Date of Adoption: May 8, 2001.

Purpose: Proposed amendments are to provide clarification and to incorporate SHB 1536, chapter 334, Laws of 1997, into chapter 18.89 RCW, that mandates the licensure of respiratory care practitioners who were formally certified by the Department of Health and requires that applicants complete programs with a two-year curriculum.

Citation of Existing Rules Affected by this Order: Repealing WAC 246-928-015 Scope of practice -- Allowed procedures, 246-928-020 Recognized educational programs -- Respiratory care practitioners, 246-928-030 State examination -- Examination waiver -- Examination application deadline, 246-928-040 Examination eligibility, 246-928-050 Definition of "commonly accepted standards for the profession," 246-928-060 Grandfather -- Verification of practice, 246-928-080 Reciprocity -- Requirements for certification, 246-928-085 Temporary permits -- Issuance and duration, 246-928-110 General provisions, 246-928-120 Mandatory reporting, 246-928-130 Health care institutions, 246-928-140 Respiratory care practitioner associations or societies, 246-928-150 Professional liability carriers, 246-928-160 Courts, 246-928-170 State and federal agencies, 246-928-180 Cooperation with investigation, 246-928-190 AIDS prevention and information education requirements, 246-928-200 Temporary practice, 246-928-210 Definitions -- Alternative training respiratory care practitioners and 246-928-220 Alternative training requirements; new sections WAC 246-928-310 Introduction, 246-928-320 General definitions, PART I DEFINITIONS AND PROCEDURES FOR LICENSING AS A RESPIRATORY CARE PRACTITIONER, WAC 246-928-410 Who must be licensed as a respiratory care practitioner with the department, 246-928-420 How to become licensed as a respiratory care practitioner, 246-928-430 How and when to renew a respiratory care practitioner license, 246-928-450 How to reinstate an expired respiratory care practitioner license, PART II REQUIREMENTS FOR LICENSURE AS A RESPIRATORY CARE PRACTITIONER, WAC 246-928-510 Overview of the qualifications required for licensure as a respiratory care practitioner, 246-928-520 Minimum educational qualifications for licensure as a respiratory care practitioner, 246-928-530 How new graduates may qualify for temporary practice and what is required, 246-928-540 Examination requirements for licensure as a respiratory care practitioner, 246-928-550 Education and training in AIDS prevention is required for licensure as a respiratory care practitioner, 246-928-560 How to apply for licensure for persons credentialed out-of-state, 246-928-570 How to apply for temporary practice permit for persons credentialed out-of-state, PART III REQUIREMENTS FOR REPORTING UNPROFESSIONAL CONDUCT, WAC 246-928-710 Mandatory reporting, 246-928-720 Health care institutions, 246-928-730 Respiratory care practitioner associations or societies, 246-928-740 Professional liability carriers, 246-928-750 Courts and 246-928-760 State and federal agencies; and amending PART IV RESPIRATORY CARE PRACTITIONER LICENSING AND RENEWAL FEES, WAC 246-928-990 Respiratory care fees and renewal cycle.

Statutory Authority for Adoption: RCW 18.89.050(1).

Adopted under notice filed as WSR 01-07-086 on March 21, 2001.

Changes Other than Editing from Proposed to Adopted Version: Deleted all references relating to grandfathering of credentials.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 19, Amended 1, Repealed 20.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 19, Amended 1, Repealed 20. Effective Date of Rule: Thirty-one days after filing.

May 18, 2001

Nancy Ellison

Deputy

for Mary Selecky

Secretary

OTS-2553.7

NEW SECTION
WAC 246-928-310   Introduction.   This chapter explains the requirements for respiratory care practitioner licensure. These rules, which implement the provisions of chapter 18.89 RCW, are divided into four parts:

Part I explains the definitions for and the process to become licensed as a respiratory care practitioner;

Part II specifies the requirements for licensure including educational and examination criteria;

Part III explains the requirements for reporting unprofessional conduct;

Part IV lists the fees for licensure and renewal cycle for respiratory care practitioners.

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(1) "Respiratory care practitioner" means a person licensed by the department of health, who is authorized under chapter 18.89 RCW and these rules to practice respiratory therapy. WAC 246-928-410 explains who must be licensed as a respiratory care practitioner.

(2) "Applicant" means a person whose application for licensure as a respiratory care practitioner is being submitted to the department of health.

(3) "Department" means the Washington state department of health.

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DEFINITIONS AND PROCEDURES FOR LICENSING AS A RESPIRATORY CARE PRACTITIONER
NEW SECTION
WAC 246-928-410   Who must be licensed as a respiratory care practitioner with the department.   This section identifies who must be licensed as a respiratory care practitioner with the department and who is exempt from licensure.

(1) Any person performing or offering to perform the functions authorized in RCW 18.89.040 must be licensed as a respiratory care practitioner. A certification, registration or other credential issued by a professional organization does not substitute for licensure as a respiratory care practitioner in Washington state.

(2) The following individuals are exempt from licensure as a respiratory care practitioner with the department:

(a) Any person performing or offering to perform the functions authorized in RCW 18.89.040, if that person already holds a current licensure, certification or registration that authorizes these functions;

(b) Any person employed by the United States government who is practicing respiratory care as a performance of the duties prescribed for him or her by the laws of and rules of the United States;

(c) Any person who is pursuing a supervised course of study leading to a degree or certificate in respiratory care, 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) Any person who is licensed as a registered nurse under chapter 18.79 RCW;

(e) Any person who is practicing respiratory care without compensation for a family member.

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(1) The department shall provide forms for use by an applicant for licensure as a respiratory care practitioner. All applications for licensure must be submitted on these forms, with the appropriate fee required in WAC 246-928-990. The specific requirements and process for licensure is set forth in WAC 246-12-020.

(2) The applicant shall certify that all information on the application forms is accurate. The applicant is subject to investigation and discipline by the department for any apparent violation of chapters 18.130 and 18.89 RCW, or this chapter.

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(1) Applications for renewal of the license for respiratory care practitioner shall be submitted on forms provided by the department, with the appropriate fee required in WAC 246-928-990. The specific requirements and process for renewal of a license are set forth in WAC 246-12-030.

(2) Renewal fees must be postmarked on or before the renewal date or the department will charge a late renewal penalty fee and licensure reissuance fee.

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REQUIREMENTS FOR LICENSURE AS A RESPIRATORY CARE PRACTITIONER
NEW SECTION
WAC 246-928-510   Overview of the qualifications required for licensure as a respiratory care practitioner.   This section provides an overview of the qualifications required for licensure as a respiratory care practitioner.

The requirements for licensure are intended to ensure the minimum level of knowledge, skill and experience necessary to practice safely as a respiratory care practitioner. Licensure requires applicants to submit proof to the department that they have satisfied educational and examination requirements in this chapter.

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(1) To meet the educational requirements required by RCW 18.89.090, an applicant must be a graduate of a two-year respiratory therapy educational program. Programs must be:

Accredited by the Committee On Accreditation for Respiratory Care (COARC) or accredited by the American Medical Association's (AMA) Committee on Allied Health Education and Accreditation (CAHEA), or its successor, the Commission on Accreditation of Allied Health Education Program (CAAHEP).

(2) An official transcript indicating completion of a two-year program must be provided as evidence of fulfillment of the required education.

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(a) Submit the application and fee as required in WAC 246-928-990;

(b) Sit for the examination within ninety days of graduation as required in WAC 246-928-560; and

(c) Be under the supervision of a licensed respiratory care practitioner.

Temporary practice may begin from the time the application and fee is submitted to the department.

(2) An applicant shall request examination results be submitted directly to the department from National Board for Respiratory Care.

(3) An applicant who receives notification that he or she successfully passed the examination may continue to practice under the supervision of a licensed respiratory care practitioner until the department has issued a license to the applicant.

(4) An applicant who receives notification of failure to pass the examination shall cease practice immediately. Resumption of practice may occur only after successfully passing the examination and becoming licensed as a respiratory care practitioner by the department.

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An applicant who has taken and passed the National Board for Respiratory Care (NBRC) entry level examination, has met the minimum examination requirements of RCW 18.89.090 (1)(b). Applicants shall request the NBRC to verify to the department that the applicant has successfully passed the NBRC examination.

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Applicants must complete seven hours of AIDS education as required in chapter 246-12 WAC, Part 8.

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(1) An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. Applicants must submit the following documentation to be considered for licensure:

(a) An application fee and forms as specified in WAC 246-928-420 and 246-928-990; and

(b) Written verification directly from all states in which the applicant is or was credentialed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment; and

(c) Verification of completion of the required education and examination as specified in WAC 246-928-520.

(2) Applicants who have completed a two-year program recognized by the Canadian Society of Respiratory Therapists (CSRT) in their current list, or any previous lists, and are eligible to sit for the CSRT registry examination; or have been issued a registration by the CSRT are considered to have met the educational and examination requirements in this chapter. Canadian applicants are required to submit verification directly from CSRT, as well as all of the information listed above for applicants licensed in another jurisdiction.

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(1) An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. Applicants must submit the following documentation to be considered for a temporary practice permit:

(a) A completed application on forms provided by the department with the request for a temporary practice permit indicated;

(b) An application fee and a temporary practice permit fee as specified in WAC 246-928-990;

(c) Written verification directly from all states or jurisdictions in which the applicant is or was licensed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment; and

(d) Verification of completion of the required education and examination as specified in WAC 246-928-520.

(2) The department shall issue a one-time-only temporary practice permit unless the department determines a basis for denial of the license or issuance of a conditional license.

(3) The temporary permit shall expire upon the issuance of a license by the department, or within three months, whichever occurs first. The permit shall not be extended beyond the expiration date.

(4) Issuance of a temporary practice permit does not ensure that the department will grant a full license. Temporary permit holders are subject to the same education and examination requirements as set forth in WAC 246-928-520 and 246-928-550.

(5) The following situations are not considered substantially equal for Washington state licensure:

(a) Certification of persons credentialed out-of-state through a state-constructed examination; or

(b) Grandfathering provisions where proof of education and examination was not required.

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REQUIREMENTS FOR REPORTING UNPROFESSIONAL CONDUCT
NEW SECTION
WAC 246-928-710   Mandatory reporting.   (1) All reports required by this chapter shall be submitted to the department as soon as possible, but no later than twenty days after a determination is made.

(2) A report should contain the following information if known:

(a) The name, address, and telephone number of the person making the report.

(b) The name, address, and telephone numbers of the respiratory care practitioner being reported.

(c) The case number of any patient whose treatment is a subject of the report.

(d) A brief description or summary of the facts which prompted the issuance of the report, including dates of occurrences.

(e) If court action is involved, the name of the court in which the action is filed along with the date of filing and docket number.

(f) Any further information which would aid in the evaluation of the report.

(3) Mandatory reports shall be exempt from public inspection and copying to the extent permitted under RCW 42.17.310 or to the extent that public inspection or copying of the report or any portion of the report would invade or violate a person's right to privacy as set forth in RCW 42.17.255.

(4) A person is immune from civil liability, whether direct or derivative, for providing information to the department pursuant to RCW 18.130.070.

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RESPIRATORY CARE PRACTITIONER LICENSING AND RENEWAL FEES
AMENDATORY SECTION(Amending WSR 99-08-101, filed 4/6/99, effective 7/1/99)

WAC 246-928-990   Respiratory care fees and renewal cycle.   (1) ((Certificates)) Licenses must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

(2) The following nonrefundable fees will be charged:

Title of Fee	Fee
Application	$ 70.00
Temporary practice permit	35.00
((Examination application	110.00
Examination retake	25.00))
Duplicate license	15.00
((Certification of certificate)) Verification of licensure	15.00
Renewal	50.00
Late renewal penalty	50.00
Expired ((certificate)) license reissuance	50.00

[Statutory Authority: RCW 43.70.250. 99-08-101, 246-928-990, filed 4/6/99, effective 7/1/99. Statutory Authority: RCW 43.70.280. 98-05-060, 246-928-990, filed 2/13/98, effective 3/16/98. Statutory Authority: Chapter 18.89 RCW and RCW 43.70.040. 95-18-019, 246-928-990, filed 8/24/95, effective 9/24/95. Statutory Authority: RCW 43.70.250. 92-15-032 (Order 285), 246-928-990, filed 7/7/92, effective 8/7/92. Statutory Authority: RCW 18.89.050 and 43.70.250. 92-02-018 (Order 224), 246-928-990, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as 246-928-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.24.086. 88-17-099 (Order PM 741), 308-195-110, filed 8/23/88.]

     The following sections of the Washington Administrative Code are repealed:

WAC 246-928-015	Scope of practice -- Allowed procedures.
WAC 246-928-020	Recognized educational programs -- Respiratory care practitioners.
WAC 246-928-030	State examination -- Examination waiver -- Examination application deadline.
WAC 246-928-040	Examination eligibility.
WAC 246-928-050	Definition of "commonly accepted standards for the profession."
WAC 246-928-060	Grandfather -- Verification of practice.
WAC 246-928-080	Reciprocity -- Requirements for certification.
WAC 246-928-085	Temporary permits -- Issuance and duration.
WAC 246-928-110	General provisions.
WAC 246-928-120	Mandatory reporting.
WAC 246-928-130	Health care institutions.
WAC 246-928-140	Respiratory care practitioner associations or societies.
WAC 246-928-150	Professional liability carriers.
WAC 246-928-160	Courts.
WAC 246-928-170	State and federal agencies.
WAC 246-928-180	Cooperation with investigation.
WAC 246-928-190	AIDS prevention and information education requirements.
WAC 246-928-200	Temporary practice.
WAC 246-928-210	Definitions -- Alternative training respiratory care practitioners.
WAC 246-928-220	Alternative training requirements.

Washington State Code Reviser's Office