Bill Summary – FastDemocracy

HOUSE BILL NO. 5794
     June 06, 2024, Introduced by Reps. Xiong, Rogers, Roth, Rheingans, Grant, Glanville, McFall,
        Conlin, Wilson, Price, MacDonell, Tsernoglou, Farhat, Bezotte, Scott and Bruck and referred
        to the Committee on Health Policy.
          A bill to amend 1978 PA 368, entitled
    "Public health code,"
    by amending sections 16204, 16344, 18701, 18703, 18707, and 18709
    (MCL 333.16204, 333.16344, 333.18701, 333.18703, 333.18707, and
18709), section 16204 as amended by 2005 PA 273 and sections
    16344, 18701, 18703, 18707, and 18709 as added by 2004 PA 3, and by
    adding sections 18710 and 18712.
                      THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
       Sec. 16204. (1) Effective for the renewal of licenses or
    EMR                                                                                   02547'23
                                    2
  registrations issued under this article and expiring after January
  1, 1997 if the completion of continuing education is a condition
  for renewal, the appropriate board shall by rule require an
  applicant for renewal to complete an appropriate number of hours or
  courses in pain and symptom management. Rules promulgated by a
  board under section 16205(2) for continuing education in pain and
  symptom management shall must cover both course length and content
  and shall must take into consideration the recommendation for that
  health care profession by the interdisciplinary advisory committee
 created in section 16204a. A board shall submit the notice of
 public hearing for the rules as required under section 42 of the
 administrative procedures act of 1969, 1969 PA 306, MCL 24.242, not
 later than 90 days after the first interdisciplinary advisory
 committee makes its initial recommendations and shall promulgate
 the rules as expeditiously as possible.
       (2) If a board proposes rules under section 16205(2) to
 institute a requirement that continuing education be a mandatory
 condition for the renewal of a license or registration issued under
 this article, the rules shall must require, as part of the
 continuing education requirements, completion of an appropriate
 number of hours or courses in pain and symptom management, taking
 into consideration the recommendation for that health care
 profession by the interdisciplinary advisory committee created in
 section 16204a.
       (3) This section does not apply to individuals licensed or
 registered under part 184, 187, or 188.
       Sec. 16344. Fees for an individual licensed or seeking
 licensure as a respiratory therapist under part 187 are as follows:
     EMR                                                            02547'23
                                     3
        (a) Application processing fee...................... $ 20.0075
                                                                  .00
        (b) License fee, per year...........................      75.0082
                                                                  .70
        (c) Temporary license...............................      75.00
        (d) Limited license.................................      27.50
        Sec. 18701. (1) As used in this part:
        (a) "Health facility" means a health facility or agency
  licensed under article 17.
       (b) "Medical director" means a physician who is responsible
 for the quality, safety, appropriateness, and effectiveness of the
 respiratory care services provided by a respiratory therapist, who
 assists in quality monitoring, protocol development, and competency
 validation, and who meets all of the following:
       (i) Is the medical director of an inpatient or outpatient
 respiratory care service or department within a health facility, or
 of a home care agency, durable medical equipment company, or
 educational program.
       (ii) Has special interest and knowledge in the diagnosis and
 treatment of cardiopulmonary disorders and diseases.
       (iii) Is qualified by training or experience, or both, in the
 management of acute and chronic cardiopulmonary disorders and
 diseases.
       (c) "Physician" means that term as defined in sections 17001
 and 17501.
       (d) "Practice of respiratory care" means the provision of
 respiratory care services. Practice of respiratory care may be
 provided by an inpatient or outpatient service or department within
 a health facility, by a home care agency or durable medical
     EMR                                                           02547'23
                                     4
  equipment company, or by an educational program.
        (e) "Qualified licensed practitioner" means a licensee who is
  responsible for the care of the patient, who is acting within the
  licensee's scope of practice, and who is authorized to prescribe
  respiratory care services in accordance with hospital policies and
  procedures and the laws of this state.
        (f) (e) "Respiratory care services" means preventative
  services, diagnostic services, therapeutic services, and
  rehabilitative services under the written, verbal, or
 telecommunicated order of a physician or other qualified licensed
 practitioner to an individual with a disorder, disease, or
 abnormality of the cardiopulmonary system as diagnosed by a
 physician. Respiratory care services involve, but are not limited
 to, observing, and providing or offering to provide a service
 involving the evaluation of cardiopulmonary function, the treatment
 of cardiopulmonary impairment, the assessment of treatment
 effectiveness, and the care of patients with deficiencies and
 abnormalities associated with the cardiopulmonary system.
 Respiratory care services include, but are not limited to, the
 following:
       (i) Observing, assessing, and monitoring signs and symptoms,
 reactions, general behavior, and general physical clinical response
 of individuals to respiratory care, services, including
 determination of whether those signs, symptoms, reactions,
 behaviors, or general physical clinical response exhibit abnormal
 characteristics. ; the
       (ii) The administration, monitoring, documentation, and
 instruction of pharmacological, diagnostic, and therapeutic agents
 related to respiratory care. services; the collection of blood
     EMR                                                             02547'23
                                     5
  specimens and other bodily fluids and tissues for, and the
  performance of, cardiopulmonary diagnostic testing procedures
  including, but not limited to, blood gas analysis;
        (iii) Obtaining, analyzing, testing, measuring, and monitoring
  blood and gas samples in the determination of cardiopulmonary
  parameters and related physiologic data, including, but not limited
  to, flows, pressures, and volumes, and the use of equipment
  employed for the purposes described in this subparagraph.
        (iv) The development, implementation, and modification of
 respiratory care treatment plans based on assessed abnormalities of
 the cardiopulmonary system, respiratory care protocols, clinical
 pathways, referrals, and written, verbal, or telecommunicated
 orders of a physician or other qualified licensed practitioner. ;
 application,
       (v) The application, operation, and management of mechanical
 ventilatory support and other means of life support. ; and the
       (vi) Performing cardiopulmonary resuscitation, inserting and
 maintaining artificial airways and arterial and venous lines, and
 hemodynamic monitoring.
       (vii) The initiation of emergency procedures under the rules
 promulgated by the board.under this part.
       (viii) Performing therapeutic bronchoscopy, diagnostic
 bronchoscopy, hyperbaric oxygen therapy, electrophysiological
 monitoring, and extracorporeal membrane oxygenation.
       (g) (f) "Respiratory therapist" and "respiratory care
 practitioner" mean an individual engaged who is licensed under this
 article to engage in the practice of respiratory care. and who is
 responsible for providing respiratory care services and who is
 licensed under this article as a respiratory therapist or
     EMR                                                            02547'23
                                      6
  respiratory care practitioner.
        (2) In addition to the definitions in this part, article 1
  contains general definitions and principles of construction
  applicable to all articles in this code and part 161 contains
  definitions applicable to this part.
        Sec. 18703. Beginning the effective date of the amendatory act
  that added this part, an An individual shall not use the titles
  "respiratory therapist", "respiratory care practitioner", "licensed
  respiratory therapist", "licensed respiratory care practitioner",
 "r.t.", "r.c.p.", "l.r.t.", "l.r.c.p.", or similar words that
 indicate the individual is a respiratory therapist unless the
 individual is licensed under this article as a respiratory
 therapist or respiratory care practitioner.
       Sec. 18707. (1) An individual shall not engage in the practice
 of respiratory care or provide or offer to provide respiratory care
 services unless the individual is licensed under this part.
       (2) Subsection (1) does not prevent any of the following:
       (a) An individual licensed under any other part or act from
 performing activities that are considered the practice of
 respiratory care services if those activities are within the
 individual's scope of practice and if the individual does not use
 the titles protected under section 18703.
       (b) An individual not licensed under this part from performing
 activities that are considered the practice of respiratory care
 services while under the supervision of an individual who is
 licensed under this part as a respiratory therapist or respiratory
 care practitioner, if the individual does not use the titles
 protected under section 18703.
       (c) An individual not licensed under this part from performing
     EMR                                                           02547'23
                                      7
  activities that are considered diagnostic services if the
  individual possesses a level of training approved by the board, has
  successfully passed a credentialing examination approved by the
  department, in consultation with the board, and if the individual
  does not use the titles protected under section 18703.
        (d) The practice of respiratory care which is an integral part
  of a program of study by students a student enrolled in an
  accredited respiratory therapist educational program approved by
  the board, provided that they are if the student is identified as a
 student and provide provides respiratory care services only while
 under the supervision of a licensed respiratory therapist or
 respiratory care practitioner.
       (e) Self-care by a patient or uncompensated care by a friend
 or family member who does not represent or hold himself or herself
 themself out to be a licensed respiratory therapist or respiratory
 care practitioner.
       Sec. 18709. (1) The department, in consultation with the
 board, shall promulgate rules under section 16145 as necessary or
 appropriate to fulfill its functions under this article. In
 promulgating rules to establish requirements for licensure, under
 section 16145, the department, in consultation with the board,
 shall adopt all of the following requirements:
       (a) Successful completion of an accredited respiratory
 therapist training educational program approved by the department
 in consultation with the board.
       (b) Having at least a 2-year associate's associate degree from
 an accredited college or university approved by the department in
 consultation with the board.
       (c) Having the credential conferred by the national board
     EMR                                                            02547'23
                                    8
  National Board for respiratory care Respiratory Care or its
  successor organization as a respiratory therapist or its successor
  credential, as approved by the department in consultation with the
  board.
        (2) The department shall issue An individual must be granted a
  license as a respiratory therapist to an individual who had either
  of the credentials if the individual meets any of the following
  conditions:
        (a) Until 1 year after the effective date of the amendatory
 act that added subdivision (b), the individual holds a current and
 active credential as a registered respiratory therapist or
 certified respiratory therapist , or their predecessor credentials,
 conferred by from the national board National Board for respiratory
 care, Respiratory Care or its successor, or its predecessor
 organization, on or before the effective date of this part, and who
 applies for licensure as a respiratory therapist within 1 year
 after the effective date of this part.an equivalent credential as
 determined by the department in consultation with the board.
       (b) Beginning on or after 1 year after the effective date of
 the amendatory act that added this subdivision, the individual
 holds a current and active credential as a registered respiratory
 therapist from the National Board for Respiratory Care or its
 successor, or an equivalent credential as determined by the
 department in consultation with the board.
       (3) The department shall issue a license as a respiratory
 therapist to an individual who is a holder of a temporary license
 as a respiratory therapist if a holder of a temporary license meets
 all of the following requirements:
       (a) Applies for licensure as a respiratory therapist prior to
     EMR                                                           02547'23
                                      9
  the expiration of his or her temporary license as prescribed in
  section 18711(2).
        (b) Provides proof to the department that he or she has
  successfully completed the national credentialing exam by the
  national board for respiratory care or its successor organization,
  as approved by the department.
        (4) The department may utilize the standards contained in the
  clinical practice guidelines issued by the American association of
  respiratory care that are in effect on the effective date of this
 part as interim standards, which are adopted by reference, until
 rules are promulgated under subsection (1).
       Sec. 18710. (1) An individual who, in addition to meeting the
 requirements of part 161, meets both of the following requirements
 must be granted a limited license:
       (a) Is enrolled and in good standing in a respiratory
 therapist educational program that meets the requirements described
 in section 18709(1) or is a graduate of a respiratory therapist
 educational program that meets the requirements described in
 section 18709(1).
       (b) Provides a verification of education form that is
 completed by the respiratory therapist educational program
 described in subdivision (a) to the department.
       (2) An individual who is granted a limited license under this
 section may perform duties only while under the supervision of a
 respiratory therapist, in consultation with the health facility.
       (3) A limited license granted under this section expires at
 the earliest of the following times:
       (a) One year after the date the limited license is granted.
       (b) The date the individual becomes licensed under section
     EMR                                                           02547'23
                                    10
  18709(2)(b).
        (4) A limited license granted under this section may be
  renewed once.
        (5) This section does not require a student meeting the
  requirements described in section 18707(2)(d) to obtain a limited
  license under this section.
        Sec. 18712. (1) In addition to the requirements of part 161, a
  licensee seeking renewal of the licensee's license shall furnish
  the department with satisfactory evidence that, during the
 licensing period immediately preceding the licensee's application
 for renewal, the licensee has met 1 of the following conditions:
       (a) Subject to subsection (2), if the licensee is licensed
 under section 18709, the licensee completed at least 15 clock hours
 of continuing education courses that are designed to further
 educate licensees, as approved by the board.
       (b) The licensee has successfully passed 1 of the following:
       (i) A written professional examination administered by the
 National Board for Respiratory Care, including, but not limited to,
 the registry examination for advanced respiratory therapists, the
 recredentialing examination for certified respiratory therapists,
 the pulmonary function technology examination, the neonatal or
 pediatric specialty examination, the sleep disorder specialty
 examination, or an equivalent written professional examination as
 determined by the board.
       (ii) The registered polysomnographic technologist examination
 administered by the Board of Registered Polysomnographic
 Technologists, the certified asthma ed