Purpose

• The bill would adopt and implement the Respiratory Care Interstate Compact in Minnesota. The goal is to make it easier for respiratory therapists licensed in Minnesota or other member states to practice in other member states, while keeping states’ authority to protect public health and safety.

Key Goals and What the Bill Seeks to Accomplish

• Improve public access to respiratory therapy services by creating a streamlined, multistate pathway for practice.
• Preserve and support each state’s regulatory authority over respiratory therapy licensure.
• Promote cooperation among member states to regulate respiratory therapy and reduce administrative burdens.
• Help relocating active military members and their spouses, and address workforce shortages and mobility of professionals.

Main Provisions and How It Works

• Establishes a multi-state framework (the compact) for respiratory therapists to practice across member states through a “compact privilege.”
• Creates a governing Commission (the Respiratory Care Interstate Compact Commission) made up of representatives from member states to run the compact, make bylaws, set rules, and oversee operations.
• Requires Minnesota and other states to enact a model compact that aligns with the national compact language and participate in a shared data system and complaint/disciplinary processes.
• Sets up a process for background checks and other regulatory steps to permit cross-state practice.

Key Definitions Used in the Compact

• Respiratory therapy / respiratory care: the care and services provided by a licensed respiratory therapist or equivalent title under a supervising respiratory therapist.
• Home state: the licensee’s primary state of residence and licensure.
• Remote state: any member state where the licensee seeks to practice under the compact privilege.
• Compact privilege: the authorization that allows a licensee from one member state to practice in another member state under that state’s laws.
• Licensee: an individual who currently holds authorization to practice respiratory therapy in a state.
• Adverse action: actions a state may take against a license (denial, revocation, suspension, etc.).
• Data system: the commission’s database containing information about licensees.
• Encumbered license: a license limited or restricted by a state licensing authority.
• Jurisprudence requirement: knowledge assessment of a state’s laws governing respiratory therapy.
• Active military member / spouse: service members and their spouses who may benefit from the compact provisions.

Member State Participation and Responsibilities

• Each member state must enact the compact in substantially the same form as the model compact.
• States must license respiratory therapists, participate in the data system, have mechanisms to receive and investigate complaints, notify the commission of adverse actions, and comply with commission rules.
• States must grant the compact privilege to active home-state license holders who meet the requirements and pay applicable fees.
• States must conduct criminal background checks for new licensees as part of initial licensure.

Compact Privilege Details

• To obtain the compact privilege, a licensee must:
  • Hold an active home-state license in good standing.
  • Hold an active credential from the National Board for Respiratory Care (or its successor) suitable for licensure in the remote state.
  • Have had no adverse action against their license in the previous two years.
  • Notify the commission when seeking the compact privilege, and comply with address reporting and service-of-process requirements.
  • Pay any applicable fees (state and commission) for the compact privilege.
  • Meet the remote state’s jurisprudence requirements.
  • Report any adverse action taken by a nonmember state within 30 days.
• The compact privilege remains valid until its expiration or revocation, or as long as the home-state license is valid and other conditions are met.
• Practice in a remote state must occur within that state’s allowed scope of practice for the license type.
• If a remote state removes the licensee’s compact privilege, or if the home-state license becomes encumbered, the licensee may lose the compact privilege in all remote states until conditions are resolved (including a waiting period if the encumbrance is lifted).
• If a home-state license is encumbered, the licensee loses the compact privilege in all remote states until the encumbrance ends and two years pass after clearance.

Active Military Members and Spouses

• Active military members or their spouses must designate a home state where they hold a license in good standing.
• They may retain the home-state designation during active duty.
• They may be exempt from certain fees charged by the commission; remote states may offer reduced or no fees for compact privileges.

Adverse Actions and Investigations

• Each member state retains authority to impose adverse action against licenses issued by that state.
• A state can take adverse action based on significant investigative information, following its own procedures.
• Alternative programs (nondisciplinary remediation) may be used in place of adverse action where allowed by state law and must remain confidential if required.
• Remote states may issue subpoenas for hearings and investigations and enforce them in other states; licensees or witnesses may be compensated via the issuing state’s rules.
• States may share significant investigative information for joint investigations, with strict confidentiality unless all parties agree otherwise.
• A state may not take adverse or disciplinary action for conduct that was legal in another member state at the time it occurred.

Establishment and Governance of the Compact Commission

• The Compact Commission is a joint government agency consisting of all member states that have enacted the compact.
• Each member state has one commissioner (from its respiratory therapy licensing authority) with voting rights.
• The Commission has powers to:
  • Establish and amend fiscal year, bylaws, rules, and policies.
  • Maintain records and financial affairs, and conduct audits.
  • Enter contracts, hire staff, and manage personnel matters.
  • Collect fees from member states and licensees to fund operations.
  • Accept gifts and manage revenue sources, while avoiding conflicts of interest.
  • Initiate legal proceedings in the name of the commission.
• The Commission has an Executive Committee (up to nine members) to manage day-to-day operations, propose rule changes, and oversee compliance and administration between full Commission meetings.
• Meetings of the Commission are generally open to the public, with procedures for emergency or closed sessions when legally permitted.
• The Commission must publish an annual report and provide timely notice of meetings.
• Financing: the Commission can assess member states and licensees to cover operations, but cannot incur obligations without securing funds. Annual financial reviews by a certified public accountant are required.
• Immunity and indemnification: Commission members, officers, and staff have certain protections from liability for acts within the scope of their duties, consistent with state law.

Summary Impact for Minnesota

• Minnesota would join a national framework to enable respiratory therapists licensed in Minnesota to practice in other member states (and vice versa) through a compact privilege.
• The bill creates a centralized governing body (the Commission) and standard processes for licensure, background checks, investigations, and disciplinary actions across states.
• It includes protections for active military members and spouses, confidentiality measures for investigations, and financial oversight and accountability for the new commission.
• Overall, the bill aims to streamline cross-state practice for respiratory therapists, reduce barriers to mobility, and address workforce needs while maintaining state control over licensure and safety.

Relevant Terms - respiratory therapy / respiratory care - compact / Respiratory Care Interstate Compact - home state - remote state - compact privilege - licensee - adverse action - alternative program - data system - jurisprudence requirement - encumbered license - active military member / spouse - National Board for Respiratory Care (NBRC) - credential - background check - subpoenas - joint investigations - executive committee - commission - multistate licensure - model compact - complaint mechanism - public health and safety - compliance and bylaw rules - fiscal year and annual audit