54 N.J.R. 525(a)

VOLUME 54, ISSUE 7, APRIL 4, 2022
RULE PROPOSALS

Reporter
54 N.J.R. 525(a)
NJ - New Jersey Register  >  2022  >  APRIL  >  APRIL 4, 2022  >  RULE PROPOSALS  >  LAW AND PUBLIC SAFETY -- DIVISION OF CONSUMER AFFAIRS

Interested Persons Statement 

INTERESTED PERSONS 
Interested persons may submit comments, information or arguments concerning any of the rule proposals in this issue until the date indicated in the proposal. Submissions and any inquiries about submissions should be addressed to the agency officer specified for a particular proposal. 
The required minimum period for comment concerning a proposal is 30 days. A proposing agency may extend the 30-day comment period to accommodate public hearings or to elicit greater public response to a proposed new rule or amendment. Most notices of proposal include a 60-day comment period, in order to qualify the notice for an exception to the rulemaking calendar requirements of  N.J.S.A. 52:14B-3. An extended comment deadline will be noted in the heading of a proposal or appear in a subsequent notice in the Register. 
At the close of the period for comments, the proposing agency may thereafter adopt a proposal, without change, or with changes not in violation of the rulemaking procedures at      N.J.A.C. 1:30-6.3. The adoption becomes effective upon publication in the Register of a notice of adoption, unless otherwise indicated in the adoption notice. Promulgation in the New Jersey Register establishes a new or amended rule as an official part of the New Jersey Administrative Code. 
Agency


LAW AND PUBLIC SAFETY > DIVISION OF CONSUMER AFFAIRS > NEW JERSEY STATE BOARD OF RESPIRATORY CARE

Administrative Code Citation


Proposed Readoption with Amendments: N.J.A.C. 13:44F
Text

 Board of Respiratory Care Rules
Authorized By: New Jersey State Board of Respiratory Care, Renee Clark, Executive Director.
Authority: N.J.S.A. 45:14E-7.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2022-046.
Submit comments by June 3, 2022, to:

Renee Clark, Executive Director
New Jersey State Board of Respiratory Care
124 Halsey Street
PO Box 45031
Newark, NJ 07101

or electronically at: www.NJConsumerAffairs.gov/proposal/comment.

The agency proposal follows:
Summary
The Board of Respiratory Care (Board) proposes to readopt N.J.A.C. 13:44F with amendments. These rules were scheduled to expire on March 4, 2022, pursuant to N.J.S.A. 52:14B-5.1. Because this notice of readoption has been filed with the Office of Administrative Law prior to March 4, 2022, the expiration date of the chapter is extended by 180 days, to August 31, 2022, pursuant to N.J.S.A. 52:14B-5.1.c(2).
In compliance with Executive Order No. 66 (1978), the Board undertook a thorough review of the existing provisions at N.J.A.C. 13:44F in order to delete any unnecessary or unreasonable rules and to clarify existing provisions. After its review, the Board determined that amendments are necessary to provide regulatory congruence and make practical and comprehensive updates to the Board's rules. The Board believes that the rules proposed for readoption, as amended, are necessary, reasonable, understandable, and responsive to the purposes for which they were promulgated.
Subchapter 1 sets forth the purpose, scope, and definitions for the chapter. Specifically, N.J.A.C. 13:44F-1.1 sets forth the purpose and scope of the chapter. N.J.A.C. 13:44F-1.2 sets forth the definitions for terms used in the chapter.
Subchapter 2 is reserved.
Subchapter 3 sets forth the scope of practice and requirements for the authorized practice of respiratory care. N.J.A.C. 13:44F-3.1 sets forth the scope of practice of respiratory care practitioners. N.J.A.C. 13:44F-3.2 addresses the practice of respiratory care by trainees. N.J.A.C. 13:44F-3.3 concerns the delegation of respiratory care services by licensees to unlicensed persons. N.J.A.C. 13:44F-3.3(c) prohibits a licensee from authorizing an assistant to engage in direct patient care. The Board believes that this provision is unduly restrictive and confusing as some of the tasks that a licensee may delegate pursuant to subsection (d) may constitute direct patient care. The Board proposes to delete subsection (c). Subsection (d), proposed for recodification as subsection (c), sets forth tasks that may be delegated in the in-patient or out-patient setting. The Board believes that all of these tasks can be safely delegated in either setting and proposes to delete references to in-patient and out-patient settings. The rule permits a licensed practitioner to delegate the demonstration of basic, non-assisted ventilation and oxygen equipment. The Board believes that unlicensed persons can safely replace such equipment pursuant to a delegation and proposes to amend the rule to allow the delegation of replacing this equipment. The Board proposes to delete a reference to the administration of medication constituting direct patient care. As there will no longer be a prohibition on unlicensed assistants providing direct patient care pursuant to a delegation, such a reference is no longer appropriate.
Subchapter 4 sets forth the rules concerning qualifications for licensure. N.J.A.C. 13:44F-4.1 delineates applicant qualifications. N.J.A.C. 13:44F-4.2 sets forth requirements for the licensure examination. N.J.A.C. 13:44F-4.3 authorizes the Board to refuse to issue, or to suspend or revoke, any license after an opportunity for a hearing. N.J.A.C. 13:44F-4.4 permits an applicant for licensure to apply education, training, and experience completed while serving in the Armed Forces towards licensure requirements.
Subchapter 5 details the requirements for temporary licensure. N.J.A.C. 13:44F-5.1 outlines the requirements for obtaining a temporary license and imposes requirements upon temporary license holders.
Subchapter 6 sets forth the eligibility and application requirements for licensure by endorsement. N.J.A.C. 13:44F-6.1 permits an applicant to receive a license if the applicant is licensed in another state that has requirements for licensure substantially equivalent to the Board's requirements. N.J.A.C. 13:44F-6.2 sets forth the information an applicant for licensure through endorsement must submit to the Board.
Subchapter 7 sets forth requirements for license renewals. N.J.A.C. 13:44F-7.1 requires licensees to renew licensure every two years. The rule permits licensees to renew as inactive. If a licensee fails to renew licensure, the license will be suspended. Licensees on inactive status or who have been suspended are prohibited from practicing respiratory care. N.J.A.C. 13:44F-7.2 establishes standards for reactivating an inactive license. N.J.A.C. 13:44F-7.3 sets forth how a suspended license may be reinstated.
Subchapter 8 contains general provisions. N.J.A.C. 13:44F-8.1 sets forth the schedule of fees charged by the Board. The Board proposes to amend this section to reduce the fee for a duplicate license from $ 50.00 to $ 25.00. N.J.A.C. 13:44F-8.2 sets forth requirements for the maintenance of patient records. N.J.A.C. 13:44F-8.3 delineates activities deemed to constitute sexual misconduct by licensees. N.J.A.C. 13:44F-8.4 sets forth the mailing address and website for the Board. N.J.A.C. 13:44F-8.5 outlines notification requirements for a change of address. The Board proposes to amend this section to require licensees to provide the Board with their business address and to update the Board when either a residential or business address changes. N.J.A.C. 13:44F-8.6 requires licensees to notify the Board of a change of name and N.J.A.C. 13:44F-8.7 details the procedure for obtaining a duplicate license.
Subchapter 9 addresses unlicensed practice. N.J.A.C. 13:44F-9.1 delineates those acts deemed to constitute unlicensed practice. N.J.A.C. 13:44F-9.2 makes it unlawful to aid and abet the unlicensed practice of respiratory care.
Subchapter 10 establishes requirements for continuing education. N.J.A.C. 13:44F-10.1 requires licensees to complete 30 credits of continuing education in order to renew licensure. N.J.A.C. 13:44F-10.2 sets forth the ways in which licensees may complete continuing education credits, one of which is to complete an advanced credentialing [page=526] examination offered by the American Association for Respiratory Care. The Board proposes to amend this section to recognize nine examinations that can be completed in order to obtain continuing education credits and to recognize that licensees earn 10 credits for completing such examinations (rather than one credit).
N.J.A.C. 13:44F-10.2A permits licensees to obtain continuing education credits by completing performance-based competency assessments and the method for determining if such an assessment will be approved by the Board. N.J.A.C. 13:44F-10.3 outlines continuing education recordkeeping requirements for licensees and the Board's authority to conduct continuing education audits. N.J.A.C. 13:44F-10.4 outlines requirements for obtaining a waiver or a modification of continuing education requirements from the Board.
The Board has provided a 60-day comment period for this notice of proposal. Therefore, this notice is excepted from the rulemaking calendar requirement pursuant to N.J.A.C. 1:30-3.3(a)5.
Social Impact
The rules proposed for readoption with amendments have had a beneficial impact on society by establishing licensure procedures and standards of practice for respiratory care practitioners. Regulatory authority over respiratory care practitioners protects the public by ensuring that respiratory care services are rendered by competent individuals who have the knowledge and skills appropriate to practice respiratory care. Additionally, the public is shielded from being misled by incompetent or unauthorized persons and from unprofessional conduct on the part of licensed respiratory care practitioners.
The proposed amendments at N.J.A.C. 13:44F-3.3 will clarify the tasks that licensed respiratory care practitioners may delegate to unlicensed assistants. Proposed amendments at N.J.A.C. 13:44F-8.5 will ensure that the Board is aware of a licensee's place of business, which it is required to have pursuant to N.J.S.A. 45:14E-7.
Economic Impact
The rules proposed for readoption with amendments will impose costs on licensed respiratory care practitioners. The fee schedule at N.J.A.C. 13:44F-8.1 is projected to yield revenues sufficient to cover expenses incurred by the Board for the functions it performs. These fees are not being changed, except for the fee for a duplicate license, which is proposed for reduction to $ 25.00.
The provisions at Subchapter 4 will have an impact on all individuals seeking licensure as respiratory care practitioners in New Jersey. Applicants for licensure will incur costs associated with obtaining the education required prior to sitting for the licensure examination. Individuals seeking licensure will also have to pay an examination fee.
Maintenance of patient records as mandated at N.J.A.C. 13:44F-8.2 has an economic impact on licensees. Licensees will incur costs when they establish and maintain detailed records for every patient for seven years from the date of the last entry.
The continuing education requirements at Subchapter 10 impose costs on licensees. Licensees are required to complete continuing education every biennial period. The costs for obtaining this education is borne by licensees.
Federal Standards Statement
A Federal standards analysis is not required because the rules proposed for readoption with amendments are governed by N.J.S.A. 45:14E-1 et seq., and are not subject to any Federal requirements or standards.
Jobs Impact
The Board does not believe that the rules proposed for readoption with amendments will result in the creation or loss of jobs in the State.
Agriculture Industry Impact
The Board does not believe that the rules proposed for readoption with amendments will have an impact on the agriculture industry in the State.
Regulatory Flexibility Analysis
As licensed respiratory care practitioners are individually licensed by the Board, they may be considered "small businesses" under the Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq.
The costs imposed on small businesses by the rules proposed for readoption with amendments are the same costs that are imposed on all businesses as outlined in the economic impact statement. The Board believes that licensees will not need to employ professional services to comply with the rules proposed for readoption or the proposed amendments. The rules contain no reporting requirements; however, the rules contain recordkeeping and compliance requirements, which are described in the Summary above.
As the compliance and recordkeeping requirements contained in the rules proposed for readoption with amendments are necessary to adequately regulate licensed respiratory care practitioners and protect the health, safety, and welfare of consumers who use their services, the Board believes that the rules must be uniformly applied to all licensees and no exemptions are provided based on the size of a licensee's business.
Housing Affordability Impact Analysis
The rules proposed for readoption with amendments will have an insignificant impact on the affordability of housing in New Jersey and there is an extreme unlikelihood that the rules would evoke a change in the average costs associated with housing because the proposed readoption with amendments concern the practice of respiratory care.
Smart Growth Development Impact Analysis
The rules proposed for readoption with amendments will have an insignificant impact on smart growth and there is an extreme unlikelihood that the rules would evoke a change in housing production in Planning Areas 1 or 2, or within designated centers, under the State Development and Redevelopment Plan in New Jersey because the rules proposed for readoption with amendments concern the practice of respiratory care.
Racial and Ethnic Community Criminal Justice and Public Safety Impact
The Board has evaluated this rulemaking and determined that it will not have an impact on pretrial detention, sentencing, probation, or parole policies concerning adults and juveniles in the State. Accordingly, no further analysis is required.
Full text of the rules proposed for readoption may be found in the New Jersey Administrative Code at N.J.A.C. 13:44F.
Full text of the proposed amendments follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):
SUBCHAPTER 3. AUTHORIZED PRACTICE
13:44F-3.3 Delegation by a respiratory care practitioner to unlicensed persons
(a)-(b) (No change.)
[(c) A licensed respiratory care practitioner shall not authorize or permit an assistant to engage in direct patient care.]
[(d)] (c) Activities that a licensed respiratory care practitioner may delegate to assistants are limited to the following routine tasks:
1. [In an in-patient and out-patient setting: disassembling] Disassembling, cleaning, disinfecting, sterilizing, assembling, and delivery of all respiratory equipment;
2. [In an out-patient setting only: demonstrating] Demonstrating and replacing basic respiratory, non-assisted ventilation, and oxygen equipment. Demonstrating or replacing such equipment shall not include administration of medication[, which would constitute direct patient care]; and
3. [In an in-patient and out-patient setting: maintaining] Maintaining and safe handling of oxygen, [and] specialty gas cylinders, and oxygen concentrators, including the performance of oxygen checks and charges.
Recodify existing (e)-(f) as (d)-(e) (No change in text.)
SUBCHAPTER 8. GENERAL PROVISIONS
13:44F-8.1 Fees
(a) State Board of Respiratory Care charges for licensure and other services are as follows:
1.-4. (No change.)
5. Duplicate license fee ......................................[50.00] 25.00
6.-11. (No change.)
[page=527] 13:44F-8.5 Notification of business address and change of address
(a) Licensees shall provide the State Board of Respiratory Care with their business address.
(b) A licensee, whether active or inactive, of the State Board of Respiratory Care shall notify the Board, in writing, of any change of residential address or business address from that which the Board maintains in its records and which the licensee's current license displays. The licensee shall forward the notice to the Board by certified mail, return receipt requested, no later than 30 days following the change of address.
SUBCHAPTER 10. CONTINUING EDUCATION
13:44F-10.2 Approval of continuing education programs, courses, seminars and articles; determination of credits
(a) The following are acceptable sources of continuing education, provided the subject matter falls within the content areas set forth [in] at N.J.A.C. 13:44F-10.1(c):
1. (No change.)
2. Successful completion of an advanced credentialing examination listed below; [approved for continuing education credit by the American Association for Respiratory Care: one] 10 continuing education credits for each examination [credit awarded] completed:
i. Registered Respiratory Therapist (RRT) offered by the National Board for Respiratory Care;
ii. Registered Pulmonary Function Technologist (RPFT) offered by the National Board for Respiratory Care;
iii. Certified Pulmonary Function Technologist (CPFT) offered by the National Board for Respiratory Care;
iv. Neonatal/Pediatric Specialist (RRT/CRT--NPS) offered by the National Board for Respiratory Care;
v. Sleep Disorder Specialist (RRT/CRT--SDS) offered by the National Board for Respiratory Care;
vi. Acute Critical Care Specialist (RRT-ACCS) offered by the National Board for Respiratory Care;
vii. Asthma Educator--Certified (AE-C) offered by the National Asthma Educator Certification Board;
viii. Registered Polysomnographic Technologist (RPSGT) offered by the Board of Registered Polysomnographic Technologists; and
ix. Certified Hyperbaric Technologist (CHT) offered by the National Board of Diving and Hyperbaric Medical Technology;
3.-8. (No change.)
(b) (No change.)