time requirements pass.
  • If a licensee’s scope or status becomes restricted in the remote state, they must regain full compliance before continuing the privilege in that state.

• Active military members and spouses

  • Active military members and their spouses designate a home state and can keep that designation during active duty.
  • They should not be charged a Commission compact-privilege fee; remote states may choose to charge reduced or no fee.

• Adverse actions and investigations

  • Each member state can impose adverse actions on licenses issued by that state.
  • A state may rely on significant investigative information from another state, following its own procedures.
  • Alternative programs can be used instead of adverse actions and may remain confidential as required by state law.
  • Remote states may issue subpoenas for hearings and investigations; witness travel and related costs are covered as allowed by law.
  • Joint investigations among member states are allowed, with confidentiality protections for shared information.
  • Actions may not be taken for conduct that was legal in another state at the time it occurred.

• Commission governance and operations

  • The Commission is a joint government entity, not a single-state agency.
  • It can establish and change fiscal rules, bylaws, and policies; maintain records; hire staff; and oversee budgets.
  • There is an executive committee (up to nine members) to manage day-to-day operations and enforce rules between full Commission meetings.
  • Meetings must be open to the public unless legally allowed to be closed; advance notice and agendas are required.
  • The Commission can assess member states and licensees to fund its work, and annual financial reviews are required.
  • Immunity provisions protect Commission officials and staff from certain suits, while not limiting licensed professionals’ accountability for malpractice under state law.

• Data, records, and confidentiality

  • A centralized data system will hold licensee information and other accountability data.
  • Records and investigative materials shared between states are to be kept confidential unless agreed otherwise.

Significant Changes to Existing Law

• Creates a new, binding multistate framework (the Respiratory Care Interstate Compact) to allow licensed respiratory therapists to practice across member states with a shared set of rules and oversight.
• Establishes a new Commission and an executive committee to oversee multistate regulation, enforcement, and financial affairs.
• Requires Minnesota to enact compact provisions that align with a model compact, join a national data system, and implement uniform processes for background checks, investigations, and disciplinary actions across states.
• Introduces the concept of a “compact privilege” for practicing in remote states and details the conditions, fees, and ongoing requirements for maintaining that privilege.
• Extends protections and processes for active military members and their spouses, including fee considerations.
• Sets up procedures for subpoenas, joint investigations, and cross-state enforcement while preserving each state’s primary licensing authority.

Potential Impacts

• Pros: Greater access to respiratory therapy across state lines; easier relocation and mobility for therapists and their families; potential relief for workforce gaps; clearer, standardized processes for reciprocity and discipline.
• Cons: New costs (fees) and administrative requirements for states and licensees; need to align state laws to the model compact; privacy and data-sharing considerations; reliance on a new interstate governance body.

Relevant Terms - Respiratory Care Interstate Compact - Compact privilege - Home state license - Remote state - Member state - National Board for Respiratory Care (NBRC) - Adverse action - Alternative program - Encumbered license - Jurisprudence requirements - Data system - Commissioner - Respiratory therapy licensing authority - Commission (Respiratory Care Interstate Compact Commission) - Executive committee - Model compact - Criminal background check - Domicile - Subpoenas - Joint investigations - Public meetings / open meeting requirements - Financial assessment and annual financial review - Immunity and indemnification