2. Who is CSG?
Non-partisan organization serving all three branches of state government.
Collaborative, national reach combined with regional offices.
Fosters the exchange of insights and ideas to help state officials shape public policy.
Extensive experience providing
guidance and technical assistance in
the field of interstate compacts.

3. TECHNICAL ASSISTANCE CSG AFFILIATES REGIONAL COMPACTS & COMMISSIONS
NATIONAL CENTER FOR INTERSTATE COMPACTS
BORDER LEGISLATIVE CONFERENCE
JUSTICE CENTER
REGIONAL COMPACTS & COMMISSIONS
CSG AFFILIATES
The Council of State Governments |

4. What is an Interstate Compact?
Simple, versatile and proven tool
Effective means of cooperatively addressing common problems
Contract between states
Creates economies of scale
Responds to national priorities with one voice
Retains collective state sovereignty over issues belonging to the states

5. 3 Primary Uses Used to resolve boundary disputes.
Used to manage shared natural resources.
Used to create administrative agencies which have jurisdiction over a wide variety of state concerns:
State transportation
Taxation
Environmental matters
Regulation
Education
Corrections
Public safety
Licensure

6. Compacts Approximately 215 active compacts About 40 are inactive
On average, each state is a member of 25 compacts
Precedence for international participation
Port Authority of NY & NJ (1922) signaled a new era in regulatory compacts.

8. Interstate Compacts – Beneficial Attributes
National data & information sharing systems
Uniform compact language and rules
Proven governance structures
Permanent funding mechanism
National interface with external stakeholders / national
organizations
Coordination with other interstate compacts and federal partners
National office and staff (if necessary)

9. Interstate Compacts – Practical Challenges
Governed by tenets of contract law
Requires an offer from the first state to join and acceptance from additional states.
Compact must be passed and signed into law like any bill.
Requires an interstate transaction
Congressional Consent – Article 1, Clause 10, Sec. 3
“No State shall, without the Consent of Congress enter into any Agreement or Compact with another State ”
Courts have held consent isn’t required unless the compact infringes on federal supremacy.
I’ve spend the last few minutes talking about some of the benefits of compacts. With that in mind I think it is important that I also spend a little time talking about the potential challenges we often see in our compact work. First, as I’ve said at different points during my remarks, we’re talking about an instrument that functions as a contract between states. In essence that means every states must adopt the same legislative language. It is hard enough to get two states to agree to something. It often becomes very difficult and time consuming to get several states to adopt the same piece of legislation. The second challenge that we also run into with compacts is the question of Congressional Consent. I actually tend to look at this question in 2 parts. First, is consent required. A literal reading of the Constitution would suggest that all compacts necessitate consent. In reality though the courts have tended to side more with the states and have concluded that so long as a proposed compact doesn’t infringe on an enumerated power of the federal government consent isn’t required. Assuming that consent is necessary the second challenge becomes when and how to seek it.

10. Notable Medical and Licensing Compacts
Nurse Licensure Compact – 24 States
Compact on Mental Health – 45 states
Agreement on the Qualification of Education Personnel – 36 states
Interstate Compact on Licensure of Participants in Horse Racing --13 states
EMS Licensure Compact – In development
Medical Licensure Compact – In development
Physical Therapy Compact – In development

11. Medical Licensing Compact – Transition and Next Steps
State legislative action, including a fiscal note
Enactment threshold met – 7 states
State notifications and appointment of state commissioners
Convene first interstate commission meeting
Establishment of the commission and supporting governance structure

12. Interstate Compacts – Sovereignty and Autonomy
Provided for by the U.S. Constitution – Article 1, Clause 10, Section 3
Significant legal and historical precedence
Over 200 active compacts, with each state belonging to 25 on average
Only giving up the authority to act unilaterally
Allows states to maintain collective sovereignty

13. Interstate Compacts – Financing
Compacts typically allow for the funding of commission activities, including the following:
Annual business meeting and standing committee meetings
Staff support and infrastructure
Legal counsel
Web site and data system (if necessary)
3 Primary Options
User fees to be established by the commission
Grants and awards from federal agencies or private foundations
State appropriations – state as the funder of “last resort

14. Interstate Compacts – Typical Governance Structure
The Commission is comprised of voting representatives from each member state and is responsible for key decisions with respect to the compact.
The Commission can form committees, including an executive committee that is responsible for making day-to-day decisions.
Compact Commissions are frequently granted the authority to hire staff, which is responsible for implementing the policies and procedures established by the Commission
Commissions serve agencies of the member states and are tasked with acting on their behalf and not on the behalf of particular groups or organizations.

15. Interstate Compacts – Role and Authority of the Commission
The member states create the Interstate Medical Licensure Compact Commission, which functions as a body corporate and a joint agency of the member states.
The Commission shall be comprised of two voting representatives per member state
It is granted the authority to promulgate rules, pass bylaws, establish committees, hire staff, etc.
Those powers are not unique. Similar authority has been granted to at least 3 other compact commissions that have expanded to 50 states.

16. Typical Compact Governance Structure
Advisory Council
Interstate Commission
Executive Committee
Executive Committee
Executive Director
Executive Director
Staff
Staff

17. Licensure Compacts – Discipline and Dispute Resolution
Regulatory authority for the home state remains with that state’s
Medical Licensure Board
Member Boards may participate with other member boards in joint investigations of physicians licensed by the member boards
Boards may share information and other materials
Subpoenas issued by member states are enforceable in other member states
Additionally, the Commission has the authority to promulgate rules which provide for mediation and binding dispute resolution when appropriate.

18. Licensure Compacts – Discipline and Dispute Resolution
Which state is the home state?
Did the violation occur in the home or remote state?
Which state should conduct the investigation (home state, remote state, or both states?

19. Licensure Compacts – Due Process
Investigations of alleged misconduct should probably be permitted to be jointly managed by home and remote states based upon due process considerations including access to witnesses, evidence, and timely ‘trial.’ See Morrissey v. Brewer, 408 U.S. 471 (1972

20. Licensure Compacts – Discipline and Due Process (CONT’)
Which state should take the lead?
Due process considerations include:
Where the incident occurred;
Access to witnesses;
Access to respondents;
Ability to obtain evidence;
Public risk involved;
Timely case processing;

21. Visit CSG’s National Center for Interstate Compacts online at:
Contact Information
Crady deGolian
(859)
Rick Masters
(502)
Visit CSG’s National Center for Interstate Compacts online at: