WeVote
Log In

Bill

Bill

SB 2544

Interstate Compacts - As introduced, enacts the "Respiratory Care Interstate Compact Act." - Amends TCA Title 4 and Title 63.

114th Regular Session (2025-2026)

Tennessee joins the Respiratory Care Interstate Compact to enable multi-state licensure and practice for respiratory therapists across member states while preserving state licensur

Transmitted to Governor for action.
#interstatecompacts
0
WeVote Research Nonpartisan
Bill Summary · SB 2544

Summary of SB 2544 (Session 114) – Tennessee

Topic: Interstate Compacts – Respiratory Care Interstate Compact Act

Scope: Tennessee enters into the Respiratory Care Interstate Compact and creates the enabling framework for multi-state licensing and practice of respiratory therapy across member states.

Effective date: The compact takes effect on the date the statute is enacted into law in the seventh member state (the seventh state to enact). The bill also establishes a process for charter member states and future participants, and sets procedures for withdrawal, amendments, and termination.

Key sections and provisions

  • 63-27-201 to 63-27-214: Establishment and text of the Respiratory Care Interstate Compact.

    • Purpose (63-27-202): Facilitate interstate practice of respiratory therapy, enhance public access, preserve state licensure authority, promote cooperation among member states, reduce administrative burdens, support relocating military members and spouses, and address workforce shortages.
    • Definitions (63-27-203): Includes terms such as home state, remote state, compact privilege, licensee, adverse action, significant investigative information, data system, and more.
    • State participation (63-27-204): States must enact a model compact, license therapists, participate in the commission's data system, handle complaints and adverse actions, report adverse actions and significant investigative information, comply with rules, and grant compact privilege to eligible licensees. Also authorizes criminal background checks for new licensees (where allowed by federal law).
    • Compact privilege (63-27-205): Requirements for a therapist to practice in a remote state under the compact, including:
    • Active home state license
    • Active NBRC credential or equivalent
    • No adverse action in the previous 2 years
    • Notification to the commission
    • Payment of applicable fees
    • Compliance with jurisprudence requirements of the remote state
    • Reporting adverse actions by non-member states within 30 days
    • Domicile information and changes reported to the commission
    • Consent to service of process by mail
    • Duration and scope: The compact privilege remains valid until the home license expires or is revoked, subject to ongoing compliance. Practice must stay within the remote state's scope of practice.
    • Military members: Active military members or spouses designate a home state; special consideration regarding fees (likely reduced or free) for compact privileges.
    • Encumbered home licenses: If the home state license is encumbered, the compact privilege is suspended in remote states until encumbrance is cleared and 2 years have elapsed since resolution of the adverse action.

  • 63-27-206: Active military member or spouse provisions.

    • Designate a home state and may retain designation during active duty.
    • No fee charged by the commission to military members/spouses for the compact privilege; remote states may offer reduced or no fee.

  • 63-27-207: Adverse actions and enforcement.

    • Each member state may impose adverse action against a license issued in that state.
    • Adverse actions can be based on significant investigative information in other states; joint investigations permitted.
    • Remote state authority to issue subpoenas and enforce them; costs of witnesses and production of evidence may be borne by the issuing state.
    • Prohibits actions for conduct legal in another member state at the time it occurred.
    • Inter-state sharing of significant investigative information; confidentiality provisions apply.

  • 63-27-208: Establishment of the Respiratory Care Interstate Compact Commission.

    • A joint government agency (the Commission) representing member states, not a single state entity.
    • Each member state appoints one commissioner (from its licensing authority); commission meetings at least annually; voting single commissioner per state.
    • Commission powers include: rules and bylaws; budget; contracts; fees; data management; joint investigations; and more.
    • Executive committee (up to 9 members) with defined duties to manage day-to-day operations, enforcement, and compliance between full Commission meetings.

  • 63-27-209 to 63-27-210: Data system and rulemaking.

    • Establishment and maintenance of a centralized data system containing licensure, adverse action, and significant investigative information.
    • Data sharing is governed by rules; certain data (e.g., criminal history records) are not to be uploaded into the system.
    • Rules adopted by the Commission have the force of law in member states; hearings and public comments required for rulemaking.

  • 63-27-211 to 63-27-212: Oversight, dispute resolution, and enforcement; withdrawal and amendments.

    • Default procedures and termination processes for non-compliant states; opportunity for cure and potential termination by majority vote.
    • Withdrawal requires repeal of compact statute in the withdrawing state; a 180-day transition period.
    • Dispute resolution includes mediation and binding processes; enforcement through federal courts if necessary.

  • 63-27-213 to 63-27-215: Construction, consistent effect, and implementation.

    • Compact supersedes conflicting state laws to the extent of the conflict; other non-conflicting state laws remain unaffected.
    • Board may implement the Compact through state rules; Tennessee Board of Respiratory Care to promulgate implementing rules via the Uniform Administrative Procedures Act.

  • 63-27-216: Effective date notice.

    • Board must notify legislative chairs and the Tennessee Code Commission when the compact becomes effective or when withdrawal/amendment becomes effective.

Additional statutory adjustments

  • Section 2, 3, 4, 5: Minor cross-references and terminology changes to align Tennessee law with the new part.
  • Section 7: Effective date clause for the act itself.

Fiscal and administrative impact

  • Fiscal Note indicates the Board of Respiratory Care may incur costs exceeding $10,000 once the Compact takes effect, with ongoing financing potentially via new fees and annual assessments authorized by the Commission.
  • The Board has historically operated with deficits; the compact is expected to influence licensure and administrative costs, potentially offset by fee adjustments.

What would be affected

  • Respiratory therapists licensed in Tennessee (and other member states) who seek to practice in other member states under the compact privilege.
  • Tennessee's Board of Respiratory Care (administrative and licensing authority) and its processes.
  • The proposed Respiratory Care Interstate Compact Commission (creation, governance, data system, and rulemaking).
  • Military service members and spouses who may benefit from fee exemptions or reductions and streamlined licensure mobility.

Overall purpose and impact

  • The bill creates Tennessee’s participation in the Respiratory Care Interstate Compact to modernize and streamline multi-state practice for respiratory therapists, improve access to care, and support mobility in the healthcare workforce while preserving each state's public health authority. It establishes governance, data sharing, enforcement, and funding mechanisms to operate a shared regulatory framework across member states.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.