OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 28 Final Analysis
135th General Assembly
Click here for S.B. 28’s Fiscal Note
Primary Sponsor: Sen. Roegner
Effective Date: October 24, 2024
Effective date:
Meredith Bray, Attorney
SUMMARY
▪ Enters Ohio into the Physician Assistant Licensure Compact to enhance the portability of
physician assistant licenses through a comprehensive process that complements the
existing authority of the State Medical Board to license and discipline Ohio-licensed
physician assistants.
▪ As a member of the Compact, requires Ohio to extend the privilege to practice to a
physician assistant who is licensed in another state participating in the Compact, subject
to Ohio’s laws and rules governing physician assistants.
▪ Requires Ohio to submit data regarding physician assistant licensees to the Physician
Assistant Licensure Compact Commission’s data system, including information related to
identification, examination, licensure, investigations, and adverse action.
▪ Revises the law governing the practice and certification of medication aides.
▪ Removes a restriction that obtaining a limited license to practice veterinary medicine is
only available to nonresidents.
DETAILED ANALYSIS
Physician Assistant Licensure Compact
The act enters Ohio as a party to the Physician Assistant Licensure Compact. The Compact
is an agreement among participating states to allow physician assistants to provide medical
services by mutual recognition of the licensee’s qualifying license – which is an unrestricted
license to practice as a physician assistant by a participating state – by other participating states.
The Compact requires physician assistants that are providing medical services to a patient to be
under the jurisdiction of the state licensing board where the patient is located. State licensing
August 5, 2024
Office of Research and Drafting LSC Legislative Budget Office
boards that participate in the Compact retain jurisdiction to impose adverse action against a
physician assistant that has compact privilege in the state that issued the privilege.1
Each state’s enacting statute cannot be materially different from the Model Compact. The
Compact became active in April 2024 when seven states enacted it into law; it is anticipated to
be fully operational by April 2026.2 The Compact has been enacted in 12 other states, Colorado,
Delaware, Maine, Minnesota, Nebraska, Oklahoma, Tennessee, Utah, Virginia, Washington, West
Virginia, and Wisconsin.3
State participation in the Compact
To participate in the Compact, a state must:4
1. License physician assistants;
2. Participate in the Physician Assistant Licensure Compact Commission’s data system (see
“Compact Commission,” and “Data system,” below);
3. Have a mechanism in place for receiving and investigating complaints against licensees
and license applicants;
4. Notify the Commission 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 and report to the Commission
whether a 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 National Commission on
Certification of Physician Assistants (NCCPA) Physician Assistant National Certifying
Examination, as a requirement of physician assistant licensure;
8. Grant compact privilege to a holder of a qualifying license in a participating state.
Compact privilege
Compact privilege is authorization granted by a remote state to allow a physician assistant
from another participating state to practice as a physician assistant to provide medical services
and other licensed activity to a patient located in the remote state under the remote state’s laws
and regulations.5 Compact privilege is valid until the expiration or revocation of the qualifying
1R.C. 4730.70, Section 1 (unless otherwise noted, subsequent “Section” references in this analysis are to
specific sections of the Compact as enacted in R.C. 4730.70).
2 Section 11.A.
3What is the PA licensure compact?, which is also available by selecting “Compact Map” on the PA
Compact website: pacompact.org.
4 Section 3.A.
5 Section 2.B.
P a g e |2 S.B. 28
Final Analysis
Office of Research and Drafting LSC Legislative Budget Office
license, unless terminated pursuant to an adverse action.6 Participating states may charge a fee
for granting compact privilege.7
Requirements to grant privilege
To exercise the compact privilege, a licensee must:8
1. Have graduated from a physician assistant 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 convictions;
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 must 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 compact privilege, that
participating state must have the discretion not to consider the action as an adverse
action requiring the denial or removal of compact privilege;
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 (a jurisprudence requirement is an assessment of an
individual’s knowledge of the laws and rules governing physician assistant practice in a
state);
12. Report to the Commission any adverse action taken by a nonparticipating state within
30 days after the action is taken.
6 Section 4.B.
7 Section 3.B.
8 Section 4.A.
P a g e |3 S.B. 28
Final Analysis
Office of Research and Drafting LSC Legislative Budget Office
Adverse actions
The Compact provides that a participating state in which the physician assistant is licensed
has the exclusive power to impose adverse action against the qualifying license that is issued by
that participating state. Adverse actions are any administrative, civil, equitable, or criminal action
permitted by a state’s laws that is imposed by a licensing board or other authority against a
physician assistant license or license application or compact privilege such as license denial,
censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the
licensee’s practice.9
If a participating state takes adverse action against a qualifying license, the licensee loses
the compact privilege in any remote state in which the licensee has a compact privilege until the
qualifying license is no longer restricted or limited and two years have passed since the date that
the license is no longer limited or restricted from the adverse action.10
The participating state that granted the qualifying license may take adverse action based
on factual findings of a remote state, so long as it follows its own procedures. Joint investigations
between participating states are also permissible.11
Remote states are authorized to take adverse action against a physician assistant’s
compact privilege within that state and to take actions to protect the health and safety of citizens
in accordance with that state’s law. A remote state also may issue subpoenas for hearings and
investigations.12
Prescribing controlled substances
If a physician assistant seeks authority to prescribe controlled substances, the Compact
requires the physician assistant to satisfy all requirements imposed by a remote state in granting
or renewing the authority to prescribe controlled substances for each remote state where the
physician assistant will prescribe controlled substances.13
Compact Commission
The Compact provides for the creation of the Physician Assistant Licensure Compact
Commission, which is an instrumentality of the Compact states acting jointly. 14
Membership
Each participating state is to have one delegate selected by its licensing board.
The delegate must be a current physician assistant, physician, a public member of a licensing
board or physician assistant council or committee, or an administrator of a licensing board. The
9 Sections 6.A. and 2.A.
10 Section 4.B.
11 Section 6.E. and F.
12 Section 6.B.2.
13 Section 4.D.
14 Section 7.A.
P a g e |4 S.B. 28
Final Analysis
Office of Research and Drafting LSC Legislative Budget Office
participating state’s licensing board must fill vacancies in the Commission within 60 days. Each
delegate is entitled to one vote on all matters voted on by the Commission. Any delegate may be
removed or suspended from the Commission as provided by the laws from the state from which
the delegate is appointed.15
Regarding Ohio’s delegate, the act requires the State Medical Board to select the delegate
within 60 days of entering into the Compact. Any future vacancies must be filled within 60 days.16
Powers and duties
The Compact specifies numerous powers and duties of the Commission, some of which
include establishing bylaws, maintaining financial records, promulgating rules, prosecuting legal
proceedings, purchasing and maintaining insurance and bonds, hiring employees and taking
related actions, borrowing money, and performing other functions as necessary and appropriate
to achieve the purposes of the Compact.17
Commission meetings
The Commission must meet at least once per calendar year. Any other meetings will be
held as set forth in the Compact and the bylaws. Commission meetings generally must be open
to the public, and public notice of the meetings generally must be provided 30 days in advance.
Minutes must be kept.18
Closed, nonpublic Commission meetings may occur to receive legal advice or discuss
limited topics, such as participating state noncompliance; employment, compensation, and
discipline of specific employees; litigation; contract negotiation; criminal accusations; and trade
secrets and confidential information. The chair of a closed meeting must certify that the meeting
may be closed and must reference each relevant exempting provision.19
Commission finances
The Commission is required to pay for reasonable expenses of its establishment,
organization, and ongoing activities. It may collect an annual assessment from participating
states. The Commission cannot incur an obligation without first securing funds to meet the
obligation, and cannot pledge the credit of participating states without their authority. The
Commission must keep accurate accounts of receipts and disbursements, which are subject to
audit.20
15 Section 7.B.
16 R.C. 4730.71.
17 Section 7.C.
18 Section 7.B.6. and D.
19 Section 7.D.3.
20 Section 7.E.
P a g e |5 S.B. 28
Final Analysis
Office of Research and Drafting LSC Legislative Budget Office
Executive Committee
The Compact provides that the Executive Committee has the power to act on the
Commission’s behalf. The Executive Committee, which must meet annually, is comprised of the
following nine members:
1. Seven voting members elected by the Commission from its current membership;
2. One ex-officio, nonvoting member from a recognized national physician assistant
professional association;
3. One ex-officio, nonvoting member from a recognized national physician assistant
certification organization.
Duties and responsibilities of the Executive Committee include:
▪ Recommending changes to rules, bylaws, Compact legislation, and fees paid by
participating states and licensees;
▪ Ensuring Compact administration services are appropriately provided;
▪ Preparing and recommending the budget;
▪ Maintaining financial records;
▪ Monitoring Compact compliance of participating states and providing compliance
reports;
▪ Establishing additional committees;
▪ Any other duties provided in the Commission rules or bylaws.21
Qualified immunity, defense, and indemnification
The Compact provides that the members, officers, executive director, employees, and
representatives of the Commission are immune from suit and liability for damages caused by or
arising out of acts or omissions occurring within the scope of Commission employment, duties,
or responsibilities, so long as the loss is not caused by intentional or willful or wanton misconduct.
The Commission must defend individuals entitled to the immunity, but individuals also may retain
their own counsel at their own expense.
The Commission must indemnify and hold harmless any member, officer, executive
director, employee, or representative of the Commission for a settlement or judgment obtained
against the individual arising out of acts or omissions occurring within the scope of Commission
employment, duties, or responsibilities, except in the case of intentional or willful or wanton
misconduct.22
21 Section 7.F.
22 Section 7.G.
P a g e |6 S.B. 28
Final Analysis
Office of Research and Drafting LSC Legislative Budget Office
Data system
The Commission must develop and operate a coordinated database and reporting system
containing licensure, adverse action, and investigative information reporting on all individuals
licensed by participating states. Each member state must submit a uniform data set to the data
system for each licensee, including:
1. Identifying information;
2. Licensure data;
3. Adverse actions;
4. License application denial information;
5. Significant investigative information;
6. Other information as specified in Commission rules.
The Commission must promptly notify all participating states of adverse action against a
licensee or license applicant. Adverse action information and investigative information is
available to other participating states. Participating states may designate information provided
to the data system as not to be shared with the public.23
Rulemaking
The Commission has the power to adopt rules pursuant to the criteria and process set
forth in the Compact, including requirements related to public notice, comments, and hearings.
Emergency rules may be adopted in limited circumstances. If a majority of state legislatures of
participating states reject a rule by enacting a statute or resolution within four years after the
rule was adopted, the rule has no further force or effect.
Regarding Commission rules that establish medical services a physician assistant may
perform in a participating state, if a court of competent jurisdiction finds a conflict with the laws
of a participating state regarding those services, the Commission rules are ineffective in that
state, to the extent of the conflict.24
Commission oversight, dispute resolution, and enforcement
The Compact provides that the executive and judicial branches of government for each
state must enforce the Compact and take necessary actions to implement it.
If the Commission determines that a participating state has defaulted under the Com