S*583 Session 112 (1997-1998)
S*0583(Rat #0289, Act #0280 of 1998) General Bill, By Giese
A BILL TO AMEND SECTION 40-47-510, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA,
1976, RELATING TO DEFINITIONS RELEVANT TO RESPIRATORY CARE, SO AS TO REVISE
THE DEFINITIONS OF THE "PRACTICE OF RESPIRATORY CARE"; TO AMEND SECTION
40-47-530, RELATING TO EXEMPTIONS FROM RESPIRATORY CARE REGULATION, SO AS TO
ELIMINATE THE EXEMPTION FOR HOSPITAL EMPLOYEES AND INCLUDE AN EXEMPTION FOR
CERTAIN EMPLOYEES OF DURABLE MEDICAL EQUIPMENT COMPANIES UNDER CERTAIN
CONDITIONS; TO AMEND SECTIONS 40-47-520, 40-47-590, 40-47-600, AS AMENDED,
40-47-610, 40-47-620, 40-47-625, 40-47-630, AS AMENDED, 40-47-640, 40-47-650,
40-47-655, AS AMENDED, AND 40-47-660, AS AMENDED, ALL RELATING TO THE
CERTIFICATION AND REGULATION OF RESPIRATORY CARE THERAPISTS, SO AS TO REQUIRE
LICENSURE RATHER THAN CERTIFICATION AND TO PROVIDE A TRANSITIONAL PERIOD FOR
PERSONS CURRENTLY CERTIFIED TO MEET THE REQUIREMENTS FOR LICENSURE.-AMENDED
TITLE
03/26/97 Senate Introduced and read first time SJ-12
03/26/97 Senate Referred to Committee on Medical Affairs SJ-12
05/20/97 Senate Committee report: Favorable with amendment
Medical Affairs SJ-17
05/21/97 Senate Amended SJ-44
05/21/97 Senate Read second time SJ-44
05/22/97 Senate Read third time and sent to House SJ-29
05/27/97 House Introduced and read first time HJ-14
05/27/97 House Referred to Committee on Medical, Military,
Public and Municipal Affairs HJ-14
02/18/98 House Committee report: Favorable Medical, Military,
Public and Municipal Affairs HJ-6
02/19/98 House Read second time HJ-12
02/19/98 House Unanimous consent for third reading on next
legislative day HJ-14
02/20/98 House Read third time and enrolled HJ-4
04/01/98 Ratified R 289
04/08/98 Became law without Governor's signature
04/08/98 Effective date 01/01/99
05/04/98 Copies available
05/04/98 Act No. 280
(A280, R289, S583)
AN ACT TO AMEND SECTION 40-47-510, AS AMENDED,
CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO
DEFINITIONS RELEVANT TO RESPIRATORY CARE, SO AS TO
REVISE THE DEFINITIONS OF THE PRACTICE OF RESPIRATORY
CARE; TO AMEND SECTION 40-47-530, RELATING TO
EXEMPTIONS FROM RESPIRATORY CARE REGULATION, SO AS
TO ELIMINATE THE EXEMPTION FOR HOSPITAL EMPLOYEES
AND INCLUDE AN EXEMPTION FOR CERTAIN EMPLOYEES OF
DURABLE MEDICAL EQUIPMENT COMPANIES UNDER CERTAIN
CONDITIONS; TO AMEND SECTIONS 40-47-520, 40-47-590,
40-47-600, AS AMENDED, 40-47-610, 40-47-620, 40-47-625,
40-47-630, AS AMENDED, 40-47-640, 40-47-650, 40-47-655, AS
AMENDED, AND 40-47-660, AS AMENDED, ALL RELATING TO
THE CERTIFICATION AND REGULATION OF RESPIRATORY
CARE THERAPISTS, SO AS TO REQUIRE LICENSURE RATHER
THAN CERTIFICATION AND TO PROVIDE A TRANSITIONAL
PERIOD FOR PERSONS CURRENTLY CERTIFIED TO MEET THE
REQUIREMENTS FOR LICENSURE.
Be it enacted by the General Assembly of the State of South Carolina:
Definitions revised
SECTION 1. Section 40-47-510 of the 1976 Code, as last amended by
Act 223 of 1996, is further amended to read:
"Section 40-47-510. As used in this article:
(1) 'Board' means the Board of Medical Examiners of South Carolina.
(2) 'Committee' means the Respiratory Care Committee which is
established by this article as an advisory committee responsible to the
board.
(3) 'Respiratory care or respiratory therapy' means the allied health
profession or specialty which provides educational, therapeutic, or
diagnostic procedures utilized in the prevention, detection, and
management of deficiencies or abnormalities, or both, of the
cardiopulmonary systems.
(4) 'Practice of respiratory care' may include, but is not limited to, the
administration of pharmacologic, diagnostic, and therapeutic agents
related to respiratory care procedures necessary to implement a treatment,
disease prevention, pulmonary rehabilitative, or diagnostic regimen
prescribed by a physician; transcription and implementation of written or
verbal orders of a physician pertaining to the practice of respiratory care;
observing and monitoring the signs and symptoms, general behavior,
general physical response to respiratory care treatment and diagnostic
testing including determination of whether such signs, symptoms,
reactions, behavior, or general response exhibit abnormal characteristics
and implementation, based on observed abnormalities or appropriate
reporting, referral, respiratory care protocols or changes in treatment
pursuant to the written or verbal orders of a person licensed to practice
medicine under the laws of this State; or the initiation of emergency
procedures under the regulations of the board or as otherwise permitted
in this article. The practice of respiratory care may be performed in a
clinic, hospital, skilled nursing facility, private dwelling, or other place
considered appropriate or necessary by the board in accordance with the
written or verbal order of a physician and must be performed under a
qualified medical director.
(5) 'Respiratory care practitioner' means a respiratory therapist or a
respiratory therapy technician licensed to practice respiratory therapy who
is a graduate of a school for respiratory therapy approved by the American
Medical Association or a successor accrediting authority recognized as
such by the board.
(6) 'Medical director' means a physician licensed to practice medicine
in South Carolina who has special interest and knowledge in the
diagnosis, treatment, and assessment of respiratory problems. The
practice of respiratory care or respiratory therapy must occur under the
supervision of a qualified medical director. In the home care of
cardiopulmonary patients, the existence of qualified physician
sponsorship must be submitted and documented to the committee and
approved by the board."
Reference changed from certified to licensed
SECTION 2. Section 40-47-520 of the 1976 Code is amended to read:
"Section 40-47-520. Individuals practicing as respiratory therapists
and respiratory therapy technicians employed to provide respiratory
therapy procedures for inpatients, outpatients, and home patients must be
licensed in accordance with this article."
Exemptions revised
SECTION 3. Section 40-47-530 of the 1976 Code, as last amended by
Act 223 of 1996, is further amended to read:
"Section 40-47-530. (A) This article does not affect:
(1) a person employed to provide respiratory care by the United
States government if the person provides respiratory care solely under the
direction or control of the organization by which the person is employed;
(2) a person actively pursuing a course of study leading to a degree
or certificate in respiratory therapy in a program accredited by the
American Medical Association or a successor accrediting authority
recognized as such by the board if the activities and services constitute a
part of a supervised course of study and if the person is designated by a
title which clearly indicates the status of student;
(3) an individual or other health care professional who is licensed
by the State or who has proven competency in one or more of the
functions included in the definition of the practice of respiratory care as
long as the person does not represent himself as a respiratory care
practitioner. As it relates to respiratory care, individuals exempt pursuant
to this section must provide proof of formal training for these functions
which includes an evaluation of competence through a mechanism that is
determined by the board and the committee to be both valid and reliable.
The clinical assessment of artificial pressure adjuncts to the respiratory
system may not be performed by any other person without proof of formal
training and exemption by the board.
(4) a respiratory therapy student, active and in good standing, who
may be employed and works under the direct supervision of a respiratory
care practitioner and practices to the person's level of proven clinical
competency as certified by a program approved by the American Medical
Association or a successor accrediting authority recognized as such by the
board;
(5) employees of durable medical equipment companies delivering
and setting up respiratory equipment in an individual's home, pursuant to
a written prescription by a physician, except that any instructions to the
patient regarding the clinical use of the equipment, any patient
monitoring, patient assessment or other procedures designed to evaluate
the effectiveness of the treatment must be performed by a licensed
respiratory care practitioner or other individual who is exempt by statute
or regulation.
(B) Nothing in this article is intended to limit, preclude, or otherwise
interfere with the practice of other persons and health providers formally
trained and licensed by the appropriate agencies of this State."
References changed from certification to licensure
SECTION 4. Section 40-47-590 of the 1976 Code is amended to read:
"Section 40-47-590. (A) The committee shall evaluate the
qualifications and supervise the examinations of applicants for licensure
and shall make appropriate recommendations to the board.
(B) The board may issue subpoenas, examine witnesses, and
administer oaths, and may investigate allegations of practices violating the
provisions of this article.
(C) The committee:
(1) shall recommend regulations to the board relating to
professional conduct to carry out the policy of this article including, but
not limited to, professional licensure and the establishment of ethical
standards of practice for persons holding a license to practice respiratory
care or respiratory therapy in this State;
(2) shall conduct hearings and keep records and minutes necessary
to carry out its functions;
(3) shall provide notice of all hearings authorized under this article
pursuant to the Administrative Procedures Act;
(4) shall determine the qualifications and make appropriate
recommendations regarding the issuance of licenses to qualified
respiratory care practitioners;
(5) shall recommend to the board whether to issue or renew licenses
under those conditions prescribed in this article;
(6) may recommend continuing professional education to the board;
(7) shall keep a record of its proceedings and a register of all
persons licensed. The register shall show the name of every registrant and
the registrant's last known place of employment and residence. The board
annually shall compile and make available a list of respiratory care
practitioners authorized to practice in this State. Any interested person
may obtain a copy of this list upon application to the board and payment
of an amount fixed by the board;
(8) shall make an annual report to the board containing an account
of duties performed, actions taken, and appropriate recommendations;
(9) shall hear all disciplinary cases and recommend findings of fact,
conclusions, and sanctions to the board. The board shall conduct a final
order hearing at which it makes a final decision."
References changed from certification to licensure
SECTION 5. Section 40-47-600 of the 1976 Code, as last amended by
Act 422 of 1992, is further amended to read:
"Section 40-47-600. An applicant for licensure as a respiratory care
practitioner shall file a written application on forms provided by the board
showing to the satisfaction of the committee and the board that the
applicant has successfully passed the entry-level examination given by the
National Board for Respiratory Care, Inc., or other examination or
requirement as the committee may administer or approve."
Reference changed from certify to license and period to meet
licensure requirements provided for
SECTION 6. Section 40-47-610 of the 1976 Code is amended to read:
"Section 40-47-610. (A) The board may license as a respiratory care
practitioner, upon payment of the fee set by the board, an applicant who
is a respiratory therapist or a respiratory therapy technician of another
state, territory, or the District of Columbia, if the requirements were
substantially equal to the requirements of this State as determined by the
board;
(B) The committee initially shall waive the professional education and
examination requirements and issue a license to any person who can
demonstrate to the committee, through evidence verified under oath, that
the person was employed as or actively performing the duties of a
respiratory care practitioner in South Carolina in November and
December of 1998; however, within three years of applying for initial
licensure, the person must have complied with the educational and
examination requirements provided for in Section 40-47-600. The
applicants shall produce proof of high school graduation or the equivalent
and shall apply within ninety days after public notification by the
department."
Reference changed from certification to licensing
SECTION 7. Section 40-47-620 of the 1976 Code is amended to read:
"Section 40-47-620. The board shall issue a license to any person who
meets the requirements of this article upon payment of the license fee."
Reference changed from certificate to license
SECTION 8. Section 40-47-625 of the 1976 Code, as added by Act
541 of 1988, is amended to read:
"Section 40-47-625. The board may issue a temporary license if all
licensing requirements have been met."
References changed from certificate to license
SECTION 9. Section 40-47-630 of the 1976 Code, as last amended by
Act 181 of 1993, is amended to read:
"Section 40-47-630. (A) The committee may recommend to the board
that it revoke, suspend, issue a public or private reprimand, or impose any
other reasonable limitation or practice where the unprofessional,
unethical, or illegal conduct of the respiratory care practitioner is likely
to endanger the health, welfare, or safety of the public. This conduct
includes a license:
(1) using any false, fraudulent, or forged statement or engaging in
any fraudulent, deceitful, or dishonest act in connection with any of the
certifying requirements;
(2) having an addiction to alcohol or drugs to such a degree as to
render the licensee unfit to practice respiratory care;
(3) having been convicted of the illegal or unauthorized practice of
respiratory care;
(4) knowingly performing an act which in any way assists an
unlicensed person to practice respiratory care;
(5) having sustained any physical or mental disability which renders
further practice by the licensee dangerous to the public;
(6) having violated the code of ethics or regulations as adopted by
the committee and the board;
(7) guilty of engaging in any dishonorable, unethical, or
unprofessional conduct that is likely to deceive or harm the public;
(8) guilty of the use of any false or fraudulent statement in any
document connected with the practice of respiratory care;
(9) having intentionally violated or attempted to violate, directly or
indirectly, or assisting in or abetting the violation or conspiring to violate
any provisions of this article;
(10) guilty of the commission of any act, during the course of
practice conducted pursuant to a license issued under this article, that
constitutes fraud, dishonest dealing, illegality, incompetence, or gross
negligence.
(B) The suspension, revocation, reprimand, or imposition of
probationary conditions upon a respiratory care practitioner may be
recommended by the committee to the board after a hearing is conducted
in accordance with the Administrative Procedures Act. A transcribed
record of the hearing must be made.
(C) A respiratory care practitioner aggrieved by a decision of the
committee or board under this section may appeal the decision to an
administrative law judge as provided under Article 5 of Chapter 23 of
Title 1 on the record made before the committee or board."
Reference changed from certificate to license
SECTION 10. Section 40-47-640 of the 1976 Code is amended to read:
"Section 40-47-640. (A) Licenses issued under this article are subject
to annual renewal and expire unless renewed in the manner prescribed by
the regulations of the committee. The committee may recommend
additional requirements for license renewal which provide evidence of
continued competency. The board may provide for the late renewal of a
license upon payment of a late fee.
(B) An inactive license is subject to expiration and may be renewed as
provided in this section, but renewal does not entitle the respiratory care
practitioner, while the license remains inactive, to engage in the certified
activity of respiratory therapy. If a certificate suspended on disciplinary
grounds is reinstated, the respiratory care practitioner, as a condition of
reinstatement, shall pay the renewal fee and any applicable late fee."
Reference changed from certification to licensure
SECTION 11. Section 40-47-650 of the 1976 Code is amended to read:
"Section 40-47-650. The board and the committee shall prescribe fees
in amounts recommended by the committee for:
(1) initial licensure, not to exceed two hundred dollars;
(2) renewal of license fee, not to exceed fifty dollars;
(3) late renewal fee, not to exceed double renewal fee.
The fees must be set in such an amount as to reimburse the State to the
extent feasible for the cost of the services rendered by the board."
Reference changed from certificate to license
SECTION 12. Section 40-47-655 of the 1976 Code, as last amended by
Act 223 of 1996, is further amended to read:
"Section 40-47-655. (A) Upon payment of a fee prescribed by the
committee and approved by the board, the board may issue a limited
license to practice respiratory care under the direct supervision of a
licensed respiratory care practitioner to an applicant who presents written
documentation, verified by oath, that the applicant is a graduate of or
student of a respiratory care program approved by the American Medical
Association or a successor accrediting authority recognized as such by the
board. If a student, the applicant must be scheduled to graduate from this
program within forty-five days of the date on which the limited license is
to be issued.
(B) A limited license issued under this section is valid for a period of
six months. Upon expiration of a limited license and payment of the fee
prescribed by the committee and approved by the board, the board may
renew the limited license once for a period of six months. A limited
license must not be renewed more than twelve months from the date it
was originally issued."
Reference changed from certificate to license
SECTION 13. Section 40-47-660 of the 1976 Code, as last amended by
Act 181 of 1993, is further amended to read:
"Section 40-47-660. (A) It is unlawful for any person who is not
licensed under this article to hold himself out as a respiratory care
practitioner, respiratory therapist, or a respiratory therapy technician. A
person who holds himself out or practices as a respiratory care practitioner
without being licensed under this article, during a period of suspension,
or after his certificate has been revoked by the board is guilty of a
misdemeanor and, upon conviction, must be fined not more than three
hundred dollars or imprisoned for not more than ninety days, or both.
(B) For the purpose of an investigation or proceeding under this
article, the board or a person designated by it may administer oaths and
affirmations, subpoena witnesses, take testimony, and require the
production of documents or records which the board considers relevant to
the inquiry. In the case of contumacy by, or refusal to obey a subpoena
issued to a person, an administrative law judge as provided under Article
5 of Chapter 23 of Title 1, upon application by the board, may issue an
order requiring the person to appear before the board or the person
designated by it, produce documentary evidence, and give other evidence
concerning the matter under inquiry.
When the board has sufficient evidence that a person is violating any
provisions of this article, it may, in addition to all other remedies, order
the person to immediately desist and refrain from this conduct. The board
may apply to an administrative law judge as provided under Article 5 of
Chapter 23 of Title 1 for an injunction restraining the person from this
conduct. An administrative law judge may issue a temporary injunction
ex parte and upon notice and full hearing may issue any other order in the
matter it considers proper. No bond may be required of the board by an
administrative law judge as a condition to the issuance of any injunction
or order contemplated by the provisions of this section.
(C) Every communication, whether oral or written, made by or on
behalf of a person or firm to the board or any person designated by it to
investigate or otherwise hear matters relating to the revocation,
suspension, or other restriction on a license or other discipline of a
licensee, whether by way of complaint or testimony, is privileged. No
action or proceeding, civil or criminal, may lie against the person or firm
for the communication except upon proof that the communication was
made with malice.
(D) No provision of this article may be construed as prohibiting the
respondent or his legal counsel from exercising the respondent's
constitutional right of due process under the law nor prohibiting the
respondent from normal access to the charges and evidence filed against
him as a part of due process under the law."
Regulations continue to be in effect
SECTION 14. Regulations of the Board of Medical Examiners in effect
on this act's effective date pertaining to the certification and certification
requirements for respiratory care therapists are deemed to be applicable
to the licensure and licensure requirements for respiratory care therapists
until the Board of Medical Examiners amends or otherwise modifies these
regulations.
Time effective
SECTION 15. This act takes effect January 1, 1999.
Became law without the signature of the Governor -- 04/08/98. |