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1 H.572
2 Introduced by Representatives Hango of Berkshire, Cina of Burlington,
3 Berbeco of Winooski, Pajala of Londonderry, Andrews of
4 Westford, Andriano of Orwell, Anthony of Barre City, Arrison
5 of Weathersfield, Arsenault of Williston, Austin of Colchester,
6 Bluemle of Burlington, Boyden of Cambridge, Brumsted of
7 Shelburne, Burrows of West Windsor, Buss of Woodstock,
8 Carpenter of Hyde Park, Chapin of East Montpelier, Chesnut-
9 Tangerman of Middletown Springs, Coffey of Guilford, Farlice-
10 Rubio of Barnet, Garofano of Essex, Graning of Jericho,
11 Gregoire of Fairfield, Harrison of Chittenden, Holcombe of
12 Norwich, Howard of Rutland City, Hyman of South Burlington,
13 Labor of Morgan, Leavitt of Grand Isle, Minier of South
14 Burlington, Morgan of Milton, Nugent of South Burlington,
15 Ode of Burlington, Page of Newport City, Parsons of Newbury,
16 Patt of Worcester, Priestley of Bradford, Rice of Dorset,
17 Roberts of Halifax, Sims of Craftsbury, Stone of Burlington,
18 Surprenant of Barnard, Taylor of Milton, Templeman of
19 Brownington, Troiano of Stannard, White of Bethel, and
20 Williams of Granby VT LEG #372398 v.1
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1 Referred to Committee on
2 Date:
3 Subject: Professions and occupations; physician assistant; compact
4 Statement of purpose of bill as introduced: This bill proposes to enact the
5 Physician Assistant Licensure Compact in Vermont.
6 An act relating to enacting the Physician Assistant Licensure Compact
7 It is hereby enacted by the General Assembly of the State of Vermont:
8 Sec. 1. 26 V.S.A. chapter 31 is amended to read:
9 CHAPTER 31. PHYSICIAN ASSISTANTS
10 Subchapter 1. General Provisions
11 ***
12 Subchapter 2. Physician Assistant Licensure Compact
13 § 1747. PHYSICIAN ASSISTANT LICENSURE COMPACT; ADOPTION
14 Vermont hereby enacts and adopts the Physician Assistant Licensure
15 Compact. The form, format, and text of the Compact have been conformed to
16 the conventions of the Vermont Statutes Annotated. It is the intent of the
17 General Assembly that this subchapter be interpreted as substantively the same
18 as the Physician Assistant Licensure Compact that is enacted by other Compact
19 party states.
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1 § 1747a. PURPOSE
2 In order to strengthen access to medical services, and in recognition of the
3 advances in the delivery of medical services, the Participating States of the PA
4 Licensure Compact have allied in common purpose to develop a
5 comprehensive process that complements the existing authority of state
6 licensing boards to license and discipline PAs and seeks to enhance the
7 portability of a license to practice as a PA while safeguarding the safety of
8 patients. This Compact allows medical services to be provided by PAs, via the
9 mutual recognition of the licensee’s qualifying license by other Compact
10 Participating States. This Compact also adopts the prevailing standard for PA
11 licensure and affirms that the practice and delivery of medical services by the
12 PA occurs where the patient is located at the time of the patient encounter, and
13 therefore requires the PA to be under the jurisdiction of the state licensing
14 board where the patient is located. State licensing boards that participate in
15 this Compact retain the jurisdiction to impose adverse action against a
16 Compact Privilege in that State issued to a PA through the procedures of this
17 Compact. The PA Licensure Compact will alleviate burdens for military
18 families by allowing active-duty military personnel and their spouses to obtain
19 a Compact Privilege based on having an unrestricted license in good standing
20 from a Participating State.
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1 § 1747b. DEFINITIONS
2 In this Compact:
3 (1) “Adverse action” means any administrative, civil, equitable, or
4 criminal action permitted by a state’s laws that is imposed by a licensing board
5 or other authority against a PA license or license application or Compact
6 Privilege such as license denial, censure, revocation, suspension, probation,
7 monitoring of the licensee, or restriction on the licensee’s practice.
8 (2) “Compact Privilege” means the authorization granted by a Remote
9 State to allow a licensee from another Participating State to practice as a PA to
10 provide medical services and other licensed activity to a patient located in the
11 Remote State under the Remote State’s laws and regulations.
12 (3) “Conviction” means a finding by a court that an individual is guilty
13 of a felony or misdemeanor offense through adjudication or entry of a plea of
14 guilt or no contest to the charge by the offender.
15 (4) “Criminal background check” means the submission of fingerprints
16 or other biometric-based information for a license applicant for the purpose of
17 obtaining that applicant’s criminal history record information, as defined in 28
18 C.F.R. § 20.3(d), from the state’s criminal history record repository as defined
19 in 28 C.F.R. § 20.3(f).
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1 (5) “Data system” means the repository of information about licensees,
2 including but not limited to license status and adverse actions, that is created
3 and administered under the terms of this Compact.
4 (6) “Executive Committee” means a group of directors and ex-officio
5 individuals elected or appointed pursuant to subdivision 1747g(f)(2) of this
6 subchapter.
7 (7) “Impaired practitioner” means a PA whose practice is adversely
8 affected by one or more health-related conditions that impacts the
9 practitioner’s ability to practice.
10 (8) “Investigative information” means information, records, or
11 documents received or generated by a licensing board pursuant to an
12 investigation.
13 (9) “Jurisprudence requirement” means the assessment of an
14 individual’s knowledge of the laws and rules governing the practice of a PA in
15 a state.
16 (10) “License” means current authorization by a state, other than
17 authorization pursuant to a Compact Privilege, for a PA to provide medical
18 services, which would be unlawful without current authorization.
19 (11) “Licensee” means an individual who holds a license from a state to
20 provide medical services as a PA.
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1 (12) “Licensing board” means any state entity authorized to license and
2 otherwise regulate PAs.
3 (13) “Medical services” means health care services provided for the
4 diagnosis, prevention, treatment, cure, or relief of a health condition, injury, or
5 disease, as defined by a state’s laws and regulations.
6 (14) “Model compact” means the model for the PA Licensure Compact
7 on file with the Council of State Governments or other entity as designated by
8 the Commission.
9 (15) “Participating State” means a state that has enacted this Compact.
10 (16) “PA” means an individual who is licensed as a physician assistant
11 in a state. For purposes of this Compact, any other title or status adopted by a
12 state to replace the term “physician assistant” shall be deemed synonymous
13 with “physician assistant” and shall confer the same rights and responsibilities
14 to the licensee under the provisions of this Compact at the time of its
15 enactment.
16 (17) “PA Licensure Compact Commission,” “Compact Commission,” or
17 “Commission” means the national administrative body created pursuant to
18 subsection 1747g(a) of this subchapter.
19 (18) “Qualifying license” means an unrestricted license issued by a
20 Participating State to provide medical services as a PA.
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1 (19) “Remote State” means a Participating State where a licensee who is
2 not licensed as a PA is exercising or seeking to exercise the Compact Privilege.
3 (20) “Rule” means a regulation promulgated by an entity that has the
4 force and effect of law.
5 (21) “Significant investigative information” means investigative
6 information that a licensing board, after an inquiry or investigation that
7 includes notification and an opportunity for the PA to respond if required by
8 state law, has reason to believe is not groundless and, if proven true, would
9 indicate more than a minor infraction.
10 (22) “State” means any state, commonwealth, district, or territory of the
11 United States.
12 § 1747c. STATE PARTICIPATION IN THIS COMPACT
13 (a) To participate in this Compact, a Participating State shall:
14 (1) license PAs;
15 (2) participate in the Compact Commission’s data system;
16 (3) have a mechanism in place for receiving and investigating
17 complaints against licensees and license applicants;
18 (4) notify the Commission, in compliance with the terms of this
19 Compact and Commission rules, of any adverse action against a licensee or
20 license applicant and the existence of significant investigative information
21 regarding a licensee or license applicant;
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1 (5) fully implement a criminal background check requirement, within a
2 time frame established by Commission rule, by its licensing board receiving
3 the results of a criminal background check and reporting to the Commission
4 whether the license applicant has been granted a license;
5 (6) comply with the rules of the Compact Commission;
6 (7) utilize passage of a recognized national exam such as the NCCPA
7 PANCE as a requirement for PA licensure; and
8 (8) grant the Compact Privilege to a holder of a qualifying license in a
9 Participating State.
10 (b) Nothing in this Compact prohibits a Participating State from charging a
11 fee for granting the Compact Privilege.
12 § 1747d. COMPACT PRIVILEGE
13 (a) To exercise the Compact Privilege, a licensee must:
14 (1) have graduated from a PA program accredited by the Accreditation
15 Review Commission on Education for the Physician Assistant, Inc. or other
16 programs authorized by Commission rule;
17 (2) hold current NCCPA certification;
18 (3) have no felony or misdemeanor conviction;
19 (4) have never had a controlled substance license, permit, or registration
20 suspended or revoked by a state or by the U.S. Drug Enforcement
21 Administration;
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1 (5) have a unique identifier as determined by Commission rule;
2 (6) hold a qualifying license;
3 (7) have had no revocation of a license or limitation or restriction on any
4 license currently held due to an adverse action;
5 (8) if a licensee has had a limitation or restriction on a license or
6 Compact Privilege due to an adverse action, two years must have elapsed from
7 the date on which the license or Compact Privilege is no longer limited or
8 restricted due to the adverse action;
9 (9) if a Compact Privilege has been revoked or is limited or restricted in
10 a Participating State for conduct that would not be a basis for disciplinary
11 action in a Participating State in which the licensee is practicing or applying to
12 practice under a Compact Privilege, that Participating State shall have the
13 discretion not to consider such action as an adverse action requiring the denial
14 or removal of a Compact Privilege in that state;
15 (10) notify the Compact Commission that the licensee is seeking the
16 Compact Privilege in a Remote State;
17 (11) meet any jurisprudence requirement of a Remote State in which the
18 licensee is seeking to practice under the Compact Privilege and pay any fees
19 applicable to satisfying the jurisprudence requirement; and
20 (12) report to the Commission any adverse action taken by a non-
21 Participating State within 30 days after the action is taken.
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1 (b) The Compact Privilege is valid until the expiration or revocation of the
2 qualifying license unless terminated pursuant to an adverse action. The
3 licensee must also comply with all of the requirements of subsection (a) of this
4 section to maintain the Compact Privilege in a Remote State. If the
5 Participating State takes adverse action against a qualifying license, the
6 licensee shall lose the Compact Privilege in any Remote State in which the
7 licensee has a Compact Privilege until all of the following occur:
8 (1) the license is no longer limited or restricted; and
9 (2) two years have elapsed from the date on which the license is no
10 longer limited or restricted due to the adverse action.
11 (c) Once a restricted or limited license satisfies the requirements of
12 subdivisions (b)(1) and (2) of this section, the licensee must meet the
13 requirements of subsection (a) of this section to obtain a Compact Privilege in
14 any Remote State.
15 (d) For each Remote State in which a PA seeks authority to prescribe
16 controlled substances, the PA shall satisfy all requirements imposed by such
17 state in granting or renewing such authority.
18 § 1747e. DESIGNATION OF THE STATE FROM WHICH LICENSEE IS
19 APPLYING FOR A COMPACT PRIVILEGE
20 Upon a licensee’s application for a Compact Privilege, the licensee shall
21 identify to the Commission the Participating State from which the licensee is
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1 applying, in accordance with applicable rules adopted by the Commission, and
2 subject to the following requirements:
3 (1) When applying for a Compact Privilege, the licensee shall provide
4 the Commission with the address of the licensee’s primary residence and
5 thereafter shall immediately report to the Commission any change in the
6 address of the licensee’s primary residence.
7 (2) When applying for a Compact Privilege, the licensee is required to
8 consent to accept service of process by mail at the licensee’s primary residence
9 on file with the Commission with respect to any action brought against the
10 licensee by the Commission or a Participating State, including a subpoena,
11 with respect to any action brought or investigation conducted by the
12 Commission or a Participating State.
13 § 1747f. ADVERSE ACTIONS
14 (a) A Participating State in which a licensee is licensed shall have exclusive
15 power to impose adverse action against the qualifying license issued by that
16 Participating State.
17 (b) In addition to the other powers conferred by state law, a Remote State
18 shall have the authority, in accordance with existing state due process law, to
19 do all of the following:
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1 (1) Take adverse action against a PA’s Compact Privilege within that
2 state to remove a licensee’s Compact Privilege or take other action necessary
3 under applicable law to protect the health and safety of its citizens.
4 (2) I