SB 1304: Respiratory Care Practice Act.

Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California to license and regulate respiratory care practitioners. Existing law authorizes the board to employ an executive office, as specified. Existing law establishes fees for license and examination requirements for respiratory care practitioners, including an initial license fee of no more than $300 and a license renewal fee at $230, as specified. Existing law authorizes the board to increase the license renewal fee, by regulation, to no more than $330. Existing law repeals the existence of the board and the authority for employment of an executive officer on January 1, 2027. This bill would extend the operation of the existence of the board and the executive officer to January 1, 2031, and would delete the initial license fee provision. The bill would increase the license renewal fee to $330 and would authorize the board to increase the license renewal fee, by regulation, to $375. Existing law establishes requirements for licensure as a respiratory care practitioner and generally prohibits an applicant for licensure from being licensed without first successfully passing the National Board for Respiratory Care's Therapist Multiple-Choice Examination, at the cut-off level required to qualify for the Clinical Simulation Examination, and the Clinical Simulation Examination, or any succeeding examinations. This bill would revise the above provision to instead prohibit an applicant from being licensed under these provisions without first successfully passing the National Board for Respiratory Care's Respiratory Therapy Examination, at the cut-off level required to qualify for the Registered Respiratory Therapist credential, or any succeeding examinations. Existing law authorizes the board to order the denial, suspension, or revocation of, or the imposition of probationary conditions upon, a license of a respiratory care practitioner for certain specified acts, including the commission of any fraudulent, dishonest, or corrupt act that is substantially related to the qualifications, functions, or duties of a licensee. Existing law further requires the board to revoke or suspend a license for the conviction of a crime that is substantially related to the qualifications, functions, or duties of a licensee. Existing law deems a crime involving sexual misconduct or attempted sexual misconduct, regardless of whether committed with a patient, to be a substantially related crime and requires the board to revoke a license for sexual contact with a patient or for the commission of, or conviction for, a sex offense, as defined. This bill would additionally require the board to suspend the license of a respiratory care practitioner convicted of specified felonies, regardless of whether the offense was committed in the course of practice, and notwithstanding any other provision. The bill would require the board to revoke the license if the specified conviction becomes final. The bill would authorize the board to decline to impose or to set aside a suspension in the interest of justice and would require the board to rescind a license suspension or revocation if the conviction is overturned, as provided. The bill would authorize a licensee to request a hearing to determine the appropriate level of discipline and would prohibit an administrative law judge from considering expert testimony regarding whether the conviction is substantially related to the practice of respiratory care. The Respiratory Care Practice Act authorizes the board to promulgate regulations defining specified levels of respiratory care, with each requiring a greater degree of training or skill to perform. Existing law specifies the lowest level as basic services, which are tasks or services that do not require a respiratory assessment and only require manual, technical skills, or data collection. Existing law, the Vocational Nursing Practice Act, limits a licensed vocational nurse to basic respiratory tasks and services, as prescribed. Existing law exempts from the Respiratory Care Practice Act specified tasks performed by a licensed vocational nurse. In this regard, existing law authorizes a licensed vocational nurse to perform respiratory tasks and services under specified circumstances that vary depending on the task or service, the nurse's training, demonstrated competency, and employer, and the setting in which the task or service is performed, as provided. Specifically, existing law authorizes a licensed vocational nurse who is employed by a home health agency to perform respiratory tasks and services identified by the board if, on or before January 1, 2028, the licensed vocational nurse has completed patient-specific training satisfactory to their employer, and, on and after that date, the licensed vocational nurse has completed that training in accordance with guidelines promulgated by the board, in collaboration with the Board of Vocational Nursing and Psychiatric Technicians of the State of California. This bill would expand the respiratory tasks and services a licensed vocational nurse is authorized to perform. In this regard, the bill would remove the above requirement that a licensed vocational nurse be employed by a home health agency to perform respiratory tasks and services identified by the board, and would, instead, authorize a licensed vocational nurse to perform these services in expanded settings, including, among others, congregate living health facilities, group homes, and adult residential facilities. The bill would authorize a licensed vocational nurse to perform certain suctioning tasks, as specified. Existing law specifies that the Respiratory Care Practice Act is not intended to limit, preclude, or otherwise interfere with the practice of other licensed personnel carrying out authorized and customary duties and functions. This bill would provide that certain activities are not considered to be practicing respiratory care, including documenting observations and gathering and reporting data to another health care provider, as specified.