BILL NUMBER: SB 525 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 16, 2015
AMENDED IN SENATE APRIL 6, 2015
INTRODUCED BY Senator Nielsen
FEBRUARY 26, 2015
An act to amend Sections 3701 , 3702, and 3702.7 of the
Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 525, as amended, Nielsen. Respiratory care practice.
Existing law, the Respiratory Care Practice Act, provides for the
licensure and regulation of the practice of respiratory therapy
by the Respiratory Care Board of California . A violation of
the act is a crime.
Existing law declares it is the intent of the Legislature to
recognize the existence of overlapping functions between physicians
and surgeons, registered nurses, physical therapists, respiratory
care practitioners, and other licensed health care personnel, and to
permit additional sharing of functions within organized health care
systems, as specified. Existing law also states that nothing in the
act shall be construed to authorize a respiratory care practitioner
to practice medicine, surgery, or any other form of healing, except
as authorized by the act.
This bill would define , for intent purposes,
would define "overlapping functions" to include providing
therapy, management, rehabilitation, diagnostic evaluation, and care
for nonrespiratory-related diagnoses or conditions provided certain
requirements are met.
Under existing law, respiratory care as a practice means a health
care profession employed under the supervision of a medical director
in the therapy, management, rehabilitation, diagnostic evaluation,
and care of patients with deficiencies and abnormalities which affect
the pulmonary system and associated aspects of cardiopulmonary and
other systems functions, and includes, among other things, direct and
indirect pulmonary care services that are safe, aseptic, preventive,
and restorative to the patient. Existing law provides for the
registration and regulation of certified polysomnographic
technologists by the Medical Board of California. Under existing law
governing polysomnographic technologists, the practice of
polysomnography is defined to include the treatment, management,
diagnostic testing, control, education, and care of patients with
sleep and wake disorders. Existing law governing polysomnographic
technologists exempts from those provisions, among others,
respiratory care practitioners working within the scope of practice
of their license.
This bill would provide that associated aspects of cardiopulmonary
and other systems functions includes patients with deficiencies and
abnormalities affecting the heart and cardiovascular system. The bill
would further define the respiratory care practice to include, among
other things, the administration of medical gases and
pharmacological agents for the purpose of inducing conscious or deep
sedation under specified supervision and direct orders, all forms of
specified life support, and the treatment, management, diagnostic
testing, control, education, and care of patients with sleep and wake
disorders. By changing the definition of a crime, the bill would
impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 3701 of the Business and Professions Code is
amended to read:
3701. (a) The Legislature finds and declares that the practice of
respiratory care in California affects the public health, safety,
and welfare and is to be subject to regulation and control in the
public interest to protect the public from the unauthorized and
unqualified practice of respiratory care and from unprofessional
conduct by persons licensed to practice respiratory care. The
Legislature also recognizes the practice of respiratory care to be a
dynamic and changing art and science, the practice of which is
continually evolving to include newer ideas and more sophisticated
techniques in patient care.
(b) It is the intent of the Legislature in this chapter to
provide clear legal authority for functions and procedures which have
common acceptance and usage. It is the intent also to recognize the
existence of overlapping functions between physicians and surgeons,
registered nurses, physical therapists, respiratory care
practitioners, and other licensed health care personnel, and to
permit additional sharing of functions within organized health care
systems. The organized health care systems include, but are not
limited to, health facilities licensed pursuant to Chapter 2
(commencing with Section 1250) of Division 2 of the Health and Safety
Code, clinics, home health agencies, physicians' offices, and public
or community health services.
(c) For purposes of this section, it is the intent of the
Legislature that "overlapping functions" includes, but is not limited
to, providing therapy, management, rehabilitation, diagnostic
evaluation, and care for nonrespiratory-related diagnoses or
conditions provided (1) a health care facility has authorized the
respiratory care practitioner to provide these services and (2) the
respiratory care practitioner has maintained current competencies in
the services provided, as needed.
SEC. 2. Section 3702 of the Business
and Professions Code is amended to read:
3702. (a) Respiratory care as a practice
means a health care profession employed under the supervision of a
medical director in the therapy, management, rehabilitation,
diagnostic evaluation, and care of patients with deficiencies and
abnormalities which affect the pulmonary system and associated
aspects of cardiopulmonary and other systems functions, and includes
all of the following:
(a)
(1) Direct and indirect pulmonary care services that
are safe, aseptic, preventive, and restorative to the patient.
(b)
(2) Direct and indirect respiratory care services,
including, but not limited to, the administration of pharmacological
and diagnostic and therapeutic agents related to respiratory care
procedures necessary to implement a treatment, disease prevention,
pulmonary rehabilitative, or diagnostic regimen prescribed by a
physician and surgeon.
(c)
(3) Observation and monitoring of signs and symptoms,
general behavior, general physical response to respiratory care
treatment and diagnostic testing and (1) (A)
determination of whether such signs, symptoms, reactions,
behavior, or general response exhibits abnormal characteristics;
(2) (B) implementation based on
observed abnormalities of appropriate reporting or referral or
respiratory care protocols, or changes in treatment regimen, pursuant
to a prescription by a physician and surgeon or the initiation of
emergency procedures.
(d)
(4) The diagnostic and therapeutic use of any of the
following, in accordance with the prescription of a physician and
surgeon: administration of medical gases, exclusive of general
anesthesia; aerosols; humidification; environmental control systems
and baromedical therapy; pharmacologic agents related to respiratory
care procedures; mechanical or physiological ventilatory support;
bronchopulmonary hygiene; cardiopulmonary resuscitation; maintenance
of the natural airways; insertion without cutting tissues and
maintenance of artificial airways; diagnostic and testing techniques
required for implementation of respiratory care protocols; collection
of specimens of blood; collection of specimens from the respiratory
tract; analysis of blood gases and respiratory secretions.
(e)
(5) The transcription and implementation of the written
and verbal orders of a physician and surgeon pertaining to the
practice of respiratory care.
(b) As used in this section, the following apply:
(1) "Associated aspects of cardiopulmonary and other systems
functions" includes patients with deficiencies and abnormalities
affecting the heart and cardiovascular system.
(2) "Respiratory care protocols" as
used in this section means policies and protocols
developed by a licensed health facility through collaboration, when
appropriate, with administrators, physicians and surgeons, registered
nurses, physical therapists, respiratory care practitioners, and
other licensed health care practitioners.
SEC. 2. SEC. 3. Section 3702.7 of
the Business and Professions Code is amended to read:
3702.7. The respiratory care practice is further defined and
includes, but is not limited to, the following:
(a) Mechanical or physiological ventilatory support as used in
paragraph (4) of subdivision (d)
(a) of Section 3702 includes, but is not limited to, any
system, procedure, machine, catheter, equipment, or other device used
in whole or in part, to provide ventilatory or oxygenating support.
(b) Administration of medical gases and pharmacological agents for
the purpose of inducing conscious or deep sedation under physician
and surgeon supervision and the direct orders of the physician and
surgeon performing the procedure.
(c) All forms of extracorporeal life support, including, but not
limited to, extracorporeal membrane oxygenation (ECMO) and
extracorporeal carbon dioxide removal (ECCO2R).
(d) Educating students, health care professionals, or consumers
about respiratory care, including, but not limited to, education of
respiratory core courses or clinical instruction provided as part of
a respiratory educational program and educating health care
professionals or consumers about the operation or application of
respiratory care equipment and appliances.
(e) "Associated aspects of cardiopulmonary and other systems
functions," as used in Section 3702, includes patients with
deficiencies and abnormalities affecting the heart and cardiovascular
system.
(f)
(e) The treatment, management, diagnostic testing,
control, education, and care of patients with sleep and wake
disorders as provided in Chapter 7.8 (commencing with Section 3575).
SEC. 3. SEC. 4. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.