HB 1114
SignedHouse
Respiratory care compact
Concerning the respiratory care interstate compact.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill creates a new respiratory care interstate compact to let Washington-licensed respiratory therapists practice in other participating states more easily, improving access to care and supporting military mobility. It establishes a multi-state commission to coordinate licensing, oversight, and enforcement while preserving state regulatory authority.
- Creates a new respiratory care interstate compact allowing licensed respiratory therapists in Washington (and other participating states) to practice in other member states under a 'compact privilege' without obtaining separate licenses.
- Requires licensees to hold an active Washington license, maintain national certification, have no adverse actions in the past two years, pay applicable fees, and meet any state-specific jurisprudence requirements to obtain and maintain compact privilege.
- Establishes a Respiratory Care Interstate Compact Commission composed of representatives from each member state to administer the compact, maintain a shared data system, and issue binding rules.
- Requires states to share information about adverse actions, investigations, and license status through a centralized data system, while protecting confidential and privileged information.
- Provides special provisions for active military members and their spouses, including exemption from compact privilege fees and flexibility in maintaining their home-state license designation during service.
- Includes procedures for handling cross-state disciplinary actions, joint investigations, and enforcement—including authority for states to issue subpoenas and recover investigation costs.
Who is affected
- Respiratory therapists — Respiratory therapists licensed in Washington who want to practice in other states that join the compact can do so more easily without needing separate licenses in each state, provided they meet the compact's requirements.
- Patients needing respiratory care — Patients in Washington and other compact states may gain better access to respiratory care services, especially in areas with workforce shortages or where military families relocate.
- Active military members and their spouses — Active military members and their spouses who are respiratory therapists can practice in other compact states without paying standard fees, supporting mobility during relocations.
- State regulatory agencies — State agencies responsible for licensing and regulating respiratory therapists (e.g., Washington State Department of Health) will need to participate in a new interstate compact, share data, and comply with new reporting and oversight requirements.
- Other state regulatory agencies — Other states that join the compact will collaborate with Washington on licensing, investigations, and enforcement, and may benefit from shared regulatory resources and data.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Active military members and their spouses—who often relocate frequently—can practice respiratory therapy across state lines without paying standard fees, improving continuity of care for military families and supporting workforce stability in underserved areas where military bases are located.
Public SafetyPeopleRef: Sec. 5(1)-(2), Sec. 4(1)(a)The bill establishes a centralized data system for sharing adverse actions and significant investigative information across states, enabling more effective cross-border enforcement and improving patient safety by preventing licensees with serious disciplinary histories from moving between states undetected.
Public SafetyPeopleRef: Sec. 3(1)(g), Sec. 8(1)-(2), Sec. 6(5)Washington-licensed respiratory therapists can more easily provide care in other compact states, easing workforce shortages in rural or underserved areas of Washington (where 20% of counties have no respiratory therapist) and expanding access for patients needing time-sensitive respiratory services (e.g., COPD, asthma, critical care).
HealthcarePeopleRef: Sec. 4(1)(a), Sec. 3(1)(h), Sec. 1(2)(f)The compact supports military spouse employment—spouses of active-duty service members face unemployment rates up to 25% due to frequent relocations; by waiving fees and allowing home-state designation, the bill helps retain qualified respiratory therapists in the workforce during transitions.
Business & EmploymentPeopleRef: Sec. 1(2)(e), Sec. 5(1)The bill promotes mobility for respiratory therapy graduates and students by reducing barriers to multistate practice, which may encourage enrollment in local respiratory therapy programs (e.g., at community colleges like Everett CC or Yakima Valley College) by increasing career portability.
EducationPeopleRef: Sec. 1(2)(a), Sec. 4(1)(f), Sec. 14(4)
Potential Concerns (4)
The bill creates a new multi-state commission with authority to assess annual fees on member states and licensees to cover operational costs, which may impose new administrative and financial burdens on Washington’s Department of Health and other state agencies, potentially diverting resources from other public health priorities.
Local GovernmentPeopleRef: Sec. 7(7)(c)While the bill allows states to charge fees for compact privilege, it does not cap or limit those fees, and the commission may impose its own assessments—potentially creating a new cost burden on respiratory therapists, many of whom earn modest wages (median annual wage ~$72K in WA), especially those working in rural or underserved areas.
Business & EmploymentPeopleRef: Sec. 7(7)(c), Sec. 4(1)(e)The bill authorizes remote states to recover investigation and disciplinary costs from licensees—including licensees practicing lawfully in their home state—which could result in out-of-state financial penalties for Washington-based therapists without adequate due process safeguards in the remote jurisdiction.
Rights & LibertiesLean peopleRef: Sec. 6(4)(a)(iii)The bill permits closed (nonpublic) meetings to discuss confidential investigative records, litigation, and trade secrets—limiting public transparency around regulatory oversight of a health profession, even though the commission is otherwise required to hold open meetings.
Rights & LibertiesRef: Sec. 7(6)(d)(vii)
Who Is Most Affected
Respiratory therapists licensed in Washington gain the ability to practice in other compact states without separate licensing, improving job mobility and career flexibility—especially beneficial for those in rural areas with limited local opportunities. However, they may face new fees and increased liability exposure across states.
Patients benefit from improved access to respiratory care, especially in areas with therapist shortages or where military families relocate. However, if compact privilege fees rise, some patients may face higher out-of-pocket costs for services.
Active military members and spouses gain fee waivers and licensing flexibility during relocations, directly supporting workforce stability and family continuity. This is a targeted, positive benefit for a specific subgroup.
Washington’s Department of Health and other state agencies must implement the compact—designating staff, maintaining data system compliance, and participating in commission activities—potentially increasing administrative costs and workload without new funding.
Other states that join the compact benefit from shared regulatory resources and data, but must also comply with reporting and fee obligations. States with existing workforce shortages may see net positive effects from increased therapist mobility.