GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2017

H                                                                                                                                                    1

HOUSE BILL 358

Short Title:      Modernize Respiratory Care Practice Act.		(Public)
Sponsors:	Representatives Burr, Goodman, and Boles (Primary Sponsors). For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to:	Health, if favorable, Finance

March 16, 2017

A BILL TO BE ENTITLED

AN ACT updating 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) Advanced practice. – Procedures that require formal training by rules adopted pursuant to this Article.

(1)(1a) Board. – The North Carolina Respiratory Care Board.

…

(3a) Endorsement. – A certificate issued by the Board recognizing the person named on the certificate as having met the requirements to perform respiratory care procedures as defined in this Article.

…

(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 of:

a.         Medical gases, humidity, and aerosols including the maintenance use of associated apparatus, respiratory care equipment, 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.

The term also means the interpretation and implementation of a physician's written or verbal order pertaining to the acts described in this subdivision.

…

(13)      Support activities. – Procedures Tasks that do not require formal academic training, including the delivery, setup, and routine maintenance and repair of apparatus. respiratory care equipment. The term also includes giving instructions on the use, fitting, and application of apparatus, respiratory care equipment, but does not include therapeutic evaluation and assessment.assessment for an individual patient as defined in rules adopted by the Board."

SECTION 2.  G.S. 90‑649(a)(4) reads as rewritten:

"(4)      One North Carolina member shall represent the North Carolina Association of Medical Equipment Services.Atlantic Coast Medical Equipment Services Association."

SECTION 3.  G.S. 90‑650(a)(7) reads as rewritten:

"(7)      The North Carolina Association of Medical Equipment Services Atlantic Coast Medical Equipment Services Association shall appoint the member described in G.S. 90‑649(a)(4)."

SECTION 4.  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 Public Safety 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 Public Safety, Justice, along with the request, the fingerprints of the applicant, applicant and any additional information required by the Department of Public Safety, 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. Department of 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 Public Safety Justice and shall remit the fees to the Department of Public Safety Justice for expenses associated with conducting the criminal history record check.

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(14) Establish and adopt rules defining the education and credential requirements for persons seeking endorsement under this Article."

SECTION 5.  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:do all of the following:

(1)        Submit a completed application as required by the Board.Board, including a form signed by the applicant consenting to a 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.

(3)        Submit to the Board written evidence, verified by oath, that the applicant has successfully completed the minimal requirements of a an associate's degree in respiratory care education program as approved by the Commission for Accreditation of Allied Health Educational Programs, or the Canadian Council on Accreditation for Respiratory Therapy Education.Commission 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.

(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.

(5)        Pass the entry‑level Submit to the Board written evidence, verified by oath, that the applicant passed the Therapist Multiple‑Choice (TMC) examination given by the National Board for Respiratory Care, Inc.Inc., or its successor.

(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.

(b1) When issuing a license, the Board shall state the terms and conditions of the use of the license to the licensee."

SECTION 6.  G.S. 90‑660(b)(6) reads as rewritten:

"(6)      For a license with a provisional or temporary an endorsement, a fee not to exceed fifty dollars ($50.00)."

SECTION 7.  G.S. 90‑654 and G.S. 90‑656 are repealed.

SECTION 8.  This act becomes effective October 1, 2017.