Bill Summary – FastDemocracy

S-4038.1
                           SUBSTITUTE SENATE BILL 5815
     State of Washington        68th Legislature         2024 Regular Session
     By Senate Health & Long Term Care (originally sponsored by Senators
     Muzzall, Conway, Dhingra, Holy, Padden, Rivers, and Wagoner)
      AN ACT Relating to the physician assistant compact; adding a new
  section to chapter 42.56 RCW; and adding a new chapter to Title 18
  RCW.
  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
     NEW SECTION. Sec. 1. PURPOSE. In order to strengthen access to
 medical services, and in recognition of the advances in the delivery
 of medical services, the participating states of the physician
 assistant licensure compact have allied in common purpose to develop
 a comprehensive process that complements the existing authority of
 state licensing boards to license and discipline physician assistants
 and seeks to enhance the portability of a license to practice as a
 physician assistant while safeguarding the safety of patients. This
 compact allows medical services to be provided by physician
 assistants, via the mutual recognition of the licensee's qualifying
 license by other compact participating states. This compact also
 adopts the prevailing standard for physician assistant licensure and
 affirms that the practice and delivery of medical services by the
 physician assistant occurs where the patient is located at the time
 of the patient encounter, and therefore requires the physician
 assistant to be under the jurisdiction of the state licensing board
 where the patient is located. State licensing boards that participate
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  in this compact retain the jurisdiction to impose adverse action
  against a compact privilege in that state issued to a physician
  assistant through the procedures of this compact. The physician
  assistant licensure compact will alleviate burdens for military
  families by allowing active duty military personnel and their spouses
  to obtain a compact privilege based on having an unrestricted license
  in good standing from a participating state.
     NEW SECTION. Sec. 2. DEFINITIONS. In this compact:
     (1) "Adverse action" means any administrative, civil, equitable,
 or criminal action permitted by a state's laws which 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.
     (2) "Compact privilege" means the authorization granted by a
 remote state to allow a licensee 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.
     (3) "Conviction" means a finding by a court that an individual is
 guilty of a felony or misdemeanor offense through adjudication or
 entry of a plea of guilt or no contest to the charge by the offender.
     (4)   "Criminal  background   check"  means   the  submission   of
 fingerprints or other biometric-based information for a license
 applicant for the purpose of obtaining that applicant's criminal
 history record information, as defined in 28 C.F.R. Sec. 20.3(d),
 from the state's criminal history record repository as defined in 28
 C.F.R. Sec. 20.3(f).
     (5) "Data system" means the repository of information about
 licensees, including but not limited to license status and adverse
 actions, which is created and administered under the terms of this
 compact.
     (6) "Executive committee" means a group of directors and ex
 officio individuals elected or appointed pursuant to section 7(6)(b)
 of this act.
     (7) "Impaired practitioner" means a physician assistant whose
 practice is adversely affected by health-related condition(s) that
 impact their ability to practice.
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     (8) "Investigative information" means information, records, or
 documents received or generated by a licensing board pursuant to an
 investigation.
     (9) "Jurisprudence requirement" means the assessment of an
 individual's knowledge of the laws and rules governing the practice
 of a physician assistant in a state.
     (10) "License" means current authorization by a state, other than
 authorization pursuant to a compact privilege, for a physician
 assistant to provide medical services, which would be unlawful
 without current authorization.
     (11) "Licensee" means an individual who holds a license from a
 state to provide medical services as a physician assistant.
     (12) "Licensing board" means any state entity authorized to
 license and otherwise regulate physician assistants.
     (13) "Medical services" means health care services provided for
 the diagnosis, prevention, treatment, cure or relief of a health
 condition, injury, or disease, as defined by a state's laws and
 regulations.
     (14) "Model compact" means the model for the physician assistant
 licensure compact on file with the council of state governments or
 other entity as designated by the commission.
     (15) "Participating state" means a state that has enacted this
 compact.
     (16) "Physician assistant" means an individual who is licensed as
 a physician assistant in a state. For purposes of this compact, any
 other title or status adopted by a state to replace the term
 "physician assistant" shall be deemed synonymous with "physician
 assistant" and shall confer the same rights and responsibilities to
 the licensee under the provisions of this compact at the time of its
 enactment.
     (17) "Physician assistant licensure compact commission," "compact
 commission," or "commission" mean the national administrative body
 created pursuant to section 7(1) of this act.
     (18) "Qualifying license" means an unrestricted license issued by
 a participating state to provide medical services as a physician
 assistant.
     (19) "Remote state" means a participating state where a licensee
 who is not licensed as a physician assistant is exercising or seeking
 to exercise the compact privilege.
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     (20) "Rule" means a regulation promulgated by an entity that has
 the force and effect of law.
     (21) "Significant investigative information" means investigative
 information that a licensing board, after an inquiry or investigation
 that includes notification and an opportunity for the physician
 assistant to respond if required by state law, has reason to believe
 is not groundless and, if proven true, would indicate more than a
 minor infraction.
     (22) "State" means any state, commonwealth, district, or
 territory of the United States.
     NEW SECTION.   Sec. 3.   STATE PARTICIPATION IN THIS COMPACT. (1)
 To participate in this compact, a participating state shall:
     (a) License physician assistants;
     (b) Participate in the compact commission's data system;
     (c) Have a mechanism in place for receiving and investigating
 complaints against licensees and license applicants;
     (d) Notify the commission, in compliance with the terms of this
 compact and commission rules, of any adverse action against a
 licensee or license applicant and the existence of significant
 investigative information regarding a licensee or license applicant;
     (e) Fully implement a criminal background check requirement,
 within a time frame established by commission rule, by its licensing
 board receiving the results of a criminal background check and
 reporting to the commission whether the license applicant has been
 granted a license;
     (f) Comply with the rules of the compact commission;
     (g) Utilize passage of a recognized national exam such as the
 national commission on certification of physician assistants'
 physician assistant national certifying examination as a requirement
 for physician assistant licensure; and
     (h) Grant the compact privilege to a holder of a qualifying
 license in a participating state.
     (2) Nothing in this compact prohibits a participating state from
 charging a fee for granting the compact privilege.
     NEW SECTION.   Sec. 4.    COMPACT PRIVILEGE. (1) To exercise the
 compact privilege, a licensee must:
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     (a) 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;
     (b) Hold current national commission on certification of
 physician assistants' certification;
     (c) Have no felony or misdemeanor conviction;
     (d) Have never had a controlled substance license, permit, or
 registration suspended or revoked by a state or by the United States
 drug enforcement administration;
     (e) Have a unique identifier as determined by commission rule;
     (f) Hold a qualifying license;
     (g) Have had no revocation of a license or limitation or
 restriction on any license currently held due to an adverse action;
     (i) 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;
     (ii) 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 a compact
 privilege, that participating state shall have the discretion not to
 consider such action as an adverse action requiring the denial or
 removal of a compact privilege in that state;
     (h) Notify the compact commission that the licensee is seeking
 the compact privilege in a remote state;
     (i) 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;
 and
     (j) Report to the commission any adverse action taken by a
 nonparticipating state within 30 days after the action is taken.
     (2) The compact privilege is valid until the expiration or
 revocation of the qualifying license unless terminated pursuant to an
 adverse action. The licensee must also comply with all of the
 requirements of subsection (1) of this section to maintain the
 compact privilege in a remote state. If the participating state takes
 adverse action against a qualifying license, the licensee shall lose
 the compact privilege in any remote state in which the licensee has a
 compact privilege until all of the following occur:
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     (a) The license is no longer limited or restricted; and
     (b) Two years have elapsed from the date on which the license is
 no longer limited or restricted due to the adverse action.
     (3) Once a restricted or limited license satisfies the
 requirements of subsection (2)(a) and (b) of this section, the
 licensee must meet the requirements of subsection (1) of this section
 to obtain a compact privilege in any remote state.
     (4) For each remote state in which a physician assistant seeks
 authority to prescribe controlled substances, the physician assistant
 shall satisfy all requirements imposed by such state in granting or
 renewing such authority.
     NEW SECTION.   Sec. 5.    DESIGNATION OF THE STATE FROM WHICH
 LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE. Upon a licensee's
 application for a compact privilege, the licensee shall identify to
 the commission the participating state from which the licensee is
 applying, in accordance with applicable rules adopted by the
 commission, and subject to the following requirements:
     (1) When applying for a compact privilege, the licensee shall
 provide the commission with the address of the licensee's primary
 residence and thereafter shall immediately report to the commission
 any change in the address of the licensee's primary residence.
     (2) When applying for a compact privilege, the licensee is
 required to consent to accept service of process by mail at the
 licensee's primary residence on file with the commission with respect
 to any action brought against the licensee by the commission or a
 participating state, including a subpoena, with respect to any action
 brought   or  investigation   conducted  by   the   commission or   a
 participating state.
     NEW SECTION. Sec. 6. ADVERSE ACTIONS. (1) A participating state
 in which a licensee is licensed shall have exclusive power to impose
 adverse action against the qualifying license issued by that
 participating state.
     (2)(a) In addition to the other powers conferred by state law, a
 remote state shall have the authority, in accordance with existing
 state due process law, to do all of the following:
     (i) Take adverse action against a physician assistant's compact
 privilege within that state to remove a licensee's compact privilege
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 or take other action necessary under applicable law to protect the
 health and safety of its citizens;
     (ii) Issue subpoenas for both hearings and investigations that
 require the attendance and testimony of witnesses as well as the
 production of evidence. Subpoenas issued by a licensing board in a
 participating state for the attendance and testimony of witnesses or
 the production of evidence from another participating state shall be
 enforced in the latter state by any court of competent jurisdiction,
 according to the practice and procedure of that court applicable to
 subpoenas issued in proceedings pending before it. The issuing
 authority shall pay any witness fees, travel expenses, mileage, and
 other fees required by the service statutes of the state in which the
 witnesses or evidence are located.
     (b) Notwithstanding (a)(ii) of this subsection, subpoenas may not
 be issued by a participating state to gather evidence of conduct in
 another state that is lawful in that other state for the purpose of
 taking adverse action against a licensee's compact privilege or
 application for a compact privilege in that participating state.
     (c) Nothing in this compact authorizes a participating state to
 impose discipline against a physician assistant's compact privilege
 or to deny an application for a compact privilege in that
 participating state for the individual's otherwise lawful practice in
 another state.
     (3) For purposes of taking adverse action, the participating
 state which issued the qualifying license shall give the same
 priority and effect to reported conduct received from any other
 participating state as it would if the conduct had occurred within
 the participating state which issued the qualifying license. In so
 doing, that participating state shall apply its own state laws to
 determine appropriate action.
     (4) A participating state, if otherwise permitted by state law,
 may recover from the affected physician assistant the costs of
 investigations and disposition of cases resulting from any adverse
 action taken against that physician assistant.
     (5) A participating state may take adverse action based on the
 factual findings of a remote state, provided that the participating
 state follows its own procedures for taking the adverse action.
     (6) Joint investigations.
     (a) In addition to the authority granted to a participating state
 by its respective state physician assistant laws and regulations or
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 other applicable state law, any participating state may participate
 with other participating states in joint investigations of licensees.
     (b)   Participating   states  shall   share    any  investigative,
 litigation, or compliance materials in furtherance of any joint or
 individual investigation initiated under this compact.
     (7) If an adverse action is taken against a physician assistant's
 qualifying license, the physician assistant's compact privilege in
 all remote states shall be deactivated until two years have elapsed
 after all restrictions have been removed from the state license. All
 disciplinary orders by the participating state which issued the
 qualifying license that impose adverse action against a physician
 assistant's license shall include a statement that the physician
 assistant's compact privilege is deactivated in all participating
 states during the pendency of the order.
     (8) If any participating state takes adverse action, it promptly
 shall notify the administrator of the data system.
     NEW SECTION.   Sec. 7.   ESTABLISHMENT OF THE PHYSICIAN ASSISTANT
 LICENSURE COMPACT COMMISSION. (1) The participa