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S1077....................................................by HEALTH AND WELFARE
POLYSOMNOGRAPHY - Amends and adds to existing law to define and provide
registration for practitioners of polysomnography related respiratory care
services as a technologist, technician or trainee; and to provide procedures
and requirements; to include a registered polysomnography technologist in the
membership of the licensure board; and to provide the time frame for
implementation.
02/06 Senate intro - 1st rdg - to printing
02/07 Rpt prt - to Health/Wel
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
IN THE SENATE
SENATE BILL NO. 1077
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO REGULATION OF POLYSOMNOGRAPHY RELATED RESPIRATORY CARE PROVIDERS;
3 AMENDING SECTION 54-4303, IDAHO CODE, TO FURTHER DEFINE TERMS AND TO MAKE
4 TECHNICAL CORRECTIONS; AMENDING CHAPTER 43, TITLE 54, IDAHO CODE, BY THE
5 ADDITION OF A NEW SECTION 54-4304A, IDAHO CODE, TO PROVIDE REGISTRATION
6 FOR PRACTITIONERS OF POLYSOMNOGRAPHY RELATED RESPIRATORY CARE SERVICES AS
7 A TECHNOLOGIST, TECHNICIAN OR TRAINEE AND TO GOVERN PROCEDURES AND
8 REQUIREMENTS; AMENDING SECTION 54-4313, IDAHO CODE, TO INCLUDE A REGIS-
9 TERED POLYSOMNOGRAPHY TECHNOLOGIST IN THE MEMBERSHIP OF THE LICENSURE
10 BOARD; PROVIDING TRANSITION TO MEMBERSHIP OF THE LICENSURE BOARD; PROVID-
11 ING AN EFFECTIVE DATE AND DECLARING AN EMERGENCY.
12 Be It Enacted by the Legislature of the State of Idaho:
13 SECTION 1. That Section 54-4303, Idaho Code, be, and the same is hereby
14 amended to read as follows:
15 54-4303. DEFINITIONS. As used in this chapter:
16 (1) "Act" means the respiratory care practice act of 1991, chapter 43,
17 title 54, Idaho Code.
18 (2) "Applicant" means a person who applies for a license or a temporary
19 permit pursuant to this chapter.
20 (3) "Board" means the Idaho state board of medicine established by and
21 constituted pursuant to section 54-1805, Idaho Code, or any successor section
22 or statute.
23 (4) "Certified pulmonary function technologist" (CPFT) means the profes-
24 sional designation earned by a person who has successfully completed the entry
25 level pulmonary function certification examination administered by the
26 national board for respiratory care, inc.
27 (5) "Certified respiratory therapy technician" (CRTT) means the profes-
28 sional designation earned by a person who has successfully completed the entry
29 level examination administered by the national board for respiratory care,
30 inc.
31 (6) "Entry level examination" means the certification examination for
32 entry level respiratory therapy practitioners administered by the national
33 board for respiratory care, inc., the successful completion of which entitles
34 a person to the professional designation of "certified respiratory therapy
35 technician" (CRTT).
36 (7) "Licensure" means the issuance of a license to an applicant under the
37 provisions of this chapter entitling such person to hold himself out as a
38 respiratory care practitioner and entitling him to practice or perform respi-
39 ratory care in the state.
40 (8) "Licensure board" means the licensure board established by this chap-
41 ter to accept applications under this chapter, to make recommendations and
42 consult with the board and to perform such other duties as may be required or
43 authorized in this chapter or by the board.
2
1 (9) "National board for respiratory care, inc." means the nationally rec-
2 ognized private testing, examining and credentialing body for the respiratory
3 care profession.
4 (10) "Performance of respiratory care" means respiratory care practiced or
5 performed in accordance with the written, telephonic or verbal prescription of
6 a licensed physician and includes, but is not limited to, the diagnostic and
7 therapeutic use of the following: administration of medical gases, (except for
8 the purpose of anesthesia), aerosols and humidification; environmental control
9 mechanisms and hyperbaric therapy; pharmacologic agents related to respiratory
10 care protocols; mechanical or physiological ventilatory support;
11 bronchopulmonary hygiene; cardiopulmonary resuscitation; maintenance of the
12 natural airway; insertion and maintenance of artificial airways; specific
13 diagnostic and testing techniques employed in the medical management of
14 patients to assist in diagnosis, monitoring, treatment and research of pulmo-
15 nary abnormalities, including measurements of ventilatory volumes, pressures
16 and flows, collection, reporting and analysis of specimens of blood and blood
17 gases, arterial punctures, insertion and maintenance of arterial lines,
18 expired and inspired gas samples, respiratory secretions, and pulmonary func-
19 tion testing; and hemodynamic and other related physiologic measurements of
20 the cardiopulmonary system; observation and monitoring of signs and symptoms,
21 general behavior, general physical response to respiratory care treatment and
22 diagnostic testing and determination of whether such signs, symptoms, reac-
23 tions, behavior or general response exhibit abnormal characteristics; imple-
24 mentation based on observed abnormalities of appropriate reporting or referral
25 of respiratory care or changes in treatment regimen, pursuant to a prescrip-
26 tion by a physician or the initiation of emergency procedures.
27 (11) "Person" means an individual.
28 (12) "Polysomnography" means the process of analysis, attended monitoring
29 and recording of physiologic data during sleep and wakefulness to assess,
30 diagnose and treat sleep/wake disorders including, but not limited to, global
31 neural electroencephalographic activity (EEG), eye movements (EOG), respira-
32 tory effort, nasal and/or oral airflow, oxygen saturation (SpO2), body posi-
33 tion and limb movements.
34 (13) "Polysomnography related respiratory care services" means the prac-
35 tice of respiratory care in connection with the provision of polysomnography
36 services under the general direction of a licensed physician by an employee of
37 a sleep disorder center or laboratory who holds a permit issued by the licen-
38 sure board as a registered polysomnography technologist, polysomnography tech-
39 nician or a polysomnography trainee. Polysomnography related respiratory care
40 services include therapeutic and diagnostic use of medical gases, ventilatory
41 assistance and control, cardiopulmonary resuscitation and maintenance of natu-
42 ral and artificial airways. Polysomnography technologists, technicians and
43 trainees may implement appropriate interventions such as continuous and
44 bilevel positive airway pressure and oxygen as established by the general
45 direction of a licensed physician and by written procedures and protocols of
46 the associated sleep disorder center or laboratory.
47 (14) "Polysomnography technician" means a person who holds a permit as set
48 forth in section 54-4304A, Idaho Code, and who performs polysomnography ser-
49 vices under the general supervision of a registered polysomnography technolo-
50 gist and/or a licensed physician.
51 (15) "Polysomnography trainee" means a person who holds a permit as set
52 forth in section 54-4304A, Idaho Code, and who develops competency in and per-
53 forms the basics of polysomnography testing and associated interventions under
54 the direct supervision of a registered polysomnography technologist,
55 polysomnography technician or licensed physician.
3
1 (16) "Practice of respiratory care" means, but shall not be limited to,
2 the provision of respiratory and inhalation therapy which shall include, but
3 not be limited to: therapeutic and diagnostic use of medical gases, humidity
4 and aerosols including the maintenance of associated apparatus; administration
5 of drugs and medications to the cardiorespiratory system; provision of
6 ventilatory assistance and ventilatory control; postural drainage, percussion,
7 breathing exercises and other respiratory rehabilitation procedures; cardio-
8 pulmonary resuscitation and maintenance of natural airways, the insertion and
9 maintenance of artificial airways; and the transcription and implementation of
10 a physician's written, telephonic or verbal orders pertaining to the practice
11 of respiratory care. It also includes testing techniques employed in respira-
12 tory care to assist in diagnosis, monitoring, treatment and research. This
13 shall be understood to include, but not be limited to, measurement of
14 ventilatory volumes, pressures and flows, specimen collection of blood and
15 other materials, pulmonary function testing and hemodynamic and other related
16 physiological monitoring of the cardiopulmonary system. The practice of respi-
17 ratory care is not limited to the hospital setting but shall be performed
18 under the general supervision of a licensed physician.
19 (17) "Registered polysomnography technologist" means a person who holds a
20 permit as set forth in section 54-4304A, Idaho Code, and who has successfully
21 passed the certification process through the board of registered
22 polysomnographic technologists (BRPT) and who works under the general supervi-
23 sion of the medical director to provide comprehensive evaluation and treatment
24 of sleep disorders.
25 (138) "Respiratory care" means the allied health profession responsible
26 for the treatment, management, diagnostic testing, control and care of
27 patients with deficiencies and abnormalities associated with the cardiopulmo-
28 nary system, under the general supervision of a licensed physician.
29 (149) "Respiratory care practitioner" means a person who has been issued a
30 license by the board under the provisions of this chapter.
31 (1520) "Respiratory care protocols" means policies, procedures or
32 protocols developed or instituted by health care facilities or institutions,
33 through collaboration when appropriate or necessary with administrators, phy-
34 sicians, registered nurses, physical therapists, respiratory care practitio-
35 ners and other licensed, certified or registered health care practitioners.
36 (216) "Registered pulmonary function technologist" (RPFT) means the pro-
37 fessional designation earned by a person who has successfully completed the
38 advanced pulmonary function certification examination administered by the
39 national board for respiratory care, inc.
40 (1722) "Registered respiratory therapist" (RRT) means the professional
41 designation earned by a person who has successfully completed the written reg-
42 istry and clinical simulation examinations administered by the national board
43 for respiratory care, inc.
44 (1823) "Respiratory therapist" means a person who practices or provides
45 respiratory care.
46 (1924) "Respiratory therapy" means the practice or performance of respira-
47 tory care as defined in this chapter including, but not limited to, inhalation
48 therapy.
49 (25) "Sleep disorder center or laboratory" means a facility for sleep
50 related disorders that provides diagnostic and treatment services related to
51 sleep/wake disorders, and whose employees and contractors are under the gen-
52 eral supervision of a medical director who is responsible for patient care
53 provided in such center or laboratory.
54 (206) "Written registry and clinical simulation examinations" means the
55 certification examinations administered by the national board for respiratory
4
1 care, inc., the successful completion of which entitles a person the profes-
2 sional designation of "registered respiratory therapist" (RRT).
3 SECTION 2. That Chapter 43, Title 54, Idaho Code, be, and the same is
4 hereby amended by the addition thereto of a NEW SECTION, to be known and des-
5 ignated as Section 54-4304A, Idaho Code, and to read as follows:
6 54-4304A. POLYSOMNOGRAPHY. (1) A person who is not licensed as a respira-
7 tory care practitioner or exempt from licensure may provide polysomnography
8 related respiratory care services to the extent such services also constitute
9 the practice of respiratory therapy unless such person holds a permit issued
10 by the licensure board as a registered polysomnography technologist,
11 polysomnography technician or a polysomnography trainee who provides
12 polysomnography related respiratory care services under the general direction
13 of a licensed physician and the written procedures and protocols of the asso-
14 ciated sleep disorder center or laboratory.
15 (2) A person who wishes to provide polysomnography related respiratory
16 care services under the general direction of a licensed physician and the
17 written procedures and protocols of the associated sleep disorder center or
18 laboratory and who meets the requirements to hold a permit as a registered
19 polysomnography technologist, polysomnography technician or a polysomnography
20 trainee, under the provisions of this section who is not otherwise licensed to
21 provide respiratory care services or who is exempt from the requirements of
22 this chapter pursuant to section 54-4308, Idaho Code, shall apply to the
23 licensure board for the issuance of a permit. The application shall be upon a
24 form provided by the board.
25 (3) All applicants, regardless of the permit sought, shall make a satis-
26 factory showing to the licensure board that the applicant:
27 (a) Is, on or before the date of issuance of the permit, eighteen (18)
28 years of age or older; and
29 (b) Has not been convicted of a crime which would have a direct and
30 adverse bearing on the applicant's ability to practice or perform respira-
31 tory care in the evaluation or treatment of sleep disorders competently
32 and in the best interests of the consumer; and
33 (c) Is a high school graduate or has earned a general educational devel-
34 opment certificate.
35 (4) Eligibility for a permit as a registered polysomnography technologist
36 shall require that an applicant is certified by the board of registered
37 polysomnograph technologists as a registered polysomnography technologist or
38 other such equivalent certification as the licensure board may recognize.
39 (5) Eligibility for a permit as a polysomnography technician shall
40 require that:
41 (a) The applicant has successfully completed a polysomnography program of
42 no less than one (1) year duration, associated with a state licensed
43 and/or a nationally accredited educational facility; or
44 (b) The applicant has a minimum of seven hundred twenty (720) hours expe-
45 rience as a polysomnography trainee with documented proficiency related to
46 the practice of respiratory care as may be required by the board under the
47 direct supervision of a polysomnography technician or a registered
48 polysomnography technologist.
49 (6) A polysomnography trainee may be provided a permit for the practice
50 of respiratory care under the direct supervision of a registered
51 polysomnography technologist or polysomnography technician in connection with
52 the performance of polysomnography related respiratory care services.
53 (7) Permits for registered polysomnography technologists and
5
1 polysomnography technicians and temporary permits for polysomnography trainees
2 will be issued after payment of a fee in an amount to be fixed by the board
3 and such permits shall be issued for a period of not less than one (1) year
4 nor more than five (5) years, the exact period to be fixed by the board. Such
5 permits and temporary permits shall be renewed on their expiration upon com-
6 pletion of a renewal application and upon payment of a renewal fee, the amount
7 of which is to be fixed by the board. Permits, including renewals, for
8 polysomnography technicians shall be limited to a total period of four (4)
9 years. Temporary permits, including renewals, for polysomnography trainees
10 shall be limited to a total period of two (2) years.
11 (8) Persons practicing or performing respiratory care services as a reg-
12 istered polysomnography technologist, polysomnography technician or
13 polysomnography trainee shall do so only under the general supervision of a
14 medical director or supervising physician and the written procedures and
15 protocols of the associated sleep disorder center or laboratory.
16 (9) The provisions of this chapter governing procedures for issuance,
17 renewal, suspension and revocation of licenses, payment and assessment of fees
18 and governing misrepresentation, penalties and severability and other adminis-
19 trative procedures shall apply equally to permits for the practice of
20 polysomnography related respiratory care services as to licenses for the prac-
21 tice of respiratory care.
22 SECTION 3. That Section 54-4313, Idaho Code, be, and the same is hereby
23 amended to read as follows:
24 54-4313. LICENSURE BOARD. (1) The licensure board shall consist of five
25 (5) members appointed by the board, three two (32) of whom shall be certified
26 respiratory care practitioners, one (1) of whom shall be a registered
27 polysomnography technologist, and all of whom shall be residents of Idaho at
28 the time of their appointment and for their term of service. The persons
29 appointed to the licensure board who are required to be licensed under this
30 chapter shall have been engaged in rendering respiratory care services and
31 polysomnography services, respectively, to the public, in teaching, or in
32 research in respiratory care and polysomnography, respectively, for at least
33 five (5) years immediately preceding their appointments. These members shall
34 at all times be holders of valid licenses for the practice of respiratory care
35 or a holder of a valid permit as a registered polysomnography technologist in
36 Idaho, except for the members of the first board, all of whom shall, at the
37 time of appointment, hold the designation of certified respiratory therapy
38 technician or registered respiratory therapist conferred by the national board
39 for respiratory care, inc. and all of whom meet the requirements for licensure
40 under the provisions of this chapter. The remaining two (2) members of the
41 licensure board shall be members of health professions or members of the pub-
42 lic with an interest in the rights of the consumers of health services.
43 (2) The board, within sixty (60) days following the effective date of
44 this chapter, shall appoint two (2) licensure board members for a term of one
45 (1) year; two (2) for a term of two (2) years; and one (1) for a term of three
46 (3) years. Appointments made thereafter shall be for three (3) year terms, but
47 no person shall be appointed to serve more than two (2) consecutive terms.
48 Terms shall begin on the first day of the calendar year and end on the last
49 day of the calendar year or until successors are appointed, except for the
50 first appointed members who shall serve through the last calendar day of the
51 year in which they are appointed, before commencing the terms prescribed in
52 this section.
53 (3) The licensure board shall within sixty (60) days after the effective
6
1 date of this chapter, and annually thereafter, hold a meeting and elect a
2 chairman who shall preside at meetings of the licensure board. In the event
3 the chairman is not present at any licensure board meeting, the licensure
4 board may by majority vote of the members present appoint a temporary chair-
5 man. A majority of the members of the licensure board shall constitute a quo-
6 rum. Other meetings may be convened at the call of the chairman or the written
7 request of any two (2) licensure board members.
8 (4) Each member of the licensure board shall be compensated as provided
9 in section 59-509(h), Idaho Code.
10 SECTION 4. The first vacancy on the licensure board created pursuant to
11 section 54-4313, Idaho Code, which occurs following the passage of this act
12 shall be filled by the appointment of a registered polysomnography technolo-
13 gist or an individual qualified to hold such designation who obtains such des-
14 ignation when the rules to provide the designation have been adopted.
15 SECTION 5. This act shall be in full force and effect on and after Janu-
16 ary 1, 2004; provided, however, an emergency existing therefor, which emer-
17 gency is hereby declared to exist, the licensure board is directed and autho-
18 rized to commence rulemaking proceedings following the passage and approval of
19 this act for the implementation of this act and the issuance of permits here-
20 under as of January 1, 2004.
STATEMENT OF PURPOSE
RS 12752
The Idaho State Board of Medicine has suggested that some
sleep disorder clinic or laboratory personnel (polysomnographers)
have been practicing respiratory therapy without a license. The
purpose of this legislation is to provide for the issuance of
limited permits to some polysomnographers allowing them to
continue to perform their limited scope of duties in the field of
respiratory therapy without becoming licensed as full fledged
respiratory therapists. The legislation provides qualifications
for permits, including educational requirements, and places
polysomnographers under the direction of the respiratory therapy
licensure board, a board under the direction of the Idaho State
Board of Medicine.
FISCAL IMPACT
This bill will have no impact on the General Fund.
Contact: Molly Creswell
Agency: Givens Pursley LLP
Phone: 388 1200
STATEMENT OF PURPOSE/FISCAL NOTE S 1077