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S1165......................................................by STATE AFFAIRS POLYSOMNOGRAPHY - Amends and adds to existing law to define terms; to require a license or permit for the practice of polysomnography related respiratory care; to set forth qualifications; to provide permits; to provide continuing education; to provide for a conditional permit; and to revise provisions relating to membership of the licensure board. 03/13 Senate intro - 1st rdg - to printing 03/14 Rpt prt - to Health/Wel 03/21 Rpt out - rec d/p - to 2nd rdg 03/24 2nd rdg - to 3rd rdg 03/25 3rd rdg - PASSED - 35-0-0 AYES -- Andreason, Bailey, Brandt, Bunderson, Burkett, Burtenshaw, Calabretta, Cameron, Compton, Darrington, Davis, Gannon, Geddes, Goedde, Hill, Ingram, Kennedy, Keough, Little, Lodge, Malepeai, Marley, McKenzie, McWilliams, Noble, Noh, Pearce, Richardson, Schroeder, Sorensen, Stegner, Stennett, Sweet, Werk, Williams NAYS -- None Absent and excused -- None Floor Sponsor - Brandt Title apvd - to House 03/26 House intro - 1st rdg - to Health/Wel 03/31 Rpt out - rec d/p - to 2nd rdg 04/01 2nd rdg - to 3rd rdg 04/02 3rd rdg - PASSED - 65-2-3 AYES -- Andersen, Barraclough, Barrett, Bauer, Bedke, Bell, Bieter, Black, Block, Boe, Bolz, Bradford, Campbell, Cannon, Clark, Collins, Cuddy, Deal, Denney, Douglas, Eberle, Edmunson, Ellsworth, Eskridge, Field(18), Field(23), Gagner, Garrett, Harwood, Henbest, Jaquet, Jones, Kellogg, Lake, Langford, Langhorst, Martinez, McGeachin, Meyer, Miller, Mitchell, Moyle, Naccarato, Nielsen, Raybould, Ridinger, Ring, Ringo, Roberts, Robison, Rydalch, Sali, Sayler, Schaefer, Shepherd, Shirley, Skippen, Smith(30), Smith(24), Smylie, Snodgrass, Tilman, Wills, Wood, Mr. Speaker NAYS -- Kulczyk, McKague Absent and excused -- Crow, Stevenson, Trail Floor Sponsor - Sali Title apvd - to Senate 04/03 To enrol 04/04 Rpt enrol - Pres signed 04/07 Sp signed - To Governor 04/08 Governor signed Session Law Chapter 254 Effective: 07/01/03
|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-seventh Legislature First Regular Session - 2003IN THE SENATE SENATE BILL NO. 1165 BY STATE AFFAIRS COMMITTEE 1 AN ACT 2 RELATING TO THE PRACTICE OF RESPIRATORY THERAPY; AMENDING SECTION 54-4303, 3 IDAHO CODE, TO REVISE A DEFINITION, TO DEFINE TERMS AND TO MAKE TECHNICAL 4 CORRECTIONS; AMENDING CHAPTER 43, TITLE 54, IDAHO CODE, BY THE ADDITION OF 5 A NEW SECTION 54-4304A, IDAHO CODE, TO REQUIRE A LICENSE OR PERMIT FOR THE 6 PRACTICE OF POLYSOMNOGRAPHY RELATED RESPIRATORY CARE, TO SET FORTH QUALI- 7 FICATIONS, TO PROVIDE FOR PERMITS, TO PROVIDE FOR CONTINUING EDUCATION, TO 8 PROVIDE FOR APPLICATION OF CERTAIN PROVISIONS AND TO PROVIDE FOR A CONDI- 9 TIONAL PERMIT; AND AMENDING SECTION 54-4313, IDAHO CODE, TO REVISE PROVI- 10 SIONS RELATING TO MEMBERSHIP OF THE LICENSURE BOARD; AND TO PROVIDE FOR 11 THE FILLING OF BOARD VACANCIES FOLLOWING PASSAGE OF THE ACT. 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, permit or a 19 temporary 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) "Licensed physician" means a physician licensed by the board. 37 (8) "Licensure" means the issuance of a license to an applicant under the 38 provisions of this chapter entitling such person to hold himself out as a 39 respiratory care practitioner and entitling him to practice or perform respi- 40 ratory care in the state. 41 (89) "Licensure board" means the licensure board established by this 42 chapter to accept applications under this chapter, to make recommendations and 43 consult with the board and to perform such other duties as may be required or 2 1 authorized in this chapter or by the board. 2 (910) "National board for respiratory care, inc." means the nationally 3 recognized private testing, examining and credentialing body for the respira- 4 tory care profession. 5 (101) "Performance of respiratory care" means respiratory care practiced 6 or performed in accordance with the written, telephonic or verbal prescription 7 of a licensed physician and includes, but is not limited to, the diagnostic 8 and therapeutic use of the following: administration of medical gases, (except 9 for the purpose of anesthesia), aerosols and humidification; environmental 10 control mechanisms and hyperbaric therapy; pharmacologic agents related to 11 respiratory care protocols; mechanical or physiological ventilatory support; 12 bronchopulmonary hygiene; cardiopulmonary resuscitation; maintenance of the 13 natural airway; insertion and maintenance of artificial airways; specific 14 diagnostic and testing techniques employed in the medical management of 15 patients to assist in diagnosis, monitoring, treatment and research of pulmo- 16 nary abnormalities, including measurements of ventilatory volumes, pressures 17 and flows, collection, reporting and analysis of specimens of blood and blood 18 gases, arterial punctures, insertion and maintenance of arterial lines, 19 expired and inspired gas samples, respiratory secretions, and pulmonary func- 20 tion testing; and hemodynamic and other related physiologic measurements of 21 the cardiopulmonary system; observation and monitoring of signs and symptoms, 22 general behavior, general physical response to respiratory care treatment and 23 diagnostic testing and determination of whether such signs, symptoms, reac- 24 tions, behavior or general response exhibit abnormal characteristics; imple- 25 mentation based on observed abnormalities of appropriate reporting or referral 26 of respiratory care or changes in treatment regimen, pursuant to a prescrip- 27 tion by a physician or the initiation of emergency procedures. 28 (112) "Person" means an individual. 29 (123) "Polysomnography" means the process of analysis, attended monitoring 30 and recording of physiologic data during sleep and wakefulness to assist in 31 the assessment and diagnosis of sleep/wake disorders and other disorders, 32 syndromes and dysfunctions that either are sleep related, manifest during 33 sleep or disrupt normal sleep/wake cycles and activities. 34 (14) "Polysomnography related respiratory care services" means the limited 35 practice of respiratory care in the provision of polysomnography services, 36 under the supervision of an Idaho licensed physician, by a person at a sleep 37 disorder center or laboratory who holds a permit issued by the board as a reg- 38 istered polysomnographic technologist, polysomnographic technician or a 39 polysomnographic trainee, or who is otherwise licensed as a respiratory care 40 practitioner or who is exempt from licensure or permitting pursuant to section 41 54-4308, Idaho Code. Polysomnography related respiratory care services include 42 therapeutic and diagnostic use of oxygen, noninvasive ventilatory assistance 43 of spontaneously breathing patients and cardiopulmonary resuscitation and 44 maintenance of nasal and oral airways that do not extend into the trachea, as 45 ordered by an Idaho licensed physician or by written procedures and protocols 46 of the associated sleep disorder center or laboratory as approved by an Idaho 47 licensed physician and which do not violate a rule adopted by the board. This 48 chapter does not in any way authorize the practice of medicine or any of its 49 branches by any person not so licensed by the board. Further, licensed respi- 50 ratory practitioners, and those exempt from licensure pursuant to section 51 54-4308, Idaho Code, are not limited in their scope of practice of provision 52 of respiratory care which they may provide, including in connection with the 53 provision of polysomnography services. 54 (15) "Polysomnographic technician" means a person who holds a permit as 55 set forth in section 54-4304A, Idaho Code, and who performs polysomnography 3 1 related respiratory care services under the supervision of an Idaho permitted 2 registered polysomnographic technologist, licensed respiratory care practitio- 3 ner or an Idaho licensed physician. 4 (16) "Polysomnographic trainee" means a person who holds a temporary per- 5 mit as set forth in section 54-4304A, Idaho Code, and who performs 6 polysomnography related respiratory care services under the direct supervision 7 of an Idaho licensed respiratory care practitioner, or a person exempt from 8 such licensure pursuant to section 54-4308, Idaho Code, an Idaho permitted 9 registered polysomnographic technologist, an Idaho permitted polysomnographic 10 technician or an Idaho licensed physician. Direct supervision by an Idaho 11 licensed respiratory care practitioner, or such person exempt from such licen- 12 sure pursuant to section 54-4308, Idaho Code, or an Idaho permitted registered 13 polysomnographic technologist or technician, or an Idaho licensed physician, 14 means that such a person shall be on the premises where such polysomnographic 15 related respiratory care services are provided and shall be immediately avail- 16 able for consultation with the polysomnographic trainee. 17 (17) "Practice of respiratory care" means, but shall not be limited to, 18 the provision of respiratory and inhalation therapy which shall include, but 19 not be limited to: therapeutic and diagnostic use of medical gases, humidity 20 and aerosols including the maintenance of associated apparatus; administration 21 of drugs and medications to the cardiorespiratory system; provision of 22 ventilatory assistance and ventilatory control; postural drainage, percussion, 23 breathing exercises and other respiratory rehabilitation procedures; cardio- 24 pulmonary resuscitation and maintenance of natural airways, the insertion and 25 maintenance of artificial airways; and the transcription and implementation of 26 a physician's written, telephonic or verbal orders pertaining to the practice 27 of respiratory care. It also includes testing techniques employed in respira- 28 tory care to assist in diagnosis, monitoring, treatment and research. This 29 shall be understood to include, but not be limited to, measurement of 30 ventilatory volumes, pressures and flows, specimen collection of blood and 31 other materials, pulmonary function testing and hemodynamic and other related 32 physiological monitoring of the cardiopulmonary system. The practice of respi- 33 ratory care is not limited to the hospital setting but shall be performed 34 under the general supervision of a licensed physician. 35 (18) "Registered polysomnographic technologist" means a person who holds a 36 permit as set forth in section 54-4304A, Idaho Code, and who works under the 37 supervision of an Idaho licensed physician to provide polysomnography related 38 respiratory care services. 39 (139) "Respiratory care" means the allied health profession responsible 40 for the treatment, management, diagnostic testing, control and care of 41 patients with deficiencies and abnormalities associated with the cardiopulmo- 42 nary system, under the general supervision of a licensed physician. 43 (1420) "Respiratory care practitioner" means a person who has been issued 44 a license by the board under the provisions of this chapter. 45 (1521) "Respiratory care protocols" means policies, procedures or 46 protocols developed or instituted by health care facilities or institutions, 47 through collaboration when appropriate or necessary with administrators, phy- 48 sicians, registered nurses, physical therapists, respiratory care practitio- 49 ners and other licensed, certified or registered health care practitioners. 50 (1622) "Registered pulmonary function technologist" (RPFT) means the pro- 51 fessional designation earned by a person who has successfully completed the 52 advanced pulmonary function certification examination administered by the 53 national board for respiratory care, inc. 54 (1723) "Registered respiratory therapist" (RRT) means the professional 55 designation earned by a person who has successfully completed the written reg- 4 1 istry and clinical simulation examinations administered by the national board 2 for respiratory care, inc. 3 (1824) "Respiratory therapist" means a person who practices or provides 4 respiratory care. 5 (1925) "Respiratory therapy" means the practice or performance of respira- 6 tory care as defined in this chapter including, but not limited to, inhalation 7 therapy. 8 (26) "Sleep disorder center or laboratory" means a facility for sleep 9 related disorders that provides polysomnography and is under the supervision 10 of an Idaho licensed physician or medical director licensed by the board who 11 is responsible for patient care provided in such center or laboratory. A sleep 12 disorder center or laboratory which provides polysomnography related respira- 13 tory care to patients shall have an Idaho licensed respiratory care practitio- 14 ner, an Idaho permitted registered polysomnographic technologist, an Idaho 15 permitted polysomnographic technician, or a person exempt from licensure or 16 permitting pursuant to section 54-4308, Idaho Code, in constant attendance. 17 (207) "Written registry and clinical simulation examinations" means the 18 certification examinations administered by the national board for respiratory 19 care, inc., the successful completion of which entitles a person the profes- 20 sional designation of "registered respiratory therapist" (RRT). 21 SECTION 2. That Chapter 43, Title 54, Idaho Code, be, and the same is 22 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 23 ignated as Section 54-4304A, Idaho Code, and to read as follows: 24 54-4304A. POLYSOMNOGRAPHY RELATED RESPIRATORY CARE. (1) Only persons who 25 are licensed as respiratory care practitioners or who are exempt from licen- 26 sure pursuant to section 54-4308, Idaho Code, or who hold a permit issued by 27 the board as registered polysomnographic technologists, polysomnographic tech- 28 nicians or polysomnographic trainees may provide polysomnography related 29 respiratory care services. 30 (2) Qualification for permit. An applicant for a permit to provide 31 polysomnography related respiratory care services as a registered 32 polysomnographic technologist or polysomnographic technician or for a tempo- 33 rary permit as a polysomnographic trainee under the provisions of this section 34 who is not otherwise licensed to provide respiratory care services or exempt 35 from the requirements of this chapter pursuant to section 54-4308, Idaho Code, 36 must: 37 (a) Submit an application to the licensure board on forms prescribed by 38 the board and in accordance with the rules adopted by the board pay the 39 permit fee required under this chapter; 40 (b) Be, on or before the date of issuance of the permit, eighteen (18) 41 years of age or older; 42 (c) Not have been convicted of an offense or disciplined by a licensing 43 body in a manner that bears, in the judgment of the board, a demonstrable 44 relationship to the provision of polysomnography related respiratory care 45 services; 46 (d) Be a high school graduate or have passed a general educational devel- 47 opment (GED) examination and earned a GED certificate; and 48 (e) Be currently certified in cardiopulmonary resuscitation (CPR). 49 (3) Registered polysomnographic technologist. An applicant must possess 50 the following qualifications: successful completion of the certification exam- 51 ination as a registered polysomnographic technologist administered by the 52 board of registered polysomnographic technologists (BRPT) or an equivalent 53 examination, approved by the board as recommended by the licensure board, and 5 1 any additional reasonable minimal requirements as may be adopted by rule of 2 the board. 3 (4) Polysomnographic technician. An applicant must possess the following 4 qualifications: 5 (a) Successful completion of a polysomnography program of not less than 6 one (1) year duration, associated with a state licensed or a nationally 7 accredited educational facility; or 8 (b) Successful completion of a minimum of seven hundred twenty (720) 9 hours of experience as a polysomnographic trainee with documented profi- 10 ciency in polysomnography related respiratory care services, as approved 11 by the board, as recommended by the licensure board and adopted by board 12 rule. 13 (5) Polysomnographic trainee. An applicant must provide written documen- 14 tation that an Idaho permitted registered polysomnographic technologist, an 15 Idaho permitted polysomnographic technician, an Idaho licensed respiratory 16 care provider, or an Idaho licensed physician will directly supervise the 17 applicant's performance of basic polysomnography related respiratory care ser- 18 vices and provide documentation of at least one (1) of the following: 19 (a) That the applicant has at least seven hundred twenty (720) hours of 20 experience as a paid employee or contractor in a health care related 21 field; 22 (b) That the applicant is currently enrolled in a polysomnography program 23 associated with a state licensed or a nationally accredited education 24 facility; or 25 (c) That the applicant has successfully completed twenty-four (24) semes- 26 ter credit hours (or a quarter hour system equivalent of the same) of 27 postsecondary education at a state licensed or nationally accredited 28 facility. 29 (6) Permits. 30 (a) Permits for registered polysomnographic technologists and permits for 31 polysomnographic technicians shall be issued after applicants have met the 32 requirements of this chapter and submitted an application and payment of a 33 fee in an amount to be fixed by the board. Permits, including renewals, 34 for registered polysomnographic technologists shall be issued for a 35 period of not less than one (1) year nor more than five (5) years, the 36 exact period to be fixed by the board. Permits, including renewals, for 37 polysomnographic technicians shall be issued for a period of one (1) year, 38 and shall be renewed for successive one (1) year periods, not to exceed 39 three (3) renewals for a total period of four (4) years. Such permits 40 shall be renewed on their expiration date upon completion of a renewal 41 application and upon payment of a renewal fee in an amount to be fixed by 42 the board. 43 (b) Temporary permits for polysomnographic trainees shall be issued after 44 applicants have met the requirements of this chapter and submitted an 45 application and payment of a fee in an amount to be fixed by the board. 46 Such permits shall be issued for a period of not more than one (1) year, 47 the exact period to be fixed by the board. Such permits may be renewed on 48 their expiration date upon completion of a renewal application and upon 49 payment of a renewal fee in an amount to be fixed by the board, for a 50 period of one (1) year, with renewal limited to one (1) such renewal, pro- 51 vided however, such permits for polysomnographic trainees shall be limited 52 to a total period of two (2) years. 53 (c) Each individual applicant for renewal of an active permit shall, on 54 or before the expiration date of the permit, submit satisfactory proof to 55 the licensure board of successful completion of not less than twelve (12) 6 1 hours of approved continuing education per year in addition to any other 2 requirements for renewal as adopted by board rule. The board, as recom- 3 mended by the licensure board, may substitute all or a portion of the 4 coursework required in this section when a permittee shows evidence of 5 passing an approved challenge exam or of completing equivalent education 6 as determined by the board, as recommended by the licensure board, to be 7 in full compliance with the education requirements of this section. 8 (7) The provisions of this chapter governing procedures for suspension 9 and revocation of licenses, payment and assessment of fees and governing mis- 10 representation, penalties and severability and other administrative procedures 11 shall apply equally to permits for the practice of polysomnography related 12 respiratory care services as to licenses for the practice of respiratory care. 13 (8) Conditional permit. Any individual who desires to provide 14 polysomnography related respiratory care services as described in this chapter 15 and who meets the requirements of subsection (2) of this section, as well as 16 the necessary requirements as outlined below, may make application for a con- 17 ditional permit as follows: 18 (a) An applicant for a conditional polysomnographic technologist permit 19 must provide evidence satisfactory to the board of the successful comple- 20 tion of the certification examination as a registered polysomnographic 21 technologist administered by the board of registered polysomnographic 22 technologists (BRPT) or an equivalent examination, approved by the board, 23 as recommended by the licensure board. 24 (b) An applicant for a conditional polysomnographic technician permit 25 must provide evidence satisfactory to the board of the successful comple- 26 tion of a minimum of seven hundred twenty (720) hours of experience pro- 27 viding polysomnography services as a paid employee or contractor. 28 (c) An applicant for a conditional polysomnographic trainee permit must 29 provide evidence satisfactory to the board of the successful completion of 30 a minimum of three hundred sixty (360) hours of experience providing 31 polysomnography services as a paid employee or contractor. 32 (d) Conditional permits referred shall be issued on or after January 1, 33 2004, and shall be issued until such time as the board may adopt rules as 34 may be required for the issuance of regular permits as provided in subsec- 35 tions (3) through (7) of this section. 36 SECTION 3. That Section 54-4313, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 54-4313. LICENSURE BOARD. (1) The licensure board shall consist of five 39 (5) members appointed by the board, three (3) of whom shall be certified 40 respiratory care practitioners, one (1) of whom, in addition to being a 41 licensed respiratory care practitioner, shall also be an Idaho permitted reg- 42 istered polysomnographic technologist, and all of whom shall be residents of 43 Idaho at the time of their appointment and for their term of service. The per- 44 sons appointed to the licensure board who are required to be licensed under 45 this chapter shall have been engaged in rendering respiratory care services 46 and polysomnography related respiratory care services, respectively, to the 47 public, in teaching, or in research in respiratory care and polysomnography 48 related respiratory care services, respectively, for at least five (5) years 49 immediately preceding their appointments. These members shall at all times be 50 holders of valid licenses for the practice of respiratory care in Idaho and 51 one (1) such member shall be a holder of a valid Idaho permit as a registered 52 polysomnographic technologist, except for the members of the first board, all 53 of whom shall, at the time of appointment, hold the designation of certified 7 1 respiratory therapy technician or registered respiratory therapist conferred 2 by the national board for respiratory care, inc. and all of whom meet the 3 requirements for licensure under the provisions of this chapter. The remaining 4 two (2) members of the licensure board shall be members of health professions 5 or members of the public with an interest in the rights of the consumers of 6 health services. 7 (2) The board, within sixty (60) days following the effective date of 8 this chapter, shall appoint two (2) licensure board members for a term of one 9 (1) year; two (2) for a term of two (2) years; and one (1) for a term of three 10 (3) years. Appointments made thereafter shall be for three (3) year terms, but 11 no person shall be appointed to serve more than two (2) consecutive terms. 12 Terms shall begin on the first day of the calendar year and end on the last 13 day of the calendar year or until successors are appointed, except for the 14 first appointed members who shall serve through the last calendar day of the 15 year in which they are appointed, before commencing the terms prescribed in 16 this section. 17 (3) The two (2) members of the licensure board who shall be licensed 18 respiratory care practitioners shall be selected by the board of medicine 19 after considering a list of three (3) qualified applicants for each such 20 vacancy submitted by the Idaho society of respiratory care or other interested 21 associations. The member of the licensure board who shall be a licensed respi- 22 ratory care practitioner and an Idaho permitted registered polysomnographic 23 technologist shall be selected by the board of medicine after considering a 24 list of three (3) qualified applicants submitted by the Idaho sleep disorder 25 association or other interested associations. The remaining two (2) public 26 members shall be selected by the board of medicine which may solicit nomina- 27 tions of qualified applicants submitted by the Idaho society for respiratory 28 care, the Idaho sleep disorder association or other interested associations or 29 individuals. 30 (4) The licensure board shall within sixty (60) days after the effective 31 date of this chapter, and annually thereafter, hold a meeting and elect a 32 chairman who shall preside at meetings of the licensure board. In the event 33 the chairman is not present at any licensure board meeting, the licensure 34 board may by majority vote of the members present appoint a temporary chair- 35 man. A majority of the members of the licensure board shall constitute a quo- 36 rum. Other meetings may be convened at the call of the chairman or the written 37 request of any two (2) licensure board members. 38 (45) Each member of the licensure board shall be compensated as provided 39 in section 59-509(h), Idaho Code. 40 SECTION 4. The first vacancy on the licensure board which occurs follow- 41 ing the passage of this act shall be filled by the appointment of a licensed 42 respiratory care practitioner who is also the holder of a valid Idaho permit 43 as a registered polysomnographic technologist when the rules to provide such 44 designation have been adopted by the board.
STATEMENT OF PURPOSE RS 13155 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 Givens Pursley LLP 388-1200 STATEMENT OF PURPOSE/FISCAL NOTE S 116