Source: https://regulations.delaware.gov/register/november2019/proposed/23%20DE%20Reg%20366%2011-01-19.htm
Timestamp: 2020-07-02 13:25:42
Document Index: 748459697

Matched Legal Cases: ['§1775', '§10118', '§1776', '§1776', '§1775', '§8735', '§8735', '§1777', '§1777', '§1776', '§10142']

Pursuant to 24 Del.C. §1775(c), the Respiratory Care Practice Advisory Council (“the Council”) of the Board of Medical Licensure and Discipline (“the Board”) has proposed revisions to its rules and regulations. Currently, Section 11.0 states that a licensee whose license has expired may renew that license within one year after the expiration date upon fulfilling specified requirements. The lengthy late renewal period is inefficient and confusing for licensees. The Council proposes amending Section 11.0 by changing the late renewal period from one year to sixty days. This change will clarify and streamline the licensure renewal process and the associated continuing education audit process.
A public hearing will be held on January 8, 2020 at 3:00 p.m. in the second floor conference room B of the Cannon Building, 861 Silver Lake Boulevard, Dover, Delaware, where members of the public can offer comments. Anyone wishing to receive a copy of the proposed rules and regulations may obtain a copy from the Delaware Respiratory Care Practice Advisory Council, 861 Silver Lake Boulevard, Dover, Delaware 19904. Persons wishing to submit written comments may forward these to Devashree Singh, Executive Director, at the above address or at devashree.singh@delaware.gov. Pursuant to 29 Del.C. §10118(a), the final date to receive written comments will be January 23, 2020. The Council will deliberate on the proposed revisions at its next regularly scheduled meeting.
“Board” - means Delaware Board of Medical Licensure and Discipline.
“Council” - means the Respiratory Care Practice Advisory Council of the Board of Medical Licensure and Discipline.
“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.
"Unlicensed Personnel (UP)" - means an individual not otherwise authorized or exempt to provide respiratory care services except as provided in Section 14.0.
20 DE Reg. 187 (09/01/16)
22 DE Reg. 232 (09/01/18)
6.3.1	Performing acts beyond the scope of authorized practice by a respiratory care practitioner to include violations of 24 Del.C. §§1775-1779 or of these regulations.
6.4.1	Upon receipt of a written complaint against a respiratory care practitioner or upon its own motion, the Council may request the Division of Professional Regulation to investigate the complaint or a charge against a respiratory care practitioner and the process established by 29 Del.C. §8735(h) shall be followed with respect to any such matter.
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.
7.5	Subject to subsection 7.4, a student temporary permit shall be valid for 16 weeks.
•	American Association for Respiratory Care;
•	American Medical Association under Physician Category I;
•	American Thoracic Society;
•	American Association of Cardiovascular and Pulmonary Rehabilitation;
•	American Heart Association;
•	American Nurses Association;
•	American College of Chest Physicians;
•	American Society of Anesthesiologists;
•	American Sleep Disorders Association; or
•	Other professional or educational organizations as approved periodically by the Council.
•	Recredential exam
•	Neonatal pediatric specialty exam.
•	Pulmonary function credentialing exams
•	Sleep Disorders Specialty (SDS) Certification
•	Advanced practitioner exam
8.5	Audit of Continuing Education Contact Hours
8.5.1	Audit. Each biennium, the Division of Professional Regulation shall randomly select from the list of renewed licensees a percentage of licensees, determined by the Council, to be audited. The Council may also audit based on complaints or charges against an individual license, relative to compliance with continuing education requirements or based on a finding of past non-compliance during prior audits.
8.5.2	Documentation. When a licensee is selected for audit, the licensee shall be required to submit documentation showing detailed accounting of the various continuing education contact hours claimed by the licensee. Licensees selected for random audit are required to supplement the attestation with supporting materials which may include a syllabus, agenda, itinerary or brochure published by the sponsor of the activity and a document showing proof of attendance (i.e., certificate, a signed letter from the sponsor attesting to attendance, report of passing test score).The Council shall attempt to verify the continuing education shown on the documentation provided by the licensee. Upon completion of the review, the Council decide whether the licensee's continuing education meets the requirements of these regulations.
8.5.2.1	Any continuing education not meeting all provisions of these regulations shall be rejected in part or in whole by the Council
8.5.2.2	Any incomplete or inaccurate documentation of continuing education may be rejected in part or in whole by the Council.
8.5.2.3	Any continuing education that is rejected must be replaced by acceptable continuing education within a reasonable period of time established by the Council. This continuing education will not be counted towards the next renewal period.
8.5.3	Council Review and Hearing Process. The Council shall review all documentation requested of any licensee shown on the audit list. If the Council determines the licensee has met the requirements, the licensee's license shall remain in effect. If the Council initially determines the licensee has not met the requirements, the licensee shall be notified and a hearing may be held pursuant to the Administrative Procedures Act. This hearing will be conducted to determine if there are any extenuating circumstances justifying the apparent noncompliance with these requirements. Unjustified noncompliance of these regulations shall be considered unprofessional conduct in the practice of respiratory care pursuant to subsection 6.3.
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).
8.5.5	Requests for Extension- Extenuating Circumstances. A licensee applying for renewal may request an extension and be given up to an additional twelve (12) months to make up all outstanding required continuing education providing he/she can show good cause why he/she was unable to comply with such requirements at the same time he/she applies for renewal. The licensee must state the reason for such extension along with whatever documentation he/she feels is relevant. The Council shall consider requests such as extensive travel outside the United States, military service, extended illness of the licensee or his/her immediate family, or a death in the immediate family of the licensee. The written request for extension must be received by the Council prior to the licensure renewal. The Council shall issue an extension when it determines that one or more of these criteria have been met or if circumstances beyond the control of the licensee have rendered it impossible for the licensee to obtain the required continuing education. A licensee who has successfully applied for an extension under this paragraph shall make up all outstanding hours of continuing education within the extension period approved by the Council. Make-up credits may not be used in the next renewal period.
8.5.6	Appeal. Any licensee sanctioned pursuant to these regulations may contest such ruling by filing an appeal of the Board's final order pursuant to the Administrative Procedures Act.
4 DE Reg. 694 (10/01/00)
8 DE Reg. 1438 (04/01/05)
8 DE Reg. 1587 (05/01/05)
9.1.1	An application for a license to practice respiratory care must be completed on a form provided by the Board of Medical Licensure and Discipline and returned to the Board Office with the required, non-refundable fee.
9.2.1	An application for a license to practice respiratory care shall be considered completed when the Board has received all of the following documentation:
9.2.1.1	Non-refundable application fee.
9.2.1.2	Completed application for licensure.
9.2.1.3	Verification of Respiratory Care Education.
9.2.1.4	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.
Licensees must provide the Division of Professional Regulation with any change of address from that registered with the Division. Any change in address must be reported to the Division within thirty days of such change. All notifications and correspondence pertaining to a licensee's license that are sent through the mail will be sent only to the most recent address provided by the licensee. The failure to provide the Division with a current address will not operate to excuse any duty or responsibility of the licensee and confirmed delivery to the most recent address provided by the licensee will be considered proper notice.
11.0	Renewal of Licenses
11.1	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.
11.2	Renewal shall be effected electronically by:
11.2.1	Filing a renewal application online at www.dpr.delaware.gov;
11.2.2	Attesting on the renewal application to the completing of continuing education as required by Section 8.0; and
11.2.3	Payment of fees as determined by the Division of Professional Regulation.
11.3	Failure of a licensee to renew his/her license shall cause his/her license to expire.
11.3.1	A Effective the licensure renewal period beginning December 1, 2020, a licensee whose license has expired may renew his/her license within one (1) year sixty (60) days after the expiration date upon fulfilling the requirements in subsections 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 11.2.2 or 11.2.3, as applicable.
11.3.2	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.
11.3.3	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.
11.3.2	The failure of a licensee to renew the lapsed license within sixty (60) days as set forth in subsection 11.3.1 shall cause the license to terminate.
11.3.3	A respiratory care practitioner whose license has terminated may reapply under the same conditions that govern applicants for new licensure under 24 Del.C. Ch. 17.
11.3.4	A respiratory care practitioner who reapplies for licensure more than a year after the date of license termination must, in addition to the requirements of subsection 11.3.3, show evidence of completion of 20 hours of continuing education within the two year period prior to reapplication.
12.0	Telehealth
12.1	The respiratory care practitioner who provides treatment through telehealth shall meet the following requirements:
12.1.1	Location of patient during treatment through telehealth
12.1.1.1	The respiratory care practitioner shall have an active Delaware license in good standing to practice telehealth in the state of Delaware; and
12.1.1.2	During the telehealth treatment session, the patient shall be located within the borders of the State of Delaware.
12.1.2	Informed consent
12.1.2.1	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:
12.1.2.1.1	The use of electronic communications in the provision of care;
12.1.2.1.2	The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and
12.1.2.1.3	The potential disruption of electronic communication in the use of telehealth.
12.1.3	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.
12.1.4	Competence and scope of practice:
12.1.4.1	The respiratory care practitioner shall be responsible for determining and documenting that telehealth is an appropriate level of care for the patient;
12.1.4.2	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;
12.1.4.3	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
12.1.4.4	The respiratory care practitioner shall document in the file or record which services were provided by telehealth.
13.5	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.
7 DE Reg. 761 (12/01/03)
14.0	Unlicensed Personnel (UP)
14.1	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.
14.2	Any UP found to have violated the provisions of this section shall be prosecuted for the unlicensed practice of respiratory care.
1 DE Reg. 1746 (05/01/98)
4 DE Reg. 699 (01/01/00)
8 DE Reg. 1445 (04/01/05)
23 DE Reg. 366 (11/01/19) (Prop.)