House File 930 - Introduced HOUSE FILE 930 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO HSB 291) A BILL FOR An Act enacting the interstate podiatric medical licensure 1 compact. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2380HV (1) 91 ss/ko

H.F. 930 Section 1. NEW SECTION . 147J.1 Interstate podiatric medical 1 licensure compact. 2 1. Purpose. In order to strengthen access to health care, 3 and in recognition of the advances in the delivery of health 4 care, the member states of the interstate podiatric medical 5 licensure compact have allied in common purpose to develop a 6 comprehensive process that complements the existing licensing 7 and regulatory authority of state podiatric medical boards, 8 provides a streamlined process that allows podiatric physicians 9 to become licensed in multiple states, thereby enhancing the 10 portability of a podiatric medical license and ensuring the 11 safety of patients. The compact creates another pathway for 12 licensure and does not otherwise change a state’s existing 13 podiatric medical practice act. The compact also adopts the 14 prevailing standard for licensure and affirms that the practice 15 of podiatric medicine occurs where the patient is located 16 at the time of the podiatric physician-patient encounter, 17 and therefore, requires the podiatric physician to be under 18 the jurisdiction of the state podiatric medical board where 19 the patient is located. State podiatric medical boards that 20 participate in the compact retain the jurisdiction to impose 21 an adverse action against a license to practice podiatric 22 medicine in that state issued to a podiatric physician through 23 the procedures in the compact. 24 2. Definitions. In this compact: 25 a. “Bylaws” means those bylaws established by the interstate 26 commission pursuant to subsection 11. 27 b. “Commissioner” means the voting representative appointed 28 by each member board pursuant to subsection 11. 29 c. “Conviction” means a finding by a court that 30 an individual is guilty of a criminal offense through 31 adjudication, or entry of a plea of guilt or no contest to the 32 charge by the offender. Evidence of an entry of conviction of 33 a criminal offense by the court shall be considered final for 34 purposes of disciplinary action by a member board. 35 -1- LSB 2380HV (1) 91 ss/ko 1/ 23

H.F. 930 d. “Criminal background check” means that the member board 1 is authorized to obtain a federal bureau of investigations 2 biometric based federal criminal records check information 3 report from the authorized state agency for the exclusive 4 purpose of determining eligibility for certification of 5 qualification that would allow for an expedited license. 6 e. “Expedited license” means a full unrestricted podiatric 7 medical license granted by a member state to an eligible 8 podiatric physician through the process set forth in the 9 compact. 10 f. “Federal criminal records check information” means any 11 information obtained by a member board from the federal bureau 12 of investigation relating to a federal criminal records check 13 performed by a member board under Pub. L. No. 92-544. 14 g. “Interstate commission” means the interstate commission 15 created pursuant to subsection 11. 16 h. “License” means authorization by a member state for a 17 podiatric physician to engage in the practice of podiatric 18 medicine, which would be unlawful without authorization. 19 i. “Member board” means a state agency in a member state 20 that acts in the sovereign interest of the state by protecting 21 the public through licensure, regulation, and education of 22 podiatric physicians as directed by the state government. 23 j. “Member state” means a state which has enacted this 24 compact. 25 k. “Offense” means a felony or gross misdemeanor which 26 is the result of intentional, willful, reckless misconduct 27 and which occurred less than ten years ago, or a misdemeanor 28 related to the practice of podiatry. 29 l. “Podiatric medical practice act” means laws and 30 regulations governing the practice of podiatric medicine within 31 a member state. 32 m. “Podiatric physician” means a person who meets all of the 33 following requirements: 34 (1) Is a graduate of a podiatric medical school accredited 35 -2- LSB 2380HV (1) 91 ss/ko 2/ 23

H.F. 930 by the council of podiatric medical education. 1 (2) Passed parts I, II, and III of the national board of 2 podiatric medical examiners’ or American podiatric medical 3 licensing examination, or their recognized replacement 4 examinations. 5 (3) Successfully complete a podiatric residency program 6 approved by the council on podiatric medical education. 7 (4) Holds a specialty certification from a specialty board 8 recognized by the council on podiatric medical education. 9 (5) Possesses a full and unrestricted license to engage in 10 the practice of podiatric medicine issued by a member board. 11 (6) Has never been convicted, received adjudication, 12 deferred adjudication, community supervision, or deferred 13 disposition for any offense by a court of appropriate 14 jurisdiction. 15 (7) Has never held a license authorizing the practice 16 of podiatric medicine subjected to discipline by a licensing 17 agency in any state, federal, or foreign jurisdiction, 18 excluding any action related to the nonpayment of fees related 19 to a license. 20 (8) Has never had a controlled substance license or permit 21 suspended or revoked by a state or the United States drug 22 enforcement administration or voluntarily surrendered such 23 license after notification of investigation. 24 (9) Is not under active investigation by a licensing agency 25 or law enforcement authority in any state, federal, or foreign 26 jurisdiction. 27 n. “Practice of podiatric medicine” means that clinical 28 prevention, diagnosis, or treatment of human disease, injury, 29 or condition requiring a podiatric physician to obtain and 30 maintain a license in compliance with the podiatric medical 31 practice act of a member state. 32 o. “Rule” means a written statement by the interstate 33 commission promulgated pursuant to subsection 12 of the compact 34 that is of general applicability, implements, interprets, 35 -3- LSB 2380HV (1) 91 ss/ko 3/ 23

H.F. 930 or prescribes a policy or provision of the compact, or an 1 organizational, procedural, or practice requirement of 2 the interstate commission, and has the force and effect of 3 statutory law in a member state, and includes the amendment, 4 repeal, or suspension of an existing rule. 5 p. “State” means any state, commonwealth, district, or 6 territory of the United States. 7 q. “State of principal license” means a member state where 8 a podiatric physician holds a license to practice podiatric 9 medicine and which has been designated by such a podiatric 10 physician for purposes of registration and participation in the 11 compact. 12 3. Eligibility. 13 a. A podiatric physician must meet the eligibility 14 requirements as defined in subsection 2, paragraph “m” , to 15 receive an expedited licensure under the terms and provisions 16 of the compact. 17 b. A podiatric physician who does not meet the requirements 18 of subsection 2, paragraph “m” , may obtain a license to practice 19 podiatric medicine in a member state if the individual complies 20 with all laws and requirements, other than the compact, 21 relating to the issuance of a license to practice podiatric 22 medicine in that state. 23 4. Designation of state of principal license. 24 a. A podiatric physician shall designate a member state as 25 the state of principal license for purposes of registration 26 for expedited licensure through the compact if the podiatric 27 physician possesses a full and unrestricted license to practice 28 podiatric medicine in that state, and the state is any of the 29 following: 30 (1) The state of principal residence for the podiatric 31 physician. 32 (2) The state where at least twenty-five percent of the 33 podiatric physician’s practice of podiatric medicine occurs. 34 (3) The location of the podiatric physician’s employer. 35 -4- LSB 2380HV (1) 91 ss/ko 4/ 23

H.F. 930 (4) If no state qualifies under subparagraph (1), (2), or 1 (3), the state designated as state of residence for purpose of 2 federal income tax. 3 b. A podiatric physician may redesignate a member state as 4 state of principal license at any time, so long as the state 5 meets the requirements of paragraph “a” . 6 c. The interstate commission is authorized to develop rules 7 to facilitate redesignation of another member state as the 8 state of principal license. 9 5. Application and issuance of expedited licensure. 10 a. A podiatric physician seeking licensure through the 11 compact shall file an application for an expedited license 12 with the member board of the state selected by the podiatric 13 physician as the state of principal license. 14 b. Upon receipt of an application for an expedited license, 15 the member board within the state selected as the state 16 of principal license shall evaluate whether the podiatric 17 physician is eligible for expedited licensure and issue a 18 letter of qualification, verifying or denying the podiatric 19 physician’s eligibility to, and in the manner established 20 through rule by, the interstate commission. 21 (1) Static qualifications, which include verification 22 of podiatric medical education, podiatric graduate medical 23 education, results of any podiatric medical licensing 24 examination, and other qualifications as determined by the 25 interstate commission through rule, shall not be subject to 26 additional primary source verification where already primary 27 source verified by the state of principal license. 28 (2) The member board within the state selected as the 29 state of principal license shall, in the course of verifying 30 eligibility, perform a criminal background check of an 31 applicant, including the use of results of fingerprint or other 32 biometric data checks compliant with the requirements of the 33 federal bureau of investigation with the exception of federal 34 employees who have a suitability determination in accordance 35 -5- LSB 2380HV (1) 91 ss/ko 5/ 23

H.F. 930 with 5 C.F.R. §731.202. 1 (a) Communication between a member board and the interstate 2 commission and communication between member boards regarding 3 the verification of eligibility in subsection 3 through the 4 compact shall not include any information received from the 5 federal bureau of investigation relating to a federal criminal 6 records check performed by a member board under Pub. L. No. 7 92-544, including federal criminal records check information. 8 (b) Federal bureau of investigation information obtained 9 by a member board shall not be shared with the interstate 10 commission. 11 (3) Appeal of the determination of eligibility shall be made 12 to the member state where the application was filed and shall 13 be subject to the law of that state. 14 c. Upon receipt by a member board of verification 15 as provided in paragraph “b” of a podiatric physician’s 16 eligibility for an expedited license, the podiatric physician 17 shall complete the registration process established by the 18 interstate commission to receive a license in a member state 19 selected pursuant to paragraph “a” , including the payment of any 20 applicable fees. 21 d. After receiving verification of eligibility under 22 paragraph “b” and any fees under paragraph “c” , a member board 23 shall issue an expedited license to the podiatric physician. 24 This license shall authorize the podiatric physician to 25 practice podiatric medicine in the issuing state consistent 26 with the podiatric medical practice act and all applicable laws 27 and regulations of the issuing member board and member state. 28 e. An expedited license shall be valid for a period 29 consistent with the licensure period in the member state and 30 in the same manner as required for other podiatric physicians 31 holding a full and unrestricted license within the member 32 state. 33 f. An expedited license obtained through the compact 34 shall be terminated if a podiatric physician fails to 35 -6- LSB 2380HV (1) 91 ss/ko 6/ 23

H.F. 930 maintain a license in the state of principal licensure for a 1 nondisciplinary reason, without redesignation of a new state 2 of principal licensure. 3 g. The interstate commission is authorized to develop 4 rules regarding the application process, including payment 5 of any applicable fees, and the reporting of the issuance 6 of an expedited license by a member board to the interstate 7 commission. 8 6. Fees for expedited licensure. 9 a. A member state issuing an expedited license authorizing 10 the practice of podiatric medicine in that state may impose a 11 fee for a license issued or renewed through the compact. 12 b. The interstate commission is authorized to develop rules 13 regarding fees for expedited licenses. 14 7. Renewal and continued participation. 15 a. A podiatric physician seeking to renew an expedited 16 license granted in a member state shall complete a renewal 17 process with the interstate commission if the podiatric 18 physician meets all of the following requirements: 19 (1) Maintains a full and unrestricted license in a state of 20 principal license. 21 (2) Has not been convicted, received adjudication, deferred 22 adjudication, community supervision, or deferred disposition 23 for any offense by a court of appropriate jurisdiction. 24 (3) Has not had a license authorizing the practice of 25 podiatric medicine subject to discipline by a licensing agency 26 in any state, federal, or foreign jurisdiction, or voluntarily 27 surrendered such license in lieu of discipline, excluding any 28 action related to nonpayment of fees related to a license. 29 (4) Has not had a controlled substance license or permit 30 suspended or revoked by a state or the United States drug 31 enforcement administration or voluntarily surrendered such 32 license or permit after notification of investigation. 33 b. Podiatric physicians shall comply with all continuing 34 professional development or continuing medical education 35 -7- LSB 2380HV (1) 91 ss/ko 7/ 23

H.F. 930 requirements for renewal of a license issued by a member state. 1 c. The interstate commission shall collect any renewal fees 2 charged for the renewal of a license and distribute the fees 3 to the applicable member board. 4 d. Upon receipt of any renewal fees collected pursuant 5 to paragraph “c” , a member board shall renew the podiatric 6 physician’s license. 7 e. Podiatric physician information collected by the 8 interstate commission during the renewal process shall be 9 distributed to all member boards. 10 f. The interstate commission is authorized to develop rules 11 to address renewal of licenses obtained through the compact. 12 8. Coordinated information system. 13 a. The interstate commission shall establish a database 14 of all podiatric physicians licensed, or who have applied for 15 licensure, pursuant to subsection 5. 16 b. Notwithstanding any other provision of law to the 17 contrary, member boards shall report to the interstate 18 commission any public action or public complaints against a 19 licensed podiatric physician who has applied or received an 20 expedited license through the compact. 21 c. Member boards shall report disciplinary or investigatory 22 information determined necessary and proper by rule of the 23 interstate commission. 24 d. Member boards may report any nonpublic complaint, 25 disciplinary, or investigatory information not required by 26 paragraph “c” to the interstate commission. 27 e. Member boards shall share complaint or disciplinary 28 information about a podiatric physician upon request of another 29 member board. 30 f. All information provided to the interstate commission or 31 distributed by member boards shall be confidential, filed under 32 seal, and used only for investigatory or disciplinary matters. 33 g. The interstate commission is authorized to develop rules 34 for mandated or discretionary sharing of information by member 35 -8- LSB 2380HV (1) 91 ss/ko 8/ 23

H.F. 930 boards. 1 9. Joint investigations. 2 a. Licensure and disciplinary records of podiatric 3 physicians are deemed investigative. 4 b. In addition to the authority granted to a member board 5 by its respective podiatric medical practice act or other 6 applicable state law, a member board may participate with other 7 member boards in joint investigations of podiatric physicians 8 licensed by the member boards. 9 c. A subpoena issued by a member state as part of a joint 10 investigation shall be enforceable in other member states. 11 d. Member boards may share any investigative, litigation, or 12 compliance materials in furtherance of any joint or individual 13 investigation initiated under the compact. 14 e. Any member state may investigate an actual or alleged 15 violation of the statutes authorizing the practice of podiatric 16 medicine in any other member state in which a podiatric 17 physician holds a license to practice podiatric medicine. 18 10. Disciplinary actions. 19 a. Any conduct for which any disciplinary action is taken by 20 any member board against a podiatric physician licensed through 21 the compact shall be deemed unprofessional conduct which may 22 be subject to discipline by other member boards, in addition 23 to any violation of the podiatric medical practice act or 24 regulations in that state. 25 b. If a license granted to a podiatric physician by a member 26 board in the state of principal license is revoked, surrendered 27 or relinquished in lieu of discipline, or suspended, then all 28 licenses issued to the podiatric physician by member boards 29 shall automatically be placed, without further action necessary 30 by any member board, on the same status. If the member board 31 in the state of principal license subsequently reinstates 32 the podiatric physician’s license, a license issued to the 33 podiatric physician by any other member board shall remain 34 encumbered until that respective member board takes action to 35 -9- LSB 2380HV (1) 91 ss/ko 9/ 23

H.F. 930 reinstate the license in a manner consistent with the podiatric 1 medical practice act of that state. 2 c. If disciplinary action is taken against a podiatric 3 physician by a member board not in a state of principal 4 license, any other member board may deem the action conclusive 5 as to matters of law and fact decided and do any of the 6 following: 7 (1) Impose the same or lesser sanction against the podiatric 8 physician so long as such sanctions are consistent with the 9 podiatric medical practice act of that state. 10 (2) Pursue separate disciplinary action against the 11 podiatric physician under its respective podiatric medical 12 practice act, regardless of the action taken in other member 13 states. 14 d. If a license granted to a podiatric physician by a 15 member board is revoked, surrendered or relinquished in 16 lieu of discipline, or suspended, then any license issued 17 to a podiatric physician by any other member board shall be 18 suspended, automatically and immediately without further action 19 necessary by the other member board for ninety days upon 20 entry of the order by the disciplining board, to permit the 21 member board to investigate the basis for the action under the 22 podiatric medical practice act of that state. 23 e. A member board may terminate the automatic suspension 24 under paragraph “b” or “d” of a license it issued, in a manner 25 consistent with the podiatric medical practice act of that 26 state. 27 11. Interstate podiatric medical licensure compact 28 commission. 29 a. The member states hereby create the interstate podiatric 30 medical licensure compact commission. 31 b. The purpose of the interstate commission is the 32 administration of the interstate podiatric medical licensure 33 compact, which is a discretionary state function. 34 c. The interstate commission shall be a body corporate 35 -10- LSB 2380HV (1) 91 ss/ko 10/ 23

H.F. 930 and joint agency of the member states and shall have all the 1 responsibilities, powers, and duties set forth in the compact, 2 and such additional powers as may be conferred upon it by a 3 subsequent concurrent action of the respective legislatures of 4 the member states in accordance with the terms of the compact. 5 d. The interstate commission shall consist of one voting 6 representative appointed by each member state who shall 7 serve as a commissioner. A commissioner shall be any of the 8 following: 9 (1) A podiatric physician appointed to a member board. 10 (2) An executive director, executive secretary, or similar 11 executive of a member board. 12 (3) A member of the public appointed to a member board. 13 e. The interstate commission shall meet at least once each 14 calendar year. A portion of this meeting shall be a business 15 meeting to address such matters as may properly come before 16 the commission, including the election of officers. The 17 chairperson may call additional meetings and shall call for a 18 meeting upon the request of a majority of the member states. 19 f. The bylaws may provide for meetings of the interstate 20 commission to be conducted, in whole or in part, via 21 teleconference, video conference, or other electronic means by 22 which all participants can hear each other simultaneously and 23 participate effectively. Attendance by such electronic means 24 shall constitute presence in person at the meeting. 25 g. Each commissioner participating at a meeting of the 26 interstate commission is entitled to one vote. A majority of 27 commissioners shall constitute a quorum for the transaction 28 of business, unless a larger quorum is required by the bylaws 29 of the interstate commission. A commissioner shall not 30 delegate a vote to another commissioner. In the absence of its 31 commissioner, a member state may delegate voting authority for 32 a specified meeting to another person from that state who shall 33 meet the requirements of paragraph “d” . 34 h. The interstate commission shall provide public notice 35 -11- LSB 2380HV (1) 91 ss/ko 11/ 23

H.F. 930 of all meetings and all meetings shall be open to the public. 1 The interstate commission may close a meeting, in full or 2 in portion, where it determines by a two-thirds vote of the 3 commissioners present that any open meeting would be likely to 4 do any of the following: 5 (1) Relate solely to the internal personnel practice and 6 procedures of the interstate commission. 7 (2) Discuss matters specifically exempted from disclosure 8 by federal statute. 9 (3) Discuss a trade secret, commercial, or financial 10 information that is privileged or confidential. 11 (4) Involve accusing a person of a crime, or formally 12 censuring a person. 13 (5) Discuss information of a personal nature where 14 disclosure would constitute a clearly unwarranted invasion of 15 personal privacy. 16 (6) Discuss investigative records compiled for law 17 enforcement purposes. 18 (7) Specifically relate to the participation in a civil 19 action or other legal proceeding. 20 i. The interstate commission shall keep minutes which shall 21 fully describe all matters discussed in a meeting and shall 22 provide a full and accurate summary of actions taken, including 23 record of any roll call votes. 24 j. The interstate commission shall make its information 25 and official records, to the extent not otherwise designated 26 in the compact or by its rules, available to the public for 27 inspection. 28 k. The interstate commission shall establish an executive 29 committee, which shall include officers, members, and others as 30 determined by the bylaws. The executive committee shall have 31 the power to act on behalf of the interstate commission with 32 the exception of rulemaking, during periods when the interstate 33 commission is not in session. When acting on behalf of the 34 interstate commission, the executive committee shall oversee 35 -12- LSB 2380HV (1) 91 ss/ko 12/ 23

H.F. 930 the administration of the compact, including enforcement and 1 compliance with the provisions of the compact, its bylaws and 2 rules, and other such duties as necessary. 3 l. The interstate commission shall establish other 4 committees for governance and administration of the compact. 5 12. Powers and duties of the interstate commission. The 6 interstate commission shall have all of the following powers 7 and duties: 8 a. Oversee and maintain the administration of the compact. 9 b. Promulgate rules which shall be binding to the extent and 10 in the manner provided for in the compact. 11 c. Issue, upon the request of a member state or 12 member board, advisory opinions concerning the meeting or 13 interpretation of the compact, its bylaws, rules, and actions. 14 d. Enforce compliance with compact provisions, the rules 15 promulgated by the interstate commission, and the bylaws, using 16 all necessary and proper means, including but not limited to 17 the use of judicial process. 18 e. Establish and appoint committees including but not 19 limited to an executive committee as required by subsection 11, 20 which shall have the power to act on behalf of the interstate 21 commission in carrying out its powers and duties. 22 f. Pay, or provide for the payment of the expenses related 23 to the establishment, organization, and ongoing activities of 24 the interstate commission. 25 g. Establish and maintain one or more offices. 26 h. Borrow, accept, hire, or contract for services of 27 personnel. 28 i. Purchase and maintain insurance and bonds. 29 j. Employ an executive director who shall have the power to 30 employ, select or appoint employees, agents, consultants, and 31 to determine their qualifications, define their duties, and fix 32 their compensation. 33 k. Establish personnel policies and programs relating to 34 conflicts of interest, rates of compensation, and qualification 35 -13- LSB 2380HV (1) 91 ss/ko 13/ 23

H.F. 930 of personnel. 1 l. Accept donations and grants of money, equipment, 2 supplies, materials, and services to receive, utilize, and 3 dispose of it in a manner consistent with the conflict of 4 interest policies established by the interstate commission. 5 m. Lease, purchase, accept contributions or donations of, or 6 otherwise to own, hold, improve, or use, any property, real, 7 personal, or mixed. 8 n. Sell, convey, mortgage, pledge, lease, exchange, abandon, 9 or otherwise dispose of any property, real, personal, or mixed. 10 o. Establish a budget and make expenditures. 11 p. Adopt a seal and bylaws governing the management and 12 operation of the interstate commission. 13 q. Report annually to the legislatures and governors of 14 the member states concerning the activities of the interstate 15 commission during the preceding year. Such reports shall also 16 include reports of financial audits, and financial statements, 17 and any recommendations that may have been adopted by the 18 interstate commission. 19 r. Coordinate education, training, and public awareness 20 regarding the compact, its implementation, and its operation. 21 s. Maintain records in accordance with the bylaws. 22 t. Seek and obtain trademarks, copyrights, and patents. 23 u. Perform such functions as may be necessary or appropriate 24 to achieve the purpose of the compact. 25 13. Finance powers. 26 a. The interstate commission may levy on and collect an 27 annual assessment from each member state to cover the cost of 28 the operations and activities of the interstate commission and 29 its staff. The total assessment must be sufficient to cover 30 the annual budget approved each year for which revenue is not 31 provided by other sources. The aggregate annual assessment 32 amount shall be allocated upon a formula to be determined 33 by the interstate commission, which shall promulgate a rule 34 binding upon all member states. 35 -14- LSB 2380HV (1) 91 ss/ko 14/ 23

H.F. 930 b. The interstate commission shall not incur obligations of 1 any kind prior to securing the funds adequate to meet the same. 2 c. The interstate commission shall not pledge the credit or 3 any of the member states, except by, and with the authority of, 4 the member state. 5 d. The interstate commission shall maintain financial 6 records in accordance with the bylaws, including profit and 7 loss statements and balance sheet reports which shall be 8 included in the annual report of the interstate commission. 9 14. Organization and operation of the interstate commission. 10 a. The interstate commission shall, by a majority of 11 commissioners present and voting, adopt bylaws to govern its 12 conduct as may be necessary or appropriate to carry out the 13 purposes of the compact within twelve months of the first 14 interstate commission meeting. 15 b. The interstate commission shall elect or appoint annually 16 from among its commissioners a chairperson, a vice chairperson, 17 and a treasurer, each of whom shall have such authority and 18 duties as may be specified in the bylaws. The chairperson, 19 or in the chairperson’s absence or disability, the vice 20 chairperson shall preside at all meetings of the interstate 21 commission. 22 c. Officers selected pursuant to paragraph “b” shall serve 23 without remuneration from the interstate commission. 24 d. The officers and employees of the interstate commission 25 shall be immune from suit and liability, either personally 26 or in their official capacity, for a claim for damage to or 27 loss of property or personal injury or other civil liability 28 caused or arising out of, or relating to, an actual or alleged 29 act, error, or omission that occurred, or that such person 30 had a reasonable basis for believing occurred, within the 31 scope of the interstate commission employment, duties, or 32 responsibilities; provided that such person shall not be 33 protected from suit or liability for damage, loss, injury, 34 or liability caused by the intentional or willful and wanton 35 -15- LSB 2380HV (1) 91 ss/ko 15/ 23

H.F. 930 misconduct of such person. 1 e. The liability of the executive director and employees of 2 the interstate commission or representatives of the interstate 3 commission, acting within the scope of such person’s employment 4 or duties for acts, errors, or omissions occurring within such 5 person’s state, may not exceed the limits of liability set 6 forth under the constitution and laws of that state for state 7 officials, employees, and agents. The interstate commission 8 is considered to be an instrumentality of the states for the 9 purpose of such action. Nothing in this paragraph shall be 10 construed to protect such person from suit or liability for 11 damage, loss, injury, or liability caused by the intentional or 12 willful and wanton misconduct of such person. 13 f. The interstate commission shall defend the executive 14 director, its employees, and subject to the approval of 15 the attorney general or other appropriate legal counsel of 16 the member state represented by the interstate commission 17 representative, shall defend such interstate commission 18 representative in any civil action seeking to impose liability 19 arising out of an actual or alleged act, error, or omission 20 that occurred within the scope of interstate commission 21 employment, duties, or responsibilities, or that the defendant 22 had a reasonable basis for believing occurred within the 23 scope of the interstate commission employment, duties, or 24 responsibilities, provided that the actual or alleged act, 25 error, or omission did not result from intentional or willful 26 and wanton misconduct on the part of such person. 27 g. To the extent not covered by the state involved, member 28 state, or the interstate commission, the representatives or 29 employees of the interstate commission shall be held harmless 30 in the amount of a settlement or judgment, including attorney 31 fees and costs, obtained against such persons arising out of an 32 actual or alleged act, error, or omission that occurred within 33 the scope of the interstate commission employment, duties, 34 or responsibilities, or that such persons had a reasonable 35 -16- LSB 2380HV (1) 91 ss/ko 16/ 23

H.F. 930 basis for believing occurred within the scope of interstate 1 commission employment, duties, or responsibilities, provided 2 that the actual or alleged act, error, or omission did not 3 result from intentional or willful and wanton misconduct on the 4 part of such person. 5 15. Rulemaking functions of the interstate commission. 6 a. The interstate commission shall promulgate rules in 7 order to effectively and efficiently achieve the purpose of 8 the compact. Notwithstanding the foregoing, in the event the 9 interstate commission exercises its rulemaking authority in a 10 manner that is beyond the scope of the purposes of the compact, 11 or the powers granted hereunder, then such an action by the 12 interstate commission shall be invalid and have no force or 13 effect. 14 b. Rules deemed appropriate for the operations of the 15 interstate commission shall be made pursuant to the rulemaking 16 process that substantially conforms to the model state 17 administrative procedure Act of 2010, and subsequent amendments 18 thereto. 19 c. Not later than thirty days after a rule is promulgated, 20 any person may file a petition for judicial review of the 21 rule in the United States district court for the District 22 of Columbia or the federal district where the interstate 23 commission has its principal office, provided that the filing 24 of such a petition shall not stay or otherwise prevent the 25 rule from becoming effective unless the court finds that the 26 petitioner has a substantial likelihood of success. The 27 court shall give deference to the actions of the interstate 28 commission consistent with applicable law and shall not find 29 the rule to be unlawful if the rule represents a reasonable 30 exercise of the authority granted to the interstate commission. 31 16. Oversight of interstate compact. 32 a. The executive, legislative, and judicial branches 33 of state government in each member state shall enforce the 34 compact and shall take all actions necessary and appropriate to 35 -17- LSB 2380HV (1) 91 ss/ko 17/ 23

H.F. 930 effectuate the compact’s purposes and intent. The provisions 1 of the compact and the rules promulgated hereunder shall have 2 standing as statutory law but shall not override existing state 3 authority to regulate the practice of podiatric medicine. 4 b. All courts shall take judicial notice of the compact and 5 the rules in any judicial or administrative proceeding in a 6 member state pertaining to the subject matter of the compact 7 which may affect the powers, responsibilities, or actions of 8 the interstate commission. 9 c. The interstate commission shall be entitled to receive 10 all service of process in any such proceeding, and shall have 11 standing to intervene in the proceeding for all purposes. 12 Failure to provide service of process to the interstate 13 commission shall render judgment or order void as to the 14 interstate commission, the compact, or promulgated rules. 15 17. Enforcement of interstate compact. 16 a. The interstate commission, in the reasonable exercise of 17 its discretion, shall enforce the provisions and rules of the 18 compact. 19 b. The interstate commission may, by majority vote of 20 the commissioners present and voting, initiate legal action 21 in the United States district court for the District of 22 Columbia, or, at the discretion of the interstate commission, 23 in federal district court where the interstate commission has 24 its principal office, to enforce compliance with the provisions 25 of the compact, and its promulgated rules and bylaws, against 26 a member state in default. The relief sought may include 27 both injunctive relief and damages. In the event judicial 28 enforcement is necessary, the prevailing party shall be awarded 29 all costs of such litigation including reasonable attorney 30 fees. 31 c. The remedies herein shall not be the exclusive remedies 32 of the interstate commission. The interstate commission may 33 avail itself of any other remedies available under state law 34 or regulation of a profession. 35 -18- LSB 2380HV (1) 91 ss/ko 18/ 23

H.F. 930 18. Default procedures. 1 a. The grounds for default include but are not limited 2 to failure of a member board to perform such obligations or 3 responsibilities imposed upon it by the compact, or the rules 4 and bylaws of the interstate commission promulgated under the 5 compact. 6 b. If the interstate commission determines that a member 7 state has defaulted in the performance of its obligations 8 or responsibilities under the compact, or the bylaws or 9 promulgated rules, the interstate commission shall do all of 10 the following: 11 (1) Provide written notice to the defaulting state and 12 other member states, of the nature of the default, the means 13 of curing the default, and any action taken by the interstate 14 commission. The interstate commission shall specify the 15 conditions by which the defaulting state must cure its default. 16 (2) Provide remedial training and specific technical 17 assistance regarding the default. 18 c. If the defaulting state fails to cure the default, 19 the defaulting state shall be terminated from the compact 20 upon an affirmative vote of the majority of the commissioners 21 present and voting, and all rights, privileges, and benefits 22 conferred by the compact shall terminate on the effective date 23 of termination. A cure of the default does not relieve the 24 offending state of obligations or liabilities incurred during 25 the period of default. 26 d. Termination of membership in the compact shall be imposed 27 only after all other means of securing compliance have been 28 exhausted. Notice of intent to terminate shall be given by 29 the interstate commission to the governor, the majority and 30 minority leaders of the defaulting state’s legislature, and 31 each of the member states. 32 e. The interstate commission shall establish rules and 33 procedures to address licenses and podiatric physicians that 34 are materially impacted by the termination of a member state, 35 -19- LSB 2380HV (1) 91 ss/ko 19/ 23

H.F. 930 or the withdrawal of a member state. 1 f. The member state which has been terminated is responsible 2 for all dues, obligations, and liabilities incurred through 3 the effective date of termination including obligations, the 4 performance of which extends beyond the effective date of 5 termination. 6 g. The interstate commission shall not bear any costs 7 relating to any state that has been found to be in default or 8 which has been terminated from the compact, unless otherwise 9 mutually agreed upon in writing between the interstate 10 commission and the defaulting state. 11 h. The defaulting state may appeal the action of the 12 interstate commission by petitioning the United States district 13 court for the District of Columbia or the federal district 14 court where the interstate commission has its principal office. 15 The prevailing party shall be awarded all costs of litigation 16 including reasonable attorney fees. 17 19. Dispute resolution. 18 a. The interstate commission shall attempt, upon the request 19 of a member state, to resolve disputes which are subject to the 20 compact and which arise among member states or member boards. 21 b. The interstate commission shall promulgate rules 22 providing for both mediation and binding dispute resolution as 23 appropriate. 24 20. Member states, effective date, and amendment. 25 a. Any state is eligible to become a member of the compact. 26 b. The compact shall become effective and binding upon 27 legislative enactment of the compact into law by no less than 28 four states. Thereafter, it shall become effective and binding 29 on a state upon enactment of the compact into law by that 30 state. 31 c. The governors of nonmember states, or their designees, 32 shall be welcome to participate in the activities of the 33 interstate commission on a nonvoting basis prior to adoption 34 of the compact by all states. 35 -20- LSB 2380HV (1) 91 ss/ko 20/ 23