Bill Text: NC H285 | 2013-2014 | Regular Session | Amended
Bill Title: Amend Respiratory Care Practice Act
Spectrum: Moderate Partisan Bill (Democrat 10-3)
Status: (Engrossed - Dead) 2013-06-20 - Re-ref Com On Health Care [H285 Detail]
Download: North_Carolina-2013-H285-Amended.html
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2013
H 2
HOUSE BILL 285
Committee Substitute Favorable 3/27/13
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Short Title: Amend Respiratory Care Practice Act. |
(Public) |
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Sponsors: |
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Referred to: |
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March 13, 2013
A BILL TO BE ENTITLED
AN ACT to amend the respiratory care practice act.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 90‑648 reads as rewritten:
"§ 90‑648. Definitions.
The following definitions apply in this Article:
(1) Board. – The North Carolina Respiratory Care Board.
(2) Diagnostic testing. – Cardiopulmonary procedures and tests performed on the written order of a physician licensed under Article 1 of this Chapter that provide information to the physician to formulate a diagnosis of the patient's condition. The tests and procedures may include pulmonary function testing, electrocardiograph testing, cardiac stress testing, and sleep related testing.
(3) Direct supervision. – The authority and responsibility to direct the performance of activities as established by policies and procedures for safe and appropriate completion of services.
(4) Individual. – A human being.
(5) License. – A certificate issued by the Board recognizing the person named therein as having met the requirements to practice respiratory care as defined in this Article.
(6) Licensee. – A person who has been issued a license under this Article.
(7) Medical director. – An appointed physician who is licensed under Article 1 of this Chapter and a member of the entity's medical staff, and who is granted the authority and responsibility for assuring and establishing policies and procedures and that the provision of such is provided to the quality, safety, and appropriateness standards as recognized within the defined scope of practice for the entity.
(8) Person. – An individual, corporation, partnership, association, unit of government, or other legal entity.
(9) Physician. – A doctor of medicine licensed by the State of North Carolina in accordance with Article 1 of this Chapter.
(10) Practice of respiratory care. – As defined by the written order of a physician licensed under Article 1 of this Chapter, the observing and monitoring of signs and symptoms, general behavior, and general physical response to respiratory care treatment and diagnostic testing, including the determination of whether such signs, symptoms, reactions, behavior, or general response exhibit abnormal characteristics, and the performance of diagnostic testing and therapeutic application or assessment of:
a. Medical gases, humidity, and aerosols including the maintenance of associated apparatus, except for the purpose of anesthesia.
b. Pharmacologic agents related to respiratory care procedures, including those agents necessary to perform hemodynamic monitoring.
c. Mechanical or physiological ventilatory support.
d. Cardiopulmonary resuscitation and maintenance of natural airways, the insertion and maintenance of artificial airways under the direct supervision of a recognized medical director in a health care environment which identifies these services within the scope of practice by the facility's governing board.
e. Hyperbaric oxygen therapy.
f. New and innovative respiratory care and related support activities in appropriately identified environments and under the training and practice guidelines established by the American Association of Respiratory Care.
g. The therapeutic effectiveness of an apparatus used in respiratory care treatment for an individual patient.
The term also means the interpretation and
implementation of a physician's written or verbal order pertaining to the acts
described in this subdivision.subdivision and any act by which an
individual holds himself or herself out to the public or represents in any
manner that the individual is authorized to practice respiratory care in this
State.
(11) Respiratory care. – As defined by the written order of a physician licensed under Article 1 of Chapter 90, the treatment, management, diagnostic testing, and care of patients with deficiencies and abnormalities associated with the cardiopulmonary system.
(12) Respiratory care practitioner. – A person who has been licensed by the Board to engage in the practice of respiratory care.
(13) Support activities. – Procedures Tasks that
do not require formal academic training, including the delivery, setup, and
maintenance of apparatus. The term also includes giving instructions on the
use, fitting, and application of apparatus, but does not include therapeutic
evaluation and assessment.an apparatus and as defined in rules adopted
by the Board. The term does not include evaluation or assessment of the
therapeutic effectiveness of any respiratory treatment or apparatus for an
individual patient."
SECTION 2. G.S. 90‑648 reads as rewritten:
"§ 90‑648. Definitions.
The following definitions apply in this Article:
…
(12) Respiratory care practitioner. – A person who has
been licensed by the Board to engage in the practice of respiratory careAn
individual licensed by the Board as a respiratory care practitioner.
(12a) Respiratory therapist. — An individual licensed by the Board as a respiratory therapist who practices under the direct supervision of a licensed respiratory care practitioner."
SECTION 3. G.S. 90‑652 reads as rewritten:
"§ 90‑652. Powers and duties of the Board.
The Board shall have the power and duty to:
(1) Determine the qualifications and fitness of
applicants for licensure, renewal of licensure, and reciprocal licensure. The
Board shall, in its discretion, investigate the background of an applicant to
determine the applicant's qualifications with due regard given to the applicant's
competency, honesty, truthfulness, and integrity. The Department of Justice may
provide a criminal record check to the Board for a person who has applied for a
license through the Board. The Board shall provide to the Department of
Justice, along with the request, the fingerprints of the applicant,applicant
and any additional information required by the Department of Justice,
and a form signed by the applicant consenting to the check of the criminal
record and to the use of the fingerprints and other identifying information
required by the State or national repositories.Justice. The
applicant's fingerprints shall be forwarded to the State Bureau of
Investigation for a search of the State's criminal history record file, and the
State Bureau of Investigation shall forward a set of the fingerprints to the
Federal Bureau of Investigation for a national criminal history check. The
Board shall keep all information pursuant to this subdivision privileged, in
accordance with applicable State law and federal guidelines, and the
information shall be confidential and shall not be a public record under
Chapter 132 of the General Statutes. The Board shall collect any fees required
by the Department of Justice and shall remit the fees to the Department of
Justice for expenses associated with conducting the criminal history record
check.
(2) Establish and adopt rules necessary to conduct its business, carry out its duties, and administer this Article.
(3) Adopt and publish a code of ethics.
(4) Deny, issue, suspend, revoke, and renew licenses in accordance with this Article.
(5) Conduct investigations, subpoena individuals and
records, and do all other things necessary and proper to discipline persons
licensed under this Article and or investigate the activities of
persons not licensed under this Article who the Board has reasonable cause to
believe are engaged in the practice of respiratory care and do all other things
necessary and proper to enforce this Article.
(5a) Designate one or more of its employees to issue and serve subpoenas and other papers on behalf of the Board. Service under this subdivision is permitted in accordance with any other methods of service allowed by law.
(6) Employ professional, clerical, investigative, or special personnel necessary to carry out the provisions of this Article and purchase or rent office space, equipment, and supplies.
(7) Adopt a seal by which it shall authenticate its proceedings, official records, and licenses.
(8) Conduct administrative hearings in accordance with Article 3A of Chapter 150B of the General Statutes.
(9) Establish certain reasonable fees as authorized by
this Article for applications for examination, licensure, provisional
licensure, renewal of licensure, and other services provided by the Board.
(10) Submit an annual report to the North Carolina Medical Board, the North Carolina Hospital Association, the North Carolina Society of Respiratory Care, the Governor, and the General Assembly of all the Board's official actions during the preceding year, together with any recommendations and findings regarding improvements of the practice of respiratory care.
(11) Publish and make available upon request the licensure standards prescribed under this Article and all rules adopted pursuant to this Article.
(12) Request and receive the assistance of State educational institutions or other State agencies.
(13) Establish and approve continuing education requirements for persons seeking licensure under this Article."
SECTION 4. G.S. 90‑653 reads as rewritten:
"§ 90‑653. Licensure requirements; examination.
(a) Each applicant for licensure under this Article shall
meet the following requirements:shall:
(1) Submit a completed application as required by the Board.Board,
including a form signed by the applicant consenting to the check of the
applicant's criminal record and to the use of the applicant's fingerprints and
other identifying information required by the State and national repositories.
(2) Submit any fees required by the Board.
(b) In addition to the requirements set out in subsection (a) of this section, applicants for a respiratory therapist (RT) license shall also:
(3) Submit to the Board written evidence,
verified by oath,
(1) Demonstrate that the applicant has
successfully completed the minimal requirements of a an associate
degree respiratory care education program as currently approved
by the Commission for Accreditation of Allied Health Educational Programs,
or the Canadian Council on Accreditation for Respiratory Therapy Education.on
Accreditation for Respiratory Care (CoARC) or its successor by arranging for
the applicant's respiratory care education program to submit a verified transcript
directly to the Board.
(2) Submit to the Board written evidence, verified by oath, that the applicant has successfully completed the minimal requirements for Basic Cardiac Life Support, as recognized by the American Heart Association, the American Red Cross, or the American Safety and Health Institute.
(3) Submit to the Board written evidence, verified by oath, that the applicant has successfully passed the Certified Respiratory Therapist examination or its successor given by the National Board for Respiratory Care, Inc.
(4) Submit to the Board written evidence,
verified by oath, that the applicant has successfully completed the minimal
requirements for Basic Cardiac Life Support as recognized by the American Heart
Association, the American Red Cross, or the American Safety and Health
Institute.
(c) In addition to the requirements set out in subsection (a) of this section, applicants for a respiratory care practitioner (RCP) license shall also:
(1) Demonstrate that the applicant has successfully completed the minimal requirements of a baccalaureate degree respiratory care education program approved by the Board or has completed an equivalent program approved by the Board by arranging for the applicant's program to submit a verified transcript directly to the Board.
(2) Submit to the Board written evidence, verified by oath, that the applicant has successfully completed the minimal requirements for Advanced Cardiac Life Support, Pediatric Advanced Life Support, or Neonatal Resuscitation Program as recognized by the American Heart Association, the American Red Cross, the American Safety and Health Institute, or the American Academy of Pediatrics.
(3) Submit to the Board written evidence, verified by oath, that the applicant has successfully passed the Registered Respiratory Therapist examination or its successor given by the National Board for Respiratory Care, Inc.
(5) Pass the entry‑level examination
given by the National Board for Respiratory Care, Inc.
(d) When granting a license, the Board shall state the terms and conditions of use of the license by the licensee.
(b) At least three times each year, the
Board shall cause the examination required in subdivision (5) of subsection (a)
of this section to be given to applicants at a time and place to be announced
by the Board. Any applicant who fails to pass the first examination may take
additional examinations in accordance with rules adopted pursuant to this
Article."
SECTION 5. G.S. 90‑654 and G.S. 90‑656 are repealed.
SECTION 6. G.S. 90‑659 reads as rewritten:
"§ 90‑659. Suspension, revocation, and refusal to renew a license.
(a) The Board shall take the necessary actions to deny
or refuse to renew a license, suspend or revoke a license, or to impose
probationary conditionsconditions, including placing limitations on
the practice of respiratory care, reprimand, assessing monetary redress, or
requiring satisfactory completion of treatment programs or educational programs,
on a licensee or applicant if the licensee or applicant:
(1) Has engaged in any of the following conduct:
a. Employed fraud, deceit, or misrepresentation in in
(i) obtaining or attempting to obtain a license license or (ii)
the renewal or reinstatement of a license.license or (iii)
obtaining money or anything of value.
b. Committed an act of malpractice, gross negligence, or incompetence in the practice of respiratory care.
c. Practiced respiratory care without a license.
d. Engaged in health care practices that are determined to be hazardous to public health, safety, or welfare.
(2) Was convicted of or entered a plea of guilty or nolo contendere to any crime involving moral turpitude.
(3) Was adjudicated insane or incompetent, until
proof of recovery from the condition can be established.Has developed a
physical or mental disability that renders the licensee or applicant unfit to
practice respiratory care with reasonable skill and competence and in a manner
not harmful to the public. An adjudication of mental incompetency in a court of
competent jurisdiction or a determination of mental incompetency by other
lawful means shall be conclusive proof of unfitness to practice respiratory
care until the licensee or applicant is subsequently lawfully declared mentally
competent.
(4) Engaged Has engaged in any act or
practice that violates any of the provisions of this Article or any rule
adopted pursuant to this Article, or aided, abetted, or assisted any person in
such a violation.
(5) Has failed to respond within a reasonable period of time and in a reasonable manner, as determined by the Board, to inquiries from the Board concerning any matter affecting a license to practice respiratory care.
(6) Has developed an impairment caused by the licensee's or applicant's use of alcohol, drugs, or controlled substances, which interferes with the ability of the licensee or applicant to practice respiratory care with reasonable skill, competence, and in a manner not harmful to the public.
(7) Has practiced respiratory care outside the boundaries of demonstrated competence or the limitations of education, training, or supervised experience.
(8) Has had a license for the practice of respiratory care in any other jurisdiction suspended or revoked or been disciplined by any licensing or certification board in any other jurisdiction for conduct that would subject the licensee or applicant to disciplinary action under this Article.
(9) Is a hazard to the public health by reason of having a serious communicable disease.
(b) Except as provided in subsection (c) of this
section, denial, Denial, refusal to renew, suspension, or revocation
of a license, or imposition of probationary conditions upon a licensee may be
ordered by the Board after a hearing held in accordance with Article 3A of
Chapter 150B of the General Statutes and rules adopted pursuant to this
Article. An application may be made to the Board for reinstatement of a revoked
license if the revocation has been in effect for at least one year.
(c) The Board may deny an initial application for a license as a respiratory care practitioner without a hearing if the individual fails to submit a complete application which demonstrates that the applicant has met the education and testing requirements of G.S. 90‑653.
(d) If after notice is duly issued, a licensee or applicant fails to appear for a scheduled hearing and no continuance has been granted, the Board may hear the evidence of witnesses that have appeared, and the Board may proceed to consider the matter and dispose of the matter on the basis of the evidence before the Board. For good cause, the Board may reopen any case for further hearing.
(e) The Board and its members and staff shall not be held liable in any civil or criminal proceeding for exercising, in good faith, the powers and duties authorized by law.
(f) A person, partnership, firm, corporation, association, authority, or other entity acting in good faith without fraud or malice shall be immune from civil liability for (i) reporting, investigating, assessing, monitoring, or providing an expert medical opinion to the Board regarding the acts or omissions of a licensee or applicant that violate the provisions of subsection (a) of this section or any other provision of law relating to the fitness of a licensee or applicant to practice respiratory care or (ii) initiating or conducting proceedings against a licensee or applicant if a complaint is filed or action is taken in good faith without fraud or malice. A person shall not be held liable in any civil proceeding for testifying before the Board in good faith and without fraud or malice in any proceeding involving a violation of subsection (a) of this section or any other law relating to the fitness of an applicant or licensee to practice respiratory care, or for making a recommendation to the Board in the nature of peer review, in good faith and without fraud and malice.
(g) A licensee may, with the consent of the Board, voluntarily relinquish a license at any time. The Board may delay or refuse the granting of its consent as it may deem necessary in order to investigate any pending complaint, allegation, or issue regarding violation of any provisions of this Article by the licensee. Notwithstanding any provision to the contrary, the Board retains full jurisdiction to investigate alleged violations of this Article by any person whose license is relinquished under this subsection and, upon proof of any violation of this Article by any such person, the Board may take disciplinary action as authorized by this section."
SECTION 7. G.S. 90‑659(c) reads as rewritten:
"(c) The Board may deny an initial application for
a license as a respiratory therapist or a respiratory care practitioner
without a hearing if the individual fails to submit a complete application
which demonstrates that the applicant has met the education and testing
requirements of G.S. 90‑653.G.S. 90‑653(b) or
(c) respectively."
SECTION 8. G.S. 90‑660(b)(6) is repealed.
SECTION 9. G.S. 90‑661 reads as rewritten:
"§ 90‑661. Requirement of license.
(a) It shall be unlawful for any person who is not currently licensed under this Article to:
(1) Engage in the practice of respiratory care.
(2) Use in connection with his or her name the title
"respiratory care practitioner" or "respiratory therapist"
or the letters "RCP" or "RT" or any other words, letters,
abbreviations, or insignia that indicate or imply that the person is a licensed
respiratory care practitioner or a respiratory therapist.the title "respiratory
care practitioner".
(3) Use the letters "RCP","RTT",
"RT", or any facsimile or combination in any words, letters,
abbreviations, or insignia.
(4) Imply orally or in writing or indicate in any way that the person is a respiratory care practitioner or is otherwise licensed under this Article.
(b) It shall be unlawful for any person to
(5) Employ employ or solicit for
employment unlicensed persons to practice respiratory care."
SECTION 10. G.S. 90‑664 reads as rewritten:
"§ 90‑664. Persons and practices not affected.
The requirements of this Article shall not apply to:
(1) Any person registered, certified, credentialed, or licensed to engage in another profession or occupation or any person working under the supervision of a person registered, certified, credentialed, or licensed to engage in another profession or occupation in this State who is performing work incidental to or within the practice of that profession or occupation and does not represent himself or herself as a respiratory care practitioner.
(2) A student or trainee working under the direct supervision of a respiratory care practitioner while fulfilling an experience requirement or pursuing a course of study to meet requirements for licensure in accordance with rules adopted pursuant to this Article.
(3) A respiratory care practitioner serving in the
Armed Forces or the Public Health Service of the United States or employed by
the Veterans Administration when performing duties associated with that
service or employment.or other federal agency, to the extent permitted
under federal law, so long as the individual limits services to those directly related
to work with the employing federal agency.
(4) A person who performs only support activities as defined in G.S. 90‑648(13).
(5) A person licensed as a respiratory care practitioner in another jurisdiction while providing respiratory care in a declared emergency in this State, providing respiratory care as a member of an organ harvesting team, or providing respiratory care on board an ambulance as part of an ambulance transport team transporting a patient into or out of this State."
SECTION 11. G.S. 90‑664 reads as rewritten:
"§ 90‑664. Persons and practices not affected.
The requirements of this Article shall not apply to:
(1) Any person registered, certified, credentialed, or licensed to engage in another profession or occupation or any person working under the supervision of a person registered, certified, credentialed, or licensed to engage in another profession or occupation in this State who is performing work incidental to or within the practice of that profession or occupation and does not represent himself or herself as a respiratory care practitioner.
(2) A student or trainee working under the direct supervision of a respiratory care practitioner while fulfilling an experience requirement or pursuing a course of study to meet requirements for licensure in accordance with rules adopted pursuant to this Article.
(3) A respiratory care practitioner or respiratory therapist serving in the Armed Forces or the Public Health Service of the United States or employed by the Veterans Administration or other federal agency, to the extent permitted under federal law, so long as the individual limits services to those directly related to work with the employing federal agency.
(4) A person who performs only support activities as defined in G.S. 90‑648(13).
(5) A person licensed as a respiratory care practitioner or respiratory therapist in another jurisdiction while providing respiratory care in a declared emergency in this State, providing respiratory care as a member of an organ harvesting team, or providing respiratory care on board an ambulance as part of an ambulance transport team transporting a patient into or out of this State."
SECTION 12. Any person licensed by the Board who has passed the Certified Respiratory Therapist examination given by the National Board for Respiratory Care, Inc., on the effective date of this act shall be deemed to have complied with the requirements of G.S. 90‑653(b), as enacted in Section 4 of this act. Any person licensed as a respiratory care practitioner by the Board who has passed the Registered Respiratory Therapist examination given by the National Board for Respiratory Care, Inc., on the effective date of this act shall be deemed to have complied with the requirements of G.S. 90‑653(c), as enacted in Section 4 of this act.
SECTION 13. Sections 2, 4, 7, and 11 of this act become effective January 1, 2015. G.S. 90‑659(a), as amended in Section 6 of this act, becomes effective October 1, 2013. G.S. 90‑659(b), (c), (d), and (g), as amended in Section 6 of this act, become effective October 1, 2013, and apply to applications filed, actions commenced, or action by the Board on or after that date. G.S. 90‑659 (e) and (f), as amended in Section 6 of this act, are effective when they become law and apply to causes of action arising on or after that date. The remainder of this act is effective when it becomes law.
