Read first time 01/27/11.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to respiratory care practitioners; and amending RCW 18.89.020 and 18.89.040.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 18.89.020 and 1997 c 334 s 3 are each amended to read as follows:
     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Department" means the department of health.
     (2) "Secretary" means the secretary of health or the secretary's designee.
     (3) "Respiratory care practitioner" means an individual licensed under this chapter.
     (4) (("Physician" means an individual licensed under chapter 18.57 or 18.71 RCW.)) "Health care practitioner" means:
     (a) A physician licensed under chapter 18.71 RCW;
     (b) An osteopathic physician or surgeon licensed under chapter 18.57 RCW; or
     (c) Acting within the scope of their respective licensure, a podiatric physician and surgeon licensed under chapter 18.22 RCW, an advanced registered nurse practitioner licensed under chapter 18.79 RCW, a naturopath licensed under chapter 18.36A RCW, a physician assistant licensed under chapter 18.71A RCW, or an osteopathic physician assistant licensed under chapter 18.57A RCW.

Sec. 2   RCW 18.89.040 and 1999 c 84 s 1 are each amended to read as follows:
     (1) A respiratory care practitioner licensed under this chapter is employed in the treatment, management, diagnostic testing, rehabilitation, and care of patients with deficiencies and abnormalities which affect the cardiopulmonary system and associated aspects of other systems, and is under the direct order and under the qualified medical direction of a ((physician)) health care practitioner. The practice of respiratory care includes:
     (a) The use and administration of prescribed medical gases, exclusive of general anesthesia;
     (b) The use of air and oxygen administering apparatus;
     (c) The use of humidification and aerosols;
     (d) The administration, to the extent of training, as determined by the secretary, of prescribed pharmacologic agents related to respiratory care;
     (e) The use of mechanical ventilatory, hyperbaric, and physiological support;
     (f) Postural drainage, chest percussion, and vibration;
     (g) Bronchopulmonary hygiene;
     (h) Cardiopulmonary resuscitation as it pertains to advanced cardiac life support or pediatric advanced life support guidelines;
     (i) The maintenance of natural and artificial airways and insertion, without cutting tissues, of artificial airways, as prescribed by a ((physician)) health care practitioner;
     (j) Diagnostic and monitoring techniques such as the collection and measurement of cardiorespiratory specimens, volumes, pressures, and flows;
     (k) The insertion of devices to draw, analyze, infuse, or monitor pressure in arterial, capillary, or venous blood as prescribed by a ((physician or an advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW)) health care practitioner; and
     (l) Diagnostic monitoring of and therapeutic interventions for desaturation, ventilatory patterns, and related sleep abnormalities to aid the ((physician)) health care practitioner in diagnosis. This subsection does not prohibit any person from performing sleep monitoring tasks as set forth in this subsection under the supervision or direction of a licensed health care provider.
     (2) Nothing in this chapter prohibits or restricts:
     (a) The practice of a profession by individuals who are licensed under other laws of this state who are performing services within their authorized scope of practice, that may overlap the services provided by respiratory care practitioners;
     (b) The practice of respiratory care by an individual employed by the government of the United States while the individual is engaged in the performance of duties prescribed for him or her by the laws and rules of the United States;
     (c) The practice of respiratory care by a person pursuing a supervised course of study leading to a degree or certificate in respiratory care as a part of an accredited and approved educational program, if the person is designated by a title that clearly indicates his or her status as a student or trainee and limited to the extent of demonstrated proficiency of completed curriculum, and under direct supervision;
     (d) The use of the title "respiratory care practitioner" by registered nurses authorized under chapter 18.79 RCW; or
     (e) The practice without compensation of respiratory care of a family member.
     Nothing in this chapter shall be construed to require that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person licensed under this chapter.