PRINTER'S NO. 1093
No. 1009 Session of 1993
INTRODUCED BY WILLIAMS, CARONE, MELIO, PESCI, KAISER, TIGUE,
COY, J. TAYLOR, JAMES, BELFANTI, JOSEPHS, D. W. SNYDER, BUNT,
KENNEY, KUKOVICH, MICOZZIE, THOMAS, CORRIGAN, COWELL,
MIHALICH, DeLUCA, OLASZ, WOGAN AND O'BRIEN, MARCH 29, 1993
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, MARCH 29, 1993
AN ACT
1 Amending the act of October 5, 1978 (P.L.1109, No.261), entitled
2 "An act requiring the licensing of practitioners of
3 osteopathic medicine and surgery; regulating their practice;
4 providing for certain funds and penalties for violations and
5 repeals," further providing for the State Board of
6 Osteopathic Medicine and for penalties; and regulating the
7 practice of respiratory care practitioners.
8 The General Assembly finds and declares that the practice of
9 respiratory care in this Commonwealth affects the public health,
10 safety and welfare and is to be subject to regulation and
11 control in the public interest to protect the public from the
12 unauthorized and unqualified practice of respiratory care and
13 from unprofessional conduct by persons certified to practice
14 respiratory care.
15 The General Assembly of the Commonwealth of Pennsylvania
16 hereby enacts as follows:
17 Section 1. Section 2 of the act of October 5, 1978
18 (P.L.1109, No.261), known as the Osteopathic Medical Practice
19 Act, is amended by adding definitions to read:
1 Section 2. Definitions.
2 The following words and phrases when used in this act shall
3 have, unless the context clearly indicates otherwise, the
4 meanings given to them in this section:
5 * * *
6 "Respiratory care." A health care specialty employing
7 evaluation, analysis, care and treatment of patients with
8 cardiopulmonary disorders and related diseases.
9 "Respiratory care practitioner." An individual who is
10 certified to practice respiratory care by the State Board of
11 Medicine.
12 * * *
13 Section 2. Section 2.1(a) of the act, added December 20,
14 1985 (P.L.398, No.108), is amended to read:
15 Section 2.1. State Board of Osteopathic Medicine.
16 (a) The State Board of Osteopathic Medicine shall consist of
17 the Commissioner of Professional and Occupational Affairs[,] or
18 his designee; the Secretary of Health[,] or his designee[,]; two
19 members appointed by the Governor[, with the advice and consent
20 of a majority of the members elected to the Senate,] who shall
21 be persons representing the public at large[,]; one member
22 appointed by the Governor who shall be either a respiratory care
23 practitioner or a physician assistant; and [five] six members
24 appointed by the Governor[, with the advice and consent of a
25 majority of the members elected to the Senate,] who shall be
26 graduates of a legally incorporated and reputable college of
27 osteopathy and shall have been licensed to practice [osteopathy]
28 osteopathic medicine under the laws of this Commonwealth and
29 shall have been engaged in the practice of osteopathy in this
30 Commonwealth for a period of at least five years. All
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1 professional and public members of the board shall be appointed
2 by the Governor with the advice and consent of a majority of the
3 members elected to the Senate. The Governor shall assure that
4 respiratory care practitioners and physician assistants are
5 approved to four-year terms on a rotating basis so that, of
6 every two appointments to a four-year term, one is a physician
7 assistant and one is a respiratory care practitioner.
8 * * *
9 Section 3. The act is amended by adding sections to read:
10 Section 10.1. Respiratory care practitioners.
11 (a) Certificate required.--Eighteen months after the
12 effective date of this section, it shall be unlawful for any
13 person to hold himself out to the public as a respiratory care
14 practitioner and to practice or offer to practice respiratory
15 care unless he holds a valid, current temporary permit or
16 certificate issued by the board.
17 (b) Use of title.--A respiratory care practitioner who holds
18 a valid, current temporary permit or certificate issued by the
19 board may use the title respiratory care practitioner or
20 respiratory care practitioner-certified, or an appropriate
21 abbreviation of that title, such as "R.C.P." or "R.C.P.-C."
22 (c) Regulations.--The board is authorized to promulgate
23 regulations to implement this section.
24 (d) Supervision and scope of practice.--A respiratory care
25 practitioner certified by the board may implement direct
26 respiratory care to an individual being treated by either a
27 licensed medical doctor or a licensed doctor of osteopathic
28 medicine upon physician prescription or referral, or under
29 medical direction and approval consistent with standing orders
30 or protocols of an institution or health care facility. This
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1 care may constitute indirect services, such as consultation or
2 evaluation of an individual, and also includes, but is not
3 limited to, the following services:
4 (1) Administration of medical gases.
5 (2) Humidity and aerosol therapy.
6 (3) Administration of aerosolized medications.
7 (4) Intermittent positive pressure breathing.
8 (5) Incentive spirometry.
9 (6) Bronchopulmonary hygiene.
10 (7) Management and maintenance of natural airways.
11 (8) Maintenance and insertion of artificial airways.
12 (9) Cardiopulmonary rehabilitation.
13 (10) Management and maintenance of mechanical
14 ventilation.
15 (11) Measurement of ventilatory flows, volumes and
16 pressures.
17 (12) Analysis of ventilatory gases and blood gases.
18 (e) Exemptions.--This section shall not prevent or restrict
19 the practices, services or activities of:
20 (1) A person licensed or certified in this Commonwealth
21 to provide another health care service, including, but not
22 limited to, physicians, physical therapists, chiropractors,
23 nurses, dentists, physician assistants and podiatrists.
24 (2) A person rendering respiratory care services
25 pursuant to employment by a Federal agency.
26 (3) A person pursuing a course of study leading to a
27 degree or certificate in respiratory care in an accredited
28 educational program, if he is clearly designated as a
29 student, and provides care under supervision implemented
30 through that program.
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1 (4) A person executing or conveying medical orders
2 pursuant to lawful delegation by a physician.
3 (5) A person who, pursuant to lawful delegation by a
4 physician, delivers, installs, monitors or maintains a device
5 which enables an individual to self-administer respiratory
6 care.
7 (f) Referrals to State Board of Medicine.--Information or
8 allegations filed with the board against a respiratory care
9 practitioner certified by the State Board of Medicine shall be
10 referred to that board for appropriate action.
11 Section 10.2. Respiratory care practitioner certificates and
12 permits.
13 (a) General rule.--A respiratory care practitioner
14 certificate issued by the board empowers the holder to practice
15 respiratory care under the supervision of a licensed medical
16 doctor or a licensed doctor of osteopathic medicine. In a health
17 care facility, that supervision may consist of standing orders
18 or protocols approved by the institution, consistent with
19 acceptable and prevailing medical standards, which may include
20 services rendered directly to the patient in his home or other
21 residence.
22 (b) Temporary permits.--Twelve months after the effective
23 date of this section, the board shall issue temporary permits
24 for the practice of respiratory care to individuals who have
25 applied for certification from the board, and who meet any of
26 the following requirements:
27 (1) Graduation from an accredited respiratory care
28 training program recognized by the board.
29 (2) Enrollment in an accredited respiratory care
30 training program recognized by the board, if the individual
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1 is expected to graduate within 30 days from the date of
2 application.
3 (3) Designation as a "Certified Respiratory Therapy
4 Technician" or a "Registered Respiratory Therapist" by a
5 nationally recognized credentialing agency approved by the
6 board.
7 (4) Continuous provision of respiratory care services
8 for a minimum of 12 months immediately preceding the
9 effective date of this section.
10 (5) Holding certification, licensure or registration as
11 respiratory care practitioners issued by another state, the
12 District of Columbia or a territory of the United States,
13 where the requirements for licensure, registration or
14 certification are substantially similar to those required by
15 the board.
16 (c) Duration and effect of temporary permits.--Temporary
17 permits shall be valid for 12 months and for such additional
18 period as the board may, in each case, specially determine;
19 except that a temporary permit shall expire if the holder fails
20 the examination. An appropriate fee for a temporary permit shall
21 be established by the board by regulation. If they are not in
22 violation of any other provision of this act, holders of
23 temporary permits qualify for admission to the examination, and
24 shall apply for the next regularly scheduled certification
25 examination administered by the board. The board is authorized
26 to promulgate regulations to establish procedures for
27 application, credentials verification, examination and
28 certification, together with appropriate fees.
29 (d) Examination.--Pursuant to section 812.1 of the act of
30 April 9, 1929 (P.L.177, No.175), known as The Administrative
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1 Code of 1929, the board shall contract for the development and
2 administration of an examination for the certification of
3 respiratory care practitioners. At least one administration of
4 this examination shall be given within 12 months of the
5 effective date of this section, and the examination shall
6 thereafter be given at least twice per year. An individual
7 qualifying for a temporary permit under subsection (b)(5) shall
8 be issued a certificate by the board without examination. An
9 individual qualifying for a temporary permit under subsection
10 (b)(3) shall be issued a certificate by the board without
11 examination if the individual passed an examination in order to
12 obtain designation as a "Certified Respiratory Therapy
13 Technician" or a "Registered Respiratory Therapist" and that
14 examination was comparable to the examination developed and
15 administered pursuant to this subsection.
16 (e) Biennial renewal.--A respiratory care practitioner
17 certificate shall be renewed biennially upon application on a
18 form prescribed by the board and upon payment of a renewal fee
19 adopted by the board by regulation.
20 Section 4. Section 11(c) of the act, amended December 20,
21 1985 (P.L.398, No.108), is amended to read:
22 Section 11. Penalty provisions.
23 * * *
24 (c) Board-imposed civil penalty.--In addition to any other
25 civil remedy or criminal penalty provided for in this act, the
26 board, by a vote of the majority of the maximum number of the
27 authorized membership of the board as provided by law, or by a
28 vote of the majority of the duly qualified and confirmed
29 membership or a minimum of [four] five members, whichever is
30 greater, may levy a civil penalty of up to $1,000 on any current
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1 licensee who violates any provision of this act or on any person
2 who practices osteopathic medicine without being properly
3 licensed to do so under this act. The board shall levy this
4 penalty only after affording the accused party the opportunity
5 for a hearing, as provided in Title 2 of the Pennsylvania
6 Consolidated Statutes (relating to administrative law and
7 procedure).
8 Section 5. This act shall take effect in 180 days.
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