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H.B. 262

This document includes House Committee Amendments incorporated into the bill on Fri, Jan 27, 2006 at 1:07 PM by ddonat. -->              1     




Chief Sponsor: Bradley G. Last

Senate Sponsor: Sheldon L. Killpack

             7      LONG TITLE
             8      General Description:
             9          This bill amends the Respiratory Care Practices Act to clarify that the installation of
             10      durable medical equipment and instructions on its use does not require licensure under
             11      the chapter, and to change licensure requirements from permissive to mandatory
             12      beginning January 1, 2007.
             13      Highlighted Provisions:
             14          This bill:
             15          .    amends definitions;
             16          .    clarifies exemptions for licensure under the chapter;
             17          .    amends qualifications for licensure to reflect current entities that accredit respiratory
             18      care practitioners;
             19          .    requires licensure under the chapter beginning January 1, 2007;
             20          .    establishes that after January 1, 2007 it is unlawful conduct to practice as a
             21      respiratory care practitioner without a license under the chapter;
             22          .    establishes penalties for unlawful conduct; and
             23          .    makes technical amendments.
             24      Monies Appropriated in this Bill:
             25          None
             26      Other Special Clauses:
             27          None

             28      Utah Code Sections Affected:
             29      AMENDS:
             30          58-57-2, as last amended by Chapter 131, Laws of Utah 2003
             31          58-57-4, as last amended by Chapter 313, Laws of Utah 1994
             32          58-57-5, as enacted by Chapter 208, Laws of Utah 1990
             33          58-57-7, as last amended by Chapter 141, Laws of Utah 1999
             34          58-57-10, as enacted by Chapter 208, Laws of Utah 1990
             35          58-57-11, as enacted by Chapter 208, Laws of Utah 1990
             36          58-57-12, as enacted by Chapter 208, Laws of Utah 1990
             37      ENACTS:
             38          58-57-14, Utah Code Annotated 1953
             40      Be it enacted by the Legislature of the state of Utah:
             41          Section 1. Section 58-57-2 is amended to read:
             42           58-57-2. Definitions.
             43          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             44          (1) "Board" means the Respiratory Care Licensing Board created in Section 58-57-3 .
             45          (2) "Health care facility" means any facility or institution in which health care services
             46      are performed or furnished and includes a hospital, clinic, or emergency care center.
             47          [(3) "Physician" means a person licensed to practice medicine under Title 58, Chapter
             48      67, Utah Medical Practice Act.]
             49          [(4)] (3) "Practice of respiratory care":
             50          (a) means the treatment, operation of equipment, management, diagnostic testing, and
             51      care of any human disease, deficiency, pain, injury, or other physical condition associated with
             52      the cardiopulmonary system under the qualified medical direction or supervision of a
             53      [physician] practitioner who has training and knowledge in the diagnosis, treatment, and
             54      assessment of respiratory problems[. "Practice of respiratory care"];
             55          (b) includes:
             56          [(a)] (i) accepting and carrying out a [licensed physician's] practitioner's written,
             57      verbal, or telephonic prescription or order specifically relating to respiratory care in a hospital
             58      or other health care setting and includes consultation with licensed nurses, as appropriate;

             59          [(b)] (ii) administering respiratory care during transportation of a patient and under
             60      other circumstances where an emergency requires immediate respiratory care;
             61          [(c)] (iii) serving as a resource to other health care professionals and hospital
             62      administrators in relation to the technical aspects of, and the safe and effective methods for,
             63      administering respiratory care;
             64          [(d)] (iv) functioning in situations of patient contact requiring individual judgment in
             65      administering respiratory care under the general supervision of a qualified [physician]
             66      practitioner; and
             67          [(e)] (v) supervising, directing, or teaching personnel in the performance of respiratory
             68      care modalities as part of a respiratory care education program[.]; and
             69          (c) does not include a person who delivers, installs, or maintains respiratory related
             70      durable medical equipment and who gives instructions regarding the use of that equipment as
             71      long as that person does not perform clinical evaluation or treatment of the patient.
             72          (4) "Practitioner" means an individual currently licensed, registered, or otherwise
             73      authorized by the appropriate jurisdiction to prescribe and administer drugs and order
             74      respiratory care in the course of professional practice.
             75          (5) "Respiratory care practitioner" means any person licensed to practice respiratory
             76      care under this chapter.
             77          (6) "Respiratory related durable medical equipment" means:
             78          (a) medical grade oxygen;
             79          (b) equipment and supplies related to medical gases;
             80          (c) apnea monitors;
             81          (d) oximeters;
             82          (e) noninvasive positive pressure generators, except those with back-up respiratory rate
             83      or when used invasively;
             84          (f) bilirubin lights;
             85          (g) suctioning equipment;
             86          (h) large volume nebulizers with compressors, except when used invasively in
             87      conjunction with an artificial airway;
             88          (i) medication nebulizers;
             89          (j) enteral nutrition equipment; and

             90          (k) other respiratory related equipment intended for use in the home as defined by the
             91      division by rule.
             92          (7) "Unlawful conduct" is defined in Sections 58-1-501 and 58-57-14 .
             93          [(6)] (8) "Unprofessional conduct" as defined in Section 58-1-501 and as may be
             94      further defined by rule includes:
             95          (a) acting contrary to the instructions of the [physician] practitioner responsible for
             96      supervising the licensee;
             97          (b) knowingly operating any respiratory care equipment that is unsafe or not in
             98      compliance with standards of condition or operation consistent with the patient's safety;
             99          (c) permitting any person to operate respiratory care equipment who is not competent
             100      or not allowed to operate the equipment;
             101          (d) revealing to any unauthorized person confidential or privileged information about a
             102      patient;
             103          (e) using any controlled substance, unless the controlled substance is prescribed by a
             104      [physician] practitioner and used in accordance with the [physician's] practitioner's
             105      instructions; and
             106          (f) making any statement that is incorrect due to negligence, willfulness, or intent to
             107      provide false information or entry on any patient record or other record that is used for payment
             108      of respiratory care services.
             109          Section 2. Section 58-57-4 is amended to read:
             110           58-57-4. Qualifications for a license.
             111          (1) The division shall issue a respiratory care practitioner license to an applicant who
             112      meets the requirements specified in this section.
             113          (2) An applicant seeking licensure as a respiratory care practitioner shall:
             114          (a) submit an application on a form prescribed by the division;
             115          (b) pay a fee as determined by the department pursuant to Section 63-38-3.2 ;
             116          (c) show evidence of good moral character;
             117          (d) possess a high school education or its equivalent, as determined by the division in
             118      collaboration with the board;
             119          (e) have completed a respiratory care practitioner educational program that is
             120      [approved by the board and is] accredited by [the American Medical Association] a nationally

             121      accredited organization acceptable to the division as defined by rule; and
             122          (f) pass an examination approved by the division in collaboration with the board.
             123          [(3) An applicant who has completed a respiratory care practitioner education program
             124      approved by the board and accredited by the American Medical Association and who, in the
             125      opinion of the division and board, meets the requirements for licensure except for passing the
             126      examination, may practice under the direct supervision of a respiratory care practitioner with an
             127      interim permit. An interim permit is valid only until the applicant receives notice of the results
             128      of the examination.]
             129          Section 3. Section 58-57-5 is amended to read:
             130           58-57-5. Licensure by endorsement.
             131          If an applicant has completed a respiratory care practitioner education program that is
             132      approved by the board and accredited by [the American Medical Association] a nationally
             133      accredited organization acceptable to the division, as defined by rule, the board may
             134      recommend that the division issue a license without examination to any applicant currently
             135      licensed by another state as a respiratory care practitioner or its equivalent, if the requirements
             136      for licensing in that state are at least as stringent as the requirements under this chapter.
             137          Section 4. Section 58-57-7 is amended to read:
             138           58-57-7. Exemptions from licensure.
             139          (1) H. For purposes of Subsection (2)(b), "qualified" means an individual who is a
             139a      registered polysomnographic technologist or a Diplomate certified by the American Board of
             139b      Sleep Medicine.
             139c          (2) .H In addition to the exemptions from licensure in Section 58-1-307 , the following
             140      persons may engage in the practice of respiratory therapy subject to the stated circumstances
             141      and limitations without being licensed under this chapter:
             142          (a) any person who provides gratuitous care for a member of his immediate family
             143      without representing himself as a licensed respiratory care practitioner;
             144          (b) any person who is a licensed or qualified member of another health care profession,
             145      if this practice is consistent with the accepted standards of the profession and if the person does
             146      not represent himself as a respiratory care practitioner;
             147          (c) any person who serves in the Armed Forces of the United States or any other
             148      agency of the federal government and is engaged in the performance of his official duties; [and]
             149          (d) any person who acts under a certification issued pursuant to Title 26, Chapter 8a,
             150      Utah Emergency Medical Services System Act, while providing emergency medical services[.];
             151      and

             152          (e) any person who delivers, installs, or maintains respiratory related durable medical
             153      equipment and who gives instructions regarding the use of that equipment in accordance with
             154      Subsections 58-57-2 (3) and (6), except that this exemption does not include any clinical
             155      evaluation or treatment of the patient H.;
             155a          (f) (i) any person who is working in a practitioner's office, acting under
             155b      supervision; and
             155c          (ii) for purposes of this Subsection (f) and Subsection (g), "supervision" means
             155d      one of the following will be immediately available for consultation in person or by phone:
             155e          (A) a practitioner;
             155f          (B) a respiratory therapist;
             155g          (C) a Diplomate of the American Board of Sleep Medicine; or
             155h          (D) a registered polysomnographic technologist; and
             155i          (g) a polysomnographic technician or trainee, acting under supervision, as long as they
             155j      only administer the following in a sleep lab, sleep center, or sleep facility:
             155k          (i) oxygen titration; and
             155l          (ii) positive airway pressure that does not include mechanical ventilation. .H .
             156           H. [ (2) ] 3 .H Nothing in this chapter permits a respiratory care practitioner to
             156a      engage in the
             157      unauthorized practice of other health disciplines.
             158          Section 5. Section 58-57-10 is amended to read:
             159           58-57-10. Use of title or designation.
             160          (1) Only a respiratory care practitioner may use the following titles or designations in
             161      this state:
             162          (a) respiratory care practitioner;
             163          (b) respiratory [care] therapist; or
             164          (c) respiratory [care] technician.
             165          (2) Any person who violates this section is guilty of a class A misdemeanor.
             166          Section 6. Section 58-57-11 is amended to read:
             167           58-57-11. Provision for current practitioners.
             168          [(1)] Any person who is [practicing as a respiratory care practitioner under the
             169      supervision of a qualified physician as of July 1, 1990, shall receive a temporary license which
             170      is valid until August 31, 1991, if he:     (a) submits an application on which the supervising
             171      physician certifies that the applicant is competent to practice as a respiratory care practitioner
             172      and pays the required fee; or     (b) submits evidence of having successfully completed an

             173      education program approved by the division in collaboration with the board. (2) To obtain a
             174      permanent license, a person practicing as a respiratory care practitioner under the supervision
             175      of a qualified physician as of July 1, 1990, shall fulfill the requirements of Section 58-57-4
             176      before August 1, 1991.] engaged in the practice of respiratory care as defined in Section
             177      58-57-2 and who is not licensed under this chapter as a respiratory care practitioner, shall by
             178      January 1, 2007, obtain a license under this chapter unless exempt from licensure under the
             179      provisions of Section 58-1-307 or 58-57-7 .
             180          Section 7. Section 58-57-12 is amended to read:
             181           58-57-12. Independent practice prohibited.
             182          A respiratory care practitioner may not:

             183          (1) practice independently of a [physician] practitioner or of a health care facility while
             184      under the supervision of a [physician] practitioner; or
             185          (2) charge a fee for his services independently of a [physician] practitioner or health
             186      care facility.
             187          Section 8. Section 58-57-14 is enacted to read:
             188          58-57-14. Unlawful conduct -- Penalty.
             189          (1) Beginning January 1, 2007, "unlawful conduct" includes:
             190          (a) using the following titles, names, or initials, if the user is not properly licensed
             191      under this chapter:
             192          (i) respiratory care practitioner;
             193          (ii) respiratory therapist; and
             194          (iii) respiratory technician; and
             195          (b) using any other name, title, or initials that would cause a reasonable person to
             196      believe the user is licensed under this chapter if the user is not properly licensed under this
             197      chapter.
             198          (2) Any person who violates the unlawful conduct provision specifically defined in
             199      Subsection 58-1-501 (1)(a) is guilty of a third degree felony.
             200          (3) Any person who violates any of the unlawful conduct provisions specifically
             201      defined in Subsections 58-1-501 (1)(b) through (f) and Subsection (1) of this section is guilty of
             202      a class A misdemeanor.
             203          (4) After a proceeding pursuant to Title 63, Chapter 46b, Administrative Procedures
             204      Act, and Title 58, Chapter 1, Division of Occupational and Professional Licensing Act, the
             205      division may assess administrative penalties for acts of unprofessional or unlawful conduct or
             206      any other appropriate administrative action.

Legislative Review Note
    as of 1-10-06 3:14 PM

Based on a limited legal review, this legislation has not been determined to have a high
probability of being held unconstitutional.

Office of Legislative Research and General Counsel

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