448.66 Malpractice. Except as provided in s. 257.03, a person who practices podiatry without having a license under this subchapter may be liable for malpractice, and his or her ignorance of a duty ordinarily performed by a licensed podiatrist shall not limit his or her liability for an injury arising from his or her practice of podiatry. History: 1997 a. 175; 2005 a. 96; 2009 a. 42.
448.665 Continuing education. The affiliated credentialing board shall promulgate rules establishing requirements and procedures for licensees to complete continuing education programs or courses of study in order to qualify for renewal of a license granted under this subchapter. The rules shall require a licensee to complete at least 30 hours of continuing education programs or courses of study within each 2-year period immediately preceding the renewal date specified under s. 440.08 (2) (a). The affiliated credentialing board may waive all or part of these re-
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quirements for the completion of continuing education programs or courses of study if the affiliated credentialing board determines that prolonged illness, disability or other exceptional circumstances have prevented a licensee from completing the requirements. History: 1997 a. 175.
448.67 Practice requirements. (1) FEE SPLITTING. No licensee may give or receive, directly or indirectly, to or from any other person any fee, commission, rebate or other form of compensation or anything of value for sending, referring or otherwise inducing a person to communicate with a licensee in a professional capacity, or for any professional services not actually rendered personally by the licensee or at the licensee’s direction. (2) SEPARATE BILLING REQUIRED. Except as provided in sub. (4), a licensee who renders any podiatric service or assistance, or gives any podiatric advice or any similar advice or assistance, to any patient, podiatrist, physician, physician assistant, advanced practice registered nurse, partnership, or corporation, or to any other institution or organization, including a hospital, for which a charge is made to a patient, shall, except as authorized by Title 18 or Title 19 of the federal Social Security Act, render an individual statement or account of the charge directly to the patient, distinct and separate from any statement or account by any other podiatrist, physician, physician assistant, advanced practice registered nurse, or other person. NOTE: Sub. (2) is shown as amended eff. 9-1-26 by 2025 Wis. Act 17. Prior to 9-1-26 it reads: (2) SEPARATE BILLING REQUIRED. Except as provided in sub. (4), a licensee who renders any podiatric service or assistance, or gives any podiatric advice or any similar advice or assistance, to any patient, podiatrist, physician, physician assistant, advanced practice nurse prescriber certified under s. 441.16 (2), partnership, or corporation, or to any other institution or organization, including a hospital, for which a charge is made to a patient, shall, except as authorized by Title 18 or Title 19 of the federal Social Security Act, render an individual statement or account of the charge directly to the patient, distinct and separate from any statement or account by any other podiatrist, physician, physician assistant, advanced practice nurse prescriber, or other person.
(3) BILLING FOR TESTS PERFORMED BY THE STATE LABORATORY OF HYGIENE. A licensee who charges a patient, other person or 3rd-party payer for services performed by the state laboratory of hygiene shall identify the actual amount charged by the state laboratory of hygiene and shall restrict charges for those services to that amount. (4) BILLING BY PROFESSIONAL PARTNERSHIPS AND CORPORATIONS. If 2 or more podiatrists have entered into a bona fide partnership or formed a service corporation for the practice of podiatry, the partnership or corporation may not render a single bill for podiatry services provided in the name of the partnership or corporation unless each individual licensed, registered or certified under this chapter, subch. I of ch. 457, or ch. 446, 449, 450, 455, or 459, who provided services is individually identified on the bill as having rendered those services. History: 1997 a. 175; 2005 a. 187; 2011 a. 161; 2023 a. 55; 2025 a. 17.
448.675 Disciplinary proceedings and actions. (1) INVESTIGATION; HEARING; ACTION. (a) The affiliated credentialing board shall investigate allegations of unprofessional conduct and negligence in treatment by a licensee. Information contained in reports filed with the affiliated credentialing board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under 42 CFR 1001.2005, shall be investigated by the affiliated credentialing board. Information contained in a report filed with the affiliated credentialing board under s. 50.36 (3) (c) may, within the discretion of the affiliated credentialing board, be used as the basis of an investigation of a person named in the report. The affiliated credentialing board may require a licensee to undergo and may consider the results of a physical, mental or professional competency examination if the affiliated credentialing board be-
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lieves that the results of the examination may be useful to the affiliated credentialing board in conducting its investigation. (b) After an investigation, if the affiliated credentialing board finds that there is probable cause to believe that the person is guilty of unprofessional conduct or negligence in treatment, the affiliated credentialing board shall hold a hearing on such conduct. The affiliated credentialing board may require a licensee to undergo and may consider the results of a physical, mental or professional competency examination if the affiliated credentialing board believes that the results of the examination may be useful to the affiliated credentialing board in conducting its hearing. A finding by a court that a podiatrist has acted negligently in treating a patient is conclusive evidence that the podiatrist is guilty of negligence in treatment. A certified copy of the order of a court is presumptive evidence that the finding of negligence in treatment was made. The affiliated credentialing board shall render a decision within 90 days after the date on which the hearing is held or, if subsequent proceedings are conducted under s. 227.46 (2), within 90 days after the date on which those proceedings are completed. (c) After a disciplinary hearing, the affiliated credentialing board may, when it determines that a court has found that a person has been negligent in treating a patient or when it finds a person guilty of unprofessional conduct or negligence in treatment, do one or more of the following: warn or reprimand that person, or limit, suspend or revoke a license granted by the affiliated credentialing board to that person. The affiliated credentialing board may condition the removal of limitations on a license, or the restoration of a suspended or revoked license, upon obtaining minimum results specified by the affiliated credentialing board on a physical, mental or professional competency examination if the affiliated credentialing board believes that obtaining the minimum results is related to correcting one or more of the bases upon which the limitation, suspension or revocation was imposed. (d) A person whose license is limited shall be permitted to continue practice if the person agrees to do all of the following: 1. Refrain from engaging in unprofessional conduct. 2. Appear before the affiliated credentialing board or its officers or agents at such times and places designated by the affiliated credentialing board. 3. Fully disclose to the affiliated credentialing board or its officers or agents the nature of the person’s practice and conduct. 4. Fully comply with the limits placed on his or her practice and conduct by the affiliated credentialing board. 5. Obtain additional training, education or supervision required by the affiliated credentialing board. 6. Cooperate with the affiliated credentialing board. (e) Unless a suspended license is revoked during the period of suspension, upon expiration of the period of suspension the affiliated credentialing board shall reinstate the person’s license, except that the affiliated credentialing board may, as a condition precedent to the reinstatement of the license, require the person to pass the examinations required for the original grant of the license. (f) The affiliated credentialing board shall comply with rules of procedure for the investigation, hearing and action promulgated by the department under s. 440.03 (1). (g) Nothing in this subsection prohibits the affiliated credentialing board, in its discretion, from investigating and conducting disciplinary proceedings on allegations of unprofessional conduct by a licensee when the allegations of unprofessional conduct may also constitute allegations of negligence in treatment. (2) SUSPENSION OR LIMITATION PENDING HEARING. The affiliated credentialing board may summarily suspend or limit a li-
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cense granted by the affiliated credentialing board for a period not to exceed 30 days pending hearing if the affiliated credentialing board has in its possession evidence establishing probable cause to believe that the licensee has violated the provisions of this subchapter and that it is necessary to suspend or limit the license immediately to protect the public health, safety or welfare. The licensee shall be granted an opportunity to be heard during the determination of whether or not probable cause exists. The affiliated credentialing board may designate any of its officers to exercise the authority granted by this subsection to summarily suspend or limit a license, for a period not exceeding 72 hours. If a license has been summarily suspended or limited by the affiliated credentialing board or any of its officers, the affiliated credentialing board may, while the hearing is in progress, extend the initial period of suspension or limitation for not more than an additional 30 days. If the licensee has caused a delay in the hearing process, the affiliated credentialing board may subsequently suspend or limit the license from the time the hearing is commenced until a final decision is issued or may delegate such authority to the hearing examiner. (3) VOLUNTARY SURRENDER. A licensee may voluntarily surrender his or her license to the secretary of the affiliated credentialing board, but the secretary may refuse to accept the surrender if the affiliated credentialing board has received an allegation of unprofessional conduct against the licensee. The affiliated credentialing board may negotiate stipulations in consideration for accepting the surrender of a license. (4) RESTORATION OF LICENSE, CERTIFICATE OR LIMITED PERMIT. The affiliated credentialing board may restore a license which has been voluntarily surrendered or revoked under this subchapter on such terms and conditions as it considers appropriate. History: 1997 a. 175; 2017 a. 328.
448.68 Hospital reports. (1) Within 30 days after receipt of a report under s. 50.36 (3) (c), the affiliated credentialing board shall notify the licensee, in writing, of the substance of the report. The licensee and the licensee’s authorized representative may examine the report and may place into the record a statement, of reasonable length, of the licensee’s view of the correctness or relevance of any information in the report. The licensee may institute an action in circuit court to amend or expunge any part of the licensee’s record related to the report. (2) If the affiliated credentialing board determines that a report submitted under s. 50.36 (3) (c) is without merit or that the licensee has sufficiently improved his or her conduct, the affiliated credentialing board shall remove the report from the licensee’s record. If no report about a licensee is filed under s. 50.36 (3) (c) for 2 consecutive years, the licensee may petition the affiliated credentialing board to remove any prior reports, which did not result in disciplinary action, from his or her record. (3) Upon the request of a hospital, the affiliated credentialing board shall provide the hospital with all information relating to a licensee’s loss, reduction or suspension of staff privileges from other hospitals and all information relating to the licensee’s being found guilty of unprofessional conduct. In this subsection, “hospital” has the meaning specified under s. 50.33 (2). History: 1997 a. 175.
448.685 Injunctive relief. If the affiliated credentialing board has reason to believe that a person is violating this subchapter or a rule promulgated under this subchapter, the affiliated credentialing board, the department, the attorney general or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring an action in the name and on behalf of this state to enjoin the person from the violation. History: 1997 a. 175.
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448.69 Penalties; appeal. (1) PENALTIES. (a) Except as provided in par. (b), a person who violates any provision of this subchapter or a rule promulgated under this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both. (b) A person who violates s. 448.67 (3) may be fined not more than $250. (2) APPEAL. A person aggrieved by an action taken under this subchapter by the affiliated credentialing board, its officers or its agents may apply for judicial review as provided in ch. 227, and shall file notice of such appeal with the secretary of the affiliated credentialing board within 30 days. No court of this state may enter an ex parte stay of an action taken by the affiliated credentialing board under this subchapter. History: 1997 a. 175.
448.695 Rules. (1) The affiliated credentialing board shall promulgate all of the following rules: (a) Rules defining the acts or attempted acts of commission or omission that constitute unprofessional conduct under s. 448.60 (5). (b) Rules implementing s. 448.697. (2) The affiliated credentialing board may promulgate rules to carry out the purposes of this subchapter. (3) The affiliated credentialing board shall promulgate rules specifying the requirements for a course of instruction related to X-ray examinations by persons under the direct supervision of a podiatrist under s. 462.02 (2) (f). In promulgating the rules, the affiliated credentialing board shall consult with the radiography examining board and shall examine laws and rules in other states. The affiliated credentialing board shall approve courses that meet the requirements set forth in the rules. (4) The affiliated credentialing board shall promulgate rules establishing all of the following: (a) Practice standards for a physician assistant practicing podiatry as provided in s. 448.975 (2) (a) 2m. (b) Requirements for a podiatrist who is supervising a physician assistant as provided in s. 448.975 (2) (a) 2m. History: 1997 a. 175; 2009 a. 106; 2013 a. 345; 2017 a. 227; 2021 a. 23.
448.697 Informed consent. Any podiatrist who treats a patient shall inform the patient about the availability of reasonable alternate modes of treatment and about the benefits and risks of these treatments. The reasonable podiatrist standard is the standard for informing a patient under this section. The reasonable podiatrist standard requires disclosure only of information that a reasonable podiatrist would know and disclose under the circumstances. The podiatrist’s duty to inform the patient under this section does not require disclosure of any of the following: (1) Detailed technical information that in all probability a patient would not understand. (2) Risks apparent or known to the patient. (3) Extremely remote possibilities that might falsely or detrimentally alarm the patient. (4) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment. (5) Information in cases where the patient is incapable of consenting. (6) Information about alternate modes of treatment for any condition the podiatrist has not included in his or her diagnosis at the time the podiatrist informs the patient. History: 2013 a. 345.
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SUBCHAPTER V DIETITIANS AFFILIATED CREDENTIALING BOARD Cross-reference: See also DI, Wis. adm. code.
448.70 Definitions. In this subchapter: (1) “Affiliated credentialing board” means the dietitians affiliated credentialing board. (1m) “Certified dietitian” means an individual who is certified as a dietitian under this subchapter or who holds a compact privilege. (1r) “Compact” means the dietitian licensure compact under s. 448.9887. (1s) “Compact privilege” means a compact privilege, as defined in s. 448.9887 (2) (i), that is granted under the compact to an individual to practice in this state. (2) “Dietetics” means the integration and application of principles of nutritional science, biochemistry, food science, physiology, food systems management, behavioral science and social science in order to achieve or maintain the health of an individual or group of individuals. “Dietetics” includes assessing the nutritional needs of an individual or group of individuals and determining available resources and constraints in meeting those nutritional needs; establishing priorities, goals and objectives that meet those nutritional needs and are consistent with available resources and constraints; providing nutrition counseling; or developing, implementing and managing nutritional care systems. (3) “Dietitian” means an individual who practices dietetics. History: 1993 a. 443; 2025 a. 20.
448.72 Applicability. This subchapter does not do any of the following: (1) Require a certificate under this subchapter for any of the following: (a) A person who is lawfully practicing within the scope of a license, permit or certificate of certification or registration granted under chs. 441, 446 to 451 or 456, or who is lawfully practicing in any other health care profession that is regulated by state law. (b) A person to whom a practice or procedure is delegated by a person under par. (a). (c) A person pursuing a supervised course of study, including internships, leading to a degree or certificate in dietetics from an accredited educational program or an educational program approved by the affiliated credentialing board. (d) A dietetic technician or assistant who is working under the supervision of a certified dietitian. (e) A dietitian who is serving in the U.S. armed forces, as defined in s. 40.02 (57m), or in the commissioned corps of the federal public health service or is employed by the U.S. veterans administration, and who is engaged in the practice of dietetics as part of that service or employment. (f) A person who markets or distributes food, food materials or dietary or food supplements, who explains the use, benefits or preparation of food, food materials or dietary or food supplements, who furnishes nutritional information on food, food materials or dietary or food supplements, or who disseminates nutritional information or literature, if the person does not use the title “dietitian” or “certified dietitian” and the person complies with applicable federal, state and local laws. (2) Prohibit a dietetic student described in sub. (1) (c) from using the title “dietitian student” or any other title, letters or designation that clearly indicates his or her status as a student or trainee. (3) Prohibit an individual described in sub. (1) (e) from using
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the title “dietitian” or any letters or designation that represents or may tend to represent the individual as a dietitian, if the title, letters or designation is used only in the course of the individual’s service or employment. (4) Prohibit an individual who is registered as a dietitian with the commission on dietetic registration of the American Dietetic Association from using the title “dietitian” or “registered dietitian”. (5) Prohibit an individual who is registered as a dietetic technician with the commission on dietetic registration of the American Dietetic Association from using the title “dietetic technician” or “dietetic technician registered”. (6) Prohibit an individual from using the title “dietitian,” “licensed dietitian,” or “certified dietitian” if the person is licensed or certified as a dietitian under the laws of another state which has licensure or certification requirements that the affiliated credentialing board determines to be substantially equivalent to the requirements under s. 448.78 (1m). History: 1993 a. 443; 1997 a. 75; 2025 a. 20.
448.74 Duties of affiliated credentialing board. The affiliated credentialing board shall promulgate rules that do all of the following: (1) Establish criteria for the approval of educational programs and training under s. 448.78 (1m) (c) and (d). (2) Establish a code of ethics to govern the professional conduct of certified dietitians. History: 1993 a. 443; 2025 a. 20.
448.76 Use of titles. Except as provided in s. 448.72 (1) (e) and (2) to (6), a person who is not a certified dietitian may not designate himself or herself as a dietitian, claim to provide dietetic services or use any title or initials that represent or may tend to represent the person as certified or licensed as a dietitian or as certified or licensed in a nutrition-related field. History: 1993 a. 443; 1997 a. 75.
448.78 Certification of dietitians; compact privileges. (1m) CERTIFICATE. The affiliated credentialing board shall grant a certificate as a dietitian to an individual who does all of the following: (a) Submits an application for the certificate to the department on a form provided by the department. (b) Pays the fee specified in s. 440.05 (1). (c) Submits evidence satisfactory to the affiliated credentialing board that he or she has done any of the following: 1. Received a bachelor’s, master’s or doctoral degree in human nutrition, nutrition education, food and nutrition, dietetics or food systems management from a program at a college or university that is regionally accredited, as determined by the affiliated credentialing board, and that is located in a state or territory of the United States. 2. Received a bachelor’s, master’s or doctoral degree in human nutrition, nutrition education, food and nutrition, dietetics or food systems management from a program at a college or university that is not located in a state or territory of the United States if the affiliated credentialing board determines that the program is substantially equivalent to a program under subd. 1. 3. Received a degree from or otherwise successfully completed a program in human nutrition, nutrition education, food and nutrition, dietetics or food systems management that is approved by the affiliated credentialing board. (d) Submits evidence satisfactory to the affiliated credentialing board that he or she has completed at least 900 hours of dietetics practice in any state or territory of the United States under the supervision of any of the following:
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1. A certified dietitian. 2. An individual who is registered as a dietitian with the commission on dietetic registration of the American Dietetic Association. 3. An individual who received a doctoral degree in human nutrition, nutrition education, food and nutrition, dietetics or food systems management from any of the following: a. A program at a college or university that is regionally accredited, as determined by the affiliated credentialing board, and that is located in a state or territory of the United States. b. A program at a college or university that is not located in a state or territory of the United States if the affiliated credentialing board determines that the program is substantially equivalent to a program under subd. 3. a. 4. The internship program under s. 253.065. (e) Passes the registration examination for dietitians established by the commission on dietetic registration of the American dietetic association, or passes an equivalent examination approved by the affiliated credentialing board, and held under s. 448.84, to determine fitness to practice dietetics. (f) Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the affiliated credentialing board that he or she does not have a conviction record. (2m) LICENSE BASED ON COMPACT PRIVILEGE. The affiliated credentialing board shall grant a certificate as a dietitian to any individual who does all of the following: (a) Submits an application for the certificate to the department on a form provided by the department. (b) Pays the fee specified in s. 440.05 (1). (c) Submits evidence satisfactory to the affiliated credentialing board that he or she holds a home state license in another state that is a party to the compact, has changed his or her primary state of residence to this state, and satisfies all other requirements under s. 448.9887 (5). (d) Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the affiliated credentialing board that he or she does not have a conviction record. (3m) COMPACT PRIVILEGE. The affiliated credentialing board shall grant a compact privilege to an individual who does all of the following: (a) Submits an application for the compact privilege to the department on a form provided by the department. (b) Submits evidence satisfactory to the affiliated credentialing board that he or she holds an unencumbered home state license in another state that is a party to the compact and satisfies all other requirements under s. 448.9887 (4). (c) Pays any fee established by the department under s. 448.9888 (2). (4m) TYPES OF CERTIFICATE. A certificate as a dietitian granted under sub. (1m) may be either of the following: (a) A certificate that, subject to s. 448.9887 (4), entitles the holder to obtain and exercise a compact privilege in other states that are parties to the compact. (b) A single-state certificate, which entitles the holder to practice only in this state. Nothing in the compact applies to the holder of a single-state certificate unless otherwise applicable under this subchapter. History: 1993 a. 443; 2015 a. 276; 2025 a. 20.
448.80 Temporary certificate. Upon application and payment of the fee specified in s. 440.05 (6), the affiliated credentialing board may grant a temporary dietitian certificate to an individual who satisfies the requirements under s. 448.78 (1m) (a) to (d) and has submitted an application to take the next available examination under s. 448.84. A temporary certificate granted un-
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448.80
Updated 23-24 Wis. Stats.
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der this section is valid for a period designated by the affiliated credentialing board, not to exceed 9 months, and may be renewed once by the affiliated credentialing board. History: 1993 a. 443; 2025 a. 20.
448.82 Reciprocal certificate. Upon application and payment of the fee specified in s. 440.05 (2), the affiliated credentialing board shall grant a dietitian certificate to an individual who holds a similar certificate or license in another state or territory of the United States if the affiliated credentialing board determines that the requirements for receiving the certificate in the other state or territory are substantially equivalent to the requirements under s. 448.78 (1m). History: 1993 a. 443; 2025 a. 20.
448.84 Examinations. (1) The affiliated credentialing board shall conduct or arrange for examinations for dietitian certification at least semiannually and at times and places determined by the affiliated credentialing board, and shall provide public notice of each examination at least 90 days before the date of the examination. (2) Examinations held under sub. (1) shall consist of written or oral tests, or both, requiring applicants to demonstrate minimum competency in subjects substantially related to the practice of dietetics. History: 1993 a. 443.
448.86 Issuance of certificate; expiration and renewal. (1) The department shall issue a certificate to each individual who is certified under this subchapter. (2) The renewal dates for certificates granted under this subchapter, other than temporary certificates granted under s. 448.80, are specified under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a). History: 1993 a. 443; 1997 a. 175; 2007 a. 20.
448.87 Disciplinary proceedings and actions. (1) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred. (2) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may reprimand a certified dietitian or deny, limit, suspend or revoke a certificate granted under this subchapter or a compact privilege if it finds that the applicant or certified dietitian has done any of the following: (a) Made a material misstatement in an application for a certificate or a compact privilege or for renewal of a certificate. (b) Subject to ss. 111.321, 111.322 and 111.335, been convicted of an offense the circumstances of which substantially relate to the practice of dietetics. (c) Advertised in a manner that is false, deceptive or misleading. (d) Advertised, practiced or attempted to practice under another’s name. (e) Subject to ss. 111.321, 111.322 and 111.34, practiced dietetics while his or her ability to practice was impaired by alcohol or other drugs. (f) Engaged in unprofessional or unethical conduct in violation of the code of ethics established in the rules promulgated under s. 448.74 (2). (g) Engaged in conduct while practicing dietetics which evidences a lack of knowledge or ability to apply professional principles or skills.
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(h) Violated this subchapter or any rule promulgated under this subchapter. History: 1993 a. 443; 1999 a. 180 s. 55; 2025 a. 20.
448.94 Penalties. Any person who violates this subchapter or any rule promulgated under this subchapter may be fined not more than $1,000 or imprisoned for not more than 6 months or both. History: 1993 a. 443.
SUBCHAPTER VI ATHLETIC TRAINERS AFFILIATED CREDENTIALING BOARD Cross-reference: See also AT, Wis. adm. code.
448.95 Definitions. In this subchapter: (1) “Affiliated credentialing board” means the athletic trainers affiliated credentialing board. (4) “Athletic trainer” means an individual who engages in athletic training. (5) “Athletic training” means doing any of the following: (a) Preventing, recognizing and evaluating injuries or illnesses sustained while participating in physical activity. (b) Managing and administering the initial treatment of injuries or illnesses sustained while participating in physical activity. (c) Giving emergency care or first aid for an injury or illness sustained while participating in physical activity. (d) Rehabilitating and physically reconditioning injuries or illnesses sustained while participating in physical activity. (e) Rehabilitating and physically reconditioning injuries or illnesses that impede or prevent an individual from returning to participation in physical activity, if the individual recently participated in, and intends to return to participation in, physical activity. (f) Establishing or administering risk management, conditioning, and injury prevention programs. (6) “Licensee” means a person who is licensed as an athletic trainer under this subchapter. (7) “Physical activity” means vigorous participation in exercise, sports, games, recreation, wellness, fitness, or employment activities. History: 1999 a. 9; 2009 a. 162; 2021 a. 71.
448.951 Use of title. Except as provided in s. 448.952, no person may designate himself or herself as an athletic trainer or use or assume the title “athletic trainer”, “licensed athletic trainer”, “certified athletic trainer” or “registered athletic trainer” or append to the person’s name any other title, letters or designation that represents or may tend to represent the person as an athletic trainer unless the person is licensed under this subchapter. History: 1999 a. 9, 185.
448.952 Applicability. This subchapter does not require a license under this subchapter for any of the following: (1) Any person lawfully practicing within the scope of a license, permit, registration or certification granted by this state or the federal government, if the person does not represent himself or herself as an athletic trainer. (1m) An individual who is exempt from licensure as a physician under s. 448.03 (2m). (2) An athletic training student practicing athletic training within the scope of the student’s education or training, if he or she clearly indicates that he or she is an athletic training student.
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(3) An athletic trainer who is in this state temporarily with an individual or group that is participating in a specific athletic event or series of athletic events and who is licensed, certified, or registered by another state or country or certified as an athletic trainer by the National Athletic Trainers’ Association Board of Certification, Inc., or its successor agency. History: 1999 a. 9; 2009 a. 162; 2017 a. 341; 2021 a. 238 s. 45.
448.9525 Duties of affiliated credentialing board. (1) The affiliated credentialing board shall do all of the following: (a) Maintain a complete list of athletic trainers licensed under this subchapter that includes the address of each person on the list. (b) Provide a copy of the list maintained under par. (a) to any person who requests a copy. (c) Prescribe a form for the recording of a protocol required under s. 448.956 (1). (d) Promulgate rules establishing the minimum amount of liability insurance or surety bonding that a licensee must have to be eligible for renewal of his or her license. (e) Promulgate rules requiring each applicant for a license under this subchapter to submit evidence satisfactory to the affiliated credentialing board that the applicant has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. (2) Subject to s. 448.956 (1), (4) and (5), the affiliated credentialing board and the medical examining board shall jointly promulgate rules relating to the minimum requirements of a protocol required under s. 448.956 (1). History: 1999 a. 9; 2007 a. 104.
448.953 Licensure of athletic trainers. (1) The affiliated credentialing board shall grant an athletic trainer license to a person who does all of the following: (a) Submits an application for the license to the department on a form provided by the department. (b) Pays the fee specified in s. 440.05 (1). (c) Subject to ss. 111.321, 111.322 and 111.335, submits evidence satisfactory to the affiliated credentialing board that he or she does not have an arrest or conviction record. (d) Subject to ss. 111.321, 111.322 and 111.335, submits evidence satisfactory to the affiliated credentialing board that he or she does not have a history of alcohol or other drug abuse. (e) Submits evidence satisfactory to the affiliated credentialing board that he or she has received at least a bachelor’s degree from an accredited college or university. (f) Submits evidence satisfactory to the affiliated credentialing board that he or she has met the requirements for certification established by the National Athletic Trainers’ Association Board of Certification, Inc., or its successor agency and has passed the certification examination administered by the National Athletic Trainers’ Association Board of Certification, Inc., or its successor agency. (g) Provides all of the following information: 1. A statement as to whether the person has been granted an athletic trainer credential from any licensing jurisdiction in the United States or in any foreign country. 2. If the person has been granted an athletic trainer credential from any licensing jurisdiction in the United States or in any foreign country, a description of any disciplinary actions initiated against the person by the licensing jurisdiction that issued the credential.
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3. A statement as to whether the person has ever applied for an athletic trainer credential from any licensing jurisdiction in the United States or in any foreign country and had the application denied, along with a description of why the credential application was denied. (h) Passes an examination under s. 448.954. (i) Submits evidence satisfactory to the affiliated credentialing board that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. (2) The affiliated credentialing board may waive the requirements under sub. (1) (c) to (i) for an applicant for a license under sub. (1) who establishes to the satisfaction of the affiliated credentialing board all of the following: (a) That he or she has been issued a credential as an athletic trainer by another licensing jurisdiction in the United States. (b) That the jurisdiction that issued the credential under par. (a) has requirements for credentialing that are substantially equivalent to the requirements under sub. (1) (c) to (i). (5) An application form for a license under this section shall include all of the following: (a) An affirmation by the applicant that the information that he or she is supplying on the application is true and complete. (b) A statement that the applicant authorizes the affiliated credentialing board to have access to any of the following: 1. The applicant’s records at the college or university at which he or she received the bachelor’s degree required under sub. (1) (e). 2. The records of any credentialing authority in any licensing jurisdiction in the United States or in any foreign country that has granted the applicant a credential in athletic training. History: 1999 a. 9, 185; 2007 a. 104; 2009 a. 162.
448.954 Examination. (1) The affiliated credentialing board shall conduct or arrange for examinations for athletic trainer licensure at least semiannually and at times and places determined by the affiliated credentialing board. Examinations shall consist of written or oral tests, or both, requiring applicants to demonstrate minimum competency in subjects substantially related to athletic training. (2) In lieu of an examination under sub. (1), the affiliated credentialing board may accept the results of an examination administered by the National Athletic Trainers’ Association Board of Certification, Inc., or its successor agency. History: 1999 a. 9; 2009 a. 162.
448.9545 Continuing education. (1) (a) To be eligible for renewal of a license issued under s. 448.953 (1) or (2), a licensee shall, during the 2-year period immediately preceding the renewal date specified under s. 440.08 (2) (a), complete not less than 30 credit hours of continuing education in courses of study approved by the affiliated credentialing board. (b) No more than 10 credit hours of the continuing education required under par. (a) may be on any of the following subject areas or combination of subject areas: 1. Management. 2. Risk management. 3. Personal growth. 4. Educational techniques. (2) The affiliated credentialing board may approve any of the following courses for continuing education credit: (a) A course that has been approved for continuing education
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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credit by the National Athletic Trainers’ Association Board of Certification, Inc., or its successor agency. (b) Any course that satisfies all of the following: 1. The course is directly related to the practice of athletic training or sports medicine and lasts at least one hour. 2. Each member of the course faculty has expertise in the subject area of the course because he or she has received a degree from an accredited college or university relating to the subject area, has experience or special training in the subject area covered by the course or has previously taught the subject area covered by the course. 3. The course has specific written objectives describing the goals of the course for the participants. 4. The sponsor of the course keeps attendance records for the course and retains copies of those records for at least 4 years after the date of the course. History: 1999 a. 9; 2009 a. 162.
448.955 Issuance of license; expiration and renewal. (1) The renewal dates for licenses granted under this subchapter are specified under s. 440.08 (2) (a). (2) Renewal applications shall be submitted to the department on a form provided, subject to sub. (3), by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a) and evidence satisfactory to the affiliated credentialing board that the licensee has all of the following: (a) Completed, during the 2-year period immediately preceding the renewal date specified in s. 440.08 (2) (a), the continuing education requirements specified in s. 448.9545. (b) Current certification in cardiopulmonary resuscitation. (c) Liability insurance or a surety bond in at least the minimum amount required by the rules promulgated under s. 448.9525 (1) (d). (d) Current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. (3) A renewal application form for renewal of a license issued under this subchapter shall include all of the following: (a) A place for the licensee to describe his or her work history, including the average number of hours worked each week, for the 2-year period immediately preceding the renewal date specified in s. 440.08 (2) (a). (c) A statement signed by the licensee indicating that a current copy of the protocol required under s. 448.956 (1) is on file at the place of employment of the athletic trainer. History: 1999 a. 9; 2007 a. 20, 104; 2009 a. 162; 2021 a. 71.
448.956 Practice requirements. (1) (a) A licensee may engage in athletic training only in accordance with an evaluation and treatment protocol that is established by the athletic trainer in accordance with the rules promulgated under s. 448.9525 (2) and recorded on a protocol form prescribed by the affiliated credentialing board under s. 448.9525 (1) (c). (b) A licensee shall have a copy of the protocol established under par. (a) at his or her place of employment at all times. (c) A protocol established under par. (a) shall be updated no later than 30 days before the date specified in s. 440.08 (2) (a) 14f. (1m) Subject to sub. (1) (a), a licensee may provide ath-
letic training to an individual without a referral, except that a licensee may not provide athletic training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation setting unless the licensee has obtained a written referral
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for the individual from a practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter; under ch. 446; or under s. 441.09 or from a practitioner who holds a compact privilege under subch. XI, XII, or XIV of ch. 448. NOTE: Sub. (1m) is shown as amended eff. 9-1-26 by 2025 Wis. Act 17. Prior to 9-1-26 it reads: (1m) Subject to sub. (1) (a), a licensee may provide athletic training to an individual without a referral, except that a licensee may not provide athletic training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation setting unless the licensee has obtained a written referral for the individual from a practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter; under ch. 446; or under s. 441.16 (2) or from a practitioner who holds a compact privilege under subch. XI, XII, or XIV of ch. 448.
(2) In addition to engaging in athletic training under a protocol established under sub. (1), a licensee may do any of the following: (a) Monitor the general behavior and general physical response of a person to treatment and rehabilitation, including monitoring whether the person’s behavior or response show abnormal characteristics and monitoring whether the person exhibits abnormal signs or symptoms. (b) Suggest modifications in treatment or rehabilitation of an injured person to the health care practitioner who referred the person to the athletic trainer or to any other health care provider who is providing treatment to the person. (c) Develop and administer an athletic training program for a person. An athletic training program under this paragraph may include providing education and counseling to a person. (3) When working on behalf of his or her employer, a licensee may, in accordance with a protocol established under sub. (1) (a), do all of the following: (a) Treat and rehabilitate an injury or illness using cold, heat, light, sound, electricity, exercise, chemicals, or mechanical devices. (b) Evaluate and treat a person for an injury or illness that has not previously been diagnosed. (c) Treat or rehabilitate an employee with an injury or illness that has resulted from an employment activity as directed, supervised, and inspected by a physician, as defined in s. 448.01 (5), or by a person licensed under s. 446.02, who has the power to direct, decide, and oversee the implementation of the treatment or rehabilitation. (4) If a licensee determines that a patient’s medical condition is beyond the scope of practice of the licensee, the licensee shall, in accordance with the protocol established under sub. (1) (a), refer the patient to a health care practitioner who is licensed under ch. 446 or 447 or subch. II, III or IV of ch. 448; or who holds a compact privilege under subch. II of ch. 447 or subch. XI of ch. 448 and who can provide appropriate treatment to the patient. (5) A licensee shall modify or terminate treatment of a patient that is not beneficial to a patient or that the patient cannot tolerate. History: 1999 a. 9; 2009 a. 162; 2019 a. 100; 2021 a. 23 s. 71; 2021 a. 71, 123, 240, 251; 2023 a. 88; 2025 a. 17, 20, 128, 130.
448.957 Disciplinary proceedings and actions. (1) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred. (2) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may reprimand a licensee or may deny, limit, suspend or revoke a license granted under this subchapter if it finds that the applicant or licensee has done any of the following: (a) Made a material misstatement in an application for a license or for renewal of a license.
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(b) Subject to ss. 111.321, 111.322 and 111.335, been convicted of an offense the circumstances of which substantially relate to the practice of athletic training. (c) Advertised in a manner that is false, deceptive or misleading. (d) Advertised, practiced or attempted to practice under another’s name. (e) Subject to ss. 111.321, 111.322 and 111.34, practiced athletic training while the applicant’s or licensee’s ability to practice was impaired by alcohol or other drugs. (f) Engaged in unprofessional or unethical conduct. (g) Engaged in conduct while practicing athletic training that evidences a lack of knowledge or ability to apply professional principles or skills. (h) Failed to cooperate with the affiliated credentialing board in an investigation under this section. (i) Aided another person in violating this subchapter or any rule promulgated under this subchapter. (j) Violated this subchapter or any rule promulgated under this subchapter. (3) In addition to or in lieu of the penalties provided under sub. (2), the affiliated credentialing board may assess against an applicant or licensee a forfeiture of not more than $10,000 for each violation specified under sub. (2). History: 1999 a. 9.
448.958 Injunctive relief. If the affiliated credentialing board has reason to believe that any person is violating this subchapter or any rule promulgated under this subchapter, the affiliated credentialing board, the department, the attorney general or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring an action in the name and on behalf of this state to enjoin the person from the violation. History: 1999 a. 9.
448.959 Penalties. Any person who violates this subchapter or any rule promulgated under this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both. History: 1999 a. 9.
SUBCHAPTER VII OCCUPATIONAL THERAPISTS AFFILIATED CREDENTIALING BOARD Cross-reference: See also OT, Wis. adm. code.
448.96 Definitions. In this subchapter: (1) “Affiliated credentialing board” means the occupational therapists affiliated credentialing board. (1n) “Compact” means the occupational therapy licensure compact under s. 448.987. (1o) “Compact privilege” means a compact privilege, as defined in s. 448.987 (2) (d), that is granted under the compact to an individual to practice in this state. (2) “Licensee” means an individual granted a license under this subchapter. (3) “Occupation” means intentional, action-oriented behavior that is personally meaningful to an individual and that is determined by the individual’s characteristics, culture and environment. (4) “Occupational therapist” means an individual who is licensed by the affiliated credentialing board to practice occupa-
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tional therapy or who holds an occupational therapist compact privilege. (5) “Occupational therapy” means the therapeutic use of purposeful and meaningful occupations to evaluate and treat individuals of all ages who have a disease, disorder, impairment, activity limitation or participation restriction that interferes with their ability to function independently in daily life roles and environments and to promote health and wellness. (6) “Occupational therapy assistant” means an individual who is licensed by the affiliated credentialing board to assist in the practice of occupational therapy under the supervision of an occupational therapist or who holds an occupational therapy assistant compact privilege. History: 1999 a. 180 ss. 20, 22, 56; 2021 a. 123.
448.961 License required. (1) Except as provided in s. 448.962 (1), no person may practice occupational therapy, designate himself or herself as an occupational therapist, claim to render occupational therapy services, or use the abbreviation “O.T.” or “O.T.R.” after the person’s name unless the person is licensed as an occupational therapist or holds a valid occupational therapist compact privilege. (2) Except as provided in s. 448.962 (2), no person may assist in the practice of occupational therapy, describe himself or herself as an occupational therapy assistant, claim to render occupational therapy services as an occupational therapy assistant, or use the abbreviation “O.T.A.” or “C.O.T.A.” after the person’s name unless the person is licensed as an occupational therapy assistant or holds a valid occupational therapy assistant compact privilege. History: 1999 a. 180 ss. 24, 28, 56; 2021 a. 123.
448.962 Applicability. This subchapter does not do any of the following: (1) Require any of the following to be licensed as an occupational therapist: (a) Any person employed as an occupational therapist by a federal agency, as defined under s. 59.57 (2) (c) 1., if the person provides occupational therapy solely under the direction or control of the federal agency by which he or she is employed. (b) Any person pursuing a supervised course of study, including internship, leading to a degree or certificate in occupational therapy under an accredited or approved educational program, if the person is designated by a title which clearly indicates his or her status as a student or trainee. (c) Any person performing occupational therapy services in this state under a limited permit, as provided under s. 448.963 (4), if at least one of the following applies: 1. The person is licensed or certified as an occupational therapist under the law of another state which has licensure or certification requirements that are determined by the board to be at least as stringent as the requirements of this subchapter. 2. The person meets the requirements for initial certification as an occupational therapist, registered, established by the National Board for Certification in Occupational Therapy. (d) Any person lawfully practicing within the scope of a license, permit, registration or certification granted by this state or the federal government. (e) Any person assisting an occupational therapist or occupational therapy assistant in practice under the direct, immediate and on-premises supervision of the occupational therapist or occupational therapy assistant. (2) Require any of the following to be licensed as an occupational therapy assistant: (a) Any person employed as an occupational therapy assistant
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by a federal agency, as defined under s. 59.57 (2) (c) 1., if the person provides occupational therapy solely under the direction or control of the federal agency by which he or she is employed. (b) Any person pursuing a supervised course of study leading to a degree or certificate in occupational therapy assistantship under an approved educational program, if the person is designated by a title which clearly indicates his or her status as a student or trainee. (c) Any person performing occupational therapy services in this state under a limited permit, as provided under s. 448.963 (4), if at least one of the following applies: 1. The person is licensed or certified as an occupational therapy assistant under the law of another state which has licensure or certification requirements that are determined by the board to be at least as stringent as the requirements of this subchapter. 2. The person meets the requirements for initial certification as a certified occupational therapy assistant, established by the National Board for Certification in Occupational Therapy. (d) Any person lawfully practicing within the scope of a license, permit, registration or certification granted by this state or the federal government. History: 1999 a. 180 ss. 25 to 31, 56.
448.963 Licensure requirements; limited permits. (1) An applicant for a license granted under this subchapter shall do each of the following: (a) Submit an application for the license to the department on a form provided by the department. (b) Pay the fee specified in s. 440.05 (1). (2) The affiliated credentialing board shall grant a license as an occupational therapist to a person who does all of the following: (a) Satisfies the requirements under sub. (1). (b) Submits evidence satisfactory to the affiliated credentialing board that he or she has done any of the following: 1. Successfully completed the academic requirements and supervised internship of an educational program in occupational therapy recognized by the affiliated credentialing board and accredited by the Accreditation Council for Occupational Therapy Education of the American Occupational Therapy Association. 2. Received initial certification as an occupational therapist by the National Board for Certification in Occupational Therapy. 3. Been initially certified as an occupational therapist by the National Board for Certification in Occupational Therapy, if the affiliated credentialing board determines that the requirements for the certification are equivalent to the requirements under subds. 1. and 2. (c) Passes an examination under s. 448.964. (3) The affiliated credentialing board shall grant a license as an occupational therapy assistant to a person who does all of the following: (a) Satisfies the requirements under sub. (1). (b) Submits evidence satisfactory to the affiliated credentialing board that he or she has done any of the following: 1. Successfully completed the academic requirements and supervised internship of an educational program in occupational therapy recognized by the affiliated credentialing board and accredited by the Accreditation Council for Occupational Therapy Education of the American Occupational Therapy Association. 2. Received initial certification as an occupational therapy assistant by the National Board for Certification in Occupational Therapy. 3. Been initially certified as an occupational therapy assistant by the National Board for Certification in Occupational
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Therapy, if the affiliated credentialing board determines that the requirements for the certification are equivalent to the requirements under subds. 1. and 2. (c) Passes an examination under s. 448.964. (4) The affiliated credentialing board may, upon application, issue a permit for a limited period of time designated by the affiliated credentialing board to any of the following: (a) A person who presents evidence satisfactory to the affiliated credentialing board of having met the requirements under sub. (2) (b) 1. or 2., to practice occupational therapy in association with an occupational therapist. (b) A person who presents evidence satisfactory to the affiliated credentialing board of having met the requirements under sub. (3) (b) 1. or 2., to assist in the practice of occupational therapy under the supervision of an occupational therapist. History: 1999 a. 180 ss. 36, 38, 41, 42, 45, 56.
448.964 Examination. (1) The affiliated credentialing board shall conduct or arrange for examinations required for occupational therapist and occupational therapy assistant licensure under s. 448.963 (2) (c) and (3) (c) at times and places determined by the affiliated credentialing board. (2) Examinations under sub. (1) may consist of written or oral tests, or both, and shall require applicants to demonstrate each of the following: (a) Minimum competency in subjects substantially related to the practice of occupational therapy and assisting in the practice of occupational therapy. (b) Ability to practice occupational therapy or assist in the practice of occupational therapy with reasonable skill and safety. History: 1999 a. 180.
448.965 Duties and powers of affiliated credentialing board. (1) The affiliated credentialing board shall promulgate rules that establish each of the following: (a) Standards for acceptable examination performance by an applicant for licensure as an occupational therapist or occupational therapy assistant. (b) Continuing education requirements for license renewal for an occupational therapist or occupational therapy assistant under s. 448.967 (2). (c) Standards of practice for occupational therapy, including a code of ethics and criteria for referral. (2) The affiliated credentialing board may promulgate rules that define the scope of practice of occupational therapy or the scope of assisting in the practice of occupational therapy. History: 1999 a. 180 s. 51 to 53, 56.
448.966 Reciprocal licensure. (1) Upon application and payment of the fee specified in s. 440.05 (2), the affiliated credentialing board shall grant a license as an occupational therapist to a person who holds a similar certificate or license in another state or territory of the United States if the affiliated credentialing board determines that the requirements for receiving the certificate or license in the other state or territory are substantially equivalent to the requirements under s. 448.963 (2). (2) Upon application and payment of the fee specified in s. 440.05 (2), the affiliated credentialing board shall grant a license as an occupational therapy assistant to a person who holds a similar certificate or license in another state or territory of the United States if the affiliated credentialing board determines that the requirements for receiving the certificate or license in the other state or territory are substantially equivalent to the requirements under s. 448.963 (3). History: 1999 a. 180.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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448.967 Issuance of license; expiration and renewal. (1) The department shall issue a certificate of licensure to each person who is licensed under this subchapter. (2) The renewal dates for licenses granted under this subchapter are specified under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a) and a statement attesting compliance with the continuing education requirements established in rules promulgated under s. 448.965 (1) (b). History: 1999 a. 180; 2007 a. 20.
448.968 Disciplinary proceedings and actions. (1) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred. (2) Subject to the rules promulgated under s. 440.03 (1), the affiliated credentialing board may reprimand a licensee or compact privilege holder or deny, limit, suspend or revoke a license granted under this subchapter or a compact privilege if it finds that the applicant, licensee, or compact privilege holder has done any of the following: (a) Made a material misstatement in an application for a license or for renewal of a license. (b) Subject to ss. 111.321, 111.322 and 111.335, been convicted of an offense the circumstances of which substantially relate to the practice of occupational therapy or assisting in the practice of occupational therapy. (c) Advertised in a manner that is false, deceptive or misleading. (d) Advertised, practiced or attempted to practice under another’s name. (e) Subject to ss. 111.321, 111.322 and 111.34, practiced occupational therapy or assisted in the practice of occupational therapy while his or her ability to practice was impaired by alcohol or other drugs. (f) Engaged in unprofessional or unethical conduct in violation of the code of ethics established in the rules promulgated under s. 448.965 (1) (c). (g) Engaged in conduct while practicing occupational therapy or assisting in the practice of occupational therapy that evidences a lack of knowledge or ability to apply professional principles or skills. (h) Violated this subchapter or any rule promulgated under this subchapter. History: 1999 a. 180; 2021 a. 123.
448.969 Injunctive relief. If the affiliated credentialing board has reason to believe that any person is violating this subchapter or any rule promulgated under this subchapter, the affiliated credentialing board, the department, the attorney general or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring an action in the name and on behalf of this state to enjoin the person from the violation. History: 1999 a. 180.
448.9695 Penalties; appeal. (1) A person who violates any provision of this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both. (2) Any person aggrieved by any action taken under this subchapter by the affiliated credentialing board, its officers or its agents may apply for judicial review as provided in ch. 227, and shall file notice of such appeal with the secretary of the affiliated
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credentialing board within 30 days. No court of this state may enter an ex parte stay of any action taken by the affiliated credentialing board under this subchapter. History: 1999 a. 180; 2017 a. 364 s. 49; 2021 a. 23 s. 51; Stats. 2021 s. 448.9695; 2021 a. 251 s. 18.
SUBCHAPTER VIII GENETIC COUNSELORS AFFILIATED CREDENTIALING BOARD Cross-reference: See also Gen Couns, Wis. adm. code.
448.970 Definitions. In this subchapter: (1) “Accreditation Council for Genetic Counseling,” “American Board of Genetic Counseling,” “American Board of Medical Genetics and Genomics,” and “National Society of Genetic Counselors” include an equivalent successor organization as determined by the board. (2) “Board” means the genetic counselors affiliated credentialing board. (3) “Genetic counseling” means to do any of the following: (a) Obtain and evaluate individual, family, and medical histories to determine genetic risk for genetic or medical conditions and diseases in a patient, a patient’s offspring, and other family members. (b) Discuss the features, natural history, means of diagnosis, genetic and environmental factors, and management of risk for genetic or medical conditions and diseases. (c) Identify, coordinate, and order genetic laboratory tests as appropriate for a genetic assessment. (d) Integrate genetic laboratory test results with personal and family medical history to assess and communicate risk factors for genetic or medical conditions and diseases. (e) Explain the clinical implications of genetic laboratory tests and other diagnostic studies and their results. (f) Evaluate a patient’s or family’s responses to the condition or risk of recurrence and provide patient-centered counseling and anticipatory guidance. (g) Provide written documentation of medical, genetic, and counseling information for families and health care professionals. (4) “Genetic counselor” means an individual who is licensed by the board to practice genetic counseling. History: 2021 a. 251.
448.9701 License required; exceptions. (1) (a) Except as provided in sub. (2), no person may practice genetic counseling unless the person is licensed under this subchapter. (b) No person may designate himself or herself as a genetic counselor or use or assume the title “genetic associate,” “genetic counselor,” “licensed genetic counselor,” or “registered genetic counselor,” or append to the person’s name the letters “G.A.,” “G.C.,” “L.G.C.,” or “R.G.C.,” or use any insignia or designation that would imply that the individual is licensed or certified or registered as a genetic counselor, or claim to render genetic counseling services unless the person is licensed under this subchapter. (2) A license is not required under this subchapter for any of the following if the person does not claim to be a genetic counselor: (a) Any person, such as a physician, who is lawfully practicing within the scope of a license, permit, registration, or certification granted by this state or the federal government. (b) Any person assisting a genetic counselor in practice under the direct, on-premises supervision of the genetic counselor. (c) A student of genetic counseling assisting a genetic coun-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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selor in the practice of genetic counseling if the assistance is within the scope of the student’s education or training. (d) A person who is licensed to practice genetic counseling in another state or country and who is providing consulting services in this state on a temporary basis, as determined by the board by rule, if the person notifies the board that he or she will be providing consulting services and of the nature and date of those services and receives authorization from the board to provide consulting services on a temporary basis under this paragraph. (e) A person who is not licensed to practice genetic counseling in another state or country and who is providing consulting services in this state on a temporary basis, as determined by the board by rule, if the person satisfies all of the following: 1. The person is certified by the American Board of Genetic Counseling or the American Board of Medical Genetics and Genomics. 2. The person notifies the board that he or she will be providing consulting services and of the nature and date of those services. 3. The person receives authorization from the board to provide consulting services on a temporary basis under this paragraph. History: 2021 a. 251; 2025 a. 130.
448.9703 Duties and powers of board. The board shall promulgate rules to do all of the following: (1) Adopt the National Society of Genetic Counselors code of ethics as a code of ethics governing the professional conduct of genetic counselors. (2) Establish criteria for the approval of continuing education programs and courses required for renewal of a genetic counselor license. (3) Establish requirements for an applicant seeking renewal of a genetic counselor license, including that an applicant has satisfied all of the following: (a) Successfully completed at least 30 hours of continuing education in the prior 2-year period. (b) Maintained certification from and, if applicable, achieved recertification through the American Board of Genetic Counseling. (4) Adopt a definition of “temporary basis” for purposes of s. 448.9701 (2) (d) and (e). History: 2021 a. 251; 2025 a. 130.
448.9704 Licensure of genetic counselors. (1) Except as provided in sub. (2), the board shall grant a license as a genetic counselor to an applicant who does all of the following: (a) Submits an application for the license to the department on a form provided by the department. (b) Pays the fee specified in s. 440.05 (1). (c) Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the board that the applicant does not have an arrest or a conviction record. (d) Submits evidence satisfactory to the board that he or she has done all of the following: 1. Satisfied one of the following: a. Successfully completed the academic and clinical requirements of and developed the practice-based competencies required by a degree-granting program in genetic counseling that is accredited by the Accreditation Council for Genetic Counseling or the American Board of Medical Genetics and Genomics. b. Successfully completed a degree-granting program outside of the United States that the board determines is substantially equivalent to a program described in subd. 1. a.
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2. Passed an examination administered by the American Board of Genetic Counseling or the genetic counseling examination administered by the American Board of Medical Genetics and Genomics. 3. Obtained certification, maintained valid certification, and, if applicable, achieved recertification with the American Board of Genetic Counseling. (2) (a) The board may waive the requirements of sub. (1) (d) if the applicant holds an unexpired genetic counselor license issued by another state or territory or foreign country or province and the requirements for licensure and for renewal of a genetic counselor license of such other state or territory or foreign country or province are deemed by the board to be substantially equivalent to the requirements for licensure and for renewal of a genetic counselor license of this state. (b) The board may waive the requirements of sub. (1) (d) if the applicant does all of the following: 1. Applies for licensure under sub. (1) by September 1, 2023. 2. Submits evidence satisfactory to the board of all of the following: a. Having at least 10 years of documented work experience practicing genetic counseling. b. Having completed, within the previous 5 years, 25 hours of continuing education approved by the National Society of Genetic Counselors. 3. Submits to the board 2 letters of recommendation, one from a genetic counselor and another from a physician. History: 2021 a. 251; 2025 a. 130.
448.9705 Temporary license. (1) The board may, by rule, provide for a temporary license to practice genetic counseling for an applicant who satisfies the requirements of s. 448.9704 (1) other than the examination requirement under s. 448.9704 (1) (d) 2. (2) Except as provided in sub. (3), a temporary license issued under this section expires upon granting of a license under s. 448.9704 (1) or on whichever of the following dates occurs first: (a) The date that is one year after the date on which the temporary license was granted. (b) If, after the applicant obtains a temporary license under this section, the American Board of Genetic Counseling administers the examination required under s. 448.9704 (1) (d) 2. and the applicant takes the examination, 30 days after the results of the examination are issued by the American Board of Genetic Counseling. (3) The board may, in its discretion and only once, renew a temporary license issued to a person under this section, for a period specified by the board, if the person maintains active candidate status with the American Board of Genetic Counseling. The board may require an applicant for the renewal of a temporary license to appear before a member of the board for an interview. (4) A person who holds a temporary license issued under this section may not practice genetic counseling unless the person is under the supervision and direction of a genetic counselor or physician at all times while the person is practicing genetic counseling. The board may promulgate rules governing general supervision of a person holding a temporary license under this section by a genetic counselor or physician. History: 2021 a. 251; 2025 a. 129, 130.
448.9706 Issuance of license; expiration and renewal. (1) The department shall issue a certificate of licensure to each person who is licensed under this subchapter. (2) Except as provided in s. 448.9705, the renewal dates for licenses granted under this subchapter are specified under s.
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440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department, and shall include the renewal fee specified in s. 440.08 (2) (a) and proof of compliance with the requirements established by rules promulgated by the board under s. 448.9703 (3). History: 2021 a. 251; 2025 a. 130.
448.9707 Disciplinary proceedings and actions; prohibited practice. (1) Subject to the rules promulgated under s. 440.03 (1), the board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred. (2) Subject to the rules promulgated under s. 440.03 (1), the board may reprimand a genetic counselor or may deny, limit, suspend, or revoke a license granted under this subchapter if it finds that the applicant or genetic counselor has done any of the following: (a) Made a material misstatement in an application for a license or for renewal of a license. (b) Interfered with an investigation or disciplinary proceeding by using threats, harassment, or intentional misrepresentation of facts. (c) Subject to ss. 111.321, 111.322, and 111.335, been convicted of an offense the circumstances of which substantially relate to the practice of genetic counseling. (d) Been adjudicated mentally incompetent by a court. (e) Advertised in a manner that is false, deceptive, or misleading. (f) Advertised, practiced, or attempted to practice under another’s name. (g) Subject to ss. 111.321, 111.322, and 111.34, practiced or assisted in the practice of genetic counseling while the applicant’s or licensee’s ability to practice or assist was impaired by alcohol or other drugs. (h) Engaged in unprofessional or unethical conduct in violation of the code of ethics adopted in the rules promulgated under s. 448.9703 (1). (i) Engaged in conduct while practicing genetic counseling that evidences a lack of knowledge or ability to apply professional principles or skills. (j) Violated this subchapter or any rule promulgated under this subchapter. (3) The board shall revoke the license of a genetic counselor who has failed to maintain certification with the American Board of Genetic Counseling or whose certification with the American Board of Genetic Counseling has been revoked. (4) (a) A genetic counselor may voluntarily surrender his or her license to the board, which may refuse to accept the surrender if the board has received allegations of unprofessional conduct against the genetic counselor. The board may negotiate stipulations in consideration for accepting the surrender of licenses. (b) The board may restore a license that has been voluntarily surrendered under par. (a) on such terms and conditions as it considers appropriate. (5) The board shall prepare and disseminate to the public an annual report that describes final disciplinary action taken against genetic counselors during the preceding year. (6) The board may report final disciplinary action taken against a genetic counselor to any national database that includes information about disciplinary action taken against health care professionals. (7) A genetic counselor may not encourage an expectant parent to obtain an elective abortion. History: 2021 a. 251; 2025 a. 130.
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448.9708 Injunctive relief. If the board has reason to believe that any person is violating this subchapter or any rule promulgated under this subchapter, the board, the department, the attorney general, or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring an action in the name and on behalf of this state to enjoin the person from the violation. History: 2021 a. 251; 2025 a. 130.
448.9709 Penalties. Any person who violates this subchapter or any rule promulgated under this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both. History: 2021 a. 251; 2025 a. 130.
SUBCHAPTER IX PHYSICIAN ASSISTANT AFFILIATED CREDENTIALING BOARD Cross-reference: See also PA, Wis. adm. code.
448.971 Definitions. In this subchapter, unless the context requires otherwise: (1) “Board” means the physician assistant affiliated credentialing board. (1L) “Compact” means the PA licensure compact under s. 448.988. (1m) “Compact privilege” means a compact privilege, as defined in s. 448.988 (2) (b), that is granted under the compact to an individual to practice in this state. (2) “Physician assistant” means a person who is licensed under this subchapter or who holds a compact privilege. (3) “Podiatrist” has the meaning given in s. 448.60 (3). (4) “Podiatry” has the meaning given in s. 448.60 (4). History: 2021 a. 23; 2023 a. 81.
448.972 License required; exceptions. (1) Except as provided in subs. (2) and (3), no person may represent himself or herself as a “PA” or “physician assistant,” use or assume the title “PA” or “physician assistant,” or append to the person’s name the words or letters “physician assistant,” “PA,” “PA-C,” or any other titles, letters, or designation that represents or may tend to represent the person as a physician assistant, unless he or she is licensed by the board under this subchapter or holds a compact privilege. (2) Subsection (1) does not apply with respect to any of the following: (a) An individual employed and duly credentialed as a physician assistant or physician associate by the federal government while performing duties incident to that employment, unless a license under this subchapter is required by the federal government. (b) A person who satisfies the requirement under s. 448.974 (1) (a) 3. but who is not licensed under this subchapter. This paragraph does not allow such a person to practice medicine and surgery in violation of s. 448.03 (1) (a) or to practice podiatry in violation of s. 448.61. (3) A student who is enrolled in an accredited physician assistant educational program may use the title “physician assistant student,” “PA student,” or “PA-S.” History: 2021 a. 23; 2023 a. 81.
448.9725 Expedited partner therapy. (1) In this section: (b) “Antimicrobial drug” has the meaning given in s. 448.035 (1) (b).
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(c) “Expedited partner therapy” has the meaning given in s. 448.035 (1) (c). (2) Notwithstanding the requirements of s. 448.9785, a physician assistant may provide expedited partner therapy if a patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician assistant shall attempt to obtain the name of the patient’s sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient’s sexual partner, if known. If the physician assistant is unable to obtain the name of the patient’s sexual partner, the prescription order shall include, in ordinary, bold-faced capital letters, the words, “expedited partner therapy” or the letters “EPT.” (3) The physician assistant shall provide the patient with a copy of the information sheet prepared by the department of health services under s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact. (4) (a) Except as provided in par. (b), a physician assistant is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section. (b) The immunity under par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician assistant whose act or omission involves reckless, wanton, or intentional misconduct. History: 2021 a. 23.
448.9727 Prescriptions for and delivery of opioid antagonists. (1) In this section: (a) “Administer” has the meaning given in s. 450.01 (1). (b) “Deliver” has the meaning given in s. 450.01 (5). (c) “Dispense” has the meaning given in s. 450.01 (7). (d) “Opioid antagonist” has the meaning given in s. 450.01 (13v). (e) “Opioid-related drug overdose” has the meaning given in s. 256.40 (1) (d). (f) “Standing order” has the meaning given in s. 450.01 (21p). (2) (a) A physician assistant may do any of the following: 1. Prescribe an opioid antagonist to a person in a position to assist an individual at risk of undergoing an opioid-related drug overdose and may deliver the opioid antagonist to that person. A prescription order under this subdivision need not specify the name and address of the individual to whom the opioid antagonist will be administered, but shall instead specify the name of the person to whom the opioid antagonist is prescribed. 2. Issue a standing order to one or more persons authorizing the dispensing of an opioid antagonist. (b) A physician assistant who prescribes or delivers an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid antagonist is prescribed has or has the capacity to provide the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training. (3) A physician assistant who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with sub. (2) or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist shall be immune from criminal or
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civil liability and may not be subject to professional discipline under s. 448.978 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist. History: 2021 a. 23.
448.973 Powers and duties of board. (1) (a) The board shall promulgate rules implementing s. 448.9785. (b) The board shall promulgate rules establishing continuing education requirements for physician assistants. (c) The board may promulgate other rules to carry out the purposes of this subchapter, including any of the following: 1. Rules defining what constitutes unprofessional conduct for physician assistants for purposes of s. 448.978 (2) (d). 2. Rules under s. 448.977 (2). (2) The board shall include in the register the board maintains under s. 440.035 (1m) (d) the name of each person whose license or compact privilege issued under this subchapter was suspended or revoked within the past 2 years. The register shall be available for purchase at cost. History: 2021 a. 23; 2023 a. 81.
448.974 License; compact privilege; renewal. (1) (a) Except as provided in par. (b), the board shall grant an initial license to practice as a physician assistant to any applicant who is found qualified by three-fourths of the members of the board and satisfies all of the following requirements, as determined by the board: 1. The applicant submits an application on a form provided by the department and pays the initial credential fee determined by the department under s. 440.03 (9) (a). 2. The applicant is at least 18 years of age. 3. The applicant provides evidence of one of the following: a. That the applicant has successfully completed an educational program for physician assistants or physician associates that is accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs. b. If the applicant does not satisfy subd. 3. a., that the applicant, prior to January 1, 1986, successfully passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants. 4. The applicant passes the National Commission on Certification of Physician Assistants examination or an equivalent national examination adopted by the board. 5. The applicant provides a listing with all employers, practice settings, internships, residencies, fellowships, and other employment for the past 7 years. 6. Subject to ss. 111.321, 111.322, and 111.335, the applicant does not have an arrest or conviction record. (b) Paragraph (a) 3. does not apply to an applicant if the applicant provides evidence that he or she is licensed as a physician assistant or physician associate in another state, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States and the board determines that the requirements for obtaining the license in that state or territory are substantially equivalent to the requirements under par. (a). (1m) The board shall grant a compact privilege to any applicant who satisfies all of the following: (a) The applicant holds a qualifying license, as defined in s. 448.988 (2) (r), in another state that is a party to the compact and satisfies all other requirements under s. 448.988 (4).
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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(b) The individual applies for the compact privilege in the manner prescribed by the department. (c) The individual pays any fee established by the department under s. 448.9885 (2). (2) (am) 1. The renewal date for a license issued under this subchapter is specified under s. 440.08 (2) (a), and the renewal fees for such licenses are determined by the department under s. 440.03 (9) (a). Renewal of a license is subject to subd. 2. 2. An applicant for the renewal of a license under this subchapter shall submit with his or her application for renewal proof of having satisfied the continuing education requirements imposed by the board under s. 448.973 (1) (b). This subdivision does not apply to an applicant for renewal of a license that expires on the first renewal date after the date on which the board initially granted the license. (bm) Renewal of a compact privilege shall be governed by s. 448.988 (4) (b), except that the board may impose requirements for prescribing controlled substances in accordance with s. 448.988 (4) (d). (3) Notwithstanding sub. (1), an individual who, on April 1, 2022, was licensed by the medical examining board as a physician assistant under subch. II of ch. 448, 2019 stats., shall be considered to have been licensed under sub. (1) for purposes of this subchapter. History: 2021 a. 23; 2023 a. 81.
448.975 Practice and employment. (1) (a) Subject to the limitations and requirements under sub. (2); the physician assistant’s experience, education, and training; and any rules promulgated under sub. (5), a physician assistant may do any of the following: 1. Examine into the fact, condition, or cause of human health or disease, or treat, operate, prescribe, or advise for the same, by any means or instrumentality. 2. Apply principles or techniques of medical sciences in the diagnosis or prevention of any of the conditions described in subd. 1. and in s. 448.971 (2). 3. Penetrate, pierce, or sever the tissues of a human being. 4. Offer, undertake, attempt, or hold himself or herself out in any manner as able to do any of the acts described in this paragraph. (b) 1. Subject to subd. 2. and any rules promulgated by the board and consistent with his or her experience, education, and training, a physician assistant may order, prescribe, procure, dispense, and administer prescription drugs, medical devices, services, and supplies. 2. A physician assistant practicing under the supervision and direction of a podiatrist under sub. (2) (a) 2m. may issue a prescription order for a drug or device in accordance with guidelines established by the supervising podiatrist and the physician assistant and with rules promulgated by the board. If any conflict exists between the guidelines and the rules, the rules shall control. (c) A physician assistant may practice in ambulatory care, acute care, long-term care, home care, or other settings as a primary, specialty, or surgical care provider who may serve as a patient’s primary care provider or specialty care provider. (2) (a) 1. Except as provided in subds. 2m. and 3. and sub. (5) (a) 1. a. or b., a physician assistant who provides care to patients shall maintain and provide to the board upon request one of the following: a. Evidence that, pursuant to the physician assistant’s employment, there is a physician who is primarily responsible for the overall direction and management of the physician assistant’s professional activities and for assuring that the services provided by the physician assistant are medically appropriate. In this subd.
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448.975
1. a., “employment” includes an arrangement between the physician assistant and a 3rd party in which the 3rd party receives payment for services provided by the physician assistant. b. A written collaborative agreement with a physician that, subject to subd. 1m., describes the physician assistant’s individual scope of practice, that includes a protocol for identifying an alternative collaborating physician for situations in which the collaborating physician or the physician’s designee is not available for consultation, and that includes other information as required by the board. 1m. All of the following apply to a written collaborative agreement between a physician and physician assistant under subd. 1. b.: a. The agreement may be terminated by either party by providing written notice at least 30 days prior to the date of termination, or as otherwise agreed to by the physician and physician assistant. b. The agreement shall specify that the collaborating physician shall remain reasonably available to the physician assistant through the use of telecommunications or other electronic means within a medically appropriate time frame and that the collaborating physician may designate an alternate collaborator during periods of unavailability. c. The agreement shall specify an arrangement for physician consultation with the patient within a medically appropriate time frame for consultation, if requested by the patient or the physician assistant. d. The agreement shall be signed by the physician assistant and the collaborating physician. 2. Subdivision 1. does not require the physical presence of a physician at the time and place a physician assistant renders a service. 2m. A physician assistant may practice under the supervision and direction of a podiatrist. A physician assistant who is practicing under the supervision and direction of a podiatrist shall be limited to providing nonsurgical patient services. Subdivision 1. does not apply to a physician assistant who is practicing under the supervision and direction of a podiatrist. 3. Subdivision 1. does not apply with respect to a physician assistant who is employed by the federal government as a civilian or member of the uniformed services while performing duties incident to that employment or service. (b) A physician assistant shall limit his or her practice to the scope of his or her experience, education, and training. (c) No physician assistant may provide medical care, except routine screening and emergency care, in any of the following: 1. The practice of dentistry, dental therapy, or dental hygiene within the meaning of ch. 447. 2. The practice of optometry within the meaning of ch. 449. 3. The practice of chiropractic within the meaning of ch. 446. 4. The practice of acupuncture within the meaning of ch. 451. 5. The practice of podiatry, except when the physician assistant is acting under the supervision and direction of a podiatrist, subject to par. (a) 2m. and the rules promulgated under s. 448.695 (4). (3) (a) It shall be the obligation of a physician assistant to ensure all of the following: 1. That the scope of the practice of the physician assistant is identified and is appropriate with respect to his or her experience, education, and training. 2. For purposes of sub. (2) (a) 1. b., that the relationship with
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and access to a collaborating physician by the physician assistant is defined. 3. That the requirements and standards of licensure under this subchapter are complied with. 4. That consultation with or referral to other licensed health care providers with a scope of practice appropriate for a patient’s care needs occurs when the patient’s care needs exceed the physician assistant’s experience, education, or training. A physician assistant shall ensure that he or she has awareness of options for the management of situations that are beyond the physician assistant’s expertise. (b) A physician assistant is individually and independently responsible for the quality of the care he or she renders. (4) A physician assistant may delegate a care task or order to another clinically trained health care worker if the physician assistant is competent to perform the delegated task or order and has reasonable evidence that the clinically trained health care worker is minimally competent to perform the task or issue the order under the circumstances. (5) (a) 1. The board shall, subject to subd. 2. and s. 448.695 (4), promulgate any rules necessary to implement this section, including rules to do any of the following: a. Allow for temporary practice, specifically defined and actively monitored by the board, in the event of an interruption of a collaborative relationship under sub. (2) (a) 1. b. b. Allow a physician assistant, in the absence of an employment or collaborative relationship under sub. (2) (a) 1., to provide medical care at the scene of an emergency, during a declared state of emergency or other disaster, or when volunteering at sporting events or at camps. 2. Rules promulgated by the board may not permit a broader scope of practice than that which may be exercised in accordance with subs. (1) and (2). Notwithstanding s. 15.085 (5) (b) 2., if the Medical Examining Board reasonably determines that a rule submitted to it by the Physician Assistant Affiliated Credentialing Board under s. 15.085 (5) (b) 1. permits a broader scope of practice than that which may be exercised in accordance with subs. (1) and (2), then the Physician Assistant Examining Board shall, prior to submitting the proposed rule to the legislative council staff under s. 227.15 (1), revise the proposed rule so that it does not exceed or permit a broader scope of practice than that which may be exercised in accordance with subs. (1) and (2). (b) The board shall develop and recommend to the podiatry affiliated credentialing board practice standards for physician assistants practicing under podiatrists under sub. (2) (a) 2m. (6) The practice permissions provided in this section are permissions granted by the state authorizing the licensed practice of physician assistants. Nothing in this section prohibits an employer, hospital, health plan, or other similar entity employing or with a relationship with a physician assistant from establishing additional requirements for a physician assistant as a condition of employment or relationship. History: 2021 a. 23; 2023 a. 87.
448.976 Civil liability. No physician assistant shall be liable for any civil damages for either of the following: (1) Reporting in good faith to the department of transportation under s. 146.82 (3) a patient’s name and other information relevant to a physical or mental condition of the patient that in the physician assistant’s judgment impairs the patient’s ability to exercise reasonable and ordinary control over a motor vehicle. (2) In good faith, not reporting to the department of transportation under s. 146.82 (3) a patient’s name and other information relevant to a physical or mental condition of the patient that in the physician assistant’s judgment does not impair the patient’s
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ability to exercise reasonable and ordinary control over a motor vehicle. History: 2021 a. 23.
448.977 Malpractice liability insurance. (1) Except as provided in subs. (2) and (3), no physician assistant may practice as authorized under s. 448.975 unless he or she has in effect malpractice liability insurance coverage evidenced by one of the following: (a) Personal liability coverage in the amounts specified for health care providers under s. 655.23 (4). (b) Coverage under a group liability policy providing individual coverage for the physician assistant in the amounts under s. 655.23 (4). (2) The board may promulgate rules requiring a practicing physician assistant to have in effect malpractice liability insurance coverage in amounts greater than those specified in sub. (1) (a) or (b) or (4). If the board promulgates rules under this subsection, no physician assistant may practice as authorized under s. 448.975 unless he or she has in effect malpractice liability insurance coverage as required under those rules, except as provided in sub. (3). (3) A physician assistant who is a state, county, or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties is not required to maintain in effect malpractice insurance coverage. (4) Except as provided in subs. (2) and (3), a physician assistant may comply with sub. (1) if the physician assistant’s employer has in effect malpractice liability insurance that is at least the minimum amount specified under s. 655.23 (4) and that provides coverage for claims against the physician assistant. History: 2021 a. 23.
448.978 Professional discipline. (1g) In this section: (a) “Unprofessional conduct” includes a determination made by a physician assistant under ch. 154 or 155 if the physician assistant does not have sufficient education, training, and experience to make the determination. (b) “Unprofessional conduct” does not include any of the following: 1. Providing expedited partner therapy as described in s. 448.9725. 2. Prescribing or delivering an opioid antagonist in accordance with s. 448.9727 (2). (1r) Subject to the rules promulgated under s. 440.03 (1), the board may conduct investigations and hearings to determine whether a person has violated this subchapter or a rule promulgated under this subchapter. (2) Subject to the rules promulgated under s. 440.03 (1), if a person who applies for or holds a license or compact privilege issued under s. 448.974 does any of the following, the board may reprimand the person or deny, limit, suspend, or revoke the person’s license or compact privilege: (a) Makes a material misstatement in an application for a license or compact privilege or an application for renewal of a license or compact privilege under s. 448.974. (b) Violates any law of this state or federal law that substantially relates to the practice of a physician assistant, violates this subchapter, or violates a rule promulgated under this subchapter. (c) Advertises, practices, or attempts to practice under another person’s name. (d) Engages in unprofessional conduct. (e) Subject to ss. 111.321, 111.322, and 111.335, is arrested for or convicted of a felony.
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(f) Subject to ss. 111.321, 111.322, and 111.34, practices as a physician assistant while his or her ability is impaired by alcohol or other drugs. (g) Engages in fraud or deceit in obtaining or using his or her license or compact privilege. (h) Is adjudicated mentally incompetent by a court. (i) Demonstrates gross negligence, incompetence, or misconduct in practice. (j) Knowingly, recklessly, or negligently divulges a privileged communication or other confidential patient health care information except as required or permitted by state or federal law. (k) Fails to cooperate with the board, or fails to timely respond to a request for information by the board, in connection with an investigation under this section. (L) Prescribes, sells, administers, distributes, orders, or provides a controlled substance for a purpose other than a medical purpose. (m) Demonstrates a lack of physical or mental ability to safely practice as a physician assistant. (n) Engages in any practice that is outside the scope of his or her experience, education, or training. (o) Is disciplined or has been disciplined by another state or jurisdiction based upon acts or conduct similar to acts or conduct prohibited under pars. (a) to (n). History: 2021 a. 23; 2023 a. 81 ss. 23, 34 to 39.
448.9785 Informed consent. Any physician assistant who treats a patient shall inform the patient about the availability of reasonable alternate medical modes of treatment and about the benefits and risks of these treatments. The reasonable physician assistant standard is the standard for informing a patient under this section. The reasonable physician assistant standard requires disclosure only of information that a reasonable physician assistant in the same or a similar medical specialty would know and disclose under the circumstances. The physician assistant’s duty to inform the patient under this section does not require disclosure of any of the following: (1) Detailed technical information that in all probability a patient would not understand. (2) Risks apparent or known to the patient. (3) Extremely remote possibilities that might falsely or detrimentally alarm the patient. (4) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment. (5) Information in cases where the patient is incapable of consenting. (6) Information about alternate medical modes of treatment for any condition the physician assistant has not included in his or her diagnosis at the time the physician informs the patient. History: 2021 a. 23.
448.979 Penalties. Any person who violates this subchapter is subject to a fine not to exceed $10,000 or imprisonment not to exceed 9 months, or both. History: 2021 a. 23.
448.9793 Injunction. If it appears upon complaint to the board by any person or if it is known to the board that any person is violating this subchapter, or rules adopted by the board under this subchapter, the board or the attorney general may investigate and may, in addition to any other remedies, bring action in the name and on behalf of the state against any such person to enjoin such person from such violation. The attorney general shall represent the board in all proceedings. History: 2021 a. 23.
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448.9795 Duty to report. (1) A physician assistant who has reason to believe any of the following about another physician assistant shall promptly submit a written report to the board that includes facts relating to the conduct of the other physician assistant: (a) The other physician assistant is engaging or has engaged in acts that constitute a pattern of unprofessional conduct. (b) The other physician assistant is engaging or has engaged in an act that creates an immediate or continuing danger to one or more patients or to the public. (c) The other physician assistant is or may be medically incompetent. (d) The other physician assistant is or may be mentally or physically unable safely to engage in the practice of a physician assistant. (2) No physician assistant who reports to the board under sub. (1) may be held civilly or criminally liable or be found guilty of unprofessional conduct for reporting in good faith. History: 2021 a. 23.
SUBCHAPTER X INTERSTATE MEDICAL LICENSURE COMPACT 448.980 Interstate medical licensure compact. The following compact is hereby ratified and entered into: (1) SECTION 1 — PURPOSE. In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the interstate medical licensure compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The compact creates another pathway for licensure and does not otherwise change a state’s existing medical practice act. The compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the compact. (2) SECTION 2 — DEFINITIONS. In this compact: (a) “Bylaws” means those bylaws established by the interstate commission pursuant to sub. (11) for its governance, or for directing and controlling its actions and conduct. (b) “Commissioner” means the voting representative appointed by each member board pursuant to sub. (11). (c) “Conviction” means a finding by a court that an individual is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board. (d) “Expedited license” means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the compact. (e) “Interstate commission” means the interstate commission created pursuant to sub. (11). (f) “License” means authorization by a state for a physician to
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engage in the practice of medicine, which would be unlawful without the authorization. (g) “Medical practice act” means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state. (h) “Member board” means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government. (i) “Member state” means a state that has enacted the compact. (j) “Practice of medicine” means the clinical prevention, diagnosis, or treatment of human disease, injury, or condition requiring a physician to obtain and maintain a license in compliance with the medical practice act of a member state. (k) “Physician” means any person who: 1. Is a graduate of a medical school accredited by the Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent; 2. Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within 3 attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes; 3. Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association; 4. Holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association’s Bureau of Osteopathic Specialists; 5. Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board; 6. Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction; 7. Has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; 8. Has never had a controlled substance license or permit suspended or revoked by a state or the United States drug enforcement administration; and 9. Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction. (L) “Offense” means a felony, gross misdemeanor, or crime of moral turpitude. (m) “Rule” means a written statement by the interstate commission promulgated pursuant to sub. (12) that is of general applicability, implements, interprets, or prescribes a policy or provision of the compact, or an organizational, procedural, or practice requirement of the interstate commission, and has the force and effect of statutory law in a member state, and includes the amendment, repeal, or suspension of an existing rule. (n) “State” means any state, commonwealth, district, or territory of the United States. (o) “State of principal license” means a member state where a physician holds a license to practice medicine and which has been designated as such by the physician for purposes of registration and participation in the compact. (3) SECTION 3 — ELIGIBILITY. (a) A physician must meet the
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eligibility requirements as defined in sub. (2) (k) to receive an expedited license under the terms and provisions of the compact. (b) A physician who does not meet the requirements of sub. (2) (k) may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the compact, relating to the issuance of a license to practice medicine in that state. (4) SECTION 4 — DESIGNATION OF STATE OF PRINCIPAL LICENSE. (a) A physician shall designate a member state as the state of principal license for purposes of registration for expedited licensure through the compact if the physician possesses a full and unrestricted license to practice medicine in that state, and the state is: 1. The state of primary residence for the physician; or 2. The state where at least 25 percent of the practice of medicine occurs, or 3. The location of the physician’s employer; or 4. If no state qualifies under subd. 1., 2., or 3., the state designated as state of residence for purpose of federal income tax. (b) A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in par. (a). (c) The interstate commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license. (5) SECTION 5 — APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE. (a) A physician seeking licensure through the compact shall file an application for an expedited license with the member board of the state selected by the physician as the state of principal license. (b) 1. Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, verifying or denying the physician’s eligibility, to the interstate commission. 2. Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the interstate commission through rule, shall not be subject to additional primary source verification where already primary source verified by the state of principal license. 3. The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, perform a criminal background check of an applicant, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the federal bureau of investigation, with the exception of federal employees who have suitability determination in accordance with 5 CFR 731.202. 4. Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the law of that state. (c) Upon verification in par. (b), physicians eligible for an expedited license shall complete the registration process established by the interstate commission to receive a license in a member state selected pursuant to par. (a), including the payment of any applicable fees. (d) After receiving verification of eligibility under par. (b) and any fees under par. (c), a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the medical practice act and all applicable laws and regulations of the issuing member board and member state. (e) An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same
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manner as required for other physicians holding a full and unrestricted license within the member state. (f) An expedited license obtained though the compact shall be terminated if a physician fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without redesignation of a new state of principal licensure. (g) The interstate commission is authorized to develop rules regarding the application process, including payment of any applicable fees, and the issuance of an expedited license. (6) SECTION 6 — FEES FOR EXPEDITED LICENSURE. (a) A member state issuing an expedited license authorizing the practice of medicine in that state may impose a fee for a license issued or renewed through the compact. (b) The interstate commission is authorized to develop rules regarding fees for expedited licenses. (7) SECTION 7 — RENEWAL AND CONTINUED PARTICIPATION. (a) A physician seeking to renew an expedited license granted in a member state shall complete a renewal process with the interstate commission if the physician: 1. Maintains a full and unrestricted license in a state of principal license; 2. Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction; 3. Has not had a license authorizing the practice of medicine subject to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; and 4. Has not had a controlled substance license or permit suspended or revoked by a state or the United States drug enforcement administration. (b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state. (c) The interstate commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board. (d) Upon receipt of any renewal fees collected in par. (c), a member board shall renew the physician’s license. (e) Physician information collected by the interstate commission during the renewal process will be distributed to all member boards. (f) The interstate commission is authorized to develop rules to address renewal of licenses obtained through the compact. (8) SECTION 8 — COORDINATED INFORMATION SYSTEM. (a) The interstate commission shall establish a database of all physicians licensed, or who have applied for licensure, under sub. (5). (b) Notwithstanding any other provision of law, member boards shall report to the interstate commission any public action or complaints against a licensed physician who has applied or received an expedited license through the compact. (c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the interstate commission. (d) Member boards may report any non-public complaint, disciplinary, or investigatory information not required by par. (c) to the interstate commission. (e) Member boards shall share complaint or disciplinary information about a physician upon request of another member board. (f) All information provided to the interstate commission or distributed by member boards shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.
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(g) The interstate commission is authorized to develop rules for mandated or discretionary sharing of information by member boards. (9) SECTION 9 — JOINT INVESTIGATIONS. (a) Licensure and disciplinary records of physicians are deemed investigative. (b) In addition to the authority granted to a member board by its respective medical practice act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards. (c) A subpoena issued by a member state shall be enforceable in other member states. (d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact. (e) Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to practice medicine. (10) SECTION 10 — DISCIPLINARY ACTIONS. (a) Any disciplinary action taken by any member board against a physician licensed through the compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the medical practice act or regulations in that state. (b) If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician’s license, a license issued to the physician by any other member board shall remain encumbered until that respective member board takes action to reinstate the license in a manner consistent with the medical practice act of that state. (c) If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and: 1. Impose the same or lesser sanctions against the physician so long as such sanctions are consistent with the medical practice act of that state; or 2. Pursue separate disciplinary action against the physician under its respective medical practice act, regardless of the action taken in other member states. (d) If a license granted to a physician by a member board is revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license issued to the physician by any other member board shall be suspended, automatically and immediately without further action necessary by the other member board, for 90 days upon entry of the order by the disciplining board, to permit the member board to investigate the basis for the action under the medical practice act of that state. A member board may terminate the automatic suspension of the license it issued prior to the completion of the 90 day suspension period in a manner consistent with the medical practice act of that state. (11) SECTION 11 — INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION. (a) The member states hereby create the “Interstate Medical Licensure Compact Commission.” (b) The purpose of the interstate commission is the administration of the interstate medical licensure compact, which is a discretionary state function. (c) The interstate commission shall be a body corporate and joint agency of the member states and shall have all the responsi-
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bilities, powers, and duties set forth in the compact, and such additional powers as may be conferred upon it by a subsequent concurrent action of the respective legislatures of the member states in accordance with the terms of the compact. (d) The interstate commission shall consist of 2 voting representatives appointed by each member state who shall serve as commissioners. In states where allopathic and osteopathic physicians are regulated by separate member boards, or if the licensing and disciplinary authority is split between multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be: 1. An allopathic or osteopathic physician appointed to a member board; 2. An executive director, executive secretary, or similar executive of a member board; or 3. A member of the public appointed to a member board. (e) The interstate commission shall meet at least once each calendar year. A portion of this meeting shall be a business meeting to address such matters as may properly come before the commission, including the election of officers. The chairperson may call additional meetings and shall call for a meeting upon the request of a majority of the member states. (f) The bylaws may provide for meetings of the interstate commission to be conducted by telecommunication or electronic communication. (g) Each commissioner participating at a meeting of the interstate commission is entitled to one vote. A majority of commissioners shall constitute a quorum for the transaction of business, unless a larger quorum is required by the bylaws of the interstate commission. A commissioner shall not delegate a vote to another commissioner. In the absence of its commissioner, a member state may delegate voting authority for a specified meeting to another person from that state who shall meet the requirements of par. (d). (h) The interstate commission shall provide public notice of all meetings and all meetings shall be open to the public. The interstate commission may close a meeting, in full or in portion, where it determines by a two-thirds vote of the commissioners present that an open meeting would be likely to: 1. Relate solely to the internal personnel practices and procedures of the interstate commission; 2. Discuss matters specifically exempted from disclosure by federal statute; 3. Discuss trade secrets, commercial, or financial information that is privileged or confidential; 4. Involve accusing a person of a crime, or formally censuring a person; 5. Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; 6. Discuss investigative records compiled for law enforcement purposes; or 7. Specifically relate to the participation in a civil action or other legal proceeding. (i) The interstate commission shall keep minutes which shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including record of any roll call votes. (j) The interstate commission shall make its information and official records, to the extent not otherwise designated in the compact or by its rules, available to the public for inspection. (k) The interstate commission shall establish an executive committee, which shall include officers, members, and others as
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determined by the bylaws. The executive committee shall have the power to act on behalf of the interstate commission, with the exception of rule making, during periods when the interstate commission is not in session. When acting on behalf of the interstate commission, the executive committee shall oversee the administration of the compact including enforcement and compliance with the provisions of the compact, its bylaws and rules, and other such duties as necessary. (L) The interstate commission may establish other committees for governance and administration of the compact. (12) SECTION 12 — POWERS AND DUTIES OF THE INTERSTATE COMMISSION. The interstate commission shall have the duty and power to: (a) Oversee and maintain the administration of the compact; (b) Promulgate rules which shall be binding to the extent and in the manner provided for in the compact; (c) Issue, upon the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the compact, its bylaws, rules, and actions; (d) Enforce compliance with compact provisions, the rules promulgated by the interstate commission, and the bylaws, using all necessary and proper means, including but not limited to the use of judicial process; (e) Establish and appoint committees including, but not limited to, an executive committee as required by sub. (11), which shall have the power to act on behalf of the interstate commission in carrying out its powers and duties; (f) Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the interstate commission; (g) Establish and maintain one or more offices; (h) Borrow, accept, hire, or contract for services of personnel; (i) Purchase and maintain insurance and bonds; (j) Employ an executive director who shall have such powers to employ, select or appoint employees, agents, or consultants, and to determine their qualifications, define their duties, and fix their compensation; (k) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel; (L) Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of it in a manner consistent with the conflict of interest policies established by the interstate commission; (m) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed; (n) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed; (o) Establish a budget and make expenditures; (p) Adopt a seal and bylaws governing the management and operation of the interstate commission; (q) Report annually to the legislatures and governors of the member states concerning the activities of the interstate commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations that may have been adopted by the interstate commission; (r) Coordinate education, training, and public awareness regarding the compact, its implementation, and its operation; (s) Maintain records in accordance with the bylaws; (t) Seek and obtain trademarks, copyrights, and patents; and (u) Perform such functions as may be necessary or appropriate to achieve the purposes of the compact.
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(13) SECTION 13 — FINANCE POWERS. (a) The interstate commission may levy on and collect an annual assessment from each member state to cover the cost of the operations and activities of the interstate commission and its staff. The total assessment must be sufficient to cover the annual budget approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated upon a formula to be determined by the interstate commission, which shall promulgate a rule binding upon all member states. (b) The interstate commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same. (c) The interstate commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state. (d) The interstate commission shall be subject to a yearly financial audit conducted by a certified or licensed public accountant and the report of the audit shall be included in the annual report of the interstate commission. (14) SECTION 14 — ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION. (a) The interstate commission shall, by a majority of commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the compact within 12 months of the first interstate commission meeting. (b) The interstate commission shall elect or appoint annually from among its commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such authority and duties as may be specified in the bylaws. The chairperson, or in the chairperson’s absence or disability, the vice-chairperson, shall preside at all meetings of the interstate commission. (c) Officers selected in par. (b) shall serve without remuneration from the interstate commission. (d) 1. The officers and employees of the interstate commission shall be immune from suit and liability, either personally or in their official capacity, for a claim for damage to or loss of property or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged act, error, or omission that occurred, or that such person had a reasonable basis for believing occurred, within the scope of interstate commission employment, duties, or responsibilities; provided that such person shall not be protected from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person. 2. The liability of the executive director and employees of the interstate commission or representatives of the interstate commission, acting within the scope of such person’s employment or duties for acts, errors, or omissions occurring within such person’s state, may not exceed the limits of liability set forth under the constitution and laws of that state for state officials, employees, and agents. The interstate commission is considered to be an instrumentality of the states for the purposes of any such action. Nothing in this paragraph shall be construed to protect such person from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person. 3. The interstate commission shall defend the executive director, its employees, and subject to the approval of the attorney general or other appropriate legal counsel of the member state represented by an interstate commission representative, shall defend such interstate commission representative in any civil action seeking to impose liability arising out of an actual or alleged act, error or omission that occurred within the scope of interstate commission employment, duties or responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope of interstate commission employment, duties, or re-
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sponsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such person. 4. To the extent not covered by the state involved, member state, or the interstate commission, the representatives or employees of the interstate commission shall be held harmless in the amount of a settlement or judgment, including attorney fees and costs, obtained against such persons arising out of an actual or alleged act, error, or omission that occurred within the scope of interstate commission employment, duties, or responsibilities, or that such persons had a reasonable basis for believing occurred within the scope of interstate commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such persons. (15) SECTION 15 — RULE-MAKING FUNCTIONS OF THE INTERSTATE COMMISSION. (a) The interstate commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the compact. Notwithstanding the foregoing, in the event the interstate commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of the compact, or the powers granted hereunder, then such an action by the interstate commission shall be invalid and have no force or effect. (b) Rules deemed appropriate for the operations of the interstate commission shall be made pursuant to a rule-making process that substantially conforms to the “Model State Administrative Procedure Act” of 2010, and subsequent amendments thereto. (c) Not later than 30 days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States District Court for the District of Columbia or the federal district where the interstate commission has its principal offices, provided that the filing of such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the interstate commission consistent with applicable law and shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority granted to the interstate commission. (16) SECTION 16 — OVERSIGHT OF INTERSTATE COMPACT. (a) The executive, legislative, and judicial branches of state government in each member state shall enforce the compact and shall take all actions necessary and appropriate to effectuate the compact’s purposes and intent. The provisions of the compact and the rules promulgated hereunder shall have standing as statutory law but shall not override existing state authority to regulate the practice of medicine. (b) All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of the compact which may affect the powers, responsibilities or actions of the interstate commission. (c) The interstate commission shall be entitled to receive all service of process in any such proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to provide service of process to the interstate commission shall render a judgment or order void as to the interstate commission, the compact, or promulgated rules. (17) SECTION 17 — ENFORCEMENT OF INTERSTATE COMPACT. (a) The interstate commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the compact. (b) The interstate commission may, by majority vote of the commissioners, initiate legal action in the United States District
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Court for the District of Columbia, or, at the discretion of the interstate commission, in the federal district where the interstate commission has its principal offices, to enforce compliance with the provisions of the compact, and its promulgated rules and bylaws, against a member state in default. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation including reasonable attorney fees. (c) The remedies herein shall not be the exclusive remedies of the interstate commission. The interstate commission may avail itself of any other remedies available under state law or the regulation of a profession. (18) SECTION 18 — DEFAULT PROCEDURES. (a) The grounds for default include, but are not limited to, failure of a member state to perform such obligations or responsibilities imposed upon it by the compact, or the rules and bylaws of the interstate commission promulgated under the compact. (b) If the interstate commission determines that a member state has defaulted in the performance of its obligations or responsibilities under the compact, or the bylaws or promulgated rules, the interstate commission shall: 1. Provide written notice to the defaulting state and other member states, of the nature of the default, the means of curing the default, and any action taken by the interstate commission. The interstate commission shall specify the conditions by which the defaulting state must cure its default; and 2. Provide remedial training and specific technical assistance regarding the default. (c) If the defaulting state fails to cure the default, the defaulting state shall be terminated from the compact upon an affirmative vote of a majority of the commissioners and all rights, privileges, and benefits conferred by the compact shall terminate on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of the default. (d) Termination of membership in the compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to terminate shall be given by the interstate commission to the governor, the majority and minority leaders of the defaulting state’s legislature, and each of the member states. (e) The interstate commission shall establish rules and procedures to address licenses and physicians that are materially impacted by the termination of a member state, or the withdrawal of a member state. (f) The member state which has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which extends beyond the effective date of termination. (g) The interstate commission shall not bear any costs relating to any state that has been found to be in default or which has been terminated from the compact, unless otherwise mutually agreed upon in writing between the interstate commission and the defaulting state. (h) The defaulting state may appeal the action of the interstate commission by petitioning the United States District Court for the District of Columbia or the federal district where the interstate commission has its principal offices. The prevailing party shall be awarded all costs of such litigation including reasonable attorney fees. (19) SECTION 19 — DISPUTE RESOLUTION. (a) The interstate commission shall attempt, upon the request of a member state, to resolve disputes which are subject to the compact and which may arise among member states or member boards. (b) The interstate commission shall promulgate rules provid-
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ing for both mediation and binding dispute resolution as appropriate. (20) SECTION 20 — MEMBER STATES, EFFECTIVE DATE AND AMENDMENT. (a) Any state is eligible to become a member state of the compact. (b) The compact shall become effective and binding upon legislative enactment of the compact into law by no less than 7 states. Thereafter, it shall become effective and binding on a state upon enactment of the compact into law by that state. (c) The governors of non-member states, or their designees, shall be invited to participate in the activities of the interstate commission on a non-voting basis prior to adoption of the compact by all states. (d) The interstate commission may propose amendments to the compact for enactment by the member states. No amendment shall become effective and binding upon the interstate commission and the member states unless and until it is enacted into law by unanimous consent of the member states. (21) SECTION 21 — WITHDRAWAL. (a) Once effective, the compact shall continue in force and remain binding upon each and every member state; provided that a member state may withdraw from the compact by specifically repealing the statute which enacted the compact into law. (b) Withdrawal from the compact shall be by the enactment of a statute repealing the same, but shall not take effect until one year after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other member state. (c) The withdrawing state shall immediately notify the chairperson of the interstate commission in writing upon the introduction of legislation repealing the compact in the withdrawing state. (d) The interstate commission shall notify the other member states of the withdrawing state’s intent to withdraw within 60 days of its receipt of notice provided under par. (c). (e) The withdrawing state is responsible for all dues, obligations and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal. (f) Reinstatement following withdrawal of a member state shall occur upon the withdrawing state reenacting the compact or upon such later date as determined by the interstate commission. (g) The interstate commission is authorized to develop rules to address the impact of the withdrawal of a member state on licenses granted in other member states to physicians who designated the withdrawing member state as the state of principal license. (22) SECTION 22 — DISSOLUTION. (a) The compact shall dissolve effective upon the date of the withdrawal or default of the member state which reduces the membership in the compact to one member state. (b) Upon the dissolution of the compact, the compact becomes null and void and shall be of no further force or effect, and the business and affairs of the interstate commission shall be concluded and surplus funds shall be distributed in accordance with the bylaws. (23) SECTION 23 — SEVERABILITY AND CONSTRUCTION. (a) The provisions of the compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the compact shall be enforceable. (b) The provisions of the compact shall be liberally construed to effectuate its purposes. (c) Nothing in the compact shall be construed to prohibit the applicability of other interstate compacts to which the states are members.
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(24) SECTION 24 — BINDING EFFECT OF COMPACT AND OTHER LAWS. (a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the compact. (b) All laws in a member state in conflict with the compact are superseded to the extent of the conflict. (c) All lawful actions of the interstate commission, including all rules and bylaws promulgated by the commission, are binding upon the member states. (d) All agreements between the interstate commission and the member states are binding in accordance with their terms. (e) In the event any provision of the compact exceeds the constitutional limits imposed on the legislature of any member state, such provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state. History: 2015 a. 116; 2017 a. 364 s. 49; 2017 a. 365 s. 111; 2019 a. 49 s. 1.
448.981 Implementation of the interstate medical licensure compact. (1) In this section: (a) “Board” means the medical examining board. (b) “Compact” means the interstate medical licensure compact entered into under s. 448.980. (c) “Expedited license” has the meaning given in s. 448.980 (2) (d). (d) “Interstate commission” has the meaning given in s. 448.980 (2) (e). (e) “Member board” has the meaning given in s. 448.980 (2) (h). (f) “Member state” has the meaning given in s. 448.980 (2) (i). (g) “State of principal license” has the meaning given in s. 448.980 (2) (o). (2) Notwithstanding s. 448.980 and any rules promulgated by the interstate commission under s. 448.980, the board may only disclose information about an individual pursuant to the compact if the information meets all of the following criteria: (a) Any of the following applies: 1. The individual has a current expedited license granted by the board pursuant to the compact. 2. The individual has a current expedited license granted by another member state or is applying to receive an expedited license in another member state, and Wisconsin is currently designated as his or her state of principal license. 3. The individual is requesting to designate Wisconsin as his or her state of principal license pursuant to the compact. 4. The individual is applying to receive an expedited license to practice in Wisconsin pursuant to the compact. (b) The information is provided only to a member board with responsibility for authorizing the practice of medicine in the member state or to the interstate commission. (c) If the information pertains to an investigation or discipline, all identifying information of individuals or entities other than the individual being investigated or disciplined is removed. (d) The information is not confidential under the laws of this state. (3) A subpoena issued pursuant to s. 448.980 (9) (c) shall only be enforceable in this state or against a citizen of this state if all of the following apply: (a) The subpoena is issued by a member board with responsibility for authorizing the practice of medicine in the member state. (b) The individual being subpoenaed is one of the following:
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1. A physician with a current expedited license granted by the board pursuant to the compact. 2. A physician with a current expedited license granted by another member state, and Wisconsin is currently designated as the physician’s state of principal license. (4) In applying s. 448.980 (9) (e), the board may only undertake such investigation of violations of another state’s statute authorizing the practice of medicine if one of the following applies: (a) The physician being investigated has a current expedited license that was granted by the board and a current expedited license that was granted by the other state pursuant to the compact. (b) The physician being investigated has a current expedited license that was granted by the board pursuant to the compact and the other state is the physician’s currently designated state of principal license. (c) The physician being investigated has a current expedited license that was granted by the other state pursuant to the compact and Wisconsin is the physician’s currently designated state of principal license. (5) The board shall, by January 1 of each year, report to the members of the joint committee on finance the number of individuals investigated by the board solely pursuant to s. 448.980 (9) (e) and the expenses incurred by the board undertaking investigations pursued solely pursuant to s. 448.980 (9) (e) and shall also include in the report a copy of all rules promulgated by the interstate commission since the last report under this subsection and all changes made to any rules previously promulgated by the interstate commission since the last report. (6) The payment of assessments for the interstate medical licensure compact under s. 448.980 (13) (a) shall be made from the appropriation account under s. 20.165 (1) (hg) using the licensure fees paid by physicians licensed under the compact. No fees from physicians that have not applied for licensure through the compact shall be used to pay Wisconsin’s annual assessment pursuant to s. 448.980 (13) (a) without the approval of the joint committee on finance. History: 2015 a. 116; 2017 a. 366 s. 99; 2019 a. 49 s. 1.
SUBCHAPTER XI PHYSICAL THERAPY LICENSURE COMPACT 448.985 Physical therapy licensure compact. (1) PURPOSE. (a) The purpose of this compact is to facilitate interstate practice of physical therapy with the goal of improving public access to physical therapy services. The practice of physical therapy occurs in the state where the patient/client is located at the time of the patient/client encounter. The compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. (b) This compact is designed to achieve all of the following objectives: 1. Increase public access to physical therapy services by providing for the mutual recognition of other member state licenses. 2. Enhance the states’ ability to protect the public’s health and safety. 3. Encourage the cooperation of member states in regulating multistate physical therapy practice. 4. Support spouses of relocating military members. 5. Enhance the exchange of licensure, investigative, and disciplinary information between member states. 6. Allow a remote state to hold a provider of services with a
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compact privilege in that state accountable to that state’s practice standards. (2) DEFINITIONS. As used in this compact, and except as otherwise provided, the following definitions shall apply: (a) “Active duty military” means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 USC chs. 1209 and 1211. (b) “Adverse action” means disciplinary action taken by a physical therapy licensing board based upon misconduct, unacceptable performance, or a combination of both. (c) “Alternative program” means a nondisciplinary monitoring or practice remediation process approved by a physical therapy licensing board. This includes, but is not limited to, substance abuse issues. (d) “Compact privilege” means the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist or work as a physical therapist assistant in the remote state under its laws and rules. The practice of physical therapy occurs in the member state where the patient/client is located at the time of the patient/client encounter. (e) “Continuing competence” means a requirement, as a condition of license renewal, to provide evidence of participation in, and/or completion of, educational and professional activities relevant to practice or area of work. (f) “Data system” means a repository of information about licensees, including examination, licensure, investigative, compact privilege, and adverse action. (g) “Encumbered license” means a license that a physical therapy licensing board has limited in any way. (h) “Executive board” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the commission. (i) “Home state” means the member state that is the licensee’s primary state of residence. (j) “Investigative information” means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation. (k) “Jurisprudence requirement” means the assessment of an individual’s knowledge of the laws and rules governing the practice of physical therapy in a state. (L) “Licensee” means an individual who currently holds an authorization from the state to practice as a physical therapist or to work as a physical therapist assistant. (m) “Member state” means a state that has enacted the compact. (n) “Party state” means any member state in which a licensee holds a current license or compact privilege or is applying for a license or compact privilege. (o) “Physical therapist” means an individual who is licensed by a state to practice physical therapy. (p) “Physical therapist assistant” means an individual who is licensed/certified by a state and who assists the physical therapist in selected components of physical therapy. (q) “Physical therapy,” “physical therapy practice,” and “the practice of physical therapy” mean the care and services provided by or under the direction and supervision of a licensed physical therapist. (r) “Physical therapy compact commission” or “commission” means the national administrative body whose membership consists of all states that have enacted the compact. (s) “Physical therapy licensing board” or “licensing board” means the agency of a state that is responsible for the licensing
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and regulation of physical therapists and physical therapist assistants. (t) “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege. (u) “Rule” means a regulation, principle, or directive promulgated by the commission that has the force of law. (v) “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of physical therapy. (3) STATE PARTICIPATION IN THE COMPACT. (a) To participate in the compact, a state must do all of the following: 1. Participate fully in the commission’s data system, including using the commission’s unique identifier as defined in rules. 2. Have a mechanism in place for receiving and investigating complaints about licensees. 3. Notify the commission, in compliance with the terms of the compact and rules, of any adverse action or the availability of investigative information regarding a licensee. 4. Fully implement a criminal background check requirement, within a time frame established by rule, by receiving the results of the federal bureau of investigation record search on criminal background checks and use the results in making licensure decisions in accordance with par. (b). 5. Comply with the rules of the commission. 6. Utilize a recognized national examination as a requirement for licensure pursuant to the rules of the commission. 7. Have continuing competence requirements as a condition for license renewal. (b) Upon adoption of this statute, the member state shall have the authority to obtain biometric-based information from each physical therapy licensure applicant and submit this information to the federal bureau of investigation for a criminal background check in accordance with 28 USC 534 and 42 USC 14616. (c) A member state shall grant the compact privilege to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the compact and rules. (d) Member states may charge a fee for granting a compact privilege. (4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall satisfy all of the following: 1. Hold a license in the home state. 2. Have no encumbrance on any state license. 3. Be eligible for a compact privilege in any member state in accordance with pars. (d), (g), and (h). 4. Have not had any adverse action against any license or compact privilege within the previous 2 years. 5. Notify the commission that the licensee is seeking the compact privilege within a remote state(s). 6. Pay any applicable fees, including any state fee, for the compact privilege. 7. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege. 8. Report to the commission adverse action taken by any nonmember state within 30 days from the date the adverse action is taken. (b) The compact privilege is valid until the expiration date of the home license. The licensee must comply with the requirements of par. (a) to maintain the compact privilege in the remote state. (c) A licensee providing physical therapy in a remote state un-
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der the compact privilege shall function within the laws and regulations of the remote state. (d) A licensee providing physical therapy in a remote state is subject to that state’s regulatory authority. A remote state may, in accordance with due process and that state’s laws, remove a licensee’s compact privilege in the remote state for a specific period of time, impose fines, and/or take any other necessary actions to protect the health and safety of its citizens. The licensee is not eligible for a compact privilege in any state until the specific time for removal has passed and all fines are paid. (e) If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until all of the following occur: 1. The home state license is no longer encumbered. 2. Two years have elapsed from the date of the adverse action. (f) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of par. (a) to obtain a compact privilege in any remote state. (g) If a licensee’s compact privilege in any remote state is removed, the individual shall lose the compact privilege in any remote state until all of the following occur: 1. The specific period of time for which the compact privilege was removed has ended. 2. All fines have been paid. 3. Two years have elapsed from the date of the adverse action. (h) Once the requirements of par. (g) have been met, the license must meet the requirements in par. (a) to obtain a compact privilege in a remote state. (5) ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES. A licensee who is active duty military or is the spouse of an individual who is active duty military may designate one of the following as the home state: (a) Home of record. (b) Permanent change of station (PCS). (c) State of current residence if it is different than the PCS state or home of record. (6) ADVERSE ACTIONS. (a) A home state shall have exclusive power to impose adverse action against a license issued by the home state. (b) A home state may take adverse action based on the investigative information of a remote state, so long as the home state follows its own procedures for imposing adverse action. (c) Nothing in this compact shall override a member state’s decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member state’s laws. Member states must require licensees who enter any alternative programs in lieu of discipline to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state. (d) Any member state may investigate actual or alleged violations of the statutes and rules authorizing the practice of physical therapy in any other member state in which a physical therapist or physical therapist assistant holds a license or compact privilege. (e) A remote state shall have the authority to do all of the following: 1. Take adverse actions as set forth in sub. (4) (d) against a licensee’s compact privilege in the state. 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence. Subpoenas issued by a physical therapy li-
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censing board in a party state for the attendance and testimony of witnesses, and/or the production of evidence from another party state, shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses and/or evidence are located. 3. If otherwise permitted by state law, recover from the licensee the costs of investigations and disposition of cases resulting from any adverse action taken against that licensee. (f) Joint investigations: 1. In addition to the authority granted to a member state by its respective physical therapy practice act or other applicable state law, a member state may participate with other member states in joint investigations of licensees. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact. (7) ESTABLISHMENT OF THE PHYSICAL THERAPY COMPACT COMMISSION. (a) The compact member states hereby create and establish a joint public agency known as the physical therapy compact commission: 1. The commission is an instrumentality of the compact states. 2. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. 3. Nothing in this compact shall be construed to be a waiver of sovereign immunity. (b) Membership, voting, and meetings: 1. Each member state shall have and be limited to one delegate selected by that member state’s licensing board. 2. The delegate shall be a current member of the licensing board, who is a physical therapist, physical therapist assistant, public member, or the board administrator. 3. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. 4. The member state board shall fill any vacancy occurring in the commission. 5. Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the commission. 6. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates’ participation in meetings by telephone or other means of communication. 7. The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws. (c) The commission shall have all of the following powers and duties: 1. Establish the fiscal year of the commission. 2. Establish bylaws. 3. Maintain its financial records in accordance with the bylaws. 4. Meet and take such actions as are consistent with the provisions of this compact and the bylaws.
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5. Promulgate uniform rules to facilitate and coordinate implementation and administration of this compact. The rules shall have the force and effect of law and shall be binding in all member states. 6. Bring and prosecute legal proceedings or actions in the name of the commission, provided that the standing of any state physical therapy licensing board to sue or be sued under applicable law shall not be affected. 7. Purchase and maintain insurance and bonds. 8. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state. 9. Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the compact, and to establish the commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters. 10. Accept any and all appropriate donations and grants of money, equipment, supplies, materials, and services, and to receive, utilize, and dispose of the same; provided that at all times the commission shall avoid any appearance of impropriety and/or conflict of interest. 11. Lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve, or use, any property, real, personal, or mixed; provided that at all times the commission shall avoid any appearance of impropriety. 12. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed. 13. Establish a budget and make expenditures. 14. Borrow money. 15. Appoint committees, including standing committees composed of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this compact and the bylaws. 16. Provide and receive information from, and cooperate with, law enforcement agencies. 17. Establish and elect an executive board. 18. Perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of physical therapy licensure and practice. (d) The executive board: 1. The executive board shall have the power to act on behalf of the commission according to the terms of this compact. 2. The executive board shall be composed of nine members: a. Seven voting members who are elected by the commission from the current membership of the commission. b. One ex-officio, nonvoting member from the recognized national physical therapy professional association. c. One ex-officio, nonvoting member from the recognized membership organization of the physical therapy licensing boards. 3. The ex-officio members will be selected by their respective organizations. 4. The commission may remove any member of the executive board as provided in bylaws. 5. The executive board shall meet at least annually. 6. The executive board shall have all of the following duties and responsibilities: a. Recommend to the entire commission changes to the rules or bylaws, changes to this compact legislation, fees paid by compact member states such as annual dues, and any commission compact fee charged to licensees for the compact privilege.
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b. Ensure compact administration services are appropriately provided, contractual or otherwise. c. Prepare and recommend the budget. d. Maintain financial records on behalf of the commission. e. Monitor compact compliance of member states and provide compliance reports to the commission. f. Establish additional committees as necessary. g. Other duties as provided in rules or bylaws. (e) Meetings of the commission: 1. All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rule-making provisions in sub. (9). 2. The commission or the executive board or other committees of the commission may convene in a closed, nonpublic meeting if the commission or executive board or other committees of the commission must discuss any of the following: a. Noncompliance of a member state with its obligations under the compact. b. The employment, compensation, discipline or other matters, practices, or procedures related to specific employees or other matters related to the commission’s internal personnel practices and procedures. c. Current, threatened, or reasonably anticipated litigation. d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate. e. Accusing any person of a crime or formally censuring any person. f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential. g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy. h. Disclosure of investigative records compiled for law enforcement purposes. i. Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact. j. Matters specifically exempted from disclosure by federal or member state statute. 3. If a meeting, or portion of a meeting, is closed pursuant to this provision, the commission’s legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. 4. The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the commission or order of a court of competent jurisdiction. (f) Financing of the commission: 1. The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. 2. The commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services. 3. The commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the commission
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and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the commission, which shall promulgate a rule binding upon all member states. 4. The commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the commission pledge the credit of any of the member states, except by and with the authority of the member state. 5. The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the commission. (g) Qualified immunity, defense, and indemnification: 1. The members, officers, executive director, employees, and representatives of the commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that nothing in this paragraph shall be construed to protect any such person from suit and/or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. 2. The commission shall defend any member, officer, executive director, employee, or representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further, that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct. 3. The commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person. (8) DATA SYSTEM. (a) The commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states. (b) Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system on all individuals to whom this compact is applicable as required by the rules of the commission, including all of the following: 1. Identifying information.
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2. Licensure data. 3. Adverse actions against a license or compact privilege. 4. Nonconfidential information related to alternative program participation. 5. Any denial of application for licensure, and the reason(s) for such denial. 6. Other information that may facilitate the administration of this compact, as determined by the rules of the commission. (c) Investigative information pertaining to a licensee in any member state will only be available to other party states. (d) The commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state will be available to any other member state. (e) Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state. (f) Any information submitted to the data system that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the data system. (9) RULE MAKING. (a) The commission shall exercise its rule-making powers pursuant to the criteria set forth in this section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment. (b) If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the compact within 4 years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state. (c) Rules or amendments to the rules shall be adopted at a regular or special meeting of the commission. (d) Prior to promulgation and adoption of a final rule or rules by the commission, and at least 30 days in advance of the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rule making at all of the following: 1. On the website of the commission or other publicly accessible platform. 2. On the website of each member state physical therapy licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules. (e) The notice of proposed rule making shall include all of the following: 1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon. 2. The text of the proposed rule or amendment and the reason for the proposed rule. 3. A request for comments on the proposed rule from any interested person. 4. The manner in which interested persons may submit notice to the commission of their intention to attend the public hearing and any written comments. (f) Prior to adoption of a proposed rule, the commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public. (g) The commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by any of the following: 1. At least 25 persons.
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2. A state or federal governmental subdivision or agency. 3. An association having at least 25 members. (h) 1. If a hearing is held on the proposed rule or amendment, the commission shall publish the place, time, and date of the scheduled public hearing. If the hearing is held via electronic means, the commission shall publish the mechanism for access to the electronic hearing. 2. All persons wishing to be heard at the hearing shall notify the executive director of the commission or other designated member in writing of their desire to appear and testify at the hearing not less than 5 business days before the scheduled date of the hearing. 3. Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing. 4. All hearings will be recorded. A copy of the recording will be made available on request. 5. Nothing in this section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the commission at hearings required by this section. (i) Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the commission shall consider all written and oral comments received. (j) If no written notice of intent to attend the public hearing by interested parties is received, the commission may proceed with promulgation of the proposed rule without a public hearing. (k) The commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rule-making record and the full text of the rule. (L) Upon determination that an emergency exists, the commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rule-making procedures provided in the compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to do any of the following: 1. Meet an imminent threat to public health, safety, or welfare. 2. Prevent a loss of commission or member state funds. 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule. 4. Protect public health and safety. (m) The commission or an authorized committee of the commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing, and delivered to the chair of the commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the commission. (10) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. (a) Oversight. 1. The executive, legislative, and judicial branches of state government in each member state shall enforce this compact and take all actions necessary and appropriate to effectuate the compact’s purposes and intent. The provisions of
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this compact and the rules promulgated hereunder shall have standing as statutory law. 2. All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this compact which may affect the powers, responsibilities, or actions of the commission. 3. The commission shall be entitled to receive service of process in any such proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process to the commission shall render a judgment or order void as to the commission, this compact, or promulgated rules. (b) Default, technical assistance, and termination. 1. If the commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the commission shall do all of the following: a. Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the default, and/or any other action to be taken by the commission. b. Provide remedial training and specific technical assistance regarding the default. 2. If a state in default fails to cure the default, the defaulting state may be terminated from the compact upon an affirmative vote of a majority of the member states, and all rights, privileges, and benefits conferred by this compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. 3. Termination of membership in the compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the commission to the governor, the majority and minority leaders of the defaulting state’s legislature, and each of the member states. 4. A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. 5. The commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the compact, unless agreed upon in writing between the commission and the defaulting state. 6. The defaulting state may appeal the action of the commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees. (c) Dispute resolution. 1. Upon request by a member state, the commission shall attempt to resolve disputes related to the compact that arise among member states and between member and nonmember states. 2. The commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate. (d) Enforcement. 1. The commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this compact. 2. By majority vote, the commission may initiate legal action in the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices against a member state in default to enforce compliance with the provisions of the compact and its promulgated rules and bylaws.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees. 3. The remedies herein shall not be the exclusive remedies of the commission. The commission may pursue any other remedies available under federal or state law. (11) DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION FOR PHYSICAL THERAPY PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENTS. (a) The compact
shall come into effect on the date on which the compact statute is enacted into law in the 10th member state. The provisions, which become effective at that time, shall be limited to the powers granted to the commission relating to assembly and the promulgation of rules. Thereafter, the commission shall meet and exercise rule-making powers necessary to the implementation and administration of the compact. (b) Any state that joins the compact subsequent to the commission’s initial adoption of the rules shall be subject to the rules as they exist on the date on which the compact becomes law in that state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day the compact becomes law in that state. (c) 1. Any member state may withdraw from this compact by enacting a statute repealing the same. 2. A member state’s withdrawal shall not take effect until 6 months after enactment of the repealing statute. 3. Withdrawal shall not affect the continuing requirement of the withdrawing state’s physical therapy licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal. (d) Nothing contained in this compact shall be construed to invalidate or prevent any physical therapy licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact. (e) This compact may be amended by the member states. No amendment to this compact shall become effective and binding upon any member state until it is enacted into the laws of all member states. (12) CONSTRUCTION AND SEVERABILITY. This compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this compact shall be severable and if any phrase, clause, sentence, or provision of this compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person, or circumstance shall not be affected thereby. If this compact shall be held contrary to the constitution of any party state, the compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters. History: 2019 a. 100; 2025 a. 127.
448.986 Implementation of the physical therapy licensure compact. (1) In this section: (a) “Compact” means the physical therapy licensure compact under s. 448.985. (b) “Compact privilege” means a compact privilege, as defined in s. 448.985 (2) (d), that is granted under the compact to an individual to practice in this state. (c) “Examining board” means the physical therapy examining board.
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(2) The department may impose a fee for an individual to receive a compact privilege as provided in s. 448.985 (3) (d). (3) The examining board may, by rule, require an individual seeking a compact privilege to meet a jurisprudence requirement in accordance with s. 448.985 (4) (a) 7., if such a requirement is imposed by the examining board under s. 448.54 in order to obtain a license under s. 448.53 or 448.535. (4) (a) An individual who holds a compact privilege shall comply with s. 440.03 (13) (am). (b) Subject to s. 448.985 and any rules promulgated thereunder, ss. 440.20 to 440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual who holds a compact privilege in the same manner that they apply to holders of licenses issued under subch. III. History: 2019 a. 100.
SUBCHAPTER XII OCCUPATIONAL THERAPY LICENSURE COMPACT 448.987 Occupational therapy licensure compact. (1) PURPOSE. The purpose of this compact is to facilitate interstate practice of occupational therapy with the goal of improving public access to occupational therapy services. The practice of occupational therapy occurs in the state where the patient/client is located at the time of the patient/client encounter. The compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. This compact is designed to achieve the following objectives: (a) Increase public access to occupational therapy services by providing for the mutual recognition of other member state licenses; (b) Enhance the states’ ability to protect the public’s health and safety; (c) Encourage the cooperation of member states in regulating multi-state occupational therapy practice; (d) Support spouses of relocating military members; (e) Enhance the exchange of licensure, investigative, and disciplinary information between member states; (f) Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state’s practice standards; and (g) Facilitate the use of telehealth technology in order to increase access to occupational therapy services. (2) DEFINITIONS. As used in this compact, and except as otherwise provided, the following definitions shall apply: (a) “Active duty military” means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 USC ch. 1209 and 10 USC ch. 1211. (b) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws which is imposed by a licensing board or other authority against an occupational therapist or occupational therapy assistant, including actions against an individual’s license or compact privilege such as censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee’s practice. (c) “Alternative program” means a non-disciplinary monitoring process approved by an occupational therapy licensing board. (d) “Compact privilege” means the authorization, which is equivalent to a license, granted by a remote state to allow a licensee from another member state to practice as an occupational therapist or practice as a occupational therapy assistant in the re-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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mote state under its laws and rules. The practice of occupational therapy occurs in the member state where the patient/client is located at the time of the patient/client encounter. (e) “Continuing competence/education” means a requirement, as a condition of license renewal, to provide evidence of participation in, and/or completion of, educational and professional activities relevant to practice or area of work. (f) “Current significant investigative information” means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the occupational therapist or occupational therapy assistant to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction. (g) “Data system” means a repository of information about licensees, including but not limited to license status, investigative information, compact privileges, and adverse actions. (h) “Encumbered license” means a license in which an adverse action restricts the practice of occupational therapy by the licensee or said adverse action has been reported to the National Practitioners Data Bank (NPDB). (i) “Executive committee” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the commission. (j) “Home state” means the member state that is the licensee’s primary state of residence. (k) “Impaired practitioner” means individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions. (L) “Investigative information” means information, records, and/or documents received or generated by an occupational therapy licensing board pursuant to an investigation. (m) “Jurisprudence requirement” means the assessment of an individual’s knowledge of the laws and rules governing the practice of occupational therapy in a state. (n) “Licensee” means an individual who currently holds an authorization from the state to practice as an occupational therapist or as an occupational therapy assistant. (o) “Member state” means a state that has enacted the compact. (p) “Occupational therapist” means an individual who is licensed by a state to practice occupational therapy. (q) “Occupational therapy assistant” means an individual who is licensed by a state to assist in the practice of occupational therapy. (r) “Occupational therapy,” “occupational therapy practice,” and the “practice of occupational therapy” mean the care and services provided by an occupational therapist or an occupational therapy assistant as set forth in the member state’s statutes and regulations. (s) “Occupational therapy compact commission” or “commission” means the national administrative body whose membership consists of all states that have enacted the compact. (t) “Occupational therapy licensing board” or “licensing board” means the agency of a state that is authorized to license and regulate occupational therapists and occupational therapy assistants. (u) “Primary state of residence” means the state (also known as the home state) in which an occupational therapist or occupational therapy assistant who is not active duty military declares a primary residence for legal purposes as verified by: driver’s license, federal income tax return, lease, deed, mortgage, or voter registration or other verifying documentation as further defined by commission rules.
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(v) “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege. (w) “Rule” means a regulation promulgated by the commission that has the force of law. (x) “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of occupational therapy. (y) “Single-state license” means an occupational therapist or occupational therapy assistant license issued by a member state that authorizes practice only within the issuing state and does not include a compact privilege in any other member state. (z) “Telehealth” means the application of telecommunication technology to deliver occupational therapy services for assessment, intervention and/or consultation. (3) STATE PARTICIPATION IN THE COMPACT. (a) To participate in the compact, a member state shall: 1. License occupational therapists and occupational therapy assistants; 2. Participate fully in the commission’s data system, including but not limited to using the commission’s unique identifier as defined in rules of the commission; 3. Have a mechanism in place for receiving and investigating complaints about licensees; 4. Notify the commission, in compliance with the terms of the compact and rules, of any adverse action or the availability of investigative information regarding a licensee; 5. Implement or utilize procedures for considering the criminal history records of applicants for an initial compact privilege. These procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant’s criminal history record information from the federal bureau of investigation and the agency responsible for retaining that state’s criminal records; a. A member state shall, within a time frame established by the commission, require a criminal background check for a licensee seeking/applying for a compact privilege whose primary state of residence is that member state, by receiving the results of the federal bureau of investigation criminal record search, and shall use the results in making licensure decisions. b. Communication between a member state, the commission or among member states regarding the verification of eligibility for licensure through the compact shall not include any information received from the federal bureau of investigation relating to a federal criminal records check performed by a member state under P.L. 92-544. 6. Comply with the rules of the commission; 7. Utilize only a recognized national examination as a requirement for licensure pursuant to the rules of the commission; and 8. Have continuing competence/education requirements as a condition for license renewal. (b) A member state shall grant the compact privilege to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the compact and rules. (c) Member states may charge a fee for granting a compact privilege. (d) A member state shall provide for the state’s delegate to attend all occupational therapy compact commission meetings. (e) Individuals not residing in a member state shall continue to be able to apply for a member state’s single-state license as provided under the laws of each member state. However, the single-state license granted to these individuals shall not be recog-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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nized as granting the compact privilege in any other member state. (f) Nothing in this compact shall affect the requirements established by a member state for the issuance of a single-state license. (4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall: 1. Hold a license in the home state; 2. Have a valid United States social security number or national practitioner identification number; 3. Have no encumbrance on any state license; 4. Be eligible for a compact privilege in any member state in accordance with pars. (d), (f), (g), and (h); 5. Have paid all fines and completed all requirements resulting from any adverse action against any license or compact privilege, and 2 years have elapsed from the date of such completion; 6. Notify the commission that the licensee is seeking the compact privilege within a remote state(s); 7. Pay any applicable fees, including any state fee, for the compact privilege; 8. Complete a criminal background check in accordance with sub. (3) (a) 5.; a. The licensee shall be responsible for the payment of any fee associated with the completion of a criminal background check. 9. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and 10. Report to the commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken. (b) The compact privilege is valid until the expiration date of the home state license. The licensee must comply with the requirements of par. (a) to maintain the compact privilege in the remote state. (c) A licensee providing occupational therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state. (d) Occupational therapy assistants practicing in a remote state shall be supervised by an occupational therapist licensed or holding a compact privilege in that remote state. (e) A licensee providing occupational therapy in a remote state is subject to that state’s regulatory authority. A remote state may, in accordance with due process and that state’s laws, remove a licensee’s compact privilege in the remote state for a specific period of time, impose fines, and/or take any other necessary actions to protect the health and safety of its citizens. The licensee may be ineligible for a compact privilege in any state until the specific time for removal has passed and all fines are paid. (f) If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur: 1. The home state license is no longer encumbered; and 2. Two years have elapsed from the date on which the home state license is no longer encumbered in accordance with subd. 1. (g) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of par. (a) to obtain a compact privilege in any remote state. (h) If a licensee’s compact privilege in any remote state is removed, the individual may lose the compact privilege in any other remote state until the following occur:
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1. The specific period of time for which the compact privilege was removed has ended; 2. All fines have been paid and all conditions have been met; 3. Two years have elapsed from the date of completing requirements under subds. 1. and 2; and 4. The compact privileges are reinstated by the commission and the compact data system is updated to reflect reinstatement. (i) If a licensee’s compact privilege in any remote state is removed due to an erroneous charge, privileges shall be restored through the compact data system. (j) Once the requirements of par. (h) have been met, the license must meet the requirements in par. (a) to obtain a compact privilege in a remote state. (5) OBTAINING A NEW HOME STATE LICENSE BY VIRTUE OF COMPACT PRIVILEGE. (a) An occupational therapist or occupational therapy assistant may hold a home state license, which allows for compact privileges in member states, in only one member state at a time. (b) If an occupational therapist or occupational therapy assistant changes primary state of residence by moving between two member states: 1. The occupational therapist or occupational therapy assistant shall file an application for obtaining a new home state license by virtue of a compact privilege, pay all applicable fees, and notify the current and new home state in accordance with applicable rules adopted by the commission. 2. Upon receipt of an application for obtaining a new home state license by virtue of compact privilege, the new home state shall verify that the occupational therapist or occupational therapy assistant meets the pertinent criteria outlined in sub. (4) via the data system, without need for primary source verification except for: a. An FBI fingerprint based criminal background check if not previously performed or updated pursuant to applicable rules adopted by the commission in accordance with P.L. 92-544; b. Other criminal background check as required by the new home state; and c. Submission of any requisite jurisprudence requirements of the new home state. 3. The former home state shall convert the former home state license into a compact privilege once the new home state has activated the new home state license in accordance with applicable rules adopted by the commission. 4. Notwithstanding any other provision of this compact, if the occupational therapist or occupational therapy assistant cannot meet the criteria in sub. (4), the new home state shall apply its requirements for issuing a new single-state license. 5. The occupational therapist or the occupational therapy assistant shall pay all applicable fees to the new home state in order to be issued a new home state license. (c) If an occupational therapist or occupational therapy assistant changes primary state of residence by moving from a member state to a non-member state, or from a non-member state to a member state, the state criteria shall apply for issuance of a single-state license in the new state. (d) Nothing in this compact shall interfere with a licensee’s ability to hold a single-state license in multiple states; however, for the purposes of this compact, a licensee shall have only one home state license. (e) Nothing in this compact shall affect the requirements established by a member state for the issuance of a single-state license. (6) ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES. (a) Active duty military personnel, or their spouses, shall desig-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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nate a home state where the individual has a current license in good standing. The individual may retain the home state designation during the period the service member is on active duty. Subsequent to designating a home state, the individual shall only change their home state through application for licensure in the new state or through the process described in sub. (5). (7) ADVERSE ACTIONS. (a) A home state shall have exclusive power to impose adverse action against an occupational therapist’s or occupational therapy assistant’s license issued by the home state. (b) In addition to the other powers conferred by state law, a remote state shall have the authority, in accordance with existing state due process law, to: 1. Take adverse action against an occupational therapist’s or occupational therapy assistant’s compact privilege within that member state. 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing board in a member state for the attendance and testimony of witnesses or the production of evidence from another member state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence are located. (c) For purposes of taking adverse action, the home state shall give the same priority and effect to reported conduct received from a member state as it would if the conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action. (d) The home state shall complete any pending investigations of an occupational therapist or occupational therapy assistant who changes primary state of residence during the course of the investigations. The home state, where the investigations were initiated, shall also have the authority to take appropriate action(s) and shall promptly report the conclusions of the investigations to the OT compact commission data system. The occupational therapy compact commission data system administrator shall promptly notify the new home state of any adverse actions. (e) A member state, if otherwise permitted by state law, may recover from the affected occupational therapist or occupational therapy assistant the costs of investigations and disposition of cases resulting from any adverse action taken against that occupational therapist or occupational therapy assistant. (f) A member state may take adverse action based on the factual findings of the remote state, provided that the member state follows its own procedures for taking the adverse action. (g) Joint investigations. 1. In addition to the authority granted to a member state by its respective state occupational therapy laws and regulations or other applicable state law, any member state may participate with other member states in joint investigations of licensees. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact. (h) If an adverse action is taken by the home state against an occupational therapist’s or occupational therapy assistant’s license, the occupational therapist’s or occupational therapy assistant’s compact privilege in all other member states shall be deactivated until all encumbrances have been removed from the state license. All home state disciplinary orders that impose adverse action against an occupational therapist’s or occupational therapy assistant’s license shall include a statement that the occupational
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therapist’s or occupational therapy assistant’s compact privilege is deactivated in all member states during the pendency of the order. (i) If a member state takes adverse action, it shall promptly notify the administrator of the data system. The administrator of the data system shall promptly notify the home state of any adverse actions by remote states. (j) Nothing in this compact shall override a member state’s decision that participation in an alternative program may be used in lieu of adverse action. (8) ESTABLISHMENT OF THE OCCUPATIONAL THERAPY COMPACT COMMISSION. (a) The compact member states hereby create and establish a joint public agency known as the occupational therapy compact commission: 1. The commission is an instrumentality of the compact states. 2. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. 3. Nothing in this compact shall be construed to be a waiver of sovereign immunity. (b) Membership, voting, and meetings. 1. Each member state shall have and be limited to one delegate selected by that member state’s licensing board. 2. The delegate shall be either: a. A current member of the licensing board, who is an occupational therapist, occupational therapy assistant, or public member; or b. An administrator of the licensing board. 3. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. 4. The member state board shall fill any vacancy occurring in the commission within 90 days. 5. Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates’ participation in meetings by telephone or other means of communication. 6. The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws. 7. The commission shall establish by rule a term of office for delegates. (c) The commission shall have the following powers and duties: 1. Establish a code of ethics for the commission; 2. Establish the fiscal year of the commission; 3. Establish bylaws; 4. Maintain its financial records in accordance with the bylaws; 5. Meet and take such actions as are consistent with the provisions of this compact and the bylaws; 6. Promulgate uniform rules to facilitate and coordinate implementation and administration of this compact. The rules shall have the force and effect of law and shall be binding in all member states; 7. Bring and prosecute legal proceedings or actions in the
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name of the commission, provided that the standing of any state occupational therapy licensing board to sue or be sued under applicable law shall not be affected; 8. Purchase and maintain insurance and bonds; 9. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state. 10. Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the compact, and establish the commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters; 11. Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and receive, utilize and dispose of the same; provided that at all times the commission shall avoid any appearance of impropriety and/or conflict of interest; 12. Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve or use, any property, real, personal or mixed; provided that at all times the commission shall avoid any appearance of impropriety; 13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed; 14. Establish a budget and make expenditures; 15. Borrow money; 16. Appoint committees, including standing committees composed of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this compact and the bylaws; 17. Provide and receive information from, and cooperate with, law enforcement agencies; 18. Establish and elect an executive committee; and 19. Perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of occupational therapy licensure and practice. (d) The executive committee. The executive committee shall have the power to act on behalf of the commission according to the terms of this compact. 1. The executive committee shall be composed of 9 members: a. Seven voting members who are elected by the commission from the current membership of the commission; b. One ex-officio, nonvoting member from a recognized national occupational therapy professional association; and c. One ex-officio, nonvoting member from a recognized national occupational therapy certification organization; 2. The ex-officio members will be selected by their respective organizations. 3. The commission may remove any member of the executive committee as provided in bylaws. 4. The executive committee shall meet at least annually. 5. The executive committee shall have the following duties and responsibilities: a. Recommend to the entire commission changes to the rules or bylaws, changes to this compact legislation, fees paid by compact member states such as annual dues, and any commission compact fee charged to licensees for the compact privilege; b. Ensure compact administration services are appropriately provided, contractual or otherwise; c. Prepare and recommend the budget; d. Maintain financial records on behalf of the commission;
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e. Monitor compact compliance of member states and provide compliance reports to the commission; f. Establish additional committees as necessary; and g. Perform other duties as provided in rules or bylaws. (e) 1. All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in sub. (10). 2. The commission or the executive committee or other committees of the commission may convene in a closed, non-public meeting if the commission or executive committee or other committees of the commission must discuss: a. Non-compliance of a member state with its obligations under the compact; b. The employment, compensation, discipline or other matters, practices or procedures related to specific employees, or other matters related to the commission’s internal personnel practices and procedures; c. Current, threatened, or reasonably anticipated litigation; d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate; e. Accusing any person of a crime or formally censuring any person; f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential; g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; h. Disclosure of investigative records compiled for law enforcement purposes; i. Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact; or j. Matters specifically exempted from disclosure by federal or member state statute. 3. If a meeting, or portion of a meeting, is closed pursuant to this provision, the commission’s legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. 4. The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the commission or order of a court of competent jurisdiction. (f) Financing of the commission. 1. The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. 2. The commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services. 3. The commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved by the commission each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the commission, which shall promulgate a rule binding upon all member states. 4. The commission shall not incur obligations of any kind
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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prior to securing the funds adequate to meet the same; nor shall the commission pledge the credit of any of the member states, except by and with the authority of the member state. 5. The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the commission. (g) Qualified immunity, defense, and indemnification. 1. The members, officers, executive director, employees and representatives of the commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities; provided that nothing in this subdivision shall be construed to protect any such person from suit and/or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. 2. The commission shall defend any member, officer, executive director, employee, or representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct. 3. The commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person. (9) DATA SYSTEM. (a) The commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states. (b) A member state shall submit a uniform data set to the data system on all individuals to whom this compact is applicable (utilizing a unique identifier) as required by the rules of the commission, including: 1. Identifying information; 2. Licensure data; 3. Adverse actions against a license or compact privilege; 4. Non-confidential information related to alternative program participation; 5. Any denial of application for licensure, and the reason(s) for such denial; 6. Other information that may facilitate the administration of this compact, as determined by the rules of the commission; and
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7. Current significant investigative information. (c) Current significant investigative information and other investigative information pertaining to a licensee in any member state will only be available to other member states. (d) The commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state will be available to any other member state. (e) Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state. (f) Any information submitted to the data system that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the data system. (10) RULEMAKING. (a) The commission shall exercise its rulemaking powers pursuant to the criteria set forth in this subsection and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment. (b) The commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the compact. Notwithstanding the foregoing, in the event the commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of the compact, or the powers granted hereunder, then such an action by the commission shall be invalid and have no force and effect. (c) If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the compact within 4 years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state. (d) Rules or amendments to the rules shall be adopted at a regular or special meeting of the commission. (e) Prior to promulgation and adoption of a final rule or rules by the commission, and at least 30 days in advance of the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rulemaking: 1. On the website of the commission or other publicly accessible platform; and 2. On the website of each member state occupational therapy licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules; (f) The notice of proposed rulemaking shall include: 1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon; 2. The text of the proposed rule or amendment and the reason for the proposed rule; 3. A request for comments on the proposed rule from any interested person; and 4. The manner in which interested persons may submit notice to the commission of their intention to attend the public hearing and any written comments. (g) Prior to adoption of a proposed rule, the commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public. (h) The commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by: 1. At least 25 persons; 2. A state or federal governmental subdivision or agency; or
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3. An association or organization having at least 25 members. (i) If a hearing is held on the proposed rule or amendment, the commission shall publish the place, time, and date of the scheduled public hearing. If the hearing is held via electronic means, the commission shall publish the mechanism for access to the electronic hearing. 1. All persons wishing to be heard at the hearing shall notify the executive director of the commission or other designated member in writing of their desire to appear and testify at the hearing not less than 5 business days before the scheduled date of the hearing. 2. Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing. 3. All hearings will be recorded. A copy of the recording will be made available on request. 4. Nothing in this subsection shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the commission at hearings required by this subsection. (j) Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the commission shall consider all written and oral comments received. (k) If no written notice of intent to attend the public hearing by interested parties is received, the commission may proceed with promulgation of the proposed rule without a public hearing. (L) The commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule. (m) Upon determination that an emergency exists, the commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rulemaking procedures provided in the compact and in this subsection shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to: 1. Meet an imminent threat to public health, safety, or welfare; 2. Prevent a loss of commission or member state funds; 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or 4. Protect public health and safety. (n) The commission or an authorized committee of the commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the chair of the commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the commission. (11) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. (a) Oversight. 1. The executive, legislative, and judicial branches of state government in each member state shall enforce this compact and take all actions necessary and appropriate to effectuate the compact’s purposes and intent. The provisions of
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this compact and the rules promulgated hereunder shall have standing as statutory law. 2. All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this compact which may affect the powers, responsibilities, or actions of the commission. 3. The commission shall be entitled to receive service of process in any such proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process to the commission shall render a judgment or order void as to the commission, this compact, or promulgated rules. (b) Default, technical assistance, and termination. 1. If the commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the commission shall: a. Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the default, and/or any other action to be taken by the commission; and b. Provide remedial training and specific technical assistance regarding the default. 2. If a state in default fails to cure the default, the defaulting state may be terminated from the compact upon an affirmative vote of a majority of the member states, and all rights, privileges and benefits conferred by this compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. 3. Termination of membership in the compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the commission to the governor, the majority and minority leaders of the defaulting state’s legislature, and each of the member states. 4. A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. 5. The commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the compact, unless agreed upon in writing between the commission and the defaulting state. 6. The defaulting state may appeal the action of the commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees. (c) Dispute resolution. 1. Upon request by a member state, the commission shall attempt to resolve disputes related to the compact that arise among member states and between member and non-member states. 2. The commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate. (d) Enforcement. 1. The commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this compact. 2. By majority vote, the commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the commission has its principal offices against a member state in default to enforce compliance with the provisions of the compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages.
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In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees. 3. The remedies herein shall not be the exclusive remedies of the commission. The commission may pursue any other remedies available under federal or state law. (12) DATE OF IMPLEMENTATION OF THE INTERSTATE COM-
(e) All agreements between the commission and the member states are binding in accordance with their terms. (f) In the event any provision of the compact exceeds the constitutional limits imposed on the legislature of any member state, the provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state.
MISSION FOR OCCUPATIONAL THERAPY PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT. (a) The compact
448.9875 Implementation of the occupational therapy licensure compact. (1) In this section: (a) “Compact” means the occupational therapy licensure compact under s. 448.987. (b) “Compact privilege” means a compact privilege, as defined in s. 448.987 (2) (d), that is granted under the compact to an individual to practice in this state. (c) “Examining board” means the occupational therapists affiliated credentialing board. (2) The department may impose a fee for an individual to receive a compact privilege as provided in s. 448.987 (3) (c). (3) The examining board may, by rule, require an individual seeking a compact privilege to meet a jurisprudence requirement in accordance with s. 448.987 (4) (a) 9., if such a requirement is imposed by the examining board under s. 448.964 in order to obtain a license under s. 448.963. (4) (a) An individual who holds a compact privilege shall comply with s. 440.03 (13) (am). (b) Subject to s. 448.987 and any rules promulgated thereunder, ss. 440.20 to 440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual who holds a compact privilege in the same manner that they apply to holders of licenses issued under subch. VII.
shall come into effect on the date on which the compact statute is enacted into law in the tenth member state. The provisions, which become effective at that time, shall be limited to the powers granted to the commission relating to assembly and the promulgation of rules. Thereafter, the commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the compact. (b) Any state that joins the compact subsequent to the commission’s initial adoption of the rules shall be subject to the rules as they exist on the date on which the compact becomes law in that state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day the compact becomes law in that state. (c) Any member state may withdraw from this compact by enacting a statute repealing the same. 1. A member state’s withdrawal shall not take effect until 6 months after enactment of the repealing statute. 2. Withdrawal shall not affect the continuing requirement of the withdrawing state’s occupational therapy licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal. (d) Nothing contained in this compact shall be construed to invalidate or prevent any occupational therapy licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact. (e) This compact may be amended by the member states. No amendment to this compact shall become effective and binding upon any member state until it is enacted into the laws of all member states. (13) CONSTRUCTION AND SEVERABILITY. This compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this compact shall be severable and if any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any member state or of the United States or the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person, or circumstance shall not be affected thereby. If this compact shall be held contrary to the constitution of any member state, the compact shall remain in full force and effect as to the remaining member states and in full force and effect as to the member state affected as to all severable matters. (14) BINDING EFFECT OF COMPACT AND OTHER LAWS. (a) A licensee providing occupational therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state. (b) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the compact. (c) Any laws in a member state in conflict with the compact are superseded to the extent of the conflict. (d) Any lawful actions of the commission, including all rules and bylaws promulgated by the commission, are binding upon the member states.
History: 2021 a. 123.
History: 2021 a. 123.
SUBCHAPTER XIII PA LICENSURE COMPACT 448.988 PA licensure compact. (1) PURPOSE. In order to strengthen access to medical services, and in recognition of the advances in the delivery of medical services, the participating states of the PA licensure compact have allied in common purpose to develop a comprehensive process that complements the existing authority of state licensing boards to license and discipline PAs and seeks to enhance the portability of a license to practice as a PA while safeguarding the safety of patients. This compact allows medical services to be provided by PAs, via the mutual recognition of the licensee’s qualifying license by other compact participating states. This compact also adopts the prevailing standard for PA licensure and affirms that the practice and delivery of medical services by the PA occurs where the patient is located at the time of the patient encounter, and therefore requires the PA to be under the jurisdiction of the state licensing board where the patient is located. State licensing boards that participate in this compact retain the jurisdiction to impose adverse action against a compact privilege in that state issued to a PA through the procedures of this compact. The PA licensure compact will alleviate burdens for military families by allowing active duty military personnel and their spouses to obtain a compact privilege based on having an unrestricted license in good standing from a participating state. (2) DEFINITIONS. In this compact: (a) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws which is imposed by a licensing board or other authority against a PA license or license application or compact privilege such as license denial,
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censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee’s practice. (b) “Compact privilege” means the authorization granted by a remote state to allow a licensee from another participating state to practice as a PA to provide medical services and other licensed activity to a patient located in the remote state under the remote state’s laws and regulations. (c) “Conviction” means a finding by a court that an individual is guilty of a felony or misdemeanor offense through adjudication or entry of a plea of guilt or no contest to the charge by the offender. (d) “Criminal background check” means the submission of fingerprints or other biometric-based information for a license applicant for the purpose of obtaining that applicant’s criminal history record information, as defined in 28 CFR 20.3 (d), from the state’s criminal history record repository, as defined in 28 CFR 20.3 (f). (e) “Data system” means the repository of information about licensees, including but not limited to license status and adverse actions, which is created and administered under the terms of this compact. (f) “Executive committee” means a group of directors and ex officio individuals elected or appointed pursuant to sub. (7) (f) 2. (g) “Impaired practitioner” means a PA whose practice is adversely affected by health-related condition(s) that impact their ability to practice. (h) “Investigative information” means information, records, or documents received or generated by a licensing board pursuant to an investigation. (i) “Jurisprudence requirement” means the assessment of an individual’s knowledge of the laws and rules governing the practice of a PA in a state. (j) “License” means current authorization by a state, other than authorization pursuant to a compact privilege, for a PA to provide medical services, which would be unlawful without current authorization. (k) “Licensee” means an individual who holds a license from a state to provide medical services as a PA. (L) “Licensing board” means any state entity authorized to license and otherwise regulate PAs. (m) “Medical services” means health care services provided for the diagnosis, prevention, treatment, cure or relief of a health condition, injury, or disease, as defined by a state’s laws and regulations. (n) “Model compact” means the model for the PA licensure compact on file with the Council of State Governments or other entity as designated by the commission. (o) “Participating state” means a state that has enacted this compact. (p) “PA” means an individual who is licensed as a physician assistant in a state. For purposes of this compact, any other title or status adopted by a state to replace the term “physician assistant” shall be deemed synonymous with “physician assistant” and shall confer the same rights and responsibilities to the licensee under the provisions of this compact at the time of its enactment. (q) “PA licensure compact commission,” “compact commission,” or “commission” mean the national administrative body created pursuant to sub. (7) (a). (r) “Qualifying license” means an unrestricted license issued by a participating state to provide medical services as a PA. (s) “Remote state” means a participating state where a licensee who is not licensed as a PA is exercising or seeking to exercise the compact privilege.
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(t) “Rule” means a regulation promulgated by an entity that has the force and effect of law. (u) “Significant investigative information” means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the PA to respond if required by state law, has reason to believe is not groundless and, if proven true, would indicate more than a minor infraction. (v) “State” means any state, commonwealth, district, or territory of the United States. (3) STATE PARTICIPATION IN THIS COMPACT. (a) To participate in this compact, a participating state shall: 1. License PAs. 2. Participate in the compact commission’s data system. 3. Have a mechanism in place for receiving and investigating complaints against licensees and license applicants. 4. Notify the commission, in compliance with the terms of this compact and commission rules, of any adverse action against a licensee or license applicant and the existence of significant investigative information regarding a licensee or license applicant. 5. Fully implement a criminal background check requirement, within a time frame established by commission rule, by its licensing board receiving the results of a criminal background check and reporting to the commission whether the license applicant has been granted a license. 6. Comply with the rules of the compact commission. 7. Utilize passage of a recognized national exam such as the NCCPA PANCE as a requirement for PA licensure. 8. Grant the compact privilege to a holder of a qualifying license in a participating state. (b) Nothing in this compact prohibits a participating state from charging a fee for granting the compact privilege. (4) COMPACT PRIVILEGE. (a) To exercise the compact privilege, a licensee must: 1. Have graduated from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc. or other programs authorized by commission rule. 2. Hold current NCCPA certification. 3. Have no felony or misdemeanor conviction. 4. Have never had a controlled substance license, permit, or registration suspended or revoked by a state or by the United States drug enforcement administration. 5. Have a unique identifier as determined by commission rule. 6. Hold a qualifying license. 7. Have had no revocation of a license or limitation or restriction on any license currently held due to an adverse action. 8. If a licensee has had a limitation or restriction on a license or compact privilege due to an adverse action, two years must have elapsed from the date on which the license or compact privilege is no longer limited or restricted due to the adverse action. 9. If a compact privilege has been revoked or is limited or restricted in a participating state for conduct that would not be a basis for disciplinary action in a participating state in which the licensee is practicing or applying to practice under a compact privilege, that participating state shall have the discretion not to consider such action as an adverse action requiring the denial or removal of a compact privilege in that state. 10. Notify the compact commission that the licensee is seeking the compact privilege in a remote state. 11. Meet any jurisprudence requirement of a remote state in which the licensee is seeking to practice under the compact privi-
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lege and pay any fees applicable to satisfying the jurisprudence requirement. 12. Report to the commission any adverse action taken by a nonparticipating state within thirty (30) days after the action is taken. (b) The compact privilege is valid until the expiration or revocation of the qualifying license unless terminated pursuant to an adverse action. The licensee must also comply with all of the requirements of par. (a) above to maintain the compact privilege in a remote state. If the participating state takes adverse action against a qualifying license, the licensee shall lose the compact privilege in any remote state in which the licensee has a compact privilege until all of the following occur: 1. The license is no longer limited or restricted; and 2. Two (2) years have elapsed from the date on which the license is no longer limited or restricted due to the adverse action. (c) Once a restricted or limited license satisfies the requirements of par. (b) 1. and 2., the licensee must meet the requirements of par. (a) to obtain a compact privilege in any remote state. (d) For each remote state in which a PA seeks authority to prescribe controlled substances, the PA shall satisfy all requirements imposed by such state in granting or renewing such authority. (5) DESIGNATION OF THE STATE FROM WHICH LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE. Upon a licensee’s application for a compact privilege, the licensee shall identify to the commission the participating state from which the licensee is applying, in accordance with applicable rules adopted by the commission, and subject to the following requirements: (a) When applying for a compact privilege, the licensee shall provide the commission with the address of the licensee’s primary residence and thereafter shall immediately report to the commission any change in the address of the licensee’s primary residence. (b) When applying for a compact privilege, the licensee is required to consent to accept service of process by mail at the licensee’s primary residence on file with the commission with respect to any action brought against the licensee by the commission or a participating state, including a subpoena, with respect to any action brought or investigation conducted by the commission or a participating state. (6) ADVERSE ACTIONS. (a) A participating state in which a licensee is licensed shall have exclusive power to impose adverse action against the qualifying license issued by that participating state. (b) In addition to the other powers conferred by state law, a remote state shall have the authority, in accordance with existing state due process law, to do all of the following: 1. Take adverse action against a PA’s compact privilege within that state to remove a licensee’s compact privilege or take other action necessary under applicable law to protect the health and safety of its citizens. 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing board in a participating state for the attendance and testimony of witnesses or the production of evidence from another participating state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state in which the witnesses or evidence are located. 3. Notwithstanding subd. 2., subpoenas may not be issued by a participating state to gather evidence of conduct in another state
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that is lawful in that other state for the purpose of taking adverse action against a licensee’s compact privilege or application for a compact privilege in that participating state. 4. Nothing in this compact authorizes a participating state to impose discipline against a PA’s compact privilege or to deny an application for a compact privilege in that participating state for the individual’s otherwise lawful practice in another state. (c) For purposes of taking adverse action, the participating state which issued the qualifying license shall give the same priority and effect to reported conduct received from any other participating state as it would if the conduct had occurred within the participating state which issued the qualifying license. In so doing, that participating state shall apply its own state laws to determine appropriate action. (d) A participating state, if otherwise permitted by state law, may recover from the affected PA the costs of investigations and disposition of cases resulting from any adverse action taken against that PA. (e) A participating state may take adverse action based on the factual findings of a remote state, provided that the participating state follows its own procedures for taking the adverse action. (f) Joint investigations. 1. In addition to the authority granted to a participating state by its respective state PA laws and regulations or other applicable state law, any participating state may participate with other participating states in joint investigations of licensees. 2. Participating states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under this compact. (g) If an adverse action is taken against a PA’s qualifying license, the PA’s compact privilege in all remote states shall be deactivated until two (2) years have elapsed after all restrictions have been removed from the state license. All disciplinary orders by the participating state which issued the qualifying license that impose adverse action against a PA’s license shall include a statement that the PA’s compact privilege is deactivated in all participating states during the pendency of the order. (h) If any participating state takes adverse action, it promptly shall notify the administrator of the data system. (7) ESTABLISHMENT OF THE PA LICENSURE COMPACT COMMISSION. (a) The participating states hereby create and establish a joint government agency and national administrative body known as the PA licensure compact commission. The commission is an instrumentality of the compact states acting jointly and not an instrumentality of any one state. The commission shall come into existence on or after the effective date of the compact as set forth in sub. (11) (a). (b) Membership, voting, and meetings. 1. Each participating state shall have and be limited to one (1) delegate selected by that participating state’s licensing board or, if the state has more than one licensing board, selected collectively by the participating state’s licensing boards. 2. The delegate shall be either: a. A current PA, physician or public member of a licensing board or PA council/committee; or b. An administrator of a licensing board. 3. Any delegate may be removed or suspended from office as provided by the laws of the state from which the delegate is appointed. 4. The participating state licensing board shall fill any vacancy occurring in the commission within sixty (60) days. 5. Each delegate shall be entitled to one (1) vote on all matters voted on by the commission and shall otherwise have an opportunity to participate in the business and affairs of the commis-
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sion. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates’ participation in meetings by telecommunications, video conference, or other means of communication. 6. The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in this compact and the bylaws. 7. The commission shall establish by rule a term of office for delegates. (c) The commission shall have the following powers and duties: 1. Establish a code of ethics for the commission; 2. Establish the fiscal year of the commission; 3. Establish fees; 4. Establish bylaws; 5. Maintain its financial records in accordance with the bylaws; 6. Meet and take such actions as are consistent with the provisions of this compact and the bylaws; 7. Promulgate rules to facilitate and coordinate implementation and administration of this compact. The rules shall have the force and effect of law and shall be binding in all participating states; 8. Bring and prosecute legal proceedings or actions in the name of the commission, provided that the standing of any state licensing board to sue or be sued under applicable law shall not be affected; 9. Purchase and maintain insurance and bonds; 10. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a participating state; 11. Hire employees and engage contractors, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of this compact, and establish the commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters; 12. Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and receive, utilize and dispose of the same; provided that at all times the commission shall avoid any appearance of impropriety or conflict of interest; 13. Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve or use, any property, real, personal or mixed; provided that at all times the commission shall avoid any appearance of impropriety; 14. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed; 15. Establish a budget and make expenditures; 16. Borrow money; 17. Appoint committees, including standing committees composed of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this compact and the bylaws; 18. Provide and receive information from, and cooperate with, law enforcement agencies; 19. Elect a chair, vice chair, secretary and treasurer and such other officers of the commission as provided in the commission’s bylaws. 20. Reserve for itself, in addition to those reserved exclusively to the commission under the compact, powers that the executive committee may not exercise; 21. Approve or disapprove a state’s participation in the com-
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pact based upon its determination as to whether the state’s compact legislation departs in a material manner from the model compact language; 22. Prepare and provide to the participating states an annual report; and 23. Perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of PA licensure and practice. (d) Meetings of the commission. 1. All meetings of the commission that are not closed pursuant to this paragraph shall be open to the public. Notice of public meetings shall be posted on the commission’s website at least thirty (30) days prior to the public meeting. 2. Notwithstanding subd. 1., the commission may convene a public meeting by providing at least twenty-four (24) hours prior notice on the commission’s website, and any other means as provided in the commission’s rules, for any of the reasons it may dispense with notice of proposed rulemaking under sub. (9) (L). 3. The commission may convene in a closed, nonpublic meeting or nonpublic part of a public meeting to receive legal advice or to discuss: a. Noncompliance of a participating state with its obligations under this compact; b. The employment, compensation, discipline or other matters, practices or procedures related to specific employees or other matters related to the commission’s internal personnel practices and procedures; c. Current, threatened, or reasonably anticipated litigation; d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate; e. Accusing any person of a crime or formally censuring any person; f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential; g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; h. Disclosure of investigative records compiled for law enforcement purposes; i. Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to this compact; j. Legal advice; or k. Matters specifically exempted from disclosure by federal or participating states’ statutes. 4. If a meeting, or portion of a meeting, is closed pursuant to this provision, the chair of the meeting or the chair’s designee shall certify that the meeting or portion of the meeting may be closed and shall reference each relevant exempting provision. 5. The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the commission or order of a court of competent jurisdiction. (e) Financing of the commission. 1. The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. 2. The commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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3. The commission may levy on and collect an annual assessment from each participating state and may impose compact privilege fees on licensees of participating states to whom a compact privilege is granted to cover the cost of the operations and activities of the commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved by the commission each year for which revenue is not provided by other sources. The aggregate annual assessment amount levied on participating states shall be allocated based upon a formula to be determined by commission rule. a. A compact privilege expires when the licensee’s qualifying license in the participating state from which the licensee applied for the compact privilege expires. b. If the licensee terminates the qualifying license through which the licensee applied for the compact privilege before its scheduled expiration, and the licensee has a qualifying license in another participating state, the licensee shall inform the commission that it is changing to that participating state the participating state through which it applies for a compact privilege and pay to the commission any compact privilege fee required by commission rule. 4. The commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the commission pledge the credit of any of the participating states, except by and with the authority of the participating state. 5. The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the financial review and accounting procedures established under its bylaws. All receipts and disbursements of funds handled by the commission shall be subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review shall be included in and become part of the annual report of the commission. (f) The executive committee. 1. The executive committee shall have the power to act on behalf of the commission according to the terms of this compact and commission rules. 2. The executive committee shall be composed of nine (9) members: a. Seven voting members who are elected by the commission from the current membership of the commission; b. One ex officio, nonvoting member from a recognized national PA professional association; and c. One ex officio, nonvoting member from a recognized national PA certification organization. 3. The ex officio members will be selected by their respective organizations. 4. The commission may remove any member of the executive committee as provided in its bylaws. 5. The executive committee shall meet at least annually. 6. The executive committee shall have the following duties and responsibilities: a. Recommend to the commission changes to the commission’s rules or bylaws, changes to this compact legislation, fees to be paid by compact participating states such as annual dues, and any commission compact fee charged to licensees for the compact privilege; b. Ensure compact administration services are appropriately provided, contractual or otherwise; c. Prepare and recommend the budget; d. Maintain financial records on behalf of the commission; e. Monitor compact compliance of participating states and provide compliance reports to the commission; f. Establish additional committees as necessary;
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g. Exercise the powers and duties of the commission during the interim between commission meetings, except for issuing proposed rule making or adopting commission rules or bylaws, or exercising any other powers and duties exclusively reserved to the commission by the commission’s rules; and h. Perform other duties as provided in the commission’s rules or bylaws. 7. All meeting of the executive committee at which it votes or plans to vote on matters in exercising the powers and duties of the commission shall be open to the public and public notice of such meetings shall be given as public meetings of the commission are given. 8. The executive committee may convene in a closed, nonpublic meeting for the same reasons that the commission may convene in a nonpublic meeting as set forth in par. (d) 3. and shall announce the closed meeting as the commission is required to under par. (d) 4. and keep minutes of the closed meeting as the commission is required to under par. (d) 5. (g) Qualified immunity, defense, and indemnification. 1. The members, officers, executive director, employees and representatives of the commission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities; provided that nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. The procurement of insurance of any type by the commission shall not in any way compromise or limit the immunity granted hereunder. 2. The commission shall defend any member, officer, executive director, employee, and representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or as determined by the commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining their own counsel at their own expense; and provided further, that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct. 3. The commission shall indemnify and hold harmless any member, officer, executive director, employee, and representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person. 4. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses in any proceedings as authorized by commission rules. 5. Nothing herein shall be construed as a limitation on the liability of any licensee for professional malpractice or miscon-
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duct, which shall be governed solely by any other applicable state laws. 6. Nothing herein shall be construed to designate the venue or jurisdiction to bring actions for alleged acts of malpractice, professional misconduct, negligence, or other such civil action pertaining to the practice of a PA. All such matters shall be determined exclusively by state law other than this compact. 7. Nothing in this compact shall be interpreted to waive or otherwise abrogate a participating state’s state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman Act, Clayton Act, or any other state or federal antitrust or anticompetitive law or regulation. 8. Nothing in this compact shall be construed to be a waiver of sovereign immunity by the participating states or by the commission. (8) DATA SYSTEM. (a) The commission shall provide for the development, maintenance, operation, and utilization of a coordinated data and reporting system containing licensure, adverse action, and the reporting of the existence of significant investigative information on all licensed PAs and applicants denied a license in participating states. (b) Notwithstanding any other state law to the contrary, a participating state shall submit a uniform data set to the data system on all PAs to whom this compact is applicable (utilizing a unique identifier) as required by the rules of the commission, including: 1. Identifying information; 2. Licensure data; 3. Adverse actions against a license or compact privilege; 4. Any denial of application for licensure, and the reason(s) for such denial (excluding the reporting of any criminal history record information where prohibited by law); 5. The existence of significant investigative information; and 6. Other information that may facilitate the administration of this compact, as determined by the rules of the commission. (c) Significant investigative information pertaining to a licensee in any participating state shall only be available to other participating states. (d) The commission shall promptly notify all participating states of any adverse action taken against a licensee or an individual applying for a license that has been reported to it. This adverse action information shall be available to any other participating state. (e) Participating states contributing information to the data system may, in accordance with state or federal law, designate information that may not be shared with the public without the express permission of the contributing state. Notwithstanding any such designation, such information shall be reported to the commission through the data system. (f) Any information submitted to the data system that is subsequently expunged pursuant to federal law or the laws of the participating state contributing the information shall be removed from the data system upon reporting of such by the participating state to the commission. (g) The records and information provided to a participating state pursuant to this compact or through the data system, when certified by the commission or an agent thereof, shall constitute the authenticated business records of the commission, and shall be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceedings in a participating state. (9) RULE MAKING. (a) The commission shall exercise its rule-making powers pursuant to the criteria set forth in this subsection and the rules adopted thereunder. Commission rules shall
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become binding as of the date specified by the commission for each rule. (b) The commission shall promulgate reasonable rules in order to effectively and efficiently implement and administer this compact and achieve its purposes. A commission rule shall be invalid and have not force or effect only if a court of competent jurisdiction holds that the rule is invalid because the commission exercised its rule-making authority in a manner that is beyond the scope of the purposes of this compact, or the powers granted hereunder, or based upon another applicable standard of review. (c) The rules of the commission shall have the force of law in each participating state, provided however that where the rules of the commission conflict with the laws of the participating state that establish the medical services a PA may perform in the participating state, as held by a court of competent jurisdiction, the rules of the commission shall be ineffective in that state to the extent of the conflict. (d) If a majority of the legislatures of the participating states rejects a commission rule, by enactment of a statute or resolution in the same manner used to adopt this compact within four (4) years of the date of adoption of the rule, then such rule shall have no further force and effect in any participating state or to any state applying to participate in the compact. (e) Commission rules shall be adopted at a regular or special meeting of the commission. (f) Prior to promulgation and adoption of a final rule or rules by the commission, and at least thirty (30) days in advance of the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rule making: 1. On the website of the commission or other publicly accessible platform; and 2. To persons who have requested notice of the commission’s notices of proposed rule making, and 3. In such other way(s) as the commission may by rule specify. (g) The notice of proposed rule making shall include: 1. The time, date, and location of the public hearing on the proposed rule and the proposed time, date and location of the meeting in which the proposed rule will be considered and voted upon; 2. The text of the proposed rule and the reason for the proposed rule; 3. A request for comments on the proposed rule from any interested person and the date by which written comments must be received; and 4. The manner in which interested persons may submit notice to the commission of their intention to attend the public hearing or provide any written comments. (h) Prior to adoption of a proposed rule, the commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public. (i) If the hearing is to be held via electronic means, the commission shall publish the mechanism for access to the electronic hearing. 1. All persons wishing to be heard at the hearing shall as directed in the notice of proposed rule making, not less than five (5) business days before the scheduled date of the hearing, notify the commission of their desire to appear and testify at the hearing. 2. Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing. 3. All hearings shall be recorded. A copy of the recording and the written comments, data, facts, opinions, and arguments
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received in response to the proposed rule making shall be made available to a person upon request. 4. Nothing in this subsection shall be construed as requiring a separate hearing on each proposed rule. Proposed rules may be grouped for the convenience of the commission at hearings required by this subsection. (j) Following the public hearing the commission shall consider all written and oral comments timely received. (k) The commission shall, by majority vote of all delegates, take final action on the proposed rule and shall determine the effective date of the rule, if adopted, based on the rule-making record and the full text of the rule. 1. If adopted, the rule shall be posted on the commission’s website. 2. The commission may adopt changes to the proposed rule provided the changes do not enlarge the original purpose of the proposed rule. 3. The commission shall provide on its website an explanation of the reasons for substantive changes made to the proposed rule as well as reasons for substantive changes not made that were recommended by commenters. 4. The commission shall determine a reasonable effective date for the rule. Except for an emergency as provided in par. (L), the effective date of the rule shall be no sooner than thirty (30) days after the commission issued the notice that it adopted the rule. (L) Upon determination that an emergency exists, the commission may consider and adopt an emergency rule with twentyfour (24) hours prior notice, without the opportunity for comment, or hearing, provided that the usual rule-making procedures provided in this compact and in this subsection shall be retroactively applied to the rule as soon as reasonably possible, in no event later than ninety (90) days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately by the commission in order to: 1. Meet an imminent threat to public health, safety, or welfare; 2. Prevent a loss of commission or participating state funds; 3. Meet a deadline for the promulgation of a commission rule that is established by federal law or rule; or 4. Protect public health and safety. (m) The commission or an authorized committee of the commission may direct revisions to a previously adopted commission rule for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the commission. The revision shall be subject to challenge by any person for a period of thirty (30) days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made as set forth in the notice of revisions and delivered to the commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the commission. (n) No participating state’s rule-making requirements shall apply under this compact. (10) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. (a) Oversight. 1. The executive and judicial branches of state government in each participating state shall enforce this compact and take all actions necessary and appropriate to implement the compact. 2. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of
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competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. Nothing herein shall affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct or any such similar matter. 3. The commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the compact or the commission’s rules and shall have standing to intervene in such a proceeding for all purposes. Failure to provide the commission with service of process shall render a judgment or order in such proceeding void as to the commission, this compact, or commission rules. (b) Default, technical assistance, and termination. 1. If the commission determines that a participating state has defaulted in the performance of its obligations or responsibilities under this compact or the commission rules, the commission shall provide written notice to the defaulting state and other participating states. The notice shall describe the default, the proposed means of curing the default and any other action that the commission may take and shall offer remedial training and specific technical assistance regarding the default. 2. If a state in default fails to cure the default, the defaulting state may be terminated from this compact upon an affirmative vote of a majority of the delegates of the participating states, and all rights, privileges and benefits conferred by this compact upon such state may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. 3. Termination of participation in this compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the commission to the governor, the majority and minority leaders of the defaulting state’s legislature, and to the licensing board(s) of each of the participating states. 4. A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. 5. The commission shall not bear any costs related to a state that is found to be in default or that has been terminated from this compact, unless agreed upon in writing between the commission and the defaulting state. 6. The defaulting state may appeal its termination from the compact by the commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees. 7. Upon the termination of a state’s participation in the compact, the state shall immediately provide notice to all licensees within that state of such termination: a. Licensees who have been granted a compact privilege in that state shall retain the compact privilege for one hundred eighty (180) days following the effective date of such termination. b. Licensees who are licensed in that state who have been granted a compact privilege in a participating state shall retain the compact privilege for one hundred eighty (180) days unless the licensee also has a qualifying license in a participating state or obtains a qualifying license in a participating state before the one hundred eighty (180)-day period ends, in which case the compact privilege shall continue. (c) Dispute resolution. 1. Upon request by a participating state, the commission shall attempt to resolve disputes related to
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this compact that arise among participating states and between participating and nonparticipating states. 2. The commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate. (d) Enforcement. 1. The commission, in the reasonable exercise of its discretion, shall enforce the provisions of this compact and rules of the commission. 2. If compliance is not secured after all means to secure compliance have been exhausted, by majority vote, the commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the commission has its principal offices, against a participating state in default to enforce compliance with the provisions of this compact and the commission’s promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. 3. The remedies herein shall not be the exclusive remedies of the commission. The commission may pursue any other remedies available under federal or state law. (e) Legal action against the commission. 1. A participating state may initiate legal action against the commission in the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices to enforce compliance with the provisions of the compact and its rules. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. 2. No person other than a participating state shall enforce this compact against the commission. (11) DATE OF IMPLEMENTATION OF THE PA LICENSURE COMPACT COMMISSION. (a) This compact shall come into effect on the date on which this compact statute is enacted into law in the seventh participating state. 1. On or after the effective date of the compact, the commission shall convene and review the enactment of each of the states that enacted the compact prior to the commission convening (“charter participating states”) to determine if the statute enacted by each such charter participating state is materially different than the model compact. a. A charter participating state whose enactment is found to be materially different from the model compact shall be entitled to the default process set forth in sub. (10) (b). b. If any participating state later withdraws from the compact or its participation is terminated, the commission shall remain in existence and the compact shall remain in effect even if the number of participating states should be less than seven. Participating states enacting the compact subsequent to the commission convening shall be subject to the process set forth in sub. (7) (c) 21. to determine if their enactments are materially different from the model compact and whether they qualify for participation in the compact. 2. Participating states enacting the compact subsequent to the seven initial charter participating states shall be subject to the process set forth in sub. (7) (c) 21. to determine if their enactments are materially different from the model compact and whether they qualify for participation in the compact. 3. All actions taken for the benefit of the commission or in furtherance of the purposes of the administration of the compact prior to the effective date of the compact or the commission coming into existence shall be considered to be actions of the commission unless specifically repudiated by the commission.
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(b) Any state that joins this compact shall be subject to the commission’s rules and bylaws as they exist on the date on which this compact becomes law in that state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day this compact becomes law in that state. (c) Any participating state may withdraw from this compact by enacting a statute repealing the same. 1. A participating state’s withdrawal shall not take effect until one hundred eighty (180) days after enactment of the repealing statute. During this one hundred eighty (180) day-period, all compact privileges that were in effect in the withdrawing state and were granted to licensees licensed in the withdrawing state shall remain in effect. If any licensee licensed in the withdrawing state is also licensed in another participating state or obtains a license in another participating state within the one hundred eighty (180) days, the licensee’s compact privileges in other participating states shall not be affected by the passage of the one hundred eighty (180) days. 2. Withdrawal shall not affect the continuing requirement of the state licensing board(s) of the withdrawing state to comply with the investigative, and adverse action reporting requirements of this compact prior to the effective date of withdrawal. 3. Upon the enactment of a statute withdrawing a state from this compact, the state shall immediately provide notice of such withdrawal to all licensees within that state. Such withdrawing state shall continue to recognize all licenses granted pursuant to this compact for a minimum of one hundred eighty (180) days after the date of such notice of withdrawal. (d) Nothing contained in this compact shall be construed to invalidate or prevent any PA licensure agreement or other cooperative arrangement between participating states and between a participating state and nonparticipating state that does not conflict with the provisions of this compact. (e) This compact may be amended by the participating states. No amendment to this compact shall become effective and binding upon any participating state until it is enacted materially in the same manner into the laws of all participating states as determined by the commission. (12) CONSTRUCTION AND SEVERABILITY. (a) This compact and the commission’s rule-making authority shall be liberally construed so as to effectuate the purposes, and the implementation and administration of the compact. Provisions of the compact expressly authorizing or requiring the promulgation of rules shall not be construed to limit the commission’s rule-making authority solely for those purposes. (b) The provisions of this compact shall be severable and if any phrase, clause, sentence or provision of this compact is held by a court of competent jurisdiction to be contrary to the constitution of any participating state, a state seeking participation in the compact, or of the United States, or the applicability thereof to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of this compact and the applicability thereof to any other government, agency, person or circumstance shall not be affected thereby. (c) Notwithstanding par. (b) or this subsection, the commission may deny a state’s participation in the compact or, in accordance with the requirements of sub. (10) (b), terminate a participating state’s participation in the compact, if it determines that a constitutional requirement of a participating state is, or would be with respect to a state seeking to participate in the compact, a material departure from the compact. Otherwise, if this compact shall be held to be contrary to the constitution of any participating state, the compact shall remain in full force and effect as to
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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the remaining participating states and in full force and effect as to the participating state affected as to all severable matters. (13) BINDING EFFECT OF COMPACT. (a) Nothing herein prevents the enforcement of any other law of a participating state that is not inconsistent with this compact. (b) Any laws in a participating state in conflict with this compact are superseded to the extent of the conflict. (c) All agreements between the commission and the participating states are binding in accordance with their terms. History: 2023 a. 81.
448.9885 Implementation of the PA licensure compact. (1) In this section: (a) “Board” means the physician assistant affiliated credentialing board. (b) “Compact” means the PA licensure compact under s. 448.988. (c) “Compact privilege” means a compact privilege, as defined in s. 448.988 (2) (b), that is granted under the compact to an individual to practice in this state. (2) The department may impose a fee for an individual to receive a compact privilege as provided in s. 448.988 (3) (b). (3) (a) An individual who holds a compact privilege shall comply with s. 440.03 (13) (am). (b) Subject to s. 448.988 and any rules promulgated thereunder, ss. 440.20 to 440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual who holds a compact privilege in the same manner that they apply to holders of licenses issued under subch. IX. History: 2023 a. 81.
SUBCHAPTER XIV DIETITIAN LICENSURE COMPACT 448.9887 Dietitian licensure compact. (1) PURPOSE. The purpose of this compact is to facilitate interstate practice of dietetics with the goal of improving public access to dietetics services. This compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure, while also providing for licensure portability through a compact privilege granted to qualifying professionals. This compact is designed to achieve the following objectives: (a) Increase public access to dietetics services; (b) Provide opportunities for interstate practice by licensed dietitians who meet uniform requirements; (c) Eliminate the necessity for licenses in multiple states; (d) Reduce administrative burden on member states and licensees; (e) Enhance the states’ ability to protect the public’s health and safety; (f) Encourage the cooperation of member states in regulating multistate practice of licensed dietitians; (g) Support relocating active military members and their spouses; (h) Enhance the exchange of licensure, investigative, and disciplinary information among member states; and (i) Vest all member states with the authority to hold a licensed dietitian accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered. (2) DEFINITIONS. As used in this compact, and except as otherwise provided, the following definitions shall apply: (a) “ACEND” means the Accreditation Council for Education in Nutrition and Dietetics or its successor organization.
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(b) “Active military member” means any individual with fulltime duty status in the active armed forces of the United States, including members of the national guard and reserve. (c) “Adverse action” means any administrative, civil, equitable or criminal action permitted by a state’s laws which is imposed by a licensing authority or other authority against a licensee, including actions against an individual’s license or compact privilege such as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee’s practice, or any other encumbrance on licensure affecting a licensee’s authorization to practice, including issuance of a cease and desist action. (d) “Alternative program” means a nondisciplinary monitoring or practice remediation process approved by a licensing authority. (dm) “CDR” means the Commission on Dietetic Registration or its successor organization. (e) “Charter member state” means any member state which enacted this compact by law before the effective date specified in sub. (12). (h) “Compact commission” means the government agency whose membership consists of all states that have enacted this compact, which is known as the dietitian licensure compact commission, as described in sub. (8), and which shall operate as an instrumentality of the member states. (i) “Compact privilege” means a legal authorization, which is equivalent to a license, permitting the practice of dietetics in a remote state. (im) “Continuing education” means a requirement, as a condition of license renewal, to provide evidence of participation in, and completion of, educational and professional activities relevant to practice or area of work. (j) “Current significant investigative information” means: 1. Investigative information that a licensing authority, after a preliminary inquiry that includes notification and an opportunity for the subject licensee to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction; or 2. Investigative information that indicates that the subject licensee represents an immediate threat to public health and safety regardless of whether the subject licensee has been notified and had an opportunity to respond. (k) “Data system” means a repository of information about licensees, including, but not limited to, continuing education, examination, licensure, investigative, compact privilege and adverse action information. (L) “Encumbered license” means a license in which an adverse action restricts a licensee’s ability to practice dietetics. (m) “Encumbrance” means a revocation or suspension of, or any limitation on, a licensee’s full and unrestricted practice of dietetics by a licensing authority. (n) “Executive committee” means a group of delegates elected or appointed to act on behalf of, and within the powers granted to them by, this compact, and the compact commission. (o) “Home state” means the member state that is the licensee’s primary state of residence or that has been designated pursuant to sub. (6). (p) “Investigative information” means information, records, and documents received or generated by a licensing authority pursuant to an investigation. (q) “Jurisprudence requirement” means an assessment of an individual’s knowledge of the state laws and regulations governing the practice of dietetics in such state. (r) “License” means an authorization from a member state to either:
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1. Engage in the practice of dietetics (including medical nutrition therapy); or 2. Use the title “dietitian,” “licensed dietitian,” “licensed dietitian nutritionist,” “certified dietitian,” or other title describing a substantially similar practitioner as the compact commission may further define by rule. (s) “Licensee” or “licensed dietitian” means an individual who currently holds a license and who meets all of the requirements outlined in sub. (4). (t) “Licensing authority” means the board or agency of a state, or equivalent, that is responsible for the licensing and regulation of the practice of dietetics. (u) “Member state” means a state that has enacted the compact. (v) “Practice of dietetics” means the synthesis and application of dietetics, primarily for the provision of nutrition care services, including medical nutrition therapy, in person or via telehealth, to prevent, manage, or treat diseases or medical conditions and promote wellness. (w) “Registered dietitian” means a person who: 1. Has completed applicable education, experience, examination, and recertification requirements approved by CDR; 2. Is credentialed by CDR as a registered dietitian or a registered dietitian nutritionist; and 3. Is legally authorized to use the title registered dietitian or registered dietitian nutritionist and the corresponding abbreviations “RD” or “RDN.” (x) “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise a compact privilege. (y) “Rule” means a regulation promulgated by the compact commission that has the force of law. (z) “Single state license” means a license issued by a member state within the issuing state and does not include a compact privilege in any other member state. (za) “State” means any state, commonwealth, district, or territory of the United States. (zb) “Unencumbered license” means a license that authorizes a licensee to engage in the full and unrestricted practice of dietetics. (3) STATE PARTICIPATION IN THE COMPACT. (a) To participate in the compact, a state must currently: 1. License and regulate the practice of dietetics; and 2. Have a mechanism in place for receiving and investigating complaints about licensees. (b) A member state shall: 1. Participate fully in the compact commission’s data system, including using the unique identifier, as defined in rules; 2. Notify the compact commission, in compliance with the terms of the compact and rules, of any adverse action or the availability of current significant investigative information regarding a licensee; 3. Implement or utilize procedures for considering the criminal history record information of applicants for an initial compact privilege. These procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant’s criminal history record information from the federal bureau of investigation and the agency responsible for retaining that state’s criminal records; a. A member state must fully implement a criminal history record information requirement, within a time frame established by rule, which includes receiving the results of the federal bureau of investigation record search and shall use those results in determining compact privilege eligibility.
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b. Communication between a member state and the compact commission or among member states regarding the verification of eligibility for a compact privilege shall not include any information received from the federal bureau of investigation relating to a federal criminal history record information check performed by a member state. 4. Comply with and enforce the rules of the compact commission; 5. Require an applicant for a compact privilege to obtain or retain a license in the licensee’s home state and meet the home state’s qualifications for licensure or renewal of licensure, as well as all other applicable state laws; and 6. Recognize a compact privilege granted to a licensee who meets all of the requirements outlined in sub. (4) in accordance with the terms of the compact and rules. (c) Member states may set and collect a fee for granting a compact privilege. (d) Individuals not residing in a member state shall continue to be able to apply for a member state’s single state license as provided under the laws of each member state. However, the single state license granted to these individuals shall not be recognized as granting a compact privilege to engage in the practice of dietetics in any other member state. (e) Nothing in this compact shall affect the requirements established by a member state for the issuance of a single state license. (f) At no point shall the compact commission have the power to define the requirements for the issuance of a single state license to practice dietetics. The member states shall retain sole jurisdiction over the provision of these requirements. (4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall: 1. Satisfy one of the following: a. Hold a valid current registration that gives the applicant the right to use the term registered dietitian; or b. Complete all of the following: i. An education program which is either: a) A master’s degree or doctoral degree that is programmatically accredited by (i) ACEND; or (ii) a dietetics accrediting agency recognized by the U.S. department of education, which the compact commission may by rule determine, and from a college or university accredited at the time of graduation by the appropriate regional accrediting agency recognized by the Council on Higher Education Accreditation and the U.S. department of education. b) An academic degree from a college or university in a foreign country equivalent to the degree described in subparagraph (a) that is programmatically accredited by (i) ACEND; or (ii) a dietetics accrediting agency recognized by the U.S. department of education, which the compact commission may by rule determine. ii. A planned, documented, supervised practice experience in dietetics that is programmatically accredited by (i) ACEND, or (ii) a dietetics accrediting agency recognized by the U.S. department of education which the compact commission may by rule determine and which involves at least 1,000 hours of practice experience under the supervision of a registered dietitian or a licensed dietitian. iii. Successful completion of either: (i) the registration examination for dietitians administered by CDR, or (ii) a national credentialing examination for dietitians approved by the compact commission by rule; such completion being no more than 5 years prior to the date of the licensee’s application for initial licensure and accompanied by a period of continuous licensure thereafter,
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all of which may be further governed by the rules of the compact commission. 2. Hold an unencumbered license in the home state; 3. Notify the compact commission that the licensee is seeking a compact privilege within a remote state; 4. Pay any applicable fees, including any state fee, for the compact privilege; 5. Meet any jurisprudence requirements established by the remote state in which the licensee is seeking a compact privilege; and 6. Report to the compact commission any adverse action, encumbrance, or restriction on a license taken by any nonmember state within 30 days from the date the action is taken. (b) The compact privilege is valid until the expiration date of the home state license. To maintain a compact privilege, renewal of the compact privilege shall be congruent with the renewal of the home state license as the compact commission may define by rule. The licensee must comply with the requirements of par. (a) to maintain the compact privilege in the remote state. (c) A licensee exercising a compact privilege shall adhere to the laws and regulations of the remote state. Licensees shall be responsible for educating themselves on, and complying with, any and all state laws relating to the practice of dietetics in such remote state. (d) Notwithstanding anything to the contrary provided in this compact or state law, a licensee exercising a compact privilege shall not be required to complete continuing education requirements required by a remote state. A licensee exercising a compact privilege is only required to meet any continuing education requirements as required by the home state. (5) OBTAINING A NEW HOME STATE LICENSE BASED ON A COMPACT PRIVILEGE. (a) A licensee may hold a home state license, which allows for a compact privilege in other member states, in only one member state at a time. (b) If a licensee changes home state by moving between 2 member states: 1. The licensee shall file an application for obtaining a new home state license based on a compact privilege, pay all applicable fees, and notify the current and new home state in accordance with the rules of the compact commission. 2. Upon receipt of an application for obtaining a new home state license by virtue of a compact privilege, the new home state shall verify that the licensee meets the criteria in sub. (4) via the data system, and require that the licensee complete the following: a. Federal bureau of investigation fingerprint based criminal history record information check; b. Any other criminal history record information required by the new home state; and c. Any jurisprudence requirements of the new home state. 3. The former home state shall convert the former home state license into a compact privilege once the new home state has activated the new home state license in accordance with applicable rules adopted by the compact commission. 4. Notwithstanding any other provision of this compact, if the licensee cannot meet the criteria in sub. (4), the new home state may apply its requirements for issuing a new single state license. 5. The licensee shall pay all applicable fees to the new home state in order to be issued a new home state license. (c) If a licensee changes their state of residence by moving from a member state to a nonmember state, or from a nonmember state to a member state, the state criteria shall apply for issuance of a single state license in the new state. (d) Nothing in this compact shall interfere with a licensee’s ability to hold a single state license in multiple states; however,
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for the purposes of this compact, a licensee shall have only one home state license. (e) Nothing in this compact shall affect the requirements established by a member state for the issuance of a single state license. (6) ACTIVE MILITARY MEMBERS OR THEIR SPOUSES. An active military member, or their spouse, shall designate a home state where the individual has a current license in good standing. The individual may retain the home state designation during the period the service member is on active duty. (7) ADVERSE ACTIONS. (a) In addition to the other powers conferred by state law, a remote state shall have the authority, in accordance with existing state due process law, to: 1. Take adverse action against a licensee’s compact privilege within that member state; and 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing authority in a member state for the attendance and testimony of witnesses or the production of evidence from another member state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure applicable to subpoenas issued in proceedings pending before that court. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence are located. (b) Only the home state shall have the power to take adverse action against a licensee’s home state license. (c) For purposes of taking adverse action, the home state shall give the same priority and effect to reported conduct received from a member state as it would if the conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action. (d) The home state shall complete any pending investigations of a licensee who changes home states during the course of the investigations. The home state shall also have authority to take appropriate action and shall promptly report the conclusions of the investigations to the administrator of the data system. The administrator of the data system shall promptly notify the new home state of any adverse actions. (e) A member state, if otherwise permitted by state law, may recover from the affected licensee the costs of investigations and dispositions of cases resulting from any adverse action taken against that licensee. (f) A member state may take adverse action based on the factual findings of another remote state, provided that the member state follows its own procedures for taking the adverse action. (g) Joint investigations. 1. In addition to the authority granted to a member state by its respective state law, any member state may participate with other member states in joint investigations of licensees. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint investigation initiated under the compact. (h) If adverse action is taken by the home state against a licensee’s home state license resulting in an encumbrance on the home state license, the licensee’s compact privilege in all other member states shall be revoked until all encumbrances have been removed from the home state license. All home state disciplinary orders that impose adverse action against a licensee shall include a statement that the licensee’s compact privileges are revoked in all member states during the pendency of the order. (i) Once an encumbered license in the home state is restored to an unencumbered license (as certified by the home state’s licensing authority), the licensee must meet the requirements of
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sub. (4) (a) and follow the administrative requirements to reapply to obtain a compact privilege in any remote state. (j) If a member state takes adverse action, it shall promptly notify the administrator of the data system. The administrator of the data system shall promptly notify the other member states of any adverse actions. (k) Nothing in this compact shall override a member state’s decision that participation in an alternative program may be used in lieu of adverse action. (8) ESTABLISHMENT OF THE DIETITIAN LICENSURE COMPACT COMMISSION. (a) The compact member states hereby create and establish a joint government agency whose membership consists of all member states that have enacted the compact known as the dietitian licensure compact commission. The compact commission is an instrumentality of the compact states acting jointly and not an instrumentality of any one state. The compact commission shall come into existence on or after the effective date of the compact as set forth in sub. (12). (b) Membership, voting, and meetings. 1. Each member state shall have and be limited to one delegate selected by that member state’s licensing authority. 2. The delegate shall be the primary administrator of the licensing authority or their designee. 3. The compact commission shall by rule or bylaw establish a term of office for delegates and may by rule or bylaw establish term limits. 4. The compact commission may recommend removal or suspension of any delegate from office. 5. A member state’s licensing authority shall fill any vacancy of its delegate occurring on the compact commission within 60 days of the vacancy. 6. Each delegate shall be entitled to one vote on all matters before the compact commission requiring a vote by the delegates. 7. Delegates shall meet and vote by such means as set forth in the bylaws. The bylaws may provide for delegates to meet and vote in person or by telecommunication, video conference, or other means of communication. 8. The compact commission shall meet at least once during each calendar year. Additional meetings may be held as set forth in the bylaws. The compact commission may meet in person or by telecommunication, video conference, or other means of communication. (c) The compact commission shall have the following powers: 1. Establish the fiscal year of the compact commission; 2. Establish code of conduct and conflict of interest policies; 3. Establish and amend rules and bylaws; 4. Maintain its financial records in accordance with the bylaws; 5. Meet and take such actions as are consistent with the provisions of this compact, the compact commission’s rules, and the bylaws; 6. Initiate and conclude legal proceedings or actions in the name of the compact commission, provided that the standing of any licensing authority to sue or be sued under applicable law shall not be affected; 7. Maintain and certify records and information provided to a member state as the authenticated business records of the compact commission, and designate an agent to do so on the compact commission’s behalf; 8. Purchase and maintain insurance and bonds; 9. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state; 10. Conduct an annual financial review; 11. Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority
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to carry out the purposes of the compact, and establish the compact commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters; 12. Assess and collect fees; 13. Accept any and all appropriate donations, grants of money, other sources of revenue, equipment, supplies, materials, services, and gifts, and receive, utilize, and dispose of the same; provided that at all times the compact commission shall avoid any actual or appearance of impropriety or conflict of interest; 14. Lease, purchase, retain, own, hold, improve, or use any property, real, personal, or mixed, or any undivided interest therein; 15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed; 16. Establish a budget and make expenditures; 17. Borrow money; 18. Appoint committees, including standing committees, composed of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this compact or the bylaws; 19. Provide and receive information from, and cooperate with, law enforcement agencies; 20. Establish and elect an executive committee, including a chair and a vice chair; 21. Determine whether a state’s adopted language is materially different from the model compact language such that the state would not qualify for participation in the compact; and 22. Perform such other functions as may be necessary or appropriate to achieve the purposes of this compact. (d) The executive committee. 1. The executive committee shall have the power to act on behalf of the compact commission according to the terms of this compact. The powers, duties, and responsibilities of the executive committee shall include: a. Oversee the day-to-day activities of the administration of the compact including enforcement and compliance with the provisions of the compact, its rules and bylaws, and other such duties as deemed necessary; b. Recommend to the compact commission changes to the rules or bylaws, changes to this compact legislation, fees charged to compact member states, fees charged to licensees, and other fees; c. Ensure compact administration services are appropriately provided, including by contract; d. Prepare and recommend the budget; e. Maintain financial records on behalf of the compact commission; f. Monitor compact compliance of member states and provide compliance reports to the compact commission; g. Establish additional committees as necessary; h. Exercise the powers and duties of the compact commission during the interim between compact commission meetings, except for adopting or amending rules, adopting or amending bylaws, and exercising any other powers and duties expressly reserved to the compact commission by rule or bylaw; and i. Other duties as provided in the rules or bylaws of the compact commission. 2. The executive committee shall be composed of 9 members: a. The chair and vice chair of the compact commission shall be voting members of the executive committee; b. Five voting members from the current membership of the compact commission, elected by the compact commission;
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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c. One ex officio, nonvoting member from a recognized professional association representing dietitians; and d. One ex officio, nonvoting member from a recognized national credentialing organization for dietitians. 3. The compact commission may remove any member of the executive committee as provided in the compact commission’s bylaws. 4. The executive committee shall meet at least annually. a. Executive committee meetings shall be open to the public, except that the executive committee may meet in a closed, nonpublic meeting as provided in par. (f) 2. b. The executive committee shall give 30 days’ notice of its meetings, posted on the website of the compact commission and as determined to provide notice to persons with an interest in the business of the compact commission. c. The executive committee may hold a special meeting in accordance with par. (f) 1. b. (e) The compact commission shall adopt and provide to the member states an annual report. (f) Meetings of the compact commission. 1. All meetings shall be open to the public, except that the compact commission may meet in a closed, nonpublic meeting as provided in subd. 2. a. Public notice for all meetings of the full compact commission shall be given in the same manner as required under the rulemaking provisions in sub. (10), except that the compact commission may hold a special meeting as provided in subd. 1. b. b. The compact commission may hold a special meeting when it must meet to conduct emergency business by giving 24 hours’ notice to all member states, on the compact commission’s website, and other means as provided in the compact commission’s rules. The compact commission’s legal counsel shall certify that the compact commission’s need to meet qualifies as an emergency. 2. The compact commission or the executive committee or other committees of the compact commission may convene in a closed, nonpublic meeting for the compact commission or executive committee or other committees of the compact commission to receive legal advice or to discuss: a. Noncompliance of a member state with its obligations under the compact; b. The employment, compensation, discipline, or other matters, practices, or procedures related to specific employees; c. Current or threatened discipline of a licensee by the compact commission or by a member state’s licensing authority; d. Current, threatened, or reasonably anticipated litigation; e. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate; f. Accusing any person of a crime or formally censuring any person; g. Trade secrets or commercial or financial information that is privileged or confidential; h. Information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; i. Investigative records compiled for law enforcement purposes; j. Information related to any investigative reports prepared by or on behalf of or for use of the compact commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact; k. Matters specifically exempted from disclosure by federal or member state law; or L. Other matters as specified in the rules of the compact commission. 3. If a meeting, or portion of a meeting, is closed, the presid-
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ing officer shall state that the meeting will be closed and reference each relevant exempting provision, and such reference shall be recorded in the minutes. 4. The compact commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release only by a majority vote of the compact commission or order of a court of competent jurisdiction. (g) Financing of the compact commission. 1. The compact commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. 2. The compact commission may accept any and all appropriate revenue sources as provided in par. (c) 13. 3. The compact commission may levy on and collect an annual assessment from each member state and impose fees on licensees of member states to whom it grants a compact privilege to cover the cost of the operations and activities of the compact commission and its staff, which must, in a total amount, be sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount for member states shall be allocated based upon a formula that the compact commission shall promulgate by rule. 4. The compact commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the compact commission pledge the credit of any of the member states, except by and with the authority of the member state. 5. The compact commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the compact commission shall be subject to the financial review and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the compact commission shall be subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review shall be included in and become part of the annual report of the compact commission. (h) Qualified immunity, defense, and indemnification. 1. The members, officers, executive director, employees and representatives of the compact commission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of compact commission employment, duties, or responsibilities; provided that nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. The procurement of insurance of any type by the compact commission shall not in any way compromise or limit the immunity granted hereunder. 2. The compact commission shall defend any member, officer, executive director, employee, and representative of the compact commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of compact commission employment, duties, or responsibilities, or as determined by the compact commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of compact commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from
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retaining their own counsel at their own expense; and provided further, that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct. 3. The compact commission shall indemnify and hold harmless any member, officer, executive director, employee, and representative of the compact commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of compact commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of compact commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person. 4. Nothing herein shall be construed as a limitation on the liability of any licensee for professional malpractice or misconduct, which shall be governed solely by any other applicable state laws. 5. Nothing in this compact shall be interpreted to waive or otherwise abrogate a member state’s state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman Act, Clayton Act, or any other state or federal antitrust or anticompetitive law or regulation. 6. Nothing in this compact shall be construed to be a waiver of sovereign immunity by the member states or by the compact commission. (9) DATA SYSTEM. (a) The compact commission shall provide for the development, maintenance, operation, and utilization of a coordinated data system. (b) The compact commission shall assign each applicant for a compact privilege a unique identifier, as determined by the rules. (c) Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system on all individuals to whom this compact is applicable as required by the rules of the compact commission, including: 1. Identifying information; 2. Licensure data; 3. Adverse actions against a license or compact privilege and information related thereto; 4. Nonconfidential information related to alternative program participation, the beginning and ending dates of such participation, and other information related to such participation not made confidential under member state law; 5. Any denial of application for licensure, and the reason for such denial; 6. The presence of current significant investigative information; and 7. Other information that may facilitate the administration of this compact or the protection of the public, as determined by the rules of the compact commission. (d) The records and information provided to a member state pursuant to this compact or through the data system, when certified by the compact commission or an agent thereof, shall constitute the authenticated business records of the compact commission, and shall be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial, or administrative proceedings in a member state. (e) Current significant investigative information pertaining to a licensee in any member state will only be available to other member states. (f) It is the responsibility of the member states to report any adverse action against a licensee and to monitor the data system to determine whether any adverse action has been taken against a
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licensee. Adverse action information pertaining to a licensee in any member state will be available to any other member state. (g) Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state. (h) Any information submitted to the data system that is subsequently expunged pursuant to federal law or the laws of the member state contributing the information shall be removed from the data system. (10) RULE MAKING. (a) The compact commission shall promulgate reasonable rules in order to effectively and efficiently implement and administer the purposes and provisions of the compact. A rule shall be invalid and have no force or effect only if a court of competent jurisdiction holds that the rule is invalid because the compact commission exercised its rule-making authority in a manner that is beyond the scope and purposes of the compact, or the powers granted hereunder, or based upon another applicable standard of review. (b) The rules of the compact commission shall have the force of law in each member state, provided however that where the rules conflict with the laws or regulations of a member state that relate to the procedures, actions, and processes a licensed dietitian is permitted to undertake in that state and the circumstances under which they may do so, as held by a court of competent jurisdiction, the rules of the compact commission shall be ineffective in that state to the extent of the conflict. (c) The compact commission shall exercise its rule-making powers pursuant to the criteria set forth in this subsection and the rules adopted thereunder. Rules shall become binding on the day following adoption or as of the date specified in the rule or amendment, whichever is later. (d) If a majority of the legislatures of the member states rejects a rule or portion of a rule, by enactment of a statute or resolution in the same manner used to adopt the compact within 4 years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state. (e) Rules shall be adopted at a regular or special meeting of the compact commission. (f) Prior to adoption of a proposed rule, the compact commission shall hold a public hearing and allow persons to provide oral and written comments, data, facts, opinions, and arguments. (g) Prior to adoption of a proposed rule by the compact commission, and at least 30 days in advance of the meeting at which the compact commission will hold a public hearing on the proposed rule, the compact commission shall provide a notice of proposed rule making: 1. On the website of the compact commission or other publicly accessible platform; 2. To persons who have requested notice of the compact commission’s notices of proposed rule making; and 3. In such other way as the compact commission may by rule specify. (h) The notice of proposed rule making shall include: 1. The time, date, and location of the public hearing at which the compact commission will hear public comments on the proposed rule and, if different, the time, date, and location of the meeting where the compact commission will consider and vote on the proposed rule; 2. If the hearing is held via telecommunication, video conference, or other means of communication, the compact commission shall include the mechanism for access to the hearing in the notice of proposed rule making; 3. The text of the proposed rule and the reason therefore; 4. A request for comments on the proposed rule from any interested person; and
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5. The manner in which interested persons may submit written comments. (i) All hearings will be recorded. A copy of the recording and all written comments and documents received by the compact commission in response to the proposed rule shall be available to the public. (j) Nothing in this subsection shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the compact commission at hearings required by this subsection. (k) The compact commission shall, by majority vote of all members, take final action on the proposed rule based on the rule-making record and the full text of the rule. 1. The compact commission may adopt changes to the proposed rule provided the changes do not enlarge the original purpose of the proposed rule. 2. The compact commission shall provide an explanation of the reasons for substantive changes made to the proposed rule as well as reasons for substantive changes not made that were recommended by commenters. 3. The compact commission shall determine a reasonable effective date for the rule. Except for an emergency as provided in par. (L), the effective date of the rule shall be no sooner than 30 days after issuing the notice that it adopted or amended the rule. (L) Upon determination that an emergency exists, the compact commission may consider and adopt an emergency rule with 24 hours’ notice, with opportunity to comment, provided that the usual rule-making procedures provided in the compact and in this subsection shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to: 1. Meet an imminent threat to public health, safety, or welfare; 2. Prevent a loss of compact commission or member state funds; 3. Meet a deadline for the promulgation of a rule that is established by federal law or rule; or 4. Protect public health and safety. (m) The compact commission or an authorized committee of the compact commission may direct revision to a previously adopted rule for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revision shall be posted on the website of the compact commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the compact commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the compact commission. (n) No member state’s rule-making requirements shall apply under this compact. (11) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. (a) Oversight. 1. The executive and judicial branches of state government in each member state shall enforce this compact and take all actions necessary and appropriate to implement this compact. 2. Except as otherwise provided in this compact, venue is proper and judicial proceedings by or against the compact commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the compact commission is located. The compact commission may waive venue and jurisdictional defenses to the extent it adopts or con-
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sents to participate in alternative dispute resolution proceedings. Nothing herein shall affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct, or any such similar matter. 3. The compact commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the compact and shall have standing to intervene in such a proceeding for all purposes. Failure to provide the compact commission service of process shall render a judgment or order void as to the compact commission, this compact, or promulgated rules. (b) Default, technical assistance, and termination. 1. If the compact commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the compact commission shall provide written notice to the defaulting state. The notice of default shall describe the default, the proposed means of curing the default, and any other action that the compact commission may take and shall offer training and specific technical assistance regarding the default. 2. The compact commission shall provide a copy of the notice of default to the other member states. (c) If a state in default fails to cure the default, the defaulting state may be terminated from the compact upon an affirmative vote of a majority of the delegates of the member states, and all rights, privileges, and benefits conferred on that state by this compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. (d) Termination of membership in the compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the compact commission to the governor, the majority and minority leaders of the defaulting state’s legislature, the defaulting state’s licensing authority, and each of the member states’ licensing authority. (e) A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. (f) Upon the termination of a state’s membership from this compact, that state shall immediately provide notice to all licensees within that state of such termination. The terminated state shall continue to recognize all compact privileges granted pursuant to this compact for a minimum of 6 months after the date of said notice of termination. (g) The compact commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the compact, unless agreed upon in writing between the compact commission and the defaulting state. (h) The defaulting state may appeal the action of the compact commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the compact commission has its principal offices. The prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. (i) Dispute resolution. 1. Upon request by a member state, the compact commission shall attempt to resolve disputes related to the compact that arise among member states and between member and nonmember states. 2. The compact commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate. (j) Enforcement. 1. By supermajority vote, the compact commission may initiate legal action against a member state in default in the U.S. District Court for the District of Columbia or the fed-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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eral district where the compact commission has its principal offices to enforce compliance with the provisions of the compact and its promulgated rules. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. The remedies herein shall not be the exclusive remedies of the compact commission. The compact commission may pursue any other remedies available under federal or the defaulting member state’s law. 2. A member state may initiate legal action against the compact commission in the U.S. District Court for the District of Columbia or the federal district where the compact commission has its principal offices to enforce compliance with the provisions of the compact and its promulgated rules. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. 3. No party other than a member state shall enforce this compact against the compact commission. (12) EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT. (a) The compact shall come into effect on the date on which the compact statute is enacted into law in the 7th member state. 1. On or after the effective date of the compact, the compact commission shall convene and review the enactment of each of the first 7 member states (“charter member states”) to determine if the statute enacted by each such charter member state is materially different than the model compact statute. a. A charter member state whose enactment is found to be materially different from the model compact statute shall be entitled to the default process set forth in sub. (11). b. If any member state is later found to be in default, or is terminated, or withdraws from the compact, the compact commission shall remain in existence and the compact shall remain in effect even if the number of member states should be less than 7. 2. Member states enacting the compact subsequent to the 7 initial charter member states shall be subject to the process set forth in sub. (8) (c) 21. to determine if their enactments are materially different from the model compact statute and whether they qualify for participation in the compact. 3. All actions taken for the benefit of the compact commission or in furtherance of the purposes of the administration of the compact prior to the effective date of the compact or the compact commission coming into existence shall be considered to be actions of the compact commission unless specifically repudiated by the compact commission. 4. Any state that joins the compact subsequent to the compact commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws as they exist on the date on which the compact becomes law in that state. Any rule that has been previously adopted by the compact commission shall have the full force and effect of law on the day the compact becomes law in that state. (b) Any member state may withdraw from this compact by enacting a statute repealing the same. 1. A member state’s withdrawal shall not take effect until 180 days after enactment of the repealing statute. 2. Withdrawal shall not affect the continuing requirement of the withdrawing state’s licensing authority to comply with the investigative and adverse action reporting requirements of this compact prior to the effective date of withdrawal. 3. Upon the enactment of a statute withdrawing from this compact, a state shall immediately provide notice of such withdrawal to all licensees within that state. Notwithstanding any subsequent statutory enactment to the contrary, such withdrawing state shall continue to recognize all compact privileges granted
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pursuant to this compact for a minimum of 180 days after the date of such notice of withdrawal. (c) Nothing contained in this compact shall be construed to invalidate or prevent any licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact. (d) This compact may be amended by the member states. No amendment to this compact shall become effective and binding upon any member state until it is enacted into the laws of all member states. (13) CONSTRUCTION AND SEVERABILITY. (a) This compact and the compact commission’s rule-making authority shall be liberally construed so as to effectuate the purposes and the implementation and administration of the compact. Provisions of the compact expressly authorizing or requiring the promulgation of rules shall not be construed to limit the compact commission’s rule-making authority solely for those purposes. (b) The provisions of this compact shall be severable and if any phrase, clause, sentence, or provision of this compact is held by a court of competent jurisdiction to be contrary to the constitution of any member state, a state seeking participation in the compact, or of the United States, or the applicability thereof to any government, agency, person, or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of this compact and the applicability thereof to any other government, agency, person, or circumstance shall not be affected thereby. (c) Notwithstanding par. (b), the compact commission may deny a state’s participation in the compact or, in accordance with the requirements of sub. (11) (b), terminate a member state’s participation in the compact, if it determines that a constitutional requirement of a member state is a material departure from the compact. Otherwise, if this compact shall be held to be contrary to the constitution of any member state, the compact shall remain in full force and effect as to the remaining member states and in full force and effect as to the member state affected as to all severable matters. (14) CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS. (a) Nothing herein shall prevent or inhibit the enforcement of any other law of a member state that is not inconsistent with the compact. (b) Any laws, statutes, regulations, or other legal requirements in a member state in conflict with the compact are superseded to the extent of the conflict. (c) All permissible agreements between the compact commission and the member states are binding in accordance with their terms. History: 2025 a. 20.
448.9888 Implementation of the dietitian licensure compact. (1) In this section: (a) “Compact” means the dietitian licensure compact under s. 448.9887. (b) “Compact privilege” means a compact privilege, as defined in s. 448.9887 (2) (i), that is granted under the compact to an individual to practice in this state. (2) The department may impose a fee for an individual to receive a compact privilege as provided in s. 448.9887 (3) (c). (3) (a) An individual who holds a compact privilege shall comply with s. 440.03 (13) (am). (b) Subject to s. 448.9887 and any rules promulgated thereunder, ss. 440.20 to 440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual who holds a compact privilege in the same manner that they apply to holders of certificates issued under subch. V. History: 2025 a. 20.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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MEDICAL PRACTICES SUBCHAPTER XV RESPIRATORY CARE INTERSTATE COMPACT
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Respiratory care interstate compact. (1) TITLE AND PURPOSE. (a) The purpose of this compact is to facilitate the interstate practice of respiratory therapy with the goal of improving public access to respiratory therapy services by providing respiratory therapists licensed in a member state the ability to practice in other member states. The compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. (b) This compact is designed to achieve the following objectives: 1. Increase public access to respiratory therapy services by creating a responsible, streamlined pathway for licensees to practice in member states with the goal of improving outcomes for patients; 2. Enhance states’ ability to protect the public’s health and safety; 3. Promote the cooperation of member states in regulating the practice of respiratory therapy within those member states; 4. Ease administrative burdens on states by encouraging the cooperation of member states in regulating multi-state respiratory therapy practice; 5. Support relocating active military members and their spouses; and 6. Promote mobility and address workforce shortages. (2) DEFINITIONS. As used in this compact, unless the context requires otherwise, the following definitions shall apply: (a) “Active military member” means any person with a fulltime duty status in the armed forces of the United States, including members of the national guard and reserve. (b) “Adverse action” means any administrative, civil, equitable, or criminal action permitted by a state’s laws which is imposed by any state authority with regulatory authority over respiratory therapists, such as license denial, censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee’s practice, not including participation in an alternative program. (c) “Alternative program” means a nondisciplinary monitoring or practice remediation process applicable to a respiratory therapist approved by any state authority with regulatory authority over respiratory therapists. This includes, but is not limited to, programs to which licensees with substance abuse or addiction issues are referred in lieu of adverse action. (d) “Charter member states” means those member states who were the first 7 states to enact the compact into the laws of their state. (e) “Commission” or “respiratory care interstate compact commission” means the government instrumentality and body politic whose membership consists of all member states that have enacted the compact. (f) “Commissioner” means the individual appointed by a member state to serve as the member of the commission for that member state. (g) “Compact” means the respiratory care interstate compact. (h) “Compact privilege” means the authorization granted by a remote state to allow a licensee from another member state to practice as a respiratory therapist in the remote state under the remote state’s laws and rules. The practice of respiratory therapy occurs in the member state where the patient is located at the time of the patient encounter. (i) “Criminal background check” means the submission by
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the member state of fingerprints or other biometric-based information on license applicants at the time of initial licensing for the purpose of obtaining that applicant’s criminal history record information, as defined in 28 CFR 20.3 (d) or successor provision, from the federal bureau of investigation and the state’s criminal history record repository, as defined in 28 CFR 20.3 (f) or successor provision. (j) “Data system” means the commission’s repository of information about licensees as further set forth in sub. (8). (k) “Domicile” means the jurisdiction which is the licensee’s principal home for legal purposes. (L) “Encumbered license” means a license that a state’s respiratory therapy licensing authority has limited in any way. (m) “Executive committee” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by the commission. (n) “Home state” except as set forth in sub. (5), means the member state that is the licensee’s primary domicile. (o) “Home state license” means an active license to practice respiratory therapy in a home state that is not an encumbered license. (p) “Jurisprudence requirement” means an assessment of an individual’s knowledge of the state laws and regulations governing the practice of respiratory therapy in such state. (q) “Licensee” means an individual who currently holds an authorization from the state to practice as a respiratory therapist. (r) “Member state” means a state that has enacted the compact and been admitted to the commission in accordance with the provisions herein and commission rules. (s) “Model compact” means the model for the respiratory care interstate compact on file with the Council of State Governments or other entity as designated by the commission. (t) “Remote state” means a member state where a licensee is exercising or seeking to exercise the compact privilege. (u) “Respiratory therapist” or “respiratory care practitioner” means an individual who holds a credential issued by the National Board for Respiratory Care (or its successor) and holds a license in a state to practice respiratory therapy. For purposes of this compact, any other title or status adopted by a state to replace the term “respiratory therapist” or “respiratory care practitioner” shall be deemed synonymous with “respiratory therapist” and shall confer the same rights and responsibilities to the licensee under the provisions of this compact at the time of its enactment. (v) “Respiratory therapy,” “respiratory therapy practice,” “respiratory care,” “the practice of respiratory care,” and “the practice of respiratory therapy” means the care and services provided by or under the direction and supervision of a respiratory therapist or respiratory care practitioner. (w) “Respiratory therapy licensing authority” means the agency, board, or other body of a state that is responsible for licensing and regulation of respiratory therapists. (x) “Rule” means a regulation promulgated by an entity that has the force and effect of law. (y) “Scope of practice” means the procedures, actions, and processes a respiratory therapist licensed in a state or practicing under a compact privilege in a state is permitted to undertake in that state and the circumstances under which the respiratory therapist is permitted to undertake those procedures, actions, and processes. Such procedures, actions, and processes, and the circumstances under which they may be undertaken may be established through means, including, but not limited to, statute, regulations, case law, and other processes available to the state respiratory therapy licensing authority or other government agency. (z) “Significant investigative information” means information, records, and documents received or generated by a state res-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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piratory therapy licensing authority pursuant to an investigation for which a determination has been made that there is probable cause to believe that the licensee has violated a statute or regulation that is considered more than a minor infraction for which the state respiratory therapy licensing authority could pursue adverse action against the licensee. (zm) “State” means any state, commonwealth, district, or territory of the United States. (3) STATE PARTICIPATION IN THIS COMPACT. (a) In order to participate in this compact and thereafter continue as a member state, a member state shall: 1. Enact a compact that is not materially different from the model compact; 2. License respiratory therapists; 3. Participate in the commission’s data system; 4. Have a mechanism in place for receiving and investigating complaints against licensees and compact privilege holders; 5. Notify the commission, in compliance with the terms of this compact and commission rules, of any adverse action against a licensee, a compact privilege holder, or a license applicant; 6. Notify the commission, in compliance with the terms of this compact and commission rules, of the existence of significant investigative information; 7. Comply with the rules of the commission; 8. Grant the compact privilege to a holder of an active home state license and otherwise meet the applicable requirements of sub. (4) in a member state; and 9. Complete a criminal background check for each new licensee at the time of initial licensure. a. Where expressly authorized or permitted by federal law, whether such federal law is in effect prior to, at, or after the time of a member state’s enactment of this compact, a member state’s enactment of this compact shall hereby authorize the member state’s respiratory therapy licensing authority to perform criminal background checks as defined herein. The absence of such a federal law as described in this subd. 9. a. shall not prevent or preclude such authorization where it may be derived or granted through means other than the enactment of this compact. (b) Nothing in this compact prohibits a member state from charging a fee for granting and renewing the compact privilege. (4) COMPACT PRIVILEGE. (a) To exercise the compact privilege under the terms and provisions of the compact, the licensee shall: 1. Hold and maintain an active home state license as a respiratory therapist; 2. Hold and maintain an active credential from the National Board for Respiratory Care (or its successor) that would qualify them for licensure in the remote state in which they are seeking the privilege; 3. Have not had any adverse action against a license within the previous 2 years; 4. Notify the commission that the licensee is seeking the compact privilege within a remote state(s); 5. Pay any applicable fees, including any state and commission fees and renewal fees, for the compact privilege; 6. Meet any jurisprudence requirements established by the remote state in which the licensee is seeking a compact privilege; 7. Report to the commission adverse action taken by any nonmember state within 30 days from the date the adverse action is taken; 8. Report to the commission, when applying for a compact privilege, the address of the licensee’s domicile and thereafter promptly report to the commission any change in the address of the licensee’s domicile within 30 days of the effective date of the change in address; and
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9. Consent to accept service of process by mail at the licensee’s domicile on record with the commission with respect to any action brought against the licensee by the commission or a member state, and consent to accept service of a subpoena by mail at the licensee’s domicile on record with the commission with respect to any action brought or investigation conducted by the commission or a member state. (b) The compact privilege is valid until the expiration date or revocation of the home state license unless terminated pursuant to adverse action. The licensee must comply with all of the requirements of par. (a), above, to maintain the compact privilege in a remote state. If those requirements are met, no adverse actions are taken, and the licensee has paid any applicable compact privilege renewal fees, then the licensee will maintain the licensee’s compact privilege. (c) A licensee providing respiratory therapy in a remote state under the compact privilege shall function within the scope of practice authorized by the remote state for the type of respiratory therapist license the licensee holds. Such procedures, actions, processes, and the circumstances under which they may be undertaken may be established through means, including, but not limited to, statute, regulations, case law, and other processes available to the state respiratory therapy licensing authority or other government agency. (d) If a licensee’s compact privilege in a remote state is removed by the remote state, the individual shall lose or be ineligible for the compact privilege in that remote state until the compact privilege is no longer limited or restricted by that state. (e) If a home state license is encumbered, the licensee shall lose the compact privilege in all remote states until the following occur: 1. The home state license is no longer encumbered; and 2. Two years have elapsed from the date on which the license is no longer encumbered due to the adverse action. (f) Once a licensee with a restricted or limited license meets the requirements of par. (e) 1. and 2., the licensee must also meet the requirements of par. (a) to obtain a compact privilege in a remote state. (5) ACTIVE MILITARY MEMBER OR THEIR SPOUSE. (a) An active military member, or their spouse, shall designate a home state where the individual has a current license in good standing. The individual may retain the home state designation during the period the service member is on active duty. (b) An active military member and their spouse shall not be required to pay to the commission for a compact privilege any fee that may otherwise be charged by the commission. If a remote state chooses to charge a fee for a compact privilege, it may choose to charge a reduced fee or no fee to an active military member and their spouse for a compact privilege. (6) ADVERSE ACTIONS. (a) A member state in which a licensee is licensed shall have authority to impose adverse action against the license issued by that member state. (b) A member state may take adverse action based on significant investigative information of a remote state or the home state, so long as the member state follows its own procedures for imposing adverse action. (c) Nothing in this compact shall override a member state’s decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member state’s laws. (d) A remote state shall have the authority to: 1. Take adverse actions as set forth herein against a licensee’s compact privilege in that state; 2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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a. Subpoenas may be issued by a respiratory therapy licensing authority in a member state for the attendance and testimony of witnesses and the production of evidence. b. Subpoenas issued by a respiratory therapy licensing authority in a member state for the attendance and testimony of witnesses shall be enforced in the latter state by any court of competent jurisdiction in the latter state, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. c. Subpoenas issued by a respiratory therapy licensing authority in a member state for production of evidence from another member state shall be enforced in the latter state, according to the practice and procedure of that court applicable to subpoenas issued in the proceedings pending before it. d. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses or evidence are located; 3. Unless otherwise prohibited by state law, recover from the licensee the costs of investigations and disposition of cases resulting from any adverse action taken against that licensee; 4. Notwithstanding subd. 2., a member state may not issue a subpoena to gather evidence of conduct in another member state that is lawful in such other member state for the purpose of taking adverse action against a licensee’s compact privilege or application for a compact privilege in that member state; and 5. Nothing in this compact authorizes a member state to impose discipline against a respiratory therapist’s compact privilege in that member state for the individual’s otherwise lawful practice in another state. (e) Joint investigations. 1. In addition to the authority granted to a member state by its respective respiratory therapy practice act or other applicable state law, a member state may participate with other member states in joint investigations of licensees, provided, however, that a member state receiving such a request has no obligation to respond to any subpoena issued regarding an investigation of conduct or practice that was lawful in a member state at the time it was undertaken. 2. Member states shall share any significant investigative information, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact. In sharing such information between member state respiratory therapy licensing authorities, all information obtained shall be kept confidential, except as otherwise mutually agreed upon by the sharing and receiving member state(s). (f) Nothing in this compact may permit a member state to take any adverse action against a licensee or holder of a compact privilege for conduct or practice that was legal in the member state at the time it was undertaken. (g) Nothing in this compact may permit a member state to take disciplinary action against a licensee or holder of a compact privilege for conduct or practice that was legal in the member state at the time it was undertaken. (7) ESTABLISHMENT OF THE RESPIRATORY CARE INTERSTATE COMPACT COMMISSION. (a) The compact member states hereby create and establish a joint government agency whose membership consists of all member states that have enacted the compact known as the respiratory care interstate compact commission. The commission is an instrumentality of the compact member states acting jointly and not an instrumentality of any one state. The commission shall come into existence on or after the effective date of the compact, as set forth in sub. (11). (b) Membership, voting, and meetings. 1. Each member state shall have and be limited to one commissioner selected by that member state’s respiratory therapy licensing authority. 2. The commissioner shall be an administrator or their desig-
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nated staff member of the member state’s respiratory therapy licensing authority. 3. The commission shall by rule or bylaw establish a term of office for commissioners and may by rule or bylaw establish term limits. 4. The commission may recommend to a member state the removal or suspension of any commissioner from office. 5. A member state’s respiratory therapy licensing authority shall fill any vacancy of its commissioner occurring on the commission within 60 days of the vacancy. 6. Each commissioner shall be entitled to one vote on all matters before the commission requiring a vote by commissioners. 7. A commissioner shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for commissioners to meet by telecommunication, videoconference, or other means of communication. 8. The commission shall meet at least once during each calendar year. Additional meetings may be held as set forth in the bylaws. (c) The commission shall have the following powers: 1. Establish and amend the fiscal year of the commission; 2. Establish and amend bylaws and policies, including but not limited to, a code of conduct and conflict of interest; 3. Establish and amend rules, which shall be binding in all member states; 4. Maintain its financial records in accordance with the bylaws; 5. Meet and take such actions as are consistent with the provisions of this compact, the commission’s rules, and the bylaws; 6. Initiate and conduct legal proceedings or actions in the name of the commission, provided that the standing of any respiratory therapy licensing authority to sue or be sued under applicable law shall not be affected; 7. Maintain and certify records and information provided to a member state as the authenticated business records of the commission, and designate an agent to do so on the commission’s behalf; 8. Purchase and maintain insurance and bonds; 9. Accept or contract for services of personnel, including, but not limited to, employees of a member state; 10. Conduct an annual financial review; 11. Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the compact, and establish the commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters; 12. Assess and collect fees; 13. Accept any and all appropriate gifts, donations, grants of money, other sources of revenue, equipment, supplies, materials, and services, and receive, utilize, and dispose of the same, provided that at all times: a. The commission shall avoid any appearance of impropriety; and b. The commission shall avoid any appearance of conflict of interest; 14. Lease, purchase, retain, own, hold, improve, or use any property, real, personal, or mixed, or any undivided interest therein; 15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed; 16. Establish a budget and make expenditures; 17. Borrow money in a fiscally responsible manner;
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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18. Appoint committees, including standing committees, composed of commissioners state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this compact and the bylaws; 19. Provide and receive information from, and cooperate with, law enforcement agencies; 20. Establish and elect an executive committee, including a chair, vice-chair, secretary, treasurer, and such other offices as the commission shall establish by rule or bylaw; 21. Enter into contracts or arrangements for the management of the affairs of the commission; 22. Determine whether a state’s adopted language is materially different from the model compact language such that the state would not qualify for participation in the compact; and 23. Perform such other functions as may be necessary or appropriate to achieve the purposes of this compact. (d) The executive committee. 1. The executive committee shall have the power to act on behalf of the commission according to the terms of this compact. The powers, duties, and responsibilities of the executive committee shall include: a. Overseeing the day-to-day activities of the administration of the compact, including enforcement and compliance with the provisions of the compact, its rules and bylaws, and other such duties as deemed necessary; b. Recommending to the commission changes to the rules or bylaws, changes to this compact legislation, fees charged to compact member states, fees charged to licensees, and other fees; c. Ensuring compact administration services are appropriately provided, including by contract; d. Preparing and recommending the budget; e. Maintaining financial records on behalf of the commission; f. Monitoring compact compliance of member states and providing compliance reports to the commission; g. Establishing additional committees as necessary; h. Exercising the powers and duties of the commission during the interim between commission meetings, except for adopting or amending rules, adopting or amending bylaws, and exercising any other powers and duties expressly reserved to the commission by rule or bylaw; and i. Performing other duties as provided in the rules or bylaws of the commission. 2. The executive committee shall be composed of up to 9 members, as further set forth in the bylaws of the commission: a. Seven voting members who are elected by the commission from the current membership of the commission; and b. Two ex-officio, nonvoting members. 3. The commission may remove any member of the executive committee as provided in the commission’s bylaws. 4. The executive committee shall meet at least annually. a. Executive committee meetings shall be open to the public, except that the executive committee may meet in a closed, nonpublic meeting as provided in par. (f) 4. below; b. The executive committee shall give advance notice of its meetings, posted on its website and as determined to provide notice to persons with an interest in the business of the commission; and c. The executive committee may hold a special meeting in accordance with par. (f) 2. below. (e) The commission shall adopt and provide to the member states an annual report. (f) Meetings of the commission. 1. All meetings of the commission that are not closed pursuant to subd. 4. shall be open to
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the public. Notice of public meetings shall be posted on the commission’s website at least 30 days prior to the public meeting. 2. Notwithstanding subd. 1., the commission may convene an emergency public meeting by providing at least 24 hours prior notice on the commission’s website, and any other means as provided in the commission’s rules, for any of the reasons it may dispense with notice of proposed rule making under sub. (9) (g). The commission’s legal counsel shall certify that one of the reasons justifying an emergency public meeting has been met. 3. Notice of all commission meetings shall provide the time, date, and location of the meeting, and if the meeting is to be held or accessible via telecommunication, video conference, or other electronic means, the notice shall include the mechanism for access to the meeting. 4. The commission or the executive committee may convene in a closed, nonpublic meeting for the commission or executive committee to receive or solicit legal advice or to discuss: a. Noncompliance of a member state with its obligations under the compact; b. The employment, compensation, discipline or other matters, practices or procedures related to specific employees; c. Current or threatened discipline of a licensee or compact privilege holder by the commission or by a member state’s respiratory therapy licensing authority; d. Current, threatened, or reasonably anticipated litigation; e. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate; f. Accusing any person of a crime or formally censuring any person; g. Trade secrets or commercial or financial information that is privileged or confidential; h. Information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; i. Investigative records compiled for law enforcement purposes; j. Information related to any investigative reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact; k. Legal advice; L. Matters specifically exempted from disclosure by federal or member state law; or m. Other matters as promulgated by the commission by rule. 5. If a meeting, or portion of a meeting, is closed, the presiding officer shall state that the meeting will be closed and reference each relevant exempting provision, and such reference shall be recorded in the minutes. 6. The commission shall keep minutes in accordance with commission rules and bylaws. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release only by a majority vote of the commission or order of a court of competent jurisdiction. (g) Financing of the commission. 1. The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. 2. The commission may accept any and all appropriate revenue sources as provided herein. 3. The commission may levy on and collect an annual assessment from each member state and impose fees on licensees of member states to whom it grants a compact privilege to cover the cost of the operations and activities of the commission and its staff. The aggregate annual assessment amount for member states, if any, shall be allocated based upon a formula that the commission shall promulgate by rule.
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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4. The commission shall not incur obligations of any kind prior to securing the funds or a loan adequate to meet the same; nor shall the commission pledge the credit of any of the member states, except by and with the authority of the member state. 5. The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the financial review and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the commission shall be subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review shall be included in and become part of the annual report of the commission. (h) Qualified immunity, defense, and indemnification. 1. Nothing herein shall be construed as a limitation on the liability of any licensee for professional malpractice or misconduct, which shall be governed solely by any other applicable state laws. 2. The member states, commissioners, officers, executive directors, employees, and agents of the commission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities; provided that nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. The procurement of insurance of any type by the commission shall not in any way compromise or limit the immunity granted hereunder. 3. The commission shall defend any commissioner, officer, executive director, employee, and agent of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or as determined by the commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining their own counsel at their own expense; and provided further, that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct. 4. The commission shall indemnify and hold harmless any commissioner, member, officer, executive director, employee, and agent of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person. 5. Nothing in this compact shall be interpreted to waive or otherwise abrogate a member state’s state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman Act, Clayton Act, or any other state or federal antitrust or anticompetitive law or regulation. 6. Nothing in this compact shall be construed to be a waiver of sovereign immunity by the member states or by the commission. (8) DATA SYSTEM. (a) The commission shall provide for the development, maintenance, operation, and utilization of a coordi-
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nated database and reporting system containing licensure, adverse action, and the presence of significant investigative information. (b) Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system as required by the rules of the commission, including but not limited to: 1. Identifying information; 2. Licensure data; 3. Adverse actions against a licensee, license applicant, or compact privilege holder and information related thereto; 4. Nonconfidential information related to alternative program participation, the beginning and ending dates of such participation, and other information related to such participation not made confidential under member state law; 5. Any denial of application for licensure, and the reason(s) for such denial; 6. The presence of current significant investigative information; and 7. Other information that may facilitate the administration of this compact or the protection of the public, as determined by the rules of the commission. (c) No member state shall submit any information which constitutes criminal history record information, as defined by applicable federal law, to the data system established hereunder. (d) The records and information provided to a member state pursuant to this compact or through the data system, when certified by the commission or an agent thereof, shall constitute the authenticated business records of the commission, and shall be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceedings in a member state. (e) Significant investigative information pertaining to a licensee in any member state will only be available to other member states. (f) It is the responsibility of the member states to report any adverse action against a licensee and to monitor the database to determine whether adverse action has been taken against a licensee. Adverse action information pertaining to a licensee in any member state will be available to any other member state. (g) Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state. (h) Any information submitted to the data system that is subsequently expunged pursuant to federal law or the laws of the member state contributing the information shall be removed from the data system. (9) RULE MAKING. (a) The commission shall promulgate reasonable rules in order to effectively and efficiently implement and administer the purposes and provisions of the compact. A rule shall be invalid and have no force or effect only if a court of competent jurisdiction holds that the rule is invalid because the commission exercised its rule-making authority in a manner that is beyond the scope and purposes of the compact, or the powers granted hereunder, or based upon another applicable standard of review. (b) For purposes of the compact, the rules of the commission shall have the force of law in each member state. (c) The commission shall exercise its rule-making powers pursuant to the criteria set forth in this subsection and the rules adopted thereunder. Rules shall become binding as of the date specified in each rule. (d) If a majority of the legislatures of the member states rejects a rule or portion of a rule, by enactment of a statute or resolution in the same manner used to adopt the compact within 4
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years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state. (e) Rules shall be adopted at a regular or special meeting of the commission. (f) Prior to adoption of a proposed rule, the commission shall hold a public hearing and allow persons to provide oral and written comments, data, facts, opinions, and arguments. (g) Prior to adoption of a proposed rule by the commission, and at least 30 days in advance of the meeting at which the commission will hold a public hearing on the proposed rule, the commission shall provide a notice of proposed rule making: 1. On the website of the commission or other publicly accessible platform; 2. To persons who have requested notice of the commission’s notices of proposed rule making, and 3. In such other way(s) as the commission may by rule specify. (h) The notice of proposed rule making shall include: 1. The time, date, and location of the public hearing at which the commission will hear public comments on the proposed rule and, if different, the time, date, and location of the meeting where the commission will consider and vote on the proposed rule; 2. If the hearing is held via telecommunication, video conference, or other electronic means, the commission shall include the mechanism for access to the hearing in the notice of proposed rule making; 3. The text of the proposed rule and the reason therefor; 4. A request for comments on the proposed rule from any interested person; and 5. The manner in which interested persons may submit written comments. (i) All hearings will be recorded. A copy of the recording and all written comments and documents received by the commission in response to the proposed rule shall be available to the public. (j) Nothing in this subsection shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the commission at hearings required by this subsection. (k) The commission shall, by majority vote of all commissioners, take final action on the proposed rule based on the rulemaking record and the full text of the rule. 1. The commission may adopt changes to the proposed rule provided the changes are consistent with the original purpose of the proposed rule. 2. The commission shall provide an explanation of the reasons for substantive changes made to the proposed rule as well as reasons for substantive changes not made that were recommended by commenters. 3. The commission shall determine a reasonable effective date for the rule. Except for an emergency as provided in par. (L), the effective date of the rule shall be no sooner than 30 days after issuing the notice that it adopted or amended the rule. (L) Upon determination that an emergency exists, the commission may consider and adopt an emergency rule with 24 hours’ notice, and with opportunity to comment, provided that the usual rule-making procedures provided in the compact and in this subsection shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to: 1. Meet an imminent threat to public health, safety, or welfare; 2. Prevent a loss of commission or member state funds; 3. Meet a deadline for the promulgation of a rule that is established by federal law or rule; or
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4. Protect public health and safety. (m) The commission or an authorized committee of the commission may direct revisions to a previously adopted rule for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the commission. (n) No member state’s rule-making process or procedural requirements shall apply to the commission. 1. The commission shall have no authority over any member state’s rule-making process or procedural requirements that do not pertain to the compact. (o) Nothing in this compact, nor any rule or regulation of the commission, shall be construed to limit, restrict, or in any way reduce the ability of a member state to enact and enforce laws, regulations, or other rules related to the practice of respiratory therapy in that state, where those laws, regulations, or other rules are not inconsistent with the provisions of this compact. (10) OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT. (a) Oversight. 1. The executive and judicial branches of state government in each member state shall enforce this compact and take all actions necessary and appropriate to implement the compact. 2. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. Nothing herein shall affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct or any such similar matter. 3. The commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the compact and shall have standing to intervene in such a proceeding for all purposes. Failure to provide the commission service of process shall render a judgment or order void as to the commission, this compact, or promulgated rules. (b) Default, technical assistance, and termination. 1. If the commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the commission shall provide written notice to the defaulting state. The notice of default shall describe the default, the proposed means of curing the default, and any other action that the commission may take, and shall offer training and specific technical assistance regarding the default. 2. The commission shall provide a copy of the notice of default to the other member states. (c) If a state in default fails to cure the default, the defaulting state may be terminated from the compact upon an affirmative vote of a majority of the commissioners of the member states, and all rights, privileges and benefits conferred on that state by this compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default. (d) Termination of membership in the compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the commission to the governor, the majority and minor-
May 22, 2026, are designated by NOTES. (Published 5-22-26)
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ity leaders of the defaulting state’s legislature, the defaulting state’s respiratory therapy licensing authority and each of the member states’ respiratory therapy licensing authorities. (e) A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination, if necessary. (f) Upon the termination of a state’s membership from this compact, that state shall immediately provide notice to all licensees and compact privilege holders (of which the commission has a record) within that state of such termination. The terminated state shall continue to recognize all licenses granted pursuant to this compact for a minimum of 180 days after the date of said notice of termination. (g) The commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the compact, unless agreed upon in writing between the commission and the defaulting state. (h) The defaulting state may appeal the action of the commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices. The prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. (i) Dispute resolution. 1. Upon request by a member state, the commission shall attempt to resolve disputes related to the compact that arise among member states and between member and nonmember states. 2. The commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes, as appropriate. (j) Enforcement. 1. By majority vote, as may be further provided by rule, the commission may initiate legal action against a member state in default in the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices to enforce compliance with the provisions of the compact and its promulgated rules. A member state by enactment of this compact consents to venue and jurisdiction in such court for the purposes set forth herein. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. The remedies herein shall not be the exclusive remedies of the commission. The commission may pursue any other remedies available under federal or the defaulting member state’s law. 2. A member state may initiate legal action against the commission in the U.S. District Court for the District of Columbia or the federal district where the commission has its principal offices to enforce compliance with the provisions of the compact and its promulgated rules. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney’s fees. 3. No person other than a member state shall enforce this compact against the commission. (11) EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT. (a) The compact shall come into effect on the date on which the compact statute is enacted into law in the 7th member state (“effective date”). 1. On or after the effective date of the compact, the commission shall convene and review the enactment of each of the first 7 member states (“charter member states”) to determine if the statute enacted by each such charter member state is materially different than the model compact. a. A charter member state whose enactment is found to be materially different from the model compact shall be entitled to the default process set forth in sub. (10).
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b. If any member state is later found to be in default, or is terminated or withdraws from the compact, the commission shall remain in existence and the compact shall remain in effect even if the number of member states should be less than 7. 2. Member states enacting the compact subsequent to the 7 initial charter member states shall be subject to the process set forth herein and commission rule to determine if their enactments are materially different from the model compact and whether they qualify for participation in the compact. 3. All actions taken for the benefit of the commission or in furtherance of the purposes of the administration of the compact prior to the effective date of the compact or the commission coming into existence shall be considered to be actions of the commission unless specifically repudiated by the commission. The commission shall own and have all rights to any intellectual property developed on behalf or in furtherance of the commission by individuals or entities involved in organizing or establishing the commission, as may be further set forth in rules of the commission. 4. Any state that joins the compact subsequent to the commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws as they exist on the date on which the compact becomes law in that state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the date the compact becomes law in that state. (b) Any member state may withdraw from this compact by enacting a statute repealing the same. 1. A member state’s withdrawal shall not take effect until 180 days after enactment of the repealing statute. 2. Withdrawal shall not affect the continuing requirement of the withdrawing state’s respiratory therapy licensing authority to comply with the investigative and adverse action reporting requirements of this compact prior to the effective date of withdrawal. 3. Upon the enactment of a statute withdrawing from this compact, a state shall immediately provide notice of such withdrawal to all licensees and compact privilege holders (of which the commission has a record) within that state. Notwithstanding any subsequent statutory enactment to the contrary, such withdrawing state shall continue to recognize all licenses granted pursuant to this compact for a minimum of 180 days after the date of such notice of withdrawal. (c) Nothing contained in this compact shall be construed to invalidate or prevent any licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact. (d) This compact may be amended by the member states. No amendment to this compact shall become effective and binding upon any member state until it is enacted into the laws of all member states. (12) CONSTRUCTION AND SEVERABILITY. (a) This compact and the commission’s rule-making authority shall be liberally construed so as to effectuate the purposes and the implementation and administration of the compact. Provisions of the compact expressly authorizing or requiring the promulgation of rules shall not be construed to limit the commission’s rule-making authority solely for those purposes. (b) The provisions of this compact shall be severable, and if any phrase, clause, sentence or provision of this compact is held by a court of competent jurisdiction to be contrary to the constitution of any member state, a state seeking participation in the compact, or of the United States, or the applicability thereof to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of this compact and the applicability thereof to any
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other government, agency, person or circumstance shall not be affected thereby. (c) Notwithstanding par. (b), the commission may deny a state’s participation in the compact or, in accordance with the requirements of sub. (10), terminate a member state’s participation in the compact, if it determines that a constitutional requirement of a member state is a material departure from the compact. Otherwise, if this compact shall be held to be contrary to the constitution of any member state, the compact shall remain in full force and effect as to the remaining member states and in full force and effect as to the member state affected as to all severable matters. (13) CONSISTENT EFFECT AND CONFLICT WITH OTHER STATE LAWS. (a) Nothing herein shall prevent or inhibit the enforcement of any other law of a member state that is not inconsistent with the compact. (b) Any laws, statutes, regulations, or other legal requirements in a member state in conflict with the compact are superseded to the extent of the conflict, including any subsequently enacted state laws. (c) All permissible agreements between the commission and the member states are binding in accordance with their terms.
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(d) Other than as expressly set forth herein, nothing in this compact will impact initial licensure. History: 2025 a. 76.
448.98895 Implementation of the respiratory care interstate compact. (1) In this section: (a) “Compact” means the respiratory care interstate compact under s. 448.9889. (b) “Compact privilege” means a compact privilege, as defined in s. 448.9889 (2) (h), that is granted under the compact to an individual to practice in this state. (2) The department may impose a fee for an individual to receive a compact privilege as provided in s. 448.9889 (3) (b). (3) (a) An individual who holds a compact privilege shall comply with s. 440.03 (13) (am). (b) Subject to s. 448.9889 and any rules promulgated thereunder, ss. 440.20 to 440.22 and the rules promulgated under s. 440.03 (1) shall apply to an individual who holds a compact privilege in the same manner that they apply to holders of certificates issued under subch. II. History: 2025 a. 76.
May 22, 2026, are designated by NOTES. (Published 5-22-26)