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Chapter 27B
ALABAMA STATE BOARD of RESPIRATORY THERAPY
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§ 34-27B-1. Legislative Findings
The Legislature finds and declares that the practice of
respiratory therapy in Alabama affects the public health,
safety, and welfare of the citizens of Alabama. It, therefore,
should be subject to regulation and control, in the public
interest to protect the citizenry against the unauthorized,
unqualified, and improper administration of respiratory therapy
and from unprofessional or unethical conduct by persons licensed
to practice respiratory therapy. (Act 2004-518, §1.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004
§ 34-27B-2 Definitions
As used in this chapter, the following terms shall have the
following meanings:
(1) BOARD. The Alabama State Board of Respiratory Therapy
(2) DIRECT CLINICAL SUPERVISION. A situation where a licensed
respiratory therapist or physician is available for the purpose
of communication, consultation, and assistance.
(3) HEALTHCARE FACILITY. The definition shall be the same as in
Section 22-21-260.
(4) MEDICALLY APPROVED PROTOCOL. A detailed plan for taking
specific diagnostic or treatment actions, or both, authorized by
the treating physician of the patient, all of which actions
shall be:
(a) In a hospital or other inpatient health care facility,
approved by the supervising physician of the respiratory
therapist or in an outpatient treatment setting approved by the
supervising physician of the respiratory therapist.
(b) Except in cases of medical emergency, instituted following
an evaluation of the patient by a physician or otherwise
directed by the supervising physician of the respiratory
therapist.
(c) Consistent with the definition of the scope of practice of
respiratory therapy, as established by this chapter.
(5) PHYSICIAN. A person who is a doctor of medicine or a doctor
of osteopathy licensed to practice in this state.
(6) RESPIRATORY THERAPIST. A person licensed by the board to
administer respiratory therapy and who has the knowledge and
skills necessary to administer respiratory therapy, monitor
patient responses, modify respiratory therapy based upon patient
response, provide information and education to patients about
deficiencies or disorders of the cardiopulmonary system, and
supervise others in the delivery of appropriate respiratory
therapy procedures.
(7) RESPIRATORY THERAPY OR CARE. Therapy, management,
rehabilitation, diagnostic evaluation, and care of patients with
deficiencies and abnormalities of the cardiopulmonary system and
associates aspects of other systems functions, given by a health
care professional under the direction of a physician. The term
includes, but is not limited to, the following activities
conducted upon written prescription, verbal order, or medically
approved protocol:
(a) Direct and indirect pulmonary care services that are safe,
aseptic, preventive, or restorative to the patient.
(b) Direct and indirect respiratory therapy services, including,
but not limited to, the administration of pharmacologic,
diagnotist, and therapeutic agents related to respiratory
therapy procedures necessary to implement a treatment, disease
prevention, pulmonary rehabilitative, or diagnostic regimen
prescribed by a physician.
(c) Observation and monitoring of signs and symptoms, general
behavior, and general physical response to respiratory therapy
treatment and diagnotist testing and determination of whether
such signs, symptoms, reactions, behavior, or general responses
exhibit abnormal characteristics and implementation, based on
observed abnormalities, of appropriate reporting or referral
practices or prescribed and medically approved respiratory
therapy protocols or appropriate changes in a treatment regimen,
pursuant to a prescription by a physician, or the initiation of
emergency procedures.
(d) The diagnostic and therapeutic use of any of the following,
in accordance with the prescription of a physician:
1. Administrative of medical gases, exclusive of general
anesthesia.
2. Aerosols.
3. Humidification.
4. Environmental control systems and hyperbaric therapy.
5. Pharmacologic agents related to respiratory therapy
procedures.
6. Mechanical or physiological ventilatory support.
7. Bronchopulmonary hygiene.
8. Cardiopulmonary resuscitation.
9. Maintenance of natural airways.
10. Insertion without cutting tissues and maintenance of
artificial airways.
11. Diagnostic and testing techniques required for
implementation of respiratory therapy protocols.
12. Collections of specimens of blood and other body fluids
including specimens from the respiratory tract.
13. Collections of inspired and expired gas samples.
14. Analysis of blood, gases, and respiratory secretions.
15. Measurements of ventilatory volumes, pressures, and flows.
16. Pulmonary function testing.
17. Hemodynamic and other related physiologic measurements of
the cardiopulmonary system.
18. Respiratory telecommunications.
19. Cardiopulmonary disease management.
20. Tobacco cessation.
(e) The transcription and implementation of the written and
verbal orders of a physician pertaining to the practice of
respiratory therapy.
(f) Institution of known and medically approved protocols
relating to respiratory therapy in emergency situations in the
absence of immediate direction by a physician and institution of
specific procedures and diagnostic testing related to
respiratory therapy as ordered by a physician to assist in
diagnosis, monitoring, treatment, and medical research.
(g) Delivery of respiratory therapy procedures, instruction, and
education of patients in the proper methods of self-care and
prevention of cardiopulmonary diseases and other conditions
requiring the use of respiratory therapy equipment or
techniques. (Act 2004-518, §2,)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004
§ 34-27B-3 License requirement; examination.
(a) Except as provided in Section 34-27B-7, no person shall hold
himself or herself out to be, or function as, a respiratory
therapist in this state unless licensed in accordance with this
chapter.
(b) In order to obtain a respiratory therapist license, an
applicant shall demonstrate to the board that he or she is at
least 18 years of age, is a high school graduate, or has the
equivalent of a high school diploma, and meets one of the
following requirements:
(1) Holds credentials as a registered respiratory therapist (RRT)
or a certified respiratory therapist (CRT), as granted by the
National Board for Respiratory Care or its successor
organization.
(2) Holds a temporary license issued under subsection (d) of
Section 34-27B-7 and passed the examination leading to the CRT
or RRT credential.
(3) Has a valid respiratory therapist license from another
state, the District of Columbia, or a territory of the United
States, whose requirements for licensure are considered by the
board as substantially similar to those of Alabama and who
otherwise meets the reciprocity requirements established by the
board.
(4) Meets the requirements of subdivision (2) of subsection (d)
of Section 34-27B-7.
(5) Has been approved by the board as otherwise qualified by
special training and has passed the licensure examination
established by the board in subsection (c ).
(6) The board shall arrange for the administration of a
licensure examination administered by the state or a national
agency approved by the board. The examination shall be validated
and nationally recognized as testing respiratory care
competencies. The board may enter into agreements or contracts,
consistent with state law, with outside organizations for the
purpose of developing, administering, grading, and reporting the
results of licensure examinations. Such organizations shall be
capable of meeting the standards of the National Commission for
Health Certifying Agencies, or its equivalent or successor
organization. The board shall establish criteria for
satisfactory performance on the examination. (Act 2004-518, §3.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004
§ 34-27B-4. State Board of Respiratory Therapy – Functions.
The board shall perform the following functions:
(1) Set respiratory therapy licensure fees, including, but not
limited to, application, initial, renewal, and reinstatement
fees.
(2) Establish and publish minimum standards of continuing
education of respiratory therapy in accordance with those
standards developed and accepted by the profession.
(3) Examine for, approve, deny, revoke, suspend, and renew
licensure of duly qualified applicants.
(4) Promulgate and publish rules in accordance with the
Administrative Procedure Act to administer this chapter.
(5) Conduct hearings on charges calling for the denial,
suspension, revocation, or refusal to renew a license.
(6) Maintain an up-to-date list of every person licensed to
practice respiratory therapy pursuant to this chapter. The list
shall include the last known place of residence and the state
license number of the licensee.
(7) Maintain an up-to-date list of persons whose licenses have
been suspended, revoked, or denied. The list shall include the
name, Social Security number, type, date, and cause of action,
penalty incurred, and the length of the penalty. The information
on the list, except for Social Security numbers, shall be
available for public inspection during reasonable business hours
and the information may be shared with others as deemed
necessary and acceptable by the board. (Act 2004-518, §4.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004
§ 34-27B-5. State Board of Respiratory Therapy – Created;
composition; liability of members; terms; meetings; expense
reimbursement and per diem allowance.
(a) The Alabama State Board of Respiratory Therapy is created to
implement and administer this chapter and shall be composed of
five members appointed by the Governor. Three of the members
shall be respiratory therapists, one member shall be the chief
executive officer of a hospital, and one member shall be a
physician. The respiratory therapist members of the board
appointed by the Governor shall be selected from a list of names
submitted by the Alabama Society for Respiratory Care. The list
shall include two names for each appointed position to be
filled. The respiratory therapist members appointed to the board
shall be registered or certified by the National Board for
Respiratory Care or its successor organization. Respiratory
therapists selected for subsequent appointments must be licensed
by the state. The hospital member shall be selected from a list
of names submitted by the Alabama Hospital Association. The
physician member appointed shall be duly licensed to practice
medicine in Alabama and shall be a member of at least one of the
following: The American Thoracic Society, the American College
of Chest Physicians, the American Society of Anesthesiologists,
or the American Academy of Pediatrics. The physician member of
the board appointed by the Governor shall be selected from a
list of names submitted by the Medical Association of the State
of Alabama. Such lists shall include two names for the position.
(b) All board members shall be residents of Alabama and the
composition of the board shall reflect the racial, gender,
geographic, urban/rural, and economic diversity of the state.
(c) The Governor shall make the appointments for all positions
for members of the board within 90 days of the date the position
becomes available, including initial appointments, vacancies,
and replacements at the end of the term of service.
(d) Members of the board shall have the same immunities from
personal liability as state employees for actions taken in the
performance of their official duties.
(e) The term of office of those members first appointed shall be
as follows: Two respiratory therapists and the hospital member,
as determined by the Governor, shall serve for terms of two
years, and one respiratory therapist and the physician member
shall serve for terms of four years. Thereafter, the term of all
members shall be for four years. No member shall be appointed
for more than three consecutive full terms. A vacancy in an
unexpired term shall be filled in the manner of the original
appointment. The board shall elect a chair and vice chair
annually.
(f) The board shall meet at least twice a year at a time and
place determined by the chair. A majority of the members of the
board shall constitute a quorum for the transaction of business.
(g) Each member shall serve without compensation, but shall be
reimbursed for travel expenses incurred in attendance at
meetings of the board and any other expenses incurred on
business of the board at its discretion. Board members shall
also receive a per diem allowance following the guidelines for
state employees. The reimbursement for expenses and per diem
shall be paid from funds derived from the Alabama State Board of
Respiratory Therapy Fund. (Act 2004-518, §5.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-6. Trust fund.
There is hereby established a separate special trust fund in the
State Treasury to be known as the Alabama State Board of
Respiratory Therapy Fund. All funds received by the board shall
be deposited into the fund and shall be expended only to
implement and administer this act. No monies shall be withdrawn
or expended only to implement and administer this act. No monies
shall be withdrawn or expended from the fund for any purpose
unless the monies have been appropriated by the Legislature and
allocated pursuant to this act. Any monies appropriated shall be
budgeted and allocated pursuant to the Budget Management Act in
accordance with Article 4, (commencing with Section 41-4-80) of
Chapter 4 of Title 41, and only in the amounts provided by the
Legislature in the general appropriations act or other
appropriations act. Funds shall be disbursed only upon a warrant
of the State Comptroller upon itemized vouchers approved by the
chair.
After the first three full fiscal years from the effective date
of this act, if a surplus of funds exists which is greater than
one year’s operating expense, the funds shall be distributed to
the general fund. (Act 2004-518, §6.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-7. Issuance, use, renewal of license; temporary
license.
(a) The board shall issue a respiratory therapist license to any
person who meets the qualifications required by this chapter and
who pays the license fee established herein.
(b) Any person who is issued a license as a respiratory
therapist under this chapter may use the words “licensed
respiratory therapist” or the letters “LRT” in connection with
his or her name to denote his or her license.
(c) A license issued under this chapter shall be subject to
biannual renewal.
(d) (1) The board may issue a six-month temporary license as a
respiratory therapist to persons who have graduated from a
respiratory therapy educational program accredited by the
Council on Allied Health Education Programs (CAHEP) in
collaboration with the Committee on Accreditation for
Respiratory Care (CoARC), or their successor organizations, and
who have applied for and are awaiting competency examination.
The temporary license shall be renewable only once for an
additional six-month period if the applicant fails the
examination. Exceptions may be made at the discretion of the
board based upon an appeal identifying extenuating
circumstances. The holder of a temporary license may only
provide respiratory therapy or care activities, services, and
procedures as defined in Section 34-27B-2 under the direct
clinical supervision of a licensed respiratory therapist or
physician.
(2) The board shall grant a license as a respiratory therapist
to other persons who do not meet the qualifications for
licensure pursuant to Section 34-27B-3, but who, on the
effective date of the adoption of the rules and regulations of
the board, are currently employed in the administration of
respiratory therapy under the direction of a physician in the
State of Alabama. The opportunity to apply for a respiratory
therapy license issued under this subdivision shall expire 365
days after implementation of the rules of the board. Holders of
these licenses shall be eligible to renew their licenses as are
any other licensed respiratory therapists under this chapter.
(Act 2004-518, §7.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-8. Disciplinary actions for unprofessional conduct;
hearings; expiration of suspended license.
(a) The board may refuse to renew a license, may suspend or
revoke a license, may impose probationary conditions, or may
impose an administrative fine not to exceed five hundred dollars
($500) per violation, as disciplinary actions if a licensee or
applicant for licensure has been found guilty of unprofessional
conduct that has endangered, or is likely to endanger, the
health, welfare, or safety of the public. Unprofessional conduct
includes, but is not limited to, the following:
(1) Obtaining a license by means of fraud, misrepresentation, or
concealment of material facts.
(2) Being found guilty of unprofessional conduct as defined by
the rules established by the board, or violating the code of
ethics adopted and published by the American Association for
Respiratory Care of its successor organization.
(3) Conviction of a crime, other than a minor offense, in any
court if the offense has a direct bearing on whether the person
should be entrusted to serve the public in the capacity of a
respiratory therapist.
(b) The board, after a hearing, may exercise the disciplinary
actions authorized in subsection (a). The board shall adopt
policies for the conduct of the hearings. One year after the
date of the revocation of a license, application may be made to
the board for reinstatement. The board shall hold a hearing to
consider any application for reinstatement.
(c) The board may establish rules regarding the disciplinary
actions authorized in subsection (a) in accordance with the
Administrative Procedure Act.
(d) A suspended license is subject to expiration during the
suspension period. (Act 2004, 518, §8.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-9. Representation as “respiratory therapist”, etc.
(a) A person who does not hold a license or a temporary license
as a respiratory therapist or whose license or temporary license
has been suspended or revoked may not do any of the following:
(1) Use in connection with the person’s practice the words
“respiratory care professional,” “respiratory therapist,”
“respiratory care practitioner,” “certified respiratory care
practitioner,” “licensed respiratory therapist,” “inhalation
therapist,” or “respiratory therapy technician”; or use the
letters “R.C.P.” or “L.R.T.”; or use any other words, letters,
abbreviations, or insignia indicating or implying that the
person is a respiratory therapist.
(2) Directly or by implication represent in any way that the
person is a respiratory therapist.
(b) A person who holds a license or a temporary license to
practice respiratory therapy under this chapter may use the
title “respiratory therapist” and the abbreviation “L.R.T.” (Act
2004-518, §9)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-10. Violations
Any person who violates this act, upon conviction, shall be
guilty of a Class B misdemeanor. (Act 2004-518, §10.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-11. Additional activities permitted under chapter.
Nothing in this chapter shall be construed as preventing or
restricting the practice, services, or activities of any of the
following:
(1) Any person who is licensed in Alabama or certified by an
organization accredited by the National Commission for
Certifying Agencies and acceptable to the state from engaging in
the profession or occupation for which the person is licensed or
certified.
(2) Any person employed by the United States government who
provides respiratory therapy solely under the direction or
control of the United States government agency or organization.
(3) Any person receiving clinical training while pursuing a
course of study leading to registry or certification in a
respiratory therapy educational program accredited by the
Council on Allied Health Education Programs in collaboration
with the Committee on Accreditation for Respiratory Care or
their successor organizations. This person will be under direct
supervision and be designated by a title clearly indicating his
or her status as a student or trainee.
(4) Any emergency medical technician licensed by the Alabama
State Board of Health who is providing care to a patient at the
scene of an emergency, or during transport of the patient in a
licensed ground ambulance, provided that such care may not
exceed the scope of care permissible under the rules of the
Alabama State Board of Health.
(5) The delivery of respiratory therapy of sick or disabled
persons by family members or domestic servants or the care of
non-institutionalized persons by a surrogate family member as
long as the persons do not represent themselves as, or hold
themselves out to be, respiratory therapists.
(6) Any individual who has demonstrated competency in one or
more areas covered by this chapter as long as the individual
performs only those functions that he or she is qualified by
examination to perform. The standards of the National Commission
for Certifying Agencies, or its equivalent, shall serve as a
standards with which to evaluate those examinations and
examining organizations.
(7) Any person performing respiratory services or care not
licensed as a respiratory therapist in accordance with this
chapter who is employed in a diagnostic laboratory, physician’s
office, clinic, or outpatient treatment facility and whose
function is to administer treatment or perform diagnostic
procedures confined to that laboratory, office, clinic, or
outpatient facility under the direction of a licensed physician.
(8) Any respiratory therapy student who performs limited
respiratory therapy procedures as an employee of any health care
provider organization while enrolled in a respiratory therapy
educational program accredited by the Council on Allied Health
Education Programs in collaboration with the Committee on
Accreditation for Respiratory Care or their successor
organizations. The employee shall be designated by title as a
student or trainee and shall work under direct supervision.
(9) Any individual employed by a durable medical equipment or
home medical equipment company who delivers, sets up, or
maintains respiratory equipment, but not including assessment or
evaluation of the patient.
(10) Any individual employed as a polysommagraphic technologist
working in a sleep center or diagnostic sleep clinic.
(11) Any licensed respiratory therapist performing advances in
the art and techniques of respiratory therapy learned through
special training acceptable to the board. (Act 2004-518, §11.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004
§ 34-27B-12. Notice provided to respiratory therapists.
(a) The board shall provide notification to all respiratory
therapists employed as such or practicing respiratory therapy in
Alabama on May 17, 2004. The notification shall summarize the
requirements of this chapter and provide information on
procedures for obtaining a license. Publication of the
notification shall be accompanied by complying with all of the
following requirements:
(1) A letter containing the notice shall be directed to all
persons registered or certified by the National Board for
Respiratory Care who reside in the State of Alabama, based on
the most current mailing list of the National Board for
Respiratory Care.
(2) Notice shall be published in all major state trade or
professional journals relating to respiratory therapy for not
less than three consecutive months.
(3) Notice shall be published in all daily newspapers in this
state at least once per month for three consecutive months.
(b) The board shall cause the notices required by this section
to commence within 30 days from the effective date of adoption
of rules and regulations by the board. (Act 2004-518, §12.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-13. Rules and Regulations
The board shall promulgate rules necessary to implement and
administer the provisions of this act. Rules shall be issued
pursuant to the Administrative Procedure Act. (Act 2004-518,
§13.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
§ 34-27B-14. Sunset Provision.
The board shall be subject to the Alabama Sunset Law, as
provided in Chapter 20, Title 41, as an enumerated agency as
provided in Section 41-20-3, and shall have a termination date
of October 1, 2008, and every four years thereafter, unless
continued pursuant to the Alabama Sunset Law. (Act 2004-518,
§14.)
HISTORY
Effective date: The act which added this chapter is effective
May 17, 2004.
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