Ratification of the Respiratory Care Interstate Compact, the official text

2025 - 2026 LEGISLATURE
LRB-2628/1
MED:emw

2025 SENATE BILL 190
April 14, 2025 - Introduced by Senators Cabral-Guevara and Testin, cosponsored by Representatives Rodriguez, Snyder, Dittrich, Gundrum, Knodl, Melotik, Murphy, O'Connor, Wichgers and Duchow. Referred to Committee on Health.

An Act to renumber 448.05 (5r); to amend 146.81 (1) (d), 146.997 (1) (d) 5., 256.15 (4) (a) 3., 440.03 (9) (a) (intro.) and 2., 440.03 (13) (b) (intro.), 440.15, 448.01 (9s), 448.01 (12), 448.02 (3) (a) to (c), (e), (f) and (h), 448.02 (4) (a) and (b), 448.02 (5), 448.02 (6), 448.02 (8) (a), 448.02 (8) (c), 448.03 (1m), 448.05 (5r) (title), 448.07 (1) (b), 448.07 (1) (c), 448.07 (1) (d), 448.07 (2), 448.08 (1m), 448.08 (4), 448.12, 448.13 (1) (a), 448.13 (2), 448.13 (3) and 990.01 (28); to repeal and recreate 448.02 (3) (a), 448.07 (title), 448.07 (1) (title) and 448.07 (1) (a); to create 14.832, 440.03 (11m) (c) 2rm., 440.03 (13) (c) 1. m., 448.015 (2m), 448.04 (1) (im), 448.04 (2m), 448.05 (1) (e), 448.05 (5r) (b), 448.05 (6) (av), 448.06 (3) and subchapter XIV of chapter 448 [precedes 448.9886] of the statutes; relating to: ratification of the Respiratory Care Interstate Compact.

Analysis by the Legislative Reference Bureau
Respiratory Care Interstate Compact
This bill ratifies and enters Wisconsin into the Respiratory Care Interstate Compact, which provides for the ability of a respiratory care practitioner to become eligible to practice in other compact states. Significant provisions of the compact include the following:
1. The creation of a Respiratory Care Interstate Compact Commission, which includes one administrator or staff member of the licensure authorities of each member state. The commission has various powers and duties granted in the compact, including establishing bylaws, promulgating binding rules for the compact, hiring officers, electing or appointing employees, and establishing and electing an executive committee. The commission may levy on and collect an annual assessment from each member state or impose fees on licensees of member states to cover the cost of the operations and activities of the commission and its staff.
2. A process whereby a respiratory care practitioner may obtain a compact privilege to practice in another member state. A licensee's primary state of residence is considered to be his or her home state, and any other member state in which the licensee wishes to practice is considered a remote state. A licensee providing respiratory therapy in a remote state under the compact privilege is required under the compact to function within the scope of practice authorized by the remote state.
A remote state may take actions against a respiratory care practitioner’s compact privilege within that remote state, and if a respiratory care practitioner’s home state license is encumbered, the respiratory care practitioner loses his or her compact privilege in all remote states until the home state license is no longer encumbered and two years have elapsed from the date on which the license is no longer encumbered.
3. The ability of member states to issue subpoenas that are enforceable in other states.
4. The creation of a coordinated database and reporting system containing licensure and disciplinary action information on respiratory care practitioners. The compact provides that member states are responsible for reporting any adverse action against a licensee and for monitoring the database to determine whether adverse action has been taken against a licensee. A member state must submit a uniform data set to the data system with certain information specified in the compact, as required by the rules of the commission.
5. Provisions regarding resolutions of disputes among member states and between member and nonmember states, including a process for termination of a state’s membership in the compact if the state defaults on its obligations under the compact.
The compact becomes effective in this state upon enactment in seven states. The compact provides that it may be amended upon enactment of an amendment by all member states. A state may withdraw from the compact by repealing the statute authorizing the compact, but the compact provides that a withdrawal does not take effect until 180 days after the effective date of that repeal.
Statutes and rules examination for respiratory care practitioners
The bill prohibits the Medical Examining Board from requiring an applicant to pass a statutes and rules examination as a condition of certification as a respiratory care practitioner. The bill allows the board to require an applicant to affirm that the applicant has read and understands the statutes and rules that apply to the applicant's practice as a respiratory care practitioner.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

Section 1. 14.832 of the statutes is created to read:
14.832 Respiratory care interstate compact. There is created a respiratory care interstate compact commission as specified in s. 448.9886. The commissioner on the commission representing this state shall be appointed by the medical examining board as provided in s. 448.9886 (7) (b) 1., with the advice of the respiratory care practitioners examining council, and shall be an individual described in s. 448.9886 (7) (b) 2. The commission has the powers and duties granted and imposed under s. 448.9886.
Section 2. 146.81 (1) (d) of the statutes is amended to read:
146.81 (1) (d) A physician, perfusionist, or respiratory care practitioner licensed or certified under subch. II of ch. 448 or a respiratory care practitioner who holds a compact privilege under subch. XIV of ch. 448.
Section 3. 146.997 (1) (d) 5. of the statutes is amended to read:
146.997 (1) (d) 5. A respiratory care practitioner licensed or who is certified under ch. 448 or who holds a compact privilege under subch. XIV of ch. 448.

Section 4. 256.15 (4) (a) 3. of the statutes is amended to read:
256.15 (4) (a) 3. If the ambulance is an aircraft and the sick, disabled, or injured individual is a pediatric patient who is being transferred from one hospital to another hospital, one individual specified in subd. 1. plus one respiratory care practitioner who is certified under subch. II of ch. 448 or who holds a compact privilege under subch. XIV of ch. 448.
Section 5. 440.03 (9) (a) (intro.) and 2. of the statutes are amended to read:
440.03 (9) (a) (intro.) Subject to pars. (b) and (c) and s. 458.33 (2) (b) and (5), the department shall, biennially, determine each fee for an initial credential for which no examination is required, for a reciprocal credential, and for a credential renewal and any fees imposed under ss. 447.51 (2), 448.986 (2), 448.9875 (2), 448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2) by doing all of the following:
2. Not later than January 31 of each odd-numbered year, adjusting for the succeeding fiscal biennium each fee for an initial credential for which an examination is not required, for a reciprocal credential, and, subject to s. 440.08 (2) (a), for a credential renewal, and any fees imposed under ss. 447.51 (2), 448.986 (2), 448.9875 (2), 448.9885 (2), 448.9887 (2), 457.51 (2), and 459.71 (2), if an adjustment is necessary to reflect the approximate administrative and enforcement costs of the department that are attributable to the regulation of the particular occupation or business during the period in which the initial or reciprocal credential, credential renewal, or compact privilege is in effect and, for purposes of each fee for a credential renewal, to reflect an estimate of any additional moneys available for the department’s general program operations as a result of appropriation transfers that have been or are estimated to be made under s. 20.165 (1) (i) during the fiscal
biennium in progress at the time of the deadline for an adjustment under this subdivision or during the fiscal biennium beginning on the July 1 immediately following the deadline for an adjustment under this subdivision.
Section 6. 440.03 (11m) (c) 2rm. of the statutes is created to read:
440.03 (11m) (c) 2rm. The coordinated data system under s. 448.9886 (8), if such disclosure is required under the respiratory care interstate compact under s. 448.9886.
Section 7. 440.03 (13) (b) (intro.) of the statutes is amended to read:
440.03 (13) (b) (intro.) The department may investigate whether an applicant for or holder of any of the following credentials has been charged with or convicted of a crime only pursuant to rules promulgated by the department under this paragraph, including rules that establish the criteria that the department will use to determine whether an investigation under this paragraph is necessary, except as provided in par. (c) and ss. 441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 448.9886 (3) (a) 9., 455.50 (3) (e) 4. and (f) 4., 457.50 (3) (b) 3. and (5) (b) 2. a., and 459.70 (3) (b) 2.:
Section 8. 440.03 (13) (c) 1. m. of the statutes is created to read:
440.03 (13) (c) 1. m. An applicant for a respiratory care practitioner certificate under s. 448.04 (1) (i).
Section 9. 440.15 of the statutes is amended to read:
440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c), 441.51 (5) (a) 5., 447.50 (3) (a) 5., 448.980 (5) (b) 3., 448.985 (3) (a) 4., 448.987 (3) (a) 5. a. and (5) (b) 2. a., 448.988 (3) (a) 5., 448.9886 (3) (a) 9., 450.071 (3) (c) 9., 450.075
(3) (c) 9., 455.50 (3) (e) 4. and (f) 4., 457.50 (3) (b) 3. and (5) (b) 2. a., and 459.70 (3) (b) 1., the department or a credentialing board may not require that an applicant for a credential or a credential holder be fingerprinted or submit fingerprints in connection with the department’s or the credentialing board’s credentialing.
Section 10. 448.01 (9s) of the statutes is amended to read:
448.01 (9s) “Scene of an emergency” means an area not within the confines of a hospital or other institution which has hospital facilities or the office of a person licensed, certified or holding a compact privilege or limited permit under this chapter.
Section 11. 448.01 (12) of the statutes is amended to read:
448.01 (12) “Warn” means to privately apprise the holder of a license or, certificate, or compact privilege of the unprofessional nature of the holder’s conduct and admonish the holder that continued or repeated conduct of such nature may give the medical examining board or an attached affiliated credentialing board cause to reprimand the holder or to limit, suspend or revoke such license or, certificate, or compact privilege.
Section 12. 448.015 (2m) of the statutes is created to read:
448.015 (2m) “Respiratory care compact privilege” means a compact privilege, as defined in s. 448.9886 (2) (h), that is granted under the respiratory care interstate compact to an individual to practice in this state.
Section 13. 448.02 (3) (a) to (c), (e), (f) and (h) of the statutes are amended to read:
448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license or, certificate, or
respiratory care compact privilege granted by the board. An allegation that a physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to mail or present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6-month period to mail or present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the 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 board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license or, certificate, or respiratory care compact privilege to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.
(b) After an investigation, if the board finds that there is probable cause to believe that the person is guilty of unprofessional conduct or negligence in treatment, the board shall hold a hearing on such conduct. The board may use any information obtained by the board or the department under s. 655.17 (7) (b), as created by 1985 Wisconsin Act 29, in an investigation or a disciplinary proceeding, including a public disciplinary proceeding, conducted under this subsection and the
board may require a person holding a license or, certificate, or respiratory care compact privilege to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its hearing. A unanimous finding by a panel established under s. 655.02, 1983 stats., or a finding by a court that a physician has acted negligently in treating a patient is conclusive evidence that the physician is guilty of negligence in treatment. A finding that is not a unanimous finding by a panel established under s. 655.02, 1983 stats., that a physician has acted negligently in treating a patient is presumptive evidence that the physician is guilty of negligence in treatment. A certified copy of the findings of fact, conclusions of law and order of the panel or the order of a court is presumptive evidence that the finding of negligence in treatment was made. The 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) Subject to par. (cm), after a disciplinary hearing, the board may, when it determines that a panel established under s. 655.02, 1983 stats., has unanimously found or 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 any license or, certificate, or respiratory care compact privilege granted by the board to that person. The board may condition the removal of limitations on a license or, certificate, or respiratory care compact privilege or the restoration of a suspended or revoked license or, certificate, or respiratory care compact privilege
upon obtaining minimum results specified by the board on one or more physical, mental or professional competency examinations if the 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.
(e) A person whose license or, certificate, or respiratory care compact privilege is limited under this subchapter shall be permitted to continue practice upon condition that the person will refrain from engaging in unprofessional conduct; that the person will appear before the board or its officers or agents at such times and places as may be designated by the board from time to time; that the person will fully disclose to the board or its officers or agents the nature of the person’s practice and conduct; that the person will fully comply with the limits placed on his or her practice and conduct by the board; that the person will obtain additional training, education or supervision required by the board; and that the person will cooperate with the board.
(f) Unless a suspended license or, certificate, or respiratory care compact privilege is revoked during the period of suspension, upon the expiration of the period of suspension the license or, certificate, or respiratory care compact privilege shall again become operative and effective. However, the board may require the holder of any such suspended license or, certificate, or respiratory care compact privilege to pass the examinations required for the original grant of the license or, certificate, or respiratory care compact privilege before allowing such suspended license or, certificate, or respiratory care compact privilege again to become operative and effective.
(h) Nothing in this subsection prohibits the board, in its discretion, from
investigating and conducting disciplinary proceedings on allegations of unprofessional conduct by persons holding a license or, certificate, or respiratory care compact privilege granted by the board when the allegations of unprofessional conduct may also constitute allegations of negligence in treatment.
Section 14. 448.02 (3) (a) of the statutes, as affected by 2023 Wisconsin Act 172 and 2025 Wisconsin Act .... (this act), is repealed and recreated to read:
448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license, certificate, or respiratory care compact privilege granted by the board. An allegation that a physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6-month period to present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the 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 board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license, certificate, or respiratory care compact privilege to undergo and may consider the results of one or more physical, mental or professional competency
examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.