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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsMarch 2018


Regulatory Flexibility Act Form

Authenticated PDF Version

24 DE Admin. Code 1770
Pursuant to 24 Del.C. § 1775(c), the Respiratory Care Practice Advisory Council ("the Council") of the Board of Medical Licensure and Discipline has proposed revisions to its regulations. Section 9.0 has been revised to clarify and streamline the licensure application process. A new Section 10.0 adds a "Duty to Update Address" requirement for all licensees. Subsection 10.2 is stricken as it is encompassed by the new Section 10.0.
“Board” - means Delaware Board of Medical Licensure and Discipline.
“Certified Respiratory Therapist (CRT)” - means the credential awarded by the NBRC to individuals who pass the certification examination for entry level respiratory therapy practitioners.
“Council” - means the Respiratory Care Practice Advisory Council of the Board of Medical Licensure and Discipline.
“Direct Supervision” - means supervising licensee or supervising physician will be present and immediately available within the treatment area.
“General Supervision” - means whether by direct observation and monitoring, protocols approved by physicians, or orders written or verbally given by physicians.
“NBRC” means the National Board for Respiratory Care, Inc.
“Programs Approved by the Board” - means initial course of study programs accredited by the Joint Review Committee for Respiratory Therapy Education (JRCRTE) or its successor organizations which have been approved by the Board.
“Registered Respiratory Therapist (RRT)” - means the credential awarded by the NBRC to individuals who pass the registry examination for advanced respiratory therapy practitioners.
“Respiratory Care” - means treatment, management, diagnostic testing, control and care of patients with deficiencies and abnormalities associated with the cardiopulmonary system under the direction of a physician. Respiratory care includes inhalation therapy and respiratory therapy under 24 Del.C. §1776(a)(2) Medical Practice Act.
“Respiratory Care Practitioner (RCP)” - means an individual who practices respiratory care under 24 Del.C. §1776(a)(2) Medical Practice Act.
“Student Respiratory Care Practitioner (Student-RCP)” - means an individual enrolled in an accredited Respiratory Care Program recognized and approved by the Board.
"Unlicensed Personnel (UP)" - means an individual not otherwise authorized or exempt to provide respiratory care services except as provided in Section 13.0 14.0.
“Working Student Respiratory Care Practitioner” - means a student respiratory care practitioner who is employed to perform respiratory care under a limited scope of practice established by the Board.
6.3.22 Violating a lawful provision of Title 24, Chapter 17, Subchapter VII, or any lawful regulation established thereunder.
6.4.2 Where feasible, within sixty (60) days of receiving a complaint from the Attorney General’s Office after an investigation pursuant to 29 Del.C. §8735(h), the Council shall conduct an evidentiary hearing upon notice to the licensee. Written findings of fact and conclusions of law shall be sent to the Board of Medical Licensure and Discipline along with any recommendation to revoke, to suspend, to refuse to renew a license, to place a licensee on probation, or to otherwise reprimand a licensee found guilty of unprofessional conduct in the licensee’s professional activity which is likely to endanger the public health, safety or welfare, or the inability to render respiratory care services with reasonable skill or safety to patients because of mental illness or mental incompetence, physical illness or excessive use of drugs including alcohol.
8.5.4 Sanctions for Unjustified Noncompliance. The minimum penalty for the first finding of unjustified noncompliance shall be a $250.00 monetary penalty; however, the Council may recommend to the Board imposing any of the additional penalties specified in 24 Del.C. §1777(e). The minimum penalty for the second finding of unjustified noncompliance shall be a thirty (30) day license suspension; however, the Council may recommend to the Board imposing any of the additional penalties specified in 24 Del.C. §1777(e).
9.2.1.3 Verification of education form Respiratory Care Education.
9.2.1.4 Verification of national examination score. NBRC Credential Verification as a certified respiratory therapist (CRT) and/or as a registered respiratory therapist (RRT).
9.2.1.4.1 Individuals who have not been licensed in any jurisdiction within three (3) years of initially passing the NBRC entry level examination will be required to re-take the NBRC examination and provide proof of a current passing score and NBRC Credential Verification as a CRT or RRT before a license will be issued.
9.3.1 When the Council determines that an applicant does not meet the qualifications for licensure as prescribed under 24 Del.C. §1776 and the regulations governing the practice of respiratory care, the Council shall make such recommendation to the Board proposing to deny the application. The Council shall notify the applicant of its intended action and reasons thereof. The Council shall inform the applicant of an appeals process prescribed under 29 Del.C. §10142.
10.011.0 Renewal of Licenses
10.111.1 Each license shall be renewed biennially. The failure of the Council/Board to notify a licensee of his/her expiration date and subsequent renewals does not, in any way, relieve the licensee of the requirement to renew his/her certificate pursuant to the Council’s regulations and 24 Del.C. Ch. 17.
10.311.2 Renewal shall be effected electronically by:
10.3.111.2.1 Filing a renewal application online at www.dpr.delaware.gov;
10.3.211.2.2 Attesting on the renewal application to the completing of continuing education as required by Section 8.0; and
10.3.311.2.3 Payment of fees as determined by the Division of Professional Regulation.
10.411.3 Failure of a licensee to renew his/her license shall cause his/her license to expire.
10.4.111.3.1 A licensee whose license has expired may renew his/her license within one (1) year after the expiration date upon fulfilling the requirements in subsections 10.3.1 - 10.3.3 11.2.1 - 11.2.3 above, certifying that he/she has not practiced respiratory care in Delaware while his/her license has expired, and paying the renewal fee and a late fee as determined by the Division of Professional Regulation. All late renewals shall be audited for compliance with CE renewal requirements. Any licensee whose license is in an expired status as of December 1, 2014 must either renew his/her license no later than November 30, 2015 or fulfill the requirements in subsections 10.3.2 or 10.3.3 11.2.2 or 11.2.3, as applicable.
10.4.211.3.2 An applicant whose license has been expired for more than one (1) year and who has been actively engaged in the practice of respiratory care during the period of expiration in another jurisdiction shall be required to submit to the Council an application for reinstatement demonstrating proof of active practice, consisting of a minimum of 500 hours over the one year preceding the date of application for reinstatement, on a Council approved form, and shall demonstrate proof of completion of 20 hours of continuing education during the two-year period preceding the application.
10.4.311.3.3 An applicant whose license has been expired for more than one (1) year and who has not been actively engaged in the practice of respiratory care during the period of expiration shall be required to submit an application for reinstatement and shall be required to give evidence of satisfactory completion of an approved respiratory care examination within two (2) years prior to the application for reinstatement before licensure will be granted. In addition the applicant shall demonstrate completion of 20 hours of continuing education during the two-year period preceding the application.
11.012.0 Telehealth
11.112.1 The respiratory care practitioner who provides treatment through telehealth shall meet the following requirements:
11.1.112.1.1 Location of patient during treatment through telehealth
11.1.1.112.1.1.1 The respiratory care practitioner shall have an active Delaware license in good standing to practice telehealth in the state of Delaware; and
11.1.1.212.1.1.2 During the telehealth treatment session, the patient shall be located within the borders of the State of Delaware.
11.1.212.1.2 Informed consent
11.1.2.112.1.2.1 Before services are provided through telehealth, the respiratory care practitioner shall obtain written, informed consent from the patient, or other appropriate person with authority to make health care treatment decisions for the patient. At minimum, the informed consent shall inform the patient and document acknowledgement of the risk and limitations of:
11.1.2.1.112.1.2.1.1 The use of electronic communications in the provision of care;
11.1.2.1.212.1.2.1.2 The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and
11.1.2.1.312.1.2.1.3 The potential disruption of electronic communication in the use of telehealth.
11.1.312.1.3 Confidentiality: The respiratory care practitioner shall ensure that the electronic communication is secure to maintain confidentiality of the patient's medical information as required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable Federal and State laws. Confidentiality shall be maintained through appropriate processes, practices and technology, including disposal of electronic equipment and data.
11.1.412.1.4 Competence and scope of practice:
11.1.4.112.1.4.1 The respiratory care practitioner shall be responsible for determining and documenting that telehealth is an appropriate level of care for the patient;
11.1.4.212.1.4.2 The respiratory care practitioner shall comply with the Council's and the Board's law and rules and regulations and all current standards of care requirements applicable to onsite care;
11.1.4.312.1.4.3 The respiratory care practitioner shall limit the practice of telehealth to the area of competence in which proficiency has been gained through education, training and experience; and
11.1.4.412.1.4.4 The respiratory care practitioner shall document in the file or record which services were provided by telehealth.
12.013.0 Voluntary Treatment Option for Chemically Dependent or Impaired Professionals
12.113.1 If the report is received by the chairperson of the regulatory Board, that chairperson shall immediately notify the Director of Professional Regulation or his/her designate of the report. If the Director of Professional Regulation receives the report, he/she shall immediately notify the chairperson of the regulatory Board, or that chairperson's designate or designates.
12.213.2 The chairperson of the regulatory Board or that chairperson's designate or designates shall, within 7 days of receipt of the report, contact the individual in question and inform him/her in writing of the report, provide the individual written information describing the Voluntary Treatment Option, and give him/her the opportunity to enter the Voluntary Treatment Option.
12.313.3 In order for the individual to participate in the Voluntary Treatment Option, he/she shall agree to submit to a voluntary drug and alcohol screening and evaluation at a specified laboratory or health care facility. This initial evaluation and screen shall take place within 30 days following notification to the professional by the participating Board chairperson or that chairperson's designate(s).
12.413.4 A regulated professional with chemical dependency or impairment due to addiction to drugs or alcohol may enter into the Voluntary Treatment Option and continue to practice, subject to any limitations on practice the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional, deem necessary, only if such action will not endanger the public health, welfare or safety, and the regulated professional enters into an agreement with the Director of Professional Regulation or his/her designate and the chairperson of the participating Board or that chairperson's designate for a treatment plan and progresses satisfactorily in such treatment program and complies with all terms of that agreement. Treatment programs may be operated by professional Committees and Associations or other similar professional groups with the approval of the Director of Professional Regulation and the chairperson of the participating Board.
12.513.5 Failure to cooperate fully with the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate in regard to the Voluntary Treatment Option or to comply with their requests for evaluations and screens may disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board chairperson or that chairperson's designate or designates shall cause to be activated an immediate investigation and institution of disciplinary proceedings, if appropriate, as outlined in subsection 12.8 of this section.
12.613.6 The Voluntary Treatment Option may require a regulated professional to enter into an agreement which includes, but is not limited to, the following provisions:
12.6.113.6.1 Entry of the regulated professional into a treatment program approved by the participating Board. Board approval shall not require that the regulated professional be identified to the Board. Treatment and evaluation functions must be performed by separate agencies to assure an unbiased assessment of the regulated professional's progress.
12.6.213.6.2 Consent to the treating professional of the approved treatment program to report on the progress of the regulated professional to the chairperson of the participating Board or to that chairperson's designate or designates or to the Director of the Division of Professional Regulation or his/her designate at such intervals as required by the chairperson of the participating Board or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate, and such person making such report will not be liable when such reports are made in good faith and without malice.
12.6.313.6.3 Consent of the regulated professional, in accordance with applicable law, to the release of any treatment information from anyone within the approved treatment program.
12.6.413.6.4 Agreement by the regulated professional to be personally responsible for all costs and charges associated with the Voluntary Treatment Option and treatment program(s). In addition, the Division of Professional Regulation may assess a fee to be paid by the regulated professional to cover administrative costs associated with the Voluntary Treatment Option. The amount of the fee imposed under this subparagraph shall approximate and reasonably reflect the costs necessary to defray the expenses of the participating Board, as well as the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board in addition to the administrative costs associated with the Voluntary Treatment Option.
12.6.513.6.5 Agreement by the regulated professional that failure to satisfactorily progress in such treatment program shall be reported to the participating Board's chairperson or his/her designate or designates or to the Director of the Division of Professional Regulation or his/ her designate by the treating professional who shall be immune from any liability for such reporting made in good faith and without malice.
12.6.613.6.6 Compliance by the regulated professional with any terms or restrictions placed on professional practice as outlined in the agreement under the Voluntary Treatment Option.
12.713.7 The regulated professional's records of participation in the Voluntary Treatment Option will not reflect disciplinary action and shall not be considered public records open to public inspection. However, the participating Board may consider such records in setting a disciplinary sanction in any future matter in which the regulated professional's chemical dependency or impairment is an issue.
12.813.8 The participating Board's chairperson, his/her designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional at any time during the Voluntary Treatment Option, restrict the practice of a chemically dependent or impaired professional if such action is deemed necessary to protect the public health, welfare or safety.
12.913.9 If practice is restricted, the regulated professional may apply for unrestricted licensure upon completion of the program.
12.1013.10 Failure to enter into such agreement or to comply with the terms and make satisfactory progress in the treatment program shall disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board shall be notified and cause to be activated an immediate investigation and disciplinary proceedings as appropriate.
12.1113.11 Any person who reports pursuant to this section in good faith and without malice shall be immune from any civil, criminal or disciplinary liability arising from such reports, and shall have his/her confidentiality protected if the matter is handled in a nondisciplinary matter.
12.1213.12 Any regulated professional who complies with all of the terms and completes the Voluntary Treatment Option shall have his/her confidentiality protected unless otherwise specified in a participating Board's rules and regulations. In such an instance, the written agreement with the regulated professional shall include the potential for disclosure and specify those to whom such information may be disclosed.
13.014.0 Unlicensed Personnel (UP)
13.114.1 Unlicensed personnel working in the State of Delaware may not perform any clinical assessments or provide patient care during the course of their job duties.
13.214.2 Any UP found to have violated the provisions of this section shall be prosecuted for the unlicensed practice of respiratory care.
Last Updated: December 31 1969 19:00:00.
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