House File 2296 - Introduced HOUSE FILE 2296 BY KOESTER A BILL FOR An Act establishing a physical therapy licensure compact. 1 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 2 TLSB 5668YH (8) 87 ss/rh

H.F. 2296 Section 1. NEW SECTION . 147C.1 Form of compact. 1 1. Article I —— Purpose. 2 a. The purpose of this compact is to facilitate interstate 3 practice of physical therapy with the goal of improving public 4 access to physical therapy services. The practice of physical 5 therapy occurs in the state where the patient is located at 6 the time of the patient encounter. The compact preserves the 7 regulatory authority of states to protect public health and 8 safety through the current system of state licensure. 9 b. This compact is designed to achieve all of the following 10 objectives: 11 (1) Increase public access to physical therapy services 12 by providing for the mutual recognition of other member state 13 licenses. 14 (2) Enhance the states’ ability to protect the public’s 15 health and safety. 16 (3) Encourage the cooperation of member states in 17 regulating multistate physical therapy practice. 18 (4) Support spouses of relocating military members. 19 (5) Enhance the exchange of licensure, investigative, and 20 disciplinary information between member states. 21 (6) Allow a remote state to hold a provider of services with 22 a compact privilege in that state accountable to that state’s 23 practice standards. 24 2. Article II —— Definitions. 25 a. “Active duty military” means full-time duty status in 26 the active uniformed service of the United States, including 27 members of the national guard and reserve on active duty orders 28 pursuant to 10 U.S.C. §1209 and 10 U.S.C §1211. 29 b. “Adverse action” means disciplinary action taken by 30 a physical therapy licensing board based upon misconduct, 31 unacceptable performance, or a combination of both. 32 c. “Alternative program” means a nondisciplinary monitoring 33 or practice remediation process approved by a physical therapy 34 licensing board. This includes but is not limited to substance 35 -1- LSB 5668YH (8) 87 ss/rh 1/ 25

H.F. 2296 abuse issues. 1 d. “Compact privilege” means the authorization granted by 2 a remote state to allow a licensee from another member state 3 to practice as a physical therapist or work as a physical 4 therapist assistant in the remote state under its laws and 5 rules. The practice of physical therapy occurs in the member 6 state where the patient is located at the time of the patient 7 encounter. 8 e. “Continuing competence” means a requirement, as 9 a condition of license renewal, to provide evidence of 10 participation in, and completion of, educational and 11 professional activities relevant to practice or area of work. 12 f. “Data system” means a repository of information about 13 licensees, including examination, licensure, investigative, 14 compact privilege, and adverse action. 15 g. “Encumbered license” means a license that a physical 16 therapy licensing board has limited in any way. 17 h. “Executive board” means a group of directors elected or 18 appointed to act on behalf of, and within the powers granted to 19 them by, the commission. 20 i. “Home state” means the member state that is the 21 licensee’s primary state of residence. 22 j. “Investigative information” means information, records, 23 and documents received or generated by a physical therapy 24 licensing board pursuant to an investigation. 25 k. “Jurisprudence requirement” means the assessment of an 26 individual’s knowledge of the laws and rules governing the 27 practice of physical therapy in a state. 28 l. “Licensee” means an individual who currently holds 29 an authorization from the state to practice as a physical 30 therapist or to work as a physical therapist assistant. 31 m. “Member state” means a state that has enacted the 32 compact. 33 n. “Party state” means any member state in which a licensee 34 holds a current license or compact privilege or is applying for 35 -2- LSB 5668YH (8) 87 ss/rh 2/ 25

H.F. 2296 a license or compact privilege. 1 o. “Physical therapist” means an individual who is licensed 2 by a state to practice physical therapy. 3 p. “Physical therapist assistant” means an individual who is 4 licensed by a state and who assists the physical therapist in 5 selected components of physical therapy. 6 q. “Physical therapy” , “physical therapy practice” , and 7 “the practice of physical therapy” mean the care and services 8 provided by or under the direction and supervision of a 9 licensed physical therapist. 10 r. “Physical therapy compact commission” or “commission” 11 means the national administrative body whose membership 12 consists of all states that have enacted the compact. 13 s. “Physical therapy licensing board” or “licensing board” 14 means the agency of a state that is responsible for the 15 licensing and regulation of physical therapists and physical 16 therapist assistants. 17 t. “Remote state” means a member state other than the home 18 state, where a licensee is exercising or seeking to exercise 19 the compact privilege. 20 u. “Rule” means a regulation, principle, or directive 21 promulgated by the commission that has the force of law. 22 v. “State” means any state, commonwealth, district, or 23 territory of the United States that regulates the practice of 24 physical therapy. 25 3. Article III —— State participation in the compact. 26 a. To participate in the compact, a state must meet all of 27 the following requirements: 28 (1) Participate fully in the commission’s data system, 29 including using the commission’s unique identifier as defined 30 in rules. 31 (2) Have a mechanism in place for receiving and 32 investigating complaints about licensees. 33 (3) Notify the commission, in compliance with the terms 34 of the compact and rules, of any adverse action or the 35 -3- LSB 5668YH (8) 87 ss/rh 3/ 25

H.F. 2296 availability of investigative information regarding a licensee. 1 (4) Fully implement a criminal background check 2 requirement, within a time frame established by rule, by 3 receiving the results of the federal bureau of investigation 4 record search on criminal background checks and using the 5 results in making licensure decisions in accordance with 6 article III, paragraph “b” . 7 (5) Comply with the rules of the commission. 8 (6) Utilize a recognized national examination as a 9 requirement for licensure pursuant to the rules of the 10 commission. 11 (7) Have continuing competence requirements as a condition 12 for license renewal. 13 b. Upon adoption of this statute, the member state shall 14 have the authority to obtain biometric-based information from 15 each physical therapy licensure applicant and submit this 16 information to the federal bureau of investigation for a 17 criminal background check in accordance with 28 U.S.C. §534 and 18 42 U.S.C. §14616. 19 c. A member state shall grant the compact privilege to a 20 licensee holding a valid unencumbered license in another member 21 state in accordance with the terms of the compact and rules. 22 d. Member states may charge a fee for granting a compact 23 privilege. 24 4. Article IV —— Compact privilege. 25 a. To exercise the compact privilege under the terms and 26 provisions of the compact, the licensee shall meet all of the 27 following requirements: 28 (1) Hold a license in the home state. 29 (2) Have no encumbrance on any state license. 30 (3) Be eligible for a compact privilege in any member state 31 in accordance with article IV, paragraphs “d” , “g” , and “h” . 32 (4) Have not had any adverse action against any license or 33 compact privilege within the previous two years. 34 (5) Notify the commission that the licensee is seeking the 35 -4- LSB 5668YH (8) 87 ss/rh 4/ 25

H.F. 2296 compact privilege within a remote state. 1 (6) Pay any applicable fees, including any state fee, for 2 the compact privilege. 3 (7) Meet any jurisprudence requirements established by 4 the remote state in which the licensee is seeking a compact 5 privilege. 6 (8) Report to the commission adverse action taken by any 7 nonmember state within thirty days from the date the adverse 8 action is taken. 9 b. The compact privilege is valid until the expiration 10 date of the home license. The licensee must comply with the 11 requirements of article IV, paragraph “a” , to maintain the 12 compact privilege in the remote state. 13 c. A licensee providing physical therapy in a remote state 14 under the compact privilege shall function within the laws and 15 regulations of the remote state. 16 d. A licensee providing physical therapy in a remote state 17 is subject to that state’s regulatory authority. A remote 18 state may, in accordance with due process and that state’s 19 laws, remove a licensee’s compact privilege in the remote state 20 for a specific period of time, impose fines, and take any other 21 necessary actions to protect the health and safety of its 22 citizens. The licensee is not eligible for a compact privilege 23 in any state until the specific time for removal has passed and 24 all fines are paid. 25 e. If a home state license is encumbered, the licensee shall 26 lose the compact privilege in any remote state until all of the 27 following occur: 28 (1) The home state license is no longer encumbered. 29 (2) Two years have elapsed from the date of the adverse 30 action. 31 f. Once an encumbered license in the home state is restored 32 to good standing, the licensee must meet the requirements of 33 article IV, paragraph “a” , to obtain a compact privilege in any 34 remote state. 35 -5- LSB 5668YH (8) 87 ss/rh 5/ 25

H.F. 2296 g. If a licensee’s compact privilege in any remote state is 1 removed, the individual shall lose the compact privilege in any 2 remote state until all of the following occur: 3 (1) The specific period of time for which the compact 4 privilege was removed has ended. 5 (2) All fines have been paid. 6 (3) Two years have elapsed from the date of the adverse 7 action. 8 h. Once the requirements of article IV, paragraph “g” , have 9 been met, the license must meet the requirements in article IV, 10 paragraph “a” , to obtain a compact privilege in a remote state. 11 5. Article V —— Active duty military personnel or their 12 spouses. A licensee who is active duty military or is the 13 spouse of an individual who is active duty military may 14 designate any of the following as the home state: 15 a. Home of record. 16 b. Permanent change of station. 17 c. State of current residence if it is different than the 18 permanent change of station state or home of record. 19 6. Article VI —— Adverse actions. 20 a. A home state shall have exclusive power to impose adverse 21 action against a license issued by the home state. 22 b. A home state may take adverse action based on the 23 investigative information of a remote state, so long as the 24 home state follows its own procedures for imposing adverse 25 action. 26 c. Nothing in this compact shall override a member state’s 27 decision that participation in an alternative program may be 28 used in lieu of adverse action and that such participation 29 shall remain nonpublic if required by the member state’s laws. 30 Member states must require licensees who enter any alternative 31 programs in lieu of discipline to agree not to practice in any 32 other member state during the term of the alternative program 33 without prior authorization from such other member state. 34 d. Any member state may investigate actual or alleged 35 -6- LSB 5668YH (8) 87 ss/rh 6/ 25

H.F. 2296 violations of the statutes and rules authorizing the practice 1 of physical therapy in any other member state in which a 2 physical therapist or physical therapist assistant holds a 3 license or compact privilege. 4 e. A remote state shall have the authority to do all of the 5 following: 6 (1) Take adverse actions as set forth in article IV, 7 paragraph “d” , against a licensee’s compact privilege in the 8 state. 9 (2) Issue subpoenas for both hearings and investigations 10 that require the attendance and testimony of witnesses, and 11 the production of evidence. Subpoenas issued by a physical 12 therapy licensing board in a party state for the attendance 13 and testimony of witnesses or the production of evidence from 14 another party state shall be enforced in the latter state by 15 any court of competent jurisdiction, according to the practice 16 and procedure of that court applicable to subpoenas issued in 17 proceedings pending before it. The issuing authority shall 18 pay any witness fees, travel expenses, mileage, and other 19 fees required by the service statutes of the state where the 20 witnesses or evidence are located. 21 (3) If otherwise permitted by state law, recover from the 22 licensee the costs of investigations and disposition of cases 23 resulting from any adverse action taken against that licensee. 24 f. Joint investigations. 25 (1) In addition to the authority granted to a member state 26 by its respective physical therapy practice act or other 27 applicable state law, a member state may participate with other 28 member states in joint investigations of licensees. 29 (2) Member states shall share any investigative, 30 litigation, or compliance materials in furtherance of any joint 31 or individual investigation initiated under the compact. 32 7. Article VII —— Establishment of the physical therapy 33 compact commission. 34 a. The compact member states hereby create and establish 35 -7- LSB 5668YH (8) 87 ss/rh 7/ 25

H.F. 2296 a joint public agency known as the physical therapy compact 1 commission. 2 (1) The commission is an instrumentality of the compact 3 states. 4 (2) Venue is proper and judicial proceedings by or against 5 the commission shall be brought solely and exclusively in a 6 court of competent jurisdiction where the principal office of 7 the commission is located. The commission may waive venue and 8 jurisdictional defenses to the extent it adopts or consents to 9 participate in alternative dispute resolution proceedings. 10 (3) Nothing in this compact shall be construed to be a 11 waiver of sovereign immunity. 12 b. Membership, voting, and meetings. 13 (1) Each member state shall have and be limited to one 14 delegate selected by that member state’s licensing board. 15 (2) The delegate shall be a current member of the licensing 16 board, who is a physical therapist, physical therapist 17 assistant, public member, or the board administrator. 18 (3) Any delegate may be removed or suspended from office 19 as provided by the law of the state from which the delegate is 20 appointed. 21 (4) The member state board shall fill any vacancy occurring 22 in the commission. 23 (5) Each delegate shall be entitled to one vote with regard 24 to the promulgation of rules and creation of bylaws and shall 25 otherwise have an opportunity to participate in the business 26 and affairs of the commission. 27 (6) A delegate shall vote in person or by such other 28 means as provided in the bylaws. The bylaws may provide for 29 delegates’ participation in meetings by telephone or other 30 means of communication. 31 (7) The commission shall meet at least once during each 32 calendar year. Additional meetings shall be held as set forth 33 in the bylaws. 34 c. The commission shall have all of the following powers and 35 -8- LSB 5668YH (8) 87 ss/rh 8/ 25

H.F. 2296 duties: 1 (1) Establish the fiscal year of the commission. 2 (2) Establish bylaws. 3 (3) Maintain its financial records in accordance with the 4 bylaws. 5 (4) Meet and take such actions as are consistent with the 6 provisions of this compact and the bylaws. 7 (5) Promulgate uniform rules to facilitate and coordinate 8 implementation and administration of this compact. The rules 9 shall have the force and effect of law and shall be binding in 10 all member states. 11 (6) Bring and prosecute legal proceedings or actions in 12 the name of the commission, provided that the standing of any 13 state physical therapy licensing board to sue or be sued under 14 applicable law shall not be affected. 15 (7) Purchase and maintain insurance and bonds. 16 (8) Borrow, accept, or contract for services of personnel, 17 including but not limited to employees of a member state. 18 (9) Hire employees, elect or appoint officers, fix 19 compensation, define duties, grant such individuals appropriate 20 authority to carry out the purposes of the compact, and 21 establish the commission’s personnel policies and programs 22 relating to conflicts of interest, qualifications of personnel, 23 and other related personnel matters. 24 (10) Accept any and all appropriate donations and grants 25 of money, equipment, supplies, materials and services, and to 26 receive, utilize, and dispose of the same; provided that at all 27 times the commission shall avoid any appearance of impropriety 28 or conflict of interest. 29 (11) Lease, purchase, accept appropriate gifts or donations 30 of, or otherwise to own, hold, improve, or use, any property, 31 whether real, personal, or mixed; provided that at all times 32 the commission shall avoid any appearance of impropriety. 33 (12) Sell, convey, mortgage, pledge, lease, exchange, 34 abandon, or otherwise dispose of any property real, personal, 35 -9- LSB 5668YH (8) 87 ss/rh 9/ 25

H.F. 2296 or mixed. 1 (13) Establish a budget and make expenditures. 2 (14) Borrow money. 3 (15) Appoint committees, including standing committees 4 comprised of members, state regulators, state legislators or 5 their representatives, and consumer representatives, and such 6 other interested persons as may be designated in this compact 7 and the bylaws. 8 (16) Provide and receive information from, and cooperate 9 with, law enforcement agencies. 10 (17) Establish and elect an executive board. 11 (18) Perform such other functions as may be necessary or 12 appropriate to achieve the purposes of this compact consistent 13 with the state regulation of physical therapy licensure and 14 practice. 15 d. The executive board. 16 (1) The executive board shall have the power to act on 17 behalf of the commission according to the terms of this 18 compact. 19 (2) The executive board shall be comprised of the following 20 nine members: 21 (a) Seven voting members who are elected by the commission 22 from the current membership of the commission. 23 (b) One ex officio, nonvoting member from the recognized 24 national physical therapy professional association. 25 (c) One ex officio, nonvoting member from the recognized 26 membership organization of the physical therapy licensing 27 boards. 28 (3) The ex officio members will be selected by their 29 respective organizations. 30 (4) The commission may remove any member of the executive 31 board as provided in bylaws. 32 (5) The executive board shall meet at least annually. 33 (6) The executive board shall have all of the following 34 duties and responsibilities: 35 -10- LSB 5668YH (8) 87 ss/rh 10/ 25

H.F. 2296 (a) Recommend to the entire commission changes to the rules 1 or bylaws, changes to this compact, fees paid by compact member 2 states such as annual dues, and any commission compact fee 3 charged to licensees for the compact privilege. 4 (b) Ensure compact administration services are 5 appropriately provided, contractual or otherwise. 6 (c) Prepare and recommend the budget. 7 (d) Maintain financial records on behalf of the commission. 8 (e) Monitor compact compliance of member states and provide 9 compliance reports to the commission. 10 (f) Establish additional committees as necessary. 11 (g) Other duties as provided in rules or bylaws. 12 e. Meetings of the commission. 13 (1) All meetings shall be open to the public, and public 14 notice of meetings shall be given in the same manner as 15 required under the rulemaking provisions in article IX. 16 (2) The commission or the executive board or other 17 committees of the commission may convene in a closed, 18 nonpublic meeting if the commission or executive board or other 19 committees of the commission must discuss all of the following: 20 (a) Noncompliance of a member state with its obligations 21 under the compact. 22 (b) The employment, compensation, discipline, or other 23 matters, practices, or procedures related to specific employees 24 or other matters related to the commission’s internal personnel 25 practices and procedures. 26 (c) Current, threatened, or reasonably anticipated 27 litigation. 28 (d) Negotiation of contracts for the purchase, lease, or 29 sale of goods, services, or real estate. 30 (e) Accusing any person of a crime or formally censuring any 31 person. 32 (f) Disclosure of trade secrets or commercial or financial 33 information that is privileged or confidential. 34 (g) Disclosure of information of a personal nature where 35 -11- LSB 5668YH (8) 87 ss/rh 11/ 25

H.F. 2296 disclosure would constitute a clearly unwarranted invasion of 1 personal privacy. 2 (h) Disclosure of investigative records compiled for law 3 enforcement purposes of any of the following. 4 (i) Disclosure of information related to any investigative 5 reports prepared by or on behalf of or for use of the 6 commission or other committee charged with responsibility of 7 investigation or determination of compliance issues pursuant 8 to the compact. 9 (j) Matters specifically exempted from disclosure by 10 federal or member state statute. 11 (3) If a meeting, or portion of a meeting, is closed 12 pursuant to this provision, the commission’s legal counsel or 13 designee shall certify that the meeting may be closed and shall 14 reference each relevant exempting provision. 15 (4) The commission shall keep minutes that fully and clearly 16 describe all matters discussed in a meeting and shall provide 17 a full and accurate summary of actions taken, and the reasons 18 therefor, including a description of the views expressed. All 19 documents considered in connection with an action shall be 20 identified in such minutes. All minutes and documents of a 21 closed meeting shall remain under seal, subject to release 22 by a majority vote of the commission or order of a court of 23 competent jurisdiction. 24 f. Financing of the commission. 25 (1) The commission shall pay, or provide for the payment of, 26 the reasonable expenses of its establishment, organization, and 27 ongoing activities. 28 (2) The commission may accept any and all appropriate 29 revenue sources, donations, and grants of money, equipment, 30 supplies, materials, and services. 31 (3) The commission may levy on and collect an annual 32 assessment from each member state or impose fees on other 33 parties to cover the cost of the operations and activities 34 of the commission and its staff, which must be in a total 35 -12- LSB 5668YH (8) 87 ss/rh 12/ 25

H.F. 2296 amount sufficient to cover its annual budget as approved each 1 year for which revenue is not provided by other sources. The 2 aggregate annual assessment amount shall be allocated based 3 upon a formula to be determined by the commission, which shall 4 promulgate a rule binding upon all member states. 5 (4) The commission shall not incur obligations of any kind 6 prior to securing the funds adequate to meet the same; nor 7 shall the commission pledge the credit of any of the member 8 states, except by and with the authority of the member state. 9 (5) The commission shall keep accurate accounts of all 10 receipts and disbursements. The receipts and disbursements of 11 the commission shall be subject to the audit and accounting 12 procedures established under its bylaws. However, all receipts 13 and disbursements of funds handled by the commission shall be 14 audited yearly by a certified or licensed public accountant, 15 and the report of the audit shall be included in and become 16 part of the annual report of the commission. 17 g. Qualified immunity, defense, and indemnification. 18 (1) The members, officers, executive director, employees, 19 and representatives of the commission shall be immune from suit 20 and liability, either personally or in their official capacity, 21 for any claim for damage to or loss of property or personal 22 injury or other civil liability caused by or arising out of any 23 actual or alleged act, error, or omission that occurred, or 24 that the person against whom the claim is made had a reasonable 25 basis for believing occurred within the scope of commission 26 employment, duties, or responsibilities; provided that nothing 27 in this paragraph “g” shall be construed to protect any such 28 person from suit or liability for any damage, loss, injury, 29 or liability caused by the intentional or willful or wanton 30 misconduct of that person. 31 (2) The commission shall defend any member, officer, 32 executive director, employee, or representative of the 33 commission in any civil action seeking to impose liability 34 arising out of any actual or alleged act, error, or omission 35 -13- LSB 5668YH (8) 87 ss/rh 13/ 25

H.F. 2296 that occurred within the scope of commission employment, 1 duties, or responsibilities, or that the person against 2 whom the claim is made had a reasonable basis for believing 3 occurred within the scope of commission employment, duties, 4 or responsibilities; provided that nothing herein shall be 5 construed to prohibit that person from retaining the person’s 6 own counsel; and provided further, that the actual or alleged 7 act, error, or omission did not result from that person’s 8 intentional, willful, or wanton misconduct. 9 (3) The commission shall indemnify and hold harmless 10 any member, officer, executive director, employee, or 11 representative of the commission for the amount of any 12 settlement or judgment obtained against that person arising 13 out of any actual or alleged act, error, or omission that 14 occurred within the scope of commission employment, duties, 15 or responsibilities, or that such person had a reasonable 16 basis for believing occurred within the scope of commission 17 employment, duties, or responsibilities, provided that the 18 actual or alleged act, error, or omission did not result from 19 the intentional, willful, or wanton misconduct of that person. 20 8. Article VIII —— Data system. 21 a. The commission shall provide for the development, 22 maintenance, and utilization of a coordinated database and 23 reporting system containing licensure, adverse action, and 24 investigative information on all licensed individuals in member 25 states. 26 b. Notwithstanding any other provision of state law to 27 the contrary, a member state shall submit a uniform data set 28 to the data system on all individuals to whom this compact 29 is applicable as required by the rules of the commission, 30 including all of the following: 31 (1) Identifying information. 32 (2) Licensure data. 33 (3) Adverse actions against a license or compact privilege. 34 (4) Nonconfidential information related to alternative 35 -14- LSB 5668YH (8) 87 ss/rh 14/ 25

H.F. 2296 program participation. 1 (5) Any denial of application for licensure, and the reason 2 for such denial. 3 (6) Other information that may facilitate the 4 administration of this compact, as determined by the rules of 5 the commission. 6 c. Investigative information pertaining to a licensee in any 7 member state will only be available to other party states. 8 d. The commission shall promptly notify all member states of 9 any adverse action taken against a licensee or an individual 10 applying for a license. Adverse action information pertaining 11 to a licensee in any member state will be available to any 12 other member state. 13 e. Member states contributing information to the data 14 system may designate information that may not be shared with 15 the public without the express permission of the contributing 16 state. 17 f. Any information submitted to the data system that is 18 subsequently required to be expunged by the laws of the member 19 state contributing the information shall be removed from the 20 data system. 21 9. Article IX —— Rulemaking. 22 a. The commission shall exercise its rulemaking powers 23 pursuant to the criteria set forth in this section and the 24 rules adopted thereunder. Rules and amendments shall become 25 binding as of the date specified in each rule or amendment. 26 b. If a majority of the legislatures of the member states 27 rejects a rule, by enactment of a statute or resolution in the 28 same manner used to adopt the compact within four years of the 29 date of adoption of the rule, then such rule shall have no 30 further force and effect in any member state. 31 c. Rules or amendments to the rules shall be adopted at a 32 regular or special meeting of the commission. 33 d. Prior to promulgation and adoption of a final rule or 34 rules by the commission, and at least thirty days in advance 35 -15- LSB 5668YH (8) 87 ss/rh 15/ 25

H.F. 2296 of the meeting at which the rule will be considered and voted 1 upon, the commission shall file a notice of proposed rulemaking 2 as follows: 3 (1) On the internet site of the commission or other publicly 4 accessible platform. 5 (2) On the internet site of each member state physical 6 therapy licensing board or other publicly accessible platform 7 or the publication in which each state would otherwise publish 8 proposed rules. 9 e. The notice of proposed rulemaking shall include all of 10 the following: 11 (1) The proposed time, date, and location of the meeting in 12 which the rule will be considered and voted upon. 13 (2) The text of the proposed rule or amendment and the 14 reason for the proposed rule. 15 (3) A request for comments on the proposed rule from any 16 interested person. 17 (4) The manner in which interested persons may submit notice 18 to the commission of their intention to attend the public 19 hearing and any written comments. 20 f. Prior to adoption of a proposed rule, the commission 21 shall allow persons to submit written data, facts, opinions, 22 and arguments, which shall be made available to the public. 23 g. The commission shall grant an opportunity for a public 24 hearing before it adopts a rule or amendment if a hearing is 25 requested by any of the following: 26 (1) At least twenty-five persons. 27 (2) A state or federal governmental subdivision or agency. 28 (3) An association having at least twenty-five members. 29 h. If a hearing is held on the proposed rule or amendment, 30 the commission shall publish the place, time, and date of 31 the scheduled public hearing. If the hearing is held via 32 electronic means, the commission shall publish the mechanism 33 for access to the electronic hearing. 34 (1) All persons wishing to be heard at the hearing shall 35 -16- LSB 5668YH (8) 87 ss/rh 16/ 25

H.F. 2296 notify the executive director of the commission or other 1 designated member in writing of their desire to appear and 2 testify at the hearing not less than five business days before 3 the scheduled date of the hearing. 4 (2) Hearings shall be conducted in a manner providing each 5 person who wishes to comment a fair and reasonable opportunity 6 to comment orally or in writing. 7 (3) All hearings will be recorded. A copy of the recording 8 will be made available on request. 9 (4) Nothing in this section shall be construed as requiring 10 a separate hearing on each rule. Rules may be grouped for the 11 convenience of the commission at hearings required by this 12 section. 13 i. Following the scheduled hearing date, or by the close 14 of business on the scheduled hearing date if the hearing was 15 not held, the commission shall consider all written and oral 16 comments received. 17 j. If no written notice of intent to attend the public 18 hearing by interested parties is received, the commission may 19 proceed with promulgation of the proposed rule without a public 20 hearing. 21 k. The commission shall, by majority vote of all members, 22 take final action on the proposed rule and shall determine the 23 effective date of the rule, if any, based on the rulemaking 24 record and the full text of the rule. 25 l. Upon determination that an emergency exists, the 26 commission may consider and adopt an emergency rule without 27 prior notice, opportunity for comment, or hearing, provided 28 that the usual rulemaking procedures provided in the compact 29 and in this section shall be retroactively applied to the rule 30 as soon as reasonably possible, in no event later than ninety 31 days after the effective date of the rule. For the purposes of 32 this provision, an emergency rule is one that must be adopted 33 immediately in order to do any of the following: 34 (1) Meet an imminent threat to public health, safety, or 35 -17- LSB 5668YH (8) 87 ss/rh 17/ 25

H.F. 2296 welfare. 1 (2) Prevent a loss of commission or member state funds. 2 (3) Meet a deadline for the promulgation of an 3 administrative rule that is established by federal law or rule. 4 (4) Protect public health and safety. 5 m. The commission or an authorized committee of the 6 commission may direct revisions to a previously adopted rule 7 or amendment for purposes of correcting typographical errors, 8 errors in format, errors in consistency, or grammatical 9 errors. Public notice of any revisions shall be posted on 10 the internet site of the commission. The revision shall be 11 subject to challenge by any person for a period of thirty days 12 after posting. The revision may be challenged only on grounds 13 that the revision results in a material change to a rule. A 14 challenge shall be made in writing, and delivered to the chair 15 of the commission prior to the end of the notice period. If 16 no challenge is made, the revision will take effect without 17 further action. If the revision is challenged, the revision 18 may not take effect without the approval of the commission. 19 10. Article X —— Oversight, dispute resolution, and 20 enforcement. 21 a. Oversight. 22 (1) The executive, legislative, and judicial branches 23 of state government in each member state shall enforce this 24 compact and take all actions necessary and appropriate to 25 effectuate the compact’s purposes and intent. The provisions 26 of this compact and the rules promulgated hereunder shall have 27 standing as statutory law. 28 (2) All courts shall take judicial notice of the compact 29 and the rules in any judicial or administrative proceeding in a 30 member state pertaining to the subject matter of this compact 31 which may affect the powers, responsibilities, or actions of 32 the commission. 33 (3) The commission shall be entitled to receive service 34 of process in any such proceeding, and shall have standing to 35 -18- LSB 5668YH (8) 87 ss/rh 18/ 25

H.F. 2296 intervene in such a proceeding for all purposes. Failure to 1 provide service of process to the commission shall render a 2 judgment or order void as to the commission, this compact, or 3 promulgated rules. 4 b. Default, technical assistance, and termination. 5 (1) If the commission determines that a member state 6 has defaulted in the performance of its obligations or 7 responsibilities under this compact or the promulgated rules, 8 the commission shall do all of the following: 9 (a) Provide written notice to the defaulting state and other 10 member states of the nature of the default, the proposed means 11 of curing the default, or any other action to be taken by the 12 commission. 13 (b) Provide remedial training and specific technical 14 assistance regarding the default. 15 (2) If a state in default fails to cure the default, the 16 defaulting state may be terminated from the compact upon an 17 affirmative vote of a majority of the member states, and all 18 rights, privileges, and benefits conferred by this compact may 19 be terminated on the effective date of termination. A cure of 20 the default does not relieve the offending state of obligations 21 or liabilities incurred during the period of default. 22 (3) Termination of membership in the compact shall be 23 imposed only after all other means of securing compliance have 24 been exhausted. Notice of intent to suspend or terminate shall 25 be given by the commission to the governor, the majority and 26 minority leaders of the defaulting state’s legislature, and 27 each of the member states. 28 (4) A state that has been terminated is responsible for 29 all assessments, obligations, and liabilities incurred through 30 the effective date of termination, including obligations that 31 extend beyond the effective date of termination. 32 (5) The commission shall not bear any costs related 33 to a state that is found to be in default or that has been 34 terminated from the compact unless agreed upon in writing 35 -19- LSB 5668YH (8) 87 ss/rh 19/ 25

H.F. 2296 between the commission and the defaulting state. 1 (6) The defaulting state may appeal the action of the 2 commission by petitioning the United States district court 3 for the District of Columbia or the federal district where 4 the commission has its principal offices. The prevailing 5 member shall be awarded all costs of such litigation, including 6 reasonable attorney fees. 7 c. Dispute resolution. 8 (1) Upon request by a member state, the commission shall 9 attempt to resolve disputes related to the compact that arise 10 among member states and between member and nonmember states. 11 (2) The commission shall promulgate a rule providing for 12 both mediation and binding dispute resolution for disputes as 13 appropriate. 14 d. Enforcement. 15 (1) The commission, in the reasonable exercise of its 16 discretion, shall enforce the provisions and rules of this 17 compact. 18 (2) By majority vote, the commission may initiate legal 19 action in the United States district court for the District 20 of Columbia or the federal district where the commission has 21 its principal offices against a member state in default to 22 enforce compliance with the provisions of the compact and its 23 promulgated rules and bylaws. The relief sought may include 24 both injunctive relief and damages. In the event judicial 25 enforcement is necessary, the prevailing member shall be 26 awarded all costs of such litigation, including reasonable 27 attorney fees. 28 (3) The remedies herein shall not be the exclusive remedies 29 of the commission. The commission may pursue any other 30 remedies available under federal or state law. 31 11. Article XI —— Date of implementation of the interstate 32 commission for physical therapy practice and associated rules, 33 withdrawal, and amendment. 34 a. The compact shall come into effect on the date on 35 -20- LSB 5668YH (8) 87 ss/rh 20/ 25