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AARC Model Practice Act

The AARC Model Practice Act outlines provisions common in licensure laws including scope of practice, establishment of a state regulatory board, requirements for licensure, reciprocity, exemptions from licensure, disciplinary criteria, and offenses, among others. The AARC’s model is non-exclusive in that it does not prohibit the practice of respiratory therapy by other individuals determined to be competent. The AARC advocates the use of its model to uniformly regulate the practice of respiratory therapy across the states.

Approved by the AARC’s Board of Directors December, 1993
Revised and Approved by the Board of Medical Advisors July 1994
Board of Medical Advisors’ Revisions approved by the AARC Board of Directors July 1994

AMERICAN ASSOCIATION FOR RESPIRATORY CARE

A MODEL STATE RESPIRATORY CARE PRACTICE ACT

Purpose

The legislature finds and declares that the practice of respiratory care in the State (Commonwealth) of _______________ affects the public health, safety and welfare, and is to be subject to regulation and control in order to protect the public from the 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 even more sophisticated techniques in patient care. The purpose of this act, therefore, is to regulate the practice of respiratory care; to create a state board …

The People of the State (Commonwealth) of _______________ enact:

TITLE
Sec. 1.

This act shall be known as the “Respiratory Care Practice Act.”

DEFINITIONS
Sec. 2.

As used in this act:

  1. “Board” means the State Board for Respiratory Care.
  2. “Formal Training” is a supervised, structured educational activity that must include preclinical didactic and laboratory activities, and clinical activities. The training must be approved by an accrediting agency recognized by the Board. It must include an evaluation of competence through a standardized testing mechanism that is determined by the Board to be both valid and reliable.
  3. “Practice of Respiratory Care” includes, but is not limited to: the administration of pharmacological, 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; transcription and implementation of the written or verbal orders of a physician pertaining to the practice of respiratory care; observing and monitoring signs and symptoms, general behavior, general physical response to respiratory care treatment and diagnostic testing, including determination of whether such signs, symptoms, reactions, behavior or general response exhibit abnormal characteristics; and implementation based on observed abnormalities, or appropriate reporting, referral, respiratory care protocols or changes in treatment pursuant to the written or verbal orders by a person licensed to practice medicine under the laws of the State of _______________; or the initiation of emergency procedures under the regulations of the Board or as otherwise permitted in this Act. The practice of respiratory care may be performed in any clinic, hospital, skilled nursing facility, and private dwelling; or other place deemed appropriate or necessary by the Board; in accordance with the written or verbal order of a physician, and shall be performed under a qualified Medical Director.
  4. “Qualified Medical Director” means the medical director of any inpatient or outpatient respiratory care service, department or home care agency. The medical director shall be a licensed physician who has special interest and knowledge in the diagnosis and treatment of respiratory problems. The medical director should be qualified by special training and/or experience in the management of acute and chronic respiratory disorders. This physician should be responsible for the quality, safety and appropriateness of the respiratory services provided, and require that respiratory care be ordered by a physician who has medical responsibility for the patient. The medical director should be readily accessible to the respiratory care practitioners and should assure their competency.
  5. “Respiratory Care” means the allied health profession responsible for the direct and indirect services in the treatment, management, diagnostic testing, control and care of patients with deficiencies and abnormalities associated with the cardiopulmonary system, under a qualified medical director. Respiratory care includes inhalation therapy and respiratory therapy.
  6. “Respiratory Care Education Program” means a course of study leading to eligibility for registry or certification in respiratory care. The program is recognized or approved by an appropriate state agency.
  7. “Respiratory Care Practitioner” means:
    1. A person employed in the practice of cardio-respiratory care who has the knowledge and skill necessary to administer respiratory care as defined in Sections 2.(C) of this Act, and
    2. A person who is capable of serving as a resource to the physician in relation to the technical aspects of cardio-respiratory care and as to the safe and effective methods for administering cardio-respiratory care modalities, and
    3. A person who is able to function in situations of unsupervised patient contact requiring great individual judgment, and
    4. A person capable of supervising, directing, or teaching less skilled personnel in the provision of respiratory care services.
BOARD STRUCTURE
Sec. 3.
  1. There is created a State Board for Respiratory Care, hereinafter referred to as the Board, within the Department of _______________ to administer the provisions of this Act. The Board shall consist of ( ) members, all citizens of the United States and residents of this state, and the director of the Department of _______________ as ex-officio without vote. There shall be ( ) public member(s), ( ) physician member(s) recommended by the appropriate state and national medical societies, ( ) member(s) engaged in the practice of respiratory care for a period of not less than _____ years immediately preceding their appointment to the Board recommended by the state affiliate of the American Association for Respiratory Care, and ( ) at-large member(s) selected from among, but not limited to: hospital administrators, nursing
  2. home administrators, or representatives of the home health care industry.
  3. The Governor, with the advice and consent of _______________ shall appoint the members of the Board for terms of _____ years. The terms of office of the members first appointed shall begin when they are appointed and shall continue thereafter for the following periods: ( ) physician(s) and ( ) respiratory care practitioner(s) for a period of ( ) year(s); and ( ) physician(s),
  4. ( ) public member(s), and ( ) respiratory care practitioner(s) for a period of ( ) years; and ( ) physician(s), ( ) respiratory care practitioner(s), and ( ) at-large representative(s) for a period of ( ) year(s). Upon the expiration of such terms and all terms thereafter, the Governor shall appoint a successor for the member whose term expires for a term of _____ years, with no member being appointed for more than _____ consecutive terms and with the respiratory care practitioner members being licensed under the provisions of this Act. Vacancies in the Board shall be filled by appointment by the Governor in like manner for the balance of an unexpired term and each member shall serve until his successor is appointed and qualified.
  5. Upon expiration of the term of a physician member, the appropriate state and national medical societies may each, as appropriate, submit to the Governor a list of ( ) persons qualified to serve on the Board replacing the expired term of their respective member. Upon expiration of the term of any respiratory care practitioner member, the state affiliate of the American Association for Respiratory Care may submit to the Governor a list of ( ) persons qualified to serve for each position vacated. Upon expiration of the term of the at-large member, organizations representing hospitals, nursing homes, home health care or other organizations as approved by the Board may submit to the Governor a list of ( ) persons qualified to serve on the Board replacing the expired term of the respective member. Appointments may be made from these lists by the Governor and additional lists may be provided by the respective organizations if requested by the Governor.
  6. The Governor may remove any member from the Board for neglect of any duty required by law or for incompetent, unethical, or dishonorable conduct.
  7. The state shall provide for adequate startup funds, sufficient to ensure the efficient and effective operations of the Board for a period of _____ years. Such startup funds are to be reimbursed from revenues generated by the Board in a manner consistent with the Laws of the State of ____________________.
BOARD OPERATING PROCEDURES
Sec. 4.
  1. The Board shall meet at least ____ each year and shall elect annually during odd numbered years, a chairman from its physician members and from its respiratory care members a vice chairman. In even numbered years, it shall elect from its respiratory care members a chairman and from its physician members a vice chairman. The Board may convene at the request of the chairman, or as determined by the Board.
  2. A majority of the members of the Board, including the chairman or vice-chairman, constitute a quorum at any meeting and a majority of the required quorum is sufficient for the Board to take action by vote.
  3. The Board may appoint and employ a qualified person who shall not be a member of the Board to serve as administrative secretary to the Board, and define the duties of the administrative secretary, in addition to those enumerated in this Act.
BOARD RESPONSIBILITIES
Sec. 5.

The Board shall:

  1. Examine, license and renew the licenses of duly qualified applicants.
  2. Maintain an up-to-date list of every living person licensed to practice respiratory therapy under this Act. The list shall show the licensee’s last known place of employment, last known place of residence, and the date and number of his license.
  3. Cause the prosecution of all persons violating this Act and incur necessary expenses therein.
  4. Keep a record of all proceedings of the Board and such record shall be made available to the public for inspection during reasonable business hours.
  5. Conduct hearings upon charges calling for discipline of a licensee, or denial, revocation or suspension of a license.
  6. Maintain an up-to-date list of persons whose licenses have been suspended, revoked or denied. This list shall include the name(s), social security numbers, type and cause of action, date and penalty incurred, and the length of penalty. This list shall be available for public inspection during reasonable
  7. business hours. This list shall be supplied to similar boards
  8. in other states upon request.
POWERS OF THE BOARD
Sec. 6.

The Board may: Adopt such rules and regulations not inconsistent with the law as may be necessary to enable it to carry into effect the provisions of this Act. Rules and regulations shall be adopted in accordance with the Public Acts of the State of ____________________.
Employ such personnel as necessary to perform the functions of the Board.
Establish relicensure requirements and procedures as deemed appropriate, which may include, but not limited to, the establishment of continuing education requirements. The Board is authorized to accept continuing education programs that are sponsored by local, state, regional, national or international scientific or professional organizations deemed appropriate by the Board.
Secure the services of resource consultants as deemed necessary by the Board. Resource consultants shall receive travel and other necessary expenses, consistent with State laws and policies, incurred while engaged in consultative service to the Board.
Enter into agreements or contracts, consistent with state law, with outside organizations for the purpose of developing, administering, grading and/or reporting the results of licensure examinations. Such groups shall be capable of meeting the standards of the National Commission for Health Certifying Agencies, or its equivalent or successor organization. The licensure examinations shall be validated and nationally recognized as testing respiratory care competencies.

COMPENSATION OF BOARD MEMBERS
Sec. 7.
  1. A member of the Board shall receive compensation at a daily rate commensurate with similar boards within this State plus actual and necessary travel and other expenses incurred while engaged in the discharge of official duties in accordance with the standard travel regulations of the State of ____________________.
  2. Members of the Board shall enjoy the same rights of protection from personal liability as those enjoyed by other employees of the state for actions taken in the course of their duties under the provisions of this act.
REQUIREMENTS FOR LICENSURE
Sec. 8.
  1. Upon payment of a fee, an applicant for a license to practice respiratory care shall submit to the Board written evidence, verified by oath, that the applicant:
    1. Has completed an approved four (4) year high school course of study or the equivalent thereof determined by the appropriate educational agency; and
    2. Has completed an accredited respiratory care educational program.
    3. Has passed an examination, except where otherwise defined in this Act. This examination may be administered by the state or by a national agency approved by the Board.
  2. If an applicant fails to complete the requirements for licensure within ( ) days from the date of filing, the application is deemed to be abandoned.
  3. The Board shall issue to the applicant a license to practice respiratory care by endorsement to:
    1. An applicant who is currently licensed to practice respiratory care under the laws of another state, territory or country if the qualifications of the applicant are deemed by the Board to be equivalent to those required in this state.
    2. Applicants holding credentials, conferred by the National Board for Respiratory Care (NBRC) or its successor organization, as a Certified Respiratory Therapy Technician (CRTT) and/or as a Registered Respiratory Therapist (RRT), providing such credential has not been suspended or revoked and not withstanding whether the applicant meets the requirements under Sec. 8(A)(II).
  4. Applicants applying under the conditions of Sec. 8(C) shall be required to certify under oath that their credentials have not been suspended or revoked.
EXAMINATIONS
Sec. 9.
  1. Examinations for licensure in respiratory care will be conducted not less than _____ time(s) a year and at such places as may be determined by the Board.
  2. A fee shall be required for each reexamination.
TEMPORARY PERMITS
Sec. 10.
  1. Upon payment of a fee, the Board may issue a temporary permit to practice respiratory care for a period of _____ month(s) to an applicant for licensure, pending compliance with the requirements for licensure and providing the applicant shows written evidence, verified by oath, that said applicant is:
    1. Currently practicing, or has within the last _____ month(s) practiced respiratory care in another state, territory or country, and is licensed to practice respiratory care in that state, or
    2. Is a student in a respiratory care education program who expects to graduate within the next _____ calendar day(s), or
    3. Is an Air Force veteran whose respiratory care training is deemed satisfactory by the state and who passes an examination administered by the state or a national agency as approved by the Board within _____ months of receiving a temporary permit.
  2. On expiration of the permit and on payment of a fee, the Board may issue a permit to practice respiratory care for an additional period not to exceed _____ month(s) from the date of issuance of the original permit, pending reexamination or compliance with this Act. Reapplication following abandonment of an application shall not entitle the applicant to a temporary permit.
GRANDFATHER CLAUSE
Sec. 11.
  1. The Board shall issue a license to perform respiratory care to an applicant who, at the time of the effective date of this Act, has passed an examination administered by the state or a national agency approved by the Board.
  2. Other applicants who have not passed these examinations or their equivalent at the time of the effective date of the Act, and who, through written evidence, verified by oath, demonstrate that they are presently functioning in the capacity of a respiratory care practitioner as defined by this Act, shall be given a temporary license to practice respiratory care for a period of _____ month(s) from the effective date of this Act. Such applicants must pass a licensure examination administered or approved by the Board during the _____ month period in order to be issued a license to practice respiratory care.
PROFESSIONAL IDENTIFICATION
Sec. 12.
  1. A person holding a license to practice respiratory care in this state may use the title, “licensed respiratory care practitioner” and the abbreviation, “LRCP,” “RCP,” or “RCP-L.”
  2. A licensee shall show his license when requested.
RENEWAL OF LICENSE
Sec. 13
  1. A license shall be renewed except as hereafter provided. The Board shall mail notices at least _____ calendar days prior to expiration for renewal of licenses to every person to whom a license was issued or renewed during the preceding renewal period. The licensee shall complete the notice of renewal and return it to the Board with a renewal fee before the date of expiration.
  2. Upon receipt of the notice of renewal and the fee, the Board shall verify its contents and shall issue the licensee a license for the current renewal period, which shall be valid for the period stated thereon. The Board may establish continuing education requirements for annual renewal of the license.
  3. A licensee who allows his license to lapse by failing to renew it may be reinstated by the Board upon payment of the renewal fee and a reinstatement fee provided that such request for reinstatement is made within _____ days of the end of the renewal period.
  4. A respiratory care practitioner who does not engage in the practice of respiratory care during the succeeding renewal period is not required to pay the renewal fee as long as he remains inactive. If he desires to resume the practice of respiratory care, he shall notify the Board of his intent and shall satisfy the current requirements of the law, in addition to remitting the current renewal fee and the reinstatement fee. Requirements of the law shall include a specific period of time of continuous inactivity after which retesting is required.
    The Board is authorized to establish fees for replacement and duplicate licenses.
FEES AND DISPOSITION OF REVENUE
Sec. 14.
  1. All fees shall be established by rule by the Board.
  2. Fees received by the Board and monies collected under this Act shall be deposited in the State Treasury to the credit of the General Fund.
  3. Expenses incurred in the implementation of this Act shall be paid in accordance with the accounting laws of the state within the appropriations made by the legislature.
DISCIPLINARY CRITERIA
Sec. 15.
  1. The Board may revoke, suspend, or refuse to renew any license or permit, or place on probation, or otherwise reprimand a licensee or permit holder or deny a license to an applicant if it finds that the person:
    1. Is guilty of fraud or deceit in procuring or attempting to procure a license or renewal of a license to practice respiratory care.
    2. Is unfit or incompetent by reason of negligence, habits, or other causes of incompetence.
    3. Is habitually intemperate in the use of alcoholic beverages.
    4. Is addicted to, or has improperly obtained, possessed, used or distributed habit-forming drugs or narcotics.
    5. Is guilty of dishonest or unethical conduct.
    6. Has practiced respiratory care after his license or permit has expired or has been suspended.
    7. Has practiced respiratory care under cover of any permit or license illegally or fraudulently obtained or issued.
    8. Has violated or aided or abetted others in violation of any provision of this Act.
    9. Has been convicted of a felony that materially affects the person’s ability to safely practice respiratory care.
DUE PROCESS PROCEDURES
Sec. 16
  1. Upon filing of written complaint with the Board, charging a person with any of the acts described in Section 15, the administrative secretary or other authorized employee of the Board shall make an investigation. If the Board finds reasonable grounds for the complaint, a time and place for a hearing shall be set, notice of which shall be served on the licensee, permit holder or applicant at least _____ calendar days prior thereto. The notice shall be by personal service or by certified or registered mail sent to the last known address of the person.
  2. The Board may petition the Circuit Court for the county within which the hearing is being held to issue subpoenas for the attendance of witnesses and the production of necessary evidence in any hearing before it. Upon request of the respondent or his counsel, the Board shall petition the court to issue subpoenas on behalf of the respondent. The Circuit Court upon petition may issue such subpoenas as it deems necessary.
  3. Unless otherwise provided in this Act, hearing procedures shall be promulgated in accordance with the Public Acts of the State of ________. A person who feels aggrieved by a decision of the Board may file an appeal pursuant to the Public Acts of the State of ____________________.
EXCEPTIONS
Sec. 17.
  1. No person shall practice respiratory care or represent himself to be a respiratory care practitioner unless he is licensed under the Respiratory Care Practice Act, except as otherwise provided by that Act.
  2. This act does not prohibit:
    1. The practice of respiratory care that is an integral part of the program of study by students enrolled in an accredited respiratory care education program approved by the Board. Students enrolled in respiratory care education programs shall be identified as “student RCP” and shall only provide respiratory care under the direct supervision of an appropriate clinical instructor recognized by the education program.
    2. Self-care by a patient, or gratuitous care by a friend or family member who does not represent or hold himself out to be a respiratory care practitioner.
    3. Respiratory care services rendered in the course of an emergency.
    4. Care administered In the course of assigned duties of persons in the military services or working in federal facilities.
    5. The respiratory care practitioner from performing advances in the art and techniques of respiratory care learned through formal or special training.
  3. Nothing in the Respiratory Care Practice Act is intended to limit, preclude or otherwise interfere with the practice of other persons and health providers formally trained and licensed by appropriate agencies of the State of ____________________.
  4. An individual who passes an examination that includes content in one or more of the functions included in this Act, shall not be prohibited from performing such procedures for which he was tested, so long as the testing body offering the examination is approved by the Board.
PRACTICE OF MEDICINE PROHIBITED
Sec. 18.

Nothing in this Act shall be construed to permit the practice of medicine.

OFFENSES
Sec. 19.
  1. It is a misdemeanor for any person to:
    1. Sell, fraudulently obtain or furnish any respiratory care license or record, or aid or abet therein.
    2. Practice respiratory care under cover of any respiratory care diploma, license or record illegally or fraudulently obtained or issued.
    3. Practice respiratory care unless duly licensed to do so under the provisions of this Act.
    4. Impersonate in any manner or pretend to be a respiratory care practitioner or use the title, “licensed care practitioner”, the letters, “LRCP”; or any other words, letters, signs, symbols or devices to indicate that the person using them is a licensed respiratory care practitioner, unless duly authorized by license to practice under the provisions of this Act.
    5. Practice respiratory care during the time his license is suspended, revoked or expired.
    6. Fail to notify the Board of the suspension, probation, or revocation of any past or currently held license required to practice respiratory care in this or any other jurisdiction.
    7. Knowingly employ unlicensed persons in the capacity of a respiratory care practitioner.
    8. Make false representations or impersonate or act as a proxy for another person or allow or aid any person to impersonate him in connection with any examination or application for licensing or request to be examined or licensed.
    9. Otherwise violate any provisions of this Act. Such misdemeanor shall be punishable by a fine of not more than $__________ or by imprisonment for not more than _____ month(s) or by both fine and imprisonment for each offense.
SEVERABILITY
Sec. 20

Should any section of this Act be found to be unconstitutional or unlawful, that portion shall be severed from this Act. The remainder of this Act shall remain in force.