Pennsylvania Act 1993-60 — MEDICAL PRACTICE ACT OF 1985 - AMEND

Act text

MEDICAL PRACTICE ACT OF 1985 - AMEND
                  Act of Jul. 2, 1993, P.L. 424, No. 60               Cl. 63
                             Session of 1993

                               No. 1993-60

                                  AN ACT

     HB 1010

     Amending the act of December 20, 1985 (P.L.457, No.112),
        entitled "An act relating to the right to practice medicine
        and surgery and the right to practice medically related acts;
        reestablishing the State Board of Medical Education and
        Licensure as the State Board of Medicine and providing for
        its composition, powers and duties; providing for the
        issuance of licenses and certificates and the suspension and
        revocation of licenses and certificates; providing penalties;
        and making repeals," further providing for the State Board of
        Medicine; and regulating the practice of respiratory care
        practitioners.

        The General Assembly finds and declares that the practice of
     respiratory care in this Commonwealth affects the public health,
     safety and welfare and is to be subject to regulation and
     control in the public interest to protect the public from the
     unauthorized and unqualified practice of respiratory care and
     from unprofessional conduct by persons certified to practice
     respiratory care.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

        Section 1.  Section 2 of the act of December 20, 1985
     (P.L.457, No.112), known as the Medical Practice Act of 1985, is
     amended by adding definitions to read:
      Section 2.  Definitions.
        The following words and phrases when used in this act shall
     have the meanings given to them in this section unless the
     context clearly indicates otherwise:
        * * *
        "Respiratory care."  A health care specialty employing
     evaluation, analysis, care and treatment of patients with
     cardiopulmonary disorders and related diseases.
        "Respiratory care practitioner."  An individual who is
     certified to practice respiratory care by the State Board of
     Medicine.
        * * *
        Section 2.  Section 3(a) and (b) of the act are amended to
     read:
      Section 3.  State Board of Medicine.
        (a)  Establishment.--The State Board of Medicine shall
     consist of the commissioner or his designee, the Secretary of
     Health or his designee, two members appointed by the Governor
     who shall be persons representing the public at large and seven
     members appointed by the Governor, six of whom shall be medical
     doctors with unrestricted licenses to practice medicine and
     surgery in this Commonwealth for five years immediately
     preceding their appointment and one who shall be a nurse
     midwife, physician assistant [or], certified registered nurse
     practitioner or respiratory care practitioner licensed or
     certified under the laws of this Commonwealth. All professional
     and public members of the board shall be appointed by the
     Governor, with the advice and consent of a majority of the
     members elected to the Senate.
        (b)  Terms of office.--The term of each professional and
     public member of the board shall be four years or until his or
     her successor has been appointed and qualified, but not longer
     than six months beyond the four-year period. In the event that
     any of said members shall die or resign or otherwise become
     disqualified during his or her term, a successor shall be
     appointed in the same way and with the same qualifications and
     shall hold office for the unexpired term. No member shall be
     eligible for appointment to serve more than two consecutive
     terms. The Governor shall assure that nurse midwives, physician
     assistants [and], certified registered nurse practitioners and
     respiratory care practitioners are appointed to four-year terms
     on a rotating basis so that, of every [three] four appointments
     to a four-year term, one is a nurse midwife, one is a physician
     assistant [and], one is a certified registered nurse
     practitioner and one is a respiratory care practitioner.
        * * *
        Section 3.  The act is amended by adding sections to read:
      Section 13.1.  Respiratory care practitioners.
        (a)  Certificate required.--Eighteen months after the
     effective date of this section, it shall be unlawful for any
     person to hold himself out to the public as a respiratory care
     practitioner and to practice or offer to practice respiratory
     care unless he holds a valid, current temporary permit or
     certificate issued by the board.
        (b)  Use of title.--A respiratory care practitioner who holds
     a valid, current temporary permit or certificate issued by the
     board may use the title respiratory care practitioner or
     respiratory care practitioner-certified or an appropriate
     abbreviation of that title such as "R.C.P." or "R.C.P.-C."
        (c)  Regulations.--The board is authorized to promulgate
     regulations to implement this section.
        (d)  Supervision and scope of practice.--A respiratory care
     practitioner certified by the board may implement direct
     respiratory care to an individual being treated by either a
     licensed medical doctor or a licensed doctor of osteopathic
     medicine, upon physician prescription or referral, or under
     medical direction and approval consistent with standing orders
     or protocols of an institution or health care facility. This
     care may constitute indirect services such as consultation or
     evaluation of an individual and also includes, but is not
     limited to, the following services:
            (1)  Administration of medical gases.
            (2)  Humidity and aerosol therapy.
            (3)  Administration of aerosolized medications.
            (4)  Intermittent positive pressure breathing.
            (5)  Incentive spirometry.
            (6)  Bronchopulmonary hygiene.
            (7)  Management and maintenance of natural airways.
            (8)  Maintenance and insertion of artificial airways.
            (9)  Cardiopulmonary rehabilitation.
            (10)  Management and maintenance of mechanical
        ventilation.
            (11)  Measurement of ventilatory flows, volumes and
        pressures.
            (12)  Analysis of ventilatory gases and blood gases.
        (e)  Exemptions.--This section shall not prevent or restrict
     the practices, services or activities of:
            (1)  A person licensed or certified in this Commonwealth
        to provide another health care service, including, but not
        limited to, physicians, physical therapists, chiropractors,
        nurses, dentists, physician assistants and podiatrists.
            (2)  A person rendering respiratory care services
        pursuant to employment by a Federal agency.
            (3)  A person pursuing a course of study leading to a
        degree or certificate in respiratory care in an accredited
        educational program, if he is clearly designated as a student
        and provides care under supervision implemented through that
        program.
            (4)  A person executing or conveying medical orders
        pursuant to lawful delegation by a physician.
            (5)  A person who, pursuant to lawful delegation by a
        physician, delivers, installs, monitors or maintains a device
        which enables an individual to self-administer respiratory
        care.
            (6)  A person qualified by academic and clinical
        education to operate extracorporeal circulation equipment in
        a medical or surgical setting which requires support to or
        the temporary replacement of a patient's circulatory or
        respiratory functions.
        (f)  Referrals to State Board of Osteopathic Medicine.--
     Information or allegations filed with the board against a
     respiratory care practitioner certified by the State Board of
     Osteopathic Medicine shall be referred to that board for
     appropriate action.
      Section 36.1.  Respiratory care practitioner certificates and
                    permits.
        (a)  General rule.--A respiratory care practitioner
     certificate issued by the board empowers the holder to practice
     respiratory care under the supervision of a licensed medical
     doctor or a licensed doctor of osteopathic medicine. In a health
     care facility, that supervision may consist of standing orders
     or protocols approved by the institution, consistent with
     acceptable and prevailing medical standards, which may include
     services rendered directly to the patient in his home or other
     residence.
        (b)  Temporary permits.--Twelve months after the effective
     date of this section, the board shall issue temporary permits
     for the practice of respiratory care to individuals who have
     applied for certification from the board and who meet any of the
     following requirements:
            (1)  Graduation from an accredited respiratory care
        training program recognized by the board.
            (2)  Enrollment in an accredited respiratory care
        training program recognized by the board, if the individual
        is expected to graduate within 30 days from the date of
        application.
            (3)  Designation as a "Certified Respiratory Therapy
        Technician" or a "Registered Respiratory Therapist" by a
        nationally recognized credentialing agency approved by the
        board.
            (4)  Continuous provision of respiratory care services
        for a minimum of 12 months immediately preceding the
        effective date of this section.
            (5)  Holding certification, licensure or registration as
        a respiratory care practitioner issued by another state, the
        District of Columbia or a territory of the United States,
        where the requirements for licensure, registration or
        certification are substantially similar to those required by
        the board.
        (c)  Duration and effect of temporary permits.--Temporary
     permits shall be valid for a period of 12 months and for such
     additional period as the board may, in each case, specially
     determine, except that a temporary permit shall expire if the
     holder fails the examination. An appropriate fee for a temporary
     permit shall be established by the board by regulation. If he is
     not in violation of any other provision of this act, a holder of
     a temporary permit qualifies for admission to the examination
     and shall apply for the next regularly scheduled certification
     examination administered by the board. The board is authorized
     to promulgate regulations to establish procedures for
     application, credentials verification, examination and
     certification, together with appropriate fees.
        (d)  Examination.--Pursuant to section 812.1 of the act of
     April 9, 1929 (P.L.177, No.175), known as The Administrative
     Code of 1929, the board shall contract for the development and
     administration of an examination for the certification of
     respiratory care practitioners. At least one administration of
     this examination shall be given within 12 months of the
     effective date of this section, and the examination shall
     thereafter be given at least twice per year. An individual
     qualifying for a temporary permit under subsection (b)(5) shall
     be issued a certificate by the board without examination. An
     individual qualifying for a temporary permit under subsection
     (b)(3) shall be issued a certificate by the board without
     examination if the individual passed an examination in order to
     obtain designation as a "Certified Respiratory Therapy
     Technician" or a "Registered Respiratory Therapist" and that
     examination was comparable to the examination developed and
     administered pursuant to this subsection.
        (e)  Biennial renewal.--A respiratory care practitioner
     certificate shall be renewed biennially upon application on a
     form prescribed by the board and upon payment of a renewal fee
     adopted by the board by regulation.
        Section 4.  This act shall take effect in 180 days.

     APPROVED--The 2nd day of July, A. D. 1993.

     MARK L. SINGEL
     ACTING GOVERNOR