KentuckyHB 362026 Regular SessionHouseWALLET

AN ACT relating to interstate licensure compacts.

Sponsored By: Steve Bratcher (Republican)

Signed by Governor

Boards And CommissionsCompacts, InterstateHealth And Medical ServicesLicensingPhysicians

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Bill Overview

Analyzed Economic Effects

36 provisions identified: 8 benefits, 6 costs, 22 mixed.

Tougher cross-state discipline for licensees

Under the compacts, any discipline that encumbers your qualifying license shuts off your compact privileges in all member states. You do not regain privileges until the encumbrance is removed and you have two years with no restrictions or fines due. Remote states can investigate and act on your compact privilege and can subpoena witnesses and records across states, but must pay required witness fees and travel. States may rely on significant investigative information from other states and still follow their own procedures. States cannot punish conduct that was legal where it happened, and shared investigation materials must stay confidential unless both states agree.

Dietitian compact: who qualifies and rules

Member states recognize a compact privilege for dietitians who meet the rules. You qualify with a current registration, or by finishing an accredited program, 1,000 supervised hours, and passing the national exam within 5 years. You must keep an unencumbered home‑state license and pay any required fees. Your compact privilege renews on the same schedule as your home license. You only need to meet your home state’s continuing education.

Cross-state discipline and regaining practice rights

Your home or another compact state can use another state's factual findings to take action, after following its own process. If you are disciplined, a state can make you pay investigation and case costs when its law allows. If your home license was encumbered and then restored, you must meet compact rules and reapply before remote privileges return.

Dietitian compact fees and limits

States may charge a fee to grant a compact privilege. A single‑state license does not allow multistate practice under the compact. States keep full control over their single‑state license standards. If you move into or out of a member state, the new state’s own single‑state licensing rules apply.

Discipline can halt multistate practice

If your home‑state license is encumbered, your compact privileges in all member states are revoked. You regain them only after the encumbrance is removed and two clean years have passed. Only your home state can discipline your home license. If you change home states during an investigation, your old state finishes it and the data system alerts the new state about any adverse action.

Changing home state for dietitians

When you switch your home state between member states, you must apply for a new home license, pay any fees, and notify both states. The new state verifies eligibility and runs an FBI fingerprint check and any other required checks before activating your new license. Kentucky does not require a criminal background check just to renew a dietetics license unless another law says so.

Compact fees and annual financial review

The commission may charge licensees a fee to grant or renew a compact privilege. It may also bill member states each year. The commission must keep accurate accounts and include a CPA financial review in its annual report.

Dietitians: compact and fingerprint checks

The law creates the Dietitian Licensure Compact so qualified dietitians can practice across member states while states keep licensure control. Kentucky requires state and FBI fingerprint checks for initial licensure, reinstatement, and for anyone seeking a compact privilege to practice outside Kentucky. The board reviews background results to decide compact‑privilege eligibility and may order checks during active investigations. Member states must share discipline and key investigative information through the compact’s data system. States may also charge a fee to issue or renew a compact privilege.

Respiratory therapists: multistate practice rules

The law creates a compact so licensed respiratory therapists can practice in other member states. To use a compact privilege, you must keep an active home‑state license and an active NBRC credential, have no adverse action in the past two years, notify the commission, meet any remote‑state law, and pay fees. Your compact privilege lasts until your home‑state license expires, unless it is revoked or you face discipline. A remote state can remove your privilege there, and you cannot use it in that state until it is restored. States may also charge their own fees for granting or renewing a compact privilege.

Athletic trainers: interstate practice and discipline

Kentucky enacts the Athletic Trainer Compact so qualified trainers can practice in other member states. To get a privilege, you must pass a criminal background check, hold a compact‑qualifying license, have current BOC certification or the approved education plus BOC exam, and have no encumbrances in the past two years. You may hold privileges in several states, but you can designate only one qualifying license at a time; the privilege lasts until that license expires. Remote states can remove your privilege, fine you, and issue subpoenas for hearings and investigations, and states must treat out‑of‑state conduct like in‑state conduct. You can still apply for a single‑state license, and states may keep alternative, confidential programs instead of public discipline.

Athletic trainers: remote practice rules

When you treat a patient in another member state, you must follow that state’s scope‑of‑practice rules. Remote states can act against your compact privilege and issue subpoenas, and courts in other member states enforce them. The state that issued your qualifying license has sole authority over that license. The issuing authority pays witness and travel fees for subpoenas. The compact applies only if you hold a compact privilege.

Compact commissions: powers, rules, and transparency

The law creates a compact commission and lets it adopt rules that carry the force of law in member states. The commission can set fees, hire staff, keep records, and sue or be sued. It must follow public rulemaking with at least 30 days’ notice and hearings, and may adopt emergency rules with 24 hours’ notice but must finish normal steps within 90 days. Meetings are public with limited closed topics, each state has one voting commissioner, and an executive committee handles daily work. Lawsuits against the commission must be filed where its main office is, and commissioners and staff get legal defense and limited liability for acts within their duties.

Rules for states to join compacts

To join and stay in the compacts, a state must pass model‑matching laws, license and oversee the profession, run complaint and investigation systems, share data, and use FBI background checks and fingerprints. Kentucky’s executive and judicial branches enforce the compact. If a state defaults, the commission sends a cure plan and offers training; if not fixed, the state can be terminated. A terminated state must notify affected licensees at once and honor compact privileges for at least 180 days. New joining states after the charter seven face a commission review, and valid setup actions taken before the commission existed still count unless later rejected.

Shared license database and privacy rules

The commission runs a shared system with license, compact privilege, denials, and adverse action records. States must send a standard set of data and monitor the system for adverse actions. Certified commission records count as business records in hearings. States can mark some data as nonpublic, and expunged records must be removed. This boosts cross‑state oversight and adds privacy protections for cleared records.

Military families: fee relief and stability

Active‑duty service members and spouses can pick and keep one home state where they hold a current license while on active duty. They do not pay the compact commission fee for a compact privilege. A state may also reduce or waive its own compact fee. This helps keep their ability to work across moves.

Guardrails on compact finances in Kentucky

The commission cannot spend money it does not have. It cannot pledge a state’s credit without that state’s permission. It must keep accurate books and get a yearly independent financial review. Kentucky’s general fund is not used for dietitian compact costs. Money must come from KRS 310.041 licensing funds.

How the compact is run and meets

Each member state names one voting commissioner. An executive committee runs daily business and prepares the budget; it includes elected members and a nonvoting dietitian‑credentialing advisor. Meetings are open with 30 days' notice; closed sessions are allowed for legal, personnel, and investigations, and minutes stay sealed unless released. Commission members and staff are immune for official acts except intentional misconduct, and the commission owns organizing intellectual property.

No discipline for acts legal elsewhere

A member state cannot punish a licensee for conduct that was legal where it happened. This protects cross‑state practice under the compacts.

Open meetings and public rulemaking

Commission meetings are open to the public, with narrow exceptions for things like litigation and privacy. The commission must give at least 30 days’ notice and hold a public hearing before adopting rules, then share recordings and comments. It may fix typos and formatting with a 30‑day public challenge window. The commission also gives member states an annual report with a financial review or audit.

Shared license data and quick discipline alerts

The commission runs a shared data system for licenses, denials, and discipline. States must upload required data. When a state takes adverse action, it must notify the system, which alerts other states. Only states can see current investigative data, and expunged records are removed.

When these compacts take effect

The compacts for these professions start when seven states have enacted them. Preparatory actions taken before that date still count unless the commission rejects them. A state that joins later must follow the commission’s existing rules and bylaws on day one. Any amendment takes effect only after every member state enacts it. The commission reviews early states’ laws for major differences. The compacts keep operating even if the number of member states later drops below seven.

Respiratory compact: practice rules and checks

These rules apply only to respiratory therapists who use a compact privilege. You must keep an active home‑state license and meet your home state’s licensing requirements. For an initial compact privilege, states check criminal history using fingerprints or other biometrics. When you practice in another state, you must follow that state’s scope‑of‑practice rules.

Only states can sue the commission

Only member states can enforce the compact against the commission. Private people and companies cannot bring enforcement actions against the commission under the compact.

Athletic trainer compact commission created

The law creates the Athletic Trainer Licensure Compact Commission. Each member state names one voting commissioner within 60 days, and an executive committee manages work between meetings. The commission can make rules, hire staff, and fund its budget with member‑state assessments and licensee fees. Commission members and staff have legal immunity for official acts, and the commission must defend them; buying insurance does not change these protections.

Commission rulemaking and binding state rules

The commission can adopt rules that bind member states after public notice and a recorded hearing. Legislatures may reject a rule within four years. In emergencies, the commission can post temporary rules with 24 hours' notice and then follow normal steps. States that join later must follow existing commission rules, and the commission may interpret the compact broadly and deny or end a state's participation for material constitutional departures.

How compact rules are enforced

State courts and agencies enforce the compact. The commission can be a party in court, and lawsuits follow venue and service rules where the commission is based. The commission must send a cure notice and offer help to any defaulting state; if problems continue, it can vote to end that state’s membership. A defaulting state can appeal in federal court, and the winning side gets costs and attorney fees. States can also ask the commission to mediate disputes, and the commission must set mediation and binding‑resolution rules.

How Kentucky implements compact rules

Kentucky lets its athletic trainer licensing office carry out compact rules. When the commission adopts a rule, the office has 60 days to file it as an emergency and ordinary regulation; failure can start withdrawal steps. If a proposed regulation is deficient or conflicts with the compact, the compact’s dispute and withdrawal procedures apply. A court can void a commission rule that exceeds its power. Kentucky funds compact work from licensing fees, not the General Fund. If a Kentucky law conflicts with the compact, the compact controls, and only member states can enforce the compact against the commission.

How states join, leave, and continue

The compact starts when a seventh state enacts it. The commission checks each joining state's law for material differences from the model. A state can withdraw, but the exit takes effect 180 days after repeal; it must notify licensees and keep recognizing compact privileges for at least 180 days. If a defaulting state does not fix problems, members can vote to end its membership; the state still owes past assessments and must keep recognizing privileges for at least six months after notice. The compact keeps running even if membership falls below seven, and states may make nonconflicting licensure deals with nonmember states.

How the new compacts run

Each compact sets up a commission, a shared data system, and rules that member states must enforce. The commission can fund its work with state assessments and fees on licensees; Kentucky cannot use the General Fund and must use specified licensing funds. For the respiratory compact, Kentucky must file commission rules as emergency and ordinary regulations within 60 days. If a state leaves, withdrawal takes effect after 180 days; the state must give immediate notice and honor current privileges for at least 180 days and keep reporting earlier actions. Compact rules apply to new states when they join, the compact overrides conflicting state laws, allowed agreements are binding, and any amendment must be passed by all member states.

If a state leaves: 180‑day grace

A state that repeals a compact must wait 180 days before the exit takes effect. It must tell licensees right away and keep recognizing compact privileges for at least 180 days after notice. The state must keep reporting any pre‑exit investigations and discipline. After termination, the state still owes assessments and other liabilities from before the exit. The commission is not responsible for that state’s costs unless both agree in writing.

Kentucky process for dietitian compact rules

Kentucky authorizes its dietetics licensing authority to carry out the compact. When the commission adopts a rule, Kentucky has 60 days to file it as an emergency and ordinary regulation under KRS Chapter 13A. If Kentucky fails to adopt a commission rule or fix a deficient rule, compact default or withdrawal steps start. The board must also write rules to run required criminal background checks.

Licensee investigations kept within member states

Current investigative records about a licensee are shared only with other member states. The public and nonmember states cannot see those ongoing investigative details. This increases privacy for licensees but reduces public transparency.

Resolving disputes and using federal courts

If a state asks, the commission must offer mediation and, when needed, binding dispute resolution. For state defaults, the commission must send a cure notice and offer training and technical help. Both the commission and member states can take compact disputes to federal court; the winner gets costs and reasonable attorney fees. Cases involving the commission are usually filed where its main office is, and the commission must be properly served in enforcement or interpretation cases.

Respiratory compact commission and data privacy

The law creates an interstate commission to run the Respiratory Care Compact. The commission can adopt binding rules, manage records, hire staff, and set a budget. Member states must send standard licensure and discipline data into a shared system. States cannot upload federal criminal history records to that system or share FBI record contents with the commission.

Shared discipline data and privacy rules

Member states must quickly report discipline to the compact data system, which alerts all states. States may run joint investigations and share materials, which stay confidential unless both agree to share them. A state can mark some data as non‑public, and expunged records must be removed. Certified commission records are admissible as business records in hearings. Where state law allows, a state may bill a disciplined licensee for investigation and case costs.

Which rules control under these compacts

The compacts set which rules apply when laws clash. If a state law conflicts with the compact, the compact controls. For athletic trainers, if a court finds a conflict, the state’s scope-of-practice limits still apply in that state. Courts can cancel a commission rule that exceeds the compact. A majority of member-state legislatures can also reject a commission rule within four years.

Sponsors & Cosponsors

Sponsor

Steve Bratcher
Republican • House

Cosponsors

Adam Moore
Democrat • House
Aaron Thompson
Republican • House
Beverly Chester-Burton
Democrat • House
Daniel Grossberg
Democrat • House
Kimberly Poore Moser
Republican • House
Vanessa Grossl
Republican • House

Roll Call Votes

All Roll Calls

Yes: 224 • No: 0

House vote • 4/1/2026

passed

Yes: 90 • No: 0

Senate vote • 3/31/2026