Bill Text: AZ SB1300 | 2016 | Fifty-second Legislature 2nd Regular | Chaptered
Bill Title: Respiratory care examiners
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2016-03-18 - Chapter 49 [SB1300 Detail]
Download: Arizona-2016-SB1300-Chaptered.html
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House Engrossed Senate Bill |
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State of Arizona Senate Fifty-second Legislature Second Regular Session 2016
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CHAPTER 49
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SENATE BILL 1300 |
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AN ACT
Amending sections 32‑3501, 32‑3503, 32-3504, 32‑3506, 32-3521, 32-3524, 32‑3525, 32‑3526 and 32‑3553, Arizona Revised Statutes; relating to the board of respiratory care examiners.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-3501, Arizona Revised Statutes, is amended to read:
32-3501. Definitions
In this chapter, unless the context otherwise requires:
1. "Board" means the board of respiratory care examiners.
2. "Diagnostic testing" includes obtaining physiologic samples and determining acid‑base status and blood gas values from blood samples and pulmonary function measurements.
3. "Licensed respiratory care practitioner" means a respiratory therapist or respiratory therapy technician who is licensed pursuant to this chapter.
4. "Medical direction" means direction by a physician who is licensed pursuant to chapter 13 or 17 of this title.
5. "Practice of respiratory care" means direct and indirect respiratory care services that are performed in a clinic, hospital, skilled nursing facility or private dwelling or other place deemed appropriate or necessary by the board in accordance with the prescription or verbal order of a physician and performed under qualified medical direction. These services include:
(a) Administering pharmacological, diagnostic and therapeutic agents that are related to respiratory care procedures and necessary to implement a treatment, disease prevention, pulmonary rehabilitative or diagnostic regimen prescribed by a physician.
(b) Transcribing and implementing the written or verbal orders of a physician pertaining to the practice of respiratory care and observing and monitoring signs and symptoms, general behavior, general physical response responses to respiratory care treatment and diagnostic testing, including a determination of whether these signs, symptoms, reactions, behavior or general response exhibits responses exhibit abnormal characteristics.
(c) Implementing appropriate reporting, referral, respiratory care protocols or changes in treatment based on observed abnormalities and pursuant to a prescription by a physician WHO IS licensed pursuant to chapter 13 or 17 of this title.
(d) Initiating emergency procedures pursuant to board rules or as otherwise permitted in this chapter.
(e) Respiratory therapy.
(f) Inhalation therapy.
(g) Therapeutics.
6. "Respiratory therapist" means a person who successfully completes a respiratory therapy training program approved by the board.
7. "Respiratory therapy technician" means a person who successfully completes a training program for respiratory therapy technicians approved by the board.
8. 7. "Respiratory therapy training program" means a program that is accredited by the American medical association's committee on allied health education and accreditation in collaboration with the joint review committee for respiratory therapy education commission on accreditation for respiratory care or its successor agency and that is adopted by the board.
9. 8. "Therapeutics" includes the following:
(a) Applying and monitoring oxygen therapy.
(b) Administering pharmacological agents to the cardiopulmonary systems.
(c) Ventilation therapy.
(d) Artificial airway care.
(e) Bronchial hygiene therapy.
(f) Cardiopulmonary resuscitation.
(g) Respiratory rehabilitation therapy.
(h) Barometric therapy.
(i) Assisting physicians licensed pursuant to chapter 13 or 17 of this title with hemodynamic monitoring.
10. 9. "Unprofessional conduct" includes the following acts:
(a) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude.
(b) Habitual intemperance in the use of alcohol.
(c) Illegal use of narcotic or hypnotic drugs or substances.
(d) Gross incompetence, repeated incompetence or incompetence resulting in injury to a patient.
(e) Having professional connection with or lending the name of the licensee to an illegal practitioner of respiratory therapy or any of the other healing arts.
(f) Failing to refer a patient whose condition is beyond the training or ability of the respiratory therapist to another professional qualified to provide such service.
(g) Immorality or misconduct that tends to discredit the respiratory therapy profession.
(h) Refusal, revocation or suspension of Having a license refused, revoked or suspended by any other state, territory, district or country, unless it can be shown that this was not caused by reasons which that relate to the person's ability to safely and skillfully practice respiratory therapy or to an act of unprofessional conduct prescribed in this paragraph.
(i) Any conduct or practice which that is contrary to recognized standards of ethics of the respiratory therapy profession or any conduct or practice which that does or might constitute a danger to the health, welfare or safety of the patient or the public.
(j) Any conduct, practice or condition which that does or might impair the person's ability to safely and skillfully practice respiratory therapy.
(k) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate a provision of this chapter.
(l) Failing to report to the board within ten calendar days an incident or incidents which that appear to show the existence of a cause for disciplinary action or that a licensed respiratory care practitioner is or may be professionally incompetent or is or may be mentally or physically unable to engage safely in the practice of respiratory care.
Sec. 2. Section 32-3503, Arizona Revised Statutes, is amended to read:
32-3503. Meetings; organization; compensation
A. The board shall meet in January of each year to elect a chairman and other officers. The board shall hold at least one additional meeting before the end of each calendar year. Other meetings may be convened at the call of the chairman or the written request of any two board members. A majority of the members of the board constitutes a quorum.
B. All board meetings are open to the public, except that the board may hold closed sessions to approve examinations or, on the request of an applicant who fails an examination, to prepare a response indicating a reason for an applicant's failure.
C. Board members are eligible to receive compensation pursuant to section 38‑611 and are entitled to reimbursement of expenses necessarily and properly incurred in carrying out board duties.
Sec. 3. Section 32-3504, Arizona Revised Statutes, is amended to read:
32-3504. Powers and duties; inspection of records; personnel examinations; immunity; program termination
A. The board shall:
1. Enforce and administer the provisions of this chapter.
2. Adopt rules necessary to administer this chapter.
3. Examine applicants for licensure pursuant to this chapter at times and places it designates.
4. Investigate each applicant for licensure, before a license is issued, in order to determine if the applicant is qualified pursuant to this chapter.
5. Keep a record of all its acts and proceedings pursuant to this chapter, including the issuance, refusal, renewal, suspension or revocation of licenses.
6. Beginning on January 1, 1999, Require each applicant for initial licensure to submit a full set of fingerprints to the board for a state and federal criminal history records check pursuant to section 41‑1750 and Public Law 92‑544.
7. Maintain a register which that contains the name, the last known place of residence and the date and number of the license of all persons who are licensed pursuant to this chapter.
8. Compile, once every two years, a list of licensed respiratory care practitioners who are authorized to practice in this state.
9. Establish minimum annual continuing education requirements for persons who are licensed under this chapter. The board shall approve organizations from which continuing education classes may be accepted.
10. Establish a confidential program for the monitoring of licensees who are chemically dependent and who enroll in rehabilitation programs that meet the criteria established by the board. The board may take further action if the licensee refuses to enter into a stipulated agreement or fails to comply with its terms. In order to protect the public health and safety, the confidentiality requirements of this paragraph do not apply if the licensee does not comply with the stipulated agreement.
B. The board, in approving training education programs for respiratory therapists and training programs for respiratory therapy technicians, shall consider the requirements and standards set by the American medical association's committee on allied health education and accreditation in collaboration with the joint review committee for respiratory therapy education commission on accreditation for respiratory care or its successor organization. The board may recognize examinations administered by a national board for respiratory care approved by the board.
C. The board may conduct examinations under a uniform examination system and may make arrangements with the national board of respiratory care or other organizations regarding examination materials it determines necessary and desirable.
D. The board and its members, personnel and board examiners are personally immune from suit with respect to all acts done and actions taken in good faith and in furtherance of the purposes of this chapter.
E. The program established pursuant to subsection A, paragraph 10 of this section ends on July 1, 2026 pursuant to section 41-3102.
Sec. 4. Section 32-3506, Arizona Revised Statutes, is amended to read:
32-3506. Executive director; duties; compensation
A. Subject to title 41, chapter 4, article 4, the board shall appoint an executive director who serves at the pleasure of the board. The executive director shall not be a board member.
B. The executive director and other board employees are eligible to receive compensation as determined pursuant to section 38‑611.
C. The executive director shall:
1. Perform the board's administrative duties.
2. Subject to title 41, chapter 4, article 4 and, as applicable, articles 5 and 6, employ, evaluate, dismiss, discipline and direct personnel as necessary to carry out board functions.
3. Initiate an investigation if there is reason to believe that a licensee is incompetent, mentally or physically unable to safely practice respiratory care or engaged in unprofessional conduct.
4. Issue subpoenas if necessary to compel the attendance and testimony of witnesses and the production of books, records, documents and evidence.
5. As directed by the board, sign and execute disciplinary orders, rehabilitative orders and notices of hearings.
6. On behalf of the board, enter into stipulated agreements with licensees for the treatment, rehabilitation and monitoring of chemical substance abuse or misuse.
7. On behalf of the board, enter into stipulated agreements with licensees for the confidential treatment, rehabilitation and monitoring of chemical dependency. A licensee who materially fails to comply with a program requirement shall be reported to the board and terminated from the confidential program established pursuant to section 32-3504. Any records of a licensee who is terminated from a confidential program are no longer confidential or exempt from the public records law. Notwithstanding any law to the contrary, stipulated agreements are not public records if the following conditions are met:
(a) The licensee voluntarily agrees to participate in the confidential program.
(b) The licensee complies with all treatment requirements or recommendations, including participation in alcoholics anonymous or an equivalent twelve‑step program and support group.
(c) The licensee refrains from the practice of respiratory care until the return to respiratory care has been approved by the treatment program and the executive director or the executive director's designee.
(d) The licensee complies with all monitoring requirements of the stipulated agreement, including random bodily fluid testing.
(e) The licensee's respiratory care employer is notified of the licensee's chemical dependency and participation in the confidential program and is provided a copy of the stipulated agreement.
7. 8. Perform all other duties required by the board.
Sec. 5. Section 32-3521, Arizona Revised Statutes, is amended to read:
32-3521. Allowable respiratory care services; transactions by medical equipment dealers
A. This chapter does not prohibit:
1. The performance of respiratory care services that are an integral part of a program of study by students who are enrolled in respiratory therapy training programs if the services are rendered under the supervision of a licensed respiratory care practitioner or a physician licensed pursuant to chapter 13 or 17 of this title.
2. Self‑care by a patient or the gratuitous care by a friend or relative who does not purport to be a licensed respiratory care practitioner.
3. The performance of respiratory care services in case of an emergency, including an epidemic or public disaster.
4. The performance of respiratory care services by registered, certified or licensed individuals as provided pursuant to chapters 7, 8, 11, 13, 14, 15, 17, 18, 19, 21, 25, 28 and 29 of this title and title 36, chapter 21.1.
5. The performance of specific diagnostic testing techniques relating to respiratory care by a person under medical direction in a clinical laboratory that is regulated pursuant to title 36, chapter 4.1.
6. The performance of respiratory care services by a person who is employed as a respiratory therapist or respiratory therapy technician by the United States government or any of its agencies if that person provides respiratory therapy only under the direction or control of the federal government or an agency of the federal government.
7. Medical equipment dealers who comply with subsection B of this section from taking a prescription for respiratory equipment, as long as that prescription is verified by a licensed respiratory therapist or respiratory therapy technician, and delivering oxygen equipment to or demonstrating the operation, safety and maintenance of oxygen equipment at a patient's home.
B. In a sale or lease of respiratory equipment by a medical equipment dealer to a patient, the terms of the sale or lease shall be in writing and signed by the parties describing the date of the sale or lease, the equipment to be sold or leased and the cost and method of payment for the equipment and shall include verification by a licensed respiratory therapist or respiratory therapy technician attesting that purchase or lease of the equipment is consistent with the prescription and the needs of the patient. The patient shall be provided a copy of all documents pertaining to the sale or lease at the time the documents are signed by the parties.
Sec. 6. Section 32-3524, Arizona Revised Statutes, is amended to read:
32-3524. Licensure without examination
The board may issue a license to an applicant without examination if the applicant:
1. Files an application pursuant to section 32‑3522.
2. Satisfies the requirements prescribed in section 32‑3523.
3. At the time of his application applying, is either:
(a) Licensed as a licensed respiratory care practitioner in another state in which, in the opinion of the board, the licensure requirements are at least equivalent to those in this state and has passed, to the satisfaction of the board, an examination in the state where he the applicant is licensed that is, in the opinion of the board, equivalent to the examination given under its direction.
(b) Registered as a respiratory therapist or certified as a respiratory therapy technician by a national organization for respiratory care approved by the board.
Sec. 7. Section 32-3525, Arizona Revised Statutes, is amended to read:
32-3525. Renewal of license; late renewal
Except as provided in section 32-4301, a license issued under this chapter is subject to renewal every other year on or before the birthday of the licensee and expires unless renewed. The board may reinstate a license cancelled for failure to renew on compliance with board requirements for renewal of licenses renew an expired license within ninety days after the expiration of the license if the applicant has complied with all late renewal application requirements and paid the application and renewal fees.
Sec. 8. Section 32-3526, Arizona Revised Statutes, is amended to read:
32-3526. Fees
A. The board by rule shall establish and collect fees that do not exceed the following:
1. Application for a license, one hundred dollars.
2. Application based on a diploma from a foreign respiratory therapy school, two hundred dollars.
3. Initial license, two hundred dollars.
4. Renewal of a license or late renewal of a license, two hundred dollars.
5. Duplicate license, fifty dollars.
6. Examination fee, one hundred fifty dollars.
B. The board shall prescribe the fee necessary to obtain a copy of the list of licensed respiratory care practitioners. Any interested person may obtain a copy upon on payment of the fee.
C. The board by rule may establish and collect fees for license renewals and verifications and for checks that are returned for nonpayment because of insufficient monies, payments stopped or closed accounts.
Sec. 9. Section 32-3553, Arizona Revised Statutes, is amended to read:
32-3553. Disciplinary action; duty to report; immunity; proceedings; board action; confidentiality
A. The board on its own motion may investigate any evidence that relates to a licensee and that appears to show the existence of any of the causes for disciplinary action prescribed in section 32‑3552 or that a licensed respiratory care practitioner is or may be professionally incompetent or is or may be mentally or physically unable to engage safely in the practice of respiratory care. A licensed respiratory care practitioner or a health care institution as defined in section 36‑401 shall, and any other person may, report to the board information the licensed respiratory practitioner, health care institution or individual may have that appears to show the existence of any of the causes for disciplinary action prescribed in section 32‑3552 or that a licensed respiratory care practitioner is or may be professionally incompetent or is or may be mentally or physically unable to engage safely in the practice of respiratory care.
B. A licensed respiratory care practitioner, a health care institution or any other person that reports or provides information to the board in good faith is not subject to an action for civil damages as a result of reporting the information, and on request the name of the reporter shall not be disclosed unless the information is essential to proceedings conducted pursuant to this section. The board shall report a health care institution that fails to report as required by this section to the institution's licensing agency.
C. Within ninety days of receipt of information, the board shall notify the licensed respiratory care practitioner about whom information has been received as to the content of the information. Within twenty days after notification, the licensed respiratory care practitioner shall submit to the board an answer to the allegation contained in the initial complaint notification.
D. A health care institution shall inform the board if a licensed respiratory care practitioner is terminated due to a cause listed in section 32‑3552, along with a general statement of the reasons that led the health care institution to take the action.
E. If the board finds, based on the information it receives pursuant to this section, that the public health, safety or welfare imperatively requires emergency action, and incorporates a finding to that effect in its order, the board may order a summary suspension of a license pending proceedings for revocation or other action. If an order of summary suspension is issued, the licensee shall also be served with a written notice of complaint and formal hearing pursuant to title 41, chapter 6, article 10, setting forth the charges made against the licensee, and is entitled to a formal hearing before the board on the charges within sixty days.
F. On determination of reasonable cause, the board, or if delegated by the board the executive director, may require a licensee or applicant to undergo at the expense of the licensee or applicant any combination of mental, physical or psychological examinations, assessments or skills evaluations necessary to determine the person's competence or ability to practice safely. These examinations may include bodily fluid testing and other examinations known to detect the presence of alcohol or drugs. If the executive director orders the licensee or applicant to undertake an examination, assessment or evaluation pursuant to this subsection and the licensee or applicant fails to affirm to the board in writing within fifteen days after receipt of the notice of the order that the licensee or applicant intends to comply with the order, the executive director shall refer the matter to the board to allow the board to determine whether to issue an order pursuant to this subsection. At each regular meeting of the board, the executive director shall report to the board data concerning orders issued by the executive director pursuant to this subsection since the last regular meeting of the board and any other data requested by the board.
F. G. If, after completing its investigation, the board finds that the information provided pursuant to this section is not of sufficient seriousness to merit direct action against the license of the licensed respiratory care practitioner, it may take any of the following actions:
1. Dismiss the complaint if the board believes that the information is without merit.
2. File a letter of concern if the board believes that while there is insufficient evidence to support direct action against the license of the licensed respiratory care practitioner there is sufficient evidence for the board to notify the licensee that continuing the activities that led to the information being submitted to the board may result in action against the license.
3. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.
G. H. If after completing the investigation the board believes that the information provided pursuant to this section is or may be true, the board may request an interview with the licensee. If the licensee refuses this request or is interviewed and the results indicate that suspension or revocation of the license might be in order, the board shall issue a formal complaint and hold a formal hearing pursuant to title 41, chapter 6, article 10. If, after completing the informal interview, the board finds that the information provided pursuant to this section is not of sufficient seriousness to merit suspension or revocation of the license, it the board may either dismiss the complaint if it the board believes it the complaint is without merit or take any combination of the following actions:
1. File a letter of concern if the board believes that while there is insufficient evidence to support direct action against the license there is sufficient evidence for the board to notify the licensee that continuation of the activities that led to the information being submitted to the board may result in action against that person's license.
2. Issue a decree of censure, which constitutes an official action against the respiratory care practitioner's license.
3. Fix a period and terms of probation best adapted to protect the public health and safety and rehabilitate or educate the licensed respiratory care practitioner concerned.
4. Restrict the licensee's practice to specific settings in a manner the board determines best protects the public health and safety.
5. Issue a civil penalty of up to five hundred dollars per violation.
5. 6. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.
H. I. Failure to comply with probation is cause for initiation of a formal proceeding for suspension or revocation of a license pursuant to this section based on the information considered by the board at the informal interview and any other acts or conduct alleged to be in violation of this chapter or rules adopted pursuant to this chapter.
I. J. If the board finds that the information provided pursuant to this section warrants suspension or revocation of a license issued under this chapter, the board shall immediately initiate formal proceedings for the revocation or suspension of the license as provided in title 41, chapter 6, article 10. If notice of the hearing is served by certified mail, service is complete on the date the notice is placed in the mail. At the conclusion of that hearing the board may dismiss the complaint or revoke or suspend the license and may take any combination of actions listed in subsection G H of this section.
K. A licensee shall respond in writing to the board within thirty days after notice of the hearing is served as prescribed in subsection j of this section. The board may consider a licensee's failure to respond within this time as an admission by default to the allegations stated in the complaint. The board may then take any disciplinary action allowed by this chapter without conducting a hearing.
J. L. In connection with the board investigation the board or its duly authorized agents or employees at all reasonable times may examine and copy any documents, reports, records or other physical evidence of any person being investigated, or the reports, the records and any of the documents maintained by and in the possession of any hospital, clinic, physician's office, or other public or private agency, and any health care institution as defined in section 36‑401, that relate to the person's professional competence, unprofessional conduct or mental or physical ability to safely practice respiratory care. These requests shall be made in writing.
K. M. Patient records, hospital records, medical staff records, medical staff review committee records, clinical records, medical reports, laboratory statements and reports, any file, film, other report or oral statement relating to the care of patients, any information from which a patient or a patient's family may be identified or information received or reports kept by the board as a result of the investigation procedure prescribed in this chapter and testimony concerning these records and proceedings relating to their creation are not available to the public, shall be kept confidential by the board and are subject to the same provisions concerning discovery and use and legal actions as are the original records in the possession and control of the hospital, the health care institutions or health care providers or other individual, practitioner or agency from which they are secured. The board shall use the records and testimony during the course of investigations and proceedings pursuant to this chapter.
Sec. 10. Rulemaking; exemption
The board of respiratory care examiners shall adopt rules to implement this act. For the purposes of this act, the board of respiratory care examiners is exempt from the rulemaking requirements of title 41, chapter 6, Arizona Revised Statutes, for one year after the effective date of this act.
APPROVED BY THE GOVERNOR MARCH 18, 2016.
FILED IN THE OFFICE OF THE SECRETARY OF STATE MARCH 18, 2016.
