CHAPTER 203

FORMERLY

SENATE BILL NO. 176

AS AMENDED BY

SENATE AMENDMENT NO. 2

AN ACT TO AMEND TITLE 24, CHAPTER 17 OF THE DELAWARE CODE RELATING TO THE BOARD OF MEDICAL PRACTICE.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE: (Two-thirds of all members elected to each House thereof concurring therein):

Section 1. Amend Chapter 17, Title 24 of the Delaware Code by adding a new Section to be designated as §1780, which new Section shall read as follows:

"§1780. Respiratory Care Practitioners (RCPs).

(a) As used in this Section:

(1) A 'Respiratory care practitioner (RCP)' is an individual who practices respiratory care.

(2) 'Respiratory Care' means the allied health profession responsible for the direct and indirect services in the treatment, management, diagnostic testing, control and care of patients with deficiencies and abnormalities associated with the cardiopulmonary system under the direction of a physician. Respiratory care includes inhalation therapy and respiratory therapy.

(b) Respiratory care practitioners shall work under the general supervision of physicians, whether by direct observation and monitoring, protocols approved by physicians, or orders written or verbally given by physicians. Practitioners may evaluate patients and make decisions within parameters defined by physicians or the Board of Medical Practice. Some examples of the types of work performed by respiratory care practitioners include, but are not limited to:

(1) Collection of samples of blood, secretions, gases and body fluids in respiratory evaluations;

(2) Measurements of cardiorespiratory volumes, flows and pressure;

(3) Administration of pharmacological agents/aerosols/medical gases via the respiratory route;

(4) Maintenance and Insertion of airways, natural or artificial, for the flow of respiratory gases;

(1) Environmental control and ventilatory support systems (hyperbaric chambers, ventilators, etc.);

(5) Resuscitation of persons with cardiorespiratory failure;

(6) Maintenance of bronchopulmonary hygiene;

(7) Research (protocols) in respiratory disorders;

(8) Pulmonary function studies.

(c) Nothing in this Section is intended to limit, preclude or otherwise interfere with the practice of other individuals and health care providers formally trained and licensed by the State of Delaware.

(d) Individuals who have passed an examination that includes content in one or more of the functions included in this Act shall not be prohibited from performing such procedures for which he or she has been tested provided that the testing body offering the examination is approved by the Board of Medical Practice.

(e) A Respiratory Care Practice Advisory Council (Council) is created.

(1) The Council shall consist of seven persons, one of whom is a physician member of the Board of Medical Practice. The remaining members shall be individuals fully trained in respiratory care, who have been employed primarily in the practice of respiratory care for at least two of the last three years immediately prior to their appointment.

(2) Members shall be selected by the Board of Medical Practice and shall serve a three-year term. The initial Council shall have one member selected for a one-year term, two members for a two-year term, and three members for a three-year term.

(3) Terms and limitations of service on the Council shall be the same as for the Board of Medical Practice.

(4) The Council shall promulgate rules and regulations governing the practice of respiratory care, after public hearing, and subject to the approval of the Board of Medical Practice, which must undertake formal action on any such proposed rules or regulations submitted to it by the Council within 60 days, or the proposed rules or regulations shall be deemed in full force and effect as it they had been approved by the Board.

(5) The Council may meet quarterly, or at such times as applications are pending for permits or licensing. The Council shall present to the Board the names of those individuals qualified to be licensed, to receive temporary permits, and recommend disciplinary action, and changes in operation or regulation.

(6) The requirements for licensure are:

i. Completion of a course of study in Respiratory Care recognized or approved by the Board of Medical Practice.

ii. Successful completion of a national qualifying examination with a passing grade that leads to a credential conferred by the National Board for Respiratory Care, Inc. (NBRC), or its successor organization, as a Certified Respiratory Therapy Technician (CRTT), and/or as a Registered Respiratory Therapist (RRT).

i. Current licensing in a state with requirements which equal or exceed those of this Section, and no outstanding or unresolved complaints pending against the applicant.

(7) Exceptions to licensure; temporary permits.

i. The Board of Medical Practice shall grant a permit to perform respiratory care to those applicants, who, at the effective date of this Act, demonstrate through written evidence, and verification by oath, that they are presently functioning in the capacity of a respiratory care practitioner as defined by this Act. Said applicants must have been working in the capacity of a respiratory care practitioner in this state for an uninterrupted period of 12 months prior to the effective date of this Act. This temporary permit will be valid for a 12-month period and may be renewed for an additional 12-month period upon documentation that the applicant is and has been working actively toward meeting the criteria for license as defined in this Act. Applicants granted a permit must pass the Entry Level CRTT exam, administered by

the National Board for Respiratory Care during this 24-month period, in order to be issued a license to practice respiratory care. This subparagraph of the Act will expire 24 months after the date the Act becomes effective.

ii. The practice of respiratory care is an integral part of the program of study by students enrolled in an accredited respiratory care education program, recognized and approved by the Board. Students enrolled in respiratory therapy programs shall be identified as 'Student-RCP and shall provide respiratory care only under direct clinical supervision of a licensed respiratory care practitioner or a licensed physician. Students may practice respiratory care under a temporary permit when not on their clinical rotation from an accredited educational program. The scope of practice of this temporary student permit shall be established by the Board of Medical Practice.

Ili. The Board of Medical Practice may grant a temporary permit to those persons, recommended by the Council, who have completed a Board-recognized or approved course of study in respiratory care and who are waiting to take the licensing examination. Such temporary permit will expire 90 days after the examination or whenever the examination results are available.

(8) Discipline. The Advisory Council, after appropriate notice and hearing, may recommend to the Board of Medical Practice to revoke, suspend, or refuse to renew a license, or place the licensee on probation, or otherwise reprimand a licensee, found guilty of unprofessional conduct, which shall include: fraud, deceit, incompetence, negligence, dishonesty or behavior in his or her professional activity which is likely to endanger the public health, safety or welfare, or the inability to render respiratory care services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness or excessive use of drugs, including alcohol. Any disciplinary action undertaken against a respiratory care practitioner shall be in accordance with those procedures applicable to disciplinary actions against physicians, as set forth in Subchapter V of this Chapter. An appeal of disciplinary action imposed by the Board shall be undertaken in accordance with Subchapter V of this Chapter.

(9) Licensure. Pursuant to §8810, Title 29 of the Delaware Code, the Division of Professional Regulation shall establish reasonable fees for licensing respiratory care practitioners and renewing the licenses of respiratory care practitioners, on a biennial basis. The licensee, when renewing his or her license, shall provide documentation of continuing education related to respiratory care. The Board of Medical Practice, in collaboration with the Advisory Council, shall establish the level of continuing education that will be required for license renewal.

(10) No person shall practice respiratory care, or represent himself or herself to be a respiratory care practitioner, unless he or she is licensed under the Respiratory Care Practice Act, except as otherwise provided by the Act.

(11) Penalties.

i. Whoever practices or attempts to practice respiratory care within the State contrary to this Chapter shall be fined not less than $500.00 nor more than $2,000.00, or imprisoned not more than 1 year.

ii The Attorney General of this State or his or her deputies shall be charged with the responsibility for the enforcement of this Chapter."

Approved July 10, 1995