flag of tennessee2024 Tennessee Code Unannotated

Title 63 Professions Of The Healing Arts

Chapter 2 Medical Records
§ 63-2-101. Release of medical records — Definitions.
  1. (a)
    1. (1) Notwithstanding any other provision of law to the contrary, a health care provider shall furnish to a patient or a patient's authorized representative a copy or summary of such patient's medical records, at the option of the health care provider, within ten (10) working days upon request in writing by the patient or such representative.
    2. (2) If a provider fails to comply with subdivision (a)(1), proper notice shall be given to the provider's licensing board or boards, and the provider may be subject to disciplinary actions that include sanctions and a monetary fine.
  2. (b)
    1. (1)
      1. (A) Except as otherwise provided by law, such patient's medical records shall not constitute public records, and nothing contained in this part shall be deemed to impair any privilege of confidentiality conferred by law on patients, their personal representatives or heirs. Nothing in this subsection (b) shall impair or abridge the right of the patient or the patient's authorized representative to obtain copies of the patient's hospital records in the manner provided in § 68-11-304. Nothing in this subsection (b) shall be construed as prohibiting a patient's medical records from being subpoenaed by a court of competent jurisdiction.
      2. (B) As used in subdivision (b)(1)(A), “medical records” includes any list of patients that is compiled or maintained by or for such patient's health care provider.
    2. (2) Except for any statutorily required reporting to health or government authorities and except for access by an interested third-party payer or their designee for the purpose of utilization review, case management, peer reviews or other administrative functions, the name and address and other identifying information of a patient shall not be divulged. The name and address and other identifying information shall not be sold for any purpose. Any violation of this subdivision (b)(2) shall be an invasion of the patient's right to privacy.
    3. (3) Except as otherwise authorized in this section, title 38, chapter 7, part 1, title 68, chapter 11, part 3 and title 68, chapter 11, part 15, a health care provider shall have in place a policy to protect the dignity of a patient, even if the patient dies or becomes incapacitated, by limiting the use and disclosure of medical records, images, videos or pictures intended to be used for appropriate medical educational purposes, even if the patient's information is de-identified. The policy shall include when and to whom it is appropriate to use and disclose the patient's information, and when a written authorization from the patient or their authorized representative is required, whenever it is reasonably possible to obtain it, prior to use or disclosure. If the patient becomes incapacitated or dies, and there is no legal representative for the patient, the patient's next of kin will be considered to be an authorized representative for the patient. When required the written authorization will include the core elements required by 45 CFR Parts 160 and 164, “Standards for Privacy of Individually Identifiable Health Information.”
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  3. (c) As used in this chapter:
    1. (1) “De-identified” means there is no reasonable basis to believe that the information can be used to identify an individual and there is compliance with the requirements for de-identification outlined in 45 CFR Part 164, § 164.514 “Other requirements relating to uses and disclosures of protected health information”;
    2. (2) “Health care provider” means any person required to be licensed under this title;
    3. (3) “Incapacitated” means that a patient is in a physical or mental condition such that the patient is incapable of granting or denying informed consent; and
    4. (4) “Medical records” means all medical histories, records, reports and summaries, diagnoses, prognoses, records of treatment and medication ordered and given, X-ray and radiology interpretations, physical therapy charts and notes and lab reports.
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  4. (d) Nothing in this chapter shall be construed to prevent a true, correct and complete copy of the medical records from being subject to a subpoena duces tecum.
  5. (e) To further the effectiveness of the immunization program of the department of health, a physician or any third party payor or health insurance entity regulated by the department of commerce and insurance doing business in Tennessee, or any entity that has elected, organized and qualified as a self-insured entity that provides information to the department regarding a child's immunization status for any of the following purposes shall not be subject to liability or cause of action or a claim of any nature, including any licensing board disciplinary action, arising solely from the disclosure of information concerning such child's immunization status:
    1. (1) Compliance with the laws regarding child care and school attendance;
    2. (2) Ensuring that a child receives such immunization as is medically appropriate or assisting in efforts to ensure a child is appropriately immunized;
    3. (3) Providing immunization information to the immunization registry maintained by the department;
    4. (4) Insuring compliance with the Families First Act, compiled in title 71, chapter 3, part 1; or
    5. (5) Providing information that will allow the department to determine immunization levels in Tennessee.
  6. (f) All information received by the department pursuant to this part from any source shall be confidential and unavailable to the public. Contact of a parent or guardian of a child by the department regarding the child's immunization status as the result of the department's contact with the physician shall not be held to be a breach of confidentiality by the reporting physician.
  7. (g) The names of all children shall be included on the immunization registry established by title 37, chapter 10, part 4, unless such child's custodial parent or guardian objects to the inclusion of the child's name on the immunization registry to the department. The department shall notify the child's custodial parent or guardian in writing within six (6) months of the child's birth that inclusion on the immunization registry is not mandatory. Upon such written or oral request of exclusion by the child's custodial parent or guardian, the department shall either remove the child's name from the immunization registry or refrain from adding the child's name to the immunization registry and confirm in writing to the child's custodial parent or guardian that the child's name has been excluded from the immunization registry.
  8. (h) Notwithstanding this part or any other law to the contrary, it shall not be unlawful to disclose, nor shall there be any liability for disclosing, medical information in response to a subpoena, court order or request authorized by state or federal law.
  9. (i) Providers, as defined in § 71-5-2503, shall make available for inspection and copying to the office of inspector general and the medicaid fraud control unit, upon request, no later than by the close of business on the next business day, a complete set of all medical records requested in connection with an investigation being pursued by the agency or shall provide a compelling reason why the requested records cannot be produced; provided, that no such records shall be removed from the grounds of the provider's office without the provider's consent, unless the office of inspector general or the medicaid fraud control unit reasonably believes that the requested documents are about to be altered or destroyed.
  10. (j) On request of a provider, a duly authorized agent of the requesting agency shall sign a document acknowledging receipt of records produced pursuant to this section. On request of a duly authorized agent of the requesting agency, a duly authorized agent of the provider shall sign a document acknowledging the return of specific records to the provider.
  11. (k) No person or entity shall be subject to any civil or criminal liability for releasing patient information in response to a request from the office of inspector general or the medicaid fraud control unit.
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§ 63-2-102. Costs of reproduction, copying or mailing of records.
  1. (a) The party requesting the patient's records is responsible to the provider for the reasonable costs of copying and mailing such patient's records. For other than records involving workers' compensation cases, such reasonable costs shall not exceed twenty dollars ($20.00) for medical records five (5) pages or less in length and fifty cents (50¢) per page for each page copied after the first five (5) pages and the actual cost of mailing. Any third-party provider of record copying and related services shall be subject to the reasonable cost limits contained in this section and shall not impose any charge or fee for such services in excess of such cost limits. The costs charged for reproducing records of patients involved in a workers' compensation claim shall be as defined in § 50-6-204. A health care provider shall not charge a fee for copying or notarizing a medical record when requested by the department pursuant to a complaint, inspection or survey as set forth in § 63-1-117.
  2. (b) Any increase in charges for copying and certifying medical records permitted by this section that is above those charges established by this section as it existed on January 1, 2010, shall not apply to requests for medical records made by the department of human services, and charges for copying and certifying medical records requests made by the department of human services shall remain the same as existed under this section as of January 1, 2010.
  3. (c)
    1. (1) Upon request, the provider shall submit a notarized affidavit by the custodian of records certifying that the records provided in response to the request:
      1. (A) Are true and correct copies of records in the custody of the affiant;
      2. (B) Were made at or near the time of the occurrence of the matters set forth by, or from information transmitted by, a person with knowledge of and a business duty to record or transmit those matters;
      3. (C) Were kept in the course of regularly conducted activity; and
      4. (D) Were made by the regularly conducted activity as a regular practice.
    2. (2) In addition to the charge for the copies of the record, the provider may charge up to twenty dollars ($20.00) for the affidavit described in this subsection (c), and the records submitted with that affidavit, and the affidavit shall qualify for the business records exception to the hearsay rule.
  4. (d) Nothing in this chapter shall be construed as superseding any provision of law that establishes specific costs for the reproduction, copying or mailing of records.
  5. (e) Payment of such costs may be required by the provider prior to the records being furnished. Upon payment of the costs described in this section, the patient or a patient's authorized representative shall have the right to receive the medical records without delay.
  6. (f) In workers' compensation cases, a request for medical records shall include a medical or anatomical impairment rating as required by § 50-6-246 [See the Compiler’s Notes].
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§ 63-2-103. Authority to promulgate regulations regarding retention of physician medical records — Limit on retention of mammography records.
  1. (a) The board of medical examiners is authorized to promulgate regulations regarding the retention of physician medical records as defined in § 63-2-101(c).
  2. (b) Notwithstanding any law or rule to the contrary, such retention of mammography records shall not exceed ten (10) years.
Chapter 3 Podiatrists
Part 1 General Provisions
§ 63-3-101. “Podiatrist” defined — Performance of ankle surgery.
  1. (a) Within this chapter, “podiatrist” means one who examines, diagnoses or treats, medically mechanically or surgically, the ailments of the human foot, ankle and soft tissue structures extending no higher than the distal tibial metaphyseal flair, including the use and prescribing of drugs and medications, but excluding the direct applications of general anesthesia by a podiatrist and the amputation of the foot. A podiatrist may perform Achilles tendon repair, subject to subsection (b), but may not perform surgery on Pilon fractures or tibial fractures that do not enter the ankle joint.
  2. (b) A licensed podiatrist may perform ankle surgery only when that podiatrist meets the requirements of either subdivision (b)(1) or (b)(2):
    1. (1) Was, prior to October 2, 1995, credentialed to perform ankle surgery by a JCAHO accredited hospital in Tennessee or JCAHO accredited ambulatory surgical treatment center in Tennessee; provided, that a podiatrist who qualifies to perform ankle surgery under this subdivision (b)(1) must, if the podiatrist wishes to continue to perform ankle surgery:
      1. (A) Notify the board as to the hospital or ambulatory surgical treatment center at which the podiatrist was credentialed to perform ankle surgery prior to October 2, 1995;
      2. (B) Obtain and maintain evidence of obtaining at least ten (10) hours of approved continuing education related to ankle surgery annually; and
      3. (C) Comply with any other requirements established by the board to ensure continued proficiency in performing ankle surgery; or
    2. (2) Has completed a surgical residency program at least twenty-four (24) months in length that has been approved by the council on podiatric medical education and is currently eligible for certification to perform reconstructive rearfoot/ankle surgery by the American Board of Podiatric Surgery; provided, that a podiatrist who qualifies to perform ankle surgery under this subdivision (b)(2) must obtain certification to perform reconstructive rearfoot/ankle surgery from the American Board of Podiatric Surgery within six (6) years of May 24, 2000, or within six (6) years of first becoming eligible for certification, whichever date is later, and may not continue to perform ankle surgery if that podiatrist has not obtained certification by the end of the six-year period.
  3. (c) A licensed podiatrist may perform ankle surgery only in an accredited hospital or ambulatory surgical treatment center licensed under title 68 at which the podiatrist has surgical privileges to perform ankle surgery. For purposes of this subsection (c), an accredited hospital is one that is accredited by joint commission or the American Osteopathic Association, and an accredited ambulatory surgical treatment center is one that is accredited by joint commission, Accreditation Association for Ambulatory Health Care or American Association for Accreditation of Ambulatory Surgical Facilities. A podiatrist who performs ankle surgery in an ambulatory surgical treatment center must first have surgical privileges to perform ankle surgery at a local hospital. A licensed podiatrist who performs ankle surgery must meet the same standard of care applicable to orthopedic surgeons who perform ankle surgery.
  4. (d) Licensed podiatrists may perform nonsurgical care on the ankle without meeting the requirements of subsection (b).
  5. (e) A licensed podiatrist may collaborate with a physician assistant or an orthopedic physician assistant licensed pursuant to chapter 19 of this title. A podiatrist collaborating with a physician assistant pursuant to this subsection (e) shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-106 and 63-19-107 governing collaboration with a physician assistant. A podiatrist collaborating with an orthopedic physician assistant pursuant to this subsection (e) shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-203 — 63-19-205 governing collaboration with an orthopedic physician assistant.
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§ 63-3-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of podiatric medical examiners; and
    2. (2) “Division” means the division of health related boards of the department of health.
§ 63-3-103. Board of podiatric medical examiners — Members.
  1. (a) A board of examiners is established, to be known by the name and title of “board of podiatric medical examiners.”
  2. (b) The governor shall appoint four (4) persons who have been licensed podiatrists for a period of at least two (2) years in this state as members of this board. The terms of office shall be for four (4) years. In making appointments to the board of podiatric medical examiners, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  3. (c) Upon the expiration of the term of a member, the governor shall appoint the member's successor for a term of four (4) years.
  4. (d) The governor has the power to remove from office members of the board for neglect of duties as required by this chapter, or for malfeasance in office and incompetency or for unprofessional conduct. The governor has the authority to fill any vacancy caused by the removal of any member of the board by the member's resignation or death, from a list of all licensed podiatrists who have practiced not less than two (2) years in this state.
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§ 63-3-104. Organization, meetings and compensation of board.
  1. (a) The board shall elect a chair and a secretary from its own members.
  2. (b) The board shall hold one (1) regular meeting in each year and such additional meetings at such times and places as it may determine.
  3. (c) Each member of the board shall receive one hundred dollars ($100) per diem when actually engaged in the discharge of official duties and, in addition, shall be reimbursed for all travel and other necessary expenses. All expenses shall be claimed and paid in accordance with prevailing travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-3-105. Disposition of fees — Expenditures.
  1. (a) All fees and moneys from whatever source coming into the hands of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  2. (b) The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board, and no expenditure may be made by the board until allotment therefor has been made by the commissioner. The allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
§ 63-3-106. General powers of board.
  1. The board has the powers and duties, in addition to powers and duties granted to or imposed upon it by the other sections of this chapter, to:
    1. (1) Adopt and promulgate rules and regulations as may be necessary to govern its proceedings and carry into effect the purpose of this chapter;
    2. (2) Conduct examinations to ascertain the qualifications and fitness of applicants for a license to practice podiatry in this state;
    3. (3) Provide standards by which podiatry schools and colleges shall be approved;
    4. (4) Direct the division to issue a license for applicants who successfully pass the examination for the practice of podiatry;
    5. (5) Conduct hearings, to revoke or suspend any license or certificate under the authority of this chapter or any previous laws authorizing the holder thereof to practice podiatry for violations by a licensee of any of the provisions of this chapter or any rule or regulation of the board properly adopted and promulgated by the board; and
    6. (6) Sponsor, conduct or approve such educational programs as are necessary to carry out and make effective this chapter.
§ 63-3-107. Unlawful practice.
  1. (a) It is unlawful for any person to practice or attempt to practice podiatry in this state unless such person has been issued a valid and current license to practice podiatry by this board as provided by this chapter.
  2. (b) If any person uses any name or title that would designate that person as a podiatrist or imply that that person was or is qualified to practice podiatry under this chapter, it is deemed prima facie evidence of practicing within the meaning of this chapter.
§ 63-3-108. Exemptions.
  1. This chapter shall not apply to the commissioned physicians and surgeons of the United States army, navy, air force or marine hospital service in the actual performance of their official duties, nor to physicians and surgeons or to osteopathic physicians and surgeons regularly licensed under the laws of this state, nor to visiting podiatrists called into consultation in this state from another state where they are duly qualified under the laws of that state to practice podiatry.
§ 63-3-109. Academic license — License to practice — Requirements — Podiatrists licensed in other states.
  1. (a) Any person desiring an academic license to participate in a residency program shall:
    1. (1) Apply on a form prescribed by the board or via online application for an academic license;
    2. (2) Pay a fee as determined by the board; and
    3. (3) Have a residency program accepted by the board certify that the applicant has been accepted for its program.
  2. (b) The academic license shall terminate upon the applicant leaving the residency program.
  3. (c) Any person desiring to become licensed to practice podiatry in this state must:
    1. (1) Make application to the secretary of the board on a form prescribed by the board;
    2. (2) Pay an application fee as determined by the board;
    3. (3) Pass the examination conducted or accepted by the board; and
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    4. (4) Successfully complete at least a one-year residency program approved by the Council on Podiatric Medical Education or its successor organization.
  4. (d) The board shall have the authority to issue locum tenens licenses to podiatrists licensed in another state who wish to practice podiatry in this state for a limited period of time and who meet all the requirements established by the board by rule for a locum tenens license.
§ 63-3-110. Qualifications of applicants — Educational standards.
  1. No person shall be entitled to take any examination for a license unless that person furnishes the board with satisfactory proof that the person is at least eighteen (18) years of age, is of good moral character and has graduated from a college of podiatric medicine which is accredited by the Council on Podiatric Medical Education or its successor organization.
§ 63-3-111. Contents of examination — Grade requirement — Fee.
  1. (a)
    1. (1) The board may conduct examinations at such times and places as it may designate.
    2. (2) Examinations shall be in the English language, written and clinical, and shall include subjects of histology, surgery, hygiene, dermatology, anatomy, physiology, chemistry, bacteriology, pathology, diagnosis and treatment, materia medica and therapeutics, and clinical podiatry and such additional subjects as are pertinent to podiatry; but such examinations shall be so limited in their scope as to cover only the requirements for podiatry education as provided in this chapter.
    3. (3) The board may accept the report of the National Board of Podiatric Medical Examiners on any examinee.
  2. (b) The board shall establish the minimum passing grade by regulation.
  3. (c) The board may set an examination fee.
§ 63-3-112. Reexamination.
  1. An applicant who fails to pass an examination satisfactory to the board, and is therefore refused a license, is entitled, within six (6) months after such refusal, to a reexamination upon payment of an additional fee as set annually by the board for each such reexamination.
§ 63-3-113. Issuance of licenses.
  1. (a) If an applicant successfully passes the examination provided by this chapter and meets all of the requirements of this chapter, the board shall direct the division to issue the applicable license.
  2. (b)
    1. (1) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-3-114. Reciprocity.
  1. (a) The board, in its discretion, may waive the examination required by § 63-3-109(c)(3) and may issue a license to any applicant who holds or possesses a valid license to practice podiatry in another state; provided, that the requirements for licensure in such state are, in the opinion of the board, at least equivalent to the requirements for licensure provided by this chapter and that such applicant pays a fee as set by the board.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-3-115. Renewal of license.
  1. (a) Each person licensed to practice as a podiatrist in this state shall biennially apply to the board for renewal of the person's license and shall pay a renewal fee set by the board. A podiatrist who fails to renew the license by the date of expiration of the license shall not continue to practice as a podiatrist in this state.
  2. (b) A podiatrist who fails to timely renew the license may seek reinstatement from the board. The board may reinstate the license upon good cause shown, upon payment of all past due renewal fees and a late renewal fee and upon compliance with any other reasonable conditions imposed by the board.
  3. (c) The board may utilize the renewal system described in § 63-1-107.
  4. (d) Any licensed podiatrist who has retired from practice in this state shall not be required to renew the license if the person retired from practice files with the board an affidavit of retirement on a form furnished by the board. The affidavit shall state the date on which the person retired from practice and such other facts as the board deems necessary to verify retirement. If the person thereafter wishes to reenter practice in this state, the person shall apply for license reactivation, pay the reactivation fee set by the board and meet such other reasonable requirements deemed necessary by the board.
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§ 63-3-116. Continuing medical education — Exemptions.
  1. (a) As a condition of the biennial renewal of a podiatrist license, every licensed podiatrist must obtain at least fifteen (15) hours of continuing medical education each calendar year in programs approved by the board. The only basis upon which a podiatrist may seek an exemption from this requirement or an extension of time for meeting this requirement is illness or disability.
  2. (b) Podiatrists who have properly retired their licenses pursuant to § 63-3-115(d) are exempt from the requirement of subsection (a).
§ 63-3-117. Application of health laws.
  1. Licensed podiatrists shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases and all matters pertaining to public health, making reports to proper health officers in the same manner as other practitioners of the healing arts are required to make.
§ 63-3-118. Services provided by physician assistant or orthopedic physician assistant collaborating with podiatrist.
  1. A physician assistant collaborating with a licensed podiatrist shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101 and may prescribe only drugs that are rational to the practice of podiatry. An orthopedic physician assistant collaborating with a licensed podiatrist shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101.
§ 63-3-119. Suspension or revocation of license — Enforcement.
  1. (a) The board has the duty and authority to suspend for a specified time, within the discretion of the board or to revoke any license to practice podiatry or to otherwise discipline any licensee or refuse to grant any certificate of fitness whenever the licensee or applicant is found guilty of any of the following acts or offenses:
    1. (1) Fraud in procuring a license or certificate;
    2. (2) Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    3. (3) Habitual intoxication or personal misuse of any drugs;
    4. (4) Immoral, unethical, unprofessional or dishonorable conduct;
    5. (5) Solicitation by agents or persons or profiting by the acts of those representing themselves to be agents of the licensee or the certificate holder;
    6. (6) Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    7. (7) Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this chapter or lending one's name to another for the illegal practice of podiatry by such person;
    8. (8) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate this chapter or any lawful order of the board; issued pursuant thereto, or any criminal statute of this state;
    9. (9) Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, vaccines or other articles or materials that are offered to the public, claiming radical cure or prevention of disease by their use;
    10. (10) Any other unprofessional or unethical conduct that may be specified by the board from time to time by means of rules and regulations duly published and promulgated by the board or the violation of any provision of this chapter;
    11. (11) Making false statements or representations or being guilty of fraud or deceit in the practice of podiatry;
    12. (12) Invasion of a field of practice in which the licensee is not licensed to practice or is not within the limits of the licensee's respective callings;
    13. (13) Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice or not in good faith to relieve pain and suffering, or not to cure an ailment, physical infirmity or disease;
    14. (14) Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or any other drug to any person in violation of any law of the state or of the United States;
    15. (15) Practicing podiatry under any trade name or a name designating a given location or the name of another podiatrist or any name other than that which appears on the practitioner's license or using any title other than “podiatrist”; provided, that “foot specialist” may be used as an explanatory term of the title “podiatrist” and not alone or as a substitute for the title “podiatrist”;
    16. (16) Willful violation of the rules and regulations that may be promulgated by the board of podiatric medical examiners to regulate advertising by practitioners who are under the jurisdiction of the board;
    17. (17) Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
    18. (18) Engaging in the practice of podiatry when mentally or physically unable to safely do so; or
    19. (19) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of the practice of podiatry.
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  2. (b) The board of podiatric medical examiners may adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of the board. All methods must be allowed such as: newspaper, radio and television.
  3. (c)
    1. (1) For purposes of enforcement of this section, the board shall, upon probable cause, have authority to compel an applicant or licensee to submit to a mental and/or physical examination by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition may be involved.
    2. (2) The applicant or licensee shall have the right to have an independent medical practitioner present during such examination and to have an independent physical or mental examination, the report of which shall be filed with the board for consideration.
    3. (3) The committee will submit a report of its findings to the board, which will then hold a hearing as provided in § 63-3-120.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-3-120. Administrative procedure.
  1. All proceedings for disciplinary action against a licensee under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
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§ 63-3-121. Enjoining violations.
  1. (a) The board, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license and in the matter of the refusal to issue a certificate, is authorized and empowered to petition any circuit or chancery court, having jurisdiction, to enjoin any person who is practicing or attempting to practice podiatry without possessing a valid license to so practice and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of podiatry as defined by this chapter. No injunction bond shall be required of the board.
  2. (b) Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
§ 63-3-122. District attorneys to assist board.
  1. (a) The board at all times has the power to call upon the district attorneys general for the state in the various districts to assist the board.
  2. (b) It is hereby declared to be the duty of all district attorneys general throughout the state to assist the board, upon its request, in any suit for injunction or prosecution instituted by the board without charge or additional compensation to the district attorneys general.
§ 63-3-123. Criminal penalties.
  1. (a)
    1. (1) Any person who violates any provision of this chapter commits a Class B misdemeanor.
    2. (2) Upon being convicted of any violation of any provision of this chapter, any person who again violates any of the provisions of this chapter commits a Class E felony.
  2. (b) Any person who has been enjoined by a court of competent jurisdiction from performing any acts or rendering any services that constitute the practice of podiatry as defined by this chapter who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services commits a Class E felony.
§ 63-3-124. Retail sales of foot appliances and shoes.
  1. No part or portion of this chapter shall be deemed to prohibit the usual and customary commercial sale and adjustment of foot appliances and remedies or shoes in retail stores.
§ 63-3-125. Regulations relating to X-ray procedures.
  1. (a)
    1. (1) The board shall adopt rules and regulations that establish minimum educational standards and criteria for persons operating X-ray equipment for diagnostic purposes in podiatrist offices.
    2. (2) These regulations may include, but not be limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases.
  2. (b) After the effective date of the rules and regulations, no person shall perform X-ray procedures in a podiatrist office who does not meet these standards and who has not received a certificate of proficiency from the board.
§ 63-3-126. Cost of prosecution — Administering oaths.
  1. (a) The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
  2. (b)
    1. (1) Any elected officer of the board, or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
    2. (2) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
    3. (3)
      1. (A) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
      2. (B) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
    4. (4) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
    5. (5) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
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§ 63-3-127. Drug prescriptions.
  1. (a) Any handwritten prescription order for a drug prepared by a podiatrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing podiatrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing podiatrist must sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201.
  2. (b) Any typed or computer-generated prescription order for a drug issued by a podiatrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing podiatrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug, and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing podiatrist must sign the typed or computer-generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201.
  3. (c) Nothing in this section shall be construed to prevent a podiatrist from issuing a verbal prescription order.
  4. (d)
    1. (1) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
    2. (2) Subdivision (d)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
Part 2 Tennessee Orthotics, Prosthetics, and Pedorthics Practice Act of 2005
§ 63-3-201. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Board” means the board that licenses and regulates podiatrists in Tennessee in part 1 of this chapter;
    2. (2) “Commissioner” means the commissioner of health;
    3. (3) “Custom fabricated and fitted device” means an orthosis, prosthesis or pedorthic device that is fabricated to original measurements or to a mold for use by a patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions and that requires substantial clinical and technical judgment in its design and fitting;
    4. (4) “Custom fitted device” means a prefabricated orthosis, prosthesis or pedorthic device sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions that requires substantial clinical judgment and substantive alteration for appropriate use;
    5. (5) “Department” means the department of health;
    6. (6) “Director” means the director of the division of health related boards;
    7. (7) “Division” means the division of health related boards;
    8. (8) “Facility” means the business location where orthotic, prosthetic or pedorthic care is provided. In the case of an orthotic/prosthetic facility, the orthotic/prosthetic facility has the appropriate clinical and laboratory space and equipment to provide comprehensive orthotic or prosthetic care; and, in the case of a pedorthic facility, the pedorthic facility has the appropriate clinical space and equipment to provide pedorthic care. Licensed orthotists, prosthetists and pedorthists must be available to either provide care or to supervise the provision of care by nonlicensed staff;
    9. (9) “Licensed orthotist” means a person who is licensed under this part to practice orthotics and who represents the person to the public by title or description of services that includes the term “orthotic,” “orthotist,” “brace” or a similar title or description of services;
    10. (10) “Licensed pedorthist” means a person who is licensed under this part to practice pedorthics and who represents the person to the public by the title or description of services that includes the term “pedorthic,” “pedorthist” or a similar title or description of services;
    11. (11) “Licensed prosthetist” means a person who is licensed under this part to practice prosthetics and who represents the person to the public by title or description of services that includes the term “prosthetic,” “prosthetist,” “artificial limb” or a similar title or description of services;
    12. (12) “Off-the-shelf device” means a prefabricated prosthesis or orthosis sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions that does not require substantial clinical judgment and substantive alteration for appropriate use;
    13. (13) “Orthosis” means a custom designed, fabricated, fitted or modified device to correct, support or compensate for a neuro-musculoskeletal disorder or acquired condition. “Orthosis” does not include fabric or elastic supports, corsets, arch supports, low-temperature plastic splints, trusses, elastic hoses, canes, crutches, soft cervical collars, dental appliances or other similar devices that are carried in stock and sold without modification as over-the-counter items by a drug store, department store, corset shop or surgical supply facility;
    14. (14) “Orthotic and prosthetic education program” means a course of instruction accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), consisting of:
      1. (A) An adequate curriculum of college level training and instruction in math, physics, biology, chemistry and psychology; and
      2. (B) A specific curriculum in orthotic or prosthetic courses, including:
        1. (i) Lectures covering pertinent anatomy, biomechanics, pathomechanics, prosthetic-orthotic components and materials, training and functional capabilities, prosthetic or orthotic performance evaluation, prescription considerations, etiology of amputations and disease processes necessitating prosthetic or orthotic use and medical management;
        2. (ii) Subject matter related to pediatric and geriatric problems;
        3. (iii) Instruction in acute care techniques, such as immediate and early post-surgical prosthetics and fracture bracing techniques; and
        4. (iv) Lectures, demonstrations and laboratory experiences related to the entire process of measuring, casting, fitting, fabricating, aligning and completing prostheses or orthoses;
    15. (15) “Orthotics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing an orthosis, under an order from a licensed health care practitioner authorized by law to issue such an order, for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury or deformity;
    16. (16) “Orthotist” means an allied health professional who is specifically trained and educated to provide or manage the provision of a custom-designed, fabricated, modified and fitted external orthosis to an orthotic patient, based on a clinical assessment and a prescription from a health care practitioner authorized by law to write such prescriptions, to restore physiological function or cosmesis;
    17. (17) “Over-the-counter device” means a prefabricated, mass-produced device that is prepackaged and requires no professional advice or judgment in either size selection or use, including fabric or elastic supports, corsets, generic arch supports and elastic hose;
    18. (18) “Pedorthic device” means therapeutic footwear, foot orthoses for use at the ankle or below and modified footwear made for therapeutic purposes, as prescribed by a licensed health care practitioner authorized by law to issue such prescription. “Pedorthic device” does not include nontherapeutic accommodative inlays or nontherapeutic accommodative footwear, regardless of method of manufacture, shoe modifications made for nontherapeutic purposes, unmodified, over-the-counter shoes or prefabricated foot care products;
    19. (19) “Pedorthic education program” means a course of instruction accredited by the Board for Certification in Pedorthics, consisting of:
      1. (A) A basic curriculum of instruction in foot-related pathology of diseases, anatomy and biomechanics;
      2. (B) A specific curriculum in pedorthic courses, including lectures covering shoes, foot orthoses and shoe modifications, pedorthic components and materials, training and functional capabilities, pedorthic performance evaluation, prescription considerations, etiology of disease processes necessitating use of pedorthic devices, medical management and subject matter related to pediatric and geriatric problems; and
      3. (C) Lectures, demonstrations, and laboratory experiences related to the entire process of measuring and casting, fitting, fabricating, aligning and completing pedorthic devices;
    20. (20) “Pedorthics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing a pedorthic device, under an order from a licensed health care practitioner authorized by law to issue such order for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury or deformity;
    21. (21) “Pedorthist” means a person who measures, designs, fabricates, fits or services pedorthic devices and assists in the formulation of the order of pedorthic devices, as ordered by a licensed health care practitioner authorized by law to issue such order for the support or correction of disabilities caused by neuro-musculoskeletal diseases, injuries or deformities;
    22. (22) “Person” means a natural person;
    23. (23) “Prosthesis” means a custom designed, fabricated, fitted or modified device to replace an absent external limb, for the purpose of restoring physiological function or cosmesis. “Prosthesis” does not include artificial eyes, ears or dental appliances, cosmetic devices such as artificial breasts, eyelashes or wigs or other devices that do not have a significant impact on the musculoskeletal functions of the body;
    24. (24) “Prosthetics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing a prosthesis, under an order from a licensed health care practitioner authorized by law to issue such order;
    25. (25) “Prosthetist” means an allied health professional who is specifically trained and educated to provide or manage the provision of a custom designed, fabricated, modified and fitted external limb prosthesis to a prosthetic patient, based on a clinical assessment and a prescription from a health care practitioner authorized to write such prescriptions, to restore physiological function or cosmesis;
    26. (26) “Prosthetist/Orthotist” means a person who practices both disciplines of prosthetics and orthotics and who represents the person to the public by title or by description of services; and
    27. (27) “Resident” means a person who has completed an education program in either orthotics or prosthetics and is continuing such person's clinical education in a residency program approved by the board.
§ 63-3-202. Rules and regulations — Authority of the board.
  1. (a) The board shall adopt rules and regulations, promulgated in compliance with all requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to:
    1. (1) Establish licensure categories and issue licenses for prosthetists, orthotists and pedorthists;
    2. (2) Establish the qualifications, educational courses, curriculum, hours and standards that are prerequisite to issuance of all levels and types of licensure established pursuant to subdivision (a)(1); provided, however, that such qualifications shall include the following:
      1. (A) To qualify for a license to practice orthotics or prosthetics, a person shall:
        1. (i) Possess a baccalaureate degree or semester hours equivalent to four (4) years of study at a four-year college or university;
        2. (ii) Complete the amount of formal training, including, but not limited to, any necessary hours of classroom education and clinical practice required by the board;
        3. (iii) Complete a clinical residency in the professional area for which a license is sought, in accordance with standards, guidelines, or procedures for residencies inside or outside this state established and approved by the board. The majority of training shall be devoted to services performed under the supervision of a licensed practitioner of orthotics or prosthetics or a person who has obtained certification from the American Board for Certification in Orthotics and Prosthetics, Inc. or the Board for Orthotist/Prosthetist Certification;
        4. (iv) Pass all written, practical and oral examinations that are required and approved by the board; and
        5. (v) Be qualified to practice in accordance with commonly accepted standards of orthotic and prosthetic care acceptable to the board;
      2. (B) To qualify for a license to practice pedorthics, a person shall:
        1. (i) Possess a high school diploma or comparable credential approved by the board;
        2. (ii) Complete the amount of formal training, including, but not limited to, any necessary hours of classroom education and clinical practice required by the board;
        3. (iii) Pass all examinations that are required and approved by the board;
        4. (iv) Complete a qualified work experience program or internship in pedorthics, in accordance with standards and procedures established by the board; and
        5. (v) Be qualified to practice in accordance with commonly accepted standards of pedorthic care acceptable to the board; and
      3. (C) A person may be licensed in more than one (1) discipline;
    3. (3) Establish the circumstances or conditions, if any, under which persons shall be entitled to exemption from licensure during training, while waiting to take or receive the results of any required examination or upon meeting specified minimum educational and clinical qualifications;
    4. (4) Select the examination or examinations to be utilized as the board's licensure examination or examinations and the prerequisites, if any, for admission to the examination or examinations. The board is authorized to enter into a contract or agreement with the chosen examination service or services or select an intermediary between the board and the examination service or services to process applicants for the examination or examinations;
    5. (5) Establish any other criteria for issuance of licensure that are reasonably related to the safe and competent performance of prosthetics, orthotics and pedorthics;
    6. (6) Accredit continuing education courses;
    7. (7)
      1. (A) Establish the fees to be paid for each of the following:
        1. (i) Application for licensure;
        2. (ii) Renewal or reinstatement of licensure;
        3. (iii) Late renewal of licensure;
        4. (iv) Application for continuing education course accreditation; and
        5. (v) Duplicate or replacement license;
      2. (B) The fees shall be set at a level that is adequate to pay all of the expenses of implementing and administering this part. All deposits and disbursements shall be handled in accordance with § 63-1-137;
    8. (8) Establish the continuing education requirements for license holders, which shall include the frequency of reporting, number of hours, types of courses, approval of courses, methods of proving compliance, penalties for violation and all fees necessary for implementation of the continuing education process;
    9. (9) Regulate the nature, manner, content and extent of advertising by persons licensed under this part;
    10. (10) Delineate the actions relative to therapeutic footwear and medical devices for the foot and ankle that must be performed by licensed health care practitioners; and
    11. (11) Establish a registration process for residents as prescribed in § 63-3-209(2)(B).
  2. (b) The board shall have the authority to:
    1. (1) Conduct disciplinary hearings, in accordance with the Uniform Administrative Procedures Act; and
    2. (2) Issue advisory private letter rulings to any affected person licensed under this part who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall affect only the person making such inquiry and shall have no precedential value for any other inquiry or future contested case that might come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
§ 63-3-203. Licensing.
  1. (a) Licenses shall be issued and renewed by the board pursuant to the division's biennial issuance and renewal system.
  2. (b) Any person who has been issued a license to practice under this part and who wishes to retire that license shall file with the board an affidavit, on a form to be furnished by the board, stating the date on which the person retired from such practice and such other facts that tend to verify such retirement, as the board deems necessary. Any person who wishes to reenter practice after retiring such person's license must request reinstatement of licensure.
  3. (c) Any license issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and such other information as the board deems necessary. The address contained on the license shall be the address where all correspondence and renewal forms from the board shall be sent. Any person whose address changes shall, within thirty (30) days after the address change, notify the board of the address change. The most recent address contained in the board's records for each license holder shall be the address deemed sufficient for purposes of service of process.
  4. (d) Every person issued a license pursuant to this part shall either keep such license prominently displayed in the office or place in which such person practices or have it stored in a place from which it can be immediately produced upon request of a patient or a representative of the department.
  5. (e) Any person whose license has been lost or destroyed may make application to the board for a replacement. Such application shall be accompanied by an affidavit setting out the facts concerning the loss or destruction of the original license.
  6. (f) Any person whose name is changed by marriage or court order may surrender the person's license and apply to the board for a replacement license.
§ 63-3-204. Powers of the board.
  1. (a) The board shall have the power to:
    1. (1) Deny, restrict or condition a license;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, limit or restrict a previously issued license, for such time and in such manner as the board may determine;
    4. (4) Reprimand, suspend, revoke or take such other disciplinary action in relation to an applicant or license holder as the board, in its discretion, may deem proper; or
    5. (5) Permanently revoke a license.
  2. (b) The grounds upon which the board shall exercise such power include, but are not limited to, circumstances in which the person:
    1. (1) Is guilty of fraud or deceit in the procurement or holding of the license;
    2. (2) Has been convicted of a felony in a court of competent jurisdiction, either within or outside of this state, unless the conviction has been reversed and the holder of the license discharged or acquitted or if the holder has been pardoned with full restoration of civil rights, in which case the license shall be restored;
    3. (3) Is or has been afflicted with any medical problem, disability or addiction that, in the opinion of the board, would impair professional competence;
    4. (4) Has knowingly aided and abetted a person who is not a license holder or is not otherwise authorized pursuant to this chapter to perform the duties of a license holder under this chapter;
    5. (5) Has undertaken or engaged in any practice beyond the scope of duties permitted a license holder under this chapter;
    6. (6) Has impersonated a license holder or former license holder or is under an assumed name performing the duties authorized to be performed only by a licensed person;
    7. (7) Has been found guilty of violations of a code of ethics, which the board shall establish by regulation;
    8. (8) Is or has been found guilty of incompetence or negligence in performance as a license holder;
    9. (9) Acts in a manner unprofessional, dishonorable or unethical or has been found guilty of unprofessional, dishonorable or unethical conduct;
    10. (10) Violates, or attempts to violate, directly or indirectly, or assists or aids in the violation of, or conspires to violate, any provision of this chapter or any lawful order of the board issued pursuant to this chapter or any of the rules or regulations promulgated pursuant to this chapter, or any criminal statute of the state;
    11. (11) Is habitually intoxicated or engages in personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice; or
    12. (12) Has received disciplinary action from another state or territory of the United States that has licensed or certified the person to practice in that state for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order, or other equivalent document memorializing the disciplinary action from the disciplining state or territory, shall constitute prima facie evidence of violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal or to discipline a person licensed in this state.
  3. (c) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-3-205. Application.
  1. (a) On and after January 1, 2008, no person shall practice orthotics, prosthetics or pedorthics in this state, or hold out as being able to practice either profession, or dispense an orthosis, prosthesis or pedorthic device, unless such person is licensed in accordance with the requirements of this part.
  2. (b) Until January 1, 2008, a person certified by the American Board for Certification in Orthotics and Prosthetics, Inc., with the title of Certified Orthotist (CO), Certified Prosthetist (CP) or Certified Orthotist-Prosthetist (CPO), or by the Board for Orthotist/Prosthetist Certification with the title of Board of Orthotic Certification — Orthotist (BOCO) or Board of Certification — Prosthetist (BOCP), or holding similar certifications from other accrediting bodies with equivalent educational requirements and examination standards, may apply for and may be granted orthotic or prosthetic licensure under this part, upon payment of the required fee. After January 1, 2008, any applicant for initial licensure as an orthotist or a prosthetist shall meet the requirements of this part regarding license.
  3. (c) Until January 1, 2008, a person certified as a Certified Pedorthist (CPED) by the Board of Certification in Pedorthics, Inc., or a person certified as a CO, CP or CPO by the American Board for Certification in Orthotics and Prosthetics, Inc., or certified as a BOCO or BOCP by the Board for Orthotist/Prosthetist Certification, or holding similar certifications from other accrediting bodies with equivalent educational requirements and examination standards, may apply for and may be granted pedorthic licensure under this part, upon payment of the required fee. After that date, any applicant for initial licensure as a pedorthist shall meet the requirements of this part regarding licensure.
  4. (d) Notwithstanding any other provision of this part to the contrary, a person who has practiced full time for a minimum of the past five (5) years in a prosthetic/orthotic facility as an orthotist or prosthetist or in a pedorthic facility as a pedorthist may file an application with the board before January 1, 2007, in order to continue to practice orthotics, prosthetics or pedorthics and may be issued a license to practice orthotics, prosthetics or pedorthics under this part without examination, upon receipt by the division of payment of the licensing fee required and after the board has completed an investigation of the applicant's work history. The investigation may include, but is not limited to, completion by the applicant of a questionnaire regarding the applicant's work history and scope of practice.
§ 63-3-206. Order from licensed health care provider required to provide care or services.
  1. A licensed orthotist, prosthetist or pedorthist may provide care or services only if the care or services are provided pursuant to an order from a licensed health care practitioner authorized to issue such an order.
§ 63-3-207. Scope of practice.
  1. (a) The scope of practice of a licensed orthotist, prosthetist or pedorthist shall not include the right to diagnose a medical problem or condition or the right to give medical advice as to the nature, cause or treatment for the problem or condition for which the orthotic, prosthetic or pedorthic device is being dispensed; however, the scope of practice of a licensed orthotist, prosthetist or pedorthist does include the right to provide information or demonstration regarding the proper use and care of the device and to make adjustments to the device as needed.
  2. (b) No person shall dispense or sell an over-the-counter or off-the-shelf device based upon an image of the customer's limb captured by the person through a mold, cast, scanning device, digital appliance, or pressure sensitive device, unless the customer has first presented to that person a written prescription for that device from a health care practitioner authorized by law to write such a prescription.
§ 63-3-208. Interpretation of part.
  1. (a) Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted to limit or restrict a health care practitioner licensed under this title from engaging in the full scope of practice of such person's profession, training or services. Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted or permitted to limit or restrict individuals acting under the supervision and control of a pharmacist or pharmacy licensed under this title or home medical equipment provider licensed under title 68 from measuring, fitting or adjusting any non-custom-fabricated and fitted device, including, but not limited to, over-the-counter or off-the-shelf devices, so long as such individual does not create a cast, mold or scan of a part of the human body for the purpose of constructing a medical device to treat a patient's medical condition and so long as such individual meets one (1) of the following criteria for such device:
    1. (1) Documented training from a manufacturer or training from a licensed or certified orthotist, prosthetist or pedorthist;
    2. (2) Certification or registration as a fitter of orthotic, prosthetic or pedorthic devices from a nationally recognized board or association such as the Board for Orthotist/Prosthetist Certification (BOC), the Board of Certification for Pedorthists, the National Community Pharmacists Association (NCPA) or the American Board for Certification in Orthotics and Prosthetics (ABC); or
    3. (3) Direct supervision by a trained and experienced, or certified or registered, fitter of orthotic, prosthetic or pedorthic devices.
  2. (b) Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted or permitted to limit or restrict individuals acting under the supervision and control of a pharmacist or pharmacy licensed under this title or home medical equipment provider licensed under title 68 from measuring, fitting or adjusting any non-custom-fabricated and fitted pedorthic devices, including, but not limited to, diabetic shoes, so long as such individual meets the criteria of either subdivision (a)(2) or (a)(3) and so long as the individual does not create a cast, mold or scan of a part of the human body for the purpose of constructing a medical device to treat a patient's medical problem.
§ 63-3-209. Construction of part.
  1. Nothing in this part shall be construed to restrict:
    1. (1) The practice of orthotics, prosthetics or pedorthics by a person who is employed by the federal government or any bureau, division or agency of the federal government while in the discharge of the employee's official duties;
    2. (2) The practice of orthotics, prosthetics or pedorthics by:
      1. (A) A student enrolled in a school of orthotics, prosthetics or pedorthics;
      2. (B) A resident continuing such resident's clinical education in a residency accredited by the National Commission on Orthotic and Prosthetic Education; provided, that such person has first registered as a resident with the board; or
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      3. (C) A student in a qualified work experience program or internship in pedorthics; or
    3. (3) The measuring, fitting or adjusting of an orthotic device by an employee or authorized representative of an orthosis manufacturer registered with the federal food and drug administration, when such employee or representative is supervised by a licensed health care professional authorized by law to prescribe, measure or fit such device, and the measuring, fitting or adjusting of such device occurs in the office of such licensed health care professional or in a health care facility.
§ 63-3-210. Violation of part.
  1. (a) Any person who practices in this state without having first complied with this part commits a Class C misdemeanor; provided, however, that, for a period of one (1) year after January 1, 2006, an offense under this section shall only result in a warning and such person shall have thirty (30) days to comply with this part.
  2. (b) The board of registration in podiatry shall inform persons to be regulated by this part of the regulations to be imposed by this part.
§ 63-3-211. Injunction — Jurisdiction.
  1. (a) The board is authorized to petition any circuit or chancery court having jurisdiction over any person who is practicing without a license, or to whom a license has been denied or whose license has been suspended or revoked by action of the board to enjoin such person from continuing to practice within this state.
  2. (b) Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all such causes and to exercise full and complete jurisdiction in such injunctive proceedings.
§ 63-3-212. Screening panels in investigative and disciplinary process.
  1. (a) The board may utilize one (1) or more screening panels in its investigative and disciplinary process, to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for resolution of complaints or diversion to professional peer review organizations or impaired professionals' associations or foundations of those cases that the board, through established guidelines, deems appropriate.
  2. (b) The screening panel has the authority to administer oaths to witnesses.
  3. (c) Members of a screening panel may be drawn from the membership of the board or may be appointed by the board. Nonboard members shall meet the requirements of membership on the board and may include a consumer member. A board member serving on a panel shall not participate in a contested case involving any matter heard by the panel.
§ 63-3-213. Appointments to the board.
  1. (a) To assist in the implementation and administration of this part, the governor shall initially appoint to the board one (1) person who is eligible for licensure as an orthotist, or prosthetist or pedorthist.
  2. (b) That person's term of office on the board shall be three (3) years. Upon expiration of that person's term, the governor shall appoint a person licensed under this part to fill this position on the board.
  3. (c) A person may serve more than one (1) term in this position on the board.
  4. (d) The governor may remove this member of the board from office for neglect of duties, malfeasance in office, incompetence or professional misconduct.
  5. (e) The governor may fill a vacancy in this position upon the member's resignation or death.
  6. (f) In making appointments to this position on the board, the governor shall consider persons recommended by the professional organization of orthotists, prosthetists and pedorthists in Tennessee.
  7. (g) The person filling this position on the board shall receive the same per diem and reimbursement for travel and other necessary expenses that is received by other members of the board.
  8. (h) The person filling this position shall have the right to vote on all matters considered by the board.
§ 63-3-214. Use of non-licensed persons.
  1. A licensed orthotist or prosthetist may utilize one (1) or more non-licensed persons to assist in:
    1. (1) The performance of minor repairs on devices which have been previously dispensed to patients; and
    2. (2) The performance of other tasks approved by the board of podiatric medical examiners.
Chapter 4 Chiropractors
§ 63-4-101. Practice of chiropractic — Education and clinical training — Scope of practice.
  1. (a)
    1. (1) As used in this chapter, unless the context otherwise requires:
      1. (A) “Diagnosis” means:
        1. (i) The differential diagnosis of human ailments through examination and evaluation of patients and through diagnostic procedures necessary to clinically correlate a physical examination to a diagnostic impression;
        2. (ii) The ordering of X-rays, advanced diagnostic imaging, and other diagnostic procedures;
        3. (iii) The performance of X-rays and other non-invasive diagnostic procedures, as well as minimally invasive procedures for which the chiropractic physician has received training by an institution accredited by the Council on Chiropractic Education or its successor and which have been approved by the board of chiropractic examiners after consultation with the board of medical examiners; and
        4. (iv) The collection of blood, urine, saliva, and hair for analysis; provided, however, venipuncture shall only be done by a phlebotomist or other person who is properly trained to draw blood;
      2. (B) “Differential diagnosis” means the examination of body systems and structures of a patient to determine the source, nature, and extent of a disease or other physical condition for the purpose of establishing an appropriate plan of care for the patient, which may include referral to another provider for care that is outside the scope of practice of a chiropractic physician;
      3. (C) “Practice of chiropractic” means the diagnosis and treatment of patients, as defined in subdivisions (a)(1)(B) and (a)(1)(D); and
      4. (D) “Treatment” means:
        1. (i) The treatment of neuromuscular, musculoskeletal, and related conditions through the use of chiropractic adjustment and manipulation; physical agent modalities; manual, rehabilitative, and other therapeutic care; and mechanical, chemical, electrical, and thermal methods;
        2. (ii) The use of acupuncture by a chiropractic physician who has completed two hundred fifty (250) hours of an accredited acupuncture course and has passed the National Board of Chiropractic Examiners Acupuncture Exam;
        3. (iii) The location and removal of interference with nerve transmission and nerve function;
        4. (iv) The making of appropriate referrals to other healthcare professionals for conditions that are outside the scope of practice of a chiropractic physician;
        5. (v) The ordering of durable medical equipment for patients who need such equipment to assist in the restoration of their health under the plan of care for treatment of their neuromuscular, musculoskeletal, and related conditions; and
        6. (vi) The provision of supportive care with due regard for nutrition, hygiene, sanitation, and rehabilitation designed to assist in the restoration and maintenance of a patient's health.
    2. (2) Nothing in this chapter authorizes a chiropractic physician to engage in the practice of medicine and surgery or osteopathy, as defined in chapters 6 and 9 of this title, or to prescribe legend drugs or controlled substances.
  2. (b) As used in this chapter, “chiropractic physician” means a person who is a graduate of a chiropractic college accredited by the Council on Chiropractic Education or its successor, or is a graduate of an international chiropractic college approved by the board of chiropractic examiners, and who has received a license issued by the board of chiropractic examiners.
  3. (c)
    1. (1) No person licensed under this title may perform a spinal manipulation or spinal adjustment without first having the legal authority to differentially diagnose and having received a minimum of four hundred (400) hours of classroom instruction in spinal manipulation or spinal adjustment and a minimum of eight hundred (800) hours of supervised clinical training at a facility where spinal manipulation or spinal adjustment is a primary method of treatment. “Spinal manipulation” and “spinal adjustment” are interchangeable terms that identify a method of skillful and beneficial treatment where a person uses direct thrust to move a joint of the patient's spine beyond its normal range of motion, but without exceeding the limits of anatomical integrity. A violation of this section is an unlawful practice of chiropractic and is grounds for the offending health care provider's licensing board to suspend, revoke or refuse to renew such provider's license or take other disciplinary action allowed by law.
    2. (2) Nothing in this subsection (c) shall in any way apply to the scope of practice of:
      1. (A) An osteopathic physician licensed under chapter 9 of this title; or
      2. (B) Any person who practices medicine or surgery who is licensed under chapter 6 of this title.
§ 63-4-102. Board — Members and officers — Terms of appointment — Quorum — Administrative support.
  1. (a) There shall be a board of chiropractic examiners, referred to as “board” in this chapter, consisting of five (5) chiropractic physicians, residents in Tennessee who have been actively engaged in the practice of their profession in Tennessee for a period of at least five (5) years, one (1) member who is a chiropractic X-ray technician or chiropractic therapy assistant and who has been certified in this state for not less than two (2) years, and one (1) consumer member who is not affiliated with the practice of chiropractic. The members of the board shall be appointed by the governor and shall hold office for a term of five (5) years commencing on May 1 and expiring on April 30, five (5) years thereafter.
  2. (b) All vacancies occurring on the board by reason of death or resignation shall be filled by the governor for the unexpired term.
  3. (c) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  4. (d) In order to stagger the terms of office, for the year 2000 the governor shall appoint the board members for transition terms in the following manner:
    1. (1) One (1) chiropractic physician and one (1) consumer member for one (1) year with the term to expire on April 30, 2001;
    2. (2) One (1) chiropractic physician for a two-year term to expire on April 30, 2002;
    3. (3) One (1) chiropractic physician for a three-year term to expire on April 30, 2003;
    4. (4) One (1) chiropractic physician and one (1) consumer member for a four-year term to expire April 30, 2004; and
    5. (5) One (1) chiropractic physician for a five-year term to expire April 30, 2005.
  5. (e) Any person appointed shall be eligible for successive appointments, in the discretion of the governor, and all members shall hold office until the appointment of their successors.
  6. (f) No chiropractor shall be eligible for appointment unless such chiropractor is actively engaged in the practice of the profession of chiropractic within this state.
  7. (g) Further, no persons shall be eligible for appointment on the board who at the time are actively engaged in the practice, or holding themselves out as practitioners, of any other branch of the healing arts.
  8. (h) The governor has the discretion to seek recommendations and nominations from the Tennessee Chiropractic Association in making appointments to the board.
  9. (i) The board is authorized to annually elect from among its members a president, vice president and secretary and to create such officers it deems necessary for its efficient operations. Four (4) members of the board shall constitute a quorum, and a majority of those present shall be necessary to pass or reject any official business.
  10. (j) The board shall be provided administrative support by the division of health related boards, referred to as the “division” in this chapter.
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§ 63-4-103. Powers and duties of board.
  1. It is the duty of the board to:
    1. (1) Examine applicants and have licenses issued to practice chiropractic to all applicants who have successfully passed the examination approved by the board or whose applications for license by reciprocity have been acted upon favorably by the board;
    2. (2) Conduct hearings to revoke or suspend any license or certificate under the authority of this or any previous laws authorizing the holder thereof to practice chiropractic for violations by the licensee of any of the provisions of this chapter;
    3. (3) Sponsor, conduct or approve such educational programs as are necessary to carry out and make effective this chapter; and
    4. (4) Issue advisory private letter rulings to any affected licensee who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall only affect the licensee making such inquiry and shall have no precedential value for any other inquiry or future contested case to come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
§ 63-4-104. Meetings of board.
  1. The board shall hold one (1) regular meeting in each year and such additional meetings at such times and places as it may determine.
§ 63-4-105. Disposition of fees — Operating expenses — Compensation.
  1. (a) All fees and moneys from whatever source coming into the hands of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  2. (b) The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board, and no expenditure may be made by the board until the allotment for the expenditure has been made by the commissioner. The allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  3. (c) Each member of the board shall receive one hundred dollars ($100) per diem when actually engaged in the discharge of that member's official duties and, in addition, be reimbursed for all travel and other necessary expenses. The secretary of the board shall, in lieu of the per diem provided by this section, receive a salary not to exceed one hundred dollars ($100) per month as set annually by the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-4-106. Rules and regulations.
  1. The board is authorized to adopt such rules and regulations as are necessary to carry out and enforce this chapter and that are consistent with this chapter. Rules and regulations of the board shall be subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-4-107. License requirement.
  1. It is unlawful for any person to practice chiropractic within this state without having procured a license.
§ 63-4-108. Eligibility for licensure.
  1. Any person of good moral character is eligible for licensure, if that person:
    1. (1) Is a graduate of a chiropractic college having status with the commission on accreditation of the Council on Chiropractic Education, or its successor, or graduated from an international chiropractic college approved by the board;
    2. (2) Has attended a chiropractic college for four (4) school years of not less than nine (9) months each; and
    3. (3) Submits to the board proof of additional parachiropractic education as follows:
      1. (A) For applicants matriculating in a chiropractic college prior to year 2000, the applicant must provide a transcript of grades showing a minimum of two (2) full academic years of college or university work of at least sixty (60) semester hours or its equivalent from an accredited institution; or
      2. (B) For applicants matriculating in a chiropractic college in year 2000 and beyond, proof that a bachelor's level education or its equivalent has been obtained from an accredited college or university.
§ 63-4-109. Application for licensure.
  1. (a) Application for licensure shall be made to the board in writing or via online application.
  2. (b) The application shall be accompanied by the applicant's photograph and shall state the name, age, sex and place of residence of the applicant, the name and location of the school or college from which the applicant was graduated, the length of time devoted to the study of chiropractics and the date of graduation.
  3. (c) All applications shall be signed and sworn to by the applicant.
  4. (d)
    1. (1) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (d), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-4-110. Examination.
  1. The examination of applicants for a license to practice chiropractic will consist of the national board examination as directed by the board. Each applicant must successfully pass all examinations before receiving a license to practice.
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§ 63-4-111. Reciprocity.
  1. (a) Applicants possessing a valid unrestricted license to practice chiropractic in another state or other regulated jurisdiction for a period of two (2) full years are not required to be examined pursuant to § 63-4-110 and may obtain a license by fulfilling the following:
    1. (1) Providing documentation from the state or jurisdiction of prior practice attesting to the length of time in practice, together with any disciplinary action taken against the licensee while in practice;
    2. (2) Passing the Special Purposes Examination for Chiropractors (SPEC) by the national board or its successor; and
    3. (3) Fulfilling all other requirements of this chapter.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-4-112. Registration and renewal — Continuing education — Reinstatement — Retirement.
  1. (a) Each licensed practitioner of chiropractic shall register the practitioner's license and renew the practitioner's certificate of registration as provided in §§ 63-1-107 and 63-1-108.
  2. (b) In addition, every licensed chiropractor shall apply to the board for a renewal of the licensed chiropractor's certificate of fitness and pay a renewal fee as set annually by the board. Each application shall be made on a form to be furnished by the board.
  3. (c)
    1. (1) The board shall renew such licensee's certificate of fitness upon application made in due form and upon payment of all required fees.
    2. (2)
      1. (A) When requested, licensees shall provide the board satisfactory proof of the licensee's attendance at a chiropractic education program or programs conducted by either the American Chiropractic Association, the International Chiropractors Association, the Tennessee Chiropractic Association, or any other educational program approved or conducted by the board which consists of the minimum number of hours established hereunder for the period beginning the preceding January 1. Prior approval of such a course may be obtained by submitting the following information to the board's administrative office at least thirty (30) days prior to the scheduled date of the course:
        1. (i) A course description or outline;
        2. (ii) Names of all lecturers;
        3. (iii) Brief resume of all lecturers;
        4. (iv) Number of hours of educational credit requested;
        5. (v) Date of course;
        6. (vi) Copies of materials to be utilized in the course; and
        7. (vii) How verification of attendance is to be documented.
      2. (B) Each chiropractic physician must retain independent documentation of continuing education hours attained for a period of four (4) years from the end of the calendar year in which the training is received. Such proof must be produced for inspection and verification, if requested in writing by the board during its verification process.
    3. (3) The minimum number of hours of required continuing education shall be at least twelve (12) hours in any calendar year.
    4. (4) The board may, in its sole discretion, waive the annual education requirement in cases of retirement, certified illness, disability or other undue hardships.
  4. (d)
    1. (1) When any such licensee fails to renew the licensee's certificate of fitness and pay the annual renewal fee within sixty (60) days after renewal becomes due as provided in this section and/or fails to meet the annual education requirements of this section, the license of such person shall be automatically revoked at the expiration of sixty (60) days after the renewal was required, without further notice or hearing.
    2. (2) Any person whose license is automatically revoked as provided in this subsection (d) may make application in writing to the board for the reinstatement of such license, and, upon good cause being shown, the board, in its discretion, may reinstate such license upon the payment of all past due fees and the payment of fifty dollars ($50.00) and upon further conditions as the board may require.
  5. (e) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter desires to reengage in such practice in this state, such person shall apply for reinstatement with the board on a form provided by the board, provide proof of continuing education as established by the board and shall meet other requirements as may be set by the board.
§ 63-4-113. Applicability of health laws — Birth certificates prohibited.
  1. (a) Chiropractic practitioners shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases and any and all matters pertaining to public health, reporting to proper health officers the same as other practitioners.
  2. (b) Nothing in this chapter shall permit any chiropractor to make or execute a birth certificate.
§ 63-4-114. Denial, suspension or revocation of license or certificate.
  1. (a) The board has the duty and authority to suspend for a specified time, within the discretion of the board, or to revoke any license to practice chiropractic, or to otherwise discipline any licensee or refuse to grant any certificate of fitness, whenever the licensee or applicant is found guilty of any of the following acts or offenses:
    1. (1) Fraud in procuring a license or certificate;
    2. (2) Conviction of a felony for violations of any law of the state or of the United States;
    3. (3) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice chiropractic;
    4. (4) Immoral, unethical, unprofessional or dishonorable conduct;
    5. (5)
      1. (A) In-person solicitation, telemarketing, or telephonic solicitation by licensees, employees of licensees, agents of licensees, or independent contractors of licensees to victims of an accident or disaster, unless it is a victim with whom a licensee has a family or prior professional relationship, shall be considered unethical if carried out within thirty (30) days of the accident or disaster;
      2. (B) Telemarketing transcripts shall be maintained for a period of two (2) years following their utilization;
      3. (C) A log of contacts shall be maintained for a period of two (2) years following a telemarketing encounter; and
      4. (D) This subdivision (5) shall not prohibit solicitation by targeted direct mail advertising or other forms of written, radio, or television advertising; provided, that the advertising does not involve coercion, duress, or harassment and is not false, deceptive, or misleading;
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    6. (6) Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    7. (7) Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this chapter or lending one's name to another for the illegal practice of chiropractic by such person;
    8. (8) Rebating or offering to rebate to an insured any payment by the insured's third-party payor to the licensee for services or treatments rendered under the insured's policy;
    9. (9) Submitting to any third-party payor a claim for a service or treatment at an inflated fee or charge or a greater fee or charge than the usual fee the licensee charges for that service or treatment when the service or treatment is rendered without third-party reimbursement;
    10. (10) Submitting to any third-party payor a claim for a service or treatment at a fee or charge in an amount greater than that advertised for such service or treatment at the time of the rendering of the service or treatment that is the subject matter of the claim;
    11. (11) Knowingly or purposefully incorrectly reporting services rendered, reporting incorrect treatment dates or reporting charges for services not rendered for the purpose of obtaining payment from a third-party payor;
    12. (12) Any other unprofessional or unethical conduct that may be specified by the board from time to time by means of rules and regulations duly published and promulgated by the board or the violation of any provision of this chapter;
    13. (13) The advertising of chiropractic business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    14. (14) Invasion of a field of practice in which the licensee is not licensed to practice or is not within the limits of the licensee's respective callings as determined by the board;
    15. (15) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of chiropractic practice; and
    16. (16) Making false, fraudulent, misleading, extravagant or grossly improbable claims or statements as to the efficacy or value of the science or practice of chiropractic.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-4-115. Procedure for suspension, revocation or denial of certificate or license.
  1. (a) In enforcing this section, the board shall, upon probable cause, have the authority to compel an applicant or licensee or certificate holder to submit to a mental and/or physical examination, by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition is involved. The applicant or licensee or certificate holder may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board for use in any hearing that may thereafter ensue.
  2. (b) The board, on its own motion, may investigate any report indicating that a chiropractor is or may be in violation of this chapter. Any chiropractor, any chiropractic society or association or any other person who in good faith shall report to the board any information that a chiropractor is or may be in violation of any provisions of this chapter shall not be subject to suit for civil damages as a result thereof.
  3. (c) All proceedings by the board to deny a certificate of fitness, to revoke or suspend any certificate of fitness or license or to otherwise discipline a licensee shall be subject to and conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  4. (d) An elected officer of the board and a hearing officer, arbitrator or mediator, if any, has the authority to administer oaths to witnesses and, upon probable cause being established, issue subpoenas for the attendance of witnesses and the production of documents and records.
  5. (e) The board may utilize one (1) or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for diversion to professional peer review organizations and/or impaired professionals, associations or foundations those cases that the board, through established guidelines, deems appropriate. Upon diversion, such entities shall retain the same immunity as provided by law for the board.
  6. (f) The screening panels shall consist of as many members as the board directs, but shall include at least one (1) but no more than three (3) licensed chiropractors, who may be members of the board or may serve either voluntarily or through employment by or under contract with the board.
  7. (g) The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings laws, compiled in title 8, chapter 44, and shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the board and are not subject to deposition or subpoena to testify regarding any matter or issues raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
  8. (h) Notwithstanding any provision of the Uniform Administrative Procedures Act to the contrary, hearing officers are authorized to and may hear board mediation, arbitration or disciplinary contested cases, but may not issue final orders in contested case matters. Notwithstanding any of §§ 4-5-314 and 4-5-315, that may be or are inconsistent, such hearing officers may only issue findings of fact and conclusions of law, which shall be referred directly to the board or a duly constituted panel thereof for final action. The board or duly constituted panel, after hearing testimony or arguments from both parties regarding the appropriate disciplinary action and, if allowed by the board, arguments on any controversy raised by the hearing officer's or designee's order, shall issue a final order to include the imposition of what, if any, disciplinary action is deemed appropriate. Only the board or a duly constituted panel thereof shall have the authority to issue final orders that dispose of a pending contested case, regardless of whether the issues resulting in the dispositive action are procedural, substantive, factual or legal. If a hearing officer is not available when a contested case, or any motion filed therein requiring action, is ready and scheduled to be heard or fails to timely prepare findings and conclusions pursuant to board established guidelines, the board or a duly constituted panel thereof may rule on the motions and/or hear the contested case or utilize the record compiled before the hearing officers and prepare its own findings of fact, conclusions of law and then issue a final order. With regard to findings or conclusions issued by the hearing officer or any mediator or arbitrator, the board or any duly constituted panel thereof that reviews the case may do any of the following:
    1. (1) Adopt the hearing officer's, mediator's or arbitrator's findings of fact and conclusions of law, in whole or in part;
    2. (2) Make its own findings of fact and conclusions of law, based solely on the record and the expertise of the members of the board or panel, in addition to or in substitution of those made by the hearing officer, mediator or arbitrator;
    3. (3) Remand the matter back to the hearing officer, mediator or arbitrator for action consistent with the board or panel findings and conclusions in the matter; or
    4. (4) Reverse the hearing officer's, mediator's or arbitrator's findings and/or dismiss the matter entirely.
  9. (i) The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section in compliance with procedures established by the board. The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case against the licensee or person.
  10. (j) Any elected officer of the board, or any duly appointed or elected chair or any panel of the board or any screening panel and any hearing officer, arbitrator or mediator has the authority to administer oaths to witnesses and, upon probable cause being established, issue subpoenas for the attendance of witnesses and the production of documents and records.
§ 63-4-116. Enjoining violations.
  1. (a)
    1. (1) The board, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license and in the matter of the refusal to issue a certificate, is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice chiropractic without possessing a valid license to so practice and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of chiropractic as defined by this chapter.
    2. (2) No injunction bond shall be required of the board.
    3. (3) Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such cases as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
  2. (b) The board is also authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is violating § 63-4-114(a)(5). No injunction bond shall be required of the board in such proceedings, and jurisdiction is conferred upon the circuit and chancery courts of this state to hear such cases.
§ 63-4-117. Violations.
  1. (a) Any person who violates any provision of this chapter commits a Class B misdemeanor.
  2. (b) Any person who has been enjoined by a court of competent jurisdiction from performing any acts or rendering any services that constitute the practice of chiropractic, who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services commits a Class E felony.
§ 63-4-118. Immunity of reviewers from liability.
  1. Any chiropractor who serves on any peer review committee or on any other committee, board, commission or other entity constituted by any statewide chiropractic association, local chiropractic society or governmental or quasi-governmental agency for the purpose of reviewing and evaluating chiropractic acts of other chiropractors or chiropractic auxiliary personnel, shall be immune from liability with respect to any action taken by that chiropractor in good faith and without malice as a member of such committee, board, commission or other entity.
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§ 63-4-119. X-ray operators.
  1. (a)
    1. (1) The board shall adopt rules and regulations that shall establish minimum educational standards and criteria for persons operating X-ray equipment for diagnostic purposes in chiropractic physicians' offices.
    2. (2) These regulations may include, but are not limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases.
  2. (b) No person shall perform X-ray procedures in a chiropractic physician's office who does not meet these standards and who has not received a certificate of proficiency from the board.
§ 63-4-120. Externship certificates.
  1. (a) The board may issue an externship certificate to practice chiropractic, to be used only under supervision of a licensed chiropractor, upon payment of a fee as set by the board, to a chiropractor who meets all qualifications and requirements for licensure pursuant to this chapter and who has applied to take the examinations as provided in § 63-4-110.
  2. (b) Externs will be allowed to perform all diagnostic tests and therapeutic interventions as allowed providers licensed by this chapter.
  3. (c) Externship is to last no longer than three hundred sixty-five (365) days from date of certificate issuance. Applicants who provide proof of illness or hardship that hindered their ability to comply with § 63-4-110 may, at the board's discretion, be allowed a second year of externship.
  4. (d) The board may revoke an extern's certificate for violation of any portion of this chapter for failure to maintain proper supervision. “Supervision” is defined as direct oversight by a Tennessee licensed chiropractor. The supervisor shall be on the facility premises while the extern is conducting patient care.
  5. (e) The board reserves the right to adopt any rules and regulations as the board may deem appropriate for externs and the administration of externship program.
  6. (f) One hundred dollars ($100) shall be the administrative fee for applying to and participating in the externship program for each year of externship.
§ 63-4-121. Chiropractic preceptor program.
  1. (a) The board will allow the chiropractic preceptor program (CPP) to function in the state so long as the preceptor and the intern meet the qualifications as specified by the chiropractic preceptor program advisory committee, or its equivalent; and provided, all guidelines of the committee are followed.
  2. (b) The board reserves the right to adopt any rules and regulations as the board may deem appropriate for the administration of this program.
§ 63-4-122. Advertising.
  1. (a) The board shall adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of such board.
  2. (b) Any licensed chiropractor who advertises or announces to the public that the licensed chiropractor is a certified acupuncturist shall be deemed to have engaged in false, misleading or deceptive advertising.
§ 63-4-123. Minimum educational standards and criteria.
  1. (a)
    1. (1) The board shall adopt rules that establish minimum educational standards and criteria for chiropractic therapy assistants performing physical agent modalities, physical treatment, and clinical services that are within the scope of practice of a chiropractic physician and, under the supervision of a chiropractic physician, either in the office of the chiropractic physician or in the presence of the chiropractic physician at another location.
    2. (2) These regulations shall include, but not be limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases.
  2. (b) No person shall perform therapeutic procedures in a chiropractic physician's office who does not meet these standards and who has not received a certificate of proficiency from the board.
§ 63-4-124. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A chiropractor licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of chiropractic examiners may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
Chapter 5 Dentists
Part 1 Dentists
§ 63-5-101. Board of dentistry.
  1. (a) The practice of dentistry and of dental hygiene shall be under the direct supervision of a board to be known as the board of dentistry, referred to in this chapter as the “board.”
  2. (b) The administrative duties pursuant to licensure and the collection of fees for licensure shall be vested in the division of health related boards of the department of health, referred to in this chapter as the “division.”
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§ 63-5-102. Composition of board.
  1. The board shall consist of seven (7) practicing dentists, two (2) practicing dental hygienists and one (1) practicing registered dental assistant, whose duty it is to carry out this chapter. Of the seven (7) dentists, two (2) shall be appointed from each grand division of the state, and the appointment of the other dentists shall alternate among the grand divisions on an equal basis, but without regard to consecutive terms of a board member.
§ 63-5-103. Appointment of members — Term of office — Removal.
  1. (a)
    1. (1) The dentist members of the board may be appointed by the governor from lists of qualified nominees submitted by interested dentist groups including, but not limited to, the Tennessee Dental Association. No person is eligible for appointment as a dentist member of the board unless such person has been an actual and bona fide resident and a legally licensed practicing dentist of this state for a period of five (5) years or more immediately preceding such appointment.
    2. (2) The dental hygienist members may be appointed by the governor from lists of qualified nominees submitted by interested dental hygienist groups including, but not limited to, the Tennessee Dental Hygienists Association. No person is eligible for appointment as a dental hygienist member of the board unless that person has been an actual and bona fide resident and a legally licensed practicing dental hygienist of this state for a period of five (5) years or more immediately preceding such appointment.
    3. (3) The dental assistant member may be appointed by the governor from lists of qualified nominees submitted by interested dental assistant groups including, but not limited to, the Tennessee Dental Assistants' Association. No person is eligible for appointment as a dental assistant member of the board unless that person has been an actual and bona fide resident and has been a legally registered and practicing dental assistant of this state for a period of five (5) years or more immediately preceding such appointment.
  2. (b) The governor shall consult with interested dental groups, including, but not limited to, the Tennessee Dental Association, the Tennessee Dental Hygienists Association and the Tennessee Dental Assistants' Association to determine qualified persons to fill the positions as provided in subsection (a).
  3. (c) The terms of members of the board are three (3) years, with the terms staggered so that the terms of no more than three (3) members expire each year. No member is eligible to serve on the board for more than three (3) consecutive full terms, but any person thus ineligible shall thereafter be eligible for nomination and appointment to the board, as provided in this section, after three (3) years have elapsed since that person's previous service on the board.
  4. (d)
    1. (1) The governor shall make appointments to the board not later than one (1) month after the expiration of the term of office of any member, and such or further delay in the appointment must be deducted from the term of the appointment. The governor shall fill vacancies occurring on the board by death or resignation for the unexpired term from lists submitted to the governor as provided in this section. If the vacancy is not filled within thirty (30) days by the governor, then the board shall fill the vacancy for the unexpired term. A person is not eligible for appointment to the board if the person is employed by or with a dental supply business or dental laboratory.
    2. (2) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  5. (e) Members of the board shall continue in office until the expiration of the terms for which they were respectively appointed and until such time as their successors have been duly appointed.
  6. (f)
    1. (1) A member of the board may be removed upon one (1) or more of the following grounds:
      1. (A) The refusal or inability for any reason of a board member to perform that member's duties as a member of the board in an efficient, responsible and professional manner;
      2. (B) The misuse of office by a member of the board to obtain personal, pecuniary or material gain or advantage for that member or another through such office; or
      3. (C) The violation of this chapter or of any of the rules and regulations of the board hereafter properly promulgated.
    2. (2) The proceedings for such removal shall be in accordance with title 8, chapter 47.
§ 63-5-104. Board meetings and officers — Records — Copy of law to licensees.
  1. (a)
    1. (1) The board shall meet at least annually and at such times and places as it may deem necessary for the proper discharge of its duties.
    2. (2) At its annual meeting the board shall elect from its membership a president, vice president and secretary-treasurer.
    3. (3) A majority of the members shall constitute a quorum for the transaction of business.
    4. (4) The proceedings of the board shall be recorded and shall constitute a public record.
  2. (b) The board shall maintain and make available to the division a permanent record that shall list the name, address and license or certificate number of all persons licensed to practice dentistry and of all persons certified as dental specialists, licensed as dental hygienists and registered as dental assistants.
  3. (c) The board shall mail a copy of the law regulating the practice of dentistry to each person who is hereafter licensed to practice dentistry or dental hygiene.
§ 63-5-105. Powers of board.
  1. The board has the following powers and duties in addition to the powers and duties granted to or imposed upon it by the other sections of this chapter:
    1. (1) Prescribe rules and regulations for examination of candidates;
    2. (2) Conduct examinations to ascertain the qualifications and fitness of applicants for licenses to practice dentistry and of applicants for certificates to practice a specialty in dentistry or licenses to practice as a dental hygienist or registered as a dental assistant;
    3. (3) Provide standards by which dental schools and colleges, graduate dental programs in hospital settings, schools of dental hygiene and courses of instruction for dental assistants are approved;
    4. (4) Issue licenses to applicants who successfully pass the examination for the practice of dentistry and dental hygiene, to issue certificates to specialists in dentistry who successfully pass the respective examinations for such certificates and to register dental assistants who meet such standards of competency as the board may require by rules and regulations and who pay a nonrefundable application fee as set annually by the board;
    5. (5) Conduct hearings to revoke, suspend or otherwise lawfully discipline the holder of any license or certificate issued under the authority of this chapter or any previous laws authorizing the holder thereof to practice dentistry, a specialty in dentistry, dental hygiene or as a certified and/or registered dental assistant for violations by the licensee or certificate holder of any of the provisions of this chapter or any rule of the board hereafter properly promulgated by the board;
    6. (6) Provide for any evaluations, including onsite, of facilities, equipment and personnel of dentists who use general anesthesia, deep sedation or conscious sedation as the board determines appropriate in the interest of public safety; and
    7. (7) To make such rules and regulations and establish such fees as are necessary to carry out and make effective this chapter.
§ 63-5-106. Annual report of board.
  1. The board shall make an annual report of its proceedings and activities to the governor, with copies to be made available to any interested parties.
§ 63-5-107. License requirement.
  1. (a) It is unlawful for any person to practice dentistry, a specialty in dentistry or dental hygiene in this state, except those who are now licensed or certified as such pursuant to law and those who may hereafter be licensed or certified and registered pursuant to this chapter.
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  2. (b) It is unlawful for any person so licensed or certified to practice dentistry or to practice dental hygiene in any calendar year unless or until such person has paid the annual renewal fee for that year as provided in this chapter.
  3. (c)
    1. (1)
      1. (A) Each person licensed as a dentist or a dental hygienist in accordance with this chapter or registered as a dental assistant pursuant to the rules of the board is required to attend and complete each year, except in the year of initial licensure or registration, the number of hours of board approved continuing education courses prescribed by the board, subject to a minimum of twelve (12) and a maximum of thirty (30) clock hours; provided, that beginning January 3, 2003, in lieu of the annual continuing education requirement, each person licensed as a dentist or dental hygienist or registered as a dental assistant is required to attend and complete during each two-year cycle, except for the two-year cycle of initial licensure, the number of hours of board approved continuing education courses that are prescribed by the board, subject to a minimum of twenty-four (24) and a maximum of sixty (60) clock hours. However, for the purposes of the biennial continuing education requirement for dental hygienists, no more than fifty percent (50%) of such continuing education requirement may be earned from on-line or web-based courses. Sponsors of such courses shall submit a sufficient description of course content to the board in order to obtain approval. The board may approve all, part or none of the course at its discretion. Additional procedures for implementing this requirement may be adopted by the board in its regulations. The board may waive all or part of the continuing education requirements in unusual situations in which an applicant for renewal has demonstrated inability to attend such courses not attributable to fault of the applicant. The board shall have discretion to require completion of continuing education courses of a type and number of hours satisfactory to the board in cases involving license renewal of dentists or dental hygienists who have not actively practiced or have been retired from practice for more than two (2) years. In addition to the foregoing, all applicants shall provide proof of current CPR certification by an organization approved by the board unless such requirement is waived by the board in its discretion; provided, that no dentist who obtains a waiver from the board for CPR requirements shall practice dentistry unless a dentist, dental hygienist or dental assistant who is currently certified in CPR is present.
      2. (B)
        1. (i) For purposes of this subdivision (c)(1), a live, interactive webinar is:
          1. (a) Considered to be in-person continuing education; and
          2. (b) Not considered remote attendance of an online or web-based course.
        2. (ii) As used in this subdivision (c)(1)(B), “live, interactive webinar” means an internet-based broadcast in which viewers may interact with a presenter in real time.
      3. (2) The board may, but is not required to, monitor or verify certificates of completion submitted by applicants for license renewal. In its discretion, by random sample or in individual cases, the board may require proof of attendance or otherwise investigate compliance with this subsection (c).
§ 63-5-108. Practice of dentistry and dental hygiene defined.
  1. (a) Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment, by nonsurgical, surgical or related procedures, of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body, provided by a dentist within the scope of such dentist's education, training, and experience, in accordance with the ethics of the profession and applicable law.
  2. (b) Any person is deemed to be practicing dentistry who, either gratuitously or for a salary, fee, money or other remuneration, paid or to be paid, directly to the operator or to any person or agency:
    1. (1) Diagnoses, prescribes for or treats any disease, pain, deformity, deficiency, injury, disorder and condition of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Such diagnosis and treatment may include the use of a complete or limited physical evaluation of patients by a board eligible or board certified oral and maxillofacial surgeon or a resident in an approved oral and maxillofacial surgery program practicing in a hospital setting;
    2. (2) Extracts human teeth;
    3. (3) Repairs or fills cavities in human teeth;
    4. (4) Corrects malformations of human teeth or of the jaws;
    5. (5) Performs any oral and maxillofacial surgery;
    6. (6) Subject to subsection (d), takes an impression of the human tooth, teeth or jaws, leading to either:
      1. (A) The fabrication of a model upon which will be constructed a replacement of natural teeth by artificial substitutes; or
      2. (B) The fabrication of a cosmetic metal apparatus to be worn in the human mouth, whether or not the apparatus features silver, gold or platinum caps, jeweled inlays or any other cosmetic features;
    7. (7) Furnishes, supplies, constructs, alters, reproduces or repairs any prosthetic denture, bridge, crown, appliance or any other structure to be used or worn in the human mouth as a substitute for natural teeth, except on the written work order of a licensed and registered dentist;
    8. (8) Places or adjusts such appliance or structure in the human mouth;
    9. (9) Delivers the same to any person other than the licensed and registered dentist upon whose written work order the work was performed;
    10. (10) Offers to the public by any method to furnish, supply, construct, reproduce, reline, repair or otherwise process any prosthetic denture, bridge, appliance or other structure to be worn in the human mouth;
    11. (11) Gives interpretations of dental radiographs;
    12. (12) Administers an anesthetic, except for a topical anesthetic in connection with a dental operation; provided, however, that a duly licensed dentist may delegate the administration of local anesthetic to dental hygienists who possess a permit to do so issued by the board. The board shall establish the qualifications, criteria and curricula required for issuance of permits to administer local anesthetic, by infiltration or by block, to duly licensed dental hygienists;
    13. (13) Uses the words, “Dentist,” “Dental Surgeon,” “Oral Surgeon,” “Oral and Maxillofacial Surgeon,” or letters “D.D.S.,” “D.M.D.,” or any other words, letters, title, or descriptive matter that in any way represents the person as being able to diagnose, treat, prescribe or operate for any disease, pain, deformity, deficiency, injury, disorder, and condition of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body;
    14. (14) States, or permits to be stated by any means or method whatsoever, that the person can or will attempt to perform dental operations or services or to render diagnosis in connection therewith;
    15. (15) Is the operator of a place where dental operations or dental services are performed; or
    16. (16) Authorizes the practice of “teledentistry” which, as used in this section, means the delivery of dental health care and patient consultation through the use of telehealth systems and technologies, including live, two-way interactions between a patient and a dentist licensed in this state using audiovisual telecommunications technology, or the secure transmission of electronic health records and medical data to a dentist licensed in this state to facilitate evaluation and treatment of the patient outside of a real-time or in-person interaction. Dentists who are licensed in this state and who deliver services using teledentistry shall establish protocols for the practice that should include proper methods of keeping the patient fully informed; proper safeguards ensuring that all state and federal laws and regulations relative to the privacy of health information are followed; proper documentation of all services or treatment rendered via teledentistry; proper procedures to ensure the referral of those patients requiring treatment beyond what can be provided via teledentistry to a dentist licensed in this state; and any such requirements as prescribed by the board of dentistry. Any and all services provided via teledentistry shall be consistent with the in-person provision of those services. Any and all services provided via teledentistry shall comply with this chapter and shall be provided in accordance with the rules of the board of dentistry.
  3. (c)
    1. (1) A dental hygienist is an individual who has graduated from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation (CODA) and is licensed under this chapter to practice dental hygiene.
    2. (2) The practice of dental hygiene means the performance of preventive, educational, and therapeutic services including the removal of all hard and soft deposits and the stain from the human teeth to the depth of the gingival sulcus, polishing natural and restored surfaces of teeth, performing clinical examination of teeth and surrounding tissues for diagnosis by the dentist, and performing other procedures that may be delegated by the dentist, under the supervision of a licensed dentist.
    3. (3) No person shall practice dental hygiene in a manner that is separate or independent from a supervising dentist, or establish or maintain an office or a practice that is primarily devoted to the provision of dental hygiene services.
    4. (4) A dental hygienist shall perform, under direct supervision only, root planing, subgingival curettage, administering nitrous oxide, and local anesthesia.
    5. (5) Under general supervision a dental hygienist may provide to patients, for not more than fifteen (15) consecutive business days, all other dental hygiene services not otherwise limited to direct supervision by this chapter or rules adopted by the board, if all of the following requirements are met:
      1. (A) The dental hygienist has at least one (1) year, full-time, or an equivalent amount of experience practicing dental hygiene;
      2. (B) The dental hygienist complies with written protocols for emergencies that the supervising dentist establishes;
      3. (C) The supervising dentist examined the patient not more than eleven (11) months prior to the date the dental hygienist provides the dental hygiene services;
      4. (D) The dental hygienist provides dental hygiene services to the patient in accordance with a written treatment plan developed by the supervising dentist for the patient; and
      5. (E) The patient is notified in advance of the appointment that the supervising dentist will be absent from the location and that the dental hygienist cannot diagnose the patient's dental health care status.
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  4. (d) Any duly licensed and registered dentist may assign to duly licensed and registered dental hygienists, registered dental assistants and/or practical dental assistants, as defined by the board in rules and regulations, any tasks or procedures to be performed in the dentist's office for which a licensed and registered dentist exercises direct supervision and full responsibility, except those procedures requiring the professional judgment or skill of a dentist; provided, that duties involving the removal of hard and soft deposits by scaling or curretage from the surfaces of human teeth are assigned only to duly licensed and registered dental hygienists. The board has the authority to permit registered dental assistants to apply sealants to and to polish human teeth, and the board has the discretion to establish criteria and curricula as necessary to ensure that such registered dental assistants are qualified to apply sealants and perform polishing. For eligibility to perform polishing, passage of a clinical and didactic examination is required. The board is authorized to permit licensed and registered dental hygienists and registered dental assistants to insert, pack, carve and finish amalgam and intracoronal nonmetallic restorations and take final impressions for fixed and removable prosthetic appliances, under the direct supervision and full responsibility of a licensed dentist, and the board shall establish such criteria and curricula as it determines in its discretion are necessary or appropriate to ensure that such hygienists and assistants are qualified to perform such procedures. Tasks and procedures assignable to licensed and registered dental hygienists shall include those enumerated in the board's regulations as of January 1, 1990, and such other additional tasks and procedures as the board may deem appropriate in the future. Procedures requiring professional judgment or skill not assignable to such dental hygienists and dental assistants include the following:
    1. (1) Diagnosis and treatment planning; oral surgery, the cutting of hard and/or soft tissues, excluding any cutting of such tissues involved in subgingival scaling, root planing and gingival curettage, and any intra-oral procedures that would affect the function and/or efficiency of an appliance that, when worn by the patient, would come in direct contact with hard or soft tissue and that could result in tissue irritation or injury;
    2. (2) The placing of permanent fillings or restorations in or on teeth except as provided in this subsection (d); and
    3. (3) Administration of a general or local anesthetic, except for a topical anesthetic in connection with a dental operation; provided, however, that dental hygienists who possess a permit issued pursuant to subdivision (b)(12) may administer a local anesthetic but only under the direct supervision of a licensed and registered dentist who is physically present at the same office location and time and in accordance with rules and regulations of the board.
  5. (e) Notwithstanding any provision of law to the contrary, a dental hygienist may administer nitrous oxide analgesia if directed by a dentist to do so, in accordance with rules and regulations of the board of dentistry, under the direct supervision of a licensed and registered dentist. Patients who have been administered nitrous oxide shall be monitored appropriately.
  6. (f)
    1. (1) Except as provided in subdivision (f)(2), a licensed dentist shall not allow, under general supervision, more than three (3) dental hygienists to work at any one (1) time.
    2. (2) A dentist may supervise, under direct supervision, no more than ten (10) dental hygienists while the dentist and each hygienist is providing dental services on a volunteer basis through a nonprofit provider of free mobile clinics in this state.
  7. (g) Any duly licensed and registered dentist who uses general anesthesia, deep sedation or conscious sedation in that dentist's practice, at a level to be determined by the board, must secure a permit from the board by meeting the standards as set in rules and regulations and by paying fees set by the board. Such permit is subject to renewal at intervals upon payment of a fee as set by the board in rules and regulations. Any dental facility in which general anesthesia, deep sedation or conscious sedation is administered by such dentist is subject to standards as may be specified in rules and regulations of the board, including, but not limited to, a facility permit.
  8. (h)
    1. (1) Notwithstanding any law to the contrary, the practice of dental hygiene also includes prescriptive authority limited to fluoride agents, topical oral anesthetic agents, and nonsystemic oral antimicrobials that:
      1. (A) Are not controlled substances under state and federal drug laws; and
      2. (B) Do not require a license from the federal drug enforcement agency.
    2. (2) Prescriptive authority under this section must be:
      1. (A) Exercised under the general supervision of a licensed dentist;
      2. (B) Pursuant to rules promulgated by the board; and
      3. (C) In compliance with all applicable laws concerning prescription packaging, labeling, and record keeping requirements.
    3. (3) A prescription written by a dental hygienist under this part must be reviewed by a dentist within thirty (30) days.
    4. (4) The board shall determine by rule the educational and training requirements necessary for a dental hygienist to exercise prescriptive authority pursuant to this section.
    5. (5) The board shall determine by rule the percentage of fluoride or any other active ingredient in any medication that may be prescribed by a dental hygienist under this subsection (h).
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§ 63-5-109. Exemptions.
  1. The following persons, acts, practices and operations are exempt from the other provisions of this chapter:
    1. (1) The practice of their professions by physicians or surgeons licensed as such under the laws of this state, unless they practice dentistry as a specialty;
    2. (2) The practice of dentistry and dental hygiene in the discharge of their official duties by graduate dentists and by dental hygienists in the United States public health service, army, navy, air force, coast guard or veterans administration;
    3. (3) The practice of dentistry by licensed dentists or the practice of dental hygiene by licensed dental hygienists of other states or countries at meetings of the Tennessee Dental Association or Pan Tennessee Dental Association, or component parts thereof, alumni meetings of dental colleges or any other like dental organizations while appearing as clinicians;
    4. (4) Licensed dentists or dental hygienists of other states who are called into Tennessee by licensed dentists of this state for consultative or operative purposes if the board or its designee gives discretionary advance approval in each such instance;
    5. (5) The practice of dentistry or of dental hygiene by graduates of schools or colleges recognized by the board who are duly licensed in other states in the discharge of their official duties in state-supported institutions or official health agencies or other special projects approved by the board between the time of their employment as such and the next examination and licensing by the board;
    6. (6) The practice of dentistry or of dental hygiene by students under the supervision of instructors in any dental school, college or dental department of any school, college, university or school of dental hygiene recognized by the board, but such activities shall not be carried on for profit;
    7. (7) The giving by a registered nurse anesthetist of any anesthetic for a dental operation under the direct supervision of a licensed dentist;
    8. (8) The construction, reproduction, restoration, alteration or repair of bridges, crowns, dentures or any other prosthetic or orthodontic appliances or materials to be used or worn as substitutes for natural teeth or for correction or regulation of natural teeth, upon order, prescription or direction of a licensed dentist, when the impressions, casts or models thereof have been made or taken by a licensed and registered dentist, a licensed and registered dental hygienist under the direct supervision of a licensed and registered dentist or a registered dental assistant under the direct supervision of a licensed and registered dentist; provided, that such prosthetic dentures or orthodontic appliances or bridges or the services rendered in construction, repair, restoration or alteration thereof are not advertised, other than in a professional or trade journal, or by direct mail to licensed dentists or other laboratories and are not sold or delivered directly or indirectly to the public by any unlicensed person or dental laboratory, either as principal or as agent;
    9. (9) Dental interns and externs or graduates of dental and dental hygiene schools or colleges recognized by the board employed by licensed hospitals or other agencies recognized and approved by the board;
    10. (10) Personnel involved in research or developmental projects, approved by the board, that are under the auspices and direction of a recognized educational institution or the department of health;
    11. (11) Graduates of dental schools or colleges serving as clinical instructors in board-recognized teaching institutions, while performing only those duties required by and under the supervision of such teaching institutions, upon completing prescribed registration forms and payment of a fee as set by the board; however, such exemption shall be confined to the interim immediately prior to the next scheduled applicable examination of the board and shall not be extended if the applicant does not successfully pass the examination;
    12. (12) Dentists and dental hygienists duly licensed in other states who desire to work with special projects recognized and approved by the board may do so under the sponsorship of a local dentist and the auspices of the local dental society for a period of six (6) months;
    13. (13) Dentists or dental hygienists duly licensed in other states practicing within authorized Tennessee department of health programs or programs affiliated with the Tennessee department of health for a period not to exceed twenty-four (24) months;
    14. (14) The application of fluoride varnish to the teeth of at-risk, underserved persons in or under the auspices of a state, county or municipal public health clinic by public health nurses or nurse practitioners;
    15. (15) The application of dental sealants to the teeth of individuals in a setting under the direction of a state or local health department by licensed hygienists, without requiring an evaluation by a dentist prior to such application, under a protocol established by the state or a metropolitan health department; or
    16. (16) The application of topical fluoride to the teeth of individuals in a setting under the direction of a state or local health department by licensed hygienists, without requiring an evaluation by a dentist prior to such application, under a protocol established by the state or a metropolitan health department.
§ 63-5-110. Application for license — Reciprocity.
  1. (a)
    1. (1) A person desiring to obtain a license to practice dentistry in this state shall make application to the board. The application must be accompanied by a certificate showing that the applicant is a graduate of an accredited dental school or college or from the dental department of a university approved by the board.
    2. (2) The applicant shall be at least eighteen (18) years of age, a citizen of the United States or Canada or legally entitled to live within the United States and of good moral character and reputation.
    3. (3) The application must be accompanied by the applicant's photograph and by a nonrefundable application fee as set by the board in rules and regulations.
  2. (b) The board is authorized to cause a license to be issued to an applicant of good moral character and professional competence who is licensed to practice dentistry in another state, which shall include the District of Columbia or a territory of the United States, if the board determines to its satisfaction that the applicant meets all of the following requirements:
    1. (1) Currently holds a valid license to practice dentistry in another state and provides a copy of such license, and also provides the name of another state in which the applicant is or has been licensed;
    2. (2) Absence of any pending disciplinary charges or action in another state or any current investigation by a disciplinary authority or another state and provides pertinent information about any disciplinary action imposed against the applicant in any other state, which the board is to evaluate and determine whether such is disqualifying for licensure in this state;
    3. (3) Has not failed previously an examination for licensure to practice dentistry in Tennessee;
    4. (4) Graduation from a dental school or college duly accredited by the American Dental Association Commission on Dental Accreditation;
    5. (5) Demonstrates intent to actively practice or teach in Tennessee;
    6. (6) Has, pursuant to the authority of a state dental licensing board or boards:
      1. (A) Practiced dentistry in another state or states for at least five (5) years;
      2. (B) Taught in an American Dental Association accredited institution for at least five (5) years;
      3. (C) Any combination of subdivision (b)(6)(A) or subdivision (b)(6)(B) for at least five (5) years;
      4. (D) Practiced dentistry for at least two (2) years in another state or states and, in addition, presents satisfactory evidence of passing an examination administered by another state substantially equivalent to the examination required for initial licensure in Tennessee, the appropriateness of such examinations to be evaluated and determined by the board;
      5. (E) Taught for at least two (2) years in an American Dental Association accredited institution and, in addition, presents satisfactory evidence of passing an examination administered by a regional testing agency or a clinical board examination administered by another state substantially equivalent to the examination required for initial licensure in Tennessee, the appropriateness of such examination to be evaluated and determined by the board; or
      6. (F) Any combination of subdivision (b)(6)(D) or subdivision (b)(6)(E) for at least two (2) years; and
    7. (7) Payment of a nonrefundable application fee as set by the board.
  3. (c) The board is authorized, in its discretion, to issue a limited license for educational purposes to any dentist who is duly licensed to practice in any other state who meets the requirements of the board and who submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  4. (d) The board shall direct the division to issue a license to an applicant, without the necessity of further examination except as required by § 63-5-113, if the board determines that the applicant meets all of the following qualifications:
    1. (1) Is a graduate with either a D.D.S. or D.M.D. degree of an accredited dental school or college or of a dental department of a university approved by the board;
    2. (2) Is licensed to practice dentistry in another state, the District of Columbia, the Commonwealth of Puerto Rico or a dependency of the United States;
    3. (3) Has successfully completed a graduate training program in a recognized specialty branch of dentistry; and
    4. (4) Is currently duly licensed to practice medicine in this state.
  5. (e) The board is authorized, in its discretion, to issue a limited license for the practice of dentistry in American Dental Association accredited institutions or dental education programs or in federally-designated health professional shortage areas, if the applicant meets the following requirements:
    1. (1) Is a graduate of a school of dentistry with a degree substantially equivalent to either a D.D.S. or D.M.D. degree;
    2. (2) Has successfully completed a graduate training program in a recognized specialty branch of dentistry from an advanced specialty program accredited by the American Dental Association;
    3. (3) Has successfully completed the national board examinations;
    4. (4) Payment of nonrefundable fee, as set by the board;
    5. (5) Provides satisfactory evidence of good moral character and professional competency;
    6. (6) Provides proof of naturalization or ability to live and work in the United States; and
    7. (7) Meets other requirements as set by the board.
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§ 63-5-111. Examinations — Issuance or denial of licenses.
  1. (a)
    1. (1) The board may conduct examinations at such times and places as it may designate and charge each examinee a fee for each examination taken as set annually by the board.
    2. (2) In addition to examinations conducted pursuant to subdivision (a)(1), the board shall recognize a certificate granted by the American Dental Association's Commission on National Board Dental Examinations and may accept the results of its own board examination or the results of an examination conducted by one (1) or more of the regional testing agencies.
    3. (3) An examination described in this subsection (a) may be written or oral, or both; shall include subjects as may be designated by the board; and may also include practical tests, working operations, and demonstrations, within the discretion of the board. An examination may be conducted on a live human patient or a non-patient-based model may be used.
  2. (b)
    1. (1) If the applicant shall successfully pass the examination and shall be found worthy, the board shall direct the division to issue a license to that applicant.
    2. (2) The board may, within its discretion, refuse to grant a certificate to any person found guilty of making false statements, cheating or of any fraud or deception, either in applying for or in taking the examination.
    3. (3) The board may, within its discretion, refuse to issue a license to any person who fails to apply for the same within ninety (90) days following notification of successful completion of all requirements for the licensure.
§ 63-5-112. Specialists.
  1. (a) No licensed dentist shall claim to the public to be a specialist, or be specially qualified in any particular branch of dentistry or to be giving special attention to any branch of dentistry, or claim to limit the dentist's practice to any branch of dentistry, until that dentist has complied with the additional requirements established by the board and has been issued a certificate by the board authorizing that dentist so to do. The board is authorized to certify “specialists” in the following branches of dentistry:
    1. (1) Dental public health;
    2. (2) Endodontics;
    3. (3) Oral and maxillofacial pathology;
    4. (4) Oral and maxillofacial surgery;
    5. (5) Orthodontics and dentofacial orthopedics;
    6. (6) Pediatric dentistry;
    7. (7) Periodontics;
    8. (8) Prosthodontics;
    9. (9) Oral and maxillofacial radiology; and
    10. (10) Any other branch of dentistry hereafter recognized as a specialty by the American Dental Association and approved by the board.
  2. (b) Oral and maxillofacial surgeons are held to the same standard of care as physicians licensed under chapters 6 or 9 of this title.
  3. (c) In considering or acting upon matters related to specialists or special areas of dentistry, the board shall utilize as consultants one (1) or more knowledgeable persons certified in the applicable specialty or knowledgeable in the special area.
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§ 63-5-113. Examination and certification of specialists.
  1. (a) Any dentist duly licensed in this state who has completed a minimum of two (2) years of graduate education in a dental school accredited by the Commission on Dental Accreditation or the equivalent thereof in a specialty branch of dentistry or who has otherwise met the requirements of the rules promulgated by the board may apply for a certificate as a specialist.
  2. (b) The board may recognize specialty certification of those dentists licensed through the licensure criteria provisions of § 63-5-110, if the requirements for certification in the original state are substantially equivalent to those requirements in this state.
  3. (c) No one shall offer or conduct any school, course, or program that grants credentialed status or that graduates individuals for credentialed status, or its equivalent, in any particular branch of dentistry or any specific area of the practice of dentistry that is not listed as a recognized specialty in § 63-5-112. Dental, dental hygiene, and dental assisting colleges, schools, or programs in this state that are accredited by the Commission on Dental Accreditation are exempt from this subsection (c).
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§ 63-5-114. Dental hygienists — Examination — Licensure — Reciprocity.
  1. (a) The board is authorized to issue a license to practice dental hygiene to applicants who are citizens of the United States or Canada or who are legally entitled to live within the United States, who have graduated and received a diploma from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation, that provides a minimum of two (2) academic years of dental hygiene curriculum and that may be completed in a period of time less than two (2) years, in or through an institution of higher education accredited by an agency recognized by the United States department of education to offer college-level programs and who have successfully passed such examinations as may be established by the board. The board may recognize a certificate granted by the joint commission of national dental examinations or accept the results of the southern regional testing agency, or either organization, in lieu of or subject to such examinations as may be required by the board.
  2. (b)
    1. (1) Each applicant for a license as a dental hygienist shall pay a nonrefundable application fee to the board, as set annually by the board.
    2. (2) Any applicant submitting to an examination conducted by the board shall, in addition to the application fee, pay a nonrefundable examination fee as set annually by the board.
    3. (3) The license shall be of the type and kind agreed upon by the board.
  3. (c) The secretary of the board shall keep a separate register showing the names and addresses of all dental hygienists so licensed by the board.
  4. (d) The board is authorized in its discretion to issue a license by criteria approval to any dental hygienist who:
    1. (1) Is licensed and has, pursuant to that license, actively engaged in practice for three (3) years or more in another state or states;
    2. (2) Is a graduate of and has received a diploma from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation that provides a minimum of two (2) academic years of dental hygiene curriculum and that may be completed in a period of time less than two (2) years, in or through an institution of higher education accredited by an agency recognized by the United States department of education to offer college-level programs; and
    3. (3) Submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  5. (e) The board is authorized in its discretion to issue a limited license for educational purposes to any dental hygienist who is duly licensed or registered to practice in any other state, who meets the requirements of the board and who submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  6. (f) The board may in its discretion revoke a license to any person who fails to register the license with the board within ninety (90) days following notification of licensure.
§ 63-5-115. Employment of and practice by hygienists and assistants.
  1. (a) A duly licensed and registered dentist may employ licensed and registered dental hygienists, registered dental assistants and practical dental assistants. Such licensed and registered dental hygienists may practice as authorized in this section or § 63-5-108 only in the office of and under the direct and/or general supervision of a licensed and registered dentist, in authorized public health programs or at other locations otherwise authorized by this chapter. Such registered and/or practical dental assistants may practice as authorized in this section or § 63-5-108 only in the office of and under the direct supervision of a licensed and registered dentist except in authorized public health programs. No provisions in this chapter shall be construed as authorizing any licensed and registered dental hygienists, registered dental assistants or practical dental assistants to practice as such except as provided in this section.
  2. (b) Definitions.
    1. (1) Direct Supervision. As used in this chapter regarding supervision of licensed and registered dental hygienists or registered dental assistants, “direct supervision” means the continuous presence of a supervising dentist within the physical confines of the dental office when licensed and registered dental hygienists or registered dental assistants perform lawfully assigned duties and functions;
    2. (2) General Supervision. As used in this chapter, “general supervision” is defined as those instances when the dentist is not present in the dental office or treatment facility while procedures are being performed by the dental hygienist, but the dentist has personally diagnosed the condition to be treated, has personally authorized the procedures being performed and will evaluate the performance of the dental hygienist.
  3. (c) Licensed and registered dental hygienists and registered dental assistants are specifically permitted to participate unsupervised in educational functions involving organized groups or health care institutions regarding preventive oral health care. Dental hygienists are permitted to participate in health screenings and similar activities; provided, that no remuneration is given by the organized group to any hygienist or the hygienist's employer for participating in these activities.
  4. (d)
    1. (1) Settings in which licensed and registered hygienists may engage in the provision of preventive dental care under the general supervision of a dentist through written protocol include nursing homes, skilled care facilities, nonprofit clinics and public health programs. Dental hygienists licensed and registered pursuant to this chapter are specifically permitted to render such preventive services as authorized in § 63-5-108 or by regulation of the board, as prescribed by the supervising dentist under a written protocol. Dental hygienists rendering such services shall be under the general supervision of a licensed dentist as specified in a written protocol between the supervising dentist and the hygienist which must be submitted in advance to the board. No dentist may enter into a written protocol with more than three (3) dental hygienists at any one time nor may any hygienist be engaged in a written protocol with more than three (3) dentists at any one time. The supervising dentist must process all patient billings. Each written protocol will be valid for a period of two (2) years at which time it must be renewed through resubmission to the board. Should a dentist cease to be the employer/supervisor of a dental hygienist where a written protocol is in force and on file with the board, the dentist must notify the board within ten (10) working days by certified mail, return receipt requested or electronic mail that the written protocol is no longer in force.
    2. (2) Licensed and registered dental hygienists working under written protocol, in addition to those requirements enumerated under the general supervision as authorized by § 63-5-108(c)(5), must have actively practiced as a licensed dental hygienist for at least five (5) years and have practiced two thousand (2,000) hours in the preceding five (5) years or taught dental hygiene courses for two (2) of the proceeding three (3) years in a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation and completed six (6) hours of public health continuing education within the past two (2) years; provided, that, after satisfying the requirement of this subsection (d), in subsequent years the hygienist may work on a part-time basis.
    3. (3) Each written protocol, required for off-site practice under general supervision, shall be submitted to the board by certified mail, return receipt requested and shall include at a minimum:
      1. (A) The name, address, telephone number and license number of the employer (supervising) dentist;
      2. (B) The name, address, telephone number and license number of the dental hygienist;
      3. (C) The name, address, telephone number and other pertinent identification from all locations where the dental hygiene services are to be performed; and
      4. (D) A statement signed by the dentist that the dentist and the dental hygienist that meets all minimum standards for general supervision as well as those required for practice under a written protocol as stipulated in this section and § 63-5-108.
    4. (4) The board will receive each written protocol submitted and keep those on file which meet the minimum requirements enumerated in subdivision (d)(3). Those received by the board and determined not to be complete shall be returned to the submitting dentist within thirty (30) days of receipt with a request for the additional information required. The dentist may then resubmit an amended written protocol to the board.
  5. (e) Teledentistry shall not alter or amend the supervision requirements or procedures authorized for licensed and registered dental hygienists or registered dental assistants. Any licensed and registered dental hygienist who, under the supervision of a dentist, assists the dentist in providing dental health services or care using teledentistry is only authorized to perform those services that the dental hygienist is authorized to perform during an in-person patient encounter under general supervision. Services provided by registered dental hygienists through teledentistry should be provided under written protocol in accordance with subsection (d).
§ 63-5-116. Penalties for unauthorized practice by hygienist or assistant.
  1. (a) The board may revoke or suspend the license of, assess a civil penalty for each separate violation against or otherwise lawfully discipline any dentist who permits any licensed and registered dental hygienist, registered dental assistant and/or practical dental assistant operating under that dentist's supervision to perform any acts or services other than those authorized by this chapter.
  2. (b) The board may also revoke or suspend the license or registration of, assess a civil penalty for each separate violation against or otherwise lawfully discipline any dental hygienist or dental assistant violating any of the provisions of this chapter.
§ 63-5-117. License renewal.
  1. (a) Each licensed dentist shall pay an annual renewal fee to the board, payable in advance. The secretary of the board shall notify each licensed dentist that such renewal fee is due.
  2. (b) Each licensed dental hygienist shall pay an annual renewal fee to the board as set by the board, payable in advance, for the ensuing year on or before December 31 of each year, which fees shall become part of the fees of the board and handled in the same manner as other fees of the board. The secretary shall notify all licensed dental hygienists prior to December 31 of each year that the fee is due.
  3. (c) Each registered dental assistant shall pay a biennial renewal fee to the board as set by the board, payable in advance, for the ensuing two (2) years on or before December 31 of each even year, which fees shall become a part of the fees of the board to be handled in the same manner as other fees of the board. The secretary shall notify all registered dental assistants prior to December 31 of each even year that such fee is due.
  4. (d) When any licensed dentist, licensed dental hygienist or registered dental assistant fails to register and pay the registration fee within sixty (60) days after registration becomes due as provided in this section, the license or certificate of such person shall be automatically revoked at the expiration of sixty (60) days after the registration was required, without further notice or hearing. Any person whose license or certificate is automatically revoked as provided in this subsection (d) may make application in writing to the Tennessee board of dental examiners for the reinstatement of such license or certificate, and, upon good cause being shown, the board in its discretion may reinstate such license or certificate upon payment of all past-due renewal fees and upon the further payment of a sum as set by the board.
  5. (e)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period; however, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in subdivision (e)(1).
§ 63-5-118. Certificate to licensee removing from state.
  1. Anyone who is licensed or certified and is an ethical practitioner of dentistry or dental hygiene in the state and who is of good moral character, who shall desire to change residence to another state, territory, the District of Columbia or to a foreign country, upon application to the board, shall receive a special certificate or endorsement signed by the secretary and bearing the seal of the board, which shall attest such facts, the date of licensure or certification and such other facts as may be deemed necessary. The nonrefundable fee for each certificate or endorsement shall be set by the board.
§ 63-5-119. Disbursement of fees, fines and penalties — Operating expenses — Compensation — Conference attendance.
  1. (a) All fees coming into the hands of the board, including examination fees, renewal fees, fines and penalties, shall be paid by the board to the state treasurer and become part of the general fund. The commissioner of finance and administration shall make allotments out of the general fund of at least eighty-five percent (85%) of the funds paid into the general fund by the board for the proper expenditures of the board, and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  2. (b) The members of the board shall receive as compensation the sum of one hundred dollars ($100) for each day they are actually engaged in the duties of the board in Tennessee, and all necessary expenses incurred in attending the meetings of the board. All reimbursements for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  3. (c) All fines, fees and penalties provided for in this chapter, whether imposed or required by the board or assessed or imposed by a court, judge or jury, shall belong to and be paid to the board.
  4. (d) The secretary of the board shall, in addition to the per diem provided by this section, receive a salary not to exceed five hundred dollars ($500) per month as set annually by the board.
  5. (e)
    1. (1) The board may select one (1) or more of its members to attend, at the expense of the board, annual meetings of such agencies and associations as the Southern Regional Testing Agency, American Association of Dental Examiners and the Southern Conference of Dental Deans and Examiners, where attendance is necessary and important to the proper functioning of the board.
    2. (2) The members of the board may receive as compensation for attendance at such annual meetings the sum of fifty dollars ($50.00) for each day they are actually engaged in the duties of the board at such annual meetings.
§ 63-5-120. Exhibit of license.
  1. The holder of the license to practice dentistry or dental hygiene shall, at all times, upon request, exhibit such license along with the annual renewal receipt to any of the members of the board, or its authorized agent, or to any officer of the law.
§ 63-5-121. Dental practice to be owned by dentist — Exception for death or disability.
  1. (a) Except where dental services are regularly made available to employees by their employer or where dental services are being provided by an official agency of the state government or any subdivision, any nonprofit organization or hospital, it is unlawful:
    1. (1) For any licensed dentist to practice dentistry as an employee of any person or other entity not engaged primarily in the practice of dentistry; or
    2. (2) For an owner of an active dental practice to be other than a dentist duly licensed to practice in this state.
  2. (b) In the event that a dentist is deceased or becomes substantially disabled, the estate or agent of such dentist may employ another dentist or dentists for a period of not more than two (2) years to provide services to patients until the practice can be sold or otherwise disposed of or closed.
  3. (c)
    1. (1) Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a dentist; provided, that the contractual relationship between the dentist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the dentist from exercising independent professional judgment in diagnosing and treating patients.
    2. (2) For the purposes of this subsection (c), the term “charitable clinic” means an entity that meets the following standards:
      1. (A) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. (B) Has clinical facilities located in this state;
      3. (C) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. (D) Provides one or more of the following services for free or at a discounted rate:
        1. (i) Medical care;
        2. (ii) Dental care;
        3. (iii) Mental health care; or
        4. (iv) Prescription medications;
      5. (E) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. (F) Is not required to be licensed under § 68-11-202(a)(1).
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§ 63-5-122. Drug prescriptions.
  1. (a) Licensed dentists of this state may dispense, prescribe or otherwise distribute drugs rational to the practice of dentistry, and any prescriptions shall be written in accordance with state and federal drug laws.
  2. (b) Licensed pharmacists of this state may fill prescriptions of licensed dentists of this state for any drug necessary or proper to the practice of dentistry.
  3. (c) Any handwritten prescription order for a drug prepared by a dentist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing dentist, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug, and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing dentist must sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201.
  4. (d) Any typed or computer-generated prescription order for a drug issued by a dentist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer generated prescription order must contain the name of the prescribing dentist, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug, and the month and day that the typed or computer generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing dentist must sign the typed or computer generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201.
  5. (e) Nothing in this section shall be construed to prevent a dentist from issuing a verbal prescription order.
  6. (f)
    1. (1) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
    2. (2) Subdivision (f)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
§ 63-5-123. Administration of COVID-19 vaccine by dentist.
  1. (a) As used in this section, “COVID-19” means an infectious respiratory disease caused by the coronavirus named SARS-CoV-2, or a mutation of that coronavirus.
  2. (b) Notwithstanding a law to the contrary, a dentist licensed under this chapter may administer a vaccination against COVID-19 if the dentist has received appropriate training as recommended by the Centers for Disease Control and Prevention.
§ 63-5-124. Grounds for denial, suspension or revocation of licenses — Examinations — Investigations of reports — Civil penalties — Costs — Oaths and subpoenas.
  1. (a) The board has the power and it is its duty to deny, suspend, revoke or otherwise restrict or condition the license of, assess a civil penalty for each separate violation against or otherwise lawfully discipline the holder of any license to practice dentistry or any certificate to practice a dental specialty, any license to practice dental hygiene or practice as a registered dental assistant, whenever the licensee or certificate holder is guilty of violating any of the provisions of this chapter or of the following acts or offenses:
    1. (1) Unprofessional, dishonorable or unethical conduct;
    2. (2) A violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, this chapter or any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    3. (3) Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or in being guilty of fraud or deceit in the practice of dentistry or dental hygiene or as a registered dental assistant;
    4. (4) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of professional practice;
    5. (5) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants, such as, but not limited to, nitrous oxide sedation, in such manner as to adversely affect the person's ability to practice dentistry, dental hygiene or as a registered dental assistant;
    6. (6) Conviction of a felony, conviction of any offense under state or federal drug laws, or conviction of any offense involving moral turpitude. However, an action taken under this subdivision (a)(6) shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title;
    7. (7) Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
    8. (8) Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice, or not in good faith to relieve pain and suffering or not to cure an ailment, physical infirmity or disease;
    9. (9) Engaging in the practice of dentistry, dental hygiene or as a registered dental assistant when mentally or physically unable to safely do so;
    10. (10) Solicitation by agents or persons of professional patronage or profiting by the acts of those representing themselves to be agents of the licensee or the certificate holder;
    11. (11) Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    12. (12) Conducting the practice of dentistry so as to permit directly or indirectly an unlicensed person to perform services or work that under this chapter can be done legally only by persons licensed to practice dentistry or dental hygiene or as a registered dental assistant;
    13. (13) Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this chapter, or lending one's name to another for the illegal practice of dentistry by such person;
    14. (14) Claiming to the public to be a specialist in some particular branch of dentistry without being certified by the board as such;
    15. (15) Payment or acceptance of commissions in any form or manner on fees for professional services, references, consultations, pathological reports, radiographs, prescriptions or on other services or articles supplied to patients;
    16. (16) Having work done by or obtaining work from a dental laboratory without issuing a written work order as provided in § 63-5-108;
    17. (17) Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, vaccines, mouth washes, dentifrices or other articles or materials that are offered to the public, claiming radical cure or prevention of diseases by their use;
    18. (18) Any other unprofessional or unethical conduct that may be specified by the board by the means of rules and regulations duly published and promulgated by the board or the violation of any provision of this chapter;
    19. (19)
      1. (A) A dentist shall not, on behalf of that dentist, that dentist's partner or associate or any other dentist affiliated with that dentist or that dentist's facility, use or participate in the use of any form of public communication containing a false, fraudulent, misleading or deceptive statement or claim;
      2. (B) Moreover, the fact of promulgation of any forms of public communication covered or prohibited in this section or the rules and regulations promulgated hereunder shall be prima facie evidence that the dentist named either used or permitted the use of the public communication;
      3. (C) A licensed dentist is authorized to use personal professional cards, appointment cards, announcements and related materials and appropriate signs and listings indicating the dentist's office and specialty in accordance with rules and regulations promulgated by the board;
    20. (20) Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or other drug to any person in violation of any law of the state or of the United States; or
    21. (21) Disciplinary action against a person licensed to practice dentistry or dental hygiene or registered to practice as a dental assistant by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed or registered in this state. A certified copy of the initial or final order, or other equivalent document memorializing the disciplinary action from the disciplining state or territory, shall constitute prima facie evidence of a violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure/registration or renewal and/or discipline a person licensed in this state.
  2. (b)
    1. (1) In enforcing this section, the board shall, upon probable cause, have the authority to compel an applicant or license or certificate holder to submit to a mental and/or physical examination, by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition is involved. The applicant or license or certificate holder may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board for use in any hearing that may thereafter ensue.
    2. (2) The board may, upon finding of probable cause, require a dentist, dental hygienist or dental assistant to complete drug and/or alcohol treatment through a program designated by, or contracting with, the board. The board in its discretion is authorized to share information, interviews, reports, statements, memoranda or other data at the program director's request. Information shared between the board and the program director shall be deemed not to violate laws requiring confidentiality of investigations or peer review records protected under § 63-5-131.
  3. (c) The board, on its own motion, may investigate any report indicating that a dentist, dental hygienist or dental assistant is or may be in violation of this chapter. Any dentist, dental hygienist, dental assistant, dental or dental related society or association, or any other person who in good faith reports to the board any information that a dentist, dental hygienist or dental assistant is or may be in violation of any provisions of this chapter, is not subject to suit for civil damages as a result thereof.
  4. (d) In assessing a civil penalty pursuant to this chapter, the board should consider the following:
    1. (1) The harm or potential harm of the violation to the public health and welfare;
    2. (2) The extent to which the public was exposed to such harm or potential harm;
    3. (3) The rate, duration and severity of the violations;
    4. (4) The value of the penalty as a deterrent to future violations;
    5. (5) Attempts by the violator to mitigate the harm to the public; and
    6. (6) Such other specific criteria as the board may wish to establish by duly promulgated regulation.
  5. (e) The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case, including investigatory costs, against the licensee or person.
  6. (f)
    1. (1) Any elected officer of the board or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
    2. (2) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
    3. (3)
      1. (A) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled is required to quash or modify a subpoena.
      2. (B) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
    4. (4) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
    5. (5) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
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§ 63-5-125. Administrative procedures.
  1. All proceedings for disciplinary action against a licensee or certificate holder under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-5-126. Enjoining unlawful practice.
  1. (a) The board, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license and in the matter of the refusal to issue a certificate, is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice dentistry or dental hygiene without possessing a valid license to so practice and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of dentistry or dental hygiene as defined in § 63-5-108. No injunction bond shall be required of the board.
  2. (b) Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
§ 63-5-127. District attorneys general to assist board.
  1. The board at all times has the power to call upon the district attorneys general for the state in the various districts to assist the board. It is the duty of all district attorneys general throughout the state to assist the board, upon its request, in any suit for injunction or prosecution instituted by the board without charge or additional compensation to the district attorneys general.
§ 63-5-128. Criminal penalties.
  1. (a) Any person who violates any provision of § 63-5-107(a) commits a Class B misdemeanor.
  2. (b) After being convicted of any violation of § 63-5-107(a), any person who again violates § 63-5-107(a) commits a Class E felony.
  3. (c) Any person who has been enjoined by a court of competent jurisdiction from performing any acts or rendering any services that constitute the practice of dentistry as defined in § 63-5-108, who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services, commits a Class E felony.
§ 63-5-129. Retirement.
  1. Any person licensed to practice dentistry or dental hygiene in this state who has retired or may hereafter retire from such practice in this state is not required to register as required by this chapter; provided, that such person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and other such facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in the practice of dentistry or dental hygiene in this state, such person shall apply for registration with the board as provided by this chapter.
§ 63-5-130. Armed forces or public health service.
  1. Any person licensed to practice dentistry or dental hygiene in this state who is an officer in the commissioned dental corps of the army, navy, air force or the public health service of the United States shall not be required to register as required in this chapter. Such person shall file with the board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person entered the army, navy, air force or the public health service of the United States and such other facts as tend to verify such service as the board shall deem necessary. When such person resigns or is honorably discharged from one (1) of the aforementioned services and engages in the practice of dentistry or dental hygiene in this state or any other state, such person shall, within thirty (30) days, apply for registration with the board as provided for in this chapter.
§ 63-5-131. Immunity of peer review committee from liability — Confidentiality.
  1. (a) As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide dental association or local dental society for the purpose of receiving and evaluating dental acts of other dentists or dental auxiliary personnel or their personal conduct as it relates to the performance of their professional duties.
  2. (b) Any dentist who serves on any peer review committee or on any other committee is immune from liability with respect to any action taken by the dentist in good faith and without malice as a member of such committee, board, commission or other entity.
  3. (c) Dentists, dental hygienists and registered dental assistants, members of boards of directors or trustees of any publicly supported or privately supported hospital or other such provider of health care, or any other individual appointed to any committee, as such term is described in subsection (a), are immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees undertaken or performed within the scope or functions of the duties of such committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
  4. (d) All information, interviews, reports, statements, memoranda or other data furnished to any such peer review committee or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee or other entity are privileged. The records and proceedings of any such committee or other entity are confidential and shall be used by such committee or other entity and the members thereof only in the exercise of the proper functions of the committee or other entity and shall not become public record nor be available for court subpoena or discovery proceedings. Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources, such records, documents or information not to be construed as immune from discovery or use in any civil proceeding solely due to presentation to the committee.
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§ 63-5-132. Inactive licenses to perform pro bono services.
  1. The board of dentistry shall establish by rule an inactive license category that allows dentists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code. Such inactive license category shall not authorize any other practice of dentistry.
§ 63-5-133. Dental referral service.
  1. (a) A dental referral service shall not participate in the advertising of, or operate, a dental referral service unless it meets all of the following requirements:
    1. (1) Its patient referrals result from patient-initiated responses to the dental referral service's advertising;
    2. (2) It discloses to any prospective patient in its advertising that participating dentists have paid a fee for participation in the service;
    3. (3) It does not impose a fee on participating dentists dependent on the number of referrals or amount of professional fees paid by the patient to the dentist; and
    4. (4) It duly registers with the board, providing all information reasonably required by the board.
  2. (b) Participating dentists shall not enter into an agreement to accept for dental care or treatment a person referred or recommended by a dental referral service unless the dental referral service meets all the requirements of subsection (a). Participating dentists shall charge no more than their usual and customary fees to any patient so referred or recommended.
  3. (c)
    1. (1) “Dental referral service” is a person, firm, partnership, association, corporation, agent or employee of any of the foregoing that engages in any business or service for profit that in whole or in part includes the referral or recommendation of persons to a dentist for any form of dental care or treatment.
    2. (2) “Participating dentist” is a dentist duly licensed under this chapter who has paid a fee to a dental referral service in order to be included in its referral service.
  4. (d) A dental referral service that advertises shall include in each advertisement legible or audible language, or both, a disclaimer containing all the following statements or information:
    1. (1) The advertisement is paid for by participating dentists who have paid a fee to participate; and
    2. (2) No representation is made about the quality of the dental services to be performed or expertise of the participating dentists, and that participating dentists are not more or less qualified than dentists who are not participating in the service.
  5. (e) Dental referral service advertisements shall not do any of the following:
    1. (1) Advertise or solicit patients in a manner that contains a false, fraudulent, misleading or deceptive statement in any material respect;
    2. (2) Publish or circulate, directly or indirectly, any false, fraudulent, misleading or deceptive statement as to the skill or methods of practice of any participating dentist;
    3. (3) Contain a statement or make a recommendation that the dental referral service provides referrals to the most qualified dentists or dental practice; or
    4. (4) Advertise a review process or a screening that misleads the public into thinking a participating dentist has obtained special recognition or joined a selective group of licensed dentists by being a participating dentist in the dental referral service.
§ 63-5-134. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A dentist or a dental hygienist licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of dentistry may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
Part 2 Dentist and Dental Hygienist Compact [Enactment contingent upon adoption; see the Compiler's Notes.]
§ 63-5-201. Short title. [Enactment contingent upon adoption; see the Compiler's Notes.]
  1. This part is known and may be cited as the “Dentist and Dental Hygienist Compact.”
§ 63-5-202. Text of compact. [Enactment contingent upon adoption; see the Compiler's Notes.]
  1. The Dentist and Dental Hygienist Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:
    1. Dentist and Dental Hygienist Compact
      1. Section 1. Title and Purpose.
        1. This statute shall be known and cited as the Dentist and Dental Hygienist Compact. The purposes of this Compact are to facilitate the interstate practice of dentistry and dental hygiene and improve public access to dentistry and dental hygiene services by providing Dentists and Dental Hygienists licensed in a Participating State the ability to practice in Participating States in which they are not licensed. The Compact does this by establishing a pathway for Dentists and Dental Hygienists licensed in a Participating State to obtain a Compact Privilege that authorizes them to practice in another Participating State in which they are not licensed. The Compact enables Participating States to protect the public health and safety with respect to the practice of such Dentists and Dental Hygienists, through the State's authority to regulate the practice of dentistry and dental hygiene in the State. The Compact:
          1. A. Enables Dentists and Dental Hygienists who qualify for a Compact Privilege to practice in other Participating States without satisfying burdensome and duplicative requirements associated with securing a License to practice in those States;
          2. B. Promotes mobility and addresses workforce shortages through each Participating State's acceptance of a Compact Privilege to practice in that State;
          3. C. Increases public access to qualified, licensed Dentists and Dental Hygienists by creating a responsible, streamlined pathway for Licensees to practice in Participating States;
          4. D. Enhances the ability of Participating States to protect the public's health and safety;
          5. E. Does not interfere with licensure requirements established by a Participating State;
          6. F. Facilitates the sharing of licensure and disciplinary information among Participating States;
          7. G. Requires Dentists and Dental Hygienists who practice in a Participating State pursuant to a Compact Privilege to practice within the Scope of Practice authorized in that State;
          8. H. Extends the authority of a Participating State to regulate the practice of dentistry and dental hygiene within its borders to Dentists and Dental Hygienists who practice in the State through a Compact Privilege;
          9. I. Promotes the cooperation of Participating States in regulating the practice of dentistry and dental hygiene within those States; and
          10. J. Facilitates the relocation of military members and their spouses who are licensed to practice dentistry or dental hygiene.
      2. Section 2. Definitions.
        1. As used in this Compact, unless the context requires otherwise, the following definitions shall apply:
          1. A. “Active Military Member” means any individual in full-time duty status in the armed forces of the United States, including members of the National Guard and Reserve.
          2. B. “Adverse Action” means disciplinary action or encumbrance imposed on a License or Compact Privilege by a State Licensing Authority.
          3. C. “Alternative Program” means a non-disciplinary monitoring or practice remediation process applicable to a Dentist or Dental Hygienist approved by a State Licensing Authority of a Participating State in which the Dentist or Dental Hygienist is licensed. This includes, but is not limited to, programs to which Licensees with substance abuse or addiction issues are referred in lieu of Adverse Action.
          4. D. “Clinical Assessment” means examination or process, required for licensure as a Dentist or Dental Hygienist as applicable, that provides evidence of clinical competence in dentistry or dental hygiene.
          5. E. “Commissioner” means the individual appointed by a Participating State to serve as the member of the Commission for that Participating State.
          6. F. “Compact” means this Dentist and Dental Hygienist Compact.
          7. G. “Compact Privilege” means the authorization granted by a Remote State to allow a Licensee from a Participating State to practice as a Dentist or Dental Hygienist in a Remote State.
          8. H. “Continuing Professional Development” means a requirement, as a condition of License renewal, to provide evidence of successful participation in educational or professional activities relevant to practice or area of work.
          9. I. “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 C.F.R. § 20.3(d) from the Federal Bureau of Investigation and the State's criminal history record repository as defined in 28 C.F.R. § 20.3(f).
          10. J. “Data System” means the Commission's repository of information about Licensees, including, but not limited to, examination, licensure, investigative, Compact Privilege, Adverse Action, and Alternative Program.
          11. K. “Dental Hygienist” means an individual who is licensed by a State Licensing Authority to practice dental hygiene.
          12. L. “Dentist” means an individual who is licensed by a State Licensing Authority to practice dentistry.
          13. M. “Dentist and Dental Hygienist Compact Commission” or “Commission” means a joint government agency established by this Compact comprised of each State that has enacted the Compact and a national administrative body comprised of a Commissioner from each State that has enacted the Compact.
          14. N. “Encumbered License” means a License that a State Licensing Authority has limited in any way other than through an Alternative Program.
          15. O. “Executive Board” means the Chair, Vice Chair, Secretary, and Treasurer and any other Commissioners as may be determined by Commission Rule or bylaw.
          16. P. “Jurisprudence Requirement” means the assessment of an individual's knowledge of the laws and Rules governing the practice of dentistry or dental hygiene, as applicable, in a State.
          17. Q. “License” means current authorization by a State, other than authorization pursuant to a Compact Privilege, or other privilege, for an individual to practice as a Dentist or Dental Hygienist in that State.
          18. R. “Licensee” means an individual who holds an unrestricted License from a Participating State to practice as a Dentist or Dental Hygienist in that State.
          19. S. “Model Compact” means the model for the Dentist and Dental Hygienist Compact on file with the Council of State Governments or other entity as designated by the Commission.
          20. T. “Participating State” means a State that has enacted the Compact and been admitted to the Commission in accordance with the provisions herein and Commission Rules.
          21. U. “Qualifying License” means a License that is not an Encumbered License issued by a Participating State to practice dentistry or dental hygiene.
          22. V. “Remote State” means a Participating State where a Licensee who is not licensed as a Dentist or Dental Hygienist is exercising or seeking to exercise the Compact Privilege.
          23. W. “Rule” means a regulation promulgated by an entity that has the force of law.
          24. X. “Scope of Practice” means the procedures, actions, and processes a Dentist or Dental Hygienist licensed in a State is permitted to undertake in that State and the circumstances under which the Licensee 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 Licensing Authority or other government agency.
          25. Y. “Significant Investigative Information” means information, records, and documents received or generated by a State Licensing Authority pursuant to an investigation, that includes notification and an opportunity to respond if required by state law, 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 Licensing Authority could pursue Adverse Action against the Licensee.
          26. Z. “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practices of dentistry and dental hygiene.
          27. AA. “State Licensing Authority” means an agency or other entity of a State that is responsible for the licensing and regulation of Dentists or Dental Hygienists.
      3. Section 3. State Participation in the Compact.
        1. A. In order to join the Compact and thereafter continue as a Participating State, a State must:
          1. 1. Enact a compact that is not materially different from the Model Compact as determined in accordance with Commission Rules;
          2. 2. Participate fully in the Commission's Data System;
          3. 3. Have a mechanism in place for receiving and investigating complaints about its Licensees and License applicants;
          4. 4. Notify the Commission, in compliance with the terms of the Compact and Commission Rules, of any Adverse Action or the availability of Significant Investigative Information regarding a Licensee and License applicant;
          5. 5. Fully implement a Criminal Background Check requirement, within a time frame established by Commission Rule, by receiving the results of a qualifying Criminal Background Check;
          6. 6. Comply with the Commission Rules applicable to a Participating State;
          7. 7. Accept the National Board Examinations of the Joint Commission on National Dental Examinations or another examination accepted by Commission Rule as a licensure examination;
          8. 8. Accept for licensure that applicants for a Dentist License graduate from a predoctoral dental education program accredited by the Commission on Dental Accreditation, or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs, leading to the Doctor of Dental Surgery (D.D.S.) or Doctor of Dental Medicine (D.M.D.) degree;
          9. 9. Accept for licensure that applicants for a Dental Hygienist License graduate from a dental hygiene education program accredited by the Commission on Dental Accreditation or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs;
          10. 10. Require for licensure that applicants successfully complete a Clinical Assessment;
          11. 11. Have Continuing Professional Development requirements as a condition for License renewal; and
          12. 12. Pay a participation fee to the Commission as established by Commission Rule.
        2. B. Providing alternative pathways for an individual to obtain an unrestricted License does not disqualify a State from participating in the Compact.
        3. C. When conducting a Criminal Background Check, the State Licensing Authority shall:
          1. 1. Consider that information in making a licensure decision;
          2. 2. Maintain documentation of completion of the Criminal Background Check and background check information to the extent allowed by State and federal law; and
          3. 3. Report to the Commission whether it has completed the Criminal Background Check and whether the individual was granted or denied a License.
        4. D. A Licensee of a Participating State who has a Qualifying License in that State and does not hold an Encumbered License in any other Participating State, shall be issued a Compact Privilege in a Remote State in accordance with the terms of the Compact and Commission Rules. If a Remote State has a Jurisprudence Requirement, a Compact Privilege will not be issued to the Licensee unless the Licensee has satisfied the Jurisprudence Requirement.
      4. Section 4. Compact Privilege.
        1. A. To obtain and exercise the Compact Privilege under the terms and provisions of the Compact, the Licensee shall:
          1. 1. Have a Qualifying License as a Dentist or Dental Hygienist in a Participating State;
          2. 2. Be eligible for a Compact Privilege in any Remote State in accordance with D, G, and H of this section;
          3. 3. Submit to an application process whenever the Licensee is seeking a Compact Privilege;
          4. 4. Pay any applicable Commission and Remote State fees for a Compact Privilege in the Remote State;
          5. 5. Meet any Jurisprudence Requirement established by a Remote State in which the Licensee is seeking a Compact Privilege;
          6. 6. Have passed a National Board Examination of the Joint Commission on National Dental Examinations or another examination accepted by Commission Rule;
          7. 7. For a Dentist, have graduated from a predoctoral dental education program accredited by the Commission on Dental Accreditation, or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs, leading to the Doctor of Dental Surgery (D.D.S.) or Doctor of Dental Medicine (D.M.D.) degree;
          8. 8. For a Dental Hygienist, have graduated from a dental hygiene education program accredited by the Commission on Dental Accreditation or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs;
          9. 9. Have successfully completed a Clinical Assessment for licensure;
          10. 10. Report to the Commission Adverse Action taken by any non-Participating State when applying for a Compact Privilege and, otherwise, within thirty (30) days from the date the Adverse Action is taken;
          11. 11. Report to the Commission when applying for a Compact Privilege the address of the Licensee's primary residence and thereafter immediately report to the Commission any change in the address of the Licensee's primary residence; and
          12. 12. Consent to accept service of process by mail at the Licensee's primary residence on record with the Commission with respect to any action brought against the Licensee by the Commission or a Participating State, and consent to accept service of a subpoena by mail at the Licensee's primary residence on record with the Commission with respect to any action brought or investigation conducted by the Commission or a Participating State.
        2. B. The Licensee must comply with the requirements of subsection A of this section to maintain the Compact Privilege in the Remote State. If those requirements are met, the Compact Privilege will continue as long as the Licensee maintains a Qualifying License in the State through which the Licensee applied for the Compact Privilege and pays any applicable Compact Privilege renewal fees.
        3. C. A Licensee providing dentistry or dental hygiene in a Remote State under the Compact Privilege shall function within the Scope of Practice authorized by the Remote State for a Dentist or Dental Hygienist licensed in that State.
        4. D. A Licensee providing dentistry or dental hygiene pursuant to a Compact Privilege 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, by Adverse Action revoke or remove a Licensee's Compact Privilege in the Remote State for a specific period of time and impose fines or take any other necessary actions to protect the health and safety of its citizens. If a Remote State imposes an Adverse Action against a Compact Privilege that limits the Compact Privilege, that Adverse Action applies to all Compact Privileges in all Remote States. A Licensee whose Compact Privilege in a Remote State is removed for a specified period of time is not eligible for a Compact Privilege in any other Remote State until the specific time for removal of the Compact Privilege has passed and all encumbrance requirements are satisfied.
        5. E. If a License in a Participating State is an Encumbered License, the Licensee shall lose the Compact Privilege in a Remote State and shall not be eligible for a Compact Privilege in any Remote State until the License is no longer encumbered.
        6. F. Once an Encumbered License in a Participating State is restored to good standing, the Licensee must meet the requirements of subsection A of this section to obtain a Compact Privilege in a Remote State.
        7. G. 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 any Remote State until the following occur:
          1. 1. The specific period of time for which the Compact Privilege was removed has ended; and
          2. 2. All conditions for removal of the Compact Privilege have been satisfied.
        8. H. Once the requirements of subsection G of this section have been met, the Licensee must meet the requirements in subsection A of this section to obtain a Compact Privilege in a Remote State.
      5. Section 5. Active Military Member or Their Spouses.
        1. An Active Military Member and their spouse shall not be required to pay to the Commission for a Compact Privilege the fee otherwise 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. Section 6. Adverse Actions.
        1. A. A Participating State in which a Licensee is licensed shall have exclusive authority to impose Adverse Action against the Qualifying License issued by that Participating State.
        2. B. A Participating State may take Adverse Action based on the Significant Investigative Information of a Remote State, so long as the Participating State follows its own procedures for imposing Adverse Action.
        3. C. Nothing in this Compact shall override a Participating State's decision that participation in an Alternative Program may be used in lieu of Adverse Action and that such participation shall remain non-public if required by the Participating State's laws. Participating States must require Licensees who enter any Alternative Program in lieu of discipline to agree not to practice pursuant to a Compact Privilege in any other Participating State during the term of the Alternative Program without prior authorization from such other Participating State.
        4. D. Any Participating State in which a Licensee is applying to practice or is practicing pursuant to a Compact Privilege may investigate actual or alleged violations of the statutes and regulations authorizing the practice of dentistry or dental hygiene in any other Participating State in which the Dentist or Dental Hygienist holds a License or Compact Privilege.
        5. E. A Remote State shall have the authority to:
          1. 1. Take Adverse Actions as set forth in Section 4.D against a Licensee's Compact Privilege in the State;
          2. 2. In furtherance of its rights and responsibilities under the Compact and the Commission's Rules, issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence. Subpoenas issued by a State Licensing Authority 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 where the witnesses or evidence are located; and
          3. 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.
        6. F. Joint Investigations
          1. 1. In addition to the authority granted to a Participating State by its Dentist or Dental Hygienist licensure act or other applicable State law, a Participating State may jointly investigate Licensees with other Participating States.
          2. 2. Participating States shall share any Significant Investigative Information, litigation, or compliance materials in furtherance of any joint investigation initiated under the Compact.
        7. G. Authority to Continue Investigation
          1. 1. After a Licensee's Compact Privilege in a Remote State is terminated, the Remote State may continue an investigation of the Licensee that began when the Licensee had a Compact Privilege in that Remote State.
          2. 2. If the investigation yields what would be Significant Investigative Information had the Licensee continued to have a Compact Privilege in that Remote State, the Remote State shall report the presence of such information to the Data System as required by Section 8.B.6 as if it was Significant Investigative Information.
      7. Section 7. Establishment and Operation of the Commission.
        1. A. The Compact Participating States hereby create and establish a joint government agency whose membership consists of all Participating States that have enacted the Compact. The Commission is an instrumentality of the Participating States acting jointly and not an instrumentality of any one (1) State. The Commission shall come into existence on or after the effective date of the Compact as set forth in Section 11A.
        2. B. Participation, Voting, and Meetings
          1. 1. Each Participating State shall have and be limited to one (1) Commissioner selected by that Participating State's State Licensing Authority or, if the State has more than one (1) State Licensing Authority, selected collectively by the State Licensing Authorities.
          2. 2. The Commissioner shall be a member or designee of such Authority or Authorities.
          3. 3. The Commission may by Rule or bylaw establish a term of office for Commissioners and may by Rule or bylaw establish term limits.
          4. 4. The Commission may recommend to a State Licensing Authority or Authorities, as applicable, removal or suspension of an individual as the State's Commissioner.
          5. 5. A Participating State's State Licensing Authority, or Authorities, as applicable, shall fill any vacancy of its Commissioner on the Commission within sixty (60) days of the vacancy.
          6. 6. Each Commissioner shall be entitled to one (1) vote on all matters that are voted upon by the Commission.
          7. 7. The Commission shall meet at least once during each calendar year. Additional meetings may be held as set forth in the bylaws. The Commission may meet by telecommunication, video conference, or other similar electronic means.
        3. C. The Commission shall have the following powers:
          1. 1. Establish the fiscal year of the Commission;
          2. 2. Establish a code of conduct and conflict of interest policies;
          3. 3. Adopt Rules and bylaws;
          4. 4. Maintain its financial records in accordance with the bylaws;
          5. 5. Meet and take such actions as are consistent with the provisions of this Compact, the Commission's Rules, and the bylaws;
          6. 6. Initiate and conclude legal proceedings or actions in the name of the Commission; provided, that the standing of any State Licensing Authority to sue or be sued under applicable law shall not be affected;
          7. 7. Maintain and certify records and information provided to a Participating State as the authenticated business records of the Commission, and designate a person to do so on the Commission's behalf;
          8. 8. Purchase and maintain insurance and bonds;
          9. 9. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a Participating State;
          10. 10. Conduct an annual financial review;
          11. 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. 12. As set forth in the Commission Rules, charge a fee to a Licensee for the grant of a Compact Privilege in a Remote State and thereafter, as may be established by Commission Rule, charge the Licensee a Compact Privilege renewal fee for each renewal period in which that Licensee exercises or intends to exercise the Compact Privilege in that Remote State. Nothing herein shall be construed to prevent a Remote State from charging a Licensee a fee for a Compact Privilege or renewals of a Compact Privilege, or a fee for the Jurisprudence Requirement if the Remote State imposes such a requirement for the grant of a Compact Privilege;
          13. 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 the Commission shall avoid any appearance of impropriety and/or conflict of interest;
          14. 14. Lease, purchase, retain, own, hold, improve, or use any property, real, personal, or mixed, or any undivided interest therein;
          15. 15. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;
          16. 16. Establish a budget and make expenditures;
          17. 17. Borrow money;
          18. 18. Appoint committees, including standing committees, which may be 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;
          19. 19. Provide and receive information from, and cooperate with, law enforcement agencies;
          20. 20. Elect a Chair, Vice Chair, Secretary, and Treasurer and such other officers of the Commission as provided in the Commission's bylaws;
          21. 21. Establish and elect an Executive Board;
          22. 22. Adopt and provide to the Participating States an annual report;
          23. 23. Determine whether a State's enacted compact is materially different from the Model Compact language such that the State would not qualify for participation in the Compact; and
          24. 24. Perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact.
        4. D. Meetings of the Commission
          1. 1. All meetings of the Commission that are not closed pursuant to this subsection 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. 2. Notwithstanding subsection D.1 of this section, the Commission may convene an emergency 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 Section 9.L. The Commission's legal counsel shall certify that one of the reasons justifying an emergency public meeting has been met.
          3. 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 through such means.
          4. 4. The Commission may convene in a closed, non-public meeting for the Commission to receive legal advice or to discuss:
            1. a. Non-compliance of a Participating State with its obligations under the Compact;
            2. 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;
            3. c. Current or threatened discipline of a Licensee or Compact Privilege holder by the Commission or by a Participating State's Licensing Authority;
            4. d. Current, threatened, or reasonably anticipated litigation;
            5. e. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
            6. f. Accusing any person of a crime or formally censuring any person;
            7. g. Trade secrets or commercial or financial information that is privileged or confidential;
            8. h. Information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
            9. i. Investigative records compiled for law enforcement purposes;
            10. 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;
            11. k. Legal advice;
            12. l. Matters specifically exempted from disclosure to the public by federal or Participating State law; and
            13. m. Other matters as promulgated by the Commission by Rule.
          5. 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. 6. 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 only by a majority vote of the Commission or order of a court of competent jurisdiction.
        5. E. Financing of the Commission
          1. 1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
          2. 2. The Commission may accept any and all appropriate sources of revenue, donations, and grants of money, equipment, supplies, materials, and services.
          3. 3. The Commission may levy on and collect an annual assessment from each Participating State and impose fees on Licensees of Participating States when 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 each fiscal year for which sufficient revenue is not provided by other sources. The aggregate annual assessment amount for Participating States shall be allocated based upon a formula that the Commission shall promulgate by Rule.
          4. 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 Participating State, except by and with the authority of the Participating State.
          5. 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.
        6. F. The Executive Board
          1. 1. The Executive Board 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 Board shall include:
            1. a. Overseeing the day-to-day activities of the administration of the Compact, including compliance with the provisions of the Compact, the Commission's Rules, and bylaws;
            2. b. Recommending to the Commission changes to the Rules or bylaws, changes to this Compact legislation, fees charged to Compact Participating States, fees charged to Licensees, and other fees;
            3. c. Ensuring Compact administration services are appropriately provided, including by contract;
            4. d. Preparing and recommending the budget;
            5. e. Maintaining financial records on behalf of the Commission;
            6. f. Monitoring Compact compliance of Participating States and providing compliance reports to the Commission;
            7. g. Establishing additional committees as necessary;
            8. 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
            9. i. Other duties as provided in the Rules or bylaws of the Commission.
          2. 2. The Executive Board shall be composed of up to seven (7) members:
            1. a. The Chair, Vice Chair, Secretary, and Treasurer of the Commission and any other members of the Commission who serve on the Executive Board shall be voting members of the Executive Board; and
            2. b. Other than the Chair, Vice Chair, Secretary, and Treasurer, the Commission may elect up to three (3) voting members from the current membership of the Commission.
          3. 3. The Commission may remove any member of the Executive Board as provided in the Commission's bylaws.
          4. 4. The Executive Board shall meet at least annually.
            1. a. An Executive Board meeting at which it takes or intends to take formal action on a matter shall be open to the public, except that the Executive Board may meet in a closed, non-public session of a public meeting when dealing with any of the matters covered under subsection D.4.
            2. b. The Executive Board shall give five (5) business days' notice of its public meetings, posted on its website and as it may otherwise determine to provide notice to persons with an interest in the public matters the Executive Board intends to address at those meetings.
          5. 5. The Executive Board may hold an emergency meeting when acting for the Commission to:
            1. a. Meet an imminent threat to public health, safety, or welfare;
            2. b. Prevent a loss of Commission or Participating State funds; or
            3. c. Protect public health and safety.
        7. G. Qualified Immunity, Defense, and Indemnification
          1. 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 paragraph 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. 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. 3. Notwithstanding subsection G.1 of this section, should any member, officer, executive director, employee, or representative of the Commission be held liable for the amount of any settlement or judgment arising out of any actual or alleged act, error, or omission that occurred within the scope of that individual's employment, duties, or responsibilities for the Commission, or that the person to whom that individual is liable had a reasonable basis for believing occurred within the scope of the individual's employment, duties, or responsibilities for the Commission, the Commission shall indemnify and hold harmless such individual; provided, that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of the individual.
          4. 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. 5. 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.
          6. 6. Nothing in this Compact shall be construed to be a waiver of sovereign immunity by the Participating States or by the Commission.
      8. Section 8. Data System.
        1. A. The Commission shall provide for the development, maintenance, operation, and utilization of a coordinated database and reporting system containing licensure, Adverse Action, and the presence of Significant Investigative Information on all Licensees and applicants for a License in Participating States.
        2. B. Notwithstanding any other provision of State law to the contrary, a Participating 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:
          1. 1. Identifying information;
          2. 2. Licensure data;
          3. 3. Adverse Actions against a Licensee, License applicant, or Compact Privilege and information related thereto;
          4. 4. Non-confidential information related to Alternative Program participation, the beginning and ending dates of such participation, and other information related to such participation;
          5. 5. Any denial of an application for licensure, and the reason(s) for such denial (excluding the reporting of any criminal history record information where prohibited by law);
          6. 6. The presence of Significant Investigative Information; and
          7. 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.
        3. C. 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.
        4. D. Significant Investigative Information pertaining to a Licensee in any Participating State will only be available to other Participating States.
        5. E. It is the responsibility of the Participating States to monitor the database to determine whether Adverse Action has been taken against a Licensee or License applicant. Adverse Action information pertaining to a Licensee or License applicant in any Participating State will be available to any other Participating State.
        6. F. Participating 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.
        7. G. 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.
      9. Section 9. Rulemaking.
        1. A. The Commission shall promulgate reasonable Rules in order to effectively and efficiently implement and administer the purposes and provisions of the Compact. A Commission 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 rulemaking 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.
        2. B. 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 Participating State's Scope of Practice 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.
        3. C. The Commission shall exercise its Rulemaking powers pursuant to the criteria set forth in this section and the Rules adopted thereunder. Rules shall become binding as of the date specified by the Commission for each Rule.
        4. D. If a majority of the legislatures of the Participating States rejects a Commission Rule or portion of a Commission Rule, by enactment of a statute or resolution in the same manner used to adopt the 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.
        5. E. Rules shall be adopted at a regular or special meeting of the Commission.
        6. 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.
        7. G. Prior to adoption of a proposed Rule by the Commission, and at least thirty (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 Rulemaking:
          1. 1. On the website of the Commission or other publicly accessible platform;
          2. 2. To persons who have requested notice of the Commission's notices of proposed rulemaking; and
          3. 3. In such other way(s) as the Commission may by Rule specify.
        8. H. The Notice of Proposed Rulemaking shall include:
          1. 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. 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 Rulemaking;
          3. 3. The text of the proposed Rule and the reason therefor;
          4. 4. A request for comments on the proposed Rule from any interested person; and
          5. 5. The manner in which interested persons may submit written comments.
        9. 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.
        10. J. Nothing in this section shall be construed as requiring a separate hearing on each Commission Rule. Rules may be grouped for the convenience of the Commission at hearings required by this section.
        11. K. The Commission shall, by majority vote of all Commissioners, take final action on the proposed Rule based on the rulemaking record.
          1. 1. The Commission may adopt changes to the proposed Rule, provided the changes do not enlarge the original purpose of the proposed Rule.
          2. 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. 3. The Commission shall determine a reasonable effective date for the Rule. Except for an emergency as provided in subsection L, the effective date of the Rule shall be no sooner than thirty (30) days after the Commission issuing the notice that it adopted or amended the Rule.
        12. L. Upon determination that an emergency exists, the Commission may consider and adopt an emergency Rule with twenty-four (24) hours' notice, with opportunity to comment; provided, that the usual rulemaking 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 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 in order to:
          1. 1. Meet an imminent threat to public health, safety, or welfare;
          2. 2. Prevent a loss of Commission or Participating State funds;
          3. 3. Meet a deadline for the promulgation of a Rule that is established by federal law or rule; or
          4. 4. Protect public health and safety.
        13. 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 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 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.
        14. N. No Participating State's rulemaking requirements shall apply under this Compact.
      10. Section 10. Oversight, Dispute Resolution, and Enforcement.
        1. A. Oversight
          1. 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. 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. 3. The Commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the Compact or Commission Rule 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.
        2. B. Default, Technical Assistance, and Termination
          1. 1. If the Commission determines that a Participating 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. 2. The Commission shall provide a copy of the notice of default to the other Participating States.
        3. 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, 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.
        4. D. Termination of participation 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, the defaulting State's State Licensing Authority or Authorities, as applicable, and each of the Participating States' State Licensing Authority or Authorities, as applicable.
        5. 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.
        6. F. Upon the termination of a State's participation in this Compact, that State shall immediately provide notice to all Licensees of the State, including Licensees of other Participating States issued a Compact Privilege to practice within that State, of such termination. The terminated State shall continue to recognize all Compact Privileges then in effect in that State for a minimum of one hundred eighty (180) days after the date of said notice of termination.
        7. 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.
        8. 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.
        9. I. Dispute Resolution
          1. 1. Upon request by a Participating State, the Commission shall attempt to resolve disputes related to the Compact that arise among Participating States and between Participating States and non-Participating States.
          2. 2. The Commission shall promulgate a Rule providing for both mediation and binding dispute resolution for disputes as appropriate.
        10. J. Enforcement
          1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions of this Compact and the Commission's Rules.
          2. 2. By majority vote, the Commission may initiate legal action against a Participating State in default in the United States 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. 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 Participating State's law.
          3. 3. 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 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.
          4. 4. No individual or entity other than a Participating State may enforce this Compact against the Commission.
      11. Section 11. Effective Date, Withdrawal, and Amendment.
        1. A. The Compact shall come into effect on the date on which the Compact statute is enacted into law in the seventh Participating State.
          1. 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.
            1. 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 Section 10.
            2. b. If any Participating 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 Participating States should be less than seven (7).
          2. 2. Participating States enacting the Compact subsequent to the Charter Participating States shall be subject to the process set forth in Section 7.C.23 to determine if their enactments are materially different from the Model Compact and whether they qualify for participation in the Compact.
          3. 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.
          4. 4. Any State that joins the Compact subsequent to the Commission's initial adoption of the Rules and bylaws shall be subject to the Commission's 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 day the Compact becomes law in that State.
        2. B. Any Participating State may withdraw from this Compact by enacting a statute repealing that State's enactment of the Compact.
          1. 1. A Participating State's withdrawal shall not take effect until one hundred eighty (180) days after enactment of the repealing statute.
          2. 2. Withdrawal shall not affect the continuing requirement of the withdrawing State's Licensing Authority or Authorities to comply with the investigative and Adverse Action reporting requirements of this Compact prior to the effective date of withdrawal.
          3. 3. Upon the enactment of a statute withdrawing from this Compact, the 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 to practice within that State granted pursuant to this Compact for a minimum of one hundred eighty (180) days after the date of such notice of withdrawal.
        3. C. Nothing contained in this Compact shall be construed to invalidate or prevent any licensure agreement or other cooperative arrangement between a Participating State and a non-Participating State that does not conflict with the provisions of this Compact.
        4. D. 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 into the laws of all Participating States.
      12. Section 12. Construction and Severability.
        1. A. This Compact and the Commission's rulemaking 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 rulemaking authority solely for those purposes.
        2. 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.
        3. C. Notwithstanding subsection B of this section, the Commission may deny a State's participation in the Compact or, in accordance with the requirements of Section 10.B, terminate a Participating State's participation in the Compact, if it determines that a constitutional requirement of a Participating State is 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 the remaining Participating States and in full force and effect as to the Participating State affected as to all severable matters.
      13. Section 13. Consistent Effect and Conflict with Other State Laws.
        1. A. Nothing herein shall prevent or inhibit the enforcement of any other law of a Participating State that is not inconsistent with the Compact.
        2. B. Any laws, statutes, regulations, or other legal requirements in a Participating State in conflict with the Compact are superseded to the extent of the conflict.
        3. C. All permissible agreements between the Commission and the Participating States are binding in accordance with their terms.
§ 63-5-203. Regulatory authority. [Enactment contingent upon adoption; see the Compiler's Notes.]
  1. The department of health, in consultation with the board of dentistry, may promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement and amend this part, as necessary, to ensure this state's participation in the compact.
§ 63-5-204. Contingent effective date. [Enactment contingent upon adoption; see the Compiler's Notes.]
  1. This part takes effect on the date the compact is enacted into law in the seventh compact state. The board of dentistry shall notify the reviser of statutes, the chair of the government operations committee of the house of representatives, and the chair of the government operations committee of the senate in writing when the condition specified in this section has occurred.
Chapter 6 Medicine and Surgery
Part 1 Board of Medical Examiners
§ 63-6-101. Creation — Composition — Administrative support — Consultants.
  1. (a)
    1. (1) There shall be a board to be known as the board of medical examiners, referred to in this chapter as the “board,” to consist of twelve (12) members. Nine (9) members shall be duly licensed physicians, each of whom must meet the following qualifications:
      1. (A) Graduation from a medical school whose curriculum is substantially similar to, and whose educational standards are as high as that of, the medical department of the University of Tennessee, as published at the time of its extant catalogue; and
      2. (B) Not less than six (6) years experience in the practice of either medicine or surgery or both.
    2. (2) Three (3) members shall be nonphysicians who are consumers of health care and who neither own nor have any financial or other interest in any health care facility or business or school of medicine or other allied health care practitioner educational program and who shall represent the public at large.
    3. (3) It shall be the board's duty to examine the qualifications of all applicants for certification of fitness to practice medicine or surgery in this state, to conduct disciplinary hearings, and to make such rules and regulations as are necessary to carry out and make effective this chapter. Any rules and regulations promulgated by the board shall comply with all requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. No member shall be employed by or be a member of the governing body of, or have a financial interest in, any medical school, college or university of the state or of any school, college or university in which allied health care practitioners who are under the regulation of the board receive their qualifying education.
    4. (4) The board is authorized to issue advisory private letter rulings to any affected licensee who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall only affect the licensee making such inquiry and shall have no precedential value for any other inquiry or future contested case to come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
  2. (b) The board shall receive administrative support from the division of health related boards in the department of health, referred to as the “division” in this chapter.
  3. (c)
    1. (1) The division shall consult the board in the hiring of a medical consultant. A licensed physician, hired by the division in consultation with the board as described in this subdivision (c)(1), and designated and authorized by the board, is vested with authority as a consultant to the board to do the following:
      1. (A) Review and make recommendations to the board on licensure, certification, exemption, renewal, reinstatement, and reactivation applications subject to the rules governing those respective applications;
      2. (B) In consultation with the office of general counsel, determine what, if any, investigation should be instituted upon complaints received by the division;
      3. (C) In consultation with the office of general counsel and in accordance with board guidelines, decide whether a licensee who is the subject of a complaint or an investigation is an appropriate candidate for diversion to a professional peer review organization or impaired professional association;
      4. (D) In consultation with the office of general counsel, determine what, if any, complaints or investigations should be referred to the office of general counsel to pursue formal disciplinary action;
      5. (E) In consultation with the office of general counsel, determine what, if any, terms of proposed settlement may be offered in any matter referred to the office of general counsel to pursue formal disciplinary action. However, a proposed settlement is not binding upon any party unless and until it is accepted by a majority vote of the entire board or a duly constituted panel of the board; and
      6. (F) In consultation with the office of general counsel, determine the terms upon which the division can agree to tentatively settle pending disciplinary actions. However, a tentative settlement is not binding upon a party unless and until it is accepted by a majority of the entire board or a duly constituted panel of the board.
    2. (2) The board may withdraw its designation and authorization for a consultant to perform all or part of the acts listed in subdivision (c)(1).
    3. (3) The department shall provide biannual surveys to the board for its feedback and review of the consultant described in this subsection (c).
    4. (4) The board may promulgate rules regarding how it will review the work of consultants described in this subsection (c).
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§ 63-6-102. Appointment — Terms — Vacancies — Removal.
  1. (a)
    1. (1)
      1. (A) The members of the board shall be appointed by the governor for terms of five (5) years' duration, which terms shall commence on May 1 and expire on April 30, five (5) years thereafter. All board members subsequently added to the board after May 2, 1993, shall be appointed so as to serve staggered terms of from one (1) to four (4) years, with one (1) member appointed to a one-year term, the second member appointed to a two-year term, the third member appointed to a three-year term, and the fourth member appointed to serve a four-year term.
      2. (B) The members appointed by the governor in 1988 shall be appointed as follows:
        1. (i) One (1) member shall be appointed to a one-year term expiring on April 30, 1989;
        2. (ii) One (1) member shall be appointed to a two-year term expiring on April 30, 1990;
        3. (iii) One (1) member shall be appointed to a three-year term expiring on April 30, 1991;
        4. (iv) One (1) member shall be appointed to a four-year term expiring on April 30, 1992; and
        5. (v) One (1) member shall be appointed to a five-year term expiring on April 30, 1993.
    2. (2) Members of the board shall, upon expiration of their terms of office, be eligible for reappointment to successive terms.
    3. (3) In making appointments to the board, the governor shall give due regard to the geographic distribution of the membership of the board to assure, to the extent feasible, that all grand divisions of the state are adequately represented on the board.
    4. (4) Board members may be selected from lists of qualified persons submitted to the governor by interested medical groups including, but not limited to, the Tennessee Medical Association. The governor shall consult with such groups to determine qualified persons to fill the positions on the board.
  2. (b) All vacancies occurring on the board by reason of death or resignation shall be filled by the board itself for the unexpired term.
  3. (c) In making appointments to the board, the governor shall, to the extent feasible, strive to ensure the full twelve-member board is composed of at least one (1) person who is sixty (60) years of age or older, one (1) person who is female and one (1) person who is an African-American.
  4. (d) When a board member is absent without excuse from the board business portion of three (3) meetings within any twelve-month period of time, that member shall, after formal action by the board, be removed from office by the governor. A new member shall be appointed by the governor to serve out the remaining term of the member being replaced. An absence shall be deemed excused if it is caused by a health problem or condition verified in writing by a physician or by an accident or similar unforeseen tragedy or event immediately prior to or during the board meeting.
§ 63-6-103. Officers — Quorum.
  1. (a) The board is authorized to elect from its own members a president and secretary and to create such other officers as may be necessary for its efficient operations.
  2. (b) For purposes of conducting administrative business and promulgating rules and regulations, seven (7) members shall constitute a quorum, and the board shall meet at least twice a year to conduct such administrative business. A majority vote of the members present at the business meetings shall be required to authorize board action on any board business. For purposes of contested case hearings and disciplinary matters, three (3) or more members shall constitute a quorum; and the board president is authorized, when it is deemed necessary, to split the board into panels of three (3) or more, each to conduct contested case hearings or disciplinary matters. A majority vote of the members present on any duly constituted panel shall be required to authorize board action in disciplinary matters and contested case hearings. The board president shall have the authority to appoint board members to serve, as necessary, on the panels regardless of the grand division from which the appointed member was chosen or the member's status as a physician or nonphysician member. The existence of a nonphysician board member creates no rights in any individual concerning the composition of any panel in any disciplinary matter or contested case hearing. Notwithstanding § 4-5-314(e) to the contrary, unavailability of a member of any panel before rendition of a final order shall not require substitution of another member unless the unavailability results in there being less than the quorum required by this section for contested case hearings or disciplinary matters. Any substitute required shall use any existing record and may conduct any further proceedings as is necessary in the interest of justice.
§ 63-6-104. Meetings — Compensation — Disposition of receipts — Operating expenses.
  1. (a) All regular meetings of the board shall be held upon the call of the president.
  2. (b)
    1. (1) The members of the board shall be entitled to a per diem of one hundred dollars ($100) for each day's service in attending meetings of the board, as provided in this section, and for conducting examinations for professional certificates and other administrative functions of the board and necessary expenses for traveling and subsistence while attending such meetings. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
    2. (2) The board shall pay all money received by it into the state treasury and the commissioner of finance and administration shall make such allotments out of the general fund as the commissioner may deem proper for the necessary and proper expenses of the board, and no expenditure shall be made by the board unless and until such allotment has been made by the commissioner. Such allotment shall be disbursed under the general budgetary laws of this state.
§ 63-6-105. Online registry for medical spas — Annual fee authorized.
  1. (a) The board of medical examiners, in consultation with the board of osteopathic examination, shall establish and maintain an online registry for medical spas as defined in § 63-1-153, and, notwithstanding § 63-1-153, the registry shall include any physician-owned practice that advertises or holds itself out as a medical spa or a physician-owned practice that primarily engages in the performance of elective cosmetic medical services. The online registry shall include, at a minimum, the following information:
    1. (1) The name and physical address of the medical spa;
    2. (2) The name of the medical director or supervising physician, the medical license number of the director or supervising physician, and the designation as a medical doctor or doctor of osteopathy; and
    3. (3) Certification information of the medical director or supervising physician as required by § 63-1-153(b) and (c).
  2. (b) Any medical director or supervising physician who is responsible for or supervises a medical spa shall provide the board of medical examiners or the board of osteopathic examination with the information described in subsection (a); provided, that the medical director or supervising physician for a medical spa in existence prior to January 1, 2017, shall submit the required information to the appropriate board prior to that date.
  3. (c) The board of medical examiners and the board of osteopathic examination shall post, in conspicuous size and type, notice of the requirements of this section on the website of each board.
  4. (d) In order to offset the cost of implementing this section, the board of medical examiners, in consultation with the board of osteopathic examination, is authorized to promulgate rules to set an annual fee to be assessed on medical spas that are listed on the online registry.
Part 2 General Provisions
§ 63-6-201. License requirements.
  1. (a) No person shall practice medicine in any of its departments within this state unless and until such person has obtained a license from the board created by § 63-6-101. The provisions in this chapter with reference to obtaining a license from the board do not apply to any person who on July 1, 1947, was duly and regularly licensed by law to practice medicine in any of its branches in this state.
  2. (b)
    1. (1) Notwithstanding the foregoing provisions visiting medical faculty licensed in a country other than the United States and employed full time by a college or university operating an accredited medical school in Tennessee are exempt from the requirement of a license; provided, that the visiting faculty member is a graduate of a medical school, a recognized medical authority approved by the board and the practice of the visiting faculty member is limited to and is incidental to the visiting faculty member's employment at an accredited medical school in Tennessee. Such person is entitled to engage in private practice; provided, that the person enrolls and satisfactorily participates in a three-year residency program approved by the board. No physician authorized under this subsection (b) to engage in private practice shall continue to engage in private practice of any form after a period of three (3) years unless such person meets all the requirements of licensure set forth in § 63-6-207.
    2. (2) It is the responsibility of the dean of the medical school to apply to the board for an exemption for each such visiting faculty member. Such application for exemption shall be filed annually, and an individual applicant may not receive an exemption for a period in excess of two (2) years. It is also the responsibility of the above-named dean to notify the board upon termination of a visiting faculty member's responsibilities.
    3. (3) The board may impose a fee to accompany each application for exemption.
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§ 63-6-202. Unlawful activities of itinerant physicians or vendors — Penalties.
  1. (a) It is unlawful for any itinerant physician or vendor of any drug, nostrum, ointment or application of any kind intended for treatment of disease or injury to sell or apply the same or for such itinerant physician or vendor, by writing, printing or other methods, to profess to cure or treat diseases or deformity by any drug, nostrum, manipulation or other expedient in this state.
  2. (b)
    1. (1) A violation of this section is a Class A misdemeanor.
    2. (2) Each violation of this section constitutes a separate offense.
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§ 63-6-203. Penalties.
  1. (a)
    1. (1) Any person who practices medicine or surgery in this state without having first complied with the provisions of this chapter commits a Class B misdemeanor for each instance of such practice.
    2. (2) Each time any person practices medicine or surgery without first obtaining a valid certificate or renewing a certificate constitutes a separate offense.
    3. (3) Any person filing or attempting to file as the person's own a diploma or license of another or a forged affidavit of identification commits a Class E felony.
  2. (b) All fines for offenses under this chapter shall be paid over to the board to constitute a part of the funds of the board to be paid into the state treasury.
§ 63-6-204. “Practice of medicine” defined — Construction.
  1. (a)
    1. (1) Any person shall be regarded as practicing medicine within the meaning of this chapter who treats, or professes to diagnose, treat, operates on or prescribes for any physical ailment or any physical injury to or deformity of another.
    2. (2) Nothing in this section shall be construed to apply to the administration of domestic or family remedies in cases of emergency or to the laws regulating the practice of dentistry.
    3. (3) This chapter shall not apply to surgeons of the United States army, navy, air force, or marine hospital service regardless of the hospital or practice site; provided, that the surgeon's practice is part of the surgeon's authorized military service or training. This chapter shall also not apply to any registered physician or surgeon of other states when called in consultation by a registered physician of this state, or to midwives, veterinary surgeons, osteopathic physicians, or chiropractors not giving or using medicine in their practice, or to opticians, optometrists, chiropodists, or Christian Scientists.
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  2. (b) Nothing in this chapter shall be so construed as to prohibit service rendered by a physician assistant, registered nurse, a licensed practical nurse, or a pharmacist pursuant to a collaborative pharmacy practice agreement, if such service is rendered under the supervision, control and responsibility of a licensed physician or to prohibit the provision of anesthesiology services in licensed health care facilities by a dentist licensed in this state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977.
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  3. (c) Nothing in this section shall be construed to prohibit a person, corporation, organization or other entity from employing a physician to treat only the entity's full-time, part-time and contract employees, the entity's retirees and dependents of the entity's employees or retirees; provided, however, that the employment relationship between the physician and the person, corporation, organization or other entity is evidenced by a written contract, job description or documentation, containing language which does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients. Under this section, such person, corporation, organization or other entity shall not be deemed to be engaged in the practice of medicine.
  4. (d) Nothing in this section shall be construed to prohibit a community mental health center as defined in § 33-1-101 from employing a physician; provided, that the employment relationship between the physician and the community mental health center is evidenced by a written contract, job description or documentation, containing language which does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients; provided, for the purposes of this subsection (d), “physician” does not include an anesthesiologist, an emergency department physician, a pathologist or a radiologist.
  5. (e)
    1. (1) Nothing in this section prohibits a federally-qualified health center or rural health clinic from employing a physician if the employment relationship between the physician and the federally-qualified health center or rural health clinic is evidenced by a written contract, job description, or documentation containing language that does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients.
    2. (2) As used in this subsection (e):
      1. (A) “Federally-qualified health center” has the same meaning as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively);
      2. (B) “Physician” does not include an anesthesiologist, an emergency department physician, a pathologist, or a radiologist; and
      3. (C) “Rural health clinic” has the same meaning as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively).
  6. (f)
    1. (1) Notwithstanding this section, nothing shall prohibit a hospital licensed under title 68, chapter 11, or title 33, chapter 2, or an affiliate of a hospital, from employing licensed physicians other than radiologists, anesthesiologists, pathologists, or emergency physicians, to provide medical services, subject to the following conditions:
      1. (A) Employing entities shall not restrict or interfere with medically appropriate diagnostic or treatment decisions;
      2. (B) Employing entities shall not restrict or interfere with physician referral decisions unless:
        1. (i) The physician so employed has agreed in writing to the specific restrictions at the time that the contract is executed;
        2. (ii) The restriction does not, in the reasonable medical judgment of the physician, adversely affect the health or welfare of the patient; and
        3. (iii) The employing entity discloses any such restrictions to the patient; and
      3. (C) In the event that there is any dispute relating to subdivision (f)(1)(A) or (B), the employing entity shall have the burden of proof.
    2. (2) Employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as follows:
      1. (A) For physicians from whom the employing entity has made a bona fide purchase of the physician's practice, the employing entity may impose reasonable geographic restrictions upon the employed physician's practice; provided, that:
        1. (i) The maximum allowable area of the restriction is the greater of:
          1. (a) The county in which the primary practice site is located; or
          2. (b) A ten (10) mile radius from the primary practice site;
        2. (ii) The duration of the restriction is two (2) years or less, unless a longer period, not to exceed five (5) years, is determined by mutual agreement of the parties in writing to be necessary to comply with federal statutes, rules, regulations, or IRS revenue rulings or private letter rulings;
        3. (iii) Any employment agreement or medical practice sale agreement restricting the right of a physician to practice shall:
          1. (a) Allow the physician to buy back the physician's medical practice for the original purchase price of the practice, or, in the alternative, if the parties agree in writing, at a price not to exceed the fair market value of the practice at the time of the buy back, at which time any such restriction on practice shall be void; and
          2. (b) Not require that the physician give more than thirty-day's notice to exercise the repurchase option; provided, that this provision shall not otherwise affect the contract termination notice requirements; and
        4. (iv) If the buy back provision is dependent upon a determination of the fair market value of the practice, the contract shall specify the method of determining fair market value by independent appraisal, in the event that the parties cannot agree as to the fair market value. The contract shall also include the following language:
          1. “In the event that the employing entity and the physician cannot agree upon the fair market value of the practice within ten (10) business days of the physician's notice of intent to repurchase the practice, the physician may remove any contractual restrictions upon the physician's practice by tendering to the employing entity the amount that was paid to the physician for the practice. The employing entity or the physician may then seek a determination of the fair market value of the practice by the independent appraisal method specified by contract.”
      2. (B) For physicians employed independently of a bona fide practice purchase, employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as allowed by § 63-1-148 or any successor section.
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    3. (3) Notwithstanding the foregoing, in the event that the employment contract with a physician employed independently of a bona fide practice purchase is terminated by the employing entity for reasons other than breach by the employee, any such restrictions shall be void.
    4. (4) In any event, nothing in this section shall prohibit any of the following from employing physicians:
      1. (A) A licensed physician; or
      2. (B) A group of licensed physicians, including, but not limited to, either of the following:
        1. (i) A physicians' professional corporation registered under title 48, chapter 101; or
        2. (ii) A domestic nonprofit public benefit corporation:
          1. (a) That is recognized as exempt under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)), or any successor section;
          2. (b) A purpose of which is to engage in medical education and medical research in conjunction with a college or university operating an accredited medical school in Tennessee;
          3. (c) Whose physician-employees are restricted to the medical faculty of such a college or university; and
          4. (d) Which operates as a “faculty practice plan” for purposes of Title XVIII of the federal Social Security Act (42 U.S.C., Chapter 7, subchapter XVIII), and regulations promulgated in connection therewith;
      3. Provided, that with respect to any such domestic nonprofit public benefit corporation, physician employees of any such faculty practice plan who practice in the specialties of radiology, pathology, anesthesiology and/or emergency medicine shall be restricted to practice as faculty practice plan employees in those health care institutions, including but not limited to hospitals or surgery centers, in which they were practicing as employees of the nonprofit public benefit corporation on May 30, 1997.
    5. (5) A hospital affiliate that employs physicians shall not engage in any business other than the employment of physicians, the management of physicians and health care facilities, or the ownership of property and facilities used in the provision of health care services. An affiliate of a hospital that employs physicians pursuant to this part shall be subject to the authority of the applicable licensing board under either title 68, chapter 11, or title 33, chapter 2 in connection with employment of physicians. Any violation of this statute by an affiliate shall subject any hospital at which the physician has staff privileges, and that controls or is under common control with the affiliate to the penalties and sanctions applied to hospitals that employ physicians.
    6. (6)
      1. (A) No radiologist, anesthesiologist, pathologist, or emergency physician may be employed by a hospital or an affiliate of a hospital, and no hospital or an affiliate of a hospital, may employ any physician to provide medical services provided by radiologists, anesthesiologists, pathologists, or emergency physicians; provided, that a physician may be employed to provide emergency medical services if such physician is employed to provide other medical services.
      2. (B) Notwithstanding subdivisions (f)(6)(A) and (f)(1), a “research hospital,” as defined in this section, may employ radiologists, anesthesiologists, or pathologists under the same terms and conditions as other physicians.
    7. (7) As used in this section, unless the context otherwise requires:
      1. (A) “Affiliate” of a hospital means an entity that directly or indirectly is controlled by, or is under common control with, a hospital licensed under title 68, chapter 11 or title 33, chapter 2. “Affiliate” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      2. (B) “Anesthesiologist” is a physician who has completed a residency in anesthesiology and whose practice is primarily limited to anesthesiology, including, without limitation, nerve block, pain management, cardiac and respiratory resuscitation, respiratory therapy, management of fluids, electrolyte and metabolic disturbances, or a dentist licensed in the state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977;
      3. (C) “Emergency physician” is a physician who has either completed a residency in emergency medicine, or practiced emergency medicine full time for a three year period, and whose practice is limited to emergency medicine. “Emergency physician” does not include, however, a physician who has been previously employed to provide nonemergent medical services who, over a period of twelve (12) months or more, becomes a full time emergency physician and who remains employed by mutual agreement;
      4. (D) “Employing entity” means a hospital licensed under title 68, chapter 11, or title 33, chapter 2, or an affiliate of such an entity, that employs one (1) or more physicians. “Employing entity” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      5. (E) “Pathologist” is a physician who has completed a residency in pathology and whose practice is primarily limited to pathology, including, without limitation, anatomic and clinical pathology;
      6. (F) “Physician” means a person licensed pursuant to chapter 6 or 9 of this title;
      7. (G) “Psychiatrist” means a physician who has completed a residency in psychiatry and whose practice is primarily limited to psychiatry.
      8. (H) “Radiologist” is a physician who has completed a residency in radiology and whose practice is primarily limited to radiology, including, without limitation, diagnostic radiology, radiation therapy, and radiation oncology; and
      9. (I) “Research hospital” means a hospital at which fifty percent (50%) or more of the inpatients treated during the previous calendar year were treated pursuant to research protocols.
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  7. (g)
    1. (1) Notwithstanding this section, nothing shall prohibit a renal dialysis clinic licensed under title 68, chapter 11 or an affiliate of a renal dialysis clinic from employing licensed physicians other than radiologists, anesthesiologists, pathologists or emergency physicians to provide medical services, subject to the following conditions:
      1. (A) Employing entities shall not restrict or interfere with medically appropriate diagnostic or treatment decisions;
      2. (B) Employing entities shall not restrict or interfere with physician referral decisions unless:
        1. (i) The physician so employed has agreed in writing to the specific restrictions at the time that the contract is executed;
        2. (ii) The restriction does not, in the reasonable medical judgment of the physician, adversely affect the health or welfare of the patient; and
        3. (iii) The employing entity discloses the restrictions to the patient; and
      3. (C) In the event that there is any dispute relating to subdivision (g)(1)(A) or (g)(1)(B), the employing entity shall have the burden of proof.
    2. (2) Employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as allowed by § 63-1-148 or any successor section.
    3. (3) Notwithstanding § 63-1-148 or any successor section, in the event that the employment contract with a physician employed independently of a bona fide practice purchase is terminated by the employing entity for reasons other than breach by the employee, the restrictions shall be void.
    4. (4) In any event, nothing in this section shall prohibit any of the following from employing physicians:
      1. (A) A licensed physician; or
      2. (B) A group of licensed physicians, including, but not limited to, either of the following:
        1. (i) A physicians' professional corporation registered under title 48, chapter 101; or
        2. (ii)
          1. (a) A domestic nonprofit public benefit corporation:
            1. (1) That is recognized as exempt under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)) or any successor section;
            2. (2) A purpose of which is to engage in medical education and medical research in conjunction with a college or university operating an accredited medical school in Tennessee;
            3. (3) Whose physician-employees are restricted to the medical faculty of such a college or university; and
            4. (4) That operates as a faculty practice plan for purposes of Title XVIII of the federal Social Security Act (42 U.S.C. chapter 7, subchapter XVIII) and regulations promulgated in connection therewith.
          2. (b) Provided, that, with respect to the domestic nonprofit public benefit corporation, physician employees of the faculty practice plan who practice in the specialties of radiology, pathology, anesthesiology or emergency medicine shall be restricted to practice as faculty practice plan employees in those health care institutions, including, but not limited to, hospitals or surgery centers, in which they were practicing as employees of the nonprofit public benefit corporation on May 30, 1997.
    5. (5) An affiliate of a renal dialysis clinic that employs physicians shall not engage in any business other than the employment of physicians, the management of physicians and health care facilities or the ownership of property and facilities used in the provision of health care services or a tissue bank or organ procurement agency. An affiliate of a renal dialysis clinic that employs physicians pursuant to this part shall be subject to the authority of the applicable licensing board under title 68, chapter 11, in connection with employment of physicians. Any violation of this subdivision (g)(5) by an affiliate shall subject any renal dialysis clinic at which the physician has staff privileges and that controls or is under common control with the affiliate to the penalties and sanctions applied to renal dialysis clinics that employ physicians.
    6. (6) No radiologist, anesthesiologist, pathologist or emergency physician may be employed by a renal dialysis clinic or an affiliate of a renal dialysis clinic, and no renal dialysis clinic or an affiliate of a renal dialysis clinic may employ any physician to provide medical services provided by radiologists, anesthesiologists, pathologists or emergency physicians; provided, that a physician may be employed to provide emergency medical services if the physician is employed to provide other medical services.
    7. (7) As used in this section, unless the context otherwise requires:
      1. (A) “Affiliate” of a renal dialysis clinic means an entity that directly or indirectly is controlled by or is under common control with a renal dialysis clinic licensed under title 68, chapter 11. “Affiliate” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      2. (B) “Anesthesiologist” is a physician who has completed a residency in anesthesiology and whose practice is primarily limited to anesthesiology, including, without limitation, nerve block, pain management, cardiac and respiratory resuscitation, respiratory therapy, management of fluids, electrolyte and metabolic disturbances or a dentist licensed in this state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977;
      3. (C) “Emergency physician” is a physician who has either completed a residency in emergency medicine or practiced emergency medicine full-time for a three year period and whose practice is limited to emergency medicine. “Emergency physician” does not include, however, a physician who has been previously employed to provide nonemergent medical services who, over a period of twelve (12) months or more, becomes a full-time emergency physician and who remains employed by mutual agreement;
      4. (D) “Employing entity” means a renal dialysis clinic licensed under title 68, chapter 11 or an affiliate of such an entity that employs one (1) or more physicians. “Employing entity” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      5. (E) “Pathologist” is a physician who has completed a residency in pathology and whose practice is primarily limited to pathology, including, without limitation, anatomic and clinical pathology;
      6. (F) “Physician” means a person licensed pursuant to chapter 6 or 9 of this title; and
      7. (G) “Radiologist” is a physician who has completed a residency in radiology and whose practice is primarily limited to radiology, including, without limitation, diagnostic radiology, radiation therapy and radiation oncology.
  8. (h)
    1. (1) The general assembly finds that there are special facts above and beyond ordinary competition that would give an unfair advantage to a physician when competing with the physician's former employer, if the former employer is a faculty practice plan. The existence of such special facts warrants protection of the faculty practice plan through restrictive covenants and prohibitions against an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship. The general assembly further finds that the faculty practice plan's right to be free of unfair competition from a former employed physician outweighs any financial hardship to the former employed physician resulting from the operation of any such restrictive covenants or prohibition. The general assembly further finds that restrictive covenants and prohibitions against an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship with a faculty practice plan are reasonable and not inimical to the public interest, subject to the temporal and geographic limitations set forth in subdivision (h)(2).
    2. (2) A faculty practice plan may impose restrictions or prohibitions upon an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship provided that:
      1. (A) The maximum area of the restrictions or prohibitions is the greater of:
        1. (i) The county in which the primary practice site is located; or
        2. (ii) A ten (10) mile radius from the primary practice site; and
      2. (B) The maximum duration of the restrictions or prohibitions is two (2) years.
    3. (3) As used in this subsection (h), “faculty practice plan” means a domestic nonprofit public benefit corporation as defined in subdivision (f)(4)(B)(ii).
    4. (4) As used in this subsection (h), “primary practice site” includes any health care institution, including, but not limited to, a hospital, clinic, surgery center, or physicians' office, that the faculty practice plan or its affiliated college or university owned, leased, or operated within two (2) years before the termination or conclusion of the employment relationship between the physician and the faculty practice plan and at which the employed physician practiced medicine within such period of two (2) years.
    5. (5) This subsection (h) shall not apply:
      1. (A) To any physician employee of a faculty practice plan who practices in the specialties of ophthalmology, pathology, anesthesiology and/or emergency medicine; or
      2. (B) With respect to any physician employee of a faculty practice plan who practices as a primary care physician or in the specialties of obstetrics or general pediatrics in a health resources shortage area as determined in the health access plan most recently published by the department of health.
    6. (6) The requirements of this subsection (h) shall not be construed to preclude the enforceability of any restrictive covenant or prohibition exceeding the requirements or conditions of this subsection (h) that is reasonable and not inimical to the public interest under the common law principles governing restrictive covenants.
  9. (i) Notwithstanding the restrictions contained in this section, a nursing home or affiliate of a nursing home may employ a physician pursuant to § 68-11-205.
  10. (j)
    1. (1) Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a physician; provided, that the contractual relationship between the physician and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the physician from exercising independent professional medical judgment in diagnosing and treating patients.
    2. (2) For the purposes of this subsection (j), the term “charitable clinic” means an entity that meets the following standards:
      1. (A) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. (B) Has clinical facilities located in this state;
      3. (C) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. (D) Provides one (1) or more of the following services for free or at a discounted rate:
        1. (i) Medical care;
        2. (ii) Dental care;
        3. (iii) Mental health care; or
        4. (iv) Prescription medications;
      5. (E) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. (F) Is not required to be licensed under § 68-11-202(a)(1).
    3. (3) For the purposes of this section, the term “employing” shall not allow the employing of those physicians exempted in subdivision (e)(3).
  11. (k) This section does not prohibit a licensed nonresidential office-based opiate treatment facility, as defined in § 33-2-402, from employing or contracting with a physician if the facility has a physician in the ownership structure of its controlling business entity and the employment relationship between the physician to be employed or contracted with and the nonresidential office-based opiate treatment facility is evidenced by a written contract or employment agreement containing language that does not restrict the physician from exercising independent professional medical judgment in diagnosing and treating patients.
  12. (l)
    1. (1) This section does not prohibit a hospital or an affiliated entity from employing an emergency physician to treat patients at a satellite emergency department, or a physician to treat patients at a primary care clinic or urgent care clinic, which are located in this state and owned or controlled by the hospital or affiliated entity, if:
      1. (A) The hospital:
        1. (i) Is located in a neighboring state in a county contiguous to this state;
        2. (ii) Is licensed by the appropriate healthcare facility licensing authority in that state; and
        3. (iii) Holds a valid certificate of need for a satellite emergency department in this state;
      2. (B) The satellite emergency department, primary care clinic, or urgent care clinic is located:
        1. (i) In a county that:
          1. (a) Borders the neighboring state and contiguous county in which the hospital is located;
          2. (b) Is designated as an economically distressed or at-risk county by the department of economic and community development, as updated annually;
          3. (c) Has a population of less than twenty-seven thousand (27,000), according to the 2020 federal census or a subsequent federal census; and
          4. (d) Had a hospital in the county close within eight (8) years before the date healthcare services are initiated at the satellite emergency department, primary care clinic, or urgent care clinic; and
        2. (ii) Less than twenty (20) miles from a hospital designated as a Level I, II, or III trauma center in the neighboring state, but more than fifty (50) miles from a hospital designated as a Level I, II, or III trauma center in this state;
      3. (C) The physician is:
        1. (i) Licensed to practice medicine in this state; and
        2. (ii) Employed at the hospital in the neighboring state; and
      4. (D) The employment relationship with the physician is evidenced by a written contract, job description, or other documentation containing language that does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients.
    2. (2) A hospital or affiliated entity that employs a physician pursuant to subdivision (l)(1) is not deemed to be engaged in the practice of medicine.
    3. (3) As used in this subsection (l), “affiliated entity” means an entity that is directly or indirectly controlled by, or is under common control with, the hospital.
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§ 63-6-205. Practice of naturopathy.
  1. (a) It is unlawful for any person to practice naturopathy in this state.
  2. (b) “Naturopathy” means nature cure or health by natural methods and is defined as the prevention, diagnosis and treatment of human injuries, ailments and disease by the use of such physical forces as air, light, water, vibration, heat, electricity, hydrotherapy, psychotherapy, dietetics or massage and the administration of botanical and biological drugs.
  3. (c) In no event shall naturopathy mean the sale of herbs or natural health information exchanges provided as a service so long as:
    1. (1) The sale or provision of information exchanges is not conducted for the purpose of the prevention, diagnosis or treatment of any physical ailment or physical injury to or deformity of another; and
    2. (2) In any instance involving natural health information exchanges, the seller obtains a signed acknowledgement from the buyer that the seller is neither a licensed practitioner of the healing arts in this state, nor meets the recognized qualification criteria that would allow the provision of any form of diagnosis, treatment recommendation or medical care in this state. For the purposes of meeting the requirements of this section, the seller shall keep the signed acknowledgement from the buyer on file for a period of three (3) years.
  4. (d) A violation of this section is a Class B misdemeanor.
  5. (e) This section does not apply to persons who comply with the regulatory laws of the state with respect to the practice of the various healing arts.
§ 63-6-206. Penalty for unlawful issuance of licenses.
  1. (a) It is a Class B misdemeanor, and disqualifies for office, for the board to issue a license to any person except as prescribed in this chapter. Should the board be so disqualified, the governor shall appoint a new board in full as provided in this chapter.
  2. (b) In no event shall the negligent issuance of a license result in criminal prosecution under this chapter.
§ 63-6-207. Application for certificate — Special training licenses — St. Jude Children's Research Hospital global collaboration license. [Effective until July 1, 2024. See the version effective on July 1, 2024.]
  1. (a) A person desiring to practice medicine or surgery in this state shall make application in writing to the board or via online application, which shall be accompanied by:
    1. (1) If a United States or Canadian medical school graduate:
      1. (A) A certificate from a medical school whose curriculum is approved by the American Medical Association or its extant accreditation program for medical education, or its successor;
      2. (B) A nonrefundable application fee as set by the board and by an examination fee prescribed in this section;
      3. (C) Evidence of the satisfactory completion of:
        1. (i) A one-year United States training program approved by the American Medical Association or its extant accreditation program for medical education, or its successor; or
        2. (ii) A primary specialty training program that is accredited by the Royal College of Physicians and Surgeons of Canada and that is of a duration of not less than four (4) years;
      4. (D) Sufficient evidence of good moral character; and
      5. (E) Evidence of being legally entitled to live or work in the United States if the person is not a citizen of the United States or Canada;
    2. (2) If an international medical school graduate:
      1. (A) A certificate from a medical school whose curriculum is judged to be acceptable by the board;
      2. (B) A copy of a permanent Educational Commission for Foreign Medical Graduates (ECFMG) certificate;
      3. (C) A nonrefundable application fee as set by the board and by an examination fee prescribed in this section;
      4. (D) Sufficient evidence of good moral character;
      5. (E) Evidence of being a citizen of the United States or Canada, or legally entitled to live or work in the United States; and
      6. (F) Evidence of satisfactory completion of a three-year post-graduate training program approved by the American Medical Association or its extant accreditation program for medical education, or its successor. Such person may apply to the board for licensure or testing in accordance with this chapter within twelve (12) months of completion of the post-graduate training program if satisfactory performance in such program is demonstrated to the satisfaction of the board.
  2. (b) All applicants shall present themselves before the board or the board's administrative designee for examination. The board may question in such subjects as the board may deem appropriate. As its qualifying examination, the board accepts the Federation Licensing Examination (FLEX), and/or the National Board of Medical Examiners examination and/or the United States Medical Licensing Examination or its successor examination. Applicants shall successfully complete the United States Medical Licensing Examination within ten (10) years from the date of whichever step of the examination was successfully completed first. An applicant is considered to have successfully completed a step of the examination on the date that the step was taken and not the date on which the passing score was made public by the examination agency; provided, however, that the board is authorized to promulgate rules and regulations creating exceptions that will extend the ten-year time frame provided in this subsection (b). In addition, the board reserves the right to write its own state board examination or contract with other national testing organizations. The board reserves the right to designate its administrative staff to administer the licensing examinations and to collect such application and examination fees as the board, in its discretion, may deem necessary.
  3. (c) The members of the board also have the right to examine all applicants in such oral examinations as they may deem necessary.
  4. (d) The board is authorized in its discretion to issue special training licenses to medical interns, residents and fellows who have met all other qualifications for licensure contained in this chapter and the rules and regulations promulgated pursuant thereto, with the exception of having completed the necessary residency or training programs required by subdivision (a)(1)(C) and/or (a)(2)(F) and the licensure examination. The board also is authorized to promulgate rules and regulations to implement this new licensure category. The initial set of these rules may be processed as emergency rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. These special training licenses will be governed by the following:
    1. (1)
      1. (A) Such licenses shall be issued only to medical interns, residents and fellows while participating in a training program of one of the accredited medical schools or of one of such medical school's affiliated teaching hospitals in Tennessee, performing duties assigned to meet the requirements of such program, and while under the supervision and control of a physician fully licensed to practice medicine in Tennessee;
      2. (B) No person holding a special training license is permitted to practice medicine outside of such person's duties and responsibilities in the training program without being fully licensed to practice medicine in Tennessee. Termination of participation in the training program for which the special license was issued for any reason terminates that license;
      3. (C) It is the responsibility of the program director or the dean responsible for the training program to submit the necessary information and applications on behalf of each applicant. It also is the responsibility of the program director or the dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason; and
      4. (D) The board may impose fees to accompany each individual application for a special training license.
      5. (E) [Deleted by the 2022 amendment.]
    2. (2)
      1. (A)
        1. (i) Notwithstanding subdivision (d)(1), medical students, interns, residents, and clinical fellows who do not hold a special training license pursuant to this subsection (d) are exempt from the requirement of a license to practice medicine or surgery in this state when such medical students, interns, residents, and clinical fellows are participating in a training program of one (1) of the accredited medical schools or of one (1) of its affiliated teaching hospitals in this state, performing duties assigned to meet the requirements of the training program, and while under the supervision and control of a physician fully licensed to practice medicine or surgery in this state. No such student, intern, resident, or clinical fellow is permitted to practice medicine or surgery outside of the person's duties and responsibilities in the training program without being fully licensed to practice medicine or surgery in this state;
        2. (ii) It is the responsibility of the program director or the dean responsible for the training program to apply to the board for an exemption for each such medical student, intern, resident, or clinical fellow. Moreover, it is the responsibility of such program director or dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason;
      2. (B) The board may impose a fee to accompany each application for exemption;
      3. (C) Eligibility for the exemption provided for in this subdivision (d)(2) shall apply to all eligible persons in training on April 8, 1994, or thereafter.
  5. (e) The board or the board's designee is specifically authorized to conduct applicant interviews periodically as it deems necessary on a case by case basis.
  6. (f)
    1. (1)
      1. (A) The general assembly finds that St. Jude Children's Research Hospital is unique as a research center hospital in this state and this nation for protocol-based therapy and treatment of children and adolescents with newly diagnosed untreated or suspected cancer, HIV infections, or certain hematologic, immunologic, or genetic diseases. St. Jude Children's Research Hospital's experts are involved in research and treatment in the fields of hematology, oncology, bone marrow transplantation, immunology, genetic diseases and infectious diseases. The hospital's research involves both basic and clinical science and it is a National Cancer Institute Comprehensive Cancer Center. The general assembly finds that supporting research and treatment by qualified physicians and researchers at St. Jude Children's Research Hospital by means of a special St. Jude Children's Research Hospital global collaboration license would substantially benefit the state, the practice of medicine and the health of persons benefitting from treatment or research conducted at the hospital.
      2. (B) The board is authorized in its discretion to issue a special St. Jude Children's Research Hospital global collaboration license to physicians who have met all other qualifications for licensure contained in this chapter and the rules and regulation promulgated pursuant to this chapter, with the exception of having completed the necessary residency or training programs required by subdivision (a)(1)(C) or (a)(2)(F). The board is also authorized to promulgate rules and regulations to implement this new special licensure category.
    2. (2) These special St. Jude Children's Research Hospital global collaboration licenses will be governed by the following:
      1. (A) Such license shall be issued only to physicians while employed by St. Jude Children's Research Hospital;
      2. (B) No person holding a special St. Jude Children's Research Hospital global collaboration license is permitted to practice medicine outside of such person's duties and responsibilities as an employee of St. Jude Children's Hospital without being fully licensed to practice medicine in Tennessee. Termination of employment with St. Jude Children's Research Hospital for any reason terminates the special license;
      3. (C) It is the responsibility of St. Jude Children's Research Hospital to submit the necessary information and applications on behalf of each applicant. It is also the responsibility of St. Jude Children's Research Hospital to notify the board of the termination of the applicant's employment;
      4. (D) The board may impose fees to accompany each individual application for this special license; and
      5. (E) [Deleted by the 2022 amendment.]
  7. (g) The board may issue a temporary license of limited duration to an international medical school graduate with demonstrated competency. A temporary license may be issued by the board in its discretion as special circumstances may require. The board may promulgate rules prescribing any other conditions or requirements with respect to the issuance of a temporary license pursuant to this subsection (g).
  8. (h) The board is authorized in its discretion to issue limited licenses to physicians who have been out of clinical practice for an extended period of time or who have been, or are at the time of their application, engaged exclusively in administrative medicine. The board may promulgate rules prescribing any other conditions or requirements with respect to the issuance of a limited license pursuant to this subsection (h).
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§ 63-6-208. Exemption for physician for visiting sports team.
  1. (a) A physician who is duly qualified to practice medicine under the laws of another state is exempt from the licensure requirements of § 63-6-201, subject to this section, if either of the following applies:
    1. (1) The physician has a written or oral agreement with a sports team to provide care to team members and coaching staff traveling with the team for a specific sporting event to take place in this state; or
    2. (2) The physician has been invited by a national sport governing body to provide services to athletes and coaching staff at a national sport training center in this state or to provide services to athletes and coaching staff at an event or competition in this state that is sanctioned by the national sport governing body.
  2. (b) The exemption provided by this section only applies while:
    1. (1) The physician's practice is limited to that required by the team or the national sport governing body; and
    2. (2) The services provided by the physician are within the physician's scope of practice.
  3. (c) The exemption provided by subsection (a) permits a physician to provide care or consultation to a person specified in subsection (a). Nothing in this section permits a physician exempt by this section to:
    1. (1) Provide care or consultation to any person residing in this state other than a person specified in subsection (a); or
    2. (2) Practice at a licensed healthcare facility in this state.
  4. (d) An exemption pursuant to subdivision (a)(1) is valid while the physician is traveling with the sports team, subject to the following:
    1. (1) The exemption shall not be longer than ten (10) days in duration for each respective sporting event without prior authorization from the board of medical examiners;
    2. (2) The board of medical examiners may grant an extension of not more than twenty (20) additional days per sporting event; and
    3. (3) No physician shall be exempt for more than thirty (30) total days in a calendar year.
  5. (e) An exemption pursuant to subdivision (a)(2) is valid during the time certified by the national sport governing body; however, no physician shall be exempt for more than thirty (30) total days in a calendar year.
  6. (f) No physician exempt pursuant to this section shall dispense or administer controlled substances unless:
    1. (1) The patient to whom the controlled substance is administered or dispensed is over eighteen (18) years of age and is a person described in subdivision (a)(1) or (a)(2); and
    2. (2) The physician reports all controlled substances dispensed or administered to any applicable state controlled substance database in the physician's state of licensure.
  7. (g) For purposes of this section, “sports team” means a professional, semi-professional, or amateur team including, but not limited to, a college, high school, grade school, or non-school affiliated team, such as those associated with the Amateur Athletic Union (AAU).
  8. (h) The board of medical examiners may enter into agreements with medical licensing boards of other states to implement this section. Agreements may include procedures for reporting potential medical license violations.
  9. (i) The board of medical examiners may promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-6-209. Issue of licenses.
  1. (a) Licenses shall be issued promptly by the division as directed by the board after the board determines that an applicant has met all licensure criteria or qualifications and successfully passed the examination. The board shall also issue to such applicant a certificate of registration signed by the administrator of the health related boards, which certificate shall recite that the person is duly registered for the years specified.
  2. (b) The board also has the authority to issue locum tenens and/or conditional licenses as it deems appropriate after reviewing the qualifications of applicants. In addition to the authority granted the board in § 63-6-214, the board has the authority to issue restricted licenses and special licenses based upon licensure to another state for the limited purpose of authorizing the practice of telemedicine to current applicants or current licensees, or both, as it deems necessary, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
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  3. (c) Any certificate of registration issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and such other information as the board deems necessary. The address contained on this certificate of registration shall be the address of the licensee where all correspondence and renewal forms from the board shall be sent during the two (2) years for which the certificate of registration has been issued and shall be the address deemed sufficient for purposes of service of process.
  4. (d) Any licensee whose address changes from the address contained on the registration certificate shall, within thirty (30) days thereafter, notify the board of the address change.
§ 63-6-210. Renewal of licenses — Retirement — Inactive status — Comparison and sharing of information with the Tennessee Medical Association
  1. (a) Each person licensed to practice medicine in this state shall, pursuant to the renewal system established in subsection (b), biennially apply to the board for a renewal of licensure and shall pay a renewal fee as set by the board. Each application shall be made on a form to be furnished by the board and sent to the licensee well in advance of the scheduled renewal date. The board shall, in its discretion, absent receipt of derogatory information, renew licensure upon application made in due form and upon payment of all required fees and shall issue a new biennial registration certificate.
  2. (b)
    1. (1) There is hereby authorized the establishment of a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under this renewal system are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during any transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under any renewal system for a period of other than twenty-four (24) months shall be proportionate to the biennial fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) A licensee may renew a license within sixty (60) days following the license expiration date upon payment of the renewal fee in addition to a late penalty established by the board for each month or fraction of a month that payment for renewal is late; provided, that the late penalty shall not exceed twice the renewal fee. When any licensee fails to renew a license and pay the biennial renewal fee within sixty (60) days after renewal becomes due, as provided in this section, the license shall be automatically revoked at the expiration of sixty (60) days after the renewal was required without further notice or hearing.
  3. (c) Any licensee whose license is automatically revoked as provided in subsection (b), may apply in writing to the board for reinstatement of such license, which may be granted by the board upon the payment of all past due fees and reinstatement fees established by the board, and upon further conditions as the board may require.
  4. (d) Any person licensed to practice by this chapter who has retired or may hereafter retire from practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit of retirement form furnished by the board. The affidavit shall state the date on which the person retired from practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If the person thereafter wishes to reenter practice in this state, the person shall apply for licensure reactivation with the board, pay a reactivation fee as set by the board and shall meet such other reasonable requirements as may be deemed necessary by the board.
  5. (e) The board shall have the authority to create a renewable inactive licensure status as it deems appropriate upon payment of an appropriate fee assessment and compliance with the requirements established by the board for those licensees who actively practice medicine in a state other than Tennessee.
  6. (f) In order to ensure that the board has the most recent and accurate data on licensees and applicants for licensure within this state, the board shall cooperate with the Tennessee Medical Association by comparing and sharing computer data bases and other physician identification file information, including, without limitation, license numbers, medical education numbers, social security numbers, home and business address information and any other data of a similar, nonconfidential nature, for a reasonable charge.
§ 63-6-211. Licensure of out-of-state and international applicants.
  1. (a)
    1. (1) The board is authorized to accept the certificates of licensure from other states as long as the applicant's certificates and qualifications meet or exceed the requirements set forth in § 63-6-207 and the rules promulgated pursuant thereto.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within forty-five (45) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) The board is likewise authorized to accept certificates of license from other states or countries and grant licenses to practice medicine in Tennessee to individuals who, at the sole discretion of the board based upon its examination and evaluation of such individuals' credentials, qualifications and reputation within the medical community, qualify as distinguished faculty members at a rank of full professor and upon application and payment of a nonrefundable licensure fee as determined by the board. This type of license shall authorize the practice of medicine in conjunction with a faculty appointment and shall automatically expire at any time the licensee fails to maintain a full-time appointment. The board shall retain the sole discretionary authority to grant or deny annual renewal of such licenses. To be considered for licensure pursuant to this subsection (b), an individual must meet each of the following minimum criteria:
    1. (1) Possess a degree of doctor of medicine or its equivalent;
    2. (2) Have a full-time appointment at professorial rank at an accredited college of medicine in Tennessee;
    3. (3) Have current membership in good standing in medical specialty societies that have restricted and selective membership;
    4. (4) Have been invited to be a lecturer or visiting professor at medical educational institutions either abroad or within the United States;
    5. (5) Have delivered scholarly medical papers before national or international meetings; and
    6. (6) Possess letters of support from the dean of the appointing college of medicine and its appropriate department chairs, as well as from academic colleagues from outside of Tennessee attesting to the individual's distinguished status.
  3. (c) For purposes of enforcing federal immigration laws which relate to the licensure of foreign physicians in this state, the board of medical examiners shall enter into a written agreement, in accordance with federal and other applicable law, between the board and the United States department of homeland security concerning the enforcement of federal immigration laws, which may include participation in the federal systematic alien verification of entitlements program, referred to as the “SAVE program,” and its verification information system, operated by the United States department of homeland security or a successor program designated by the United States department of homeland security or any additional certifying agent within the department or approved by the department.
§ 63-6-212. Records.
  1. The board shall keep a record of their proceedings in a book provided for that purpose, which book shall be open for inspection and shall record the name of each applicant, the time of granting a license and the names of the members of the board present. Where a license is denied by the board to any applicant under authority of this chapter, the fact and ground of such denial shall be entered on the minutes of the board and shall be communicated in writing to such applicant.
§ 63-6-213. Investigation and prosecution of violations — Injunctions — Contested cases.
  1. (a) The members of the board shall investigate any supposed violation of this chapter and report to the proper district attorney general all the cases that in the judgment of such member or members warrant prosecution.
  2. (b) It is the duty of the district attorneys general to prosecute violators of this chapter.
  3. (c)
    1. (1) The board may, through the department of health's general counsel, petition any circuit or chancery court having jurisdiction over any person within this state who is practicing medicine without a license or in violation of a restriction or condition placed upon a license, regardless of whether such practice resulted from a license being restricted, conditioned, denied, or because a license has been suspended or revoked by action of the board, or any other reason, to enjoin such person from conducting or continuing to conduct the unlawful practice of medicine within this state.
    2. (2) Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all such causes as equity causes and are authorized to exercise full and complete jurisdiction in these injunctive proceedings. Nothing in this section shall be construed as conferring criminal jurisdiction upon any court not now possessing such criminal jurisdiction, nor shall any such court, as an incident to the injunctive proceedings authorized in this section, have the power to assess criminal penalties.
  4. (d) The board shall retain rulemaking authority to adjust the administration of its contested case docket in order to provide for the efficient and orderly disposition of contested cases. This authority may include rulemaking for the setting of reasonable limitations on deadlines for case settlements, and whether several contested cases are set on each meeting's docket of business.
§ 63-6-214. Grounds for license denial, suspension or revocation — Reporting misconduct.
  1. (a) The board has the power to:
    1. (1) Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, or limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or licensee, including, but not limited to, informal settlements, private censures and warnings, as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license.
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  2. (b) The grounds upon which the board shall exercise such power include, but are not limited to:
    1. (1) Unprofessional, dishonorable or unethical conduct;
    2. (2) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate any provision of this chapter or, any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    3. (3) Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the practice of medicine;
    4. (4) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of medical practice;
    5. (5) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice medicine;
    6. (6) Violation of the laws governing abortion;
    7. (7) Willfully betraying a professional secret;
    8. (8) The advertising of medical business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or conditions;
    9. (9) Willful violation of the rules and regulations promulgated by the board of medical examiners to regulate advertising by practitioners who are under the jurisdiction of such board;
    10. (10) Conviction of a felony, conviction of any offense under state or federal laws relative to drugs or the practice of medicine, conviction of any offense involving moral turpitude or conviction of any offense for which the person is required to register as a sexual offender or violent sexual offender pursuant to title 40, chapter 39, part 2;
    11. (11) Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
    12. (12) Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice, or not in good faith to relieve pain and suffering, or not to cure an ailment, physical infirmity or disease, or in amounts and/or for durations not medically necessary, advisable or justified for a diagnosed condition;
    13. (13) Dispensing, prescribing or otherwise distributing to any person a controlled substance or other drug if such person is addicted to the habit of using controlled substances without making a bona fide effort to cure the habit of such patient;
    14. (14) Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or other drug to any person in violation of any law of the state or of the United States;
    15. (15) Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality;
    16. (16) Giving or receiving, or aiding or abetting the giving or receiving, of rebates, either directly or indirectly;
    17. (17) Engaging in the practice of medicine under a false or assumed name, or the impersonation of another practitioner, or a like, similar or different name;
    18. (18) Engaging in the practice of medicine when mentally or physically unable to safely do so;
    19. (19) Using radiation in the treatment of any noncancerous disease, disorder or condition of the skin without first adequately warning the patient of the extent of any known risk of cancer associated with such treatment or repetition of such treatment. Receipt of such advance warning shall be acknowledged by signature of the patient or, in the case of a minor, the patient's parent or guardian and shall be retained by the physician for the period prescribed by the board;
    20. (20) Disciplinary action against a person licensed to practice medicine by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state;
    21. (21)
      1. (A) Transferring of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in the state of Tennessee using any electronic, telephonic or fiber optic means or by any other method if such information is employed to diagnose and/or treat persons physically located within the state of Tennessee;
      2. (B) Notwithstanding the provision of subdivision (b)(21)(A), the transfer of such information shall not be prohibited if such information is:
        1. (i) To be used for a second opinion requested by a Tennessee licensed medical doctor or osteopathic physician;
        2. (ii) To be used by an out-of-state physician for treatment of a person who is seeking treatment out of Tennessee;
        3. (iii) Used to determine if such patient is covered by insurance;
        4. (iv) Used by a physician in another state to provide occasional academic consultations to a medical school located in Tennessee;
        5. (v) Used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimants' rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of persons physically located within Tennessee as prohibited by subdivision (b)(21)(A); or
        6. (vi) Used in clinical trials for drugs approved by the food and drug administration;
      3. (C) This subdivision (b)(21) does not apply to research hospitals, as defined in § 63-6-204(f)(7)(I);
      4. (D) This subdivision (b)(21) only applies to X-rays and medical imaging; and
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    22. (22) No person licensed in this state to practice medicine shall agree or contract with any clinical, bioanalytical or hospital laboratory, wherever located, to pay such laboratory for anatomic pathology services or cytology services and thereafter include such costs in the bill or statement submitted to the patient or any entity or person for payment, unless the practitioner is in compliance with the requirements of § 56-7-1015(g) and discloses on the bill or statement or in writing by a separate disclosure statement in a minimum print size of ten (10) font the name and address of the laboratory and the net amount or amounts paid or to be paid to the laboratory for the anatomic pathology services or cytology services. This subdivision (b)(22) shall not apply to the state or any local government.
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  3. (c) In enforcing this section, the board shall, upon probable cause, have authority to compel an applicant or licensee to submit to a mental and/or physical examination by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition is involved. The applicant or licensee may have an independent medical practitioner present during such examination, and the applicant may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board, which will then hold a hearing as provided in § 63-6-216.
  4. (d) The board, on its own motion, may investigate any report indicating that a doctor of medicine is or may be in violation of subsection (b). Any doctor of medicine, any medical society or any other person who in good faith reports to the board any information that a doctor of medicine is or may be in violation of subsection (b) shall not be subject to suit for civil damages as a result thereof.
  5. (e) Within thirty (30) days after the conviction of a person known to be a physician, licensed or otherwise lawfully practicing within this state or applying to be so licensed or to practice, of a felony under the laws of this state, the clerk of the court of record in which the conviction was entered shall prepare and forward to the board a certified true and correct abstract of record of the court governing the case. The abstract shall include the name and address of the physician or applicant, the nature of the offense committed, the sentence and the judgment of the court. The board shall prepare the form of the abstract and shall distribute copies thereof to all clerks of courts of record within this state with appropriate instruction for preparation and filing.
  6. (f) The board shall report within sixty (60) days its action regarding restriction, suspension or revocation of a physician's license, limitation on practice privileges or other disciplinary action of the board against any physician to appropriate federal and state agencies. The board may report any of the above-mentioned disciplinary actions to the Federation of State Medical Boards of the United States and the Tennessee Medical Association.
  7. (g) For purposes of actions taken pursuant to subdivisions (b)(4), (12) and (13) or any other subsection in which the standard of care is an issue, any Tennessee licensed physician serving as a board member, hearing officer, designee, arbitrator or mediator is entitled to rely upon that person's own expertise in making determinations concerning the standard of care and is not subject to voir dire concerning such expertise. Expert testimony is not necessary to establish the standard of care. The standard of care for such actions is a statewide standard of minimal competency and practice that does not depend upon expert testimony for its establishment. However, to sustain actions based upon a violation of this standard of care, the board must, in the absence of admissions or other testimony by any respondent or such respondent's agent to the effect that the standard was violated, articulate what the standard of care is in its deliberations. Title 29, chapter 26, and specifically § 29-26-115, concerning the locality rule, do not apply to actions taken pursuant to this chapter.
  8. (h)
    1. (1) All materials, documents and other matters relating to, compiled or created pursuant to an investigation conducted by the board's investigators against any health care practitioner under the board's jurisdiction, shall be exempt from the public records act until the filing of a notice of charges. After the filing of a notice of charges, only the information and those materials and documents upon which the charges are based are available for disclosure under the public records act; provided, that the identifying information of the following, as well as all investigator created documents and reports, shall remain confidential at all times unless and until introduced in the proceedings:
      1. (A) A complainant;
      2. (B) Any witness who requests anonymity;
      3. (C) A patient; and
      4. (D) Medical records.
    2. (2) This section does not modify or limit the prehearing discovery provisions set forth in the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, part 3.
  9. (i)
    1. (1) The board may utilize one (1) or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for diversion to professional peer review organizations and/or impaired professionals associations or foundations of those cases that the board, through established guidelines, deems appropriate; upon diversion, such entities shall retain the same immunity as provided by law for the board.
    2. (2) The screening panels shall consist of as many members as the board directs, but shall include at least one (1) but no more than three (3) licensed physicians, who may be members of the board or may serve either voluntarily or through employment by or under contract with the board;
    3. (3) The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings law, compiled in title 8, chapter 44, and, to the extent required by subdivision (h)(2), shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the board and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
  10. (j) Notwithstanding any provision of the Uniform Administrative Procedures Act, to the contrary, hearing officers are authorized to and may hear board mediation, arbitration or disciplinary contested cases, but may not issue final orders in contested case matters. Notwithstanding any of the provisions of §§ 4-5-314 and 4-5-315 which may be or are inconsistent, such hearing officers may only issue findings of fact and conclusions of law, which shall be referred directly to the board or a duly constituted panel thereof for final action. The board or duly constituted panel, after hearing testimony and arguments from both parties regarding the appropriate disciplinary action and, if allowed by the board, arguments on any controversy raised by the hearing officer's or designee's order, shall issue a final order to include the imposition of what, if any, disciplinary action is deemed appropriate. Only the board or a duly constituted panel thereof shall have the authority to issue final orders that dispose of a pending contested case regardless of whether the issues resulting in the dispositive action are procedural, substantive, factual or legal. If a hearing officer is not available when a contested case, or any motion filed therein requiring action, is ready and scheduled to be heard or fails to timely prepare findings and conclusions pursuant to board established guidelines, the board or a duly constituted panel thereof may rule on the motions and/or hear the contested case or utilize the record compiled before the hearing officers and prepare its own findings of fact, conclusions of law and then issue a final order. With regard to findings and conclusions issued by the hearing officer, or any mediator or arbitrator, the board or any duly constituted panel thereof that reviews the case may do any of the following:
    1. (1) Adopt the hearing officer's, mediator's or arbitrator's findings of fact and conclusions of law, in whole or in part;
    2. (2) Make its own findings of fact and conclusions of law, based solely on the record and the expertise of the members of the board or panel, in addition to or in substitution of those made by the hearing officer, mediator or arbitrator;
    3. (3) Remand the matter back to the hearing officer, mediator or arbitrator for action consistent with the board or panel findings and conclusions in the matter; or
    4. (4) Reverse the hearing officer's, mediator's or arbitrator's findings and/or dismiss the matter entirely.
  11. (k) The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section in compliance with procedures established by the board. The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case against the licensee or person.
  12. (l) Any elected officer of the board, or any duly appointed or elected chair of any panel of the board, or any screening panel, and any hearing officer, arbitrator or mediator has the authority to administer oaths to witnesses and, upon probable cause being established, issue subpoenas for the attendance of witnesses and the production of documents and records.
  13. (m) Notwithstanding any provision of this chapter or chapter 9 of this title, or any rule or regulation promulgated thereto to the contrary, it shall not be a violation for a physician or osteopathic physician to prescribe, order, sell or otherwise distribute the Schedule IV drugs fenfluramine, its salts and isomers, and salts of isomers and phentermine, for their currently accepted medical use in the United States.
  14. (n) Notwithstanding any provision of this chapter or chapter 9 of this title, or any rule or regulation promulgated thereto to the contrary, whenever a physician is treating obesity in a child who is under eighteen (18) years of age with Schedule IV drugs fenfluramine, its salts and isomers, and salts of isomers and phentermine, the physician shall:
    1. (1) Obtain the consent of the child's parent or guardian; and
    2. (2) Determine that the child's body mass index (BMI) is at least twenty-seven (27), or is at least twenty-five (25) with co-morbidities, including, but not limited to:
      1. (A) Diabetes;
      2. (B) Hypertension;
      3. (C) Dyslipidemia;
      4. (D) Cardiovascular diseases; and
      5. (E) Sleep apnea.
  15. (o) It is not a violation of this chapter or chapter 9 of this title for a physician or osteopathic physician to prescribe, order, or otherwise distribute, for the purpose of treating binge eating disorder, a drug which is approved by the federal food and drug administration for that indication.
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§ 63-6-215. Advertising.
  1. (a) The board shall adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of such board.
  2. (b) If advertising is permitted, all methods must be allowed: newspaper, radio and television.
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§ 63-6-216. Disciplinary proceedings governed by Administrative Procedures Act.
  1. All proceedings for disciplinary action against a licensee under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
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§ 63-6-217. Practice after license revocation — Penalty.
  1. After the board has revoked the license of any person for any of the grounds specified in §§ 63-6-214 and 63-6-215, such person shall not thereafter practice medicine or surgery in the state, and for each and every instance of such practice the person commits a Class B misdemeanor.
§ 63-6-218. “Good Samaritan Law.”
  1. (a) This section shall be known and cited as the “Good Samaritan Law.”
  2. (b) Any person, including those licensed to practice medicine and surgery and including any person licensed or certified to render service ancillary thereto, or any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services, shall not be liable to victims or persons receiving emergency care for any civil damages as a result of any act or omission by such person in rendering the emergency care or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person, except such damages as may result from the gross negligence of the person rendering such emergency care, who in good faith:
    1. (1) Renders emergency care at the scene of an accident, medical emergency and/or disaster, while en route from such scene to a medical facility and while assisting medical personnel at the receiving medical facility, including use of an automated external defibrillator, to the victim or victims thereof without making any direct charge for the emergency care; or
    2. (2) Participates or assists in rendering emergency care, including use of an automated external defibrillator, to persons attending or participating in performances, exhibitions, banquets, sporting events, religious or other gatherings open to the general public, with or without an admission charge, whether or not such emergency care is made available as a service, planned in advance by the promoter of the event and/or any other person or association.
  3. (c) A receiving medical facility shall not be liable for any civil damages as a result of any act or omission on the part of any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services while such person is assisting medical personnel at the receiving medical facility.
  4. (d) The members of such volunteer fire squad, while providing fire protection within such area outside of a plant, shall be liable to suit under the provisions of the Governmental Tort Liability Act, compiled in title 29, chapter 20, part 2, if:
    1. (1) A volunteer fire squad is organized by a private company for the protection of the plant and grounds of such company;
    2. (2) Such squad is willing to respond and does respond to calls to provide fire protection for residents living within a six (6) mile radius of the county surrounding such plant; and
    3. (3) The plant is located in a county that does not otherwise provide fire protection to such residents.
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§ 63-6-219. Surgical assistants.
  1. (a) No person shall use or assume the title “registered surgical assistant” unless such person is registered with the board as a registered surgical assistant.
  2. (b) The board shall register as a registered surgical assistant any applicant who presents satisfactory evidence that the applicant:
    1. (1) Holds and maintains a current credential as a surgical assistant or surgical first assistant issued by the National Board of Surgical Technology and Surgical Assisting, the National Surgical Assistant Association, or the National Commission for Certification of Surgical Assistants or their successors;
    2. (2) Has successfully completed a surgical assistant training program during the applicant's service as a member of any branch of the armed forces of the United States; or
    3. (3) Has practiced as a surgical assistant at any time in the six (6) months prior to July 1, 2017, provided the applicant registers with the board by December 31, 2019.
  3. (c) The board shall have the authority to deny, restrict, condition, revoke, or otherwise discipline the registration of a surgical assistant for violation of this section, violation of any rules promulgated pursuant to this section, or any basis provided in § 63-6-214.
§ 63-6-220. Treatment of juvenile drug abusers without parental consent.
  1. (a) Physicians may treat juvenile drug abusers without prior parental consent.
  2. (b) A physician may use the physician's own discretion in determining whether to notify the juvenile's parents of such treatment.
§ 63-6-221. Office-based surgeries.
  1. (a) For the purposes of this section, unless the context otherwise requires:
    1. (1) “Board” means the board of medical examiners;
    2. (2) “Level II office-based surgery” means Level II surgery, as defined by the board of medical examiners in its rules and regulations, that is performed outside of a hospital, an ambulatory surgical treatment center or other medical facility licensed by the health facilities commission;
    3. (3) “Office-based surgery” or “Level III office-based surgery” means Level III surgery requiring a level of sedation beyond the level of sedation defined by the board of medical examiners as Level II surgery that is performed outside a hospital, an ambulatory surgical treatment center or other medical facility licensed by the health facilities commission;
    4. (4) “Physician” means any person licensed under this chapter; and
    5. (5) “Surgical suite” means both the operating and recovery room or rooms located in a physician's office where Level III office-based surgery is to be performed.
  2. (b) The board shall have the duty and responsibility to regulate the practice of office-based surgery, including the promulgation of rules necessary to promote patient health and safety in such practices, including, but not limited to, a mechanism by which all office-based surgical suites are surveyed and certified by the board.
  3. (c) The board shall specifically identify in rules the parameters to be used in determining Level III surgical procedures and multiple procedures that may be performed in an office-based setting pursuant to the level of anesthesia involved in the procedures. In addition, the board shall promulgate age and risk classification criteria of patients eligible for Level III office-based surgical procedures.
  4. (d) By December 30, 2007, the board shall adopt rules establishing a specific list of approved Level III surgical procedures that can be performed in a physician's office in this state. The ambulatory surgical center covered procedures list promulgated by the centers of medicare and medicaid shall be used as a guide. No physician shall perform any Level III surgical procedures that are not included on the list promulgated by the board. The board may modify the list as the board deems necessary. The board shall also promulgate rules addressing the minimum requirements deemed necessary by the board for the safe performance of office-based surgery.
  5. (e) Using the rules established for ambulatory surgical treatment centers as guidelines, the board shall promulgate rules relative to infection control, life safety, patient rights, hazardous waste and equipment and supplies necessary to assure the safety of patients undergoing office-based surgery. Any provision in the ambulatory surgical treatment center rules addressing infection control, life safety, patient rights, hazardous waste and equipment and supplies that is not adopted by the board shall require a statement entered into the official minutes from the board justifying the board's decision.
  6. (f) No more than three (3) patients undergoing Level III office-based surgery in a physician’s office may be incapable of self-preservation at the same time. The board shall promulgate rules requiring physician offices that perform office-based surgery to adopt bylaws that put in place a management system and documentation that will ensure that no more than three (3) patients that are in surgery or recovery are incapable of self-preservation at the same time. The bylaws and documentation of the management system shall be included in the application for surgical suite certification.
  7. (g) Except for emergencies, a surgical suite certified for office-based surgery may be utilized only by physician employees of the practice in which the surgical suite is located. Surgical suites may not be shared with other practices or other physicians.
  8. (h) The board shall enter into a memorandum of understanding, contract or other written arrangement with the health facilities commission such that the commission:
    1. (1) Provides a site survey of the surgical suites sought to be certified to perform office-based surgery. A physician office at which office-based surgeries are being performed as of October 1, 2007, shall submit both a request for a site survey on an application form developed by the board and remit payment of the office-based surgery fee to the commission by October 1, 2007. If the office makes a timely filing in accordance with this subdivision (h)(1), the physician's office may continue to be a site for office-based surgeries pending completion of a survey confirming compliance with board rules and subsequent issuance of a certification of the surgical suite or suites. A physician office at which office-based surgeries are not being performed as of October 1, 2007, shall not perform any such procedures until an application form and payment of the office-based surgery fee is submitted to the board and a site survey is completed by the commission and a certification of the surgical suite is issued by the board;
    2. (2) Is authorized to require plans of correction and to verify that the plans of correction have been implemented;
    3. (3) Is authorized to initiate subsequent, unannounced site surveys during regular business hours as long as the physician office continues to be used to perform office-based surgeries, but no more frequently than once every twelve (12) months; and
    4. (4) Is authorized to respond to any complaints made by patients or the public against a physician who performs office-based surgery or a physician's office at which office-based surgery is being performed at the request of the office of investigations.
  9. (i) The results of all site surveys shall be transmitted by the health facilities commission to the board. The results shall include any requirement for plans of correction, the commission's determination of the acceptability of the submitted plans of correction and the commission's verification that the plans of correction have been implemented. The board shall make a final determination on certifying the surgical suite for performance of office-based surgeries. The results of site surveys and board determinations shall be shared on a routine basis with the board for licensing health care facilities.
  10. (j) The results of all complaint investigations by health facilities commission staff shall be transmitted to the board for resolution; however, that information shall at all times be maintained as confidential and not available to the public except to the extent § 63-1-117(g) applies.
  11. (k) Any physician office that desires to be certified to perform office-based surgery shall pay to the health facilities commission an annual office-based surgery fee as set by the board.
  12. (l) A physician office at which office-based surgery is being performed shall ensure that claims data is reported to the executive director of the health facilities commission on a form approved by the health facilities commission. The data shall be submitted through a third party approved by the health facilities commission for the purpose of editing the data according to rules and regulations established by the executive director. The physician office shall be responsible for the costs associated with processing of the data by the approved vendors. The claims data shall be reported at least quarterly to the executive director. No information shall be made available to the public by the executive director that reasonably could be expected to reveal the identity of any patient. The claims data reported to the executive director under this section are confidential and not available to the public until the executive director processes and verifies the data. The executive director shall prescribe conditions under which the processed and verified data are available to the public.
  13. (m)
    1. (1) Except as provided in subdivision (h)(1), a physician office surgical suite is required to be certified by the board in order to perform office-based surgery. A physician office that proposes to perform office-based surgery shall submit to the board, on an application form provided by the board, at least the following:
      1. (A) Level III procedures expected to be performed by each physician;
      2. (B) The specialty board certification or board eligibility of the physician or physicians performing Level III procedures, if any;
      3. (C) Verification of health care liability coverage for all physicians performing Level III procedures;
      4. (D) Verification of hospital staff privileges for all physicians performing Level III procedures;
      5. (E) The name of a responsible physician in whose name the surgical suite certification shall be issued for that office and a list of the physicians with the practice who are going to be performing Level III office-based surgeries; and
      6. (F) The documentation required by subsection (f) regarding incapacitated patient limits.
    2. (2) The form required by subdivision (m)(1) shall serve as an application form, but the information on the form shall be updated as appropriate when any information on it has changed.
  14. (n) The board shall notify all physicians of the office-based surgery certification requirements. Failure of a physician performing office-based surgery or a physician office at which office-based surgery is being performed to abide by this section, any rules promulgated pursuant to this section or of § 68-11-211 may be grounds for disciplinary action or termination of either the rights of the physician to perform office-based surgery or the surgical suite's certification by the physician's licensing board, or both disciplinary action and termination. For purposes of § 4-5-320(c), the public health, safety and welfare imperatively require emergency action at any time that a previously authorized surgical suite fails to maintain the standards set by the board.
  15. (o) Applicants for initial licensure or reinstatement of a previously issued license shall indicate to the board on the appropriate licensure application if they intend to perform Level II office-based surgery procedures as defined by the rules of the board of medical examiners and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  16. (p) Licensed physicians who perform Level II office-based surgery at the time of licensure renewal shall indicate to the board on the licensure renewal application if the licensee currently performs Level II office-based surgery procedures as defined in the rules of the board of medical examiners and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  17. (q) In order for health care providers and the board to work together to collect meaningful health care data, so as to minimize the frequency and severity of certain unexpected events and improve the delivery of health care services, each physician who performs any Level II office-based surgery or Level III office-based surgery that results in any of the following unanticipated events shall notify the board in writing within fifteen (15) calendar days following the physician's discovery of the event:
    1. (1) The death of a patient during any Level II office-based surgery or Level III office-based surgery or within seventy-two (72) hours thereafter;
    2. (2) The transport of a patient to a hospital emergency department except those related to a natural course of the patient's illness or underlying condition;
    3. (3) The unplanned admission of a patient to a hospital within seventy-two (72) hours of discharge, only if the admission is related to the Level II office-based surgery or Level III office-based surgery, except those related to a natural course of the patient's illness or underlying condition;
    4. (4) The discovery of a foreign object erroneously remaining in a patient from a Level II office-based surgery or Level III office-based surgery at that office; or
    5. (5) The performance of the wrong surgical procedure, surgery on the wrong site or surgery on the wrong patient.
  18. (r) Records of reportable events should be in writing and should include at a minimum the following:
    1. (1) The physician's name and license number;
    2. (2) The date and time of the occurrence or discovery of the incident;
    3. (3) The office and address where the incident took place;
    4. (4) The name and address of the patient;
    5. (5) The type of Level II office-based surgery or Level III office-based surgery that was performed;
    6. (6) The type and dosage of sedation or anesthesia utilized during the procedure;
    7. (7) The circumstances surrounding the incident; and
    8. (8) The type or types of events required to be reported as provided in subsection (q).
  19. (s) The filing of a report as required by subsection (q) does not, in and of itself, constitute an acknowledgement or admission of health care liability, error or omission. Upon receipt of the report, the board may, in its discretion, obtain patient and other records pursuant to authority granted to it in § 63-1-117. The reporting form and any supporting documentation reviewed or obtained by the board pursuant to this section and any amendments to the reports shall be confidential and not subject to discovery, subpoena or legal compulsion for release to any person or entity; nor shall they be admissible in any civil or administrative proceeding, other than a disciplinary proceeding by the board; nor shall they be subject to any open records request made pursuant to title 10, chapter 7, part 5 or any other law. This section shall not affect any of the provisions of or limit the protections provided by § 63-1-150.
  20. (t) Failure to comply with the requirements of subsections (o)-(s) constitutes grounds for disciplinary action by the board in its discretion pursuant to § 63-6-214.
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§ 63-6-222. Emergency treatment of minors.
  1. (a) Any licensed physician may perform emergency medical or surgical treatment on a minor, despite the absence of parental consent or court order, where such physician has a good faith belief that delay in rendering emergency care would, to a reasonable degree of medical certainty, result in a serious threat to the life of the minor or a serious worsening of such minor's medical condition and that such emergency treatment is necessary to save the minor's life or prevent further deterioration of the minor's condition.
  2. (b) Such treatment shall be commenced only after a reasonable effort is made to notify the minor's parents or guardian, if known or readily ascertainable.
  3. (c) Any physician rendering emergency care to a minor pursuant to this section shall not be liable for civil damages, except such damages as may result from the negligence of the physician in rendering such care.
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§ 63-6-223. Prenatal and peripartum care for minors.
  1. (a) Any person licensed to practice medicine, including those persons rendering service pursuant to § 63-6-204, may, for the purpose of providing prenatal care, examine, diagnose and treat a minor without the knowledge or consent of the parents or legal guardian of the minor and shall incur no civil or criminal liability in connection therewith except for negligence.
  2. (b) Any person licensed to practice medicine, including those persons rendering service pursuant to § 63-6-204, may, for the purpose of providing peripartum care, which may include providing peripartum analgesia, examine, diagnose, and treat a minor who is at least fourteen (14) years of age without the knowledge or consent of the parents or legal guardian of the minor and shall incur no civil or criminal liability in connection therewith except for negligence.
§ 63-6-224. Board authority on x-ray equipment — Certificates and accreditations — Requirements to perform x-ray procedures — Limitations.
  1. (a) The board has, in regard to operators of X-ray equipment and machines in physician offices, the authority by rule to:
    1. (1) Establish and issue limited X-ray certifications to qualified individuals in the areas of densitometry, chest, extremities, skull, sinus, and spine;
    2. (2) Establish and issue full X-ray certifications to individuals who hold current and unrestricted national certification from the American Registry of Radiologic Technologists or another equivalent nationally recognized radiologic organization recognized by the board;
    3. (3) Establish the minimum educational courses, curricula, hours, and standards that are prerequisite to the issuance of the limited certificates;
    4. (4) Select at least one (1) examination to be utilized as the board's limited certification examination and the prerequisites, if any, for admission to the examination. The board may enter into a contract or agreement with the chosen examination service or select an intermediary between the board and the examination service to process applicants for the examination;
    5. (5) Establish other criteria for issuance of limited certificates that are reasonably related to the safe and competent performance of X-ray procedures;
    6. (6) Establish a mechanism for board accreditation of educational courses that are operating for purposes of qualifying individuals for limited certification, that meet the requirements established pursuant to the rules promulgated under the authority of subdivision (a)(3), and that establish the causes and standards that are grounds for withdrawal of the course accreditation and the mechanism for such withdrawal;
    7. (7) Establish the fees to be paid for application, certification, renewal, and late renewal of certificates and the fees required to be paid for application, renewal, and late renewal of educational course accreditation; and
    8. (8) Establish the required number of hours, types of courses, and method of proving compliance for biennial continuing education for all certificate holders.
  2. (b) The certificates and accreditations issued pursuant to this section must be renewed and may be retired and reactivated pursuant to procedures established by the board. A person holding a certificate issued pursuant to this section may be disciplined for the same causes and under the same procedures as contained in § 63-6-214 for the board of medical examiners and § 63-9-111 for the board of osteopathic examination.
  3. (c) The standards established by the board pursuant to subsection (a) must be at least as stringent as any mandatory federal standards.
  4. (d)
    1. (1) A person shall not perform an X-ray procedure in a physician's office without being licensed as a physician or certified by the board pursuant to this section.
    2. (2) Notwithstanding subdivision (d)(1):
      1. (A) A person who has enrolled in a board-recognized radiologic training program is exempt from the certification requirements of this section only as to X-ray procedures performed within or under the auspices of the program in which the person is enrolled;
      2. (B) A person who has successfully completed a board-recognized training program is exempt from the certification requirements of this section while awaiting the first opportunity to sit for the certification examination, but only for a period not to exceed six (6) months after the date of completion of the program; and
      3. (C) A person who has taken the certification examination is exempt from the certification requirements of this section while awaiting the scores of the certification examination, but only for a period not to exceed seventy-five (75) days after the date of the examination.
  5. (e) A person who holds a certificate issued pursuant to this section shall not perform X-ray procedures without:
    1. (1) An order from a physician licensed pursuant to this chapter or an osteopathic physician licensed pursuant to chapter 9 of this title; and
    2. (2) A physician licensed pursuant to this chapter or an osteopathic physician licensed pursuant to chapter 9 of this title exercising full supervision, responsibility, and control over the services being provided. The board is authorized to establish by rule the level of supervision required of physicians utilizing persons certified pursuant to this section.
  6. (f) A person shall not operate a business in this state in which X-ray procedures contemplated by this section are performed if the business is not owned by a physician, group of physicians, medical professional corporation, limited liability medical professional company, or an entity or facility licensed by the health facilities commission.
  7. (g) As used in this section, “physician's office” means anywhere the practice of medicine as defined in § 63-6-204, or the practice of osteopathic medicine as defined in § 63-9-106, which includes the performance of X-ray procedures contemplated by this section, is being conducted, except where that practice is conducted in or under the auspices of a facility or entity licensed by the health facilities commission.
§ 63-6-225. Unlawful division of fees by physicians.
  1. (a) It is an offense for any licensed physician or surgeon to divide or to agree to divide any fee or compensation of any sort received or charged in the practice of medicine or surgery with any person without the knowledge and consent of the person paying the fee or compensation or against whom the fee may be charged.
  2. (b) This section does not prohibit a physician from compensating any independent contractor that provides goods or services to the physician on the basis of a percentage of the physician's fees generated in the practice of medicine. The percentage paid must be reasonably related to the value of the goods or services provided. Payments by physicians in return for referrals are prohibited.
  3. (c) A violation of this section is a Class B misdemeanor.
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§ 63-6-226. Additional penalty — Suit for recovery.
  1. (a) Any person who violates § 63-6-225 shall also forfeit and pay treble the value of the fee or compensation to the person applying the same or against whom the fee may be charged, or from whom it may have been demanded, and if the party entitled to sue does not sue within two (2) years after the fee or compensation has been paid or demanded, then the state shall have the right to sue for and recover such treble amount, which shall, upon recovery, be paid one-half (½) into the state treasury and one-half (½) to the officer prosecuting the suit.
  2. (b) It is the duty of the attorney general and reporter, or of the district attorney general of any county in which service of process may be had upon the person liable, to institute in the name of the state all suits necessary for the recovery of the sum of money.
§ 63-6-227. Cancellation of license upon conviction.
  1. The license of any physician or surgeon who is convicted of a violation of § 63-6-225 may, upon the first conviction, and shall, upon any subsequent conviction, be adjudged to be cancelled and annulled by the court before which the conviction may be and, without further trial or hearing, the physician or surgeon shall not thereafter again be admitted to practice medicine or surgery within this state.
§ 63-6-228. Community health management information systems.
  1. (a) This section shall be known and may be cited as the “Tennessee Community Health Management Information System Law of 1993.”
  2. (b) As used in this section, unless the context otherwise requires:
    1. (1) “Collected data” means health care data consisting of all information, interviews or other reports, statements, memoranda or other information furnished from all sources and in whatever form to the quality assessment committee, together with the records, reports, proceedings and other information used by the quality assessment committee to reach its conclusions in the form of releasable data as defined in this section;
    2. (2) “Community health management information system (CHMIS)” means any broad based organization, including, but not limited to, providers of health care goods and services, payors for health care goods and services, including insurors and employers, and users of health care goods and services, whose goal is to monitor and improve the level of community wellness and the quality of health care rendered by providers of health care delivery services and the financial reimbursement systems in a county having a population in excess of eight hundred thousand (800,000), according to the 1990 federal census or any subsequent federal census;
    3. (3) “Quality assessment committee” means a committee of a CHMIS consisting primarily of physicians and other providers of health care, with insurors and employers, whose purpose is to collect, analyze and refine health care data as part of the CHMIS; and
    4. (4) “Releasable data” means summaries and conclusions of collected data of the quality assessment committee determined by such quality assessment committee to be scientifically valid and formally delivered to the quality executive committee to achieve the purposes of the CHMIS.
  3. (c) It is the stated policy of Tennessee to encourage each CHMIS to candidly, conscientiously and objectively monitor and improve the level of community wellness and quality of health care delivery services and financial reimbursement systems. Tennessee further recognizes that confidentiality is essential both to effective functioning of the CHMIS and to continued improvement in the access to, the efficiency of and the quality of health care services. As incentive for the providers, payors and users of health care services to participate in a quality assessment committee, such quality assessment committee must be protected from liability for its good faith efforts. To this end, a quality assessment committee of a CHMIS should be granted certain immunities relating to its actions undertaken as part of its responsibility to collect, analyze and refine health care data. In instances of a quality assessment committee examining the appropriateness of physicians' fees, this immunity must also extend to restraint of trade claims under title 47, chapter 25.
  4. (d)
    1. (1) All health care professional associations and societies and other organizations, including insurors and employers, institutions, foundations, entities and associated communities as identified in subsection (c), physicians, registered nurses, hospitals, hospital administrators and employees, members of boards of directors or trustees of any publicly supported or privately supported hospital or other such provider of health care, any person acting as a staff member of a quality assessment committee of a CHMIS, any person under a contract or other formal agreement with a quality assessment committee of a CHMIS, any person who participates with or assists a quality assessment committee of a CHMIS with respect to its functions or any other individual appointed to any quality assessment committee as such term is described in subsection (b) shall be immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such quality assessment committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by a quality assessment committee undertaken or performed within the scope or function of the duties of such quality assessment committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
    2. (2) Notwithstanding subdivision (d)(1), any person providing information to a quality assessment committee of a CHMIS regarding the analysis and refinement of health care data shall be immune from liability to any person, unless such information is false and the person providing it had actual knowledge of such falsity.
  5. (e) All collected data of the CHMIS are declared to be privileged and shall not be public records nor be available for court subpoena or for discovery proceedings. The CHMIS, through a quality executive committee or similar committee, shall establish particular categories of health care data and refinement periods for each category of health care data, whether such data is collected data or releasable data. Releasable data shall be subject to the privileges and limitations of collected data for refinement periods as determined by the quality executive committee. When the refinement period has expired for a particular category of releasable data, then such immunities and privileges set forth in this subsection (e) shall no longer apply to the releasable data for such category. The disclosure of confidential, privileged quality assessment committee information to original sources during the refinement period, or as a report by the quality assessment committee to the quality executive committee, the CHMIS board of directors or another executive committee within the CHMIS, prior to the expiration of the refinement period does not constitute either a waiver of confidentiality or privilege. Nothing contained in this subsection (e) applies to records made in the regular course of business by a hospital or other provider of health care and information, documents or records otherwise available from original sources are not to be construed as immune from discovery or use in any civil proceedings merely because they were presented during the refinement period of the quality assessment committee.
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§ 63-6-229. Consent to medical treatment by a minor.
  1. Notwithstanding any other provision of law to the contrary, in the absence or unavailability of a spouse, any minor is authorized and empowered to consent for such minor's child, either orally or otherwise, to any surgical or medical treatment or procedures not prohibited by law that may be suggested, recommended, prescribed or directed by a duly licensed physician.
§ 63-6-230. Inactive licenses to perform pro bono services.
  1. The board of medical examiners shall establish by rule an inactive license category that allows physicians to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of medicine.
§ 63-6-231. Transfer of patient medical information outside the state.
  1. (a) The transfer of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in the state of Tennessee, using any electronic, telephonic or fiber optic means or by any other method, constitutes the practice of medicine or osteopathy if such information is employed to diagnose and/or treat, any person physically located within the state of Tennessee.
  2. (b) Notwithstanding subsection (a) to the contrary, the transfer of such information shall not constitute the practice of medicine if:
    1. (1) Such information is to be used by a medical doctor or doctor of osteopathy licensed in Tennessee;
    2. (2) Such information is to be used for a second opinion requested by a Tennessee licensed medical doctor or doctor of osteopathy; provided, no charges are assessed for such second opinion;
    3. (3) Such information is to be used by an out-of-state physician for treatment of a person who is seeking medical treatment out of Tennessee;
    4. (4) Such information is used to determine if such patient is covered by insurance;
    5. (5) Such information is to be used by physicians in another state to provide occasional academic consultations to a medical school located in Tennessee; or
    6. (6) Such information is used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimant's rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of any person physically located within the state of Tennessee as prohibited by subsection (a).
  3. (c) This section shall not apply to research hospitals, as defined in § 63-6-204(f)(7).
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§ 63-6-232. Disciplinary complaints against chelation therapist.
  1. All disciplinary complaints filed against a chelation therapist shall be judged by the standard of medical care in the community where such complaint originated.
§ 63-6-233. Continuing medical education.
  1. (a) Any person licensed to practice medicine in this state shall complete continuing medical education as required by the board of medical examiners. The board of medical examiners may establish waivers from such continuing medical education requirements and exemptions for certain licensees through rules and regulations.
  2. (b) The board of medical examiners shall establish the continuing medical educational requirements, waivers and exemptions through rules and regulations promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-6-234. Physicians serving as United States public health service commissioned officers.
  1. A physician serving as a United States public health service commissioned officer who is trained as a national health service corps ready responder shall be authorized to practice medicine at federally qualified health centers while pursuing licensure as provided in this part under the following conditions:
    1. (1) The physician has first filed an application for licensure as provided in this part;
    2. (2) The physician, prior to commencing practice, submits a written statement to the board that all of the physician's medical licenses, including the authority to practice in United States public health service, are unencumbered by disciplinary actions, unresolved disciplinary complaints or unresolved health care liability lawsuits; and
    3. (3) The physician timely complies with all board rules governing the application process and immediately ceases practicing medicine until a license is subsequently granted should the initial licensure application be closed either for failure to provide timely required information or is denied by the board.
§ 63-6-235. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. (a) A physician licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of medical examiners may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
  2. (b) Notwithstanding any other provision of this chapter to the contrary, a retired or inactive physician may apply for and receive a special volunteer license for practice only in volunteer service at benevolent or humanitarian service project locations outside of the state. The board of medical examiners is authorized to promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this section.
§ 63-6-236. Drug prescriptions.
  1. (a) Any handwritten prescription order for a drug prepared by a physician or surgeon who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing physician or surgeon, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician or surgeon must sign the handwritten prescription order on the day it is issued, unless the prescription order is:
    1. (1) Issued as a standing order in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201; or
    2. (2) Prescribed by a physician or surgeon in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
  2. (b) Any typed or computer-generated prescription order for a drug issued by a physician or surgeon who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the typed or computer-generated prescription order. The prescription order must contain the name of the prescribing physician or surgeon, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician or surgeon must sign the typed or computer-generated prescription order on the day it is issued, unless the prescription order is:
    1. (1) Issued as a standing order in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201; or
    2. (2) Prescribed by a physician or surgeon in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
  3. (c) Nothing in this section shall be construed to prevent a physician or surgeon from issuing a verbal prescription order.
  4. (d)
    1. (1) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
    2. (2) Subdivision (d)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions, writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
§ 63-6-237. Radiologist assistants.
  1. (a) In addition to the practice permitted by [former] § 63-6-902 [repealed], a radiologist may utilize the services of a radiologist assistant to practice radiology assistance under the supervision of such radiologist to the extent not prohibited by [former] § 63-6-902 [repealed].
  2. (b) The board of medical examiners shall define the scope of practice of a radiologist assistant and the educational qualifications necessary to practice as a radiologist assistant by rules promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Such rules shall be consistent with guidelines adopted by the American College of Radiology, the American Society of Radiologic Technologists and the American Registry of Radiologic Technologists (ARRT).
  3. (c) A radiologist assistant must be a radiologic technologist certified by the board of medical examiners under [former] § 63-6-902 [repealed] and certified and registered with ARRT and credentialed to provide radiology services under the supervision of a radiologist.
  4. (d) A radiologist assistant may not interpret images, make diagnoses or prescribe medications or therapies.
  5. (e) On or after July 1, 2004, a radiology practitioner assistant shall only be known as a radiologist assistant.
  6. (f) On or after July 1, 2008, any person seeking to become a radiologist assistant in Tennessee must have completed an advanced academic program encompassing a nationally recognized radiologist assistant curriculum, as well as completed a radiologist directed clinical preceptorship, all culminating in a baccalaureate degree.
  7. (g) Any person who, on or before December 31, 2008, was practicing as a radiology practitioner assistant in Tennessee and who submits satisfactory proof of that practice to the board, along with an application and the certification fee on or before December 31, 2009, shall be entitled to be certified by the board as a radiologist assistant without having to meet the educational, certification, registration, credentialing or examination requirements of subsections (b) and (c) and rules promulgated pursuant to subsections (b) and (c).
§ 63-6-238. Notice to patients of departure.
  1. Psychiatrists are not required to notify patients that were treated by them at community mental health centers, as defined in § 33-1-101, of their departure from such community mental health centers. Patient records shall remain with the community mental health centers. The transfer of patients' records shall be in compliance with standards set by state and federal law.
§ 63-6-240. Remedial action against persons licensed to practice medicine who are required to register as a sexual offender or violent sexual offender in order to assure safety.
  1. (a)
    1. (1) The general assembly finds that a person who is licensed to practice medicine in this state and who is required to register with the Tennessee bureau of investigation (TBI) as a sexual offender or violent sexual offender is injurious to the public safety, health and welfare as well as the public's perception of and confidence in the medical profession.
    2. (2) The general assembly further finds that the strongest remedial action possible should be taken against a person's license to practice medicine when such person has been convicted of a sexual offense, or violent sexual offense as both are defined in title 40, chapter 39, part 2, and continues to engage in the practice of medicine in this state after such conviction.
    3. (3) Enactment of this section by the general assembly is declared to be a remedial action necessary to assure the safety of the citizens of this state and their faith and confidence in the medical profession. This section is not to be construed to be punitive against any person to whom this section may apply.
  2. (b) As used in this section:
    1. (1) “Registering agency” means a sheriff's office, municipal police department, metropolitan police department, campus law enforcement agency, the Tennessee department of correction, a private contractor with the Tennessee department of correction or the board with whom sexual offenders and violent sexual offenders are required to register under title 40, chapter 39, part 2;
    2. (2) “Registry” means the registry created by the Tennessee Sexual Offender and Violent Sexual Offender Registration, Verification and Tracking Act of 2004, compiled in title 40, chapter 39, part 2;
    3. (3) “Sexual offense” means those offenses defined as “sexual offenses” in § 40-39-202; and
    4. (4) “Violent sexual offense” means those offenses defined as “violent sexual offenses” in § 40-39-202.
  3. (c)
    1. (1) If the registering agency of a person who registers as a sexual offender or violent sexual offender, as defined by title 40, chapter 39, part 2, has reason to believe that such person is licensed to practice medicine in this state pursuant to this chapter, the registering agency shall prepare and forward to the board of medical examiners a certified copy of the offender's TBI registration form within thirty (30) days of the sexual offender's or violent sexual offender's registration.
    2. (2)
      1. (A) Upon receipt of the form, or upon receipt of credible evidence from any other source indicating that a person licensed to practice medicine in this state has been convicted of a sexual offense or a violent sexual offense, the board shall investigate to determine whether such person is a sexual offender or violent sexual offender, as defined by § 40-39-202, and a person licensed to practice medicine pursuant to this chapter.
      2. (B) If the board determines that the person named on the TBI registration form, or by another source, is a person licensed to practice medicine in this state pursuant to this chapter and the offense for which the person is required to register is a violent sexual offense, such conviction constitutes a material change in the person's licensure qualifications, and the board shall conduct a hearing at which the person may present evidence that the information received by the board is incorrect. If, after the hearing, the board finds the person was convicted of a violent sexual offense and is required to register with the TBI as a violent sexual offender, the board shall revoke the person's license to practice medicine in accordance with § 63-6-216. The person may appeal the ruling of the board as provided in the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, but such appeal shall be limited to the issue of whether or not such person has been convicted of a violent sexual offense and is therefore required to register as a violent sexual offender. The license revocation shall remain in effect during the pendency of any appeal.
      3. (C) If the person licensed to practice medicine is required to register as a sexual offender, the board shall conduct a hearing to determine the extent to which the person poses a continuing risk to patients; the degree to which the person has been rehabilitated; what treatment, if any, the person has undergone; the areas of medicine in which the person is qualified to engage without endangering the safety of patients; and any other factor the board deems relevant in determining the outcome most likely to protect the public while considering the interests of the person. At the conclusion of the hearing, the board may:
        1. (i) Revoke the license of the person; or
        2. (ii) If the board does not revoke the license, it may place such conditions on the person's license as it deems appropriate and advisable to protect the interests and safety of the public; provided, the board shall place the following restrictions on the person's license:
          1. (a) Prohibit the physician from engaging in direct patient care or contact; and
          2. (b) Such other conditions and limitations on the person's license as the board deems advisable.
      4. (D)
        1. (i) If a person's license to practice medicine was revoked, suspended or conditioned pursuant to subdivision (c)(2)(C) because such person was convicted of a sexual offense and such person applies for and is granted termination of sexual offender registry requirements pursuant to § 40-39-207, such person may petition the board for reinstatement of the person's license to practice medicine.
        2. (ii) If a petition is filed for reinstatement pursuant to this subsection (c), the board shall hear the petition within thirty (30) calendar days of its receipt. At the hearing the board shall use the same analysis set out in subdivision (c)(2)(C) to determine whether the person should be permitted to practice medicine in this state under any circumstances.
        3. (iii) If the written findings of the board are that the person is no longer a threat to public safety and could return to the practice of medicine in some capacity, it may:
          1. (a) Reinstate the person's license without conditions;
          2. (b) Reinstate the person's license with any or all the conditions available under subdivision (c)(2)(C); or
          3. (c) Remove some or all of the restrictions or conditions that were placed on a license made conditional pursuant to subdivision (c)(2)(C).
        4. (iv) If the written findings of the board are that the person could not safely return to the practice of medicine, it shall deny the person's petition and set a date certain after which the person may repetition the board.
      5. (E) If the board receives credible evidence from any source indicating that the person is in violation of the restrictions placed upon such person's license to practice medicine pursuant to this section, the board shall conduct a hearing as provided in subdivision (c)(2)(C). If at the conclusion of the hearing, the board finds that the person is in violation of the restrictions placed upon the person's license in a material respect or in a repetitive manner, the board shall revoke the license. If the board finds that the violation is minor or isolated, it may place other conditions on the person's license, such as increased reporting to the board by both the person and the person's employer or contractor, if any.
      6. (F) This subdivision (c)(2) shall apply regardless of whether commission of the sexual offense or violent sexual offense resulting in the person being required to register as a sexual or violent sexual offender occurred prior to or subsequent to the date the person was licensed to practice medicine in this state.
  4. (d) By September 1, 2010, the board shall compare or have compared a list of all persons who are licensed to practice medicine in this state against the list of persons who are registered as sexual offenders or violent sexual offenders pursuant to title 40, chapter 39, part 2. If it appears from this comparison that the same name appears on both lists, the board shall request a certified copy of that person's TBI registration form. Upon receipt of the form from the TBI, the board shall conduct an investigation to determine if the person licensed to practice medicine in this state is the same person who is a registered sexual offender or violent sexual offender. Such investigation shall take no more than thirty (30) days. If the board determines that the person whose name appears on both lists is the same person, it shall immediately take action as provided in subdivision (c)(2). If the person whose name appears on both lists is not the same person, the board shall take no action.
  5. (e)
    1. (1) On July 1, 2010, the board shall determine, before granting a license to practice medicine in this state, or renewing an existing license, if the person who is applying for such a license is registered or is required to be registered as a sexual offender or violent sexual offender pursuant to title 40, chapter 39, part 2.
    2. (2) If any applicant for a license to practice medicine in this state is a registered violent sexual offender or is required to register as a violent sexual offender, the board shall deny the application. If any person who is licensed to practice medicine in this state and is seeking to renew such license is a registered violent sexual offender or is required to register as a violent sexual offender, the board shall revoke the physician's license.
    3. (3) If any applicant to the board is registered as a sexual offender or is required to register as a sexual offender, the board shall consider whether the applicant poses a risk to patients; the degree to which the person has been rehabilitated; what treatment, if any, the person has undergone; the areas of medicine in which the applicant is qualified to engage without endangering the safety of patients; and any other factor the board deems relevant in determining what conditions are most likely to protect the public while considering the interests of the applicant. The board may deny the application or may place such conditions upon the applicant as are necessary to protect the public. If the board grants the license, at a minimum the board shall prohibit the applicant from engaging in direct patient care or contact for so long as the applicant is required to register as a sexual offender.
§ 63-6-242. Employee or contractor's unauthorized use of medical doctor's DEA registration number to write prescriptions.
  1. (a) Any medical doctor licensed pursuant to this chapter who has reason to believe that an employee or contractor of the doctor or the doctor's firm, partnership or corporation has used the doctor's federal drug enforcement administration (DEA) registration number without authorization to write prescriptions may make a report to a law enforcement agency.
  2. (b) Any medical doctor, firm, partnership, or corporation making a report pursuant to subsection (a) shall be immune from any civil liability for making such report when made in good faith.
§ 63-6-243. Hormone replacement therapy.
  1. (a)
    1. (1) “Hormone replacement therapy clinic” or “hormone therapy clinic” means a medical office in which the clinicians are primarily engaged in hormone replacement or supplementation therapy or a medical office which holds itself out to the public as being primarily or substantially engaged in hormone replacement therapy. For the purposes of this definition, “primarily engaged” means that a majority of the clinic's patients receive hormone replacement therapy and may be further defined by the board by rule. “Hormone replacement therapy clinic” does not mean a medical office in which the clinicians are primarily engaged in obstetrics and gynecology (OB/GYN), urology or primary care.
    2. (2) “Hormone replacement therapy” or “hormone therapy” means the branch of the practice of medicine whereby the patient is treated with medications that include, but are not limited to, creams or natural formulas taken through the skin, under the tongue, in subcutaneous pellets, or orally that contain hormones that have the same bioidentical or similar chemical formula as those produced naturally in the human body or that the provider thinks or claims to be similar or identical, but shall not include the treatment of patients with birth control pills.
  2. (b) In hormone replacement therapy clinics:
    1. (1) All hormone replacement therapy shall be performed by a physician licensed under this chapter or chapter 9 of this title, or delegated by such physician to a certified nurse practitioner licensed pursuant to chapter 7 of this title or a physician assistant licensed pursuant to chapter 19 of this title; and
    2. (2) If hormone replacement therapy is delegated, the supervising physician shall ensure that written protocols are developed for licensees to whom hormone replacement therapy is delegated, that such protocols are updated as necessary and that the patient is informed of both the name and contact information of the supervising physician and an indication of whether the physician is available onsite or remotely.
  3. (c) A physician supervising hormone replacement therapy in a hormone replacement therapy clinic shall ensure that for each patient all of the following requirements are met:
    1. (1) Prior to the initial hormone replacement therapy or course of treatments, an appropriate physical examination shall be conducted;
    2. (2) An appropriate medical history shall be taken and documented on the patient;
    3. (3) A written order for hormone replacement therapy shall be entered by the treating provider in the patient's medical record documenting the diagnosis and medical reason for the patient's need for hormone replacement therapy. If the treating provider is not a physician, the supervising physician shall make a personal review of the historical, physical and therapeutic data gathered by the treating provider and shall so certify the review in the patient's chart within seven (7) days of the patient being served;
    4. (4) The patient gives written consent for hormone replacement therapy, which includes notification of possible complications and reasonable expectations and any applicable FDA warnings associated with any part of the therapy; and
    5. (5) The supervising physician shall be immediately notified upon discovery of a complication.
§ 63-6-244. Interventional pain management.
  1. (a) A physician licensed pursuant to this chapter may only practice interventional pain management if the licensee is either:
    1. (1) Board certified through the American Board of Medical Specialties (ABMS) or the American Board of Physician Specialties (ABPS)/American Association of Physician Specialists (AAPS) in one of the following medical specialties:
      1. (A) Anesthesiology;
      2. (B) Neurological surgery;
      3. (C) Orthopedic surgery;
      4. (D) Physical medicine and rehabilitation;
      5. (E) Radiology; or
      6. (F) Any other board certified physician who has completed an ABMS subspecialty board in pain medicine or completed an ACGME-accredited pain fellowship;
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    2. (2) A recent graduate in a medical specialty listed in subdivision (a)(1) not yet eligible to apply for ABMS or ABPS/AAPS board certification; provided, that there is a practice relationship with a physician who meets the requirements of subdivision (a)(1) or an osteopathic physician who meets the requirements of § 63-9-121(a)(1);
    3. (3) A licensee who is not board certified in one of the specialties listed in subdivision (a)(1) but is board certified in a different ABMS or ABPS/AAPS specialty and has completed a post-graduate training program in interventional pain management approved by the board;
    4. (4) A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
    5. (5) A licensee who has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization.
  2. (b) For purposes of this section, “interventional pain management” is the practice of performing invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves of the spine or block of major peripheral nerves of the spine in any setting not licensed under title 68, chapter 11.
  3. (c) The board is authorized to define through rulemaking the scope and length of the practice relationship established in subdivision (a)(2).
  4. (d) A physician who provides direct supervision of an advanced practice registered nurse or a physician's assistant pursuant to § 63-7-126 or § 63-19-107 must meet the requirements set forth in subdivision (a)(1) or (a)(3).
  5. (e) A physician who violates this section is subject to disciplinary action by the board pursuant to § 63-6-214, including, but not limited to, civil penalties of up to one thousand dollars ($1,000) for every day this section is violated.
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§ 63-6-245. Notice to patients of determination that patient has dense or extremely dense breasts.
  1. (a) As used in this section, “physician” means an individual authorized by this chapter to practice medicine and surgery or osteopathic medicine and surgery pursuant to chapter 9 of this title.
  2. (b) If a physician has determined, after a mammogram is performed, that a patient has dense breasts or extremely dense breasts, based on the breast imaging reporting and data system established by the American College of Radiology, the facility where the mammogram was performed shall provide the following notice to the patient:
    1. Your mammogram shows that you have dense breast tissue. Dense breast tissue is common. However, dense breast tissue can hide breast cancer, so that it may not be seen on routine mammography. It may also be associated with an increased risk of developing breast cancer. You should discuss these results with your doctor to determine if additional tests might be helpful. A report of your mammogram results, which contains information about your breast density, has been sent to your doctor's office.
  3. (c) This section shall become operative on January 1, 2014. Nothing in this section shall be construed to create or impose liability for failing to comply with the requirements of this section. Nothing in this section shall be deemed to create a duty of care or other legal obligation beyond the duty to provide notice as set forth in this section. Nothing in this section shall be deemed to require a notice that is inconsistent with the federal Mammography Quality Standards Act (42 U.S.C. § 263b) or any regulations promulgated pursuant to that act.
§ 63-6-246. Maintenance of licensure or certification not required.
  1. (a) As used in this section:
    1. (1) “Continuing medical education” means continued postgraduate medical education required by the board of medical examiners intended to provide medical professionals with knowledge of new developments or reinforcement of previously learned information in their field;
    2. (2) “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
    3. (3) “Maintenance of licensure” means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
    4. (4) “Specialty medical board certification” means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the board of medical examiners' requirements to practice medicine.
  2. (b) The board shall not deny a physician licensure based on a physician's non-participation in any form of maintenance of licensure, including requiring any form of maintenance of licensure tied to maintenance of certification. The board's regular requirements, including continuing medical education, demonstrate professional competency.
  3. (c) The board shall not require any form of specialty medical board re-certification or any maintenance of certification to practice medicine in this state.
§ 63-6-248. Short-term visitor clinical training license.
  1. (a) The board of medical examiners may issue to an eligible physician or medical graduate from a foreign country or foreign territory a short-term visitor clinical training license for a period of time not to exceed ninety (90) days.
  2. (b) To be eligible for a short-term visitor clinical training license under this section, an applicant physician or medical graduate must provide to the board, in a manner and form prescribed by the board by rule:
    1. (1) Proof that the applicant holds a medical degree from an institution recognized in the World Directory of Medical Schools;
    2. (2) Proof of written acceptance to a clinical professional development or short-term clinical training program in this state;
    3. (3) Proof that the applicant is able to lawfully enter and remain in the United States during the period of the clinical professional development or short-term clinical training program;
    4. (4) Evidence that the host institution or the Educational Commission for Foreign Medical Graduates (ECFMG) has verified the applicant's credentials;
    5. (5) Evidence that the applicant:
      1. (A) Has an unrestricted license to practice medicine in the applicant's country or territory of origin or country or territory of practice; or
      2. (B) Is enrolled in an accredited resident training program in the applicant's country or territory of origin;
    6. (6) A written statement that the applicant does not have, as determined by the board:
      1. (A) A disqualifying criminal history; or
      2. (B) A history of disqualifying disciplinary action by an educational or training institution, employer, or foreign licensing authority;
    7. (7) Proof of medical liability insurance coverage; and
    8. (8) A written statement signed by the applicant acknowledging that a short-term visitor clinical training license cannot be used to:
      1. (A) Obtain or hold a position in a residency program in the United States;
      2. (B) Satisfy United States graduate medical education requirements; or
      3. (C) Remain in this state to practice medicine beyond the expiration date of the license.
  3. (c) A short-term visitor clinical training licensee:
    1. (1) Shall not assume independent responsibility for patient care;
    2. (2) May only engage in training activities under the supervision and control of a physician licensed under this chapter or chapter 9 of this title; and
    3. (3) To the extent permitted by the board based upon the licensee's education and training, and by compliance with subdivision (c)(2), may engage in direct interaction with a patient, including, but not limited to:
      1. (A) Taking medical history;
      2. (B) Conducting a physical examination;
      3. (C) Reading a radiologic study;
      4. (D) Administering anesthesia; and
      5. (E) Performing a surgical procedure.
Part 3 Phil Timp–Amanda Wilcox Right to Try Act
§ 63-6-301. Short title.
  1. This part shall be known and may be cited as the “Phil Timp-Amanda Wilcox Right to Try Act.”
§ 63-6-302. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Advanced illness” means a progressive disease or medical or surgical condition that entails significant functional impairment, that is not considered by a treating physician to be reversible even with administration of current federal drug administration approved and available treatments, and that, without life-sustaining procedures, will soon result in death;
    2. (2) “Adverse event” means any untoward medical occurrence associated with the use of an investigational drug, biological product, or device in humans, regardless if drug-related;
    3. (3) “Eligible patient” means an individual who meets all of the following conditions:
      1. (A) Has an advanced illness, attested to by the patient's treating physician and confirmed by a second physician;
      2. (B) Has considered all other treatment options currently approved by the United States food and drug administration, and is unable to enter, or be accepted within one (1) week after applying to, a clinical trial within fifty (50) miles of the individual's home;
      3. (C) Has received a recommendation from the patient's physician for an investigational drug, biological product, or device;
      4. (D) Has given written, informed consent for the use of the investigational drug, biological product, or device; and
      5. (E) Has documentation from the patient's physician that the patient meets the requirements of this subdivision (3);
    4. (4) “Investigational drug, biological product, or device” means a drug, biological product, or device that has successfully completed phase 1 of a clinical trial as documented by the National Institutes of Health but has not yet been approved for general use by the federal food and drug administration (FDA) and remains under investigation in a clinical trial that is approved by the FDA; and
    5. (5) “Written, informed consent” means a written document that is signed by the patient, the patient's parent, if the patient is a minor, the patient's legal guardian, or the patient's attorney-in-fact designated by the patient under title 34, chapter 6, part 2, and attested to by the patient's physician and a witness, and that, at a minimum, includes all of the following:
      1. (A) An explanation of the currently approved products and treatments for the disease or condition from which the patient suffers;
      2. (B) An attestation that the patient concurs with the patient's physician in believing that all currently approved and conventionally recognized treatments are unlikely to prolong the patient's life;
      3. (C) Clear identification of the specific proposed investigational drug, biological product, or device that the patient is seeking to use;
      4. (D) A description of the potentially best and worst outcomes of using the investigational drug, biological product, or device and a realistic description of the most likely outcome. The description shall include the possibility that new, unanticipated, different, or worse symptoms might result and that death could be hastened by the proposed treatment. The description shall be based on the physician's knowledge of the proposed treatment in conjunction with an awareness of the patient's condition;
      5. (E) A release of liability relative to the treating physician, licensed healthcare providers, hospital, and manufacturer of the investigational drug, biological product, procedure, or device;
      6. (F) A statement that the patient's health plan or third-party administrator and provider are not obligated to pay for any care or treatments consequent to the use of the investigational drug, biological product, or device, unless they are specifically required to do so by law or contract;
      7. (G) A statement that the patient's eligibility for hospice care may be withdrawn if the patient begins curative treatment with the investigational drug, biological product, or device and that care may be reinstated if this treatment ends and the patient meets hospice eligibility requirements; and
      8. (H) A statement that the patient understands that the patient is liable for all expenses consequent to the use of the investigational drug, biological product, or device and that this liability extends to the patient's estate, unless a contract between the patient and the manufacturer of the drug, biological product, or device states otherwise.
§ 63-6-303. Manufacturer permitted to provide investigational drug, biological product, or device to eligible patient — Conditions.
  1. (a) A manufacturer of an investigational drug, biological product, or device may make available, and an eligible patient may request, the manufacturer's investigational drug, biological product, or device under this part; provided, that this part does not require that a manufacturer make available an investigational drug, biological product, or device to an eligible patient.
  2. (b) A manufacturer may do all of the following:
    1. (1) Provide an investigational drug, biological product, or device to an eligible patient without receiving compensation; and
    2. (2) Require an eligible patient to pay the costs of, or the costs associated with, the manufacture of the investigational drug, biological product, or device.
§ 63-6-304. Payment of costs — Provision of items or services without approval not required.
  1. (a) This part does not expand the coverage required of an insurer under title 56, chapter 7.
  2. (b) A health plan, third-party administrator, or governmental agency may, but is not required to, provide coverage for the cost of an investigational drug, biological product, or device, or the cost of services related to the use of an investigational drug, biological product, or device under this part.
  3. (c) This part does not require any governmental agency to pay costs associated with the use, care, or treatment of a patient with an investigational drug, biological product, or device.
  4. (d) This part does not require any hospital or facility licensed under title 68, chapter 11, or any physician or healthcare provider to provide any items or services unless a request by an eligible patient is approved by the hospital, facility, physician, or healthcare provider.
§ 63-6-305. Patient's heirs not liable for outstanding debt.
  1. If a patient dies while being treated by an investigational drug, biological product, or device, the patient's heirs are not liable for any outstanding debt related to the treatment or lack of insurance due to the treatment.
§ 63-6-306. Action against healthcare provider's license or medicare certification prohibited.
  1. A licensing board or disciplinary subcommittee shall not revoke, fail to renew, suspend, or take any action against a healthcare provider's license issued under this title, based solely on the healthcare provider's recommendations to an eligible patient regarding access to or treatment with an investigational drug, biological product, or device. An entity responsible for medicare certification shall not take action against a healthcare provider's medicare certification based solely on the healthcare provider's recommendation that a patient have access to an investigational drug, biological product, or device.
§ 63-6-307. Official, employee, or agent of state prohibited from blocking eligible patient's access.
  1. An official, employee, or agent of this state shall not block or attempt to block an eligible patient's access to an investigational drug, biological product, or device. The rendering of counseling, advice, or a recommendation consistent with medical standards of care from a licensed healthcare provider is not a violation of this section.
§ 63-6-308. No private cause of action for harm done to eligible patient resulting from investigational drug, biological product, or device — Part does not affect requirements under § 56-7-2365.
  1. (a) This part does not create a private cause of action against a manufacturer of an investigational drug, biological product, or device or against any other person or entity involved in the care of an eligible patient using the investigational drug, biological product, or device for any harm done to the eligible patient resulting from the investigational drug, biological product, or device, if the manufacturer or other person or entity is complying in good faith with the terms of this part and has exercised reasonable care.
  2. (b) This part does not affect any mandatory healthcare coverage for participation in clinical trials under § 56-7-2365.
§ 63-6-309. Reporting of adverse events.
  1. If a patient suffers an adverse event associated with the use of an investigational drug, biological product, or device, the patient's physician shall report the adverse event to the manufacturer of the investigational drug, biological product, or device
Part 4 Interstate Medical Licensure Compact
§ 63-6-401. Short title.
  1. This part shall be known and may be cited as the “Interstate Medical Licensure Compact.”
§ 63-6-402. Interstate Medical Licensure Compact.
  1. The Interstate Medical Licensure Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:
      1. INTERSTATE MEDICAL LICENSURE COMPACT
        1. SECTION 1. PURPOSE
          1. 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
          1. In this compact:
            1. (a) “Bylaws” means those bylaws established by the Interstate Commission pursuant to Section 11 for its governance, or for directing and controlling its actions and conduct.
            2. (b) “Commissioner” means the voting representative appointed by each member board pursuant to Section 11.
            3. (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.
            4. (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.
            5. (e) “Interstate Commission” means the interstate commission created pursuant to Section 11.
            6. (f) “License” means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.
            7. (g) “Medical Practice Act” means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.
            8. (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.
            9. (i) “Member State” means a state that has enacted the Compact.
            10. (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.
            11. (k) “Physician” means any person who:
              1. (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. (2) Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;
              3. (3) Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;
              4. (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. (5) Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;
              6. (6) Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
              7. (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. (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. (9) Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.
            12. (l) “Offense” means a felony, gross misdemeanor, or crime of moral turpitude.
            13. (m) “Rule” means a written statement by the Interstate Commission promulgated pursuant to Section 12 of the Compact 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.
            14. (n) “State” means any state, commonwealth, district, or territory of the United States.
            15. (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
          1. (a) A physician must meet the eligibility requirements as defined in Section 2(k) to receive an expedited license under the terms and provisions of the Compact.
          2. (b) A physician who does not meet the requirements of Section 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
          1. (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. (1) the state of primary residence for the physician, or
            2. (2) the state where at least 25% of the practice of medicine occurs, or
            3. (3) the location of the physician's employer, or
            4. (4) if no state qualifies under subsection (1), subsection (2), or subsection (3), the state designated as state of residence for purpose of federal income tax.
          2. (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 subsection (a).
          3. (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
          1. (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.
          2. (b) 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.
            1. (i) 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.
            2. (ii) 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 C.F.R. 731.202.
            3. (iii) 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.
          3. (c) Upon verification in subsection (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 subsection (a), including the payment of any applicable fees.
          4. (d) After receiving verification of eligibility under subsection (b) and any fees under subsection (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.
          5. (e) An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same manner as required for other physicians holding a full and unrestricted license within the member state.
          6. (f) An expedited license obtained through 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.
          7. (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
          1. (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.
          2. (b) The Interstate Commission is authorized to develop rules regarding fees for expedited licenses.
        7. SECTION 7. RENEWAL AND CONTINUED PARTICIPATION
          1. (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. (1) Maintains a full and unrestricted license in a state of principal license;
            2. (2) Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
            3. (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. (4) Has not had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration.
          2. (b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state.
          3. (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.
          4. (d) Upon receipt of any renewal fees collected in subsection (c), a member board shall renew the physician's license.
          5. (e) Physician information collected by the Interstate Commission during the renewal process will be distributed to all member boards.
          6. (f) The Interstate Commission is authorized to develop rules to address renewal of licenses obtained through the Compact.
        8. SECTION 8. COORDINATED INFORMATION SYSTEM
          1. (a) The Interstate Commission shall establish a database of all physicians licensed, or who have applied for licensure, under Section 5.
          2. (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.
          3. (c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the Interstate Commission.
          4. (d) Member boards may report any non-public complaint, disciplinary, or investigatory information not required by subsection (c) to the Interstate Commission.
          5. (e) Member boards shall share complaint or disciplinary information about a physician upon request of another member board.
          6. (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.
          7. (g) The Interstate Commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.
        9. SECTION 9. JOINT INVESTIGATIONS
          1. (a) Licensure and disciplinary records of physicians are deemed investigative.
          2. (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.
          3. (c) A subpoena issued by a member state shall be enforceable in other member states.
          4. (d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
          5. (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
          1. (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.
          2. (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.
          3. (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. (i) impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state; or
            2. (ii) pursue separate disciplinary action against the physician under its respective Medical Practice Act, regardless of the action taken in other member states.
          4. (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(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days upon entry of the order by the disciplining board, to permit the member board(s) 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 ninety (90) day suspension period in a manner consistent with the Medical Practice Act of that state.
        11. SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION
          1. (a) The member states hereby create the “Interstate Medical Licensure Compact Commission”.
          2. (b) The purpose of the Interstate Commission is the administration of the Interstate Medical Licensure Compact, which is a discretionary state function.
          3. (c) The Interstate Commission shall be a body corporate and joint agency of the member states and shall have all the responsibilities, 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.
          4. (d) The Interstate Commission shall consist of two 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 a(n):
            1. (1) Allopathic or osteopathic physician appointed to a member board;
            2. (2) Executive director, executive secretary, or similar executive of a member board; or
            3. (3) Member of the public appointed to a member board.
          5. (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.
          6. (f) The bylaws may provide for meetings of the Interstate Commission to be conducted by telecommunication or electronic communication.
          7. (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 subsection (d).
          8. (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. (1) Relate solely to the internal personnel practices and procedures of the Interstate Commission;
            2. (2) Discuss matters specifically exempted from disclosure by federal statute;
            3. (3) Discuss trade secrets, commercial, or financial information that is privileged or confidential;
            4. (4) Involve accusing a person of a crime, or formally censuring a person;
            5. (5) Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
            6. (6) Discuss investigative records compiled for law enforcement purposes; or
            7. (7) Specifically relate to the participation in a civil action or other legal proceeding.
          9. (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.
          10. (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.
          11. (k) The Interstate Commission shall establish an executive committee, which shall include officers, members, and others as determined by the bylaws. The executive committee shall have the power to act on behalf of the Interstate Commission, with the exception of rulemaking, 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.
          12. (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
          1. The Interstate Commission shall have the duty and power to:
            1. (a) Oversee and maintain the administration of the Compact;
            2. (b) Promulgate rules which shall be binding to the extent and in the manner provided for in the Compact;
            3. (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;
            4. (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;
            5. (e) Establish and appoint committees including, but not limited to, an executive committee as required by Section 11, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties;
            6. (f) Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission;
            7. (g) Establish and maintain one or more offices;
            8. (h) Borrow, accept, hire, or contract for services of personnel;
            9. (i) Purchase and maintain insurance and bonds;
            10. (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;
            11. (k) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel;
            12. (l) Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of them in a manner consistent with the conflict of interest policies established by the Interstate Commission;
            13. (m) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed;
            14. (n) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
            15. (o) Establish a budget and make expenditures;
            16. (p) Adopt a seal and bylaws governing the management and operation of the Interstate Commission;
            17. (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;
            18. (r) Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation;
            19. (s) Maintain records in accordance with the bylaws;
            20. (t) Seek and obtain trademarks, copyrights, and patents; and
            21. (u) Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact.
        13. SECTION 13. FINANCE POWERS
          1. (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.
          2. (b) The Interstate Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same.
          3. (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.
          4. (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
          1. (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 twelve (12) months of the first Interstate Commission meeting.
          2. (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.
          3. (c) Officers selected in subsection (b) shall serve without remuneration from the Interstate Commission.
          4. (d) 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.
            1. (1) 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 subsection 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.
            2. (2) 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 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 person.
            3. (3) 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's 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. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION
          1. (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.
          2. (b) Rules deemed appropriate for the operations of the Interstate Commission shall be made pursuant to a rulemaking process that substantially conforms to the “Model State Administrative Procedure Act” of 2010, and subsequent amendments thereto.
          3. (c) Not later than thirty (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
          1. (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.
          2. (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.
          3. (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
          1. (a) The Interstate Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the Compact.
          2. (b) The Interstate Commission may, by majority vote of the Commissioners, initiate legal action in the United States District 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's fees.
          3. (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
          1. (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.
          2. (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. (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. (2) Provide remedial training and specific technical assistance regarding the default.
          3. (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.
          4. (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.
          5. (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.
          6. (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.
          7. (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.
          8. (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's fees.
        19. SECTION 19. DISPUTE RESOLUTION
          1. (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.
          2. (b) The Interstate Commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate.
        20. SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
          1. (a) Any state is eligible to become a member state of the Compact.
          2. (b) The Compact shall become effective and binding upon legislative enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding on a state upon enactment of the Compact into law by that state.
          3. (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.
          4. (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
          1. (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.
          2. (b) Withdrawal from the Compact shall be by the enactment of a statute repealing the same, but shall not take effect until one (1) 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.
          3. (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.
          4. (d) The Interstate Commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice provided under subsection (c).
          5. (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.
          6. (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.
          7. (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
          1. (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 (1) member state.
          2. (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
          1. (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.
          2. (b) The provisions of the Compact shall be liberally construed to effectuate its purposes.
          3. (c) Nothing in the Compact shall be construed to prohibit the applicability of other interstate compacts to which the states are members.
        24. SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS
          1. (a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.
          2. (b) All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.
          3. (c) All lawful actions of the Interstate Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states.
          4. (d) All agreements between the Interstate Commission and the member states are binding in accordance with their terms.
          5. (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.
Part 5 Physicians' Conflict of Interest Disclosure Act of 1991
§ 63-6-501. Short title.
  1. This part shall be known as the “Physicians' Conflict of Interest Disclosure Act of 1991.”
§ 63-6-502. Conflict of interest — How addressed.
  1. (a) Physicians are free to enter lawful contractual relationships, including the acquisition of ownership interests in health facilities, equipment or pharmaceuticals, but these can create potential conflicts of interest.
  2. (b) The potential conflict of interest shall be addressed by the following:
    1. (1) The physician has a duty to disclose to the patient or referring colleagues such physician's ownership interest in the facility or therapy at the time of referral and prior to utilization;
    2. (2) The physician shall not exploit the patient in any way, as by inappropriate or unnecessary utilization;
    3. (3) The physician's activities shall be in strict conformity with the law;
    4. (4) The patient shall have free choice either to use the physician's proprietary facility or therapy or to seek the needed medical services elsewhere; and
    5. (5) When a physician's commercial interest conflicts so greatly with the patient's interest as to be incompatible, the physician shall make alternative arrangements for the care of the patient.
  3. (c) The board shall have the authority to promulgate rules and regulations to effectuate this section.
§ 63-6-503. Federal law.
  1. Nothing in this part is intended to nor shall it permit any action that is inconsistent with the federal Patient and Program Protection Act of 1987, or other provisions of federal law that prohibits such arrangements as a condition to receipt of federal funds.
Part 6 Health Care Referrals
§ 63-6-601. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Entity” or “health care entity” means and includes a health care facility and an agency, company or health care professional, other than the referring physician, providing health care services;
    2. (2) “Health care facility” means and includes any real property or equipment of a health care institution as that term is defined in § 68-11-1602; and
    3. (3) “Health care service” means and includes a diagnostic, treatment, therapy or rehabilitation service.
§ 63-6-602. Physician owned health care entities — Referrals prohibited — Exceptions.
  1. (a) Physician investment in health care can provide important benefits for patient care; however, when physicians refer patients to entities in which they have an ownership interest, a potential conflict of interest exists. A physician having an investment interest in a health care entity shall not refer patients to the entity unless:
    1. (1) The physician performs health care services at the entity; or
    2. (2) The investment interest satisfies the requirements set forth in § 63-6-603.
  2. (b) Subsection (a) shall not apply to physicians when a health care facility leases premises or equipment from an entity owning the premises or equipment, even if physicians have an ownership interest in the entity that leases the premises or equipment to the health care facility and refer patients to the health care facility, if:
    1. (1) There is a written lease agreement between the health care facility leasing the premises or equipment and the entity owning the premises or equipment;
    2. (2) The lease specifies the premises or equipment covered by the lease;
    3. (3) The term of the lease is for not less than one (1) year;
    4. (4) The aggregate rental charge is set in advance, is consistent with fair market value in arms-length transactions and is not determined in a manner that takes into account the volume or value of any referrals by physicians having an ownership interest in the entity leasing the premises or space to the health care facility; and
    5. (5) A physician having an ownership interest in the entity leasing the premises or space to the health care facility discloses that interest to any patient referred by the physician to the health care facility.
  3. (c)
    1. (1) Subsection (a) shall not apply in the limited circumstances where the referring physician is referring physical therapy services and, in writing, the physician:
      1. (A) Discloses the physician's investment interest or financial relationship to patients when making a referral of the patient for physical therapy services;
      2. (B) Notifies patients that they may receive physical therapy services at the provider of their choice;
      3. (C) Informs patients that they have the option to use one (1) of the alternative providers; and
      4. (D) Assures patients that they will not be treated differently by the physician if they do not choose to use the physician-owned entity.
    2. (2) Notwithstanding any law to the contrary, nothing in subdivision (c)(1) shall be construed to affect the ability of the commissioner of labor and workforce development to regulate, through the workers’ compensation comprehensive medical fee schedule and regulated system established by rules promulgated pursuant to § 50-6-204, all health care providers providing services to workers’ compensation patients.
  4. (d) Conduct or activity that does not violate or is protected under the federal physician self-referral law, compiled at 42 U.S.C. § 1395nn, as amended, or rules promulgated to effectuate 42 U.S.C. § 1395nn, is not a violation of this part. The conduct or activity has the same protections as provided under federal law and rule.
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§ 63-6-603. Where physicians may invest in and refer to an outside entity — Requirements.
  1. There may be situations in which a needed entity would not be built or instituted if referring physicians were prohibited from investing in the entity and a need might exist when there is no entity of reasonable quality in the community or when use of existing entities is onerous for patients. Therefore, physicians may invest in and refer to an outside entity, whether or not they provide direct care or services at or for the entity, if there is a demonstrated need in the community for the entity and alternative financing is not available. In such cases, the following requirements apply:
    1. (1) Individuals who are not in a position to refer patients to the entity shall be given a bona fide opportunity to invest in the entity and be able to invest on the same terms that are offered to referring physicians. The terms on which investment interests are offered to physicians shall not be related to the past or expected volume of referrals or other business from the physicians;
    2. (2) There is no requirement that any physician investor make referrals to the entity or otherwise generate business as a condition for remaining an investor;
    3. (3) The entity shall not market or furnish its items or services to referring physician investors differently than to other investors;
    4. (4) The entity shall not loan funds or guarantee a loan for physicians in a position to refer to the entity;
    5. (5) The return on the physician's investment shall be tied to the physician's equity in the entity rather than to the volume of referrals;
    6. (6) Investment contracts shall not include noncompetition clauses that prevent physicians from investing in other entities;
    7. (7) Physicians shall disclose their investment interest to their patients when making a referral. Patients shall be given a list of effective alternative entities if any such entities become reasonably available, informed that they have the option to use one of the alternative entities and assured that they will not be treated differently by the physician if they do not choose the physician-owned entity. These disclosure requirements also apply to physician investors who directly provide care or services for their patients in entities outside their office practice;
    8. (8) The physician's ownership interest shall be disclosed, when requested, to third party payers;
    9. (9) An internal utilization review program is established to ensure that investing physicians do not exploit their patients in any way, such as by inappropriate or unnecessary utilization; and
    10. (10) When a physician's financial interest conflicts so greatly with the patient's interest as to be incompatible, the physician shall make alternative arrangements for the care of the patient.
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§ 63-6-604. Prohibited cross referral arrangements.
  1. Cross referral arrangements or schemes between physicians or between physicians and entities, in which the physician or physicians know or should know that the arrangement has as its principal purpose generating referrals to an entity that if made directly by one of the participating physicians would be in violation of this part, are prohibited.
§ 63-6-605. Preexisting investments — Compliance.
  1. If physicians have invested in entities prior to July 1, 1993, the physicians shall reevaluate their activity in accordance with this part and comply with its provisions. If compliance with the need and alternative investor criteria is not practical, it is essential that the identification of reasonably available alternative entities be provided.
§ 63-6-606. Disposal of ownership interests — Cessation of referrals.
  1. (a) On and after July 1, 1995, all physicians are required either to:
    1. (1) Dispose of their ownership interests in entities outside their office practice at which they do not directly provide care or services when they have an investment interest in the entity unless the entity meets the requirements of § 63-6-602; or
    2. (2) Cease referring patients to such entities.
  2. (b) Physicians are encouraged to seek out potential buyers of a minority race before disposing of facilities or equipment regulated by this part. Upon request, the office of minority business enterprise in the department of economic and community development shall provide information relative to potential minority purchasers.
§ 63-6-607. Violations — Sanctions.
  1. Any physician who makes or causes to be made a referral prohibited by this part is in violation of the medical practice law, as compiled in this chapter. Willful violations of this part are considered unprofessional conduct, which conduct is subject to licensure sanction by the board of medical examiners, including suspension, revocation or other restriction deemed appropriate by the board. In addition, the board is authorized to impose civil penalties of an amount up to five thousand dollars ($5,000) for each prohibited referral.
§ 63-6-608. Investment interests in publicly traded entities.
  1. The definition of “investment interest” does not include a publicly traded entity in which such physician has an investment interest if all of the following requirements are met:
    1. (1) The entity's stock is listed for trading on the New York Stock Exchange or the American Stock Exchange or is a national market system security traded under an automated interdealer quotation system operated by the National Association of Securities Dealers;
    2. (2) The entity had, at the end of the corporation's most recent fiscal year, total assets of at least fifty million dollars ($50,000,000), determined in accordance with generally accepted accounting principles, related to the furnishing of health services;
    3. (3) The entity markets and furnishes its services to physician-investors and other physicians on the same and equal terms;
    4. (4) All stock of the entity, including the stock of any predecessor privately held company, is one (1) class without preferential treatment as to status or remuneration;
    5. (5) The entity does not issue loans or guarantee any loans for physicians who are in a position to refer patients to such entity if the physician uses any portion of the loan to obtain the investment interest;
    6. (6) The income on the physician's investment is not tied to referral volumes and is directly proportional to the physician's equity interest in the entity;
    7. (7) The physician's investment interest does not exceed one-half of one percent (0.5%) of the entity's total equity; and
    8. (8) The physician purchases the investment interest either:
      1. (A) On terms generally available to the public; or
      2. (B) In exchange for an investment interest acquired by the physician before July 1, 1993; provided, the terms of the exchange are consistent with fair market value in an arms-length transaction and are not related to the volume or value of any referrals from the physician to the corporation and the investment interest is not held after December 31, 1997.
Part 7 Volunteer Health Care Services Act
§ 63-6-701. Short title.
  1. This part shall be known and may be cited as the “Volunteer Health Care Services Act.”
§ 63-6-702. Legislative findings.
  1. (a) The general assembly finds that:
    1. (1) Access to high quality health care services is a concern of all persons;
    2. (2) Access to such services is severely limited for some residents of this state, particularly those who reside in remote, rural areas or in the inner city;
    3. (3) Physicians and other health care professionals have traditionally worked to assure broad access to health care services; and
    4. (4) Many health care providers from Tennessee and elsewhere are willing to volunteer their services to address the health care needs of Tennesseans who may otherwise not be able to obtain such services.
  2. (b) The general assembly further finds that it is the public policy of this state to encourage and facilitate voluntary provision of health care services.
§ 63-6-703. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Free clinic” means a not for profit, out-patient, nonhospital facility in which a health care provider engages in the voluntary provision of health care services to patients without charge to the recipient of the services or to a third party;
    2. (2) “Health care provider” means any physician, surgeon, dentist, nurse, optometrist or other practitioner of a health care discipline, the professional practice of which requires licensure or certification under this title or under a comparable provision of law of another state, territory, district or possession of the United States;
    3. (3) “Licensed health care provider” means any health care provider holding a current license or certificate issued under:
      1. (A) This title; or
      2. (B) A comparable provision of the law of another state, territory, district or possession of the United States;
    4. (4) “Regularly practice” means to practice for more than sixty (60) days within any ninety-day period;
    5. (5) “Sponsoring organization” means any organization that organizes or arranges for the voluntary provision of health care services and that registers with the department of health as a sponsoring organization in accordance with § 63-6-706 and charges recipients based on one (1) of the following criteria:
      1. (A) On a sliding scale according to income;
      2. (B) A fee at the time of service of no more than fifty dollars ($50.00); or
      3. (C) No fee to the recipient; and
    6. (6) “Voluntary provision of health care services” means the providing of professional health care services by the health care provider either without charge to the recipient of the services or to a third party, or recipients are charged on a sliding scale according to income. Nothing shall preclude a health care provider from collecting the charges described in subdivision (5)(B) on behalf of the sponsoring organization as long as the health care provider retains none of the payment and forwards all collections to the sponsoring organization.
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§ 63-6-704. Licensure requirements.
  1. (a) Notwithstanding any provision of law to the contrary, no additional license or certificate otherwise required under this title is necessary for the voluntary provision of health care services by any person who:
    1. (1) Is a duly licensed health care provider as defined under § 63-6-703; or
    2. (2) Lawfully practices under an exception to the licensure or certification requirements of any state, territory, district or possession of the United States; provided, that the person does not and will not regularly practice in Tennessee.
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  2. (b) Subsection (a) does not apply to any person whose license or certificate is suspended or revoked pursuant to disciplinary proceedings in any jurisdiction. Furthermore, subsection (a) does not apply to a licensed health care provider who renders services outside the scope of practice authorized by the provider's licensure, certification or exception to such licensure or certification.
§ 63-6-705. Applicability.
  1. With regard to a person who voluntarily provides health care services and who is covered by § 63-6-704(a), the prohibitions expressed in § 63-6-202, relative to itinerant physicians, shall not apply and all requirements regarding display of a license or certificate shall be satisfied by the presentation for inspection, upon request, of a photocopy of the applicable license, certificate or statement of exemption.
§ 63-6-706. Registration requirements — Revocation.
  1. (a)
    1. (1) Before providing volunteer medical services in this state, a sponsoring organization shall register with the department of health by submitting a registration fee of fifty dollars ($50.00) and filing a registration form. The fifty-dollar registration fee shall not apply to any sponsoring organization as defined in § 63-6-703 when providing volunteer health care services in cases of natural or man-made disasters. Such registration form shall contain:
      1. (A) The name of the sponsoring organization;
      2. (B) The name of principal individual or individuals who are the officers or organizational officials responsible for the operation of the sponsoring organization;
      3. (C) The address, including street, city, zip code and county, of the sponsoring organization's principal office address and the same address information for each principal or official listed in subdivision (a)(1)(B);
      4. (D) Telephone numbers for the principal office of the sponsoring agency and each principal or official listed in subdivision (a)(1)(B); and
      5. (E) Such additional information as the department shall require.
    2. (2) Upon any change in the information required under subdivision (a)(1), the sponsoring organization shall notify the department in writing of such change within thirty (30) days of its occurrence.
  2. (b) The sponsoring organization shall file a quarterly voluntary services report with the department during the current quarter that lists all licensed health care providers who provided voluntary health care services during the preceding quarter. The sponsoring organization shall maintain on file for five (5) years following the date of service additional information, including the date, place and type of services provided.
  3. (c) Each sponsoring organization shall maintain a list of health care providers associated with its provision of voluntary health services. For each such health care provider, the organization shall maintain a copy of a current license, certificate or statement of exemption from licensure or certification or, in the event that the health care provider is currently licensed in the state of Tennessee, a copy of the health care provider's license verification obtained from a state-sponsored website.
  4. (d) The sponsoring organization shall maintain such records for a period of at least five (5) years following the provision of health care services and shall furnish such records upon request to any regulatory board established under this title.
  5. (e) Compliance with subsections (a) and (b) shall be prima facie evidence that the sponsoring organization has exercised due care in its selection of health care providers.
  6. (f) The department may revoke the registration of any sponsoring organization that fails to comply with the requirements of subsections (a)-(e). Any such revocation shall be conducted in accordance with the Uniform Administrative Procedures Act, complied in title 4, chapter 5.
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§ 63-6-707. Liability insurance coverage.
  1. No contract of professional liability insurance covering a health care provider in this state, issued or renewed on or after May 26, 1995, shall exclude coverage to any provider who engages in the voluntary provision of health care services; provided, that the sponsoring organization and the health care provider comply with the requirements of this part.
§ 63-6-708. Immunity for voluntary provision of health care services.
  1. (a)
    1. (1) No person who is licensed, certified or authorized by the board of any of the professions of the healing arts, as enumerated in this title, shall be liable for any civil damages for any act or omission resulting from the rendering of such services, unless the act or omission was the result of such person's gross negligence or willful misconduct if the person:
      1. (A) Is engaging in the voluntary provision of health care services within the limits of the person's license, certification or authorization; and
      2. (B) The services are delivered to any patient of:
        1. (i) A sponsoring organization; or
        2. (ii) A free clinic.
    2. (2) The volunteer licensee who is providing free care shall not receive compensation of any type, directly or indirectly, or any benefits of any type whatsoever, or any consideration of any nature, from anyone for the free care. Nor shall such services be part of the provider's training or assignment.
    3. (3) The volunteer licensee must be acting within the scope of such license, certification or authority.
    4. (4) A health care licensee providing free health care shall not engage in activities at a clinic or at the health care licensee's office, if the activities are performed on behalf of the sponsoring organization, unless those activities are authorized by the appropriate authorities to be performed at the clinic or office and the clinic or office is in compliance with all applicable rules and regulations.
  2. (b) For purposes of this section, any commissioned or contract medical officer or dentist serving on active duty in the United States armed forces and assigned to duty as a practicing, commissioned or contract medical officer or dentist at any military hospital or medical facility owned and operated by the United States government shall be deemed to be licensed pursuant to this part.
§ 63-6-709. Liability of volunteer crisis response team member — Applicability.
  1. (a)
    1. (1) “Crisis intervention” means a session at which crisis response services are rendered by a critical incident stress management team member during or after a crisis or disaster.
    2. (2) “Crisis response services” means consultation, risk assessment, referral and crisis intervention services provided by a critical incident stress management team to individuals affected by crisis or disaster.
    3. (3) “Critical incident stress management team member,” referred to also as “team member,” means an individual specially trained to provide crisis response services as a member of an organized community or local crisis response team that holds membership in a registered critical incident stress management team.
    4. (4) “Registered team” means a team formally registered with a recognized training agency. For the purposes of this section, a recognized training agency shall include the International Critical Incident Stress Foundation, the National Organization for Victim Assistance, the National Red Cross, the Tennessee Public Safety Network and other such organizations.
    5. (5) “Training session” means a session providing crisis response training by a qualified, trained trainer utilizing the standards established by the accrediting agencies set out in subdivision (a)(4).
    6. (6) “Volunteer” means a person who serves and receives no remuneration for services except reimbursement for actual expenses.
  2. (b)
    1. (1) Any volunteer crisis response team member who participates in a crisis intervention shall not be liable in tort for any personal injuries or infliction of emotional distress of any participant to the crisis intervention that is caused by the act or an omission of a crisis response team member during the course of a crisis intervention.
    2. (2) Subdivision (b)(1) shall not apply unless the intervention or training is conducted within generally accepted protocols of a registered team as defined by a nationally recognized accrediting agency.
  3. (c) The tort immunity in subsection (b) does not apply if:
    1. (1) The team member acted with actual malice or willful intent to injure the subject;
    2. (2) The team member acted outside the scope of assigned duties;
    3. (3) The team member acted without team coordination and dispatch;
    4. (4) The action involved the commission of a crime;
    5. (5) The action involved sexual harassment, sexual or physical abuse;
    6. (6) The actions involved any form of moral turpitude or moral misconduct within the normally accepted community standards; or
    7. (7) If damages resulted from gross negligence of the team member.
§ 63-6-710. Free clinics for veterans — Use of armory as site.
  1. (a) This section may be known and cited as the “Kenneth Harry–Hill Tennessee Veterans Health Care Act of 2015.” This section may also be known as the “Mission Tennessee for Veterans Program.”
  2. (b) In addition to any other health care authorized by this part, a licensed healthcare provider who is a member of the national guard in this state, under title 58, chapter 1, part 2, may provide healthcare services to veterans and other persons who lack health insurance at a free clinic operated on the site of an armory, as defined in § 58-1-507. The free clinic is authorized to provide limited primary health care, but not emergency care or urgent care services. Healthcare providers rendering services under this subsection (b) shall be deemed to be engaging in the voluntary provision of healthcare services under this part.
  3. (c)
    1. (1) The military department is authorized to permit the use of an armory as a site of a free clinic on a temporary basis.
    2. (2) The military department is also authorized to permit members of the national guard who are licensed healthcare providers in this state to volunteer at free clinics operated at an armory under this section.
    3. (3) The military department is authorized to accept donations of medical supplies and services to assist the operation of a free clinic at an armory under this section.
  4. (d) A free clinic operating under this section is authorized to participate in appropriate networks and public information activities in order to facilitate access to free healthcare services by veterans.
  5. (e) The commissioner of health is authorized to promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  6. (f) For the purposes of this section, “veteran” means a Tennessee resident who has entered and served in the United States armed forces and who was discharged or released therefrom under conditions other than dishonorable.
§ 63-6-711. Immunity for those dispensing previously owned eyeglasses — Applicability.
  1. (a) Subject to the requirements of subsection (b), none of the following shall be civilly liable for any damages arising out of dispensing previously owned eyeglasses to a person:
    1. (1) A sponsoring organization;
    2. (2) A free clinic and any optometrist, ophthalmologist, or dispensing optician providing services at the free clinic; or
    3. (3) Any organization that provides previously owned eyeglasses to a sponsoring organization or a free clinic free of charge and that is exempt from federal taxation under § 501(c)(3) or § 501(c)(4) of the Internal Revenue Code of 1986 (26 U.S.C. § 501(c)(3) and (4)).
  2. (b) In order for the immunity conferred by subsection (a) to apply:
    1. (1) The person to whom the previously owned eyeglasses are dispensed must be fourteen (14) years of age or older;
    2. (2) The previously owned eyeglasses must be dispensed without charge; and
    3. (3) Before the previously owned eyeglasses are dispensed, a licensed optometrist or ophthalmologist shall have:
      1. (A) Personally examined the recipient of the eyeglasses and issued a prescription for the eyeglasses; or
      2. (B) Personally consulted with the licensed optometrist or ophthalmologist who issued a prescription for the eyeglasses.
  3. (c) The previously owned eyeglasses may be dispensed by an optometrist or ophthalmologist or a dispensing optician working with the optometrist or ophthalmologist.
  4. (d) The immunity conferred by this section shall not apply if the organization or person granted immunity engages in grossly negligent or willful and wanton misconduct in dispensing the previously owned eyeglasses.
§ 63-6-712. Satisfaction of continuing education requirements.
  1. (a) Notwithstanding this title to the contrary, a healthcare provider may satisfy one (1) hour of continuing education requirements for maintaining a license issued pursuant to this title through the performance of one (1) hour of voluntary provision of healthcare services as provided in this part. The maximum amount of hours of a continuing education requirement that a healthcare provider may satisfy through the voluntary provision of healthcare services pursuant to this subsection (a) is the lesser of eight (8) hours annually or twenty percent (20%) of the total annual required for the applicable license.
  2. (b) Upon providing evidence of completion of the voluntary provision of healthcare services, the healthcare provider shall identify in any documentation required to be submitted to the applicable licensing board, the name and contact information of the sponsoring organization.
  3. (c) The division of health related boards may promulgate rules to administer this section in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, including a fee to be charged to the healthcare provider for satisfying continuing education requirements pursuant to this section.
Part 8 Genetic Counselors' Licensing Act
§ 63-6-801. Short title.
  1. This part shall be known and may be cited as the “Genetic Counselors' Licensing Act.”
§ 63-6-802. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “ABGC” means the American Board of Genetic Counseling;
    2. (2) “ABMG” means the American Board of Medical Genetics;
    3. (3) “Board” means the board of medical examiners, created by § 63-6-101;
    4. (4) “CEU” means a continuing education unit as defined by the ABGC;
    5. (5) “Department” means the department of health;
    6. (6) “Division” means the division of health related boards within the department;
    7. (7) “Genetic counselor” means a person licensed under this part to engage in the practice of genetic counseling;
    8. (8) “Practice of genetic counseling” means the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease performed pursuant to a referral. This process integrates the following:
      1. (A) Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence;
      2. (B) Education about inheritance, testing, management, prevention, resources and research; and
      3. (C) Counseling to promote informed choices and adaptation to the risk or condition;
    9. (9) “Referral” means a written or telecommunicated authorization for genetic counseling services from a physician licensed to practice medicine in all its branches or an advanced practice registered nurse or physician assistant who has an agreement and signed protocols with a supervising physician that authorizes referrals to a genetic counselor; and
    10. (10) “Supervision” means the ongoing, direct clinical review for the purposes of training or teaching by an approved supervisor who monitors the performance or a person's supervised interaction with a client and provides regular documented face-to-face consultation, guidance and instructions with respect to the clinical skills and competencies of the person supervised. Supervision may include, without being limited to, the review of case presentations, audio tapes, video tapes and direct observation.
§ 63-6-803. Scope of genetic counseling.
  1. Genetic counseling is a communication process, conducted by one (1) or more appropriately trained individuals, that includes:
    1. (1) Estimating the likelihood of occurrence or recurrence of any potentially inherited or genetically influenced condition. This assessment may involve:
      1. (A) Obtaining and analyzing a complete health history of the person and family;
      2. (B) Reviewing pertinent medical records;
      3. (C) Evaluating the risks from exposure to possible mutagens or teratogens; and
      4. (D) Recommending genetic testing or other evaluations to assist in the diagnosis of a condition or determine the carrier status of one (1) or more family members;
    2. (2) Helping the individual, family, health care provider or public to:
      1. (A) Appreciate the medical, psychological and social implications of a disorder, including its features, variability, usual course and management options;
      2. (B) Learn how genetic factors contribute to the disorder and affect the chance for recurrence of the condition in other family members;
      3. (C) Understand available options for coping with, preventing, or reducing the chance of occurrence or recurrence of a condition;
      4. (D) Select the most appropriate, accurate and cost-effective methods of diagnosis; and
      5. (E) Understand genetic tests, including, but not limited to, diagnostic genetic tests, screening tests or predispositional genetic tests, coordinate testing for inherited disorders and interpret complex genetic test results;
    3. (3) Facilitating an individual's or family's:
      1. (A) Exploration of the perception of risk and burden associated with a genetic disorder;
      2. (B) Decision making regarding testing or medical interventions consistent with their beliefs, goals, needs, resources, culture and ethical/moral views; and
      3. (C) Adjustment and adaptation to the condition or their genetic risk by addressing needs for psychological, social and medical support.
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§ 63-6-804. Licensure requirement — Exceptions.
  1. (a) No person shall engage in the practice of genetic counseling, act or represent that person to be a genetic counselor, or to use such titles as “genetic counselor,” “licensed genetic counselor,” “gene counselor,” “genetic associate” or any words, letters, abbreviations or insignia indicating or implying that the person is a genetic counselor, unless that person holds a license or temporary license and otherwise complies with this part and the rules and regulations adopted by the board.
  2. (b) The following persons may engage in the practice of genetic counseling subject to the stated circumstances and limitations without being licensed under this part:
    1. (1) Other qualified and licensed health care professionals who are practicing within their scope of practice. Individuals may not use the title genetic counselor or any other title tending to indicate they are genetic counselors unless licensed as such in this state;
    2. (2) Students enrolled in an approved academic program in genetic counseling, if practice constitutes a part of a supervised course of study and the student is designated by a title clearly indicating the student's status as a student or trainee;
    3. (3) An individual trained as a genetic counselor who is reapplying for the ABGC certification examination and gathering logbook cases under supervision in an approved genetic counseling training site;
    4. (4) Individuals employed by a state genetics center that provides education regarding single gene conditions, including, but not limited to, sickle cell, cystic fibrosis and hemoglobinopathies. The individual may not use the title genetic counselor or any other title tending to indicate the individual is a genetic counselor unless licensed as such in this state; and
    5. (5) Visiting ABGC or ABMG certified genetic counselors from outside the state performing activities and services for a period of thirty (30) days each year. Visiting genetic counselors must be licensed, if licensure is available in their home state.
§ 63-6-805. Compliance with ethical codes.
  1. (a) All licensees shall comply with the current code of ethics adopted by the National Society of Genetic Counselors, except to the extent that it conflicts with state laws or the rules of the board. If the code of ethics conflicts with state law or rules, state law or rules govern the matter. A violation of the code of ethics or state law or rules may subject a licensee to disciplinary action.
  2. (b) Each applicant or licensee is responsible for being familiar with and following the code of ethics.
  3. (c) A copy of the code of ethics may be obtained by writing the National Society of Genetic Counselors, 401 N. Michigan Avenue, Chicago, IL 60611 or by visiting the website www.nsgc.org.
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§ 63-6-806. Rules and regulations — Qualifications for licensure — Fees — Renewal.
  1. (a) The board shall promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules and regulations that are reasonably necessary to regulate advertising and for the performance of the various duties imposed upon the board for the proper administration of this part.
  2. (b) No person shall represent to be or function as a genetic counselor under this part unless that person holds a valid genetic counselor license or temporary license issued by the board. The board shall establish the qualifications that are prerequisite to issuance of licenses and temporary licenses; provided, that:
    1. (1) To qualify for a license to practice genetic counseling, a person shall have:
      1. (A) Earned a masters degree from a genetic counseling training program that is accredited by the ABGC or an equivalent as determined by the ABGC or the ABMG; and
      2. (B) Met the examination requirement for certification and have current certification as a genetic counselor by the ABGC or the ABMG;
    2. (2) For one (1) year after the effective date of the rules adopted under this part, a license may be issued, at the discretion of the board, to an applicant not meeting the requirements of subdivision (b)(1)(B) if the applicant has practiced as a genetic counselor since 1980 and the committee has completed an investigation of the applicant's work history. The investigation may include, but is not limited to, completion by the applicant of a questionnaire regarding the applicant's work history and scope of practice; and
    3. (3)
      1. (A) A temporary license to practice genetic counseling may be issued to an applicant who meets all of the requirements for licensure except the examination requirement of subdivision (b)(1)(B);
      2. (B) Temporary license applicants shall have active candidate status conferred by ABGC and take the next available certification examination;
      3. (C) A temporary license shall not be issued if the applicant has failed the ABGC certification examination more than twice;
      4. (D) Temporary licensees shall practice under the general supervision of a licensed genetic counselor or a licensed physician with current ABMG certification in clinical genetics;
      5. (E) A temporary license shall expire upon the earliest of one (1) of the following:
        1. (i) Issuance of full licensure;
        2. (ii) Ninety (90) days after notification of failing the certification exam without obtaining current active candidate status; or
        3. (iii) The date printed on the temporary license.
  3. (c) The board shall set fees, after consultation with the department, relative to the application, licensing and renewal in amounts sufficient to pay all of the expenses of the board that are directly attributable to the performance of the board's duties pursuant to this part, including, but not limited to, the following fees:
    1. (1) Application, licensure and temporary licensure fee;
    2. (2) Renewal fee;
    3. (3) Late renewal fee;
    4. (4) Continuing education course approval fee; and
    5. (5) Duplicate licensure fee.
  4. (d) The board shall review and approve or reject the qualifications of applicants for licensure and to issue all approved full, restricted, conditioned or temporary licenses.
  5. (e) The board shall biennially review and approve or reject the qualifications of each applicant for biennial licensure renewal. The board shall require the receipt of evidence satisfactory to the board of the applicant's successful completion, within a two-year period prior to the application for license renewal, of five (5) CEUs, category 1 or 2, or fifty (50) contact hours approved for recertification purposes by the ABGC. A licensee shall be responsible for maintaining competent records of having completed qualified professional education for a period of four (4) years after the close of the two-year period to which the records pertain. It is the responsibility of the licensee to maintain such information with respect to having completed a qualified professional education that demonstrates the education meets the requirements under this section. The board may, in its discretion, waive or modify the continuing education requirement in cases of retirement, illness, disability or other undue hardship.
  6. (f) The board shall collect or receive all fees, fines and moneys owed pursuant to this part and shall pay the fees, fines and moneys into the general fund of the state. For purposes of implementing subsection (c), all fees, fines or moneys collected pursuant to the regulation of genetic counselors shall so be designated.
§ 63-6-807. Denial, suspension, or revocation of license — Other disciplinary actions.
  1. (a) The board shall have the power to:
    1. (1) Deny, restrict or condition a license;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, limit or restrict a previously issued license, for the time and in the manner that the board determines;
    4. (4) Reprimand, suspend, revoke or take any other disciplinary action in relation to an applicant or license holder that the board, in its discretion, deems proper; or
    5. (5) Permanently revoke a license.
  2. (b) The grounds upon which the board shall exercise the powers in subsection (a) shall include, but are not limited to, circumstances in which the person:
    1. (1) Is guilty of fraud or deceit in the procurement or holding of the license;
    2. (2) Has been convicted of a felony in a court of competent jurisdiction, either within or outside of this state, unless the conviction has been reversed and the holder of the license was discharged or acquitted or if the holder has been pardoned with full restoration of civil rights, in which case the license shall be restored;
    3. (3) Is or has been physically or mentally incapable of practicing at a level of competency that protects the public health, safety and welfare;
    4. (4) Has knowingly aided and abetted a person who is not a license holder or is not otherwise authorized pursuant to this part to perform the duties of a license holder under this part;
    5. (5) Has undertaken or engaged in any practice beyond the scope of practice stated in § 63-6-803;
    6. (6) Has impersonated a license holder or former license holder or is under an assumed name performing the duties authorized to be performed only by a licensed person;
    7. (7) Has been found guilty of a violation of the code of ethics as provided in § 63-6-805;
    8. (8) Is or has been found guilty of incompetence or negligence in performance as a license holder;
    9. (9) Has been found guilty of unethical conduct;
    10. (10) Violates or attempts to violate, directly or indirectly, or assists or aids in the violation of, or conspires to violate, any provision of this part or any lawful order of the board issued pursuant to this part, or any of the rules or regulations promulgated pursuant to this part or any criminal statute of the state;
    11. (11) Is habitually intoxicated or engages in personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in a manner that adversely affects the person's ability to practice; or
    12. (12) Has received disciplinary action from another state for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state shall constitute prima facie evidence of violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal or to discipline a person licensed in this state.
§ 63-6-808. Retirement of license and relicensure.
  1. Any person who has been issued a license to practice under this part and who wishes to retire the license shall file with the board an affidavit, on a form to be furnished by the board, stating the date on which the person retired from practice and any other information deemed necessary by the board. If that person decides to reengage in practice in this state, the person shall apply for licensure as provided by this part and shall not be liable for licensure renewal fees that accrued during the period of retirement.
Part 10 Acupuncture
§ 63-6-1001. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “ACAOM” means the Accreditation Commission for Acupuncture and Oriental Medicine;
    2. (2) “Acupuncture” means a form of health care developed from traditional and modern oriental medical concepts that employs oriental medical diagnosis and treatment and adjunctive therapies and diagnostic techniques for the promotion, maintenance and restoration of health and the prevention of disease;
    3. (3) “ADS” means an acupuncture detoxification specialist trained in, and who performs only, the five-point auricular detoxification treatment;
    4. (4) “Board” means the Tennessee board of medical examiners;
    5. (5) “NADA” means the National Acupuncture Detoxification Association;
    6. (6) “NCCAOM” means the National Certification Commission for Acupuncture and Oriental Medicine; and
    7. (7) “Practice of acupuncture” means the insertion of acupuncture needles and the application of moxibustion to specific areas of the human body based on oriental medical diagnosis as a primary mode of therapy. Adjunctive therapies within the scope of acupuncture may include acupressure, cupping, thermal and electrical treatment and the recommendation of dietary guidelines and supplements and therapeutic exercise based on traditional oriental medical concepts.
§ 63-6-1002. Application.
  1. (a) This part shall not apply to:
    1. (1) Physicians licensed under this chapter or chapter 9 of this title, nor shall this part be construed so as to prevent the practice of acupuncture by such physicians or to prevent such physicians from using the title “acupuncturist”;
    2. (2) Registered nurses who are nationally certified as holistic nurses and who have successfully completed an accredited education program in acupuncture; or
    3. (3) Chiropractic physicians licensed under chapter 4 of this title, nor shall any part of this title be construed so as to prevent the practice of acupuncture by chiropractic physicians who have completed two hundred fifty (250) hours of an accredited acupuncture course and have passed the National Board of Chiropractic Examiners acupuncture exam.
  2. (b) It is otherwise unlawful to practice acupuncture for compensation or gratuitously unless certified under this part. This restriction does not apply to the following:
    1. (1) Students practicing acupuncture under the supervision of a certified acupuncturist as part of a course of study approved by the committee; or
    2. (2) Individuals who do not otherwise possess the credentials required for the practice of acupuncture by this part or regulations promulgated hereunder by the board are granted limited certification as an ADS for the purpose of the treatment of alcoholism, substance abuse or chemical dependency if they meet the following conditions:
      1. (A) Provide documentation of successful completion of a board-approved training program in auricular detoxification acupuncture that meets or exceeds standards of training set by NADA;
      2. (B) Practice auricular detoxification treatment in a hospital, clinic or treatment facility that provides comprehensive alcohol and substance abuse or chemical dependency services, including counseling, under the supervision of a certified acupuncturist or medical director;
      3. (C) Satisfy all appropriate ethical standards specified in § 63-6-1007; and
      4. (D) Limit their practice to the five-point auricular detoxification treatment.
  3. (c) A violation of this section is a Class C misdemeanor. A person who violates this section shall also be subject to the sanctions specified in § 63-6-1007.
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§ 63-6-1003. Tennessee advisory committee for acupuncture.
  1. (a) To assist the board in the performance of its duties, there is hereby established the Tennessee advisory committee for acupuncture.
  2. (b) The committee shall consist of five (5) members appointed by the governor. Three (3) of the members shall be certified acupuncturists, one (1) shall be an ADS practicing in Tennessee and one (1) shall be a consumer member who is neither employed in nor has any other direct or indirect affiliation with the health care profession or industry. The three (3) acupuncturists initially appointed need not be certified at the time of their appointments, but must meet all the qualifications for certification.
  3. (c)
    1. (1) Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the committee:
      1. (A) Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the committee shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the committee, prior to serving as a member of the committee. This subdivision (c)(1)(A) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010;
      2. (B) No person who is a member of the committee shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the committee during such person's period of service as a member of the committee. This subdivision (c)(1)(B) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010, and to all persons serving on the committee on such date who are not registered as lobbyists; and
      3. (C) No person who serves as a member of the committee shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the committee for one (1) year following the date such person's service on the committee ends. This subdivision (c)(1)(C) shall apply to persons serving on the committee as of July 1, 2010, and to persons appointed to the committee subsequent to such date.
    2. (2) A person who violates this subsection (c) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. (3) The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (c). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  4. (d) In addition to all other requirements for membership on the committee, all persons appointed or otherwise named to serve as members of the committee after July 1, 2010, shall be residents of this state.
  5. (e) Of the initial appointments to the committee, two (2) members shall be appointed for terms of three (3) years, two (2) members shall be appointed for terms of two (2) years and one (1) member shall be appointed for a term of one (1) year. All regular appointments thereafter shall be for terms of four (4) years. No person may serve more than two (2) consecutive full terms as a member of the committee. Each member shall serve on the committee until a successor is appointed. Vacancies shall be filled by appointment of the governor for the unexpired term.
  6. (f) At the committee's first meeting each year after any new members have been appointed, the members shall choose one (1) member to chair the committee for the year and another to serve as co-chair. No person shall chair the committee for more than five (5) consecutive years.
  7. (g)
    1. (1) The committee shall meet at least once each year within forty-five (45) days after the appointment of the new members. The committee shall meet at other times as needed to perform its duties.
    2. (2)
      1. (A) Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the committee.
      2. (B) The committee's chair shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (g)(2)(A).
  8. (h) Each member shall receive all necessary expenses incident to conducting the business of the committee and, in addition thereto, shall be entitled to a per diem of fifty dollars ($50.00) for each day's service in conducting the business of the committee. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  9. (i) The committee shall receive from the division of health related boards of the department of health all administrative, investigatory and clerical services as provided for in § 63-1-101. Committee expenses shall be paid from funds generated by certification fees generated by acupuncturists and acupuncture detoxification specialists.
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§ 63-6-1004. Promulgation of rules and regulations.
  1. (a) The board, in consultation with the committee, shall:
    1. (1) Establish the qualifications and fitness of applicants of certifications, renewal of certifications and reciprocal certifications;
    2. (2) Establish grounds for revocation, suspension or denial of certification;
    3. (3) Establish grounds for placing on probation a holder of a certificate;
    4. (4) Establish the categories of fees and the amount of fees that may be imposed in connection with certification;
    5. (5) Issue declaratory orders pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    6. (6) If deemed necessary by the committee, establish standards of continuing education; and
    7. (7) Adopt and use a seal to authenticate official documents of the committee.
  2. (b) Any actions taken under this section shall only be effective after adoption of a majority vote of the members of the committee. The board, by a majority vote of its members at the next board meeting at which administrative matters are considered, may rescind any action taken by the committee.
§ 63-6-1005. Certification to practice.
  1. (a) To receive certification to practice acupuncture from the board, a person must document:
    1. (1) Either:
      1. (A) Current active status as a diplomate in acupuncture of the NCCAOM; or
      2. (B) Current state licensure in good standing by another state with substantially equivalent or higher standards;
    2. (2) Successful completion of a three-year post secondary training program or acupuncture college program that is ACAOM accredited or in candidacy status or that meets ACAOM's standards; and
    3. (3) Successful completion of a NCCAOM-approved clean needle technique course.
  2. (b) The committee shall waive the requirements of subsection (a) for an applicant residing in Tennessee upon July 1, 2001, who presents satisfactory evidence to the committee of successful completion of an approved apprenticeship or tutorial program that meets NCCAOM standards shall be granted certification by the board.
  3. (c) The committee shall waive the requirements of subsection (a) and an applicant presenting satisfactory evidence to the committee that such applicant held a license in good standing from another state immediately prior to practicing in Tennessee and who has continually practiced in Tennessee since that time shall be granted certification by the board.
  4. (d) ADSs who meet the requirements listed in § 63-6-1002 shall be issued a limited acupuncture certificate.
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§ 63-6-1006. Renewal of certificate.
  1. A certificate to practice acupuncture must be renewed every two (2) years. To renew a certificate, a person must submit proof of current active NCCAOM certification in acupuncture or document compliance with § 63-6-1005. To renew an ADS certificate, a person must submit proof of current active practice in auricular detoxification treatment, as determined by the committee.
§ 63-6-1007. Disciplinary action.
  1. The board, in consultation with the committee, may deny, suspend or revoke certification, require remedial education or issue a letter of reprimand, if an applicant or certified acupuncturist:
    1. (1) Engages in false or fraudulent conduct that demonstrates an unfitness to practice acupuncture, including:
      1. (A) Misrepresentation in connection with an applicant for certification or an investigation by the committee;
      2. (B) Attempting to collect fees for services that were not performed;
      3. (C) False advertising, including guaranteeing that a cure will result from an acupuncture treatment; or
      4. (D) Dividing or agreeing to divide a fee with anyone for referring the patient for acupuncture;
    2. (2) Fails to exercise proper control over one's practice by:
      1. (A) Delegating professional responsibilities to a person the acupuncturist knows or should know is not qualified to perform; or
      2. (B) Failing to exercise proper control over uncertified personnel working with the practice;
    3. (3) Fails to maintain records in a proper manner by:
      1. (A) Failing to keep written records describing the course of treatment for each patient;
      2. (B) Refusing to provide a patient, upon request, records that have been prepared for or paid for by the patient; or
      3. (C) Revealing personally identifiable information about a patient, without consent, unless otherwise authorized by law;
    4. (4) Fails to exercise proper care of a patient, including the exercising or attempting to exercise undue influence in the acupuncturist-patient relationship by making sexual advances or requests for sexual activity or making submission to such conduct a condition of treatment;
    5. (5) Displays substance abuse or mental impairment to such a degree as to interfere with the ability to provide safe and effective treatment;
    6. (6) Is convicted of or pleads guilty or no contest to any crime that demonstrates an unfitness to practice acupuncture;
    7. (7) Negligently fails to practice acupuncture with the level of skill recognized within the profession as acceptable under such circumstances;
    8. (8) Willfully violates any provision of this part or rule of the commission; or
    9. (9) Has had a certificate or license denied, suspended or revoked in another jurisdiction for any reason that would be grounds for such action in Tennessee.
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§ 63-6-1008. Use of needles.
  1. (a) All certified individuals under this part shall use only presterilized, disposable needles in their administration of acupuncture treatments. The use of staples in the practice of acupuncture is prohibited.
  2. (b) Health practices shall include:
    1. (1) Hands shall be washed with soap and water or other disinfectant before handling needles and between treatment of different patients;
    2. (2) Skin in the area of penetration shall be thoroughly swabbed with alcohol or other germicidal solution before inserting needles; and
    3. (3) Individuals shall pass a nationally recognized clean needle technique course before being allowed to practice acupuncture and related techniques.
§ 63-6-1009. Fees.
  1. (a) The board, in consultation with the committee, shall set fees relative to the application, certification and renewal thereof in amounts sufficient to pay all of the expenses of certification and of the committee directly attributable to the performance of its duties under this part.
  2. (b) All deposits and disbursements shall be handled in accordance with § 63-1-137.
§ 63-6-1010. Use of titles.
  1. (a) The titles “licensed acupuncturist” or “ADS” may be used by persons certified under this part. No person who is not properly licensed to practice medicine or osteopathy shall use certification under this part to identify such person as a doctor or physician.
  2. (b) Each person certified to practice acupuncture shall post the certificate in a conspicuous location at such person's place of practice.
Part 11 Tennessee Abortion-Inducing Drug Risk Protocol Act
§ 63-6-1101. Short title.
  1. This part is known and may be cited as the “Tennessee Abortion-Inducing Drug Risk Protocol Act.”
§ 63-6-1102. Part definitions.
  1. As used in this part:
    1. (1) “Abortion”:
      1. (A) Means the elective use or prescription of an instrument, medicine, drug, or other substance, or device, with the intent to terminate the clinically diagnosable pregnancy of a patient, with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child; and
      2. (B) Does not mean an act to terminate a pregnancy with the intent to:
        1. (i) Save the life or preserve the health of the unborn child;
        2. (ii) Remove a dead unborn child caused by spontaneous abortion;
        3. (iii) Remove an ectopic pregnancy; or
        4. (iv) Treat a maternal disease or illness for which the prescribed drug is indicated;
    2. (2) “Abortion-inducing drug” or “chemical abortion”:
      1. (A) Means a medicine, drug, or other substance provided with the intent of terminating the clinically diagnosable pregnancy of a patient, with knowledge that the termination will, with reasonable likelihood, cause the death of the unborn child;
      2. (B) Includes the off-label use of drugs known to have abortion-inducing properties that are prescribed specifically with the intent of causing an abortion, such as mifepristone, misoprostol, and methotrexate; and
      3. (C) Does not include drugs that may be known to cause an abortion that are prescribed for other medical indications;
    3. (3) “Adverse event” means an untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related;
    4. (4) “Associated physician” means an individual licensed, and in good standing, to practice medicine in this state pursuant to chapter 6 or 9 of this title and who has entered into an associated physician agreement pursuant to § 63-6-1104(b);
    5. (5) “Complication” means an adverse physical or psychological condition arising from the performance of an abortion, including, but not limited to, uterine perforation; cervical perforation; infection; heavy or uncontrolled bleeding; hemorrhage; blood clots resulting in pulmonary embolism or deep vein thrombosis; failure to actually terminate the pregnancy; incomplete abortion; pelvic inflammatory disease; endometritis; missed ectopic pregnancy; cardiac arrest; respiratory arrest; renal failure; metabolic disorder; shock; embolism; coma; placenta previa in subsequent pregnancies; preterm delivery in subsequent pregnancies; free fluid in the abdomen; hemolytic reaction due to the administration of ABO-incompatible blood or blood products; adverse reactions to anesthesia and other drugs; subsequent development of breast cancer; death; psychological complications, such as depression, suicidal ideation, anxiety, and sleeping disorders; and other adverse events;
    6. (6) “Department” means the department of health;
    7. (7) “Facility” means a public or private hospital, clinic, center, medical school, medical training institution, healthcare business, physician's office, infirmary, dispensary, ambulatory surgical center, or other institution, location, or business where medical care or pharmaceuticals are provided to individuals;
    8. (8) “Hospital” has the same meaning as defined by § 68-11-201;
    9. (9) “Last menstrual period” means the time that has elapsed since the first day of the patient's last menstrual period;
    10. (10) “Physician” means an individual licensed, and in good standing, to practice medicine in this state pursuant to chapter 6 or 9 of this title;
    11. (11) “Pregnant” or “pregnancy” means the female reproductive condition of having an unborn child in the patient's uterus;
    12. (12) “Provide” means an act of giving, selling, dispensing, administering, transferring possession to, or otherwise providing or prescribing, an abortion-inducing drug;
    13. (13) “Qualified physician” means a physician who has the ability to:
      1. (A) Identify and document a viable intrauterine pregnancy;
      2. (B) Assess the gestational age of pregnancy and inform the patient of gestational age-specific risks;
      3. (C) Diagnose ectopic pregnancy;
      4. (D) Determine blood type and administer RhoGAM if a patient is Rh negative;
      5. (E) Assess for signs of domestic abuse, reproductive control, human trafficking, and other signals of coerced abortion;
      6. (F) Provide surgical intervention, or has entered into a contract with another qualified physician to provide surgical intervention; and
      7. (G) Supervise and bear legal responsibility for an agent, employee, or contractor who is participating in any part of a procedure, including, but not limited to, preprocedure evaluation and care;
    14. (14) “Reasonable medical judgment” means a medical judgment that would be made by a reasonably prudent physician knowledgeable about the patient's case and the treatment possibilities with respect to the medical conditions involved; and
    15. (15) “Unborn child” means an individual organism of the species homo sapiens, beginning at fertilization, until the point of being born alive as defined in 1 U.S.C. § 8(b).
§ 63-6-1103. In-person requirement.
  1. (a) An abortion-inducing drug may be provided only by a qualified physician following the procedures set forth in this part.
  2. (b) A manufacturer, supplier, pharmacy, physician, qualified physician, or other person shall not provide an abortion-inducing drug to a patient via courier, delivery, or mail service.
§ 63-6-1104. Distribution of abortion-inducing drugs.
  1. (a) Because the failure and complication rates from a chemical abortion increase with advancing gestational age and because the physical symptoms of chemical abortion can be identical to the symptoms of ectopic pregnancy and abortion-inducing drugs do not treat ectopic pregnancies and are contraindicated in ectopic pregnancies, a qualified physician providing an abortion-inducing drug shall examine the patient in person and, prior to providing an abortion-inducing drug:
    1. (1) Independently verify that a pregnancy exists;
    2. (2) Determine the patient's blood type, and, if the patient is Rh negative, offer to administer RhoGAM at the time of the abortion;
    3. (3) Inform the patient that the patient may see the remains of the unborn child in the process of completing the abortion; and
    4. (4) Document, in the patient's medical chart, the gestational age and intrauterine location of the pregnancy, and whether the patient received treatment for Rh negativity, as diagnosed by the most accurate standard of medical care.
  2. (b) A qualified physician providing an abortion-inducing drug must be credentialed and competent to handle complication management, including emergency transfer, or must have a signed agreement with an associated physician who is credentialed to handle complications and be able to produce the signed agreement on demand by the patient or the department. The qualified physician providing an abortion-inducing drug to a patient shall provide the patient with the name and phone number of the associated physician.
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  3. (c) A qualified physician providing an abortion-inducing drug, or an agent of the qualified physician, shall schedule a follow-up visit for the patient at approximately seven (7) to fourteen (14) days after administration of the abortion-inducing drug to confirm that the pregnancy is completely terminated and to assess the degree of bleeding. The qualified physician shall make all reasonable efforts to ensure that the patient returns for the scheduled appointment. A brief description of the efforts made to comply with this subsection (c), including the date, time, and identification by name of the individual making the efforts, must be included in the patient's medical record.
§ 63-6-1105. Criminal penalties.
    1. (a) An individual who intentionally, knowingly, or recklessly violates this part commits a Class E felony and, upon conviction, may be fined not more than fifty thousand dollars ($50,000). As used in this subsection (a), “intentional,” “knowing,” and “reckless” have the same meanings as provided in § 39-11-302.
    2. (b) A criminal penalty shall not be assessed against a patient upon whom a chemical abortion is attempted or performed.
§ 63-6-1106. Civil remedies and professional sanctions.
  1. (a) In addition to all other remedies available under the laws of this state, failure to comply with this part:
    1. (1) Provides a basis for a civil malpractice action for actual and punitive damages;
    2. (2) Provides a basis for professional disciplinary action under this title or title 68 for the suspension or revocation of the license of a healthcare provider or facility;
    3. (3) Provides a basis for recovery for the patient's survivors for the wrongful death of the patient under a wrongful death action; and
    4. (4) Provides a basis for a cause of action for injunctive relief against an individual who has provided an abortion-inducing drug in violation of this part to prevent the enjoined defendant from providing further abortion-inducing drugs in violation of this part. The action may be maintained by:
      1. (A) A patient to whom the abortion-inducing drug was provided;
      2. (B) An individual who is the spouse, parent, or guardian of, or a current or former licensed healthcare provider of, a patient to whom the abortion-inducing drug was provided; or
      3. (C) A prosecuting attorney with appropriate jurisdiction.
  2. (b) Civil liability shall not be imposed against a patient on whom a chemical abortion is attempted or performed.
  3. (c) When requested, the court shall allow a patient to proceed using solely the patient's initials or a pseudonym and may close any proceedings in the case and enter other protective orders to preserve the privacy of the patient on whom the chemical abortion was attempted or performed.
  4. (d) If judgment is rendered in favor of the plaintiff, the court shall also render judgment for reasonable attorney fees in favor of the plaintiff against the defendant.
  5. (e) If judgment is rendered in favor of the defendant and the court finds that the plaintiff's suit was frivolous and brought in bad faith, the court may render judgment for reasonable attorney fees in favor of the defendant against the plaintiff.
§ 63-6-1107. Construction.
  1. This part does not:
    1. (1) Create or recognize a right to abortion;
    2. (2) Make lawful an abortion that is otherwise unlawful; or
    3. (3) Repeal, replace, or otherwise invalidate existing federal laws, regulations, or policies.
§ 63-6-1108. Right of intervention.
  1. The attorney general and reporter may bring an action to enforce compliance with this part or intervene as a matter of right in a case in which the constitutionality of this part is challenged.
Part 12 Cytopathology Services
§ 63-6-1201. Part definitions.
  1. For purposes of this part, unless the context otherwise requires:
    1. (1) “Cytopathology services” means the examination of cells from fluids, aspirates, washings, brushings or smears, including the Pap test examination performed by a physician or under the supervision of a physician; and
    2. (2) “Onsite medical clinic” means a medical clinic located on the premises of the patient's employer for which cytopathology services are provided and for which a patient has no financial obligation to pay for the cytopathology services.
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§ 63-6-1202. Claims, bills or demands for payment for services.
  1. A clinical laboratory or physician, located in this state, or in another state, providing cytopathology services for patients in this state, shall present or cause to be presented a claim, bill or demand for payment for these services only to the following:
    1. (1) The patient directly;
    2. (2) The responsible insurer or other third party payor;
    3. (3) The hospital, public health clinic, nonprofit health clinic ordering the services, or onsite medical clinic;
    4. (4) The referring laboratory, other than a laboratory of a physician's office or group practice that does not perform the technical or professional component of the cytopathology service for which the claim, bill, or demand is presented; or
    5. (5) Governmental agencies or their specified public or private agent, agency, or organization on behalf of the recipient of the services.
§ 63-6-1203. Restrictions on solicitation for payment by licensed practitioner.
  1. Except as provided by § 63-6-1206, no licensed practitioner in the state shall, directly or indirectly, charge, bill or otherwise solicit payment for cytopathology services, unless the professional component of the services was rendered personally by the licensed practitioner or under the licensed practitioner's direct supervision in accordance with § 353 of the Public Health Service Act (42 U.S.C. § 263a).
§ 63-6-1204. Reimbursement of licensed practitioner.
  1. No patient, insurer, third party payor, hospital, public health clinic or nonprofit health clinic shall be required to reimburse any licensed practitioner for charges or claims submitted in violation of this part.
§ 63-6-1205. Assignment of benefits.
  1. Nothing in this part shall be construed to mandate the assignment of benefits for cytopathology services as defined in § 63-6-1201.
§ 63-6-1206. Referring laboratory.
  1. This part does not prohibit billing of a referring laboratory for cytopathology services in instances where a sample or samples must be sent to another specialist; provided, that, for purposes of this section, “referring laboratory” does not include a laboratory of a physician's office or group practice that does not perform the technical or professional component of the cytopathology service involved.
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§ 63-6-1207. Violations.
  1. The appropriate state licensing board having jurisdiction over any practitioner who may request or provide cytopathology services may revoke, suspend or deny renewal of the license of any practitioner who violates this part.
Chapter 7 Nursing
Part 1 General Provisions
§ 63-7-101. Purpose of chapter.
  1. The purpose of this chapter is to safeguard life and health by requiring each person who is practicing or is offering to practice nursing to submit evidence that the person is qualified to practice and to be licensed as provided in this chapter. Such evidence of qualifications shall be submitted to the state board of nursing, which is the regulatory body authorized to enforce this chapter.
§ 63-7-102. Exemptions.
  1. Nothing in this chapter shall be construed as applying to:
    1. (1) The domestic administration of family remedies or the furnishing of assistance in the case of an emergency;
    2. (2) Persons employed in the office of a licensed physician or dentist, assisting in the nursing care of patients where adequate medical or nursing supervision, or both, is provided;
    3. (3) The practice of nursing incidental to a program of study by students enrolled in nursing education programs approved by the board;
    4. (4) Persons belonging to a recognized church or religious denomination having religious teachings and beliefs in regard to the care of the sick by prayer;
    5. (5) Care of persons in their homes by domestic servants, housekeepers, attendants or household aides of any type, whether employed regularly or because of an emergency or illness if such persons are not initially employed in a nursing capacity;
    6. (6) The practice of any lawfully qualified nurse of another state who is employed by the United States government or any bureau, division or agency thereof while in the discharge of the nurse's official duties in this state;
    7. (7) The practice of any currently licensed nurse of another state who is presenting educational programs or consultative services within this state for a period not to exceed fourteen (14) days in a calendar year;
    8. (8) The practice of any currently licensed nurse of another state whose responsibilities include transporting patients into, out of or through this state. Such exemption shall be limited to a period not to exceed forty-eight (48) hours for each transport;
    9. (9) The practice of nursing by students who are enrolled in board-approved refresher programs or comprehensive orientation programs;
    10. (10) Persons trained in accordance with § 68-1-904(c) who are:
      1. (A) Providing personal support services to clients living in their own home or private residence pursuant to a contract or agreement under any medicaid waiver or other program of the department of intellectual and developmental disabilities;
      2. (B) Employed by agencies that are both licensed under title 33 and under contract to provide residential or adult day programs for people with intellectual disabilities and persons trained in accordance with § 68-1-904(c); or
      3. (C) Employed by community-based licensed intermediate care facilities for people with intellectual disabilities who will administer medication only at a location other than the community-based facility. The employees of the community-based licensed intermediate care facilities for people with intellectual disabilities may additionally receive medication administration training specific to the person served. For the purposes of this subdivision (10)(C), when administered by employees of the intermediate care facilities, medications shall be packaged in individual doses labeled with the name of the individual patient, the time of administration and the drug name and dosage;
    11. (11) Except for those persons covered under subdivision (10)(A), a person employed by an agency licensed under title 33, chapter 2, part 4 providing personal support services to clients living in their own home or private residence may assist the client with medication, except for injections, upon a written authorization by the client or the client's authorized representative. For the purpose of this section, assistance is limited to opening medication packaging and providing medication reminders and does not permit giving the client any form of medication. Before any such person is authorized to assist the client with medication as provided in this subdivision (11), the person shall receive and be able to document training in medication assistance performed by or under the general supervision of a registered nurse and consistent with the state's home and community-based services (HCBS) training in assisting with medications. For the purposes of this subdivision (11), assisting with medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized so to do by specific professional acts under this title or by rules or regulations;
    12. (12)
      1. (A) Persons trained in accordance with § 68-1-904(c)(2), who are employed by agencies that are both licensed under title 37 and under contract with the department of children's services to provide services, can assist children and youth with the self-administration of medication in a group home setting. Before that person is authorized to assist the child or youth with self-administration of medication, that person must have received and be able to document six (6) hours of training in medication administration from a registered nurse licensed pursuant to this chapter;
      2. (B) For the purposes of subdivision (12)(A), assisting with self-administration of medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized to do so by specific professional acts under this title or by rules or regulations; and
    13. (13) Except to the extent that it applies to the administration of medication, an individual who holds a valid medication technician certificate issued under this chapter, if the medication is administered in accordance with this chapter.
§ 63-7-103. “Practice of professional nursing” and “professional nursing” defined.
  1. (a)
    1. (1) “Practice of professional nursing” means the performance for compensation of any act requiring substantial specialized judgment and skill based on knowledge of the natural, behavioral and nursing sciences and the humanities as the basis for application of the nursing process in wellness and illness care.
    2. (2) “Professional nursing” includes:
      1. (A) Responsible supervision of a patient requiring skill and observation of symptoms and reactions and accurate recording of the facts;
      2. (B) Promotion, restoration and maintenance of health or prevention of illness of others;
      3. (C) Counseling, managing, supervising and teaching of others;
      4. (D) Administration of medications and treatments as prescribed by a licensed physician, dentist, podiatrist, or nurse authorized to prescribe pursuant to § 63-7-123, or selected, ordered, or administered by an advanced practice registered nurse specializing as a certified registered nurse anesthetist (CRNA) during services ordered by a physician, dentist, or podiatrist and provided by a CRNA in collaboration with the ordering physician, dentist, or podiatrist that are within the scope of practice of the CRNA and authorized by clinical privileges granted by the medical staff of the facility. A CRNA shall collaborate in a cooperative working relationship with the ordering physician, dentist, or podiatrist in the provision of patient care, which includes consultation regarding patient treatment and cooperation in the management and delivery of health care;
      5. (E) Application of such nursing procedures as involve understanding of cause and effect; and
      6. (F) Nursing management of illness, injury or infirmity including identification of patient problems.
  2. (b) Notwithstanding subsection (a), the practice of professional nursing does not include acts of medical diagnosis or the development of a medical plan of care and therapeutics for a patient, except to the extent such acts may be authorized by §§ 63-1-132, 63-7-123 and 63-7-207.
  3. (c)
    1. (1) This section does not preclude a qualified registered nurse from determining whether a patient presenting to a hospital has an emergency medical condition if the determination is pursuant to:
      1. (A) A cooperative working relationship with a physician; and
      2. (B) Protocols jointly developed by the hospital's medical and nursing leadership and adopted by the hospital's medical staff and governing body.
    2. (2) The protocols described in subdivision (c)(1) must include a requirement that the qualified registered nurse obtain the concurrence of a physician when making a determination authorized under subdivision (c)(1).
    3. (3) As used in this subsection (c):
      1. (A) “Emergency medical condition” means:
        1. (i) A medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
          1. (a) Placing the health of the individual or, with respect to a pregnant woman, the health of the woman or the woman's unborn child, in serious jeopardy;
          2. (b) Serious impairment to bodily functions; or
          3. (c) Serious dysfunction of any bodily organ or part; and
        2. (ii) With respect to a pregnant woman who is having contractions:
          1. (a) That there is inadequate time to effect a safe transfer to another hospital before delivery; or
          2. (b) That transfer may pose a threat to the health or safety of the woman or the woman's unborn child; and
      2. (B) “Qualified registered nurse” means a registered nurse who has been approved by the hospital governing body, based on the recommendation of hospital nursing leadership, as possessing the skills and competency to make a determination of the existence of a specified emergency medical condition of a patient presenting to a hospital.
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§ 63-7-104. Registered nurse qualifications.
  1. An applicant for a license to practice professional nursing shall submit to the board evidence in such form as the board may prescribe that such applicant:
    1. (1) Is in good physical and mental health;
    2. (2) Holds a diploma from a four-year accredited high school, or the equivalent thereof, as determined by the board; and
    3. (3) Has successfully completed a course of study in an approved school of nursing, as defined by the board, and the applicant holds a diploma or degree from an approved school of nursing or the approved school has certified to the board that the applicant has met all requirements for a diploma or degree.
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§ 63-7-105. Registered nurse licensure.
  1. (a) By Examination. An applicant for a license to practice professional nursing shall be required to pass an examination in such subjects as the board may determine. The board shall issue a license to practice professional nursing to an applicant who successfully completes the examination.
  2. (b) Without Examination.
    1. (1) The board may issue a license to practice professional nursing to a professional or registered nurse who has been duly licensed in another state or territory if, in the opinion of the board, the individual meets the professional nurse qualifications that, at the time of the applicant's graduation, were in effect in this state.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory, then the board shall, within forty-five (45) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (b)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
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  3. (c) Temporary Permits. The board may issue a temporary permit to a professional or registered nurse duly licensed according to the laws of another state and who has made application for permanent licensure in Tennessee. A permit issued under this subsection (c) shall be valid for a single period of six (6) months.
  4. (d)
    1. (1) Notwithstanding a law to the contrary, a graduate nurse may engage in the practice of professional nursing without a license for a period not to exceed one hundred twenty (120) calendar days from the date of receipt of the first authorization to take the NCLEX-RN examination if:
      1. (A) The graduate nurse's practice occurs in a healthcare institution licensed under title 33 or 68, or an affiliate of the institution;
      2. (B) The graduate nurse is at all times working under the supervision of an individual licensed to practice professional nursing pursuant to § 63-7-105. The graduate nurse must provide the healthcare institution or affiliate of the institution in which they are practicing with:
        1. (i) Proof of the first authorization to take the NCLEX-RN examination; and
        2. (ii) Proof of graduation from an approved school of nursing within the previous ninety (90) days; and
      3. (C) The supervising individual licensed to practice professional nursing pursuant to § 63-7-105 is limited to supervising no more than one (1) graduate nurse at a time.
    2. (2) A graduate nurse is prohibited from:
      1. (A) Being deemed a qualified registered nurse pursuant to § 63-7-103; and
      2. (B) Using another title or identifying as anything but a “graduate nurse” in a clinical setting.
    3. (3) As used in this subsection (d):
      1. (A) “Graduate nurse” means an individual who:
        1. (i) Holds a diploma or degree from an approved school of nursing that entitles the individual to take the NCLEX-RN licensing examination; and
        2. (ii) Has received authorization to take the NCLEX-RN examination;
      2. (B) “NCLEX-RN” means the national council licensure examination for registered nurses; and
      3. (C) “Supervision” means that the graduate nurse's supervisor is located in the same unit as the graduate nurse when the graduate nurse is performing duties pursuant to this subsection (d).
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§ 63-7-106. Registered nurse fees — Certification to other states.
  1. (a)
    1. (1) The applicant for a license to practice as a professional or registered nurse by examination must pay a fee as set by the board and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
    2. (2) An unsuccessful applicant for licensure by examination may rewrite the examination upon payment of a fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
    3. (3) The applicant for a license to practice as a professional or registered nurse without examination under § 63-7-105(b) shall pay a fee as set by the board.
  2. (b) The applicant for a temporary permit shall pay a fee as set by the board.
  3. (c) Any person who holds a license to practice professional nursing under this chapter, and who seeks to be licensed in another state by endorsement on the basis of the person's Tennessee license, shall have the license certified by the board for a fee as set by the board.
  4. (d) The applicant for a duplicate original license or a duplicate renewal certificate shall pay a fee as set by the board.
  5. (e) The applicant for a school transcript shall pay a fee as set by the board.
  6. (f) The applicant for a change in name shall pay a fee as set by the board.
  7. (g) An applicant for a certificate of fitness or a temporary certificate of fitness pursuant to § 63-7-123 shall pay a fee as set by the board.
§ 63-7-107. Use of “registered nurse” title.
  1. Any person who holds a license to practice professional nursing under this chapter shall, during the effective period of such license, be entitled to use the title “nurse,” “registered nurse,” or the abbreviation “R.N.” No other person shall assume such titles or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a professional or registered nurse.
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§ 63-7-108. “Practice of practical nursing” defined.
  1. The “practice of practical nursing” means the performance for compensation of selected acts required in the nursing care of the ill, injured or infirm and/or carrying out medical orders prescribed by a licensed physician or dentist under the direction of a licensed physician, dentist or professional registered nurse. The licensed practical nurse shall have preparation in and understanding of nursing, but shall not be required to have the same degree of education and preparation as required of a registered nurse.
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§ 63-7-109. Practical nurse qualifications.
  1. An applicant for a license to practice as a licensed practical nurse shall submit to the board evidence in such form as the board may prescribe that the applicant:
    1. (1) Is in good physical and mental health;
    2. (2) Has completed the twelfth grade or its equivalent or has successfully passed the test for and has received a high school equivalency credential approved by the state board of education and such other preliminary qualifications and requirements as the board may prescribe; and
    3. (3) Has successfully completed a course of study in an approved school for practical nurses, as defined by the board, and the applicant holds a certificate therefrom, or the approved school has certified to the board that the applicant has met all requirements for a certificate.
§ 63-7-110. Practical nurse licensure.
  1. (a) By Examination. An applicant for a license to practice practical nursing shall be required to pass a written examination as prescribed by the board. The board shall issue a license to practice practical nursing to an applicant who successfully completes the examination.
  2. (b) Without Examination.
    1. (1) The board may issue a license to a licensed practical nurse who has been duly licensed in another state or territory if, in the opinion of the board, the individual meets the practical nurse qualifications that, at the time of the applicant's graduation, were in effect in this state.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory, then the board shall, within forty-five (45) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (b)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
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  3. (c) Temporary Permits. The board may issue a temporary permit to a practical nurse duly licensed according to the laws of another state and who has made application for a permanent license in Tennessee. A permit issued under this subsection (c) shall be valid for a single period of six (6) months.
  4. (d)
    1. (1) Notwithstanding a law to the contrary, a graduate practical nurse may engage in the practice of practical nursing without a license for a period not to exceed one hundred twenty (120) calendar days from the date of receipt of the first authorization to take the NCLEX-PN examination if:
      1. (A) The graduate practical nurse's practice occurs in a healthcare institution licensed under title 33 or 68, or an affiliate of the institution;
      2. (B) The graduate practical nurse is at all times working under the supervision of an individual licensed in this state to practice as a professional or registered nurse. The graduate practical nurse shall provide the healthcare institution or affiliate of the institution in which the nurse is practicing with the following:
        1. (i) Proof of the first authorization to take the NCLEX-PN examination; and
        2. (ii) Proof of graduation from an approved school of nursing within the previous ninety (90) days;
      3. (C) The supervising individual described in subdivision (d)(1)(B) is limited to supervising no more than one (1) graduate practical nurse at a time; and
      4. (D) The graduate practical nurse is prohibited from:
        1. (i) Being deemed a licensed practical nurse pursuant to this section; and
        2. (ii) Using another title or identifying as anything but a “graduate practical nurse” in a clinical setting.
    2. (2) As used in this subsection (d):
      1. (A) “Graduate practical nurse” means an individual who:
        1. (i) Holds a diploma or degree from an approved school of nursing that entitles the individual to take the NCLEX-PN licensing examination; and
        2. (ii) Has received authorization to take the NCLEX-PN examination;
      2. (B) “NCLEX-PN” means the national council licensure examination for practical nurses; and
      3. (C) “Supervision” means that the graduate practical nurse's supervising individual is located in the same unit as the graduate practical nurse when the graduate practical nurse is performing duties pursuant to this subsection (d).
§ 63-7-111. Practical nurse fees — Certification to other states.
  1. (a)
    1. (1) The applicant for a license to practice as a licensed practical nurse shall pay an examination fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
    2. (2) An applicant to rewrite an examination shall pay an examination fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
  2. (b) The applicant to practice as a licensed practical nurse without examination under § 63-7-110(b) shall pay a fee as set by the board.
  3. (c) The applicant for a permit shall pay a fee as set by the board.
  4. (d) Any person who holds a license to practice as a practical nurse under this chapter and who seeks to be licensed in another state by endorsement on the basis of the person's Tennessee license shall have the license certified by the board for a fee as set by the board.
  5. (e) The applicant for a duplicate original license or a duplicate renewal certificate shall pay a fee as set by the board.
  6. (f) The applicant for a school transcript shall pay a fee as set by the board.
  7. (g) The applicant for a change in name shall pay a fee as set by the board.
§ 63-7-112. Use of “licensed practical nurse” title.
  1. Any person who holds a license to practice practical nursing under this chapter shall, during the effective period of such license, be entitled to use the title “nurse,” “licensed practical nurse” or the abbreviation “L.P.N.” No other person shall assume such titles or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a licensed practical nurse.
§ 63-7-113. Examinations.
  1. (a) An examination for both the professional and practical nurses shall be held at least once each year at such time and place as the board may determine and additional examinations as the board may deem necessary.
  2. (b) The board shall appoint the number of nurses and proctors necessary to administer the examination in each place designated and make such rules and regulations in regard to the examinations as are essential to efficient service. Each nurse or proctor shall receive fifty dollars ($50.00) per day for each day of service, and in addition thereto, shall be reimbursed for travel and other necessary expenses. Such expenses shall be claimed and paid in accordance with the prevailing travel regulations of the state government.
§ 63-7-114. Renewal of license.
  1. (a) All licensed professional or registered nurses shall submit an application for renewal of licensure registration to the board of nursing with a biennial renewal fee as set by the board.
  2. (b) Each licensed practical nurse shall submit an application for the renewal of licensure registration to the board with a biennial renewal fee as set by the board.
  3. (c)
    1. (1) Notwithstanding this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (c).
  4. (d) The executive director of the board shall notify each person holding a current licensure registration to practice as a professional or registered nurse or as a practical nurse at least sixty (60) days prior to the due date of the renewal fee that the fee is due. Failure of any licensee to receive such notice shall not relieve or exempt such licensee from the requirements of this section.
  5. (e) The license of any nurse who fails to renew the licensure registration, provide any information requested by the board to perform its duties or pay any fees required by this chapter shall be automatically revoked unless registration is made within sixty (60) days. Reinstatement may be obtained upon good cause being shown to the board, payment of all past due fees and upon payment of a reinstatement fee as set by the board. The board may request evidence of nursing competence prior to renewal of the nursing license.
  6. (f) Any nurse who has not been engaged in the practice of nursing for five (5) years or more shall be issued an inactive license. If such nurse desires to resume practice, notice in writing shall be given to the board and evidence of nursing competence may be required prior to license renewal. The board shall evaluate, on an individual basis, evidence of nursing competence, which may include, but is not limited to, continuing education, a refresher program, comprehensive orientation program, employment in a health-related policy position or nursing educational program.
§ 63-7-115. Grounds for denial, revocation or suspension of certificate or license.
  1. (a)
    1. (1) The board has the power to deny, revoke or suspend any certificate or license to practice nursing or to otherwise discipline a licensee upon proof that the person:
      1. (A) Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing;
      2. (B) Is guilty of a crime;
      3. (C) Is unfit or incompetent by reason of negligence, habits or other cause;
      4. (D) Is addicted to alcohol or drugs to the degree of interfering with nursing duties;
      5. (E) Is mentally incompetent;
      6. (F) Is guilty of unprofessional conduct; or
      7. (G) Has violated or attempted to violate, directly or indirectly, or assisted in or abetted the violation of or conspired to violate any provision of this chapter or any lawful order of the board issued pursuant thereto.
    2. (2) This section shall also apply to members of the board.
  2. (b) The board shall have concurrent enforcement power, pursuant to [former] § 63-1-122 [repealed], with the division to revoke or suspend any certificate of fitness of a nurse practitioner who has been issued a certificate of fitness pursuant to § 63-1-104 or to otherwise discipline such person in accordance with this section.
  3. (c)
    1. (1) The board may utilize one (1) or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for diversion to professional peer review organizations and/or impaired professionals associations or foundations those cases that the board, through established guidelines, deems appropriate. Upon diversion, such entities shall retain the same immunity as provided by law for the board.
    2. (2) The screening panels shall consist of as many members as the board directs, but shall include at least one (1) but no more than three (3) licensed nurses, who may be members of the board or may serve either voluntarily or through employment by or under contract with the board.
    3. (3) The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings law, compiled in title 8, chapter 44, and shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the board and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
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  4. (d) The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section in compliance with procedures established by the board. The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case against the licensee or person.
  5. (e) Any elected officer of the board or any duly appointed or elected chair of any panel of the board or any screening panel and any hearing officer, arbitrator or mediator has the authority to administer oaths to witnesses and, upon probable cause being established, issue subpoenas for the attendance of witnesses and the production of documents and records.
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§ 63-7-116. License revocation or suspension procedure — Reissuance — Contested case hearings.
  1. (a) Any person may prefer charges against a nurse for violation of any grounds of discipline mentioned in § 63-7-115. The charges shall be in writing and submitted to the board unless they originate with the board or a member thereof.
  2. (b) Unless the charges are dismissed without a hearing by the board as unfounded or not warranting further investigation, the board shall, within ninety (90) days from the date on which the charges are preferred, set a time, date and place for a hearing on the charges. The date set for the hearing shall not be more than six (6) months from the date on which the charges are preferred.
  3. (c) A copy of the charges, together with the notice of the time and place of the hearing, shall be furnished to the accused, which may be done by registered mail directed to the address furnished to the board at the time of registration, at least thirty (30) days before the date fixed for the hearing.
  4. (d)
    1. (1) The chair or the vice chair of the board has the power to administer oaths, issue subpoenas and enforce the attendance of witnesses and the production of books, records and papers at any hearing on any matter that the board has power to investigate.
    2. (2) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a contempt.
    3. (3) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
  5. (e) At the hearing, the accused shall have the right to appear personally and by counsel to cross-examine witnesses to produce evidence and witnesses, and shall also have the right to have subpoenas issued by the board to compel the attendance of all witnesses considered by the parties to be necessary to a full and complete hearing.
  6. (f) After the hearing, if a majority of the members of the board present vote in favor of finding the accused guilty of any of the charges, the board shall suspend or revoke the certificate of registration of the accused as in its judgment the offense deserves.
  7. (g) Review of the action of the board in suspending or revoking any license shall be pursuant to title 27, chapter 9.
  8. (h) The board may reissue any license that it has revoked if a majority of the members of the board present vote in favor of the reissuance of the license for reasons the board may consider sufficient.
  9. (i) Notwithstanding any other law to the contrary, for purposes of contested case hearings and disciplinary matters, three (3) or more members shall constitute a quorum and the board chair is authorized, when it is deemed necessary, to split the board into panels of three (3) or more members, each to conduct contested case hearings or disciplinary matters. A majority vote of the members present on any duly constituted panel shall be required to authorize board action in disciplinary matters and contested case hearings. The board chair shall have the authority to appoint board members to serve, as necessary, on the panels regardless of the grand division from which the appointed member was chosen or the member's status as a nurse or non-nurse member. The participation of a non-nurse board member creates no rights in any individual concerning the composition of any panel in any disciplinary matter or contested case hearing. The unavailability of a member of any panel before rendition of a final order shall not require substitution of another member unless the unavailability results in there being less than the quorum required by this section for contested case hearings or disciplinary matters. Any substitute required shall use any existing record and may conduct any further proceedings as are necessary in the interest of justice. A decision by the panel shall be deemed an order of the board.
§ 63-7-117. Application for school accreditation.
  1. An institution desiring to conduct a school of professional nursing or a school of practical nursing on ground, distance, online or via other electronic means must apply to the board for approval, and submit evidence that it is prepared to:
    1. (1) Carry out the prescribed basic professional nursing curriculum or the prescribed curriculum for practical nursing, as the case may be; and
    2. (2) Meet other standards established by this chapter or by the board.
§ 63-7-118. Investigation of applicants for accreditation.
  1. A survey of the institution or institutions and agencies with which the school is to be affiliated shall be made by the executive director or by a qualified nurse appointed for this purpose by the board. The school shall submit a written report to the board. If, in the opinion of the board, the requirements for an approved school are found to be met, the board shall approve such school and designate it as an approved school of nursing.
§ 63-7-119. Survey of schools and report — Loss of accreditation.
  1. At least once every eight (8) years, the executive director or other authorized employee shall survey each school of nursing in Tennessee and submit a written report to the board. If the board determines that a school of nursing previously approved is not maintaining the required standards, written notice shall be furnished the school with a specification of the deficiencies claimed to exist by the board. After a hearing, which shall be afforded if demanded, a school that fails to correct the deficiencies written in such notice within the time specified shall be removed from the list of approved schools of nursing.
§ 63-7-120. Violations and penalties.
  1. (a) It is a Class B misdemeanor for any person, corporation or association to:
    1. (1) Sell or fraudulently obtain or furnish any nursing diploma, license or record, or aid or abet therein;
    2. (2) Practice nursing as defined by this chapter under cover of any diploma, license or record illegally or fraudulently obtained or assigned or issued unlawfully or under fraudulent representation;
    3. (3) Practice nursing as defined by this chapter unless duly licensed to do so under this chapter;
    4. (4) Use in connection with the person's name any designation tending to imply that the person is a registered nurse or a licensed practical nurse unless duly licensed so to practice under this chapter;
    5. (5) Practice nursing during the time the person's license issued under this chapter is suspended or revoked;
    6. (6) Conduct a school of nursing or a program for the training of practical nurses unless the school or program has been approved by the board; or
    7. (7) Otherwise violate any provisions of this chapter.
  2. (b) Legal procedure in prosecution of violations of this section shall be in accordance with general statutes.
§ 63-7-121. Validity of license issued on or before September 1, 1967.
  1. Any person holding a license to practice as a registered or professional nurse or licensed practical nurse issued by the board that is valid on September 1, 1967, shall thereafter be considered to be licensed under this chapter.
§ 63-7-122. Enjoining violations.
  1. (a) The board of nursing, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license, is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin:
    1. (1) Any person from practicing or from attempting to practice as a professional or registered nurse, as described in § 63-7-103, or as a licensed practical nurse, as described in § 63-7-108, without possessing a valid license;
    2. (2) Any licensee from practicing who has been found guilty of the acts enumerated in § 63-7-115; or
    3. (3) Any person from using the title “nurse” or from using any other title, abbreviation, or designation in connection with the person's name, occupation, or profession that indicates or implies that the person is a practicing nurse, but who does not possess a valid license or certificate from the board of nursing.
  2. (b) No injunction bond shall be required of the board.
  3. (c) Jurisdiction is conferred upon the circuit and chancery courts to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
§ 63-7-123. Certified nurse practitioners — Drug prescriptions — Temporary certificate — Rules and regulations.
  1. (a) The board shall issue a certificate of fitness to nurse practitioners who meet the qualifications, competencies, training, education and experience, pursuant to § 63-7-207(14), sufficient to prepare such persons to write and sign prescriptions and/or issue drugs within the limitations and provisions of § 63-1-132.
  2. (b)
    1. (1) A nurse who has been issued a certificate of fitness as a nurse practitioner pursuant to § 63-7-207 and this section shall file a notice with the board, containing the name of the nurse practitioner, the name of the licensed physician collaborating with the nurse practitioner who has control and responsibility for prescriptive services rendered by the nurse practitioner, and a copy of the formulary describing the categories of legend drugs to be prescribed and/or issued by the nurse practitioner. The nurse practitioner shall be responsible for updating this information.
    2. (2)
      1. (A) The nurse practitioner who holds a certificate of fitness shall be authorized to prescribe and/or issue controlled substances listed in Schedules II, III, IV, and V of title 39, chapter 17, part 4, upon joint adoption of physician collaboration rules concerning controlled substances pursuant to subsection (d).
      2. (B) Notwithstanding subdivision (b)(2)(A), a nurse practitioner shall not prescribe Schedules II, III, and IV controlled substances unless such prescription is specifically authorized by the formulary or expressly approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication.
      3. (C) A nurse practitioner who had been issued a certificate of fitness may only prescribe or issue a Schedule II or III opioid listed on the formulary for a maximum of a non-refillable, thirty-day course of treatment unless specifically approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication. This subdivision (b)(2)(C) shall not apply to prescriptions issued in a hospital, a nursing home licensed under title 68, or inpatient facilities licensed under title 33.
    3. (3)
      1. (A) Any prescription written and signed or drug issued by a nurse practitioner under collaboration with and the control of a collaborating physician shall be deemed to be that of the nurse practitioner. Every prescription issued by a nurse practitioner pursuant to this section shall be entered in the medical records of the patient and shall be written on a preprinted prescription pad bearing the name, address, and telephone number of the collaborating physician and of the nurse practitioner, and the nurse practitioner shall sign each prescription so written. Where the preprinted prescription pad contains the names of more than one (1) physician, the nurse practitioner shall indicate on the prescription which of those physicians is the nurse practitioner's primary collaborating physician by placing a checkmark beside or a circle around the name of that physician.
      2. (B) Any handwritten prescription order for a drug prepared by a nurse practitioner who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing nurse practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing nurse practitioner must sign the handwritten prescription order on the day it is issued, unless the prescription order is:
        1. (i) Issued as a standing order in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201; or
        2. (ii) Prescribed by a nurse practitioner in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
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      3. (C) Any typed or computer-generated prescription order for a drug issued by a nurse practitioner who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing nurse practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing nurse practitioner must sign the typed or computer-generated prescription order on the day it is issued, unless the prescription order is:
        1. (i) Issued as a standing order in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201; or
        2. (ii) Prescribed by a nurse practitioner in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
      4. (D) Nothing in this section shall be construed to prevent a nurse practitioner from issuing a verbal prescription order.
      5. (E)
        1. (i) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
        2. (ii) Subdivision (b)(3)(E)(i) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
    4. (4) The nurse practitioner shall maintain a copy of the protocol the nurse practitioner is using at the nurse practitioner's practice location and shall make the protocol available upon request by the board of nursing, the board of medical examiners or authorized agents of either board.
    5. (5) An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter, who provides services in a free clinic as defined in § 63-6-703 or engages in the voluntary provision of healthcare services as defined in § 63-6-703, may arrange for required personal review of the nurse's charts by a collaborating physician in the office or practice site of the physician or remotely via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (b)(5), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 CFR 164.312.
    6. (6) An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter, who provides services in a community mental health center as defined in § 33-1-101 or federally qualified health center as defined in § 63-10-601, may arrange for the required personal review of the advanced practice registered nurse's charts by a collaborating physician, with the same authority to render prescriptive services that the nurse practitioner is authorized to render, in the office or practice site of the physician, or the required visit by a collaborating physician to any remote site, or both, via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (b)(6), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. § 164.312.
    7. (7) Except for subdivisions (b)(5) and (6):
      1. (A) An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter, who provides services at a site remote from the advanced practice registered nurse's collaborating physician's practice site, may arrange for the required personal review of the advanced practice registered nurse's charts by a collaborating physician either via HIPAA-compliant electronic means or in person;
      2. (B) An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter may arrange for up to ten (10) of the required annual remote site visits by a collaborating physician by HIPAA-compliant electronic means rather than at the site of the clinic. All other of the required site visits by a collaborating physician to a remote site must take place in person at the site of the clinic;
      3. (C) For purposes of this subdivision (b)(7):
        1. (i) “Annual” means a rolling twelve-month period; and
        2. (ii) “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. § 164.312.
  3. (c)
    1. (1) The board may issue a temporary certificate of fitness to a registered nurse who:
      1. (A) Is licensed to practice in Tennessee;
      2. (B) Has a master's degree in a nursing clinical specialty area with preparation in specialized practitioner skills that includes three (3) quarter hours of pharmacology instruction or its equivalent; and
      3. (C) Has applied for examination and/or is awaiting examination results for national certification as a first-time examinee in an appropriate nursing specialty area.
    2. (2) Such temporary certificate shall remain valid until the examination results are obtained. The holder of a temporary certificate issued under this subsection (c) who has not received the results of the examination shall work only under the supervision and control of a certified nurse practitioner or physician.
  4. (d) Any rules that purport to regulate the collaboration of nurse practitioners with physicians shall be jointly adopted by the board of medical examiners and the board of nursing.
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§ 63-7-124. Authority to issue oral contraceptives and drugs relating to sexually transmitted diseases.
  1. (a) Notwithstanding [former] §§ 63-1-132(c) [repealed] and 63-7-123, a professional nurse, licensed pursuant to §§ 63-7-104 — 63-7-107, who is employed by a primary health care center established under § 68-1-701, that receives fifty percent (50%) or more of its family planning funds from funds distributed by the department of health, has the authority to issue, in the same manner as is currently permitted the department or local health departments under § 63-10-205:
    1. (1) Oral contraceptives, excluding abortifacients; and
    2. (2) Drugs relating to sexually transmitted diseases.
  2. (b) A drug issued under this section shall be issued in accordance with any protocols or standards established by the department for the use of such drug.
  3. (c) No drugs as provided in this section shall be issued unless a physician has examined the patient for the condition for which such drugs are issued; provided, that this requirement does not supersede any protocol under which a nurse practitioner is rendering service to a patient pursuant to § 63-6-204 or § 63-7-123.
§ 63-7-125. Confidentiality.
  1. (a) The confidential communications between a client and a registered nurse who is nationally certified as a specialist in psychiatric and mental health nursing and who is practicing in that specialty are considered equivalent to the confidential communications between a patient and a licensed physician practicing as a psychiatrist, under laws addressing privilege and confidentiality and shall have the same protections accorded to patient-psychiatrist communications under § 24-1-207.
  2. (b) Nothing in this section shall be construed to prevent disclosure of confidential communications in proceedings arising under title 37, chapter 1, part 4, concerning mandatory child abuse reports, or in proceedings arising under title 71, chapter 6, part 1, concerning mandatory adult abuse reports.
§ 63-7-126. Advanced practice registered nurses.
  1. (a) “Advanced practice registered nurse” means a registered nurse with a master's degree or higher in a nursing specialty and national specialty certification as a nurse practitioner, nurse anesthetist, nurse midwife or clinical nurse specialist.
  2. (b) Nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists holding such education and practice credentials shall apply to the board for a certificate to practice as an advanced practice registered nurse, including authorization to use the title “advanced practice registered nurse” or the abbreviation “APRN.” No other person shall assume such title or use such abbreviation or any other words, letters or signs to indicate that the person using the same is an advanced practice registered nurse.
  3. (c) An applicant for a certificate to practice as an advanced practice registered nurse shall pay an initial fee as set by the board as well as a biennial renewal fee as set by the board.
  4. (d) A nurse practitioner, nurse anesthetist, nurse midwife or clinical nurse specialist who holds a Tennessee registered nurse license in good standing and current national specialty certification in the advanced practice specialty shall be eligible for a certificate to practice as an advanced practice registered nurse on May 22, 2002, and shall be exempt from the requirement of a master's degree or higher in the nursing specialty if licensed in Tennessee and holding national specialty certification prior to July 1, 2005. Notwithstanding the previous requirements, a nurse anesthetist shall be eligible for a certificate to practice as an advanced practice registered nurse if the nurse anesthetist graduated prior to January 1, 1999, from a nurse anesthesia educational program approved by the American Association of Nurse Anesthetists Council on Accreditation.
  5. (e) With the exception of subsection (f), nothing in this section shall be interpreted to alter or change the current law as it existed on May 22, 2002, regarding prescriptive rights, supervision or scope of practice for nurse anesthetists regulated under this title, nurse midwives as described in § 56-7-2407, clinical nurse specialists or certified nurse practitioners as defined in § 63-7-123. Nor shall anything in this section be interpreted to allow any board or other entity to promulgate rules that would alter or change the law as it existed on May 22, 2002, regarding such prescriptive rights, supervision or scope of practice.
  6. (f) An advanced practice registered nurse shall only perform invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves of the spine or block of major peripheral nerves of the spine in any setting not licensed under title 68, chapter 11 under the direct supervision of a Tennessee physician licensed pursuant to chapter 6 or 9 of this title who is actively practicing spinal injections and has current privileges to do so at a facility licensed pursuant to title 68, chapter 11. The direct supervision provided by a physician in this subsection (f) shall only be offered by a physician who meets the qualifications established in § 63-6-244(a)(1) or (a)(3) or § 63-9-121(a)(1) or (a)(3). For purposes of this subsection (f), “direct supervision” is defined as being physically present in the same building as the advanced practice registered nurse at the time the invasive procedure is performed. This subsection (f) shall not apply to an advanced practice registered nurse performing major joint injections except sacroiliac injections, or to performing soft tissue injections or epidurals for surgical anesthesia or labor analgesia in unlicensed settings.
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§ 63-7-127. Medication aides.
  1. (a) As used in this section, “medication aide” means an individual who administers medications under the general supervision of a licensed registered or practical nurse pursuant to this section. During the course of administering medication, a medication aide shall not be assigned any other nonmedication administration duties. A medication aide shall not be prohibited from responding, as appropriate, to an emergency.
  2. (b) Any nursing home or assisted care living facility licensed pursuant to title 68 or a Program for All-Inclusive Care for the Elderly (PACE) as defined in § 56-2-121(b) may use one (1) or more medication aides to administer medications, as set forth in this section, to its patients; provided, that each and every individual used as a medication aide shall hold a current, valid medication aide certificate issued by the board of nursing under this section.
  3. (c) When carrying out their responsibilities under this section, medication aides shall wear a name tag visible to others that displays the designation “Medication Aide.”
  4. (d) An individual seeking certification as a medication aide shall apply to the board of nursing on a form prescribed and provided by the board in writing or via online application. The individual shall also pay the applicable certification fee established by the board.
  5. (e) To be eligible to receive a medication aide certificate, an applicant must:
    1. (1) Be at least eighteen (18) years of age;
    2. (2) Have completed the twelfth grade or its equivalent, or have successfully passed the test for and received a high school equivalency credential approved by the state board of education;
    3. (3) Be a nurse aide, duly certified under the standards established under federal law and title 68, chapter 11, part 2, or an occupational therapy assistant licensed pursuant to the Occupational and Physical Therapy Practice Act, compiled in chapter 13 of this title;
    4. (4) Have practiced continuously as a certified nurse aide or a licensed occupational therapy assistant for at least one (1) year in a nursing home, assisted-care living facility, or a PACE as defined in § 56-2-121;
    5. (5) Have a recommendation from a facility where the individual is employed or contracted;
    6. (6) Have successfully completed a course of instruction provided by a training program approved by the board under subsection (i); and
    7. (7) Have passed a standardized examination.
  6. (f) If an applicant meets the requirements of subsection (e), the board shall issue a medication aide certificate to the applicant.
  7. (g) A medication aide certificate is valid for two (2) years, unless it is earlier suspended or revoked. The certificate may be renewed in accordance with procedures specified in rules promulgated by the board under this section. To be eligible for renewal, an applicant shall pay a renewal fee established by the board and shall:
    1. (1) Have completed all continuing education or continued competency requirements, or both, necessary to maintain nurse aide certification under title 68, chapter 11, part 2, and the rules promulgated pursuant to title 68, chapter 11, part 2; and
    2. (2) Have completed a total of six (6) contact hours per year of continuing education; provided, that five (5) hours of the continuing education shall be in pharmacology provided by a licensed pharmacist or registered nurse.
  8. (h)
    1. (1) The board has the power to deny, revoke, or suspend any certificate to practice as a medication aide or to otherwise discipline a certificate holder, including imposing civil monetary penalties, upon proof that the medication aide:
      1. (A) Is guilty of fraud or deceit in procuring or attempting to procure a certificate as a medication aide;
      2. (B) Is guilty of a crime;
      3. (C) Is addicted to alcohol or drugs to the degree of interfering with the medication aide's professional duties;
      4. (D) Is mentally incompetent;
      5. (E) Is unfit or incompetent by reason of negligence, habits, or other cause, including the following:
        1. (i) Intentionally or negligently causing physical or emotional injury to a patient;
        2. (ii) Failing to assist in maintaining a facility record for each patient that accurately reflects the medication administration by the medication aide or failure to maintain a record for each patient that accurately reflects the name and title of the aide providing care, or both;
        3. (iii) Using or removing without authorization drugs, supplies, or equipment from any licensed nursing home, assisted care living facility, or Program for All-Inclusive Care for the Elderly (PACE) as defined in § 56-2-121;
        4. (iv) Using any intoxicating beverage or illegally using any narcotic or dangerous drug while on duty in any licensed nursing home, assisted care living facility, or PACE;
        5. (v) Being under the influence of alcoholic beverages, or under the influence of drugs that impair judgment while on duty in any licensed nursing home, assisted care living facility, or PACE;
        6. (vi) Impersonating another licensed or certified healthcare provider;
        7. (vii) Having received a revocation, suspension, probation, or other discipline of a certificate to practice as a medication aide, or its equivalent, or as a certified nurse aide, by another state for any act or omission that would constitute grounds for the revocation, suspension, probation, or other discipline of a certificate in this state;
        8. (viii) Practicing as a medication aide certified in this state on a lapsed certificate;
        9. (ix) Aiding, abetting, or assisting an individual to violate or circumvent any law or duly promulgated rule intended to guide the conduct of any certified or licensed healthcare provider;
        10. (x) Exercising undue influence on a patient, including the promotion or sale of services, goods, appliances, or drugs in such a manner as to exploit the patient for financial gain of the medication aide or of a third party;
        11. (xi) Discriminating in the rendering of services as it relates to race, age, sex, religion, national origin, or the condition of the patient;
        12. (xii) Violating confidentiality of information or knowledge concerning the patient, except when required to do so by a court of law;
        13. (xiii) Failing to take appropriate action in safeguarding the patient from incompetent healthcare practices;
        14. (xiv) Failing to report, through proper channels, facts known to the individual regarding incompetent, unethical, or illegal practices of any healthcare provider;
        15. (xv) Performing healthcare techniques or procedures without proper education and practice; or
        16. (xvi) Engaging in acts of dishonesty that relate to the practice of a medication aide;
      6. (F) Is convicted of any one (1) of the following crimes:
        1. (i) First degree murder, § 39-13-202;
        2. (ii) Second degree murder, § 39-13-210;
        3. (iii) Kidnapping, § 39-13-303;
        4. (iv) Aggravated kidnapping, § 39-13-304;
        5. (v) Especially aggravated kidnapping, § 39-13-305;
        6. (vi) Aggravated robbery, § 39-13-402;
        7. (vii) Especially aggravated robbery, § 39-13-403;
        8. (viii) Aggravated rape, § 39-13-502;
        9. (ix) Rape, § 39-13-503;
        10. (x) Exploitation of an adult under [former] § 39-14-111 [repealed]; or
        11. (xi) Abuse, neglect, or exploitation of an adult under § 71-6-117;
      7. (G) Furnished or otherwise provided the board with false or incomplete information on an application for a certificate regarding the individual's criminal conviction record; or
      8. (H) Has violated or attempted to violate, or assisted in or abetted the violation of, or conspired to violate, this chapter, any duly promulgated rule, or any lawful order of the board issued pursuant to this chapter.
    2. (2) All disciplinary actions taken by the board under this section shall conform to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, part 3, and may be heard by a screening panel pursuant to § 63-7-115(c).
  9. (i)
    1. (1) A qualified entity seeking approval to provide a medication aide training program shall apply to the board of nursing on a form prescribed and provided by the board, along with the applicable fee established by the board.
    2. (2) The board shall approve the applicant described in subdivision (i)(1) if the applicant is a qualified entity, or a combination of qualified entities, and if the content of the course of instruction to be provided by the program meets the standards, specified by the board in rules promulgated under this section, and includes:
      1. (A) At least sixty (60) hours of instruction, consisting of forty (40) classroom hours and twenty (20) clinical hours. The board shall determine the standard minimum curriculum, which must:
        1. (i) Include appropriate instruction to enable communication, attention to safety, knowledge of medications, and other factors as determined necessary by the board; and
        2. (ii) Be completed either in person or through distance learning; and
      2. (B) A supervised clinical practice component that includes an approved medication aide training program sufficient to assure that students are prepared to administer medications as a medication aide in a safe and effective manner and that:
        1. (i) Consists of twenty (20) hours, including experience in tasks related to the administration of medication, and that is conducted under the direction and supervision of a licensed nurse;
        2. (ii) Requires any licensed nursing home, assisted care living facility, or PACE participating in the training program to have a written agreement to provide licensed nurse supervision of the student; and
        3. (iii) Requires supervision of a student engaged in medication administration by a licensed nurse.
    3. (3) The board may deny, suspend, or revoke the approval granted to the qualified entity of a medication aide training program for reasons specified in rules promulgated under this subsection (i). All actions taken by the board to deny, suspend, or revoke the approval of a training program shall conform to the Uniform Administrative Procedures Act.
  10. (j)
    1. (1) The board shall provide or contract for the provision of standardized medication aide examination services by:
      1. (A) Publishing an annual schedule of examination schedules and sites;
      2. (B) Scheduling tests to be administered, except when no individual is scheduled to test at a particular test site;
      3. (C) Publishing the number of individuals passing and failing the exam on at least a quarterly basis;
      4. (D) Requiring the minimum passing grade to be seventy-five percent (75%) for the examination; and
      5. (E) Requiring individuals who fail any portion of the examination two (2) consecutive times to repeat the course of training as set forth in subsection (i) prior to taking the examination again.
    2. (2) In accordance with the Uniform Administrative Procedures Act, the board shall have rulemaking authority to establish any necessary rules for the administration of this subsection (j).
  11. (k)
    1. (1)
      1. (A) Except for the prohibited medications and the methods of medication administration specified in subdivision (k)(3), a medication aide, who holds a current, valid medication aide certificate issued under this section, may administer medications to the residents of nursing homes or assisted care living facilities or to the participants of PACE that use medication aides pursuant to this section. A medication aide shall administer medications only pursuant to delegation by a licensed nurse.
      2. (B) A delegation of medication administration to a medication aide shall be carried out in accordance with the rules for nursing delegation adopted under this chapter by the board of nursing.
      3. (C) A medication aide may only administer medication after:
        1. (i) Each resident is evaluated by a licensed nurse on admission and after any change in status, acuity, or medication; and
        2. (ii) The licensed nurse makes a determination that it is appropriate for the resident to receive medication by a medication aide.
    2. (2) In exercising the authority to administer medications pursuant to a nursing delegation, a medication aide may administer medications in any of the following categories:
      1. (A) Oral medications;
      2. (B) Topical medications; and
      3. (C) Any medications set forth in subdivision (k)(2)(A) or (k)(2)(B) prescribed with a designation authorizing or requiring administration on an as-needed basis, but only if a nursing assessment of the patient is completed by a nurse licensed under this title before the medication is administered.
    3. (3) A medication aide shall not:
      1. (A) Administer medications when administration would require a dosage decision or calculation;
      2. (B) Directly receive orders from a physician or other medication prescriber;
      3. (C) Administer barium or other contrast media;
      4. (D) Administer chemotherapeutic agents;
      5. (E) Administer rectal and vaginal medications;
      6. (F) Apply topical medications ordered for the treatment of pressure ulcers or skin grafts;
      7. (G) Change a dosage amount to adhere to a change in a physician's order;
      8. (H) Administer medications delivered by aerosol / nebulizers; or
      9. (I) Administer medications delivered by metered hand-held inhalers without a spacer.
    4. (4) A medication aide shall not, under any circumstances, administer medications by certain methods or routes, or both, as determined by rule. These methods or routes include, but are not limited to, the following:
      1. (A) Injection;
      2. (B) Intravenous;
      3. (C) Central lines;
      4. (D) Intrathecal;
      5. (E) Colostomy;
      6. (F) A surgically placed feeding tube, such as gastrostomy or jejunostomy;
      7. (G) Nasogastric;
      8. (H) Intradermal;
      9. (I) Urethral;
      10. (J) Epidural;
      11. (K) Endotracheal;
      12. (L) Intramuscular;
      13. (M) Subcutaneous; or
      14. (N) Nonmetered inhaler.
  12. (l)
    1. (1) The board of nursing shall adopt rules to implement this section. These rules shall take effect no later than January 1, 2017. All rules shall be promulgated in accordance with the Uniform Administrative Procedures Act.
    2. (2) The rules adopted to implement this section shall at a minimum establish or specify the following:
      1. (A) Fees, in an amount sufficient to cover the costs the board incurs in implementing this section;
      2. (B) Procedures for renewal of medication aide certificates;
      3. (C) Grounds for discipline of applicants or certificate holders, or both;
      4. (D) Standards for approval of peer support programs for the holders of medication aide certificates; and
      5. (E) Procedures for approval or denial of medication aide training programs.
  13. (m) A licensed nurse for the purpose of this section shall include a registered nurse, a licensed practical nurse, or either one.
  14. (n)
    1. (1) Any nursing home or assisted care living facility licensed pursuant to title 68 or a PACE that uses one (1) or more medication aides to administer medications shall implement as part of its facility policy a plan for the tracking and recording of:
      1. (A) Any medication error; and
      2. (B) Any incident of opioid or benzodiazepine diversion.
    2. (2) The incidents of medication error and diversion of opioids and benzodiazepines shall be made available to duly appointed representatives of the department of health pursuant to § 68-11-210.
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§ 63-7-128. Certificate to practice as a registered nurse first assistant.
  1. (a) As used in this section, “registered nurse first assistant” means a person who:
    1. (1) Is licensed as a registered nurse in this state;
    2. (2)
      1. (A) Is certified in perioperative nursing; or
      2. (B)
        1. (i) Is certified as an advanced practice registered nurse; and
        2. (ii) Is qualified by education and training to perform tasks involved in perioperative nursing, as determined by the board; and
    3. (3) Has successfully completed a registered nurse first assistant education program that meets the education standard of the Association of periOperative Registered Nurses for a registered nurse first assistant.
  2. (b) Registered nurses holding the education and practice credentials of a registered nurse first assistant may apply to the board of nursing for a certificate to practice as a registered nurse first assistant, including authorization to use the title “registered nurse first assistant” or the abbreviation “RNFA.” No other person shall assume such title or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a registered nurse first assistant.
  3. (c) An applicant for a certificate to practice as a registered nurse first assistant shall pay an initial fee as set by the board as well as a biennial renewal fee as set by the board.
§ 63-7-129. Use of title “nurse.”
  1. Notwithstanding any provision of any title to the contrary, a person shall not use the title “nurse” or any other title, abbreviation, or designation in connection with the person's name, occupation, or profession to indicate or imply that the person is a practicing nurse unless the person is actively licensed or certified by the board of nursing.
§ 63-7-130. Suspension for failure to collaborate — On-site supervision of healthcare prescriber subject of disciplinary action for conduct related to improper prescribing or diversion of controlled substance.
  1. (a)
    1. (1) Failure by a person licensed under and required by this chapter to collaborate with a physician for any act within the person's licensed scope of practice constitutes a threat to the public health, safety, and welfare and imperatively requires emergency action by the board.
    2. (2) Notwithstanding any law, if the board learns that a person licensed under this chapter and subject to a requirement to collaborate with a physician for any act within the person's licensed scope of practice has failed to comply with the collaboration requirement, then the board chair, or the chair's designee, shall direct the administrative staff to automatically and immediately, without further action by the board, suspend the person's license until the board receives sufficient proof that the person is in compliance with the collaboration requirements of this chapter.
    3. (3) The licensure sanction authorized by this subsection (a) is supplementary to, and does not limit, the authority of the board to take other disciplinary action against a licensee the board determines to be in violation of this chapter.
  2. (b) If a healthcare prescriber licensed under this chapter is the subject of a disciplinary action by the board for conduct related to improper prescribing or diversion of a controlled substance, but retains an active license with prescribing authority following the disciplinary action, then the healthcare prescriber shall not prescribe a controlled substance in this state unless the healthcare prescriber is working in collaboration with a physician who is physically present at the same practice site and licensed to prescribe controlled substances in this state. The board shall determine the period of time that a healthcare prescriber is subject to the on-site supervision requirement of this subsection (b), which must not be less than two (2) years.
Part 2 Board of Nursing
§ 63-7-201. Creation.
  1. There is created a board to be known as the board of nursing, composed of eleven (11) members, referred to in this chapter as “board,” appointed by the governor in the manner and for the terms of office as provided in § 63-7-202.
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§ 63-7-202. Composition — Candidates — Qualifications — Vacancies.
  1. (a) The governor shall appoint eleven (11) members to the board, as follows:
    1. (1) Nine (9) members, one (1) from each congressional district, who are either an advanced practice registered nurse or a registered nurse at the time of their appointment. At least two (2) members shall be registered nurses. At least three (3) members shall be advanced practice registered nurses. For the purposes of this section, an advanced practice registered nurse shall not include registered nurses;
    2. (2) One (1) member who is a licensed practical nurse at the time of such nurse's appointment; and
    3. (3) One (1) consumer member.
  2. (b) In making appointments to the board, the governor shall consider appointing members who work in a variety of healthcare positions, including the following practice settings:
    1. (1) A Level I trauma center licensed pursuant to title 68, chapter 11, part 2;
    2. (2) An acute care hospital;
    3. (3) A critical access hospital or a rural hospital;
    4. (4) A mental health facility licensed under title 33; and
    5. (5) A long-term care facility.
  3. (c) No more than three (3) members shall be engaged in an academic position at the time of their appointment to the board.
  4. (d) In making appointments to the board, the governor should consider the importance of geographical diversity to this board.
  5. (e)
    1. (1) Members of the board may be appointed by the governor from lists of qualified persons submitted by interested nursing groups, including, but not limited to, their respective organizations. Each list may contain a minimum of three (3) times as many names as the number of appointments to be made. Lists of persons shall be submitted at least forty-five (45) days prior to the expiration of the term of office of any members of the board. The appointment provisions of this subdivision (e)(1) shall not apply to the public member serving on the board.
    2. (2) In making appointments to the board in accordance with subdivision (e)(1), the governor shall consult with interested nursing groups, including, but not limited to, their respective organizations to determine qualified persons to fill the positions.
  6. (f) Each licensee member appointed to serve on the board shall:
    1. (1) Be a resident of this state for at least one (1) year immediately preceding appointment;
    2. (2) Be currently licensed and in good standing with an unencumbered license;
    3. (3) Be currently engaged in the practice of nursing; and
    4. (4) Have no less than five (5) years of experience as an advanced practice registered nurse, registered nurse, or licensed practical nurse.
  7. (g) The consumer member appointed to the board shall:
    1. (1) Be a resident of this state for at least one (1) year immediately preceding their appointment;
    2. (2) Not have a direct or indirect financial interest in healthcare services;
    3. (3) Not have been a healthcare provider or be enrolled in any health-related educational program; and
    4. (4) Not be a member or employee of any board of control of any public or private healthcare organization.
  8. (h) A vacancy on the board shall be filled for the unexpired term by appointment by the governor in such a manner to ensure the requirements of this section are met.
  9. (i) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  10. (j) Except as provided in subsection (k), members currently holding appointments on the board shall serve their full terms. As vacancies occur, new appointments shall be filled by the governor in accordance with this section.
  11. (k) No member shall serve more than eight (8) continuous years on the board. A member shall be eligible to be reappointed after not serving on the board for four (4) years. The term of any member of the board with eight (8) or more years of service on the board on April 25, 2012, shall terminate January 1, 2013.
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§ 63-7-203. Terms of members.
  1. Members of the board shall serve for a term of four (4) years or until their successor shall be appointed. No member may serve more than two (2) consecutive terms. At least four (4) years shall lapse before a member may be reappointed to the board or may serve in any capacity associated with the board.
§ 63-7-204. Organization.
  1. Promptly after the appointment of the board, it shall meet and organize by electing one (1) member to serve as chair and one (1) member to serve as vice chair.
§ 63-7-205. Meetings — Quorum.
  1. (a) Six (6) members of the board shall constitute a quorum for a meeting.
  2. (b) No action of the board shall be valid unless authorized by the affirmative vote of a majority of members present.
  3. (c) The board shall hold at least one (1) regular meeting each year and such other meetings as the board may determine.
§ 63-7-206. Disposition of fees and moneys received — Operating expenses — Compensation.
  1. (a) All fees and moneys from whatever source coming into the hands of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  2. (b) The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board, and no expenditure may be made by the board until allotment for the expenditure has been made by the commissioner. The allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  3. (c) The members of the board shall be entitled to a per diem of one hundred dollars ($100) for each day's service in attending meetings of the board and other administrative or disciplinary functions of the board and necessary expenses for traveling and subsistence while attending such meetings or performing such functions. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-7-207. Powers and duties.
  1. The board has the following powers and duties in addition to the powers and duties granted to or imposed upon it by other sections of this chapter:
    1. (1)
      1. (A)
        1. (i)
          1. (a) Employ, in consultation with the governor, an executive director, who must not be a member of the board, although the board is not bound by any recommendation of the governor. The executive director shall receive a salary to be fixed by the board and approved by the commissioner of human resources and the commissioner of finance and administration;
          2. (b) The board may dismiss the executive director without having to consult with the governor; and
        2. (ii) Employ such other personnel as may be necessary for the effective and efficient discharge of the duties of the board;
      2. (B) Such executive director and other employees shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter;
    2. (2) Maintain an office in Nashville;
    3. (3) Adopt a seal that shall bear the words “Tennessee Board of Nursing” and the imprint thereof shall be placed upon all official papers of the board;
    4. (4) Adopt and from time to time revise such rules and regulations as may be necessary to govern its proceedings and to carry into effect the purpose of this chapter;
    5. (5) Make an annual report to the governor the first week in July, together with a statement of the receipts and disbursements of the board and maintain such records as may be required by the applicable laws and regulations of the state;
    6. (6) Cause the prosecution of persons violating this chapter;
    7. (7) Prescribe the minimum curricular and minimum standards for schools of nursing and for courses of training preparing persons for licensure under this chapter and provide for surveys of such schools or an affiliation of schools and courses;
    8. (8) Approve such schools and courses as meet the requirements of this chapter and the rules and regulations of the board;
    9. (9) Conduct examinations to ascertain the qualifications and fitness of applicants and issue licenses to applicants who successfully pass the examination for the practice of professional nursing or practical nursing;
    10. (10) Conduct hearings upon charges of suspension or revocation of a license or approval of a school of nursing or course of training and deny, suspend or revoke for proper cause licenses or approval of schools or course of training as provided in this chapter. Any action of or ruling or order made or entered by the board shall be subject to review by the courts of this state in the same manner and subject to the same powers and conditions as now provided by law in regard to the rulings, orders and findings of other quasi-judicial bodies in Tennessee, where not otherwise specifically provided;
    11. (11) Promote nursing education and nursing service through the state through surveys, institutes, conferences or such other means as may result in improved nursing education and nursing services in the state;
    12. (12) Determine the state, national and other meetings to be attended by the employees or individual members of the board in the interest of the advancement of nursing in this state;
    13. (13) Annually publish a directory listing all persons licensed to practice as a professional or practical nurse in Tennessee. The board shall have the authority to adopt and promulgate rules and regulations governing the distribution of such directories. Such regulations may establish a reasonable price, not to exceed ten dollars ($10.00) per directory, to be charged for the directories. The directories shall be available free of charge to nonprofit health agencies operating in the state of Tennessee, federal and state governmental agencies, local health departments and individual licensees;
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    14. (14) Establish and examine the qualifications, competencies, training, education and experience required of a registered nurse applying for a certificate of fitness as a nurse practitioner, as defined by the board, sufficient to prepare such person to write and sign prescriptions and/or issue drugs in accordance with the limitations and provisions of § 63-1-132;
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    15. (15) Issue advisory private letter rulings to any affected licensee who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall only affect the licensee making such inquiry and shall have no precedential value for any other inquiry or future contested case to come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223;
    16. (16) By January 1, 2002, the board of nursing shall implement a plan to assure continuing competence of licensees, using educationally sound methods to promote learning and assess outcomes pertinent to contemporary standards of nursing practice;
    17. (17) Compile and disseminate demographic data collected on all licensees; and
    18. (18) Enter into grants, agreements, scholarships or other arrangements with statewide nonprofit agencies or other state agencies for the purpose of evaluating and guiding the development of the education, distribution, and availability of the nursing workforce to provide a basis for improving the delivery of quality health care.
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§ 63-7-208. Qualifications of executive director.
  1. The executive director shall serve as consultant on nursing education and nursing service and shall have the following minimum qualifications:
    1. (1) Master's degree in nursing from a recognized college or university;
    2. (2) License to practice nursing in this state; and
    3. (3) At least five (5) years' experience in any combination of administration, teaching or supervision in schools of nursing or public health nursing agencies.
§ 63-7-209. Duties of executive director.
  1. The duties of the executive director of the board shall be such as are prescribed by the board and shall include the following:
    1. (1) Within thirty (30) days after the election of the officers of the board, the executive director shall certify to the governor the names of the officers so elected. A vacancy in any office or in the board membership shall likewise be certified by the executive director to the governor;
    2. (2) Keep a record of the minutes of the meetings of the board, a record of all persons applying for licenses under this chapter and of the actions of the board thereon and a register of all nurses who have complied with the requirements of the chapter. Such records shall at all reasonable times be open to public inspection;
    3. (3) Make a bond in such sum as required by the board, conditioned on the faithful performance of the duties of the office. The premium of the bond shall be paid by the board;
    4. (4) Issue licenses to nurses complying with the requirements of this chapter and issue renewal certificates as provided in this chapter; and
    5. (5) From time to time, as may be determined by the board, render such reports and accountings as the board may order.
§ 63-7-210. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A nurse licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of nursing may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
Part 4 Interstate Nurse Licensure Compact
§ 63-7-401. Short title.
  1. This part may be known and cited as the “Nurse Licensure Compact.”
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§ 63-7-402. Enactment — Text of compact.
  1. The Nurse Licensure Compact is enacted into law and entered into by this state with all states legally joining the compact and in the form substantially as follows:
      1. THE NURSE LICENSURE COMPACT
        1. Article I. Findings and Declaration of Purpose
          1. a. The party states find that:
            1. 1. The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws;
            2. 2. Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public;
            3. 3. The expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation;
            4. 4. New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex;
            5. 5. The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and
            6. 6. Uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits.
          2. b. The general purposes of this compact are to:
            1. 1. Facilitate the states' responsibility to protect the public's health and safety;
            2. 2. Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;
            3. 3. Facilitate the exchange of information between party states in the areas of nurse regulation, investigation and adverse actions;
            4. 4. Promote compliance with the laws governing the practice of nursing in each jurisdiction;
            5. 5. Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses;
            6. 6. Decrease redundancies in the consideration and issuance of nurse licenses; and
            7. 7. Provide opportunities for interstate practice by nurses who meet uniform licensure requirements.
        2. Article II. Definitions
          1. As used in this compact:
            1. 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 nurse, including actions against an individual's license or multistate licensure privilege such as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee's practice, or any other encumbrance on licensure affecting a nurse's authorization to practice, including issuance of a cease and desist action.
            2. b. “Alternative program” means a non-disciplinary monitoring program approved by a licensing board.
            3. c. “Coordinated licensure information system” means an integrated process for collecting, storing and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by licensing boards.
            4. d. “Current significant investigative information” means:
              1. 1. Investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse 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. 2. Investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.
            5. e. “Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of nursing imposed by a licensing board.
            6. f. “Home state” means the party state which is the nurse's primary state of residence.
            7. g. “Licensing board” means a party state's regulatory body responsible for issuing nurse licenses.
            8. h. “Multistate license” means a license to practice as a registered or a licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board that authorizes the licensed nurse to practice in all party states under a multistate licensure privilege.
            9. i. “Multistate licensure privilege” means a legal authorization associated with a multistate license permitting the practice of nursing as either a registered nurse (RN) or LPN/VN in a remote state.
            10. j. “Nurse” means RN or LPN/VN, as those terms are defined by each party state's practice laws.
            11. k. “Party state” means any state that has adopted this compact.
            12. l. “Remote state” means a party state, other than the home state.
            13. m. “Single-state license” means a nurse license issued by a party state that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other party state.
            14. n. “State” means a state, territory or possession of the United States and the District of Columbia.
            15. o. “State practice laws” means a party state's laws, rules and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline. “State practice laws” do not include requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.
        3. Article III. General Provisions and Jurisdiction
          1. a. A multistate license to practice registered or licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each party state.
          2. b. A state must implement procedures for considering the criminal history records of applicants for initial multistate license or licensure by endorsement. Such 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.
          3. c. Each party state shall require the following for an applicant to obtain or retain a multistate license in the home state:
            1. 1. Meets the home state's qualifications for licensure or renewal of licensure, as well as, all other applicable state laws;
            2. 2.
              1. i. Has graduated or is eligible to graduate from a licensing board-approved RN or LPN/VN prelicensure education program; or
              2. ii. Has graduated from a foreign RN or LPN/VN prelicensure education program that (a) has been approved by the authorized accrediting body in the applicable country and (b) has been verified by an independent credentials review agency to be comparable to a licensing board-approved prelicensure education program;
            3. 3. Has, if a graduate of a foreign prelicensure education program not taught in English or if English is not the individual's native language, successfully passed an English proficiency examination that includes the components of reading, speaking, writing and listening;
            4. 4. Has successfully passed an NCLEX-RN® or NCLEX-PN® Examination or recognized predecessor, as applicable;
            5. 5. Is eligible for or holds an active, unencumbered license;
            6. 6. Has submitted, in connection with an application for initial licensure or licensure by endorsement, fingerprints or other biometric data for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state's criminal records;
            7. 7. Has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law;
            8. 8. Has not been convicted or found guilty, or has entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case-by-case basis;
            9. 9. Is not currently enrolled in an alternative program;
            10. 10. Is subject to self-disclosure requirements regarding current participation in an alternative program; and
            11. 11. Has a valid United States Social Security number.
          4. d. All party states shall be authorized, in accordance with existing state due process law, to take adverse action against a nurse's multistate licensure privilege such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice under a multistate licensure privilege, including cease and desist actions. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.
          5. e. A nurse practicing in a party state must comply with the state practice laws of the state in which the client is located at the time service is provided. The practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of the party state in which the client is located. The practice of nursing in a party state under a multistate licensure privilege will subject a nurse to the jurisdiction of the licensing board, the courts and the laws of the party state in which the client is located at the time service is provided.
          6. f. Individuals not residing in a party state shall continue to be able to apply for a party state's single-state license as provided under the laws of each party state. However, the single-state license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state. Nothing in this compact shall affect the requirements established by a party state for the issuance of a single-state license.
          7. g. Any nurse holding a home state multistate license, on the effective date of this compact, may retain and renew the multistate license issued by the nurse's then-current home state, provided that:
            1. 1. A nurse, who changes primary state of residence after this compact's effective date, must meet all applicable Article III.c. requirements to obtain a multistate license from a new home state.
            2. 2. A nurse who fails to satisfy the multistate licensure requirements in Article III.c. due to a disqualifying event occurring after this compact's effective date shall be ineligible to retain or renew a multistate license, and the nurse's multistate license shall be revoked or deactivated in accordance with applicable rules adopted by the Interstate Commission of Nurse Licensure Compact Administrators (“Commission”).
        4. Article IV. Applications for Licensure in a Party State
          1. a. Upon application for a multistate license, the licensing board in the issuing party state shall ascertain, through the coordinated licensure information system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any encumbrances on any license or multistate licensure privilege held by the applicant, whether any adverse action has been taken against any license or multistate licensure privilege held by the applicant and whether the applicant is currently participating in an alternative program.
          2. b. A nurse may hold a multistate license, issued by the home state, in only one party state at a time.
          3. c. If a nurse changes primary state of residence by moving between two party states, the nurse must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated in accordance with applicable rules adopted by the Commission.
            1. 1. The nurse may apply for licensure in advance of a change in primary state of residence.
            2. 2. A multistate license shall not be issued by the new home state until the nurse provides satisfactory evidence of a change in primary state of residence to the new home state and satisfies all applicable requirements to obtain a multistate license from the new home state.
          4. d. If a nurse changes primary state of residence by moving from a party state to a non-party state, the multistate license issued by the prior home state will convert to a single-state license, valid only in the former home state.
        5. Article V. Additional Authorities Invested in Party State Licensing Boards
          1. a. In addition to the other powers conferred by state law, a licensing board shall have the authority to:
            1. 1. Take adverse action against a nurse's multistate licensure privilege to practice within that party state.
              1. i. Only the home state shall have the power to take adverse action against a nurse's license issued by the home state.
              2. ii. For purposes of taking adverse action, the home state licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action.
            2. 2. Issue cease and desist orders or impose an encumbrance on a nurse's authority to practice within that party state.
            3. 3. Complete any pending investigations of a nurse who changes primary state of residence during the course of such investigations. The licensing board shall also have the authority to take appropriate action(s) and shall promptly report the conclusions of such investigations to the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any such actions.
            4. 4. 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 party state for the attendance and testimony of witnesses 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 in which the witnesses or evidence are located.
            5. 5. Obtain and submit, for each nurse licensure applicant, fingerprint or other biometric-based information to the Federal Bureau of Investigation for criminal background checks, receive the results of the Federal Bureau of Investigation record search on criminal background checks and use the results in making licensure decisions.
            6. 6. If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse.
            7. 7. Take adverse action based on the factual findings of the remote state provided that the licensing board follows its own procedures for taking such adverse action.
          2. b. If adverse action is taken by the home state against a nurse's multistate license, the nurse's multistate licensure privilege to practice in all other party states shall be deactivated until all encumbrances have been removed from the multistate license. All home state disciplinary orders that impose adverse action against a nurse's multistate license shall include a statement that the nurse's multistate licensure privilege is deactivated in all party states during the pendency of the order.
          3. c. Nothing in this compact shall override a party state's decision that participation in an alternative program may be used in lieu of adverse action. The home state licensing board shall deactivate the multistate licensure privilege under the multistate license of any nurse for the duration of the nurse's participation in an alternative program.
        6. Article VI. Coordinated Licensure Information System and Exchange of Information
          1. a. All party states shall participate in a coordinated licensure information system of all licensed registered nurses (RNs) and licensed practical/vocational nurses (LPNs/VNs). This system will include information on the licensure and disciplinary history of each nurse, as submitted by party states, to assist in the coordination of nurse licensure and enforcement efforts.
          2. b. The Commission, in consultation with the administrator of the coordinated licensure information system, shall formulate necessary and proper procedures for the identification, collection and exchange of information under this compact.
          3. c. All licensing boards shall promptly report to the coordinated licensure information system any adverse action, any current significant investigative information, denials of applications (with the reasons for such denials) and nurse participation in alternative programs known to the licensing board regardless of whether such participation is deemed nonpublic or confidential under state law.
          4. d. Current significant investigative information and participation in nonpublic or confidential alternative programs shall be transmitted through the coordinated licensure information system only to party state licensing boards.
          5. e. Notwithstanding any other provision of law, all party state licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with non-party states or disclosed to other entities or individuals without the express permission of the contributing state.
          6. f. Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board shall not be shared with non-party states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.
          7. g. Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information shall also be expunged from the coordinated licensure information system.
          8. h. The Compact administrator of each party state shall furnish a uniform data set to the Compact administrator of each other party state, which shall include, at a minimum:
            1. 1. Identifying information;
            2. 2. Licensure data;
            3. 3. Information related to alternative program participation; and
            4. 4. Other information that may facilitate the administration of this compact, as determined by Commission rules.
          9. i. The Compact administrator of a party state shall provide all investigative documents and information requested by another party state.
        7. Article VII. Establishment of the Interstate Commission of Nurse Licensure Compact Administrators
          1. a. The party states hereby create and establish a joint public entity known as the Interstate Commission of Nurse Licensure Compact Administrators.
            1. 1. The Commission is an instrumentality of the party states.
            2. 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. 3. Nothing in this compact shall be construed to be a waiver of sovereign immunity.
          2. b. Membership, Voting and Meetings
            1. 1. Each party state shall have and be limited to one administrator. The head of the state licensing board or designee shall be the administrator of this compact for each party state. Any administrator may be removed or suspended from office as provided by the law of the state from which the administrator is appointed. Any vacancy occurring in the Commission shall be filled in accordance with the laws of the party state in which the vacancy exists.
            2. 2. Each administrator shall be entitled to one (1) 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. An administrator shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for an administrator's participation in meetings by telephone or other means of communication.
            3. 3. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws or rules of the commission.
            4. 4. 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 Article VIII.
            5. 5. The Commission may convene in a closed, nonpublic meeting if the Commission must discuss:
              1. i. Noncompliance of a party state with its obligations under this compact;
              2. ii. The employment, compensation, discipline or other personnel matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;
              3. iii. Current, threatened or reasonably anticipated litigation;
              4. iv. Negotiation of contracts for the purchase or sale of goods, services or real estate;
              5. v. Accusing any person of a crime or formally censuring any person;
              6. vi. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
              7. vii. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
              8. viii. Disclosure of investigatory records compiled for law enforcement purposes;
              9. ix. Disclosure of information related to any reports prepared by or on behalf of the Commission for the purpose of investigation of compliance with this compact; or
              10. x. Matters specifically exempted from disclosure by federal or state statute.
            6. 6. 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. 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 therefor, 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.
          3. c. The Commission shall, by a majority vote of the administrators, prescribe bylaws or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of this compact, including but not limited to:
            1. 1. Establishing the fiscal year of the Commission;
            2. 2. Providing reasonable standards and procedures:
              1. i. For the establishment and meetings of other committees; and
              2. ii. Governing any general or specific delegation of any authority or function of the Commission;
            3. 3. Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals, and proprietary information, including trade secrets. The Commission may meet in closed session only after a majority of the administrators vote to close a meeting in whole or in part. As soon as practicable, the Commission must make public a copy of the vote to close the meeting revealing the vote of each administrator, with no proxy votes allowed;
            4. 4. Establishing the titles, duties and authority and reasonable procedures for the election of the officers of the Commission;
            5. 5. Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission. Notwithstanding any civil service or other similar laws of any party state, the bylaws shall exclusively govern the personnel policies and programs of the Commission; and
            6. 6. Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of this compact after the payment or reserving of all of its debts and obligations;
          4. d. The Commission shall publish its bylaws and rules, and any amendments thereto, in a convenient form on the website of the Commission.
          5. e. The Commission shall maintain its financial records in accordance with the bylaws.
          6. f. The Commission shall meet and take such actions as are consistent with the provisions of this compact and the bylaws.
          7. g. The Commission shall have the following powers:
            1. 1. To 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 party states;
            2. 2. To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any licensing board to sue or be sued under applicable law shall not be affected;
            3. 3. To purchase and maintain insurance and bonds;
            4. 4. To borrow, accept or contract for services of personnel, including, but not limited to, employees of a party state or nonprofit organizations;
            5. 5. To cooperate with other organizations that administer state compacts related to the regulation of nursing, including but not limited to sharing administrative or staff expenses, office space or other resources;
            6. 6. To hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of this compact, and to establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;
            7. 7. To accept any and all appropriate donations, grants and gifts 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 or conflict of interest;
            8. 8. To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, whether real, personal or mixed; provided that at all times the Commission shall avoid any appearance of impropriety;
            9. 9. To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, whether real, personal or mixed;
            10. 10. To establish a budget and make expenditures;
            11. 11. To borrow money;
            12. 12. To appoint committees, including advisory committees comprised of administrators, state nursing regulators, state legislators or their representatives, and consumer representatives, and other such interested persons;
            13. 13. To provide and receive information from, and to cooperate with, law enforcement agencies;
            14. 14. To adopt and use an official seal; and
            15. 15. To perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of nurse licensure and practice.
          8. h. Financing of the Commission
            1. 1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.
            2. 2. The Commission may also levy on and collect an annual assessment from each party state to cover the cost of its operations, activities and staff in its annual budget as approved each year. The aggregate annual assessment amount, if any, shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule that is binding upon all party states.
            3. 3. 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 party states, except by, and with the authority of, such party state.
            4. 4. 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.
          9. i. Qualified Immunity, Defense and Indemnification
            1. 1. The administrators, 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 or liability for any damage, loss, injury or liability caused by the intentional, willful or wanton misconduct of that person.
            2. 2. The Commission shall defend any administrator, 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, willful or wanton misconduct.
            3. 3. The Commission shall indemnify and hold harmless any administrator, 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, willful or wanton misconduct of that person.
        8. Article VIII. Rulemaking
          1. a. The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Article and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment and shall have the same force and effect as provisions of this compact.
          2. b. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
          3. c. Prior to promulgation and adoption of a final rule or rules by the Commission, and at least sixty (60) 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. 1. On the website of the Commission; and
            2. 2. On the website of each licensing board or the publication in which each state would otherwise publish proposed rules.
          4. d. The notice of proposed rulemaking shall include:
            1. 1. The proposed time, date and location of the meeting in which the rule will be considered and voted upon;
            2. 2. The text of the proposed rule or amendment, and the reason for the proposed rule;
            3. 3. A request for comments on the proposed rule from any interested person; and
            4. 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.
          5. e. 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.
          6. f. The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment.
          7. g. The Commission shall publish the place, time and date of the scheduled public hearing.
            1. 1. 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. All hearings will be recorded, and a copy will be made available upon request.
            2. 2. 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.
          8. h. If no one appears at the public hearing, the Commission may proceed with promulgation of the proposed rule.
          9. 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.
          10. j. The Commission shall, by majority vote of all administrators, 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.
          11. k. 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 this compact and in this section 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 in order to:
            1. 1. Meet an imminent threat to public health, safety or welfare;
            2. 2. Prevent a loss of Commission or party state funds; or
            3. 3. Meet a deadline for the promulgation of an administrative rule that is required by federal law or rule.
          12. l. 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 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 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.
        9. Article IX. Oversight, Dispute Resolution and Enforcement
          1. a. Oversight
            1. 1. Each party state shall enforce this compact and take all actions necessary and appropriate to effectuate this compact's purposes and intent.
            2. 2. The Commission shall be entitled to receive service of process in any proceeding that may affect the powers, responsibilities or actions of the Commission, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process in such proceeding to the Commission shall render a judgment or order void as to the Commission, this compact or promulgated rules.
          2. b. Default, Technical Assistance and Termination
            1. 1. If the Commission determines that a party state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the Commission shall:
              1. i. Provide written notice to the defaulting state and other party states of the nature of the default, the proposed means of curing the default or any other action to be taken by the Commission; and
              2. ii. Provide remedial training and specific technical assistance regarding the default.
            2. 2. If a state in default fails to cure the default, the defaulting state's membership in this compact may be terminated upon an affirmative vote of a majority of the administrators, 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. 3. Termination of membership 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 of the defaulting state and to the executive officer of the defaulting state's licensing board and each of the party states.
            4. 4. A state whose membership in this compact 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. 5. The Commission shall not bear any costs related to a state that is found to be in default or whose membership in this compact has been terminated unless agreed upon in writing between the Commission and the defaulting state.
            6. 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 in which the Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation, including reasonable attorneys' fees.
          3. c. Dispute Resolution
            1. 1. Upon request by a party state, the Commission shall attempt to resolve disputes related to the compact that arise among party states and between party and non-party states.
            2. 2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes, as appropriate.
            3. 3. In the event the Commission cannot resolve disputes among party states arising under this compact:
              1. i. The party states may submit the issues in dispute to an arbitration panel, which will be comprised of individuals appointed by the compact administrator in each of the affected party states and an individual mutually agreed upon by the compact administrators of all the party states involved in the dispute.
              2. ii. The decision of a majority of the arbitrators shall be final and binding.
          4. d. Enforcement
            1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this compact.
            2. 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 in which the Commission has its principal offices against a party state that is in default to enforce compliance with the provisions of this compact and its 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 attorneys' fees.
            3. 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.
        10. Article X. Effective Date, Withdrawal and Amendment
          1. a. This compact shall become effective and binding on the earlier of the date of legislative enactment of this compact into law by no less than twenty-six (26) states or December 31, 2018. All party states to this compact, that also were parties to the prior Nurse Licensure Compact, superseded by this compact, (“Prior compact”), shall be deemed to have withdrawn from said Prior compact within six (6) months after the effective date of this compact.
          2. b. Each party state to this compact shall continue to recognize a nurse's multistate licensure privilege to practice in that party state issued under the Prior compact until such party state has withdrawn from the Prior compact.
          3. c. Any party state may withdraw from this compact by enacting a statute repealing the same. A party state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
          4. d. A party state's withdrawal or termination shall not affect the continuing requirement of the withdrawing or terminated state's licensing board to report adverse actions and significant investigations occurring prior to the effective date of such withdrawal or termination.
          5. e. Nothing contained in this compact shall be construed to invalidate or prevent any nurse licensure agreement or other cooperative arrangement between a party state and a non-party state that is made in accordance with the other provisions of this compact.
          6. f. This compact may be amended by the party states. No amendment to this compact shall become effective and binding upon the party states unless and until it is enacted into the laws of all party states.
          7. g. Representatives of non-party states to this compact shall be invited to participate in the activities of the Commission, on a nonvoting basis, prior to the adoption of this compact by all states.
        11. Article XI. Construction and Severability
          1. 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 if 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 to be contrary to the constitution of any party state, this 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.
§ 63-7-403. “Head of the state licensing board” defined.
  1. For the purposes of this part, the term “head of the state licensing board” means the executive director of the state board of nursing.
Chapter 8 Optometry Law
§ 63-8-101. Short title.
  1. This chapter may be cited as the “Optometry Law.”
§ 63-8-102. Chapter definitions.
  1. As used in this chapter unless the context otherwise requires:
    1. (1) “Board” means the board of optometry created by this chapter or similar boards created by the optometry law of other states;
    2. (2) “Certificate of fitness” means the certificate issued by the board certifying to the division that the person therein named has met the requirements of this chapter and passed the standard examination given by the board;
    3. (3) “Certificate of registration” means the certificate issued by the division of health related boards under chapter 1 of this title;
    4. (4) “Division” means the division of health related boards in the department of health;
    5. (5) “Itinerant certificate” means a certificate issued to an itinerant optometrist;
    6. (6) “Itinerant optometrist” means an optometrist who maintains an office at a location other than such optometrist's principal office;
    7. (7) “Muscular anomalies” means any deviation from the normal standard;
    8. (8) “Objective method” means examination for observing symptoms and/or signs with various instruments and techniques that the optometrist finds by means of one (1) or more of the optometrist's five (5) senses; an examination of the eye or eyes conducted by an optometrist, independent of the patient's statements;
    9. (9) “Ophthalmic materials” means any lens that has a spherical, cylindrical or prismatic power or value used before or upon the eye, any contact lens that has no prescription power and any frame or other appliance used for the purpose of holding or positioning any ophthalmic lenses before the eyes;
    10. (10) “Optometrist” means a person who is engaged in the practice of optometry as defined;
    11. (11) “Orthoptic training” means any ocular exercise for the correction or relief of abnormal muscles or functions of the eyes;
    12. (12) “Practice of optometry as a profession” means:
      1. (A) The employment of objective or subjective methods, either or both, for the purpose of ascertaining defects of vision or muscular anomalies or other abnormal conditions of the eyes;
      2. (B) The prescribing of ophthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies and the prescribing of contact lenses, including those with prescription power and those without prescription power which are worn for cosmetic purposes;
      3. (C) The orthoptic training, the adjusting or fitting or adapting of lenses or prisms or eyeglasses or spectacles to remedy or relieve defects of vision or muscular anomalies; or
      4. (D) The supplying, replacement or duplication of an ophthalmic lens or frame; and
      5. (E)
        1. (i) One who is engaged in the practice of optometry as a profession as defined in this subdivision (12) and who has sufficient education and professional competence, as determined by the board, is authorized to examine, diagnose, manage and treat conditions and diseases of the eye and eyelid including:
          1. (a) The administration and prescribing of pharmaceutical agents rational to the diagnosis and treatment of conditions or diseases of the eye or eyelid;
          2. (b) The performance of primary eye care procedures rational to the treatment of conditions or diseases of the eye or eyelid as determined by the board;
          3. (c) The performance or ordering of procedures and laboratory tests rational to the diagnosis of conditions or diseases of the eye or eyelid;
          4. (d) Additionally, the authority to administer benadryl, epinephrine or equivalent medication to counteract anaphylaxis or anaphylactic reaction; and
          5. (e)
            1. (1) The use of a local anesthetic in conjunction with the primary care treatment of an eyelid lesion; provided, however, that no optometrist shall use a local anesthetic for this purpose unless that optometrist has met the certification requirements set forth in § 63-8-112(4) and in the rules of the board of optometry for the administration of pharmaceutical agents in the performance of primary eye care procedures. Nothing in this subdivision (12)(E)(i)(e) shall be construed as allowing an optometrist to perform any reconstructive surgical procedure on the eyelid. Nothing in this subdivision (12)(E)(i)(e) shall be construed as allowing an optometrist to perform any procedure not approved by the board of optometry prior to April 8, 2014;
            2. (2) An optometrist may utilize local anesthesia by injection in performing the following procedures pursuant to this subdivision (12)(E)(i)(e):
              1. (A) Needle drainage of an eyelid abscess, hematoma, bulla, and seroma;
              2. (B) Excision of a single epidermal lesion without characteristics of malignancy, no larger than five millimeters (5 mm) in size and no deeper than the dermal layer of the skin;
              3. (C) Incision and curettage of a nonrecurrent chalazion;
              4. (D) Simple repair of an eyelid laceration no larger than two and one-half centimeters (2.5 cm) and no deeper than the orbicularis muscle and not involving the eyelid margin or lacrimal drainage structures; or
              5. (E) Removal of foreign bodies in the eyelid not involving lid margin, lacrimal drainage structures, and extending no deeper than the orbicularis muscle;
            3. (3) An optometrist who uses a local anesthetic in the manner allowed by this subdivision (12)(E)(i)(e) shall provide to the board of optometry proof that the optometrist has current CPR certification by an organization approved by the board; provided, that the optometrist may meet this requirement by providing proof to the board that another person who has current CPR certification will be present in the office of the optometrist at all times that a local anesthetic is used by the optometrist in conjunction with the treatment of an eyelid lesion. Compliance with this provision shall also require that the optometrist maintain in the optometrist's office an AED at all times that a local anesthetic is administered by the optometrist;
        2. (ii) All optometrists practicing in this state are prohibited from using nondiagnostic ophthalmic lasers. All optometrists practicing in this state are also prohibited from performing cataract surgery or any surgical procedure requiring other than a topical anesthetic. All optometrists practicing in this state are also prohibited from performing radial keratotomy;
        3. (iii) Any optometrist practicing under the authority of this section shall be held to the same standards of care as that of other physicians providing similar services. No optometrist shall practice under this section unless and until the optometrist has submitted to the board evidence of satisfactory completion of all education requirements of § 63-8-112 and has been certified by the board as educationally qualified;
        4. (iv) One who is engaged in the practice of optometry as a profession, as hereinabove defined, and who has sufficient education and professional competence, as determined by the board, and who has transcript credit of at least six (6) quarter hours in a course or courses in general and ocular pharmacology, with particular emphasis on diagnostic pharmaceutical agents applied topically to the eye, from a college or university accredited by a regional or professional accreditation organization that is recognized or approved by the board, is authorized to utilize in connection therewith diagnostic pharmaceutical agents (miotics, mydriatics, cycloplegics and anesthetics) applied topically only;
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    13. (13) “Principal office” means the office location so designated by the optometrist involved; provided, that such office is the location at which the optometrist engages in the majority of the optometrist's practice;
    14. (14) “Standard examination” means the examination prescribed by § 63-8-115; and
    15. (15) “State” means any of the fifty (50) states of the union, the District of Columbia and territories of the United States.
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§ 63-8-103. Board of optometry — Created — Members — Terms.
  1. (a)
    1. (1) A board is created that shall be known and designated as the board of optometry. This board shall consist of five (5) members, all of whom shall be licensed to practice the full scope of optometry and be residents of Tennessee and actively practicing optometrists in Tennessee for a period of five (5) or more years immediately preceding their appointment.
    2. (2) No person shall be eligible for appointment who is in any way connected with or has any financial interest in the optical dispensary or optical department of any institution of learning or in the wholesale optical or optometric supply business.
  2. (b) The present board members shall serve out their respective terms. Thereafter, on a staggered basis, members shall be appointed for five-year terms. No member shall serve for more than ten (10) consecutive years.
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§ 63-8-104. Oath of board members.
  1. All members of the board shall, before entering upon the duties of their office, take and subscribe to the oath, filed with the secretary-treasurer of the board.
§ 63-8-105. Appointments to the board.
  1. (a) The members of the board shall be appointed by the governor. Members may be appointed from lists of qualified nominees submitted by interested optometric groups, including, but not limited to, the Tennessee Association of Optometric Physicians. The governor shall consult with such interested groups to determine qualified persons to fill the positions.
  2. (b) A member shall continue to serve until that member's successor is appointed. A vacancy created by the death, resignation or removal of a member shall be temporarily filled by the board after thirty (30) days. The person filling such vacancy shall serve until the governor makes the appointment as provided in this section. An appointment shall be for the remainder of the unexpired term.
§ 63-8-106. Removal of members of board.
  1. (a) The governor or the board shall have the right to remove from office any or all of the members of the board for inefficiency, neglect of duty or the violation of this chapter.
  2. (b) If the certificate of registration or license of any member of the board is suspended or revoked for cause after the hearing provided for in this chapter, the member's membership on the board shall automatically cease.
§ 63-8-107. Officers of board — Meetings — Examinations.
  1. (a) The board shall choose one (1) of its members as chair, one (1) as vice chair and one (1) as secretary-treasurer, annually.
  2. (b) The board may meet, in its discretion, at such times and places as it may deem proper for the examination of applicants who wish to practice optometry in this state and for the transaction of business.
  3. (c) The board shall offer the standard examination for the issuance of the certificate of fitness at least twice a year.
§ 63-8-108. Quorum — Records of board.
  1. (a) A majority of the members of the board shall at all times constitute a quorum for the transaction of business, and the proceedings of the board shall be recorded in a minute book that shall be open at all reasonable times to public inspection.
  2. (b) The board shall keep a record book in which shall be registered the name, address and a certificate of fitness, a license, certificate of registration or permit of all persons legally entitled to practice optometry in this state, together with the names and addresses of those optometrists whose certificates or licenses have been suspended or revoked.
§ 63-8-109. Reports of board.
  1. The secretary-treasurer of the board shall make such reports of the operation of the board as requested by the governor, appropriate committees of the general assembly or as otherwise required by law.
§ 63-8-110. Compensation of board members.
  1. The members of the board shall be paid their expenses, including mileage, hotel expenses, meals and the sum of one hundred dollars ($100) per diem when actually engaged in the discharge of their official duties. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-8-111. Administrative support.
  1. The board shall receive administrative support from the division.
§ 63-8-112. Powers of board — Examinations.
  1. The board is given authority to:
    1. (1) Make rules, regulations, policies and procedures not inconsistent with the laws of this state for the proper performance of its duties to carry out the purposes and to enforce this chapter;
    2. (2) Provide a standard of efficiency as to the moral, educational and experience qualifications and fitness of all persons who desire to practice optometry in Tennessee in conformity with this chapter;
    3. (3) Conduct both written examinations and written or oral clinical examinations of such character as to thoroughly test the qualifications of applicants and refuse to grant a certification to any person who, in its discretion, is found deficient. The board may prepare its own examinations, contract for the preparation of examinations or questions and may select appropriate standardized examinations, such as that of the National Board of Examiners in Optometry and the International Association of Board of Examiners in Optometry. The board is authorized to pay any expenses involved with conducting the examinations, including expenses involved with contracting with persons who participate in the examination process. The board shall not issue a certificate to any person beyond the scope of that person's education and training as determined by the board;
    4. (4)
      1. (A)
        1. (i) Certify optometrists to administer and prescribe pharmaceutical agents for treatment and perform primary eye care procedures as provided in § 63-8-102(12)(E). No optometrist shall be certified to prescribe or use pharmaceutical agents for treatment purposes in the practice of optometry unless and until that optometrist meets all of the following:
          1. (a) The optometrist has been certified to utilize diagnostic pharmaceutical agents;
          2. (b) The optometrist has completed at least one hundred fifty (150) classroom hours and at least forty (40) hours of clinical experience relative to diagnosis and treatment of ocular disease, including the use of pharmaceutical agents; and
          3. (c) The optometrist has taken and successfully passed the examination administered by or approved by the board;
        2. (ii) Nothing in this section shall be construed as prohibiting the board of optometry from requiring additional education, training or experience of an optometrist before allowing an optometrist to examine, diagnose, manage and treat conditions and diseases of the eye and eyelid authorized by this chapter;
      2. (B) The board shall require each optometrist certified to use pharmaceutical agents for treatment purposes in the practice of optometry to complete a minimum of ten (10) hours of continuing education annually on diagnosis and treatment and use of pharmaceutical agents in the practice of optometry;
      3. (C) The board shall provide the board of pharmacy semiannually with a list of optometrists so certified pursuant to this section and shall provide each certified optometrist with an application certificate that shall be prominently displayed in the optometrist's professional office;
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    5. (5) Investigate possible violations of and enforce this chapter;
    6. (6) Determine the members to attend the meetings of the persons responsible for examining and licensing optometrists in other jurisdictions and other meetings or conventions that will assist the board in performing its duties. Members shall be paid their expenses in attending such meetings in accordance with state travel regulations;
    7. (7) Seek injunctions to prevent violations of this chapter. Such actions shall be brought in the chancery court of Davidson County or the chancery court of the county in which the defendant resides or does business. Such actions may be brought by ten (10) or more licensed optometrists or a state association of optometrists as well as by the board;
    8. (8) Issue, in its discretion, a certification of identification, upon the payment of a fee as set by the board to a legal, ethical and competent practitioner of optometry in this state who may desire to become licensed in another state;
    9. (9) Issue, in its discretion, a duplicate certificate in the event the original is lost or destroyed. The person entitled thereto must make written application to the board for a duplicate, under affidavit setting forth that such certificate was lost or destroyed and the circumstances under which the loss or destruction occurred. The fee for issuing the duplicate shall be set by the board and must accompany the application. Should the original subsequently be found, it must be forwarded immediately to the secretary-treasurer and not be used by the person to whom issued originally or by any other person; and
    10. (10) Set information requirements for ocular prescriptions.
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§ 63-8-113. Unlawful practices — Advertising.
  1. (a) It is unlawful for any person not duly licensed in accordance with this chapter to:
    1. (1) Engage in the practice of optometry;
    2. (2) Claim to be a practitioner of optometry;
    3. (3) Attempt by any means whatsoever to determine the kind or power of ophthalmic materials needed by any person to remedy or relieve defects of vision or muscular anomalies;
    4. (4) Hold out as a registered or licensed optometrist;
    5. (5) Hold out as being able to examine the human eye for the purpose of fitting or prescribing ophthalmic materials;
    6. (6) Test the vision of any person by any means for the purpose of fitting that person with or prescribing ophthalmic materials;
    7. (7) Display a sign or symbol that leads the public to believe that such person is an optometrist;
    8. (8) Make measurements involving the eyes or the optical requirement thereof for the purpose of prescribing ophthalmic materials;
    9. (9) Unless otherwise authorized by law, fill an order or prescription for ophthalmic materials; or
    10. (10) Unless otherwise authorized by law, sell or dispense ophthalmic materials.
  2. (b) It is unlawful for any person, including optometrists licensed under this chapter, to:
    1. (1) Impersonate a licensed optometrist;
    2. (2) Practice optometry under a false or assumed name;
    3. (3) Peddle, sell or render optometric services from door to door;
    4. (4) Canvass or solicit ophthalmic materials or optometric services in person or by agents, except as authorized by the board. Advertising in accordance with this chapter and the rules and regulations of the board is not solicitation;
    5. (5) Practice optometry after the person's certificate of fitness or registration has been revoked or during suspension of same or, after failing to pay the annual renewal fee or after failing to submit satisfactory evidence of having met minimum continuing education requirements as set by the board;
    6. (6) Offer optometric services or ophthalmic materials as a prize, premium or gift, separately or in combination with other merchandise or services, except as authorized by the board; or
    7. (7) Discount optometric services contingent upon the purchase of ophthalmic materials or to otherwise tie in the performing of optometric services with the purchase of ophthalmic materials.
  3. (c) It is unlawful for any licensed optometrist to:
    1. (1) Advertise optometric services or ophthalmic materials, except as provided in subsection (d);
    2. (2) Practice optometry as an employee of any person or business or organization not engaged primarily in health care delivery;
    3. (3) Practice optometry under a name other than the optometrist's own unless board approved;
    4. (4) Appoint agents or other persons to take orders for optometric services or ophthalmic materials;
    5. (5) Split or share fees with any person or organization in return for solicitation of customers by that person or organization;
    6. (6) Practice or offer to practice optometry in or in conjunction with any retail store or other commercial establishment where merchandise is displayed or offered for sale. Any licensed, registered optometrist practicing in premises of such type prior to April 17, 1967, shall be permitted to continue the independent practice in that optometrist's present location or in such new location to which the retail store or other commercial establishment might move; but when any such optometrist vacates any such premises, no other optometrist shall be permitted to practice in such vacated premises; or
    7. (7) Engage in practice in any temporary or mobile office except as authorized by the board or any office that does not have the appropriate instrumentation for diagnosis and treatment for the practice of optometry as established by the board.
  4. (d)
    1. (1) An optometrist may advertise ophthalmic materials, including prices. All advertising by persons licensed to practice optometry in this state, regardless of the media employed for such advertising, shall be subject to the requirements and limitations of this section, as follows:
      1. (A) No person shall advertise optometric services or ophthalmic materials by statements that are fraudulent, deceptive or likely to mislead the public, such as bait and switch tactics;
      2. (B) No person shall advertise or infer through advertising that the person has superior professional skills or competence, except board certification may be listed;
      3. (C) No person shall advertise to guarantee optometric services or use words of similar import;
      4. (D) All advertising shall contain the optometrist's name and the designation “O.D.” or “Doctor of Optometry” or a professional corporation name, so long as such corporate name does not permit or imply action, advertising, services or practices forbidden by this chapter or rules and regulations of the board and such corporate name has been approved in advance by the board as being in compliance with the foregoing; and
      5. (E) Optometrists shall not advertise routine optometric services such as eye examinations except in accordance with regulations promulgated by the board.
    2. (2) The board is given authority to place reasonable time, place and manner restrictions on the advertising of optometric services if it finds that to be in the public interest. Further, the board may require that any advertising disclose any information necessary to protect the public, including whether specialists are certified.
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§ 63-8-114. Exemptions.
  1. Nothing in this chapter shall be construed:
    1. (1) As applying to medical doctors and doctors of osteopathic medicine lawfully entitled to practice their profession in this state;
    2. (2) As applying to an optometric faculty member licensed in another state and employed full time by an accredited school or college of optometry in this state; provided, that the practice of the faculty member is limited and is incidental to the faculty member's employment at the accredited school or college of optometry in the state of Tennessee. An optometry faculty member is limited to the scope of such member's license unless the member has passed an examination or a standardized examination that has been utilized by the therapeutic certification panel. An optometric faculty member may not practice beyond the scope of a fully certified Tennessee optometrist. This shall not be construed as a grant of permission for the optometric faculty member to engage in the private practice of optometry in any form. It is the responsibility of the dean of the school or college of optometry to apply to the board for an exemption for each such faculty member;
    3. (3) To prevent persons, firms and corporations from selling ophthalmic lenses or ophthalmic products at wholesale in a permanently established place of business on prescription to those who are legally qualified to prescribe them, nor to prevent an optical mechanic from doing the merely mechanical work upon such lenses or frames or fitting thereof nor to prevent the wholesale house from selling ready-to-wear eyeglasses or spectacles as merchandise, at wholesale, to merchants for the purpose of resale as merchandise, when neither the wholesaler nor purchaser to whom the wholesaler sells practices optometry;
    4. (4) To prevent a retail merchant from selling ready-to-wear spectacles or eyeglasses if such merchant does not assist the customer in fitting or selecting such products or otherwise engage in the practice of optometry; however, contact lenses, with or without prescription power, may not be ordered, sold or dispensed by a retail merchant;
    5. (5) To prevent licensed dispensing opticians from preparing, adapting and dispensing ophthalmic materials within the scope of their lawful practice; or
    6. (6)
      1. (A) To prohibit a charitable clinic from employing or contracting with an optometrist; provided, that the contractual relationship between the optometrist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the optometrist from exercising independent professional judgment in the practice of optometry;
      2. (B) For the purposes of this subdivision (6), the term “charitable clinic” means an entity that meets the following standards:
        1. (i) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
        2. (ii) Has clinical facilities located in this state;
        3. (iii) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
        4. (iv) Provides one (1) or more of the following services for free or at a discounted rate:
          1. (a) Medical care;
          2. (b) Dental care;
          3. (c) Mental health care; or
          4. (d) Prescription medications;
        5. (v) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
        6. (vi) Is not required to be licensed under § 68-11-202(a)(1).
§ 63-8-115. Qualifications of applicants.
  1. (a) Every person who desires to practice optometry in this state shall submit an application to the board. Each applicant must show sufficient information for the board to determine that the applicant meets all of the following requirements:
    1. (1) Is over twenty-one (21) years of age;
    2. (2) Is of good moral character;
    3. (3) Is a graduate of a school or college of optometry accredited by a regional or professional accreditation organization that is recognized or approved by the board and is in good standing, as determined by the board; and
    4. (4) Has passed examinations and met the requirements established by the board for the scope of practice desired.
  2. (b)
    1. (1) An applicant who is licensed to practice optometry in a state other than Tennessee, in addition to the foregoing requirements, must show that the applicant is an optometrist in good standing in such state. If the applicant has been disciplined, the applicant must fully set forth the circumstances surrounding the discipline, so that the board may determine therefrom the applicant's character and fitness.
    2. (2)
      1. (A) When the board receives a completed application for initial licensure or a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (b)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  3. (c) All applications to take examinations shall be accompanied by nonrefundable fees to defray the cost of preparing and conducting the examination and the application process as determined by the board.
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§ 63-8-116. Display of certificate.
  1. Each person to whom a certificate of registration is issued shall keep the certificate conspicuously displayed in that person's office, as required by § 63-1-109 and shall when requested exhibit the same to any member or representative of the board.
§ 63-8-118. Discrimination between ocular practitioners prohibited.
  1. No state board, commission or department created or existing by act of the general assembly, including public schools or other state agencies in the performance of their duties, shall in any way show any discrimination between ocular practitioners. All boards or commissions shall honor ocular reports or other professional services by legally qualified and licensed optometrists in this state.
§ 63-8-119. Annual registration — Continuing education.
  1. (a) Every registered optometrist who desires to continue to practice in this state shall pay an annual renewal fee to defray the cost of regulating optometry and shall furnish satisfactory evidence of having met minimum continuing education requirements, as set by the board. The board may, in its sole discretion, waive the annual educational requirement and/or fee in cases of certified illness, disability, other undue hardship or retirement.
  2. (b) The board shall annually arrange for or approve a program or programs of continuing optometric education held in this state sufficient to meet the minimum annual educational requirements for each level of practice. The board shall list on its website the organizations whose continuing education courses are deemed approved to meet the requirements of the board. The courses offered by these organizations shall be considered approved by the board and shall be available to optometrists as a means of satisfying their annual continuing education obligation, in addition to the continuing education courses which have been approved by the Council on Optometric Practitioner Education.
  3. (c) The board is authorized to use such portion of the annual renewal fees as is deemed necessary or proper to provide for continuing optometric educational programs.
  4. (d) The board is authorized to adopt such rules and regulations as it may deem necessary or appropriate for establishing an approved program or programs of continuing optometric education, including, but not limited to, those prescribing the substantive content of all courses or other forms of optometric education that will satisfy the annual educational requirement.
  5. (e) The board shall issue annual renewal certificates to optometrists who pay their annual renewal fees and furnish satisfactory evidence of having met minimum continuing education requirements.
  6. (f) The board is authorized to promulgate rules and regulations providing for the automatic revocation of the certificates of optometrists failing to meet the terms of this section.
  7. (g)
    1. (1) After hearing, the board may provide conditions for the reinstatement of the certificates. These conditions may include, but are not limited to, the payment of delinquent fees, the payment of a civil penalty, the attendance or completion of courses of study, the passage of examinations, the passage of physical or mental examinations and the treatment of any physical or mental ailments.
    2. (2) After hearing, the board may refuse to reinstate the certificates revoked under this section upon any of the grounds set forth in § 63-8-120.
  8. (h) The board may formulate a policy that would allow retirees to practice where their services are needed on a temporary basis.
  9. (i)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (i).
§ 63-8-120. Discipline of certificate holders.
  1. (a) The board may refuse to issue an annual renewal certificate, may suspend or revoke any certificate issued by it, censure, reprimand, place on probation and assess a civil penalty up to one thousand dollars ($1,000) for each separate violation whenever the certificate holder is found guilty of any of the following acts or offenses:
    1. (1) Fraud in procuring a license;
    2. (2) Immoral, unprofessional or dishonorable conduct;
    3. (3) Habitual intoxication or addiction or misuse of drugs;
    4. (4) Conviction of a felony;
    5. (5) Use of untruthful or improbable statements or flamboyant or extravagant claims concerning such licensee's professional excellence or abilities;
    6. (6) Practicing under any other name than the certificate holder's own unless board approved;
    7. (7) Failure to renew annual certificate;
    8. (8) Solicitation of optometric services or ophthalmic materials in person or by agent by any means other than advertising authorized by this chapter;
    9. (9) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the practice of optometry;
    10. (10) Practice beyond the scope of the certificate;
    11. (11) Furnishing spectacle prescriptions that do not at least meet the informational requirements established by the board or refusing to furnish a copy of a spectacle prescription at no additional cost to the patient at the end of the examination;
    12. (12) Advertising of optometric services or ophthalmic materials in any manner other than permitted by this chapter or rule and regulation of the board;
    13. (13) Engaging in the practice of optometry as an employee of any person, firm or corporation not engaged primarily in health care delivery;
    14. (14) Division of fees or agreeing to split or divide the fees received for professional services with any person for bringing or referring a patient;
    15. (15) Peddle or sell ophthalmic materials as to render or attempt to render optometric services from house to house or door to door. This shall not prohibit, however, an optometrist from attending, prescribing and furnishing ophthalmic materials to a patient who, by reason of illness or physical or mental infirmity, is confined to the patient's place of abode or in a hospital or other institution;
    16. (16) Signing or making in one's professional capacity any certificate known to be false at the time it is signed or made;
    17. (17) Committing any act that is made unlawful by § 63-8-113; or
    18. (18) Committing any act contrary to this chapter or the rules and regulations of the board.
  2. (b) The board may set guidelines for the implementation of the discipline of certificate holders.
  3. (c) The board may require a mental or physical examination of a certificate holder that the board believes may be a threat to that certificate holder or the public or incapable of practicing optometry in accordance with this chapter and the standards established by the board.
  4. (d) The board may provide conditions upon optometrists continuing to practice or upon the reinstatement of certificates. These conditions may include, but are not limited to, the payment of civil penalties, the attendance or completion of courses of study, the passage of examinations, the passage of physical or mental examinations and the treatment of any physical or mental ailments.
  5. (e)
    1. (1) The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
    2. (2) Any elected officer of the board, or any duly appointed or elected chair, has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
    3. (3) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
    4. (4)
      1. (A) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
      2. (B) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
    5. (5) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
    6. (6) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
  6. (f) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-8-121. Administrative procedures.
  1. The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall apply to all proceedings of the board and regulations promulgated pursuant to this chapter.
§ 63-8-122. Penalties.
  1. A violation of this chapter is a Class B misdemeanor.
§ 63-8-123. Regulation of laboratory practices of optometrists.
  1. The commissioner of health has the authority to regulate the laboratory practices of optometrists to ensure that such practices are in full compliance with the Clinical Laboratory Improvement Act (CLIA) (42 U.S.C. § 263a).
§ 63-8-124. Public policy.
  1. It is the public policy of the state that:
    1. (1) Optometrists rendering visual care to citizens shall practice in an ethical, professional manner;
    2. (2) Optometrists' practices shall be free from any influences that would interfere with their exercise of professional judgment;
    3. (3) The visual welfare of the optometrist's patient shall be the prime consideration at all times; and
    4. (4) Optometrists shall not be associated with any person or persons in any manner that might degrade or reduce the quality of visual care received by the citizens of this state.
§ 63-8-125. Lease between an optometrist and manufacturer, wholesaler or retailer of ophthalmic materials — Control of professional judgment or practice by lessor prohibited.
  1. (a) A manufacturer, wholesaler or retailer of ophthalmic materials who leases space to an optometrist shall not, directly or indirectly, control or attempt to control the professional judgment or practice of an optometrist.
  2. (b) As used in this section, the phrase “control or attempt to control the professional judgment or practice of an optometrist” includes, but is not limited to:
    1. (1) Setting or attempting to set the professional fees or hours of an optometrist or the number of patients to be seen by an optometrist;
    2. (2) Restricting or attempting to restrict an optometrist's discretion to schedule appointments at times convenient to the optometrist's patients;
    3. (3) Terminating or threatening to terminate a lease with an optometrist as a means of controlling or attempting to control the professional judgment or practice of the optometrist;
    4. (4) Sharing with an optometrist telephone lines or other telecommunication services; provided, however, that nothing in this section shall preclude an optometrist from entering into a business arrangement involving the delegation of clerical tasks and functions to persons who are not employees of the optometrist but are under the optometrist's general supervision, so long as the business arrangement is in compliance with state and federal law;
    5. (5) Employing or contracting for the services of an optometrist if part of the optometrist's duties involve the practice of optometry, except that an optometrist may legally contract to provide optometric services to the employees of the manufacturer, wholesaler or retailer;
    6. (6) Paying an optometrist for a service not provided;
    7. (7) Restricting an optometrist's access to leased office space when the optometrist needs such access to provide emergency care to a patient;
    8. (8) Restricting or attempting to restrict the scope of practice of the optometrist in a way that prevents the optometrist from providing the full range of diagnostic and treatment services authorized by Tennessee law; provided, however, that a manufacturer, wholesaler or retailer of ophthalmic materials who leases space to an optometrist may restrict that optometrist from offering spectacles, lenses or frames to the optometrist's patients or to the public in the leased space in direct competition with the lessor;
    9. (9) Limiting or attempting to limit the optometric services and ophthalmic materials that the optometrist may prescribe to the optometrist's patients or the information that may be disseminated to the patients or the public by the optometrist; and
    10. (10) Limiting or attempting to limit the optometrist's exercise of independent professional judgment or responsibility in any way.
  3. (c) A lease between an optometrist and a manufacturer, wholesaler or retailer of ophthalmic materials must comply with all the following provisions:
    1. (1) The lease must not contain any provision through which the manufacturer, wholesaler or retailer of ophthalmic materials controls or attempts to control the professional judgment or practice of the optometrist; and
    2. (2) The leased space must be large enough to include a secure location for storage of confidential patient records. Representatives of the lessor are only permitted on the lessee's premises on reasonable notice and at times not disruptive to the practice of the optometrist. Lessor shall have no access to confidential patient information except in compliance with state and federal law.
  4. (d) The board may promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this section.
  5. (e) The board may file an action in an appropriate court to enjoin any violation of this section by any manufacturer, wholesaler or retailer of ophthalmic materials. If successful in establishing a violation or violations of this section, the board may recover court costs and reasonable attorney's fees.
  6. (f) An optometrist may file an action in an appropriate court to enjoin a manufacturer, wholesaler or retailer of ophthalmic materials from controlling or attempting to control the professional judgment or practice of that optometrist. If successful in establishing a violation or violations of this section, the optometrist may also recover any actual damages sustained by the optometrist, as well as court costs and reasonable attorney's fees.
  7. (g) The attorney general and reporter may file suit in an appropriate court to enjoin any violation of this section by a manufacturer, wholesaler or retailer of ophthalmic materials. If successful in establishing a violation or violations of this section, the attorney general and reporter may also recover a civil penalty not to exceed one thousand dollars ($1,000) per day for each violation of this section, plus court costs and reasonable attorney's fees.
§ 63-8-126. Drug prescriptions.
  1. (a) Any handwritten prescription order for a drug prepared by an optometrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing optometrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug, and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing optometrist must sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201.
  2. (b) Any typed or computer-generated prescription order for a drug issued by an optometrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing optometrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug, and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing optometrist must sign the typed or computer-generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201.
  3. (c) Nothing in this section shall be construed to prevent an optometrist from issuing a verbal prescription order.
  4. (d)
    1. (1) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
    2. (2) Subdivision (d)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
§ 63-8-127. Prohibition against requirement of minimum purchase of ophthalmic materials as a condition of participation in vision or health care plan.
  1. (a) No person shall require an optometrist to purchase a minimum quantity or minimum dollar amount of a specified brand of ophthalmic materials in order to participate as a provider in a vision or other health care plan.
  2. (b) An optometrist may file an action in the chancery court of the county in which the optometrist's office is located to enjoin a violation of this section. If successful in establishing a violation, the optometrist may recover court costs and reasonable attorney's fees.
§ 63-8-128. Inactive licenses to perform pro bono services.
  1. The board of optometry shall establish by rule an inactive license category that allows optometrists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under §  501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of optometry.
Chapter 9 Osteopathic Physicians
§ 63-9-101. Board — Composition and terms of members — Administrative support.
  1. (a) There shall be a board of osteopathic examination, referred to as “board” in this chapter, consisting of six (6) persons, appointed by the governor. One (1) of these persons shall be a citizen member who does not engage in any profession, business or activity subject to regulation by the board, and five (5) members shall be osteopathic physicians. These persons shall be residents of this state; and the five (5) osteopathic physician members shall be graduates of a legally chartered osteopathic college in good standing and having the power to confer degrees in osteopathic medicine and shall have been, at the time of their appointment, actively engaged in the practice of their profession for a period of at least five (5) years. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  2. (b) Their terms of office shall be so designated by the governor that the term of one (1) member shall expire each year. Thereafter, in each year the governor shall appoint one (1) person to fill the vacancy on the board, the term of the appointee to be five (5) years. A vacancy occurring from any other cause shall be filled by the governor for the unexpired term in the same manner.
  3. (c) The board shall have a common seal and shall formulate rules to govern its actions.
  4. (d) The board shall receive administrative support from the division of health related boards, referred to as the “division” in this chapter.
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§ 63-9-102. Meetings and records of board.
  1. (a) The board shall meet at the call of the president and at such other times and places as a majority of the board may appoint.
  2. (b) Four (4) members of the board shall constitute a quorum, but no certificates of fitness to practice osteopathic medicine shall be granted on an affirmative vote of less than three (3).
  3. (c) The board shall keep a record of its proceedings and a register of all applicants for certificates of fitness, giving the name and location of the institution granting the applicant the degree of doctor of or diploma in osteopathic medicine, the date of the applicant's diploma and also stating whether the applicant was rejected or a certificate granted. The books and register shall be prima facie evidence of all matters recorded therein.
§ 63-9-103. Disposition of funds — Operating expenses — Compensation of members.
  1. (a) The board shall pay all money received as fees into the state treasury, and the commissioner of finance and administration shall make such allotments out of the general fund as the commissioner may deem proper for the necessary and proper expenses of the board. No expenditures shall be made by the board unless and until such allotment has been made by the commissioner. Such allotment shall be disbursed under the general budgetary laws of the state.
  2. (b) Each member of the board shall receive one hundred dollars ($100) per diem and expenses when actually engaged in the discharge of official duties. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-9-104. Application for certificate to practice — Special training and conditional licenses.
  1. (a) Before engaging in the practice of osteopathic medicine, a person shall submit an application to the secretary of the board for a certificate of fitness to practice osteopathic medicine on a form prescribed by the board in writing or via online application, which includes:
    1. (1) The person's name, age, which shall not be less than eighteen (18) years, and residence;
    2. (2) The name of the school of osteopathic medicine from which the person was graduated, which shall have been in good repute as such at the time of the issuing of the person's diploma, as determined by the board;
    3. (3) The date of the person's diploma, evidence that such diploma was granted on personal attendance and completion of the course of study approved by the board;
    4. (4) Such other information as the board may require; and
    5. (5) Sufficient evidence that the applicant is of good moral character.
  2. (b)
    1. (1) Each applicant shall pay a nonrefundable application fee as set by the board.
    2. (2) On notice of acceptance, each applicant for examination shall pay an examination fee as set by the board.
    3. (3) Each applicant accepted by reciprocity will pay a reciprocity fee as set by the board.
  3. (c)
    1. (1) Notwithstanding subsection (a), osteopathic medical students, interns, residents, and clinical fellows, while participating in a training program approved by the American Osteopathic Association or the American Medical Association, performing duties assigned to meet the requirements of such a training program and while under the supervision and control of a physician, either a doctor of osteopathic medicine or a doctor of medicine licensed to practice in this state, are exempt from the requirement of a license. No such student, intern, resident, or clinical fellow shall be permitted to practice osteopathic medicine outside of the person's duties and responsibilities in the approved training program without being licensed to practice osteopathic medicine.
    2. (2) It is the responsibility of the program director or the dean responsible for the training program to apply to the board of osteopathic examination for an exemption for each such medical student, intern, resident, or clinical fellow. It is the responsibility of such program director or dean to notify the board of the termination of an applicant's participation in the training program, whether by completion of the program or for any other reason.
    3. (3) The board of osteopathic examination may impose a fee to accompany each application for exemption.
  4. (d) The board is authorized, in its discretion, to issue special training licenses to osteopathic medical interns, residents and fellows who have met all other qualifications for licensure contained in this chapter and the rules and regulations promulgated pursuant thereto, with the exception of having completed the necessary residency or training programs required by subdivision (a)(4) and properly promulgated rules, and the licensure examination. The board also is authorized to promulgate rules and regulations to implement this new licensure category. The initial set of these rules may be processed as emergency rules pursuant to § 4-5-208. These special training licenses will be governed by the following:
    1. (1) Such licenses shall be issued only to osteopathic medical interns, residents and fellows while participating in a training program of one of the accredited medical schools or of one of such medical school's affiliated teaching hospitals in Tennessee, performing duties assigned to meet the requirements of such program and while under the supervision and control of a physician, either a doctor of osteopathic medicine or a doctor of medicine fully licensed to practice medicine in Tennessee;
    2. (2) No person holding a special training license is permitted to practice osteopathic medicine outside of such person's duties and responsibilities in the training program without being fully licensed to practice medicine in Tennessee. Termination of participation in the training program for which the special license was issued for any reason terminates that license;
    3. (3) It is the responsibility of the program director or the dean responsible for the training program to submit the necessary information and applications on behalf of each applicant. It also is the responsibility of the program director or the dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason;
    4. (4) The board may impose fees to accompany each individual application for a special training license; and
    5. (5) [Deleted by the 2022 amendment.]
  5. (e) The board also has the authority to issue locum tenens and/or conditional licenses as it deems appropriate after reviewing the qualifications of applicants. In addition to the authority granted the board in § 63-9-111, the board has the authority to issue restricted licenses to current applicants or current licensees, or both, as it deems necessary, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  6. (f)
    1. (1) Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with an osteopathic physician; provided, that the contractual relationship between the osteopathic physician and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the osteopathic physician from exercising independent professional medical judgment in diagnosing and treating patients.
    2. (2) For the purposes of this subsection (f), the term “charitable clinic” means an entity that meets the following standards:
      1. (A) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. (B) Has clinical facilities located in this state;
      3. (C) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. (D) Provides one (1) or more of the following services for free or at a discounted rate:
        1. (i) Medical care;
        2. (ii) Dental care;
        3. (iii) Mental health care; or
        4. (iv) Prescription medications;
      5. (E) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. (F) Is not required to be licensed under § 68-11-202(a)(1).
    3. (3) For the purposes of this section, the term “employing” shall not allow the employing of osteopathic physicians with the same specialties as those physicians exempted in § 63-6-204(e)(3).
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§ 63-9-105. Examination of applicants — Reciprocity.
  1. (a) The board shall subject all applicants to an examination in the subjects of diagnosis, surgery, gynecology, obstetrics and such other subjects as the board may require. The board may, in its discretion, conduct its own written examination or administer a national examination.
  2. (b)
    1. (1) The board may, in its discretion, dispense with an examination in the case of an osteopathic physician duly licensed to practice osteopathic medicine in any other state or territory of the United States or in the District of Columbia, if the applicant has met the same or equivalent educational standards required by the state of Tennessee, and shall present a certificate of examination and registration by the legally constituted board of such other state or district or a certificate issued by the national board of examiners for osteopathic physicians and surgeons.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within forty-five (45) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (b)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-9-106. Right of licensees to practice — Cross-referrals.
  1. (a) Upon the issuance of a certificate of fitness by the board and the issuance of a license and a certificate of registration by the division as provided in chapter 1 of this title, the person receiving the same shall be entitled to practice in any county of this state osteopathic medicine, which is defined as a separate, complete and independent school of medicine and surgery utilizing full methods of diagnosis and treatment of physical and mental health and disease, including the prescription and administration of drugs, medicines and biologicals, operative surgery, obstetrics and radiological and other electromagnetic emissions, which places special emphasis on the interrelationship of the musculoskeletal system to other body systems as taught and practiced by recognized associated colleges of osteopathic medicine.
  2. (b)
    1. (1) The provisions of chapter 6, part 6 of this title relative to cross-referral arrangements and physician ownership and investment interests in and referrals to a health care entity shall apply to any person practicing osteopathic medicine in this state.
    2. (2) Any osteopathic physician who makes or causes to be made a referral prohibited pursuant to subdivision (b)(1) is in violation of this chapter as of the dates specified in chapter 6, part 6 of this title. Willful violations of subdivision (b)(1) are considered unprofessional conduct, subject to licensure sanctions by the board of osteopathic examination, including suspension, revocation or other restriction deemed appropriate by the board. In addition, the board is authorized to impose civil penalties of an amount up to five thousand dollars ($5,000) for each prohibited referral.
  3. (c) When medical training and specialty board certification are considerations in the credentialing of osteopathic physicians, no state board, commission or department, created or existing, or hospital, health care facility, medical staff, professional service corporation or professional limited liability corporation, health maintenance organization, preferred provider organization, independent practice association, managed care organization, health plan or any other insurance provider shall discriminate, on the basis of education, against eligible osteopathic physicians who have:
    1. (1) Graduated from medical school and postdoctoral programs approved by either the American Osteopathic Association or the Accreditation Council for Graduate Medical Education; or
    2. (2) Been awarded board eligibility or board certification by specialty boards recognized by either the American Osteopathic Association or the American Board of Medical Specialties.
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§ 63-9-107. Renewal of certificates and licenses — Continuing education — Retirement.
  1. (a) Every registered osteopathic physician shall annually pay a renewal fee as set by the board; provided, that satisfactory evidence is presented to the board that such licensee in the year preceding the application for renewal successfully completed the required number of hours in courses, programs, internships or residencies as established and approved by the board through rules and regulations promulgated in accordance with the Uniform Administrative Procedures Act, as compiled in title 4, chapter 5.
  2. (b) Each person having a certificate of registration or license shall be notified prior to the due date of the renewal fee.
  3. (c)
    1. (1) When any licensed osteopathic physician shall fail to register and pay the annual registration fee within sixty (60) days after registration becomes due as provided in this section, the license of such person shall be automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing.
    2. (2) Any person whose license is automatically revoked as provided in this chapter may make application in writing to the board for the reinstatement of such license and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of all past-due renewal fees and upon further payment of a sum to be set by the board.
  4. (d) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
  5. (e)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (e).
§ 63-9-108. Application of health laws.
  1. (a) Osteopathic physicians shall observe and be subject to all state and municipal regulations relating to:
    1. (1) The control of contagious diseases;
    2. (2) The reporting and certifying of births and deaths; and
    3. (3) All matters pertaining to public health.
  2. (b) Such reports shall be accepted by the officer or department to whom the same are made, equally with reports of physicians of any other school of medicine.
§ 63-9-109. Penalties.
  1. (a) Any person who practices or pretends or attempts to practice or use the science or system of osteopathic medicine in treating diseases of the human body or any person who buys, sells or fraudulently obtains any diploma, certificate, license or record of registration to practice osteopathic medicine illegally obtained or signed or issued unlawfully or under fraudulent representation or who uses in any of the forms or letters, “osteopathy,” “osteopath,” “osteopathist,” “diplomate in osteopathy,” “D.O.,” “osteopathic physician,” “doctor of osteopathy,” or any other title or letters, either alone or with other qualifying words or phrases, under such circumstances as to induce the belief that the person who uses such term is engaged in the practice of osteopathic medicine without having complied with this chapter commits a Class B misdemeanor.
  2. (b) Nothing in this section shall be construed to prohibit any lawfully qualified osteopathic physician or surgeon in any other state meeting a registered osteopathic practitioner in the state of Tennessee for consultation.
§ 63-9-110. Investigation and prosecution of violations.
  1. (a) The board shall investigate every supposed violation of this chapter coming within the scope of the authority of such board and report to the proper district attorney general all cases that, in the judgment of the board, warrant prosecution.
  2. (b) Every police officer, sheriff and peace officer is charged with the duty of investigating every supposed violation of this chapter that comes to such officer's notice or of which such officer has received complaint and of apprehending and arresting all violators.
  3. (c) It is the duty of the attorney general and reporter and of the several district attorneys general to prosecute violations of this chapter.
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§ 63-9-111. Denial, suspension and revocation of licenses or certificates — Enjoining violations — Enforcement — Investigations.
  1. (a) The board has the power to:
    1. (1) Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend or limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or licensee as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license.
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  2. (b) The grounds upon which the board shall exercise the powers set forth in subsection (a) include, but are not limited to:
    1. (1) Unprofessional, dishonorable or unethical conduct;
    2. (2) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provisions of this chapter or any lawful order of the board issued pursuant thereto or any criminal statute of the state;
    3. (3) Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or in being guilty of fraud or deceit in the practice of medicine;
    4. (4) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of medical practice;
    5. (5) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice medicine;
    6. (6) Violation of the laws governing abortion;
    7. (7) The willful violation without legal justification of a privileged communication;
    8. (8) Obtaining a fee as personal compensation or causing financial gain or benefit for an employer, person, partnership, corporation or any other legal entity by a fraudulent representation or by the use of a fraudulent diagnosis, therapy or treatment;
    9. (9) Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    10. (10) The use of any false or fraudulent statement in any document connected with practice under this chapter;
    11. (11) Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice, or not in good faith to relieve pain and suffering or not to cure an ailment, physical infirmity or disease;
    12. (12) Dispensing, prescribing or otherwise distributing to any person a controlled substance or other drug if such person is addicted to the habit of using controlled substances without making a bona fide effort to cure the habit of such patient;
    13. (13) Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or any other drug to any person in violation of any law of the state or the United States;
    14. (14) Engaging in the practice of medicine under a false or assumed name, or the impersonation of another practitioner, or a like, similar or different name;
    15. (15) Knowingly performing any act that in any way assists an unlicensed person to unlawfully practice as provided under this chapter;
    16. (16) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provisions of this chapter;
    17. (17) The failure of the licensee to designate the licensee's professional degree in accordance with § 63-1-109;
    18. (18) Should any person holding a license to practice hereunder be adjudged mentally incompetent or insane by any final order or adjudication of any court of competent jurisdiction, the license of such person shall forthwith be automatically suspended upon the entry of the order, and such suspension shall be effective and continue until the licensee is found or adjudged by such court to be mentally competent or until such person is duly discharged as restored to mental competence in any other manner provided by law;
    19. (19) The advertising of medical business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    20. (20) Engaging in the practice of medicine when mentally or physically unable to safely do so;
    21. (21) Disciplinary action against the licensee to practice medicine by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a licensee licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of a violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a licensee licensed in this state;
    22. (22) No person licensed in this state to practice osteopathy shall agree or contract with any clinical, bioanalytical or hospital laboratory, wherever located, to pay such laboratory for anatomic pathology services or cytology services and thereafter include such costs in the bill or statement submitted to the patient or any entity or person for payment, unless the practitioner is in compliance with the requirements of § 56-7-1015(g) and discloses on the bill or statement, or in writing by a separate disclosure statement in a minimum print size of ten (10) font, the name and address of the laboratory and the net amount or amounts paid or to be paid to the laboratory for the anatomic pathology services or cytology services. This subdivision (b)(22) shall not apply to the state or any local government; and
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    23. (23)
      1. (A) Transferring of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in Tennessee using any electronic, telephonic or fiber optic means or by any other method if such information is employed to diagnose and/or treat persons physically located within Tennessee is prohibited;
      2. (B) Notwithstanding subdivision (b)(23)(A), the transfer of such information shall not be prohibited if such information is:
        1. (i) To be used for a second opinion requested by a Tennessee licensed medical doctor or osteopathic physician;
        2. (ii) To be used by an out-of-state physician for treatment of a person who is seeking treatment out of Tennessee;
        3. (iii) Used to determine if such patient is covered by insurance;
        4. (iv) Used by a physician in another state to provide occasional academic consultations to a medical school located in Tennessee;
        5. (v) Used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimants’ rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of persons physically located within Tennessee; or
        6. (vi) Used in clinical trials for drugs approved by the food and drug administration;
      3. (C) This subdivision (b)(23) does not apply to research hospitals, as defined in § 63-6-204(f)(7)(I);
      4. (D) This subdivision (b)(23) only applies to X-rays and medical imaging.
  3. (c)
    1. (1) In enforcing this section, the board shall, upon probable cause, have authority to compel an applicant or licensee to submit to a mental and/or physical examination by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition is involved.
    2. (2) Failure of an applicant or a licensee to submit to such examination when ordered shall constitute an admission of the allegations against the applicant or licensee, unless such failure was due to circumstances beyond the applicant's or licensee's control.
    3. (3) The applicant or licensee may have an independent medical practitioner present during such examination.
    4. (4) The committee will submit a report of its findings to the board, which will then hold a hearing as provided in this section.
  4. (d) All proceedings for disciplinary action against a licensee under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  5. (e)
    1. (1) In addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license or certificate, the board is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice osteopathy without possessing a valid license so to practice and to enjoin any unauthorized person, firm or corporation from performing any act or rendering any service in violation of this chapter.
    2. (2) Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
  6. (f) The board shall at all times have the power to call upon the district attorneys general in the various judicial districts to assist the board, and it is hereby declared to be the duty of all district attorneys general throughout the state to assist the board, upon its request, in any suit for injunction or prosecution instituted by the board without charge or additional compensation to the district attorneys general. The attorney general and reporter and the attorney general and reporter's assistants shall serve as legal advisers to the board.
  7. (g) The board, on its own motion, may investigate any report that an osteopathic physician is or may be in violation of subsection (b). Any osteopathic physician, any medical society or any other person who in good faith shall report to the board any information that an osteopathic physician is or may be in violation of subsection (b) shall not be subject to suit for civil damage as a result thereof.
  8. (h) The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case against the licensee or person.
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§ 63-9-112. Operation of X-ray equipment in physicians' offices — Adoption of rules and regulations establishing minimum educational standards.
  1. (a) The board shall have, in regard to operators of X-ray equipment and/or machines in physician offices, the authority, by rules and regulations, to:
    1. (1) Establish and issue limited X-ray certifications to qualified individuals in the areas of densitometry, chest, extremities, skull and/or sinus and lumbar spine;
    2. (2) Establish and issue full X-ray certifications to individuals who hold current and unrestricted national certification from the American Registry of Radiologic Technologists;
    3. (3) Establish the minimum educational courses, curriculum, hours and standards that are prerequisite to issuance of the limited certificates;
    4. (4) Select the examination or examinations to be utilized as the board's limited certification examination or examinations and the prerequisites, if any, for admission to the examination or examinations. The board is authorized to enter into a contract or agreement with the chosen examination service or services or select an intermediary between the board and the examination service or services to process applicants for the examination or examinations;
    5. (5) Establish any other criteria for issuance of limited certificates that are reasonably related to the safe and competent performance of X-ray procedures;
    6. (6) Establish a mechanism for the board accreditation of educational courses that are operating for purposes of qualifying individuals for limited certification and that meet the requirements established pursuant to the rules promulgated under the authority of subdivision (a)(3) and that establish the causes and standards that are grounds for withdrawal of the course accreditation and the mechanism for that withdrawal;
    7. (7) Establish the fees to be paid for application and certification, renewal and late renewal of certificates and the fees required to be paid for application, renewal and late renewal of educational course accreditation; and
    8. (8) Establish the required number of hours, types of courses and methods of proving compliance for biennial continuing education for all certificate holders.
  2. (b) The certificates and accreditations issued pursuant to this section must be renewed and may be retired and reactivated pursuant to board established procedures. A person holding a certificate issued pursuant to this section may be disciplined for the same causes and under the same procedures as contained in § 63-6-214 for the medical board and § 63-9-111 for the board of osteopathic examination.
  3. (c) The standards established by the board pursuant to subsection (a) shall be at least as stringent as any mandatory federal standards.
  4. (d) No person shall perform X-ray procedures in a physician's office without being licensed as a physician or certified by the board pursuant to this section. Persons who have enrolled in a board recognized radiologic training program are exempt from the certification requirements of this section only as to X-ray procedures performed within or under the auspices of the program in which they are enrolled. After completion of the course but while awaiting the first opportunity to sit for the certification examination, but for no more than six (6) months, and for a period of time within which to receive the examination scores, but no more than seventy-five (75) days thereafter, such persons are exempt from the certification requirements of this section.
  5. (e) No X-ray procedures may be performed by any person holding a certificate issued pursuant to this section without:
    1. (1) An order from a physician licensed pursuant to chapter 6 of this title or an osteopathic physician licensed pursuant to this chapter; and
    2. (2) A physician licensed pursuant to chapter 6 of this title or an osteopathic physician licensed pursuant to this chapter exercising full supervision, responsibility and control over the services being provided. The board is authorized to establish, by rules and regulations, the levels of supervision required of physicians utilizing persons certified pursuant to this section.
  6. (f) A physician's office for purposes of this section means anywhere the practice of medicine as defined in § 63-6-204 or the practice of osteopathy as defined in § 63-9-106, which includes the performance of X-ray procedures contemplated by this section, is being conducted, except where that practice is conducted in or under the auspices of a facility or entity licensed by the health facilities commission. The operation of a business in which X-ray procedures contemplated by this section are performed that is not owned by a physician, group of physicians, medical professional corporation, limited liability medical professional company or an entity or facility licensed by the division of health care facilities is prohibited.
§ 63-9-113. Supervised osteopathic medical service by physician assistant, registered nurse, licensed practical nurse, or pharmacist not prohibited. [Effective until January 1, 2025. See the version effective on January 1, 2025.]
  1. Nothing in this chapter shall be so construed as to prohibit osteopathic medical service rendered by a physician assistant, registered nurse, a licensed practical nurse, or a pharmacist pursuant to a collaborative pharmacy practice agreement, if such osteopathic medical service is rendered under the supervision, control and responsibility of a licensed osteopathic physician.
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§ 63-9-115. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A physician licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of osteopathic examination may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
§ 63-9-116. Drug prescriptions.
  1. (a) Any handwritten prescription order for a drug prepared by an osteopathic physician who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing osteopathic physician, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing osteopathic physician must sign the handwritten prescription order on the day it is issued, unless the prescription order is:
    1. (1) Issued as a standing order in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201; or
    2. (2) Prescribed by an osteopathic physician in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
  2. (b) Any typed or computer-generated prescription order for a drug issued by an osteopathic physician who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing osteopathic physician, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing osteopathic physician must sign the typed or computer-generated prescription order on the day it is issued, unless the prescription order is:
    1. (1) Issued as a standing order in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201; or
    2. (2) Prescribed by an osteopathic physician in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
  3. (c) Nothing in this section shall be construed to prevent an osteopathic physician from issuing a verbal prescription order.
  4. (d)
    1. (1) All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
    2. (2) Subdivision (d)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
§ 63-9-117. Office-based surgery.
  1. (a) For the purposes of this section, unless the context otherwise requires:
    1. (1) “Board” means the board of osteopathic examination;
    2. (2) “Level II office-based surgery” means Level II surgery as defined by the board of osteopathic medical examination in its rules and regulations that is performed outside of a hospital, ambulatory surgical treatment center or other medical facility licensed by the health facilities commission;
    3. (3) “Office-based surgery” means Level III surgery requiring a level of sedation beyond the level of sedation defined by the board of medical examiners as Level II surgery that is performed outside a hospital, an ambulatory surgical treatment center or other medical facility licensed by the health facilities commission;
    4. (4) “Physician” means any person licensed under this chapter; and
    5. (5) “Surgical suite” means both the operating and recovery room or rooms located in a physician's office where Level III office-based surgery is to be performed.
  2. (b) The board shall have the duty and responsibility to regulate the practice of office-based surgery, including the promulgation of rules necessary to promote patient health and safety in such practices, including, but not limited to, a mechanism by which all office-based surgical suites are surveyed and certified by the board.
  3. (c) The board shall specifically identify in rules the parameters to be used in determining Level III surgical procedures and multiple procedures that may be performed in an office-based setting pursuant to the level of anesthesia involved in the procedures. In addition, the board shall promulgate age and risk classification criteria of patients eligible for Level III office-based surgical procedures.
  4. (d) By December 30, 2007, the board shall adopt rules establishing a specific list of approved Level III surgical procedures that can be performed in a physician's office in this state. The ambulatory surgical center covered procedures list promulgated by the centers of medicare and medicaid shall be used as a guide. No physician shall perform any Level III surgical procedures that are not included on the list promulgated by the board. The board may modify the list as the board deems necessary. The board shall also promulgate rules addressing the minimum requirements deemed necessary by the board for the safe performance of office-based surgery.
  5. (e) Using the rules established for ambulatory surgical treatment centers as guidelines, the board shall promulgate rules relative to infection control, life safety, patient rights, hazardous waste and equipment and supplies necessary to assure the safety of patients undergoing office-based surgery. Any provision in the ambulatory surgical treatment center rules addressing infection control, life safety, patient rights, hazardous waste and equipment and supplies that is not adopted by the board shall require a statement entered into the official minutes from the board justifying the board's decision.
  6. (f) No more than three (3) patients undergoing Level III office-based surgery in a physician's office may be incapable of self-preservation at the same time. The board shall promulgate rules requiring physician offices that perform office-based surgery to adopt bylaws that put in place a management system and documentation that will insure that no more than three (3) patients that are in surgery or recovery are incapable of self-preservation at the same time. The bylaws and documentation of the management system shall be included in the application for surgical suite certification.
  7. (g) Except for emergencies, a surgical suite certified for office-based surgery may be utilized only by physician employees of the practice in which the surgical suite is located. Surgical suites may not be shared with other practices or other physicians.
  8. (h) The board shall enter into a memorandum of understanding, contract or other written arrangement with the health facilities commission such that the commission:
    1. (1) Provides a site survey of the surgical suites sought to be certified to perform office-based surgery. A physician office at which office-based surgeries are being performed as of October 1, 2007, shall submit both a request for a site survey on an application form developed by the board and remit payment of the office-based surgery fee to the commission by October 1, 2007. If the office makes a timely filing in accordance with this subdivision (h)(1), the physician's office may continue to be a site for office-based surgeries pending completion of a survey confirming compliance with board rules and subsequent issuance of a certification of the surgical suite or suites. A physician office at which office-based surgeries are not being performed as of October 1, 2007, shall not perform any such procedures until an application form and payment of the office-based surgery fee is submitted to the board and a site survey is completed by the commission and a certification of the surgical suite is issued by the board;
    2. (2) Is authorized to require plans of correction and to verify that the plans of correction have been implemented;
    3. (3) Is authorized to initiate subsequent, unannounced site surveys during regular business hours as long as the physician office continues to be used to perform office-based surgeries, but no more frequently than once every twelve (12) months; and
    4. (4) Is authorized to respond to any complaints made by patients or the public against a physician who performs office-based surgery or a physician's office at which office-based surgery is being performed at the request of the office of investigations.
  9. (i) The results of all site surveys shall be transmitted by the health facilities commission to the board. The results shall include any requirement for plans of correction, the commission's determination of the acceptability of the submitted plans of correction, and the commission's verification that the plans of correction have been implemented. The board shall make a final determination on certifying the surgical suite for performance of office-based surgeries. The results of site surveys and board determinations shall be shared on a routine basis with the board for licensing health care facilities.
  10. (j) The results of all complaint investigations by health facilities commission staff shall be transmitted to the board for resolution; however, the information shall at all times be maintained as confidential and not available to the public except to the extent § 63-1-117(b) applies.
  11. (k) Any physician office that desires to be certified to perform office-based surgery shall pay to the health facilities commission an annual office-based surgery fee as set by the board.
  12. (l) A physician office at which office-based surgery is being performed shall ensure that claims data is reported to the executive director of the health facilities commission on a form approved by the health facilities commission. The data shall be submitted through a third party approved by the health facilities commission for the purpose of editing the data according to rules and regulations established by the executive director. The physician office shall be responsible for the costs associated with processing of the data by the approved vendors. The claims data shall be reported at least quarterly to the executive director. No information shall be made available to the public by the executive director that reasonably could be expected to reveal the identity of any patient. The claims data reported to the executive director under this section are confidential and not available to the public until the executive director processes and verifies the data. The executive director shall prescribe conditions under which the processed and verified data are available to the public.
  13. (m)
    1. (1) Except as provided in subdivision (h)(1), a physician office surgical suite is required to be certified by the board in order to perform office-based surgery. A physician office that proposes to perform the surgery shall submit to the board, on an application form provided by the board, at least the following:
      1. (A) Level III procedures expected to be performed by each physician;
      2. (B) The specialty board certification or board eligibility of the physician or physicians performing Level III procedures, if any;
      3. (C) Verification of health care liability coverage for all physicians performing Level III procedures;
      4. (D) Verification of hospital staff privileges for all physicians performing Level III procedures;
      5. (E) The name of a responsible physician in whose name the surgical suite certification shall be issued for that office and a list of the physicians with the practice who are going to be performing Level III office-based surgeries; and
      6. (F) The documentation required by subsection (f) regarding incapacitated patient limits.
    2. (2) The form required by subdivision (m)(1) shall serve as an application form, but the information on the form shall be updated as appropriate when any information on it has changed.
  14. (n) The board shall notify all physicians of the office-based surgery certification requirements. Failure of a physician performing office-based surgery, or a physician office at which office-based surgery is being performed, to abide by this section, any rules promulgated pursuant to this section or of § 68-11-211 may be grounds for disciplinary action or termination of either the rights of the physician to perform office-based surgery or the surgical suite's certification by the physician's licensing board, or both disciplinary action and termination. For purposes of § 4-5-320(c), the public health, safety and welfare imperatively require emergency action at any time that a previously authorized surgical suite fails to maintain the standards set by the board.
  15. (o) Applicants for initial licensure or reinstatement of a previously issued license shall indicate to the board on the appropriate licensure application if they intend to perform Level II office-based surgery procedures as defined by the rules of the board of osteopathic examination and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  16. (p) Licensed osteopathic physicians who perform Level II office-based surgery at the time of licensure renewal shall indicate to the board on the licensure renewal application if the licensee currently performs Level II office-based surgery procedures as defined in the rules of the board of osteopathic examination and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  17. (q) In order for health care providers and the board to work together to collect meaningful health care data, so as to minimize the frequency and severity of certain unexpected events and improve the delivery of health care services, each osteopathic physician who performs any Level II office-based surgery that results in any of the following unanticipated events shall notify the board in writing within fifteen (15) calendar days following the physician's discovery of the event:
    1. (1) The death of a patient during any Level II office-based surgery or within seventy-two (72) hours thereafter;
    2. (2) The transport of a patient to a hospital emergency department except those related to a natural course of the patient's illness or underlying condition;
    3. (3) The unplanned admission of a patient to a hospital within seventy-two (72) hours of discharge, only if the admission is related to the Level II office-based surgery except those related to a natural course of the patient's illness or underlying condition;
    4. (4) The discovery of a foreign object erroneously remaining in a patient from a Level II office-based surgery at that office; or
    5. (5) The performance of the wrong surgical procedure, surgery on the wrong site or surgery on the wrong patient.
  18. (r) Records of reportable events should be in writing and should include at a minimum the following:
    1. (1) The physician's name and license number;
    2. (2) The date and time of the occurrence or discovery of the incident;
    3. (3) The office and address where the incident took place;
    4. (4) The name and address of the patient;
    5. (5) The type of Level II office-based surgery that was performed;
    6. (6) The type and dosage of sedation or anesthesia utilized during the procedure;
    7. (7) The circumstances surrounding the incident; and
    8. (8) The type or types of events required to be reported as provided in subsection (q).
  19. (s) The filing of a report as required by subsection (q) does not, in and of itself, constitute an acknowledgement or admission of health care liability, error or omission. Upon receipt of the report, the board may, in its discretion, obtain patient and other records pursuant to authority granted to it in § 63-1-117. The reporting form and any supporting documentation reviewed or obtained by the board pursuant to this section and any amendments to the reports shall be confidential and not subject to discovery, subpoena or legal compulsion for release to any person or entity; nor shall they be admissible in any civil or administrative proceeding, other than a disciplinary proceeding by the board; nor shall they be subject to any open records request made pursuant to title 10, chapter 7, part 5 or any other law. This section shall not affect any of the provisions of or limit the protections provided by § 63-1-150.
  20. (t) Failure to comply with the requirements of subsections (o)-(s) constitutes grounds for disciplinary action by the board in its discretion pursuant to § 63-9-111.
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§ 63-9-119. Employee or contractor's unauthorized use of osteopathic physician's DEA registration number to write prescriptions.
  1. (a) Any osteopathic physician licensed pursuant to this chapter who has reason to believe that an employee or contractor of the physician or the physician's firm, partnership or corporation has used the physician's federal drug enforcement administration (DEA) registration number without authorization to write prescriptions may make a report to a law enforcement agency.
  2. (b) Any osteopathic physician, firm, partnership, or corporation making a report pursuant to subsection (a) shall be immune from any civil liability for making such report when made in good faith.
§ 63-9-120. Hormone replacement therapy.
  1. (a)
    1. (1) “Hormone replacement therapy clinic” or “hormone therapy clinic” means a medical office in which the clinicians are primarily engaged in hormone replacement or supplementation therapy or a medical office which holds itself out to the public as being primarily or substantially engaged in hormone replacement therapy. For the purposes of this definition, “primarily engaged” means that a majority of the clinic's patients receive hormone replacement therapy and may be further defined by the board by rule. “Hormone replacement therapy clinic” does not mean a medical office in which the clinicians are primarily engaged in obstetrics and gynecology (OB/GYN), urology or primary care.
    2. (2) “Hormone replacement therapy” or “hormone therapy” means the branch of the practice of medicine whereby the patient is treated with medications that include, but are not limited to, creams or natural formulas taken through the skin, under the tongue, in subcutaneous pellets, or orally that contain hormones that have the same bioidentical or similar chemical formula as those produced naturally in the human body or that the provider thinks or claims to be similar or identical, but shall not include the treatment of patients with birth control pills.
  2. (b) In hormone replacement therapy clinics:
    1. (1) All hormone replacement therapy shall be performed by a physician licensed under chapter 6 of this title or this chapter, or delegated by such physician to a certified nurse practitioner licensed pursuant to chapter 7 of this title or a physician assistant licensed pursuant to chapter 19 of this title; and
    2. (2) If hormone replacement therapy is delegated, the supervising physician shall ensure that written protocols are developed for licensees to whom hormone replacement therapy is delegated, that such protocols are updated as necessary and that the patient is informed of both the name and contact information of the supervising physician and an indication of whether the physician is available onsite or remotely.
  3. (c) A physician supervising hormone replacement therapy in a hormone replacement therapy clinic shall ensure that for each patient, all of the following requirements are met:
    1. (1) Prior to the initial hormone replacement therapy or course of treatments, an appropriate physical examination shall be conducted;
    2. (2) An appropriate medical history shall be taken and documented on the patient;
    3. (3) A written order for hormone replacement therapy shall be entered by the treating provider in the patient's medical record documenting the diagnosis and medical reason for the patient's need for hormone replacement therapy. If the treating provider is not a physician, the supervising physician shall make a personal review of the historical, physical and therapeutic data gathered by the treating provider and shall so certify the review in the patient's chart within seven (7) days of the patient being served;
    4. (4) The patient gives written consent for hormone replacement therapy, which includes notification of possible complications and reasonable expectations and any applicable FDA warnings associated with any part of the therapy; and
    5. (5) The supervising physician shall be immediately notified upon discovery of a complication.
§ 63-9-121. Interventional pain management.
  1. (a) A physician licensed in this chapter may only practice interventional pain management if the licensee is either:
    1. (1) Board certified through the American Osteopathic Association (AOA) or the American Board of Physician Specialties (ABPS)/American Association of Physician Specialists (AAPS) in one of the following medical specialties:
      1. (A) Anesthesiology;
      2. (B) Neuromusculoskeletal medicine;
      3. (C) Orthopedic surgery;
      4. (D) Physical medicine and rehabilitation;
      5. (E) Radiology; or
      6. (F) Any other board certified physician who has completed an ABMS subspecialty board in pain medicine or completed an ACGME-accredited pain fellowship;
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    2. (2) A recent graduate of a medical specialty listed in subdivision (a)(1) not yet eligible to apply for AOA or ABPS/AAPS specialty certification; provided, that there is a practice relationship with an osteopathic physician who meets the requirements of subdivision (a)(1) or a physician who meets the requirements of § 63-6-244(a)(1);
    3. (3) A licensee who is not board certified in one of the specialties listed in subdivision (a)(1) but is board certified in a different AOA or ABPS/AAPS specialty and has completed a post-graduate training program in interventional pain management approved by the board;
    4. (4) A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
    5. (5) A licensee who has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization.
  2. (b) For purposes of this section, interventional pain management is the practice of performing invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves of the spine or block of major peripheral nerves of the spine in any setting not licensed under title 68, chapter 11.
  3. (c) The board is authorized to define through rulemaking the scope and length of the practice relationship established in subdivision (a)(2).
  4. (d) An osteopathic physician who provides direct supervision of an advanced practice registered nurse or a physician's assistant pursuant to § 63-7-126 or § 63-19-107 must meet the requirements set forth in subdivision (a)(1) or (a)(3).
  5. (e) An osteopathic physician who violates this section is subject to disciplinary action by the board pursuant to § 63-9-111, including, but not limited to, civil penalties of up to one thousand dollars ($1,000) for every day this section is violated.
§ 63-9-122. Exemption for physician for visiting sports team.
  1. (a) A physician who is duly qualified to practice medicine under the laws of another state is exempt from the licensure requirements of § 63-9-104, subject to this section, if either of the following applies:
    1. (1) The physician has a written or oral agreement with a sports team to provide care to team members and coaching staff traveling with the team for a specific sporting event to take place in this state; or
    2. (2) The physician has been invited by a national sport governing body to provide services to athletes and coaching staff at a national sport training center in this state or to provide services to athletes and coaching staff at an event or competition in this state that is sanctioned by the national sport governing body.
  2. (b) The exemption provided by this section only applies while:
    1. (1) The physician's practice is limited to that required by the team or the national sport governing body; and
    2. (2) The services provided by the physician are within the physician's scope of practice.
  3. (c) The exemption provided by subsection (a) permits a physician to provide care or consultation to a person specified in subsection (a). Nothing in this section permits a physician exempt by this section to:
    1. (1) Provide care or consultation to any person residing in this state other than a person specified in subsection (a); or
    2. (2) Practice at a licensed healthcare facility in this state.
  4. (d) An exemption pursuant to subdivision (a)(1) is valid while the physician is traveling with the sports team, subject to the following:
    1. (1) The exemption shall not be longer than ten (10) days in duration for each respective sporting event without prior authorization from the board of osteopathic examination;
    2. (2) The board of osteopathic examination may grant an extension of not more than twenty (20) additional days per sporting event; and
    3. (3) No physician shall be exempt for more than thirty (30) total days in a calendar year.
  5. (e) An exemption pursuant to subdivision (a)(2) is valid during the time certified by the national sport governing body; however, no physician shall be exempt for more than thirty (30) total days in a calendar year.
  6. (f) No physician exempt pursuant to this section shall dispense or administer controlled substances unless:
    1. (1) The patient to whom the controlled substance is administered or dispensed is over eighteen (18) years of age and is a person described in subdivision (a)(1) or (a)(2); and
    2. (2) The physician reports all controlled substances dispensed or administered to any applicable state controlled substance database in the physician's state of licensure.
  7. (g) For purposes of this section, “sports team” means a professional, semi-professional, or amateur team including, but not limited to, a college, high school, grade school, or non-school affiliated team, such as those associated with the Amateur Athletic Union (AAU).
  8. (h) The board of osteopathic examination may enter into agreements with medical licensing boards of other states to implement this section. Agreements may include procedures for reporting potential medical license violations.
  9. (i) The board of osteopathic examination may promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-9-123. Maintenance of licensure or certification not required.
  1. (a) As used in this section:
    1. (1) “Continuing medical education” means continued postgraduate medical education required by the board of osteopathic medical examination intended to provide medical professionals with knowledge of new developments or reinforcement of previously learned information in their field;
    2. (2) “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
    3. (3) “Maintenance of licensure” means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
    4. (4) “Specialty medical board certification” means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the board of osteopathic examination's requirements to practice medicine.
  2. (b) The board shall not deny a physician licensure based on a physician's non-participation in any form of maintenance of licensure, including requiring any form of maintenance of licensure tied to maintenance of certification. The board's regular requirements, including continuing medical education, demonstrate professional competency.
  3. (c) The board shall not require any form of specialty medical board recertification or any maintenance of certification to practice medicine in this state.
§ 63-9-124. Short-term visitor clinical training license.
  1. (a) The board of osteopathic examination may issue to an eligible physician or medical graduate from a foreign country or foreign territory a short-term visitor clinical training license for a period of time not to exceed ninety (90) days.
  2. (b) To be eligible for a short-term visitor clinical training license under this section, an applicant physician or medical graduate must provide to the board, in a manner and form prescribed by the board by rule:
    1. (1) Proof that the applicant holds a medical degree from an institution recognized in the World Directory of Medical Schools;
    2. (2) Proof of written acceptance to a clinical professional development or short-term clinical training program in this state;
    3. (3) Evidence that the host institution or the Educational Commission for Foreign Medical Graduates (ECFMG) has verified the applicant's credentials;
    4. (4) Evidence that the applicant:
      1. (A) Has an unrestricted license to practice medicine in the applicant's country or territory of origin or country or territory of practice; or
      2. (B) Is enrolled in an accredited resident training program in the applicant's country or territory of origin;
    5. (5) A written statement that the applicant does not have, as determined by the board:
      1. (A) A disqualifying criminal history; or
      2. (B) A history of disqualifying disciplinary action by an educational or training institution, employer, or foreign licensing authority;
    6. (6) Proof of medical liability insurance coverage; and
    7. (7) A written statement signed by the applicant acknowledging that a short-term visitor clinical training license cannot be used to:
      1. (A) Obtain or hold a position in a residency program in the United States;
      2. (B) Satisfy United States graduate medical education requirements; or
      3. (C) Remain in this state to practice medicine beyond the expiration date of the license.
  3. (c) A short-term visitor clinical training licensee:
    1. (1) Shall not assume independent responsibility for patient care;
    2. (2) May only engage in training activities under the supervision and control of a physician licensed under this chapter or chapter 6 of this title; and
    3. (3) To the extent permitted by the board based upon the licensee's education and training, and by compliance with subdivision (c)(2), may engage in direct interaction with a patient, including, but not limited to:
      1. (A) Taking medical history;
      2. (B) Conducting a physical examination;
      3. (C) Reading a radiologic study;
      4. (D) Administering anesthesia; and
      5. (E) Performing a surgical procedure.
Chapter 10 Pharmacy
Part 1 Third-Party Prescription Program Act
§ 63-10-101. Short title.
  1. This part shall be known and may be cited as the “Third-Party Prescription Program Act.”
§ 63-10-102. Part definitions.
  1. As used in this part, “program” and “third-party prescription program” mean any system of providing for the reimbursement of pharmaceutical services under a contractual arrangement or agreement between a provider of such services and another party who is not the consumer of those services. Such programs may include, but not be limited to, employee benefit plans whereby a consumer receives prescription drugs or other pharmaceutical services and those services are paid for by an agent of the employer or others.
§ 63-10-103. Contract between pharmacy and program administrator.
  1. Any agreement or contract entered into in this state between the program administrator of a third-party prescription program and a pharmacy shall include a statement of:
    1. (1) The method and amount of reimbursement to the pharmacy for services rendered to persons enrolled in such program;
    2. (2) The frequency of payment by such program administrator to the pharmacy for such services rendered; and
    3. (3) A method for the adjudication of complaints or the settlement of disputes between the parties.
§ 63-10-104. Cancellation of program benefits.
  1. (a) The administrator of a program shall notify all pharmacies enrolled in such program of any cancellation of the coverage of benefits of any group enrolled in such program at least thirty (30) days prior to the effective date of such cancellation. In those cases where the administrator of a program is not notified at least thirty (30) days prior to the effective date of such cancellation, the administrator shall notify all pharmacies enrolled in such program of the cancellation as soon as practicable after having received such notice.
  2. (b) All persons enrolled in a program shall be notified of its cancellation, and the administrator of such program shall make every reasonable effort to gain possession of any plan identification cards such persons may have been issued pursuant to such program.
  3. (c) Any person who utilizes a program identification card to obtain services from a pharmacy after having received notice of the cancellation of the person's benefits shall be liable to the program administrator of such program for all moneys paid by such program administrator for any services received pursuant to the illegal use of such identification card.
§ 63-10-105. Denying or withholding payment.
  1. (a) No program administrator shall deny payment for services to any pharmacy that may have resulted from the fraudulent or illegal use of an identification card by any person, unless the pharmacy has been notified that the card has been cancelled or discontinued and that the program administrator has been unsuccessful in attempting to regain possession of the card.
  2. (b) No program administrator shall withhold any payments to any pharmacy beyond the time period specified in the payment schedule provisions of the agreement, except that individual claims for payment may be returned to the pharmacy for cause, such as incomplete or illegible information, and may then be resubmitted by the pharmacy to the program administrator after the appropriate corrections have been made.
  3. (c) No program administrator shall deny or withhold payment to any pharmacy for duplicate prescription refills or prescription refills that are dispensed early in relation to the prior day's supply dispensed, where such refills are for the purpose of replacing lost or destroyed medication or providing the patient with the quantity necessary for extended travel away from the community in which the patient resides or for any other bona fide reason that causes the patient to be without medication, when the discontinuation of the medicine would, in the pharmacist's professional judgment, place the patient at risk of harm.
§ 63-10-106. Reimbursement rates.
  1. No agreement between a program administrator and a pharmacy shall establish reimbursement rates or procedures that result in reimbursement rates for services rendered to persons covered by the plan that are less than the usual and customary rate charged by that vendor and paid by ordinary consumers for the same or similar services. This section does not apply to any agreements involving a pharmacy that is a member of an organized pharmacy network, such as a preferred provider organization (PPO) or a professional service administration organization (PSAO).
§ 63-10-107. Applicability.
  1. This part does not apply to any services rendered pursuant to the Medical Assistance Act of 1968, compiled in title 71, chapter 5, part 1.
§ 63-10-108. Price level determinations.
  1. (a) The commissioner of health, in cooperation with the board of pharmacy, shall determine the price level of prescriptions furnished under this part and those furnished otherwise. A determination shall also be made of the price level in other states having a program similar to that provided in this part and those that do not.
  2. (b) The commissioner shall prepare a comparison of the price level determinations required by this section no later than January 31 of each year and shall furnish copies of such comparison to committees of the general assembly.
Part 2 Pharmacy Practice
§ 63-10-201. Short title.
  1. Parts 2-5 of this chapter shall be known and may be cited as the “Tennessee Pharmacy Practice Act of 1996.”
§ 63-10-202. Practice of pharmacy.
  1. The practice of pharmacy within the state is declared to be a professional practice affecting public health, safety and welfare and is subject to regulation and control in the public interest. It is further declared to be a matter of public interest and concern that the practice of pharmacy, as defined in § 63-10-204, merit and receive the confidence of the public and that only qualified persons be permitted to engage in the practice of pharmacy.
§ 63-10-203. Statement of purpose.
  1. (a) The purpose of parts 2-5 of this chapter is to define and regulate the practice of pharmacy to protect the health, safety and welfare of the people of Tennessee.
  2. (b) The persons engaged in the practice of pharmacy shall be pharmacists, duly recognized by the state as necessary health care providers, and shall be entrusted through parts 4-6 of this chapter with a provision of care intended to enhance patients' wellness, prevent illness and optimize outcomes.
§ 63-10-204. Definitions.
  1. As used in parts 2-5 of this chapter, unless the context otherwise requires:
    1. (1) “Administer” means the direct application of a drug to a patient or research subject by injection, inhalation, ingestion, topical application or by any other means;
    2. (2) “Board” means the Tennessee board of pharmacy;
    3. (3) “Certification” means a voluntary process by which a practitioner's training, experience and knowledge are identified as meeting or surpassing a standard, defined or approved by the board beyond that required for licensure or registration;
    4. (4) “Collaborative pharmacy practice” is the practice of pharmacy whereby one (1) or more licensed pharmacists licensed in this state, jointly and voluntarily work with one (1) or more prescribers licensed in this state, under a collaborative pharmacy practice agreement to provide patient care services, to achieve optimal medication use and desired patient outcomes;
    5. (5) “Collaborative pharmacy practice agreement” is a written and signed agreement entered into voluntarily between one (1) or more licensed pharmacists in this state, and one (1) or more prescribers licensed in this state, each of whom is in active practice in this state providing patient care services in this state, that provides for collaborative pharmacy practice, as defined by law;
    6. (6) “Compounding” means the preparation, mixing, assembling, packaging or labeling of a drug or device:
      1. (A) As the result of a prescription order or initiative based on the prescriber-patient-pharmacist relationship in the course of professional practice;
      2. (B) In anticipation of prescription orders based on routine, regularly observed prescribing patterns;
      3. (C) For the purpose of, or as an incident to, research, teaching or chemical analysis and not for sale or dispensing;
      4. (D) For use in a licensed prescribing practitioner's office for administration to the prescribing practitioner's patient or patients when the product is not commercially available upon receipt of an order from the prescriber;
      5. (E) For use in a health care facility for administration to a patient or patients receiving treatment or services provided by that facility when the product is not commercially available upon receipt of an order from an authorized licensed medical practitioner of the facility;
      6. (F) For use by emergency medical services for administration to a patient or patients receiving services from them under authorized medical control when the product is not commercially available upon receipt of an order from a licensed prescriber authorized to provide medical control; or
      7. (G) For use by a licensed veterinarian for administration to their nonhuman patient or patients or for dispensing to nonhuman patients in the course of the practice of veterinary medicine upon receipt of an order from a veterinarian when the product is not commercially available.
    7. (7) “Continuing education” means planned, organized learning experiences and activities beyond the basic educational or preparatory program. These learning experiences and activities are designed to promote the continuous development of skills, attitudes and knowledge necessary to maintain proficiency, provide quality service or products, be responsive to needs and keep abreast of significant change;
    8. (8) “Continuous quality improvement program” means a system of standards and procedures to identify and evaluate quality-related events and to improve patient care;
    9. (9) “Controlled substance” means a drug, substance or immediate precursor identified, defined or listed in title 39, chapter 17, part 4 and title 53, chapter 11;
    10. (10) “Deliver” or “delivery” means the actual, constructive or attempted transfer from one person to another whether or not there is an agency relationship;
    11. (11) “Device” means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent or other similar or related article, including any component part or accessory, that is required under federal or state law to be ordered or prescribed by a person duly authorized;
    12. (12) “Dietary supplement” means a product, other than tobacco, intended to supplement the diet that bears or contains one (1) or more of the following ingredients: a vitamin, mineral, herb or other botanical, amino acid, dietary substance for use by humans to supplement the diet by increasing the total dietary intake, or a concentrate, metabolite, constituent, extract or combination of any of these ingredients and any other products designated as dietary supplements by federal or state law;
    13. (13) “Director” means the director of the health related boards;
    14. (14) “Dispense” means preparing, packaging, compounding or labeling for delivery and actual delivery of a prescription drug, nonprescription drug or device in the course of professional practice to a patient or the patient's agent, to include a licensed health care practitioner or a health care facility providing services or treatment to the patient or patients, by or pursuant to the lawful order of a prescriber;
    15. (15) “Distribute” or “distribution” means the sale, purchase, trade, delivery, handling, storage, or receipt of a product or the arrangement of the sale, purchase, trade, delivery, handling, storage, or receipt of a product through third parties; provided, that “distribute” or “distribution” does not include dispensing or administering a product pursuant to a prescription, medical order, or an over-the-counter order. For the purposes of this part, transfers and sales of drugs or devices from one (1) licensed pharmacy to another shall not constitute distribution of drugs or devices;
    16. (16) “Distributor” means a person engaged in the distribution of drugs or devices; provided, that “distributor” does not include licensed wholesale distributors or licensed third-party logistics providers;
    17. (17) “Division” means the division of health related boards;
    18. (18) “Doctor of pharmacy” means a person duly licensed by the board to engage in the practice of pharmacy. “Doctor of pharmacy” and “pharmacist” shall be used interchangeably within parts 4-6 of this chapter and, any other provision of Tennessee Code Annotated and in any rule or regulation promulgated by the state and its agencies;
    19. (19) “Drug” means any of the following:
      1. (A) Articles recognized as drugs or drug products in any official compendium or supplement thereto;
      2. (B) Articles, other than food, intended to affect the structure or function of the body of humans or other animals;
      3. (C) Articles, including radioactive substances, intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or other animals; or
      4. (D) Articles intended for use as a component of any articles specified in this subdivision (19);
    20. (20) “Executive director” means the executive director of the Tennessee board of pharmacy;
    21. (21) “Label” means any written, printed or graphic matter on the immediate container of a drug or device;
    22. (22) “Labeling” means the process of affixing all labels and other written, printed or graphic matter:
      1. (A) Upon any article or any of its containers or wrappers; or
      2. (B) Accompanying such article;
    23. (23) “Licensure” means the process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety and welfare will be reasonably protected;
    24. (24) “Manufacturer” means any person, except a pharmacist compounding in the normal course of professional practice, engaged in the commercial production, preparation, propagation, conversion or processing of a drug, either directly or indirectly, by extraction from substances of natural origin or independently by means of chemical synthesis, or both, and includes any packaging or repackaging of a drug or the labeling or relabeling of its container and the promotion and marketing of such drugs or devices;
    25. (25) “Medical order” means a lawful order of a prescriber for a specific patient that may or may not include a prescription order, such orders subject to rules and regulations as may be promulgated from time to time by the respective boards that license the persons who are authorized to prescribe drugs;
    26. (26) “Medication therapy management program” means the distinct pharmacist-provided service or group of services that optimize therapeutic outcomes for individual patients. Medication therapy management services are independent of but can occur in conjunction with the provision of a medication product;
    27. (27) “Nonprescription device” means a device that may be sold or dispensed without a prescription order and that is labeled and packaged in compliance with applicable state or federal law;
    28. (28) “Nonprescription drug” means a drug that may be sold or dispensed without a prescription and that is labeled and packaged in compliance with applicable state or federal law;
    29. (29) “Outsourcing facility” means a facility engaged in the compounding of sterile drugs that has elected to register as an outsourcing facility with the U.S. food and drug administration and that complies with all relevant federal laws and regulations;
    30. (30) “Patient education” means the communication of information to the patient or caregiver by the pharmacist;
    31. (31) “Patient profile” means a written or electronic record of individual patient information, created in a pharmacy practice, for use by a pharmacist in the provision of pharmacy patient care services, including drug use review and patient counseling requirements. The profile may include, but is not limited to, demographic information, medical history, medication and devices utilized, testing results and pharmacist comments;
    32. (32) “Peer review committee” or “pharmacist review committee” means any committee, board, commission or other entity of any national, state or local professional association or society, including an impaired pharmacist peer review committee, a drug utilization review committee or a committee of any pharmacy benefits management organization, health care provider network, licensed health care institution or any health care organization, system or foundation, the function of which, or one of the functions of which, is to review, evaluate and improve the quality of pharmacy-related services provided by pharmacists or pharmacy auxiliary personnel, to provide intervention, support or rehabilitative referrals or services or to determine that pharmacy-related services rendered by pharmacists or pharmacy auxiliary personnel were professionally indicated or were performed in compliance with applicable quality standards, or that the cost of pharmacy-related services rendered by pharmacists or pharmacy auxiliary personnel was reasonable;
    33. (33) “Person” means any individual, partnership, association, corporation and the state, its departments, agencies and employees, and the political subdivisions of Tennessee and their departments, agencies and employees, except the department of health and local health departments;
    34. (34) “Pharmacist” means an individual health care provider licensed by the state, pursuant to parts 4-6 of this chapter, to practice the profession of pharmacy;
    35. (35) “Pharmacist-in-charge” means the supervisory pharmacist who has the authority and responsibility for compliance with laws and rules pertaining to the practice of pharmacy at the practice site of the pharmacist-in-charge;
    36. (36) “Pharmacy” means a location licensed by this state where drugs are compounded or dispensed under the supervision of a pharmacist, as defined in the rules of the board and where prescription orders are received or processed;
    37. (37) “Pharmacy intern” means an individual enrolled in or a graduate of a recognized school or college of pharmacy under rules established by the board who is serving a period of time of practical experience under the supervision of a pharmacist, as defined in the rules of the board;
    38. (38) “Pharmacy technician” means an individual who is specifically trained and designated to assist a pharmacist and may perform tasks delegated by the pharmacist, including participation in drug, dietary supplement and device selection, storage, and distribution and administration, consistent with the pharmacy technician's education, training, and experience, as defined by rules promulgated by the board;
    39. (39)
      1. (A) “Practice of pharmacy” means a patient-oriented health service profession in which pharmacists interact and consult with patients and other health care professionals to enhance patients' wellness, prevent illness, and optimize outcomes. The practice involves:
        1. (i) Interpretation, evaluation and implementation of medical orders and prescription orders;
        2. (ii) Responsibility for compounding and dispensing prescription orders, including radioactive substances;
        3. (iii) Participation in drug, dietary supplement and device selection, storage, distribution and administration;
        4. (iv) Drug evaluation, utilization or regimen review;
        5. (v) Maintenance of patient profiles and other pharmacy records;
        6. (vi) Provision of patient education and counseling;
        7. (vii) Provision of patient care services and activities pursuant to a collaborative pharmacy practice agreement;
        8. (viii) Drug or drug-related research; and
        9. (ix) Those professional acts, professional decisions or professional services necessary to maintain all areas of a patient's pharmacist-provided care;
      2. (B) Nothing in this chapter authorizes a pharmacist to order laboratory tests or prescribe any prescription drugs except pursuant to a medical order by the attending prescriber for each patient or pursuant to a collaborative pharmacy practice agreement jointly agreed upon by a pharmacist or pharmacists and a prescriber or prescribers; provided, that pharmacists are authorized to conduct and assist patients with tests approved for home use. Pharmacists may convey orders for laboratory tests when authorized by the attending prescriber and may prescribe prescription drugs when required to carry out a medical order or perform activities pursuant to a collaborative pharmacy practice agreement when authorized by the attending prescriber;
    40. (40) “Prescriber” means an individual authorized by law to prescribe drugs;
    41. (41) “Prescription drug” means a drug that under federal or state law is required to be dispensed only pursuant to a prescription order or is restricted to use by prescribers and that under federal law must be labeled with either the symbol “Rx only” or the statement “Caution: Federal law restricts this drug to use by, or on the order of, a licensed veterinarian”;
    42. (42)
      1. (A)
        1. (i) “Prescription order” means and includes any order, communicated through written, verbal, or electronic means by a physician, certified physician assistant, pharmacist in accordance with a collaborative pharmacy practice agreement pursuant to this section, dentist, veterinarian, optometrist authorized pursuant to § 63-8-102(12), or other allied medical practitioner, for any drug, device, or treatment;
        2. (ii) “Prescription order” means and includes any order, communicated through written, verbal, or electronic means by a nurse authorized pursuant to § 63-6-204, who is prescribing in collaboration with and under the control and responsibility of a licensed physician, and who meets the requirements pursuant to § 63-7-207(14);
      2. (B) Nothing in this chapter shall prohibit the verbal communication to a pharmacist of a direct order for a prescription from a physician, registered nurse, licensed practical nurse or physician assistant pursuant to § 63-6-204, or dentist, veterinarian, optometrist authorized pursuant to § 63-8-102(12), or other allied medical practitioner by a pharmacist pursuant to § 63-9-113 nor shall this chapter prohibit verbal communication of a direct order for a prescription from one (1) pharmacist to another when ordered pursuant to a collaborative pharmacy practice agreement;
      3. (C) Nothing in this chapter shall require an advanced practice registered nurse specializing as a certified registered nurse anesthetist (CRNA) to obtain authorization to prescribe pursuant to § 63-7-123 in order to select, order, or administer appropriate drugs during services ordered by a physician, dentist, or podiatrist and provided by a CRNA in collaboration with the ordering physician, dentist, or podiatrist that are within the scope of practice of the CRNA and authorized by clinical privileges granted by the medical staff of the facility. Such an order by a CRNA for drugs shall only be valid for dispensing for administration at the facility where the anesthesia services are being provided;
    43. (43) “Provider” or “necessary health care provider” includes a pharmacist who provides health care services within the scope of pharmacy practice;
    44. (44) “Quality assurance program” means a system for identifying problems in patient care that are resolved via administrative, clinical or educational actions to ensure that final products and outcomes meet applicable specifications;
    45. (45) “Quality-related event” means the inappropriate dispensing or administration of a prescribed medication, including, but not limited to:
      1. (A) A variation from the prescriber's medical or prescription order, including, but not limited to:
        1. (i) Dispensing an incorrect drug;
        2. (ii) Dispensing an incorrect drug strength;
        3. (iii) Dispensing an incorrect dosage form;
        4. (iv) Dispensing the drug to the wrong patient; and
        5. (v) Providing inadequate or incorrect packaging, labeling or directions for use; and
      2. (B) Failure to identify, prevent, resolve and manage potential and actual drug and drug-related problems, including, but not limited to:
        1. (i) Over-utilization and under-utilization;
        2. (ii) Therapeutic duplication;
        3. (iii) Drug-age contraindications;
        4. (iv) Drug-allergy contraindications;
        5. (v) Drug-disease contraindications;
        6. (vi) Drug-gender contraindications;
        7. (vii) Drug-drug interactions;
        8. (viii) Incorrect drug dosage;
        9. (ix) Incorrect duration of drug therapy; and
        10. (x) Clinical abuse or misuse;
    46. (46) “Third-party logistics provider” means a person who provides or coordinates warehousing or other logistics services of a drug or device on behalf of a manufacturer, wholesale distributor, or dispenser of the drug or device, but does not take ownership of the drug or device, nor has responsibility to direct the sale or disposition of the drug or device;
    47. (47) “Unprofessional conduct” means the conduct of a pharmacist, pharmacy intern or pharmacy technician that is detrimental to patients or to the profession of pharmacy;
    48. (48) “Wholesale distribution” means the distribution of a drug or device to persons other than the patient or consumer, or the receipt of a drug or device by persons other than the patient or consumer; provided, that “wholesale distribution” does not include the distribution or receipt of products, transactions, or services that are exempted from this definition by rule. For the purposes of this part, transfers and sales of drugs or devices from one licensed pharmacy to another shall not constitute wholesale distribution of drugs or devices; and
    49. (49) “Wholesaler” or “wholesale distributor” means a person primarily engaged in the wholesale distribution of drugs or devices; provided, that “wholesaler” or “wholesale distributor” does not include licensed third-party logistics providers. For the purposes of this part, transfers and sales of drugs or devices from one licensed pharmacy to another shall not constitute wholesale distribution of drugs or devices.
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§ 63-10-205. Consultation on drugs by board to department of health.
  1. (a) The board shall, at the request of the commissioner of health, provide consultation to the department of health regarding drugs to be issued by the department or by a local health clinic.
  2. (b) The department of health shall develop policies and protocols for inventory controls, accountability, repackaging, security, storage and issuance of drugs by state and local health departments. The commissioner shall appoint a state or regional pharmacist to oversee these activities.
  3. (c) The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this section.
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§ 63-10-206. Sale of nonprescription drugs and devices.
  1. (a) Any nonprescription drug or device can be sold in its original single package by any retail business unless such nonprescription drug or device is required by federal or state law to be dispensed or sold only by or under the supervision of a pharmacist.
  2. (b) Notwithstanding subsection (a) to the contrary, any insulin preparation shall be dispensed only by or under the supervision of a pharmacist. All insulin preparations must be properly stored in an area not accessible to the general public.
  3. (c) In order to comply with federal and state law requiring pharmacies to maintain patient profiles with a comprehensive list of medications and devices, pharmacists are authorized to execute prescription orders for nonprescription drugs and devices.
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  4. (d) Nothing in this section shall be construed as exempting nonprescription drugs and devices dispensed on a prescription order executed by a pharmacist from application of the sales and use tax provisions of title 67, chapter 6.
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§ 63-10-207. Dispensing of medication prior to authorization.
  1. (a) Notwithstanding any provision of law to the contrary, a pharmacist may, in good faith, dispense to a patient without proper authorization the number of dosages of a prescription drug necessary to allow such patient to secure such authorization from such patient's prescriber, not to exceed a seventy-two-hour supply, if:
    1. (1) The patient offers satisfactory evidence to the pharmacist that the prescriber has placed the patient on a maintenance medication and that such patient is without valid refills or for some valid reason cannot obtain proper authorization; and
    2. (2) In the judgment of the pharmacist, the health, safety and welfare of the patient would otherwise be endangered.
  2. (b) This section shall not be construed to authorize dispensing of controlled substance medication without proper authorization.
  3. (c) If proper authorization cannot be obtained during the seventy-two-hour period, then the pharmacist may dispense the number of dosages necessary for one (1) additional consecutive seventy-two-hour period in accordance with the requirements of this section.
  4. (d)
    1. (1) For the purpose of this subsection (d) only, “patient” means a patient from this state, or another state or territory, who was displaced by a disaster, as defined in § 58-2-101, when the patient is present in this state.
    2. (2) A pharmacist in this state may, in good faith, dispense to a patient without proper authorization or a valid prescription the number of dosages of a prescription drug necessary to allow the patient to secure proper authorization or a valid prescription from the patient's prescriber.
    3. (3) The amount of a prescription drug dispensed under this subsection (d) shall not exceed a twenty-day supply.
    4. (4) Prescription information may be obtained from a prescription label, verbal medical order, verbal prescription order, or any other means determined to be legitimate in the professional judgment of the pharmacist.
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§ 63-10-208. Penalty for violation.
  1. Any violation of parts 2-5 of this chapter, unless otherwise specified by law, shall be classified as a Class C misdemeanor.
§ 63-10-209. Distribution of drugs or drug samples by manufacturer's representative — Distribution of free samples.
  1. (a) Nothing in this chapter shall prohibit the distribution of drugs or sample drugs by a manufacturer's representatives acting in the normal and customary performance of their duties.
  2. (b) Manufacturers or their agents may distribute free samples of prescription drugs or controlled substances to practitioners authorized by law to prescribe or dispense such drugs or to pharmacies of health care entities at the written request of a practitioner in accordance with federal law.
§ 63-10-210. Registration fees for out-of-state pharmacies mailing into Tennessee.
  1. A pharmacy that dispenses and mails a prescription into Tennessee from another state shall first pay the licensure fee required of a Tennessee pharmacy in accordance with the fees established by the board under the authority of [former] § 63-10-308 [now § 63-10-312]. The license fees for out-of-state pharmacies and pharmacists shall not exceed those charged to Tennessee pharmacies and pharmacists.
§ 63-10-211. Consortia for bulk purchases authorized.
  1. It is not a violation of any state law relative to restraint of trade, antitrust or any provision of the licensing laws for pharmacists, pharmacies, wholesalers, distributors or manufacturers under § 63-10-306 for pharmacists, independently or through any pharmacist or pharmacy, to form a consortium for the purpose of making bulk purchases of drugs or other medical equipment and supplies for the purpose of resale in their pharmacies.
§ 63-10-212. Confidentiality of information entrusted to pharmacist.
  1. (a) Notwithstanding any requirement of state law to the contrary, a pharmacist is immune from liability to any person for disclosing patient information to a person authorized by this title to prescribe drugs or devices or to communicate a prescription order where necessary to:
    1. (1) Fulfill the pharmacist's responsibility to carry out prospective drug use review under state law and 42 CFR Part 456 for the purpose of identifying and resolving actual or potential drug-related problems, including, for example, therapeutic duplication, drug-drug interactions, incorrect drug dosage, drug-disease contraindication, duration of drug treatment, or over-utilization or under-utilization and any other drug therapy problems outlined in 42 CFR § 456.705;
    2. (2) Assist prescribers in obtaining a comprehensive drug history on a patient;
    3. (3) Prevent abuse or misuse of any drug or device and the diversion of controlled substances; or
    4. (4) Provide a medication therapy management program or a quality assurance program.
  2. (b) Disclosure of information pursuant to this section shall not constitute a waiver of any confidentiality or privilege that may be provided by law.
  3. (c) This section shall apply only to confidentiality or privilege and shall not apply to actions arising in negligence.
§ 63-10-213. Legibility of prescriptions.
  1. (a) No pharmacist may dispense medication pursuant to a handwritten, typed or computer-generated prescription order for a drug issued by a prescriber in this state, unless the prescription order is comprehensible to the pharmacist. Nothing in this section shall be construed to prohibit a pharmacist from dispensing medication pursuant to a verbal prescription order.
  2. (b) If a prescriber issues a prescription order, then it is the duty of the prescriber to issue a legible order. A pharmacist shall make a reasonable attempt to contact the prescriber to seek clarification of a prescription order that is not comprehensible to the pharmacist, in which case the pharmacist must not dispense medication until the pharmacist obtains clarification. A pharmacist shall not be liable to any person for any reasonable delay caused when a pharmacist has reasonably sought clarification of a prescription order.
  3. (c) Nothing in this section shall be construed to prevent a pharmacist from dispensing medication prior to authorization in accordance with § 63-10-207.
§ 63-10-214. Centralized prescription processing — Licensing — Rules.
  1. (a) Each pharmacy participating in centralized prescription processing shall be licensed by the board of pharmacy.
  2. (b) The board shall promulgate rules relative to centralized prescription processing, including, but not limited to, the usage of common electronic files or a common database.
§ 63-10-215. Transfer of prescriptions to another prescription form.
  1. (a) Pharmacists, pharmacy interns and pharmacy technicians are authorized to comply with federal and state prescription requirements, including the requirement of a separate prescription for a Schedule II controlled substance found in §§ 63-1-160, 63-7-123(b)(3)(B), and 63-19-107(2)(E)(ii), by transferring from a prescription containing a Schedule II controlled substance any drug that is a nonscheduled prescription drug or any prescribed supply to another prescription form.
  2. (b) The transfer authorized in subsection (a) may be accomplished by scanning, photocopying or transcribing, by hand or other means, and shall include all information regarding each drug or supply being transferred.
  3. (c) The prescription generated in a pharmacy by the transfer process shall not be required to be on tamper-resistant prescription paper.
  4. (d) The prescription generated in a pharmacy utilizing the transfer process shall be recognized as a valid, legal prescription order and shall serve as the original prescription for recordkeeping and other purposes.
§ 63-10-216. Compounding pharmacies.
  1. (a)
    1. (1) Prior to initial licensure in this state as a compounding pharmacy, a pharmacy located outside of this state must have an inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located. Out-of-state pharmacy practice sites must provide to the board a copy of the most recent inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located, or an equivalent inspection accepted by the board, that must have been within the previous twelve (12) months.
    2. (2) Prior to renewal of its license in this state, an out-of-state pharmacy practice site must provide to the board the most recent inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located, or an equivalent inspection accepted by the board, that must have been within the previous twelve (12) months.
    3. (3) The board may require additional information before issuing or renewing a pharmacy license to ensure compliance with applicable laws of this state and rules of the board.
  2. (b) A compounding pharmacy that has an active license issued by the board shall notify the board within fourteen (14) business days of receipt of an order or decision by a regulatory or licensing agency, other than the board, imposing a disciplinary action, including a warning, on the pharmacy.
  3. (c) A pharmacy engaged in compounding must comply with relevant United States Pharmacopeia (USP) guidelines as adopted by the board by rule.
  4. (d) A pharmacy that engages in sterile compounding, except hospital pharmacies compounding for inpatients of a hospital, shall, upon request, make available to the board the quantity of sterile compounded products dispensed in a defined time period in accordance with rules promulgated by the board. However, the executive director of the board may request this information from a hospital pharmacy for cause and the hospital pharmacy shall respond in a timely manner as defined by the executive director of the board.
§ 63-10-217. Collaborative pharmacy practice agreements.
  1. (a) A collaborative pharmacy practice agreement under this chapter shall be between one (1) or more pharmacists licensed in this state and an individual prescriber licensed in this state, or one (1) or more prescribers licensed in this state in an organized medical group, including but not limited to, staff of a licensed health care facility, clinic, group medical practice, accountable care organization, or patient-centered medical home. When a collaborative practice pharmacy agreement is being established between a pharmacist or pharmacists and an organized medical group or one (1) or more members employed or contracted by an organized medical group, the chief medical officer, medical director, or a designated physician in that group shall be required to approve the collaborative pharmacy practice agreement in order to permit provision of patient care services, as defined in the collaborative pharmacy practice agreement.
  2. (b) The collaborative pharmacy practice agreement shall define the nature and scope of patient care services to be provided by the pharmacist. The prescriber or prescribers entering into the agreement retain the ultimate authority regarding the scope of services provided by pharmacists in accordance with a collaborative pharmacy practice agreement. The patient care services authorized to be provided by one (1) or more pharmacists in accordance with a collaborative pharmacy practice agreement shall be within the scope of practice of the authorizing prescriber or prescribers. Any patient care services provided by a pharmacist or pharmacists pursuant to a collaborative pharmacy practice agreement shall be documented in a patient record accessible by the pharmacist and the prescriber or communicated to the prescriber or prescribers within three (3) business days in accordance with the collaborative pharmacy practice agreement.
  3. (c) An individual prescriber licensed in this state or one (1) or more prescribers licensed in this state in an organized medical group, as described in the definition of collaborative pharmacy practice agreement in § 63-10-204, may employ pharmacists for the purpose of providing patient care services pursuant to a collaborative pharmacy practice agreement, as defined in § 63-10-204, for the benefit of a patient or patients of that prescriber or prescribers in that organized medical group. No retail pharmacy may employ a prescriber for the purpose of maintaining, establishing or entering into a collaborative practice agreement with a patient. Nothing shall prohibit a pharmacy or pharmacist or group of pharmacists from employing or entering into a professional contract with a physician or licensed medical practitioner for the purpose of conducting quality assurance reviews of its pharmacists that are engaged in the practice of collaborative drug therapy.
  4. (d)
    1. (1) If the collaborative practice agreement includes one (1) or more prescribers who are advanced practice registered nurses (APRNs), the collaborating physician who has primary responsibility for collaborating with the APRN, must also approve and sign the collaborative pharmacy practice agreement. The collaborating physician may only approve a collaborative pharmacy practice agreement of an APRN if the services authorized in the agreement are included in the routine services delivered by the collaborating physician in the physician's medical practice. An authorizing prescriber entering into collaborative pharmacy practice agreements shall be available for consultation with the pharmacist or pharmacists as needed.
    2. (2) If the collaborative practice agreement includes one (1) or more prescribers who are physician assistants (PAs), the supervising physician who has primary responsibility for supervising the PA, must also approve and sign the collaborative pharmacy practice agreement. The supervising physician may only approve a collaborative pharmacy practice agreement of a PA if the services authorized in the agreement are included in the routine services delivered by the supervising physician in the physician's medical practice. An authorizing prescriber entering into collaborative pharmacy practice agreements shall be available for consultation with the pharmacist or pharmacists as needed.
  5. (e) Pharmacists and authorizing prescribers entering into collaborative pharmacy practice agreements shall maintain a copy of the written collaborative pharmacy practice agreement on file at their places of practice.
  6. (f) Collaborative pharmacy practice agreements shall be reviewed and renewed biennially, at a minimum.
  7. (g) The board of pharmacy, in collaboration with the board of medical examiners and board of osteopathic examination, shall promulgate rules establishing appropriate minimum standards applicable for provisions to be contained in any collaborative practice agreement, including, but not limited to, provisions regarding drugs or drug categories such as controlled substances covered under the collaborative pharmacy practice agreement. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
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§ 63-10-218. Professional judgment in dispensing of varying quantities of medication not to exceed ninety-day supply — Exclusion of controlled substances.
  1. (a) Unless the prescriber has specified on the prescription that dispensing a prescription for a maintenance medication in an initial amount followed by periodic refills is medically necessary, a pharmacist may exercise professional judgment to dispense varying quantities of medication per fill up to the total number of dosage units as authorized by the prescriber on the original prescription including any refills, so long as the units dispensed do not exceed a ninety-day supply.
  2. (b) This section does not apply to controlled substances or to any medications for which a report to the controlled substance database is required pursuant to § 53-10-305.
§ 63-10-219. Provision of hormonal contraceptives.
  1. (a) As used in this section, “hormonal contraceptive” means a self-administered drug, or a transdermal patch applied to the skin of a patient, by the patient or by a practitioner, that releases a drug composed of a combination of hormones that are approved by the United States food and drug administration to prevent pregnancy.
  2. (b) Pursuant to this section, a pharmacist, in good faith, is authorized to provide hormonal contraceptives according to a valid collaborative pharmacy practice agreement containing a nonpatient-specific prescriptive order and standardized procedures developed and executed by one (1) or more authorized prescribers.
  3. (c) Pursuant to this section, a pharmacist may provide hormonal contraceptives to individuals who are:
    1. (1) Eighteen (18) years of age or older; or
    2. (2) Under eighteen (18) years of age, if the individual is an emancipated minor as defined in § 39-11-106.
  4. (d) The board of pharmacy, in collaboration with the board of medical examiners and the board of osteopathic examination, shall adopt rules to establish standard procedures for the provision of hormonal contraceptives by pharmacists. The standardized procedures adopted pursuant to this section shall require a pharmacist to:
    1. (1) Complete a training program approved by the department of health related to the provision of hormonal contraceptives;
    2. (2) Provide the patient with a self-screening risk assessment tool developed or approved by the department of health;
    3. (3) Provide the patient with documentation about the hormonal contraceptive that was provided to the patient and advise the patient to consult with a primary care practitioner or women's healthcare practitioner;
    4. (4) Provide the patient with a standardized factsheet that includes, but is not limited to, the indications and contraindications for use of the drug, the appropriate method for using the drug, the importance of medical follow-up, and other appropriate information;
    5. (5) Provide the patient with the contact information of a primary care practitioner or women's healthcare practitioner within a reasonable period of time after provision of the hormonal contraceptive; and
    6. (6) Either dispense the hormonal contraceptive, or refer the patient to a pharmacy that may dispense the hormonal contraceptive, as soon as practicable after the pharmacist determines that the patient should receive the medication.
  5. (e) The rules promulgated under this section shall prohibit a pharmacist from requiring a patient to schedule an appointment with the pharmacist for the provision or dispensing of a hormonal contraceptive.
  6. (f)
    1. (1) A pharmacist, pharmacist's employer, or pharmacist's agent may charge an annual administrative fee for services provided pursuant to this section in addition to any costs associated with the dispensing of the drug and paid by the pharmacy benefit.
    2. (2) Upon an oral, telephonic, electronic, or written request from a patient or customer, a pharmacist or pharmacist's employee shall disclose the total cost that a consumer would pay for pharmacist-provided hormonal contraceptives. As used in this subdivision (f)(2), “total cost” includes providing the consumer with specific information regarding the price of the hormonal contraceptive and the price of the administrative fee charged. This limitation is not intended to interfere with other contractually agreed-upon terms between a pharmacist, a pharmacist's employer, or a pharmacist's agent, and a health insurance plan or insurer. Patients who are insured or covered and receive a pharmacy benefit that covers the cost of hormonal contraceptives shall not be required to pay an administrative fee. These patients shall be required to pay co-payments pursuant to the terms and conditions of their coverage.
  7. (g) All state and federal laws governing insurance coverage of contraceptive drugs, devices, products, and services shall apply to hormonal contraceptives provided by a pharmacist under this section.
  8. (h) The board of pharmacy, board of medical examiners, and board of osteopathic examination are authorized to ensure compliance with this section, and each board is specifically charged with the enforcement of this section with respect to its respective licensees.
  9. (i) Any pharmacist or prescriber acting in good faith and with reasonable care involved in the provision of hormonal contraceptives pursuant to this section shall be immune from disciplinary or adverse administrative actions under this title for acts or omissions during the provision of a hormonal contraceptive.
  10. (j) Any pharmacist or prescriber involved in the provision of hormonal contraceptives pursuant to this section shall be immune from civil liability in the absence of gross negligence or willful misconduct for actions authorized by this section.
  11. (k) This section shall not apply to a valid patient-specific prescription for a hormonal contraceptive issued by an authorized prescriber and dispensed by a pharmacist pursuant to that valid prescription.
§ 63-10-220. Facilities engaging in distribution of dialysate and devices for home use.
    1. (a) This chapter does not apply to a facility to the extent the facility engages in the distribution of dialysate or devices necessary to perform home peritoneal kidney dialysis to patients with end stage renal disease if:
      1. (1) The dialysate are comprised of dextrose or icodextrin, and the dialysate and devices are approved or cleared by the federal food and drug administration, as required by federal law;
      2. (2) The dialysate and devices are lawfully held by a manufacturer or manufacturer's agent that is properly registered with the board as a manufacturer or third-party logistics provider;
      3. (3) The dialysate and devices are held and delivered in their original, sealed packaging from the facility;
      4. (4) The dialysate and devices are delivered only by the manufacturer or the manufacturer's agent and only upon receipt and review of a physician's prescription by a pharmacist licensed in this state before dispensing; and
      5. (5) The manufacturer or manufacturer's agent delivers the dialysate and devices directly to:
        1. (A) Patients with end stage renal disease or such patient's designee for the patient's self-administration of the dialysis therapy; or
        2. (B) Healthcare providers or institutions for administration or delivery of the dialysis therapy to a patient with end stage renal disease.
    2. (b) Records of all sales and distribution of dialysate and devices made pursuant to this section must be retained and made readily available for inspection and copying by the board of pharmacy for two (2) years from the date of distribution.
    3. (c) The board of pharmacy retains oversight of all drugs for peritoneal dialysis except dialysate.
§ 63-10-221. Medication therapy management — Standards.
  1. Medication therapy management provided under this chapter as part of the practice of pharmacy shall meet the standards for medication therapy management established by rule by the board of pharmacy.
§ 63-10-222. Medication therapy management pilot program — Reporting of costs and patient outcomes.
  1. The bureau of TennCare is directed to report to the senate health and welfare committee and the health committee of the house of representatives regarding program costs and patient outcomes related to incorporating the pharmacist-provided medication therapy management pilot program on or before April 15 of each year the pilot program is supported.
§ 63-10-223. Agreement limiting ability of pharmacist to discuss issue related to dispensing of controlled substance with patient void and unenforceable.
    1. (a) The general assembly finds that patient access to information about controlled substances is crucial to combating the deadly opioid epidemic in this state and that any obstacle to patients' receiving information about controlled substances is a serious threat to public health.
    2. (b) Any agreement purporting to limit the ability of a pharmacist to discuss any issue related to the dispensing of a controlled substance with a patient is contrary to the public policy of this state and is void and unenforceable. This includes, but is not limited to, information about the risks, effects, and characteristics of the controlled substance; what to expect when taking the controlled substance and how the controlled substance should be used; reasonable alternatives to the prescribed controlled substance; and any applicable cost sharing for a controlled substance or any amount an individual would pay for a controlled substance if that individual were paying cash.
§ 63-10-224. Provision of ivermectin by pharmacists.
  1. (a) A pharmacist, in good faith, may provide ivermectin to a patient who is eighteen (18) years of age or older pursuant to a valid collaborative pharmacy practice agreement containing a non-patient-specific prescriptive order and standardized procedures developed and executed by one (1) or more authorized prescribers.
  2. (b) The pharmacist shall maintain the collaborative pharmacy practice agreement in accordance with § 63-10-217.
  3. (c) The board of pharmacy shall adopt rules to establish standard procedures for the provision of ivermectin by pharmacists, including:
    1. (1) Providing the patient with a screening risk assessment tool;
    2. (2) Providing the patient with a standardized factsheet that includes, but is not limited to, the indications and contraindications for use of ivermectin, the appropriate method for using ivermectin, the importance of medical follow-up, and other information deemed appropriate by the board; and
    3. (3) Either dispensing the ivermectin or referring the patient to a pharmacy that may dispense the medication as soon as practical.
  4. (d) A pharmacist, pharmacist's employer, or pharmacist's agent may charge an administrative fee for services provided pursuant to this section in addition to costs associated with the dispensing of ivermectin and paid by the pharmacy benefit.
  5. (e) A pharmacist or prescriber acting in good faith and with reasonable care involved in the provision of ivermectin pursuant to this section is immune from disciplinary or adverse administrative actions under this title for acts or omissions during the provision of ivermectin.
  6. (f) A pharmacist or prescriber involved in the provision of ivermectin pursuant to this section is immune from civil liability in the absence of gross negligence or willful misconduct for actions authorized by this section.
Part 3 Board of Pharmacy
§ 63-10-301. Designation.
  1. (a) There is created a board of pharmacy, referred to herein as the “board,” to be administratively attached to and receive administrative support from the division of health related boards within the department of health.
  2. (b) The responsibility for enforcement of the provisions of parts 2-7 of this chapter and all laws that pertain to the practice of pharmacy is vested in the board.
  3. (c) The board has all of the duties, powers, responsibilities, and authority necessary for the enforcement of parts 2-7 of this chapter, as well as other duties, powers, and authority as it may be granted.
  4. (d) The board shall cooperate with state and federal agencies regarding any violations of a pharmacy drug or drug-related law.
  5. (e) If a state of emergency is declared that involves the board under this part, then the board may waive the requirements of this chapter to protect the public health, safety, or welfare of its citizens and to facilitate the provision of drugs, devices, and pharmacist care services to the public.
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§ 63-10-302. Membership.
  1. (a) The board consists of nine (9) members to be appointed by the governor as follows:
    1. (1) One (1) consumer member;
    2. (2) One (1) registered pharmacy technician; and
    3. (3) Seven (7) pharmacists who possess the qualifications specified in § 63-10-303.
  2. (b) The six (6) pharmacist members serving on the board on June 30, 2023, shall serve as members on July 1, 2023, through to the end of the members' existing six-year terms; provided, that the members are qualified to serve pursuant to § 63-10-303 if reappointed to the board after July 1, 2023.
§ 63-10-303. Qualifications.
  1. (a) Each pharmacist member of the board appointed on or after July 1, 2023, must, at the time of their appointment:
    1. (1) Have been a resident of this state for no less than five (5) years;
    2. (2) Must be a graduate of a recognized school or college of pharmacy;
    3. (3) Be licensed and in good standing to engage in the practice of pharmacy in this state;
    4. (4) Be actively engaged in the practice of pharmacy, as defined in § 63-10-204, in this state; and
    5. (5) Have at least five (5) consecutive years of experience in the practice of pharmacy providing patient care services after licensure.
  2. (b) Each registered pharmacy technician member of the board must, at the time of their appointment:
    1. (1) Have been a resident of this state for not less than five (5) years;
    2. (2) Be currently licensed and in good standing as a registered pharmacy technician in this state;
    3. (3) Be actively practicing as a registered pharmacy technician in this state;
    4. (4) Be a certified pharmacy technician as defined by board rules; and
    5. (5) Have at least five (5) consecutive years of experience as a pharmacy technician after registration.
  3. (c)
    1. (1) Each consumer member of the board must, at the time of their appointment:
      1. (A) Be a current resident of this state for at least five (5) years; and
      2. (B) Not be a licensed healthcare professional.
    2. (2) The consumer member must not own or have a financial or other interest in any healthcare facility or healthcare business during the consumer's term on the board.
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§ 63-10-304. Appointment.
  1. (a) Interested pharmacist groups, including, but not limited to, the Tennessee Pharmacists Association, may annually recommend five (5) duly qualified persons for each vacancy from whom the governor may be requested to make appointments. The governor shall consult with such groups to determine qualified persons to fill the positions. This subsection (a) does not apply to the consumer member serving on the board.
  2. (b) A member appointed to the board shall take an oath or affirmation that the member will faithfully and impartially perform their duties within ten (10) days after the member's appointment to the board. A member's oath or affirmation taken pursuant to this subsection (b) must be filed with the secretary of state.
  3. (c) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older, one (1) person serving on the board is a member of a racial minority, and the members on the board are representative of a variety of practice settings.
§ 63-10-305. Terms of office and removal.
  1. (a) Board members shall serve seven-year terms or until their successors have been qualified. A member of the board is not eligible for reappointment; provided, however, that a member may be reappointed for one (1) full term if the member is appointed to fill a vacancy for which occurred prior to the expiration of a former member's term.
  2. (b) The terms of the members of the board are staggered so that the terms of no more than three (3) members expire in one (1) year.
  3. (c) A member of the board who is found to have committed misconduct may be removed by the governor upon the recommendation of the remaining members. As used in this subsection (c), “misconduct” means:
    1. (1) The refusal or inability of a board member to perform their duties as a member of the board due to inefficiency, irresponsibility, and unprofessional manner;
    2. (2) The misuse of office by a member of the board to obtain personal, pecuniary, or material gain or advantage for their self or another through the office; or
    3. (3) The violation of a law pertaining to the practice of pharmacy or the distribution of drugs and devices.
§ 63-10-306. Organization.
  1. (a) The pharmacist members of the board shall annually appoint a president and a vice president.
  2. (b) The president of the board, and the vice president in the president's absence, shall preside at all meetings of the board and is responsible for the performance of all duties and functions of the board under this part.
  3. (c) The board president may, if deemed necessary, split the board into panels of three (3) or more to conduct contested case hearings regarding disciplinary matters. A quorum of at least three (3) panel members is required at such hearings.
  4. (d) The board shall meet at least annually and at such other times as it deems necessary to perform its duties under this chapter. A majority of the members of the board constitutes a quorum for the conduct of board meetings and, except where a different number is required by this part or by any board rule, all actions of the board must be by a majority of a quorum.
  5. (e) The members of the board receive a per diem of one hundred dollars ($100) for each day the member is engaged in performance of the official duties of the board, and must be reimbursed for all reasonable and necessary expenses incurred in connection with the discharge of such official duties. All reimbursement for travel expenses are in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
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§ 63-10-307. Executive director.
  1. (a) The board shall consult with the division of health related boards in the department of health in appointing a person to serve as executive director of the board; however, the board is not bound by any recommendation of the division. The executive director must be licensed as a pharmacist in this state for at least five (5) consecutive years immediately preceding the appointment.
  2. (b) The board shall specify the executive director's duties, and the executive director is responsible for the performance of the administrative functions of the board, which may include, but are not limited to:
    1. (1) Recording and compiling the minutes of the board;
    2. (2) Supervising employees assigned by the division of health related boards to support the board;
    3. (3) Performing studies and research as the board or division directs;
    4. (4) Representing the board at functions as authorized by the board and the division; and
    5. (5) Serving as a consultant to the division in its enforcement duties on behalf of the board.
  3. (c) The board may dismiss the executive director without consulting with the division.
§ 63-10-308. Enforcement of pharmaceutical laws — Promulgation of rules.
  1. (a) The board shall enforce laws in this state relating to the practice of pharmacy; the manufacture, distribution, and sale of drugs; the medication use process, including, but not limited to, compounding, selection, preparation, production, dispensing, and distribution; patient administration; and the education and monitoring of drugs, devices, chemicals, and poisons.
  2. (b) The division of health related boards shall employ the necessary administrative and clerical staff and investigators who are pharmacists to carry out the board's duty to enforce pharmaceutical laws. The pharmacist investigators may conduct inspections of pharmacies and other sites where drugs, medicines, chemicals, pharmaceuticals, or poisons are manufactured, stored, sold, dispensed, distributed, or administered and shall conduct investigations of a board licensee. The pharmacist investigators may also assist in inspections and investigations undertaken by other health related boards attached to the division, and investigators assigned to these other health related boards may assist pharmacist investigators as appropriate.
  3. (c) The board shall promulgate rules:
    1. (1) To establish minimum standards and conditions for the operation of a pharmacy;
    2. (2) Regarding the practice of pharmacy in this state to protect the health and welfare of the citizens of this state;
    3. (3) Regarding professional conduct appropriate to the establishment and maintenance of a high standard of integrity and dignity in the profession of pharmacy;
    4. (4) To set minimum standards and conditions for receiving, preparing, maintaining, transferring, and dispensing of prescription orders; and
    5. (5) To ensure that persons who are blind, visually impaired, or otherwise print disabled have appropriate access to prescription labels, bag tags, and medical guides.
  4. (d)
    1. (1) The board shall:
      1. (A) Keep a record of the board's meetings and other proceedings;
      2. (B) Issue and maintain a register of all persons who have been issued licenses and who have had their licenses renewed; and
      3. (C) Maintain a register of pharmacists who have been designated as a pharmacist-in-charge.
    2. (2) The board may maintain a register of pharmacy technicians as necessary to maintain public welfare.
  5. (e)
    1. (1) The board may petition a circuit or chancery court having jurisdiction over persons who practice pharmacy in this state without a valid license or who have violated the provisions of parts 2-7 of this chapter or rules promulgated by the board to enjoin a person from continuing to practice in this state.
    2. (2) The executive director may issue subpoenas for witnesses and records and to administer oaths to witnesses.
  6. (f)
    1. (1) Board members may join professional organizations and associations organized to promote the improvement of the standards of the practice of pharmacy for the protection of the health and welfare of the public.
    2. (2) The board may authorize, subject to the approval of the commissioner, administrative and investigative personnel and board members to attend local, state, regional, and national meetings. All reimbursement for travel expenses directly incurred as a result of attending such meetings shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  7. (g) The board shall:
    1. (1) Regularly notify licensed pharmacists of changes that are implemented or enforced by the board that affect the licensees resulting from newly promulgated rules, amended statutes, and adopted policies and guidelines;
    2. (2) Establish and publish on its website the statutes, rules, policies, and guidelines that are implemented or enforced by the board and that affect licensees; and
    3. (3) Require licensees to maintain a copy of the board of pharmacy statutes, rules, policies, and guidelines at the location in which they practice pharmacy.
  8. (h) The board may issue advisory private letter rulings to any affected licensee making a request for a ruling regarding matters within the board's jurisdiction. The private letter ruling affects only the licensee making the inquiry and has no precedential value for any other inquiry or future contested case to come before the board. The board may resolve a dispute regarding a private letter ruling pursuant to declaratory orders under § 4-5-223.
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§ 63-10-309. Power of board to suspend, revoke, or refuse to issue licenses — Civil penalties.
  1. The board may deny, restrict, or condition any application for licensure; revoke or suspend any license or certification previously issued; or discipline and assess civil penalties against an applicant, licensee, or holder of a certificate upon a finding that the applicant, licensee, or holder of a certificate has:
    1. (1) Been convicted of a criminal offense, including, but not limited to, violating a law of this state or of the United States relating to drugs or to the practice of pharmacy;
    2. (2) Been addicted to the use of alcohol, narcotics, or other drugs;
    3. (3) Engaged in conduct that is prohibited or unlawful under parts 2-7 of this chapter, or another state or federal law relating to drugs or to the practice of pharmacy;
    4. (4) Exhibited an incapacity of a nature that prevents a pharmacist from engaging in the practice of pharmacy with reasonable skill, confidence, and safety to the public;
    5. (5) Been guilty of dishonorable, immoral, unethical, or unprofessional conduct;
    6. (6) Had the license to practice pharmacy suspended or revoked by another state for disciplinary reasons; or
    7. (7) Failed to comply with a lawful order or duly promulgated rule of the board.
§ 63-10-310. License requirements.
  1. (a) Except as otherwise provided in parts 2-7 of this chapter, it is unlawful for a person to engage in the practice of pharmacy unless the person is licensed or otherwise authorized to practice under parts 2-7 of this chapter.
  2. (b) The board may establish the experience and educational qualifications necessary for admission to the board's licensure or certification examinations.
  3. (c) The board may use any national certification, licensure examination, or contract with a qualified examination agency to prepare and administer its licensure examination. The board shall promulgate rules to establish the minimum score necessary to pass a licensure or certification examination required by the board.
  4. (d) To apply for a pharmacist license, a person must:
    1. (1) Be at least twenty-one (21) years of age;
    2. (2) Be a graduate of a school or college of pharmacy recognized by the board; and
    3. (3) Submit an application for licensure on forms approved by the board in writing or by online application and pursuant to rules promulgated by the board.
  5. (e) The board may grant licenses to reciprocal applicants from other states upon making a determination that the qualifications of pharmacists licensed in other states are equivalent to or greater than requirements for licensure in this state. The board may refuse to issue licenses to reciprocal applicants from other states on grounds as determined by the board's rule.
  6. (f) The board may license and register pharmacists, pharmacies, wholesalers, distributors, pharmacy technicians, pharmacy interns, manufacturers, third-party logistics providers, and other persons as may be required under federal or state law. This subsection (f) does not include manufacturers' representatives unless otherwise required by federal or state law.
  7. (g)
    1. (1) The board may promulgate rules to:
      1. (A) Establish the criteria, timing and procedure for the renewal of licenses;
      2. (B) Establish the requirements for continuing education for persons the board licenses or to whom the board issues certificates. This authority includes, but is not limited to, the establishment of the number of continuing education hours required, approval of providers and course content, enforcement of continuing education requirements, and qualification for waiver of the requirements or extension of time in which to obtain the continuing education; and
      3. (C) Designate which national or other qualified pharmacy technician certification agencies are recognized in this state for maintaining certification as a pharmacy technician.
    2. (2) The board shall promulgate rules to define the scope of practice of pharmacy technicians and the qualifications necessary to practice as a pharmacy technician.
§ 63-10-311. Inspection of sites — Physicians regulated by board of medical examiners.
  1. (a) The board or its designated agents are authorized to regulate the practice of pharmacy and to inspect any site or professional pharmacy practice, other than storage sites utilized by manufacturer's representatives, where drugs, medicines, chemicals, pharmaceuticals, or poisons are manufactured, stored, sold, dispensed, distributed, or administered.
  2. (b) The authority over drug dispensing in the office of a physician licensed to practice under chapter 6 of this title is vested in the board of medical examiners.
§ 63-10-312. Administrative fees.
  1. (a) The board may promulgate rules to establish licensure fees necessary to carry out parts 2-7 of this chapter.
  2. (b) All monies received by the board must be deposited and dispensed pursuant to § 63-1-137.
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§ 63-10-313. Administrative procedure.
  1. All matters and procedures regarding the hearing and judicial review of a contested case arising under parts 2-7 of this chapter are governed under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-10-314. Promulgation of rules regarding oversight of facilities that manufacture, warehouse, and distribute medical devices.
  1. (a) The board shall promulgate rules regarding the board's oversight of facilities that manufacture, warehouse, and distribute medical devices. The rules promulgated under this subsection (a) must include the formation of an advisory committee, in accordance with § 4-5-205, composed of medical device industry representatives and a representative of the department of economic and community development.
  2. (b) The rules promulgated pursuant to this section must be reviewed by the advisory committee every three (3) years to review the advancements of new medical device technologies.
  3. (c) The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-10-315. Promulgation of rules.
  1. All rules to effectuate this part must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Part 4 Peer Review
§ 63-10-401. Statement of policy.
  1. It is the policy of the state to encourage committees made up of Tennessee's licensed pharmacists to candidly, conscientiously and objectively evaluate their peers' professional conduct, competence and ability to practice pharmacy and their personal conduct as it relates to the performance of their professional duties. It is further the policy of the state to encourage pharmacists to implement continuous quality improvement programs and quality assurance programs to identify and evaluate quality-related events, reduce medication-related errors, generate data useful to studying the causes of medication errors and improve patient care. The state further recognizes that confidentiality is essential to effective functioning of peer review committees, continuous quality improvement programs and quality assurance programs and to continued improvement in patient safety and patient care.
§ 63-10-402. Immunity for furnishing information to peer review committees.
  1. All national, state or local public or private organizations, institutions, foundations, systems, provider networks or professional associations or societies, pharmacists, auxiliary pharmacy personnel, pharmacy committee staff personnel, any person under a contract or other formal agreement with a peer review committee and any person who participates with or assists a peer review committee, members of boards of directors or trustees of any public or private hospital, managed care organization or other health care provider or any individual appointed to any peer review committee is immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees, if made or taken in good faith without malice and on the basis of facts reasonably known or reasonably believed to exist.
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§ 63-10-403. Immunity for reports regarding competence or professional conduct of pharmacist or personnel.
  1. Notwithstanding § 63-10-402, any person providing information, whether as a witness or otherwise, to a peer review committee regarding the competence or professional conduct of a pharmacist or pharmacy auxiliary personnel is immune from liability to any person, unless such information is false and the person providing it had actual knowledge of its falsity.
§ 63-10-404. Presumption of good faith.
  1. A member of a peer review committee or any other person reporting information to a peer review committee is presumed to have acted in good faith and without malice. Any person alleging lack of good faith has the burden of proving bad faith and malice.
§ 63-10-405. Information provided to committees privileged.
  1. (a) All information, interviews, reports, statements, memoranda or other data furnished to any peer review committee, association board, organization board or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee, board or entity are privileged. The records and proceedings of any peer review committee, board or entity are confidential and shall be used by such committee, board or entity, and the members thereof, only in the exercise of the proper functions of the committee, board or entity and shall not be public records nor be available for court subpoena or for discovery proceedings. One (1) proper function of a peer review committee includes advocacy for pharmacists and pharmacy auxiliary personnel before other peer review committees, health care organizations, insurance companies, national, state or local accreditation organizations, federal and state agencies and the board of pharmacy of this state or any other state. The disclosure of confidential, privileged peer review committee information during advocacy, or as a report to the board of pharmacy, or to the affected pharmacist or pharmacy auxiliary personnel under review does not constitute either a waiver of confidentiality or privilege. Nothing contained in this subsection (a) applies to records, documents or information otherwise available from original sources and such records, documents or information are not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.
  2. (b) All information, interviews, reports, statements, memoranda or other documents and materials created in the course of operation of a pharmacy continuous quality improvement program or quality assurance program shall be privileged and confidential and shall not be subject to discovery or subpoena or other means of legal process or introduction into evidence in any civil action, arbitration, administrative proceeding or state board of pharmacy proceeding. The pharmacy shall hold the privilege to all information, interviews, reports, statements, memoranda or other documents and materials created in the course of the pharmacy's continuous quality improvement program or quality assurance program. The privilege may be waived by the pharmacy. Nothing in this subsection (b) shall affect the discoverability of any records not solely generated for or maintained as a component of a pharmacy's ongoing continuous quality improvement program and quality assurance program.
  3. (c) Nothing in subsection (b) shall be construed to prohibit a pharmacy from compiling, disclosing, reporting or otherwise using information or data that may be generated from the privileged and confidential documents and materials described in subsection (b), where the compiling, disclosing, reporting or otherwise using of the information or data is for the purpose of conducting research, providing education, reporting to federal or state patient safety or quality improvement databases, developing best practice guidelines or for similar other purposes, if personal information is redacted prior to disclosure.
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§ 63-10-406. Part not applicable to review of physician's conduct.
  1. In no event, however, shall the protections provided in this part apply to any type of review by a peer review committee or pharmacist review committee, as defined in this chapter, related to any acts, conduct or professional services rendered by physicians under chapter 6 or 9 of this title. A peer review committee or pharmacist review committee may convey information to licensed physicians or physician licensing boards.
Part 5 Kevin Clauson Drug Donation Act [Effective on January 1, 2024. See the version effective until January 1, 2024.]
§ 63-10-501. Short title. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. This part is known and may be cited as the “Kevin Clauson Drug Donation Act.”
§ 63-10-502. Part definitions. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. As used in this part:
    1. (1) “Anti-rejection drug” means a prescription drug that suppresses the immune system to prevent or reverse rejection of a transplanted organ;
    2. (2) “Board” means the board of pharmacy;
    3. (3) “Cancer drug” means a prescription drug that is used to treat:
      1. (A) Cancer or the side effects of cancer; or
      2. (B) The side effects of a prescription drug that is used to treat cancer or the side effects of cancer;
    4. (4) “Controlled substance” has the same meaning as defined in § 39-17-402;
    5. (5) “Department” means the department of health;
    6. (6) “Donor” means any of the following that donates prescription drugs to a repository program approved pursuant to this part:
      1. (A) A person;
      2. (B) A pharmacy;
      3. (C) A medical facility;
      4. (D) A drug manufacturer or wholesaler licensed by the board; or
      5. (E) A prison or government entity federally authorized to possess prescription drugs with a license or permit in good standing in the state in which the entity is located;
    7. (7) “Eligible individual” means an indigent, an uninsured person, or an underinsured person who meets the criteria for eligibility pursuant to this part;
    8. (8) “Indigent” means a person with an income that is below six hundred percent (600%) of the federal poverty level as defined by the most recently revised poverty income guidelines published by the United States department of health and human services;
    9. (9) “Medical facility” means:
      1. (A) A physician's office;
      2. (B) A hospital;
      3. (C) A health clinic;
      4. (D) A nonprofit health clinic, including a federally qualified health center as defined in 42 U.S.C. § 1396d(l)(2)(B); a rural health clinic, as defined in 42 U.S.C. § 1396d(l)(1); and a nonprofit health clinic that provides medical care to patients who are indigent, uninsured, or underinsured;
      5. (E) A free clinic as defined in § 63-6-703;
      6. (F) A charitable organization as defined in § 48-101-501; or
      7. (G) A nursing home as defined in § 68-11-201;
    10. (10) “Pharmacy” means a pharmacy as defined in § 63-10-204;
    11. (11) “Prescription drug”:
      1. (A) Has the same meaning as defined in § 63-10-204;
      2. (B) Includes, but is not limited to, cancer drugs and anti-rejection drugs; and
      3. (C) Does not include:
        1. (i) Controlled substances; or
        2. (ii) Drugs covered by the risk evaluation and mitigation strategy program of the United States food and drug administration;
    12. (12) “Repository” means a pharmacy that:
      1. (A) Has a license or permit in good standing with the board; and
      2. (B) Meets the requirements established by § 63-10-503;
    13. (13) “Supplies” means the supplies necessary to administer the prescription drugs donated pursuant to this part; and
    14. (14) “Unopened tamper-evident packaging” has the same meaning as defined in United States Pharmacopeia (USP) General Chapter 659, Packaging and Storage Requirements.
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§ 63-10-503. Prescription drug donation repository program. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a) A pharmacy may elect to participate in the prescription drug donation repository program by providing written notification to the department of the following:
    1. (1) The name, street address, and telephone number of the pharmacy and the license or registration number issued by the board;
    2. (2) The name, telephone number, and pharmacy license number of the responsible pharmacist who is employed, or under contract, with the repository; and
    3. (3) A statement signed and dated by the responsible pharmacist indicating that the repository meets the eligibility requirements and will comply with the program.
  2. (b) The repository shall develop and implement standards and procedures to determine, based on basic visual inspection, that the prescription drugs appear to be unadulterated, safe, and suitable for dispensing.
  3. (c) Donated prescription drugs must be in unopened tamper-evident packaging. However, drugs packaged in single use doses may be accepted and dispensed when the outside packaging is opened if the single unit dose packaging is undisturbed.
  4. (d) Donations of prescription drugs and supplies may be made on the premises of, or mailed to, a repository that participates in the program.
  5. (e) A repository may receive, accept, replenish, repackage, and store donated prescription drugs and supplies in accordance with this part.
  6. (f) Donation and facilitation of a donation are not considered wholesale distribution, and a person donating or facilitating a donation does not require licensure as a wholesaler.
  7. (g) Repositories shall prioritize dispensing of donated prescription drugs and supplies as follows:
    1. (1) First, to an indigent person;
    2. (2) Second, to a person who has no prescription insurance or cannot afford the out-of-pocket expenses for the prescription drug or supplies prescribed; and
    3. (3) Lastly, to another individual if an indigent, uninsured, or underinsured person is unavailable.
  8. (h) A repository shall not charge or collect fees from an eligible individual for prescription drugs or supplies dispensed pursuant to the program. However, a repository may charge a handling fee for each donated prescription drug or supply that is dispensed.
  9. (i) A repository may charge fees, including, but not limited to, a usual and customary charge, to donors, eligible individuals, health plans, pharmacy benefit managers, drug manufacturers, veterans' affairs hospitals, and government agencies.
  10. (j) A repository that receives donated prescription drugs or supplies may distribute the donated prescription drugs or supplies to another repository for use pursuant to the program or to similar repository programs in other states.
  11. (k) Participation in the program is voluntary.
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§ 63-10-504. Acceptance and dispensing of donated prescription drugs and supplies. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. Prescription drugs or supplies may be accepted and dispensed under the prescription drug donation repository program in accordance with the following:
    1. (1) Prior to the first donation from a new donor, a repository shall verify and record the following:
      1. (A) The person or entity qualifies as a donor as defined in § 63-10-502;
      2. (B) The donor's name, address, phone number, and license number, if applicable; and
      3. (C) That the donor will only make donations in accordance with this part;
    2. (2) A licensed pharmacist employed, or under contract, with the program shall inspect donated prescription drugs and supplies prior to dispensing to determine if the donated prescription drugs and supplies are suitable for dispensing pursuant to this section;
    3. (3) Repositories shall store donated prescription drugs and supplies in a secure area in compliance with all United States food and drug administration and United States Pharmacopeia packaging and storage requirements;
    4. (4) Donated prescription drugs and supplies must be physically or electronically separated from non-donated prescription drugs and supplies;
    5. (5) Repositories shall redact donor information from the packaging of donated prescription drugs and supplies prior to dispensing;
    6. (6) Donated prescription drugs and supplies may be repackaged. Repackaged donated prescription drugs must be relabeled with the drug name, dose, and expiration date;
    7. (7) Repositories shall maintain an electronic inventory of accepted donated prescription drugs and supplies that includes the drug name, national drug code number, quantity, and date of donation;
    8. (8) Repositories shall return or destroy donated prescription drugs or supplies that are not suitable for dispensing;
    9. (9) Repositories shall dispose of donated prescription drugs and supplies by returning to the donor, transferring to a reverse distributor, or incinerating in an incinerator that is approved by the federal environmental protection agency;
    10. (10) The record of transaction history for donated prescription drugs and supplies must be maintained, beginning with the donor, including all prior donations, but not including information that is not required by law to be placed on the prescription drug's label;
    11. (11) An identifier or bar code may be used in place of information required by law for a record or label if the identifier or bar code allows for that information to be readily retrievable;
    12. (12) Repositories shall dispense in compliance with all applicable federal and state laws and regulations for dispensing, labeling, packaging, and record keeping;
    13. (13) An expiration date is required on all dispensed prescription drugs and supplies. If multiple packaged donated drugs are used to fill a single prescription, then the shortest expiration date must be used for the dispensed prescription;
    14. (14) A donated prescription drug or supply must not be dispensed after its expiration date;
    15. (15) Donated prescription drugs must not expire before the end-use date by the patient based on the prescriber's directions;
    16. (16) Controlled substances are not acceptable for donation and must be disposed of pursuant to regulations promulgated by the federal drug enforcement administration (DEA);
    17. (17) Prescription drugs that are part of a risk evaluation and mitigation strategy (REMS) program of the federal food and drug administration must not be accepted for donation;
    18. (18) Records required pursuant to this section must be retained in physical or electronic format for a period of three (3) years. A donor or repository may contract with one another or a third party to create or maintain records on each other's behalf; and
    19. (19) Donated prescription drugs and supplies may be used to replenish inventory in compliance with applicable provisions of 42 U.S.C. § 256b and regulations promulgated pursuant to that statute.
§ 63-10-505. Immunity and exemption. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a) Except for acts of gross negligence, willful misconduct, or bad faith, a drug manufacturer is not civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property for matters related to the donation, acceptance, or dispensing of a prescription drug manufactured by the drug manufacturer that is donated under this part, including liability for failure to transfer or communicate product or consumer information or the expiration date of the donated prescription drug.
  2. (b) Except as provided in subsection (d), a medical facility or another person who is not a drug manufacturer subject to subsection (a) is not civilly liable or subject to criminal prosecution for injury to or the death of an individual to whom a donated prescription drug is dispensed under this part except due to its own acts of gross negligence, willful misconduct, or bad faith.
  3. (c) Except for acts of gross negligence, willful misconduct, or bad faith, the department of health or the board of pharmacy are not civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property resulting from matters related to the donation, acceptance, distribution, or dispensing of a prescription drug donated pursuant to this part.
  4. (d) The immunity and exemption provided in subsections (b) and (c) do not apply to the following:
    1. (1) The donation, acceptance, distribution, or dispensing of a donated prescription drug under this part by a person if the person's acts or omissions are not performed reasonably and in good faith; or
    2. (2) Acts or omissions outside the scope of the program.
§ 63-10-506. No restriction on use of samples. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. This part does not restrict the use of samples by a physician or other person legally authorized to prescribe drugs pursuant to this title during the course of the physician's or other person's duties at a medical facility or pharmacy.
§ 63-10-509. Donation by long-term care facility. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. Notwithstanding this title, title 68, or any rule, a long-term care facility licensed under title 68 may donate prescription drugs to the repository program established by this part.
§ 63-10-510. Authority. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. The prescription drug donation repository program is governed by this part. This part supersedes a law or rule inconsistent with this part.
Part 5 Prescription Drug Donation Repository Program [Effective until January 1, 2024. See the version effective on January 1, 2024.]
§ 63-10-501. Part definitions. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. As used in this part:
    1. (1) “Anti-rejection drug” means a prescription drug that suppresses the immune system to prevent or reverse rejection of a transplanted organ;
    2. (2) “Board” means the board of pharmacy;
    3. (3) “Cancer drug” means a prescription drug that is used to treat any of the following:
      1. (A) Cancer or the side effects of cancer; or
      2. (B) The side effects of any prescription drug that is used to treat cancer or the side effects of cancer;
    4. (4) “Controlled substance” means the same as defined in § 39-17-402;
    5. (5) “Department” means the department of health;
    6. (6) “Donor” means a person, a pharmacy, or medical facility as well as any drug manufacturer or wholesaler licensed by the board of pharmacy, who donates prescription drugs to a repository program approved pursuant to this part;
    7. (7) “Eligible individual” means an indigent person or an uninsured person who meets all other criteria established by board rule;
    8. (8) “Indigent” means a person with an income that is below two hundred percent (200%) of the federal poverty level as defined by the most recently revised poverty income guidelines published by the United States department of health and human services;
    9. (9) “Medical facility” means any of the following:
      1. (A) A physician's office;
      2. (B) A hospital;
      3. (C) A health clinic;
      4. (D) A nonprofit health clinic, which includes a federally qualified health center as defined in 42 U.S.C. § 1396d(l)(2)(B); a rural health clinic, as defined in 42 U.S.C. § 1396d(l)(1); and a nonprofit health clinic that provides medical care to patients who are indigent, uninsured, or underinsured;
      5. (E) A free clinic as defined in § 63-6-703;
      6. (F) A charitable organization as defined in § 48-101-501; or
      7. (G) A nursing home as defined in § 68-11-201;
    10. (10) “Pharmacy” means a pharmacy as defined in § 63-10-204;
    11. (11) “Prescription drug” means the same as defined in § 63-10-204, except the drug is only tablet or capsule form, and includes cancer drugs and anti-rejection drugs, but does not include controlled substances and drugs covered by the risk evaluation and mitigation strategy program of the federal food and drug administration; and
    12. (12) “Supplies” means the supplies necessary to administer the prescription drugs donated.
§ 63-10-502. Prescription drug donation repository program. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a)
    1. (1) The department of health, in cooperation with the board of pharmacy, may promulgate rules to establish and enforce a prescription drug donation repository program under which a person or organization may donate prescription drugs and supplies for use by an organization that has received a determination of exemption from the United States internal revenue service pursuant to 26 U.S.C. § 501(c)(3), and that meets eligibility criteria specified by rule for administering the program.
    2. (2) Enforcement authority for rules promulgated pursuant to this part shall vest in the board of pharmacy.
    3. (3) Organizations who administer a drug donation repository program shall report the following data to the department every year:
      1. (A) Number of donors during the reporting year;
      2. (B) Number of donations during the reporting year;
      3. (C) List of prescription drugs and supplies donated during the reporting year;
      4. (D) Number of people who received donations of prescription drugs or supplies during the reporting year;
      5. (E) Total number of prescription drugs and supplies dispensed during the reporting year; and
      6. (F) Total cost to eligible individuals who received donations during the reporting year.
    4. (4) Rules promulgated pursuant to this part shall specify the format and method of transmission for data reported pursuant to subdivision (a)(3).
  2. (b) Donations of prescription drugs and supplies under the program may be made directly to the repository program as required by the department or on the premises of a medical facility or pharmacy that elects to participate in the program and meets the requirements established by the department. Donations of prescription drugs and supplies may be made by mail.
  3. (c) A medical facility or pharmacy may charge an individual who receives a prescription drug or supplies a handling fee that does not exceed an amount established by rule.
  4. (d) A medical facility or pharmacy that receives prescription drugs or supplies may distribute the prescription drugs or supplies to another eligible medical facility or pharmacy for use pursuant to the program.
  5. (e) Participation in the program is voluntary.
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§ 63-10-503. Acceptance and dispensing of donated prescription drugs and supplies. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) A prescription drug or supplies may be accepted and dispensed under the prescription drug donation repository program if all of the following conditions are met:
    1. (1) The prescription drug is in its original sealed and tamper-evident packaging. However, a prescription drug in a single-unit dose or blister pack with the outside packaging opened may be accepted if the single-unit dose packaging remains intact;
    2. (2) The prescription drug or supplies are inspected before the prescription drug or supplies are dispensed by a licensed pharmacist employed by or under contract with the medical facility or pharmacy, and the licensed pharmacist determines that the prescription drug or supplies are not adulterated or misbranded; and
    3. (3) The prescription drug or supplies are prescribed by a healthcare practitioner for use by an eligible individual and are dispensed by a pharmacist.
  2. (b) A prescription drug or supplies donated under this part shall not be resold.
  3. (c)
    1. (1) If a donor receives official notice of a recall of a prescription drug donated pursuant to this part, the donor shall make every effort, as required by rule, to notify the repository program to whom the drugs were donated of the recall.
    2. (2) If an organization who is administering a drug repository program receives official notice of a recall of a prescription drug donated pursuant to this part, the organization shall make every effort as required by rule, to notify the pharmacy, medical facility, or patient, if known, to whom such donated drugs were dispensed, of the recall.
    3. (3) Any donor or drug repository program who receives notice of a recall shall dispose of all recalled prescription drugs pursuant to board of pharmacy rules.
  4. (d) A prescription drug dispensed through the prescription drug donation repository program is not eligible for reimbursement under the medical assistance program.
  5. (e) The department shall adopt rules establishing all of the following:
    1. (1) Requirements for medical facilities and pharmacies to accept and dispense donated prescription drugs and supplies, including all of the following:
      1. (A) Eligibility criteria for participation by medical facilities and pharmacies;
      2. (B) Standards and procedures for accepting, safely storing, and dispensing donated prescription drugs and supplies;
      3. (C) Standards and procedures for inspecting donated prescription drugs to determine if the prescription drugs are in their original sealed and tamper-evident packaging, or if the prescription drugs are in single-unit doses or blister packs and the outside packaging is opened, if the single-unit dose packaging remains intact; and
      4. (D) Standards and procedures for inspecting donated prescription drugs and supplies to determine that the prescription drugs and supplies are not adulterated or misbranded;
    2. (2) Additional eligibility criteria for indigent or uninsured persons;
    3. (3) Necessary forms for administration of the prescription drug donation repository program, including forms for use by individuals who donate, accept, distribute, or dispense the prescription drugs or supplies under the program;
    4. (4) A means by which an individual who is eligible to receive donated prescription drugs and supplies may indicate eligibility;
    5. (5) The maximum handling fee that a medical facility or pharmacy may charge for accepting, distributing, or dispensing donated prescription drugs and supplies under the program; and
    6. (6) A list of prescription drugs that the prescription drug donation repository program will accept.
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§ 63-10-504. Immunity and exemption. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Except for gross negligence, willful misconduct, or bad faith, a drug manufacturer is not civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property for matters related to the donation, acceptance, or dispensing of a prescription drug manufactured by the drug manufacturer that is donated under this part, including liability for failure to transfer or communicate product or consumer information or the expiration date of the donated prescription drug.
  2. (b) Except as provided in subsection (d), a medical facility or another person who is not a drug manufacturer subject to subsection (a) is not civilly liable or subject to criminal prosecution for injury to or the death of an individual to whom a donated prescription drug is dispensed under this part except due to its own gross negligence, willful misconduct, or bad faith. The medical facility or other person who is not a drug manufacturer subject to subsection (a) is also exempt from disciplinary action related to the facility's or person's acts or omissions related to the donation, acceptance, distribution, or dispensing of a donated prescription drug under this part.
  3. (c) Except for gross negligence, willful misconduct, or bad faith, the department of health or the board of pharmacy shall not be civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property resulting from matters related to the donation, acceptance, distribution, or dispensing of a prescription drug donated pursuant to this part.
  4. (d) The immunity and exemption provided in subsections (b) and (c) do not extend to the following:
    1. (1) The donation, acceptance, distribution, or dispensing of a donated prescription drug under this part by a person if the person's acts or omissions are not performed reasonably and in good faith; or
    2. (2) Acts or omissions outside the scope of the program.
§ 63-10-505. No restriction on use of samples. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. This part shall not restrict the use of samples by a physician or other person legally authorized to prescribe drugs pursuant to this title during the course of the physician's or other person's duties at a medical facility or pharmacy.
§ 63-10-507. Dispensing after expiration date prohibited. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. A medical facility or pharmacy may not dispense a prescription drug after the expiration date of the drug.
§ 63-10-508. Donation by long-term facility. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. Notwithstanding this title or title 68, or any rule, a long-term care facility licensed under title 68 may donate prescription drugs to the repository program established by this part.
§ 63-10-509. Promulgation of rules. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. The department of health, in consultation with the board, is authorized to promulgate rules to effectuate the purposes of this part. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-10-510. Providing rule to health committee of house of representatives and health and welfare committee of senate for comment. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. Notwithstanding this part or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement this part shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.
Part 6 Federally Qualified Health Center Prescription Drug Dispensing Pilot Program
§ 63-10-601. Definitions — Requirements — Legislative intent.
  1. (a) As used in this section, unless the context otherwise requires:
    1. (1) “Federally qualified health center (FQHC)” means such entities as they are defined in §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d); and
    2. (2) “Telepharmacy in FQHCs” means an FQHC central pharmacy with one (1) or more FQHC remote sites in which all sites are connected via computer link, videolink and audiolink.
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  2. (b) Notwithstanding any other provision of this chapter, in an FQHC pilot project, as authorized in this section, a registered pharmacy technician employed by the FQHC is authorized to issue prescription drugs that have been filled by a pharmacist employed by the FQHC and delivered to the FQHC satellite clinic by an agent of the FQHC. The issuance of the prescription drugs may occur without the physical, onsite supervision of an on-duty pharmacist only under the conditions as provided in subsection (c). Registered pharmacy technicians performing services authorized in this section shall be permitted to function under the supervision of the FQHC pharmacist by means of telepharmacy with at least one (1) monthly onsite visit to review inventory controls, accountability, security, storage and issuance.
  3. (c) In an FQHC pilot project, as authorized in this section, a registered pharmacy technician is authorized to issue prescription drugs to a patient of the FQHC and offer counseling by a pharmacist by means of telepharmacy. The FQHC pharmacist may provide patient counseling and supervision of the registered pharmacy technician when on duty at the pharmacy practice site of a FQHC.
  4. (d) It is the intent of the general assembly that this section shall comply with all applicable requirements of the federal 340B drug pricing program, pursuant to § 340B of the Public Health Service Act (42 U.S.C. § 256b), and shall apply exclusively to the uninsured or underinsured income-eligible patients of the FQHCs participating as defined in subsection (e) for whom the prescription is not covered by third-party reimbursement.
  5. (e) On or after July 1, 2008, the department of health and the board of pharmacy shall identify one (1) FQHC for a voluntary pilot program originating in a county located in the eastern grand division of the state in order to implement the telepharmacy provisions at no more than two (2) eligible satellite clinics as described in this section. The eligible FQHC shall have an onsite pharmacy in one (1) location, eligible satellite clinics, be responsible for all costs associated with the telemedicine equipment and connectivity, have at least one (1) year of experience with telemedicine, adequate technical support, appropriate staffing, access to the patient's medical record and participate in the 340B drug pricing program. Only the approved pilot program in the FQHC shall be eligible for the supervision, delivery and issuance of prescription drugs to qualified patients as defined in subsection (d). This pilot program is not authorized to deliver or issue pharmaceutical products defined elsewhere as Schedule I, II, III or IV drugs. The pilot program shall report information regarding patient satisfaction and safety to the board of pharmacy, the health and human resources committee of the house of representatives and the general welfare health and human resources committee of the senate by February 1, 2010. If the board of pharmacy determines that data demonstrates the pilot is successful, then the board may expand the project beyond the one (1) FQHC to as many FQHCs as it deems appropriate.
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§ 63-10-602. Rules for administration and enforcement.
  1. The board of pharmacy shall adopt, amend and repeal rules for the proper administration and enforcement of parts 2-5 of this chapter consistent with § 63-10-601. The rules shall be adopted, amended or repealed in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Part 7 Ensuring Patient Access to Pharmacy Drug Disposal Programs Act of 2015
§ 63-10-701. Short title.
  1. This part shall be known and may be cited as the “Ensuring Patient Access to Pharmacy Drug Disposal Programs Act of 2015.”
§ 63-10-702. Part definitions.
  1. As used in this part:
    1. (1) “Authorized pharmacy disposal site” means any pharmacy practice site that qualifies as a collection site under 21 CFR 1317.40; and
    2. (2) “Pharmacy drug disposal program” means any voluntary drug disposal program located at, or implemented by, a Tennessee-licensed pharmacy located in this state, in accordance with all state and federal rules and regulations.
§ 63-10-703. Participation in pharmacy drug disposal programs.
  1. (a) Any Tennessee-licensed pharmacy located within this state is authorized to participate in a pharmacy drug disposal program that meets or exceeds the minimum requirements set forth in federal rules and regulations regarding collection and destruction of prescription drugs, including controlled and noncontrolled substances.
  2. (b)
    1. (1) Participation in a pharmacy drug disposal program by a Tennessee-licensed pharmacy located within this state shall be voluntary.
    2. (2) The pharmacist-in-charge, as defined by § 63-10-204, for the pharmacy practice site shall be responsible for deciding whether the pharmacy participates in a pharmacy drug disposal program.
    3. (3) No person shall mandate pharmacist participation in a pharmacy drug disposal program at a pharmacy practice site.
§ 63-10-704. Immunity of participants.
  1. Any pharmacy practice site voluntarily participating in a pharmacy drug disposal program shall be held harmless and shall not be held liable for any theft, robbery, or other criminal activity related to its participation in the pharmacy drug disposal program or the collection, storage, or destruction of prescription drugs, including controlled and noncontrolled substances collected through a pharmacy drug disposal program, as long as the pharmacy practice site is acting in good faith and operating in compliance with all state and federal rules and regulations regarding drug disposal.
§ 63-10-705. List of participants to be maintained by board.
  1. The board of pharmacy shall maintain a list of Tennessee-licensed pharmacies located within this state that participate in pharmacy drug disposal programs as authorized by state and federal rules and regulations.
§ 63-10-706. Promulgation of rules.
  1. The board of pharmacy shall promulgate rules necessary for implementation of this part. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Chapter 11 Psychologists
Part 1 Board of Examiners in Psychology
§ 63-11-101. Board creation — Composition — Immunity from civil action.
  1. (a) There is created a board of examiners in psychology, referred to as the “board” in this chapter, to consist of ten (10) members who shall be appointed by the governor under conditions set forth in this chapter.
  2. (b)
    1. (1) Two (2) members shall be chosen from and shall be members of the faculty, with the rank of assistant professor or above, of the accredited colleges and universities in the state and shall be engaged in teaching, research and/or administration of psychology.
    2. (2) Four (4) members shall be licensed psychologists.
    3. (3) Two (2) members shall be either a licensed psychological examiner or a licensed senior psychological examiner.
    4. (4) One (1) member shall be a private citizen who is neither a licensed psychologist nor a licensed psychological examiner or licensed senior psychological examiner and who has no professional or commercial interest in the practice of psychology.
    5. (5) Beginning July 1, 2014, the chair of the applied behavior analyst licensing committee of the board of examiners in psychology shall serve as an ex officio voting member of the board.
  3. (c) The board shall perform such duties and exercise such powers as this chapter prescribes and confers upon it.
  4. (d) No member of the board shall be liable to civil action for any act performed in good faith in the performance of its duties as set forth in this chapter.
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§ 63-11-102. Appointment and terms of members — Removal.
  1. (a) Original appointments to the board are for terms as follows: One (1) practicing psychologist for a term of one (1) year, one (1) academic psychologist for a term of two (2) years, one (1) practicing psychologist for a term of three (3) years, one (1) academic psychologist for a term of four (4) years and one (1) practicing psychologist for a term of five (5) years. The original appointments to the board for the licensed psychological examiner member and citizen member shall be four (4) and five (5) years, respectively. All subsequent appointments shall be for terms of five (5) years.
  2. (b) Vacancies shall be filled for any unexpired terms, and members shall serve until their successors are appointed and have qualified. Only practicing psychologists shall be appointed to succeed practicing psychologists, and only academic psychologists shall be appointed to succeed academic psychologists. Board members shall be ineligible for reappointments for a period of five (5) years following completion of their terms.
  3. (c)
    1. (1) Appointments to the board for the psychologist members may be made from lists of qualified candidates to be furnished to the governor by interested psychology groups, including, but not limited to, the Tennessee Psychological Association. Each list shall contain the names of academic psychologists and practicing psychologists. Appointments to the board for the psychological examiner and senior psychological examiner members may be made from lists of qualified candidates to be submitted to the governor from interested psychological examiner groups, including, but not limited to, the Tennessee Psychological Association Division of Psychological Examiners. Each list shall contain the names of psychological examiners and senior psychological examiners. All vacancies occurring in the board may be filled by the governor for the unexpired term from the lists of qualified candidates within thirty (30) days after the vacancy occurs. The governor shall consult with such interested groups to determine qualified persons to fill positions on the board.
    2. (2) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  4. (d) Any board members may be removed by the governor after notice and hearing for incompetence, neglect of duty, malfeasance in office or moral turpitude.
§ 63-11-103. Members' oath — Reports and records.
  1. (a) Immediately and before entering upon the duties of the office, the members of the board shall take the constitutional oath of office and shall file the same in the office of the governor who, upon receiving the oath of office, shall issue to each member a certificate of appointment.
  2. (b) The board shall have available for the governor or the governor's representative detailed reports on proceedings, and shall keep adequate records of all licenses and certificates and shall make an annual report in such form as required by the governor.
§ 63-11-104. Organization — Meetings — Expenses — Powers. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) The board shall elect annually a chair and vice chair.
  2. (b) Each member shall receive all necessary expenses incident to conducting the business of the board and, in addition thereto, shall be entitled to a per diem of one hundred dollars ($100) for each day's service in conducting the business of the board. All reimbursements for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  3. (c) The board shall hold at least one (1) regular meeting each year, the required meeting to be held at the state capitol. Called meetings may be held at the discretion of the chair or at the written request of any two (2) members of the board.
  4. (d) The board shall adopt a seal, which must be affixed to all certificates issued by the board.
  5. (e)
    1. (1) The board shall, periodically, adopt such rules and regulations as it may deem necessary for the performance of its duties and shall examine and pass upon the qualifications of the applicants for the practice of psychology as provided in this chapter.
    2. (2)
      1. (A) Six (6) members of the board at all times constitute a quorum.
      2. (B) Any action taken by the board shall require the approval of six (6) of its members.
  6. (f) The board shall be empowered to hire such assistance as is necessary to carry on its activities, within the limits of funds available to the board, and shall be empowered to accept grants from foundations or institutions to develop tests and carry on its functions.
  7. (g) The board shall receive administrative support from the division of health related boards in the department of health, referred to as the “division” in this chapter.
  8. (h) The board shall establish continuing educational requirements for psychologists designated as health service providers and psychological examiners, senior psychological examiners and certified psychological assistants.
§ 63-11-104. Organization — Meetings — Expenses — Powers. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a) The board shall elect annually a chair and vice chair.
  2. (b) Each member shall receive all necessary expenses incident to conducting the business of the board and, in addition thereto, shall be entitled to a per diem of one hundred dollars ($100) for each day's service in conducting the business of the board. All reimbursements for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  3. (c) The board shall hold at least one (1) regular meeting each year, the required meeting to be held at the state capitol. Called meetings may be held at the discretion of the chair or at the written request of any two (2) members of the board.
  4. (d) The board shall adopt a seal, which must be affixed to all certificates issued by the board.
  5. (e)
    1. (1) The board shall, periodically, adopt such rules and regulations as it may deem necessary for the performance of its duties and shall examine and pass upon the qualifications of the applicants for the practice of psychology as provided in this chapter.
    2. (2)
      1. (A) Six (6) members of the board at all times constitute a quorum.
      2. (B) Any action taken by the board shall require the approval of six (6) of its members.
  6. (f) The board shall be empowered to hire such assistance as is necessary to carry on its activities, within the limits of funds available to the board, and shall be empowered to accept grants from foundations or institutions to develop tests and carry on its functions.
  7. (g) The board shall receive administrative support from the division of health related boards in the department of health, referred to as the “division” in this chapter.
  8. (h) The board shall establish continuing educational requirements for psychologists designated as health service providers and psychological examiners, senior psychological examiners, certified psychological assistants, and certified psychological testing technicians.
Part 2 General Provisions
§ 63-11-201. Levels of practice — Valid license or certificate required. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Four (4) levels of psychological practice are defined for the purposes of this chapter. Such levels are to be known and are referred to as:
    1. (1) Psychological examiner;
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    2. (2) Senior psychological examiner;
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    3. (3) Psychologist; and
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    4. (4) Certified psychological assistant.
  2. (b) Any and all individuals who engage in the practice of psychology as a psychological examiner, senior psychological examiner or psychologist must possess in full force and virtue a valid license under this chapter.
  3. (c) Any person engaged in the practice of psychology as a certified psychological assistant must possess in full force and virtue a valid certificate to practice under this chapter.
  4. (d)
    1. (1) Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a psychologist; provided, that the contractual relationship between the psychologist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the psychologist from exercising independent professional judgment in diagnosing and treating patients.
    2. (2) For the purposes of this subsection (d), the term “charitable clinic” means an entity that meets the following standards:
      1. (A) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. (B) Has clinical facilities located in this state;
      3. (C) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. (D) Provides one (1) or more of the following services for free or at a discounted rate:
        1. (i) Medical care;
        2. (ii) Dental care;
        3. (iii) Mental health care; or
        4. (iv) Prescription medications;
      5. (E) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. (F) Is not required to be licensed under § 68-11-202(a)(1).
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§ 63-11-201. Levels of practice — Valid license or certificate required. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a) Five (5) levels of psychological practice are defined for the purposes of this chapter. Such levels are to be known and are referred to as:
    1. (1) Psychological examiner;
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    2. (2) Senior psychological examiner;
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    3. (3) Psychologist;
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    4. (4) Certified psychological assistant; and
    5. (5) Certified psychological testing technician.
  2. (b) Any and all individuals who engage in the practice of psychology as a psychological examiner, senior psychological examiner or psychologist must possess in full force and virtue a valid license under this chapter.
  3. (c) Any person engaged in the practice of psychology as a certified psychological assistant or certified psychological testing technician must possess in full force and virtue a valid certificate to practice under this chapter.
  4. (d)
    1. (1) Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a psychologist; provided, that the contractual relationship between the psychologist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the psychologist from exercising independent professional judgment in diagnosing and treating patients.
    2. (2) For the purposes of this subsection (d), the term “charitable clinic” means an entity that meets the following standards:
      1. (A) Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. (B) Has clinical facilities located in this state;
      3. (C) Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. (D) Provides one (1) or more of the following services for free or at a discounted rate:
        1. (i) Medical care;
        2. (ii) Dental care;
        3. (iii) Mental health care; or
        4. (iv) Prescription medications;
      5. (E) Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. (F) Is not required to be licensed under § 68-11-202(a)(1).
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§ 63-11-202. Practice of psychological examiner — Senior psychological examiners.
  1. (a) A person practices as a psychological examiner within the meaning of this chapter when the person claims to be a psychological examiner and/or renders to individuals or to the public health-related clinical activities or services involving the application of recognized principles, methods and procedures of the science and profession of psychology, such as interviewing or administering and interpreting tests of mental abilities, aptitudes, interests and personality characteristics, for such purposes as psychological evaluation or for educational or vocational selection, guidance or placement. The psychological examiner shall practice the following health-related clinical activities or services only under qualified supervision provided by a psychologist or a senior psychological examiner:
    1. (1) Overall personality appraisal or classification;
    2. (2) Personality counseling;
    3. (3) Psychotherapy;
    4. (4) Behavior analysis; or
    5. (5) Personality readjustment techniques.
  2. (b) Nothing in this section shall be construed as expanding or restricting the scope of practice for a psychological examiner.
  3. (c) Those psychological examiners rendering health-related clinical activities or services who have been duly licensed prior to July 1, 1991, who request to the board in writing or via online application, shall be senior psychological examiners. Those duly licensed psychological examiners rendering health-related clinical activities or services licensed after July 1, 1991, will qualify for senior psychological examiner licensure upon completion of at least five (5) years of applied experience from the date their temporary permit was first issued by the board and upon completion of two hundred (200) hours of post-licensure continuing education units distributed by categories according to the November 1997 rules and regulations governing continuing education units. A person practices as a senior psychological examiner within the meaning of this chapter when the person claims to be a senior psychological examiner and/or renders to individuals or to the public for remuneration any service involving the application of recognized principles, methods and procedures of the science and profession of psychology. A senior psychological examiner, while possessing a different scope of practice than a psychologist, shall be considered a health service provider and thereby able to engage in these designated areas of health-related psychological practice without supervision:
    1. (1) Interviewing or administering and interpreting tests of mental abilities, aptitudes, interests and personality characteristics for such purposes as psychological evaluation or for educational or vocational selection guidance or placement;
    2. (2) Overall personality appraisal or classification, psychological testing, projective testing, evaluations for disability or vocational purposes;
    3. (3) Diagnosis of nervous and mental disorders;
    4. (4) Personality counseling;
    5. (5) Psychotherapy;
    6. (6) Behavior analysis;
    7. (7) Personality readjustment techniques; or
    8. (8) Supervision of a psychological examiner.
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§ 63-11-203. Practice of psychologist.
  1. (a)
    1. (1) “Practice of psychologist” means the observation, description, evaluation, interpretation and modification of human behavior by the application of psychological principles, methods and procedures for the purpose of assessing, preventing or eliminating symptomatic, maladaptive or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health and mental health.
    2. (2)
      1. (A) “Practice of psychologist” includes, but is not limited to:
        1. (i) Psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes and neuropsychological functioning;
        2. (ii) Counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback and behavior analysis and therapy;
        3. (iii) Psychological diagnosis and treatment of mental, emotional and nervous disorders or disabilities, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury or disability;
        4. (iv) Case management and utilization review of psychological services;
        5. (v) Psychoeducational evaluation, therapy, remediation and consultation;
        6. (vi) Forensic evaluation; provided, that a person licensed under this chapter performing forensic evaluation is considered to be acting within their lawful scope of practice and the practice of forensic evaluation is not exclusive to individuals licensed under this chapter;
        7. (vii) Parent coordination; provided, that a person licensed under this chapter performing parent coordination is considered to be acting within their lawful scope of practice and the practice of parent coordination is not exclusive to individuals licensed under this chapter; and
        8. (viii) Telepsychology, which means the practice of psychology via electronic communications technology by persons licensed under this chapter.
      2. (B) Psychological services may be rendered to individuals, families, groups and the public.
    3. (3) “Practice of psychologist” is construed within the meaning of this definition without regard to whether payment is received for services rendered.
  2. (b) A person represents that person to be a psychologist if that person uses any title or description of services incorporating the words “psychology,” “psychological” or “psychologist,” if such person possesses expert qualification in any area of psychology or if that person offers to the public or renders to individuals or to groups of individuals services defined as the practice of psychology in this chapter.
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§ 63-11-204. Restrictions on methods of treatment. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Nothing in §§ 63-11-201 — 63-11-203 shall be construed as permitting the use of those forms of psychotherapy that involve the administration or prescription of drugs or electroshock or in any way infringing upon the practice of medicine as defined in the laws of this state.
  2. (b) The psychologist, or psychological examiner or senior psychological examiner or certified psychological assistant who engages in psychotherapy must establish and maintain effective intercommunication with a psychologically-oriented physician, usually a psychiatrist, to make provision for the diagnosis and treatment of medical problems by a physician with an unlimited license to practice the healing arts in this state.
  3. (c) A psychologist or, psychological examiner or senior psychological examiner or certified psychological assistant must not attempt to diagnose, prescribe for, treat or advise a client with reference to problems or complaints falling outside the boundaries of psychological practice.
  4. (d) Sections 63-11-203 and 63-11-208(c) and (d) are subject to the limitations of this section.
§ 63-11-204. Restrictions on methods of treatment. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a) Nothing in §§ 63-11-201 — 63-11-203 shall be construed as permitting the use of those forms of psychotherapy that involve the administration or prescription of drugs or electroshock or in any way infringing upon the practice of medicine as defined in the laws of this state.
  2. (b) The psychologist, psychological examiner, senior psychological examiner, certified psychological assistant, or certified psychological testing technician who engages in psychotherapy must establish and maintain effective intercommunication with a psychologically-oriented physician, usually a psychiatrist, to make provision for the diagnosis and treatment of medical problems by a physician with an unlimited license to practice the healing arts in this state.
  3. (c) A psychologist, psychological examiner, senior psychological examiner, certified psychological assistant, or certified psychological testing technician must not attempt to diagnose, prescribe for, treat or advise a client with reference to problems or complaints falling outside the boundaries of psychological practice.
  4. (d) Sections 63-11-203 and 63-11-208(c) and (d) are subject to the limitations of this section.
§ 63-11-205. Use of identifying terms. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a)
    1. (1) It is specifically prohibited that any individuals or organizations shall present themselves or be presented to the public by any title incorporating the name “psychological,” “psychologist” or “psychology” other than those licensed as psychologists or, psychological examiners or, senior psychological examiners or certified psychological assistants.
    2. (2) Any psychological scientist employed by a recognized research laboratory, college or university may use the academic or research title conferred upon such psychological scientist by the administration of such laboratory, college or university; and
    3. (3) Persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker and employed as such in the department of education or in any public or nonpublic elementary or secondary school are not required to be licensed under this chapter while performing in the course of their employment. Nothing in this chapter shall be construed so as to apply to persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker who are employed as such in the department of education or in any public or nonpublic elementary or secondary school while performing in the course of their employment.
  2. (b) Nothing in this section shall be construed as permitting such persons to offer their services to any other persons or organizations as consultants or to accept remuneration for any psychological services other than that of their institutional salaries unless they have been licensed or certified under this chapter.
  3. (c) Visiting lecturers from recognized laboratories, colleges or universities are exempt from this section and may utilize their academic or research title when presenting lectures to similar institutions or organizations.
  4. (d) Students of psychology, psychological interns and other persons preparing for the profession of psychological examiner or, senior psychological examiner or, certified psychological assistant or psychologist under qualified supervision in recognized training institutions or facilities may be designated by such titles as “psychological intern,” “psychological trainee” or others clearly indicating such training status.
  5. (e) Psychologists with competency in areas other than the provision of health services shall retain the right to use the title of licensed psychologist with competence in areas other than health services and to practice within their area of competency.
§ 63-11-205. Use of identifying terms. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. (a)
    1. (1) It is specifically prohibited that any individuals or organizations shall present themselves or be presented to the public by any title incorporating the name “psychological,” “psychologist” or “psychology” other than those licensed as psychologists, psychological examiners, senior psychological examiners, certified psychological assistants, or certified psychological testing technicians.
    2. (2) Any psychological scientist employed by a recognized research laboratory, college or university may use the academic or research title conferred upon such psychological scientist by the administration of such laboratory, college or university; and
    3. (3) Persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker and employed as such in the department of education or in any public or nonpublic elementary or secondary school are not required to be licensed under this chapter while performing in the course of their employment. Nothing in this chapter shall be construed so as to apply to persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker who are employed as such in the department of education or in any public or nonpublic elementary or secondary school while performing in the course of their employment.
  2. (b) Nothing in this section shall be construed as permitting such persons to offer their services to any other persons or organizations as consultants or to accept remuneration for any psychological services other than that of their institutional salaries unless they have been licensed or certified under this chapter.
  3. (c) Visiting lecturers from recognized laboratories, colleges or universities are exempt from this section and may utilize their academic or research title when presenting lectures to similar institutions or organizations.
  4. (d) Students of psychology, psychological interns and other persons preparing for the profession of psychological examiner, senior psychological examiner, certified psychological assistant, certified psychological testing technician, or psychologist under qualified supervision in recognized training institutions or facilities may be designated by such titles as “psychological intern,” “psychological trainee” or others clearly indicating such training status.
  5. (e) Psychologists with competency in areas other than the provision of health services shall retain the right to use the title of licensed psychologist with competence in areas other than health services and to practice within their area of competency.
§ 63-11-206. Unlicensed practice — Penalties — Supervised practice — Evaluation techniques — Temporary licenses — Provisional licenses. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Any person who engages in the practice of psychology and does not then possess in full force and virtue a valid license to practice as psychological examiner or, psychologist or senior psychological examiner or a certificate to practice as a psychological assistant under this chapter and chapter 1 of this title commits a Class B misdemeanor.
  2. (b) Nothing in this chapter shall be construed to prevent members of other recognized professions that are licensed, certified or regulated under the laws of this state from rendering services consistent with their professional training and code of ethics; provided, that they do not represent themselves to be psychologists or, psychological examiners or, senior psychological examiners or certified psychological assistants. Duly recognized members of the clergy shall not be restricted from functioning in their ministerial capacity; provided, that they do not represent themselves to be psychologists or psychological examiners or senior psychological examiners or certified psychological assistants.
  3. (c)
    1. (1) Students of psychology, psychological interns and other persons preparing for the profession of psychological examiner or, psychologist or, senior psychological examiner or certified psychological assistant may perform as a part of their training the functions in §§ 63-11-202 and 63-11-203, but only under qualified supervision.
    2. (2) A person practices as a “certified psychological assistant” within the meaning of this chapter when the person claims to be a certified psychological assistant and/or renders to individuals or to the public for remuneration any service involving the application of recognized principles, methods and procedures of the science and profession of psychology and only under the direct employment and supervision of either the psychologist or senior psychological examiner employing the certified psychological assistant or the employing community mental health center or state governmental agency. Any and all work performed by a certified psychological assistant is supervised by a psychologist or senior psychological examiner as determined by the board.
  4. (d) Use of psychological techniques by governmental institutions and by business and industrial organizations for employment placement, evaluation, promotion or job adjustment of their own officers or employees or by employment agencies for the evaluation of their own clients prior to recommendation for employment is also specifically allowed; however, no industrial or business firm or corporation may sell or offer to the public or to other firms or corporations for remuneration any psychological services as specified in §§ 63-11-202 and 63-11-203, unless such services are performed or supervised by individuals duly and appropriately licensed under this chapter.
  5. (e)
    1. (1)
      1. (A)
        1. (i) The board may issue a temporary license to an applicant who has successfully completed the academic course work and training for the license sought, and who has not yet taken the required written examinations. The board shall not issue a temporary permit for a psychological examiner for applications received by the board after December 31, 2004.
        2. (ii) A temporary license is valid for a period not to exceed one (1) year. The board may extend the expiration date of a temporary license following a petition from the licensee and finding that extraordinary circumstances exist that necessitate a delay in taking a required written examination prior to the expiration of the initial temporary license period.
        3. (iii) A temporary license is revoked thirty (30) days after the date a temporary licensee receives notice of the licensee's second failure of the examination for professional practice in psychology (EPPP) or jurisprudence examination. During the thirty-day period prior to revocation of the temporary license, the licensee and the licensee's supervisor shall ensure the notification, and transfer, of care for the temporary licensee's clients.
      2. (B) The temporary license will allow the applicant to perform the functions specified in §§ 63-11-202 and 63-11-203, for which the applicant is seeking licensure under qualified supervision.
      3. (C) In order to receive a temporary license, the applicant must submit a completed application for a temporary license with the applicant's completed application for the desired license, and all appropriate fees, to the board.
    2. (2)
      1. (A)
        1. (i) A temporary license may be issued by the board for an applicant who has a current license from another state or territory. The temporary license will allow the applicant to perform under qualified supervision the functions specified in §§ 63-11-202 and 63-11-203.
        2. (ii) In order to receive a temporary license, the applicant must submit a completed application for a temporary license with the applicant's completed application for the desired license, and all appropriate fees, to the board.
        3. (iii) Applications for temporary licenses for applicants currently licensed in another state or territory shall be reviewed and approved or denied by a current member of the board designated by the board to perform this function.
        4. (iv) If an applicant is issued a temporary license, the license shall remain valid until the board grants or denies the license application.
        5. (v) However, no person shall be issued more than one (1) temporary license nor shall any temporary license be valid for a period of more than one (1) year.
      2. (B) Such a temporary license may be issued to allow an applicant to perform the functions specified in § 63-11-203 if the applicant has:
        1. (i) Successfully completed an approved American Psychological Association academic course of study;
        2. (ii) Previously taken and passed, according to Tennessee standards, the national licensing examination;
        3. (iii) A current license in another state or territory in good standing.
      3. (C) Such a temporary license with designation as a health service provider may be issued to an applicant who meets the requirements of subdivision (e)(2)(B) and has:
        1. (i) Successfully completed an American Psychological Association-approved internship; and
        2. (ii) Had at least one (1) year of full-time postdoctoral experience delivering health services.
      4. (D) Such a temporary license may be issued to allow an applicant to perform the functions specified in § 63-11-202 if the applicant has:
        1. (i) Previously taken and passed, according to Tennessee standards, the national licensing examination; and
        2. (ii) A current license in another state or territory in good standing.
    3. (3) The fee for all temporary licenses shall be set by the board in an amount not to exceed one hundred dollars ($100). Until such time as the board establishes a fee by rule, the fee shall be fifty dollars ($50.00).
  6. (f) Nothing in this chapter shall be construed to expand or limit in any way the practice of psychological examiners as provided in § 63-11-202 or, senior psychological examiners as provided in § 63-11-202 or certified psychological assistants as provided in subdivision (c)(2) and § 63-11-207(b), nor shall this chapter limit the use of the title “psychological examiner” for persons duly licensed as psychological examiners.
  7. (g) Notwithstanding subsection (a), persons providing services in programs of the department of mental health and substance abuse services or the department of intellectual and developmental disabilities either as employees or through contract agencies are not engaged in the practice of psychology and need not be licensed or certified under this chapter unless they provide services as a psychological examiner or as a psychologist, or as a senior psychological examiner or certified psychological assistant.
  8. (h)
    1. (1) A provisional license to practice as a psychologist with the designation as a health service provider may be issued by the board of examiners in psychology to an applicant who has successfully completed the academic and internship requirements of § 63-11-208(c)(3) and (d)(1)(A) and who is to be engaged in a one-year post-doctoral experience required by § 63-11-208(d)(2)(A). Such provisional licensure will allow the applicant to perform the functions specified in §§ 63-11-203 and 63-11-208(d)(2)(B) under the qualified supervision of a psychologist acceptable to the board and who is licensed in Tennessee with a designation as a health service provider in good standing.
    2. (2) In order for a provisional license to remain valid, the licensee must take, and pass, the examination for professional practice in psychology (EPPP) at the level set for licensure as a psychologist in this state within one (1) year of the issuance of the provisional license unless the applicant previously passed the EPPP at that level. A provisional license is revoked thirty (30) days after the date a provisional licensee receives notice of the licensee's second failure of the EPPP following issuance of the provisional license. During the thirty-day period prior to revocation of the provisional license, the licensee and the licensee's supervisor shall ensure the notification, and transfer, of care for the provisional licensee's clients.
    3. (3) In order for the provisional license to remain valid, the licensee must take, and pass, the oral or jurisprudence examination, or both, developed by the board within two (2) years of the issuance of the provisional license. A provisional license is revoked thirty (30) days after the date a provisional licensee receives notice of the licensee's second failure of the oral or jurisprudence examination following issuance of the provisional license. During the thirty-day period prior to revocation of the provisional license, the licensee and the licensee's supervisor shall ensure the notification, and transfer, of care for the provisional licensee's clients.
    4. (4) The board may consider petitions of the licensee regarding extraordinary circumstances that would necessitate delay in taking the written or oral examination.
§ 63-11-207. Qualifications and application to practice as examiner — Expiration of period to issue licenses — Certification of psychological assistants. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a)
    1. (1) Any person wishing to obtain the right to practice as a psychological examiner in this state, who has not heretofore been licensed to do so, shall, before it is lawful for such person to practice as a psychological examiner in this state, make application to the board through the chair, upon such form and in such manner as shall be adopted and prescribed by the board.
    2. (2) Unless such a person has obtained a license as prescribed in subdivision (a)(1), it is unlawful for such person to practice; and if such person practices as a psychological examiner without first having obtained such a license, such person has violated this chapter.
    3. (3) A candidate for such license shall furnish the board with satisfactory evidence that such candidate:
      1. (A) Is of good moral character;
      2. (B) Is a citizen of the United States;
      3. (C) Has had two (2) academic years of graduate training in psychology, including a master's degree, from an accredited educational institution recognized by the board as maintaining satisfactory standards, or in lieu thereof, such training and experience as the board shall consider equivalent thereto. The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a masters' degree in psychology whose credentials differ slightly than those prescribed in this subdivision (a)(3)(C). In such cases the qualified candidate must petition the board for a waiver and specifically request the board utilize its discretionary authority;
      4. (D) Is competent as a psychological examiner, as shown by passing such examinations, written or oral, or both, as the board deems necessary;
      5. (E) Is not considered by the board to be engaged in unethical practice; and
      6. (F) Has not, within the preceding six (6) months, failed an examination given by the board; provided, that the board may, at its discretion, accept satisfactory substitute training and experience in lieu of that prescribed in subdivision (c)(3).
    4. (4) No new psychological examiner licenses shall be issued for applications received by the board after December 31, 2004.
    5. (5) The discontinued issuance of psychological examiners licenses or the designation of senior psychological examiners shall in no way impair or abridge the right of duly licensed psychological examiners to practice within the scope of their license or to renew their licensure status as required by law.
  2. (b)
    1. (1) Any person seeking to practice as a certified psychological assistant in this state shall, before it is lawful for such person to practice as a certified psychological assistant, make application to the board through the chair, upon such form and in such manner as shall be adopted and prescribed by the board, including, but not limited to, the proper registration with the board of the supervisor of record for the certified psychological assistant. Unless such person obtains a proper certificate as issued by the board, it is unlawful for a person to practice; and if such person practices as a certified psychological assistant without first having obtained a proper certificate, such person has violated this chapter.
    2. (2) A candidate for certification shall furnish the board with satisfactory evidence that such candidate:
      1. (A) Is of good moral character;
      2. (B) Is a citizen of the United States;
      3. (C) Is not considered by the board to be engaged in unethical practice; and
      4. (D) Has had two (2) academic years of graduate training in psychology, including a master's degree, from an accredited educational institution recognized by the board as maintaining satisfactory standards, or in lieu thereof, such training and experience as the board shall consider equivalent thereto. Such graduate training must include specialized training in psychological assessment, test construction and measurement, the administration and interpretation of psychological testing, interviewing skills and social history methods. The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a master's degree in psychology whose credentials differ slightly than those prescribed in this subdivision (b)(2)(D). However, all applicants must in their graduate training show evidence of supervised practicum experience in the administration and interpretation of psychological testing, assessment procedures and social history and feedback interviewing techniques as determined by the board in order to fulfill educational requirements for certification.
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§ 63-11-208. Qualifications and application to practice as psychologist — Specialty certification. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Any person wishing to obtain the right to practice as a psychologist in this state, who has not heretofore been licensed to do so, shall, before it is lawful for such person to practice psychology in this state, make application to the board through the chair upon such form and in such manner as shall be adopted and prescribed by the board.
  2. (b) Unless such a person has obtained a license as prescribed in subsection (a), it is unlawful for such person to practice; and if such person practices psychology without first having obtained such a license, such person has violated this chapter.
  3. (c) A candidate for such license shall furnish the board with satisfactory evidence that such candidate:
    1. (1) Is of good moral character;
    2. (2) Is a citizen or legal resident of the United States;
    3. (3) Has received a doctorate in psychology from an accredited educational institution recognized by the board as maintaining satisfactory standards. After December 31, 1995, all such doctoral programs must be approved by the American Psychological Association, listed by the American Association of State Psychology Boards, or such equivalent standards as are determined by the board;
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    4. (4) Is competent in psychology, as shown by passing such examinations, written or oral, or both, as the board deems necessary;
    5. (5) Is not considered by the board to be engaged in unethical practice;
    6. (6) Has not within the preceding six (6) months failed an examination given by the board; and
    7. (7) The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a doctoral degree in psychology whose credentials differ slightly than those prescribed in subdivisions (c)(3) and (d)(1)(A). In such cases, the applicant must petition the board for a waiver and specifically request the board utilize its discretionary authority.
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  4. (d) Any licensed psychologist who provides or offers health services to the public must be designated by the board as a health service provider. In addition to the requirements for licensure as a psychologist prescribed in subsection (c), an applicant for designation as a health service provider must demonstrate to the board that such applicant:
    1. (1)
      1. (A) Has had at least a one-year internship of no less than one thousand nine hundred (1,900) hours in psychology at a site where health services are normally provided and that is part of an organized integrated training program. After December 30, 1995, all such internships must be approved by the American Psychological Association (APA) or listed by the Association of Psychological Post-Doctoral and Internship Centers (APPIC), or such equivalent standards as are determined by the board;
      2. (B) Until December 31, 1999, internships listed in the Directory of Internships for Doctoral Students in School Psychology, published by the Joint Committee on Internships for the Council of Directors of School Psychology Programs, Division 16 of the American Psychological Association and the National Association of School Psychologists, shall be considered to satisfy the internship approval requirement of this subsection (d); and
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    2. (2)
      1. (A) Has successfully completed at least one (1) year postdoctoral experience delivering health services, supervised by a licensed psychologist designated by the board as a health service provider. If the year of postdoctoral training was not in the state of Tennessee, equivalent supervision must be documented to the satisfaction of the board;
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      2. (B) For purposes of this chapter, “health service,” in any variation, means the delivery of direct, preventive, assessment and therapeutic intervention services to individuals whose growth, adjustment or functioning is actually impaired or may be at risk of impairment.
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  5. (e) Notwithstanding subsection (d), the board may designate as a health service provider, with practice restriction to recipients in an intellectual disabilities facility under the department of intellectual and developmental disabilities, a person who meets all of the following criteria:
    1. (1) The person holds a doctorate in psychology from a regionally accredited institution;
    2. (2) The person is currently licensed as a psychologist in at least one (1) state;
    3. (3) The person has academic training in intellectual disability and postdoctoral clinical experience in the field of intellectual disability of at least five (5) years' duration;
    4. (4) The department submits to the board a description of the applicant's proposed functioning at the intellectual disability facility;
    5. (5) The department certifies that the applicant has training and experience adequate to perform the applicant's proposed functioning within the department, that the department is unable to recruit otherwise qualified psychologists to provide psychological services and that this inability threatens the integrity of the department's services and the ability of the department to meet the needs of its clients; and
    6. (6) Any psychologist granted designation as a health service provider by the board under this subsection (e) shall surrender this designation upon termination of such person's employment with the department, which designation shall, thereafter, be null and void.
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§ 63-11-209. Application and examination fees.
  1. (a) Each applicant for a permanent license or certificate shall pay to the board a nonrefundable application fee as set annually by the board.
  2. (b) In addition thereto, each applicant subject to examination under this chapter shall pay an examination fee to the board as set annually by the board.
  3. (c) Each applicant seeking licensure without examination as provided in § 63-11-211 shall, in addition to the application fee provided in this section, pay a fee as set annually by the board.
§ 63-11-210. Examination of applicants.
  1. (a) Examination of applicants for a license or certificate to practice psychology shall be made by the board at least once a year according to methods and in such subject fields as may be deemed by the board to be the most practical and expeditious to test the applicant's qualifications.
  2. (b)
    1. (1) Such examinations shall include the basic psychological sciences.
    2. (2) The board shall require the examinations to be written or oral, or both; provided, that in any written examination such applicant shall be designated by a number instead of the applicant's name so that the applicant's identity shall not be disclosed to the members of the board until the examination papers have been graded.
    3. (3) The board shall grade the written examinations returned by the candidates and shall keep them for at least one (1) year.
    4. (4) A candidate shall be held to have passed the examination upon the affirmative vote of three (3) or more members of the board.
    5. (5) Any unsuccessful candidate may, upon written request to the board, see the candidate's graded paper.
§ 63-11-211. Licensure without examination.
  1. (a) The board may, at its discretion, grant a certificate without an assembled examination to any person residing or employed in the state who has not previously failed the appropriate examination given by the board and who, at the time of application, is licensed or certified by a similar board of another state whose standards, in the opinion of the board, are not lower than those required by this chapter, or who has been practicing psychology in another state and has qualifications not lower than those required by this chapter, and is able to satisfy the board that to grant that person a license would be in the public interest, or who has been certified by the American Board of Examiners in Professional Psychology.
  2. (b) Notwithstanding subsection (a), the board shall grant a license without an assembled written or oral examination to any person who at the time of application:
    1. (1) Is licensed or certified in good standing with a similar board of another state;
    2. (2) Has passed the National Examination for the Practice of Professional Psychology at a level greater than or equal to the level required in this state;
    3. (3) Can show reasonable proof that the applicant has available employment in this state by means of letters or other reasonable proof;
    4. (4) Received a psychologist license after January 1, 1995, but before June 1, 1995; and
    5. (5) The board may permit a psychologist licensed in good standing in another state, who meets standards acceptable to the board, to perform the functions of §§ 63-11-203 and 63-11-208(d)(2)(B) and practice as a psychologist in Tennessee without possessing a current license for a period of time, not to exceed twelve (12) days per year, for such purposes as special training or consultation, special evaluation and/or intervention or serving as an expert witness. Nothing in this section shall be construed to permit the regular, repetitive or ongoing provision of psychological services, the supervision of psychological services or the solicitation or advertisement of services to the general public, all of which are governed by the usual and customary processes of licensure for psychologists.
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§ 63-11-212. Issuing license or certificate — Enforcement of chapter.
  1. (a) The board has authority to administer oaths, to summon witnesses and to take testimony in all matters relating to its duties.
  2. (b)
    1. (1) The board shall be the sole agency in this state empowered to certify concerning competence in the practice of psychology to the division and the sole board empowered to recommend licensure or certification for the practice of psychology to the division.
    2. (2) No individual shall be issued a license or certificate for the practice of psychology who has not been previously certified at the appropriate level of practice by the board.
    3. (3) The board shall certify as competent to practice psychology all persons who shall present satisfactory evidence of attainments and qualifications under provisions of this chapter, the rules and regulations of the board and chapter 1 of this title.
    4. (4) Such certification shall be signed by the chair of the board under the board's adopted seal.
  3. (c) It is the duty of the board chair under the direction of the board to aid the solicitors in the enforcement of this chapter and the prosecution of all persons charged with the violation of its provisions.
§ 63-11-213. Privileged communications. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. For the purpose of this chapter, the confidential relations and communications between licensed psychologist or psychological examiner or senior psychological examiner or certified psychological assistant and client are placed upon the same basis as those provided by law between attorney and client; and nothing in this chapter shall be construed to require any such privileged communication to be disclosed.
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§ 63-11-213. Privileged communications. [Effective on January 1, 2024. See the version effective until January 1, 2024.]
  1. For the purpose of this chapter, the confidential relations and communications between licensed psychologist, licensed psychological examiner, licensed senior psychological examiner, certified psychological assistant, or certified psychological testing technician and client are placed upon the same basis as those provided by law between attorney and client; and nothing in this chapter shall be construed to require any such privileged communication to be disclosed.
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§ 63-11-214. Code of ethics.
  1. The board of examiners shall adopt a code of ethics to govern appropriate practices or behavior as referred to in §§ 63-11-207, 63-11-208 and 63-11-215 and shall file such code with the secretary of state within thirty (30) days prior to the effective date of such code.
§ 63-11-215. Denial, restriction, suspension or revocation of license or certificate — Disciplinary action.
  1. (a) The board has the power to:
    1. (1) Deny an application for a license or certificate to any applicant;
    2. (2) Permanently or temporarily withhold issuance of a license or certificate;
    3. (3) Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or licensee or certified person as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license or certificate.
  2. (b) The grounds upon which the board shall exercise the powers enumerated in subsection (a) include, but are not limited to:
    1. (1) Unprofessional, dishonorable or unethical conduct;
    2. (2) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter or any lawful order of the board issued pursuant thereto, or any criminal statute of the state;
    3. (3) Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the course of professional practice;
    4. (4) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of practice;
    5. (5) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice the person's profession;
    6. (6) Willfully betraying a professional secret;
    7. (7) The advertising of psychological practice in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    8. (8) Willful violation of the rules and regulations that may be promulgated by the board to regulate advertising by practitioners who are under the jurisdiction of such board;
    9. (9) Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    10. (10) Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
    11. (11) Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality;
    12. (12) Giving, receiving or aiding or abetting in the giving or receiving of rebates, either directly or indirectly;
    13. (13) Engaging in practice under a false or assumed name or the impersonation of another practitioner of a like, similar or different name;
    14. (14) Engaging in practice when mentally or physically unable to safely do so;
    15. (15) Violation of chapter 6 of this title; and
    16. (16) Practice of a level of psychology inappropriate or beyond the scope of the particular license or licenses or certification held by the licensee or certified person.
  3. (c) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-11-216. Administrative procedure.
  1. All proceedings for disciplinary action against a licensee or certified person under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-11-217. Review of board actions.
  1. Any action of or ruling or order made or entered by the board declining to issue a certificate, declining to recommend licensure or certification or suspending or revoking a certificate or license shall be subject to review by the courts of this state in the same manner and subject to the same powers and conditions as now provided by law in regard to rulings, orders and findings of other quasi-judicial bodies in this state, where not otherwise specifically provided.
§ 63-11-218. Annual registration fee — Revocation and renewal of licenses and certification — Registration by retirees. [Effective until January 1, 2024. See the version effective on January 1, 2024.]
  1. (a) Each licensed psychologist or psychological examiner or senior psychological examiner or certified psychological assistant shall pay an annual registration fee as set annually by the board, payable in advance, for the ensuing year. As a condition of renewal, the board may require that the licensee or certified person establish that the licensee or certified person has satisfied any continuing education requirements established by board rule.
  2. (b)
    1. (1) When any licensee or certified person shall fail to pay the annual fee after the renewal fee becomes due and satisfy such continuing education requirements for renewal as may be established by the board, as provided in this section, the license or certificate of such person shall be automatically revoked by the board without further notice or hearing, unless renewal is completed and all fees paid prior to the expiration of sixty (60) days from the date such renewal fees become due.
    2. (2) Any person whose license or certificate is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license or certificate; and upon good cause being shown, the board, in its discretion, may reinstate such license or certificate upon payment of all past due annual registration fees, proof that any continuing education renewal requirement established by the board has been satisfied and upon further payment of a sum to be set by the board.
  3. (c) Any person licensed or certified to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
  4. (d)
    1. (1) Notwithstanding this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license or certification renewals at alternative intervals that will allow for the distribution of the license or certification workload as uniformly as is practicable throughout the calendar year. Licenses or certificates issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license or certification period. However, during a transition period, or at any time thereafter, when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or certificates or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license or certificate under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license or certification expiration date under the alternative method authorized in this subsection (d).
§ 63-11-220. Peer review committees — Liability — Confidentiality of information.
  1. (a) As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide psychological association or local psychological association for the purpose of receiving and evaluating professional acts of other practitioners of psychology as defined in this chapter.
  2. (b) Any practitioner of psychology who serves on any peer review committee or on any other committee is immune from liability with respect to any action taken in good faith and without malice as a member of such committee, board, commission or other entity.
  3. (c) Practitioners of psychology, any individuals appointed to a committee as defined in subsection (a) and members of the boards of directors of facilities as defined in §§ 33-5-402 and 68-11-201 are immune from liability to any client, patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committee, undertaken or performed within the scope or functions of the duties of such committee, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
  4. (d)
    1. (1) All information, interviews, reports, statements, memoranda or other data furnished to a peer review committee, associational board or governing board, and any findings, conclusions or recommendations resulting from the proceedings of such committees, associational boards and governing boards are privileged.
    2. (2) The records and proceedings are confidential and shall be used only in the exercise of the proper functions of the committees, associational boards or governing boards and shall not become public records nor be available for court subpoena or discovery proceedings.
    3. (3) Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources and such records, documents or information are not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.
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§ 63-11-221. Health service providers in internship program — Waiver of supervised postdoctoral experience.
  1. Any person currently enrolled in an internship program satisfying the requirements of § 63-11-208(d)(1) and who completes the internship and all other degree requirements by December 31, 1992, shall be designated as a health service provider without completing the one-year full-time supervised postdoctoral experience as provided in § 63-11-208(d)(1) if an application for such designation is submitted by July 1, 1993.
§ 63-11-222. Psychologists licensed as of June 30, 1992 — Health service provider designation.
  1. (a) Any psychologist licensed under this chapter as a school, clinical or counseling psychologist as of June 30, 1992, shall be designated by the board as a health service provider; provided, that such person submits an application to the board for such designation by July 1, 1993. Any psychologist licensed under this chapter other than as a school, clinical or counseling psychologist as of June 30, 1992, who documents to the satisfaction of the board that such person has been engaged in providing health services as a psychologist for a minimum of two (2) years shall be designated by the board as a health service provider; provided, that application for such designation is submitted to the board by July 1, 1993.
  2. (b) Notwithstanding any provision of subsection (a) or any other law to the contrary, the board shall designate as a health service provider any person who meets the following criteria:
    1. (1) Holds a Ph.D. in education from an accredited college or university;
    2. (2) Possesses at least three thousand nine hundred (3,900) hours of clinical experience supervised by licensed clinical and counseling psychologists at an accredited school of medicine;
    3. (3) Is a national board certified counselor;
    4. (4) Has been practicing in Tennessee as a professional counselor for a period of six (6) or more years;
    5. (5) Was licensed by the board as a psychologist on July 15, 1992, with a declared specialty area other than school, clinical or counseling psychology; and
    6. (6) Has submitted to the board an application for such designation by December 31, 1994.
§ 63-11-223. Titles referring to licensed psychologist and health care provider.
  1. For purposes of federal legislation and regulations referencing qualifications with respect to the provision of psychological services and other titles in this code, unless the context otherwise requires, “licensed clinical psychologist,” “licensed counseling psychologist” or “licensed school psychologist” in any variation refers to a psychologist licensed under this chapter and designated as a health service provider.
§ 63-11-224. Third-party reimbursement.
  1. “Community mental health centers,” as defined in § 33-1-101, institutes or governmental agencies, doctoral clinical psychology students in university-operated training clinics and those qualifying psychologists employing psychologists with temporary or provisional licenses shall be eligible to receive third-party reimbursement from any managed care plan or third-party payor for usual and customary professional services rendered by the employed psychologist with a provisional or temporary license.
§ 63-11-225. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A psychologist licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of examiners in psychology may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
§ 63-11-226. Notice to patients of departure.
  1. Psychologists, senior psychological examiners and psychological examiners are not required to notify patients that were treated by them at community mental health centers, as defined in § 33-1-101, of their departure from such community mental health centers. Patient records shall remain with the community mental health centers. The transfer of patients' records shall be in compliance with standards set by state and federal law.
Part 3 Applied Behavior Analyst Licensing Committee
§ 63-11-301. Public policy statement — Committee established.
  1. (a) The practice of behavior analysis in this state is hereby declared to affect the public health, safety, and welfare of citizens of this state.
  2. (b) To assist the board of examiners in psychology in the performance of its duties, there is hereby established the applied behavior analyst licensing committee to protect the public from:
    1. (1) The practice of applied behavior analysis by unqualified persons; and
    2. (2) Unprofessional, unethical and harmful conduct by behavior analysis practitioners.
  3. (c) No person shall represent to be or function as a behavior analyst or assistant behavior analyst in this state unless such person holds a valid license issued by the committee. The committee shall also regulate the practice of applied behavior analysis.
§ 63-11-302. Part definitions.
  1. As used in this part:
    1. (1) “Board” means the board of examiners in psychology, created by § 63-11-101;
    2. (2) “Certifying entity” or “BACB” means the nationally accredited behavior analyst certification board or its successor;
    3. (3) “Co-employed relationship” means the licensed behavior analyst and licensed assistant behavior analyst are employed by the same employer;
    4. (4) “Committee” means the applied behavior analyst licensing committee of the board of examiners in psychology, created by § 63-11-303;
    5. (5) “Employee-employer relationship” means the licensed behavior analyst is the employer of the licensed assistant behavior analyst. This relationship may include contractual employment or consultant services;
    6. (6) “Human services professional” means an individual licensed or certified in this state as a:
      1. (A) Physical therapist or physical therapist assistant;
      2. (B) Occupational therapist or occupational therapist assistant;
      3. (C) Clinical social worker;
      4. (D) Masters social worker;
      5. (E) Social work associate;
      6. (F) Psychologist or health service psychologist;
      7. (G) Speech pathologist;
      8. (H) Audiologist;
      9. (I) Professional counselor or professional counselor candidate;
      10. (J) Marital and family therapist or marital and family therapist candidate;
      11. (K) Licensed psychological examiner; or
      12. (L) Senior licensed psychological examiner;
    7. (7) “Licensed assistant behavior analyst” or “LABA” means an individual who is certified as a board certified assistant behavior analyst (BCABA) and is licensed in this state to practice applied behavior analysis under the extended authority and supervision of a licensed behavior analyst;
    8. (8) “Licensed behavior analyst” or “LBA” means an individual who is certified as a board certified behavior analyst (BCBA) or board certified behavior analyst-doctoral (BCBA-D) and is licensed in this state to practice applied behavior analysis as an independent practitioner;
    9. (9)
      1. (A) “Practice of applied behavior analysis” means the design, implementation, and evaluation of environmental modifications by a behavior analyst to produce socially significant improvements in human behavior. It includes the empirical identification of functional relations between behavior and environmental factors, known as functional assessment and analysis;
      2. (B) Applied behavior analysis (ABA) interventions are based on scientific research and the direct observation and measurement of behavior and environment. They utilize contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other procedures to help people develop new behaviors, increase or decrease existing behaviors, and emit behaviors under specific environmental conditions;
      3. (C) The practice of applied behavior analysis expressly excludes psychological testing, neuropsychology, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, and long-term counseling as treatment modalities;
    10. (10) “Real-time supervision” means observation and provision of feedback to a supervisee's delivery of ABA services by an LBA or an LABA who is supervised by an LBA during interactions occurring in person or via technology that permits auditory and visual contact between supervisors and supervisees;
    11. (11) “Supervisee” means a person who delivers ABA services under the extended authority and supervision of an LBA or an LABA who is supervised by an LBA; and
    12. (12) “Supervision” means the direct observation and provision of feedback to a supervisee by an LBA or an LABA who is supervised by an LBA.
§ 63-11-303. Creation — Authority — Membership — Conduct of meetings.
  1. (a) There is hereby created the applied behavior analyst licensing committee of the board of examiners in psychology, which shall consist of five (5) members appointed by the governor.
  2. (b) The committee is authorized to issue licenses to individuals who meet the requirements specified in this part, and to promulgate rules and regulations for the implementation of the part including, but not limited to, the setting of fees and the establishment of disciplinary actions. The committee shall maintain a list of all licensees that shall be provided to any interested party on written request.
  3. (c)
    1. (1) The committee as created shall consist of:
      1. (A) Three (3) persons licensed as board certified behavior analysts or board certified behavior analysts-doctoral;
      2. (B) One (1) person certified as a board certified assistant behavior analyst; and
      3. (C) One (1) public member who is a consumer of applied behavior analysis services and holds neither certification.
    2. (2) The members listed in subdivisions (c)(1)(A) and (B) may be appointed by the governor from lists of qualified nominees submitted by interested behavior analyst groups including, but not limited to, the Tennessee Association of Behavior Analysts.
    3. (3) The governor shall consult with interested behavior analyst groups including, but not limited to, the Tennessee Association of Behavior Analysts, to determine qualified persons to fill the positions as provided in this subsection (c).
    4. (4) Initial appointees to the committee shall serve staggered terms as follows:
      1. (A) One (1) of the persons appointed pursuant to subdivision (c)(1)(A) shall serve an initial term of one (1) year;
      2. (B) One (1) of the persons appointed pursuant to subdivision (c)(1)(A) and the person listed in subdivision (c)(1)(C) shall serve initial terms of two (2) years; and
      3. (C) One (1) of the persons appointed pursuant to subdivision (c)(1)(A) and the person listed in subdivision (c)(1)(B) shall serve initial terms of three (3) years.
    5. (5)
      1. (A)
        1. (i) Upon the expiration of the first full term of the member appointed pursuant to subdivision (c)(4)(A) on June 30, 2018, the governor shall appoint a licensed board certified behavior analyst to serve on the committee for a term of three (3) years.
        2. (ii) Upon the expiration of the first full terms of the members appointed pursuant to subdivision (c)(4)(B) on June 30, 2019, the governor shall appoint a licensed board certified behavior analyst and a public member, who holds no credentials as a licensed board certified behavior analyst or as a licensed assistant behavior analyst, to serve on the committee for terms of three (3) years.
        3. (iii) Upon the expiration of the first full terms of the members appointed pursuant to subdivision (c)(4)(C) on June 30, 2020, the governor shall appoint a licensed board certified behavior analyst and a licensed assistant behavior analyst to serve on the committee for terms of three (3) years.
      2. (B) No member appointed pursuant to subdivision (c)(5)(A) or any member appointed subsequent to such members shall be eligible to serve more than one (1) consecutive three-year term.
      3. (C) Members' terms shall begin on July 1 and expire on June 30.
  4. (d) All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter. All members of the committee shall serve as such without compensation, but they shall be entitled to receive necessary travel and other appropriate expenses while engaged in the committee's work.
  5. (e) The committee shall be provided administrative support by the division of health related boards in the department of health.
  6. (f)
    1. (1) The committee shall meet at least once per quarter.
    2. (2)
      1. (A) Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the committee.
      2. (B) The chair of the committee shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (f)(2)(A).
  7. (g) The committee shall elect a chair from among its members appointed pursuant to subdivision (c)(1)(A) at the first meeting held in each fiscal year. A committee meeting may be called upon reasonable notice in the discretion of the chair and shall be called at any time upon reasonable notice by a petition of three (3) committee members to the chair.
  8. (h) Any actions taken in accordance with this part shall only be effective after adoption by majority vote of the members of the committee and after adoption by a majority vote of the members of the board at the next board meeting at which administrative matters are considered following the adoption by the committee.
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§ 63-11-304. Application for license — Requirements.
  1. (a) Each person desiring to obtain a license shall submit an application and fee to the committee. The application shall include evidence that the applicant meets all of the following requirements for licensure:
    1. (1) The applicant is at least twenty-one (21) years of age;
    2. (2) The applicant is of good moral character and conducts his or her professional activities in accordance with accepted professional and ethical standards, including the certifying entity's Professional Disciplinary and Ethical Standards and Guidelines for Responsible Conduct for Behavior Analysts;
    3. (3) The applicant has not had a professional credential refused, revoked, suspended, or restricted and does not have a complaint, allegation, or investigation pending in any regulatory jurisdiction in the United States or in another country for reasons that relate to unprofessional conduct, unless the committee finds that the conduct has been corrected or that mitigating circumstances exist that prevent resolution;
    4. (4) LBA applicants shall:
      1. (A) Be certified as a BCBA or board certified behavior analyst-doctoral at the time of application; and
      2. (B) Not be the subject of disciplinary actions by the certifying entity; and
    5. (5) LABA applicants shall:
      1. (A) Be certified as a board certified assistant behavior analyst at the time of application;
      2. (B) Not be the subject of disciplinary actions by the certifying entity; and
      3. (C) Provide proof of ongoing supervision by an LBA who is currently certified as a BCBA or board certified behavior analyst-doctoral in a manner consistent with the certifying entity's requirements for supervision of board certified assistant behavior analysts.
  2. (b)
    1. (1) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-11-305. Use of titles — Practice of applied behavior analysis — Penalty for violation.
  1. (a) No person shall use the title “licensed behavior analyst” or “licensed assistant behavior analyst” unless that person holds the applicable license issued by the committee.
  2. (b) No person shall practice applied behavior analysis unless that person is licensed by the committee as an LBA or an LABA or meets criteria for one (1) of the exemptions in § 63-11-306.
  3. (c) Any person who violates this section commits a Class B misdemeanor, punishable by a fine only, the suspension or revocation of a license issued pursuant to this part, or both fine and loss of licensure.
§ 63-11-306. Exceptions from application of part.
  1. This part shall not be construed as prohibiting or restricting the practice of any of the following:
    1. (1) Other human services professionals who are licensed, registered, or certified by the state; provided, such individuals are working within the scope of practice of their professions and the scope of their training and competence;
    2. (2) Unlicensed persons who deliver applied behavior analysis (ABA) services under the extended authority and direction of an LBA or an LABA who is supervised by an LBA. Such persons shall not represent themselves as professional behavior analysts;
    3. (3) Family members of recipients of ABA services who implement certain ABA procedures with recipients under the extended authority and direction of LBAs or LABAs who are supervised by LBAs. Such persons shall not represent themselves as professional behavior analysts;
    4. (4) Behavior analysts who practice with nonhumans, including applied animal behaviorists and animal trainers. Such persons may use the title “behavior analyst” but may not represent themselves as LBAs or LABAs unless they hold one (1) of the credentials issued by the committee;
    5. (5) Persons who provide general ABA services to organizations, so long as those services are for the benefit of the organizations and do not involve direct services to individuals;
    6. (6) Matriculated college or university students, interns, or postdoctoral fellows whose activities are part of a defined behavior analysis program of study, practicum, or intensive practicum; provided, that the practice under this exemption is directly supervised by an LBA in this state or an instructor in a BACB approved course sequence. Students, interns, and postdoctoral fellows shall not represent themselves as professional behavior analysts but shall use titles that clearly indicate their trainee status, such as “behavior analysis student,” “behavior analysis intern,” or “behavior analysis trainee”;
    7. (7) Persons who teach behavior analysis or conduct behavior analytic research; provided, that such teaching or research does not involve the delivery of direct behavior analytic services. Such persons may use the title “behavior analyst” but may not represent themselves as LBAs or LABAs unless they hold one (1) of the credentials issued by the committee; and
    8. (8) Unlicensed persons pursuing experiential training in behavior analysis consistent with the BACB's experience requirements; provided, such experience is supervised by an LBA in this state who meets BACB supervisor requirements, and that the supervised experience is conducted in accordance with other BACB standards and requirements.
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§ 63-11-307. Term of license — Requirements for initial or renewed licensure — Provisional licensing — Promulgation of rules.
  1. (a) Licenses for LBAs and LABAs shall be valid for two (2) years from the date of issuance.
  2. (b) A person applying for initial or renewed licensure shall provide:
    1. (1) Evidence of current certification at the required certification level;
    2. (2) A photocopy of valid photo identification;
    3. (3) A completed application form; and
    4. (4) A notarized statement indicating that the applicant is in good standing with the certifying entity and the committee, and has complied with all requirements of this part.
  3. (c) The committee may grant provisional licenses for LBA and LABA to any person qualified by the department of intellectual and developmental disabilities (DIDD) to provide behavior analysis services prior to July 12, 2012, if such person:
    1. (1) Provides a notarized statement and evidence that they are in good standing with the standards and the guidelines of DIDD for granting such qualification;
    2. (2) Provides a photocopy of a valid photo identification;
    3. (3) Submits a completed application form;
    4. (4) Pays all applicable fees for licensure and licensure renewal for the required certification level; and
    5. (5) Has received certification by the BACB and applied for and obtained a regular license under the terms of this section by July 1, 2019.
  4. (d) The committee shall promulgate rules to establish reasonable and necessary fees for licensure and licensure renewal for both LBAs and LABAs so that, in the aggregate, such fees produce sufficient revenue to cover the cost of administering this part.
§ 63-11-308. Supervision of licensed assistant behavior analysts.
  1. (a) A LBA shall provide supervision of applied behavior analysis (ABA) services under the LBA's extended authority and direction to all designated persons as provided in this part.
  2. (b) A LABA shall work under the supervision of an LBA.
  3. (c)
    1. (1) A LBA shall provide supervision to a maximum of six (6) LABAs concurrently, with the supervision to be conducted as follows:
      1. (A) A minimum of two (2) hours for each forty (40) hours of services provided by a LABA;
      2. (B) A minimum of one-half (½) of all supervision hours shall involve real time interactions;
      3. (C) A minimum of one-half (½) of all supervision hours shall involve one-to-one interactions between supervisors and supervisees. The remainder may be conducted in small group format.
    2. (2) Acceptable supervision activities include:
      1. (A) Direct observation of the LABA delivering ABA services to service recipients;
      2. (B) Direct observation of the LABA training family members and staff to implement ABA assessment or intervention procedures;
      3. (C) Demonstrating ABA assessment or intervention procedures;
      4. (D) Coaching supervisees in implementing ABA assessment or intervention procedures;
      5. (E) Reviewing and discussing treatment goals and procedures;
      6. (F) Reviewing service recipient progress data; and
      7. (G) Reviewing and discussing relevant research articles and other professional literature.
  4. (d) A formal professional relationship shall exist between a supervising LBA and LABA in the form of:
    1. (1) A co-employed relationship; or
    2. (2) An employee-employer relationship.
  5. (e) LABAs shall notify the committee within ten (10) business days of any change in supervision status.
§ 63-11-309. Complaints regarding unprofessional conduct — Sanctions.
  1. (a) All complaints regarding the unprofessional conduct of licensees shall be submitted to the committee in writing.
  2. (b) An administrative staff person shall be appointed to serve under the direction of the committee to assist with investigations conducted in accordance with this section.
  3. (c) Sanctions for unprofessional conduct shall be established by the committee.
§ 63-11-310. Compliance with ethical standards — Reporting of disciplinary sanctions — Grounds for forfeiture or nonrenewal of license — Notifications to committee.
  1. (a) All licensees shall comply with their respective certifying entity's Guidelines for Responsible Conduct and Professional Disciplinary and Ethical Standards.
  2. (b) Any person licensed under this part who receives disciplinary sanctions from the person's certifying entity shall report such sanctions to the committee within five (5) business days after the disciplinary sanctions have been imposed. Such sanctions may include, but not be limited to, the denial of initial or renewal certification, revocation, suspension, or any other limitation of certification or combination of sanctions. Any licensee who loses certification for any reason shall immediately forfeit their license issued by the committee and shall stop providing ABA services in this state.
  3. (c) Other grounds for forfeiture or nonrenewal of a license issued in accordance with this part include:
    1. (1) Obtaining or attempting to obtain a license by making a false or misleading statement, failing to make a required statement, or engaging in fraud or deceit in any communication to the committee;
    2. (2) Gross or repeated negligence, incompetence, misconduct, or malpractice in professional work including, but not limited to:
      1. (A) Any physical or mental condition that currently impairs a licensee's competent professional performance or that poses a substantial risk to the recipient of behavior analysis services;
      2. (B) Professional conduct that constitutes an extreme and unjustified deviation from the customary standard of practice accepted in the applied behavior analytic community that creates a serious risk of harm to, or deception of, service recipients;
      3. (C) Abandonment of a service recipient resulting in the termination of imminently needed care without adequate notice or provision for transition;
      4. (D) Professional record keeping or data collection that constitutes an extreme and unjustified deviation from the customary standard of practice for the field, or deceptively altering a service recipient's records or data;
      5. (E) Engaging in blatant fraud, deception, misrepresentation, false promise or pretense, intimidation in the practice of applied behavior analysis, or in solicitation of service recipients;
      6. (F) The unauthorized material disclosure of confidential service recipient information;
      7. (G) Limitation, sanction, revocation, or suspension by a health care organization, professional organization, or other private or governmental body, relating to behavior analysis practice, public health or safety, or behavior analysis certification or licensure; or
      8. (H) Any conviction of a felony or misdemeanor directly relating to behavior analysis practice or public health or safety.
  4. (d) Applicants and licensees shall notify the committee of the following within thirty (30) days of their occurrence:
    1. (1) A change of name, address, or other vital information;
    2. (2) The filing of any criminal charge or civil action against the applicant or licensee;
    3. (3) The initiation of any disciplinary charges, investigations, or findings or sanctions by a health care organization, federal or state agency, or other professional association against the licensee; and
    4. (4) Any other change in information provided by the applicant or licensee to the committee.
  5. (e) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-11-311. Reciprocal licensing.
  1. (a)
    1. (1) The committee may, in its discretion, grant a license to any person residing or employed in this state who has not previously failed to attain a license as a behavior analyst or assistant behavior analyst and who, at the time of application:
      1. (A) Is licensed or certified by a similar entity in another state whose standards, in the opinion of the committee, are not less stringent than those required by this part; and
      2. (B) Is able to satisfy the committee that to grant such person a license would be in the public interest.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) Notwithstanding subsection (a), the committee shall grant a license to a person who at the time of application:
    1. (1) Is licensed or certified in good standing with a similar entity of another state;
    2. (2) Is certified as a BCBA, a BCBA-D or a BCABA; and
    3. (3) Can show reasonable proof that the applicant has available employment in this state.
§ 63-11-312. Administration of behavioral scales by LBA.
  1. (a) An LBA may administer behavioral scales that are within the scope of the practice of applied behavior analysis.
  2. (b) When administering behavioral scales, an LBA:
    1. (1) Shall only use the results of the behavioral scales to guide treatment planning or monitor the progress of treatment for behavioral disorders;
    2. (2) Shall not interpret the overall results or use the results of the scales for diagnosis, an overall conceptualization of psychological functioning, intelligence, or neuropsychological functioning; and
    3. (3) May submit the scores derived from behavioral scales to an insurer if the LBA is required to do so.
Part 4 Professional Art Therapy
§ 63-11-401. Professional art therapist advisory committee — License required for practice of art therapy.
  1. (a) The practice of art therapy in this state is declared to affect the public health, safety, and welfare of citizens of this state.
  2. (b) To assist the board of examiners in psychology in the performance of its duties, there is established the professional art therapist advisory committee to protect the public from:
    1. (1) The practice of art therapy by unqualified persons; and
    2. (2) Unprofessional, unethical, and harmful conduct by art therapy practitioners.
  3. (c) A person shall not represent to be or function as a professional art therapist in this state unless the person holds a valid license issued by the advisory committee. The committee shall also regulate the practice of art therapy.
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§ 63-11-402. Part definitions.
  1. As used in this part:
    1. (1) “Advisory committee” means the professional art therapist advisory committee of the board of examiners in psychology, created by § 63-11-401;
    2. (2) “Appraisal activities”:
      1. (A) Means selecting, administering, scoring, and interpreting art therapy instruments that are used to understand, measure, or facilitate an individual's normal human growth and development; and
      2. (B) Does not include the use of projective techniques in the assessment of personality, nor the use of psychological or clinical tests designed to identify or classify abnormal or pathological human behavior, nor the use of individually administered intelligence tests;
    3. (3) “Art therapy” means the integrated application of psychotherapeutic principles and methods with specialized training in visual art media, the neurobiological implications of art-making and the creative process, and art-based assessment models to assist individuals, families, or groups to improve mental functioning, increase self-awareness and self-esteem, resolve conflicts and distress, and enhance social functioning;
    4. (4) “Art therapy certified supervisor” means a person credentialed by the Art Therapy Credentials Board, Inc., to provide supervised clinical experience for an associate art therapist;
    5. (5) “Associate art therapist” means a person holding a master's or doctoral degree in art therapy while engaged in the practice of professional art therapy under supervision as part of clinical training to fulfill the supervised experience requirement for becoming a licensed professional art therapist;
    6. (6) “Board” means the board of examiners in psychology, created by § 63-11-101;
    7. (7) “Certified art therapist” means a person holding national board certification (ATR-BC) from the Art Therapy Credentials Board, Inc.;
    8. (8) “Credentialed art therapist” means a person holding credentials in good standing with the Art Therapy Credentials Board, Inc., as a registered art therapist (ATR), certified art therapist (ATR-BC), or art therapy certified supervisor;
    9. (9) “Licensed professional art therapist” means a person who is licensed to practice professional art therapy in this state;
    10. (10) “Practice of professional art therapy”:
      1. (A) Means rendering or offering to render to individuals, groups, organizations, or the general public any service as an independent or adjunctive therapist involving the application of art therapy principles, techniques, methods, or procedures; and
      2. (B) Includes, but is not limited to, therapeutic interventions to facilitate alternative modes of receptive and expressive communication, development of treatment plans, appraisal activities, consulting and referral activities, and prevention and treatment of mental and emotional conditions; and
    11. (11) “Supervision” means the regular observation and oversight of the functions and activities of a graduate art therapy student as part of an internship or practicum experience, or an associate art therapist engaged in the practice of art therapy to fulfill the requirements for licensure under § 63-11-405.
§ 63-11-403. Members of professional art therapist advisory committee.
  1. (a) The professional art therapist advisory committee of the board of examiners in psychology consists of three (3) members appointed by the governor. The advisory committee is authorized to issue licenses to persons who meet the requirements specified in this part, and to promulgate rules for the implementation of the part, including, but not limited to, the setting of fees and the establishment of disciplinary actions. The advisory committee shall maintain a list of all licensees and shall provide the list to any interested party on written request.
  2. (b) Advisory committee members must be licensed professional art therapists and must be actively engaged in the practice or teaching of art therapy in this state at the time of their appointment, except that initial appointments to the advisory committee made prior to the promulgation of rules to implement this part must be certified art therapists who are residents of this state and have engaged in the practice of art therapy for not less than five (5) years.
  3. (c) The governor shall consult with interested art therapy groups, including, but not limited to, a professional organization that represents the profession of art therapy in this state, to determine qualified persons for appointment as advisory committee members.
  4. (d)
    1. (1) Except as provided in subdivision (d)(2), the terms of the members of the advisory committee are three (3) years.
    2. (2) In order to stagger the terms of the newly appointed advisory committee members, initial appointments are to be made as follows:
      1. (A) One (1) person appointed pursuant to subsection (a) shall serve an initial term of one (1) year, which expires on June 30, 2022;
      2. (B) One (1) person appointed pursuant to subsection (a) shall serve an initial term of two (2) years, which expires on June 30, 2023; and
      3. (C) One (1) person appointed pursuant to subsection (a) shall serve an initial term of three (3) years, which expires on June 30, 2024.
    3. (3)
      1. (A) Following the expiration of members' initial terms as prescribed in subdivision (d)(2), all three-year terms must begin on July 1 and terminate on June 30, three (3) years thereafter.
      2. (B) In the event of a vacancy, the governor shall fill the vacancy for the unexpired term. Each member shall serve until a successor is duly appointed and qualified.
      3. (C) Members are eligible for reappointment to the advisory committee following the expiration of their initial terms, but shall serve no more than two (2) consecutive three-year terms.
  5. (e) All reimbursement for travel expenses must be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter. Members of the advisory committee serve without compensation, but are entitled to receive necessary travel and other appropriate expenses while engaged in committee business.
  6. (f) The division of health related boards in the department of health shall provide administrative support to the advisory committee.
  7. (g)
    1. (1) The advisory committee shall meet at least twice a year and may hold additional meetings as the advisory committee may determine necessary to carry out its duties under this part.
    2. (2) Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year may be removed as a member of the advisory committee.
    3. (3) The chair of the advisory committee shall promptly notify, or cause to be notified, the appointing authority of any member who is removed for failing to satisfy the attendance requirement as prescribed in subdivision (g)(2).
  8. (h) The advisory committee shall elect a chair from among its members at the first meeting held each fiscal year.
  9. (i) Any actions taken in accordance with this part are only effective after adoption by majority vote of the members of the advisory committee and after adoption by a majority vote of the members of the board at the next board meeting at which administrative matters are considered following the adoption by the advisory committee.
§ 63-11-404. Promulgation of rules — Other duties of advisory committee.
  1. (a) The advisory committee shall:
    1. (1) Promulgate rules for the implementation of this part, including rules to establish:
      1. (A) Requirements and procedures for licensure and licensure renewal for licensed professional art therapists and associate art therapists;
      2. (B) Standards of practice, ethics, and professional responsibility to govern the conduct of persons licensed under this part;
      3. (C) Standards and requirements for engaging in private outpatient independent practice of professional art therapy;
      4. (D) Procedures for investigating reports of professional misconduct and unlawful acts by licensed professional art therapists; and
      5. (E) Criteria and procedures for licensure by endorsement and reciprocity, waiver of examinations, and temporary licenses;
    2. (2) Establish reasonable and necessary fees for licensure and licensure renewal that, in the aggregate, cover the cost of administering this part; and
    3. (3) Maintain a list of persons holding licenses under this part, to be provided to any interested party upon written request.
  2. (b) The advisory committee shall also:
    1. (1) Review issues related to complaints and disciplinary actions involving licensed professional art therapists;
    2. (2) Review the qualifications of licensure applications and issue licenses to individuals who meet the requirements for licensure under this part;
    3. (3) Establish requirements for supervised clinical practice by associate art therapists engaged in the practice of professional art therapy to fulfill requirements for licensure under this part;
    4. (4) Establish guidelines and criteria for continuing education for the renewal of licenses; and
    5. (5) Perform additional duties and responsibilities as requested by the board.
  3. (c) The rules promulgated by the advisory committee for the implementation of this part must:
    1. (1) Provide for the requirements for licensure as set forth in § 63-11-405; and
    2. (2) Take into consideration the standards of ethics and professional conduct of the Code of Ethics, Conduct and Disciplinary Procedures of the Art Therapy Credentials Board, Inc., and other national mental health organizations in effect on January 1, 2021.
§ 63-11-405. Application for licensure as a licensed professional art therapist.
  1. (a) Applicants for licensure as a licensed professional art therapist shall submit an application and fee to the advisory committee. The application must include evidence that the applicant meets the following requirements for licensure:
    1. (1) The applicant has attained the age of majority;
    2. (2) The applicant is of good moral character and conducts the applicant's professional activities in accordance with accepted professional and ethical standards;
    3. (3) The applicant has not had a professional credential refused, revoked, suspended, or restricted and does not have a complaint, allegation, or investigation pending in any regulatory jurisdiction in the United States or in another country for unprofessional conduct, unless the advisory committee finds that the conduct has been corrected or that mitigating circumstances exist that prevent resolution;
    4. (4) The applicant has:
      1. (A) Received a master's degree or doctoral degree in art therapy from a program approved by the American Art Therapy Association or accredited by the Commission on Accreditation of Allied Health Education Programs at the time the degree was conferred, and has completed not less than one thousand (1,000) client contact hours of experience after the master's degree was conferred under the supervision of an art therapy certified supervisor, licensed professional art therapist, credentialed art therapist, or other licensed mental health professional approved by the advisory committee. At least one-half (½) of the required supervision hours must be provided by an art therapy certified supervisor, licensed professional art therapist, or certified art therapist; or
      2. (B) Received a master's degree or doctoral degree from a college or university that was accredited by a national or regional accrediting organization recognized by the Council for Higher Education Accreditation in a program with a graduate-level course of study and clinical training that, as determined by the advisory committee, is equivalent to an approved or accredited program in art therapy, and has completed not less than one thousand five hundred (1,500) hours of client contact experience after the qualifying degree was conferred under the supervision of an art therapy certified supervisor, licensed professional art therapist, credentialed art therapist, or other licensed mental health professional approved by the advisory committee. At least one-half (½) of the required supervision hours must be provided by an art therapy certified supervisor, licensed professional art therapist, or certified art therapist; and
    5. (5) The applicant has passed the board certification examination of the Art Therapy Credentials Board, Inc.
  2. (b) A person holding a national credential in good standing as a certified art therapist is deemed to have met the requirements of this section upon submitting an application and fee and providing evidence satisfactory to the advisory committee that the applicant:
    1. (1) Is of good moral character and conducts the applicant's professional activities in accordance with accepted professional and ethical standards; and
    2. (2) Has not had a professional credential refused, revoked, suspended, or restricted and does not have a complaint, allegation, or investigation pending in any regulatory jurisdiction in the United States or in another country for unprofessional conduct, unless the advisory committee finds that the conduct has been corrected or that mitigating circumstances exist that prevent resolution.
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§ 63-11-406. Reciprocal licensing.
  1. (a) The advisory committee may, at its discretion, grant a license to any person residing or employed in this state who is licensed by a similar entity in another state whose standards, as determined by the advisory committee, are not less stringent than the standards required by this part.
  2. (b) The advisory committee may enter into a reciprocal agreement with another state or jurisdiction that licenses individuals engaged in the practice of professional art therapy, if the advisory committee determines that the other state has substantially similar or more stringent licensing requirements than this state.
§ 63-11-407. Term of license — Renewal — Automatic revocation — Required notifications.
  1. (a) A licensed professional art therapist license issued under this part is valid for twenty-four (24) months from the date of issuance.
  2. (b) A licensee requesting renewal of a license must provide the following to the advisory committee in advance of the expiration date of the license:
    1. (1) A completed application on a form provided by the advisory committee and payment of the fee set by the advisory committee; and
    2. (2) A certified or sworn statement to the advisory committee that the licensee:
      1. (A) Has completed at least forty (40) hours of continuing education prior to the expiration date of the license; and
      2. (B) Has not had a professional credential revoked, suspended, or restricted by the Art Therapy Credentials Board, Inc., and does not have a complaint, allegation, or investigation pending in this state or in any regulatory jurisdiction for unethical or unprofessional conduct.
  3. (c) If a licensee fails to submit an application for license renewal and to pay any fee required by the advisory committee prior to the expiration date of the license, then the license is automatically revoked by the advisory committee without further notice or hearing, unless renewal is completed and all fees are paid prior to the expiration of sixty (60) days from the date of the expiration of the license.
  4. (d) A person whose license is automatically revoked under this section may apply in writing to the advisory committee for reinstatement of the license. Upon the showing of good cause by the person and submitting documentation that all continuing education requirements have been satisfied, the advisory committee may reinstate the license upon the payment of all fees set by the advisory committee.
  5. (e) Applicants and licensees must notify the advisory committee of the following within thirty (30) days of their occurrence:
    1. (1) A change of name, address, or other vital information;
    2. (2) The filing of any criminal charge or civil action against the applicant or licensee;
    3. (3) The initiation of any disciplinary charges, investigations, findings, or sanctions by a healthcare organization, federal or state agency, or other professional association against the applicant or licensee; and
    4. (4) Any other change in information provided by the applicant or licensee to the committee.
§ 63-11-408. Use of titles — Practice of professional art therapy — Penalty for violation.
  1. (a) A person shall not use the title “licensed professional art therapist” or “licensed art therapist,” or use an abbreviation to indicate or imply that the person is a licensed professional art therapist, in this state unless the person holds a license issued by the advisory committee under this part. This subsection (a) does not prohibit an associate art therapist from using the title “associate art therapist” in accordance with this part.
  2. (b) A person shall not practice professional art therapy unless the person is:
    1. (1) Licensed by the advisory committee as a licensed professional art therapist;
    2. (2) An associate art therapist, as long as the person uses the title of “associate art therapist” and does not represent themselves to the public as a licensed professional art therapist; or
    3. (3) Exempt from licensure under § 63-11-410.
  3. (c) A violation of this section is a Class B misdemeanor, punishable by a fine only, the suspension or revocation of a license issued under this part, or both a fine and loss of licensure.
§ 63-11-409. Practice with centers — Private outpatient independent practice.
  1. (a) A licensed professional art therapist may practice independently for and with organizations that include, but are not limited to, addiction and rehabilitation centers, art studios and centers, behavioral health hospitals and outpatient settings, cancer treatment centers, community centers, community services boards, correctional facilities, disability services, eating disorder clinics, government agencies, medical hospitals and outpatient settings, military bases and veterans and family services, museums, nonprofits, nursing homes, physical rehabilitation, residential treatment centers, schools, senior living facilities, state programs, and wellness centers.
  2. (b) Until the advisory committee promulgates rules to establish the requirements for private outpatient independent practice by a licensed professional art therapist, a licensed professional art therapist may only work in a private, outpatient independent setting if the patient is referred to the therapist by:
    1. (1) A physician licensed under chapter 6 or 9 of this title;
    2. (2) A psychologist licensed under this chapter;
    3. (3) A professional counselor licensed under chapter 22 of this title;
    4. (4) A professional counselor designated as a mental health service provider under chapter 22 of this title;
    5. (5) A marital and family therapist licensed under chapter 22 of this title;
    6. (6) A pastoral counselor licensed under chapter 22 of this title;
    7. (7) A licensed master's social worker licensed under chapter 23 of this title;
    8. (8) A licensed clinical social worker licensed under chapter 23 of this title; or
    9. (9) Another advanced medical or mental health professional licensed under this title, as determined by the board.
§ 63-11-410. Scope of part.
  1. (a) This part does not:
    1. (1) Require licensure or restrict the activities of a student enrolled in a graduate program in art therapy approved by the advisory committee while practicing art therapy under qualified supervision and as part of an approved course of study; or
    2. (2) Prohibit or restrict the practice of persons authorized to practice under this title who perform services consistent with the scope of practice of their profession and within the scope of their training and competence; provided, that the persons do not represent themselves to the public as a professional art therapist or as holding a license issued under this part.
  2. (b) This part does not permit any method of treatment that involves the administration or prescription of drugs or the practice of medicine in this state or permits a person licensed as a professional art therapist to perform psychological testing.
  3. (c) Subsection (b) does not prohibit a licensed professional art therapist from conducting appraisal activities. Consistent with each licensed professional art therapist's formal education and training, licensed professional art therapists may administer and utilize appropriate art therapy assessment instruments that measure or determine problems or dysfunctions within the context of human growth and development as part of the therapeutic process or in the development of a treatment plan.
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§ 63-11-411. Denial, suspension, or revocation of license or other disciplinary action — Grounds.
  1. (a) The advisory committee may deny a person's application for a license, restrict, suspend, or revoke an existing license, or take other action that the advisory committee deems proper.
  2. (b) The grounds upon which the advisory committee may exercise the powers enumerated in subsection (a) include, but are not limited to:
    1. (1) Obtaining or attempting to obtain a license by making a false or misleading statement, failing to make a required statement, or engaging in fraud or deceit in any communication to the advisory committee;
    2. (2) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any criminal statute of this state, any provision of this chapter, a rule promulgated by the advisory committee, or any lawful order of the advisory committee issued pursuant to rules;
    3. (3) Gross or repeated negligence, incompetence, misconduct, or malpractice in professional work including, but not limited to:
      1. (A) Any physical or mental condition that currently impairs a licensee's competent professional performance or that poses a substantial risk to the recipient of art therapy services;
      2. (B) Professional conduct that constitutes an extreme and unjustified deviation from the customary standard of practice accepted in the professional practice of art therapy;
      3. (C) Abandonment of a service recipient resulting in the termination of imminently needed care without adequate notice or provision for transition;
      4. (D) Professional recordkeeping or data collection that constitutes an extreme and unjustified deviation from the customary standard of practice for the field, or deceptively altering a service recipient's records or data; and
      5. (E) Unauthorized disclosure of confidential client information, including, but not limited to, client records, art work, and artistic expressions; and
    4. (4) Any other action deemed to be grounds for disciplinary action under § 63-11-215.
  3. (c) All proceedings for disciplinary action against a licensee under this part must be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Part 5 Psychology Interjurisdictional Compact
§ 63-11-501. Short title.
  1. This part is known and may be cited as the “Psychology Interjurisdictional Compact Act.”
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§ 63-11-502. Compact approved and ratified.
    1. The general assembly hereby approves and ratifies, and the governor shall enter into, a compact on behalf of the state of Tennessee with any of the United States or other jurisdictions legally joining therein in the form substantially as follows:
  2. PSYCHOLOGY INTERJURISDICTIONAL COMPACT
    1. ARTICLE I. PURPOSE
      1. Whereas, states license psychologists, in order to protect the public through verification of education, training, and experience and ensure accountability for professional practice; and
      2. Whereas, this Compact is intended to regulate the day to day practice of telepsychology (i.e. the provision of psychological services using telecommunication technologies) by psychologists across state boundaries in the performance of their psychological practice as assigned by an appropriate authority; and
      3. Whereas, this Compact is intended to regulate the temporary, in-person, face-to-face practice of psychology by psychologists across state boundaries for thirty (30) days within a calendar year in the performance of their psychological practice as assigned by an appropriate authority; and
      4. Whereas, this Compact is intended to authorize State Psychology Regulatory Authorities to afford legal recognition, in a manner consistent with the terms of the Compact, to psychologists licensed in another state; and
      5. Whereas, this Compact recognizes that states have a vested interest in protecting the public's health and safety through their licensing and regulation of psychologists and that such state regulation will best protect public health and safety; and
      6. Whereas, this Compact does not apply when a psychologist is licensed in both the Home and Receiving States; and
      7. Whereas, this Compact does not apply to permanent, in-person, face-to-face practice, it does allow for authorization of temporary psychological practice. Consistent with these principles, this Compact is designed to achieve the following purposes and objectives:
        1. 1. Increase public access to professional psychological services by allowing for telepsychological practice across state lines as well as temporary, in-person, face-to-face services into a state which the psychologist is not licensed to practice psychology;
        2. 2. Enhance the states' ability to protect the public's health and safety, especially client/patient safety;
        3. 3. Encourage the cooperation of Compact States in the areas of psychology licensure and regulation;
        4. 4. Facilitate the exchange of information between Compact States regarding psychologist licensure, adverse actions, and disciplinary history;
        5. 5. Promote compliance with the laws governing psychological practice in each Compact State; and
        6. 6. Invest all Compact States with the authority to hold licensed psychologists accountable through the mutual recognition of Compact State licenses.
    2. ARTICLE II. DEFINITIONS
      1. A. “Adverse Action” means: any action taken by a State Psychology Regulatory Authority which finds a violation of a statute or regulation that is identified by the State Psychology Regulatory Authority as discipline and is a matter of public record.
      2. B. “Association of State and Provincial Psychology Boards (ASPPB)” means: the recognized membership organization composed of State and Provincial Psychology Regulatory Authorities responsible for the licensure and registration of psychologists throughout the United States and Canada.
      3. C. “Authority to Practice Interjurisdictional Telepsychology” means: a licensed psychologist's authority to practice telepsychology, within the limits authorized under this Compact, in another Compact State.
      4. D. “Bylaws” means: those Bylaws established by the Psychology Interjurisdictional Compact Commission pursuant to Article X for its governance, or for directing and controlling its actions and conduct.
      5. E. “Client/Patient” means: the recipient of psychological services, whether psychological services are delivered in the context of healthcare, corporate, supervision, and/or consulting services.
      6. F. “Commissioner” means: the voting representative appointed by each State Psychology Regulatory Authority pursuant to Article X.
      7. G. “Compact State” means: a state, the District of Columbia, or United States territory that has enacted this Compact legislation and which has not withdrawn pursuant to Article XIII, Section C or been terminated pursuant to Article XII, Section B.
      8. H. “Coordinated Licensure Information System,” also referred to as “Coordinated Database,” means: an integrated process for collecting, storing, and sharing information on psychologists' licensure and enforcement activities related to psychology licensure laws, which is administered by the recognized membership organization composed of State and Provincial Psychology Regulatory Authorities.
      9. I. “Confidentiality” means: the principle that data or information is not made available or disclosed to unauthorized persons and/or processes.
      10. J. “Day” means: any part of a day in which psychological work is performed.
      11. K. “Distant State” means: the Compact State where a psychologist is physically present (not through the use of telecommunications technologies), to provide temporary, in-person, face-to-face psychological services.
      12. L. “E.Passport” means: a certificate issued by the Association of State and Provincial Psychology Boards (ASPPB) that promotes the standardization in the criteria of interjurisdictional telepsychology practice and facilitates the process for licensed psychologists to provide telepsychological services across state lines.
      13. M. “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.
      14. N. “Home State” means: a Compact State where a psychologist is licensed to practice psychology. If the psychologist is licensed in more than one Compact State and is practicing under the Authorization to Practice Interjurisdictional Telepsychology, the Home State is the Compact State where the psychologist is physically present when the telepsychological services are delivered. If the psychologist is licensed in more than one Compact State and is practicing under the Temporary Authorization to Practice, the Home State is any Compact State where the psychologist is licensed.
      15. O. “Identity History Summary” means: a summary of information retained by the FBI, or other designee with similar authority, in connection with arrests and, in some instances, federal employment, naturalization, or military service.
      16. P. “In-Person, Face-to-Face” means: interactions in which the psychologist and the client/patient are in the same physical space and which does not include interactions that may occur through the use of telecommunication technologies.
      17. Q. “Interjurisdictional Practice Certificate (IPC)” means: a certificate issued by the Association of State and Provincial Psychology Boards (ASPPB) that grants temporary authority to practice based on notification to the State Psychology Regulatory Authority of intention to practice temporarily, and verification of one's qualifications for such practice.
      18. R. “License” means: authorization by a State Psychology Regulatory Authority to engage in the independent practice of psychology, which would be unlawful without the authorization.
      19. S. “Non-Compact State” means: any State which is not at the time a Compact State.
      20. T. “Psychologist” means: an individual licensed for the independent practice of psychology.
      21. U. “Psychology Interjurisdictional Compact Commission,” also referred to as “Commission,” means: the national administration of which all Compact States are members.
      22. V. “Receiving State” means: a Compact State where the client/patient is physically located when the telepsychological services are delivered.
      23. W. “Rule” means: a written statement by the Psychology Interjurisdictional Compact Commission promulgated pursuant to Article XI of the Compact 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 Commission and has the force and effect of statutory law in a Compact State, and includes the amendment, repeal, or suspension of an existing rule.
      24. X. “Significant Investigatory Information” means:
        1. 1. Investigative information that a State Psychology Regulatory Authority, after a preliminary inquiry that includes notification and an opportunity to respond if required by state law, has reason to believe, if proven true, would indicate more than a violation of state statute or ethics code that would be considered more substantial than minor infraction; or
        2. 2. Investigative information that indicates that the psychologist represents an immediate threat to public health and safety regardless of whether the psychologist has been notified and/or had an opportunity to respond.
      25. Y. “State” means: a state, commonwealth, territory, or possession of the United States, or the District of Columbia.
      26. Z. “State Psychology Regulatory Authority” means: the Board, office, or other agency with the legislative mandate to license and regulate the practice of psychology.
      27. AA. “Telepsychology” means: the provision of psychological services using telecommunication technologies.
      28. BB. “Temporary Authorization to Practice” means: a licensed psychologist's authority to conduct temporary, in-person, face-to-face practice, within the limits authorized under this Compact, in another Compact State.
      29. CC. “Temporary, In-Person, Face-to-Face Practice” means: where a psychologist is physically present (not through the use of telecommunications technologies), in the Distant State to provide for the practice of psychology for thirty (30) days within a calendar year and based on notification to the Distant State.
    3. ARTICLE III. HOME STATE LICENSURE
      1. A. The Home State shall be a Compact State where a psychologist is licensed to practice psychology.
      2. B. A psychologist may hold one or more Compact State licenses at a time. If the psychologist is licensed in more than one Compact State, the Home State is the Compact State where the psychologist is physically present when the services are delivered as authorized by the Authority to Practice Interjurisdictional Telepsychology under the terms of this Compact.
      3. C. Any Compact State may require a psychologist not previously licensed in a Compact State to obtain and retain a license to be authorized to practice in the Compact State under circumstances not authorized by the Authority to Practice Interjurisdictional Telepsychology under the terms of this Compact.
      4. D. Any Compact State may require a psychologist to obtain and retain a license to be authorized to practice in a Compact State under circumstances not authorized by Temporary Authorization to Practice under the terms of this Compact.
      5. E. A Home State's license authorizes a psychologist to practice in a Receiving State under the Authority to Practice Interjurisdictional Telepsychology only if the Compact State:
        1. 1. Currently requires the psychologist to hold an active E.Passport;
        2. 2. Has a mechanism in place for receiving and investigating complaints about licensed individuals;
        3. 3. Notifies the Commission, in compliance with the terms herein, of any adverse action or significant investigatory information regarding a licensed individual;
        4. 4. Requires an Identity History Summary of all applicants at initial licensure, including the use of the results of fingerprints or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation (FBI), or other designee with similar authority, no later than ten (10) years after activation of the Compact; and
        5. 5. Complies with the Bylaws and Rules of the Commission.
      6. F. A Home State's license grants Temporary Authorization to Practice to a psychologist in a Distant State only if the Compact State:
        1. 1. Currently requires the psychologist to hold an active IPC;
        2. 2. Has a mechanism in place for receiving and investigating complaints about licensed individuals;
        3. 3. Notifies the Commission, in compliance with the terms herein, of any adverse action or significant investigatory information regarding a licensed individual;
        4. 4. Requires an Identity History Summary of all applicants at initial licensure, including the use of the results of fingerprints or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation (FBI), or other designee with similar authority, no later than ten (10) years after activation of the Compact; and
        5. 5. Complies with the Bylaws and Rules of the Commission.
    4. ARTICLE IV. COMPACT PRIVILEGE TO PRACTICE TELEPSYCHOLOGY
      1. A. Compact States shall recognize the right of a psychologist, licensed in a Compact State in conformance with Article III, to practice telepsychology in other Compact States (Receiving States) in which the psychologist is not licensed, under the Authority to Practice Interjurisdictional Telepsychology as provided in the Compact.
      2. B. To exercise the Authority to Practice Interjurisdictional Telepsychology under the terms and provisions of this Compact, a psychologist licensed to practice in a Compact State must:
        1. 1. Hold a graduate degree in psychology from an institute of higher education that was, at the time the degree was awarded:
          1. a. Regionally accredited by an accrediting body recognized by the U.S. Department of Education to grant graduate degrees, OR authorized by Provincial Statute or Royal Charter to grant doctoral degrees; or
          2. b. A foreign college or university deemed to be equivalent to 1(a) above by a foreign credential evaluation service that is a member of the National Association of Credential Evaluation Services (NACES) or by a recognized foreign credential evaluation service; and
        2. 2. Hold a graduate degree in psychology that meets the following criteria:
          1. a. The program, wherever it may be administratively housed, must be clearly identified and labeled as a psychology program. Such a program must specify in pertinent institutional catalogues and brochures its intent to educate and train professional psychologists;
          2. b. The psychology program must stand as a recognizable, coherent, organizational entity within the institution;
          3. c. There must be a clear authority and primary responsibility for the core and specialty areas whether or not the program cuts across administrative lines;
          4. d. The program must consist of an integrated, organized sequence of study;
          5. e. There must be an identifiable psychology faculty sufficient in size and breadth to carry out its responsibilities;
          6. f. The designated director of the program must be a psychologist and a member of the core faculty;
          7. g. The program must have an identifiable body of students who are matriculated in that program for a degree;
          8. h. The program must include supervised practicum, internship, or field training appropriate to the practice of psychology;
          9. i. The curriculum shall encompass a minimum of three (3) academic years of full-time graduate study for doctoral degree and a minimum of one (1) academic year of full-time graduate study for master's degree; and
          10. j. The program includes an acceptable residency as defined by the Rules of the Commission;
        3. 3. Possess a current, full, and unrestricted license to practice psychology in a Home State which is a Compact State;
        4. 4. Have no history of adverse action that violate the Rules of the Commission;
        5. 5. Have no criminal record history reported on an Identity History Summary that violates the Rules of the Commission;
        6. 6. Possess a current, active E.Passport;
        7. 7. Provide attestations in regard to areas of intended practice, conformity with standards of practice, competence in telepsychology technology; criminal background; and knowledge and adherence to legal requirements in the Home and Receiving States, and provide a release of information to allow for primary source verification in a manner specified by the Commission; and
        8. 8. Meet other criteria as defined by the Rules of the Commission.
      3. C. The Home State maintains authority over the license of any psychologist practicing into a Receiving State under the Authority to Practice Interjurisdictional Telepsychology.
      4. D. A psychologist practicing into a Receiving State under the Authority to Practice Interjurisdictional Telepsychology will be subject to the Receiving State's scope of practice. A Receiving State may, in accordance with that state's due process law, limit or revoke a psychologist's Authority to Practice Interjurisdictional Telepsychology in the Receiving State and may take any other necessary actions under the Receiving State's applicable law to protect the health and safety of the Receiving State's citizens. If a Receiving State takes action, the state shall promptly notify the Home State and the Commission.
      5. E. If a psychologist's license in any Home State, another Compact State, or any Authority to Practice Interjurisdictional Telepsychology in any Receiving State, is restricted, suspended, or otherwise limited, the E.Passport shall be revoked and therefore the psychologist shall not be eligible to practice telepsychology in a Compact State under the Authority to Practice Interjurisdictional Telepsychology.
    5. ARTICLE V. COMPACT TEMPORARY AUTHORIZATION TO PRACTICE
      1. A. Compact States shall also recognize the right of a psychologist, licensed in a Compact State in conformance with Article III, to practice temporarily in other Compact States (Distant States) in which the psychologist is not licensed, as provided in the Compact.
      2. B. To exercise the Temporary Authorization to Practice under the terms and provisions of this Compact, a psychologist licensed to practice in a Compact State must:
        1. 1. Hold a graduate degree in psychology from an institute of higher education that was, at the time the degree was awarded:
          1. a. Regionally accredited by an accrediting body recognized by the U.S. Department of Education to grant graduate degrees, OR authorized by Provincial Statute or Royal Charter to grant doctoral degrees; or
          2. b. A foreign college or university deemed to be equivalent to 1(a) above by a foreign credential evaluation service that is a member of the National Association of Credential Evaluation Services (NACES) or by a recognized foreign credential evaluation service; and
        2. 2. Hold a graduate degree in psychology that meets the following criteria:
          1. a. The program, wherever it may be administratively housed, must be clearly identified and labeled as a psychology program. Such a program must specify in pertinent institutional catalogues and brochures its intent to educate and train professional psychologists;
          2. b. The psychology program must stand as a recognizable, coherent, organizational entity within the institution;
          3. c. There must be a clear authority and primary responsibility for the core and specialty areas whether or not the program cuts across administrative lines;
          4. d. The program must consist of an integrated, organized sequence of study;
          5. e. There must be an identifiable psychology faculty sufficient in size and breadth to carry out its responsibilities;
          6. f. The designated director of the program must be a psychologist and a member of the core faculty;
          7. g. The program must have an identifiable body of students who are matriculated in that program for a degree;
          8. h. The program must include supervised practicum, internship, or field training appropriate to the practice of psychology;
          9. i. The curriculum shall encompass a minimum of three (3) academic years of full-time graduate study for doctoral degrees and a minimum of one (1) academic year of full-time graduate study for master's degrees; and
          10. j. The program includes an acceptable residency as defined by the Rules of the Commission.
        3. 3. Possess a current, full, and unrestricted license to practice psychology in a Home State which is a Compact State;
        4. 4. No history of adverse action that violate the Rules of the Commission;
        5. 5. No criminal record history that violates the Rules of the Commission;
        6. 6. Possess a current, active IPC;
        7. 7. Provide attestations in regard to areas of intended practice and work experience and provide a release of information to allow for primary source verification in a manner specified by the Commission; and
        8. 8. Meet other criteria as defined by the Rules of the Commission.
      3. C. A psychologist practicing into a Distant State under the Temporary Authorization to Practice shall practice within the scope of practice authorized by the Distant State.
      4. D. A psychologist practicing into a Distant State under the Temporary Authorization to Practice will be subject to the Distant State's authority and law. A Distant State may, in accordance with that state's due process law, limit or revoke a psychologist's Temporary Authorization to Practice in the Distant State and may take any other necessary actions under the Distant State's applicable law to protect the health and safety of the Distant State's citizens. If a Distant State takes action, the state shall promptly notify the Home State and the Commission.
      5. E. If a psychologist's license in any Home State, another Compact State, or any Temporary Authorization to Practice in any Distant State, is restricted, suspended, or otherwise limited, the IPC shall be revoked and therefore the psychologist shall not be eligible to practice in a Compact State under the Temporary Authorization to Practice.
    6. ARTICLE VI. CONDITIONS OF TELEPSYCHOLOGY PRACTICE IN A RECEIVING STATE
      1. A psychologist may practice in a Receiving State under the Authority to Practice Interjurisdictional Telepsychology only in the performance of the scope of practice for psychology as assigned by an appropriate State Psychology Regulatory Authority, as defined in the Rules of the Commission, and under the following circumstances:
        1. 1. The psychologist initiates a client/patient contact in a Home State via telecommunications technologies with a client/patient in a Receiving State; or
        2. 2. Other conditions regarding telepsychology as determined by Rules promulgated by the Commission.
    7. ARTICLE VII. ADVERSE ACTIONS
      1. A. A Home State shall have the power to impose adverse action against a psychologist's license issued by the Home State. A Distant State shall have the power to take adverse action on a psychologist's Temporary Authorization to Practice within that Distant State.
      2. B. A Receiving State may take adverse action on a psychologist's Authority to Practice Interjurisdictional Telepsychology within that Receiving State. A Home State may take adverse action against a psychologist based on an adverse action taken by a Distant State regarding temporary, in-person, face-to-face practice.
      3. C. If a Home State takes adverse action against a psychologist's license, that psychologist's Authority to Practice Interjurisdictional Telepsychology is terminated and the E.Passport is revoked. Furthermore, that psychologist's Temporary Authorization to Practice is terminated and the IPC is revoked.
        1. 1. All Home State disciplinary orders which impose adverse action shall be reported to the Commission in accordance with the Rules promulgated by the Commission. A Compact State shall report adverse actions in accordance with the Rules of the Commission.
        2. 2. In the event discipline is reported on a psychologist, the psychologist will not be eligible for telepsychology or temporary, in-person, face-to-face practice in accordance with the Rules of the Commission.
        3. 3. Other actions may be imposed as determined by the Rules promulgated by the Commission.
      4. D. A Home State's Psychology Regulatory Authority shall investigate and take appropriate action with respect to reported inappropriate conduct engaged in by a licensee which occurred in a Receiving State as it would if such conduct had occurred by a licensee within the Home State. In such cases, the Home State's law shall control in determining any adverse action against a psychologist's license.
      5. E. A Distant State's Psychology Regulatory Authority shall investigate and take appropriate action with respect to reported inappropriate conduct engaged in by a psychologist practicing under Temporary Authorization to Practice which occurred in that Distant State as it would if such conduct had occurred by a licensee within the Home State. In such cases, Distant State's law shall control in determining any adverse action against a psychologist's Temporary Authorization to Practice.
      6. F. Nothing in this Compact shall override a Compact State's decision that a psychologist's participation in an alternative program may be used in lieu of adverse action and that such participation shall remain non-public if required by the Compact State's law. Compact States must require psychologists who enter any alternative programs to not provide telepsychology services under the Authority to Practice Interjurisdictional Telepsychology or provide temporary psychological services under the Temporary Authorization to Practice in any other Compact State during the term of the alternative program.
      7. G. No other judicial or administrative remedies shall be available to a psychologist in the event a Compact State imposes an adverse action pursuant to subsection C, above.
    8. ARTICLE VIII. ADDITIONAL AUTHORITIES INVESTED IN A COMPACT STATE'S PSYCHOLOGY REGULATORY AUTHORITY
      1. A. In addition to any other powers granted under state law, a Compact State's Psychology Regulatory Authority shall have the authority under this Compact to:
        1. 1. Issue subpoenas, for both hearings and investigations, which require the attendance and testimony of witnesses and the production of evidence. Subpoenas issued by a Compact State's Psychology Regulatory Authority for the attendance and testimony of witnesses, and/or the production of evidence from another Compact State shall be enforced in the latter state by any court of competent jurisdiction, according to that court's practice and procedure in considering subpoenas issued in its own proceedings. The issuing State Psychology Regulatory 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; and
        2. 2. Issue cease and desist and/or injunctive relief orders to revoke a psychologist's Authority to Practice Interjurisdictional Telepsychology and/or Temporary Authorization to Practice.
        3. 3. During the course of any investigation, a psychologist may not change his/her Home State licensure. A Home State Psychology Regulatory Authority is authorized to complete any pending investigations of a psychologist and to take any actions appropriate under its law. The Home State Psychology Regulatory Authority shall promptly report the conclusions of such investigations to the Commission. Once an investigation has been completed, and pending the outcome of said investigation, the psychologist may change his/her Home State licensure. The Commission shall promptly notify the new Home State of any such decisions as provided in the Rules of the Commission. All information provided to the Commission or distributed by Compact States pursuant to the psychologist shall be confidential, filed under seal, and used for investigatory or disciplinary matters. The Commission may create additional rules for mandated or discretionary sharing of information by Compact States.
    9. ARTICLE IX. COORDINATED LICENSURE INFORMATION SYSTEM
      1. A. The Commission shall provide for the development and maintenance of a Coordinated Licensure Information System (Coordinated Database) and reporting system containing licensure and disciplinary action information on all psychologists individuals to whom this Compact is applicable in all Compact States as defined by the Rules of the Commission.
      2. B. Notwithstanding any other provision of state law to the contrary, a Compact State shall submit a uniform data set to the Coordinated Database on all licensees as required by the Rules of the Commission, including:
        1. 1. Identifying information;
        2. 2. Licensure data;
        3. 3. Significant investigatory information;
        4. 4. Adverse actions against a psychologist's license;
        5. 5. An indicator that a psychologist's Authority to Practice Interjurisdictional Telepsychology and/or Temporary Authorization to Practice is revoked;
        6. 6. Non-confidential information related to alternative program participation information;
        7. 7. Any denial of application for licensure, and the reasons for such denial; and
        8. 8. Other information which may facilitate the administration of this Compact, as determined by the Rules of the Commission.
      3. C. The Coordinated Database administrator shall promptly notify all Compact States of any adverse action taken against, or significant investigative information on, any licensee in a Compact State.
      4. D. Compact States reporting information to the Coordinated Database may designate information that may not be shared with the public without the express permission of the Compact State reporting the information.
      5. E. Any information submitted to the Coordinated Database that is subsequently required to be expunged by the law of the Compact State reporting the information shall be removed from the Coordinated Database.
    10. ARTICLE X. ESTABLISHMENT OF THE PSYCHOLOGY INTERJURISDICTIONAL COMPACT COMMISSION
      1. A. The Compact States hereby create and establish a joint public agency known as the Psychology Interjurisdictional Compact Commission.
        1. 1. The Commission is a body politic and an instrumentality of the Compact States.
        2. 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. 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
      2. B. Membership, Voting, and Meetings.
        1. 1. The Commission shall consist of one (1) voting representative appointed by each Compact State, who shall serve as that state's Commissioner. The State Psychology Regulatory Authority shall appoint its delegate. This delegate shall be empowered to act on behalf of the Compact State. This delegate shall be limited to:
          1. a. Executive Director, Executive Secretary, or similar executive;
          2. b. Current member of the State Psychology Regulatory Authority of a Compact State; or
          3. c. Designee empowered with the appropriate delegate authority to act on behalf of the Compact State.
        2. 2. Any Commissioner may be removed or suspended from office as provided by the law of the state from which the Commissioner is appointed. Any vacancy occurring in the Commission shall be filled in accordance with the laws of the Compact State in which the vacancy exists.
        3. 3. Each Commissioner shall be entitled to one (1) 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 Commissioner shall vote in person or by such other means as provided in the Bylaws. The Bylaws may provide for Commissioners' participation in meetings by telephone or other means of communication.
        4. 4. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the Bylaws.
        5. 5. 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 Article XI.
        6. 6. The Commission may convene in a closed, non-public meeting if the Commission must discuss:
          1. a. Non-compliance of a Compact State with its obligations under the Compact;
          2. b. The employment, compensation, discipline or other personnel matters, practices, or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;
          3. c. Current, threatened, or reasonably anticipated litigation against the Commission;
          4. d. Negotiation of contracts for the purchase or sale of goods, services, or real estate;
          5. e. Accusation against any person of a crime or formally censuring any person;
          6. f. Disclosure of trade secrets or commercial or financial information which is privileged or confidential;
          7. g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
          8. h. Disclosure of investigatory records compiled for law enforcement purposes;
          9. i. Disclosure of information related to any investigatory reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility for investigation or determination of compliance issues pursuant to the Compact; or
          10. j. Matters specifically exempted from disclosure by federal and state statute.
        7. 7. 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. The Commission shall keep minutes which fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, of any person participating in the meeting, 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 Commission or order of a court of competent jurisdiction.
      3. C. The Commission shall, by a majority vote of the Commissioners, prescribe Bylaws and/or Rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of the Compact, including, but not limited to:
        1. 1. Establishing the fiscal year of the Commission;
        2. 2. Providing reasonable standards and procedures:
          1. a. For the establishment and meetings of other committees; and
          2. b. Governing any general or specific delegation of any authority or function of the Commission;
        3. 3. Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals of such proceedings, and proprietary information, including trade secrets. The Commission may meet in closed session only after a majority of the Commissioners vote to close a meeting to the public in whole or in part. As soon as practicable, the Commission must make public a copy of the vote to close the meeting revealing the vote of each Commissioner with no proxy votes allowed;
        4. 4. Establishing the titles, duties, and authority and reasonable procedures for the election of the officers of the Commission;
        5. 5. Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission. Notwithstanding any civil service or other similar law of any Compact State, the Bylaws shall exclusively govern the personnel policies and programs of the Commission;
        6. 6. Promulgating a Code of Ethics to address permissible and prohibited activities of Commission members and employees;
        7. 7. Providing a mechanism for concluding the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of the Compact after the payment and/or reserving of all of its debts and obligations;
        8. 8. The Commission shall publish its Bylaws in a convenient form and file a copy thereof and a copy of any amendment thereto, with the appropriate agency or officer in each of the Compact States;
        9. 9. The Commission shall maintain its financial records in accordance with the Bylaws; and
        10. 10. The Commission shall meet and take such actions as are consistent with the provisions of this Compact and the Bylaws.
      4. D. The Commission shall have the following powers:
        1. 1. The authority to 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 Compact States;
        2. 2. To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any State Psychology Regulatory Authority or other regulatory body responsible for psychology licensure to sue or be sued under applicable law shall not be affected;
        3. 3. To purchase and maintain insurance and bonds;
        4. 4. To borrow, accept, or contract for services of personnel, including, but not limited to, employees of a Compact State;
        5. 5. To 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;
        6. 6. To 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 strive to avoid any appearance of impropriety and/or conflict of interest;
        7. 7. To 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 strive to avoid any appearance of impropriety;
        8. 8. To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
        9. 9. To establish a budget and make expenditures;
        10. 10. To borrow money;
        11. 11. To appoint committees, including advisory committees comprised 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;
        12. 12. To provide and receive information from, and to cooperate with, law enforcement agencies;
        13. 13. To adopt and use an official seal; and
        14. 14. To perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of psychology licensure, temporary in-person, face-to-face practice, and telepsychology practice.
      5. E. The Executive Board. The elected officers shall serve as the Executive Board, which shall have the power to act on behalf of the Commission according to the terms of this Compact.
        1. 1. The Executive Board shall be comprised of six (6) members:
          1. a. Five (5) voting members who are elected from the current membership of the Commission by the Commission; and
          2. b. One (1) ex-officio, nonvoting member from the recognized membership organization composed of State and Provincial Psychology Regulatory Authorities.
        2. 2. The ex-officio member must have served as staff or member on a State Psychology Regulatory Authority and will be selected by its respective organization.
        3. 3. The Commission may remove any member of the Executive Board as provided in Bylaws.
        4. 4. The Executive Board shall meet at least annually.
        5. 5. The Executive Board shall have the following duties and responsibilities:
          1. a. Recommend to the entire Commission changes to the Rules or Bylaws, changes to this Compact legislation, fees paid by Compact States such as annual dues, and any other applicable fees;
          2. b. Ensure Compact administration services are appropriately provided, contractual or otherwise;
          3. c. Prepare and recommend the budget;
          4. d. Maintain financial records on behalf of the Commission;
          5. e. Monitor Compact compliance of member states and provide compliance reports to the Commission;
          6. f. Establish additional committees as necessary; and
          7. g. Other duties as provided in Rules or Bylaws.
      6. F. Financing of the Commission.
        1. 1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
        2. 2. The Commission may accept any and all appropriate revenue sources, donations and grants of money, equipment, supplies, materials, and services.
        3. 3. The Commission may levy on and collect an annual assessment from each Compact 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 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 Compact States.
        4. 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 Compact States, except by and with the authority of the Compact State.
        5. 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.
      7. G. Qualified Immunity, Defense, and Indemnification.
        1. 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. 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. 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.
    11. ARTICLE XI. RULEMAKING
      1. A. The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Article and the Rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment.
      2. B. If a majority of the legislatures of the Compact States rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the Compact, then such rule shall have no further force and effect in any Compact State.
      3. C. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
      4. D. Prior to promulgation and adoption of a final rule or Rules by the Commission, and at least sixty (60) 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. 1. On the website of the Commission; and
        2. 2. On the website of each Compact States' Psychology Regulatory Authority or the publication in which each state would otherwise publish proposed rules.
      5. E. The Notice of Proposed Rulemaking shall include:
        1. 1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;
        2. 2. The text of the proposed rule or amendment and the reason for the proposed rule;
        3. 3. A request for comments on the proposed rule from any interested person; and
        4. 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.
      6. 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.
      7. G. The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:
        1. 1. At least twenty-five (25) persons who submit comments independently of each other;
        2. 2. A governmental subdivision or agency; or
        3. 3. A duly appointed person in an association that has at least twenty-five (25) members.
      8. H. 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.
        1. 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 five (5) business days before the scheduled date of the hearing.
        2. 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. 3. No transcript of the hearing is required, unless a written request for a transcript is made, in which case the person requesting the transcript shall bear the cost of producing the transcript. A recording may be made in lieu of a transcript under the same terms and conditions as a transcript. This subsection shall not preclude the Commission from making a transcript or recording of the hearing if it so chooses.
        4. 4. 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.
      9. 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.
      10. J. 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.
      11. 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.
      12. 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 rulemaking 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 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 in order to:
        1. 1. Meet an imminent threat to public health, safety, or welfare;
        2. 2. Prevent a loss of Commission or Compact State funds;
        3. 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
        4. 4. Protect public health and safety.
      13. 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 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 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.
    12. ARTICLE XII. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
      1. A. Oversight.
        1. 1. The Executive, Legislative, and Judicial branches of state government in each Compact State shall enforce this Compact and take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of this Compact and the rules promulgated hereunder shall have standing as statutory law.
        2. 2. All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a Compact State pertaining to the subject matter of this Compact which may affect the powers, responsibilities, or actions of the Commission.
        3. 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.
      2. B. Default, Technical Assistance, and Termination.
        1. 1. If the Commission determines that a Compact State has defaulted in the performance of its obligations or responsibilities under this Compact or the promulgated rules, the Commission shall:
          1. a. Provide written notice to the defaulting state and other Compact States of the nature of the default, the proposed means of remedying the default and/or any other action to be taken by the Commission; and
          2. b. Provide remedial training and specific technical assistance regarding the default.
        2. 2. If a state in default fails to remedy the default, the defaulting state may be terminated from the Compact upon an affirmative vote of a majority of the Compact States, and all rights, privileges, and benefits conferred by this Compact shall be terminated on the effective date of termination. A remedy of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.
        3. 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 submitted by the Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the Compact States.
        4. 4. A Compact State which has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations which extend beyond the effective date of termination.
        5. 5. The Commission shall not bear any costs incurred by the state which is found to be in default or which has been terminated from the Compact, unless agreed upon in writing between the Commission and the defaulting state.
        6. 6. The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the state of Georgia or the federal district where the Compact has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.
      3. C. Dispute Resolution.
        1. 1. Upon request by a Compact State, the Commission shall attempt to resolve disputes related to the Compact which arise among Compact States and between Compact and Non-Compact States.
        2. 2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes that arise before the commission.
      4. D. Enforcement.
        1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and Rules of this Compact.
        2. 2. By majority vote, the Commission may initiate legal action in the United States District Court for the state of Georgia or the federal district where the Compact has its principal offices against a Compact 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. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.
        3. 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.
    13. ARTICLE XIII. DATE OF IMPLEMENTATION OF THE PSYCHOLOGY INTERJURISDICTIONAL COMPACT COMMISSION AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENTS
      1. A. The Compact shall come into effect on the date on which the Compact is enacted into law in the seventh Compact 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.
      2. B. Any state which 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 which 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.
      3. C. Any Compact State may withdraw from this Compact by enacting a statute repealing the same.
        1. 1. A Compact State's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
        2. 2. Withdrawal shall not affect the continuing requirement of the withdrawing state's Psychology Regulatory Authority to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.
      4. D. Nothing contained in this Compact shall be construed to invalidate or prevent any psychology licensure agreement or other cooperative arrangement between a Compact State and a Non-Compact State which does not conflict with the provisions of this Compact.
      5. E. This Compact may be amended by the Compact States. No amendment to this Compact shall become effective and binding upon any Compact State until it is enacted into the law of all Compact States.
    14. ARTICLE XIV. CONSTRUCTION AND SEVERABILITY
      1. This Compact shall be liberally construed so as to effectuate the purposes thereof. If this Compact shall be held contrary to the constitution of any state member thereto, the Compact shall remain in full force and effect as to the remaining Compact States.
§ 63-11-503. Rulemaking.
  1. The department of health, in consultation with the board of examiners in psychology, may promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this part.
§ 63-11-504. Effective date of compact; notice to revisor of statutes.
  1. This part takes effect on the date the compact is enacted into law in the seventh compact state. The board of examiners in psychology shall notify the revisor of statutes in writing when the condition specified in this section has occurred.
Chapter 12 Tennessee Veterinary Practice Act
Part 1 Tennessee Veterinary Practice Act
§ 63-12-101. Short title.
  1. This chapter shall be known and may be cited as the “Tennessee Veterinary Practice Act.”
§ 63-12-102. Purpose of chapter.
  1. It is hereby declared that the practice of veterinary medicine is a privilege that is granted by legislative authority in the interest of the public health, safety and welfare. To protect the public from being misled by incompetent, unscrupulous and unauthorized practitioners and from unprofessional or illegal practices by persons licensed to practice veterinary medicine, this chapter is enacted in the interest of the health, safety and welfare of the animal population and the citizens of Tennessee.
§ 63-12-103. Chapter definitions.
  1. As used in this chapter:
    1. (1) “Animal” means any animal other than man and includes fowl, birds, reptiles and fish, wild or domestic, living or dead;
    2. (2) “Board” means the board of veterinary medical examiners;
    3. (3) “Certified animal control agency” means a county or municipal animal shelter, dog pound or animal control agency, private humane society, state, county or municipal law enforcement agency, or any combination thereof, that temporarily houses stray, unwanted or injured animals and that is certified pursuant to this chapter;
    4. (4) “Certified animal euthanasia technician” means a person employed by a certified animal control agency who is authorized by the board to humanely euthanize animals by administering such drugs as are designated by the board for such use;
    5. (5) “Complainant” means the board or any other person who initiates a proceeding;
    6. (6) “Consultation” means when a licensed veterinarian receives advice in person, telephonically, electronically, or by any other method of communication, from a veterinarian licensed in this or any other state, or other person whose expertise, in the opinion of the licensed veterinarian, would benefit a patient. Under all circumstances, the responsibility for the welfare of the patient remains with the licensed veterinarian receiving consultation;
    7. (7) “License” means any permit, approval, registration or certificate issued by the board;
    8. (8) “Licensed veterinarian” means a person who is validly and currently licensed to practice veterinary medicine in this state;
    9. (9) “Licensed veterinary technician” means a person who has successfully completed the examination requirements prescribed by the board and has been issued a license;
    10. (10)
      1. (A) “Practice of veterinary medicine” means to:
        1. (i) Diagnose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode, including:
          1. (a) The prescription, dispensing, administration or application of any drug, medicine, biologic, apparatus, anesthetic, or other therapeutic or diagnostic substance or medical or surgical, including cosmetic, technique;
          2. (b) The use of complementary, alternative, and integrative therapies;
          3. (c) The use of any manual, mechanical, biological, or chemical procedure for the testing of pregnancy, or for the management or treatment of sterility or infertility;
          4. (d) The rendering of advice or recommendation by any means including telephonic and other electronic communications with regard to subdivisions (10)(A)(i)(a)-(c); and
          5. (e) The collection of blood or other samples for the purpose of diagnosing disease or other conditions. This shall not apply to:
            1. (1) Any unlicensed personnel employed by the United States department of agriculture or the Tennessee department of agriculture who are engaged in animal disease control programs, or who perform laboratory examinations. This section does not prohibit extension personnel or vocational agriculture teachers from doing educational work that is considered normal to their profession in their government positions; or
            2. (2) The removal of an embryo from livestock or companion animal for the purpose of transplanting such embryo into another female animal or for the purpose of cryopreserving such embryo;
        2. (ii) Represent, directly or indirectly, publicly or privately, an ability and willingness to do an act described in subdivision (10)(A); and
        3. (iii) Use any title, words, abbreviation, or letters in a manner or under circumstances that induce the belief that the person using them is qualified to do any act described in subdivision (10)(A)(i). Such use shall be prima facie evidence of the intention to represent oneself as engaged in the practice of veterinary medicine;
      2. (B) The practice of veterinary medicine occurs wherever the patient is at the time services are rendered;
    11. (11) “Preceptor” means a person who is a last year student duly enrolled and in good standing in a recognized college of veterinary medicine. Such person's presence in a practice may be as part of a formal preceptorship program of the person's college or as an informal arrangement between the person and a veterinarian licensed by the board. The preceptor must be under direct supervision of such licensed veterinarian;
    12. (12) “Responsible supervision” or words of similar purport mean the control, direction and regulation by a licensed veterinarian of the duties involving veterinary services that such veterinarian delegates to such veterinarian's personnel;
    13. (13) “School of veterinary medicine” means any veterinary school or college, department of a university or college, legally organized, whose course of study in the art and science of veterinary medicine conforms to the standards required for accreditation by the American Veterinary Medical Association and approved by the board;
    14. (14) “Temporary license” means temporary permission to practice veterinary medicine issued pursuant to this chapter;
    15. (15) “Unprofessional or unethical conduct,” among other things, means any conduct of a character likely to deceive or defraud the public, objectionable advertising, obtaining any fee or compensation by fraud or misrepresentation, sharing office space with any person illegally practicing veterinary medicine, employing either directly or indirectly any unlicensed person to practice veterinary medicine or render any veterinary service except as provided in this chapter or the violation of any rule adopted by the board, which shall provide a code of professional ethics to be followed and carried out by persons licensed under this chapter;
    16. (16) “Veterinarian” means a person who has received a doctor of veterinary medicine degree or its equivalent from an approved school or college of veterinary medicine;
    17. (17) “Veterinarian-client-patient relationship” means:
      1. (A) The veterinarian has assumed responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment, has obtained informed consent, and the client has agreed to follow the veterinarian's instructions;
      2. (B) The veterinarian has sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal;
      3. (C) The veterinarian has seen the animal within the last twelve (12) months or is personally acquainted with the keeping and care of the animal, either by virtue of an examination of the animal or by medically appropriate visits to the premises where the animal is maintained within the last twelve (12) months;
      4. (D) The veterinarian is readily available or has arranged for emergency coverage for follow-up evaluation in the event of adverse reactions or the failure of the treatment regimen;
      5. (E) The veterinarian must maintain medical records as required by the board of veterinary medical examiners; and
      6. (F) The veterinarian-client-patient relationship cannot be established or maintained solely by telephone or other electronic means;
    18. (18) “Veterinary facility” means a building, place, or mobile unit from which the practice of veterinary medicine is conducted;
    19. (19) “Veterinary medicine” includes veterinary surgery, obstetrics, dentistry and all other branches or specialties of veterinary medicine; and
    20. (20) “Veterinary technician” means a person who is a graduate of a veterinary technology program accredited by the American Veterinary Medical Association.
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§ 63-12-104. Creation of board — Appointment and removal of members.
  1. (a) There is created the board of veterinary medical examiners, referred to as the “board” in this chapter.
  2. (b) The board shall be composed of:
    1. (1) Five (5) licensed doctors of veterinary medicine, who shall be graduates of an approved school of veterinary medicine and of good standing in their profession and who have had not less than five (5) years' actual experience in the practice of veterinary medicine;
    2. (2) One (1) licensed veterinary technician who shall be a graduate of an approved veterinary technology program, is of good standing in the profession, and who has had not less than five (5) years' actual experience as a licensed veterinary technician; and
    3. (3) One (1) member of the general public as provided by § 63-1-124.
  3. (c) The members of the board shall be appointed by the governor for a term of five (5) years. Each member so appointed shall serve until the expiration of the particular five-year term to which the member is appointed and thereafter until the member's successor has been appointed by the governor. The governor shall appoint new members to the board to serve after the date of expiration of each of these terms until August 1 of the fifth calendar year thereafter. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  4. (d) In the event of a vacancy on the board, the governor shall appoint a new member to serve out the unexpired term. A member may be reappointed to serve a successive term.
  5. (e) Members of the board may be appointed by the governor from lists of qualified nominees submitted by interested veterinary groups, including, but not limited to, the Tennessee Veterinary Medical Association. The governor shall consult with such interested groups to determine qualified persons to fill the positions. This subsection (e) shall not apply to the appointment of the public member.
  6. (f) No person who has been appointed a member of the board shall continue on the board if during the term of the member's appointment the member shall:
    1. (1) Transfer the member's legal residence to another state;
    2. (2) Be or become the owner of, or be employed by, any wholesale or jobbing house dealing in supplies, equipment or instruments used or useful in the practice of veterinary medicine; or
    3. (3) Have the member's license to practice veterinary medicine rescinded for cause in accordance with this chapter.
  7. (g) The governor may suspend any member of the board for malfeasance, misfeasance, gross inefficiency or misconduct or upon any of the constitutional grounds upon which officers may be suspended by the governor.
  8. (h) The state veterinarian, as appointed by the commissioner of agriculture, shall serve as a nonvoting, ex officio member of the board of veterinary medical examiners.
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§ 63-12-105. Meetings of board — Officers — Rules and regulations — Quorum — Seal.
  1. (a) The board shall meet annually at such time and place as may be agreed upon by a majority of the members, at which meeting it shall elect from its membership a president, vice president, and secretary. The board is authorized to create other officers and to adopt such rules and regulations as may be proper for the efficient operation of the board.
  2. (b) Four (4) members of the board shall constitute a quorum for the transaction of all business.
  3. (c) The board shall meet at such other times and places to conduct business upon call of the president.
  4. (d) The board shall adopt a seal that shall be affixed to all licenses issued by the board and to other papers requiring the same.
§ 63-12-106. Powers of board.
  1. The board is authorized to:
    1. (1) Adopt reasonable rules governing the practice of veterinary medicine as are necessary to enable it to carry out and make effective the purpose and intent of this chapter. Such rules shall be adopted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    2. (2) Adopt rules of professional conduct appropriate to establish and maintain a high standard of integrity, skills and practice in the profession of veterinary medicine. In prescribing such rules of professional conduct, the board may be guided by the principles of veterinary medical ethics adopted by the American Veterinary Medical Association and the Tennessee Veterinary Medical Association;
    3. (3) Have its rules printed and distributed to all licensed doctors of veterinary medicine;
    4. (4) Bring proceedings in courts for the enforcement of this chapter or any rules made pursuant thereto;
    5. (5) Hold at least one (1) regular meeting each year at such time and place as fixed by the board. Other meetings may be held upon the call of the president and secretary. The regular meetings will be for the purpose of conducting examinations of applications for license to practice veterinary medicine, the election of officers and to consider any other business that may properly come before the board;
    6. (6) Pass upon the qualifications of applicants for a license to practice veterinary medicine in this state;
    7. (7) Prescribe the subjects, character, manner, time and place of holding examinations and the filing of applications for examinations and to conduct the examinations;
    8. (8) Issue temporary permits or licenses, which shall be signed by the secretary, to duly qualified applicants;
    9. (9) Provide for, regulate and require all persons licensed in accordance with this chapter to renew their license annually, require as a condition precedent to such annual renewal the payment of the annual renewal fee as provided in § 63-12-121, issue annual renewal licenses to such persons and suspend or revoke the license of such persons who fail, refuse or neglect to renew same or pay such fees;
    10. (10) Conduct investigations and hearings upon complaints calling for discipline of a licensee or applicant for license or certificate or permit holder or applicant for a certificate or a permit;
    11. (11) Take testimony on any matter under its jurisdiction, and any member thereof may administer oaths;
    12. (12) Issue summonses and subpoenas, including subpoenas duces tecum, which shall be signed by either the president or the secretary-treasurer of the board, for any witness in connection with any matter within the jurisdiction of the board;
    13. (13) Adopt such forms as it may deem necessary;
    14. (14) Establish continuing educational requirements; and
    15. (15) Issue such certificates as are authorized under this chapter.
§ 63-12-107. Meetings of board.
  1. (a) The board shall meet at least once each year at such times and places as it may decide upon and remain in session sufficiently long to examine all who may make application at the appointed time for a license.
  2. (b) Four (4) members of the board shall constitute a quorum for the transaction of business and examination of candidates for license. A majority of those present shall be necessary to reject any application, but such rejection shall not bar the applicant from reexamination at the next regular meeting of the board.
§ 63-12-108. Compensation of members — Expenses of board.
  1. (a) The members of the board shall receive as compensation for their services one hundred dollars ($100) per day for each day or portion thereof, each, while in actual service of the board, which, together with the necessary expenses of each meeting of the board, shall be paid out of any moneys in the treasury of the board upon the certificate of the president and secretary.
  2. (b) All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
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§ 63-12-109. Funds of board — Disposition of surplus.
  1. It is unlawful for the board or any member thereof, in any manner whatsoever or for any purpose, to charge or obligate the state for the payment of any money, and the board shall look alone to the revenue derived from the operation of this chapter for the compensation designated in § 63-12-108. If the revenue is not sufficient to pay each member in full, together with the necessary expenses of the board, then the amount available shall be prorated among the members. But if there should be a greater revenue derived than shall be required to pay the compensation and expenses, including, but not limited to, the administrative and personnel expenses deemed necessary in the discretion of the board to conduct inspections and issue licenses, permits and certificates as provided by this chapter, directed, any surplus shall be paid to the state treasurer, who shall receipt the board for the amount so received and shall account for the money as for other state revenue.
§ 63-12-110. Records of board — Confidentiality.
  1. (a) The board shall keep records of its proceedings in a book provided for that purpose, especially with relation to the issuance, denial, renewal, suspension and revocation of licenses to practice veterinary medicine.
  2. (b)
    1. (1) All licenses issued by the board shall be numbered and recorded by the secretary in a file for that purpose; and where a license is denied by the board to any applicant under this chapter, the fact and grounds for such denial shall be entered on the minutes of the board.
    2. (2) The time of issuance or denial of license shall be noted along with the names of those board members present, and such file or record shall be open to public inspection.
  3. (c) These records shall be maintained in the division.
  4. (d) Information received by the board through inspections and investigations shall be confidential and shall not be disclosed except in a proceeding involving the question of license.
§ 63-12-111. Approval of veterinary schools.
  1. (a) The board may approve schools and colleges of veterinary medicine which maintain standards of training and reputability sufficient to admit their graduates to the examinations given by the board.
  2. (b) In determining the standard of training and reputation of schools or colleges of veterinary medicine, the board may approve schools and colleges that are accredited by the American Veterinary Medical Association.
  3. (c) The board may approve graduates of foreign schools of veterinary medicine that have been approved by the American Veterinary Medical Association or by obtaining proof that the college or school maintains standards equal to the standards of approved colleges or schools in the United States to take the examinations given by the board.
§ 63-12-112. License requirement — Qualifications of applicants.
  1. (a)
    1. (1) Any person wishing to practice veterinary medicine in this state shall obtain a license from the board. It is unlawful for such person to practice veterinary medicine as defined in § 63-12-103 unless the person obtains a license; and if the person so practices, the person shall be considered to have violated this chapter.
    2. (2)
      1. (A) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) The board may admit to examination any applicant who submits satisfactory evidence that the applicant:
    1. (1) Is a graduate of a school or college of veterinary medicine approved by the board;
    2. (2) Is in good physical and mental health;
    3. (3) Is of good moral character;
    4. (4) Is a citizen of the United States or Canada or legally entitled to live within the United States;
    5. (5) Subscribes to and will uphold the principles incorporated in the Constitution of the United States; and
    6. (6) Has paid the required fee.
  3. (c) Any person holding a license to practice veterinary medicine in this state that is valid on September 1, 1967, is considered to be licensed to practice veterinary medicine under this chapter and is subject to all the provisions thereof.
§ 63-12-113. Temporary licenses.
  1. The board may issue a temporary license to practice veterinary medicine, to be used only under the direct supervision of a licensed veterinarian, upon payment of a fee as set by the board, to:
    1. (1) A veterinarian who meets all qualifications and requirements pursuant to this chapter and who has applied to take the examination as provided in § 63-12-115. Such license shall remain valid until the results of the examinations are made known to the applicant;
      1. (A) Failure on both examinations will result in immediate termination of the license;
        1. (i) If the applicant fails one (1) of the examinations, the applicant may be issued a second temporary license but must continue under direct supervision of a licensed veterinarian and only until the results of the next regularly scheduled examination are known;
        2. (ii) If an applicant fails the same examination on two (2) separate testing dates, the applicant may, in the discretion of the board, and upon agreeing to meet any additional requirements of the board, be issued a third temporary license for up to one (1) year, plus the time until the results of the second regularly scheduled examination after issuance of the temporary license are made known;
        3. (iii) No applicant shall be allowed to take the same examination more than three (3) times;
      2. (B) During the validity of the temporary license, the applicant must be under the direct supervision of a licensed veterinarian;
      3. (C) New graduates applying for such temporary license must provide the name and address of practice of the supervising veterinarian and any other requirements specified by the board in rules and regulations;
    2. (2)
      1. (A) A veterinarian duly licensed according to the laws of another state and who has made application for permanent licensure in Tennessee;
        1. (i) A temporary license issued under this section shall be valid until the board rules on the applicant's request;
        2. (ii) If the board's decision is to issue a license without examination, the temporary license expires on receipt of the permanent license;
        3. (iii) If the board's decision is for examination, then the law applies as stated in subdivision (1);
      2. (B) An applicant who holds a license in another state or states must provide the name or names of such states, meet all qualifications and requirements pursuant to this chapter, provide the name and address of practice of the supervising veterinarian, and meet such other requirements as specified by the board in rules and regulations. All information submitted by an applicant will be subject to verification by the board;
  2. (3) A graduate of a nonaccredited or nonapproved college of veterinary medicine who has satisfactorily completed the fourth year of clinical study at an accredited or approved college of veterinary medicine, successfully passed the examination as provided in § 63-12-115 and is enrolled in the Educational Commission for Foreign Veterinary Graduates (ECFVG) program of the American Veterinary Medical Association or other certification program deemed by the board to be equivalent to the ECFVG program may be granted a temporary license. The holder of a temporary license issued under this section must practice under the direct supervision of a veterinarian licensed in Tennessee. The temporary license is valid until the candidate obtains the ECFVG or equivalent certification; provided, that a temporary license issued pursuant to this section shall not be valid for more than a maximum of eighteen (18) months from the date the temporary license is issued.
§ 63-12-114. Application for examination.
  1. (a)
    1. (1) Any person desiring to take the state board written and oral examination shall make application in writing to the board on blanks provided for that purpose at least forty-five (45) days before the examination.
    2. (2) The application for the state board written and oral examination shall be accompanied by a nonrefundable application fee as set by the board.
    3. (3) The application for the national board examination shall be accompanied by a nonrefundable application fee as set by the board.
    4. (4) Any person desiring to take the clinical competency test shall make application in writing to the board on blanks provided for that purpose at least forty-five (45) days before the examination.
    5. (5) The application for the clinical competency test shall be accompanied by a nonrefundable application fee as set by the board.
  2. (b)
    1. (1) Applicants who are accepted for the state board written and oral examination shall pay a fee to the board at least forty-five (45) days prior to taking the examination, as set by the board.
    2. (2) Applicants who are accepted for the national board examination shall pay a fee to the board at least forty-five (45) days prior to taking the examination as set by the board.
    3. (3) Applicants who are accepted for the clinical competency test shall pay a fee to the board at least forty-five (45) days prior to taking the examination as set by the board.
  3. (c) The board shall give notice of the time and place of all examinations in such manner as the board may consider expedient.
§ 63-12-115. Examinations.
  1. (a) The examination of applicants for license to practice veterinary medicine shall be administered by designated board members, and will consist of the national board examination and the state board examination and will be conducted under uniform rules and regulations adopted by the board.
  2. (b) The board shall require the applicant to take a written examination in the English language, in veterinary anatomy, veterinary surgery, veterinary physiology, veterinary pathology, veterinary obstetrics, veterinary materia medica and veterinary practice, chemistry and such other subjects related to veterinary medicine as the board may require.
  3. (c) The examination may include oral and practical examinations.
  4. (d) The minimum passing grade shall be established by the board.
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§ 63-12-116. Issuance of licenses.
  1. (a) If the applicant for examination be found worthy and competent by the board, it shall issue to the applicant a certificate of license to practice veterinary medicine in this state.
  2. (b) Each licensee shall be entitled to exercise all the rights and privileges of a doctor of veterinary medicine. Every person practicing veterinary medicine shall be governed by the laws of this state and the rules adopted by the board.
§ 63-12-117. Issuance of license without examination — Reciprocity.
  1. (a) The board, in its discretion, may issue a license without a written examination to a qualified applicant who furnishes satisfactory proof that the applicant is a graduate of an approved veterinary college and meets all other standards adopted by the board in rules and regulations. At its discretion, the board may orally or practically examine any person qualifying for license under this section or may enter into agreement for reciprocal licensing with other states having substantially similar requirements for licensure.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-12-118. Veterinary wellness committees.
  1. (a) As used in this section, “veterinary wellness committee” or “committee” means any committee, board, commission, or other entity established by any state-wide veterinary medical association or local veterinary medical association for the purpose of providing immediate and continuing help to veterinary professionals licensed to practice veterinary medicine or veterinary technology, students of veterinary medicine and veterinary technology, certified animal euthanasia technicians, and employees of veterinary practices in this state who suffer from physical or mental conditions that result from disease, disorder, trauma, or age and that impair their ability to perform their duties in veterinary medicine with reasonable skill and safety.
  2. (b) Veterinary wellness committee members, employees, and agents, including volunteers, taking any action authorized by this chapter, engaging in the performance of any duties on behalf of the committee, or participating in any administrative or judicial proceeding resulting from their participation on the committee, shall be immune from civil or criminal liability with respect to any action taken in good faith and without malice.
  3. (c) All information, interviews, reports, statements, memoranda, or other data furnished to or produced by a veterinary wellness committee and any findings, conclusions, reports, or recommendations resulting from the proceedings of the committee are privileged and confidential. Information and actions taken by the committee shall be privileged and held in strictest confidence and shall not be disclosed or required to be disclosed to any person or entity outside of the committee, unless such disclosure is authorized by the member of the veterinary profession to whom it relates. Nothing contained in this subsection (c) applies to records, documents, or information otherwise available from original sources, and such records, documents, or information are not immune from discovery or use in any civil proceedings solely due to having been presented to the committee.
§ 63-12-119. Penalty for unlicensed practice.
  1. Any person who practices or attempts to practice veterinary medicine in this state and makes a charge for the practice without having complied with this chapter commits a Class B misdemeanor for each instance of such practice.
§ 63-12-120. Continuing education.
  1. (a) Each license holder under this chapter, except as otherwise provided, shall be required to meet continuing educational requirements each year within the renewal period, which are approved by the board, such as those conducted or sponsored by the Tennessee Veterinary Medical Association, the Southern Veterinary Medical Association, the American Veterinary Medical Association or any of its constituent branches. The minimum number of hours of attendance for continuing education so required shall be prescribed by the board. However, postgraduate study or attendance at an institution or an educational session approved by the board shall be considered equivalent, but the board shall have the right, for good cause shown, to prescribe the type and character of postgraduate study to be done by any doctor of veterinary medicine in order to comply with the requirements of this chapter.
  2. (b) The board, in its discretion, may waive the annual continuing education requirements for good cause shown.
  3. (c) The board shall promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, rules that establish criteria for issuance of the continuing education credits required by this section.
§ 63-12-121. Renewal of license — Disposition of fines and fees — Expenses — Retirement.
  1. (a) All persons who are now or may hereafter be licensed to practice veterinary medicine in this state shall renew such license as follows:
    1. (1) Each year, the secretary-treasurer of the board shall mail an application for renewal of license to every person holding a valid current license;
    2. (2) The applicant shall fill in the application and return it to the secretary-treasurer of the board;
    3. (3) The applicant shall furnish the board such evidence as it may require of having complied with provisions pursuant to this chapter relating to the annual educational program;
    4. (4) The annual renewal fee shall be set by the board and shall be paid at the time the application for renewal of license is filed;
    5. (5) If any holder of a license fails to renew the license within sixty (60) days after registration becomes due, as provided in this section, the license or certificate of such person shall be automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing unless requested;
    6. (6) However, during any war or national emergency, the holder of a license on active duty with the armed services shall not be required to renew the license until January 1 of the year following the date of the holder's release from such active duty; and
    7. (7) The acceptance of any fee by the board shall not in any way affect the board's powers or duties with respect to the revocation, suspension or refusal to grant any license.
  2. (b) All fines for offenses for the violation of this chapter shall be paid over to the board and shall become a part of the receipts of the board. All money received by the board shall be paid into the state treasury and become a part of the general fund of the state. The budget director shall make such allotments out of the general fund as the budget director may deem proper for the necessary expenses of the board, and no expenditure shall be made by the board unless and until such allotment has been made by the budget director. Such allotments shall be disbursed under the general budgetary laws of this state.
  3. (c) Any person licensed to practice veterinary medicine who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in the practice of veterinary medicine in this state, such person shall apply for registration with the board as provided by this chapter and shall meet continuing education requirements as set by the board.
  4. (d)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (d).
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§ 63-12-122. Reissuance of license after revocation or suspension.
  1. (a) The board, by an affirmative vote of three (3), at any time after suspension or revocation of a license for good and sufficient cause, may reissue a license to the person affected, conferring upon the person all the rights and privileges pertaining to the practice of veterinary medicine.
  2. (b) Any person to whom such license may be reissued shall pay the same fee as upon the issuance of the original license.
§ 63-12-123. Issuance of duplicate license.
  1. (a) The board may issue a duplicate license to replace one that has been lost or destroyed or where a name change is requested, for a fee as set by the board.
  2. (b) Each duplicate license shall have the word “Duplicate” typed or printed across its face.
§ 63-12-124. Denial, suspension or revocation of license — Investigation — Immunity of informants.
  1. (a) The board, pursuant to the procedure prescribed in this section, has the power to deny, suspend or revoke any license or to otherwise discipline an applicant or licensee who is found guilty by the board of one (1) or more of the following:
    1. (1) Willful or repeated violation of any provisions of this chapter or any rules of the board;
    2. (2) Fraud or deceit in procuring or attempting to procure a license to practice veterinary medicine, or presenting to the board dishonest or fraudulent evidence of qualification or fraud or deception in the process of examination for the purpose of securing a license;
    3. (3) The willful failure to display a license;
    4. (4) Fraud, deception, misrepresentation, dishonest or illegal practices in or connected with the practice of veterinary medicine in any of its branches;
    5. (5) Willfully making any misrepresentation in the inspection of food for human consumption;
    6. (6) Fraudulently issuing or using any health certificate, vaccination certificate, inspection certificate, test chart or other blank form used in the practice of veterinary medicine to the dissemination of animal disease, transportation of diseased animals or the sale of inedible products of animal origin for human consumption;
    7. (7) Fraud or dishonesty in applying, treating or reporting on tuberculin, diagnostic or other biological test;
    8. (8) Failure to keep the equipment and premises of the business establishment in a clean and sanitary condition;
    9. (9) Refusing to permit the board or any legal representative of the board to inspect the business premises of the licensee during regular business hours;
    10. (10) Circulating knowingly untrue, fraudulent, misleading or deceptive advertising;
    11. (11) Gross malpractice or a pattern of continued or repeated malpractice, ignorance, negligence or incompetence in the course of veterinary medical practice;
    12. (12) Unprofessional or unethical conduct or engaging in practices in connection with the practice of veterinary medicine that are in violation of the standards of professional conduct as defined in this section or prescribed by the rules of the board;
    13. (13) Conduct reflecting unfavorably upon the profession of veterinary medicine;
    14. (14) The willful making of any false statement as to a material matter in any oath or affidavit that is required by this chapter;
    15. (15) Revocation by another state of a license to practice veterinary medicine in that state, in which case the record of such revocation shall be conclusive evidence;
    16. (16) Conviction on a charge of cruelty to animals;
    17. (17) Conviction of a felony under federal or state law involving use, misuse, possession or sale of any controlled substance or controlled substance analogue;
    18. (18) Conviction of a felony in the courts of this state, or of any other state, territory or country that, if committed in this state, would be a felony;
      1. (A) The record of conviction in a court of competent jurisdiction shall be sufficient evidence for disciplinary action to be taken as may be considered proper by the board. For the purpose of this chapter, a conviction shall be considered to be a conviction that has been upheld by the highest appellate court having jurisdiction or a conviction upon which the time for filing an appeal has passed; and
      2. (B) A record of conviction upon charges that involve the unlawful practice of veterinary medicine; and based upon such record of conviction, without any other testimony, the board may take temporary disciplinary action even though an appeal for review by a higher court may be pending;
    19. (19) Permitting or allowing another to use the licensee's license for the purpose of treating or offering to treat sick, injured or affected animals;
    20. (20) Engaging in the practice of veterinary medicine under a false or assumed name or the impersonation of another practitioner of a like, similar or different name;
    21. (21) Has been guilty of employing or permitting any person who does not hold a license to practice veterinary medicine in this state to perform work that, under this chapter, can lawfully be done only by persons holding such license and permitted by law to practice veterinary medicine in this state. It shall be conclusively presumed that any unlicensed person, if employed by a licensed person, was employed for such purpose if the unlicensed person has attended any school of veterinary medicine or surgery, accredited or otherwise, for a period of over thirty (30) days;
    22. (22) Addiction to the habitual use of intoxicating liquors, narcotics or other stimulants to such an extent as to incapacitate the applicant or licensee from the performance of the applicant's or the licensee's professional obligations and duties;
    23. (23) Professional incompetence;
    24. (24) Having been adjudged mentally incompetent by a court of competent jurisdiction and the disabilities of such person not having been restored or the voluntary commitment or admission to a state hospital or other mental institution. The record of adjudication, judgment, order or voluntary commitment is conclusive evidence of such mental illness; and upon receipt of a certified copy of any such adjudication, judgment, order or record of voluntary commitment by the board, it may suspend the license of the person so adjudicated or committed;
    25. (25) Failure to report, as required by law, or making false report of, any contagious or infectious disease as referred to under the United States department of agriculture (USDA) standards for accreditation of veterinarians in Tennessee and other states;
    26. (26) Has been found guilty of using biologicals or other drugs that have deteriorated or after the expiration date of that particular lot or serial number;
    27. (27) Has been convicted of any crime involving moral turpitude;
    28. (28) Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of the accepted practice of veterinary medicine; or
    29. (29) Practicing veterinary medicine without establishing and maintaining a valid veterinarian-client-patient relationship.
  2. (b) The board may, on its own motion, cause to be investigated any report indicating that a veterinarian is or may be in violation of this chapter.
  3. (c) Any person who in good faith shall report to the board any information that a veterinarian is or may be in violation of any provisions of this chapter shall not be subject to suit for civil damages as a result thereof.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-12-125. Administrative procedures.
  1. The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall apply to all proceedings of the board and regulations promulgated pursuant to this chapter.
§ 63-12-128. Disciplinary orders against violators — Judicial review.
  1. (a) The board has the authority to enter an order to discipline any person, corporation or other similar organization, public or private, for-profit or not-for-profit, who or which, after proper hearing, has been found guilty by the board of a violation of one (1) or more provisions of this chapter or any rule of the board. The board, based upon the evidence and its findings of fact, may enter its final order, which may include one (1) or more of the following provisions:
    1. (1) Suspend or limit the right to practice veterinary medicine in this state;
    2. (2) Suspend or limit the right to hold a certificate or premises permit in this state;
    3. (3) Revoke the license to practice veterinary medicine. Following revocation of such license, the licensee may be relicensed at the discretion of the board with or without examination;
    4. (4) Impose judgment and penalties, but suspend enforcement thereof and place the licensee or license applicant, certificate holder or certificate applicant, premises permit holder or premises permit applicant on probation;
    5. (5) Suspend the imposition of judgment and penalties;
    6. (6) Refuse to issue a new license, certificate or premises permit;
    7. (7) Withhold any license, certificate or premises permit, either permanently or for a period of time, when the same, has not been delivered;
    8. (8) Suspend or limit the right to own or operate a veterinary facility in this state; or
    9. (9) Take such other action in relation to discipline as the board in its discretion may deem proper.
  2. (b) Immediately upon entry of the final order by the board, a copy thereof shall be delivered to the respondent and the respondent's counsel, if any, either personally or by registered or certified mail.
  3. (c) Judicial review of orders of the board may be had by writ of certiorari or as otherwise provided by the laws of this state.
§ 63-12-129. Enforcement.
  1. (a) The enforcement of the laws and rules of the board regulating the practicing of veterinary medicine in this state is primarily vested in the board, who may have the following powers and duties:
    1. (1) To employ investigators, counsel and clerical assistance or any other necessary personnel;
    2. (2) To inspect all veterinary facilities to determine sanitary conditions, physical equipment, methods of operation, keeping of records, etc. This inspection shall be by a member of the board or a licensed veterinarian representing the board;
    3. (3) To inspect licenses; and
    4. (4) To conduct investigations of all alleged violations.
  2. (b) The powers granted to the board shall not curtail or in any manner affect or eliminate the duties, efforts and assistance of the department of health in the enforcement of this chapter.
  3. (c) All expenses, compensation or fees incurred in connection with enforcement duties and powers shall be paid from the funds of the board and in all respects treated as other expenses of the board, subject to this chapter.
§ 63-12-130. Prosecution of violators.
  1. (a) The state and county prosecuting attorneys shall prosecute all persons charged with the violation of any of this chapter or rules of the board.
  2. (b) The secretary-treasurer of the board, or other person employed or designated by the board, shall assist the prosecuting attorneys by furnishing them evidence of such violations whenever the board comes into possession of same.
§ 63-12-131. Fraudulent filing of license or diploma.
  1. Any person filing or attempting to file as the person's own the diploma or license of another, a forged or fictitious license or diploma or certificate or forged affidavit or identification commits a Class E felony.
§ 63-12-132. Enjoining violations.
  1. In addition to the penalties herein provided in this chapter, the board may institute legal proceedings to enjoin the violation of this chapter or rules of the board in any court of competent jurisdiction; and such court may grant a temporary or permanent injunction restraining the violation thereof.
§ 63-12-133. Exemptions.
  1. (a) This chapter shall not be construed as applying to:
    1. (1) Students in schools or colleges of veterinary medicine when in performance of duties or actions assigned by their instructors or when working under the immediate supervision of a licensed veterinarian;
    2. (2) Any lawfully qualified veterinarian residing in another state or country, when meeting in consultation with a licensed veterinarian of this state, who:
      1. (A) Does not open an office or appoint a place to do business within this state;
      2. (B) Does not print or use letterhead or business cards reflecting addresses in this state;
      3. (C) Does not establish answering services or advertise the existence of a practice's address within this state; and
      4. (D) Practices veterinary medicine as a consultant while rendering services directly to the public, under the direction of and in consultation with licensees of this state, for less than twelve (12) days per calendar year.
    3. (3) Any veterinarian in the employ of a state agency or the United States government while actually engaged in the performance of the veterinarian's official duties; however, this exemption shall not apply to such person when the person is not engaged in carrying out the person's official duties or is not working at the installations for which the person's services were engaged;
    4. (4) Prevent any person or the person's regular employee from administering to the ills and injuries of the person's own animals, including, but not limited to, castration of animals and dehorning of cattle, unless title has been transferred or employment provided for the purpose of circumventing this law;
    5. (5) State agencies, accredited schools, institutions, foundations, business corporations or associations, physicians licensed to practice medicine and surgery in all its branches, graduate doctors of veterinary medicine or persons under the direct supervision thereof, who or which conduct experiments and scientific research on animals in the development of pharmaceuticals, biologicals, serums or methods of treatment or techniques for the diagnosis or treatment of human ailments, or when engaged in the study and development of methods and techniques directly or indirectly applicable to the problems of the practice of veterinary medicine;
    6. (6) Veterinary aides, nurses, laboratory technicians or other employees of a licensed veterinarian who administer medication or render auxiliary or supporting assistance under the responsible supervision of such licensed veterinarian;
    7. (7) Any person gratuitously treating animals in cases of emergency; provided, that the person does not claim to be a veterinarian or use any title or degree appertaining to the practice thereof;
    8. (8) Any merchant or manufacturer selling at the merchant's or manufacturer's regular place of business medicines, feed, appliances or other products used in the prevention or treatment of animal diseases. This shall not be construed to authorize the sale of medicines or biologicals that must be obtained by a prescription from a veterinarian, but shall only include the right to sell those medicines that are classified as proprietary and that are commonly known as over-the-counter medicines;
    9. (9) Any person advising with respect to or performing acts that the board by rule has prescribed as accepted livestock management practice;
    10. (10) Any person or such person's employees when removing an embryo from the person's own food animal for the purpose of transplanting or cryopreserving such embryo; and
    11. (11) The use of any manual procedure for the testing of pregnancy in bovine animals when performed by a farmer as defined in § 67-6-207(e)(1), (3), (4) and (5), only if:
      1. (A) Such farmer testing for pregnancy is not compensated by the person who owns such animals, other than by the exchange of services for or the use of equipment by such farmer performing the pregnancy test; and
      2. (B) The results of such testing are for the owner's use only and not to affect commerce.
  2. (b) The operations known as castrating and dehorning are not regarded as practicing veterinary surgery, and nothing in this chapter shall be construed to prohibit anyone from castrating or dehorning any wild or domestic animal.
  3. (c) For the purposes of this chapter, the practice of veterinary medicine shall not include the artificial insemination of livestock, as the term livestock is defined in § 43-1-114. The practice of artificial insemination shall be considered an accepted livestock management practice.
§ 63-12-134. Lien for services.
  1. (a) Every licensed veterinarian has a lien on each animal or pet treated, boarded or cared for by the veterinarian while in the veterinarian's custody and under contract with the owner of such animal or pet for payment of charges for treatment, board or care of such animal or pet. Such veterinarian has the right to retain such animal or pet until such charges are paid.
  2. (b)
    1. (1) If the charges due for the services named in this section are not paid within ten (10) days after demand for the charges due on the owner of such animal or pet, in person, or by registered or certified mail with return receipt requested, addressed to the owner at the address given when such animal or pet is delivered, and the receipt has been returned by the United States postal authorities, such animal or pet shall be deemed to be abandoned and the licensed veterinarian is authorized to sell the animal or pet either at public or private sale and if the veterinarian does not succeed in selling such animal or pet within ten (10) days, then the veterinarian is authorized to dispose of such animal or pet in any manner that the veterinarian deems proper or turn the animal or pet over to the nearest humane society or dog pound in the area for disposal as such custodian deems proper.
    2. (2) An animal shall also be considered abandoned by its owner if the owner gives a licensed veterinarian a false address and telephone number and the demand mailed by the licensed veterinarian by registered or certified mail, return receipt requested, is returned undelivered. Under the circumstances provided in this subdivision (b)(2), the licensed veterinarian may consider the animal abandoned when the veterinarian receives notice that the mailed demand is undeliverable; and the licensed veterinarian may dispose of the animal as provided in subdivision (b)(1). As an alternative, the licensed veterinarian may turn the animal or pet over to the nearest humane society or animal control shelter in the area for disposition of the animal as such custodian deems proper without first offering the animal or pet for sale.
  3. (c) The giving of notice to the owners as provided in subsection (b) relieves the licensed veterinarian or any custodian to whom such animal or pet may be given of any further liability for disposal.
  4. (d) Failure of the owner of any such animal or pet to receive the demand by registered or certified mail provided for in this section does not render the licensed veterinarian liable to the owner of such animal or pet for the disposal thereof in any manner provided in this section.
  5. (e) When any animal or pet is sold as authorized in this section to satisfy a lien for any of the services enumerated, any moneys realized from the sale, less such charges and any expenses incurred in making the demand for payment thereof in connection with the sale, shall be paid to the owner of the animal or pet.
  6. (f) No legal proceeding for the enforcement of the lien created by this law is necessary concerning abandoned animals as defined in subsection (b), other than compliance with the requirements provided in this section.
§ 63-12-135. Licensed veterinary technicians — Unauthorized practice.
  1. (a) The board shall examine and license veterinary technicians and has the same authority in the regulation, examination and qualification of licensed veterinary technicians as it has under this chapter for the practice of veterinary medicine and veterinarians.
  2. (b) Any licensed veterinarian may assign to a licensed veterinary technician regularly employed by the veterinarian any task or procedure to be performed for which the veterinarian exercises responsible supervision and full responsibility except those procedures requiring professional judgment or skill as prescribed by board rule.
  3. (c) The fees provided in this chapter pertaining to applications, licensing and renewal for veterinarians also apply to licensed veterinary technicians.
  4. (d) It is a Class B misdemeanor for any person to use in connection with the person's name any designation intending to imply that the person is a veterinary technician or a licensed veterinary technician unless the person meets the requirements contained in this chapter.
  5. (e) The board may, on its own motion, cause to be investigated any report indicating that a licensed veterinary technician is or may be in violation of this chapter. Any person who in good faith reports to the board any information that a licensed veterinary technician is or may be in violation of any provisions of this chapter is not subject to suit for civil damages as a result thereof.
§ 63-12-137. Veterinary practice to be owned by veterinarian — Exemptions.
  1. (a) It is unlawful for any licensed veterinarian to practice veterinary medicine as an employee of any person other than a veterinarian duly licensed in this state or a veterinary facility operated at all times under the direct medical supervision of a veterinarian duly licensed in this state.
  2. (b) No person, corporation or other similar organization, public or private, for-profit or not-for-profit, other than a veterinarian duly licensed in this state, shall own or operate a veterinary facility within this state, except as follows:
    1. (1) Any person, corporation or other similar organization, public or private, for-profit or not-for-profit, shall apply for and receive a premises permit before the commencement of operations at the veterinary facility; and
    2. (2) The owner of the veterinary facility shall not restrict or interfere with medically appropriate veterinary diagnostic or treatment decisions by the licensed veterinarians employed at the veterinary facility.
  3. (c) The following are exempt from this section:
    1. (1) A veterinarian employed by a person, corporation or other similar organization, public or private, for-profit or not-for-profit, to treat such employer's animals;
    2. (2) A veterinarian employed by an official agency of the federal or state government or any subdivision thereof; and
    3. (3) A veterinarian employed by any licensed research facility.
§ 63-12-138. Peer review committees — Immunity — Confidentiality of information.
  1. (a) As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide veterinary medical association, or local veterinary medical association or local veterinary association for the purpose of receiving and evaluating veterinary acts of other veterinarians or veterinary auxiliary personnel.
  2. (b) Any veterinarian who serves on any peer review committee or on any other committee shall be immune from liability with respect to any action taken by the veterinarian in good faith and without malice as a member of such committee, board, commission or other entity.
  3. (c) Veterinarians, licensed veterinary technicians and members of boards of directors of any publicly supported or privately supported animal health care facility, or any other individual appointed to any committee, as described in subsection (a), shall be immune from liability to any client, patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees undertaken or performed within the scope or functions of the duties of such committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
  4. (d) All information, interviews, reports, statements, memoranda or other data furnished to any such peer review committee or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee or other entity are privileged. The records and proceedings of any such committee or other entity are confidential and shall be used by such committee or other entity and the members thereof only in the exercise of the proper functions of the committee or other entity and shall not become public record nor be available for court subpoena or discovery proceedings. Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources, such records, documents or information not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.
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§ 63-12-139. Premises permits.
  1. (a) Any person who owns or operates any veterinary facility, including mobile clinics, or any other premises where a licensed veterinarian practices or where the practice of veterinary medicine occurs shall apply for and secure a premises permit from the board prior to the commencement of any services that would subject the provider of those services to licensure under this chapter. Any premises in operation on January 1, 1997, shall register with the board by filling out an application as required by the board.
  2. (b) Any premises at which veterinary services are provided and not owned or leased by a licensed veterinarian on January 1, 1997, shall be inspected prior to the opening of such premises. Upon receipt of the application and payment of the application and inspection fee established by the board, the board shall cause such premises to be inspected by an authorized agent of the board within thirty (30) days of receipt of the application. Any premises in which a licensed veterinarian operates a practice on January 1, 1997, shall be granted a temporary permit upon submission of the registration required by subsection (a), which temporary permit shall remain in effect until the premises are inspected by the board. Any premises for which a permit has been granted on or after January 1, 1997, shall be inspected by the board within sixty (60) days of any change of ownership or legal responsibility for the premises. If the board is unable to complete any inspection of the premises within the thirty- or sixty-day time periods prescribed in this subsection (b), it shall issue a temporary premises permit, which shall remain in effect until the inspection required by this section is completed.
  3. (c)
    1. (1) A premises permit shall be issued if the premises meet minimum standards established by board rules as to sanitary conditions and physical plant. In lieu of the procedures identified in subsection (b), the board may issue a premises permit upon certification by the applicant that the premises have been inspected and accredited by a recognized organization, the standards of which are found by the board to meet or exceed the minimum standards established by board rules.
    2. (2) Except as provided in subdivision (c)(3), all veterinary facilities located in retail establishments shall have an entrance into the permitted premises that is directly on a public street or other area which adjoins the establishment, and such entrance shall be separate from the entrance primarily used by regular retail customers. For purposes of this chapter, “retail establishment” means any retail store in excess of two thousand five hundred (2,500) square feet that primarily sells goods not related to the practice of veterinary medicine; companion animal retail facilities that primarily sell goods in the categories of companion animal nutrition, food, supplies, and behavioral products; or any veterinary facility located in an enclosed shopping mall or enclosed shopping center.
    3. (3) Veterinary facilities located in retail establishments that were issued a premises permit prior to January 1, 2015, and that have a separate entrance used by regular retail customers shall maintain and utilize the separate entrance in order to comply with subdivision (c)(2). Veterinary facilities located in retail establishments that were issued a premises permit prior to January 1, 2015, and that do not have a separate entrance used by regular retail customers on July 1, 2016, are in compliance with subdivision (c)(2).
    4. (4) The costs of any inspection undertaken by the board shall be set by the board and paid in advance by the applicant, in addition to the fee established by the board for the premises permit.
  4. (d) Each application for a premises permit submitted by a person not licensed under this chapter shall state the name and address of the licensed veterinarian who will be responsible for the practice of veterinary medicine on the premises. The supervising veterinarian shall be licensed in Tennessee. The applicant shall also include the name or names and address or addresses of the licensee or licensees who will be onsite when the practice of veterinary medicine occurs. The applicant shall affirm that the practice of veterinary medicine shall not be provided on the premises without the physical presence of a veterinarian licensed in this state. An application for a premises permit submitted pursuant to this subsection (d) may be denied if any veterinarian submitted by the applicant has been previously disciplined by the board. The holder of a premises permit shall notify the board of any change of ownership or legal responsibility for premises for which a permit has been issued, any change as to the supervising veterinarian for the premises and any change as to the licensed veterinarian or veterinarians who will be employed to provide veterinary medical services at the premises at least thirty (30) days prior to the effective date of the change unless the change arises from unforeseen circumstances, in which case notice shall be given within five (5) days of the effective date of the change.
  5. (e) The board shall deny any application for a premises permit if the inspection reveals that the premises do not meet the minimum standards established by the board. The applicant shall pay the inspection fee for each additional reinspection required to determine whether any deficiencies found by the board have been brought into compliance with the minimum standards established by board rules and regulations as to sanitary conditions and physical plant.
  6. (f) Any practitioner who provides veterinary services on a house-call basis and does not maintain a veterinary facility for the receipt of patients shall not be required to secure a premises permit, but must provide for appropriate equipment and facilities as established by the board.
  7. (g) Any practitioner who provides veterinary services solely to agricultural animals and does not maintain a veterinary facility for the receipt of patients shall not be required to obtain a premises permit, but must provide for appropriate equipment and facilities as established by the board.
  8. (h) Mobile large and small animal veterinary clinics operating in more than one (1) location and examining and/or treating animals belonging to multiple clients whose animals are not permanently housed or boarded at that location shall have a premises permit for the mobile facilities that are utilized unless exempted by state or local public health officials. Such mobile clinics shall also specify the locations at which such mobile clinics will operate. Such information shall be considered as part of the application for a premises permit. Any change in the locations at which the mobile clinics will operate shall be reported to the board at least thirty (30) days in advance of the effective date of the change.
  9. (i) The following are exempt from this section:
    1. (1) A veterinary facility owned by a person, corporation or other similar organization, public or private, for-profit or not-for-profit, to treat such employer's animals;
    2. (2) A veterinary facility operated by an official agency of the federal or state government; and
    3. (3) A licensed research facility.
  10. (j) The board shall be authorized to employ such persons who may be required, in its discretion, to inspect premises under the jurisdiction of the board. The board shall establish a fee schedule for inspections required under this chapter. An applicant for a premises permit shall remit to the board an application fee, which shall be equal to the license fee required of licensed veterinarians. A licensed veterinarian or an applicant for licensure as a veterinarian shall not be required to submit an additional fee for a premises permit but shall be required to submit the required inspection fee, if such licensed veterinarian or applicant also submits an application for a premises permit.
  11. (k) The board of veterinary examiners is authorized to issue a limited waiver to the requirement for a premises permit under this section to a veterinarian who meets the following requirements:
    1. (1) The waiver is granted for one (1) day, once in a calendar year;
    2. (2) The waiver is applicable to only one (1) county and only one (1) waiver shall be granted in each county in a calendar year;
    3. (3) The waiver is only for livestock testing; and
    4. (4) The waiver is only for one (1) location, which shall be a farm.
§ 63-12-140. Operation without permit prohibited — Penalty.
  1. (a) It is an offense to knowingly operate a veterinary facility in this state without a premises permit.
  2. (b) A violation of this section is a Class B misdemeanor and each violation constitutes a separate offense.
§ 63-12-141. Euthanasia of animals — Certificate — Fees — Penalty.
  1. (a) The board of veterinary medical examiners, upon submission of a complete application and payment of a fee established by the board, shall issue to any animal control agency that it determines to be qualified a certificate authorizing the agency to apply to the federal drug enforcement agency, including any successor entity, for a restricted controlled substance registration certificate for the purchase, possession and use of sodium pentobarbital or other drugs as authorized by the board for administration by a certified animal euthanasia technician to euthanize injured, sick or abandoned animals. It is a Class B misdemeanor for any person or entity to use or imply that such person or entity has been granted a certificate as a certified animal control agency unless a certificate has been granted under this title.
  2. (b) The board, upon submission of a complete application and payment of a fee established by the board, shall issue to any person who it determines to be qualified a certificate for such person to function as a certified animal euthanasia technician. It is a Class B misdemeanor for any person or entity to use or imply that such person or entity has been granted a certificate as a certified animal euthanasia technician unless a certificate has been granted under this title.
  3. (c) Euthanasia of animals. Euthanasia of animals in a certified animal control agency may only be performed by a licensed veterinarian, including a licensed veterinary technician employed by and functioning under the direct supervision of a licensed veterinarian or a certified animal euthanasia technician as provided by law. A certified animal control agency that employs a certified animal euthanasia technician may purchase, possess and administer sodium pentobarbital or such other drug that the board may approve for the euthanasia of animals. Sodium pentobarbital and such other drugs approved by the board shall be the only drugs used for the euthanasia of animals in a certified animal control agency.
  4. (d) Renewal of Certification. Certified animal control agencies and certified animal euthanasia technicians shall be required to renew their certificates at such intervals, upon such conditions and upon the payment of such fees as may be established by the board.
§ 63-12-142. Immunity for certain emergency treatment.
  1. Any licensed veterinarian or ancillary veterinary personnel employed by and working under the direct supervision of a licensed veterinarian who, in good faith, at such person's own initiative, renders emergency treatment to an ill or injured animal gratuitously and without making charge for such treatment is not liable to the owner of the animal for any civil damages arising from the treatment provided to the animal except in cases of gross negligence. If the licensed veterinarian or ancillary veterinary personnel acting under the direct supervision of a licensed veterinarian performs euthanasia on an animal, it is presumed that it was a humane act necessary to relieve pain and suffering.
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§ 63-12-143. Cost of prosecution.
  1. The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
§ 63-12-144. Certificate authorizing chemical capture of animals by certified animal chemical capture technicians — Protocol — Offense — Certification course.
  1. (a)
    1. (1) The board of veterinary medical examiners, upon submission of a complete application and payment of a fee established by the board, shall issue to any governmental animal control agency that the board determines to be qualified and that has a valid premises permit issued by the board a certificate authorizing chemical capture of animals under this section by certified animal chemical capture technicians.
    2. (2) The agencies shall submit, as part of the application, a written protocol for chemical capture of animals by certified animal chemical capture technicians to the board for approval. The protocol shall include, at a minimum:
      1. (A) The procedure for removing the dart from a captured animal;
      2. (B) First aid care of the dart wound;
      3. (C) The procedure for providing veterinary care to the animal immediately upon capture;
      4. (D) The appropriate location and handling of the animal during recovery from anesthesia; and
      5. (E) The supervisory structure regarding who makes the final decision to proceed with the chemical capture of an animal.
    3. (3) It is a Class B misdemeanor for any person or entity to engage in the chemical capture of animals or imply that the person or entity has been granted a certificate as a certified animal control agency with a premises permit unless the certificate and permit have been granted under this title.
  2. (b)
    1. (1) The board, upon submission of a complete application and payment of a fee established by the board, shall issue to any person who the board determines to be qualified a certificate for the person to function as a certified animal chemical capture technician. Applicants shall be required to have successfully completed a sixteen-hour chemical immobilization certification course. The course must be approved by the board, and the curriculum of the course shall include pharmacology, proper administration, recordkeeping, chemical capture technology, animal behavior, postimmobilization procedures, proper public and personnel safety, and marksmanship training.
    2. (2) It is a Class B misdemeanor for any person to chemically capture animals or imply that the person has been granted a certificate as a certified animal chemical capture technician unless a certificate has been granted under this title.
  3. (c) The chemical capture of dogs and cats, as defined in § 44-17-601, shall only be performed by a licensed veterinarian, a licensed veterinary technician employed by and functioning under the direct supervision of a licensed veterinarian or a certified animal chemical capture technician as provided by law. Telazol and such other drugs that the board may approve shall be the only drugs used for the chemical capture of dogs and cats by a certified animal chemical capture technician.
  4. (d) Tranquilizer guns shall be used for the humane chemical capture of dogs and cats. Any such tranquilizer gun shall have the capability to track the darts it shoots and shall be well maintained and kept in a high state of repair at all times.
  5. (e) Certified animal control agencies and certified animal chemical capture technicians shall be required to renew their certificates at such intervals, upon such conditions and upon the payment of such fees as may be established by the board.
  6. (f) Nothing in this part shall be construed to limit in any way the practice of a licensed veterinarian as provided by law.
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§ 63-12-145. Preemption of regulation of veterinarian medicine — Local regulation.
  1. (a) The general assembly intends by this chapter, other provisions of the Tennessee Code Annotated and any rules and regulations promulgated pursuant to this chapter and the Tennessee Code Annotated to occupy and preempt the entire field of legislation concerning the regulation of the practice of veterinary medicine, including, but not limited to, the regulation of any act or procedure utilized within the practice of veterinary medicine.
  2. (b) Notwithstanding subsection (a), a municipality, metropolitan government or county may regulate the time and place of the business operations of a person or facility holding a license or certificate under this chapter; provided, that the regulation does not conflict with state laws or regulations governing the practice of veterinary medicine.
Part 2 Animal Massage Therapy
§ 63-12-201. Part definitions.
  1. As used in this part:
    1. (1) “Animal massage therapy” means the manipulation of the soft tissues of the animal body with the intention of positively affecting the health and well-being of the animal. “Animal massage therapy” does not include the diagnosis, treatment, correction, alleviation, or prevention of any animal disease, illness, pain, deformity, defect, injury, or other physical or mental condition, or otherwise constitute the practice of veterinary medicine;
    2. (2) “Certified animal massage therapist” means a person who qualifies for, and voluntarily obtains, certification under this part; and
    3. (3) “Registered animal massage therapist” means a person who qualifies for, and voluntarily obtains, certification under this part.
§ 63-12-202. Use of term “certified animal massage therapist” or “registered animal massage therapist” — Prohibitions.
  1. (a) No person shall use the title “certified animal massage therapist” or “registered animal massage therapist” unless the person meets the requirements of this part.
  2. (b) This part shall not prohibit any person from rendering or offering to render animal massage therapy services; provided, that a person who is not certified or registered under this part shall not use, or knowingly allow themselves to be identified by, the title “certified animal massage therapist” or “registered animal massage therapist”.
  3. (c) Persons who hold themselves out as certified animal massage therapists or registered animal massage therapists without complying with § 63-12-203 are in violation of the Tennessee Consumer Protection Act, compiled in title 47, chapter 18, part 1.
§ 63-12-203. Use of term “certified animal massage therapist” or “registered animal massage therapist” — Requirements.
  1. In order to use the term “certified animal massage therapist” or “registered animal massage therapist”, a person must:
    1. (1) Complete at least fifty (50) hours of training in anatomy and physiology, kinesiology, and pathologies in order to gain aptitude in preventing the delay of care to animals;
    2. (2) Complete at least fifty (50) hours of supervised in-class hands-on work, which would include assessment and execution of bodywork skills being studied, benefits of massage, benefits of acupressure, and practice guidelines; and
    3. (3) Take and pass an examination by the National Board of Certification for Animal Acupressure and Massage or a comparable examination that tests the aptitude in the course of training described in subdivisions (1) and (2).
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§ 63-12-204. Liability insurance requirement.
  1. A person practicing animal massage therapy shall obtain liability insurance in the amount of twenty-five thousand dollars ($25,000) for the benefit of any person who is damaged because of the negligence of the person in the performance of animal massage therapy services.
Chapter 13 Occupational and Physical Therapy Practice Act
Part 1 General Provisions
§ 63-13-101. Short title.
  1. This chapter shall be known and may be cited as the “Occupational and Physical Therapy Practice Act.”
§ 63-13-102. Legislative intent.
  1. This chapter is enacted for the purposes of protecting the public health, safety, and welfare and providing for state administrative control, supervision, licensure and regulation of the practice of physical therapy and occupational therapy. It is the general assembly's intent that only individuals who meet and maintain prescribed standards of competence and conduct may engage in the practice of physical therapy and occupational therapy as authorized by this chapter. This chapter is intended to promote the public interest and to accomplish the purposes stated in this section.
§ 63-13-103. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “ACOTE” means the Accreditation Council for Occupational Therapy Education, a nationally recognized accrediting agency for professional programs in the field of occupational therapy;
    2. (2) “AOTA” means the American Occupational Therapy Association;
    3. (3) “Board” means:
      1. (A) As used in part 2 of this chapter, the board of occupational therapy; and
      2. (B) As used in part 3 of this chapter, the board of physical therapy;
    4. (4) “Competence” is the application of knowledge, skills, and behaviors required to function effectively, safely, ethically, and legally within the context of the patient's role and environment;
    5. (5) “Division” means the division of health related boards of the department of health;
    6. (6) “Dry needling” means a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular, and connective tissues for the management of neuromusculoskeletal conditions, pain, and movement impairments;
    7. (7) “NBCOT” means the National Board for Certification in Occupational Therapy;
    8. (8) “Occupational therapist” means a person licensed to engage in occupational therapy practice under this chapter;
    9. (9) “Occupational therapy assistant” means a person licensed to assist in occupational therapy practice under the supervision of an occupational therapist;
    10. (10)
      1. (A) “Occupational therapy practice” means the therapeutic use of everyday life activities (occupations) for the purpose of enabling individuals or groups to participate in roles and situations in home, school, workplace, community and other settings. Occupational therapy addresses the physical, cognitive, psychosocial and sensory aspects of performance in a variety of contexts to support engagement in occupations that affect health, well-being and quality of life. “Occupational therapy practice” includes, but is not limited to:
        1. (i) Screening, evaluation, assessment, planning, implementation, or discharge planning in order to determine an occupational therapy treatment diagnosis, prognosis, plan of therapeutic intervention, or discharge plan, or to assess the ongoing effect of intervention;
        2. (ii) Selection and administration of standardized and nonstandardized tests and measurements to evaluate factors affecting activities of daily living, instrumental activities of daily living, education, work, play, leisure and social participation, including:
          1. (a) Body functions and body structures;
          2. (b) Habits, routines, roles and behavior patterns;
          3. (c) Cultural, physical, environmental, social and spiritual context and activity demands that affect performance; and
          4. (d) Performance skills, including motor, process and communication/interaction skills;
        3. (iii) Methods or strategies selected to direct the process of interventions, such as:
          1. (a) Modification or adaptation of an activity or the environment to enhance performance;
          2. (b) Establishment, remediation or restoration of a skill or ability that has not yet developed or is impaired;
          3. (c) Maintenance and enhancement of capabilities without which performance in occupations would decline;
          4. (d) Health promotion and wellness to enable or enhance performance and safety of occupations; and
          5. (e) Prevention of barriers to performance, including disability prevention;
        4. (iv) Interventions and procedures to promote or enhance safety and performance in activities of daily living, instrumental activities of daily living, education, work, play, leisure and social participation, including:
          1. (a) Therapeutic use of occupations, exercises and activities;
          2. (b) Training in self-care, self-management, home management and community/work reintegration;
          3. (c) Development, remediation or compensation of physical, cognitive, neuromuscular and sensory functions and behavioral skills;
          4. (d) Therapeutic use of self, including an individual's personality, insights, perceptions and judgments as part of the therapeutic process;
          5. (e) Education and training of individuals, family members, caregivers and others;
          6. (f) Care coordination, case management, discharge planning and transition services;
          7. (g) Consulting services to groups, programs, organizations or communities;
          8. (h) Assessment, recommendations and training in techniques and equipment to enhance functional mobility, including wheelchair management;
          9. (i) Driver rehabilitation and community mobility; and
          10. (j) Management of feeding and eating skills to enable feeding and eating performance;
        5. (v) Management of occupational therapy services, including the planning, organizing, staffing, coordinating, directing or controlling of individuals and organizations;
        6. (vi) Providing instruction in occupational therapy to students in an accredited occupational therapy or occupational therapy assistant educational program by persons who are trained as occupational therapists or occupational therapy assistants; and
        7. (vii) Administration, interpretation and application of research to occupational therapy services;
      2. (B) Occupational therapy services are provided for the purpose of promoting health and wellness to those clients who have, or are at risk of developing, illness, injury, disease, disorder, impairment, disability, activity limitation or participation restriction and may include:
        1. (i) Training in the use of prosthetic devices;
        2. (ii) Assessment, design, development, fabrication, adaptation, application, fitting and training in the use of assistive technology and adaptive and selective orthotic devices;
        3. (iii) Application of physical agent modalities with proper training and certification;
        4. (iv) Assessment and application of ergonomic principles;
        5. (v) Adaptation or modification of environments, at home, work, school or community, and use of a range of therapeutic procedures, such as wound care management, techniques to enhance sensory, perceptual and cognitive processing and manual therapy techniques, to enhance performance skills, occupational performance or the promotion of health and wellness; and
        6. (vi) Practice of dry needling of the upper limb, with proper training and certification;
      3. (C) Occupational therapy practice may occur in a variety of settings, including, but not limited to:
        1. (i) Institutional inpatient settings, such as acute rehabilitation facilities, psychiatric hospitals, community and specialty hospitals, nursing facilities and prisons;
        2. (ii) Outpatient settings, such as clinics, medical offices and therapist offices;
        3. (iii) Home and community settings, such as homes, group homes, assisted living facilities, schools, early intervention centers, daycare centers, industrial and business facilities, hospices, sheltered workshops, wellness and fitness centers and community mental health facilities;
        4. (iv) Research facilities;
        5. (v) Educational institutions; and
        6. (vi) Telehealth, telemedicine, or provider-based telemedicine, as authorized by § 63-1-155; and
      4. (D) “Occupational therapy practice” includes specialized services provided by occupational therapists or occupational therapy assistants who are certified or trained in areas of specialization that include, but are not limited to, hand therapy, neurodevelopmental treatment, dry needling of the upper limb, sensory integration, pediatrics, geriatrics and neurorehabilitation, through programs approved by AOTA or other nationally recognized organizations;
    11. (11) “Occupations” means everyday life activities, named, organized and given value and meaning by individuals and their culture. “Occupations” includes everything that people do to occupy their time, including caring for their needs, enjoying life and contributing to the social and economic fabric of their communities;
    12. (12) “Onsite supervision” means the supervising physical therapist or physical therapist assistant must:
      1. (A) Be continuously onsite and present in the department or facility where assistive personnel are performing services;
      2. (B) Be immediately available to assist the person being supervised in the services being performed; and
      3. (C) Maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated to assistive personnel;
    13. (13) “Physical therapist” or “physiotherapist” means a person who is licensed pursuant to this chapter to practice physical therapy;
    14. (14) “Physical therapist assistant” means a person who meets the requirements of this chapter for licensure as a physical therapist assistant and who performs physical therapy procedures and related tasks that have been selected and delegated only by the supervising physical therapist;
    15. (15) “Physical therapy” means the care and services provided by or under the direction and supervision of a physical therapist who is licensed pursuant to this chapter;
    16. (16) “Physical therapy assistive personnel”:
      1. (A) “Other assistive personnel” means other trained or educated health care personnel not defined in subdivisions (14) and (16)(B), who perform specific designated tasks related to physical therapy under the supervision of a physical therapist. At the discretion of the supervising physical therapist, and if properly credentialed and not prohibited by any other law, “other assistive personnel” or “other support personnel” may be identified by the title specific to their training or education; and
      2. (B) “Physical therapy aide,” inclusive of the terms “aide,” “technician” and “transporter,” means a person trained by and under the direction of a physical therapist who performs designated and supervised routine physical therapy tasks;
    17. (17) “Practice of physical therapy” means, whether by in-person encounter or via telehealth, telemedicine, or provider-based telemedicine, as authorized by § 63-1-155, the following:
      1. (A) Examining, evaluating and testing individuals with mechanical, physiological and developmental impairments, functional limitations and disability or other health and movement-related conditions in order to determine a physical therapy treatment diagnosis, prognosis, a plan of therapeutic intervention and to assess the ongoing effect of intervention;
      2. (B) Alleviating impairments and functional limitations by designing, implementing, and modifying therapeutic interventions that include, but are not limited to, therapeutic exercise, functional training, manual therapy, therapeutic massage, assistive and adaptive orthotic, prosthetic, protective and supportive equipment, airway clearance techniques, debridement and wound care, physical agents or modalities, dry needling, mechanical and electrotherapeutic modalities and patient-related instruction;
      3. (C) Reducing the risk of injury, impairments, functional limitation and disability, including the promotion and maintenance of fitness, health and quality of life in all age populations; and
      4. (D) Engaging in administration, consultation, education and research;
    18. (18) “Restricted physical therapist assistant license” means a license on which the committee has placed any restrictions due to action imposed by the committee;
    19. (19) “Restricted physical therapy license” means a license on which the committee places restrictions or conditions, or both, as to scope of practice, place of practice, supervision of practice, duration of licensed status or type of condition of patient to whom the licensee may provide services;
    20. (20) “Supervision” of the physical therapist assistant means the supervising physical therapist will be readily available to the physical therapist assistant being supervised. When the physical therapist assistant is practicing in an offsite setting, the supervising physical therapist will be immediately accessible by telecommunications. Patient conferences will be regularly scheduled and documented and supervisory visits will be made as further outlined in the rules and regulations;
    21. (21) “Unlicensed person working in occupational therapy” means a person who performs specific supportive tasks related to occupational therapy practice under the direct supervision of an occupational therapist or an occupational therapy assistant and whose activities do not require professional or advanced training in the basic anatomical, biological, psychological and social sciences involved in the provision of occupational therapy services. Such persons are often referred to as aides, technicians, transporters or support staff; and
    22. (22) “Upper limb” means the hand, wrist, elbow, and shoulder girdle.
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§ 63-13-104. Unauthorized practice of medicine — Scope of practice.
  1. (a) Nothing in this chapter shall be construed as allowing physical therapists to practice medicine, osteopathy, podiatry, chiropractic or nursing.
  2. (b)
    1. (1) Except as provided in § 63-13-303, the scope of practice of physical therapy is under the written or oral referral of a licensed:
      1. (A) Doctor of medicine, chiropractic, dentistry, podiatry, or osteopathy; or
      2. (B) Nurse practitioner or physician assistant pursuant to § 63-6-204(b).
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    2. (2) The scope of practice of physical therapy shall not include the performance of treatment where the physical therapist or physical therapist assistant uses direct thrust to move a joint of the patient's spine beyond its normal range of motion without exceeding the limits of anatomical integrity.
Part 2 Certification of Occupational Therapists and Assistants
§ 63-13-201. Legislative purpose.
  1. (a) This part is enacted to:
    1. (1) Safeguard the public health, safety and welfare;
    2. (2) Protect the public from being misled by incompetent, unscrupulous and unauthorized persons;
    3. (3) Assure the highest degree of professional conduct on the part of occupational therapists and occupational therapy assistants; and
    4. (4) Assure that the available occupational therapy services are of high quality to persons in need of such services.
  2. (b) It is the purpose of this part to provide for the regulation of persons offering occupational therapy services to the public.
§ 63-13-202. Applicants for licensure — Qualifications — Examinations.
  1. (a) An applicant for licensure as an occupational therapist or as an occupational therapy assistant shall file an application showing, to the satisfaction of the board of occupational therapy, that the applicant:
    1. (1) Is of good moral character;
    2. (2) Has successfully completed the academic requirements of an educational program accredited by ACOTE or its predecessor organization. The accredited program shall be a program for occupational therapists or a program for occupational therapy assistants, depending upon the category of licensure for which the applicant is applying;
    3. (3) Has successfully completed the period of supervised fieldwork experience required by ACOTE; and
    4. (4) Has made an acceptable score on a written or computerized examination designed to test the applicant's knowledge of the basic and clinical services related to occupational therapy, occupational therapy techniques and methods and other subjects that may help to determine an applicant's fitness to practice. The board of occupational therapy shall approve an examination for occupational therapists and an examination for occupational therapy assistants and shall establish standards for acceptable performance on each examination. The board is authorized to use the entry level national examinations prepared and administered by NBCOT as the examinations used to test applicants for licensure as occupational therapists or occupational therapy assistants and is authorized to use the standards of NBCOT in determining an acceptable score on each examination.
  2. (b)
    1. (1) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
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§ 63-13-203. Determining qualifications of applicants — Granting licenses and permits.
  1. (a) In determining the qualifications of an applicant for licensure as an occupational therapist or as an occupational therapy assistant, only a majority vote of the board of occupational therapy shall be required.
  2. (b) Licenses and permits issued by the board shall be granted by the board as provided in § 63-13-204.
§ 63-13-204. Licenses — Issuance — Fees — Revocation — Reinstatement — Renewal.
  1. (a)
    1. (1) The board of occupational therapy shall issue a license to any person who meets the requirements of this part upon payment of the appropriate fees.
    2. (2) Each licensed occupational therapist or occupational therapy assistant shall pay a biennial renewal fee to the board as prescribed in this part, payable in advance, for the ensuing years. The secretary of the board shall notify each licensee.
    3. (3) When any licensee fails to register and pay the biennial registration fee within thirty (30) days after registration becomes due as provided in this section, the license of such person shall be administratively revoked at the expiration of the thirty (30) days after the registration was required, without further notice or hearing. Any person whose license is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license; and, upon good cause being shown, the board in its discretion may reinstate such license upon payment of all past-due renewal fees.
  2. (b) For purposes of implementing § 63-13-108(b) [repealed], the board shall prescribe and publish nonrefundable fees.
  3. (c)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period; however, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the biennial fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (c).
  4. (d) The board is authorized to establish requirements for assessing continued competence of licensees.
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§ 63-13-205. Limited permits — Failure of initial examination.
  1. (a) A limited permit may be issued by the board to an applicant who has applied for a license under § 63-13-202, has successfully completed the educational and field experience requirements of § 63-13-202(2) and (3) and is scheduled to take the examination required by § 63-13-202(4).
  2. (b) An applicant who has received a limited permit shall take the examination within ninety (90) days of the date the applicant received the limited permit. If the applicant does not take the examination within that ninety-day period, the limited permit expires at the end of the ninety-day period.
  3. (c) If an applicant fails the examination, the applicant's limited permit expires upon the board's receipt of notice that the applicant failed the examination.
  4. (d) If an applicant passes the examination, the applicant's limited permit remains effective until the board grants or denies a license to the applicant.
  5. (e) An applicant may obtain a limited permit only once.
  6. (f) A limited permit allows an applicant to engage in occupational therapy practice under the supervision of a licensed occupational therapist.
  7. (g) The board shall adopt rules governing the supervision of persons to whom a limited permit has been issued. The rules shall address, at a minimum, initial and periodic inspections, written evaluations, written treatment plans, patient notes and periodic evaluation of performance.
§ 63-13-206. Supervision of an occupational therapy assistant by an occupational therapist.
  1. (a) A licensed occupational therapy assistant shall practice under the supervision of an occupational therapist who is licensed in Tennessee.
  2. (b) The supervising occupational therapist is responsible for all services provided by the occupational therapy assistant, including, but not limited to, the formulation and implementation of a plan of occupational therapy services for each client, and has a continuing responsibility to follow the progress of each client and to ensure the effective and appropriate supervision of the occupational therapy assistant according to the needs of the client.
  3. (c) The supervising occupational therapist shall assign to the occupational therapy assistant only those duties and responsibilities that the occupational therapy assistant is qualified to perform.
  4. (d) The board shall adopt rules governing the supervision of occupational therapy assistants by occupational therapists. Those rules may address the following:
    1. (1) The manner in which the supervising occupational therapist oversees the work of the occupational therapy assistant;
    2. (2) The ratio of occupational therapists to occupational therapy assistants required under different conditions and in different practice settings; and
    3. (3) The documentation of supervision contacts between the supervising occupational therapist and the occupational therapy assistant.
  5. (e) The rules adopted by the board shall recognize that the frequency, methods and content of supervision of occupational therapy assistants by occupational therapists may vary by practice setting and are dependent upon the following factors, among others:
    1. (1) Complexity of the client's needs;
    2. (2) Number and diversity of clients;
    3. (3) Skills of the occupational therapy assistant and the supervising occupational therapist;
    4. (4) Type of practice setting; and
    5. (5) Requirements of the practice setting.
§ 63-13-207. Delegation of tasks to unlicensed personnel.
  1. (a) A licensed physician, occupational therapist or licensed occupational therapy assistant may delegate to an unlicensed person specific routine tasks associated with nontreatment aspects of occupational therapy practice that are not evaluative, assessive, task selective or recommendational in nature and do not require making decisions or making assessment or treatment entries in official patient records, if the following conditions are met:
    1. (1) The physician, occupational therapist or occupational therapy assistant accepts professional responsibility for the performance of that duty by the person to whom it is delegated. In the case of duties delegated by an occupational therapy assistant, the occupational therapy assistant, the physician and occupational therapist who supervises the occupational therapy assistant shall be responsible;
    2. (2) The unlicensed person does not perform any duties that require licensure under this chapter; and
    3. (3) The physician, occupational therapist or occupational therapy assistant ensures that the unlicensed person has been appropriately trained for the performance of the tasks.
  2. (b) Tasks that may be delegated may include:
    1. (1) Transporting of patients;
    2. (2) Preparing or setting up a work area or equipment;
    3. (3) Routine department maintenance or housekeeping activities;
    4. (4) Taking care of patient's personal needs during treatments; and
    5. (5) Clerical, secretarial or administrative duties.
§ 63-13-208. Construction of part — Activities not prohibited.
  1. (a) Nothing in this part shall be construed as preventing or restricting the practice, services or activities of:
    1. (1) Any person licensed under any chapter of this title;
    2. (2) Any person employed as an occupational therapist or occupational therapy assistant by an agency of the United States government while providing occupational therapy services in that capacity;
    3. (3) Any person pursuing a course of study leading to a degree or certificate in occupational therapy in an educational program accredited or granted developing program status by ACOTE, if:
      1. (A) The activities and services constitute a part of a supervised course of study; and
      2. (B) The person is designated by a title that clearly indicates the person's status as a student;
    4. (4) Any person fulfilling the supervised fieldwork experience requirements of § 63-13-202(3), if the activities and services constitute a part of the experience necessary to meet the requirements of § 63-13-202(3);
    5. (5) An occupational therapist or occupational therapy assistant who is licensed or certified to practice in another state that has licensure or certification requirements at least as stringent as the requirements of this part while in Tennessee for the purpose of providing educational, consulting or training services for no more than fourteen (14) days in a calendar year; and
    6. (6) Any person who is certified by the National Council for Therapeutic Recreation Certification as a certified therapeutic recreation specialist, while engaged in practicing the profession of recreation therapy.
  2. (b) Nothing in this part shall prevent certified orthotists from designing, fabricating and fitting orthotic devices.
  3. (c) Nothing in this part shall prevent any person employed by a physician from performing activities related to casting and splinting or teaching exercises related to specific treatment by the employing physician.
  4. (d) The practice of dry needling of the upper limb by an occupational therapist licensed under this chapter does not constitute the practice of acupuncture under chapter 6, part 10, of this title.
§ 63-13-209. Denial, suspension or revocation of license.
  1. (a) The board of occupational therapy has the power and it is its duty to deny, suspend or revoke the license of or to otherwise lawfully discipline a licensee whenever the licensee is guilty of violating any of this part or is guilty of any of the following acts or offenses:
    1. (1) Unprofessional, dishonorable or unethical conduct;
    2. (2) Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this part or any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    3. (3) Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the licensee's practice;
    4. (4) Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of professional practice;
    5. (5) Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such a manner as to adversely affect the person's ability to practice;
    6. (6) Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    7. (7) Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
    8. (8) Engaging in practice when mentally or physically unable to safely do so;
    9. (9) Solicitation by agents or persons generally known as “cappers” or “steerers” of professional patronage or profiting by the acts of those representing themselves to be agents of the licensee;
    10. (10) Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    11. (11) Conducting practice so as to permit, directly or indirectly, an unlicensed person to perform services or work that, under this part, can be done legally only by persons licensed to practice;
    12. (12) Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this part or lending one's name to another for illegal practice;
    13. (13) Payment or acceptance of commissions, in any form or manner, on fees for professional services, references, consultations, pathological reports, prescriptions or on other services or articles supplied to patients;
    14. (14) Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, or other articles or materials that are offered to the public, claiming radical cure or prevention of diseases by their use;
    15. (15) Violating the code of ethics adopted by the board;
    16. (16) Any other unprofessional or unethical conduct that may be specified by the rules duly published and promulgated by the board or the violation of any provision of this part;
    17. (17) On behalf of the licensee, the licensee's partner, associate or any other person affiliated with the licensee or the licensee's facility, use or participate in the use of any form of public communication containing a false, fraudulent, misleading or deceptive statement or claim; or
    18. (18) Disciplinary action against a person licensed to practice occupational therapy by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state.
  2. (b) In enforcing this section, the board of occupational therapy shall, upon probable cause, have the authority to compel an applicant or licensee to submit to a mental or physical examination, or both, by a designated board of at least three (3) practicing physicians, including a psychiatrist, where a question of mental condition is involved. The applicant or licensee may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The physicians' board shall submit a report of its findings to the board for use in any hearing that may thereafter ensue.
  3. (c) The board, on its own motion, may cause to be investigated any report indicating that a licensee is or may be in violation of this part. Any licensee, any occupational therapist or occupational therapy-related society or association or any other person who in good faith reports to the board any information that a licensee is or may be in violation of any provisions of this part shall not be subject to suit for civil damages as a result thereof.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-13-210. Administrative procedure.
  1. All administrative proceedings for disciplinary action against a licensee under this part shall be conducted by the board of occupational therapy in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-13-211. Unlawful practices — Penalty.
  1. (a) It is unlawful for any person to violate this part. It is unlawful for any person who is not licensed under this part as an occupational therapist or an occupational therapy assistant or whose license has been suspended or revoked to use, in connection with the person's name or place of business, the words “occupational therapist,” “occupational therapist registered,” “licensed occupational therapist,” “occupational therapy assistant,” “certified occupational therapy assistant” or “licensed occupational therapy assistant,” the letters “OT,” “OTA,” “OTR,” “OT/L,” “OTA/L” or “COTA” or any other words, letters, abbreviations or insignia indicating or implying that the person is an occupational therapist or an occupational therapy assistant or who in any way, orally, in writing, in print or by sign, directly or by implication, claims to be an occupational therapist or an occupational therapy assistant.
  2. (b) A violation of this part is a Class B misdemeanor.
§ 63-13-212. License requirement.
  1. No person shall practice occupational therapy or act as an occupational therapy assistant, nor claim to be able to practice occupational therapy or act as an occupational therapy assistant, unless the person holds a license and otherwise complies with this part and the rules adopted by the board.
§ 63-13-213. Reciprocity.
  1. (a) The board of occupational therapy may grant a license to an applicant who presents proof of current licensure or certification as an occupational therapist or occupational therapy assistant in another state, the District of Columbia or a territory of the United States and who possesses educational and experiential qualifications that meet or exceed the requirements for licensure in Tennessee, as determined by the board of occupational therapy.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-13-214. Internationally trained applicants.
  1. Applicants for licensure who have completed educational programs outside the United States shall furnish proof of good moral character and of completion of an educational program and supervised fieldwork substantially similar to those contained in § 63-13-202(2) and (3) and shall satisfy the examination requirements of § 63-13-202(4).
§ 63-13-215. Retirement — Inactive status.
  1. (a) Any person licensed by the board of occupational therapy to practice in this state who has retired or may retire from such practice in this state shall not be required to register as required by this chapter if such person files with the board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which the person retired from such practice and any other facts, as the board shall consider necessary, that tend to verify such retirement. If such person thereafter reengages in practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet such continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.
  2. (b) Any person licensed by the board of occupational therapy may place the person's license on inactive status by filing the proper forms with the board and by paying a biennial fee in accordance with rules adopted by the board. If the person thereafter reengages in active practice in this state, the person shall apply for relicensure with the board as provided by this part and shall meet the continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.
§ 63-13-216. Board of occupational therapy.
  1. (a) There is created a board of occupational therapy, which shall perform the same functions and have the same duties and responsibilities that were performed by the committee of occupational therapy prior to July 1, 2007.
  2. (b) The board shall consist of five (5) members appointed by the governor, each of whom shall be a resident of this state. Three (3) members of the board shall be licensed occupational therapists who have had at least five (5) years of experience in the actual practice or teaching of occupational therapy immediately preceding their appointment. One (1) member of the board shall be a licensed occupational therapy assistant who has had at least five (5) years of experience in the actual practice of occupational therapy or teaching of an occupational therapy assistant curriculum immediately preceding the appointment. One (1) member of the board shall be a person who is not engaged in the practice of occupational therapy and who is not professionally or commercially associated with the health care industry.
  3. (c) The occupational therapist and occupational therapy assistant members may be appointed by the governor from lists of nominees submitted by interested occupational therapy groups, including, but not limited to, the Tennessee Occupational Therapy Association. The governor shall consult with the interested occupational therapy groups to determine qualified persons to fill positions on the board.
  4. (d) The occupational therapists and the occupational therapy assistant who are serving on the committee of occupational therapy on July 1, 2007, shall continue to serve as members of the board until the expiration of their terms.
  5. (e) The board shall organize annually and select a chair and a secretary. Meetings shall be held as frequently as may be required.
  6. (f) A quorum of the board shall consist of at least three (3) members.
  7. (g) The division shall provide administrative, investigatory and clerical services to the board.
  8. (h) Each member of the board shall be reimbursed for actual expenses incurred in the performance of official duties on the board and shall be entitled to a per diem of one hundred dollars ($100) for each day of service in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  9. (i) All regular appointments to the board shall be for terms of three (3) years each. Each member shall serve until a successor is appointed. Vacancies shall be filled by appointment of the governor for the remainder of the unexpired term.
  10. (j) The governor may, at the request of the board, remove any member of the board for misconduct, incompetence or neglect of duty.
  11. (k) In making appointments to the board, the governor shall strive to ensure that at least one (1) member is sixty (60) years of age or older, that at least one (1) member is a racial minority and that the gender balance of the board reflects the gender balance of the state's population.
  12. (l) The board shall have the power and duty to:
    1. (1) Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules reasonably necessary for the performance of its duties and the proper administration of this part;
    2. (2) Grant, in the board's name, all licenses approved by the board;
    3. (3) Collect and receive all fees, fines and moneys owed pursuant to this part and to pay the fees, fines and moneys into the general fund of the state; and
    4. (4) Establish minimum competency requirements that an occupational therapist must demonstrate in order to practice dry needling of the upper limb.
  13. (m) After July 1, 2007, the board shall assume and fulfill all powers and duties previously assigned to the committee of occupational therapy, and the rules adopted by the committee of occupational therapy shall become the rules of the board without further action by the board.
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Part 3 Licensure of Physical Therapists and Assistants
§ 63-13-301. License requirement.
  1. (a)
    1. (1) A physical therapist, or physiotherapist, licensed under this chapter is fully authorized to practice physical therapy.
    2. (2) A physical therapist, or physiotherapist, is not licensed under this chapter unless the individual holds a degree from a professional physical therapy program accredited by a national accreditation agency recognized by the United States department of education and by the board of physical therapy.
  2. (b) No person shall practice or in any manner claim to be engaging in the practice of physical therapy or designate as being a physical therapist unless duly licensed as a physical therapist in accordance with this chapter.
§ 63-13-302. Referrals — Ethical standards.
  1. (a) A physical therapist shall refer persons under the physical therapist's care to appropriate health care practitioners, after consultation with the referring practitioner, if the physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice or when physical therapy treatment is contraindicated.
  2. (b) Physical therapists shall adhere to the recognized standards of ethics of the physical therapy profession and as further established by rule.
§ 63-13-303. Exceptions to referral requirements.
  1. (a)
    1. (1) The practice of physical therapy must be under the written or oral referral of a referring practitioner as described in § 63-13-104(b)(1), except that a licensed physical therapist may:
      1. (A) Conduct an initial patient visit without referral;
      2. (B) Provide physical assessments or instructions, including a recommendation of exercise to an asymptomatic person, without the referral of a referring practitioner;
      3. (C) In emergency circumstances, including minor emergencies, provide assistance to a person to the best of a physical therapist's ability without the referral of a referring practitioner. Except as provided in subdivision (a)(1)(D), the physical therapist shall refer the person to the appropriate healthcare practitioner, as indicated, immediately after providing assistance; and
      4. (D) Treat a patient without a referral, within the scope of practice of physical therapy, when the following are met:
        1. (i) The patient's physician, as defined in § 63-6-204(f)(7), has been notified by the physical therapist;
        2. (ii) If the physical therapist determines, based on clinical evidence, that no progress has been made with respect to that patient's condition within thirty (30) days, immediately following the date of the patient's initial visit with the physical therapist, then the physical therapist does not provide additional physical therapy services and refers the patient to a healthcare practitioner who qualifies as a referring practitioner;
        3. (iii) The physical therapist does not continue physical therapy services for the patient beyond ninety (90) days without consulting with the patient's appropriate healthcare practitioner;
        4. (iv) If the patient was previously diagnosed by a licensed physician with chronic, neuromuscular, or developmental conditions, and the evaluation, treatment, or services are being provided for problems or symptoms associated with one (1) or more of those previously diagnosed conditions, then subdivisions (a)(1)(D)(ii) and (iii) do not apply; and
        5. (v) A physical therapist refers patients under the physical therapist's care to appropriate healthcare practitioners, if, at any time, the physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice of a physical therapist, reasonable therapeutic progress is not being achieved for the patient, or physical therapy treatment is contraindicated.
    2. (2) As used in this subsection (a):
      1. (A) “Emergency circumstances” means instances where emergency medical care is required;
      2. (B) “Emergency medical care” means bona fide emergency services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
        1. (i) Placing the patient's health in serious jeopardy;
        2. (ii) Serious impairment to bodily functions; or
        3. (iii) Serious dysfunction of a bodily organ or part; and
      3. (C) “Notified” means to give notice to or inform a patient's physician, as defined in § 63-6-204(f)(7), when a licensed physical therapist treats a patient pursuant to subdivision (a)(1)(D).
  2. (b) It is unprofessional conduct, for the purposes of § 63-13-312, for a physical therapist to knowingly initiate services to a patient in violation of subdivision (a)(1)(D).
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§ 63-13-304. Board powers and duties.
  1. (a) The board of physical therapy has the power and authority to:
    1. (1) Evaluate the qualifications of applicants for licensure and provide for the examination of physical therapists and physical therapist assistants;
    2. (2) Adopt passing scores for examination;
    3. (3) Issue licenses to those who qualify under this chapter;
    4. (4) Regulate the practice of physical therapy by interpreting and enforcing this chapter, including disciplinary action;
    5. (5) Adopt and revise rules, as it deems necessary and appropriate, consistent with this chapter, for the discharge of its obligation under this section. Such rules, when lawfully adopted, shall have the effect of law;
    6. (6) Establish requirements for assessing continuing competence of licensees; and
    7. (7) Assess all license and registration fees.
  2. (b) The board of physical therapy shall establish minimum competency requirements that a physical therapist shall demonstrate in order to practice dry needling.
§ 63-13-305. Claims and practices of other licensed professionals — Exemptions from licensure.
  1. (a) Nothing in this chapter shall be construed as restricting a person licensed or certified under any other law of this state from engaging in the profession or practice for which the person is licensed or certified; provided, that the person does not claim to be a physical therapist, a physical therapist assistant or a provider of physical therapy.
  2. (b) The following persons shall be exempt from licensure as a physical therapist or physical therapist assistant under this chapter:
    1. (1) A person who is pursuing a course of study leading to a degree as a physical therapist or physical therapist assistant in a professional education program approved by the board and is satisfying supervised clinical education requirements related to physical therapy education;
    2. (2) A physical therapist or physical therapist assistant while practicing in the United States armed services, United States public health service or veterans administration as based on requirements under federal regulations for state licensure of health care providers;
    3. (3) A physical therapist or physical therapist assistant licensed in another United States jurisdiction, or a foreign-educated or internationally trained physical therapist credentialed in another country, performing physical therapy as part of teaching or participating in an educational seminar of no more than sixty (60) days in a calendar year; and
    4. (4) A physical therapist or physical therapist assistant licensed in another United States jurisdiction who is temporarily performing physical therapy for members of established athletic teams, athletic corporations or performing arts companies that are training, competing or performing in Tennessee; provided, however, that a person performing physical therapy in this state pursuant to this subdivision (b)(4) shall agree to use the secretary of state for service of process pursuant to title 20, chapter 2, part 2.
  3. (c) The practice of dry needling by a physical therapist licensed under this chapter shall not constitute the practice of acupuncture under chapter 6, part 10 of this title.
  4. (d) Nothing in this chapter shall be construed as restricting persons licensed under any other law of this state from performing physical agent modalities for which they have received education and training.
§ 63-13-306. Application — Examinations.
  1. (a)
    1. (1) An applicant for licensure as a physical therapist or physical therapist assistant shall file an application as required by the board. A nonrefundable application fee and cost of the examination shall accompany the completed written or online application. Fees shall be established by the rules promulgated by the board.
    2. (2)
      1. (A) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) After the application process has been completed, an applicant shall take the examination for physical therapist licensure that covers current physical therapy practice.
  3. (c) After the application process has been completed, an applicant shall take the examination for physical therapist assistant licensure that covers current technical application of physical therapy services.
  4. (d) Examinations shall be available within the state at such time and place as the board shall determine. The board shall determine the passing score.
  5. (e) Applicants who do not pass the examination after the first attempt may retake the examination one (1) additional time without reapplication for licensure up to a total of six (6) attempts. Applications remain active for twelve (12) months. After twelve (12) months, applicants must submit a new application with all applicable fees.
§ 63-13-307. Qualifications of applicants — Reciprocity.
  1. (a) An applicant for licensure as a physical therapist shall have the following qualifications:
    1. (1) Be of good moral character;
    2. (2) Have completed the application process;
    3. (3) Be a graduate of a professional physical therapy program accredited by a national accreditation agency recognized by the United States department of education and by the board of physical therapy; and
    4. (4) Have successfully passed an examination approved by the board.
  2. (b) An applicant for license as a physical therapist assistant shall meet the following requirements:
    1. (1) Be of good moral character;
    2. (2) Have completed the application process;
    3. (3) Be a graduate of a physical therapist assistant education program accredited by an accreditation agency approved by the board; and
    4. (4) Have successfully passed an examination approved by the board.
  3. (c)
    1. (1) The board shall issue a license to a physical therapist or physical therapist assistant who has a valid unrestricted license from another United States jurisdiction in which such person, when granted such license, previously met all requirements as specified in subsections (a) and (b) and as further established by rules promulgated by the board.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (c)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  4. (d) An applicant for licensure as a physical therapist who has been educated outside the United States, foreign-educated, or internationally trained shall meet the following qualifications:
    1. (1) Be of good moral character;
    2. (2) Have completed the application process;
    3. (3) Provide satisfactory evidence that the applicant's education is substantially equivalent to the requirements of physical therapists educated in accredited educational programs as determined by the board. If the board determines that a foreign-educated applicant's education is not substantially equivalent, it may require completion of additional course work before proceeding with the application process;
    4. (4) Provide written proof that the school of physical therapy education is recognized by its own ministry of education;
    5. (5) Provide written proof of authorization to practice as a physical therapist without limitations in the country where the professional education occurred;
    6. (6) Provide proof of legal authorization to reside and seek employment in the United States or its territories;
    7. (7) Have the applicant's educational credentials evaluated by a board-approved credential evaluation agency;
    8. (8) Have passed the board approved English proficiency examinations, if the applicant's native language is not English;
    9. (9) Have participated in and completed an interim supervised clinical practice period prior to licensure; and
    10. (10) Have successfully passed the examination approved by the board.
  5. (e) Notwithstanding this section, if the foreign-educated physical therapist applicant is a graduate of a professional physical therapy education program accredited by an agency approved by the board, the requirements in subdivisions (d)(3), (4), (7) and (9) may be waived.
  6. (f) In determining the qualifications of an applicant for licensure as a physical therapist or as a physical therapist assistant, only a majority vote of the board of physical therapy shall be required.
§ 63-13-308. License renewal — Eligibility to apply for physical therapy licensure compact privileges — Changes in name or address — Retirement — Inactive Status — Exemption from continuing education requirements.
  1. (a) A physical therapist or physical therapist assistant licensed under this part shall renew the person's license as specified in the rules. An individual who fails to renew the license by the date of expiration shall not practice physical therapy or function as a physical therapist assistant in this state.
  2. (b) A physical therapist or physical therapist assistant licensed in a jurisdiction that is a member state of the Physical Therapy Licensure Compact is eligible to become a licensee for compact privileges in this state, subject to the requirements in § 63-13-402.
  3. (c) Each licensee shall report to the division a name change and changes in business and home address within thirty (30) days of the change.
  4. (d) A person licensed by the board to the practice of physical therapy in this state who has retired, or may retire, from the practice in this state is not required to register as required by this part if the person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which the person retired from the practice and any other facts the board considers necessary that tend to verify the retirement. If the person thereafter reengages in the practice in this state, the person must apply for licensure with the board as provided by this part and meet the continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.
  5. (e) A person licensed by the board may place their license on inactive status by filing the proper forms with the board and by paying a biennial fee in accordance with rules. If the person thereafter reengages in active practice of physical therapy in this state, then the person must apply for relicensure with the board as provided by this part and meet the continuing education requirements as are established by the board, except for good and sufficient reasons as determined by the board.
§ 63-13-309. Reinstatement of license — Failure to renew license.
  1. (a) Reinstatement of a lapsed license following a renewal deadline requires payment of a renewal fee, a late renewal penalty fee and a reinstatement fee, in accordance with rules promulgated by the board.
  2. (b) Reinstatement of a license that has lapsed for more than three (3) consecutive years requires reapplying for a license and payment of fees in accordance with board rules. The individual shall successfully demonstrate to the board competency in the practice of physical therapy or, shall serve an internship under a restricted license or take remedial courses as determined by the board, or any combination of the preceding, at the board's discretion. The board may also require the applicant to take an examination.
  3. (c) When any license holder fails to renew and pay the biennial renewal fee within sixty (60) days after renewal becomes due, as provided in this section, the license of such person shall be administratively revoked at the expiration of the sixty (60) days after the renewal was required, without further notice or hearing. Any person whose license is administratively revoked, as provided in this subsection (c), may make application in writing to the board for the reinstatement of such license; and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of all required fees.
§ 63-13-310. Unlawful use of titles or designations indicating licensure.
  1. (a) A physical therapist shall use the letters “PT” or “DPT”, as appropriate for the individual's education, in connection with their name or place of business to denote licensure under this part.
  2. (b) It is unlawful for any person or for any business entity, its employees, agents or representatives to use in connection with such person's name or the name or activity of the business the words “physical therapy,” “physical therapist,” “physiotherapy,” “physiotherapist,” “registered physical therapist,” “licensed physical therapist,” “doctor of physical therapy,” or the letters “PT,” “LPT,” “DPT,” or “RPT” or any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless such services are provided by or under the direction of a physical therapist licensed in accordance with this part.
  3. (c) Nothing in this chapter shall be construed as restricting a person licensed or certified under any other law of this state from engaging in the profession or practice for which the person is licensed or certified; provided, that the person does not claim to be a physical therapist, a physical therapist assistant or a provider of physical therapy.
  4. (d) A physical therapist assistant shall use the letters “PTA” in connection with the person's name to denote licensure.
  5. (e) No person shall use the title “physical therapist assistant” or use the letters “PTA” in connection with the person's name or any other words, abbreviations or insignia indicating or implying, directly or indirectly, that the person is a physical therapist assistant unless the person is licensed as a physical therapist assistant in accordance with this part.
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§ 63-13-311. Supervision of students and assistive personnel.
  1. (a) Physical therapists are responsible for the patient care given by physical therapist assistants, assistive personnel and students on clinical affiliations under their supervision. The physical therapist may delegate to the physical therapist assistant, assistive personnel and clinical students selected acts, tasks or procedures that fall within the scope of their education or training.
  2. (b) Physical therapist assistants shall at all times be under the supervision of a licensed physical therapist as defined in § 63-13-103 and as further set forth in the rules promulgated by the board.
  3. (c) Physical therapy aides, other assistive personnel and clinical students shall at all times perform patient care activities under the onsite supervision of a licensed physical therapist or physical therapist assistant as defined in § 63-13-103.
  4. (d) Physical therapist students and physical therapist assistant students shall at all times be under the supervision of a physical therapist as further set forth in the rules promulgated by the board.
§ 63-13-312. Denial, suspension or revocation of licenses.
  1. (a) The board has the power, and it shall be its duty, to deny, suspend or revoke the license of, or to otherwise lawfully discipline, a licensee who is guilty of violating any of this part or is guilty of the following acts or offenses:
    1. (1) Practicing physical therapy in violation of this chapter or any rule or written order adopted by the board;
    2. (2) Practicing or offering to practice beyond the scope of physical therapy practice as defined in this chapter;
    3. (3) Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the licensee's practice;
    4. (4) Engaging in the performance of substandard care by a physical therapist due to ignorance, incompetence or a deliberate or negligent act or failure to act, regardless of whether actual injury to the patient is established;
    5. (5) Engaging in the performance of substandard care by a physical therapist assistant, which includes exceeding the authority to perform the task selected and delegated by the supervising physical therapist, regardless of whether actual injury to the patient is established;
    6. (6) Inadequately supervising or delegating duties that exceed the scope of practice for assistive personnel in accordance with this chapter and rules adopted by the board;
    7. (7) Conviction of a felony or any offense involving moral turpitude in the courts of this state or any other state, territory or country. “Conviction,” as used in this subdivision (a)(7), includes a finding or verdict of guilt or a plea of nolo contendere;
    8. (8) Practicing as a physical therapist or working as a physical therapist assistant when physical or mental abilities are impaired by the use of controlled substances, controlled substance analogues, other habit-forming drugs, chemicals or alcohol;
    9. (9) Disciplinary action against a person licensed to practice as a physical therapist or physical therapist assistant by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document shall constitute prima facie evidence of a violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state;
    10. (10) Engaging in sexual misconduct. “Sexual misconduct,” for the purpose of this section, includes:
      1. (A) Engaging in or soliciting sexual relationships, whether consensual or nonconsensual, while a physical therapist or physical therapist assistant/patient relationship exists;
      2. (B) Making sexual advances, requesting sexual favors and engaging in other verbal conduct or physical conduct or physical contact of a sexual nature with patients; and
      3. (C) Intentionally viewing a completely or partially disrobed patient in the course of treatment, if the viewing is not related to patient diagnosis or treatment under current practice standards;
    11. (11) Directly or indirectly requesting, receiving or participating in the dividing, transferring, assigning, rebating or refunding of an unearned fee or profiting by means of a credit or other valuable consideration, such as an unearned commission, discount or gratuity in connection with the furnishing of physical therapy services. Nothing in this subdivision (a)(11) prohibits the members of any regularly and properly organized business entity recognized by law and comprised of physical therapists from dividing fees received for professional services among themselves as they determine necessary to defray their joint operating expenses. Physical therapists employed by or contracting with a physician, physician group, as defined in accordance with the federal Physician Self-Referral Law (42 U.S.C. § 1395nn), or entity primarily owned by physicians and receiving wages or other compensation and/or benefits pursuant to the employment or contract shall not be deemed to be in violation of any provision under this chapter solely by virtue of the employment or contract and shall not be subject to licensure denial, suspension, revocation or any other disciplinary action or other penalty described under this chapter solely by virtue of the employment or contract. This subdivision (a)(11) shall not be interpreted in such a way as to create a prohibition on the corporate practice of any health care professional where no such prohibition previously existed;
    12. (12) Failing to adhere to standards of ethics of the physical therapy profession;
    13. (13) Charging unreasonable or fraudulent fees for services performed or not performed;
    14. (14) Making misleading, deceptive, untrue or fraudulent representations in violation of this chapter, or otherwise, in practice of the profession;
    15. (15) Being under a current judgment of mental incompetency rendered by a court of competent jurisdiction;
    16. (16) Aiding or abetting a person not licensed in this state who directly or indirectly performs activities requiring a license;
    17. (17) Failing to report to the board any act or omission of a licensee, applicant or any other person which violates this chapter;
    18. (18) Interfering with, or refusing to cooperate in, an investigation or disciplinary proceeding, including willful misrepresentation of facts or by the use of threats or harassment against any patient or witness to prevent the patient or witness from providing evidence in a disciplinary proceeding or any legal action;
    19. (19) Failing to maintain patient confidentiality without prior written consent or unless otherwise required by law;
    20. (20) Failing to maintain adequate patient records that contain a minimum of an evaluation of objective finding, a physical therapy treatment diagnosis, the plan of care including desired outcomes, the treatment record, a discharge plan including results of intervention and sufficient information to identify the patient;
    21. (21) Promoting unnecessary devices, treatment intervention or service for the financial gain of the practitioner or of a third party;
    22. (22) Providing treatment intervention unwarranted by the condition of the patient, nor shall the licensee continue treatment beyond the point of reasonable benefit;
    23. (23) A violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provisions of this chapter or any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    24. (24) Division of fees or agreeing to split fees or divide fees received for professional services with any person for bringing or referring a patient outside the scope of § 63-13-315;
    25. (25) Payment or acceptance of commissions, in any form or manner, on fees for professional services, references, consultations, pathological reports, prescriptions or on other services or articles supplied to patients;
    26. (26) Acting in a manner inconsistent with generally accepted standards of physical therapy practice; or
    27. (27) Practicing physical therapy with a mental or physical condition that impairs the ability of the licensee to practice with skill and safety.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-13-313. Disciplinary actions of the board.
  1. The board may, upon proof of the violation of any provision of this chapter, take the following disciplinary actions singly or in combination:
    1. (1) Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. (4) Issue a letter of reprimand;
    5. (5) Reprimand or take such action in relation to disciplining an applicant or licensee, including, but not limited to, informal settlements and letters of warning as the board, in its discretion, may deem proper;
    6. (6) Revoke a license;
    7. (7) Refuse to issue or renew a license; or
    8. (8) Impose civil penalties for violation of this chapter pursuant to § 63-1-134. In addition, the board may, in its discretion, assess and collect the reasonable costs incurred in a disciplinary hearing when action is taken against a person's license.
§ 63-13-314. Administrative procedure for disciplinary actions — Jurisdiction of board.
  1. (a) All proceedings for disciplinary action against a licensee shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  2. (b) The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section.
§ 63-13-315. Penalties.
  1. (a) A person commits a Class B misdemeanor if the person engages in an activity requiring a license issued according to this chapter and who fails to obtain the required license, who violates any other provision of this chapter or who uses any word, title, or representation implying that the person is licensed to engage in the practice of physical therapy. A person claims to be a physical therapist when using a title, letters or any description of services that incorporates one (1) or more of the terms, designations or abbreviations specifically restricted under §§ 63-13-103 and 63-13-310.
  2. (b) The board may authorize an investigation of any person to the extent necessary to determine if the person is engaged in the unlawful practice of physical therapy.
  3. (c) The board may, through the office of the attorney general and reporter, apply for injunctive relief in any court of competent jurisdiction to enjoin any person from committing an act in violation of this chapter. Injunctive proceedings are in addition to, and not in lieu of, all penalties and other remedies prescribed in this chapter.
  4. (d) A person who aids or requires another person to directly or indirectly violate this chapter or rules, who permits the person's license or a license issued by this board to be used by any person other than the licensee or who acts with the intent to violate or evade this chapter or rules is subject to a civil penalty of not more than one thousand dollars ($1,000) for each violation.
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§ 63-13-316. Peer assistance program — Fees.
  1. (a) In lieu of a disciplinary proceeding as set forth in this chapter, the board may permit a licensee pursuant to this part to actively participate in a board approved peer assistance program under the following conditions:
    1. (1) The board has evidence that the licensee is impaired;
    2. (2) The licensee has not been convicted of a felony relating to a controlled substance or controlled substance analogue in a court of law of the United States or any other territory or country;
    3. (3) The licensee enters into a written agreement with the board for a restricted license and complies with all the terms of the agreement, including making satisfactory progress in the program and adhering to any limitations on the licensee's practice imposed by the board to protect the public. Failure to enter into such an agreement shall activate an immediate investigation and disciplinary proceeding by the board; and
    4. (4) As part of the agreement established between the licensee and the board, the licensee shall sign a waiver allowing the peer assistance program to release information to the board if the licensee does not comply with the requirements of this section or is unable to practice with reasonable skill or safety.
  2. (b) The board shall establish fees for all licensees to effect the purposes of this section.
§ 63-13-317. Disclosures to patient — Confidentiality of information — Complaints — Display of license.
  1. (a) Physical therapists shall inform the patient of any financial arrangements connected to the referral process.
  2. (b) Physical therapists shall disclose in writing any financial interest in products they endorse and recommend to their patients.
  3. (c) The licensee has the responsibility to ensure that the patient has knowledge of freedom of choice in services and products.
  4. (d) Information relating to the physical therapist-patient relationship is confidential and may not be communicated to a third party not involved in that patient's care without the prior written consent of the patient. The physical therapist-patient confidentiality does not extend to cases in which the physical therapist has a duty to report information as required by law.
  5. (e) Any person may submit a complaint regarding any licensee or any other person potentially in violation of this chapter. Confidentiality shall be maintained subject to law.
  6. (f) The department shall keep all information relating to the receiving and investigation of complaints filed against licensees confidential until the information becomes public record as required by law.
  7. (g) Each licensee shall display a copy of the licensee's license or current renewal verification in a location accessible to public view at the licensee's place of employment.
§ 63-13-318. Board of physical therapy.
  1. (a) There is created a board of physical therapy, which shall perform the same functions and have the same duties and responsibilities that were performed by the committee of physical therapy prior to July 1, 2007.
  2. (b) The board shall consist of five (5) members appointed by the governor, each of whom shall be a resident of this state. Three (3) members of the board shall be licensed physical therapists who have had at least five (5) years of experience in the actual practice or teaching of physical therapy immediately preceding their appointment. One (1) member of the board shall be a licensed physical therapist assistant who has had at least five (5) years of experience in the actual performance of physical therapy procedures and related tasks or teaching of a physical therapist assistant curriculum immediately preceding the appointment. One (1) member of the board shall be a person who is not engaged in the practice of physical therapy and who is not professionally or commercially associated with the health care industry.
  3. (c) The physical therapist and physical therapist assistant members may be appointed by the governor from lists of nominees submitted by interested physical therapy groups, including, but not limited to, the Tennessee Physical Therapy Association. The governor shall consult with the interested physical therapy groups to determine qualified persons to fill positions on the board.
  4. (d) The physical therapists and the physical therapist assistant who are serving on the committee of physical therapy on July 1, 2007, shall continue to serve as members of the board until the expiration of their terms.
  5. (e) The board shall organize annually and select a chair and a secretary. Meetings shall be held as frequently as may be required.
  6. (f) A quorum of the board shall consist of at least three (3) members.
  7. (g) The division shall provide administrative, investigatory and clerical services to the board.
  8. (h) Each member of the board shall be reimbursed for actual expenses incurred in the performance of official duties on the board and shall be entitled to a per diem of one hundred dollars ($100) for each day of service in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  9. (i) All regular appointments to the board shall be for terms of three (3) years each. Each member shall serve until a successor is appointed. Vacancies shall be filled by appointment of the governor for the remainder of the unexpired term.
  10. (j) The governor may, at the request of the board, remove any member of the board for misconduct, incompetence or neglect of duty.
  11. (k) In making appointments to the board, the governor shall strive to ensure that at least one (1) member is fifty-five (55) years of age or older, that at least one (1) member is a racial minority, and that the gender balance of the board reflects the gender balance of the state's population.
  12. (l) After July 1, 2007, the board shall assume and fulfill all powers and duties previously assigned to the committee of physical therapy, and the rules adopted by the committee of physical therapy shall become the rules of the board without further action by the board.
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Part 4 Physical Therapy Licensure Compact [Contingent implementation date. See Compiler's Notes.]
§ 63-13-401. Short title.
  1. This part shall be known and may be cited as the “Physical Therapy Licensure Compact.”
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§ 63-13-402. Text of Compact.
  1. The Physical Therapy Licensure Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:
    1. Physical Therapy Licensure Compact
      1. Section 1. Purpose
        1. 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. This Compact is designed to achieve the following objectives:
          1. 1. Increase public access to physical therapy services by providing for the mutual recognition of other member state licenses;
          2. 2. Enhance the states' ability to protect the public's health and safety;
          3. 3. Encourage the cooperation of member states in regulating multi-state physical therapy practice;
          4. 4. Support spouses of relocating military members;
          5. 5. Enhance the exchange of licensure, investigative, and disciplinary information between member states; and
          6. 6. Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state's practice standards.
      2. Section 2. Definitions
        1. As used in this Compact, and except as otherwise provided, the following definitions shall apply.
          1. 1. “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 U.S.C. Section 1209 and 1211.
          2. 2. “Adverse Action” means disciplinary action taken by a physical therapy licensing board based upon misconduct, unacceptable performance, or a combination of both.
          3. 3. “Alternative Program” means a non-disciplinary monitoring or practice remediation process approved by a physical therapy licensing board. This includes, but is not limited to, substance abuse issues.
          4. 4. “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.
          5. 5. “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.
          6. 6. “Data system” means a repository of information about licensees, including examination, licensure, investigative, compact privilege, and adverse action.
          7. 7. “Encumbered license” means a license that a physical therapy licensing board has limited in any way.
          8. 8. “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.
          9. 9. “Home state” means the member state that is the licensee's primary state of residence.
          10. 10. “Investigative information” means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation.
          11. 11. “Jurisprudence Requirement” means the assessment of an individual's knowledge of the laws and rules governing the practice of physical therapy in a state.
          12. 12. “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.
          13. 13. “Member state” means a state that has enacted the Compact.
          14. 14. “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.
          15. 15. “Physical therapist” means an individual who is licensed by a state to practice physical therapy.
          16. 16. “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.
          17. 17. “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.
          18. 18. “Physical Therapy Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.
          19. 19. “Physical therapy licensing board” or “licensing board” means the agency of a state that is responsible for the licensing and regulation of physical therapists and physical therapist assistants.
          20. 20. “Remote State” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege.
          21. 21. “Rule” means a regulation, principle, or directive promulgated by the Commission that has the force of law.
          22. 22. “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of physical therapy.
      3. Section 3. State Participation in the Compact
        1. A. To participate in the Compact, a state must:
          1. 1. Participate fully in the Commission's data system, including using the Commission's unique identifier as defined in rules;
          2. 2. Have a mechanism in place for receiving and investigating complaints about licensees;
          3. 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. 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 Section 3.B.;
          5. 5. Comply with the rules of the Commission;
          6. 6. Utilize a recognized national examination as a requirement for licensure pursuant to the rules of the Commission; and
          7. 7. Have continuing competence requirements as a condition for license renewal.
        2. 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 U.S.C. § 534 and 42 U.S.C. § 14616.
        3. 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.
        4. D. Member states may charge a fee for granting a compact privilege.
      4. Section 4. Compact Privilege
        1. A. To exercise the compact privilege under the terms and provisions of the Compact, the licensee shall:
          1. 1. Hold a license in the home state;
          2. 2. Have no encumbrance on any state license;
          3. 3. Be eligible for a compact privilege in any member state in accordance with Section 4D, G and H;
          4. 4. Have not had any adverse action against any license or compact privilege within the previous 2 years;
          5. 5. Notify the Commission that the licensee is seeking the compact privilege within a remote state(s);
          6. 6. Pay any applicable fees, including any state fee, for the compact privilege;
          7. 7. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and
          8. 8. Report to the Commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken.
        2. B. The compact privilege is valid until the expiration date of the home license. The licensee must comply with the requirements of Section 4.A. to maintain the compact privilege in the remote state.
        3. C. A licensee providing physical therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state.
        4. 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.
        5. E. If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:
          1. 1. The home state license is no longer encumbered; and
          2. 2. Two years have elapsed from the date of the adverse action.
        6. F. Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4A to obtain a compact privilege in any remote state.
        7. 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 the following occur:
          1. 1. The specific period of time for which the compact privilege was removed has ended;
          2. 2. All fines have been paid; and
          3. 3. Two years have elapsed from the date of the adverse action.
        8. H. Once the requirements of Section 4G have been met, the license must meet the requirements in Section 4A to obtain a compact privilege in a remote state.
      5. Section 5. Active Duty Military Personnel or Their Spouses
        1. 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:
          1. A. Home of record;
          2. B. Permanent Change of Station (PCS); or
          3. C. State of current residence if it is different than the PCS state or home of record.
      6. Section 6. Adverse Actions
        1. A. A home state shall have exclusive power to impose adverse action against a license issued by the home state.
        2. 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.
        3. 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 non-public 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.
        4. 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.
        5. E. A remote state shall have the authority to:
          1. 1. Take adverse actions as set forth in Section 4.D. against a licensee's compact privilege in the state;
          2. 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 licensing 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; and
          3. 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.
        6. F. Joint Investigations
          1. 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. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
      7. Section 7. Establishment of the Physical Therapy Compact Commission.
        1. A. The Compact member states hereby create and establish a joint public agency known as the Physical Therapy Compact Commission:
          1. 1. The Commission is an instrumentality of the Compact states.
          2. 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. 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
        2. B. Membership, Voting, and Meetings. Each member state shall have and be limited to one (1) delegate selected by that member state's licensing board. 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. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. The member state board shall fill any vacancy occurring in the Commission. Each delegate shall be entitled to one (1) 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. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
        3. C. The Commission shall have the following powers and duties:
          1. 1. Establish the fiscal year of the Commission;
          2. 2. Establish bylaws;
          3. 3. Maintain its financial records in accordance with the bylaws;
          4. 4. Meet and take such actions as are consistent with the provisions of this Compact and the bylaws;
          5. 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. 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. 7. Purchase and maintain insurance and bonds;
          8. 8. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;
          9. 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. 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. 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. 12. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;
          13. 13. Establish a budget and make expenditures;
          14. 14. Borrow money;
          15. 15. Appoint committees, including standing committees comprised 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. 16. Provide and receive information from, and cooperate with, law enforcement agencies;
          17. 17. Establish and elect an Executive Board; and
          18. 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.
        4. D. The Executive Board. The Executive Board shall have the power to act on behalf of the Commission according to the terms of this Compact.
          1. 1. The Executive Board shall be comprised of nine members:
            1. a. Seven voting members who are elected by the Commission from the current membership of the Commission;
            2. b. One ex-officio, nonvoting member from the recognized national physical therapy professional association; and
            3. c. One ex-officio, nonvoting member from the recognized membership organization of the physical therapy licensing boards.
          2. 2. The ex-officio members will be selected by their respective organizations.
          3. 3. The Commission may remove any member of the Executive Board as provided in bylaws.
          4. 4. The Executive Board shall meet at least annually.
          5. 5. The Executive Board shall have the following duties and responsibilities:
            1. 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;
            2. b. Ensure Compact administration services are appropriately provided, contractual or otherwise;
            3. c. Prepare and recommend the budget;
            4. d. Maintain financial records on behalf of the Commission;
            5. e. Monitor Compact compliance of member states and provide compliance reports to the Commission;
            6. f. Establish additional committees as necessary; and
            7. g. Other duties as provided in rules or bylaws.
        5. E. Meetings of the Commission
          1. 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 Section 9.
          2. 2. The Commission or the Executive Board or other committees of the Commission may convene in a closed, non-public meeting if the Commission or Executive Board or other committees of the Commission must discuss:
            1. a. Non-compliance of a member state with its obligations under the Compact;
            2. 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;
            3. c. Current, threatened, or reasonably anticipated litigation;
            4. d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
            5. e. Accusing any person of a crime or formally censuring any person;
            6. f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
            7. g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
            8. h. Disclosure of investigative records compiled for law enforcement purposes;
            9. 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
            10. j. Matters specifically exempted from disclosure by federal or member state statute.
          3. 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. 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.
        6. F. Financing of the Commission
          1. 1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
          2. 2. The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
          3. 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 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. 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. 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.
        7. G. Qualified Immunity, Defense, and Indemnification
          1. 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. 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. 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. Section 8. Data System
        1. 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.
        2. 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:
          1. 1. Identifying information;
          2. 2. Licensure data;
          3. 3. Adverse actions against a license or compact privilege;
          4. 4. Non-confidential information related to alternative program participation;
          5. 5. Any denial of application for licensure, and the reason(s) for such denial; and
          6. 6. Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.
        3. C. Investigative information pertaining to a licensee in any member state will only be available to other party states.
        4. 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.
        5. 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.
        6. 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. Section 9. Rulemaking
        1. A. The Commission shall exercise its rulemaking 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.
        2. 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.
        3. C. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
        4. D. 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 Rulemaking:
          1. 1. On the website of the Commission or other publicly accessible platform; and
          2. 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.
        5. E. The Notice of Proposed Rulemaking shall include:
          1. 1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;
          2. 2. The text of the proposed rule or amendment and the reason for the proposed rule;
          3. 3. A request for comments on the proposed rule from any interested person; and
          4. 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.
        6. 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.
        7. G. The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:
          1. 1. At least twenty-five (25) persons;
          2. 2. A state or federal governmental subdivision or agency; or
          3. 3. An association having at least twenty-five (25) members.
        8. H. 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. 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 five (5) business days before the scheduled date of the hearing.
          2. 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. 3. All hearings will be recorded. A copy of the recording will be made available on request.
          4. 4. 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.
        9. 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.
        10. 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.
        11. 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 rulemaking record and the full text of the rule.
        12. 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 rulemaking 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 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 in order to:
          1. 1. Meet an imminent threat to public health, safety, or welfare;
          2. 2. Prevent a loss of Commission or member state funds;
          3. 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
          4. 4. Protect public health and safety.
        13. 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 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 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. Section 10. Oversight, Dispute Resolution, and Enforcement
        1. A. Oversight
          1. 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 this Compact and the rules promulgated hereunder shall have standing as statutory law.
          2. 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. 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.
        2. B. Default, Technical Assistance, and Termination
          1. 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:
            1. 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
            2. b. Provide remedial training and specific technical assistance regarding the default.
          2. 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. 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. 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. 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. 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.
        3. C. Dispute Resolution
          1. 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. 2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
        4. D. Enforcement
          1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
          2. 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. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.
          3. 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. Section 11. Date of Implementation of the Interstate Commission for Physical Therapy Practice and Associated Rules, Withdrawal, and Amendment
        1. A. The Compact 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.
        2. 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.
        3. C. Any member state may withdraw from this Compact by enacting a statute repealing the same.
          1. 1. A member state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
          2. 2. 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.
        4. 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 non-member state that does not conflict with the provisions of this Compact.
        5. 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. Section 12. Construction and Severability
        1. 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.
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Part 5 Occupational Therapy Licensure Compact
§ 63-13-501. Short title.
  1. This part is known and may be cited as the “Occupational Therapy Licensure Compact.”
§ 63-13-502. Text of compact.
  1. The Occupational Therapy Licensure Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:
    1. Occupational Therapy Licensure Compact
      2. 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.
      3. This Compact is designed to achieve the following objectives:
        1. A. Increase public access to occupational therapy services by providing for the mutual recognition of other member state licenses;
        2. B. Enhance the states' ability to protect the public's health and safety;
        3. C. Encourage the cooperation of member states in regulating multi-state occupational therapy practice;
        4. D. Support spouses of relocating military members;
        5. E. Enhance the exchange of licensure, investigative, and disciplinary information between member states;
        6. 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
        7. G. Facilitate the use of telehealth technology in order to increase access to occupational therapy services.
      4. As used in this Compact, and except as otherwise provided, the following definitions shall apply:
        1. 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 U.S.C. Chapter 1209 and 10 U.S.C. Chapter 1211.
        2. 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.
        3. C. “Alternative program” means a non-disciplinary monitoring process approved by an occupational therapy licensing board.
        4. 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 an occupational therapy assistant in the remote 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.
        5. 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.
        6. 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.
        7. G. “Data system” means a repository of information about licensees, including but not limited to license status, investigative information, Compact privileges, and adverse actions.
        8. 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).
        9. 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.
        10. J. “Home state” means the member state that is the licensee's primary state of residence.
        11. K. “Impaired practitioner” means individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions.
        12. L. “Investigative information” means information, records, and/or documents received or generated by an occupational therapy licensing board pursuant to an investigation.
        13. 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.
        14. 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.
        15. O. “Member state” means a state that has enacted the Compact.
        16. P. “Occupational therapist” means an individual who is licensed by a state to practice occupational therapy.
        17. Q. “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.
        18. R. “Occupational therapy assistant” means an individual who is licensed by a state to assist in the practice of occupational therapy.
        19. S. “Occupational Therapy Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.
        20. 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.
        21. 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.
        22. V. “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise the Compact privilege.
        23. W. “Rule” means a regulation promulgated by the Commission that has the force of law.
        24. X. “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of occupational therapy.
        25. 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.
        26. Z. “Telehealth” means the application of telecommunication technology to deliver occupational therapy services for assessment, intervention, and/or consultation.
      5. A. To participate in the Compact, a member state shall:
        1. 1. License occupational therapists and occupational therapy assistants;
        2. 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. 3. Have a mechanism in place for receiving and investigating complaints about licensees;
        4. 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. 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;
          1. 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.
          2. b. Communication between a member state, the Commission and 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 Public Law 92-544.
        6. 6. Comply with the rules of the Commission;
        7. 7. Utilize only a recognized national examination as a requirement for licensure pursuant to the rules of the Commission; and
        8. 8. Have continuing competence/education requirements as a condition for license renewal.
      6. 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.
      7. C. Member states may charge a fee for granting a Compact privilege.
      8. D. A member state shall provide for the state's delegate to attend all Occupational Therapy Compact Commission meetings.
      9. 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 recognized as granting the Compact privilege in any other member state.
      10. F. Nothing in this Compact shall affect the requirements established by a member state for the issuance of a single-state license.
      11. A. To exercise the Compact privilege under the terms and provisions of the Compact, the licensee shall:
        1. 1. Hold a license in the home state;
        2. 2. Have a valid United States Social Security Number or National Practitioner Identification number;
        3. 3. Have no encumbrance on any state license;
        4. 4. Be eligible for a Compact privilege in any member state in accordance with Section 4D, F, G, and H;
        5. 5. Have paid all fines and completed all requirements resulting from any adverse action against any license or Compact privilege, and two years have elapsed from the date of such completion;
        6. 6. Notify the Commission that the licensee is seeking the Compact privilege within a remote state(s);
        7. 7. Pay any applicable fees, including any state fee, for the Compact privilege;
        8. 8. Complete a criminal background check in accordance with Section 3A(5);
          1. a. The licensee shall be responsible for the payment of any fee associated with the completion of a criminal background check.
        9. 9. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a Compact privilege; and
        10. 10. Report to the Commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken.
      12. B. The Compact privilege is valid until the expiration date of the home state license. The licensee must comply with the requirements of Section 4A to maintain the Compact privilege in the remote state.
      13. 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.
      14. 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.
      15. 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.
      16. F. If a home state license is encumbered, the licensee shall lose the Compact privilege in any remote state until the following occur:
        1. 1. The home state license is no longer encumbered; and
        2. 2. Two years have elapsed from the date on which the home state license is no longer encumbered in accordance with Section 4(F)(1).
      17. G. Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4A to obtain a Compact privilege in any remote state.
      18. 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:
        1. 1. The specific period of time for which the Compact privilege was removed has ended;
        2. 2. All fines have been paid and all conditions have been met;
        3. 3. Two years have elapsed from the date of completing requirements for 4(H)(1) and (2); and
        4. 4. The Compact privileges are reinstated by the Commission, and the Compact data system is updated to reflect reinstatement.
      19. 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.
      20. J. Once the requirements of Section 4H have been met, the licensee must meet the requirements in Section 4A to obtain a Compact privilege in a remote state.
      21. 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.
      22. B. If an occupational therapist or occupational therapy assistant changes primary state of residence by moving between two member states:
        1. 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. 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 Section 4 via the data system, without need for primary source verification except for:
          1. 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 Public Law 92-544;
          2. b. Other criminal background check as required by the new home state; and
          3. c. Submission of any requisite jurisprudence requirements of the new home state.
        3. 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. 4. Notwithstanding any other provision of this Compact, if the occupational therapist or occupational therapy assistant cannot meet the criteria in Section 4, the new home state shall apply its requirements for issuing a new single-state license.
        5. 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.
      23. 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.
      24. 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.
      25. E. Nothing in this Compact shall affect the requirements established by a member state for the issuance of a single-state license.
      26. Active duty military personnel, or their spouses, 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. 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 Section 5.
      27. 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.
      28. 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. 1. Take adverse action against an occupational therapist's or occupational therapy assistant's Compact privilege within that member state.
        2. 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.
      29. 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.
      30. 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.
      31. 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.
      32. 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.
      33. G. Joint Investigations
        1. 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. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
      34. 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 therapist's or occupational therapy assistant's Compact privilege is deactivated in all member states during the pendency of the order.
      35. 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.
      36. 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.
      37. A. The Compact member states hereby create and establish a joint public agency known as the Occupational Therapy Compact Commission:
        1. 1. The Commission is an instrumentality of the Compact states.
        2. 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. 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
      38. B. Membership, Voting, and Meetings
        1. 1. Each member state shall have and be limited to one (1) delegate selected by that member state's licensing board.
        2. 2. The delegate shall be either:
          1. a. A current member of the licensing board, who is an occupational therapist, occupational therapy assistant, or public member; or
          2. b. An administrator of the licensing board.
        3. 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. 4. The member state board shall fill any vacancy occurring in the Commission within 90 days.
        5. 5. Each delegate shall be entitled to one (1) 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. 6. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
        7. 7. The Commission shall establish by rule a term of office for delegates.
      39. C. The Commission shall have the following powers and duties:
        1. 1. Establish a code of ethics for the Commission;
        2. 2. Establish the fiscal year of the Commission;
        3. 3. Establish bylaws;
        4. 4. Maintain its financial records in accordance with the bylaws;
        5. 5. Meet and take such actions as are consistent with the provisions of this Compact and the bylaws;
        6. 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. 7. Bring and prosecute legal proceedings or actions in the 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. 8. Purchase and maintain insurance and bonds;
        9. 9. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;
        10. 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. 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. 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. 13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;
        14. 14. Establish a budget and make expenditures;
        15. 15. Borrow money;
        16. 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. 17. Provide and receive information from, and cooperate with, law enforcement agencies;
        18. 18. Establish and elect an Executive Committee; and
        19. 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.
      40. D. The Executive Committee
      41. The Executive Committee shall have the power to act on behalf of the Commission according to the terms of this Compact.
        1. 1. The Executive Committee shall be composed of nine members:
          1. a. Seven voting members who are elected by the Commission from the current membership of the Commission;
          2. b. One ex-officio, nonvoting member from a recognized national occupational therapy professional association; and
          3. c. One ex-officio, nonvoting member from a recognized national occupational therapy certification organization.
        2. 2. The ex-officio members will be selected by their respective organizations.
        3. 3. The Commission may remove any member of the Executive Committee as provided in bylaws.
        4. 4. The Executive Committee shall meet at least annually.
        5. 5. The Executive Committee shall have the following duties and responsibilities:
          1. 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;
          2. b. Ensure Compact administration services are appropriately provided, contractual or otherwise;
          3. c. Prepare and recommend the budget;
          4. d. Maintain financial records on behalf of the Commission;
          5. e. Monitor Compact compliance of member states and provide compliance reports to the Commission;
          6. f. Establish additional committees as necessary; and
          7. g. Perform other duties as provided in rules or bylaws.
      42. E. Meetings of the Commission
        1. 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 Section 10.
        2. 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:
          1. a. Non-compliance of a member state with its obligations under the Compact;
          2. 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;
          3. c. Current, threatened, or reasonably anticipated litigation;
          4. d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
          5. e. Accusing any person of a crime or formally censuring any person;
          6. f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
          7. g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
          8. h. Disclosure of investigative records compiled for law enforcement purposes;
          9. 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
          10. j. Matters specifically exempted from disclosure by federal or member state statute.
        3. 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. 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.
      43. F. Financing of the Commission
        1. 1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
        2. 2. The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
        3. 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. 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. 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.
      44. G. Qualified Immunity, Defense, and Indemnification
        1. 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. 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. 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.
      45. 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.
      46. 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. 1. Identifying information;
        2. 2. Licensure data;
        3. 3. Adverse actions against a license or Compact privilege;
        4. 4. Non-confidential information related to alternative program participation;
        5. 5. Any denial of application for licensure, and the reason(s) for such denial;
        6. 6. Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission; and
        7. 7. Current significant investigative information.
      47. 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.
      48. 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.
      49. 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.
      50. 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.
      51. A. The Commission shall exercise its rulemaking 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.
      52. 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.
      53. 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.
      54. D. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
      55. E. 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 rulemaking:
        1. 1. On the website of the Commission or other publicly accessible platform; and
        2. 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.
      56. F. The notice of proposed rulemaking shall include:
        1. 1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;
        2. 2. The text of the proposed rule or amendment and the reason for the proposed rule;
        3. 3. A request for comments on the proposed rule from any interested person; and
        4. 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.
      57. 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.
      58. 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. 1. At least twenty five (25) persons;
        2. 2. A state or federal governmental subdivision or agency; or
        3. 3. An association or organization having at least twenty five (25) members.
      59. 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. 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 five (5) business days before the scheduled date of the hearing.
        2. 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. 3. All hearings will be recorded. A copy of the recording will be made available on request.
        4. 4. 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.
      60. 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.
      61. 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.
      62. 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.
      63. 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 section 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 in order to:
        1. 1. Meet an imminent threat to public health, safety, or welfare;
        2. 2. Prevent a loss of Commission or member state funds;
        3. 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
        4. 4. Protect public health and safety.
      64. 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 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 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.
      65. A. Oversight
        1. 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 this Compact and the rules promulgated hereunder shall have standing as statutory law.
        2. 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. 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.
      66. B. Default, Technical Assistance, and Termination
        1. 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:
          1. 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
          2. b. Provide remedial training and specific technical assistance regarding the default.
        2. 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. 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. 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. 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. 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.
      67. C. Dispute Resolution
        1. 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. 2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
      68. D. Enforcement
        1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
        2. 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. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.
        3. 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.
      69. A. The Compact 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.
      70. 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.
      71. C. Any member state may withdraw from this Compact by enacting a statute repealing the same.
        1. 1. A member state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
        2. 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.
      72. 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 non-member state that does not conflict with the provisions of this Compact.
      73. 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.
      74. 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.
      75. 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.
      76. B. Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.
      77. C. Any laws in a member state in conflict with the Compact are superseded to the extent of the conflict.
      78. D. Any lawful actions of the Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states.
      79. E. All agreements between the Commission and the member states are binding in accordance with their terms.
      80. 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.
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Chapter 14 Dispensing Opticians
§ 63-14-101. Board — Creation — Composition — Appointments — Organization — Duties.
  1. (a) There is hereby created a board to be known as “board of dispensing opticians,” referred to as “board” in this chapter, constituted as set out and with the duties and powers provided in this chapter.
  2. (b)
    1. (1) The board shall consist of five (5) members. No member shall be eligible to serve more than three (3) consecutive terms. All appointments shall be made for a term of four (4) years, and members of the board shall serve until their successors are appointed and qualified.
    2. (2) The governor shall make appointments to the board not later than thirty (30) days after the expiration of the term of office of any member. Members of the board may be appointed by the governor from lists of qualified persons submitted by interested optician groups including, but not limited to, the Tennessee Dispensing Opticians Association, and the governor shall consult with the interested optician groups to determine qualified persons to fill the positions. No person shall be eligible for appointment to the board unless the person shall have been a resident of this state and engaged in the practice as a dispensing optician within this state for not less than five (5) years immediately preceding the time of such appointment by the governor; however, no person shall be eligible to appointment who is in any way connected with or interested in any school of optometry, optometric school or the optical or optometric department of any institution of learning or the wholesale optical or optometric supply business. In the event of a vacancy on the board, the governor shall appoint a new member to serve the unexpired term; provided, that such appointment, if not effective within sixty (60) days of the vacancy, shall be filled by the board.
    3. (3) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  3. (c) The board shall convene and organize by selecting from among its members a chair and a secretary-treasurer and shall adopt rules and regulations governing the examination of applicants, the enforcement of this chapter and shall establish a code of ethics and standards of practice for dispensing opticians in this state and such other rules and regulations as may be necessary for the proper carrying out of this chapter. The chair and secretary-treasurer thus elected shall serve for a period of two (2) years or until their successors are appointed and qualified.
  4. (d)
    1. (1) The board shall provide for meetings at least once each year for the purpose of receiving applications and giving examinations as provided in this chapter and may meet at such other times and places as the board shall designate from time to time by rules and regulations regularly adopted.
    2. (2) The board may administer oaths, summon witnesses and take testimony in all matters relating to its duties.
    3. (3) A majority of the board shall constitute a quorum for the transaction of any and all business that may be lawfully transacted by the board.
  5. (e) The board shall determine the nature and character of the examination to be given applicants for license to practice as dispensing opticians and is empowered to issue licenses with respect to all persons who shall satisfactorily pass the examination as determined in accordance with the rules and regulations of the board. Each license shall be signed by the chair of the board and attested by the secretary-treasurer under its adopted seal. Each license issued by the board to any such applicant shall be signed by the members of the board, and such license exclusively shall be evidence of the right and authority of the person to whom it is issued to practice as dispensing optician within this state.
  6. (f) The board shall not discriminate in the issuance of any license pursuant to this chapter. “Discrimination” means any direct or indirect act or practice of exclusion, distinction, restriction, segregation, limitation, refusal, denial or any other act or practice of differentiation or preference in the treatment of a person or persons because of race, creed, color, religion, sex, age or national origin.
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§ 63-14-102. “Practice of dispensing opticians” defined — Prohibited practices.
  1. (a) “Practice of dispensing opticians” means the preparation, adaptation and dispensing of lenses, spectacles, eye glasses and optical devices to the intended user thereof on the written prescription of a physician or optometrist duly licensed to practice the physician's or the optometrist's profession and the dispensing of frames as a unit or individually to the intended user thereof.
  2. (b) A person registered under this chapter is specifically prohibited from engaging in the practice of ocular refraction, orthoptics, visual training, prescribing contact lenses or the prescribing of subnormal vision aids or telescopic spectacles.
  3. (c) Nothing in this section shall be construed to authorize or permit any dispensing optician to claim to be able to, or to offer, undertake or attempt, by any means or method, to examine or exercise eyes, fit contact lenses or diagnose, treat, correct, relieve, operate or prescribe for any human ailment, deficiency, deformity, disease, injury, pain or physical condition; however, dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.
  4. (d) Nor shall anything in this section or in this chapter be construed to require the licensing of persons, firms or corporations that are wholesale suppliers to opticians, optometrists or ophthalmologists, of lenses, spectacles, eye glasses or optical devices or to prevent such persons, firms or corporations from the preparation of lenses, spectacles, eye glasses or optical devices, defined to be the surfacing, fabrication or finishing of any substance or material used or to be used for the correction of human vision, or the adaptation of such lenses, spectacles, eye glasses or optical devices, defined to be the mounting of such a prepared substance or material to frames or to other devices designed to be worn by the user thereof, as long as such preparation or adaptation is done under the written order of an ophthalmologist or optometrist only and as long as such lenses, spectacles, eye glasses or optical devices so prepared or adapted are delivered directly to an ophthalmologist, optometrist or dispensing optician, and as long as such persons, firms or corporations do not engage in advertising as to the price of either the finished product or any part thereof.
§ 63-14-103. Qualifications — Examinations — Display of license — Unlawful acts.
  1. (a)
    1. (1) Any person who is a citizen of the United States and of good moral character, and who is eighteen (18) years of age or over and who has satisfactorily completed not less than two (2) years of the prescribed course of a school for dispensing opticians recognized by the board or who has had practical training and experience of a grade and character satisfactory to the board as an apprentice or student under the supervision of a dispensing optician, optometrist or ophthalmologist licensed by the state for a period of not less than three (3) years or the equivalent amount of time under the supervision of such licensed professionals of another state that has dispensing opticianry licensure criteria at least as strict as Tennessee shall be entitled to make application to the board for examination.
    2. (2) The form of application shall be prescribed by the board, and each applicant shall pay the fee provided in § 63-14-107 for the privilege of taking the examination.
    3. (3) If, in the opinion of the board, the applicant possesses the qualifications prescribed in this section and successfully passes the examination, in the judgment of the board, a license to practice as dispensing optician in this state shall be issued to the applicant by the board upon payment of the license fee as provided in § 63-14-107.
  2. (b) Applicants may be examined by the board upon matters pertaining to dispensing opticians and practical subjects, such as practical optic neutralization of lenses, frame measuring and adjustments, pupilary distances and such other subjects essential to the practice as dispensing opticians as the board may prescribe.
  3. (c) Every licensee shall cause such licensee's license to be displayed conspicuously in the office or establishment operated and conducted by the licensee or the office or establishment in which such licensee is employed, and each year, as the license is renewed, such renewal license shall be displayed in the same manner until revoked or suspended by the board as provided in § 63-14-104.
  4. (d) It is unlawful for any person to practice or offer to practice as a dispensing optician as an employee of any person not engaged primarily in the practice as dispensing optician as a licensee under this chapter or of any firm or corporation not engaged primarily in the practice of dispensing opticians under the actual and personal supervision of partners, officers, managers or stockholders who possess valid unrevoked licenses as dispensing opticians entitled to practice within this state in accordance with this chapter.
  5. (e) It is unlawful for any dispensing optician licensed to practice such dispensing optician's profession in accordance with this chapter to be employed by, perform any work in or have any financial interest, directly or indirectly, in the operation of any establishment or place of business that undertakes or attempts to engage in the business of a dispensing optician in violation of this chapter or that advertises in any way that would conflict with this chapter in regard to advertising by a licensed dispensing optician.
  6. (f) It is lawful for any apprentice dispensing optician or student dispensing optician to perform any of the services or do any of the acts included in the definition of dispensing optician contained in this chapter; provided, that such apprentice dispensing optician or student dispensing optician does so under the direct supervision, direction and control of a dispensing optician, optometrist or ophthalmologist licensed by the state or the equivalent amount of time under the supervision of such licensed professionals of another state that has dispensing opticianry licensure criteria at least as strict as Tennessee and practicing in strict accordance with all of the terms and provisions of this chapter; and provided further, that a licensed dispensing optician inspects the finished glasses and fits them to the face of the patient.
  7. (g) It is unlawful for a dispensing optician to publish or display, or cause or permit to be published or displayed, in any newspaper or by radio, television, window display, poster, sign or any other means or media any statement or advertisement concerning ophthalmic lenses, frames, eyeglasses, spectacles, contact lenses or any other optical devices or materials, or parts thereof, that is fraudulent or of a character tending to deceive or mislead the public, including, but not limited to, statements or advertisements of bait, premiums, gifts or other similar nature.
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  8. (h) It is unlawful for a dispensing optician to publish or display, or cause or permit to be published or displayed, in any newspaper or by radio, television, window display, poster, sign or any other means or media any statement or advertisement of or reference to the price or prices of any ophthalmic lenses, frames, eyeglasses, spectacles, contact lenses or any other optical devices or materials, or parts thereof, unless such is consistent with the following standards deemed to protect the consumer interest:
    1. (1) Any statement advertising the price of ophthalmic lenses, eyeglasses, spectacles or contact lenses shall, to the extent applicable, be accompanied by a further readily legible statement identifying the lens as single vision, bifocal or trifocal and as clear or tinted and specifying the type of material, the name of the manufacturer, the manufacturer's identifying name or number of the lens and the country of manufacture;
    2. (2) Any statement advertising the price of ophthalmic frames shall be accompanied by a further readily legible statement specifying the type of material, the name of the manufacturer, the manufacturer's identifying name or number of the frame and the country of manufacture;
    3. (3) The price so advertised shall be in effect for a period of not less than seven (7) days, and each advertisement shall set forth the expiration date, if any, of the advertised price. During such time, the item so advertised shall be available to all persons at the advertised price. Any advertised price discounts shall not be limited to any particular group or classification but shall be advertised as being available to all persons; and
    4. (4) Any such advertisements quoting a price or prices shall contain a readily legible statement that the quoted price or prices “Does Not Include Professional Services of an Examining Optometrist or Physician.”
  9. (i) Advertising by a dispensing optician shall be subject further to such rules or regulations, not inconsistent with the foregoing, as may be adopted from time to time by the board in protecting the consumer interest.
§ 63-14-104. Revocation or suspension of license.
  1. (a) It is unlawful for a dispensing optician to act as the agent or representative of any physician or optometrist on any account. The board has the power and it is hereby its duty to suspend for a specified period of time to be determined by the board in its discretion or to revoke or otherwise discipline any person holding a certificate to practice as a dispensing optician in this state whenever the dispensing optician is found guilty of any of the following acts or offenses:
    1. (1) Fraud in procuring a license;
    2. (2) Immoral, unprofessional or dishonorable conduct;
    3. (3) Habitual intoxication or addiction to the use of drugs;
    4. (4) Conviction of felony;
    5. (5) Use of comparative statements or claims concerning the professional excellence or abilities of any person or group of persons licensed to practice their profession under the laws of the state;
    6. (6) Failure to renew annual certificate required under §§ 63-14-106 and 63-14-107;
    7. (7) Offering discounts or inducements to prospective patrons by means of coupons or otherwise to perform professional services; provided, that nothing in this section shall be construed to prohibit the giving of a discount on either merchandise or services to charitable institutions; or
    8. (8) Division of fees or agreement to split or divide the fee received for professional services with any person for bringing or referring a customer.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-14-105. License not required for employees.
  1. Nothing contained in this chapter shall be construed so as to require an employee of a licensed physician or licensed optometrist to secure a license under this chapter or otherwise be subject to this chapter, so long as the employee remains an employee of the licensed physician or the licensed optometrist entitled to practice that profession within this state. Nothing contained in this chapter shall be construed to prohibit a licensed physician or licensed optometrist from employing a licensed dispensing optician as defined in this chapter.
§ 63-14-106. License renewal — Continuing education — Retirement.
  1. (a) The board shall, in its discretion, renew such licensee's certificate of fitness upon application made in due form and upon payment of all required fees. Every licensed dispensing optician must, on or before December 31 of each year, submit satisfactory proof of the licensee's attendance at an education program or programs approved or conducted by the board which consists of the minimum number of hours established by the board under subdivision (a)(1) for the period beginning the preceding January 1:
    1. (1) The minimum number of hours of attendance at education programs so required shall be prescribed by the board by February 1 of each year, but shall not be less than three (3) clock hours nor exceed twelve (12) clock hours in any calendar year;
    2. (2) The board may, in its sole discretion, waive the annual education requirement in cases of certified illness, disability or other undue hardships;
    3. (3) The board shall annually arrange for or approve a program or programs of continuing education sufficient to meet the minimum education requirements under this section;
    4. (4) The board is authorized to adopt such rules and regulations as it may deem necessary or appropriate for establishing an approved program or programs of continuing education pursuant to this section, including, but not limited to, those describing the substantive content of all courses or other forms of education that will satisfy the annual education requirement provided in this section;
    5. (5) The board is authorized to use such portion of the annual renewal fees as it deems necessary or proper to provide for continuing education programs and is further authorized to treat an appropriate amount of such renewal fees collected as state funds for the purpose of accepting any funds made available for the promulgation and maintenance of programs of continuing education;
    6. (6) Failure to meet the minimum continuing education requirements shall be deemed a violation of this chapter, for which disciplinary action pursuant to § 63-14-111(a) may be taken; and
    7. (7) The board shall reinstate a license that was suspended or revoked for failure to meet the continuing education requirements and issue a renewal certificate upon payment of all fees due, payment of a further sum to be set by the board and submission of satisfactory proof that within six (6) months following the date of suspension or revocation the dispensing optician attended the required minimum hours of continuing education programs to make up such deficiency.
  2. (b)
    1. (1) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board shall deem necessary.
    2. (2) If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
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§ 63-14-107. Examination — Renewal — Fees.
  1. (a) Each year, each and every licensed dispensing optician shall pay to the secretary-treasurer of the board an annual renewal fee to be fixed by the board. The secretary of the board shall notify the holder of each license that the renewal fee is due, and the failure to pay such renewal fee by any license holder at the expiration of sixty (60) days after the renewal fee was due constitutes a violation of this chapter.
  2. (b) All applicants for licensure shall include with their application a nonrefundable application fee to be set by the board. Applicants who are accepted for examination shall pay an examination fee as set by the board prior to taking the examination, and the examination fee shall be paid in a manner prescribed by the board. Any applicant failing to pass the examination may apply to take a successive examination by submitting to the board a successive application for examination, which shall be accompanied by an examination fee as set by the board. The fee required to be paid by all persons successfully passing the examination shall be fixed annually by the board, and no license or certificate shall be issued until the fee has been fully paid. All such licenses shall be subject to renewal upon the same terms and conditions as prescribed in this chapter with respect to the issuance of original licenses and renewals thereof.
  3. (c) All applicants for apprenticeship shall include with their application a nonrefundable fee, to be set by the board.
  4. (d)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (d).
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§ 63-14-108. Disposition of fees — Board expenditures and compensation.
  1. (a) All fees coming into the possession of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  2. (b) The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board, and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  3. (c) Each member of the board shall receive one hundred dollars ($100) per diem expenses when actually engaged in the discharge of each member's official duties and all legitimate and necessary expenses incurred in attending the meetings of the board. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-14-109. Secretary — Investigators — Administrative support.
  1. (a)
    1. (1) The secretary shall keep an accurate record of the minutes of the meetings of the board and shall keep an accurate and complete register showing the names and addresses of all persons to whom licenses or certificates to practice as dispensing opticians have been issued by the board.
    2. (2) The secretary of the board shall be paid a salary not to exceed five hundred dollars ($500) per year, in addition to per diem and mileage allowances and necessary expenses as fixed and approved by the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  2. (b) The board will employ such investigators as are deemed necessary to effectually carry out this chapter and shall be represented by the attorney named to represent the state regulatory and registration boards.
  3. (c) The board shall receive administrative support from the division of health related boards in the department of health, referred to as the “division” in this chapter.
§ 63-14-110. Penalties.
  1. (a)
    1. (1) Any person who practices as a dispensing optician as defined in this chapter without first complying with this chapter or who violates any of this chapter commits a Class B misdemeanor.
    2. (2) Each time any person practices as a dispensing optician without meeting all the requirements of this chapter and of any other law, a compliance with which may hereafter be prescribed as a condition precedent to the practice of such profession, constitutes a separate offense.
    3. (3) All fines for offenses for the violation of this chapter shall be paid over to the board and shall be paid to the state treasurer as all other funds received by the board.
  2. (b) Nothing in this chapter shall be construed as applying to physicians or optometrists licensed under the laws of this state to practice their professions, nor shall such licensed physicians or optometrists be subject to the jurisdiction of the board created by this chapter.
§ 63-14-111. Suspension or revocation of license — Injunction.
  1. (a) The board of dispensing opticians may suspend or revoke the license of, or otherwise discipline, any dispensing optician who is found guilty by the board of the violation of this chapter or of the code of ethics and standards of practice for dispensing opticians established by the board in accordance with this chapter; provided, that in all proceedings for suspension or revocation of license, the holder of the license is given fifteen (15) days' notice of the charges made against the holder and is entitled to be heard in person, by counsel, or both.
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  2. (b) The penalty for first violations of § 63-14-103(g)-(i) is suspension of the offender's license for a period of time to be set by the board after a proper hearing. A second suspension may be grounds for revocation of the license by the board.
  3. (c) The board is thereby authorized to proceed in any of the courts of this state by injunction to restrain any continued violation of this chapter or of any rule or regulation of the code of ethics and standards of practice for dispensing opticians legally adopted or established by the board in accordance with this chapter. Any dispensing optician whose license is suspended or revoked under this chapter has the right to a review in the circuit or chancery court of the county in which such dispensing optician resides or has a place of business, in the manner provided by title 27, chapter 9.
Chapter 15 Doula Services Advisory Committee
§ 63-15-101. Legislative findings and intent.
  1. (a) The general assembly finds that:
    1. (1) Pregnant and postpartum women who receive doula care are found to have improved health outcomes for themselves and their infants, including higher breastfeeding initiation rates, fewer low birth weight babies, and lower rates of cesarean deliveries;
    2. (2) The benefits of doula care can have a financial impact in helping families and this state avoid the costs associated with low birth weight babies, cesarean births, and other pregnancy-related complications; and
    3. (3) A successful program of medicaid coverage for doula care must honor and support the autonomy of doulas, and be as inclusive as possible of the wide variety of birth support work that exists, including community-based and traditional birth support work.
  2. (b) It is the intent of the general assembly to identify and mobilize an educated and prepared doula workforce to serve pregnant women in this state by supporting the ongoing practices of doulas working with communities that experience the highest burden of birth disparities, but without the barriers to entry that licensure would entail.
§ 63-15-102. Chapter definitions.
  1. As used in this chapter:
    1. (1) “Committee” means the doula services advisory committee;
    2. (2) “Community-based doula” means a doula who serves pregnant women in a community in this state with a high rate of maternal or infant mortality and morbidity, and whose services are tailored to the specific needs of that community;
    3. (3) “Department” means the department of health;
    4. (4) “Doula” means a birth worker who provides child birth education, advocacy, and physical, emotional, and nonmedical support for pregnant and postpartum women before, during, and after childbirth and loss;
    5. (5) “Doula services” means at least three (3) prenatal appointments, continuous labor support during birth, and at least three (3) postpartum appointments with a pregnant woman; and
    6. (6) “Postpartum” means the twelve-month period immediately following childbirth.
§ 63-15-103. Doula services advisory committee — Creation — Purpose — Duties.
  1. (a) There is created the doula services advisory committee. The committee is attached to the department of health for administrative purposes.
  2. (b) The purpose of the committee is to:
    1. (1) Advise the department of health by establishing core competencies and standards for the provision of doula services in this state; and
    2. (2) Recommend reimbursement rates and fee schedules for TennCare reimbursement for doula services.
  3. (c) The doula services advisory committee shall:
    1. (1) Develop a set of core competencies and standards for doulas providing doula services in this state, for the purpose of verifying competency, including a demonstration of competency, through training or attestation of equivalency or lived experience, in the following areas:
      1. (A) Understanding basic anatomy and physiology as related to pregnancy, the childbearing process, breastfeeding, and the postpartum period;
      2. (B) Utilizing different strategies to provide emotional support, education, and resources during the perinatal period;
      3. (C) Knowledge of and the ability to assist families with utilizing a wide variety of nonclinical labor coping and physical comfort strategies;
      4. (D) Strategies to foster effective communication between clients, clients' families, support services, and healthcare providers; and
      5. (E) Knowledge of community-based, government-funded, and clinical resources available to the client for needs outside the doula's scope of practice;
    2. (2) Propose multiple options for medicaid reimbursement for doula services, including doulas operating as independent providers and doulas working with licensed providers;
    3. (3) Propose reimbursement rates and fee schedules reflecting the reasonable number of clients a doula can sustain at the same time;
    4. (4) Propose incentive-based programs such as fee waivers to encourage participation from doulas in rural communities; and
    5. (5) Examine outcomes, findings, and reports from existing pilot programs related to the provision of doula services.
  4. (d) The doula services advisory committee shall compile a report of its findings and recommendations from the duties described in subsection (c). No later than eighteen (18) months following the date of the committee's first meeting, the department of health shall publish a copy of the committee's report on its public website, and the committee shall transmit a copy of the report to the chair of the health and welfare committee of the senate, the chair of the health committee of the house of representatives, and the legislative librarian.
§ 63-15-104. Membership — Appointment — Terms.
  1. (a) The committee consists of the following five (5) members:
    1. (1) The commissioner of health, or the commissioner's designee with experience in maternal health or medicaid policy;
    2. (2) The director of TennCare, or the director's designee;
    3. (3) Two (2) community-based doulas, to be appointed by the commissioner of health or the commissioner's designee, who have documented experience providing services to:
      1. (A) Medicaid recipients; or
      2. (B) Women in municipalities or unincorporated areas in this state with high rates of maternal and infant mortality; and
    4. (4) One (1) doula, to be appointed by the commissioner of health or the commissioner's designee, who has documented experience providing services to medicaid recipients.
  2. (b) If a membership position on the committee becomes vacant, then the commissioner shall appoint a replacement member who meets the qualifications as described in subsection (a) for the vacant position.
  3. (c)
    1. (1) The commissioner shall remove any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year and appoint a new member to serve.
    2. (2) Notwithstanding subdivision (c)(1), the commissioner may excuse an absence of a committee member for good cause, in the discretion of the commissioner.
  4. (d) The chair shall convene the first meeting of the committee no later than October 1, 2023, and elect a committee member to serve as chair and conduct the committee meetings.
  5. (e) All reimbursement for travel expenses must be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter. Members of the advisory committee serve without compensation, but are entitled to receive necessary travel and other appropriate expenses while engaged in committee business.
  6. (f) The committee ceases to exist on July 1, 2026.
Chapter 16 Nursing Home Administrators
§ 63-16-101. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of examiners for nursing home administrators;
    2. (2) “Division” means the division of health related boards in the department of health;
    3. (3) “Nursing home” means any institution or facility defined as such pursuant to Tennessee state law or the rules and regulations for nursing homes promulgated by the department. “Nursing home” applies equally to Christian Science sanatoria and services therein;
    4. (4) “Nursing home administrator” means any individual responsible for planning, organizing, directing or controlling the operation of a nursing home or who in fact performs such functions, whether or not such functions are shared by one (1) or more other people;
    5. (5) “Practice of nursing home administration” means the planning, organizing, directing or controlling the operation of a nursing home; and
    6. (6) “Single state agency” means the department of health.
§ 63-16-102. Board of examiners — Composition.
  1. (a) There is hereby created the board of examiners for nursing home administrators, which shall consist of eight (8) members to be appointed by the governor as follows:
    1. (1) Four (4) members shall be representatives of the nursing home industry, three (3) of whom may be appointed from lists of qualified persons submitted to the governor by interested healthcare groups including, but not limited to, the Tennessee Health Care Association, and one (1) of whom shall be a nursing home administrator who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;
    2. (2) One (1) member shall be a hospital administrator who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;
    3. (3) One (1) member shall be a physician who may be appointed from a list of qualified physician nominees submitted by interested medical groups, including, but not limited to, the Tennessee Medical Association;
    4. (4) One (1) member shall be a nurse representative who may be appointed from lists of qualified persons submitted by interested nursing groups, including, but not limited to, the Tennessee Nurses Association; and
    5. (5) One (1) member shall be a consumer representative.
  2. (b)
    1. (1) Each member shall serve for three (3) years, except that initially three (3) members shall be appointed for a term of three (3) years, three (3) members for a term of two (2) years, and two (2) members for a term of one (1) year. At the expiration of a member's term, each interested group may submit lists of qualified persons to the governor for appointment to that vacancy in the same manner as provided for initial appointments in subsection (a). Any vacancy occurring on the board prior to the expiration of a member's term may also be filled by the governor for the unexpired term from lists of qualified persons submitted by the interested groups as provided for initial appointments in subsection (a).
    2. (2) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
    3. (3) The governor shall consult with interested medical groups, including, but not limited to, the nominating associations for the respective classifications listed in subsection (a) to determine qualified persons to fill the positions. This subdivision (b)(3) shall not apply to the appointment of the consumer representative member.
  3. (c) The commissioner of health or the commissioner's designated representative shall serve as an ex officio member and as the executive officer of the board.
  4. (d) The governor may remove any member for misconduct, incapacity, incompetence or neglect of duty after the member so charged has been served with a written statement of charges and has been given an opportunity to be heard.
  5. (e) Each member shall be reimbursed for actual expenses incurred in the performance of the member's official duties, in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter. In addition, each member shall be compensated fifty dollars ($50.00) per day for the member's services. All vouchers for the expenditure of any funds shall be signed by the executive officer of the board.
  6. (f)
    1. (1) The board shall meet at least annually and a majority of the board shall constitute a quorum.
    2. (2)
      1. (A) Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the board in accordance with subsection (d).
      2. (B) The executive officer of the board shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (f)(2)(A).
  7. (g) The division, as provided for in § 68-1-101, is the administrative agency for the board of examiners for nursing home administrators.
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§ 63-16-103. Duties of the board.
  1. It is the function and duty of the board to:
    1. (1) Develop, impose and enforce standards that must be met by individuals in order to receive a license as a nursing home administrator, which standards are designed to ensure that nursing home administrators are individuals who are of good character and otherwise suitable and who, by training or experience in the field of institutional administration, are qualified to serve as nursing home administrators;
    2. (2) Develop and apply appropriate techniques, including examinations and investigations, for determining whether an individual meets such standards;
    3. (3) Issue a license to individuals determined, after the application of such techniques, to meet such standards and authorize the state licensing board to revoke or suspend licenses previously issued in any case where the individual holding any such license is determined by the board to have substantially failed to conform to the requirements of such standards;
    4. (4) Establish and carry out procedures designed to ensure that individuals licensed as nursing home administrators will, during any period that they serve as such, comply with the requirements of such standards;
    5. (5) Receive, investigate and take appropriate action with respect to any charge or complaint filed with the board to the effect that any individual licensed as a nursing home administrator has failed to comply with the requirements of such standards;
    6. (6) Conduct a continuing study and investigation of nursing homes and administrators of nursing homes within the state with a view to the improvement of standards imposed for the licensing of such administrators and of procedures and methods for the enforcement of such standards with respect to administrators of nursing homes who have been licensed as such;
    7. (7) Conduct or cause to be conducted courses of instruction and training sufficient to meet the requirements of this chapter. In lieu thereof, the board may approve courses conducted by other groups or organizations;
    8. (8) Have the authority to adopt, promulgate and enforce rules and regulations necessary for the proper performance of its duties; and
    9. (9) The single state agency has the authority to receive and disburse federal funds pursuant to § 1908(e)(1) of the Social Security Act (42 U.S.C. 1396g(e)(1)).
§ 63-16-104. Qualifications for licensure.
  1. (a)
    1. (1) An applicant for a license shall submit evidence of good moral character and suitability prescribed by the board and that the applicant:
      1. (A) Is at least eighteen (18) years of age;
      2. (B) Is a citizen of the United States or legally in this country;
      3. (C) Has completed preliminary education satisfactory to the board; and
      4. (D) Has paid a nonrefundable application fee as set annually by the board no later than fifty (50) days in advance of the next scheduled examination.
    2. (2) Such applicant, upon notification by the board that the applicant has fulfilled the requirements for admission and upon payment of an examination fee as set annually by the board shall be admitted to the examination.
    3. (3) No applicant for license as a nursing home administrator shall be admitted to such licensing examination, nor be entitled to a license or to be certified to the state licensing board for issuance of a license as a nursing home administrator, unless the applicant has graduated from a high school or secondary school approved by the state in which the school is located or has submitted a certificate indicating that the applicant has obtained a high school diploma or high school equivalency credential approved by the state board of education.
  2. (b) The board has the authority to grant a temporary license, not to exceed six (6) months, to an individual applying for licensure to fill a position of nursing home administrator that unexpectedly becomes vacant. To receive a temporary license, the individual must either be licensed in another state or meet the majority of the board's standards for licensure. If the individual holding a temporary license must take the board required examination to be fully licensed and fails to achieve the required scores, the temporary license shall be revoked.
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§ 63-16-105. Examination for license.
  1. (a) The board shall determine the subjects of examination for applicants for licensure as nursing home administrators. The board shall also determine the scope, content and format of such an examination, which in any examination shall be the same for all candidates; however, all examinations must include testing of the applicant's proficiency in the rules and regulations of health and safety.
  2. (b) Any applicant having failed to achieve a passing grade, score or level of proficiency as determined by the board on such examination is not prohibited from taking successive examinations; provided, that such applicant pays the examination fee set by the board pursuant to § 63-16-104 for each successive examination.
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§ 63-16-106. License issuance and registration.
  1. (a) An applicant for a license as a nursing home administrator shall be certified to the division for issuance of a license certifying that the applicant has met the requirements of the law, rules and regulations entitling the applicant to practice as a nursing home administrator who has:
    1. (1) Complied with the requirements of § 63-16-104 and the standards provided in § 63-16-104; and
    2. (2) Passed the examination provided for in § 63-16-105.
  2. (b) The license must be registered annually as required by the state licensing board pursuant to § 63-1-107.
§ 63-16-107. Certificates of registration — Renewal of registration — Continuing education.
  1. (a)
    1. (1) Each individual who is initially issued a license as a nursing home administrator is deemed registered with the board and shall be issued a certificate of registration.
    2. (2) Certificates of registration expire each odd-numbered year.
    3. (3) Each licensed nursing home administrator shall submit an application to the board for a new certificate of registration and submit, along with any information requested by the board, a biennial renewal fee as set by the board.
    4. (4) Although the license renewal is on a biennial basis, continuing education is required on an annual basis.
    5. (5) The board shall promulgate, in accordance with the procedures of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules as shall be necessary to prescribe programs of continuing education for nursing home administrators and to designate the levels of participation required in programs of continuing education. As a prerequisite for renewal of registration, an individual shall submit to the board satisfactory proof of attendance and participation in such programs.
  2. (b) Upon receipt of such application for registration and the registration fee, the board shall issue a certificate of registration to such nursing home administrator unless the board finds reason to deny the same pursuant to § 63-16-108, under the rules and regulations developed by the board.
  3. (c)
    1. (1) If a nursing home administrator fails to renew the nursing home administrator's license and pays the biennial renewal fee after renewal becomes due, the license of such person is automatically revoked without further notice or hearing unless renewal is made and all fees are paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
    2. (2) Any person whose license is automatically revoked as provided in this section may have the license reinstated by the board in its discretion upon good cause being shown, upon payment of all past due renewal fees and upon the further payment of a nonrefundable sum as set by the board.
  4. (d) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
  5. (e) The commissioner of health shall notify the board of all cases in which a nursing home is sanctioned by suspension of admissions or imposition of a civil monetary penalty or in which the commissioner determines that the quality of care provided to residents is seriously inadequate due to acts or omissions of the administrator. In all such cases, the license or certificate of registration of any person who has engaged in the practice of nursing home administration at that facility during the year preceding the imposition of sanctions or the commissioner's finding of inadequacy shall not be renewed by the board, until the board has reviewed all information compiled by regulatory agencies pertaining to the quality of care rendered at facilities under the person's administration. Following such review, the board may renew the license or certificate of registration only upon an affirmative finding that the person can be expected to satisfactorily discharge the duties of an administrator in the future, in a manner that assures an adequate level of care for nursing home residents.
  6. (f)
    1. (1) Notwithstanding any provision of this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (f).
§ 63-16-108. Suspension or revocation of license or registration — Discipline — Reissuance of license or registration.
  1. (a) The license and/or registration of any person practicing or offering to practice nursing home administration or the license of a nursing home administrator holding a provisional license may be revoked or suspended, or the licensee be disciplined in accordance with this section upon decision and after due hearing by the board in any of the following cases:
    1. (1) Upon proof that the licensee is unfit or incompetent by reasons of negligence, habits or other causes;
    2. (2) Upon proof that the licensee has willfully or repeatedly violated this chapter or the rules or regulations promulgated in accordance therewith; or willfully or repeatedly acted in a manner inconsistent with the health and safety of the patients in the home in which the licensee is the administrator;
    3. (3) Upon proof that the licensee is guilty of fraud or deceit in the practice of nursing home administration; or
    4. (4) Upon proof that the licensee has been convicted of a felony in a court of competent jurisdiction, either within or without this state.
  2. (b) The members of the board have jurisdiction to hear all charges brought under this section against persons licensed and registered as nursing home administrators or nursing home administrators holding a provisional license and, upon such hearing, shall determine the charges upon their merits. The board or hearing officer designated as such by the board, acting in an official capacity, has the authority to issue subpoenas, compel the attendance of witnesses, administer oaths and take testimony concerning all matters within the jurisdiction of the board. The board is not bound by the strict rules of evidence in the conduct of its proceedings, but any determinations made shall be founded upon sufficient legal evidence to sustain them.
  3. (c) If the board determines that a person is guilty of the charges, the board may direct revocation of the person's license and/or revoke the person's registration, suspend the person from practice or otherwise discipline the licensee.
  4. (d) In all disciplinary proceedings of a licensee, the holder shall be given thirty (30) days' written notice of the hearing. The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, apply to all disciplinary proceedings of the board and all regulations promulgated pursuant to this chapter.
  5. (e) If the board suspends the licensee, it may also specify conditions to be met by the licensee during the period of suspension in order to entitle the licensee to again qualify for the license. The board may, in its discretion, after hearing, hold the case under advisement and make a recommendation as to the requirements to be met by the licensee in order to avoid suspension, revocation or other disciplinary actions. In such cases the board shall enter an order accordingly and notify the licensee by registered mail. If the licensee complies with such order and proves that fact to the satisfaction of the board, the board may enter an order showing satisfactory compliance in dismissing the case because of such compliance.
  6. (f) The board may, in its discretion, certify for licensure and/or registration any person whose license and/or registration has been revoked. Application for the reissuance of a license and/or registration shall not be made prior to one (1) year after revocation, and shall be made in such manner as the board may direct. Any licensee or applicant for a license aggrieved by the action of the board may have such action reviewed pursuant to title 27, chapter 9.
  7. (g) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-16-109. Reciprocity.
  1. The board may approve and authorize issuance of a nursing home administrator license without examination to any person who holds a current license as a nursing home administrator from another jurisdiction, upon payment of a nonrefundable application fee as set annually by the board and upon proper registration and payment of the annual fee provided in this chapter, if the board finds that the applicant's personal qualifications and education are at least substantially equivalent to the licensure standards in this state.
§ 63-16-110. Certain religious groups exempt.
  1. (a) Nothing in this chapter or the rules and regulations thereunder shall be construed to require an applicant for a license who is certified by a recognized church or religious denomination that teaches reliance on spiritual means alone for healing to demonstrate proficiency in any medical techniques or to meet any medical educational qualifications or medical standards not in accordance with remedial care and treatment provided in such institutions.
  2. (b) Such administrative practice is limited to institutions certified by such church or denominations for the care and treatment of the sick in accordance with its teachings.
§ 63-16-111. Penalties.
  1. (a) It is unlawful for any person to sell or fraudulently obtain or furnish any license or aid or abet therein or practice as a nursing home administrator, under cover of any license or registration illegally or fraudulently obtained, or practice as a nursing home administrator or offer to practice unless the person is duly licensed and registered to so practice under this chapter, or practice as a nursing home administrator during the time the person's licensure registration issued under this chapter shall be suspended or revoked, or otherwise violate this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.
  2. (b) No nursing home in the state may operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator license and registration or provisional license issued pursuant to this chapter.
  3. (c)
    1. (1) Any person convicted of violating this section shall be fined not less than fifty dollars ($50.00) and not more than two hundred fifty dollars ($250).
    2. (2) For the purposes of this section, each day's operation constitutes a separate offense.
  4. (d) It is the duty of the district attorneys general in the various districts throughout the state to assist the board by prosecuting any person the board has reasonable cause to believe is violating any provisions of this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.
§ 63-16-112. Enjoining violations.
  1. The board may cause to be instituted a civil action in any court of competent jurisdiction for injunctive relief to prevent any violation of any provision of this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.
§ 63-16-113. Disposition of fines and receipts — Budgetary allotments.
  1. (a) All fines for the offenses of the violation of this chapter and fees received from all sources and purposes shall be paid to the board and shall become part of its receipts. All moneys received by the board shall be paid into the general fund of the state.
  2. (b) The commissioner of finance and administration shall make such allotments out of the general fund as may be necessary for the implementation of this chapter. Such allotments shall be disbursed under the general budgetary laws of Tennessee.
§ 63-16-114. Temporary administration following unexpected loss of administrator.
  1. Notwithstanding this chapter to the contrary, a nursing home licensed in Tennessee may be administered on a temporary basis after the unexpected loss of an administrator in accordance with title 68, chapter 11, part 2.
§ 63-16-115. Cost of prosecution — Witnesses — Subpoenas.
  1. (a) The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
  2. (b)
    1. (1) Any elected officer of the board or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
    2. (2) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
    3. (3)
      1. (A) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
      2. (B) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
    4. (4) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides, and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
    5. (5) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
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Chapter 17 Licensure Act for Communication Disorders and Sciences
Part 1 Speech Language Pathologists and Audiologists
§ 63-17-101. Short title.
  1. This chapter shall be known and may be cited as the “Licensure Act for Communication Disorders and Sciences.”
§ 63-17-102. Purpose.
  1. It is the purpose and intent of the general assembly by this enactment to safeguard the public health, safety and welfare, to protect the public from being misled by incompetent, unscrupulous and unauthorized persons and to protect the public from unprofessional conduct by qualified speech language pathologists and audiologists and hearing instrument specialists, by providing regulatory authority over persons offering speech language pathology, audiology and hearing instrument dispensing services to the public.
§ 63-17-103. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1)
      1. (A) “Audiologist” means one who practices audiology or one holding oneself out to the public by any title or description of services incorporating the words “audiologist,” “audiology,” “audiological,” “hearing center,” “hearing clinic,” “hearing clinician,” “hearing therapist” or any similar titles or descriptions of service;
      2. (B) Nothing in this chapter shall prevent or prohibit any hearing instrument specialist from employing and using such terms as “hearing aid center,” “hearing aid clinic,” “hearing instrument center,” “hearing instrument clinic” or any similar titles or descriptions of services, so long as the word “aid” or “instrument” is incorporated in any such title or description of service and insofar as such terms do not connote qualifications or education for which the hearing instrument specialist does not have valid credentials or do not imply rehabilitative or professional services that the hearing instrument specialist is not qualified to offer;
    2. (2) “Board” means the board of communications disorders and sciences;
    3. (3) “Person” means any individual, organization or corporate body except that only individuals can be licensed under this chapter;
    4. (4)
      1. (A) “Practice of audiology” means the nonmedical application of principles, methods and procedures for the assessment of the auditory and vestibular systems, including the interpretation of behavioral and physiologic measures, and the design and implementation of programs of hearing conservation and preservation and programs of habilitation and rehabilitation for auditory and vestibular disorders including the assessment, selection, fitting and sale of amplification systems or other assistive devices and technologies;
      2. (B) Nothing in this chapter shall prevent a person licensed under part 2 of this chapter as a hearing instrument dispenser from engaging in the practice of measuring, testing, appraisal, prediction, counseling and instructions related to fitting, usage and dispensing of hearing instruments;
    5. (5)
      1. (A) “Practice of speech language pathology” means the nonmedical application of principles, methods and procedures for the measurement, testing, assessment, prediction, counseling or instruction related to the development and disorders of speech, voice, language or oral, pharyngeal and laryngeal sensorimotor competencies for the purpose of assessing, preventing, treating, ameliorating or modifying such disorders and conditions in individuals and groups of individuals;
      2. (B) The practice of speech language pathology shall include the use of rigid and flexible endoscopes to observe the pharyngeal and laryngeal areas of the throat in order to observe, collect data and measure the parameters of communication and swallowing for the purpose of functional assessment and rehabilitation planning. A speech language pathologist who uses an endoscope shall meet all of the following conditions:
        1. (i) Obtain written verification from a board certified otolaryngologist that the speech language pathologist is competent in the proper and safe use of an endoscope. The otolaryngologist's determination of competency shall be based on the speech language pathologist's training in the proper use of endoscopes, the successful completion of a university course or other educational program of at least fifteen (15) hours on endoscopy and the successful performance of at least twenty-five (25) endoscopic procedures under the supervision of an otolaryngologist or another speech language pathologist who has successfully performed at least fifty (50) endoscopic procedures and has been approved in writing by a board-certified otolaryngologist to provide that supervision. The speech language pathologist shall maintain this written verification on file at all times at the primary practice location of the speech language pathologist;
        2. (ii) Not perform a procedure utilizing an endoscope unless the patient has been referred to the speech language pathologist by an otolaryngologist or other qualified physician for the performance of the procedure;
        3. (iii) Perform only nonoperative procedures with an endoscope;
        4. (iv) Have protocols in place for emergency medical backup for every setting in which the speech language pathologist performs a procedure using an endoscope. A physician must provide general supervision and be readily available in the event of an emergency, including, but not limited to, physical presence at the setting or availability by telephone or telehealth, as defined in § 63-1-155; and
        5. (v) Send to the referring physician in a timely manner a report and visual recording of each endoscopic procedure performed upon referral of that physician. If the referring physician is not an otolaryngologist, the speech language pathologist shall also provide a visual recording of the endoscopic procedure to an otolaryngologist, if directed to do so by the referring physician;
    6. (6) “Speech language pathologist” means one who practices speech pathology, one who holds out to the public by any title or description of services incorporating the words “speech language pathologist,” “speech pathologist,” “speech pathology,” “speech therapy,” “speech correction,” “speech correctionist,” “speech therapist,” “speech clinic,” “speech clinician,” “language pathologist,” “language pathology,” “language therapist,” “logopedics,” “logopedist,” “communicology,” “communicologist,” “asphasiologist,” “voice therapy,” “voice therapist,” “voice pathology,” “voice pathologist” or “phoniatrist” or any similar titles or description of services; and
    7. (7) “Speech language pathology assistant” means any person who meets minimum qualifications that the board may establish for speech language pathology assistants, which qualifications are less than those established by this chapter as necessary for licensure as a speech language pathologist and who works under the supervision of a licensed speech language pathologist.
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§ 63-17-104. Board.
  1. (a)
    1. (1) There is hereby created a board of communications disorders and sciences.
    2. (2) The board shall consist of seven (7) members who are appointed by the governor, who are residents of this state, five (5) of whom are currently practicing as speech language pathologists or audiologists and who have been engaged in rendering services, teaching or research in speech language pathology or audiology for a period of at least five (5) years, one (1) of whom shall be a consumer member who is not affiliated with the profession of speech language pathology and audiology and one (1) physician licensed by this state whose medical specialty is otolaryngology.
    3. (3) Of the six (6) nonphysician members of the board, at least two (2) shall be audiologists and at least two (2) shall be speech language pathologists, the fifth member shall be either a speech language pathologist or audiologist and the sixth member shall be a consumer. The five (5) nonphysician members engaged in rendering services, teaching or research in speech language pathology or audiology shall hold an active and valid license in this state.
  2. (b) The members of the board shall serve until the expiration of the term for which they have been appointed or until their successors are qualified. Their appointments shall be made as follows:
    1. (1) Initially, of the six (6) nonphysician members of the board, two (2) shall be appointed for a term of one (1) year, two (2) members shall be appointed for a term of two (2) years and two (2) members shall be appointed for a term of three (3) years. The consumer member shall be appointed for a term of three (3) years. All appointments made thereafter shall be for a term of three (3) years;
    2. (2) The physician member of the board may be selected by the governor from lists of qualified nominees submitted by interested otolaryngology groups including, but not limited to, the Tennessee Academy of Otolaryngology and shall serve for a term of three (3) years. The governor shall consult with such interested groups to determine qualified persons to fill the position. If for any reason a vacancy occurs in the office of a physician member of the board, an appointment shall be made as provided in this section, and the person so appointed shall serve for the remainder of the unexpired term; and
    3. (3) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  3. (c)
    1. (1) The board shall reorganize annually and select a chair and a secretary. Four (4) members of the board constitute a quorum to do business.
    2. (2) The board shall hold at least one (1) regular meeting each year. Additional meetings may be held upon call of the chair or after the written request of any two (2) members of the board.
    3. (3) All meetings of the board shall be open and public, except that the board may hold executive sessions:
      1. (A) To prepare, approve, grade or administer examinations; and
      2. (B) Upon the request of an applicant who fails an examination, to prepare a response indicating the cause of the applicant's failure.
    4. (4) No person shall be appointed to serve more than two (2) consecutive terms.
    5. (5) When a vacancy in the office of one (1) of the five (5) nonphysician members engaged in rendering services, teaching or research in speech language pathology or audiology occurs, interested audiology and speech pathology groups including, but not limited to, the Tennessee Association of Audiologists and Speech Language Pathologists may submit lists of qualified nominees to be considered for the vacancy. The governor shall consult with such interested groups to determine qualified persons to fill the vacancy.
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§ 63-17-105. Powers and duties of board.
  1. (a) The board is authorized to:
    1. (1) Administer, coordinate and enforce this chapter, evaluate the qualifications of applicants, supervise the examination for applicants, and may issue subpoenas, examine witnesses and administer oaths and shall investigate persons engaging in practices that violate this chapter;
    2. (2) Conduct such hearings and keep such records and minutes as shall be necessary to an orderly dispatch of business;
    3. (3) Adopt and publish responsible rules and regulations, including, but not limited to, regulations that establish ethical standards of practice and may amend or repeal the same; and
    4. (4) Govern and control every person who holds a license or is registered to practice in the field of communication disorders and sciences in this state by the rules of professional conduct adopted by the board.
  2. (b) The conferral or enumeration of specific powers elsewhere in this chapter shall not be construed as a limitation of the general powers conferred by this section.
§ 63-17-106. Compensation of board.
  1. The board members shall receive no compensation for their services, but may receive fifty dollars ($50.00) per diem when actually engaged in the discharge of their official duties and, in addition, shall be reimbursed for all travel and other necessary expenses. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-17-107. Employees of board.
  1. (a) The board shall employ and, at its pleasure, discharge, a secretary and such attorneys, inspectors, clerks and any other employees it deems necessary and shall outline their duties and fix their compensation.
  2. (b) The amount of per diem and travel expenses shall be paid in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
§ 63-17-108. Seal — Records as evidence.
  1. (a) The board shall adopt a seal by which it shall authenticate its proceedings.
  2. (b) Copies of the proceedings, records and acts of the board and certificates purporting to relate the facts concerning such proceedings, records and acts, signed by the secretary and authenticated by the seal, shall be prima facie evidence in all courts of the state.
§ 63-17-109. Disposition of fees — Allotment of funds.
  1. (a) All fees coming into the custody of the board, including examination fees, license fees, renewal fees, fines, penalties and other payments, shall be paid by the board to the state treasurer and become a part of the general fund.
  2. (b) The commissioner of finance and administration shall make allotments of the general fund for proper expenditures of the board, and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
§ 63-17-110. License requirements — Qualifications of applicants — Provisional license.
  1. (a)
    1. (1) Any person wishing to practice or represent such person as a speech language pathologist or audiologist in this state shall obtain a license from the board. Unless such person obtains a license, it is unlawful for such person to practice or represent such person as a speech language pathologist or audiologist as defined in § 63-17-103; and if that person so practices or represents, the person shall be considered to have violated this chapter.
    2. (2)
      1. (A) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) To be eligible for licensure by the board as a speech language pathologist or audiologist, the applicant must:
    1. (1) Be of good moral character, be eighteen (18) years of age or older and possess at least a master's degree in the area of speech language pathology or audiology obtained from educational institutions approved by the board according to the regulations duly adopted under this chapter;
    2. (2) Pass an examination covering the areas of speech language pathology, audiology and speech and hearing services approved by the board. The board determines the scope of the examinations. Written examinations may be supplemented by such oral examinations as the board determines. An applicant who fails the examination may be reexamined at a subsequent examination upon payment of another examination fee; and
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    3. (3) Submit evidence of the completion of the educational, clinical experience and employment requirements prescribed by the rules and regulations adopted pursuant to this chapter.
  3. (c)
    1. (1) A person who has completed the educational requirements for licensure as a speech language pathologist and has received at least a master's degree from an approved educational institution may apply for and receive from the board a provisional license to practice as a clinical fellow during the person's period of supervised clinical experience. The board may adopt rules to establish standards and procedures to govern provisional licenses and the provisional license fee.
    2. (2) Until such time as the board has adopted rules to establish standards and procedures to govern provisional licenses, the provisions of Rules and Regulations of the State of Tennessee, Rule 1370-01-.10, governing registration of clinical fellows, apply to persons seeking a provisional license to practice as a clinical fellow during the period of supervised clinical experience.
    3. (3) Any person who, on May 8, 2019, has been registered as a clinical fellow pursuant to Rules and Regulations of the State of Tennessee, Rule 1370-01-.10, is deemed to have a provisional license for the same period of time that the person's registration would be effective under that rule.
  4. (d) A person who applies for licensure as an audiologist on or after January 1, 2009, shall possess a doctoral degree from an accredited educational program approved by the board. The doctoral degree may be a doctor of audiology degree (Au.D.) or other doctoral degree approved by the board. In addition to possessing a doctoral degree, the applicant shall meet the other requirements of subsection (b), except that the doctoral degree shall be in lieu of the master's degree previously required of applicants.
  5. (e) The requirement to have a doctoral degree shall not apply to audiologists who were licensed in this or any other state prior to January 1, 2009.
§ 63-17-111. Examination of applicants.
  1. (a) Each person desiring to obtain a license from the board shall make application to the board upon a form and in such a manner as the board prescribes in regulations adopted pursuant to this chapter. Each applicant shall be examined by the committee and shall pay to the board, at least thirty (30) days prior to the date of the examination, the examination fee prescribed by the board, which fee will not be refunded.
  2. (b) The board may examine by written or oral examination or by both. The examination shall be given at least twice a year at the time and place and under such supervision as the board may determine. Standards for acceptable performance shall be determined by the board.
  3. (c) The board may waive the written examination if the applicant has successfully passed a comparable examination.
  4. (d) The board may examine or direct the applicant to be examined for knowledge in whatever theoretical or applied fields in speech language pathology or audiology as it deems appropriate. It may examine the candidate with regard to the candidate's professional skills and the candidate's judgment in the utilization of speech language pathology or audiology techniques and methods.
  5. (e) The board shall grade the written examination or direct it to be graded and keep the written examination papers for at least one (1) year.
  6. (f) The board shall keep an accurate transcript of the oral examination and keep such transcripts as part of its records for at least one (1) year following the date of examination.
  7. (g) A speech language pathologist or audiologist who holds an American Speech and Hearing Association (ASHA) certification or equivalent, or holds a doctor of audiology degree (Au.D.) from an accredited institution of higher learning and has passed the examination required for licensure under § 63-17-110(b)(2) or is licensed in another state and who has made application to the board for a license in this state may perform activities and services of a speech language pathology or audiological nature without a valid license pending disposition of application.
§ 63-17-112. Issuance of license.
  1. The board shall issue a license to all applicants who meet the requirements of this chapter and who pay to the board the initial license fee.
§ 63-17-113. Reciprocity.
  1. (a) The board shall waive the examination and grant a license to an applicant who presents proof of current licensure in a state that has standards equivalent to those of this state.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-17-114. Exemptions.
  1. Nothing in this part shall be construed to:
    1. (1) Prevent a qualified person licensed in this state under any other law from engaging in the profession for which such person is licensed;
    2. (2) Restrict or prevent activities of a speech language pathology or audiology nature or the use of the official title of the position for which they were employed on the part of the following persons:
      1. (A) Persons who hold a valid and current credential as a speech and hearing specialist issued by the department of education; and
      2. (B) Speech language pathologists or audiologists employed by federal governmental agencies; provided, that such persons are performing such activities solely within the confines of, or under the jurisdiction of, the organization in which they are employed and do not offer to render speech language pathology or audiology services as defined in § 63-17-103, to the public outside of the institutions or organizations in which they are employed. However, such persons may, without obtaining a license under this chapter, consult or disseminate their research findings and scientific information to other such accredited academic institutions or governmental agencies. They also may offer lectures to the public for a fee, monetary or otherwise, without being licensed under this chapter;
    3. (3) Restrict the activities and services of a student or a speech language pathology intern in speech language pathology pursuing a course of study leading to a degree in speech language pathology at an accredited or approved college or university or an approved clinical training facility; provided, that these activities and services constitute a part of the student's supervised course of study and that such persons are designated by such title as “speech language pathology intern,” “speech language pathology trainee” or other such title clearly indicating the training status appropriate to the student's level of training;
    4. (4) Restrict the activities and services of a student of audiology or intern in audiology pursuing a course of study leading to a degree in audiology at an accredited or approved college or university or an approved clinical training facility; provided, that these activities and services constitute a part of the student's supervised course of study and that such person is designated by such title as “audiology intern,” “audiology trainee” or other such title clearly indicating the training status appropriate to the student's level of training;
    5. (5)
      1. (A) Restrict a person from another state from offering such person's speech language pathology or audiology services in the state; provided, that such services are performed for no more than five (5) days in any calendar year and that such person meets the qualifications and requirements stated in the section on qualifications and does not sell hearing instruments;
      2. (B) However, a person from another state who is licensed or certified as a speech language pathologist by a similar board of another state, territory of the United States or of a foreign country or province and whose standards are equivalent to, or higher than, at the date of such person's certification or licensure, the requirements of this chapter and regulations duly adopted pursuant to this part or a person who meets the qualifications and requirements and resides in a state or territory of the United States or a foreign country or province that does not grant certification or license to speech language pathologists may also offer speech language pathology services in this state for a total of not more than thirty (30) days in any calendar year without being licensed under this law;
    6. (6) Prevent the activities and services of a speech language pathologist obtaining the pathologist's year of paid professional experience; provided, that such person is under the supervision of a speech language pathologist licensed under this chapter or a speech language pathologist certified under the American Speech and Hearing Association (ASHA). A licensed or ASHA certified speech language pathologist shall not supervise more than three (3) speech language pathologists with a provisional license at any one (1) time;
    7. (7) Restrict the activities and services of an audiologist obtaining the audiologist's year of paid professional experience; provided, that such person is under the supervision of a licensed or ASHA certified audiologist. A licensed or ASHA certified audiologist shall not supervise more than three (3) unlicensed audiologists at any one (1) time;
    8. (8) Restrict the activities and services of a person performing audiometric tests under the direct supervision of a physician licensed to practice by the state board of medical examiners; and
    9. (9) Permit any person licensed by this chapter to practice medicine in any form or in any of its branches. Nothing in this chapter shall be construed as applying to physicians licensed under chapters 1 and 6 of this title.
§ 63-17-115. Fees.
  1. (a) The amount of fees prescribed in connection with a license as a speech language pathologist or audiologist shall be determined by the board.
  2. (b) An applicant wishing to be licensed in both speech language pathology and audiology shall pay the examination fee for each license. Such individual, however, is required to pay only one (1) initial license fee and only one (1) renewal or delinquency fee; provided, that the applications for the two (2) licenses are submitted simultaneously.
  3. (c) The fees shall be fixed by the board and shall be set forth with the regulations that are duly adopted under this chapter.
  4. (d) Every person to whom a license is issued shall, as a condition precedent to its issuance and in addition to any application, examination or other fee, pay the prescribed initial license fee. The board may, by regulation, provide for the waiver where the license is issued less than forty-five (45) days before the date on which it will expire.
§ 63-17-116. Expiration of licenses — Renewal — Retirement.
  1. (a) Each licensed speech language pathologist or audiologist shall pay to the board a fee for a license renewal. The secretary of the board shall notify each licensed speech language pathologist and audiologist each year that such fee is due.
  2. (b) When any licensed speech language pathologist or audiologist fails to register and pay the registration fee within sixty (60) days after registration becomes due, as provided in this section, the license of such person is automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing. Any person whose license is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license or certificate, and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of current renewal fee and upon further payment of a sum to be set by the board.
  3. (c) A suspended license is subject to expiration and shall be renewed as provided in this chapter, but such renewal does not entitle the licensee while the license remains suspended and, until it is reinstated, to engage in the licensed activity or in any other activity or conduct in violation of the order or judgment by which the license was suspended.
  4. (d) A license revoked on disciplinary grounds is subject to expiration as provided in this section, but it may be renewed. If it is reinstated after its expiration, the licensee, as a condition of reinstatement, shall pay a reinstatement fee in an amount equal to the renewal fee in effect on the last preceding regular renewal date before the date on which it is reinstated, plus the delinquency fee, if any, accrued at the time of its revocation.
  5. (e) A person who fails to renew a license within the five (5) years after its expiration may not renew it and it may not be restored, reissued or reinstated thereafter; but, such person may apply for and obtain a new license if such person meets the requirements of this chapter.
  6. (f) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
  7. (g)
    1. (1) Notwithstanding this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (g).
§ 63-17-117. Denial, revocation and suspension of licenses.
  1. (a) The board may refuse to issue a license or may suspend or revoke the license of any licensee if the licensee has been found guilty of unprofessional conduct that has endangered or is likely to endanger the health, welfare or safety of the public. Such unprofessional conduct may include:
    1. (1) Obtaining the license by means of fraud, misrepresentation or concealment of material facts;
    2. (2) Being guilty of unprofessional conduct as defined by the rules established by the board or violating the code of ethics adopted and published by the board;
    3. (3) Violating any lawful order, rule or regulation rendered or adopted by the board; or
    4. (4) Violating any provisions of this chapter.
  2. (b) The board shall deny an application for, suspend or revoke or impose probationary conditions upon a license as ordered by the board in any decision made after a hearing as provided in this chapter. One (1) year from the date of revocation of a license under this chapter, application may be made to the board for reinstatement. The board has discretion to accept or reject an application for reinstatement and may require an examination for such reinstatement.
  3. (c) A plea or verdict of guilty or a conviction following a plea of nolo contendere made to a charge of a felony or of any offense involving moral turpitude is deemed to be a conviction within the meaning of this chapter. However, an action taken under this subsection (c) shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-17-118. Charges against licensees and applicants.
  1. (a) Any person, including the board or any member thereof, may prefer charges against any licensee or applicant for license. Such charges shall be in writing and shall be sworn to by the person or persons making them. The charges, unless made by the board, shall be preferred by delivering them to the secretary of the board, who shall furnish all members of the board with a copy. All charges, unless dismissed by the board, shall be heard within a reasonable time after the date upon which they were preferred. The time and place of the hearings shall be fixed by the board.
  2. (b) The complaint shall be in writing and shall include, but not be limited to, the following:
    1. (1) The name of the licensee or the applicant, the licensee's or applicant's last known address and the number of the licensee's or applicant's license, if known;
    2. (2) The nature of the charges, which, if true, would constitute grounds upon which disciplinary action may be taken;
    3. (3) A statement to inform the respondent that the respondent may but need not be represented by counsel and that the respondent is entitled to the issuance of subpoenas to compel the attendance of witnesses, the production of books, documents or other evidence relevant to the matter to be heard;
    4. (4) The date and time set for the hearing of the charges and the place where the hearing is to be held; and
    5. (5) The date of the signing of the complaint, which shall be signed by the chair and secretary of the board.
  3. (c) A copy of the complaint shall be served upon the person against whom preferred, whether personally or by registered or certified mail, addressed to the person at the person's last known address as the same appears on the records of the board, at least twenty (20) days before the time fixed for the hearing. Where such personal service cannot be made or where registered or certified mail is returned undelivered, the secretary-treasurer of the board may cause a brief notice to the licensee to be published in a newspaper of general circulation in the county of the licensee's last known address, or, if no newspaper is published in the county, the notice may be published in an adjoining county. If the address is in some state, territory or country other than this state, then the notice may be published in Davidson County. Proof of service or of publication shall be filed with the secretary-treasurer and shall be recorded by the secretary-treasurer in the minutes of the board.
  4. (d)
    1. (1) The board shall not be bound by strict rules of procedure or by the laws of evidence in the conduct of proceedings, but the determination shall be based upon sufficient legal evidence to sustain it.
    2. (2) The proceeding at the hearing shall be either stenographically or mechanically transcribed.
    3. (3) Oral evidence shall be taken only upon oath or affirmation administered by any member of the board.
    4. (4) Every party to a disciplinary hearing shall have the right to call and examine witnesses and to introduce documentary evidence relevant to the issues of the case.
    5. (5) After the hearing, the board shall consider all the evidence offered and shall decide the issue based upon such evidence. If the decision is for the respondent, the board shall dismiss the proceeding and it shall be so stated in the order entered in the matter.
    6. (6) If the board determines from the evidence and proofs submitted that the respondent is guilty of the charge or charges set forth in the complaint, it may take such action and impose such penalties provided in this chapter as it may deem proper.
  5. (e) Any action of or ruling or order made or entered by the board is subject to review by the courts of this state in the same manner and subject to the rulings, orders and findings of other quasi-judicial bodies and to the same powers and conditions as now provided by law in regard to Tennessee, where not otherwise specifically provided.
§ 63-17-119. Enjoining violations.
  1. (a) The board, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license and in the matter of the refusal to issue a certificate, is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is engaging in any act or practice that constitutes an offense against this chapter. No injunction bond shall be required of the board.
  2. (b) Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
§ 63-17-120. Assistance of district attorneys general.
  1. The board at all times has the power to call upon the district attorneys general for the state in the various districts to assist the board. It is hereby declared to be the duty of all district attorneys general throughout the state to assist the board, upon its request, in any suit for injunction or prosecution instituted by the board without charge or additional compensation to the district attorneys general.
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§ 63-17-121. Penalties.
  1. A violation of this chapter is a Class B misdemeanor.
§ 63-17-124. Continuing education.
  1. The board has the authority to promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, establishing mandatory continuing education. The board's rules shall require a minimum of ten (10) hours per year of continuing education.
§ 63-17-125. Return of purchased hearing instruments.
  1. (a) Within thirty (30) days of the date of delivery, any purchaser of a hearing instrument from an audiologist licensed by the board to practice the assessing, selecting, fitting or dispensing or engaging in the sale of hearing instruments to the human ear is entitled to return the hearing instrument for any reason; provided, that such instrument is returned in satisfactory condition, and such purchaser shall pay only reasonable charges for the hearing instrument and related services. Such return privileges apply only to a first-time purchaser of a hearing instrument.
  2. (b) Charges to be imposed upon return of a hearing instrument as provided in subsection (a) shall be clearly stated in the bill of sale.
  3. (c) This section shall not be construed to supersede any duly promulgated regulation issued by the federal trade commission.
§ 63-17-126. Standards of conduct.
  1. When engaging in assessment, selection, fitting and sale of amplification systems or other assistive devices and technologies, a licensed audiologist shall perform such activities in compliance with the highest standards of professional conduct specifically prescribed for such activities by the United States food and drug administration, the Academy of Dispensing Audiologists, the American Academy of Audiology, the American Speech-Language-Hearing Association and the council for licensing hearing instrument specialists. Through promulgation of rules, publication and distribution of pamphlets, and/or other appropriate means, the board shall periodically notify and update all licensed audiologists concerning the applicable standards of conduct enforced pursuant to this section.
§ 63-17-127. Inactive licenses to perform pro bono services.
  1. The board shall establish by rule an inactive license category that allows audiologists and speech language pathologists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of audiology or speech language pathology.
§ 63-17-128. Registration as a speech language pathology assistant.
  1. (a) No person shall engage in practice as a speech language pathology assistant unless that person has first registered with the board.
  2. (b) A person who desires to register as a speech language pathology assistant shall provide proof that the person meets the minimum qualifications established by the board for speech language pathology assistants in its rules and shall pay the registration fees set by the board. The minimum qualifications previously established by the board in its rules shall remain in effect unless and until amended by the board.
  3. (c) Registration shall be valid for two (2) years. Each person registered as a speech language pathology assistant shall renew the person's registration biennially if that person desires to continue practicing as a speech language pathology assistant. The board may utilize the renewal system as described in § 63-1-107.
  4. (d) The amount of the fees required to be paid by speech language pathology assistants in connection with their registration shall be determined by the board.
  5. (e) Sections 63-17-117 — 63-17-120 shall apply to speech language pathology assistants in the same way they apply to speech language pathologists.
  6. (f) The board's rules shall require that each registered speech language pathology assistant obtain the minimum number of hours of continuing education each year that the board deems necessary to ensure the continued competence of the speech language pathology assistant.
  7. (g) The board shall adopt rules to implement this section in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Part 2 Hearing Instrument Specialists
§ 63-17-201. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Apprentice licensee applicant” means any person who is registered with the council and, who is engaged in an approved licensing program and who is sponsored by a hearing instrument specialist duly licensed in this state. The apprentice licensee applicant shall meet the qualifications of § 63-17-207;
    2. (2) “Apprentice program” means sixty (60) classroom hours of prescribed coursework under the direct supervision of a hearing instrument specialist, with such coursework pertaining to all aspects of hearing instrument dispensing;
    3. (3) “Board” means the board of communication disorders and sciences created by § 63-17-104;
    4. (4) “Cerumen” means a wax like secretion from glands in the external auditory canal;
    5. (5) “Council” means the council for licensing hearing instrument specialists;
    6. (6) “Division” means the division of health related boards in the department of health;
    7. (7) “Hearing instrument” means any instrument or device designed for or represented as aiding, improving or correcting defective human hearing and any parts, attachments or accessories of such an instrument or device;
    8. (8) “Licensed hearing instrument specialist” means any person licensed by this part who has passed a council-approved psychometrically-sound examination for hearing instrument specialists;
    9. (9) “Otolaryngologist” means a physician specialist dedicated to the care of patients with disorders of the ears, nose, throat, and related structures of the head and neck, commonly referred to as ENTs;
    10. (10) “Practice of dispensing and fitting hearing instruments” includes:
      1. (A) The evaluation or measurement of the powers or range of human hearing by means of an audiometer for the consequent selection or adaptation for sale of hearing instruments intended to compensate for hearing loss, and the appropriate instructions, consultations, suggestions, recommendations, or opinions related to this practice;
      2. (B) Making an impression of the ear, or an ear mold; and
      3. (C) Cerumen management in the course of examining ears by a person who holds a certification of completion of a cerumen management course, as described in § 63-17-224; and
    11. (11) “Sell” or “sale” includes any transfer of title or of the right to use by lease, bailment or any other contract, either oral or written, except wholesale sales to distributors or dispensers.
§ 63-17-202. Council for licensing hearing instrument specialists.
  1. (a) There is hereby created a council within the board to be known as the council for licensing hearing instrument specialists, with the duties and powers as provided in § 63-17-203.
  2. (b)
    1. (1) The council shall consist of five (5) members, to be appointed by the governor. Such members shall possess the following qualifications:
      1. (A) Three (3) members shall be qualified hearing instrument specialists and fitters of hearing instruments who have been duly licensed as such in Tennessee, and who are certified by the National Board for Certification — Hearing Instrument Sciences. Such members may be appointed from lists of qualified persons submitted to the governor by interested audiology groups including, but not limited to, the Tennessee Hearing Aid Society. The governor shall consult with such interested groups to determine qualified persons to fill the positions;
      2. (B) One (1) member shall be a physician who has been duly licensed to practice medicine in Tennessee, and who has received certification from the American Council of Otolaryngology. The member may be appointed from lists of qualified persons submitted to the governor by interested medical groups including, but not limited to, the Tennessee Medical Association. The governor shall consult with such interested groups to determine a qualified person to fill the position; and
      3. (C) One (1) member shall be a person who has been a user of hearing instruments for a period of at least five (5) years preceding that person's appointment to the council and who shall never have been engaged in the practice of hearing instrument dispensing and fitting, audiology or medicine.
    2. (2) In order that the terms may be appropriately staggered, initial appointments to the council are for the following terms: one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed to a term of one (1) year; one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed for a term of two (2) years; one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed for a term of four (4) years; the member appointed pursuant to subdivision (b)(1)(B) shall be appointed to a term of three (3) years; and the member appointed pursuant to subdivision (b)(1)(C) shall be appointed to a term of four (4) years. Thereafter, each member appointed to the council shall be appointed to a term of five (5) years. No person is eligible to serve successive terms on the council; provided, that those members appointed to a one- or two-year term under this subsection (b) are eligible to succeed themselves for one (1) successive five-year term. In the event of a vacancy on the council, the governor shall appoint a person qualified under the appropriate subdivision of this subsection (b) to fill the unexpired vacancy. The initial appointments to the council shall include the current and immediate past board chair of the licensing board of hearing aid dispensers. In making appointments to the council, the governor shall strive to ensure that at least one (1) person serving on the council is sixty (60) years of age or older and that at least one (1) person serving on the council is a member of a racial minority.
  3. (c) Each member of the council shall receive fifty dollars ($50.00) per diem expenses when actually engaged in the discharge of such member's official duties and, in addition, shall be reimbursed for attending any meeting of the council within this state, in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  4. (d) Such council shall be administratively attached to the board of communications disorders and sciences and the division of health related boards.
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§ 63-17-203. Powers and duties of the council.
  1. The powers and duties of the council are to:
    1. (1) Supervise and administer qualifying examinations to test the knowledge and proficiency of applicants for a license;
    2. (2) License persons who apply to the council and who are qualified to practice the fitting of hearing instruments;
    3. (3) Purchase and maintain or rent audiometric equipment and facilities necessary to carry out the examination of applicants for license;
    4. (4) Issue and renew licenses, under the name of the board;
    5. (5) Deny, suspend or revoke licenses pursuant to this part;
    6. (6) Appoint representatives to conduct or supervise the examination of applicants for license;
    7. (7) Designate the time and place for examining applicants for license;
    8. (8) Make and publish rules and regulations not inconsistent with the laws of this state that are necessary to carry out this part. All rules relating to hearing instrument specialists shall be initiated and adopted by a majority of the members of the council and then shall be approved by a majority of the members of the board;
    9. (9) Require an annual calibration of audiometric equipment;
    10. (10) Provide all examinations required by this part. The council may contract with organizations to conduct examinations;
    11. (11) Establish minimum requirements of test procedure and test equipment to be used in the fitting of hearing instruments and also the retention of records of all fittings;
    12. (12) Inspect the facilities or records, or both, of persons who practice the fitting and selling of hearing instruments, upon a showing of probable cause of a violation of this part;
    13. (13) Require lists, set standards and approve programs for trainees as provided in § 63-17-207;
    14. (14) Prescribe regulations requiring continuing education as a prerequisite for renewal of licenses to practice; and
    15. (15) Employ a consultant to assist the council in its duties.
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§ 63-17-204. Meetings.
  1. (a) The council shall meet at least once each year at a place and time determined by the chair. The council shall also meet at such other times and places as may be appropriate to carry out the purposes of this part.
  2. (b)
    1. (1) Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the council.
    2. (2) The presiding officer of the council shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (b)(1).
§ 63-17-205. License required.
  1. (a) No person shall engage in the sale of or practice of dispensing and fitting hearing instruments or display a sign or in any other way advertise or hold out to be a hearing instrument specialist unless direct hands-on testing and follow-up services are provided to persons to whom the hearing instrument specialist has dispensed and/or sold a hearing instrument, and such person holds a current, unsuspended, unrevoked license issued by the council as provided in this part.
  2. (b) The license required by this section shall be kept conspicuously posted in the specialist's principal office or place of business at all times.
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§ 63-17-206. Construction — Application.
  1. (a) This part shall not be construed to prevent any person who is a physician licensed to practice by the board of medical examiners from treating or fitting hearing instruments to the human ear.
  2. (b) It is lawful for any person, who meets the requirements of §§ 63-17-205 and 63-17-207 and, who is listed as an apprentice licensee applicant with the council and who is under the direct supervision of a sponsoring licensed hearing instrument specialist to perform any of the services or acts included in the definition of hearing instrument dispensing and fitting as contained in this part; provided, that such person does so under the direct supervision of the licensed hearing instrument specialist and with the licensed dispenser making final selection and fitting to the client. No licensed dispenser shall supervise more than two (2) such apprentice licensee applicants or apprentice licensees combined at the same time.
  3. (c) This part shall not be construed to prevent any person who is an audiologist licensed by the board from practicing audiology as defined in § 63-17-103, nor to prevent any person who is a speech-language pathologist licensed by the board from practicing speech-language pathology as defined in § 63-17-103.
§ 63-17-207. Preliminary application requirements — Fees.
  1. (a) An applicant for a license shall:
    1. (1) Be at least eighteen (18) years of age; and
    2. (2) Have an education equivalent to two (2) years of accredited college level coursework or national board for certification in hearing instrument sciences (NBC-HIS) board certification.
  2. (b) Such applicant shall pay a nonrefundable application fee as set by the council no later than forty-five (45) days in advance of the next scheduled examination.
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§ 63-17-208. Apprentice license.
  1. (a) Applicants who meet the requirements of § 63-17-207 with respect to age and education may apply for an apprentice license.
  2. (b) The apprentice licensee shall function under the direct supervision of the sponsoring licensed hearing instrument specialist for a period of at least three (3) months after submitting an application, and during such three-month period, the sponsoring licensed dispenser must make the final selection and fitting of the hearing instrument.
  3. (c) During the apprentice period, the apprentice licensee shall complete sixty (60) classroom hours of prescribed coursework.
  4. (d) The apprentice license will remain in effect no longer than one (1) year and cannot be renewed.
  5. (e) Applicants for an apprentice license shall pay the council a nonrefundable fee as set by the council.
§ 63-17-209. Examination.
  1. (a) Upon the payment of an examination fee as set by the council, an applicant for a license who is notified by the council that the applicant has fulfilled the requirements of § 63-17-207 shall appear at a time, place and before such persons as the council may designate to be examined by written and practical tests in order to demonstrate that such applicant is qualified to practice the fitting of hearing instruments.
  2. (b) The council shall give at least one (1) examination of the type prescribed in this section each year and such additional examinations as the volume of applications may make appropriate.
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§ 63-17-210. Examination requirements.
  1. (a) The examination provided in § 63-17-209 shall consist of:
    1. (1) Tests of knowledge in the following areas as they pertain to the fitting of hearing instruments:
      1. (A) Basic physics of sound;
      2. (B) The human hearing mechanism, including the science of hearing and the causes and rehabilitation of abnormal hearing and hearing disorders; and
      3. (C) Structure and function of hearing instruments;
    2. (2) Tests of proficiency in the following techniques as they pertain to the fitting of hearing instruments:
      1. (A) Pure tone audiometry, including air conduction testing and bone conduction testing;
      2. (B) Live voice or recorded voice speech audiometry, including speech reception threshold testing and speech discrimination testing;
      3. (C) Effective masking;
      4. (D) Recording and evaluation of audiograms and speech audiometry to determine hearing instrument candidacy;
      5. (E) Selection and adaption of hearing instruments and testing of hearing instruments;
      6. (F) Taking earmold impressions; and
      7. (G) Other skills as may be required for the fitting of hearing instruments; and
    3. (3) Tests of knowledge of the provisions and requirements of this part.
  2. (b) The tests under this section shall not include questions requiring a medical or surgical education.
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§ 63-17-211. Provisions for fees.
  1. (a)
    1. (1) Upon payment of an initial license fee as determined by the council, the council shall issue a license to each applicant who passes the examination. Such initial license shall expire as provided by rules and regulations promulgated by the board.
    2. (2) During the second year of a biennial renewal period, the initial license fee shall be one-half (½) of the biennial renewal fee.
  2. (b) The council may, in its discretion, license as a hearing instrument specialist, without examination, on the payment of a fee as set by the council, an applicant who is a hearing instrument specialist, certified, registered or licensed under the laws of another state or country, if the applicant's qualifications for certification, registration or licensure meet the licensure requirements in force in this state upon the date of the specialist's application for certification, registration or licensure in this state.
§ 63-17-212. Notification of change of address.
  1. Each licensee shall notify the council of any change of address of the licensee's place of business, within thirty (30) days of such change. Failure to give such notice shall be deemed just cause for disciplinary action by the council.
§ 63-17-213. Registry of license holders — Review of qualifications.
  1. The council shall issue, under the board's name, all licenses approved by the council, and the board and shall maintain a registry of all license holders. It is the duty of the council to review and approve the qualifications of applicants for certification or renewal as hearing instrument specialists.
§ 63-17-214. Renewal — Fees — Retirement.
  1. (a)
    1. (1) Each licensed hearing instrument specialist shall pay to the council a biennial renewal fee as set by the council, payable in advance, for the ensuing two (2) years.
    2. (2) The council shall notify each licensee that such renewal is due.
  2. (b) As a condition of renewal, the licensee shall be reexamined by the council and shall pay a reexamination fee as set by the council or shall submit verification of compliance of continuing education requirements as may be set by the council. The reexamination shall consist of all of the areas required pursuant to § 63-17-210.
  3. (c) When any licensed hearing instrument specialist fails to pay the license fee within sixty (60) days after it becomes due, as provided in this section, the license of such person is automatically revoked at the expiration of the sixty (60) days after the renewal fee was required, without further notice or hearing.
  4. (d) Any person whose license is automatically revoked as provided in § 63-17-219 may make application in writing to the council for the reinstatement of such license; and, upon good cause being shown, the council, in its discretion, may reinstate such license upon payment of all past due renewal fees and upon further payment of a sum set by the council.
  5. (e) Any person licensed to practice by this part who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this part if such person files with this council an affidavit on a form to be furnished by the council, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the council deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the council as provided by this part and shall meet other requirements as may be set by the council.
  6. (f)
    1. (1) Notwithstanding this part to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the council determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest twenty-five cents (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (f).
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§ 63-17-215. Expenses of board and council paid by fees.
  1. The fees relating to the practice of dispensing hearing instruments shall be set by the board in an amount sufficient to pay all of the expenses of the council, as well as all of the expenses of the board that are directly attributable to the performance of its duties pursuant to this part. Expenditures of the council for investigations and disciplinary actions shall be the financial responsibility of the licensees who are regulated by such council.
§ 63-17-216. Sale of hearing instruments.
  1. (a) Any person who engages in the practice of dispensing and fitting hearing instruments shall deliver to each person supplied with a hearing instrument, by the dispensing person's or at the dispensing person's order or direction, a bill of sale that contains each of the following:
    1. (1) The signature of the licensed hearing instrument specialist, the address of the specialist's regular place of business and the specialist's license number and license expiration date;
    2. (2) The make and model of the hearing instrument supplied, and the amount charged for the hearing instrument and whether the hearing instrument is new, used or rebuilt;
    3. (3) A clear statement of the terms of sale, including the provisions required by § 63-17-217; and
    4. (4) The name and address of the council and a statement that the council will receive complaints on any matter relating to the fitting and dispensing of hearing instruments.
  2. (b) Any sale of a hearing instrument is subject to the same conditions and provisions as are prescribed by the United States food and drug administration and the federal trade commission.
  3. (c) Any hearing aid that is sold, fitted or dispensed to a consumer in this state shall be clearly and permanently marked with:
    1. (1) The name of the manufacturer or distributor or the model name or number;
    2. (2) The serial number; and
    3. (3) The year of manufacture.
§ 63-17-217. Return of purchased hearing instruments.
  1. (a) Within thirty (30) days of the date of delivery, any purchaser of a hearing instrument from a licensee is entitled to return the hearing instrument for any reason; provided, that such instrument is returned in satisfactory condition and such purchaser pays only reasonable charges for the hearing instrument and related services. Such return privileges apply only to a first time purchaser of a hearing instrument.
  2. (b) Charges to be imposed upon return of a hearing instrument as provided in subsection (a) shall be clearly stated in the bill of sale.
  3. (c) This section shall not be construed to supersede any duly promulgated regulation issued by the federal trade commission.
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§ 63-17-218. Liability of sponsors.
  1. Any person sponsoring an apprentice licensee and/or apprentice licensee applicant under this part shall be held responsible for the acts or omissions of the sponsor's apprentice licensee and/or apprentice licensee applicant within the course and scope of the licensee's or applicant's employment, during the apprenticeship, as well as the sponsor's employees.
§ 63-17-219. Causes of denial, revocation or suspension — Costs of prosecution — Witnesses — Subpoenas.
  1. (a) Subject to the due process requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any person registered under this part may have such license denied, revoked or suspended for a fixed period to be determined by the council for any of the following causes:
    1. (1) Conviction of an offense involving moral turpitude. The record of such conviction or certified copy thereof from the clerk of the court where such conviction occurred or by the judge of such court is sufficient evidence to warrant revocation or suspension;
    2. (2) Securing a license under this part through fraud or deceit;
    3. (3) Unethical conduct, gross and/or repeated acts of ignorance or inefficiency in the conduct of such person's practice;
    4. (4) Knowingly practicing while suffering with a contagious or infectious disease;
    5. (5) Use of a false name or alias in the practice of the profession; and
    6. (6) Violating any of this part.
  2. (b)
    1. (1) The council shall promulgate rules governing the assessment of costs against a licensee or other person found by the council to have violated any provision of this chapter. The costs assessed by the council may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The council shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
    2. (2)
      1. (A) Any elected officer of the council or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the council, by a vote of two-thirds (⅔) of the members to which the council is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
      2. (B) Service of a subpoena issued by the council shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
      3. (C)
        1. (i) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the council for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the council votes upon the request to quash or modify the subpoena. A majority vote of the members to which the council is entitled shall be required to quash or modify a subpoena.
        2. (ii) A motion to appeal from a decision by the council regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
      4. (D) If any witness fails or refuses to obey a subpoena issued by it, the council is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides, and the court shall have power to attach the body of the witness and compel the witness to appear before the council and give testimony or produce books, records or papers as ordered; and any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
      5. (E) Each witness who appears before the council by order of the council shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the council in the same manner as all other expenses of the council are paid.
  3. (c)
    1. (1) The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
    2. (2)
      1. (A) Any elected officer of the board or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
      2. (B) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
      3. (C)
        1. (i) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
        2. (ii) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
      4. (D) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered, and any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
      5. (E) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
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§ 63-17-220. Hearing before council required.
  1. (a) Except as otherwise provided by § 63-17-214, no license issued pursuant to this part may be suspended, revoked, denied or renewal denied without a hearing before the council or its duly authorized trial examiner, if requested by the certificate holder or applicant, on due notice.
  2. (b) Any action of the council taken pursuant to this part shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-17-221. Penalties council may enforce by seeking court injunction.
  1. (a) A violation of this part is a Class B misdemeanor.
  2. (b) The council, with the approval of the board, may seek to enforce any provision of this part by petitioning a court of appropriate jurisdiction for an injunction to enjoin continuing violations of this part or by any other appropriate proceeding. No such proceeding is barred by any proceeding had or pending pursuant to § 63-17-214 or by the imposition of any fine or term of imprisonment pursuant thereto.
§ 63-17-222. Licensed hearing aid dispenser eligible for hearing instrument specialist license.
  1. (a) Upon July 1, 1995, any person who is a trainee, apprentice or who has entered into a training program to become a licensed hearing aid dispenser shall be eligible to receive a license as a hearing instrument specialist; provided, that such person complies with all of the requirements of chapter 15 of this title [repealed], as it existed upon July 1, 1995.
  2. (b) Upon July 1, 1995, any person who is a licensed hearing aid dispenser shall be eligible to receive a license as a hearing instrument specialist. Any person who is a licensed hearing aid dispenser upon July 1, 1995, who wishes to obtain a license as a hearing instrument specialist shall submit a request to the council to receive the appropriate license as a hearing instrument specialist. No additional fee shall be imposed upon persons for the issuance of a license as a hearing instrument specialist pursuant to this subsection (b).
§ 63-17-223. Cerumen management.
  1. A licensed hearing instrument specialist shall comply with the following cerumen management principles:
    1. (1) The indications for cerumen management for a licensed hearing instrument specialist include:
      1. (A) Enabling audiometric testing;
      2. (B) Making ear impressions;
      3. (C) Fitting hearing protection or prosthetic devices; and
      4. (D) Monitoring continuous use of hearing aids;
    2. (2) The licensed hearing instrument specialist shall refer a patient who exhibits any of the following contraindications to cerumen removal for medical consultation or medical intervention to an otolaryngologist or a licensed physician:
      1. (A) An age less than twelve (12) years of age;
      2. (B) A perforated tympanic membrane;
      3. (C) History of pain, active drainage, or bleeding from the ear;
      4. (D) Evidence of congenital or traumatic deformity of the ear;
      5. (E) Ear surgery within the last six (6) months;
      6. (F) Tympanostomy tubes, such that irrigation should not be used;
      7. (G) A bleeding disorder;
      8. (H) Actual or suspected foreign body in the ear;
      9. (I) Stenosis or bony exostosis of the ear canal;
      10. (J) Cerumen impaction that totally occludes the ear canal;
      11. (K) Cerumen located medial to the cartilaginous external auditory canal; or
      12. (L) A tympanic membrane that the licensee is unable to see;
    3. (3) In performing cerumen removal, a licensed hearing instrument specialist shall only remove cerumen lateral to the external auditory canal using the following instruments:
      1. (A) Cerumen loop;
      2. (B) Cerumenolytic liquid;
      3. (C) Irrigation, for patients with intact tympanic membranes and a closed mastoid cavity, no tympanostomy tubes, no recent ear surgery, and no recent dizziness; or
      4. (D) Suction used lateral to the bony canal, only for patients with no recent surgery, intact tympanic membranes and no clear otorrhea;
    4. (4) If the patient, while undergoing cerumen management that did not present contraindications, complains of significant pain, exhibits uncontrolled bleeding or a laceration of the external auditory canal, or notices the acute onset of dizziness or vertigo or sudden hearing loss, then the licensed hearing instrument specialist shall immediately stop the procedure and refer the patient to an otolaryngologist or a licensed physician;
    5. (5) The licensed hearing instrument specialist shall maintain the following proper infection control practices:
      1. (A) Universal health precautions;
      2. (B) Decontamination;
      3. (C) Cleaning, disinfection, and sterilization of multiple use equipment; and
      4. (D) Universal precautions for prevention of the transmission of human immunodeficiency virus (HIV), hepatitis B virus, and other bloodborne pathogens, as defined by occupational safety and health standards promulgated pursuant to 29 CFR 1910;
    6. (6) The licensed hearing instrument specialist who performs cerumen management shall maintain a case history for every patient and informed consent signed by the patient as part of the patient's records;
    7. (7) The licensed hearing instrument specialist shall carry appropriate professional liability insurance before performing cerumen removal; and
    8. (8) The licensed hearing instrument specialist is prohibited from requiring patients to sign any form that eliminates liability if the patient is harmed.
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§ 63-17-224. Cerumen management course.
  1. (a) A licensed hearing instrument specialist who engages in cerumen management under § 63-17-223, must have completed a cerumen management course approved by the International Hearing Society, the American Academy of Otolaryngology-Head and Neck Surgery, or another organization approved by the council for licensing hearing instrument specialists. The course must:
    1. (1) Be overseen by a physician, preferably an otolaryngologist;
    2. (2) Consist of at least six (6) hours of a participant practicing removing cerumen from an ear canal model using a variety of safe techniques; and
    3. (3) Result in a certificate of completion and attestation of competence signed by the overseeing physician.
  2. (b) The council for licensing hearing instrument specialists is authorized to promulgate rules to effectuate the requirements of the course outlined in this section only after consultation with the board of medical examiners established at § 63-6-101. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
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Part 3 Audiology and Speech-Language Pathology Interstate Compact
§ 63-17-301. Short title.
  1. This part is known and may be cited as the “Audiology and Speech-Language Pathology Interstate Compact.”
§ 63-17-302. Text of compact.
  1. The Audiology and Speech-Language Pathology Interstate Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:
    1. Audiology and Speech-Language Pathology Interstate Compact
      1. The purpose of this Compact is to facilitate interstate practice of audiology and speech-language pathology with the goal of improving public access to audiology and speech-language pathology services. The practice of audiology and speech-language pathology occurs in the state where the patient/client/student is located at the time of the patient/client/student encounter. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure.
      2. This Compact is designed to achieve the following objectives:
        1. 1. Increase public access to audiology and speech-language pathology services by providing for the mutual recognition of other member state licenses;
        2. 2. Enhance the states' ability to protect the public's health and safety;
        3. 3. Encourage the cooperation of member states in regulating multistate audiology and speech-language pathology practice;
        4. 4. Support spouses of relocating active duty military personnel;
        5. 5. Enhance the exchange of licensure, investigative and disciplinary information between member states;
        6. 6. 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
        7. 7. Allow for the use of telehealth technology to facilitate increased access to audiology and speech-language pathology services.
      3. As used in this Compact, and except as otherwise provided, the following definitions shall apply:
        1. 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 U.S.C. Chapter 1209 and 1211.
        2. 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 audiologist or speech-language pathologist, including actions against an individua's license or privilege to practice such as revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee's practice.
        3. C. “Alternative program” means a non-disciplinary monitoring process approved by an audiology or speech-language pathology licensing board to address impaired practitioners.
        4. D. “Audiologist” means an individual who is licensed by a state to practice audiology.
        5. E. “Audiology” means the care and services provided by a licensed audiologist as set forth in the member state's statutes and rules.
        6. F. “Audiology and Speech-Language Pathology Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.
        7. G. “Audiology and speech-language pathology licensing board,” “audiology licensing board,” “speech-language pathology licensing board,” or “licensing board” means the agency of a state that is responsible for the licensing and regulation of audiologists and/or speech-language pathologists.
        8. H. “Compact privilege” means the authorization granted by a remote state to allow a licensee from another member state to practice as an audiologist or speech-language pathologist in the remote state under its laws and rules. The practice of audiology or speech-language pathology occurs in the member state where the patient/client/student is located at the time of the patient/client/student encounter.
        9. I. “Current significant investigative information” means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the audiologist or speech-language pathologist 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.
        10. J. “Data system” means a repository of information about licensees, including, but not limited to, continuing education, examination, licensure, investigative, Compact privilege and adverse action.
        11. K. “Encumbered license” means a license in which an adverse action restricts the practice of audiology or speech-language pathology by the licensee and said adverse action has been reported to the National Practitioners Data Bank (NPDB).
        12. L. “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.
        13. M. “Home state” means the member state that is the licensee's primary state of residence.
        14. N. “Impaired practitioner” means individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions.
        15. O. “Licensee” means an individual who currently holds an authorization from the state licensing board to practice as an audiologist or speech-language pathologist.
        16. P. “Member state” means a state that has enacted the Compact.
        17. Q. “Privilege to practice” means a legal authorization permitting the practice of audiology or speech-language pathology in a remote state.
        18. R. “Remote state” means a member state other than the home state where a licensee is exercising or seeking to exercise the Compact privilege.
        19. S. “Rule” means a regulation, principle or directive promulgated by the Commission that has the force of law.
        20. T. “Single-state license” means an audiology or speech-language pathology license issued by a member state that authorizes practice only within the issuing state and does not include a privilege to practice in any other member state.
        21. U. “Speech-language pathologist” means an individual who is licensed by a state to practice speech-language pathology.
        22. V. “Speech-language pathology” means the care and services provided by a licensed speech-language pathologist as set forth in the member state's statutes and rules.
        23. W. “State” means any state, commonwealth, district or territory of the United States of America that regulates the practice of audiology and speech-language pathology.
        24. X. “State practice laws” means a member state's laws, rules and regulations that govern the practice of audiology or speech-language pathology, define the scope of audiology or speech-language pathology practice, and create the methods and grounds for imposing discipline.
        25. Y. “Telehealth” means the application of telecommunication, audio-visual or other technologies that meets the applicable standard of care to deliver audiology or speech-language pathology services at a distance for assessment, intervention and/or consultation.
      4. A. A license issued to an audiologist or speech-language pathologist by a home state to a resident in that state shall be recognized by each member state as authorizing an audiologist or speech-language pathologist to practice audiology or speech-language pathology, under a privilege to practice, in each member state where the licensee obtains such a privilege.
      5. B. A state must implement or utilize procedures for considering the criminal history records of applicants for initial privilege to practice. 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
        1. 1. A member state must 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.
        2. 2. Communication between a member state, the Commission, and 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 Public Law 92-544.
      6. C. Upon application for a privilege to practice, the licensing board in the issuing remote state shall ascertain, through the data system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any encumbrances on any license or privilege to practice held by the applicant, whether any adverse action has been taken against any license or privilege to practice held by the applicant.
      7. D. Each member state shall require an applicant to obtain or retain a license in the home state and meet the home state's qualifications for licensure or renewal of licensure, as well as all other applicable state laws.
      8. E. For an audiologist:
        1. 1. Must meet one of the following educational requirements:
          1. a. On or before Dec. 31, 2007, has graduated with a master's degree or doctorate in audiology, or equivalent degree regardless of degree name, from a program that is accredited by an accrediting agency recognized by the Council for Higher Education Accreditation, or its successor, or by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by the board; or
          2. b. On or after, Jan. 1, 2008, has graduated with a Doctoral degree in audiology, or equivalent degree, regardless of degree name, from a program that is accredited by an accrediting agency recognized by the Council for Higher Education Accreditation, or its successor, or by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by the board; or
          3. c. Has graduated from an audiology program that is housed in an institution of higher education outside of the United States (a) for which the program and institution have been approved by the authorized accrediting body in the applicable country and (b) the degree program has been verified by an independent credentials review agency to be comparable to a state licensing board-approved program.
        2. 2. Has completed a supervised clinical practicum experience from an accredited educational institution or its cooperating programs as required by the Commission;
        3. 3. Has successfully passed a national examination approved by the Commission;
        4. 4. Holds an active, unencumbered license;
        5. 5. Has not been convicted or found guilty, and has not entered into an agreed disposition, of a felony related to the practice of audiology, under applicable state or federal criminal law; and
        6. 6. Has a valid United States Social Security or National Practitioner Identification number.
      9. F. For a speech-language pathologist:
        1. 1. Must meet one of the following educational requirements:
          1. a. Has graduated with a master's degree from a speech-language pathology program that is accredited by an organization recognized by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by the board; or
          2. b. Has graduated from a speech-language pathology program that is housed in an institution of higher education outside of the United States (a) for which the program and institution have been approved by the authorized accrediting body in the applicable country and (b) the degree program has been verified by an independent credentials review agency to be comparable to a state licensing board-approved program.
        2. 2. Has completed a supervised clinical practicum experience from an educational institution or its cooperating programs as required by the Commission;
        3. 3. Has completed a supervised postgraduate professional experience as required by the Commission
        4. 4. Has successfully passed a national examination approved by the Commission;
        5. 5. Holds an active, unencumbered license;
        6. 6. Has not been convicted or found guilty, and has not entered into an agreed disposition, of a felony related to the practice of speech-language pathology, under applicable state or federal criminal law; and
        7. 7. Has a valid United States Social Security or National Practitioner Identification number.
      10. G. The privilege to practice is derived from the home state license.
      11. H. An audiologist or speech-language pathologist practicing in a member state must comply with the state practice laws of the state in which the client is located at the time service is provided. The practice of audiology and speech-language pathology shall include all audiology and speech-language pathology practice as defined by the state practice laws of the member state in which the client is located. The practice of audiology and speech-language pathology in a member state under a privilege to practice shall subject an audiologist or speech-language pathologist to the jurisdiction of the licensing board, the courts, and the laws of the member state in which the client is located at the time service is provided.
      12. I. 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 the privilege to practice audiology or speech-language pathology in any other member state. Nothing in this Compact shall affect the requirements established by a member state for the issuance of a single-state license.
      13. J. Member states may charge a fee for granting a compact privilege.
      14. K. Member states must comply with the bylaws and rules and regulations of the Commission.
      15. A. To exercise the compact privilege under the terms and provisions of the Compact, the audiologist or speech-language pathologist shall:
        1. 1. Hold an active license in the home state;
        2. 2. Have no encumbrance on any state license;
        3. 3. Be eligible for a compact privilege in any member state in accordance with Section 3;
        4. 4. Have not had any adverse action against any license or compact privilege within the previous 2 years from date of application;
        5. 5. Notify the Commission that the licensee is seeking the compact privilege within a remote state(s);
        6. 6. Pay any applicable fees, including any state fee, for the compact privilege;
        7. 7. Report to the Commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken.
      16. B. For the purposes of the compact privilege, an audiologist or speech-language pathologist shall only hold one home state license at a time.
      17. C. Except as provided in Section 6, if an audiologist or speech-language pathologist changes primary state of residence by moving between two-member states, the audiologist or speech-language pathologist must apply for licensure in the new home state, and the license issued by the prior home state shall be deactivated in accordance with applicable rules adopted by the Commission.
      18. D. The audiologist or speech-language pathologist may apply for licensure in advance of a change in primary state of residence.
      19. E. A license shall not be issued by the new home state until the audiologist or speech-language pathologist provides satisfactory evidence of a change in primary state of residence to the new home state and satisfies all applicable requirements to obtain a license from the new home state.
      20. F. If an audiologist or speech-language pathologist changes primary state of residence by moving from a member state to a non-member state, the license issued by the prior home state shall convert to a single-state license, valid only in the former home state and the privilege to practice in any member state is deactivated in accordance with the rules promulgated by the Commission.
      21. G. The compact privilege is valid until the expiration date of the home state license. The licensee must comply with the requirements of Section 4A to maintain the compact privilege in the remote state.
      22. H. A licensee providing audiology or speech-language pathology services in a remote state under the compact privilege shall function within the laws and regulations of the remote state.
      23. I. A licensee providing audiology or speech-language pathology services 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.
      24. J. If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:
        1. 1. The home state license is no longer encumbered; and
        2. 2. Two years have elapsed from the date of the adverse action.
      25. K. Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4A to obtain a compact privilege in any remote state.
      26. L. Once the requirements of Section 4J have been met, the licensee must meet the requirements in Section 4A to obtain a compact privilege in a remote state.
      27. A. Member states shall recognize the right of an audiologist or speech-language pathologist, licensed by a home state in accordance with Section 3 and under rules promulgated by the Commission, to practice audiology or speech-language pathology in any member state via telehealth under a privilege to practice as provided in the Compact and rules promulgated by the Commission.
      28. B. A licensee providing audiology or speech-language pathology services in a remote state under the compact privilege shall function within the laws and regulations of the state where the patient/client is located.
      29. Active duty military personnel, 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. Subsequent to designating a home state, the individual shall only change their home state through application for licensure in the new state.
      30. 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. 1. Take adverse action against an audiologist's or speech-language pathologist's privilege to practice within that member state.
        2. 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.
        3. 3. Only the home state shall have the power to take adverse action against an audiologist's or speech-language pathologist's license issued by the home state.
      31. B. 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.
      32. C. The home state shall complete any pending investigations of an audiologist or speech-language pathologist who changes primary state of residence during the course of the investigations. The home state shall also have the authority to take appropriate action(s) 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.
      33. D. If otherwise permitted by state law, the member state may recover from the affected audiologist or speech-language pathologist the costs of investigations and disposition of cases resulting from any adverse action taken against that audiologist or speech-language pathologist.
      34. E. The member state may take adverse action based on the factual findings of the remote state, provided that the member state follows the member state's own procedures for taking the adverse action.
      35. F. Joint Investigations
        1. 1. In addition to the authority granted to a member state by its respective audiology or speech-language pathology practice act or other applicable state law, any member state may participate with other member states in joint investigations of licensees.
        2. 2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
      36. G. If adverse action is taken by the home state against an audiologist's or speech language pathologist's license, the audiologist's or speech-language pathologist's privilege to practice 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 audiologist's or speech language pathologist's license shall include a statement that the audiologist's or speech-language pathologist's privilege to practice is deactivated in all member states during the pendency of the order.
      37. H. If a member state takes adverse action against a licensee, it shall promptly notify the administrator of the data system. The administrator of the data system shall promptly notify the home state and any remote states in which the licensee has a privilege to practice, of any adverse actions by the home state or remote states.
      38. I. 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.
      39. A. The Compact member states hereby create and establish a joint public agency known as the Audiology and Speech-Language Pathology Compact Commission:
        1. 1. The Commission is an instrumentality of the Compact states.
        2. 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. 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
      40. B. Membership, Voting and Meetings
        1. 1. Each member state shall have two (2) delegates selected by that member state's licensing board. The delegates shall be current members of the licensing board. One shall be an audiologist and one shall be a speech-language pathologist.
        2. 2. An additional five (5) delegates, who are either a public member or board administrator from a state licensing board, shall be chosen by the Executive Committee from a pool of nominees provided by the Commission at Large.
        3. 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. 4. The member state board shall fill any vacancy occurring on the Commission, within 90 days.
        5. 5. Each delegate shall be entitled to one (1) 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. 6. A delegate shall vote in person or by other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telephone or other means of communication.
        7. 7. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
      41. C. The Commission shall have the following powers and duties:
        1. 1. Establish the fiscal year of the Commission;
        2. 2. Establish bylaws;
        3. 3. Establish a Code of Ethics;
        4. 4. Maintain its financial records in accordance with the bylaws;
        5. 5. Meet and take actions as are consistent with the provisions of this Compact and the bylaws;
        6. 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 to the extent and in the manner provided for in the Compact;
        7. 7. Bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state audiology or speech-language pathology licensing board to sue or be sued under applicable law shall not be affected;
        8. 8. Purchase and maintain insurance and bonds;
        9. 9. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;
        10. 10. Hire employees, elect or appoint officers, fix compensation, define duties, grant 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;
        11. 11. 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;
        12. 12. 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;
        13. 13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
        14. 14. Establish a budget and make expenditures;
        15. 15. Borrow money;
        16. 16. Appoint committees, including standing committees composed of members, and other interested persons as may be designated in this Compact and the bylaws;
        17. 17. Provide and receive information from, and cooperate with, law enforcement agencies;
        18. 18. Establish and elect an Executive Committee; and
        19. 19. Perform other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of audiology and speech-language pathology licensure and practice.
      42. D. The Commission shall have no authority to change or modify the laws of the member states which define the practice of audiology and speech-language pathology in the respective states.
      43. E. The Executive Committee
      44. The Executive Committee shall have the power to act on behalf of the Commission, within the powers of the Commission, according to the terms of this Compact:
        1. 1. The Executive Committee shall be composed of ten (10) members:
          1. a. Seven (7) voting members who are elected by the Commission from the current membership of the Commission;
          2. b. Two (2) ex-officio members, consisting of one (1) nonvoting member from a recognized national audiology professional association and one (1) nonvoting member from a recognized national speech-language pathology association; and
          3. c. One (1) ex-officio, nonvoting member from the recognized membership organization of the audiology and speech-language pathology licensing boards.
      45. F. The ex-officio members shall be selected by their respective organizations.
        1. 1. The Commission may remove any member of the Executive Committee as provided in bylaws.
        2. 2. The Executive Committee shall meet at least annually.
        3. 3. The Executive Committee shall have the following duties and responsibilities:
          1. 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;
          2. b. Ensure Compact administration services are appropriately provided, contractual or otherwise;
          3. c. Prepare and recommend the budget;
          4. d. Maintain financial records on behalf of the Commission;
          5. e. Monitor Compact compliance of member states and provide compliance reports to the Commission;
          6. f. Establish additional committees as necessary; and
          7. g. Other duties as provided in rules or bylaws.
        4. 4. Meetings of the Commission or the Executive Committee
        5. 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 Section 10.
        6. 5. 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:
          1. a. Non-compliance of a member state with its obligations under the Compact;
          2. 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;
          3. c. Current, threatened, or reasonably anticipated litigation;
          4. d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
          5. e. Accusing any person of a crime or formally censuring any person;
          6. f. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
          7. g. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
          8. h. Disclosure of investigative records compiled for law enforcement purposes;
          9. 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
          10. j. Matters specifically exempted from disclosure by federal or member state statute.
        7. 6. 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.
        8. 7. 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 minutes. All minutes and documents of meetings other than closed meetings shall be made available to members of the public upon request at the requesting person's expense. 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.
        9. 8. Financing of the Commission
          1. a. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
          2. b. The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
          3. c. 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 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.
        10. 9. 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.
        11. 10. 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.
      46. G. Qualified Immunity, Defense, and Indemnification
        1. 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 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. 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. 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 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.
      47. 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.
      48. 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:
        1. 1. Identifying information;
        2. 2. Licensure data;
        3. 3. Adverse actions against a license or compact privilege;
        4. 4. Non-confidential information related to alternative program participation;
        5. 5. Any denial of application for licensure, and the reason(s) for denial; and
        6. 6. Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.
      49. C. Investigative information pertaining to a licensee in any member state shall only be available to other member states.
      50. 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 shall be available to any other member state.
      51. 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.
      52. 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.
      53. A. The Commission shall exercise its rulemaking 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.
      54. 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, the rule shall have no further force and effect in any member state.
      55. C. Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
      56. D. 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 shall be considered and voted upon, the Commission shall file a Notice of Proposed Rulemaking:
        1. 1. On the website of the Commission or other publicly accessible platform; and
        2. 2. On the website of each member state audiology or speech-language pathology licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules.
      57. E. The Notice of Proposed Rulemaking shall include:
        1. 1. The proposed time, date, and location of the meeting in which the rule shall be considered and voted upon;
        2. 2. The text of the proposed rule or amendment and the reason for the proposed rule;
        3. 3. A request for comments on the proposed rule from any interested person; and
        4. 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.
      58. F. Prior to the 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.
      59. G. The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:
        1. 1. At least twenty-five (25) persons;
        2. 2. A state or federal governmental subdivision or agency; or
        3. 3. An association having at least twenty-five (25) members.
      60. H. 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. 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 five (5) business days before the scheduled date of the hearing.
        2. 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. 3. All hearings shall be recorded. A copy of the recording shall be made available to any person upon request and at the requesting person's expense.
        4. 4. 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.
      61. 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.
      62. 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.
      63. 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 rulemaking record and the full text of the rule.
      64. 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 rulemaking 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 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 in order to:
        1. 1. Meet an imminent threat to public health, safety, or welfare;
        2. 2. Prevent a loss of Commission or member state funds; or
        3. 3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule.
      65. 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 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 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 shall take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.
      66. A. Dispute Resolution
        1. 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. 2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
      67. B. Enforcement
        1. 1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
        2. 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. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of litigation, including reasonable attorney's fees.
        3. 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.
      68. 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 rulemaking powers necessary to the implementation and administration of the Compact.
      69. 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.
      70. C. Any member state may withdraw from this Compact by enacting a statute repealing the same.
        1. 1. A member state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
        2. 2. Withdrawal shall not affect the continuing requirement of the withdrawing state's audiology or speech-language pathology licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.
      71. D. Nothing contained in this Compact shall be construed to invalidate or prevent any audiology or speech-language pathology licensure agreement or other cooperative arrangement between a member state and a non-member state that does not conflict with the provisions of this Compact.
      72. 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.
      73. 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.
      74. A. Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.
      75. B. All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.
      76. C. All lawful actions of the Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states.
      77. D. All agreements between the Commission and the member states are binding in accordance with their terms.
      78. E. 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.
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Chapter 18 Massage Licensure Act of 1995
§ 63-18-101. Short title.
  1. This chapter shall be known and may be cited as the “Massage Licensure Act of 1995.”
§ 63-18-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the massage licensure board;
    2. (2) “Compensation” means the payment, loan, advance, donation, contribution, deposit or gift of money or anything of value;
    3. (3) “Massage/bodywork/somatic” means the manipulation of the soft tissues of the body with the intention of positively affecting the health and well being of the client;
    4. (4) “Massage establishment” means a place of business held out to the public wherein massage is practiced; and
    5. (5) “Massage therapist” means a person who practices massage for compensation and is licensed by the board.
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§ 63-18-103. Tennessee massage licensure board.
  1. (a) There is hereby created the Tennessee massage licensure board.
  2. (b) The board shall be composed of seven (7) members who are residents of the state. Except for the two (2) citizen members, each member shall have at least five (5) years current experience in the practice of massage. Persons with a conflict of interest are ineligible for membership on the board.
  3. (c) All members shall be appointed by the governor. Initial appointments to the board shall be as follows:
    1. (1) Three (3) members shall serve terms of one (1) year; and
    2. (2) Four (4) members shall serve terms of two (2) years.
  4. (d) Except for two (2) members who shall be citizen members with no direct or indirect financial interest in massage, all board members shall be duly licensed or eligible to be licensed by the board.
  5. (e)
    1. (1) Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the board:
      1. (A) Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the board shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the board, prior to serving as a member of the board. This subdivision (e)(1)(A) shall apply to all persons appointed or otherwise named to the board after July 1, 2010;
      2. (B) No person who is a member of the board shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the board during such person's period of service as a member of the board. This subdivision (e)(1)(B) shall apply to all persons appointed or otherwise named to the board after July 1, 2010, and to all persons serving on the board on such date who are not registered as lobbyists; and
      3. (C) No person who serves as a member of the board shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the board for one (1) year following the date such person's service on the board ends. This subdivision (e)(1)(C) shall apply to persons serving on the board as of July 1, 2010, and to persons appointed to the board subsequent to such date.
    2. (2) A person who violates this subsection (e) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. (3) The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (e). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  6. (f) Subsequent appointees to the board shall have the professional qualifications required by their predecessors and shall be appointed to five-year terms. Each member shall serve until such member's successor is appointed and qualified, unless such board member is no longer competently performing the duties of office. Any vacancy on the board shall be filled by the governor for the balance of the unexpired term. The governor may remove members of the board from office for cause.
  7. (g) For each day engaged in the business of the board, a member shall receive as compensation one hundred dollars ($100) and shall also receive actual expenses to be paid in accordance with the comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  8. (h) The members of the board shall elect annually a chair and a secretary/treasurer.
  9. (i) The board shall meet as frequently as shall be reasonably necessary to implement this chapter. Four (4) or more members of the board shall constitute a quorum for the purpose of transacting board business.
  10. (j) For administrative purposes, the board shall be attached to the division of health related boards as defined in § 68-1-101, referred to as “division” in this chapter, which shall supply support.
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§ 63-18-104. License required.
  1. (a) Persons or massage establishments engaged in massage for compensation shall be licensed by the massage licensure board.
  2. (b) Any person or establishment who advertises or engages in massage for compensation without a current valid license from the massage licensure board commits a Class B misdemeanor. It is unlawful to use the word “massage” or any other term that implies massage technique or method when advertising a service by a person who is not licensed under this chapter or another chapter of state law.
  3. (c) The practice of reflexology shall not be subject to the licensure requirements of this chapter. For the purposes of this chapter, “reflexology” means the application of specific pressures to reflex points in the hands and feet only.
§ 63-18-105. License requirements — Issuance.
  1. (a) The board shall establish procedures and criteria for the issuance of licenses to persons and establishments engaged in massage for compensation.
  2. (b) No person or establishment shall be issued a license until the applicant and each person engaged in massage at such massage establishment has provided evidence satisfactory to the board that:
    1. (1) The applicant is eighteen (18) years of age or older;
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    2. (2) The applicant has not been convicted of the offense of prostitution or sexual misconduct;
    3. (3) The applicant has:
      1. (A) Successfully completed the curriculum or curricula of one (1) or more post-secondary academic institutions for massage, bodywork or somatic therapy as defined by board regulations, totaling five hundred (500) hours or more, such institutions being approved by the board pursuant to § 63-18-115, and either authorized by the Tennessee higher education commission, or its equivalent in other states, or approved, or under the governance of, the Tennessee board of regents;
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      2. (B) Received a passing score on a competency examination approved by the board;
      3. (C)
        1. (i) Any person who has completed a program of study as required by subdivision (b)(3)(A) in a post-secondary academic institution located in Tennessee and receives a diploma or certificate prior to September 1, 2005, shall be issued a license without completing the examination requirement of this section;
        2. (ii) Any person who meets the requirements of subdivision (b)(3)(C)(i) shall have until January 1, 2006, to apply for such a license;
        3. (iii) Persons licensed under this subdivision (b)(3)(C) shall not be considered to have national certification and shall not hold themselves out to be nationally certified; and
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    4. (4) All required fees have been paid.
  3. (c) Notwithstanding the requirements of this part, no establishment license is required for the office of a physician licensed under chapter 4, 6, or 9 of this title if a massage for compensation is provided within that office by a licensed massage therapist.
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§ 63-18-106. Investigation — Inspection — Revocation of license.
  1. In order to effectuate this chapter, the board or its authorized representative is empowered to conduct an investigation of persons engaged in massage or massage establishments and to inspect the license of practitioners and establishments for compliance. The refusal of a practitioner or establishment to permit inspections shall be grounds for revocation, suspension or refusal to issue a license pursuant to this chapter.
§ 63-18-107. Enjoining violation.
  1. The board has the power and authority to enter into any court of this state having proper jurisdiction to seek an injunction against any person or massage establishment not in compliance with this chapter and is further empowered to enter into any such court to enforce this chapter in order to ensure compliance with such provisions.
§ 63-18-108. Grounds for denial, revocation, or suspension of license or other discipline.
  1. (a) The board is authorized to deny, restrict or condition any application for licensure or revoke, suspend or otherwise discipline the license of a massage therapist or an establishment, if the applicant, licensee or holder of an establishment license upon proof:
    1. (1) Is guilty of fraud in the practice of massage or fraud or deceit in the licensee's admission to the practice of massage;
    2. (2) Has been convicted in a court of competent jurisdiction of an offense that constitutes a felony or a misdemeanor under the laws of this state;
    3. (3) Is engaged in the practice of massage under a false or assumed name or is impersonating another practitioner of a like or different name;
    4. (4) Abuses or is addicted to the habitual use of intoxicating liquors, drugs or stimulants to such an extent as to incapacitate such person's performance of professional duties;
    5. (5) Is guilty of fraudulent, false, misleading or deceptive advertising or for prescribing medicines or drugs or practicing any licensed profession without legal authority. The licensee may not diagnose or imply or advertise, in any way, services for a condition that would require a diagnosis;
    6. (6) Is guilty of willful negligence in the practice of massage or has been guilty of employing, allowing or permitting any unlicensed person to perform massage in such licensee's establishment;
    7. (7) Has violated this chapter or any substantive rule promulgated under the authority of this chapter;
    8. (8) Has been convicted of sexual misconduct, assignation or the solicitation or attempt thereof;
    9. (9) Has violated or attempted to violate, directly or indirectly, or has assisted in or abetted the violation of, or conspired to violate, any provision of this chapter or any lawful order of the board issued pursuant to this chapter;
    10. (10) Has practiced as a licensed massage therapist in an unlicensed massage establishment;
    11. (11) Is mentally incompetent; or
    12. (12) Is guilty of unethical or unprofessional conduct.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-18-109. Accusation — Hearing.
  1. (a) Charges relative to a violation of this chapter may be presented by any person, or the board may, on its own motion, direct the chair of the board to present charges. An accusation may be filed with the chair of the board, charging any licensed massage therapist with any of the offenses enumerated in § 63-18-108.
  2. (b) The board shall provide an applicant denied issuance of a license or a practitioner whose license is suspended, revoked or not renewed a hearing on such suspension, revocation or nonrenewal, which hearing shall be conducted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Upon a decision of the board to refuse to issue, revoke or not to renew a license, the practitioner or establishment shall be prohibited from engaging in massage until the board's decision is overturned.
§ 63-18-110. Exemptions.
  1. (a) Any person granted an exemption under this chapter is effective only to the extent that the bona fide practice of the profession or business that is licensed, certified or registered under the laws of this state overlaps into the field comprehended by this chapter, and exemptions under this chapter are only for those activities that are performed in the course of the bona fide practice of the business or profession of the person exempted.
  2. (b) Persons exempt under subsection (a) include, but are not limited to any branch of medicine, nursing, osteopathy, chiropractic, podiatry, and also barbers, cosmetologists, athletic trainers, physical and occupational therapists and any student of an institution described in § 63-18-105(b)(3)(A) or public school of this state; provided, that the student does not hold out as a licensed massage therapist and does not receive compensation for massage.
  3. (c) Nothing in this chapter shall apply to massage therapists licensed in other states or countries or meeting standards set forward in § 63-18-105 when providing educational programs or services for a period of time not to exceed thirty (30) days within a calendar year.
§ 63-18-111. Authorization to promulgate rules, regulations and fees.
  1. (a) The board is hereby authorized to promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules and regulations as are necessary to implement this chapter.
  2. (b) The board may adopt reasonable rules and regulations regarding personal cleanliness of massage therapists and the sanitary condition of towels, linens, creams, lotions, oils and other materials, facilities and equipment used in the practice of massage.
  3. (c) All fees for licensure, renewal of licensure and all other related matters shall be set by the board.
  4. (d) All education and other requirements for licensure in this chapter shall be set by the board.
  5. (e) The board may adopt rules and regulations for ethics.
  6. (f) All continuing education and other requirements for renewal of licensure not enumerated in this chapter shall be set by the board.
  7. (g) The board is authorized to set an application fee for all continuing education courses submitted to the board for approval.
§ 63-18-112. Reciprocity — Temporary license.
  1. (a) The board may, at its discretion, grant licensure to any person who is licensed or registered in another state or country with standards as stringent as those required by this chapter.
  2. (b)
    1. (1) The board may, in its discretion, grant a temporary license to a person who has been licensed, registered, or certified, in good standing, in another state, territory of the United States, or the District of Columbia, that meets all other requirements for reciprocity under this chapter and rules promulgated pursuant to this chapter, but which does not require successful passage of a competency examination approved by the board.
    2. (2) A person granted a temporary license pursuant to this section may work if the person is at all times working under the supervision of a person licensed pursuant to § 63-18-105.
    3. (3) To obtain licensure through reciprocity, a person granted a temporary license pursuant to this section must:
      1. (A) Successfully complete a competency exam approved by the board;
      2. (B) Submit verification of successful completion of the competency exam to the board within six (6) months of the date of issuance of the temporary license; and
      3. (C) Complete or satisfy all other requirements under this chapter and the rules promulgated pursuant to this chapter.
    4. (4)
      1. (A) A temporary license issued pursuant to this section expires six (6) months after the date of issuance.
      2. (B) A person granted a temporary license pursuant to this section may apply for one (1) extension of the person's temporary license for an additional six (6) months if:
        1. (i)
          1. (a) The person has been unable to take a competency exam approved by the board within the initial temporary license period; and
          2. (b) Is registered to take an upcoming competency exam approved by the board; or
        2. (ii) The person is still waiting for the results of the most recent competency exam approved by the board.
§ 63-18-113. Tax.
  1. Notwithstanding law to the contrary, the act of a duly licensed massage therapist in performing a massage shall be deemed to be medically therapeutic in nature and shall not be subject to the collection of any form of state or local taxation regulations not also imposed on other medically therapeutic activities. Additionally, a massage performed on or before October 1, 1995, by a person who becomes licensed in accordance with this chapter shall also not be subject to the collection of any form of state or local tax not also imposed on other medically therapeutic activities.
§ 63-18-114. Massage therapists are not primary care providers.
  1. No person licensed by the massage licensure board shall ever be referred to as a primary care provider nor be permitted to use such designation.
§ 63-18-115. Powers and duties of the board.
  1. In addition to the powers and duties granted to or imposed upon it by other provisions of this chapter, the board shall have the following powers and duties:
    1. (1) Prescribe the minimum curricular and minimum standards for schools of massage therapy and for courses of training that prepare individuals for licensure under this chapter;
    2. (2) Approve such schools and courses as meet the requirements of this chapter and the rules and regulations of the board;
    3. (3) Issue certificates of approval to such schools and courses that meet the requirements of this chapter and the rules and regulations of the board;
    4. (4) Conduct hearings for disciplinary action against schools or courses that fail to meet the minimum requirements of this chapter and the rules and regulations of the board; and
    5. (5) Annually publish passage rates for each school of massage therapy, based upon the results of each student's success in taking a national examination approved by the board. Schools that fail to achieve an overall passing rate of seventy percent (70%) shall be required to submit a remedial plan to be approved by the board.
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§ 63-18-116. Authority to issue license — Qualifications — Rules and regulations.
  1. (a) The board is authorized to issue a license to practice massage therapy to an applicant who:
    1. (1) Meets the qualifications set forth in § 63-18-105(b)(1) and (2); and
    2. (2) Has been certified by the National Certification Board for Therapeutic Massage and Bodywork for the five-year period immediately preceding application for licensure and can submit documentation satisfactory to the board that the applicant has engaged in the practice of massage therapy in another state for the five-year period immediately preceding application for licensure, and who either:
      1. (A) Has met the qualifications set forth in § 63-18-105(b)(3), but is unable, because the educational institution either was not state approved or is no longer in existence, to produce a transcript to document compliance; or
      2. (B) Graduated from a qualified massage school or course prior to October 1, 1995.
  2. (b) The board is authorized to promulgate rules that are necessary to effectuate this section.
Chapter 19 Physician Assistants
Part 1 Physician Assistants Act
§ 63-19-101. Short title.
  1. This part is known and may be cited as the “Physician Assistants Act.”
§ 63-19-102. Part definitions.
  1. As used in this part:
    1. (1) “Board” means the board of physician assistants, created by § 63-19-103;
    2. (2) “Orthopedic physician assistant” (OPA-C) means an individual who renders service in collaboration with a licensed orthopedic physician or surgeon and who has been licensed by the board of physician assistants pursuant to this chapter as an orthopedic physician assistant;
    3. (3) “Physician” means an individual lawfully licensed to practice medicine and surgery pursuant to chapter 6 of this title, osteopathic medicine pursuant to chapter 9 of this title, or podiatry pursuant to chapter 3 of this title; and
    4. (4) “Physician assistant” means an individual who is licensed to render services, whether diagnostic or therapeutic, that are acts constituting the practice of medicine or osteopathic medicine and who meets the qualifications defined in this part.
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§ 63-19-103. Board of physician assistants.
  1. (a)
    1. (1) There is established the board of physician assistants to regulate physician assistants. The board must consist of nine (9) members appointed by the governor, each of whom is a resident of this state, seven (7) of whom are physician assistants who meet the criteria for licensure as established by this part, one (1) of whom is a physician licensed under chapter 6 or 9 of this title, and one (1) of whom is a public member who is not licensed under this title.
    2. (2) On the date this act becomes law for the purposes of the board being established, those members who are currently serving as members of the board of medical examiners' committee on physician assistants will become members of the board of physician assistants, except that any current member who is an orthopedic physician assistant will not become a member of the board of physician assistants pursuant to this subdivision (a)(2).
  2. (b)
    1. (1) Except as provided in subdivision (b)(2), each regular appointment is for a term of four (4) years. The governor shall fill a vacant term for the balance of the unexpired term. A member shall not serve more than two (2) consecutive four-year terms and each member shall serve on the board until a successor is appointed. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
    2. (2)
      1. (A) The former committee members' board appointments are four (4) years from the date the members were appointed to serve as members of the physician assistant committee.
      2. (B) The former committee members shall not serve more than two (2) consecutive four-year terms, including the time served on the board of medical examiners' committee on physician assistants.
      3. (C) The governor shall appoint one (1) board member with an initial term of one (1) year, one (1) board member with an initial term of two (2) years, and one (1) board member with an initial term of three (3) years. After the initial terms described in this subdivision (b)(2)(C), each term shall be four (4) years.
  3. (c) While engaged in the business of the board, board members shall receive a per diem of one hundred dollars ($100) and shall also receive compensation for actual expenses to be paid in accordance with comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  4. (d) The board shall elect a chair and secretary from among its members at the first meeting held in each fiscal year. A board meeting may be called upon reasonable notice in the discretion of the chair and must be called at any time upon reasonable notice by a petition of three (3) board members to the chair.
  5. (e)
    1. (1) On May 26, 2021, for purposes of the board being established, the secretary of state shall transfer the rules of the board of medical examiners' committee on physician assistants, including Chapter 0880-03, general rules governing the practice of a physician assistant, and Chapter 0880-10, general rules governing the practice of an orthopedic physician assistant, to the board of physician assistants.
    2. (2) The rules of the board of medical examiners' committee on physician assistants Chapters 0880-03 and 0880-10 will have full force and effect for the board of physician assistants until the board of physician assistants promulgates its own rules pursuant to this act and in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
    3. (3) The board of physician assistants is granted full power and authority to oversee and regulate physician assistants under the rules of the board of medical examiners' committee on physician assistants chapters 0880-03 and 0880-10 and the statutes and policies that governed physician assistants and orthopedic physician assistants before the formation of the board of physician assistants.
  6. (f) For purposes of conducting administrative business and promulgating rules, five (5) members constitute a quorum, and the board shall meet at least twice a year to conduct such administrative business. A majority vote of the members present at the business meetings is required to authorize board action on any board business. For purposes of contested case hearings and disciplinary matters, three (3) or more members constitute a quorum, and the board chair is authorized, when it is deemed necessary, to split the board into panels of three (3) or more, each to conduct contested case hearings or disciplinary matters.
  7. (g) A majority vote of the members present on any duly constituted panel is required to authorize board action in disciplinary matters and contested case hearings. The board chair has the authority to appoint board members to serve, as necessary, on the panels regardless of the grand division from which the appointed member was chosen or the member's status as a physician assistant, physician, or public member. The existence of a public member of the board creates no rights in any individual concerning the composition of any panel in any disciplinary matter or contested case hearing. Notwithstanding § 4-5-314(e) to the contrary, unavailability of a member of any panel before rendition of a final order does not require substitution of another member unless the unavailability results in there being less than the quorum required by this section for contested case hearings or disciplinary matters. Any substitute required shall use any existing record and may conduct further proceedings as is necessary in the interest of justice.
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§ 63-19-104. Powers and duties of board.
  1. The board has the duty to:
    1. (1) Unless otherwise specified in this chapter, promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the implementation of this chapter, including, but not limited to, rules that implement the administrative functions of the board and that specify the acts and offenses that subject the license holder to disciplinary action by the board pursuant to subdivision (7);
    2. (2) Set fees, subject to the maximum limitations prescribed by this part, relative to the examination, licensure, and licensure renewal of physician assistants in an amount sufficient to pay all of the expenses of the board and establish and collect a late renewal fee from those physician assistants who fail to renew their licenses in a timely manner;
    3. (3) Review the qualifications of, and approve or reject each applicant for initial licensure as a physician assistant;
    4. (4) Biennially review the qualifications of, and approve or reject each applicant for biennial licensure renewal. The board shall condition approval for renewal on the receipt of evidence satisfactory to the board of the applicant's successful completion, within a two-year period prior to the application for license renewal, of one hundred (100) hours of continuing medical education approved by the American Academy of Physician Assistants, the American Medical Association, or the Accreditation Council for Continuing Medical Education. The two-year period within which an applicant must have obtained the required continuing medical education hours is either the twenty-four (24) months prior to submitting the application for renewal or the most recent two-year period utilized by the National Commission on Certification of Physician Assistants to determine whether that person has obtained sufficient continuing medical education hours to maintain that person's professional certification. The board may, in its discretion, waive or modify the continuing medical education requirement in cases of retirement, illness, disability, or other undue hardship;
    5. (5) Issue all approved physician assistant licenses and renewals;
    6. (6) Collect or receive all fees, fines, and moneys owed pursuant to this part and to pay the same into the general fund of the state. For the purpose of implementing subdivision (2), all fees, fines, and moneys collected pursuant to the regulation of physician assistants must be so designated. Any fiscal balance or deficit that the board of medical examiners' committee on physician assistants has at the time that this act becomes law must be transferred to the board of physician assistants' budget; and
    7. (7) Deny a license, or discipline in accordance with § 63-19-110(a), a license holder who is guilty of violating any of the provisions of this part or who is guilty of violating the rules of the board promulgated pursuant to subdivision (1). When sanctions are imposed on a license holder pursuant to this subdivision (7) or this part, the license holder may, in addition, be required to pay the actual and reasonable costs of the investigation and prosecution of the case, including the costs incurred and assessed for the time of the prosecuting attorney or attorneys, the investigator or investigators, and any other persons involved in the investigation, prosecution, and hearing of the case. The board may limit, restrict, or impose one (1) or more conditions on a license at the time it is issued, renewed, or reinstated or as a sanction imposed at the conclusion of a disciplinary hearing.
§ 63-19-105. Qualifications and licensure.
  1. (a)
    1. (1) An individual shall not represent to be or function as a physician assistant under this part unless the individual holds a valid physician assistant license or temporary license issued by the board. The board shall not license an individual as a physician assistant unless the individual:
      1. (A) Has successfully completed a physician assistant educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or its successor accrediting agency or, prior to 2001, by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs;
      2. (B) Has passed the examination of the National Commission on Certification of Physician Assistants, or its successor agency;
      3. (C) Submits an application on forms approved by the board;
      4. (D) Pays the appropriate fees as determined by the board;
      5. (E) Is mentally and physically able to engage safely in practice as a physician assistant;
      6. (F) Has no license as a physician assistant under current discipline, revocation, suspension, or probation for cause resulting from the applicant's practice as a physician assistant, unless the board considers the condition and agrees to licensure; and
      7. (G) Submits to the board other information the board deems necessary to evaluate the applicant's qualifications.
    2. (2) Notwithstanding subdivisions (a)(1)(A) and (B), the board may license a person qualified as a physician assistant prior to April 26, 1983, and who has continued to represent to be or functioned as a physician assistant since that time. However, the board shall not license any person as a physician assistant after July 1, 1991, unless the person meets the requirements of subdivisions (a)(1)(A) and (B); provided, the board may continue to issue license renewals to any person who was licensed as a physician assistant prior to July 1, 1991.
  2. (b)
    1. (1) An individual licensed, registered, or certified as a physician assistant in another jurisdiction may be licensed as a physician assistant by the board if the individual meets the requirements and standards of this part. The board shall charge an applicant with any reasonable expense incurred by the board in verifying the licensure, registration, or certification by another jurisdiction of the applicant for licensure under this chapter.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another jurisdiction, then the board shall, within forty-five (45) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (b)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  3. (c) The board may issue a temporary license to an individual that allows the individual to function as a physician assistant under this part:
    1. (1) For a period of twelve (12) months immediately following graduation to allow the individual an opportunity to attempt the examination;
    2. (2) For a period of one (1) additional year thereafter in which to attempt and successfully complete the examination if the individual is not successful on the first attempt; or
    3. (3) As provided in § 63-1-104, for an individual who has been out of clinical practice or inactive in their practice for an extended period of time, or who has been or is at the time of their application engaged exclusively in administrative practice.
  4. (d) While an individual's application is pending, the board may issue a temporary license to that individual if the individual is licensed, registered, or certified as a physician assistant in another jurisdiction and if the board finds that the application is complete. The temporary license allows the individual to function as a physician assistant under this chapter. A temporary license issued under this subsection (d) is valid for a period of six (6) months and is not renewable. The board may require that an applicant for licensure as a physician assistant appear before the board to answer any questions regarding the applicant's fitness for licensure.
  5. (e)
    1. (1) The board may authorize any of its members or its consultant to conduct a review of the qualifications of an applicant for a license to practice as a physician assistant in this state and to make an initial determination as to whether the applicant has met all the requirements for licensure. If the board member or board consultant determines that the applicant has met all the requirements for licensure, then the applicant is authorized to practice as a physician assistant in this state until the board makes a final decision on the application for licensure. The board may authorize the use of this procedure with respect to applicants for license renewal or reinstatement as well. A temporary authorization issued pursuant to a determination made by the board member or board consultant must not be effective for longer than a six-month period measured from the date of issuance. The applicant shall not utilize this process more than once.
    2. (2) If temporary authorization pursuant to subdivision (e)(1) is issued to an applicant for a license to practice as a physician assistant in this state and if the subsequent decision of the board is to deny the application based upon a good faith determination that the applicant has not, in fact, complied with all the requirements for licensure, then the doctrine of estoppel does not apply against the state based upon its issuance of temporary authorization and its subsequent denial of licensure.
    3. (3) Notwithstanding a law to the contrary, a person serving as a consultant solely for the board of medical examiners' committee on physician assistants, and not for any other board or committee, as of January 1, 2021, may continue to serve as a consultant for the board of physician assistants until such time that the board of physician assistants decides otherwise.
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§ 63-19-106. Authorized services — Collaboration.
  1. (a)
    1. (1) A physician assistant is authorized to perform selected medical services only in collaboration with a licensed physician.
    2. (2) Collaboration requires active and continuous overview of the physician assistant's activities to ensure that the physician's directions and advice are in fact implemented, but does not require the continuous and constant physical presence of the collaborating physician. The board of medical examiners and board of physician assistants shall adopt regulations governing the collaborating physician's personal review of historical, physical, and therapeutic data contained in the charts of patients examined by the physician assistant. Until the rules are jointly adopted by the board of physician assistants and the board of medical examiners, the rules jointly adopted by the committee on physician assistants and the board of medical examiners in effect as of December 31, 2020, remain in effect.
    3. (3) The range of services that may be provided by a physician assistant must be set forth in a written protocol, jointly developed by the collaborating physician and the physician assistant. The protocol must also contain a discussion of the problems and conditions likely to be encountered by the physician assistant and the appropriate treatment for these problems and conditions. The physician assistant shall maintain the protocol at the physician assistant's practice location and shall make the protocol available upon request by the board of medical examiners, board of physician assistants, or the authorized agents of the boards.
    4. (4) A physician assistant may perform only those tasks that are within the physician assistant's range of skills and competence, that are within the usual scope of practice of the collaborating physician, and that are consistent with the protection of the health and well-being of the patients.
    5. (5) The physician assistant may render emergency medical service in accordance with guidelines previously established by the collaborating physician pending the arrival of a responsible physician in cases where immediate diagnosis and treatment are necessary to avoid disability or death.
  2. (b) A physician assistant shall, at all times, practice in collaboration with a licensed physician who has control of and responsibility for the services provided by the physician assistant and the duty of assuring that there is a proper collaboration with the physician and that the activities of the physician assistant are otherwise appropriate.
  3. (c) Rules that purport to regulate the collaboration of physician assistants with physicians must be jointly adopted by the board of medical examiners and the board of physician assistants.
  4. (d) A physician assistant practicing in collaboration with a licensed podiatrist:
    1. (1) Shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101;
    2. (2) Shall comply with the requirements of, and rules adopted pursuant to, this section and § 63-19-107 governing the collaboration with a physician assistant; and
    3. (3) May prescribe only drugs that are rational to the practice of podiatry.
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§ 63-19-107. Practices for collaboration with physician assistants.
  1. A licensed physician collaborating with physician assistants shall comply with the following practices:
    1. (1) More than one (1) physician may collaborate with the same physician assistant; provided, each physician assistant has a primary collaborating physician and may have additional alternate collaborating physicians who collaborate with the physician assistant in the absence or unavailability of the primary collaborating physician. Each physician assistant shall notify the board of physician assistants of the name, address, and license number of the physician assistant's primary collaborating physician and shall notify the board of physician assistants of a change in the primary collaborating physician within fifteen (15) days of the change. The number of physician assistants for whom a physician may serve as the collaborating physician must be determined by the physician at the practice level, consistent with good medical practice. The collaborating physician shall designate one (1) or more alternate physicians who have agreed to accept the responsibility of collaborating with the physician assistant on a prearranged basis in the collaborating physician's absence;
    2. (2)
      1. (A) In accordance with rules adopted by the board of medical examiners and the board of physician assistants, a collaborating physician may delegate to a physician assistant working in collaboration with the physician the authority to prescribe or issue legend drugs and controlled substances listed in Schedules II, III, IV, and V of title 39, chapter 17, part 4. The rules adopted prior to March 19, 1999, by the board of medical examiners and the committee on physician assistants governing the prescribing of legend drugs by physician assistants remain effective after March 19, 1999, and may be revised from time to time as deemed appropriate by the board of medical examiners and the board of physician assistants. The board of medical examiners and the board of physician assistants may adopt additional rules governing the prescribing of controlled substances by physician assistants. A physician assistant to whom is delegated the authority to prescribe or issue controlled substances must register and comply with all applicable requirements of the drug enforcement administration;
      2. (B)
        1. (i) A physician assistant to whom the authority to prescribe legend drugs and controlled substances has been delegated by the collaborating physician shall file a notice with the board of physician assistants containing the name of the physician assistant, the name of the licensed physician collaborating with the physician assistant who has responsibility for and control of prescription services rendered by the physician assistant, and a copy of the formulary describing the categories of legend drugs and controlled substances to be prescribed or issued, by the physician assistant. The physician assistant is responsible for updating this information;
        2. (ii) Notwithstanding another rule or law, a physician assistant shall not prescribe Schedules II, III, and IV controlled substances unless the prescription is specifically authorized by the formulary or expressly approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication;
        3. (iii) A physician assistant to whom the authority to prescribe controlled drugs has been delegated by the collaborating physician may only prescribe or issue a Schedule II or III opioid listed on the formulary for a maximum of a nonrefillable, thirty-day course of treatment, unless specifically approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication. This subdivision (2)(B)(iii) does not apply to prescriptions issued in a hospital, a nursing home licensed under title 68, or inpatient facilities licensed under title 33;
      3. (C) The prescriptive practices of physician assistants and the collaborating physicians with whom the physician assistants are rendering services must be monitored by the board of medical examiners and the board of physician assistants. As used in this section, “monitor” does not include the regulation of the practice of medicine or the regulation of the practice of a physician assistant, but may include site visits by members of the board of medical examiners and the board of physician assistants;
      4. (D) Complaints against physician assistants or collaborating physicians must be reported to the director of the division of health related boards, board of medical examiners, and the board of physician assistants, as appropriate;
      5. (E)
        1. (i) Every prescription order issued by a physician assistant pursuant to this section must be entered in the medical records of the patient and must be written on a preprinted prescription pad bearing the name, address, and telephone number of the collaborating physician and of the physician assistant, and the physician assistant shall sign each prescription order so written. If the preprinted prescription pad contains the names of more than one (1) physician, then the physician assistant shall indicate on the prescription which of those physicians is the physician assistant's primary collaborating physician by placing a checkmark beside or a circle around the name of that physician;
        2. (ii) A handwritten prescription order for a drug prepared by a physician assistant who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing physician assistant, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician assistant shall sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home, or an assisted care living facility as defined in § 68-11-201;
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        3. (iii) A typed or computer-generated prescription order for a drug issued by a physician assistant who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing physician assistant, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug, and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician assistant shall sign the typed or computer-generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home, or an assisted care living facility as defined in § 68-11-201;
        4. (iv) This section does not prevent a physician assistant from issuing a verbal prescription order;
        5. (v)
          1. (a) Handwritten, typed, or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the federal United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007 (P.L. 110-28), and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions;
          2. (b) Subdivision (2)(E)(v)(a) does not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201, or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state, or federal correctional facility;
      6. (F) Drugs must not be dispensed by a physician assistant except under the control and responsibility of the collaborating physician;
      7. (G) A physician assistant authorized to prescribe drugs under this subdivision (2), who provides services in a free or reduced fee clinic under the Volunteer Healthcare Services Act, compiled in chapter 6, part 7 of this title, may arrange for required personal review of the physician assistant's charts by a collaborating physician in the office or practice site of the physician or remotely via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (2)(G), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. 164.312;
      8. (H) A physician assistant authorized to prescribe drugs under this subdivision (2), who provides services in a community mental health center as defined in § 33-1-101 or federally qualified health center as defined in § 63-10-601, or solely via telehealth as defined in § 63-1-155, may arrange for the required personal review of the physician assistant's charts by a collaborating physician, with the same authority to render prescriptive services that the physician assistant is authorized to render, in the office or practice site of the physician, or the required visit by a collaborating physician to any remote site, or both, via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (2)(H), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. § 164.312;
      9. (I) Except for subdivisions (2)(G) and (H):
        1. (i) A physician assistant licensed to prescribe drugs under this subdivision (2), who provides services at a site remote from the physician assistant's collaborating physician's practice site, may arrange for the required personal review of the physician assistant's charts by a collaborating physician either via HIPAA-compliant electronic means or in person;
        2. (ii) A physician assistant licensed to prescribe drugs under this subdivision (2), may arrange for up to ten (10) of the required annual remote site visits by a collaborating physician by HIPAA-compliant electronic means rather than at the site of the clinic. All other of the required site visits by a collaborating physician to a remote site must take place in person at the site of the clinic;
        3. (iii) For purposes of subdivision (2)(I)(ii):
          1. (a) “Annual” means a rolling twelve-month period; and
          2. (b) “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. § 164.312;
    3. (3) The patient of a physician receiving services from that physician assistant shall be fully informed that the individual is a physician assistant or a sign must be conspicuously placed within the office of the physician indicating that certain services may be rendered by a physician assistant;
    4. (4) A physician who does not normally provide patient care is not authorized to collaborate with or utilize the services of a physician assistant; and
    5. (5)
      1. (A) A physician assistant shall only perform invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves of the spine, or block of major peripheral nerves of the spine in any setting not licensed under title 68, chapter 11, under the direct supervision of a Tennessee physician licensed pursuant to chapter 6 or 9 of this title who is actively practicing spinal injections and has current privileges to do so at a facility licensed pursuant to title 68, chapter 11. The direct supervision provided by a physician in this subdivision (5)(A) must only be offered by a physician who meets the qualifications established in § 63-6-244(a)(1) or (a)(3) or § 63-9-121(a)(1) or (a)(3);
      2. (B) For purposes of this subdivision (5), “direct supervision” means being physically present in the same building as the physician assistant at the time the invasive procedure is performed; and
      3. (C) This subdivision (5) does not apply to a physician assistant performing major joint injections except sacroiliac injections, or to performing soft tissue injections or epidurals for surgical anesthesia or labor analgesia in unlicensed settings.
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§ 63-19-108. Unprofessional conduct by physician collaborating with a physician assistant.
  1. When a licensed physician collaborates with a physician assistant or orthopedic physician assistant in a manner that is inconsistent with this chapter, it constitutes grounds for a finding of unprofessional conduct and the physician is subject to disciplinary action by the board of medical examiners in accordance with § 63-6-214, the board of osteopathic examination in accordance with § 63-9-111, or the board of podiatric medical examiners in accordance with § 63-3-119. As used in this section, “disciplinary action” includes, but is not limited to, the discipline described in §§ 63-6-214(a), 63-9-111(a), and 63-3-119(a), and the suspension of privileges to collaborate with a physician assistant or an orthopedic physician assistant.
§ 63-19-109. Exclusions of limitations on employment.
  1. This part does not limit the employment arrangement of a physician assistant licensed under this part.
§ 63-19-110. Grounds for denial, suspension, or revocation of licenses.
  1. (a) The board has the power to:
    1. (1) Deny an application for a license to an applicant who applies for a license through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, limit, or restrict a previously issued license for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or licensee, including, but not limited to, informal settlements, private censures and warnings, and issuing civil penalties, as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license.
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  2. (b) The grounds upon which the board shall exercise such power include, but are not limited to:
    1. (1) The conviction of a crime;
    2. (2) Fraud in procuring or attempting to procure a license to practice medicine as a physician assistant;
    3. (3) The commission of unprofessional or unethical conduct;
    4. (4) An addiction to the use of alcohol, narcotics, or other drugs;
    5. (5) Engaging in the inappropriate prescribing, dispensing, or otherwise distributing a controlled substance or other drug in the course of professional practice;
    6. (6) Suspension or revocation of a license in another state for disciplinary reasons; or
    7. (7) Failure to comply with the lawful order or duly promulgated rules of the board.
  3. (c) Upon issuing disciplinary action to a licensee, the board shall notify the board of medical examiners, board of osteopathic examination, or board of podiatry, as appropriate, of the disciplinary action and the licensee's primary collaborating physician of record.
  4. (d) A disciplinary action issued by the board for a violation involving the prescribing, dispensing, or otherwise issuing of controlled substances by a physician assistant must also be approved by the board of medical examiners, and the board shall give notice to the appropriate licensing board of the primary collaborating physician of record.
§ 63-19-111. Exemptions.
  1. (a) This part does not:
    1. (1) Modify or supersede any existing laws relating to other paramedical professions or services;
    2. (2) Permit a physician assistant to:
      1. (A) Measure the powers or range of human vision, or determine the refractive state of the human eye or the scope of its functions in general or prescribe or direct the use of ophthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies;
      2. (B) Prescribe or fit or adapt contact lenses to or for the human eye; or
      3. (C) Practice chiropractic or to analyze or palpate the articulations of the spinal column for the purposes of giving a spinal adjustment; or
    3. (3) Prohibit a physician assistant from testing visual acuity or performing routine vision screening.
  2. (b) This part does not apply to registered nurses or licensed practical nurses utilized by a physician under § 63-6-204 or § 63-9-113, or to technicians, other assistants, or employees of a physician not rendering services as a physician assistant and who perform delegated tasks in the office of a physician or to students enrolled in physician assistant training programs accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or its successor entity.
§ 63-19-112. Administrative proceedings.
  1. The board shall conduct all administrative proceedings for disciplinary action against a license holder under this part in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-19-113. Licensure renewal by retired physician assistants.
  1. A person licensed by the board as a physician assistant who has retired or may retire from practice in this state is not required to biennially renew the person's license as required by this part, if the person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which the person retired from practice and any other facts, as the board considers necessary, that tend to verify the retirement. If the person thereafter reengages in practice in this state, then the person must apply for licensure by the board as provided by this part and is not liable for payment of licensure renewal fees that accrued during the period of retirement.
§ 63-19-114. Use of title “physician assistant” or abbreviation “PA.”
  1. (a) A person who holds a valid license or temporary license from the board has the right to use the title “physician assistant,” the abbreviation “PA,” or the abbreviation “PA-C.” No other person may assume that title or use those abbreviations, or any words, signs, letters, or devices to indicate that the person using them is a physician assistant.
  2. (b) A person who meets the qualifications for licensure under this chapter but does not possess a current license may use the title “PA,” “physician assistant,” or “PA-C,” but may not act or practice as a PA unless licensed under this chapter.
  3. (c) This section does not apply to public accountants or certified public accountants. This section does not prevent a public accountant from using the abbreviation “P.A.”.
§ 63-19-115. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A physician assistant licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic is not subject to license fees under this chapter. The board may issue a special volunteer license, as defined in § 63-1-201, to qualified applicants without fee or charge. The license is for a period of two (2) years and may be renewed on a biennial basis.
§ 63-19-116. Suspension for failure to collaborate — On-site supervision of healthcare prescriber subject of disciplinary action for conduct related to improper prescribing or diversion of controlled substance.
  1. (a)
    1. (1) Failure by a person licensed under and required by this chapter to collaborate with a physician for any act within the person's licensed scope of practice constitutes a threat to the public health, safety, and welfare and imperatively requires emergency action by the board.
    2. (2) Notwithstanding any law, if the board learns that a person licensed under this chapter and subject to a requirement to collaborate with a physician for any act within the person's licensed scope of practice has failed to comply with the collaboration requirement, then the board chair shall direct the administrative staff to automatically and immediately, without further action by the board, suspend the person's license until the board receives sufficient proof that the person is in compliance with the collaboration requirements of this chapter.
    3. (3) The licensure sanction authorized by this subsection (a) is supplementary to, and does not limit, the authority of the board to take other disciplinary action against a licensee the board determines to be in violation of this chapter.
  2. (b) If a healthcare prescriber licensed under this chapter is the subject of a disciplinary action by the board for conduct related to improper prescribing or diversion of a controlled substance, but retains an active license with prescribing authority following the disciplinary action, then the healthcare prescriber shall not prescribe a controlled substance in this state unless the healthcare prescriber is working in collaboration with a physician who is physically present at the same practice site and licensed to prescribe controlled substances in this state. The board shall determine the period of time that a healthcare prescriber is subject to the on-site supervision requirement of this subsection (b), which must not be less than two (2) years.
Part 2 Orthopedic Physician Assistants
§ 63-19-201. Jurisdiction — Duties of the committee.
  1. (a) Licensed orthopedic physician assistants are under the jurisdiction of the board of physician assistants created by § 63-19-103.
  2. (b) The board of physician assistants has the duty to:
    1. (1) Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the duties of orthopedic physician assistants, including, but not limited to, rules that specify the acts and offenses that subject the license holder to disciplinary action by the board pursuant to subdivision (b)(7);
    2. (2) Set fees relative to the examination, licensure, and licensure renewal of orthopedic physician assistants in an amount sufficient to pay all of the expenses of the board, and to establish and collect a late renewal fee from those orthopedic physician assistants who fail to renew their licenses in a timely manner;
    3. (3) Review and approve or reject the qualifications of each applicant for initial licensure as an orthopedic physician assistant;
    4. (4) Biennially review and approve or reject the qualifications of each applicant for biennial licensure renewal. The board shall condition approval for renewal on the receipt of evidence satisfactory to the board of the applicant's successful completion of sixty (60) hours of continuing medical education approved by the American Medical Association or other appropriate professional association. The board may, in its discretion, waive or modify the continuing medical education requirement in cases of retirement, illness, disability, or other undue hardship;
    5. (5) Issue all approved orthopedic physician assistant licenses and renewals;
    6. (6) Collect or receive all fees, fines, and moneys owed pursuant to this part and pay the fees, fines, and moneys into the general fund of the state. For the purpose of implementing subdivision (b)(2), all fees, fines, and moneys collected pursuant to the regulation of orthopedic physician assistants must be so designated; and
    7. (7) Deny, suspend, or revoke the license of, or otherwise discipline by a fine not to exceed five hundred dollars ($500), or by reprimand, a license holder who is guilty of violating this part or who is guilty of violating the rules of the board promulgated pursuant to subdivision (b)(1). If sanctions are imposed on a licensee pursuant to this subdivision (b)(7), then the licensee may, in addition, be required to pay the actual and reasonable costs of the investigation and prosecution of the case, including the costs incurred and assessed for the time of the prosecuting attorney or attorneys, the investigator or investigators, and any other persons involved in the investigation, prosecution, and hearing of the case. The board may limit, restrict, or impose one (1) or more conditions on a license at the time it is issued, renewed, or reinstated or as a sanction imposed at the conclusion of a disciplinary hearing.
  3. (c) Actions taken under this section are only effective after adoption by majority vote of the members of the board of physician assistants.
  4. (d) For purposes of this part, unless the context requires otherwise, “physician” means a person lawfully licensed to practice orthopedic medicine and surgery pursuant to chapter 6 of this title, or osteopathic medicine pursuant to chapter 9 of this title.
§ 63-19-202. Licensure requirement.
  1. (a) A person shall not claim to be or function as an orthopedic physician assistant unless the person holds a valid orthopedic physician assistant license issued by the board.
  2. (b) The board shall not license a person as an orthopedic physician assistant or renew the license of an orthopedic physician assistant unless:
    1. (1)
      1. (A) The person is a graduate of an orthopedic physician assistant training program approved by the board;
      2. (B) The person has successfully completed the examination of the National Board for Certification of Orthopedic Physician Assistants; and
      3. (C) The person was performing services as an orthopedic physician assistant in this state on January 1, 2021; or
    2. (2) The person was performing services as an orthopedic physician assistant in this state on or after January 1, 2021, and has been continuously licensed as an orthopedic physician assistant in this state since 1995.
  3. (c) The board may require that an applicant for licensure as an orthopedic physician assistant appear before the board to answer questions regarding the applicant's fitness for licensure.
§ 63-19-203. Collaboration with orthopedic physician assistant.
  1. (a) A licensed orthopedic physician assistant is authorized to perform services only in collaboration with a licensed orthopedic physician or surgeon within the specialty of orthopedic medicine and surgery, or in collaboration with a licensed podiatrist.
  2. (b) Collaboration between a collaborating physician and a licensed orthopedic physician assistant shall require active and continuous overview by the collaborating physician to ensure that the physician's directions, orders, and advice are in fact being implemented, but does not require the constant physical presence of the collaborating physician. The collaborating physician shall, however, make a personal review of historical, physical, and therapeutic data on all patients and their condition and so certify by personal signature in a timely manner.
  3. (c) An orthopedic physician assistant collaborating with a licensed podiatrist:
    1. (1) Shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101; and
    2. (2) Shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-203 — 63-19-205 governing collaboration with a physician assistant.
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§ 63-19-204. Standard of care.
  1. (a) The licensed orthopedic physician assistant shall function in accordance with written policies and procedures involving management of care that have been established by the collaborating physician and the orthopedic physician assistant.
  2. (b) With respect to follow-up care rendered in a clinic, hospital, nursing home or patient's home and in similar situations where a therapeutic regimen, policy or protocol has been established by the collaborating physician, the licensed orthopedic physician assistant may check and record the patient's progress within the confines of the written regimen, policy or protocol and report the patient's progress and changes to the physician after each visit. When a new problem arises, the collaborating physician shall undertake personal review of the patient's problem or complaint.
  3. (c) The orthopedic physician assistant may render emergency services in accordance with guidelines previously established by the collaborating physician, pending the arrival of a responsible physician in cases where immediate diagnosis and treatment are necessary to avoid disability or death.
§ 63-19-205. Practices of collaborating physician.
  1. A licensed physician who is collaborating with orthopedic physician assistants shall comply with the following practices:
    1. (1) No one (1) collaborating physician shall collaborate with more than two (2) licensed orthopedic physician assistants at any one time;
    2. (2) More than one (1) physician may collaborate with the same licensed orthopedic physician assistant;
    3. (3) The collaborating physician shall designate one (1) or more alternate physicians who have agreed to accept the responsibility of collaborating with the orthopedic physician assistant on a prearranged basis in the absence of the collaborating physician;
    4. (4) The licensed orthopedic physician assistant shall render services and care commensurate with such orthopedic assistant's education, training and experience;
    5. (5) The licensed orthopedic physician assistant shall not make any definitive diagnosis or prescribe any treatment program independent of the collaborating physician;
    6. (6) Pre-signed prescriptions shall not be used by the licensed orthopedic physician assistant. Medications dispensed by the licensed orthopedic physician assistant shall be approved by the collaborating physician; and
    7. (7) The patient of any physician receiving services from a licensed orthopedic physician assistant shall be fully informed that the individual is a licensed orthopedic physician assistant and/or a sign shall be conspicuously placed within the office of the physician indicating that certain services may be rendered by a licensed orthopedic physician assistant.
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§ 63-19-206. Unauthorized practice.
  1. Any licensed orthopedic physician assistant rendering services inconsistent with this part shall be considered to be practicing medicine without a license and shall be subject to appropriate legal action by the board of medical examiners.
§ 63-19-207. Unauthorized utilization of services.
  1. When a licensed orthopedic physician or surgeon utilizes the services of a licensed orthopedic physician assistant inconsistent with this part, it shall constitute grounds for a finding of unprofessional conduct, and the physician shall be subject to disciplinary action by the board of medical examiners. Such disciplinary action may include, but is not limited to, the suspension of privileges to utilize a licensed orthopedic physician assistant or the revocation or suspension of the license of the orthopedic physician or surgeon.
§ 63-19-208. Scope.
  1. (a) Nothing in this part shall be construed to modify or supersede any existing laws or rules pertaining to any other allied health professionals, professions, or services.
  2. (b) Nothing in this part shall permit a licensed orthopedic physician assistant to:
    1. (1) Practice chiropractic or analyze or palpate the articulations of the spinal column for the purposes of giving a spinal adjustment; or
    2. (2) Measure the powers or range of human vision, or determine the refractive state of the human eye or the scope of its functions in general, or prescribe or direct the use of opthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies or prescribe or fit or adapt contact lenses to or for the human eye.
  3. (c) This part does not apply to other physician extenders, physician assistants, family nurse practitioners, registered nurses, licensed practical nurses, technologists, technicians and other assistants or employees that perform delegated services in a medical setting.
§ 63-19-209. Retired orthopedic physician assistant.
  1. Any person licensed by the board as an orthopedic physician assistant who has retired from such practice in this state shall not be required to biennially renew such person's license as required by this part, if such person files an affidavit on a form furnished by the board. Such affidavit shall state the date on which the person retired from practice and any other information deemed necessary by the board. If such person decides to reengage in practice in this state, such person shall apply for licensure as provided by this part and shall not be liable for payment of licensure renewal fees that accrued during the period of retirement.
§ 63-19-210. Correct title.
  1. Any person who holds a valid license from the board of medical examiners under this part may use the title “orthopedic physician assistant” or the abbreviation “OPA-C” or “OPA,” but such person shall not use the title “physician assistant” or the abbreviation “PA” or “PA-C.”
Chapter 20 Graduate Physicians Act [Effective on January 1, 2025.]
§ 63-20-101. Short title. [Effective on January 1, 2025.]
  1. This chapter is known and may be cited as the “Graduate Physicians Act.”
§ 63-20-102. Chapter definitions. [Effective on January 1, 2025.]
  1. As used in this chapter:
    1. (1) “Graduate physician” means a medical school graduate who:
      1. (A) Is a resident and citizen of the United States or a legal resident alien in the United States; and
      2. (B) Has successfully completed Step 1 and Step 2 of the United States Medical Licensing Examination (USMLE), or the equivalent of Step 1 and Step 2 of any other medical licensing examination or combination of examinations that is approved by the board of medical examiners or board of osteopathic examination, within the two-year period immediately preceding the date of the person's application for licensure as a graduate physician, but not more than three (3) years after graduation from a medical school or school of osteopathic medicine;
    2. (2) “Graduate physician collaborative practice arrangement” means an agreement between a licensed physician and a graduate physician that meets the requirements of this chapter;
    3. (3) “Medical school graduate” means any person who has graduated from a medical school as described in § 63-6-207 or a school of osteopathic medicine as described in § 63-9-104; and
    4. (4) “Primary care services” means medical services in pediatrics, internal medicine, and family medicine.
§ 63-20-103. Collaborative practice arrangement requirements. [Effective on January 1, 2025.]
  1. A graduate physician collaborative practice arrangement must limit the graduate physician to providing primary care services in:
    1. (1) A medically underserved rural area of this state;
    2. (2) A pilot project area established for graduate physicians to practice; or
    3. (3) A rural health clinic as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively).
§ 63-20-104. Graduate physicians' supervision requirements. [Effective on January 1, 2025.]
  1. Graduate physicians are subject to the supervision requirements established in any controlling federal law, any supervision requirements provided in this chapter, and any supervision requirements established by the board of medical examiners. Graduate physicians are not subject to any additional supervision requirements, other than the supervision requirements outlined in this section.
§ 63-20-105. Promulgation of licensure rules. [Effective on January 1, 2025.]
  1. (a) The board of medical examiners, in consultation with the board of osteopathic examination, is authorized to promulgate rules:
    1. (1) To establish the process for licensure of graduate physicians, supervision requirements, and additional requirements for graduate physician collaborative practice arrangements;
    2. (2) To set fees, which must include a requirement that the total fees collected each year must be greater than or equal to the total costs necessary to facilitate the graduate physician collaborative practice arrangement each year; and
    3. (3) To address any other matters necessary to protect the public and discipline the profession.
  2. (b) A graduate physician's license issued pursuant to this chapter and the rules promulgated by the board of medical examiners is only valid for two (2) years from the date of issuance and is not subject to renewal. The board of medical examiners or board of osteopathic examination may deny an application for licensure or suspend or revoke the license of a graduate physician for violation of the standards provided in §§ 63-6-214 and 63-9-111, as applicable, or for a violation of the standards of conduct established by the board of medical examiners by rule.
  3. (c) Any rule promulgated under the authority delegated to the board of medical examiners in this chapter becomes effective only if it complies with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-20-106. Graduate physician identification — Collaborative practice arrangement required. [Effective on January 1, 2025.]
  1. A graduate physician shall clearly identify as a graduate physician and is permitted to use the identifiers “doctor” or “Dr.” A graduate physician shall not practice, or attempt to practice, without a graduate physician collaborative practice arrangement, except as otherwise provided in this chapter.
§ 63-20-107. Licensed physician supervision of graduate physicians. [Effective on January 1, 2025.]
  1. The licensed physician collaborating with a graduate physician is responsible for supervising the activities of the graduate physician and must accept full responsibility for the primary care services provided by the graduate physician.
§ 63-20-108. Eligibility requirements for graduate physicians arrangements — Arrangement requirements. [Effective on January 1, 2025.]
  1. (a) This chapter applies to all graduate physician collaborative practice arrangements. To be eligible to practice as a graduate physician, a licensed graduate physician must enter into a graduate physician collaborative practice arrangement with a licensed physician no later than six (6) months after the date on which the graduate physician obtains initial licensure.
  2. (b) Only a physician licensed pursuant to title 63, chapter 6 or chapter 9 may enter into a graduate physician collaborative practice arrangement with a graduate physician. Graduate physician collaborative practice arrangements must take the form of a written agreement that includes mutually agreed upon protocols and any standing orders for the delivery of primary care services. Graduate physician collaborative practice arrangements may delegate to a graduate physician the authority to administer or dispense drugs and provide treatment, as long as the delivery of the primary care services is within the scope of the graduate physician's practice and is consistent with the graduate physician's skill, training, and competence and the skill, training, and competence of the collaborating physician; except that a graduate physician shall not prescribe controlled substances. The collaborating physician must be board-certified in the specialty that the graduate physician is practicing, which must only include pediatrics, internal medicine, or family medicine.
  3. (c) The graduate physician collaborative practice arrangement must contain the following provisions:
    1. (1) Complete names, home and business addresses, and telephone numbers of the collaborating physician and the graduate physician;
    2. (2) A requirement that the graduate physician practice at the same location as the collaborating physician;
    3. (3) A requirement that a prominently displayed disclosure statement informing patients that they may be seen by a graduate physician, and advising patients that the patient has the right to see the collaborating physician, be posted in every office where the graduate physician is authorized to prescribe;
    4. (4) All specialty or board certifications of the collaborating physician and all certifications of the graduate physician;
    5. (5) The manner of collaboration between the collaborating physician and the graduate physician, including how the collaborating physician and the graduate physician will:
      1. (A) Engage in collaborative practice consistent with each professional's skill, training, education, and competence; and
      2. (B) Maintain geographic proximity. However, the graduate physician collaborative practice arrangement may only allow for geographic proximity to be waived for no more than twenty-eight (28) days per calendar year for rural health clinics, as long as the graduate physician collaborative practice arrangement includes alternative plans as required in subdivision (c)(5)(C). The exception to the geographic proximity requirement applies only to independent rural health clinics, provider-based rural health clinics if the provider is a critical access hospital as provided in 42 U.S.C. § 1395i-4, and provider-based rural health clinics if the primary location of the hospital sponsor is more than twenty-five (25) miles from the clinic. The collaborating physician must maintain documentation related to the geographic proximity requirement and present the documentation to the board of medical examiners upon request;
    6. (6) A requirement that the graduate physician shall not provide patient care during an absence of the collaborating physician for any reason;
    7. (7) A list of all other graduate physician collaborative practice arrangements of the collaborating physician and the graduate physician;
    8. (8) The duration of the graduate physician collaborative practice arrangement between the collaborating physician and the graduate physician;
    9. (9) A provision describing the time and manner of the collaborating physician's review of the graduate physician's delivery of primary care services. The provision must require the graduate physician to submit to the collaborating physician a minimum of twenty-five percent (25%) of the charts documenting the graduate physician's delivery of primary care services for review by the collaborating physician or by any other physician designated in the graduate physician collaborative practice arrangement every fourteen (14) days after the initial observation year. For the first three (3) months of the initial observation year, the collaborating physician shall review one hundred percent (100%) of the charts documenting the graduate physician's delivery of primary care services. For months four (4) through twelve (12), the collaborating physician shall review seventy-five percent (75%) of the charts documenting the graduate physician's delivery of primary care services; and
    10. (10) A requirement that a collaborating physician be on premises if the graduate physician performs services in a hospital or emergency department.
§ 63-20-109. Board promulgation rules regarding graduate physician collaborative practice arrangements — Arrangement limitations. [Effective on January 1, 2025.]
  1. (a) The board of medical examiners, in consultation with the board of osteopathic examination, shall promulgate rules regulating the use of graduate physician collaborative practice arrangements for graduate physicians. The rules must specify:
    1. (1) The geographic areas to be covered;
    2. (2) The methods of treatment that may be covered by the graduate physician collaborative practice arrangement;
    3. (3) The educational methods and programs to be performed during the collaborative practice service, developed in consultation with deans of medical schools and primary care residency program directors in this state, which must facilitate the advancement of the graduate physician's medical knowledge and capabilities, the successful completion of which may lead to credit toward a future residency program that deems the documented educational achievements of the graduate physician through the methods and programs acceptable; and
    4. (4) Require review of the services provided under a graduate physician collaborative practice arrangement.
  2. (b) A collaborating physician shall not enter into a graduate physician collaborative practice arrangement with more than three (3) graduate physicians at the same time.
§ 63-20-110. Limitations of the boards rulemaking and disciplinary authority — Reporting requirements — Consent required from physician and graduate physician — Identification requirements. [Effective on January 1, 2025.]
  1. (a) The board of medical examiners, in consultation with the board of osteopathic examination, shall promulgate rules applicable to graduate physicians that are consistent with the guidelines established for federally funded clinics. The rulemaking authority granted to the board of medical examiners in this subsection (a) does not extend to graduate physician collaborative practice arrangements of hospital employees providing inpatient care within hospitals.
  2. (b) The state board of medical examiners or board of osteopathic examination shall not deny, revoke, suspend, or otherwise take disciplinary action against a collaborating physician for primary care services delegated to a graduate physician as long as the provisions of this section and any applicable rules promulgated by the board of medical examiners are satisfied.
  3. (c) Within thirty (30) days of any licensure change, the state board of medical examiners or board of osteopathic examination must require every physician to identify whether the physician is engaged in a graduate physician collaborative practice arrangement, and to report to the board the name of each graduate physician with whom the physician has entered into an arrangement. The board may make the information available to the public. The board shall track the reported information and may routinely conduct reviews or inspections to ensure that the arrangements are being carried out in compliance with this chapter.
  4. (d) A contract or other agreement cannot require a physician to act as a collaborating physician for a graduate physician against the physician's will. A physician has the right to refuse to act as a collaborating physician, without penalty, for a particular graduate physician. A contract or other agreement cannot limit the collaborating physician's authority over any protocols or standing orders, or delegate the physician's authority to a graduate physician. However, this subsection (d) does not authorize a physician in implementing protocols, standing orders, or delegation to violate applicable standards for safe medical practice established by a hospital's medical staff.
  5. (e) A contract or other agreement cannot require a graduate physician to serve as a graduate physician for any collaborating physician against the graduate physician's will. A graduate physician has the right to refuse to collaborate, without penalty, with a particular physician.
  6. (f) All collaborating physicians and graduate physicians under a graduate physician collaborative practice arrangement must wear identification badges while acting within the scope of the arrangement. The identification badges must prominently display the licensure status of the collaborating physician and the graduate physician.
§ 63-20-111. Certification course for collaborating physicians — Collaborative practice arrangements superseding hospital licensing regulations. [Effective on January 1, 2025.]
  1. (a) The collaborating physician must complete a certification course, which may include material on the laws pertaining to the professional relationship. The certification course must be approved by the board of medical examiners or board of osteopathic examination.
  2. (b) A graduate physician collaborative practice arrangement supersedes current hospital licensing regulations governing hospital medication orders under protocols or standing orders for the purpose of delivering inpatient or emergency care within a hospital as defined in § 68-11-201, if the protocols or standing orders have been approved by the hospital's medical staff and pharmaceutical therapeutics committee.
Chapter 22 Professional Counselors, Marital and Family Therapists, and Clinical Pastoral Therapists
Part 1 Professional Counselors, Marital and Family Therapists
§ 63-22-101. Creation of board — Composition — Members — Terms — Compensation — Meetings — Administrative functions.
  1. (a) There is hereby created the board for professional counselors, marital and family therapists and clinical pastoral therapists, referred to as the “board” in this chapter.
  2. (b)
    1. (1) The board shall consist of five (5) members who shall be appointed by the governor.
    2. (2)
      1. (A) Members of the board may be appointed from lists of qualified persons submitted by interested counseling and therapy groups including, but not limited to, the Tennessee Counseling Association, the Tennessee Association for Marriage and Family Therapy, the Tennessee Association of Pastoral Therapists, and the Tennessee Licensed Professional Counselors Association.
      2. (B) In making appointments to the board, the governor shall consult with interested counseling and therapy groups including, but not limited to, the organizations listed in subdivision (b)(2)(A) to determine qualified persons to fill the positions.
    3. (3) The fifth member shall be a citizen-at-large appointed by the governor.
    4. (4) All board members shall be resident citizens of Tennessee.
    5. (5) Board candidates shall be licensed or certified prior to nomination except for the fifth member who shall be a citizen-at-large.
  3. (c)
    1. (1) Each member of the board shall serve for a term of five (5) years.
    2. (2) With the exception of the citizen-at-large member, a board member who vacates the member's seat may be replaced by a person from the same profession as that of the vacating member.
    3. (3) A vacancy of the citizen-at-large board position shall be replaced by a person appointed by the governor.
    4. (4) Members whose terms of office have expired shall continue to serve until their replacements are named.
    5. (5) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  4. (d) A majority of the members to which the board is entitled constitutes a quorum.
  5. (e) Each member of the board shall receive fifty dollars ($50.00) per diem expenses when actually engaged in the discharge of the member's official duties and all legitimate and necessary expenses incurred in attending the meetings of the board. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  6. (f) The board shall choose one (1) of its members president, one (1) vice president and one (1) secretary-treasurer thereof, at each annual meeting, held in July, at such place as may be selected or designated by the board. The board may meet more often if necessary, in the discretion of the board, at such times and places as it may deem proper, for the examination of applicants and for the transaction of any business that may come before it.
  7. (g)
    1. (1) The administrative functions and duties of the board are vested in the division of health related boards, referred to as “division” in this chapter. The division shall employ such persons as may be necessary for the effective and efficient discharge of the duties of the board.
    2. (2) Such administrative assistants and other employees shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  8. (h) In making appointments to the board, the governor should consider the importance of geographical diversity to this board. Whenever practicable, the governor shall strive to ensure that members on the board are from each of the three (3) grand divisions of the state.
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§ 63-22-102. Powers and duties of board.
  1. The board shall:
    1. (1) Adopt rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as are necessary to carry out and make effective this part;
    2. (2) Review the credentials of licensure of applicants to determine if they are eligible for licensure, upon payment of a nonrefundable fee as set by the board;
    3. (3) Prepare or select and administer examinations to applicants for licensure;
    4. (4) License as professional counselors applicants who satisfy the requirements of §§ 63-22-104, 63-22-107 and 63-22-110 and establish by rule any additional qualifications of the applicants necessary for the practice of professional counseling as provided in this part;
    5. (5) Review the credentials for licensure of marital and family therapy applicants to determine if they are eligible for licensure upon payment of a nonrefundable review fee as set by the board;
    6. (6) Prepare or select and administer examinations to marital and family therapist applicants for licensure;
    7. (7) License as marital and family therapists applicants who satisfy the requirements of §§ 63-22-106, 63-22-107 and 63-22-108 or § 63-22-103;
    8. (8) Set continuing education requirements for renewal of licenses and certificates;
    9. (9) Renew, revoke and reinstate licenses and certificates as described in §§ 63-22-108 and 63-22-110;
    10. (10) Review the credentials of clinical pastoral therapist applicants to determine if they are eligible for certification upon payment of a nonrefundable review fee as set by the board;
    11. (11) Prepare or select and administer examinations to clinical pastoral therapy applicants for certification; and
    12. (12) Certify clinical pastoral therapists who satisfy the requirements of § 63-22-203.
§ 63-22-103. Reciprocity — Licensure without examination — Licensure by endorsement.
  1. (a) The board may license without examination a marital and family therapist applicant who is licensed in another state if the applicant's qualifications meet the licensure requirements under this part. The board may license by endorsement an applicant who is a clinical member of the American Association for Marriage and Family Therapy if that person otherwise meets the requirements of this part.
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  2. (b) The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers marital and family therapists, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee.
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§ 63-22-104. Professional counselors — Fees — Qualifications.
  1. An applicant for licensure as a professional counselor shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:
    1. (1) Is at least eighteen (18) years of age;
    2. (2) Is of good moral character;
    3. (3)
      1. (A) Has obtained a minimum of sixty (60) graduate hours in counseling or a closely related field and which includes a master's degree in counseling; and
      2. (B) Has completed a supervised field experience as either a practicum or internship;
    4. (4) Has had at least two (2) years of professional experience of a type judged to be acceptable by the board subsequent to being granted a graduate degree and has not violated § 63-22-110;
    5. (5) Has passed the examination offered by the National Board for Certified Counselors (NBCC) or such other examination approved by the board; and
    6. (6) Has met any additional criteria of the board established by rule.
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§ 63-22-106. Marital and family therapists — Fees — Qualifications.
  1. An applicant for licensure as a marital and family therapist shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:
    1. (1) Is at least eighteen (18) years of age;
    2. (2) Is of good moral character;
    3. (3) Has met standards set by the board no less stringent than the American Association for Marriage and Family Therapy's standards for a clinical member so long as such standards specify a minimum of a master's level degree; and
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    4. (4) Shall pass such examination as may be administered by the board. Applicants shall bear the fee for testing in addition to the review fee and application fee.
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§ 63-22-107. Educational requirements and examinations.
  1. (a) On and after July 1, 1991, an applicant for licensure as a professional counselor shall meet the requirements of §§ 63-22-104 and 63-22-110 and, in addition, shall pass an examination as adopted and administered by the board.
  2. (b) Effective July 1, 1991, no additional certificates for professional counselors shall be issued by the board. Those persons so certified as professional counselors on or before June 30, 1991, may retain their certification indefinitely by meeting current renewal requirements and may upgrade from certification to licensure by any of the following methods:
    1. (1) Complying with this part;
    2. (2) Becoming certified by the National Board for Certified Counselors (NBCC); or
    3. (3) Verifying, to the board's satisfaction, that such person has had five (5) prior years' work experience as a certified professional counselor in this state or another state with certification standards that are at least the equivalent of those of this state.
  3. (c) An applicant for licensure on or after July 1, 1991, as a licensed marital and family therapist, shall meet the requirements of § 63-22-103(a) or § 63-22-106, and, in addition, shall pass such examinations as may be administered by the board. After July 1, 1991, no additional marital and family therapist certifications will be issued. Those persons so certified as of July 1, 1991, as marital and family therapists may maintain certification or may upgrade from certification to licensure by any of the following methods:
    1. (1) By acquiring the minimum standards provided in § 63-22-106(3);
    2. (2) By receiving two hundred (200) hours clinical supervision from not more than two (2) supervisors deemed qualified by the board; or
    3. (3) By validating fifteen (15) years of clinical practice while maintaining certification by continuing a practice of marital and family therapy.
  4. (d) On or after July 1, 1995, an applicant for licensure as a professional counselor designated as a mental health service provider shall meet the requirements of §§ 63-22-104, 63-22-110 and 63-22-120.
  5. (e) Until June 30, 1997, a currently licensed professional counselor who wishes to obtain designation as a mental health service provider may do so by documenting both training and experience relative to the diagnosis, treatment, appraisal and assessment of mental disorders or by documenting training and experience in teaching these courses for a minimum of three (3) years as a university professor. The training and experience documented must be substantially equivalent to that required for new licensed professional counselors designated as mental health service providers.
  6. (f) Any licensed professional counselor who does not wish to secure designation as a mental health service provider may maintain a professional counselor license, but is ineligible to appraise, assess, diagnose or treat conditions attributable to a mental disorder.
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§ 63-22-108. Renewal, revocation and reinstatement of licenses or certificates — Fees — Disposition of funds — Operating expenses — Retirement.
  1. (a) Each and every license or certificate holder shall pay to the secretary-treasurer of the board a renewal fee to be fixed by the board and shall submit verification of compliance of continuing education requirements as may be set by the board. The secretary of the board shall notify the holder of each license or certificate that the renewal fee is due, and the failure to pay such renewal fee by any license or certificate holder at the expiration of sixty (60) days after the renewal fee is due constitutes a violation of this part. Any license or certificate not renewed within sixty (60) days of the renewal date shall be revoked without further notice, but may be reinstated, if continuing education requirements have been met, upon payment of all past due renewal fees and a penalty per license or certificate.
  2. (b) All fees coming into the possession of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  3. (c) The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  4. (d) Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this part if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this part and shall meet other requirements as may be set by the board.
  5. (e)
    1. (1) Notwithstanding this part to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
    2. (2) No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in subdivision (e)(1).
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§ 63-22-109. Board action on completed applications for initial licensure or transfer.
  1. (a) When the board receives a completed application for initial licensure or a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
    1. (1) Render a decision on the application; or
    2. (2) Inform the applicant of the need to appear before the board.
  2. (b) As used in this section, “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-22-110. Denial, withholding, restricting or revoking licensure or certification — Disciplinary actions — Unprofessional conduct.
  1. (a) The board has the power to:
    1. (1) Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license or certificate;
    3. (3) Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or license or certificate holder as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license or certificate.
  2. (b) The grounds upon which the board shall exercise such power includes, but is not limited to, the following:
    1. (1) Conviction of a felony;
    2. (2) Using fraud or deception in applying for a license or certificate or in taking an examination required by this part;
    3. (3) Violating the rules and regulations adopted by the board, except that a violation of A.11.b of the 2014 American Counseling Association Code of Ethics, or any similar or successor provision, shall not be grounds upon which the board shall exercise its powers pursuant to subsection (a); provided, however, that a violation of A.11.b shall be a ground for the board to exercise these powers in cases involving an individual seeking or undergoing counseling where the individual was in imminent danger of harming themselves or others; or
    4. (4) Engaging in professional misconduct, unethical or unprofessional conduct, including, but not limited to, willful acts, negligence and conduct likely to deceive, defraud or harm the public or engaged in such conduct.
  3. (c) The board has the power to:
    1. (1) Deny an application for a license to any marital and family therapist applicant who applies for the same through reciprocity or otherwise where the applicant does not meet the standards in this part;
    2. (2) Permanently or temporarily withhold issuance of a marital and family therapist license where the applicant does not meet the standards in this part;
    3. (3) Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. (4) Reprimand or take such action in relation to disciplining an applicant or license holder or certificate holder as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license or certificate.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-22-111. Reinstatement of revoked license or certificate.
  1. A person whose license or certificate has been revoked by the board is not eligible to apply for reinstatement earlier than one (1) year from the date of revocation.
§ 63-22-113. Exemptions.
  1. (a) This part does not apply to a person if the person is preparing for the practice of marital and family therapy under qualified supervision in a training institution or facility or supervisory arrangement recognized and approved by the board; provided, that such person is designated by such titles as “marital therapy intern,” “family therapy trainee” or others clearly indicating such training status.
  2. (b) Nothing in this part shall be construed to prevent qualified members of other professional groups as defined by the board, including, but not limited to, licensed clinical social workers, licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants, psychiatric nurses, physicians, attorneys at law or members of the clergy from doing or advertising that they perform the work of a marital and family therapy nature consistent with the accepted standards of their respective professions, nor to prevent alcohol and drug abuse counselors licensed under § 68-24-605 or operating under qualified supervision while seeking such certification from doing counseling consistent with the accepted standards of that profession.
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§ 63-22-114. Confidentiality.
  1. The confidential relations and communications between licensed marital and family therapists, licensed professional counselors or certified clinical pastoral therapists and clients are placed upon the same basis as those provided by law between attorney and client, and nothing in this part shall be construed to require any such privileged communication to be disclosed. However, nothing contained within this section shall be construed to prevent disclosures of confidential communications in proceedings arising under title 37, chapter 1, part 4 concerning mandatory child abuse reports.
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§ 63-22-115. Marital therapy and counseling services — Definitions — Prohibited conduct — Penalty.
  1. (a) As used in this section, unless the context clearly requires a different meaning:
    1. (1) “Advertise” means, but is not limited to, the issuing or causing to be distributed any card, sign or device to any person, or the causing, permitting or allowing any sign or marking on or in any building or structure, or in any newspaper or magazine or, in any directory, or on radio or television or by advertising by any other means designed to secure public attention;
    2. (2) “Approved supervisor” means a licensed marital and family therapist, psychologist or psychiatrist who is either an American Association for Marriage and Family Therapy-approved supervisor or a board-approved marriage and family supervisor;
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    3. (3) “Board-approved marriage and family supervisor” means a person who gives to the board evidence of:
      1. (A) Five (5) years full-time experience in marriage and family therapy practice and supervision;
      2. (B) Thirty-six (36) hours of supervision specifically in the skill of providing marriage and family therapy supervision; and
      3. (C) A recommendation for board-approved supervisor status from a supervisor who provided supervision of the supervision referred to in subdivision (a)(3)(B);
    4. (4) “Licensed marital and family therapist” means a person to whom a license has been issued pursuant to this part, which license is in force and not suspended or revoked as of the particular time in question;
    5. (5) “Marital and family therapy” means the diagnosis and treatment of cognitive, affective and behavioral problems and dysfunctions within the context of marital and family systems. Marital and family therapy involves the professional application of psychotherapeutic family systems theories and techniques in the delivery of services to individuals in the context of family systems theory and practice, couples and families;
    6. (6) “Person” means any individual, firm, corporation, partnership, organization or body politic;
    7. (7) “Practice of marital and family therapy” means the rendering of professional marital and family therapy to individuals, couples and family groups, singly or in groups, whether such services are offered directly to the general public or through organizations, either public or private, for a fee;
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    8. (8) “Recognized educational institution” means any educational institution that is recognized by the board and by a nationally or regionally recognized educational or professional accrediting body;
    9. (9) “Supervision” means the direct clinical review, for the purpose of training or teaching, by an approved supervisor of a marriage and family therapist's interaction with clients. The purpose of supervision shall be to promote the development of the practitioner's clinical skills. Supervision may include, without being limited to, the review of case presentations, audiotapes, videotapes and direct observation; and
    10. (10) “Use a title or description of” means to hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationery, announcements, business cards or other instruments of professional identification.
  2. (b) Except as specifically provided in § 63-22-113, commencing July 1, 1991, no person who is not licensed or certified as a marital and family therapist under this part shall:
    1. (1) Advertise the performance of marital and family therapy or counseling service by such person; or
    2. (2) Use a title or description such as “licensed or certified marital or marriage therapist, counselor, advisor, or consultant,” or any other name, style or description denoting that the person is a marital and family therapist or practices marital and family therapy.
  3. (c) Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
  4. (d) In addition to the foregoing, the department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  5. (e) Nothing in this section shall be construed as permitting any person licensed or certified as a marital and family therapist to engage in the practice of “licensed psychological examiner,” “licensed senior psychological examiner,” “certified psychological assistant,” “licensed psychologist” or “licensed social worker,” as defined in the laws of this state.
  6. (f) Nothing in this section, except subsection (b), applies to any person regulated by the board of nursing.
  7. (g) Nothing in this section permits any person certified or licensed as a marital and family therapist to perform psychological testing intended to measure and/or diagnose mental illness. Consistent with each therapist's formal education and training, licensed marital and family therapists may administer and utilize appropriate assessment instruments that measure and/or diagnose, cognitive, affective and behavioral problems and dysfunctions of individuals in the context of marital and family systems, couples and families as part of the therapy process or in the development of a treatment plan.
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§ 63-22-116. Reciprocal agreements.
  1. (a) The board may license, without examination, a professional counselor applicant who is currently licensed in another state if the applicant's qualifications meet the licensure requirements under this part.
  2. (b) The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers professional counselors, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee. This agreement shall provide that the board shall license any resident of another state who is currently licensed, certified or registered by that state, if such resident has met the same or higher requirements as provided for in this part.
§ 63-22-117. Prohibited activities — Penalties — Exceptions to limitations.
  1. (a)
    1. (1) Except as specifically provided elsewhere in this part, commencing July 1, 1991, it is an offense for any person to engage in any of the following acts:
      1. (A) Representing or advertising such person as, or using a title or description such as, “licensed professional counselor” without being duly licensed according to this part;
      2. (B) Making use of any title, words, letters or abbreviations, or any combination thereof, that may reasonably be confused with licensure provided by this part to denote a standard of professional or occupational competence, without being duly licensed under this part; and
      3. (C) Performing activities that may reasonably be construed to fall within the defined scope of practice of persons licensed under this part who are designated as mental health service providers as defined in § 63-22-122 without being duly licensed hereunder.
    2. (2) Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
    3. (3) In addition to the foregoing, the department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  2. (b) Nothing in this part shall be construed as permitting any person licensed or certified as a professional counselor or designated as a mental health service provider under this chapter to engage in the practice of licensed psychological examiner, licensed senior psychological examiner, certified psychological assistant, licensed psychologist, licensed social worker, psychiatric nurse, law or medicine.
  3. (c) This part does not apply to the person if the person is preparing for the practice of professional counseling or the practice permitted to a person designated as a mental health service provider pursuant to this chapter under qualified supervision.
  4. (d) Nothing in this chapter shall be construed as limiting the ministry, activities or services of a rabbi, priest, minister of the gospel or others authorized by a regularly organized and functioning religious body in performing the ordinary duties or functions of the clergy; nor shall anything in this chapter apply to or be construed as limiting the activities or services of Christian Science practitioners. Nor shall any rabbi, priest, or minister who offers counseling services, even if fees are charged, be subject to the limitations of this chapter, as long as they do not hold themselves out as certified or licensed professional counselors.
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§ 63-22-118. Applicability of part.
  1. (a) The provisions of this part, except those contained in § 63-22-122, shall not apply to any persons regulated by the board of nursing or the state board of education, nor to professional counselors employed in community/human service agencies and working directly under the supervision of a licensed professional counselor nor to nurses licensed under chapter 7 of this title.
  2. (b) Nothing in this part shall be construed to prevent members of other professional groups, including, without limitation, licensed social workers, psychologists, psychiatrists and other physicians, attorneys or members of the clergy, from performing or advertising that they provide or offer counseling services consistent with the accepted standards of their respective professions; provided, that none of such persons shall violate § 63-22-117.
§ 63-22-119. Applicability of chapter 11 of this title.
  1. Notwithstanding this part to the contrary, any person licensed pursuant to this part and chapter 11 of this title shall be subject to the limitations of chapter 11 of this title.
§ 63-22-120. Requirements for licensure.
  1. A professional counselor licensed under this part and designated as a mental health service provider must have:
    1. (1) Completed coursework specifically related to the diagnosis, treatment, appraisal, and assessment of mental disorders; and
    2. (2) Completed two (2) years of postgraduate supervised experience required for licensure in a clinical setting that provides substantial opportunities to diagnose, treat, appraise, and assess mental disorders.
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§ 63-22-121. Temporary licenses.
  1. (a)
    1. (1) A temporary license may be issued by the board for a licensed professional counselor designated as a mental health service provider applicant who has completed the academic coursework and training required for the license sought and who has successfully passed the examination required by the board.
    2. (2) A temporary license obtained pursuant to this section authorizes an applicant to perform the functions specified in § 63-22-122(5), for which the applicant is seeking licensure under qualified supervision.
    3. (3) In order to receive a temporary license, an applicant must submit to the board a completed application for a temporary license with the applicant's completed application for the desired license and all appropriate fees.
    4. (4) If an applicant is granted a temporary license, the license shall remain valid for up to four (4) years and shall be eligible for extension at the discretion of the board.
    5. (5) The applicant shall notify the board and present supporting documentation demonstrating the satisfactory completion of the required postgraduate supervised experience in a clinical setting. The board shall then grant or deny the license application based on satisfactory completion of all requirements for licensure.
  2. (b)
    1. (1) A temporary license may be issued by the board to a marital and family therapist applicant who has completed the academic course work and training required for the license sought; provided, that in order to retain such temporary license, the applicant must take the written examination required by the board the first time it is scheduled following issuance of the temporary license. The applicant must successfully pass the exam within two (2) years following issuance of the temporary license.
    2. (2) A temporary license obtained pursuant to this section authorizes the applicant to engage in the practice of marital and family therapy, as defined by § 63-22-115(a)(7), under the supervision of an approved supervisor, as defined by § 63-22-115(a)(2) and (a)(9).
    3. (3) In order to receive a temporary license, the applicant must submit to the board the following:
      1. (A) A completed application for a temporary license;
      2. (B) Satisfactory evidence of an agreement with an approved supervisor under whose supervision the applicant intends to practice; and
      3. (C) All appropriate fees.
    4. (4) A temporary license shall be nonrenewable and shall be valid for a period of not more than three (3) years. Within such three-year period, the applicant must submit to the board an application for the regular license and must present supporting documentation demonstrating the satisfactory completion of the required amount of post-master's degree supervised experience in a clinical setting under an approved supervisor. The board shall then grant or deny the application for the regular license, based on satisfactory completion of all requirements for licensure, including the oral examination. If the board approves or denies the application for the regular license or if the board revokes the temporary license for any reason, then the temporary license shall cease to be valid and must be returned to the board.
    5. (5) The holder of a temporary license as a marital and family therapist shall not represent such temporary licensee to be a licensed marital and family therapist. The holder of such a license may only represent such temporary licensee to be a “marital therapy intern,” a “family therapy trainee” or such other title designation that clearly reflects trainee status and temporary licensure.
§ 63-22-122. Part definitions.
  1. As used in this part, unless the context otherwise requires:
    1. (1) “Appraisal activities” means selecting, administering, scoring and interpreting instruments designed to assess an individual's aptitudes, achievements or interests, which are used to understand, measure or facilitate such individual's normal human growth and development, but does not include the use of projective techniques in the assessment of personality, nor the use of psychological or clinical tests designed to identify or classify abnormal or pathological human behavior, nor the use of individually administered intelligence tests. Consistent with each counselor's formal education and training, licensed professional counselors may administer and utilize appropriate assessment instruments that measure and/or diagnose problems and/or dysfunctions within the context of human growth and development as part of the counseling process or in the development of a treatment plan;
    2. (2) “Counseling” means assisting an individual, through the counseling relationship, in a manner intended to facilitate normal human growth and development, using a combination of mental health and human development principles, methods and techniques, to achieve mental, emotional, physical, social, moral, educational, spiritual and/or career development and adjustment throughout the life span;
    3. (3) “Licensed professional counselor” means a person licensed under this part who is professionally trained in counseling and guidance services designed to facilitate normal human growth and development through individual, family or group counseling, educational procedures, assessment, consultation and research and who assists individuals by the practice of counseling with their personal, social, career or educational development as they pass through life stages;
    4. (4) “Practice of counseling” means rendering or offering to render to individuals, groups, organizations or the general public any service involving the application of principles, techniques, methods or procedures of the counseling profession, including appraisal activities, counseling, consulting and referral activities. Nothing in this section shall be construed to permit the treatment of any mental, emotional or adjustment disorder other than marital problems, parent-child problems, child and adolescent antisocial behavior, adult antisocial behavior, other specified family circumstances, other interpersonal problems, phase of life problems, other life circumstance problems, occupational problems and uncomplicated bereavement, except as provided in subdivision (5); and
    5. (5) “Practice of counseling as a mental health service provider” means the application of mental health and human development principles in order to:
      1. (A) Facilitate human development and adjustment throughout the life span;
      2. (B) Prevent, diagnose, and treat mental, emotional or behavioral disorders and associated disorders that interfere with mental health;
      3. (C) Conduct assessments and diagnoses for the purpose of establishing treatment goals and objectives within the limitations prescribed in subdivision (1); and
      4. (D) Plan, implement and evaluate treatment plans using counseling treatment interventions. “Counseling treatment interventions” means the application of cognitive, affective, behavioral and systemic counseling strategies that include principles of development, wellness and pathology that reflect a pluralistic society. Nothing in this definition shall be construed to permit the performance of any act that licensed professional counselors designated as mental health service providers are not educated and trained to perform, nor shall it be construed to permit the designation of testing reports as “psychological.”
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Part 2 Clinical Pastoral Therapy
§ 63-22-201. Part definitions.
  1. The following definitions shall apply in this part, unless the context clearly requires a different meaning:
    1. (1) “Advertise” means, but is not limited to, business solicitations, with or without limiting qualifications, in a card, sign or device issued to a person, in a sign or marking in or on any building or in any newspaper, magazine, directory or other printed matter. Advertising also includes business solicitations communicated by individual, radio, video or television broadcasting or other means designed to secure public attention;
    2. (2) “Certified clinical pastoral therapist” means a person who has met the qualifications for certified clinical pastoral therapist and holds a current, unsuspended or unrevoked certificate that has been lawfully issued by the board;
    3. (3) “Clinical pastoral education” means program of training designed to acquaint students of theology and practicing clergy with the clinical method of learning, increase skills in the arts of pastoral care and facilitate integration of a professional pastoral identity. Programs typically occur in general medical, psychiatric or penal institutions;
    4. (4) “Clinical pastoral therapy” means the diagnosis and treatment, from a clinical pastoral perspective, of the psychodynamics, interpersonal dynamics and spiritual dynamics of persons experiencing emotional behavioral or relational distress or dysfunction. Clinical pastoral therapy involves the integration and professional application of resources and techniques from the religious community's traditions of pastoral care and counsel along with recognized principles, methods and procedures of the contemporary psychotherapy community in the delivery of counseling and psychotherapeutic services to individuals, couples, families and groups;
    5. (5) “Licensed clinical pastoral therapist” means a person who has met the qualifications for a licensed clinical pastoral therapist and who holds a current, unsuspended or unrevoked license that has been issued lawfully by the board;
    6. (6) “Practice of clinical pastoral therapy” means the rendering of professional clinical pastoral therapy to individuals, couples, families or groups, either offered directly to the general public by an individual operating independently of any institution, organization or agency, through mental health clinics or agencies, whether public or private or through hospitals, whether public or private, for a fee, excluding volunteer hours;
    7. (7) “Recognized educational institution” means any educational institution that is accredited by a nationally or regionally recognized educational accrediting body;
    8. (8) “Supervision” means the direct clinical review, for the purpose of training or teaching, by a board-approved supervisor, of a clinical pastoral therapist's interaction with clients. The purpose of supervision shall be to promote the development of the practitioner's clinical skills. Supervision may include, without being limited to, the review of case presentations, audiotapes, videotapes and direct observation; and
    9. (9) “Use a title or description of” means to hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationery, announcements, business cards or other instruments of professional identification.
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§ 63-22-202. Prohibited acts by nonlicensed therapists — Penalties.
  1. (a) Except as specifically provided in § 63-22-204, beginning January 1, 2004, no person who is not licensed as a clinical pastoral therapist under this part shall:
    1. (1) Advertise that the performance of clinical pastoral therapy services is by a licensed clinical pastoral therapist; or
    2. (2) Use the title “licensed clinical pastoral therapist” to denote that the person is a licensed clinical pastoral therapist.
  2. (b) Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
  3. (c) The department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  4. (d) Nothing in this section shall be construed as permitting any person certified as a clinical pastoral therapist to engage in the practice of licensed psychological examiner, licensed senior psychological examiner, certified psychological assistant, licensed psychologist, or licensed social worker, as defined in the laws of this state.
  5. (e) Nothing in this section, except in subsection (b), applies to any person regulated by the board of nursing.
  6. (f) Nothing in this section shall be construed as permitting a certified clinical pastoral therapist to prescribe medications or to interpret psychological tests intended to measure and/or diagnose mental illness.
  7. (g) Certified clinical pastoral therapists shall establish and maintain effective working relationships with an interdisciplinary network of professionals, including at least one (1) psychologically oriented physician, usually a psychiatrist, with an unlimited license to practice the healing arts in Tennessee, in order to make provision for referral for the diagnosis and treatment of medical or mental conditions falling outside the scope of clinical pastoral therapy as defined in § 63-22-201.
§ 63-22-203. Application for license — Fees — Qualifications.
  1. (a) An applicant for licensure as a licensed clinical pastoral therapist shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:
    1. (1) Is at least eighteen (18) years of age;
    2. (2) Is of good moral character;
    3. (3) Has met the educational standards set by the board, which shall include:
      1. (A) The completion of a course of studies consisting of a minimum of sixty (60) graduate semester hours in a curriculum approved by the board, of which a minimum of nine (9) graduate semester hours must relate specifically to the diagnosis and treatment of mental disorders, and the awarding of a master's or doctoral degree from a recognized educational institution; and
      2. (B) The completion of a supervised clinical experience within the academic degree program as either a practicum or internship that includes experience in the assessment, diagnosis, and treatment of the psychodynamics, interpersonal dynamics, and spiritual dynamics of persons experiencing emotional, behavioral, relational, or spiritual distress or dysfunction. The experience required under this subdivision (3)(B) must be conducted under the supervision of a board-approved supervisor;
    4. (4) Has provided a minimum of one thousand four hundred (1,400) hours of pastoral therapy with individuals, couples, families, or groups while receiving a minimum of two hundred seventy (270) hours of supervision of such therapy under board-approved supervision; and
    5. (5) Has passed examinations as approved by the board.
  2. (b)
    1. (1) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
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§ 63-22-204. Exclusions from part.
  1. (a) Nothing in this chapter shall be construed as limiting the ministry, activities or services of a rabbi, priest, minister of the gospel or others authorized by a regularly organized and functioning religious body in performing the ordinary duties or functions of the clergy, nor shall anything in this chapter apply to or be construed as limiting the activities or services of Christian Science practitioners. Nor shall any rabbi, priest or minister who offers counseling services, even if fees are charged, shall be subject to the limitations of this part, as long as they do not hold themselves out as licensed pastoral therapists or licensed pastoral counselors and as long as they do not purport to provide the integration and professional application of resources and techniques from the religious community's traditions of pastoral care and counsel along with recognized principles, methods and procedures of clinical psychotherapy.
  2. (b) This part does not apply to a person if the person is preparing for the practice of clinical pastoral therapy under qualified supervision in a training institution or facility or supervisory arrangement recognized and approved by the board; provided, that such person is designated by such titles as “pastoral therapy intern,” “pastoral therapy trainee” or others clearly indicating such training status.
  3. (c) Nothing in this part shall be construed to prevent qualified members of other professional groups as defined by the board, including, but not limited to, licensed clinical social workers, licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants, psychiatric nurses, physicians or attorneys at law, from performing or advertising that they provide or offer counseling services consistent with the accepted standards of their respective professions nor to prevent alcohol and drug abuse counselors licensed under § 68-24-605 or operating under qualified supervision while seeking such licensure from doing counseling consistent with the accepted standards of such profession.
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§ 63-22-205. Reciprocal agreements — License by endorsement.
  1. (a)
    1. (1) The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers clinical pastoral therapists, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee. This agreement shall provide that the board may license without examination any resident of another state who is currently licensed, certified or registered by the state, if that resident has met the same or higher requirements as provided in this part.
    2. (2)
      1. (A) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
        1. (i) Render a decision on the application; or
        2. (ii) Inform the applicant of the need to appear before the board.
      2. (B) As used in this subdivision (a)(2), “completed application” means an application that satisfies all statutory and board rule requirements.
  2. (b) The board may license by endorsement a clinical pastoral therapist applicant who is a fellow or diplomate of the American Association of Pastoral Counselors if that person otherwise meets the requirements of this chapter.
  3. (c) The board may also license by endorsement a clinical pastoral therapist applicant who is:
    1. (1) Certified as a clinical member of the American Association of Pastoral Counselors;
    2. (2) Can document five (5) years of full-time practice in pastoral therapy subsequent to AAPC certification; and
    3. (3) Otherwise meets the requirements of this chapter.
§ 63-22-206. License of certain applicants prior to January 1, 2006 — Documentation.
  1. (a) Until January 1, 2006, applicants who fulfill at least one (1) of the following conditions shall be entitled to receive a license as a licensed clinical pastoral therapist:
    1. (1) Hold current certification as a clinical pastoral therapist. Such certification must be lawfully issued by the board and not be suspended or revoked;
    2. (2) Document satisfaction of the requirements of § 63-22-203(1)-(4) only;
    3. (3) Document current active status as a fellow or diplomate of AAPC and being actively engaged in the practice of pastoral psychotherapy for at least five (5) years prior to January 1, 2003; or
    4. (4) Document having received a graduate theological degree from a recognized educational institution and being currently licensed in Tennessee as a psychologist designated as a health service provider, a professional counselor designated as a mental health service provider, a marital and family therapist, a clinical social worker or an alcohol and drug abuse counselor and, in addition, document being actively engaged in the practice of clinical pastoral therapy for at least five (5) years prior to January 1, 2003.
  2. (b) Persons who qualify for licensure as a clinical pastoral therapist pursuant to this section shall provide satisfactory proof to the board of such qualification. The board shall issue a license as a licensed clinical pastoral therapist to those persons who meet the qualifications of subsection (a) and who submit required proof of such qualifications.
§ 63-22-207. Issuance of license.
  1. A person who is certified as a certified clinical pastoral therapist on June 3, 2003, shall be issued a license as a licensed clinical pastoral therapist when such person's certification is renewed or upon request of such person before the expiration of such person's current certification.
§ 63-22-208. Temporary license.
  1. (a) The board is authorized to issue a temporary license to a clinical pastoral therapist applicant who has completed the academic course work and supervised clinical experience for the license sought; provided, that in order to retain the temporary license, the applicant shall take the written examination required by the board the first time it is scheduled following issuance of the temporary license unless granted an extension by the board after submitting a written request to the board and making a showing of good cause as determined by the board. The applicant must successfully pass the exam within two (2) years following issuance of the temporary license unless the applicant receives a good cause extension by the board. An applicant may only receive one (1) good cause extension from the board.
  2. (b) A temporary license obtained pursuant to this section authorizes the applicant to engage in the practice of clinical pastoral therapy under the supervision of a board-approved supervisor.
  3. (c) In order to receive a temporary license, the applicant must submit to the board the following:
    1. (1) A completed application for a temporary license;
    2. (2) Satisfactory evidence of an agreement with a board-approved supervisor; and
    3. (3) All required fees.
  4. (d) A temporary license shall be nonrenewable and shall be valid for a period of not more than three (3) years. A temporary license may be extended beyond the three-year period at the discretion of the board if an applicant shows good cause for an extension as determined by the board. Only one (1) extension may be granted by the board for an applicant to extend the length of the applicant's temporary license. Within the period of temporary licensure, the applicant shall submit to the board an application for the regular license and shall present supporting documentation demonstrating the satisfactory completion of the required supervised clinical experience. The board shall then grant or deny the application for the regular license, based on satisfactory completion of all requirements for licensure. If the board approves or denies the application for the regular license or if the board revokes the temporary license for any reason, then the temporary license shall cease to be valid and shall be returned to the board.
  5. (e) The holder of a temporary license as a clinical pastoral therapist shall not represent himself or herself to be a licensed clinical pastoral therapist. The holder of a temporary license as a clinical pastoral therapist may only represent himself or herself to be a “pastoral therapy intern,” a “pastoral therapy trainee,” or such other title designation that clearly reflects trainee status and temporary licensure.
Part 3 Conscientious Objections to Provision of Counseling or Therapy Services
§ 63-22-301. Part definitions.
  1. For purposes of this part, “counseling or therapy services” means assisting an individual, who is seeking or engaged in the counseling relationship in a private practice setting, in a manner intended to facilitate normal human growth and development, using a combination of mental health and human development principles, methods, and techniques, to achieve mental, emotional, physical, social, moral, educational, spiritual, or career development and adjustment throughout the individual's life span.
§ 63-22-302. Conscientious objections — Referrals to other providers — Liability.
  1. (a) No counselor or therapist providing counseling or therapy services shall be required to counsel or serve a client as to goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselor or therapist; provided, that the counselor or therapist coordinates a referral of the client to another counselor or therapist who will provide the counseling or therapy.
  2. (b) The refusal to provide counseling or therapy services as described in subsection (a) shall not be the basis for:
    1. (1) A civil cause of action; or
    2. (2) Criminal prosecution.
  3. (c) Subsections (a) and (b) shall not apply to a counselor or therapist when an individual seeking or undergoing counseling is in imminent danger of harming themselves or others.
Part 4 Interstate Compact for License Portability Act
§ 63-22-401 Short title.
  1. This part is known and may be cited as the “Interstate Compact for License Portability Act.”
§ 63-22-402. Compact approved and ratified.
  1. The general assembly hereby approves and ratifies, and the governor shall enter into, a compact on behalf of the state of Tennessee with any of the United States or other jurisdictions legally joining therein in the form substantially as follows:
    1. INTERSTATE COMPACT FOR LICENSE PORTABILITY
      2. The purpose of this Compact is to facilitate interstate practice of licensed professional counselors with the goal of improving public access to professional counseling services. The practice of professional counseling occurs in the state where the client is located at the time of the counseling services. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure.
      3. This Compact is designed to achieve the following objectives:
        1. (A) Increase public access to professional counseling services by providing for the mutual recognition of other member state licenses;
        2. (B) Enhance the states' ability to protect the public's health and safety;
        3. (C) Encourage the cooperation of member states in regulating multistate practice for licensed professional counselors;
        4. (D) Support spouses of relocating active duty military personnel;
        5. (E) Enhance the exchange of licensure, investigative, and disciplinary information among member states;
        6. (F) Allow for the use of telehealth technology to facilitate increased access to professional counseling services;
        7. (G) Support the uniformity of professional counseling licensure requirements throughout the states to promote public safety and public health benefits;
        8. (H) Invest all member states with the authority to hold a licensed professional counselor accountable for meeting all state practice laws in the state in which the client is located at the time care is rendered through the mutual recognition of member state licenses;
        9. (I) Eliminate the necessity for licenses in multiple states; and
        10. (J) Provide opportunities for interstate practice by licensed professional counselors who meet uniform licensure requirements.
      4. As used in this Compact, and except as otherwise provided, the following definitions shall apply:
        1. (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 U.S.C. Chapters 1209 and 1211.
        2. (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 a licensed professional counselor, including actions against an individual's license or privilege to practice such as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee's practice, or any other encumbrance on licensure affecting a licensed professional counselor's authorization to practice, including issuance of a cease and desist action.
        3. (C) “Alternative program” means a non-disciplinary monitoring or practice remediation process approved by a professional counseling licensing board to address impaired practitioners.
        4. (D) “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.
        5. (E) “Counseling Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.
        6. (F) “Current significant investigative information” means:
          1. (1) Investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the licensed professional counselor 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. (2) Investigative information that indicates that the licensed professional counselor represents an immediate threat to public health and safety regardless of whether the licensed professional counselor has been notified and had an opportunity to respond.
        7. (G) “Data system” means a repository of information about licensees, including, but not limited to, continuing education, examination, licensure, investigative, privilege to practice, and adverse action information.
        8. (H) “Encumbered license” means a license in which an adverse action restricts the practice of licensed professional counseling by the licensee and said adverse action has been reported to the National Practitioners Data Bank (NPDB).
        9. (I) “Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of licensed professional counseling by a licensing board.
        10. (J) “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.
        11. (K) “Home state” means the member state that is the licensee's primary state of residence.
        12. (L) “Impaired practitioner” means an individual who has a condition(s) that may impair their ability to practice as a licensed professional counselor without some type of intervention and may include, but are not limited to, alcohol and drug dependence, mental health impairment, and neurological or physical impairments.
        13. (M) “Investigative information” means information, records, and documents received or generated by a professional counseling licensing board pursuant to an investigation.
        14. (N) “Jurisprudence requirement” if required by a member state, means the assessment of an individual's knowledge of the laws and rules governing the practice of professional counseling in a state.
        15. (O) “Licensed professional counselor” means a counselor licensed by a member state, regardless of the title used by that state, to independently assess, diagnose, and treat behavioral health conditions.
        16. (P) “Licensee” means an individual who currently holds an authorization from the state to practice as a licensed professional counselor.
        17. (Q) “Licensing board” means the agency of a state, or equivalent, that is responsible for the licensing and regulation of licensed professional counselors.
        18. (R) “Member state” means a state that has enacted the Compact.
        19. (S) “Privilege to practice” means a legal authorization, which is equivalent to a license, permitting the practice of professional counseling in a remote state.
        20. (T) “Professional counseling” means the assessment, diagnosis, and treatment of behavioral health conditions by a licensed professional counselor.
        21. (U) “Remote state” means a member state other than the home state, where a licensee is exercising or seeking to exercise the privilege to practice.
        22. (V) “Rule” means a regulation promulgated by the Commission that has the force of law.
        23. (W) “Single state license” means a licensed professional counselor license issued by a member state that authorizes practice only within the issuing state and does not include a privilege to practice in any other member state.
        24. (X) “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of professional counseling.
        25. (Y) “Telehealth” means the application of telecommunication technology to deliver professional counseling services remotely to assess, diagnose, and treat behavioral health conditions.
        26. (Z) “Unencumbered license” means a license that authorizes a licensed professional counselor to engage in the full and unrestricted practice of professional counseling.
      5. (A) To participate in the Compact, a state must currently:
        1. (1) License and regulate licensed professional counselors;
        2. (2) Require licensees to pass a nationally recognized exam approved by the Commission;
        3. (3) Require licensees to have a 60 semester-hour (or 90 quarter-hour) master's degree in counseling or 60 semester-hours (or 90 quarter-hours) of graduate course work including the following topic areas:
          1. (a) Professional counseling orientation and ethical practice;
          2. (b) Social and cultural diversity;
          3. (c) Human growth and development;
          4. (d) Career development;
          5. (e) Counseling and helping relationships;
          6. (f) Group counseling and group work;
          7. (g) Diagnosis and treatment;
          8. (h) Assessment and testing;
          9. (i) Research and program evaluation; and
          10. (j) Other areas as determined by the Commission;
        4. (4) Require licensees to complete a supervised postgraduate professional experience as defined by the Commission; and
        5. (5) Have a mechanism in place for receiving and investigating complaints about licensees.
      6. (B) A member state shall:
        1. (1) Participate fully in the Commission's data system, including using the Commission's unique identifier as defined in rules;
        2. (2) 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;
        3. (3) Implement or utilize procedures for considering the criminal history records of applicants for an initial privilege to practice. 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:
          1. (a) A member state must 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 and shall use the results in making licensure decisions; and
          2. (b) Communication between a member state, the Commission, and 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 Public Law 92-544;
        4. (4) Comply with the rules of the Commission;
        5. (5) Require an applicant to obtain or retain a license in the home state and meet the home state's qualifications for licensure or renewal of licensure, as well as all other applicable state laws;
        6. (6) Grant the privilege to practice to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the Compact and rules; and
        7. (7) Provide for the attendance of the state's commissioner to the Counseling Compact Commission meetings.
      7. (C) Member states may charge a fee for granting the privilege to practice.
      8. (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 privilege to practice professional counseling in any other member state.
      9. (E) Nothing in this Compact shall affect the requirements established by a member state for the issuance of a Single State License.
      10. (F) A license issued to a licensed professional counselor by a home state to a resident in that state shall be recognized by each member state as authorizing a licensed professional counselor to practice professional counseling, under a privilege to practice, in each member state.
      11. (A) To exercise the privilege to practice under the terms and provisions of the Compact, the licensee shall:
        1. (1) Hold a license in the home state;
        2. (2) Have a valid United States social security number or National Practitioner Identifier;
        3. (3) Be eligible for a privilege to practice in any member state in accordance with Section 4(D), (G), and (H);
        4. (4) Have not had any encumbrance or restriction against any license or privilege to practice within the previous two (2) years;
        5. (5) Notify the Commission that the licensee is seeking the privilege to practice within a remote state(s);
        6. (6) Pay any applicable fees, including any state fee, for the privilege to practice;
        7. (7) Meet any continuing competence/education requirements established by the home state;
        8. (8) Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a privilege to practice; and
        9. (9) Report to the Commission any adverse action, encumbrance, or restriction on a license taken by any non-member state within thirty (30) days from the date the action is taken.
      12. (B) The privilege to practice is valid until the expiration date of the home state license. The licensee must comply with the requirements of Section 4(A) to maintain the privilege to practice in the remote state.
      13. (C) A licensee providing professional counseling in a remote state under the privilege to practice shall adhere to the laws and regulations of the remote state.
      14. (D) A licensee providing professional counseling services 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 privilege to practice 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 privilege to practice in any member state until the specific time for removal has passed and all fines are paid.
      15. (E) If a home state license is encumbered, the licensee shall lose the privilege to practice in any remote state until the following occur:
        1. (1) The home state license is no longer encumbered; and
        2. (2) Have not had any encumbrance or restriction against any license or privilege to practice within the previous two (2) years.
      16. (F) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4(A) to obtain a privilege to practice in any remote state.
      17. (G) If a licensee's privilege to practice in any remote state is removed, the individual may lose the privilege to practice in all other remote states until the following occur:
        1. (1) The specific period of time for which the privilege to practice was removed has ended;
        2. (2) All fines have been paid; and
        3. (3) Have not had any encumbrance or restriction against any license or privilege to practice within the previous two (2) years.
      18. (H) Once the requirements of Section 4(G) have been met, the licensee must meet the requirements in Section 4(A) to obtain a privilege to practice in a remote state.
      19. (A) A licensed professional counselor may hold a home state license, which allows for a privilege to practice in other member states, in only one member state at a time.
      20. (B) If a licensed professional counselor changes primary state of residence by moving between two member states:
        1. (1) The licensed professional counselor shall file an application for obtaining a new home state license based on a privilege to practice, pay all applicable fees, and notify the current and new home state in accordance with applicable rules adopted by the Commission;
        2. (2) Upon receipt of an application for obtaining a new home state license by virtue of a privilege to practice, the new home state shall verify that the licensed professional counselor meets the pertinent criteria outlined in Section 4 via the data system, without need for primary source verification except for:
          1. (a) Federal Bureau of Investigation fingerprint based criminal background check if not previously performed or updated pursuant to applicable rules adopted by the Commission in accordance with Public Law 92-544;
          2. (b) Other criminal background check as required by the new home state; and
          3. (c) Completion of any requisite Jurisprudence Requirements of the new home state;
        3. (3) The former home state shall convert the former home state license into a privilege to practice once the new home state has activated the new home state license in accordance with applicable rules adopted by the Commission;
        4. (4) Notwithstanding any other provision of this Compact, if the licensed professional counselor cannot meet the criteria in Section 4, the new home state may apply its requirements for issuing a new Single State License; and
        5. (5) The licensed professional counselor shall pay all applicable fees to the new home state in order to be issued a new home state license.
      21. (C) If a licensed professional counselor 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.
      22. (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.
      23. (E) Nothing in this Compact shall affect the requirements established by a member state for the issuance of a Single State License.
      24. Active duty military personnel, 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. 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 outlined in Section 5.
      25. (A) Member states shall recognize the right of a licensed professional counselor, licensed by a home state in accordance with Section 3 and under rules promulgated by the Commission, to practice professional counseling in any member state via telehealth under a privilege to practice as provided in the Compact and rules promulgated by the Commission.
      26. (B) A licensee providing professional counseling services in a remote state under the privilege to practice shall adhere to the laws and regulations of the remote state.
      27. (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. (1) Take adverse action against a licensed professional counselor's privilege to practice within that member state, and
        2. (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.
        3. (3) Only the home state shall have the power to take adverse action against a licensed professional counselor's license issued by the home state.
      28. (B) 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.
      29. (C) The home state shall complete any pending investigations of a licensed professional counselor who changes primary state of residence during the course of the investigations. The home state shall also have the authority to take appropriate action(s) and shall promptly report the conclusions of the investigations to the administrator of the data system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any adverse actions.
      30. (D) A member state, if otherwise permitted by state law, may recover from the affected licensed professional counselor the costs of investigations and dispositions of cases resulting from any adverse action taken against that licensed professional counselor.
      31. (E) 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.
      32. (F) Joint investigations:
        1. (1) In addition to the authority granted to a member state by its respective professional counseling practice act or other applicable state law, any member state may participate with other member states in joint investigations of licensees.
        2. (2) Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
      33. (G) If adverse action is taken by the home state against the license of a licensed professional counselor, the licensed professional counselor's privilege to practice 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 the license of a licensed professional counselor shall include a statement that the licensed professional counselor's privilege to practice is deactivated in all member states during the pendency of the order.
      34. (H) 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. 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.
      35. (A) The Compact member states hereby create and establish a joint public agency known as the Counseling Compact Commission:
        1. (1) The Commission is an instrumentality of the Compact states.
        2. (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. (3) Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
      36. (B) Membership, Voting, and Meetings.
        1. (1) Each member state shall have and be limited to one (1) delegate selected by that member state's licensing board.
        2. (2) The delegate shall be either:
          1. (a) A current member of the licensing board at the time of appointment, who is a licensed professional counselor or public member; or
          2. (b) An administrator of the licensing board.
        3. (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. (4) The member state licensing board shall fill any vacancy occurring on the Commission within sixty (60) days.
        5. (5) Each delegate shall be entitled to one (1) 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. (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. (7) The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
        8. (8) The Commission shall by rule establish a term of office for delegates and may by rule establish term limits.
      37. (C) The Commission shall have the following powers and duties:
        1. (1) Establish the fiscal year of the Commission;
        2. (2) Establish bylaws;
        3. (3) Maintain its financial records in accordance with the bylaws;
        4. (4) Meet and take such actions as are consistent with the provisions of this Compact and the bylaws;
        5. (5) Promulgate rules which shall be binding to the extent and in the manner provided for in the Compact;
        6. (6) 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;
        7. (7) Purchase and maintain insurance and bonds;
        8. (8) Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;
        9. (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 establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;
        10. (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. (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. (12) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
        13. (13) Establish a budget and make expenditures;
        14. (14) Borrow money;
        15. (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. (16) Provide and receive information from, and cooperate with, law enforcement agencies;
        17. (17) Establish and elect an Executive Committee; and
        18. (18) Perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of professional counseling licensure and practice.
      38. (D) The Executive Committee.
        1. (1) The Executive Committee shall have the power to act on behalf of the Commission according to the terms of this Compact.
        2. (2) The Executive Committee shall be composed of up to eleven (11) members:
          1. (a) Seven (7) voting members who are elected by the Commission from the current membership of the Commission; and
          2. (b) Up to four (4) ex-officio, nonvoting members from four (4) recognized national professional counselor organizations.
        3. (3) The ex-officio members will be selected by their respective organizations.
        4. (4) The Commission may remove any member of the Executive Committee as provided in bylaws.
        5. (5) The Executive Committee shall meet at least annually.
        6. (6) The Executive Committee shall have the following duties and responsibilities:
          1. (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 privilege to practice;
          2. (b) Ensure Compact administration services are appropriately provided, contractual or otherwise;
          3. (c) Prepare and recommend the budget;
          4. (d) Maintain financial records on behalf of the Commission;
          5. (e) Monitor Compact compliance of member states and provide compliance reports to the Commission;
          6. (f) Establish additional committees as necessary; and
          7. (g) Other duties as provided in rules or bylaws.
      39. (E) Meetings of the Commission.
        1. (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 Section 11.
        2. (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:
          1. (a) Non-compliance of a member state with its obligations under the Compact;
          2. (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;
          3. (c) Current, threatened, or reasonably anticipated litigation;
          4. (d) Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
          5. (e) Accusing any person of a crime or formally censuring any person;
          6. (f) Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
          7. (g) Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
          8. (h) Disclosure of investigative records compiled for law enforcement purposes;
          9. (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
          10. (j) Matters specifically exempted from disclosure by federal or member state statute.
        3. (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. (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.
      40. (F) Financing of the Commission.
        1. (1) The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
        2. (2) The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
        3. (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 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. (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. (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.
      41. (G) Qualified Immunity, Defense, and Indemnification.
        1. (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. (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. (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.
      42. (A) The Commission shall provide for the development, maintenance, operation, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.
      43. (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:
        1. (1) Identifying information;
        2. (2) Licensure data;
        3. (3) Adverse actions against a license or privilege to practice;
        4. (4) Non-confidential information related to Alternative Program participation;
        5. (5) Any denial of application for licensure, and the reason(s) for such denial;
        6. (6) Current significant investigative information; and
        7. (7) Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.
      44. (C) Investigative information pertaining to a licensee in any member state will only be available to other member states.
      45. (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.
      46. (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.
      47. (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.
      48. (A) The Commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purpose 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 or effect.
      49. (B) The Commission shall exercise its rulemaking 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.
      50. (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 four (4) years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state.
      51. (D) Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
      52. (E) 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 rulemaking:
        1. (1) On the website of the Commission or other publicly accessible platform; and
        2. (2) On the website of each member state professional counseling licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules.
      53. (F) The notice of proposed rulemaking shall include:
        1. (1) The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;
        2. (2) The text of the proposed rule or amendment and the reason for the proposed rule;
        3. (3) A request for comments on the proposed rule from any interested person; and
        4. (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.
      54. (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.
      55. (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. (1) At least twenty-five (25) persons;
        2. (2) A state or federal governmental subdivision or agency; or
        3. (3) An association having at least twenty-five (25) members.
      56. (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. (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 five (5) business days before the scheduled date of the hearing.
        2. (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. (3) All hearings will be recorded. A copy of the recording will be made available on request.
        4. (4) 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.
      57. (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.
      58. (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.
      59. (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.
      60. (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 section 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 in order to:
        1. (1) Meet an imminent threat to public health, safety, or welfare;
        2. (2) Prevent a loss of Commission or member state funds;
        3. (3) Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
        4. (4) Protect public health and safety.
      61. (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 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 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.
      62. (A) Oversight.
        1. (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 this Compact and the rules promulgated hereunder shall have standing as statutory law.
        2. (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. (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.
      63. (B) Default, technical assistance, and termination.
        1. (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:
          1. (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
          2. (b) Provide remedial training and specific technical assistance regarding the default.
      64. (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 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.
      65. (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 minority leaders of the defaulting state's legislature, and each of the member states.
      66. (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.
      67. (F) 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.
      68. (G) 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.
      69. (H) Dispute resolution.
        1. (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. (2) The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
      70. (I) Enforcement.
        1. (1) The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
        2. (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. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.
        3. (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.
      71. (A) The Compact 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.
      72. (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.
      73. (C) Any member state may withdraw from this Compact by enacting a statute repealing the same.
        1. (1) A member state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
        2. (2) Withdrawal shall not affect the continuing requirement of the withdrawing state's professional counseling licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.
      74. (D) Nothing contained in this Compact shall be construed to invalidate or prevent any professional counseling licensure agreement or other cooperative arrangement between a member state and a non-member state that does not conflict with the provisions of this Compact.
      75. (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.
      76. 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.
      77. (A) A licensee providing professional counseling services in a remote state under the privilege to practice shall adhere to the laws and regulations, including scope of practice, of the remote state.
      78. (B) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.
      79. (C) Any laws in a member state in conflict with the Compact are superseded to the extent of the conflict.
      80. (D) Any lawful actions of the Commission, including all rules and bylaws properly promulgated by the Commission, are binding upon the member states.
      81. (E) All permissible agreements between the Commission and the member states are binding in accordance with their terms.
      82. (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.
§ 63-22-403. Rulemaking.
  1. The board for professional counselors, marital and family therapists, and clinical pastoral therapists, in consultation with the department of health, may promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this part.
§ 63-22-404. Effective date of compact; notice to revisor of statutes.
  1. This part takes effect on the date the compact is enacted into law in the tenth compact state. The board for professional counselors, marital and family therapists, and clinical pastoral therapists shall notify the executive secretary of the Tennessee code commission, the chair of the government operations committee of the senate, and the chair of the government operations committee of the house of representatives in writing when the condition specified in this section has occurred.
Chapter 23 Social Workers
§ 63-23-101. Board — Creation — Membership.
  1. (a) There is created the board of social worker licensure. On and after July 1, 2008, the former board of social worker certification and licensure is renamed and shall be known as the board of social worker licensure.
  2. (b)
    1. (1) On and after July 1, 2008, the board shall consist of eleven (11) members, one (1) of whom shall be a representative of the public, having neither a direct nor an indirect association with the social work profession, and each of the remainder shall be social workers who possess the qualifications specified in §§ 63-23-102 — 63-23-105. The board shall at all times be composed of two (2) licensed baccalaureate social workers, two (2) licensed master's social workers, three (3) licensed advanced practice social workers and three (3) licensed clinical social workers, all of whom shall be residents of the state, and who shall be appointed by the governor.
    2. (2) In order to transition to the eleven-member board with new licensure classifications, appointments to the board on and after July 1, 2008, shall be made in the following manner:
      1. (A) A licensed advanced practice social worker shall be appointed to the board as a new member for a five-year term;
      2. (B) A licensed advanced practice social worker shall be appointed to the board as a new member for a four-year term;
      3. (C) A licensed baccalaureate social worker shall be appointed to the board as a new member for a five-year term;
      4. (D) A licensed baccalaureate social worker shall be appointed to the board as a new member for a four-year term;
      5. (E) A certified master social worker whose term expires in 2008 shall be replaced by the appointment of a licensed advanced practice social worker for a three-year term;
      6. (F) A certified master social worker whose term expires in 2008 shall be replaced by the appointment of a licensed master's social worker for a five-year term;
      7. (G) Two (2) independent practitioners whose terms expire in 2009 shall be replaced by the appointment of two (2) licensed clinical social workers for five-year terms;
      8. (H) A certified master social worker whose term expires in 2009 shall be replaced by the appointment of a licensed master's social worker for a five-year term;
      9. (I) An independent practitioner whose term expires in 2010 shall be replaced by the appointment of a licensed clinical social worker for a five-year term; and
      10. (J) The member of the public who is not directly or indirectly engaged in social work whose term expires in 2011 shall be replaced by a member of the public for a five-year term.
    3. (3) The social worker members may be appointed by the governor from lists of nominees submitted by interested social worker groups, including, but not limited to, the Tennessee chapter of the National Association of Social Workers. The governor shall consult with the interested social worker groups to determine qualified persons to fill positions on the board.
    4. (4) All board members, except the member of the public who is not directly or indirectly engaged in social work, shall be duly licensed or eligible to be licensed by the board. Subsequent appointees to the board shall possess the professional qualifications required by their predecessors as required in this section and shall be appointed to five-year terms.
    5. (5) Members shall serve until their successors are appointed and qualified. Any vacancy occurring on the board shall be filled by the governor for the balance of the unexpired term. A board member is eligible for reappointment.
    6. (6) In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  3. (c) For each day engaged in the business of the board, members shall receive as compensation fifty dollars ($50.00) and shall also receive actual expenses to be paid in accordance with the comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  4. (d) The members of the board shall annually elect a chair and a secretary.
  5. (e) The board shall meet as frequently as reasonably necessary to implement this chapter. Six (6) or more members of the board constitute a quorum for transacting board business.
  6. (f) For administrative purposes, the board shall be attached to the division of health related boards, as defined in § 68-1-101, referred to as “division” in this chapter.
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§ 63-23-102. Practice of baccalaureate social work — Licensing requirements.
  1. (a) The practice of baccalaureate social work is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The practice of baccalaureate social work is basic generalist practice that includes interviewing, assessment, planning, intervention, evaluation, case management, mediation, supportive counseling, direct nonclinical practice, information and referral, problem solving, client education, advocacy, community organization, supervision of employees, and the development, implementation, and administration of policies, programs and activities. Baccalaureate social workers are not qualified to diagnose or treat mental illness nor provide psychotherapy services. A social worker at this level shall not provide services to clients in exchange for direct payment or third-party reimbursement. A social worker at this level shall work in or for an agency or organization and may not practice privately or independently. Licensed baccalaureate social workers shall not engage in advanced social work practice or in clinical social work practice or hold themselves out as a licensed master's social worker, a licensed advance practice social worker or a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
  2. (b)
    1. (1) To obtain a license to engage in the practice of baccalaureate social work, an applicant must provide evidence satisfactory to the board that the applicant has:
      1. (A) Submitted a written application in the form prescribed by the board;
      2. (B) Paid all applicable fees specified by the board relative to the licensure process;
      3. (C) Attained the age of majority;
      4. (D) Graduated and received a baccalaureate degree in social work from a council on social work education approved program; and
      5. (E) Successfully passed the association of social work board's bachelor's licensing exam.
    2. (2) Any baccalaureate social worker who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure as a baccalaureate social worker without examination until December 31, 2010.
  3. (c) No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed baccalaureate social worker unless the person possesses a valid license issued pursuant to subsection (b).
  4. (d) A violation of subsection (c) is a Class A misdemeanor.
  5. (e) The board shall establish regulations for the issuance of temporary licenses to baccalaureate social workers who hold a baccalaureate degree in social work granted by any college, university, or school of social work that has applied for, but has not yet received, accreditation by the council on social work education.
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§ 63-23-103. Practice of licensed master social work — Licensing requirements.
  1. (a) The practice of licensed master's social work is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The practice of master's social work requires the application of specialized knowledge and advanced practice skills in the areas of assessment, treatment planning, implementation and evaluation, case management, mediation, counseling, supportive counseling, direct practice, information and referral, supervision of employees, consultation, education, research, advocacy, community organization and the development, implementation, and administration of policies, programs and activities. The practice of master's social work may include the practice activities of a licensed baccalaureate social worker. The practice of master's social work may include the practice of clinical social work under the clinical supervision of a licensed clinical social worker as an avenue for licensure as a clinical social worker. A social worker at this level shall not provide services to clients in exchange for direct payment or third-party reimbursement. Licensed master's social workers shall engage only in supervised practice in or for an agency or organization and may not practice privately or independently. Licensed master's social workers may not hold themselves out as a licensed advance practice social worker or a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
  2. (b)
    1. (1) To obtain a license to engage in the practice as a licensed master's social worker an applicant must provide evidence satisfactory to the board that the applicant has:
      1. (A) Submitted a written application in a form prescribed by the board or via online application;
      2. (B) Paid all applicable fees specified by the board relative to the licensure process;
      3. (C) Attained the age of majority;
      4. (D) Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work; and
      5. (E) Successfully passed the association of social work board's master's licensing exam.
    2. (2) Any person possessing a CMSW certificate at the time of implementation of this law will automatically become a licensed master's social worker without meeting any additional requirements.
    3. (3) Any MSW who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure without examination until December 31, 2010.
  3. (c) No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed master's social worker unless the person possesses a valid license issued pursuant to subsection (b).
  4. (d) A violation of subsection (c) is a Class A misdemeanor.
  5. (e) The board shall establish regulations for the issuance of temporary licenses for master's social workers who hold the degree of master's in social work granted by any college, university, or school of social work that has applied for, but has not yet received, accreditation by the council on social work education. This practice activity shall be applicable toward meeting the provisions and requirements of § 63-23-104(b) or § 63-23-105(b).
§ 63-23-104. Practice of advanced social work — Licensing requirements.
  1. (a) The practice of advanced social work as a nonclinical social worker is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. Advanced master's or doctorate social work practice requires the application of specialized knowledge and advanced practice skills in the areas of education, research, advocacy, community organization, mediation, consultation, assessment, treatment planning, implementation and evaluation, case management, counseling, supportive counseling, direct practice, information and referral, supervision, and the development, implementation, and administration of policies, programs and activities. The nonclinical advanced practice of social work may occur independently outside the jurisdiction of an agency or organizational setting in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third-party reimbursement. The practice of advanced social work as a nonclinical social worker may include the practice activities of a licensed baccalaureate social worker or licensed master's social worker, or both. The practice of advanced master's or doctorate social work may include the practice of clinical social work under the clinical supervision of a licensed clinical social worker as an avenue for licensure as a clinical social worker without the benefit of direct payments or third-party reimbursements for clinical practice. Practice at this level may include the provision of supervision for licensed or temporarily licensed master's social workers seeking to become licensed advanced practice social workers. Licensed advanced practice social workers may not hold themselves out as a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
  2. (b)
    1. (1) To obtain a license to engage in the practice as a licensed advanced practice social worker an applicant must provide evidence satisfactory to the board that the applicant has:
      1. (A) Submitted a written application in a form prescribed by the board or via online application;
      2. (B) Paid all applicable fees specified by the board relative to the licensure process;
      3. (C) Attained the age of majority;
      4. (D) Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work;
      5. (E) Practiced for no less than two (2) years as a licensed master's social worker or temporarily licensed master's social worker under the supervision of a licensed advanced practice social worker or licensed clinical social worker; and
      6. (F) Successfully passed the association of social work board's advanced generalist licensing exam.
    2. (2) Any graduate who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure without meeting the requirements of subdivisions (b)(1)(E) and (F) until December 31, 2010. The applicant must provide a work history of not less than three (3) years and a professional reference. Applicants who hold the current credentials of ACSW or DCSW from the National Association of Social Workers may submit documentation of these credentials in lieu of work history and professional reference.
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  3. (c) No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed advanced practice social worker unless the person possesses a valid license issued pursuant to subsection (b).
  4. (d) A violation of subsection (c) is a Class A misdemeanor.
§ 63-23-105. Practice of advanced master's or doctorate social work as licensed clinical social worker — Licensing requirements.
  1. (a) The practice of advanced master's or doctorate social work as a licensed clinical social worker is a specialty within the practice of social work that requires the application of social work theory, knowledge, methods, principles, values, ethics, and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups or persons who are adversely affected by social or psychosocial stress or health impairment. The practice of clinical social work requires the application of specialized clinical knowledge and advanced clinical skills in the areas of assessment, diagnosis and treatment of mental, emotional and behavioral disorders, conditions and addictions, including severe mental illness in adults and serious emotional disturbances in children, case management, direct practice, information and referral, clinical and nonclinical supervision, and the development, implementation, and administration of policies, programs and activities. Treatment methods include the provision of individual, marital, couple, family, and group therapy, mediation, counseling, supportive counseling, advanced case management, direct practice and psychotherapy. Clinical social workers are qualified to use the Diagnostic and Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), and other diagnostic classification systems in assessment, diagnosis, treatment planning and other activities. The advanced practice of clinical social work may occur outside the jurisdiction of an agency or organizational setting in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third-party reimbursement. Practice at this level may include the provision of supervision for licensed or temporarily licensed master's social workers seeking advanced licensure as an advanced practice social worker or as a licensed clinical social worker. Licensed clinical social workers may engage in both independent clinical and agency-based, nonclinical, macro social work practice. A social worker may not prescribe medication or interpret psychological tests. The practice of advanced master's or doctorate social work as a licensed clinical social worker may include the practice activities of a licensed baccalaureate social worker, licensed master's social worker and/or licensed advanced practice social worker.
  2. (b) To obtain a license to engage in the practice independently as a licensed clinical social worker an applicant must provide evidence satisfactory to the board that the applicant has:
    1. (1) Submitted a written application in a form prescribed by the board or via online application;
    2. (2) Paid all applicable fees specified by the board relative to the licensure process;
    3. (3) Attained the age of majority;
    4. (4) Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work;
    5. (5) Worked for not less than two (2) years as a licensed master's social worker, or temporarily licensed master's social worker under the supervision of a licensed clinical social worker or, if the applicant is from another state, has worked for not less than two (2) years prior to the date of application under the supervision of a person who possesses educational and experiential qualifications that meet or exceed the requirements for licensure in this state as a licensed clinical social worker; and
    6. (6) Successfully passed the association of social work board's clinical licensing exam.
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  3. (c) No person shall practice independently as a clinical social worker or act as, or represent the person to be, a licensed clinical social worker as defined in this section unless the person possesses a valid license issued pursuant to subsection (b).
  4. (d) A violation of subsection (c) is a Class A misdemeanor.
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§ 63-23-106. Renewal of licenses — Continuing education requirements.
  1. (a) All persons who are licensed to practice social work shall renew their licenses as follows:
    1. (1) Biennial licensure renewal fees in an amount established by the board shall accompany each renewal application;
    2. (2) If any holder of a license fails to renew the license within sixty (60) days of expiration, the license of the person shall be automatically revoked without further notice or hearing unless specifically requested; and
    3. (3) Notwithstanding any provision of this chapter to the contrary, the division of health related boards, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the biennial fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢). No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subdivision (a)(3).
  2. (b) In accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the board shall promulgate rules to establish continuing education requirements for persons seeking renewal of social work licenses.
§ 63-23-107. Retirement.
  1. Any person licensed to practice social work in this state who has retired or may hereafter retire from such practice is not required to maintain that person's licensure as required by this chapter; provided, that the person files with the board an affidavit on a form, prescribed by the board, which affidavit states the date on which the person retired from the practice and such other facts as are required by the board. If the person thereafter reengages in the practice of social work, the person shall renew that person's license with the board as provided by this chapter.
§ 63-23-108. Denial, suspension or revocation of licenses.
  1. (a) The board has the power, which is its duty, to deny, suspend or revoke any license, or to otherwise discipline, an applicant or holder of a license who is found guilty by the board of one (1) or more of the following:
    1. (1) Willful or repeated violation of any provisions of this chapter or any rules of the board;
    2. (2) Fraud or deceit in procuring or attempting to procure a license, presenting to the board dishonest or fraudulent evidence of qualification, or fraud or deception in the process of examination for the purpose of securing a license;
    3. (3) Willful failure to display a license;
    4. (4) Fraud, deception, misrepresentation, dishonest or illegal practices in or connected with the practice of social work;
    5. (5) Circulating knowingly untrue, fraudulent, misleading or deceptive advertising;
    6. (6) Gross health care liability, or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of practice;
    7. (7) Unprofessional or unethical conduct, or engaging in practices in connection with the practice of social work that are in violation of the standards of professional conduct, as defined in this section or prescribed by the rules of the board;
    8. (8) Incapacity or impairment that prevents a licensee from engaging in the practice of social work with reasonable skill, competence, and safety to the public;
    9. (9) Conduct reflecting unfavorably upon the profession of social work;
    10. (10) Willful making of any false statement as to material in any oath or affidavit that is required by this chapter;
    11. (11) Revocation by another state of a license or certificate to practice in that state in which case the record of the revocation shall be conclusive evidence;
    12. (12) Conviction of a felony under federal or state law involving use, misuse, possession or sale of any controlled substance or controlled substance analogue;
    13. (13) Conviction of a felony in the courts of this state or any other state, territory or country that, if committed in this state, would be a felony:
      1. (A) The record of conviction in a court of competent jurisdiction is sufficient evidence for disciplinary action to be taken as may be considered proper by the board. For the purpose of this chapter, a conviction is considered to be a conviction that has been upheld by the highest appellate court having jurisdiction, or a conviction upon which the time for filing an appeal has passed; and
      2. (B) A record of conviction upon charges that involve unlawful practice. Based upon the record of conviction, without any other testimony, the board may take temporary disciplinary action even though an appeal for review by a higher court may be pending;
    14. (14) Permitting or allowing another to use the license for the purpose of treating or offering to treat patients;
    15. (15) Engaging in practice under a false or assumed name, or the impersonation of another practitioner of a like, similar or different name;
    16. (16) Employing or permitting any person who does not hold a license to practice social work in this state to perform work that, under this chapter, can lawfully be done only by persons holding the license and permitted by law to practice social work in this state; or
    17. (17) Addiction to the habitual use of intoxicating liquors, narcotics or other stimulants to such an extent as to incapacitate the applicant or holder from the performance of the applicant's or holder's professional obligations and duties.
  2. (b) The board may on its own motion cause to be investigated any report indicating that a license holder is or may be in violation of this chapter. Any person who in good faith reports to the board any information that a license holder is or may be in violation of this chapter is not subject to suit for civil damages as a result of the good faith report.
  3. (c) All administrative proceedings for disciplinary action against a licensee undertaken pursuant to this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-23-109. Privileged communications.
  1. (a) The confidential relations and communications between a client and licensed social worker as defined in this chapter, are placed upon the same basis as those provided by law between licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants and client, and nothing in this chapter shall be construed to require any such privileged communication to be disclosed.
  2. (b) Nothing contained in this section shall be construed to prevent disclosure of confidential communications in proceedings arising under title 37, chapter 1, part 4, concerning mandatory child abuse reports.
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§ 63-23-110. Rules and regulations.
  1. The board is authorized to promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules as are necessary to implement this chapter.
§ 63-23-111. Reciprocity.
  1. (a) The board may, at its discretion, grant a social worker license without examination, to any person residing or employed in the state who has not previously failed the examination given by the board and who at the time of application is licensed by another state whose standards, in the opinion of the board, are as stringent as those required by this chapter.
  2. (b)
    1. (1) When the board receives a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, then the board shall, within sixty (60) days from the date the board receives the completed application:
      1. (A) Render a decision on the application; or
      2. (B) Inform the applicant of the need to appear before the board.
    2. (2) As used in this subsection (b), “completed application” means an application that satisfies all statutory and board rule requirements.
§ 63-23-112. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.
  1. A person licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of social worker licensure may issue a special volunteer license, as the license is defined in § 63-1-201, to qualified applicants without fee or charge. The license shall be for a period of two (2) years and may be renewed on a biennial basis.
§ 63-23-113. Criteria for use of title of social worker.
  1. (a) A social worker is an individual who:
    1. (1) Has received a baccalaureate or master's degree in social work from an accredited social work program approved by the council on social work education;
    2. (2) Has received a doctorate or Ph.D. in social work; or
    3. (3) Is a current licensed social worker, as set forth in §§ 63-23-102 — 63-23-105.
  2. (b) No person shall hold out to be a social worker unless the person:
    1. (1) Has received a baccalaureate or master's degree in social work from an accredited social work school or program;
    2. (2) Has received a doctorate or Ph.D. in social work; or
    3. (3) Is a current licensed social worker, as set forth in §§ 63-23-102 — 63-23-105.
  3. (c) No government entities, public or private agencies, business or organizations in the state shall use the title social worker, or any form of the title, for volunteer or employment positions or within contracts for services, documents, manuals, or reference material, effective July 1, 2005, unless the volunteers or employees in those positions meet the criteria set forth in this section.
  4. (d) Any individual meeting the qualifications provided for in 42 CFR 483 may practice as a qualified social worker, as defined in those regulations, in any nursing home licensed in the state and shall not be required to meet the requirements of subsections (a)-(c). Any such individual may not use the title social worker, except in connection with the activities of the nursing home.
§ 63-23-114. Rendering of decision by board — Time limitations.
  1. (a) When the board receives a completed application for initial licensure from an applicant, then the board shall, within sixty (60) days from the date the board receives the completed application:
    1. (1) Render a decision on the application; or
    2. (2) Inform the applicant of the need to appear before the board.
  2. (b) As used in this section, “completed application” means an application that satisfies all statutory and board rule requirements.
Chapter 24 Athletic Trainers
§ 63-24-101. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Athletic injury” means any injury sustained by a person as a result of such person's participation in exercises, sports, games, or recreation requiring physical strength, agility, flexibility, range of motion, speed, or stamina, or comparable athletic injury that prevents such person from participating in such activities;
    2. (2) “Athletic trainer” means a person with specific qualifications as set forth in this chapter, who, upon the advice, consent and oral or written prescriptions or referrals of a physician licensed under this title, carries out the practice of prevention, recognition, evaluation, management, disposition, treatment, or rehabilitation of athletic injuries, and, in carrying out these functions the athletic trainer is authorized to use physical modalities, such as heat, light, sound, cold, electricity, or mechanical devices related to prevention, recognition, evaluation, management, disposition, rehabilitation, and treatment; an athletic trainer shall practice only in those areas in which such athletic trainer is competent by reason of training or experience that can be substantiated by records or other evidence found acceptable by the board in the exercise of the board's considered discretion; and
    3. (3) “Board” means the board of athletic trainers.
§ 63-24-102. Board — Establishment and appointment — Terms — Officers — Meetings — Reimbursement.
  1. (a) There is established the board of athletic trainers to consist of five (5) members. Of the five (5) members:
    1. (1) Three (3) members shall be athletic trainers licensed in the state;
    2. (2) One (1) member shall be a physician licensed in the state; and
    3. (3) One (1) member shall be a representative of the public who is not an athletic trainer and is not commercially or professionally associated with the health care industry.
  2. (b)
    1. (1) Members of the board shall be appointed by the governor. The Tennessee Athletic Trainers Society and the Tennessee Medical Association may each supply a list to the governor of at least three (3) nominees for each appointment or vacancy on the board in their respective categories. The governor may make an appointment from the lists.
    2. (2)
      1. (A) Each licensed athletic trainer appointed to serve on the board shall:
        1. (i) Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. (ii) Be currently licensed in good standing as a licensed athletic trainer in this state;
        3. (iii) Be currently engaged in the practice of athletic training as a licensed athletic trainer; and
        4. (iv) Have been licensed as an athletic trainer in the state for no fewer than five (5) years.
      2. (B) Each physician appointed to serve on the board shall:
        1. (i) Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. (ii) Be currently licensed in good standing in the state; and
        3. (iii) Have been licensed as a physician in the state for no fewer than five (5) years.
      3. (C) The representative of the public appointed to serve on the board shall:
        1. (i) Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. (ii) Have no direct or indirect financial interest in health care services;
        3. (iii) Have never been, or while serving on the board be, an athletic trainer or enrolled in any health care educational program; and
        4. (iv) Not be a member or employee of any board of control of any public or private health care group or organization.
    3. (3) Members of the board shall serve one (1) four-year term and may be reappointed. Any board member may be removed by the governor after notice and a hearing for incompetence, neglect of duty, malfeasance in office or moral turpitude. Vacancies on the board created by the expiration of a term of office or for any other reason shall be filled by the governor in the same manner as the original appointment. Appointed members shall serve until their replacement has been appointed and has agreed to serve. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is a member of a racial minority.
  3. (c)
    1. (1) Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the board:
      1. (A) Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the board shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the board, prior to serving as a member of the board. This subdivision (c)(1)(A) shall apply to all persons appointed or otherwise named to the board after July 1, 2010;
      2. (B) No person who is a member of the board shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the board during such person's period of service as a member of the board. This subdivision (c)(1)(B) shall apply to all persons appointed or otherwise named to the board after July 1, 2010, and to all persons serving on the board on such date who are not registered as lobbyists; and
      3. (C) No person who serves as a member of the board shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the board for one (1) year following the date such person's service on the board ends. This subdivision (c)(1)(C) shall apply to persons serving on the board as of July 1, 2010, and to persons appointed to the board subsequent to such date.
    2. (2) A person who violates this subsection (c) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. (3) The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (c). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  4. (d) The chair and vice chair of the board shall be chosen from one (1) of the three (3) athletic trainer members and elected by the board. The chair shall preside over all meetings and business of the board. The vice chair shall preside over the meetings and business of the board in the absence of the chair and shall be responsible for signing the approved minutes of the board. The length of the terms of the elected officers shall be determined by rules duly promulgated by the board.
  5. (e) The board, for administrative purposes, shall meet at least annually and at such other times as necessary to conduct the business of the board at the call of the chair. For purposes of conducting board business, a majority of the members of the board shall constitute a quorum.
  6. (f) The members of the board shall be entitled to a per diem of one hundred dollars ($100) for each day's service in attending meetings of the board, and other official business of the board, and necessary expenses for traveling and subsistence while attending meetings. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  7. (g) The board shall receive its administrative, legal and investigative support from the division of health related boards.
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§ 63-24-103. Licensure requirement.
  1. (a) No person shall represent themselves or claim to be an athletic trainer or perform, for compensation, any of the activities of an athletic trainer as defined in this chapter without first obtaining a license under this chapter.
  2. (b) Nothing in this chapter shall be construed to prevent any person from serving as a student-trainer, or any similar position if such service is not primarily for compensation and is carried out under the supervision of an athletic trainer duly licensed as defined in this chapter and a physician licensed under this title. Such supervision will be provided under the guidelines of the National Athletic Trainers' Association (NATA) Board of Certification, Inc. and/or approved by the board.
  3. (c)
    1. (1) Persons who are certified by the board as athletic trainers on May 9, 2000, may practice as licensed athletic trainers, provided such persons meet all of the other requirements of this chapter.
    2. (2) Upon the expiration of an athletic trainer's certificate, the board shall issue a license to replace such certificate, provided the athletic trainer has met all of the other requirements of this chapter.
§ 63-24-104. Qualifications of applicants — Reciprocity.
  1. (a) An applicant for an athletic trainer license must possess the following qualifications:
    1. (1) Have met the athletic training curriculum requirements of a college or university approved by the board and give proof of graduation; and
    2. (2) Satisfactorily completed all of the National Athletic Trainers' Association (NATA) Board of Certification, Inc. qualifications and be certified as an athletic trainer in good standing by the NATA Board of Certification, Inc., and/or approved by the board.
  2. (b) An out-of-state applicant must possess the stated qualifications of subsection (a). Upon receipt of the initial athletic trainer licensure fee, the board may grant, without examination, a license to any qualified nonresident athletic trainer who holds a valid license or certificate issued by another state and whose qualifications are deemed by the board to be at least equivalent to those required for licensure in this state; provided, that such other state extends the same privilege to qualified athletic trainers who are residents of this state. An out-of-state applicant from a state not having a licensure or certification act will be eligible to take the jurisprudence examination if certified by the NATA Board of Certification, Inc., and approved by the board.
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§ 63-24-105. Licensure — Renewal — Retirement.
  1. (a)
    1. (1) An applicant for an athletic trainer license must submit an application to the board on forms prescribed by the board and submit the examination fee required by this chapter.
    2. (2) The applicant is entitled to an athletic trainer's license if the applicant possesses the qualifications enumerated in § 63-24-104; completes and passes the certification requirements and examination of the National Athletic Trainers' Association Board of Certification, Inc. or its equivalent as determined by the board; completes the jurisprudence examination administered and/or selected by the board, to its satisfaction; pays the licensure fee as set in § 63-24-106; and has not committed an act that constitutes grounds for denial of a license under § 63-24-107.
  2. (b) Any person who is issued initial licensure as an athletic trainer is deemed to be registered as such for two (2) years, or to the next even-numbered year immediately following conclusion of the initial two (2) calendar years. Thereafter, such person shall biennially apply to the board for certificate renewal and shall submit such information as may be requested by the board. Upon making an application for renewal, such person shall pay a renewal fee as prescribed pursuant to § 63-24-106.
  3. (c) Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person files with the board, an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration, with the board as provided by this chapter, and shall meet other requirements as may be set by the board.
  4. (d) Notwithstanding any provision of this chapter to the contrary, the division of health related boards, with the approval of the commissioner of health, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months, and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢). No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (d).
  5. (e) Any person who possesses a certificate or temporary certificate issued by the board shall be deemed to possess a license or temporary license, respectively. At the time of renewal, a certificate holder who is approved for renewal shall receive a license from the board rather than a renewal of the certificate.
§ 63-24-106. Fees.
  1. (a) The board shall, by duly promulgated rules, establish the following fees:
    1. (1) Athletic trainer application-examination fee;
    2. (2) Initial athletic trainer licensure fee;
    3. (3) Biennial licensure renewal fee;
    4. (4) Late renewal fee;
    5. (5) Licensure restoration fee; and
    6. (6) Fee for obtaining a duplicate of licensure.
  2. (b) The board is hereby authorized, by duly promulgated rules, to specify the conditions and circumstances, if any, under which one (1) or more of the fees in subsection (a) may be refunded in whole or in part.
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§ 63-24-107. Denial, suspension or revocation of licensure.
  1. (a) The board has the power and duty to:
    1. (1) Deny, restrict or condition a license to any applicant who applies for the license through reciprocity or otherwise;
    2. (2) Permanently or temporarily withhold issuance of a license;
    3. (3) Suspend, limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. (4) Reprimand, suspend, revoke or take such other disciplinary action in relation to an applicant or license holder as the board in its discretion may deem proper; or
    5. (5) Permanently revoke a license.
  2. (b) The grounds upon which the board shall exercise such power include, but are not limited to, circumstances in which the person has:
    1. (1) Violated standards of practice as determined by the board;
    2. (2) Practiced athletic training for compensation without holding an active license under this chapter;
    3. (3) Used or attempted to use an athletic trainer license that has been suspended or revoked;
    4. (4) Obtained or attempted to obtain an athletic trainer license by misleading statements, fraud or deceit or knowing misrepresentation;
    5. (5) Used the title “athletic trainer” without being licensed under this chapter;
    6. (6) Violated or conspired to violate this chapter, or rules and regulations promulgated pursuant to this chapter; or
    7. (7) Been convicted of a felony for the commission of an offense that bears directly on the person's fitness to practice competently, as determined by the board.
  3. (c) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-24-108. Hearings — Procedure — Reissuance of licenses.
  1. (a) Any person whose application is denied is entitled to a hearing before the board if the person submits a written request to the board. Disciplinary proceedings shall be conducted in accordance with the contested case provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  2. (b) On application, the board may reissue a license to a person whose license has been cancelled or revoked, but the application may not be made prior to the expiration of a period of six (6) months after the order of cancellation or revocation has become final, and application shall be made in the manner and form as the board may require.
  3. (c)
    1. (1) Any person who practices in this state without having first complied with this chapter commits a Class B misdemeanor for each instance of such practice. Each day any person practices without first obtaining a valid license or renewing a license constitutes a separate offense.
    2. (2) The board, in addition to the powers and duties expressed in this chapter with respect to the grant, denial and discipline of licensure is empowered to petition any circuit or chancery court having jurisdiction of any person within this state who is practicing without a license or to whom a license has been denied, or whose license has been suspended or revoked by action of the board, to enjoin the person from continuing to practice within this state. Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all such causes as equity causes and exercise full and complete jurisdiction in such injunctive proceedings. Nothing in this section shall be construed as conferring criminal jurisdiction upon any court not now possessing such criminal jurisdiction, nor shall any such court, as an incident to the injunctive proceedings authorized in this subdivision (c)(2), have the power to assess the criminal penalties.
§ 63-24-110. Exemptions.
  1. (a) No provision of this chapter shall be construed so as to limit or prevent any person duly licensed or certified under the laws of this state from practicing the profession for which the person was licensed or certified.
  2. (b) This chapter shall not be construed to apply to any person engaging in the practice of athletic training while employed for such purpose by a non-Tennessee post secondary educational institution or professional athletic organization that is temporarily present in this state for an athletic competition or exhibition.
  3. (c) The board shall have the authority to assess civil penalties commensurate with those assessable under § 63-1-134 against persons who have knowingly employed, contracted for or otherwise utilized unlicensed persons in the practice of athletic training, with or without compensation.
  4. (d) Nothing in this chapter shall be construed as applying to physicians duly licensed under this title who employ or contract for services provided by persons in the physician's office assisting in the care of patients and rendered under the supervision, control and responsibility of the licensed physician.
§ 63-24-111. Powers and duties of board — Budget.
  1. (a) The board has the power and duty to:
    1. (1) Promulgate all rules that are reasonably necessary for the performance of its duties, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    2. (2) License athletic trainers in compliance with this chapter;
    3. (3) Prescribe application forms for licensure and conduct, or select a licensure examination and establish the prerequisites, if any, for admission to the examination. The board is authorized to enter into a contract or agreement with an examination service and/or select an intermediary between the board and the examination service to process applicants for the examination;
    4. (4) Establish fees, in addition to those enumerated in § 63-24-106, that are necessary for the operation of the board, in accordance with § 9-4-5117;
    5. (5) Establish guidelines and standards for athletic trainers in the state that are not inconsistent with the other provisions of this chapter, and the grounds upon which disciplinary action may be taken, in addition to those causes enumerated in § 63-24-107;
    6. (6) Establish all requirements for mandatory continuing education as a condition of continued licensure, including a mechanism for waiver of the requirements in cases of undue hardship; and
    7. (7) Issue advisory private letter rulings to any affected licensed practitioner or license holder who makes a request regarding any matters within the board's primary jurisdiction. The private letter ruling shall only affect the person making the inquiry, and shall have no precedential value for any other inquiry or future contested case that might come before the board. Any dispute regarding a private letter ruling may be resolved pursuant to the declaratory order provisions of § 4-5-223, if the board chooses to do so.
  2. (b) The board shall pay all money received by it into the state treasury and the commissioner of finance and administration shall make such allotments out of the general fund that the commissioner may deem proper for the necessary and proper expenses of the board. No expenditure shall be made by the board, unless and until the allotment has been made by the commissioner. The allotment shall be disbursed under the general budgetary laws of the state.
Chapter 25 Dietetics/Nutrition Practice Act
§ 63-25-101. Short title.
  1. This chapter shall be known and may be cited as the “Dietetics/Nutrition Practice Act.”
§ 63-25-102. Legislative findings.
  1. The general assembly finds that the application of scientific knowledge relating to food is important in the treatment of illness and disease and the attainment and maintenance of health. There are currently no clear means for the public to identify the qualifications of persons providing dietetic services and nutritional care for infants, children, pregnant females, elderly persons, poor persons, overweight persons, chronically and terminally ill persons and fitness enthusiasts. Consumers and patients are becoming increasingly concerned about their diets and nutrition as well as the effectiveness of the information and services being offered to the public. The general assembly further finds that in order to protect the public health, safety and welfare, it is necessary to define the qualifications and requirements for persons offering certain dietetic and nutritional advice and services to the public. It is the purpose of this chapter to restrict the use of certain titles to persons who are professionally qualified to use them, thereby ensuring that persons practicing the profession of dietetics and nutrition meet minimum standards of proficiency and competency acquired through adequate training and experience.
§ 63-25-103. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of dietitian/nutritionist examiners;
    2. (2) “Department” means the department of health;
    3. (3) “Dietetics/nutrition practice” means the integration and application of scientific principles of food, nutrition, biochemistry, physiology, management and behavioral and social sciences in achieving and maintaining health through the life cycle and in the treatment of disease. Methods of practice include, but are not limited to, nutritional assessment, development, implementation and evaluation of nutrition care plans, nutritional counseling and education, and the development and administration of nutrition care standards and systems;
    4. (4) “Dietitian” and “nutritionist” may be used interchangeably;
    5. (5) “Dietitian/nutritionist” means a health care professional practicing dietetics/nutrition and licensed under this chapter; and
    6. (6) “Division” means the division of health related boards within the department.
§ 63-25-104. Prohibited representations — License required — Construction.
  1. (a) It is unlawful for any person to engage in the practice of dietetics/nutrition, to act or represent such person to be a dietitian or a nutritionist or to use such titles as “dietitian/nutritionist,” “licensed dietitian,” “licensed nutritionist,” or such letters as “L.D.,” “L.N.,” or any facsimile thereof, or any word, letters or title indicating or implying that such person is a dietitian/nutritionist, unless such person holds a license and otherwise complies with this chapter and the rules and regulations adopted by the board.
  2. (b) Nothing in this chapter shall be construed to affect, prevent or restrict:
    1. (1) Persons qualified and licensed to practice other health professions from engaging in the practice of dietetics/nutrition when incidental to the practice of their profession. This chapter shall in no way apply to persons licensed to practice medicine or osteopathic medicine pursuant to chapters 6 and 9 of this title;
    2. (2) Students enrolled in an approved academic program in dietetics, if such practice constitutes a part of a supervised course of study and such student is designated by title clearly indicating such student's status as a student or trainee;
    3. (3) A dietitian serving in the armed forces or the public health service of the United States or employed by the veterans administration from engaging in the practice of dietetics; provided, that such practice is related to such service or employment;
    4. (4) Persons performing the activities and services of a nutrition educator in the employment of a federal, state, county or municipal agency or an elementary or secondary school or accredited degree granting educational institution, insofar as such activities and services are part of a salaried position;
    5. (5) Federal, state, county or local employees involved with nutrition-related programs, including, but not limited to, the cooperative extension service, child nutrition programs and Project Headstart from engaging in the practice of dietetics/nutrition within the discharge of their official duties; provided, that any such person engaging in dietetic/nutrition practice outside the scope of such official duty must be licensed as provided in this section;
    6. (6) Persons employed in a hospital or nursing home as defined in § 68-11-201 and subject to licensure by the Tennessee board for licensing health care facilities; or
    7. (7)
      1. (A) Persons who do not hold themselves out to be licensed and/or registered dietitians/nutritionists of the right to provide services and information related to nonmedical nutrition while:
        1. (1) Employed by or operating a health weight loss or fitness program;
        2. (2) Employed by or operating a health food store;
        3. (3) Employed by or operating a business that sells health products, including dietary supplements, food or food materials, or provides nonmedical nutritional information or distributes nutritional literature; or
        4. (4) Conducting classes or disseminating information related to non-medical nutrition.
      2. (B) “Nonmedical” means engaging in any practice that does not constitute the practice of medicine, osteopathy, chiropractic, dentistry or podiatry.
§ 63-25-105. Development of therapeutic dietary regimens.
  1. No therapeutic dietary regimen may be developed unless pursuant to the appropriate orders and/or referral of licensed practitioners of medicine, osteopathy, chiropractic, dentistry or podiatry when incidental to the practice of their respective professions.
§ 63-25-106. Board of dietitian/nutritionist examiners.
  1. (a) There is hereby created the board of dietitian/nutritionist examiners to consist of five (5) members appointed by the governor, each of whom shall be a resident of this state and shall have had at least five (5) years' experience in the actual practice or teaching of dietetics and/or nutrition. Appointments may be made from lists of qualified persons submitted to the governor by interested dietitian/nutritionist, hospital and medical groups, including, but not limited to, the Tennessee Dietetic Association, the Tennessee Hospital Association, and the Tennessee Medical Association, and shall represent such areas of practice as administrative dietetics, clinical dietetics, dietetic education, community nutrition and consultation and private practice. The governor shall consult with such interested groups to determine qualified persons to fill the positions.
  2. (b) Of the initial appointments to the board, two (2) members shall be appointed for a term of three (3) years, two (2) members for a term of two (2) years, and one (1) member for a term of one (1) year. All regular appointments thereafter shall be for terms of three (3) years each. No member shall be eligible for appointment for more than two (2) consecutive terms, and each member shall serve on the board until a successor is appointed. Vacancies shall be filled by appointment of the governor for the unexpired term. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
  3. (c) The board shall organize annually and select a chair and a secretary. A quorum of the board shall consist of three (3) members, and meetings of the board shall be held as frequently as its duties may require. The division shall perform administrative functions for the board.
  4. (d) Each member of the board shall receive compensation for services in an amount determined by the department, not to exceed fifty dollars ($50.00) per diem when actually engaged in the discharge of their official duties, and, in addition, shall be reimbursed for all travel expenses in accordance with the comprehensive state travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
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§ 63-25-107. Powers and duties of board.
  1. In addition to the powers granted elsewhere in this chapter, the board has the duty to:
    1. (1) Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the various duties imposed upon the board in the proper administration of this chapter;
    2. (2) Set fees, after consultation with the department and subject to the maximum limitations prescribed in this chapter, relative to the application, examination, licensing and renewal thereof in amounts sufficient to pay all of the expenses of the board directly attributable to the performance of its duties pursuant to this chapter;
    3. (3) Review and approve or reject the qualifications of applicants for licensure and to issue, in the board's name, all approved licenses, certificates and permits;
    4. (4) Collect or receive all fees, fines and moneys owed pursuant to this chapter and to pay the same into the general fund of the state. For purposes of implementing subdivision (2), the board shall designate any such fees, fines or moneys collected pursuant to the regulation of dietitians/nutritionists; and
    5. (5) Deny, suspend or revoke the license of or to otherwise discipline by an administrative penalty not to exceed five hundred dollars ($500), or by reprimand, a license holder who is guilty of violating any provisions of this chapter or who is guilty of violating the rules and regulations of the board duly promulgated pursuant to this chapter.
§ 63-25-108. Applications for licensure.
  1. An applicant for licensure as a dietitian/nutritionist shall file a written application on forms provided by the department or via online application showing to the satisfaction of the board that such person:
    1. (1) Is of good moral character;
    2. (2) Has received a baccalaureate or post-baccalaureate degree from a regionally accredited college or university that provides a major course of study in human nutrition, food and nutrition, dietetics, or food systems management, or an equivalent major course of study as approved by the board;
    3. (3) Has successfully completed a planned continuous preprofessional experience in nutrition practice of not less than nine hundred (900) hours under the supervision of a registered dietitian, or successfully completed a program of supervised clinical experience approved by the commission on dietetic registration of the American Dietetic Association; and
    4. (4) Has passed the national examination prepared and administered by the commission on dietetic registration of the American Dietetic Association.
§ 63-25-109. Issuance of licenses — Temporary permits.
  1. (a) The board may, in its discretion, issue a license to an applicant upon such person providing evidence of current registration as a registered dietitian and upon payment of a licensing fee. The board may further waive the examination, education or experience requirements of this chapter and grant a license to an applicant who shall present proof of current licensure, certification or registration as a dietitian under the laws of another state, the District of Columbia, or territory of the United States, if, in the board's opinion, the educational and experiential qualifications and requirements were substantially equivalent to those required for licensure in this state.
  2. (b)
    1. (1) The board may, in its discretion, issue temporary permits to practice dietetics/nutrition to an applicant upon submission of satisfactory evidence that such person:
      1. (A) Has successfully completed the academic and experiential requirements to be licensed as a dietitian/nutritionist;
      2. (B) Has applied for or taken a licensing examination;
      3. (C) Is awaiting notification of examination results; and
      4. (D) Has paid the fee required for temporary permits.
    2. (2) Temporary permits expire one (1) year from the date of issuance and may be renewed for a period not to exceed six (6) months upon submitting to the board a satisfactory explanation of the applicant's failure to become licensed within the one-year term.
§ 63-25-110. Disciplinary action.
  1. (a) The board is empowered to deny or refuse to renew a license, or suspend or revoke a license or permit, or issue orders to cease and desist from certain conduct or to otherwise lawfully discipline an applicant, a licensee, a permittee or a person found guilty of violating any provisions of this chapter when such person has:
    1. (1) Attempted or obtained licensure by fraud or misrepresentation;
    2. (2) Engaged in unethical or unprofessional conduct, including, but not limited to, willful acts, negligence or a pattern of continued and repeated health care liability, negligence or incompetence in the course of professional practice;
    3. (3) Engaged in habitual intoxication or personal misuse of any drug, narcotic, controlled substance or controlled substance analogue so as to adversely affect the person's ability to practice;
    4. (4) Been convicted of a felony or any offense under state or federal laws involving moral turpitude;
    5. (5) Violated any lawful order, rule or regulation rendered or adopted by the board; or
    6. (6) Violated any provision of this chapter.
  2. (b) All administrative proceedings for disciplinary action against a license holder or permittee shall be conducted by the board in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  3. (c) The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
  4. (d)
    1. (1) Any elected officer of the board, or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two-thirds (⅔) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
    2. (2) Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
    3. (3)
      1. (A) A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
      2. (B) A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
    4. (4) If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides, and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
    5. (5) Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
  5. (e) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
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§ 63-25-111. Fees.
  1. For the purpose of implementing this chapter, the board, by duly promulgated rule, shall establish fees for applications, examinations, renewals, reciprocity and other related matters.
§ 63-25-112. Failure to renew license or pay fee — Revocation and reinstatement of license.
  1. (a) A licensee who fails to renew the licensee's license and to pay the biannual renewal fee after renewal becomes due shall have the license automatically revoked without further notice of hearing, unless renewal is made and all fees paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
  2. (b) Any person whose license is automatically revoked as provided in this section may have the license reinstated by the board in its discretion for good cause being shown, upon payment of all past-due renewal fees and upon the further payment of a nonrefundable sum as set by the board.
§ 63-25-113. Retirees.
  1. Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice, and such other facts as tend to verify such retirement as the board deems necessary. If such person reengages in such practice in this state, such person shall apply for licensure with the board as provided by this chapter, and shall meet other requirements as may be set by the board.
Chapter 26 Electrologists Practice Act
§ 63-26-101. Short title.
  1. This chapter shall be known and may be cited as the “Electrologists Practice Act.”
§ 63-26-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Commissioner” means the commissioner of health and includes designees of the commissioner of health;
    2. (2) “Electrologist” means any person practicing electrolysis for the permanent removal of hair;
    3. (3) “Electrology” means the art and practice relating to the removal of hair from the normal skin of the human body by application of an electric current to the hair papilla by means of a needle or needles so as to cause growth inactivity of the hair papilla and thus permanently remove the hair;
    4. (4) “Electrology instructor” means an electrologist who is licensed by the commissioner to practice and teach electrology;
    5. (5) “Electrolysis” means the process by which the hair is removed from the normal skin by the application of an electric current to the hair root by means of a needle or needles, whether the process employs direct electric current or short wave alternating electric current or combination of both, or by FDA approved laser beam process designated for permanent hair removal; and
    6. (6) “School” means an electrology school teaching the art of electrology.
§ 63-26-103. Prohibited practices.
  1. (a) This chapter does not authorize the use of roentgen rays and radium for diagnostic and therapeutic purposes, or the use of electricity for purposes of skin cauterization, removal of warts, moles or other skin deformities.
  2. (b) Electronic tweezers or nonneedle methods are prohibited within the practice of electrology, except as provided in this chapter.
§ 63-26-106. Personnel.
  1. Subject to appropriations for that purpose, the director of the division of health related boards shall employ and supervise all administrative personnel necessary to conduct the functions of this chapter.
§ 63-26-107. Cumulative deficit of the board of electrolysis examiners — Disposition of fees — Expenditures.
  1. (a) Any cumulative deficit of the board of electrolysis examiners remaining on June 23, 2009, shall be transferred to the account created in subsection (b) to be eliminated through payment of fees assessed on persons regulated pursuant to this chapter.
  2. (b) All fees collected by the commissioner pursuant to this chapter shall be deposited by the state treasurer in a separate account exclusively for the electrolysis program established in this chapter, and shall be used by the commissioner to defray expenses necessary to administer this chapter. Unexpended and unobligated fees remaining in this account at the end of any fiscal year shall not revert to the general fund but shall be used to eliminate the cumulative deficit of the board of electrolysis examiners remaining on June 23, 2009. Upon elimination of the deficit, unexpended and unobligated fees remaining in this account shall not revert to the general fund but shall remain available for the purposes set forth in this chapter. Penalties imposed by the commissioner shall be deposited into the state general fund.
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§ 63-26-108. Powers and duties of commissioner of health.
  1. (a) The commissioner of health shall:
    1. (1) Promulgate such rules and regulations as are necessary and reasonable for the enforcement of this chapter;
    2. (2) Establish continuing education requirements;
    3. (3) Establish standards for the training and practice of electrolysis;
    4. (4) Maintain a list of all current licensed electrologists, licensed electrolysis schools and training centers, and licensed electrology instructors; and
    5. (5) Adopt a code of ethics governing the practice of electrology by licensees under this chapter.
  2. (b) In no event shall this chapter be interpreted as conferring on the commissioner the authority or jurisdiction to regulate the practice of medicine or osteopathy by persons licensed under chapter 6 or 9 of this title, or to regulate the activities of those persons employed by such licensed physicians, and who perform services under the supervision and control of licensed physicians or osteopaths who have made an evaluation of the patient and who have supervised a diagnostic screening with respect to the patient, unless such employees or agents are holding themselves out to be licensed electrologists. It is the specific intent of the general assembly that the regulation of the practice of medicine or osteopathy falls within the sole and exclusive purview of the licensing boards designated under chapter 6 and 9 of this title. Further, the commissioner shall have no jurisdiction or authority to regulate in any manner the practice of electrology by individuals licensed under chapter 6 or 9 of this title.
§ 63-26-109. Setting of fees.
  1. The commissioner shall set fees for applications, examinations, renewals, reciprocity, school licensure and other related matters.
§ 63-26-110. Civil liability.
  1. A person who acts in good faith shall not be civilly liable for providing information to the commissioner or a designee of the commissioner on any matter relative to the practice of electrolysis. This section shall apply to any person who acts in good faith to provide information to a designee of the commissioner in the course of an investigation of the practice of electrolysis.
§ 63-26-111. Qualifications of applicants.
  1. An applicant for a license to be an electrologist must:
    1. (1) Be at least eighteen (18) years of age;
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    2. (2) Be of good moral character;
    3. (3) Have been graduated by an accredited high school or have completed equivalent recognized education;
    4. (4) Have completed an electrology education program that is approved under this chapter, which includes:
      1. (A) At least one hundred fifty (150) hours of electrolysis theory and at least three hundred fifty (350) hours of clinical practice taught by a licensed electrology instructor;
      2. (B) An electrology education program in any other state that the commissioner determines is substantially equivalent to that required by subdivision (4)(A); or
      3. (C)
        1. (i) At least six hundred (600) hours of electrology practice taught by a dermatologist approved by the commissioner who has documented continuing education in electrology theory and practice;
        2. (ii) Applicants who satisfy the educational requirements for licensure under this subdivision (4)(C) shall be eligible for practice as an electrologist only under the direct supervision and control of a dermatologist approved by the commissioner, and shall receive a limited license that bears an endorsement to that effect, upon passing the state board examination, payment of all prescribed fees and the satisfying of license renewal fees and requirements;
        3. (iii) The dermatologist shall notify the commissioner or the commissioner's designee as to each student who begins the training program pursuant to this subdivision (4)(C);
        4. (iv) The dermatologist shall also notify the commissioner or the commissioner's designee when an electrologist is no longer under the supervision and control of such dermatologist; and
        5. (v) Hours of training and experience received by applicants after January 1, 1989, may be applied to the experience provisions of this subdivision (4)(C);
    5. (5) Have successfully passed an examination approved by the commissioner;
    6. (6) Have paid all fees required by this chapter; and
    7. (7) Have submitted an application to the commissioner on a prescribed form.
§ 63-26-112. Qualifications to be instructor.
  1. To be eligible for licensing as an electrology instructor, in addition to the requirements of the registered electrologist, an applicant shall have:
    1. (1) Practiced electrolysis actively for at least five (5) of the last ten (10) years prior to the application;
    2. (2) Successfully passed an examination for an electrology instructor license that consists of written and verbal sections covering theoretical and clinical studies;
    3. (3) Paid an examination fee set by the commissioner; and
    4. (4) Submitted to the commissioner at least thirty (30) days before the examination is administered an approved form for application for license.
§ 63-26-113. Examinations.
  1. (a) Examinations for qualified applicants shall be offered at least once a year at the times and places determined by the commissioner or the commissioner's designee.
  2. (b) Completed applications for examination must be received by the commissioner thirty (30) days prior to the examination date.
  3. (c) The commissioner or the commissioner's designee shall notify each qualified applicant of the time and place of examination.
  4. (d) The commissioner shall select an examination in which the testing and grading systems are recognized as standard in the field of professional licensure examinations.
§ 63-26-114. Reexamination.
  1. (a) If a candidate fails a part or parts of an examination, the candidate may retake a failed section of the examination or retake a subsequent examination, after paying the reexamination fee and submitting the commissioner-approved form for reexamination at least thirty (30) days prior to reexamination date.
  2. (b) If, after two (2) attempts, the examination is not passed, the complete examination may be taken again only after the candidate:
    1. (1) Completes an additional electrolysis education program that the commissioner recommends; and
    2. (2) Pays the full examination fee.
§ 63-26-115. Licensing without examination.
  1. (a) Without the required examination, the commissioner shall approve as a licensed electrologist any person meeting the provisions of § 63-26-111(1)-(3), (6) and (7) and who has actively been engaged in the practice of electrology in this state for a period of six (6) months or more prior to making application for licensure.
  2. (b) Payment of the scheduled registration fee to the commissioner shall accompany an application.
  3. (c)
    1. (1) Except as provided in subdivision (c)(2), no electrologist shall be registered by the commissioner to practice without examination, unless a recognized out-of-state license is valid and acceptable.
    2. (2) The commissioner is authorized to register an electrologist to practice in this state without taking the required examination, even if an out-of-state license has not been issued, to a person who provides proof satisfactory to the commissioner that:
      1. (A) The person requesting a license has practiced electrology five (5) years or more in a state that does not require a license for practice; and
      2. (B) The person is a certified electrologist; or
      3. (C) The person requesting a license meets requirements as determined by rules adopted by the commissioner.
  4. (d) The commissioner shall require satisfactory documentation of any prior continuous electrolysis practice.
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§ 63-26-116. Licensing of instructors without examination.
  1. (a) The commissioner shall approve as a licensed electrology instructor without the required examination any person who meets the waiver requirements in § 63-26-115 and who has taught electrology for at least three (3) consecutive years prior to June 30, 1989.
  2. (b) The commissioner shall require satisfactory documentation of prior continuous teaching in electrology.
  3. (c) Application for an electrology teaching license shall be made on a form provided by the commissioner.
  4. (d) Payment of the scheduled fee for an electrology instructor license shall accompany an application.
§ 63-26-117. Waiver of examination.
  1. (a) The commissioner may grant a waiver of examination; provided, that the applicant:
    1. (1) Provides adequate evidence that an electrology license was acquired after passing an electrology examination in another state, and that the examination was substantially equivalent to the examination for which the applicant seeks waiver in this state;
    2. (2) Became licensed in another state after meeting other requirements that are substantially equivalent to the requirements of this chapter;
    3. (3) Pays the appropriate application and license fees; and
    4. (4) Submits the required application form for licensing.
  2. (b) The commissioner may grant a waiver of examination for an electrology instructor license; provided, that the applicant:
    1. (1) Furnishes proof that the applicant has met the requirements of subdivisions (a)(1) and (2);
    2. (2) Has filed an application for a license; and
    3. (3) Has paid the required license fee.
  3. (c) The commissioner or a designee of the commissioner shall have the discretion to grant a waiver of examination to an applicant; provided, that a written explanation of the waiver is provided to the applicant and made available to persons requesting a copy of the explanation.
§ 63-26-118. Issuance of license — Display — Changes.
  1. (a) The commissioner shall issue a license to an applicant meeting the requirements of this chapter for the license designation as an electrologist, or an electrology instructor, or an approved school teaching electrology.
  2. (b) All licenses issued by the commissioner must be conspicuously displayed at the site of use.
  3. (c) All licensees shall keep the commissioner informed of any changes of address.
§ 63-26-119. Authority over educational programs — Fraudulent or deceptive promotions.
  1. (a) In addition to other powers and duties, the commissioner has the authority to:
    1. (1) Set standards by which an electrology education program may be approved;
    2. (2) Review with the state board of education and the Tennessee higher education commission a progressive electrology education program in the state;
    3. (3) Evaluate the need for such programs in the geographical area in which the electrology program will be located;
    4. (4) Approve and license institutions in this state that meet the requirements of the electrology education program;
    5. (5) Maintain a list of the institutions offering electrology education programs approved by the commissioner; and
    6. (6) Remove an institution from the list of institutions that offer approved electrology education if the institution:
      1. (A) Is guilty of fraud or deceit in obtaining or attempting to obtain approval;
      2. (B) Acts in a manner not consistent with generally accepted standards for the practice of electrology;
      3. (C) Violates standards set under this chapter and fails to correct the violation in a reasonable time after notice has been given;
      4. (D) No longer operates a program that is approved under this chapter; or
      5. (E) Promotes electrology in a manner that the commissioner determines is unreasonable, misleading or fraudulent.
  2. (b) The commissioner shall monitor fraudulent or deceptive promotion of permanent hair removal procedures.
§ 63-26-120. Renewal of licenses — Revocation and reinstatement.
  1. (a) Each licensed electrologist and each licensed electrology instructor shall pay the scheduled annual renewal fee to the commissioner, payable in advance, for the following year on or before December 31 of each year that such renewal fee is due.
  2. (b) Each licensed electrology school shall pay the scheduled annual renewal fee to the commissioner, payable in advance, for the following year on or before December 1 of each year that such renewal fee is due.
  3. (c) The commissioner shall renew the license of each licensee who meets the specified requirements for renewal or for registration.
  4. (d) When any electrologist licensee, electrology instructor licensee, or licensed electrology school shall fail to register and pay the annual registration fee within sixty (60) days after such registration becomes due, the license of such person or school shall be automatically revoked without further notice or hearing.
  5. (e) Any person or school whose license is automatically revoked may make application in writing to the commissioner for the reinstatement of such license, and upon good cause being shown, the commissioner, in the commissioner's discretion, may reinstate such license upon payment of all past-due renewal fees and upon payment of the scheduled reinstatement fee.
§ 63-26-121. Retirement from practice.
  1. Any licensee who has retired, or may hereafter retire from practice in this state, shall not be made to register if such person files with the commissioner an affidavit on a form to be furnished by the commissioner. The affidavit shall state the date on which the person retired from practice and any other facts the commissioner deems necessary to verify the retirement. If such person thereafter reengages in practice in this state, then such person shall apply for registration with the commissioner and meet any other requirements as may be prescribed by the commissioner.
§ 63-26-122. Unlawful practice.
  1. It is unlawful for any person to practice or attempt to practice electrology in this state, unless such person has been issued a valid and current license to practice electrology. This section does not apply to a student who is practicing electrolysis as part of an approved electrolysis education program.
§ 63-26-123. Grounds for suspending, revoking or denying a license.
  1. (a) The commissioner has the authority to suspend, revoke or otherwise deny a license whenever a licensee is found guilty of any of the following acts or offenses:
    1. (1) Fraud in procuring a license;
    2. (2) Conviction of a felony;
    3. (3) Habitual intoxication or addiction to the use of narcotic drugs or controlled substances or controlled substance analogues;
    4. (4) Immoral, unprofessional, unethical or dishonorable conduct; or
    5. (5) Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this chapter, or lending one's name to another for the illegal practice of electrology by such person.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-26-124. Administrative procedures.
  1. All proceedings shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-26-125. Enjoining prohibited practices.
  1. The commissioner is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice electrology without possessing a valid license to practice, and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of electrology.
§ 63-26-126. Assistance of district attorneys general.
  1. The commissioner shall at all times have the power to call upon the district attorneys general in the various districts to assist the commissioner. It is hereby declared to be the duty of all district attorneys general throughout the state to assist the commissioner, upon the commissioner's request, in any suit for injunction or prosecution instituted by the commissioner, without charge or additional compensation.
§ 63-26-127. Penalties — Disposition of fines.
  1. (a) Any person who practices electrology without a license commits a Class C misdemeanor.
  2. (b) Each violation of this chapter constitutes a separate offense.
  3. (c) All civil penalties for a violation of this chapter shall be paid to the commissioner and given to the state treasurer as provided in § 63-26-107.
Chapter 27 Respiratory Care Practitioner Act
§ 63-27-101. Short title.
  1. This chapter shall be known and may be cited as the “Respiratory Care Practitioner Act.”
§ 63-27-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of respiratory care;
    2. (2) “Certified respiratory therapist” means any person who has obtained the credential “certified respiratory therapist” (CRT) or the credential “certified respiratory therapy technician” (CRTT) from the National Board for Respiratory Care;
    3. (3) “Division” means the division of health related boards as defined by § 68-1-101;
    4. (4)
      1. (A)
        1. (i) “Practice of respiratory care” means, under the supervision, control and responsibility of a licensed physician, the therapy, management, education and instruction, rehabilitation, diagnostic testing evaluation, and care of patients with deficiencies and abnormalities that affect the cardiorespiratory system and associated aspects of other system functions. “Practice of respiratory care” also means, under the supervision, control and responsibility of a licensed physician, the performance of cardiorespiratory research, cardiorespiratory health promotion and disease prevention, and community wellness and education programs. “Practice of respiratory care” includes, under the supervision, control and responsibility of a licensed physician:
          1. (a) The administration of pharmacologic agents and medical gasses necessary to diagnose, implement treatment, promote disease prevention, and provide rehabilitation to the cardiorespiratory system. In no event, however, shall a respiratory care practitioner prescribe controlled substances of any kind;
          2. (b) The performance of specific diagnostic and testing techniques employed in the medical management of patients to assist in diagnosis, patient and family education, monitoring, treatment, maintenance of patient health status, and cardiorespiratory research including, but not limited to, pulmonary function testing, hemodynamic and physiologic monitoring and diagnosis of cardiac function, and specimen collection and analysis;
          3. (c) The establishment and maintenance of the airways, bronchopulmonary hygiene, and cardiopulmonary resuscitation, and cardiac and respiratory life support; and
          4. (d) The receipt and implementation of written and verbal physician orders and the development and implementation of care plans and protocols;
        2. (ii) The practice of respiratory care may be performed in an inpatient or outpatient setting, clinic, hospital, nursing home facility, private dwelling, or other place deemed appropriate or necessary;
      2. (B) Registered respiratory therapists, certified respiratory therapists, and respiratory assistants who have been issued a license or certificate by the board, pursuant to the authority of § 63-27-104(a)(1), shall be exempt from any licensing, certification or permit requirements of the Tennessee Medical Laboratory Act, compiled in title 68, chapter 29, as amended, for medical laboratory personnel or medical laboratory trainees insofar as they engage in performing blood gases and PH analyses;
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    5. (5) “Registered respiratory therapist” means any person who has obtained the credential “registered respiratory therapist” (RRT) from the National Board for Respiratory Care;
    6. (6) “Respiratory assistant” or “assistant” means any person certified as such pursuant to this chapter, who has:
      1. (A) Received on-the-job training equivalent to at least one thousand (1,000) hours of clinical training in respiratory care, during an eighteen (18) consecutive month period; provided, that such training shall have been received under supervision of either a:
        1. (i) Registered respiratory therapist;
        2. (ii) Certified respiratory therapist; or
        3. (iii) Licensed physician experienced in respiratory care; and
      2. (B) Passed a board-approved examination for respiratory assistants. The National Board for Respiratory Care (NBRC) entry level examination, as provided to the board by the NBRC, by contract, is the examination accepted by the board. This examination will not grant the respiratory assistant the NBRC credential. In addition, the board reserves the right to write its own state board examination or contract with other national testing organizations; and
    7. (7) “Respiratory care practitioner” means a registered respiratory therapist, a certified respiratory therapist, or a respiratory assistant licensed under this chapter.
§ 63-27-103. Board of respiratory care.
  1. (a) A board is created, which shall be known as the board of respiratory care. This board shall consist of eight (8) members, who shall be appointed by the governor in the manner and for the terms of office as provided in this section.
  2. (b) The board shall be composed of four (4) members who are respiratory care practitioners holding a credential from the National Board for Respiratory Care, at least two (2) of whom shall be registered respiratory therapists; one (1) member who is a currently practicing physician having expertise in pulmonary medicine; one (1) member who is a hospital administrator; one (1) member who is a hospital employee licensed as a registered respiratory therapist; and one (1) citizen member who is not commercially or professionally associated with the health care field.
  3. (c) Each member of the board shall:
    1. (1) Be a resident of Tennessee for at least one (1) year immediately preceding appointment and during the member's term;
    2. (2) Be currently licensed in good standing in Tennessee, in the case of a professional member; and
    3. (3) Have had at least three (3) years of experience in that profession (in the case of a professional member).
  4. (d) The governor may consider for appointment to the board the names of qualified persons recommended by interested respiratory care groups, including, but not limited to, the professional organizations for each profession represented on the board. The Tennessee Society for Respiratory Care may submit a list of three (3) names for each position to be filled by a respiratory care practitioner. The Tennessee Medical Association may submit a list of three (3) names for the position to be filled by a physician having expertise in pulmonary medicine. The Tennessee Hospital Association (THA), an association of hospitals and health systems, may submit a list of three (3) names for the position to be filled by a hospital administrator and a list of three (3) names for the position to be filled by a hospital employee licensed as a registered respiratory therapist. The governor shall consult with the interested respiratory care groups to determine qualified persons to fill the positions.
  5. (e) Each member shall serve a term of three (3) years, except that initially the members of the council on respiratory care shall become members of the board and shall remain members of the board until their terms on the council on respiratory care would have expired. The governor shall stagger the terms of the remaining members appointed to the board, so that the terms of either two (2) or three (3) members shall expire each year. A vacancy occurring on the board shall be filled by the board itself for the unexpired term of that member. At or before the expiration of a member's term, an organization named in subsection (d) may submit three (3) names to the governor for appointment to that position. Each member shall serve until a successor is appointed. Members are eligible for reappointment to successive terms.
  6. (f) In making appointments to the board, the governor shall strive to ensure that at least one (1) member is sixty (60) years of age or older, that at least one (1) member is a member of a racial minority, and that the gender balance of the board reflects the gender balance of the state's population.
  7. (g) Each member shall be reimbursed for actual expenses incurred in the performance of official duties on the board, and in addition thereto, shall be entitled to a per diem of fifty dollars ($50.00) for each day's services in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  8. (h) Annually, the board shall choose a chair and a secretary from among its members.
  9. (i) The board shall hold at least one (1) regular meeting each year and such other meetings as the board determines necessary to conduct its business.
  10. (j) A majority of the members of the board shall constitute a quorum for the transaction of business. No action of the board shall be valid unless approved by a majority of members present at a meeting at which there is a quorum.
  11. (k) The governor has the power to remove from office any member of the board for neglect of duties required by this chapter, for malfeasance in office, for incompetence, or for unprofessional conduct.
  12. (l) The board shall deposit all moneys received by the board into the state treasury, and the department shall make such allotments out of the board's account in the general fund as the department deems proper for the necessary expenses of the board.
  13. (m) The division shall provide administrative, investigatory, and clerical services to the board as are necessary to implement and enforce this chapter.
  14. (n) On and after January 1, 1999, the board shall assume and fulfill all powers and duties heretofore assigned to the council on respiratory care and the board of medical examiners, and the rules heretofore adopted by the council on respiratory care and the board of medical examiners shall become the rules of the board on January 1, 1999, without further action by the board. The board shall consult with respiratory care professional organizations in the development of any additional regulations.
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§ 63-27-104. Powers of board.
  1. (a) In addition to the powers elsewhere in this chapter, the board has the duty to:
    1. (1)
      1. (A) Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the various duties imposed upon the board by this chapter. Except as otherwise specifically provided by this subdivision (a)(1)(A), all rules relating exclusively to registered respiratory therapists, certified respiratory therapists or respiratory assistants shall be initiated and adopted by a majority of the members of the board. Subject to the limitations contained in this section, all rulemaking authority delegated by this chapter shall be vested in the board. The board shall conduct at least one (1) public hearing each year, and shall undertake such other activities as shall be reasonably necessary, to solicit comments from license and certificate holders and the public concerning policies of the board relating to respiratory care, as well as any problems existing within the practice of respiratory care that may affect the public;
      2. (B) Within the maximum limitations established elsewhere in this chapter, fees relating to the practice of respiratory care shall be set by the board in an amount sufficient to pay all of the expenses of the board;
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    2. (2) Issue, under the board's name, all licenses approved by the board and to maintain a registry of all license holders. It is the duty of the board to review and approve the qualifications of applicants for licensure or renewal as registered respiratory therapists, certified respiratory therapists or respiratory assistants. The board may limit, restrict, or impose one (1) or more conditions on a license at the time it is issued, renewed, reactivated, or reinstated; and
    3. (3) Collect or receive all fees, fines and moneys owed pursuant to this chapter and to pay the same into the general fund of the state.
  2. (b) The board is authorized to issue advisory private letter rulings to any person licensed under this chapter who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall affect only the licensee making such inquiry and shall have no precedential value for any other inquiry or future contested case to come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
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§ 63-27-105. Practice of respiratory care — License renewal.
  1. (a) In order to safeguard life, health and property and promote public welfare by requiring that only properly qualified persons shall practice respiratory care in this state, any person practicing respiratory care shall be licensed as provided in this chapter, and it is unlawful for any person to practice or offer to practice respiratory care unless such person has been duly licensed under this chapter, except as provided in this section.
  2. (b)
    1. (1) A person seeking licensure as a registered respiratory therapist or a certified respiratory therapist must be at least eighteen (18) years of age and of good moral character, must pay the required fees set by the board, and must meet the requirements of subdivisions (b)(1)(A) or (b)(1)(B):
      1. (A) A person applying for licensure as a registered respiratory therapist shall provide evidence satisfactory to the board that such person has successfully completed a respiratory care educational program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) in collaboration with the Committee on Accreditation for Respiratory Care (CoARC), or their successor organizations, and has successfully passed the National Board for Respiratory Care registry examination for advanced respiratory therapists; and
      2. (B) A person applying for licensure as a certified respiratory therapist shall provide evidence satisfactory to the board that the person has successfully completed a respiratory care educational program accredited by the CAAHEP in collaboration with the CoARC, or their successor organizations, and has successfully passed the National Board for Respiratory Care certification examination for entry level respiratory therapists.
    2. (2) After January 1, 2000, no person may be licensed as a respiratory assistant if that person has not been previously licensed as a respiratory assistant in Tennessee. However, persons who have been licensed as respiratory assistants may continue to renew their licenses indefinitely so long as they meet all the requirements for renewal.
  3. (c)
    1. (1) Each respiratory care practitioner licensed pursuant to this chapter shall biennially apply to the board for renewal of the license and shall pay a renewal fee set by the board. A respiratory care practitioner who fails to renew the license by the date of expiration of the license shall not continue to practice respiratory care in the state.
    2. (2) A respiratory care practitioner who fails to timely renew the license may seek reinstatement of the license from the board. The board may reinstate the license upon good cause shown, upon payment of all past due renewal fees and a late renewal fee, and upon compliance with any other reasonable conditions imposed by the board.
  4. (d) A person licensed to practice as a certified respiratory therapist may upgrade the license to registered respiratory therapist if the person furnishes evidence satisfactory to the board that the person meets all the requirements to be licensed as a registered respiratory therapist. A person licensed to practice as a respiratory assistant may upgrade the license to certified respiratory therapist or registered respiratory therapist if the person furnishes evidence satisfactory to the board that the person meets all the requirements to be licensed as a certified respiratory therapist or registered respiratory therapist. A person may not hold more than one (1) Tennessee license to practice respiratory care at the same time.
§ 63-27-106. Registered respiratory therapist.
  1. (a) The knowledge and skills for performing the functions of a registered respiratory therapist shall be acquired by academic and clinical preparation in a respiratory care program approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor organization or other accrediting organization recognized by the board or by registry from the National Board for Respiratory Care. Registered respiratory therapists may assume primary clinical responsibility for all respiratory care modalities. Such modalities shall include, but are not limited to, accepting telephone and verbal orders and responsibilities involving the supervision of certified respiratory therapists and respiratory assistants.
  2. (b) Under the supervision of a physician, a registered respiratory therapist may be required to exercise considerable independent clinical judgment in the respiratory care of patients. The registered respiratory therapist must also be capable of serving as a technical resource person to the physician regarding current practices in respiratory care and to the hospital staff regarding effective and safe methods for administering respiratory care.
§ 63-27-107. Certified respiratory therapist.
  1. (a) The knowledge and skills for performing the functions of a certified respiratory therapist shall be acquired by academic and clinical preparation in a respiratory care program approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor organization or other accrediting organization recognized by the board or by certification from the National Board for Respiratory Care. Under the supervision of a physician, certified respiratory therapists may assume clinical responsibility for specified respiratory care modalities involving the application of well-defined therapeutic techniques.
  2. (b) The certified respiratory therapist's role shall not require the exercising of independent, clinical judgment; however, the certified respiratory therapist may be expected to adjust or modify therapeutic techniques within well-defined procedures based on a limited range of patient responses. Therefore, the effective use of the certified respiratory therapist, especially in the critical care setting, shall require the supervision of a physician experienced in respiratory care. The certified respiratory therapist may accept telephone or verbal orders and responsibilities involving the supervision of respiratory care therapists and respiratory assistants.
§ 63-27-108. Respiratory assistants.
  1. (a) The knowledge and skills for performing the functions of a respiratory assistant shall be acquired through compliance with the requirements of § 63-27-102(4).
  2. (b) The assistant's role shall not include the exercising of independent, clinical judgment. The assistant may be expected to adjust or modify therapeutic techniques within well-defined procedures based on a limited range of patient responses. Therefore, the use of the assistant requires the supervision of a registered respiratory therapist, certified respiratory therapist, or physician experienced in respiratory care. No assistant shall be permitted to perform the functions for which the assistant is certified on a critical care patient being maintained on mechanical ventilation, unless the assistant possesses a certificate that indicates the assistant has passed the critical care section of the board approved examination for respiratory assistants.
§ 63-27-109. Continuing education — Revocation of license — Retirement.
  1. (a) Every licensed respiratory care practitioner shall obtain, during each calendar year, at least ten (10) hours of continuing professional respiratory care education that meets the guidelines established for such continuing education by the rules of the board. Each licensed practitioner shall maintain written proof of obtaining such continuing education for a period of at least three (3) years and shall, upon request, make such proof available to the board or the division.
  2. (b) The board shall approve only those continuing education courses that conform with the guidelines established by the rules of the board. Providers of such courses shall also be approved by the board in accordance with guidelines established by the rules of the board. Course offerings approved for in-service training by the joint commission on accreditation of health care organizations and in-service training programs sponsored or conducted by the Tennessee Society of Respiratory Care shall be deemed to be approved courses.
  3. (c) The rules of the board may establish exceptions from the requirements of this section in emergency or hardship cases. Such cases shall be individually reviewed and approved by the board.
  4. (d) When any such person shall fail to renew that person's license and pay the renewal fee after renewal becomes due, the license of such person shall be automatically revoked without further notice or hearing unless renewal is made and all fees paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
  5. (e) Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person shall file with the board, an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
§ 63-27-110. Exemptions.
  1. (a)
    1. (1) Nothing in this chapter shall prohibit:
      1. (A) Any person licensed or certified to practice any of the other health-related professions in this state under any other law from engaging in the practice for which such person is licensed or certified; or
      2. (B) Persons employed as subsidiary workers who do not represent themselves to be registered respiratory therapists, certified respiratory therapists or assistants from assisting in the respiratory care of patients under the direction and supervision of a licensed physician.
    2. (2) As used in this section, “subsidiary worker” means an individual who occasionally administers oxygen or other therapeutic gas under the orders of a licensed physician, osteopath or doctor of dentistry, and who is not involved in any other aspect of the direct delivery of respiratory care procedures or the administration of diagnostic tests of the cardio-respiratory function. “Subsidiary worker” does not include an individual who delivers and installs respiratory care equipment in hospitals, in the home and in alternate care sites.
  2. (b) Nothing in this chapter shall be construed to apply to a registered nurse or to a licensed practical nurse employed by a licensed nursing home when such person is under the supervision of a registered nurse or a licensed physician, and so long as such licensed practical nurse does not maintain and manage life support systems.
  3. (c) With respect to licensed health care professionals that lawfully engage in the practice of respiratory care within the scope of practice of their professions, the board may develop mechanisms and standards for ensuring the competency of such licensed professionals in their practice of respiratory care, and may recommend to the health-related board for each such profession that that board adopt, by rule or otherwise, mechanisms and standards for ensuring competency in the practice of respiratory care; provided, that the board has no authority to regulate a health care professional subject to regulation by another health-related board.
  4. (d) Nothing in this chapter shall be construed as prohibiting the practice of respiratory care by students while they are under the supervision of instructors in any respiratory care educational program that has been approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or its successor organization, so long as the students' activities are not performed for compensation and so long as the students wear an appropriate badge indicating their status as students.
  5. (e) Nothing in this chapter shall prohibit self-care by the patient or the gratuitous care by a friend or member of the family who does not represent or hold out to be a respiratory care practitioner certified under this chapter.
  6. (f) Nothing in this chapter shall prohibit an individual who holds a credential from the National Board for Respiratory Care entitled “certified pulmonary function technologist (CPFT)” or “registered pulmonary function technologist (RPFT)” from engaging in the performance of pulmonary function diagnostic testing.
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§ 63-27-111. Prohibited practices — Criminal penalties.
  1. (a) No person shall by verbal claim, advertisement, letterhead, card, or in any other way, claim to be a registered respiratory therapist, certified respiratory therapist or respiratory assistant unless such person possesses a valid license issued pursuant to this chapter.
  2. (b) It is unlawful for any person to practice or offer to practice respiratory care unless such person has been duly licensed under this chapter, except as provided in § 63-27-110.
  3. (c) Each violation of this section is a Class A misdemeanor.
§ 63-27-112. Disciplinary sanctions — Complaints of violations — Civil penalties — Use of witnesses.
  1. (a) The board has the power to impose any of the disciplinary sanctions set forth in this section whenever the licensee is found guilty of violating this chapter or committing any of the following acts or offenses:
    1. (1) Making false or misleading statements or committing fraud in procuring a license;
    2. (2) Immoral, unethical, unprofessional or dishonorable conduct;
    3. (3) Habitual intoxication or personal misuse of narcotics, controlled substances, controlled substance analogues or any other drugs or the use of alcoholic beverages or stimulants in such manner as to adversely affect the person's ability to practice respiratory care;
    4. (4) Conviction of a felony or of any offense involving moral turpitude or of any violation of the drug laws of this state or of the United States;
    5. (5) Violation or attempted violation, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter or any lawful order of the board or any criminal statute of this state;
    6. (6) Gross health care liability, ignorance, negligence or incompetence in the course of professional practice;
    7. (7) Making or signing in one's professional capacity any document that is known to be false at the time it is made or signed;
    8. (8) Engaging in the practice of respiratory care when mentally or physically unable to safely do so;
    9. (9) Making false statements or representations or being guilty of fraud or deceit in the practice of respiratory care;
    10. (10) Having disciplinary action imposed by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed to practice respiratory care in this state; provided, further, that a certified copy of the order or other document memorializing the disciplinary action by the other state or territory shall constitute prima facie evidence of a violation of this section; or
    11. (11) Any other unprofessional or unethical conduct specified in the rules of the board.
  2. (b) Complaints alleging violations of this chapter, or any rule duly promulgated pursuant to § 63-27-104, shall be filed with the board, shall be referred by the board to the division for investigation, and shall be resolved by the board in accordance with this chapter and the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. A file shall be maintained on each such complaint filed with the board and shall reflect all activities taken by the board and division in response to such complaint.
  3. (c) The board may impose one (1) or more of the following penalties for violations of this chapter or any rule duly promulgated pursuant to § 63-27-104:
    1. (1) Denial of an application for licensure;
    2. (2) Revocation or suspension of licensure;
    3. (3) Imposition of an administrative fine not to exceed five hundred dollars ($500) for each count or separate offense;
    4. (4) Placement of the certified respiratory therapist, respiratory assistant or registered respiratory therapist on probation for such length of time and subject to such conditions as the board may specify, including requiring the certified respiratory therapist, respiratory assistant or registered respiratory therapist to submit to treatment, to attend continuing education courses, or to work under the supervision of another certified respiratory therapist or registered respiratory therapist; or
    5. (5) Issuance of a reprimand.
  4. (d) The board shall be empowered to refuse to reinstate licensure or cause a license to be issued to a person it has deemed unqualified, until such time as it finds that such person has complied with all the terms and conditions set forth in the final order rendered pursuant to subsection (a) and that the respiratory assistant, certified respiratory therapist or registered respiratory therapist is capable of safely engaging in the delivery of respiratory care services.
  5. (e) The chair of the board has the authority to administer oaths to witnesses and, upon probable cause being established, to issue subpoenas for the attendance of witnesses and the production of documents and records.
  6. (f) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-27-113. Required credentials for registered respiratory therapist.
  1. Any person currently licensed as a registered respiratory therapist who has not obtained the credential “registered respiratory therapist (RRT)” from the National Board for Respiratory Care shall have until January 1, 2004, to obtain such credential in order to continue being licensed as a registered respiratory therapist in this state. If such person has not obtained such credential by January 1, 2004, such person's license shall be renewed as a certified respiratory therapist license when it is next renewed.
§ 63-27-115. Blood gas analysis — Performance of blood gas laboratory functions.
  1. Blood gas analysis, and maintenance and quality assurance of a blood gas laboratory may not be performed by any practitioner licensed under this chapter unless:
    1. (1) In the case of a registered respiratory therapist or certified respiratory therapist, the registered respiratory therapist or certified respiratory therapist:
      1. (A) Has been trained in blood gas analysis as approved by the board;
      2. (B) Has been granted a license by the board bearing the endorsement “ABG analyst”; and
      3. (C) Holds either the NBRC credentials “CRT,” “CRTT” or “RRT” or has passed a board approved examination testing competency for blood gas analysis; and
    2. (2) In the case of a respiratory assistant:
      1. (A) Has been trained in blood gas analysis as approved by the board;
      2. (B) Has been granted a license by the board bearing the endorsement “ABG analyst”; and
      3. (C) Has passed a board approved examination testing competency for blood gas analysis. The National Board for Respiratory Care entry level examination, as provided to the board by the NBRC, by contract, is the examination accepted by the board. This examination will not grant the respiratory assistant the NBRC credential. In addition, the board reserves the right to write its own state council examination or contract with other national testing organizations.
§ 63-27-116. Licenses for registered respiratory therapist and certified respiratory therapist — Temporary license — Reciprocity.
  1. (a) The board may issue a temporary license to an individual applicant who has completed the required respiratory care educational program but who has not yet successfully completed the NBRC examination. A temporary license shall automatically expire one (1) year from its date of issuance and may not be renewed.
  2. (b) The board may issue a license to practice respiratory care by endorsement to an applicant who is currently licensed to practice respiratory care under the laws of another state, territory or country if the qualifications of the applicant are deemed by the board to be equivalent to those required in this state.
  3. (c)
    1. (1) The board may authorize any of its members or its consultant to conduct a review of the qualifications of an applicant for a license or temporary license to practice respiratory care in this state and to make an initial determination as to whether the applicant has met all the requirements for a license or temporary license. If the board member or board consultant determines that the applicant has met all the requirements for a license or temporary license, the applicant is then authorized to practice respiratory care in this state until the board makes a final decision on the application for a license or temporary license. The board may authorize the use of this procedure with respect to applicants for license renewal or reinstatement as well. In no event shall the temporary authorization issued pursuant to a determination made by the board member or board consultant be effective for longer than a six (6) month period measured from the date of issuance. This process shall not be utilized by the applicant more than once.
    2. (2) If temporary authorization, pursuant to this subsection (c), is issued to an applicant for a license to practice respiratory care in this state and if the subsequent decision of the board is to deny the application based upon a good faith determination that the applicant has not, in fact, complied with all the requirements for a license, then the doctrine of estoppel shall not apply against the state based upon its issuance of temporary authorization and its subsequent denial of licensure.
§ 63-27-117. Training for respiratory equipment delivery technicians.
  1. As a part of its licensing and regulation of home medical equipment providers under § 68-11-226, the board for licensing health care facilities shall establish uniform standards to ensure the competency of persons who deliver and install respiratory equipment.
Chapter 28 Clinical Perfusionist Licensure Act
§ 63-28-101. Short title.
  1. This chapter shall be known and may be cited as the “Clinical Perfusionist Licensure Act.”
§ 63-28-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of medical examiners, created by chapter 6 of this title;
    2. (2) “Committee” means the committee for clinical perfusion;
    3. (3) “Division” means the division of health related boards;
    4. (4) “Extracorporeal circulation” means the diversion of a patient's blood through a heart-lung machine or a similar device that assumes the functions of the patient's heart, lungs, kidneys, liver or other organs;
    5. (5) “Licensed clinical perfusionist” means a person licensed pursuant to this chapter;
    6. (6) “Perfusion” means the functions necessary for the support, treatment, measurement or supplementation of the cardiovascular, circulatory or respiratory systems, or other organs, or a combination of such activities, and to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems under an order and under the supervision of a licensed physician, including:
      1. (A) The use of extracorporeal circulation, long-term cardiopulmonary support techniques including extracorporeal carbon dioxide removal and extracorporeal membrane oxygenation and associated therapeutic and diagnostic technologies;
      2. (B) Counterpulsation, ventricular assistance, autotransfusion, blood conservation techniques, myocardial and organ preservation, extracorporeal life support and isolated limb perfusion;
      3. (C) The use of techniques involving blood management, advanced life support and other related functions; and
      4. (D) In the performance of the acts described in this subdivision (6), the administration of:
        1. (i) Pharmacological and therapeutic agents; or
        2. (ii) Blood products or anesthetic agents through the extracorporeal circuit or through an intravenous line as ordered by a physician;
      5. (E) The performance and use of:
        1. (i) Anticoagulation monitoring and analysis;
        2. (ii) Physiologic monitoring and analysis;
        3. (iii) Blood gas and chemistry monitoring and analysis;
        4. (iv) Hematological monitoring and analysis;
        5. (v) Hypothermia and hyperthermia;
        6. (vi) Hemoconcentration and hemodilution; and
        7. (vii) Hemodialysis; and
      6. (F) The observation of signs and symptoms related to perfusion services, the determination of whether the signs and symptoms exhibit abnormal characteristics and the implementation of appropriate reporting, clinical perfusion protocols or changes in, or the initiation of, emergency procedures;
    7. (7) “Perfusion protocols” means perfusion-related policies and protocols developed or approved by a licensed health care facility or a physician through collaboration with administrators, licensed clinical perfusionists and other health care professionals; and
    8. (8) “Provisional licensed clinical perfusionist” means a person provisionally licensed pursuant to this chapter.
§ 63-28-103. License eligibility.
  1. A person is eligible to make application to the committee and receive a license if such person is actively engaged in the practice of perfusion consistent with this chapter and if such person, on January 1, 2000, has at least four (4) years' experience, within the immediately preceding six (6) years, operating cardiopulmonary bypass systems during cardiac surgical cases in a licensed health care facility as the person's primary function.
§ 63-28-104. Committee to issue licenses.
  1. The committee shall license by examination, or otherwise as provided in this chapter, all licensed clinical perfusionists in this state who meet the requirements of this chapter.
§ 63-28-105. Application — Qualification for examination.
  1. (a) A candidate for a license to practice as a licensed clinical perfusionist shall submit an application accompanied by the required fees. The committee shall prescribe the form of the application and the dates by which applications and fees must be received.
  2. (b) To qualify for the licensing examination, the applicant shall have successfully completed a perfusion education program approved by the committee. In approving perfusion education programs necessary for qualification for licensing examination, the committee shall approve only a program that has education standards established by the accreditation committee for perfusion education and approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor.
§ 63-28-106. Competency examination.
  1. (a) Except as otherwise provided in this chapter, to qualify for a license, an applicant shall pass a competency examination. The examination shall be prepared or approved by the committee and administered to qualified applicants at least once each calendar year. The examination prescribed by the committee may be or may include the complete examinations given by the American Board of Cardiovascular Perfusion (ABCP) or its successor organization.
  2. (b) Not later than forty-five (45) days after the date on which a licensing examination is administered, the division shall notify each examinee of the results of the examination.
  3. (c) The committee shall establish:
    1. (1) A limit on the number of times an applicant who fails an examination may retake the examination;
    2. (2) The requirements for reexamination; and
    3. (3) The amount of any reexamination fee.
§ 63-28-107. Renewal of expired and unexpired licenses.
  1. (a) A license to practice perfusion is valid for two (2) years. The committee may provide that licenses expire on various dates. A person may renew an unexpired license by submitting proof of compliance with the continuing professional education requirements prescribed by the committee and paying the required renewal fee to the committee before the expiration date of the license.
  2. (b) If a person's license has been expired for not more than two (2) years, the person may renew the license by submitting proof, satisfactory to the committee, of compliance with the continuing professional education requirements prescribed by the committee and any penalty fee prescribed by the committee.
  3. (c) If a person's license has been expired two (2) years or more, the person may not renew the license. The person may obtain a new license by submitting to reexamination and complying with the current requirements and procedures for obtaining a license.
  4. (d) The committee may renew without reexamination an expired license of a person who was licensed in this state, moved to another state or states, and is currently licensed or certified and has been in practice in another state or states for the two (2) years immediately preceding the person's application to renew a license. The person shall pay the required fee as established by the committee. The committee shall not renew an expired license pursuant to this subsection (d) if such expired license is subject to a penalty or restriction in another state.
  5. (e) The committee shall notify each license holder in writing of the license expiration date more than thirty (30) days before such date by notice to the license holder at the license holder's last known address according to the records of the committee.
§ 63-28-108. Provisional licenses.
  1. (a) A license as a provisional licensed clinical perfusionist may be issued by the committee to a person who has successfully completed an approved perfusion education program, has made application to sit for the licensure examination, and upon such person filing an application, paying of the application fee and submitting evidence satisfactory to the committee of the successful completion of the education requirements as provided in this chapter.
  2. (b) A provisional licensed clinical perfusionist shall be under the supervision and direction of a licensed clinical perfusionist at all times during which the provisional licensed clinical perfusionist performs perfusion. The committee may promulgate rules governing such supervision and direction. Such rules shall not require the immediate physical presence of the supervising licensed clinical perfusionist.
  3. (c) A provisional license shall be valid for one (1) year from the date it is issued and may be renewed by the same procedures established for the renewal of licenses pursuant to this chapter, if the application for renewal is signed by a supervising licensed clinical perfusionist.
  4. (d) If the person fails any portion of the licensure examination, such person shall surrender the person's provisional license to the committee.
§ 63-28-109. Waiver of examination and educational requirements.
  1. On receipt of an application and application fee, the committee may waive the examination and educational requirements for an applicant who at the time of application:
    1. (1) Is appropriately licensed or certified by another state, territory or possession whose requirements for the license or certificate are substantially equivalent to the requirements of this chapter, and such applicant is not under any restriction or encumbrance imposed by such state; or
    2. (2) Holds a current certificate as a certified clinical perfusionist issued by the American Board of Cardiovascular Perfusion, or its successor.
§ 63-28-110. Unauthorized use of professional title or designation.
  1. (a) A person may not engage in or offer to engage in perfusion for compensation or use the title or represent or imply that the person has the title of “licensed clinical perfusionist” or “provisional licensed clinical perfusionist” or use the letters “LCP” or “PLCP” and may not use any facsimile of such titles in any manner to indicate or imply that the person is a licensed perfusionist or provisional licensed perfusionist unless the person holds an appropriate license issued pursuant to this chapter.
  2. (b) A person may not use the title or represent or imply that such person has the title of “certified clinical perfusionist” or use the letters “CCP” and may not use any facsimile of such title in any manner to indicate or imply that such person is a certified clinical perfusionist by the American Board of Cardiovascular Perfusion unless the person holds a certificate as a certified clinical perfusionist issued by the American Board of Cardiovascular Perfusion.
  3. (c) Any person who violates subsection (a) or (b) commits a Class B misdemeanor.
§ 63-28-111. Persons exempted from compliance with this chapter.
  1. This chapter shall not apply to:
    1. (1) A person licensed as a health care professional in this state if:
      1. (A) The person does not represent to the public, directly or indirectly, that the person is licensed pursuant to this chapter, and does not use any name, title or designation indicating that the person is licensed pursuant to this chapter; and
      2. (B) The person limits the person's acts or practice to the scope of practice authorized by the appropriate licensing agency;
    2. (2) A student enrolled in an accredited perfusion education program if the perfusion services performed are:
      1. (A) An integral part of the student's course of study; and
      2. (B) Performed under the direct supervision of a licensed clinical perfusionist assigned to supervise the student and who is on duty and immediately available in the assigned patient care area; or
    3. (3) The practice of any legally qualified perfusionist employed by the United States government while in the discharge of the person's official duties.
§ 63-28-112. Committee members — Term of office — Compensation — Removal.
  1. (a) To assist the board of medical examiners in the performance of its duties, there is hereby established the committee for clinical perfusionists, composed of seven (7) members who are each appointed by the governor. The committee shall approve the examination required by this chapter. The chair of the committee shall be a perfusionist.
  2. (b) The committee shall consist of four (4) perfusionist members, one (1) hospital administrator from a licensed healthcare facility in Tennessee in which cardiac surgery is performed, one (1) licensed physician who shall be either a cardiac surgeon or a cardiac anesthesiologist, and one (1) public member. The public member shall be a resident of Tennessee for one (1) year and shall be a registered voter. The public member shall be a person who is not and never was a member of any medical profession or the spouse of a medical professional. The public member shall not be a member of, or a consultant to, any trade association in the field of health care. The public member shall not have or have had a material financial interest in either the provision of professional services specified by this chapter, or any activity or organization directly related to any licensed profession specified in this chapter. Perfusionist members may be appointed from lists of qualified persons submitted to the governor by interested perfusionist groups and the committee for clinical perfusionists. The governor shall consult with such groups and the committee to determine qualified persons to fill the positions. The members of the committee shall be appointed for terms of six (6) years, except those first appointed, of whom one (1) shall be appointed for a term of one (1) year, one (1) shall be appointed for a term of two (2) years, two (2) shall be appointed for a term of three (3) years, one (1) shall be appointed for a term of four (4) years, one (1) shall be appointed for a term of five (5) years and one (1) shall be appointed for a term of six (6) years. The perfusionist committee members shall be residents of the state of Tennessee for at least one (1) year, shall be United States citizens and shall meet all the requirements for licensing provided in this chapter. In making appointments to the committee, the governor shall ensure that the committee is representative of the environments in which perfusionists practice. The hospital administrator member and the physician member shall be residents of Tennessee. In making appointments to the committee, the governor shall strive to ensure that at least one (1) person serving on the committee is sixty (60) years of age or older and that at least one (1) person serving on the committee is a member of a racial minority. Of the total membership of the committee, no less than two (2) members shall be from each grand division of the state. In making the initial appointments to the committee, the perfusionist members shall not be required to be licensed but shall apply for a license from the committee within ninety (90) days of the issuance of licenses by the committee.
  3. (c) If a member of the committee shall, during the member's term as a committee member, remove the member's domicile from the state of Tennessee, then the committee shall immediately notify the governor and the seat of that committee member shall be declared vacant. All such vacancies shall be filled by appointment in the same manner as provided in subsection (b).
  4. (d) No member of the committee shall be entitled to any compensation for the performance of the member's official duties but shall receive compensation for travel expenses pursuant to the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  5. (e) A member of the committee may be removed by the governor, if the member:
    1. (1) Does not have, at the time of appointment, the qualifications required for appointment to the committee;
    2. (2) Does not maintain during service on the committee the qualifications required for appointment to the committee;
    3. (3) Violates any provision of this chapter;
    4. (4) Cannot discharge the member's duties for a substantial part of the term for which the member is appointed because of illness or disability; or
    5. (5) Is absent from more than one-half (½) of the regularly scheduled committee meetings that the member is eligible to attend during a calendar year, unless the absence is excused by a majority vote of the committee.
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§ 63-28-113. Committee chair and vice chair — Meetings — Quorum.
  1. Not later than thirty (30) days after the governor appoints the initial members of the committee and annually thereafter, the committee shall meet and elect one (1) of its members as chair and one (1) of its members as vice chair. The committee shall meet annually or at any other time if called by the chair or a majority of the committee. A majority of the members of the committee shall constitute a quorum.
§ 63-28-114. Committee powers and duties.
  1. (a) The committee shall:
    1. (1) Adopt and publish a code of ethics;
    2. (2) Establish the qualifications and fitness of applicants for licenses, renewal of licenses and reciprocal licenses;
    3. (3) Establish the grounds for revocation, suspension, or denial of a license;
    4. (4) Establish the grounds for placing on probation a holder of a license;
    5. (5) Establish the categories of fees and the amount of fees that may be imposed in connection with a license;
    6. (6) Establish continuing professional education requirements for licensed clinical perfusionists and provisional licensed clinical perfusionists, the standards of which shall be at least as stringent as those of the American Board of Cardiovascular Perfusion or its successor agency for the license holder's professional duties; and
    7. (7) Assist in such matters dealing with perfusion as the board may, in its discretion, direct.
  2. (b) Any actions taken under this section shall only be effective after adoption by a majority vote of the members of the committee. The board of medical examiners, by a majority vote of its members at the next board meeting at which administrative matters are considered, may rescind or supersede any action taken by the committee.
§ 63-28-115. Complaints.
  1. (a) The committee shall keep an information file about each complaint filed with the committee. The committee's information file shall be kept current and contain a record for each complaint of:
    1. (1) All persons contacted in relation to the complaint;
    2. (2) A summary of findings made at each step of the complaint process;
    3. (3) An explanation of the legal basis and reason for a complaint that is dismissed; and
    4. (4) Other relevant information.
  2. (b) If a written complaint is filed with the committee that the committee has authority to resolve, the committee at least as frequently as quarterly and until final disposition of the complaint shall notify the parties to the complaint of the status of the complaint unless the notice would jeopardize an ongoing investigation.
  3. (c) The committee shall develop a form to standardize information concerning complaints made to the committee. The committee shall prescribe information to be provided to a person when the person files a complaint with the committee.
  4. (d) The committee shall provide reasonable assistance to a person who wishes to file a complaint with the committee.
§ 63-28-116. Rules for complaint investigation — Disposal of complaints.
  1. (a) The committee shall promulgate rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, concerning the investigation of a complaint filed with the committee. The rules adopted pursuant to this section shall:
    1. (1) Distinguish between categories of complaints;
    2. (2) Ensure that complaints are not dismissed without appropriate consideration;
    3. (3) Require that the board be advised of a complaint that is dismissed and that a letter be sent to the person who filed the complaint explaining the action taken on the dismissed complaint;
    4. (4) Ensure that the person who filed the complaint has an opportunity to explain the allegations made in the complaint; and
    5. (5) Prescribe guidelines concerning the categories of complaints that require the use of a private investigator and the procedures for the committee to obtain the services of a private investigator.
  2. (b) The committee shall dispose of all complaints in a timely manner.
§ 63-28-117. Revocation or suspension of licenses — Probation of licensees.
  1. (a) The committee shall revoke or suspend a license, place on probation a person whose license has been suspended, or reprimand a license holder if there is proof of:
    1. (1) Any violation of this chapter;
    2. (2) Any violation of a rule or code of ethics adopted by the committee; or
    3. (3) Unprofessional conduct, which includes, but is not limited to:
      1. (A) Incompetence or gross negligence in carrying out usual perfusion functions;
      2. (B) A conviction of practicing perfusion without a license or a provisional license;
      3. (C) The use of advertising relating to perfusion in a way that violates state law;
      4. (D) Procuring a license or provisional license by fraud, misrepresentation or mistake;
      5. (E) Making or giving any false statement or information in connection with the application for a license or provisional license;
      6. (F) Conviction of a felony or of any offense substantially related to the qualifications, functions and duties of a perfusionist, in which event the record of the conviction shall be conclusive evidence of such offense; or
      7. (G) Impersonating an applicant or acting as proxy for an applicant in any examination required pursuant to this chapter for the issuance of a license.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-28-118. Administrative rules.
  1. The committee may promulgate administrative rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to administer this chapter.
Chapter 29 Midwifery
§ 63-29-101. Findings of general assembly.
  1. The general assembly recognizes the need for a person to have the freedom to choose the manner, cost, and setting for giving birth. The general assembly finds that access to prenatal care and delivery services is limited by the inadequate number of providers of such services and that the practice of midwifery may help to reduce this shortage. The general assembly also recognizes the need for the safe and effective delivery of newborn babies and the health, safety, and welfare of their mothers in the delivery process. The general assembly, in the interest of public health, promotes the regulation of the practice of midwifery in this state for the purpose of protecting the health and welfare of women and infants. The general assembly recognizes that midwifery is a profession in its own right and that it is not the practice of medicine.
§ 63-29-102. Chapter definitions.
  1. As used in this chapter, unless the context requires otherwise:
    1. (1) “Antepartal” means occurring during pregnancy;
    2. (2) “Board” means the board of osteopathic examiners of the department of health to which the council of certified professional midwifery reports;
    3. (3) “Certified professional midwife (CPM)” means a person who has obtained national certification from the North American Registry of Midwives;
    4. (4) “Consultation” means exchange of information and advice regarding the client condition and indicated treatment with a physician;
    5. (5) “Council” means the council of certified professional midwifery;
    6. (6) “CPM-TN” means certified professional midwife in Tennessee. A “CPM-TN” must be certified to practice midwifery by the North American Registry of Midwives;
    7. (7) “Department” means the department of health;
    8. (8) “Intrapartal” means occurring during the process of giving birth;
    9. (9) “Midwife” means a person who is trained to give the necessary care and advice to women during pregnancy, labor, and the post-birth period, to conduct normal deliveries on the midwive's own responsibility and to care for the newly born infant. The midwife is able to recognize the warning signs of abnormal conditions requiring referral to and/or collaboration with a physician;
    10. (10) “Midwifery” means the practice of attending low-risk women during pregnancy, labor and the post-birth period with the informed consent of the mother. The scope of midwifery shall include comprehensive care of the pregnant woman during the antepartal phase, intrapartal phase, and postpartal phase, and application of emergency care when necessary;
    11. (11) “NARM” means the North American Registry of Midwives;
    12. (12) “Physician” means a person who is duly licensed in the state of Tennessee to practice medicine by the state board of medical examiners or to practice osteopathy by the board; and
    13. (13) “Postpartal” means occurring subsequent to birth.
§ 63-29-103. Council established.
  1. (a) There is hereby established a council of certified professional midwifery, which shall serve as a subcommittee of and report to the board.
  2. (b) The council members shall be appointed by the commissioner of health. The council shall consist of six (6) members.
  3. (c) Members shall be residents of Tennessee.
  4. (d) Members shall consist of three (3) certified professional midwives, one (1) consumer who has no direct or indirect affiliation with the midwifery profession or industry, one (1) certified nurse midwife, and one (1) physician.
  5. (e)
    1. (1) Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the council:
      1. (A) Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the council shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the council, prior to serving as a member of the council. This subdivision (e)(1)(A) shall apply to all persons appointed or otherwise named to the council after July 1, 2010;
      2. (B) No person who is a member of the council shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the council during such person's period of service as a member of the council. This subdivision (e)(1)(B) shall apply to all persons appointed or otherwise named to the council after July 1, 2010, and to all persons serving on the council on such date who are not registered as lobbyists; and
      3. (C) No person who serves as a member of the council shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the council for one (1) year following the date such person's service on the council ends. This subdivision (e)(1)(C) shall apply to persons serving on the council as of July 1, 2010, and to persons appointed to the council subsequent to such date.
    2. (2) A person who violates this subsection (e) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. (3) The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (e). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  6. (f) Members of the council shall serve without pay. Members shall be entitled to reimbursement for per diem and travel expenses.
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§ 63-29-104. Members — Terms of office.
  1. The terms of office of the members of the council shall be staggered four-year terms. In making the initial appointments, the commissioner shall appoint four (4) members to four-year terms, three (3) members to three-year terms and two (2) members to two-year terms. All subsequent terms shall be for a period of four (4) years. No member shall be appointed for more than two (2) consecutive terms.
§ 63-29-105. Removal of council member for absenteeism.
  1. When a council member is absent from three (3) consecutive meetings without excuse, that member shall be removed from office, and a new member shall be appointed by the commissioner of health. An absence shall be deemed excused if caused by a health problem or condition verified in writing by a physician, or by an accident or similar unforeseeable tragedy or event prior to or at the time of the next council meeting.
§ 63-29-106. Election of chair and vice chair — Quorum — Meetings — Notice — Records.
  1. (a) The council members shall elect annually from their membership a chair and vice chair.
  2. (b) A quorum shall consist of a majority of the members.
  3. (c) No final action shall be taken on any matter without a quorum and majority vote of the members present.
  4. (d) The council shall meet at least once each year.
  5. (e) Emergency meetings may be called by the chair with written notice to all members.
  6. (f) Public notice shall be given for all meetings.
  7. (g) All meetings are open to the public.
  8. (h) All records are available to the public. Persons wishing to obtain copies of such records may request the same in writing from the council.
§ 63-29-107. Responsibilities of council.
  1. The council shall:
    1. (1) Assist and advise the board and the department in developing rules with guidance from the Midwives Alliance of North America's Core Competencies and not inconsistent with the law. The rules shall include, but not be limited to, the allowable scope of midwifery practice regarding use of equipment, procedures, and administration of medication as prescribed by a physician;
    2. (2) Make recommendations to the board and the department regarding:
      1. (A) Certified professional midwifery;
      2. (B) Applications and renewals;
      3. (C) Development of forms for reporting and receiving certified professional midwifery forms as set forth in this chapter;
      4. (D) Up-to-date files on all active CPM-TN in Tennessee including emergency plan guidelines; and
      5. (E) Compilation of annual statistics on CPM-TN deliveries; and
    3. (3) Educate the public and other providers of obstetrical care about the role of the CPM-TN.
§ 63-29-108. Certification.
  1. (a) A midwife who has met the standards set forth in this chapter may apply to the board for Tennessee certification. An application for Tennessee certification shall provide information as required by this section and as may be required by the board. Except for the American College of Nurse Midwives certified midwives and certified nurse midwives, a certificate under this chapter is required to practice midwifery for monetary compensation in which service has been offered for a fee. A certificate under this chapter is not required for certified nurse midwives who maintain their licensure as registered nurses pursuant to chapter 7 of this title.
  2. (b) In order to receive certification as a CPM-TN, an applicant shall:
    1. (1) Obtain certification from NARM and currently hold the title of CPM;
    2. (2) Read, understand, and agree to practice under the guidelines set forth in this chapter and any rules promulgated pursuant to this chapter; and
    3. (3) Have proof of current CPR certification including infant or neonatal resuscitation.
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§ 63-29-109. Title — Term of initial certificate — Renewal — Denial of applications — Third party payment.
  1. (a) A midwife who is certified under the standard found in § 63-29-108 may use the initials “CPM-TN.”
  2. (b) An initial certificate is available for no more than a two-year period.
  3. (c) The certificate is renewable pursuant to the division of health related boards' biennial birthdates renewal system.
  4. (d) Renewal is available to the CPM who maintains current certification from NARM by complying with the continuing education requirement applicable to the CPM.
  5. (e) Renewal is available to the CPM-TN whose certification from NARM remains in good standing and who has current CPR certification.
  6. (f) The board may deny an application for certification only if the applicant is not in compliance with the standards in this chapter.
  7. (g) A CPM-TN may receive third party payment from private agencies that provide coverage for maternity and obstetrical care. No managed care organization or insurance company shall require a patient to be served by a CPM-TN instead of a medical doctor or a nurse practitioner.
§ 63-29-110. Status.
  1. Any CPM who is not practicing midwifery in Tennessee may be placed in inactive status by requesting such status in writing and submitting it to the council. Active status may be renewable by requesting a change of status from inactive to active in writing to the council and by fulfilling the requirements for renewal set forth in this chapter.
§ 63-29-111. Reapplication after expiration of certificate.
  1. Any CPM who does not seek inactive status and allows the certificate to expire after a sixty-day grace period must apply for a new certificate as prescribed in this chapter.
§ 63-29-112. Fees.
  1. The application and renewal fees are to be set by the commissioner of health and shall not be less than that sum necessary to permit the council to recover its costs of operation.
§ 63-29-113. Display of certificate.
  1. The certificate shall be displayed at all times in a conspicuous place where the CPM-TN is practicing, when applicable.
§ 63-29-114. Revocation or suspension of license — Appeals.
  1. (a)
    1. (1) A CPM-TN's license may be revoked or suspended for any of the grounds set forth in subdivision (a)(2), or for failing to follow the standards set forth in this section. Such action may occur only after investigations by the department. Any action on the certification shall be made by the council, subject to approval by the board.
    2. (2) The board has the power to deny, revoke or suspend any certificate or to otherwise discipline a certificate holder upon proof that the person:
      1. (A) Is guilty of fraud or deceit in procuring or attempting to procure a certificate to practice midwifery;
      2. (B) Is guilty of a crime;
      3. (C) Is unfit or incompetent by reason of negligence, habits or other cause;
      4. (D) Is addicted to alcohol or drugs to the degree of interfering with midwifery duties;
      5. (E) Is mentally incompetent;
      6. (F) Is guilty of unprofessional conduct; or
      7. (G) Has violated or attempted to violate, directly or indirectly, or assisted in or abetted the violation of, or conspired to violate, any provision of this chapter or any lawful order of the board issued pursuant thereto.
  2. (b) Any contested case hearing held pursuant to this section shall be conducted in compliance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-29-115. Responsibilities of midwife.
  1. (a) The CPM-TN may provide care for the low-risk client who is expected to have a normal pregnancy, labor, birth and postpartal phase in the setting of the mother's choice. The CPM-TN shall form a collaborative care plan with a physician for all clients.
  2. (b) The CPM-TN shall ensure that the client has signed an informed consent form. This form shall include information to inform the client of the qualifications of the CPM-TN.
  3. (c) For screening purposes only, the CPM-TN may order routine antepartal and postpartal laboratory analysis to be performed by a licensed laboratory. Abnormal findings would require a consultation with a physician.
  4. (d) The CPM-TN shall develop an emergency plan that shall be signed by the client and placed in the client chart at the initial visit. The emergency plan shall include documentation of the initial consultation with the physician previously referenced in subsection (a). The documentation shall also include referral and transfer plans for the patient in the event of an emergency. A copy of the plan shall be sent to the named physicians.
  5. (e) The CPM-TN shall determine the progress of labor and, when birth is imminent, shall be available until delivery is accomplished.
  6. (f) The CPM-TN shall remain with the postpartal mother during the postpartal period until the conditions of the mother and newborn are stabilized.
  7. (g) The CPM-TN shall instruct the parents regarding the requirements of § 68-5-202.
  8. (h) The CPM-TN shall instruct the parents regarding the requirement of § 68-5-401.
  9. (i) The CPM-TN shall maintain a birth certificate for each birth in accordance with the requirements of title 68. A copy of the birth certificate shall be filed with the department.
  10. (j) The CPM-TN shall practice in compliance with the rules and regulations promulgated pursuant to this chapter.
§ 63-29-116. Rules and regulations.
  1. The board and department, with assistance and advice from the council, are authorized to promulgate rules and regulations to effectuate the purposes of this chapter. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Chapter 30 Reflexology Practitioners Registration Act of 2001
§ 63-30-101. Short title.
  1. This chapter shall be known and may be cited as the “Reflexology Practitioners Registration Act of 2001.”
§ 63-30-102. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Certification” means completion of a two hundred (200) hour reflexology only course offered by an institution approved by the Tennessee higher education commission or its equivalent in other states;
    2. (2) “Client” means any person who engages the services of a reflexology practitioner;
    3. (3) “Commissioner” means the commissioner of health or the commissioner's designee;
    4. (4) “Department” means the department of health;
    5. (5) “Division” means the division of health-related boards in the department of health;
    6. (6) “Reflexology” means the application of specific pressures to reflex points in the hands and feet only;
    7. (7) “Reflexology practitioner” or “reflexologist” means any person who engages in the practice of reflexology for compensation and who has completed a study of the principles of reflexology, anatomy and physiology generally included in a regular course of study of reflexology; and
    8. (8) “Registration” means satisfying the requirements for registration by the department of health.
§ 63-30-103. Registration.
  1. (a) No person shall engage in the practice of reflexology unless such person has registered with the division of health-related boards.
  2. (b) No person shall be registered to practice reflexology unless such person completes all necessary application forms and can demonstrate to the satisfaction of the division that such person complies with the criteria specified in this chapter.
  3. (c) Any person who desires registration as a certified reflexologist shall submit an application to the division on the prescribed forms. The application shall be accompanied by:
    1. (1) Documentation of completion of a two hundred (200) hour reflexology only course offered by an institution approved by the Tennessee higher education commission or its equivalent in other states;
    2. (2) Proof that the applicant has attained eighteen (18) years of age;
    3. (3) Two (2) character references stating that the applicant is of good moral character;
    4. (4) A statement certifying that the applicant has not been convicted of a felony under the laws of this state or any other state for the commission of an offense that bears directly on the applicant's fitness to practice competently, as determined by the division. However, such determination shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title; and
    5. (5) All required fees.
§ 63-30-105. Application.
  1. This chapter shall not apply to the activities or services of physicians, chiropractors, physical therapists, occupational therapists, athletic trainers, cosmetologists, registered nurses, massage therapists, or members of other professions licensed, certified, or registered by the state who may, on occasion, apply pressure to specific reflex points in the hands and feet in the course of their work.
§ 63-30-106. Registration of applicants from another state.
  1. The division shall register an individual from another state who applies for registration, pays the applicable fees, meets or exceeds the requirements established by this chapter, and who has no imposed or pending disciplinary actions in any state.
§ 63-30-107. Use of title.
  1. Reflexologists registered by the state may hold themselves out as “registered certified reflexologists” and may use the title or the initials “RCR” following the person's name in connection with the profession. No person may use the title “registered certified reflexologist” or the initials “RCR” unless registered in accordance with this chapter.
§ 63-30-108. Unauthorized practice — Violations — Penalties.
  1. (a) Except as provided in subsection (b), any person who advertises or engages in reflexology for compensation without registering with the division pursuant to this chapter commits a Class C misdemeanor, punishable by a fine only. It is unlawful to use the word “reflexology” or any other term that implies reflexology technique or method when advertising a service by a person who is not registered under this chapter.
  2. (b) This section shall not apply to licensed massage therapists who use reflexology techniques or methods or who advertise reflexology as a service offered to massage therapy clients.
  3. (c) The division may, when it deems appropriate, seek such civil remedies at law or equity to restrain or enjoin any unauthorized practice or other violation of this chapter.
§ 63-30-109. Prohibited practices.
  1. (a) A registered reflexologist may not use invasive procedures during the practice of reflexology.
  2. (b) A registered reflexologist may not diagnose or treat for specific diseases, practice spinal or other joint manipulations, prescribe, administer, or adjust medication, or prescribe or administer vitamins.
§ 63-30-110. Fees for registration — Renewal.
  1. Fees for the registration of a certified reflexologist shall be determined by the division but shall not exceed the costs of investigations, disciplinary actions and administering the registration process for certified reflexologists. Registration shall be valid for two (2) years and shall be renewed biennially.
§ 63-30-111. Revocation or suspension of registration — Civil penalties — Complaints.
  1. (a) The registration of a certified reflexologist may be revoked or suspended by the division or the division may impose a civil penalty upon a finding that the person is guilty of any one (1) or more of the following:
    1. (1) The practitioner is guilty of gross health care liability or incompetence;
    2. (2) The practitioner's mental or physical health endangers public health or safety;
    3. (3) The practitioner is guilty of false or deceptive advertising;
    4. (4) The practitioner engages in unprofessional conduct;
    5. (5) The practitioner falsifies any requirements for registration as set forth;
    6. (6) The practitioner is convicted of a felony for the commission of an offense that bears directly on the practitioner's fitness to practice competently, as determined by the division;
    7. (7) The practitioner is subject to disciplinary action in another state; or
    8. (8) The unauthorized practice of reflexology.
  2. (b) Any person may file with the department of health's office of investigations a written complaint against a registered reflexologist for any violation of this chapter.
  3. (c) Complaints alleging violations of this chapter, or any rule duly promulgated pursuant to § 63-30-112, shall be filed with the division, and shall be resolved by the division in accordance with this chapter and the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. A file shall be maintained on each such complaint filed with the division and shall reflect all activities taken by the division in response to such complaint.
  4. (d) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-30-112. Rules and regulations.
  1. The commissioner or the commissioner's designee may promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to administer this chapter.
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§ 63-30-113. Advisory private letter rulings.
  1. The division may issue advisory private letter rulings to any affected registrant who makes such a request regarding any matters within the division's primary jurisdiction. Such private letter ruling shall only affect the registrant making such inquiry, and shall have no precedential value for any other inquiry or future contested case to come before the division. Any dispute regarding a private letter ruling may, if the division chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
Chapter 31 Polysomnography
§ 63-31-101. Chapter definitions.
  1. As used in this chapter, unless the context otherwise requires:
    1. (1) “Board” means the board of medical examiners;
    2. (2) “Committee” means the polysomnography professional standards committee established by § 63-31-103;
    3. (3) “Direct supervision” means that the polysomnographic technologist providing supervision must be present in the area where the polysomnographic procedure is being performed and immediately available to furnish assistance and direction throughout the performance of the procedure;
    4. (4) “General supervision” means that the polysomnographic procedure is provided under a physician's overall direction and control, but the physician's presence is not required during the performance of the procedure;
    5. (5) “Polysomnographic student” means a person who is enrolled in an educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), as provided in § 63-31-106(b)(1), and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;
    6. (6) “Polysomnographic technician” means a person who has graduated from an accredited educational program described in § 63-31-106(b)(1) but has not yet passed the national certifying examination given by the board of registered polysomnographic technologists, who has obtained a temporary permit from the board, and who may provide sleep-related services under the general supervision of a licensed physician;
    7. (7) “Polysomnographic technologist” means a person who is credentialed by the board of registered polysomnographic technologists and is licensed by the board to engage in the practice of polysomnography under the general supervision of a licensed physician;
    8. (8) “Polysomnographic trainee” means a person who is enrolled in an accredited sleep technologist education program (A-STEP) that is accredited by the American Academy of Sleep Medicine and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;
    9. (9)
      1. (A) “Practice of polysomnography” means the staging and scoring of sleep by continuous and simultaneous monitoring of the stages of sleep and wake through use of an electroencephalogram (EEG), an electroculogram (EOG) and a submental electromyogram (EMG), in conjunction with the recording and monitoring of other physiological variables, and the assignment of values for duration, frequency and type of event to each stage of sleep in which the event occurred. The following tasks are considered a part of the practice of polysomnography only when performed as part of the staging and scoring of sleep under the general supervision of a licensed physician:
        1. (i) Monitoring and recording physiologic data during the evaluation of sleep-related disorders, including sleep-related respiratory disturbances, by applying the following techniques, equipment, and procedures:
          1. (a) Continuous or bilevel positive airway pressure titration on spontaneously breathing patients using a mask or oral appliance; provided, that the mask or oral appliance does not extend into the trachea or attach to an artificial airway;
          2. (b) Supplemental low flow oxygen therapy of less than six (6) liters per minute, utilizing nasal cannula or continuous or bilevel positive airway pressure during a polysomnogram;
          3. (c) Capnography during a polysomnogram;
          4. (d) Cardiopulmonary resuscitation;
          5. (e) Pulse oximetry;
          6. (f) Gastroesophageal pH monitoring;
          7. (g) Esophageal pressure monitoring;
          8. (h) Sleep staging, including surface electroencephalography, surface electrooculography, and surface submental electromyography;
          9. (i) Surface electromyography;
          10. (j) Electrocardiography;
          11. (k) Respiratory effort monitoring, including thoracic and abdominal movement;
          12. (l) Plethysmography blood flow monitoring;
          13. (m) Snore monitoring;
          14. (n) Audio or video monitoring;
          15. (o) Body movement monitoring;
          16. (p) Nocturnal penile tumescence monitoring;
          17. (q) Nasal and oral airflow monitoring;
          18. (r) Body temperature monitoring; and
          19. (s) Monitoring the effects that a mask or oral appliance used to treat sleep disorders has on sleep patterns; provided, however, that the mask or oral appliance shall not extend into the trachea or attach to an artificial airway;
        2. (ii) Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;
        3. (iii) Analyzing and scoring data collected during the monitoring described in subdivisions (9)(A)(i) and (ii) for the purpose of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders that result from developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;
        4. (iv) Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography; and
        5. (v) Education of a patient regarding the treatment regimen that assists the patient in improving the patient's sleep;
      2. (B) A licensed dentist shall make or direct the making and use of any oral appliance used to treat sleep disordered breathing and shall evaluate the structures of the patient's oral and maxillofacial region for purposes of fitting the appliance;
      3. (C) The practice of polysomnography shall take place only in a hospital, a stand-alone sleep laboratory or sleep center, or in the patient's home in accordance with a physician's order; provided, however, that the scoring of data and the education of patients may take place in settings other than in a sleep laboratory, sleep center or the patient's home; and
    10. (10) “Sleep-related services” means acts performed by polysomnographic technicians, polysomnographic trainees, polysomnographic students, and other persons permitted to perform those services under this chapter, in a setting described in subdivision (9)(C) that would be considered the practice of polysomnography if performed by a polysomnographic technologist.
§ 63-31-102. Interpretation of chapter — Application.
  1. (a) Nothing in this chapter shall be interpreted to limit or restrict a health care practitioner licensed under this title from engaging in the full scope of practice of the person's profession.
  2. (b) Nothing in this chapter shall apply to diagnostic electroencephalograms conducted in accordance with the guidelines of the American Clinical Neurophysiology Society.
§ 63-31-103. Polysomnography professional standards committee.
  1. (a) To assist the board in the performance of its duties under this chapter, there is established the polysomnography professional standards committee.
  2. (b) The committee shall consist of seven (7) members, who shall be appointed by the governor in the manner and for the terms of office as set forth in this section.
  3. (c) The committee shall be composed of:
    1. (1) Three (3) registered polysomnographic technologists;
    2. (2) One (1) physician who is certified in sleep medicine by a national certifying body recognized by the American Academy of Sleep Medicine;
    3. (3) One (1) person who is the director of an accredited, hospital-based sleep center;
    4. (4) One (1) respiratory therapist who is also a registered polysomnographic technologist; and
    5. (5) One (1) consumer member who is not commercially or professionally associated with the health care field, either directly or indirectly.
  4. (d)
    1. (1) Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the committee:
      1. (A) Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the committee shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the committee, prior to serving as a member of the committee. This subdivision (d)(1)(A) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010;
      2. (B) No person who is a member of the committee shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the committee during such person's period of service as a member of the committee. This subdivision (d)(1)(B) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010, and to all persons serving on the committee on such date who are not registered as lobbyists; and
      3. (C) No person who serves as a member of the committee shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the committee for one (1) year following the date such person's service on the committee ends. This subdivision (d)(1)(C) shall apply to persons serving on the committee as of July 1, 2010, and to persons appointed to the committee subsequent to such date.
    2. (2) A person who violates this subsection (d) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. (3) The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (d). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  5. (e) Initial appointments to the committee shall be made as follows: two (2) members shall be appointed to terms of four (4) years, two (2) members shall be appointed to terms of three (3) years, two (2) members shall be appointed to terms of two (2) years, and one (1) member shall be appointed to a term of one (1) year. Each regular appointment thereafter shall be for a term of four (4) years. Any vacant term shall be filled by the governor for the balance of the four-year term and each member shall serve on the committee until a successor is appointed. In making appointments to the committee, the governor shall strive to ensure that at least one (1) person serving on the committee is sixty (60) years of age or older and that at least one (1) person serving on the committee is a member of a racial minority. Each member of the committee shall be a resident of the state.
  6. (f) The governor may consider for appointment to the committee the names of persons recommended by the professional organizations for each profession represented on the committee. The Tennessee Sleep Society may submit a list of three (3) names for each position to be filled by a polysomnographic technologist. The Tennessee Society for Respiratory Care may submit a list of three (3) names for the position to be filled by a respiratory therapist. The Tennessee Medical Association may submit a list of three (3) names for the position to be filled by a physician. The Tennessee Hospital Association (THA), an association of hospitals and health systems may submit a list of three (3) names for the position to be filled by a director of a hospital-based sleep center.
  7. (g) While engaged in the business of the committee, members shall receive a per diem of one hundred dollars ($100) and shall also receive compensation for actual expenses to be paid in accordance with comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  8. (h) The committee shall choose annually a chair and a secretary from among its members.
  9. (i) The committee shall hold at least one (1) regular meeting each year and such other meetings as the committee deems necessary to conduct its business.
  10. (j) A majority of the members of the committee shall constitute a quorum for the transaction of business. No action of the committee shall be valid unless approved by a majority of members present at a meeting at which there is a quorum.
  11. (k) The governor has the power to remove from office any member of the committee for neglect of duties required by this chapter, for malfeasance in office, for incompetence, or for unprofessional conduct.
  12. (l) All funds received by the committee shall be deposited into the state treasury, and the department of health shall make such allotments out of the committee's account in the general fund as the department deems proper for the necessary expenses of the committee.
  13. (m) The division of health related boards shall provide administrative, investigatory, and clerical services to the committee as necessary to implement and enforce this chapter.
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§ 63-31-104. Powers of the committee.
  1. The committee shall have the power to:
    1. (1) Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are necessary for the implementation and administration of this chapter;
    2. (2) Establish the fees to be paid for temporary permits and for initial licensure, renewal or reinstatement of a license, late renewal of a license, and replacement of a lost license, at a level that is adequate to pay all the expenses of implementing and administering this chapter, in accordance with § 63-1-137;
    3. (3) Review and approve or reject the application of each person who applies for licensure as a polysomnographic technologist;
    4. (4) Biennially review and approve or reject each application for license renewal;
    5. (5) Issue, in the board's name, all temporary permits and all approved licenses and renewal of licenses;
    6. (6) Collect or receive all fees, fines, and money owed pursuant to this chapter and pay the fees, fines and money into the general fund of the state;
    7. (7) Deny, suspend, revoke, restrict, or impose one (1) or more conditions on a license, as the committee deems necessary or appropriate at the time a license is issued, renewed, or reinstated, or as a sanction imposed at the conclusion of a disciplinary hearing;
    8. (8) Issue private advisory letter rulings to any person licensed under this chapter who makes a request for a ruling regarding any matter within the committee's jurisdiction; provided, however, that the ruling shall affect only the licensee making the inquiry and shall have no precedential value for any other contested case or inquiry before the committee;
    9. (9) Develop a code of ethics for the practice of polysomnography in this state;
    10. (10) Develop standards of care for the practice of polysomnography in this state;
    11. (11) Develop standards for the educational and clinical training of polysomnographic technologists, including the evaluation of the accreditation status of educational programs in polysomnography;
    12. (12) Develop criteria for the evaluation of applications for licensure submitted by registered polysomnographic technologists who are licensed in other states;
    13. (13) Develop continuing education requirements that shall be met by licensed polysomnographic technologists; and
    14. (14) Conduct disciplinary hearings in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and impose whatever sanctions the committee deems appropriate on an applicant or licensee.
§ 63-31-105. Board approval of committee actions.
  1. All actions of the committee shall be approved by the board in order to become final actions. All actions of the committee shall be considered by the board at its next regular meeting after the committee has taken its actions.
§ 63-31-106. Licensing requirement.
  1. (a)
    1. (1) On and after July 1, 2010, any person who is engaged in the practice of polysomnography shall be licensed as provided in this chapter. It shall be unlawful for any person to engage in the practice of polysomnography after July 1, 2010, unless the person has been duly licensed as a polysomnographic technologist under this chapter.
    2. (2) Prior to July 1, 2010, any person who is engaged in the practice of polysomnography without being licensed under this chapter shall not be deemed to be in violation of this chapter or the Respiratory Care Practitioner Act, compiled in chapter 27 of this title.
  2. (b) A person seeking licensure as a polysomnographic technologist shall be of good moral character, shall be at least eighteen (18) years of age, shall pay the fees established by the board for licensure, and shall present proof that the person meets all of the following requirements:
    1. (1) Meet one (1) of the following educational requirements:
      1. (A) Graduation from a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs;
      2. (B) Graduation from a respiratory care educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs and completion of the curriculum for a polysomnography certificate established and accredited by the Committee on Accreditation for Respiratory Care of the Commission on Accreditation of Allied Health Education Programs;
      3. (C) Graduation from an electroneurodiagnostic technologist educational program with a polysomnographic technology track that is accredited by the Commission on Accreditation of Allied Health Education Programs; or
      4. (D) Successful completion of an accredited sleep technologist educational program (A-STEP) that is accredited by the American Academy of Sleep Medicine; provided, however, that this option shall not remain available after July 1, 2012, if there are at least four (4) polysomnographic technologist educational programs in this state, at least two (2) in the east grand division and one (1) each in the middle and west grand divisions that remain accredited by the commission on accreditation of allied health educational programs for two (2) years. If there are not four (4) such accredited educational programs by July 12, 2012, this option shall remain available until there are four (4) such programs that have been accredited for two (2) years;
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    2. (2) Pass the national certifying examination given by the board of registered polysomnographic technologists;
    3. (3) Be credentialed by the board of registered polysomnographic technologists; and
    4. (4) Meet any additional educational or clinical requirements established by the committee.
  3. (c) Any person who is engaged in the practice of polysomnography on July 1, 2007, shall be eligible for licensure under this chapter without meeting the educational requirement of subdivision (b)(1); provided, that the person meets the requirements of subdivisions (b)(2)-(4).
  4. (d) To be eligible for renewal of a license to engage in the practice of polysomnography, a polysomnographic technologist shall continue to be credentialed by the board of registered polysomnographic technologists.
§ 63-31-107. Classes exempt from licensing requirement — Temporary permit.
  1. (a) The following persons may provide sleep-related services without being licensed as a polysomnographic technologist under this chapter:
    1. (1) A polysomnographic technician may provide sleep-related services under the general supervision of a licensed physician for a period of up to one (1) year from the date of the person's graduation from one (1) of the accredited programs described in § 63-31-106(b)(1), and the board may in its sole discretion grant a one-time extension of up to three (3) months beyond this one-year period;
    2. (2) A polysomnographic trainee may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program while actively enrolled in an accredited sleep technologist educational program (A-STEP) that is accredited by the American Academy of Sleep Medicine;
    3. (3) A polysomnographic student may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program while actively enrolled in a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP);
    4. (4) A person who is credentialed in one (1) of the health-related fields accepted by the board of registered polysomnographic technologists may provide sleep-related services under the direct supervision of a polysomnographic technologist, for a period of up to one (1) year, while obtaining the clinical experience necessary to be eligible to sit for the examination given by the board of registered polysomnographic technologists; and
    5. (5) Respiratory therapists who provide polysomnography services shall be credentialed as a registered polysomnographic technologist by the board of polysomnographic technologists, or as a sleep disorders specialist by the national board for respiratory care, or have undergone a standardized, uniform mechanism to document competency in polysomnography as approved by the Tennessee board of respiratory care with documentation of passage of this mechanism made available at the request of the board of respiratory care. The Tennessee board of respiratory care shall consult with the Tennessee board of medical examiners in the development of this mechanism. The consultation with the board of medical examiners shall be documented and the documentation, including any comments by the board of medical examiners regarding the mechanism developed by the board of respiratory care, shall be filed with the chairs of the health committee of the house of representatives and the health and welfare committee of the senate. Respiratory therapists are not required to have a second license as a polysomnographic technologist.
  2. (b) Before providing any sleep-related services, a polysomnographic technician shall obtain a temporary permit from the board. While providing sleep-related services, the technician shall wear a badge that appropriately identifies the person as a polysomnographic technician.
  3. (c) Before providing any sleep-related services, a polysomnographic trainee shall give notice to the board that the trainee is enrolled in an A-STEP educational program accredited by the American Academy of Sleep Medicine. Trainees shall wear a badge that appropriately identifies the trainee as a polysomnographic trainee while providing such services.
  4. (d) Before providing any sleep-related services, a person who is obtaining clinical experience pursuant to subdivision (a)(4) shall give notice to the board that the person is working under the direct supervision of a polysomnographic technologist in order to gain the experience to be eligible to sit for the examination given by the board of registered polysomnographic technologists. The person shall wear a badge that appropriately identifies the person while providing such services.
  5. (e) Polysomnographic students shall not receive compensation for the sleep-related services they provide and shall wear badges that appropriately identify them as students.
§ 63-31-108. Issuance, renewal and retirement of licenses — Display of license — Lost license — Change of address or name.
  1. (a) Licenses shall be issued and renewed by the board pursuant to the biennial issuance and renewal system of the division of health related boards.
  2. (b) Any person who has been issued a license to practice under this chapter who wishes to retire that license shall file with the committee an affidavit on a form to be furnished by the committee stating the date on which the person retired from practice and other facts that verify the retirement as the board deems necessary. Any such person who thereafter wishes to reenter practice shall request reinstatement of licensure.
  3. (c) Any license issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and other information that the board deems necessary. The address contained on the license shall be the address where all correspondence and renewal forms from the board shall be sent. Any person whose address changes shall, within thirty (30) days after the change in address, notify the board of the address change. The most recent address contained in the board's records for each license holder shall be the address deemed sufficient for purposes of service of process.
  4. (d) Every person issued a license pursuant to this chapter shall either keep the license prominently displayed in the office or place in which the person practices or have it stored in a place from which it can be immediately produced upon request of a patient or representative of the department of health.
  5. (e) Any person whose license has been lost may make application to the committee for a replacement. The application shall be accompanied by an affidavit setting out the facts concerning the loss of the original license.
  6. (f) Any person whose name is changed by marriage or court order may surrender the person's license and apply to the board for a replacement license.
§ 63-31-109. Power of board to impose sanctions.
  1. (a) The board has the power to impose any sanctions on a licensee, up to and including license revocation, if the licensee is found guilty of violating any of the provisions of this chapter or of committing any of the following acts or offenses:
    1. (1) Making false or misleading statements or committing fraud in procuring a license;
    2. (2) Moral turpitude;
    3. (3) Habitual intoxication or personal misuse of narcotics, controlled substances, controlled substance analogues or any other drugs or the use of alcoholic beverages or stimulants in a manner that adversely affects the person's ability to practice polysomnography;
    4. (4) Conviction of a felony or of any offense involving moral turpitude or any violation of the drug laws of this or any other state or of the United States;
    5. (5) Violation or attempted violation, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate, this chapter or any lawful order of the board or any criminal statute of this state;
    6. (6) Gross health care liability, ignorance, negligence or incompetence in the course of professional practice;
    7. (7) Making or signing in one's professional capacity any document that is known to be false at the time it is made or signed;
    8. (8) Engaging in the practice of polysomnography when mentally or physically unable to safely do so;
    9. (9) Making false statements or representations or being guilty of fraud or deceit in the practice of polysomnography when mentally or physically unable to safely do so;
    10. (10) Having disciplinary action imposed by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed to practice polysomnography in this state; provided, that a certified copy of the order or other document memorializing the disciplinary action by the other state or territory constitutes prima facie evidence of a violation of this section;
    11. (11) Undertaking any duties that are outside the authorized scope of practice of a licensed polysomnographic technologist, as set forth in this chapter;
    12. (12) Violating the code of ethics adopted by the committee for polysomnographic technologists;
    13. (13) Use or attempted use of a polysomnographic procedure or equipment for which the licensee has not received sufficient education or training in the proper use of that procedure or equipment;
    14. (14) Promoting the sale of services, drugs, devices, appliances, or goods to a patient to exploit the patient for financial gain;
    15. (15) Willfully failing to file, or willfully impeding the filing of, any report or record that is required by law;
    16. (16) Knowingly engaging in the practice of polysomnography with an unlicensed person, knowingly aiding an unlicensed person in the practice of polysomnography, or knowingly delegating a task involved in the practice of polysomnography to an unlicensed person;
    17. (17) Knowingly failing to meet appropriate standards for the delivery of polysomnographic services;
    18. (18) Breaching patient confidentiality;
    19. (19) Paying or agreeing to pay any sum or providing any form of remuneration or material benefit to any person for bringing or referring a patient, or accepting or agreeing to accept any form of remuneration or material benefit from a person for bringing or referring a patient; or
    20. (20) Any other unprofessional or unethical conduct specified in the rules of the board.
  2. (b) An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.
§ 63-31-110. Violation.
  1. Any person who engages in the practice of polysomnography in violation of this chapter is guilty of a Class B misdemeanor.
§ 63-31-111. Injunction against unlicensed practice — Jurisdiction of court.
  1. (a) The board shall have the authority to petition any circuit or chancery court having jurisdiction over any person who is practicing without a license, or to whom a license has been denied, or whose license has been suspended or revoked by action of the board, to enjoin the person from continuing to practice within this state.
  2. (b) Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all causes brought under subsection (a) and to exercise full and complete jurisdiction in the injunctive proceedings.
§ 63-31-112. Screening panel for investigative and disciplinary process.
  1. (a) The committee may utilize one (1) or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for resolution of complaints or diversion to professional peer review organizations or impaired professionals' associations or foundations of those cases that the board, through established guidelines, deems appropriate.
  2. (b) The screening panel has the authority to administer oaths to witnesses.
  3. (c) Members of a screening panel may be drawn from the membership of the committee or may be appointed by the committee. Noncommittee members shall meet the requirements of membership on the committee and may include a consumer member. A committee member serving on a panel shall not participate in a contested case involving any matter heard by the panel.
§ 63-31-113. Use of title “polysomnographic technologist” or abbreviation “PSGP”.
  1. Any person who is licensed to engage in the practice of polysomnography in this state shall have the right to use the title “polysomnographic technologist” or the abbreviation “PSGP.” No other person may use that title or abbreviation or any other words or letters indicating that the person is a polysomnographic technologist.
§ 63-31-114. Annual meeting of standards committee.
  1. The polysomnographic professional standards committee shall conduct at least one (1) meeting in each of the years 2007-2010 to allow public discussion of new developments in the practice of polysomnography, including, but not limited to, the availability of accredited polysomnographic educational programs to persons in all parts of the state, the availability of other certification examinations and credentialing bodies, and the settings in which the practice of polysomnography may properly take place. The committee shall notify the Tennessee Sleep Society, the Tennessee Society for Respiratory Care, the Tennessee Medical Association, the Tennessee Hospital Association (THA), an association of hospitals and health systems, and any other person or organization that requests to be notified as to the time and place of the annual meeting.
Chapter 32 Health Care Consumer Right-to-Know Act of 1998
§ 63-32-101. Short title.
  1. The title of this chapter is and may be cited as the “Health Care Consumer Right-to-Know Act of 1998.”
§ 63-32-102. Health care consumers.
  1. (a) Health care is a valuable commodity, and the health care consumer needs to make informed decisions when making health care choices. Due to the current trends in health care, patients have a close relationship with their health care provider and must depend on the provider for most of their health care needs. Health care consumers need to know as much as possible before committing their health care to such provider. Likewise current trends make decisions about which managed care organizations to choose equally important to health care consumers. Because of the foregoing reasons and because of the increasing concerns over the quality of health care, the general assembly finds that a system should be established to provide public access to information about certain health care providers and managed care organizations in this state.
  2. (b) For the purposes of this chapter, “provider” or “health care provider” means a physician, regulated pursuant to chapter 6 of this title; osteopathic physician, regulated pursuant to chapter 9 of this title; chiropractor, regulated pursuant to chapter 4 of this title; dentist, regulated pursuant to chapter 5 of this title; podiatrist, regulated pursuant to chapter 3 of this title; optometrist, regulated pursuant to chapter 8 of this title; dietitian or nutritionist, regulated pursuant to chapter 25 of this title; physician assistant, regulated pursuant to chapter 19 of this title; respiratory care practitioner, regulated pursuant to chapter 27 of this title; pharmacist, regulated pursuant to chapter 10 of this title; audiologist and speech pathology therapist, regulated pursuant to chapter 17 of this title; certified nurse practitioner, as such nurses are regulated pursuant to § 63-7-123; registered nurse anesthetist, regulated pursuant to chapter 7 of this title; social worker regulated pursuant to chapter 23 of this title; psychologist, regulated pursuant to chapter 11 of this title; professional counselor, marital and family therapist, and clinical pastoral therapist regulated pursuant to chapter 22 of this title; massage therapist, regulated pursuant to chapter 18 of this title; medical laboratory personnel, regulated pursuant to title 68, chapter 29; alcohol and drug abuse counselors, regulated pursuant to title 68, chapter 24; occupational therapist and physical therapist regulated pursuant to chapter 13 of this title; dispensing optician, regulated pursuant to chapter 14 of this title; electrologist, regulated pursuant to chapter 26 of this title; veterinarian, regulated by chapter 12 of this title; and nursing home administrator, regulated pursuant to chapter 16 of this title.
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§ 63-32-103. Duties of division of health related boards.
  1. It is the duty of the division of health related boards to compile, consolidate, manage and disseminate the information collected by entities of the department of health and the department of commerce and insurance as required by this chapter.
§ 63-32-104. Requirements.
  1. (a) When collecting information or compiling reports intended to compare individual health care providers, the commissioner of health shall require that:
    1. (1) Provider organizations that are representative of the target group for profiling shall be meaningfully involved in the development of all aspects of the profile methodology, including collection methods, formatting and methods and means for release and dissemination;
    2. (2) The entire methodology for collecting and analyzing the data shall be disclosed to all relevant provider organizations and to all providers under review;
    3. (3) Data collection and analytical methodologies shall be used that meet accepted standards of validity and reliability;
    4. (4) The limitations of the data sources and analytic methodologies used to develop provider profiles shall be clearly identified and acknowledged, including, but not limited to, the appropriate and inappropriate uses of the data;
    5. (5) To the greatest extent possible, provider-profiling initiatives shall use standard-based norms derived from widely accepted, provider-developed practice guidelines;
    6. (6) Provider profiles and other information that have been compiled regarding provider performance shall be shared with providers under review prior to dissemination; provided, that an opportunity for corrections and additions of helpful explanatory comments shall be provided prior to publication; and provided, further, that such profiles shall only include data that reflect care under the control of the provider for whom such profile is prepared;
    7. (7) Comparisons among provider profiles shall adjust for patient care-mix and other relevant risk factors and control for provider peer groups, when deemed appropriate by the respective board; and
    8. (8) The quality and accuracy of provider profiles, data sources and methodologies shall be evaluated at least biannually.
  2. (b) The department of health is authorized to charge a reasonable fee for any information, documents, or reports requested by the public that are not required as part of the implementation of this chapter. The fee shall be set per rules and regulations promulgated by the department in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 63-32-105. Information for public dissemination.
  1. (a) Each board regulating a provider, as defined in § 63-32-102, shall collect the following information and provide to the department of health in order for the department to create individual profiles on licensees, in a format created by the department that shall be available for dissemination to the public:
    1. (1) A description of any criminal convictions for felonies and, as determined by the board, serious misdemeanors, within the most recent ten (10) years. For the purposes of this subsection (a), a person shall be deemed to be convicted of a crime if such person was found or adjudged guilty by a court of competent jurisdiction. Misdemeanor convictions later expunged by a court of competent jurisdiction shall be stricken from the provider's profile;
    2. (2) A description of any final board disciplinary actions within the most recent ten (10) years, which actions shall include final board action as defined by § 4-5-314, and reprimand action taken pursuant to a board practice act;
    3. (3) A description of any final disciplinary actions of licensing boards in other states within the most recent ten (10) years;
    4. (4) A description of revocation or involuntary restriction of hospital privileges for reasons related to competence or character that has been taken by the hospital's governing body or any other official action of the hospital after procedural due process has been afforded, or the resignation from or nonrenewal of medical staff membership or the restriction of privileges at a hospital taken in lieu of or in settlement of a pending disciplinary case related to competence or character in that hospital, all as taken pursuant to procedures promulgated by the board for licensing health care facilities. Only cases that have occurred within the most recent ten (10) years shall be disclosed by the department to the public;
    5. (5)
      1. (A) All health care liability court judgments, all health care liability arbitration awards in which a payment is awarded to a complaining party and all settlements of health care liability claims in which a payment is made to a complaining party beginning with reports for 1998 and each subsequent year; provided, such reports shall not be disseminated beyond the most recent ten-year period, but shall include the most recent ten-year period for which reports have been filed. Each provider licensing board shall set by rule adopted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, a threshold amount below which judgments or settlements shall not be reportable; provided, such threshold shall, for chapter 6 or 9 of this title licensees, be set at seventy-five thousand dollars ($75,000), for doctors of chiropractic, regulated pursuant to chapter 4 of this title, be set at fifty thousand dollars ($50,000), for dentists, regulated pursuant to chapter 5 of this title, be set at twenty-five thousand dollars ($25,000), and for all other licensees under this title be set at ten thousand dollars ($10,000). Dispositions of paid claims shall be reported in a minimum of three (3) graduated categories indicating the level of significance of the award or settlement. Information concerning paid health care liability claims shall be put in context by comparing an individual licensee's health care liability judgment awards and settlements to the experience of other providers within the same specialty. Information concerning the existence of a court-sealed settlement shall be reported in cases involving such a settlement. Information concerning all settlements shall be accompanied by the following statement: “Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the provider. A payment in settlement of a health care liability action or claim should not be construed as creating a presumption that health care liability has occurred.” Nothing in this subdivision (a)(5) shall be construed to limit or prevent the department from providing further explanatory information regarding the significance of categories in which settlements are reported;
      2. (B) Pending health care liability claims shall not be disclosed by a board to the public. Nothing in this subdivision (a)(5) shall be construed to prevent a board from investigating and disciplining a licensee on the basis of health care liability claims that are pending;
    6. (6) Names of medical schools or professional and training schools and dates of graduation;
    7. (7) Graduate medical education or other graduate-level training;
    8. (8) Specialty board certification as determined by the relevant board;
    9. (9) Names of the hospitals where the licensee has privileges;
    10. (10) Appointments to medical school faculties and indication as to whether a licensee has a responsibility for graduate medical education within the most recent ten (10) years;
    11. (11) Information regarding publications in peer-reviewed medical literature;
    12. (12) Information regarding professional or community service associations, activities and awards;
    13. (13) The location of the licensee's primary practice setting;
    14. (14) The identification of any translating services that may be available at the licensee's primary practice location;
    15. (15) An indication of which managed care plans in which the licensee participates;
    16. (16) An indication of TennCare plans in which the licensee participates;
    17. (17) No information that is otherwise privileged under this title, and that is generated by any peer review program, provider health program, or impaired professionals program operated or administered by a provider association or foundation that such association has created for peer review purposes, shall be included in any profile unless such information is not contemplated by the particular title 63 statute as being privileged;
    18. (18) For the profile of a holder of a certificate of fitness pursuant to § 63-7-123, the name of the holder's collaborating physician; and
    19. (19) For any physician assistant licensed under § 63-19-105, the name of the assistant's collaborating physician.
  2. (b) Each board shall provide individual licensees with a copy of their profiles prior to release to the public. A licensee shall be provided a reasonable time to correct factual inaccuracies that appear in such profile.
  3. (c) A provider may elect to have the provider's profile omit certain information provided pursuant to subdivisions (a)(10)-(12), inclusive, concerning academic appointments and teaching responsibilities, publications in peer-reviewed journals and professional and community service awards. In collecting information for such profiles and in disseminating such profiles, each board shall inform providers that they may choose not to provide such information required pursuant to subdivisions (a)(10)-(12), inclusive.
  4. (d) The department shall develop formats for dissemination of such information to the public, which, at a minimum shall include electronic media, including the world wide web of the internet, and a toll-free telephone line.
  5. (e) On or before January 1, 1999, the division of health related boards of the department shall become a participant in the national practitioners databank.
  6. (f) Individual profiles posted pursuant to § 63-32-107 shall not contain the licensee’s home address and social security number, unless such home address is provided by the licensee, along with a request that it be contained in the profile, as their official mailing or practice address. Notwithstanding this subsection (f), a record containing the home address of the licensee on file with the department of health concerning this chapter shall continue to remain a public record.
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§ 63-32-106. Conviction of unlicensed provider—Report to relevant board.
  1. The district attorney general for any court in which an unlicensed provider is convicted of being represented as a licensed provider shall, within one (1) week thereafter, report the same to the relevant board together with a copy of the court proceedings in the case.
§ 63-32-107. Publication of provider profiles — Certain restrictions.
  1. The department of health, in implementing § 63-32-105 shall not disseminate a provider profile by electronic media, including the World Wide Web of the internet or toll-free telephone line before May 1, 1999. The department shall conduct a study of the impact of publication of provider profiles by electronic media on the personal safety of providers and their families, and shall report its findings to the government operations committees on or before October 1, 1998. The department shall include in such report a sample profile designed with safeguards recommended by the department pursuant to the aforementioned study. No later than January 1, 1999, and after public hearing, the board shall promulgate regulations to eliminate, to the extent practicable, the possibility that certain information contained in such profiles may jeopardize the personal safety of providers and their families.
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§ 63-32-108. Assessment of costs.
  1. The department of health shall assess boards of providers that they regulate for the costs reasonably associated with providing the services and information pursuant to this chapter. Further, the department shall provide the cost to the department of commerce and insurance that is associated with providing the services and information relative to the board of pharmacy and managed care organizations. The department of commerce and insurance shall assess the cost to the providers that the department regulates. These costs shall be assessed in compliance with § 9-4-5117 and § 56-1-310.
§ 63-32-109. Costs assessed against boards.
  1. The costs assessed against each board of providers shall be paid from the separate account established pursuant to § 63-1-137 in the general fund for each board.
§ 63-32-110. Managed care organizations.
  1. (a) Managed care organizations regulated pursuant to title 56, chapter 32, shall provide an accurate listing of provider information as required by this chapter to the department of health.
  2. (b) A managed care organization shall report any addition or deletion of a provider from its panel of contracted members within twenty-one (21) business days of the date on which the managed care organization receives notice of the addition or deletion of a provider. The department shall cross-reference the change with the existing provider profile within seven (7) days of receipt of the information.
  3. (c) The department of commerce and insurance, to the extent to which it already collects the data required by this chapter, shall forward the existing data and all subsequent data to the department in such manner as the commissioner of health shall direct after consultation with the commissioner of commerce and insurance.
§ 63-32-111. Annual report and provider profiles — Availability.
  1. (a) The annual report required by [former] § 56-32-110(b)(4) [repealed], and information required for a profile by this section shall be made available to consumers by the department of health through the World Wide Web of the internet or a toll-free telephone line. Such information shall be made available by May 1, 1999, and shall be updated by May 1 of each succeeding year.
  2. (b) The information made available by the department pursuant to subsection (a) shall be based on reports filed with the department of commerce and insurance pursuant to [former] § 56-32-110 [repealed], and shall include, to the extent practicable, the following:
    1. (1) A description of the grievance review system;
    2. (2) The total number of grievances handled through such grievance review system, and a compilation of the causes underlying the grievances filed;
    3. (3) The ratio of the number of adverse decisions issued to the number of grievances received;
    4. (4) The ratio of the number of successful grievance appeals to the total number of appeals;
    5. (5) The average of:
      1. (A) The number of enrollees at the beginning of the calendar year; and
      2. (B) The number of enrollees at the end of the calendar year; and
    6. (6) The number, amount and disposition of health care liability claims made by enrollees that resulted in settlements, court judgments and arbitration awards by the plans during the calendar year.
  3. (c) For each year the reports are filed, the information described in subdivisions (b)(2)-(6) shall be shown for a period of five (5) consecutive calendar years. The information for more than five (5) calendar years shall not be required.
  4. (d) The profile of managed care organizations regulated pursuant to title 56, chapter 32, maintained by the department shall include:
    1. (1) The number of years in existence;
    2. (2) A summary of the financial information, including profits or losses, as reported by the plan in its annual statement filed with the commissioner of commerce and insurance;
    3. (3) The geographic plan area for which the plan is authorized;
    4. (4) The composition of the provider network, including names, addresses and specialties of providers;
    5. (5) Identification of those providers that have notified the plan that they are not accepting new patients;
    6. (6) Measures of quality and consumer satisfaction if the commissioner of health determines by rule that such measures are valid and comparable among organizations;
    7. (7) The certification and accreditation status of the organization, if any;
    8. (8) Procedures governing access to specialists and emergency care services; and
    9. (9) The information voluntarily submitted by the managed care organization to the commissioner relative to consumer satisfaction and quality standards or measures.
§ 63-32-112. Hospitals.
  1. (a) Hospitals regulated pursuant to title 68, chapter 11, shall provide an accurate listing of information as required by this act to the department of health.
  2. (b) The information that the department shall disseminate shall include, but not be limited to:
    1. (1) The corporate form of the facility, including whether the facility is publicly or privately owned, whether the facility is not-for-profit or for-profit, the nature of the ownership and management, and its affiliations with other corporate entities;
    2. (2) Health care plans accepted by the hospital;
    3. (3) Accreditation status; and
    4. (4) The specialty programs that meet the guidelines established by the specialty societies or other appropriate bodies as determined by the commissioner.
§ 63-32-113. Intentional misrepresentations.
  1. A provider who makes an intentional misrepresentation when providing information to the department of health that the department uses in a provider profile commits a violation of the practice act under which the provider is licensed or certified.
§ 63-32-114. Development of system for collection and dissemination of information.
  1. (a) The initial development of a system for the collection and dissemination of information as provided under this chapter shall be contracted to an appropriate service provider by the department under compliance with title 12, chapters 3 and 4. The cost of such contract shall be paid from fees collected from providers regulated by the division of health related boards.
  2. (b) In disseminating information under this chapter, the department of health is directed to use the department's existing toll-free telephone resources. The creation of an additional toll-free telephone line is not required by this chapter.
§ 63-32-115. Compiling and dissemination of information — Liability of the department of health.
  1. (a) Under this chapter, the department of health only compiles information. The department shall not vouch for or assert the accuracy of any information it disseminates under this chapter. Before the department disseminates information to consumers under this chapter, the department shall permit each provider, hospital, or managed care organization, whose information is to be disseminated, the opportunity to review and correct any information the department proposes to disseminate. The department shall also allow a collaborating physician at any time the opportunity to review, accept, and update the existence of a collaborating relationship between the physician and a physician assistant licensed under § 63-19-105. The department shall also allow a collaborating physician at any time the opportunity to review, accept, and update the existence of a collaborating relationship between the physician and the holder of a certificate of fitness pursuant to § 63-7-123.
  2. (b) On or after January 1, 2015, the collaborative relationship contained in the controlled substance database, as established in title 53, chapter 10, part 3, shall be used by the department to update provider profiles which have been established pursuant to this chapter.
  3. (c) The department shall not be subject to any suit for damages concerning any information that the department disseminates that a provider, hospital, managed care organization, collaborating physician, or supervisory physician had the opportunity to correct, but did not correct.
  4. (d) Nothing contained in this section shall repeal or override the confidentiality provisions contained in title 53, chapter 10, part 3, except to the extent that the department uses the information to update the existence of:
    1. (1) A collaborating relationship between a physician and a holder of a certificate of fitness pursuant to § 63-7-123; or
    2. (2) A collaborating relationship between a physician and a physician assistant licensed under § 63-19-105.
§ 63-32-116. Public records.
  1. No provision of this chapter shall be construed as restricting the status of any record as a public record for the purposes of title 10, chapter 7.
§ 63-32-117. Provision of information prior to licensure.
  1. (a) Each licensed provider, as defined in § 63-32-102, must provide the information required by this chapter to be compiled into provider profiles by the department of health.
  2. (b) Each provider, as defined in § 63-32-102, seeking licensure must provide the information required by this chapter before licensure will be granted.
  3. (c) Before the issuance of the licensure renewal notice, the department shall send a notice to each licensed provider at the provider's last known address of record with the department regarding the requirements for information to be submitted by such provider pursuant to this chapter.
  4. (d) Each provider who has submitted information pursuant to this chapter must update that information in writing or online by notifying the department within thirty (30) days after the occurrence of an event or the attainment of a status that is required to be reported. With respect to updated information required to be submitted pursuant to § 63-32-105, the department shall accept information updating a profile as it relates only to a physician licensed pursuant to chapter 6 or 9 of this title if the information is received within thirty (30) days of final payment in writing or online from either the provider or the provider's health care liability carrier and the carrier attests, in writing to the department, that it is the provider's health care liability carrier that has made the payment and that the carrier has confirmed in writing or online to the provider that the information has been reported to the department for purposes of updating the provider's profile.
  5. (e) Failure by a provider to comply with these requirements to submit information and to update information constitutes a ground for disciplinary action under the respective practice act for that profession. For such failure to comply, the department or board may:
    1. (1) Refuse to issue a license to any provider applying for initial licensure who fails to submit or update the required information;
    2. (2) Refuse to renew a license to any provider who fails to submit or update the required information; and/or
    3. (3) Process any licensed provider before the board who fails to submit and/or update the required information for formal disciplinary action, and may assess a penalty against the provider of up to fifty dollars ($50.00) for each day that the provider is not in compliance with this subsection (e).
§ 63-32-118. Violations.
  1. Failure to comply with the requirements of this chapter by a person or entity required to submit or report information as required by this chapter constitutes a violation of the relevant practice or licensing statute and subjects the violator to appropriate enforcement or disciplinary action.
§ 63-32-119. Rules and regulations.
  1. The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this chapter. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.