BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                       CONSENT


          Bill No:  AB 1972
          Author:   Jones (R)
          Amended:  3/28/14 in Assembly
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  9-0, 6/16/14
          AYES:  Lieu, Wyland, Berryhill, Block, Corbett, Galgiani,  
            Hernandez, Hill, Torres

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  73-0, 5/8/14 (Consent) - See last page for vote


           SUBJECT  :    Respiratory care practitioners

           SOURCE  :     California Society for Respiratory Care
                      Respiratory Care Board


           DIGEST  :    This bill requires an applicant for licensure as a  
          respiratory care practitioner (RCP) to pass the national  
          registered respiratory therapist examination (RRT), unless the  
          applicant provides evidence that he/she passed the national  
          certified respiratory therapist examination (CRT) prior to  
          January 1, 2015, and there is no evidence of discipline against  
          the practitioner; and authorizes the Respiratory Care Board  
          (RCB) to extend the dates an applicant may perform as an RCP  
          applicant for up to six months under specified circumstances.

           ANALYSIS  :    

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                                                                    AB 1972
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          2

          Existing law:

          1. Establishes the Respiratory Care Practice Act (Act), which is  
             enforced by RCB, to license and regulate the practice of  
             RCPs.  


          2. Prohibits an applicant from receiving a license without first  
             successfully passing the national respiratory therapist  
             examination in the manner and under the rules and regulations  
             as prescribed by RCB.  

          3. Provides that the requirements to pass the written  
             examination shall not apply to an applicant who, at the time  
             of his/her application, has passed, to the satisfaction of  
             RCB, an examination that is, in the opinion of RCB,  
             equivalent to the examination given in this state.  

          4. Authorizes every person who has filed an application for  
             licensure with RCB to perform as an RCP applicant under the  
             direct supervision of an RCP licensed in this state, between  
             the dates specified by RCB, if he/she has met education  
             requirements for licensure as may be certified by his/her  
             respiratory care program, and, if ever attempted, has passed  
             the CRT examination.  

          5. Ceases all privileges to practice as an RCP applicant on the  
             date specified by RCB if for any reason the license is not  
             issued or the applicant fails the CRT examination.  

          6. Prohibits an applicant for an RCP license from performing as  
             an RCP applicant if cause exists to deny the license.  

          7. Requires, except as specified, all applicants for licensure  
             to have completed an education program for respiratory care  
             that is accredited by the Commission on Accreditation for  
             Respiratory Care or its successor and been awarded a minimum  
             of an associate degree.  

          8. Deems as equivalent to the required education an applicant's  
             enrollment in a baccalaureate degree program, as specified,  
             and completion of science, general academic and respiratory  
             therapy coursework commensurate with the requirements of an  
             associate degree for respiratory care.

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                                                                    AB 1972
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          3


          9. Authorizes RCB to waive its educational requirements if  
             evidence is presented and RCB deems it as meeting the current  
             educational requirements that will ensure the safe and  
             competent practice of respiratory care.




          This bill:

          1. Specifies that any person applying for licensure who provides  
             evidence that he/she passed the CRT examination, prior to  
             January 1, 2015, shall not be required to pass the RRT  
             examination.

          2. Specifies that there must be no evidence of prior license or  
             job-related discipline as determined by RCB. 

          3. Authorizes RCB to extend the dates an applicant may perform  
             as an RCP applicant for up to six months under the following  
             circumstances:

             A.    When the applicant is unable to complete the  
                application for licensure process to due to causes  
                outside his/her control; or 

             B.    When the applicant provides evidence that he/she has  
                successfully passed the CRT examination and has  
                otherwise completed the application for licensure  
                process and has not previously been authorized to  
                practice as an RCP.

          4. Specifies that authorization to practice as an RCP applicant  
             shall not exceed six months from the date of graduation or  
             the date the application was filed, whichever is later.

          5. Authorizes RCB to deny, rescind the privilege to work as an  
             RCP applicant for any reason, including, but not limited to,  
             failure to pass the RRT examination or if cause exists to  
             deny the license. 

           Background  


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                                                                    AB 1972
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           RCPs  .  According to information received from the Association  
          for Respiratory Care, there are over 150,000 RCPs in the U.S.   
          The first RCP license in California was issued in 1985, and  
          nearly 10,000 applicants were licensed through a grandfather  
          provision in that same year.  To date, over 35,000 RCP licenses  
          have been issued in California.  

          RCPs treat patients with chronic lung problems such as asthma,  
          bronchitis and emphysema.  They also treat accident victims,  
          premature infants, patients who have had heart attacks, cystic  
          fibrosis, lung cancer and AIDS.  Patients typically receive  
          treatment from an RCP under the supervision of a physician.  

          Most RCPs work in hospitals where they perform intensive care,  
          critical care and neonatal procedures.  They are a vital part of  
          a hospital's lifesaving response team which handles patient  
          emergencies.  Of more than 7,000 hospitals in the U.S.,  
          approximately 5,700 have respiratory care departments.  

           National Board of Respiratory Care (NBRC) Examinations  .  Since  
          1985, RCB has required the passage of the NBRC CRT examination.   
          The examination was designed to objectively measure the  
          knowledge, skills and abilities required of entry-level  
          practitioners.  The NBRC's RRT examination was developed to  
          objectively measure the knowledge, skills and abilities of  
          advanced-level practitioners.  

          Each exam has slightly different admission requirements.  For  
          example, for the CRT, the applicant must graduate from an  
          entry-level educational program, and for the RRT, the applicant  
          must graduate from an advanced-level educational program.   
          However, the entry-level educational programs were phased out in  
          December 2012; thus, all current graduates meet the minimum  
          admission requirements for the RRT examination.  Additionally,  
          accreditation of education programs is based upon the RRT  
          passage rate.  As such, numerous states are moving towards  
          adopting the RRT as a pre-requisite for licensure. 

           Comments  

          According to the author, "This bill is necessary because  
          advancements in technology and accreditation standards coupled  
          with the restructuring of nationally recognized exams (effective  
          1/1/15) will make the current requirement to pass the CRT exam  

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                                                                    AB 1972
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          5

          for licensure as a Respiratory Care Practitioner inadequate,  
          outdated and insufficient in meeting the Respiratory Care  
          Board's consumer protection mandate or the needs of the  
          healthcare industry.  Over the last ten years, there have been  
          legislative amendments and modifications in accreditation and  
          credentialing requirements to such a point that all current  
          graduates of respiratory care educational programs qualify to  
          take the NBRC's Registered Respiratory Therapist Exam." 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  6/30/14)

          California Society for Respiratory Care (co-source)
          Respiratory Care Board (co-source)
          California Hospital Association
          Kaiser Permanente

           ARGUMENTS IN SUPPORT  :    One of the bill's sponsors, the  
          California Society for Respiratory Care, writes, "All current  
          graduates from Respiratory Care Practitioner accredited  
          educational programs meet the minimum admission requirements to  
          take the RRT exam as this is the direction the industry is  
          headed.  Employers now seek RCP's who have passed the RRT exam  
          rather than the CRT exam?Changes made by the national exam  
          provider and oversight accreditation agency make it necessary to  
          remove the obsolete exam requirement."

          The California Hospital Association writes, "AB 1972 will  
          combine the entry level exam and the higher level exam into one  
          exam and 'grandfather' currently licensed Respiratory Care  
          Practitioners by holding the affected date at January 2015.   
          This opportunity will increase the safe and practical utility of  
          California Respiratory Care Practitioners for California  
          consumers without negatively affecting those currently in  
          practice."

           ASSEMBLY FLOOR  :  73-0, 5/8/14
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Donnelly, Fong, Fox,  
            Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,  

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                                                                    AB 1972
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          6

            Grove, Hagman, Harkey, Roger Hern�ndez, Holden, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,  
            Medina, Melendez, Mullin, Muratsuchi, Nazarian, Nestande,  
            Olsen, Pan, Patterson, Perea, Quirk, Quirk-Silva, Rendon,  
            Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,  
            Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, John A.  
            P�rez
          NO VOTE RECORDED:  Eggman, Gorell, Gray, Hall, Mansoor, V.  
            Manuel P�rez, Vacancy


          MW:d  7/2/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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