2001 Minnesota Statutes

CHAPTER 147C. Respiratory care practitioners

     147C.01 Definitions. 

    Subdivision 1.    Applicability.  The definitions in 
 this section apply to this chapter. 

    Subd. 2.    Advisory council.  "Advisory council" means 
 the respiratory care practitioner advisory council established 
 under section 147C.35. 

    Subd. 3.    Approved education program.  "Approved 
 education program" means a university, college, or other 
 post-secondary education program leading to eligibility for 
 registry or certification in respiratory care, that, at the time 
 the student completes the program, is accredited by a national 
 accrediting organization approved by the board.  

    Subd. 4.    Board.  "Board" means the board of medical 
 practice or its designee. 

    Subd. 5.    Contact hour.  "Contact hour" means an 
 instructional session of 50 consecutive minutes, excluding 
 coffee breaks, registration, meals without a speaker, and social 
 activities. 

    Subd. 6.    Credential.  "Credential" means a license, 
 permit, certification, registration, or other evidence of 
 qualification or authorization to engage in respiratory care 
 practice in this state or any other state. 

    Subd. 7.    Credentialing examination.  "Credentialing 
 examination" means an examination administered by the National 
 Board for Respiratory Care or other national testing 
 organization approved by the board for credentialing as a 
 certified respiratory therapy technician, registered respiratory 
 therapist, or other title indicating an entry or advanced level 
 respiratory care practitioner.  

    Subd. 8.    Health care facility.  "Health care facility"
 means a hospital as defined in section 144.50, subdivision 2, a 
 medical facility as defined in section 144.561, subdivision 1, 
 paragraph (b), or a nursing home as defined in section 144A.01, 
 subdivision 5, a long-term acute care facility, a subacute care 
 facility, an outpatient clinic, a physician's office, or a 
 hospice. 

    Subd. 9.    Qualified medical direction.  "Qualified 
 medical direction" means direction from a licensed physician who 
 is on the staff or is a consultant of a health care facility or 
 home care agency or home medical equipment provider and who has 
 a special interest in and knowledge of the diagnosis and 
 treatment of deficiencies, abnormalities, and diseases of the 
 cardiopulmonary system.  

    Subd. 10.    Respiratory care.  "Respiratory care" means 
 the provision of services described under section 147C.05 for 
 the assessment, treatment, education, management, evaluation, 
 and care of patients with deficiencies, abnormalities, and 
 diseases of the cardiopulmonary system, under the guidance of 
 qualified medical direction and pursuant to a referral from a 
 physician who has medical responsibility for the patient.  It 
 includes education pertaining to health promotion and disease 
 prevention, patient care, and treatment. 

    HIST: 1997 c 120 s 2 

     147C.05 Scope of practice. 

    (a) The practice of respiratory care by a registered 
 respiratory care practitioner includes, but is not limited to, 
 the following services: 

    (1) providing and monitoring therapeutic administration of 
 medical gases, aerosols, humidification, and pharmacological 
 agents related to respiratory care procedures, but not including 
 administration of general anesthesia; 

    (2) carrying out therapeutic application and monitoring of 
 mechanical ventilatory support; 

    (3) providing cardiopulmonary resuscitation and maintenance 
 of natural airways and insertion and maintenance of artificial 
 airways; 

    (4) assessing and monitoring signs, symptoms, and general 
 behavior relating to, and general physical response to, 
 respiratory care treatment or evaluation for treatment and 
 diagnostic testing, including determination of whether the 
 signs, symptoms, reactions, behavior, or general response 
 exhibit abnormal characteristics; 

    (5) obtaining physiological specimens and interpreting 
 physiological data including: 

    (i) analyzing arterial and venous blood gases; 

    (ii) assessing respiratory secretions; 

    (iii) measuring ventilatory volumes, pressures, and flows; 

    (iv) testing pulmonary function; 

    (v) testing and studying the cardiopulmonary system; and 

    (vi) diagnostic testing of breathing patterns related to 
 sleep disorders; 

    (6) assisting hemodynamic monitoring and support of the 
 cardiopulmonary system; 

    (7) assessing and making suggestions for modifications in 
 the treatment regimen based on abnormalities, protocols, or 
 changes in patient response to respiratory care treatment; 

    (8) providing cardiopulmonary rehabilitation including 
 respiratory-care related educational components, postural 
 drainage, chest physiotherapy, breathing exercises, aerosolized 
 administration of medications, and equipment use and 
 maintenance; 

    (9) instructing patients and their families in techniques 
 for the prevention, alleviation, and rehabilitation of 
 deficiencies, abnormalities, and diseases of the cardiopulmonary 
 system; and 

    (10) transcribing and implementing physician orders for 
 respiratory care services. 

    (b) Patient service by a practitioner must be limited to: 

    (1) services within the training and experience of the 
 practitioner; and 

    (2) services within the parameters of the laws, rules, and 
 standards of the facilities in which the respiratory care 
 practitioner practices.  

    (c) Respiratory care services provided by a registered 
 respiratory care practitioner, whether delivered in a health 
 care facility or the patient's residence, must not be provided 
 except upon referral from a physician. 

    HIST: 1997 c 120 s 3 

     147C.10 Protected titles and restrictions on use. 

    Subdivision 1.    Protected titles.  No individual may 
 use the title "Minnesota registered respiratory care 
 practitioner," "registered respiratory care practitioner," 
 "respiratory care practitioner," "respiratory therapist," 
 "respiratory therapy (or care) technician," "inhalation 
 therapist," or "inhalation therapy technician," or use, in 
 connection with the individual's name, the letters "RCP," or any 
 other titles, words, letters, abbreviations, or insignia 
 indicating or implying that the individual is eligible for 
 registration by the state as a respiratory care practitioner 
 unless the individual has been registered as a respiratory care 
 practitioner according to this chapter. 

    Subd. 2.    Other health care practitioners.  (a) 
 Nonphysician individuals practicing in a health care occupation 
 or profession are not restricted in the provision of services 
 included in section 147C.05, as long as they do not hold 
 themselves out as respiratory care practitioners by or through 
 the use of the titles provided in subdivision 1 in association 
 with provision of these services. 

    (b) Physician practitioners are exempt from this chapter. 

    (c) Nothing in this chapter shall be construed to require 
 registration of: 

    (1) a respiratory care practitioner student enrolled in a 
 respiratory therapy education program accredited by the 
 Commission on Accreditation of Allied Health Education Programs 
 or another accrediting organization approved by the board; and 

    (2) a respiratory care practitioner employed in the service 
 of the federal government while performing duties incident to 
 that employment. 

    Subd. 3.    Penalty.  A person who violates subdivision 
 1 is guilty of a gross misdemeanor. 

    Subd. 4.    Identification of registered practitioners.  
 Respiratory care practitioners registered in Minnesota shall 
 wear name tags that identify them as respiratory care 
 practitioners while in a professional setting.  If not written 
 in full, this must be designated as RCP.  A student attending a 
 respiratory therapy training program or a tutorial intern 
 program must be identified as a student respiratory care 
 practitioner.  This abbreviated designation is Student RCP.  
 Unregulated individuals who work in an assisting respiratory 
 role under the supervision of respiratory care practitioners 
 must be identified as respiratory care assistants or aides. 

    HIST: 1997 c 120 s 4 

     147C.15 Registration requirements. 

    Subdivision 1.    General requirements for registration. 
  To be eligible for registration, an applicant, with the 
 exception of those seeking registration by reciprocity under 
 subdivision 2, must: 

    (1) submit a completed application on forms provided by the 
 board along with all fees required under section 147C.40 that 
 includes: 

    (i) the applicant's name, social security number, home 
 address and telephone number, and business address and telephone 
 number; 

    (ii) the name and location of the respiratory care 
 education program the applicant completed; 

    (iii) a list of degrees received from educational 
 institutions; 

    (iv) a description of the applicant's professional training 
 beyond the first degree received; 

    (v) the applicant's work history for the five years 
 preceding the application, including the average number of hours 
 worked per week; 

    (vi) a list of registrations, certifications, and licenses 
 held in other jurisdictions; 

    (vii) a description of any other jurisdiction's refusal to 
 credential the applicant; 

    (viii) a description of all professional disciplinary 
 actions initiated against the applicant in any jurisdiction; and 

    (ix) any history of drug or alcohol abuse, and any 
 misdemeanor or felony conviction; 

    (2) submit a certificate of completion from an approved 
 education program; 

    (3) achieve a qualifying score on a credentialing 
 examination within five years prior to application for 
 registration; 

    (4) submit a verified copy of a valid and current 
 credential, issued by the National Board for Respiratory Care or 
 other board-approved national organization, as a certified 
 respiratory therapy technician, registered respiratory 
 therapist, or other entry or advanced level respiratory care 
 practitioner designation; 

    (5) submit additional information as requested by the 
 board, including providing any additional information necessary 
 to ensure that the applicant is able to practice with reasonable 
 skill and safety to the public; 

    (6) sign a statement that the information in the 
 application is true and correct to the best of the applicant's 
 knowledge and belief; and 

    (7) sign a waiver authorizing the board to obtain access to 
 the applicant's records in this or any other state in which the 
 applicant has completed an approved education program or engaged 
 in the practice of respiratory care. 

    Subd. 2.    Registration by reciprocity.  To be eligible 
 for registration by reciprocity, the applicant must be 
 credentialed by the National Board for Respiratory Care or other 
 board-approved organization and have worked at least eight weeks 
 of the previous five years as a respiratory care practitioner 
 and must: 

    (1) submit the application materials and fees as required 
 by subdivision 1, clauses (1), (4), (5), (6), and (7); 

    (2) provide a verified copy from the appropriate government 
 body of a current and unrestricted credential for the practice 
 of respiratory care in another jurisdiction that has initial 
 credentialing requirements equivalent to or higher than the 
 requirements in subdivision 1; and 

    (3) provide letters of verification from the appropriate 
 government body in each jurisdiction in which the applicant 
 holds a credential.  Each letter must state the applicant's 
 name, date of birth, credential number, date of issuance, a 
 statement regarding disciplinary actions, if any, taken against 
 the applicant, and the terms under which the credential was 
 issued. 

    Subd. 3.    Temporary permit.  The board may issue a 
 temporary permit to practice as a respiratory care practitioner 
 to an applicant eligible for registration under this section if 
 the application for registration is complete, all applicable 
 requirements in this section have been met, and a nonrefundable 
 fee set by the board has been paid.  The permit remains valid 
 only until the meeting of the board at which a decision is made 
 on the respiratory care practitioner's application for 
 registration. 

    Subd. 4.    Temporary registration.  The board may issue 
 temporary registration as a respiratory care practitioner for a 
 period of one year to an applicant for registration under this 
 section if the application for registration is complete, all 
 applicable requirements have been met with exception of 
 completion of a credentialing examination, and a nonrefundable 
 fee set by the board has been paid.  A respiratory care 
 practitioner with temporary registration may qualify for full 
 registration status upon submission of verified documentation 
 that the respiratory care practitioner has achieved a qualifying 
 score on a credentialing examination within one year after 
 receiving temporary registration status.  Temporary registration 
 may not be renewed. 

    Subd. 5.    Practice limitations with temporary 
 registration.  A respiratory care practitioner with temporary 
 registration is limited to working under the direct supervision 
 of a registered respiratory care practitioner or physician able 
 to provide qualified medical direction.  The respiratory care 
 practitioner or physician must be present in the health care 
 facility or readily available by telecommunication at the time 
 the respiratory care services are being provided.  A registered 
 respiratory care practitioner may supervise no more than two 
 respiratory care practitioners with temporary registration 
 status. 

    Subd. 6.    Registration expiration.  Registrations 
 issued under this chapter expire annually. 

    Subd. 7.    Renewal.  (a) To be eligible for 
 registration renewal a registrant must: 

    (1) annually, or as determined by the board, complete a 
 renewal application on a form provided by the board; 

    (2) submit the renewal fee; 

    (3) provide evidence every two years of a total of 24 hours 
 of continuing education approved by the board as described in 
 section 147C.25; and 

    (4) submit any additional information requested by the 
 board to clarify information presented in the renewal 
 application.  The information must be submitted within 30 days 
 after the board's request, or the renewal request is nullified. 

    (b) Applicants for renewal who have not practiced the 
 equivalent of eight full weeks during the past five years must 
 achieve a passing score on retaking the credentialing 
 examination, or complete no less than eight weeks of advisory 
 council-approved supervised clinical experience having a broad 
 base of treatment modalities and patient care.  

    Subd. 8.    Change of address.  A registrant who changes 
 addresses must inform the board within 30 days, in writing, of 
 the change of address.  All notices or other correspondence 
 mailed to or served on a registrant by the board at the 
 registrant's address on file with the board shall be considered 
 as having been received by the registrant. 

    Subd. 9.    Registration renewal notice.  At least 30 
 days before the registration renewal date, the board shall send 
 out a renewal notice to the last known address of the registrant 
 on file.  The notice must include a renewal application and a 
 notice of fees required for renewal.  It must also inform the 
 registrant that registration will expire without further action 
 by the board if an application for registration renewal is not 
 received before the deadline for renewal.  The registrant's 
 failure to receive this notice shall not relieve the registrant 
 of the obligation to meet the deadline and other requirements 
 for registration renewal.  Failure to receive this notice is not 
 grounds for challenging expiration of registered status. 

    Subd. 10.    Renewal deadline.  The renewal application 
 and fee must be postmarked on or before July 1 of the year of 
 renewal or as determined by the board.  If the postmark is 
 illegible, the application shall be considered timely if 
 received by the third working day after the deadline. 

    Subd. 11.    Inactive status and return to active status. 
  (a) A registration may be placed in inactive status upon 
 application to the board by the registrant and upon payment of 
 an inactive status fee.  

    (b) Registrants seeking restoration to active from inactive 
 status must pay the current renewal fees and all unpaid back 
 inactive fees.  They must meet the criteria for renewal 
 specified in subdivision 7, including continuing education hours 
 equivalent to one hour for each month of inactive status, prior 
 to submitting an application to regain registered status.  If 
 the inactive status extends beyond five years, a qualifying 
 score on a credentialing examination, or completion of an 
 advisory council-approved eight-week supervised clinical 
 training experience is required.  If the registrant intends to 
 regain active registration by means of eight weeks of advisory 
 council-approved clinical training experience, the registrant 
 shall be granted temporary registration for a period of no 
 longer than six months. 

    Subd. 12.    Registration following lapse of registration 
 status for two years or less.  For any individual whose 
 registration status has lapsed for two years or less, to regain 
 registration status, the individual must: 

    (1) apply for registration renewal according to subdivision 
 7; 

    (2) document compliance with the continuing education 
 requirements of section 147C.25 since the registrant's initial 
 registration or last renewal; and 

    (3) submit the fees required under section 147C.40 for the 
 period not registered, including the fee for late renewal. 

    Subd. 13.    Cancellation due to nonrenewal.  The board 
 shall not renew, reissue, reinstate, or restore a registration 
 that has lapsed and has not been renewed within two annual 
 registration renewal cycles starting July 1997.  A registrant 
 whose registration is canceled for nonrenewal must obtain a new 
 registration by applying for registration and fulfilling all 
 requirements then in existence for initial registration as a 
 respiratory care practitioner.  

    Subd. 14.    Cancellation of registration in good 
 standing.  (a) A registrant holding active registration as a 
 respiratory care practitioner in the state may, upon approval of 
 the board, be granted registration cancellation if the board is 
 not investigating the person as a result of a complaint or 
 information received or if the board has not begun disciplinary 
 proceedings against the registrant.  Such action by the board 
 shall be reported as a cancellation of registration in good 
 standing. 

    (b) A registrant who receives board approval for 
 registration cancellation is not entitled to a refund of any 
 registration fees paid for the registration year in which 
 cancellation of the registration occurred. 

    (c) To obtain registration after cancellation, a registrant 
 must obtain a new registration by applying for registration and 
 fulfilling the requirements then in existence for obtaining 
 initial registration as a respiratory care practitioner.  

    HIST: 1997 c 120 s 5 

     147C.20 Board action on applications for registration. 

    (a) The board shall act on each application for 
 registration according to paragraphs (b) to (d). 

    (b) The board shall determine if the applicant meets the 
 requirements for registration under section 147C.15.  The board 
 or advisory council may investigate information provided by an 
 applicant to determine whether the information is accurate and 
 complete.  

    (c) The board shall notify each applicant in writing of 
 action taken on the application, the grounds for denying 
 registration if registration is denied, and the applicant's 
 right to review under paragraph (d).  

    (d) Applicants denied registration may make a written 
 request to the board, within 30 days of the board's notice, to 
 appear before the advisory council and for the advisory council 
 to review the board's decision to deny the applicant's 
 registration.  After reviewing the denial, the advisory council 
 shall make a recommendation to the board as to whether the 
 denial shall be affirmed.  Each applicant is allowed only one 
 request for review per yearly registration period.  

    HIST: 1997 c 120 s 6 

     147C.25 Continuing education requirements. 

    Subdivision 1.    Number of required contact hours.  Two 
 years after the date of initial registration, and every two 
 years thereafter, a registrant applying for registration renewal 
 must complete a minimum of 24 contact hours of board-approved 
 continuing education in the two years preceding registration 
 renewal and attest to completion of continuing education 
 requirements by reporting to the board. 

    Subd. 2.    Approved programs.  The board shall approve 
 continuing education programs that have been approved for 
 continuing education credit by the American Association of 
 Respiratory Care or the Minnesota Society for Respiratory Care 
 or their successor organizations.  The board shall also approve 
 programs substantially related to respiratory care that are 
 sponsored by an accredited university or college, medical 
 school, state or national medical association, national medical 
 specialty society, or that are approved for continuing education 
 credit by the Minnesota board of nursing.  

    Subd. 3.    Approval of continuing education programs.  
 The board shall also approve continuing education programs that 
 do not meet the requirements of subdivision 2 but that meet the 
 following criteria: 

    (1) the program content directly relates to the practice of 
 respiratory care; 

    (2) each member of the program faculty is knowledgeable in 
 the subject matter as demonstrated by a degree from an 
 accredited education program, verifiable experience in the field 
 of respiratory care, special training in the subject matter, or 
 experience teaching in the subject area; 

    (3) the program lasts at least one contact hour; 

    (4) there are specific, measurable, written objectives, 
 consistent with the program, describing the expected outcomes 
 for the participants; and 

    (5) the program sponsor has a mechanism to verify 
 participation and maintains attendance records for three years. 

    Subd. 4.    Hospital, health care facility, or medical 
 company in-services.  Hospital, health care facility, or 
 medical company in-service programs may qualify for continuing 
 education credits provided they meet the requirements of this 
 section. 

    Subd. 5.    Accumulation of contact hours.  A registrant 
 may not apply contact hours acquired in one two-year reporting 
 period to a future continuing education reporting period.  

    Subd. 6.    Verification of continuing education credits. 
  The board shall periodically select a random sample of 
 registrants and require those registrants to supply the board 
 with evidence of having completed the continuing education to 
 which they attested.  Documentation may come directly from the 
 registrant or from state or national organizations that maintain 
 continuing education records. 

    Subd. 7.    Restriction on continuing education topics.  
 A registrant may apply no more than a combined total of eight 
 hours of continuing education in the areas of management, risk 
 management, personal growth, and educational techniques to a 
 two-year reporting period. 

    Subd. 8.    Credit for credentialing examination.  A 
 registrant may fulfill the continuing education requirements for 
 a two-year reporting period by achieving a qualifying score on 
 one of the credentialing examinations or a specialty 
 credentialing examination of the National Board for Respiratory 
 Care or another board-approved testing organization.  A 
 registrant may achieve 12 hours of continuing education credit 
 by completing a National Board for Respiratory Care or other 
 board-approved testing organization's specialty examination.  

    HIST: 1997 c 120 s 7 

     147C.30 Discipline; reporting. 

    For purposes of this chapter, registered respiratory care 
 practitioners and applicants are subject to the provisions of 
 sections 147.091 to 147.162.  

    HIST: 1997 c 120 s 8 

     147C.35 Respiratory care practitioner advisory council. 

    Subdivision 1.    Membership.  The board shall appoint a 
 seven-member respiratory care practitioner advisory council 
 consisting of two public members as defined in section 214.02, 
 three registered respiratory care practitioners, and two 
 licensed physicians with expertise in respiratory care. 

    Subd. 2.    Organization.  The advisory council shall be 
 organized and administered under section 15.059.  The council 
 expires June 30, 2003. 

    Subd. 3.    Duties.  The advisory council shall: 

    (1) advise the board regarding standards for respiratory 
 care practitioners; 

    (2) provide for distribution of information regarding 
 respiratory care practitioner standards; 

    (3) advise the board on enforcement of sections 147.091 to 
 147.162; 

    (4) review applications and recommend granting or denying 
 registration or registration renewal; 

    (5) advise the board on issues related to receiving and 
 investigating complaints, conducting hearings, and imposing 
 disciplinary action in relation to complaints against 
 respiratory care practitioners; 

    (6) advise the board regarding approval of continuing 
 education programs using the criteria in section 147C.25, 
 subdivision 3; and 

    (7) perform other duties authorized for advisory councils 
 by chapter 214, as directed by the board. 

    HIST: 1997 c 120 s 9; 2001 c 31 s 1 

     147C.40 Fees. 

    Subdivision 1.    Fees.  The board shall adopt rules 
 setting: 

    (1) registration fees; 

    (2) renewal fees; 

    (3) late fees; 

    (4) inactive status fees; 

    (5) fees for temporary permits; and 

    (6) fees for temporary registration. 

    Subd. 2.    Proration of fees.  The board may prorate 
 the initial annual registration fee.  All registrants are 
 required to pay the full fee upon registration renewal. 

    Subd. 3.    Penalty fee for late renewals.  An 
 application for registration renewal submitted after the 
 deadline must be accompanied by a late fee in addition to the 
 required fees. 

    Subd. 4.    Nonrefundable fees.  All of the fees in 
 subdivision 1 are nonrefundable. 

    HIST: 1997 c 120 s 10