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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Respiratory Care Practice Act is amended by | |||||||||||||||||||||||
5 | changing Sections 10 and 15 and by adding Section 22 as | |||||||||||||||||||||||
6 | follows:
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7 | (225 ILCS 106/10)
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8 | (Section scheduled to be repealed on January 1, 2016)
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9 | Sec. 10. Definitions. In this Act:
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10 | "Advanced practice nurse" means an advanced practice nurse | |||||||||||||||||||||||
11 | licensed under the Nurse Practice Act.
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12 | "Board" means the Respiratory Care Board appointed by the | |||||||||||||||||||||||
13 | Director. | |||||||||||||||||||||||
14 | "Basic respiratory care activities" means and includes all | |||||||||||||||||||||||
15 | of the following activities: | |||||||||||||||||||||||
16 | (1) Cleaning, disinfecting, and sterilizing equipment | |||||||||||||||||||||||
17 | used in the practice of respiratory care as delegated by a | |||||||||||||||||||||||
18 | licensed health care professional or other authorized | |||||||||||||||||||||||
19 | licensed personnel. | |||||||||||||||||||||||
20 | (2) Assembling equipment used in the practice of | |||||||||||||||||||||||
21 | respiratory care as delegated by a licensed health care | |||||||||||||||||||||||
22 | professional or other authorized licensed personnel. | |||||||||||||||||||||||
23 | (3) Collecting and reviewing patient data through |
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1 | non-invasive means, provided that the collection and | ||||||
2 | review does not include the individual's interpretation of | ||||||
3 | the clinical significance of the data. Collecting and | ||||||
4 | reviewing patient data includes the performance of pulse | ||||||
5 | oximetry and non-invasive monitoring procedures in order | ||||||
6 | to obtain vital signs and notification to licensed health | ||||||
7 | care professionals and other authorized licensed personnel | ||||||
8 | in a timely manner. | ||||||
9 | (4) Maintaining a nasal cannula or face mask for oxygen | ||||||
10 | therapy in the proper position on the patient's face. | ||||||
11 | (4.5) The transferring of oxygen devices, including, | ||||||
12 | but not limited to, nasal cannulas, face masks, or similar | ||||||
13 | devices, with a liter flow of 6 liters per minute or less, | ||||||
14 | as specified by a licensed health care professional, from | ||||||
15 | the wall flowmeter to the oxygen cylinder and back while | ||||||
16 | under the proximate supervision of a licensed health care | ||||||
17 | professional or other authorized licensed personnel if an | ||||||
18 | unlicensed practitioner has received the training required | ||||||
19 | under subsection (j) of Section 15 of this Act. This item | ||||||
20 | (4.5) does not include neonatal and pediatric oxygen | ||||||
21 | transports. | ||||||
22 | (5) Assembling a nasal cannula or face mask for oxygen | ||||||
23 | therapy at patient bedside in preparation for use. | ||||||
24 | (6) Maintaining a patient's natural airway by | ||||||
25 | physically manipulating the jaw and neck, suctioning the | ||||||
26 | oral cavity, or suctioning the mouth or nose with a bulb |
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1 | syringe. | ||||||
2 | (7) Performing assisted ventilation during emergency | ||||||
3 | resuscitation using a manual resuscitator. | ||||||
4 | (8) Using a manual resuscitator at the direction of a | ||||||
5 | licensed health care professional or other authorized | ||||||
6 | licensed personnel who is present and performing routine | ||||||
7 | airway suctioning. These activities do not include care of | ||||||
8 | a patient's artificial airway or the adjustment of | ||||||
9 | mechanical ventilator settings while a patient is | ||||||
10 | connected to the ventilator.
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11 | "Basic respiratory care activities" does not mean activities | ||||||
12 | that involve any of the following:
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13 | (1) Specialized knowledge that results from a course of | ||||||
14 | education or training in respiratory care. | ||||||
15 | (2) An unreasonable risk of a negative outcome for the | ||||||
16 | patient. | ||||||
17 | (3) The assessment or making of a decision concerning | ||||||
18 | patient care. | ||||||
19 | (4) The administration of aerosol medication or | ||||||
20 | medical gas oxygen . | ||||||
21 | (5) The insertion and maintenance of an artificial | ||||||
22 | airway. | ||||||
23 | (6) Mechanical ventilatory support. | ||||||
24 | (7) Patient assessment. | ||||||
25 | (8) Patient education.
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26 | "Department" means the Department of Professional |
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1 | Regulation.
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2 | "Director" means the Director of
Professional Regulation.
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3 | "Licensed" means that which is required to hold oneself
out | ||||||
4 | as
a respiratory care
practitioner as defined in this Act.
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5 | "Licensed health care professional" means a physician | ||||||
6 | licensed to practice medicine in all its branches, a certified | ||||||
7 | registered nurse anesthetist, an advanced practice nurse who | ||||||
8 | has a written collaborative agreement with a collaborating | ||||||
9 | physician that authorizes the advanced practice nurse to | ||||||
10 | transmit orders to a respiratory care practitioner, or a | ||||||
11 | physician assistant who has been delegated the authority to | ||||||
12 | transmit orders to a respiratory care practitioner by his or | ||||||
13 | her supervising physician.
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14 | "Order" means a written, oral, or telecommunicated | ||||||
15 | authorization for respiratory care services for a patient by | ||||||
16 | (i) a licensed health care professional who maintains medical | ||||||
17 | supervision of the patient and makes a diagnosis or verifies | ||||||
18 | that the patient's condition is such that it may be treated by | ||||||
19 | a respiratory care practitioner or (ii) a certified registered | ||||||
20 | nurse anesthetist in a licensed hospital or ambulatory surgical | ||||||
21 | treatment center.
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22 | "Other authorized licensed personnel" means a licensed | ||||||
23 | respiratory care practitioner, a licensed registered nurse, or | ||||||
24 | a licensed practical nurse whose scope of practice authorizes | ||||||
25 | the professional to supervise an individual who is not | ||||||
26 | licensed, certified, or registered as a health professional. |
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1 | "Proximate supervision" means a situation in which an | ||||||
2 | individual is
responsible for directing the actions of another | ||||||
3 | individual in the facility and is physically close enough to be | ||||||
4 | readily available, if needed, by the supervised individual.
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5 | "Respiratory care" and "cardiorespiratory care"
mean | ||||||
6 | preventative services, evaluation and assessment services, | ||||||
7 | therapeutic services, cardiopulmonary disease management, and | ||||||
8 | rehabilitative services under the order of a licensed health | ||||||
9 | care professional or a certified registered nurse anesthetist | ||||||
10 | in a licensed hospital for an individual with a disorder, | ||||||
11 | disease, or abnormality of the cardiopulmonary system. These | ||||||
12 | terms include, but are not limited to, measuring, observing, | ||||||
13 | assessing, and monitoring signs and symptoms, reactions, | ||||||
14 | general behavior, and general physical response of individuals | ||||||
15 | to respiratory care services, including the determination of | ||||||
16 | whether those signs, symptoms, reactions, behaviors, or | ||||||
17 | general physical responses exhibit abnormal characteristics; | ||||||
18 | the administration of pharmacological and therapeutic agents | ||||||
19 | and procedures related to respiratory care services; the | ||||||
20 | collection of blood specimens and other bodily fluids and | ||||||
21 | tissues for, and the performance of, cardiopulmonary | ||||||
22 | diagnostic testing procedures, including, but not limited to, | ||||||
23 | blood gas analysis; development, implementation, and | ||||||
24 | modification of respiratory care treatment plans based on | ||||||
25 | assessed abnormalities of the cardiopulmonary system, | ||||||
26 | respiratory care guidelines, referrals, and orders of a |
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1 | licensed health care professional; application, operation, and | ||||||
2 | management of mechanical ventilatory support and other means of | ||||||
3 | life support , including, but not limited to, hemodynamic | ||||||
4 | cardiovascular support ; and the initiation of emergency | ||||||
5 | procedures under the rules promulgated by the Department. A | ||||||
6 | respiratory care practitioner shall refer to a physician | ||||||
7 | licensed to practice medicine in all its branches any patient | ||||||
8 | whose condition, at the time of evaluation or treatment, is | ||||||
9 | determined to be beyond the scope of practice of the | ||||||
10 | respiratory care practitioner.
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11 | "Respiratory care education program" means a course of | ||||||
12 | academic study leading
to eligibility for registry or | ||||||
13 | certification in respiratory care. The training
is to be | ||||||
14 | approved by an accrediting agency recognized by the Board and | ||||||
15 | shall
include an evaluation of competence through a | ||||||
16 | standardized testing mechanism
that is determined by the Board | ||||||
17 | to be both valid and reliable.
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18 | "Respiratory care practitioner" means a person who is | ||||||
19 | licensed by the
Department of Professional Regulation and meets | ||||||
20 | all of the following
criteria:
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21 | (1) The person is engaged in the practice of | ||||||
22 | cardiorespiratory care and
has the knowledge and skill | ||||||
23 | necessary to administer respiratory care.
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24 | (2) The person is capable of serving as a resource to | ||||||
25 | the
licensed
health care professional in
relation to the | ||||||
26 | technical aspects of cardiorespiratory care and the safe |
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1 | and
effective methods for administering cardiorespiratory | ||||||
2 | care modalities.
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3 | (3) The person is able to function in situations of | ||||||
4 | unsupervised patient
contact requiring great individual | ||||||
5 | judgment.
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6 | (Source: P.A. 94-523, eff. 1-1-06; 95-639, eff. 10-5-07.)
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7 | (225 ILCS 106/15)
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8 | (Section scheduled to be repealed on January 1, 2016)
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9 | Sec. 15. Exemptions.
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10 | (a) This Act does not prohibit a person legally regulated | ||||||
11 | in this State by
any other Act from engaging in any practice | ||||||
12 | for which he or she is authorized.
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13 | (b) Nothing in this Act shall prohibit the practice of | ||||||
14 | respiratory care by a
person who is employed by the United | ||||||
15 | States government or any bureau, division,
or agency thereof
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16 | while in the discharge of the employee's official duties.
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17 | (c) Nothing in this Act shall be construed to limit the | ||||||
18 | activities and
services of a person enrolled in an approved | ||||||
19 | course of study leading to a
degree or certificate of registry | ||||||
20 | or certification eligibility in respiratory
care if these | ||||||
21 | activities and services constitute a part of a supervised | ||||||
22 | course
of study and if the person is designated by a title | ||||||
23 | which clearly indicates his
or her status as a student or | ||||||
24 | trainee. Status as a student or trainee shall
not exceed 3 | ||||||
25 | years from the date of enrollment in an approved course.
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1 | (d) Nothing in this Act shall prohibit a person from | ||||||
2 | treating ailments by
spiritual means through prayer alone in | ||||||
3 | accordance with the tenets and
practices of a recognized church | ||||||
4 | or religious denomination.
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5 | (e) Nothing in this Act shall be construed to prevent a | ||||||
6 | person who is a
registered nurse, an advanced practice nurse, a | ||||||
7 | licensed
practical nurse, a physician assistant, or a physician | ||||||
8 | licensed to practice medicine in all its branches from | ||||||
9 | providing respiratory care.
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10 | (f) Nothing in this Act shall limit a person who is | ||||||
11 | credentialed by the
National Society for Cardiopulmonary | ||||||
12 | Technology or the National Board for
Respiratory Care from | ||||||
13 | performing pulmonary function tests and
respiratory care | ||||||
14 | procedures related to the pulmonary function test. Individuals | ||||||
15 | who do not possess a license to practice respiratory care or a | ||||||
16 | license in another health care field may perform basic | ||||||
17 | screening spirometry limited to peak flow, forced vital | ||||||
18 | capacity, slow vital capacity, and maximum voluntary | ||||||
19 | ventilation if they possess spirometry certification from the | ||||||
20 | National Institute for Occupational Safety and Health, an | ||||||
21 | Office Spirometry Certificate from the American Association | ||||||
22 | for Respiratory Care, or other similarly accepted | ||||||
23 | certification training.
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24 | (g) Nothing in this Act shall prohibit the collection and | ||||||
25 | analysis of blood
by clinical laboratory personnel meeting the | ||||||
26 | personnel standards of the
Illinois Clinical Laboratory Act.
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1 | (h)
Nothing in this Act shall prohibit a polysomnographic | ||||||
2 | technologist, technician, or trainee, as defined in the job | ||||||
3 | descriptions jointly accepted by the American Academy of Sleep | ||||||
4 | Medicine, the Association of Polysomnographic Technologists, | ||||||
5 | the Board of Registered Polysomnographic Technologists, and | ||||||
6 | the American Society of Electroneurodiagnostic Technologists, | ||||||
7 | from performing activities within the scope of practice of | ||||||
8 | polysomnographic technology while under the direction of a | ||||||
9 | physician licensed in this State.
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10 | (i)
Nothing in this Act shall prohibit a family member from | ||||||
11 | providing respiratory care services to an ill person.
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12 | (j) Nothing in this Act shall be construed to limit an | ||||||
13 | unlicensed practitioner in a licensed hospital who is working | ||||||
14 | under the proximate supervision of a licensed health care | ||||||
15 | professional or other authorized licensed personnel and | ||||||
16 | providing direct patient care services from performing basic | ||||||
17 | respiratory care activities if the unlicensed practitioner
(i) | ||||||
18 | has been trained to perform the basic respiratory care | ||||||
19 | activities at the facility that employs or contracts with the | ||||||
20 | individual and (ii) at a minimum, has annually received an | ||||||
21 | evaluation of the unlicensed practitioner's performance of | ||||||
22 | basic respiratory care activities documented by the facility.
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23 | (k) Nothing in this Act shall be construed to prohibit a | ||||||
24 | person enrolled in a respiratory care education program or an | ||||||
25 | approved course of study leading to a degree or certification | ||||||
26 | in a health care-related discipline that provides respiratory |
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1 | care activities within his or her scope of practice and | ||||||
2 | employed in a licensed hospital in order to provide direct | ||||||
3 | patient care services under the direction of other authorized | ||||||
4 | licensed personnel from providing respiratory care activities. | ||||||
5 | (l) Nothing in this Act prohibits a person licensed as a | ||||||
6 | respiratory care practitioner in another jurisdiction from | ||||||
7 | providing respiratory care: (i) in a declared emergency in this | ||||||
8 | State; (ii) as a member of an organ procurement team; or (iii) | ||||||
9 | as part of a medical transport team that is transporting a | ||||||
10 | patient into or out of this State.
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11 | (Source: P.A. 96-456, eff. 8-14-09.)
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12 | (225 ILCS 106/22 new) | ||||||
13 | Sec. 22. Durable medical equipment use and training. | ||||||
14 | (a) Notwithstanding any other provision of this Act, | ||||||
15 | unlicensed or non-credentialed individuals who deliver | ||||||
16 | prescribed respiratory care equipment, including, but not | ||||||
17 | limited to, oxygen, oxygen concentrators, pulmonary hygiene | ||||||
18 | devices, aerosol compressors and generators, suction machines, | ||||||
19 | positive airway pressure devices, and mechanical ventilators, | ||||||
20 | may deliver, set up, calibrate, and demonstrate the mechanical | ||||||
21 | operation of the device to the patient, family, and caregivers. | ||||||
22 | Demonstration of the mechanical operation of the device | ||||||
23 | includes demonstration of the on-off switches, emergency | ||||||
24 | buttons, and alarm silence and reset buttons, as appropriate. | ||||||
25 | In order for unlicensed or non-credentialed personnel to |
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1 | deliver, set up, calibrate, and demonstrate the equipment as | ||||||
2 | allowed in this subsection (a), the employer must document that | ||||||
3 | the employee has both received training and demonstrated | ||||||
4 | competency using the specific devices under the supervision of | ||||||
5 | a respiratory care practitioner licensed by this State or some | ||||||
6 | other licensed practitioner operating within his or her scope | ||||||
7 | of practice. | ||||||
8 | Equipment demonstration is not to be interpreted as | ||||||
9 | teaching, administration, or performance of respiratory care. | ||||||
10 | Unlicensed or non-credentialed individuals may not attach the | ||||||
11 | equipment to the patient or instruct the patient, family, or | ||||||
12 | caregiver on the use of the equipment beyond the mechanical | ||||||
13 | functions of the device. | ||||||
14 | (b) Patients, family, and caregivers must be taught to use | ||||||
15 | the equipment for the intended clinical application by a | ||||||
16 | licensed respiratory care practitioner or other licensed | ||||||
17 | health care professional operating within his or her scope of | ||||||
18 | practice. This instruction may occur through follow-up after | ||||||
19 | delivery, with an identical model in the health care facility | ||||||
20 | prior to discharge or with an identical model at the medical | ||||||
21 | supply office. Instructions to the patient regarding the | ||||||
22 | clinical use of equipment, patient monitoring, patient | ||||||
23 | assessment, or any other procedure used with the intent of | ||||||
24 | evaluating the effectiveness of the treatment must be performed | ||||||
25 | by a respiratory care practitioner licensed by this State or | ||||||
26 | any other licensed practitioner operating within his or her |
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1 | scope of practice.
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