Colorado 2024 Regular Session

Colorado House Bill HB1253 Compare Versions

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Version 2 (New)

Old	New		Differences
	1	+	Second Regular Session
	2	+	Seventy-fourth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 24-0566.01 Sarah Lozano x3858
1	8		HOUSE BILL 24-1253
2		-	BY REPRESENTATIVE(S) English and Holtorf, Duran, Hamrick, Snyder,
3		-	Woodrow;
4		-	also SENATOR(S) Ginal.
	9	+	House Committees Senate Committees
	10	+	Health & Human Services Finance
	11	+	Finance Appropriations
	12	+	Appropriations
	13	+	A BILL FOR AN ACT
5	14		C
6		-	ONCERNING THE CONTINUATION OF THE REGULATION OF RESPIRATORY
7		-	THERAPY
8		-	, AND, IN CONNECTION THEREWITH , IMPLEMENTING THE
9		-	RECOMMENDATIONS IN THE
10		-	2023 SUNSET REPORT BY THE
11		-	DEPARTMENT OF REGULATORY AGENCIES
12		-	.
13		-
14		-	Be it enacted by the General Assembly of the State of Colorado:
15		-	SECTION 1. In Colorado Revised Statutes, amend 12-300-116 as
16		-	follows:
17		-	12-300-116. Repeal of article - review of functions. This article
	15	+	ONCERNING THE CONTINUATIO N OF THE REGULATION OF101
	16	+	RESPIRATORY THERAPY , AND, IN CONNECTION THEREWITH ,102
	17	+	IMPLEMENTING THE RE COMMENDATIONS IN THE 2023 SUNSET103
	18	+	REPORT BY THE DEPARTMENT OF REGULATORY AGENCIES .104
	19	+	Bill Summary
	20	+	(Note: This summary applies to this bill as introduced and does
	21	+	not reflect any amendments that may be subsequently adopted. If this bill
	22	+	passes third reading in the house of introduction, a bill summary that
	23	+	applies to the reengrossed version of this bill will be available at
	24	+	http://leg.colorado.gov/
	25	+	.)
	26	+	Sunset Process - House Health and Human Services
	27	+	Committee. The bill implements the recommendations of the department
	28	+	of regulatory agencies (department), as specified in the department's
	29	+	SENATE
	30	+	3rd Reading Unamended
	31	+	April 24, 2024
	32	+	SENATE
	33	+	2nd Reading Unamended
	34	+	April 23, 2024
	35	+	HOUSE
	36	+	3rd Reading Unamended
	37	+	April 11, 2024
	38	+	HOUSE
	39	+	2nd Reading Unamended
	40	+	April 10, 2024
	41	+	HOUSE SPONSORSHIP
	42	+	English and Holtorf, Duran, Hamrick, Snyder, Woodrow
	43	+	SENATE SPONSORSHIP
	44	+	Ginal,
	45	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	46	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	47	+	Dashes through the words or numbers indicate deletions from existing law. sunset review of the regulation of respiratory therapy, as follows:
	48	+	! Sections 1 and 2 of the bill continue the regulation of
	49	+	respiratory therapy for 11 years, until September 1, 2035;
	50	+	! The definition of respiratory therapy in current law
	51	+	includes certain treatments of patients pursuant to a
	52	+	prescription issued by a physician, advanced practice
	53	+	registered nurse, or certified midwife. Section 3 expands
	54	+	the definition to also include a prescription issued by a
	55	+	physician assistant.
	56	+	! Current law exempts an unregistered polysomnographic
	57	+	technologist (technologist) who practices respiratory
	58	+	therapy from the state regulatory requirements for
	59	+	respiratory therapists if the technologist is practicing under
	60	+	the supervision of a respiratory therapist, physician, or
	61	+	certain other practitioner. Section 4 narrows this exemption
	62	+	to practices that do not exceed oxygen titration with pulse
	63	+	oximetry and noninvasive positive pressure ventilation
	64	+	titration.
	65	+	! Sections 5 and 6 repeal an obsolete provision and a
	66	+	redundant provision.
	67	+	Be it enacted by the General Assembly of the State of Colorado:1
	68	+	SECTION 1. In Colorado Revised Statutes, amend 12-300-1162
	69	+	as follows:3
	70	+	12-300-116. Repeal of article - review of functions. This article4
18	71		300 is repealed, effective September 1, 2024
19		-	SEPTEMBER 1, 2035. Before
20		-	the repeal, the licensure functions of the director under this article 300 are
21		-	scheduled for review in accordance with section 24-34-104.
22		-	SECTION 2. In Colorado Revised Statutes, 24-34-104, repeal
23		-	(25)(a)(XI); and add (36) as follows:
24		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
25		-	officers and the Governor. To determine whether the Governor has signed the bill
26		-	or taken other action on it, please consult the legislative status sheet, the legislative
27		-	history, or the Session Laws.
28		-	________
29		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
30		-	through words or numbers indicate deletions from existing law and such material is not part of
31		-	the act. 24-34-104. General assembly review of regulatory agencies and
32		-	functions for repeal, continuation, or reestablishment - legislative
33		-	declaration - repeal. (25) (a) The following agencies, functions, or both,
34		-	are scheduled for repeal on September 1, 2024:
35		-	(XI) The licensing and regulation of respiratory therapists by the
36		-	division of professions and occupations in the department of regulatory
37		-	agencies in accordance with article 300 of title 12;
38		-	(36) (a) THE FOLLOWING AGENCIES , FUNCTIONS, OR BOTH, ARE
39		-	SCHEDULED FOR REPEAL ON
40		-	SEPTEMBER 1, 2035:
	72	+	SEPTEMBER 1, 2035. Before5
	73	+	the repeal, the licensure functions of the director under this article 300 are6
	74	+	scheduled for review in accordance with section 24-34-104.7
	75	+	SECTION 2. In Colorado Revised Statutes, 24-34-104, repeal8
	76	+	(25)(a)(XI); and add (36) as follows:9
	77	+	24-34-104. General assembly review of regulatory agencies10
	78	+	and functions for repeal, continuation, or reestablishment - legislative11
	79	+	declaration - repeal. (25) (a) The following agencies, functions, or both,12
	80	+	are scheduled for repeal on September 1, 2024:13
	81	+	(XI) The licensing and regulation of respiratory therapists by the14
	82	+	1253-2- division of professions and occupations in the department of regulatory1
	83	+	agencies in accordance with article 300 of title 12;2
	84	+	(36) (a) T
	85	+	HE FOLLOWING AGENCIES, FUNCTIONS, OR BOTH, ARE3
	86	+	SCHEDULED FOR REPEAL ON SEPTEMBER 1, 2035:4
41	87		(I) T
42		-	HE LICENSING AND REGULATION OF RESPIRATORY ~~THERAPISTS~~
43		-	BY THE DIVISION OF PROFESSIONS AND OCCUPATIONS IN THE ~~DEPARTMENT~~
44		-	OF REGULATORY AGENCIES IN ACCORDANCE WITH ARTICLE
45		-	~~300 OF TITLE~~ 12;
	88	+	HE LICENSING AND REGULATION OF RESPIRATORY THERAPISTS5
	89	+	BY THE DIVISION OF PROFESSIONS AND OCCUPATIONS IN THE DEPARTMENT6
	90	+	OF REGULATORY AGENCIES IN ACCORDANCE WITH ARTICLE 300 OF TITLE7
	91	+	12;8
46	92		(b) T
47		-	HIS SUBSECTION (36) IS REPEALED, EFFECTIVE SEPTEMBER 1,
48		-	2037.
49		-	SECTION 3. In Colorado Revised Statutes, 12-300-104, ~~amend~~
50		-	(3)(c), (3)(d)(II), and (3)(e) as follows:
51		-	12-300-104. Definitions. As used in this article 300, unless ~~the~~
52		-	context otherwise requires:
53		-	(3) "Respiratory therapy" means providing therapy, management,
54		-	rehabilitation, support services for diagnostic evaluation, and care of
55		-	patients with deficiencies and abnormalities that affect the ~~pulmonary~~
56		-	system under the overall direction of a medical director. ~~Respiratory therapy~~
57		-	includes the following:
58		-	(c) Direct and indirect respiratory care services, including ~~the~~
59		-	administration of pharmacological, diagnostic, and therapeutic ~~agents~~
60		-	related to respiratory care procedures necessary to implement a treatment,
61		-	disease prevention, and pulmonary rehabilitative or diagnostic ~~regimen~~
	93	+	HIS SUBSECTION (36) IS REPEALED, EFFECTIVE SEPTEMBER 1,9
	94	+	2037.10
	95	+	SECTION 3. In Colorado Revised Statutes, 12-300-104, amend11
	96	+	(3)(c), (3)(d)(II), and (3)(e) as follows:12
	97	+	12-300-104. Definitions. As used in this article 300, unless the13
	98	+	context otherwise requires:14
	99	+	(3) "Respiratory therapy" means providing therapy, management,15
	100	+	rehabilitation, support services for diagnostic evaluation, and care of16
	101	+	patients with deficiencies and abnormalities that affect the pulmonary17
	102	+	system under the overall direction of a medical director. Respiratory18
	103	+	therapy includes the following:19
	104	+	(c) Direct and indirect respiratory care services, including the20
	105	+	administration of pharmacological, diagnostic, and therapeutic agents21
	106	+	related to respiratory care procedures necessary to implement a treatment,22
	107	+	disease prevention, and pulmonary rehabilitative or diagnostic regimen23
62	108		prescribed by a physician,
63		-	A PHYSICIAN ASSISTANT, an advanced practice
64		-	registered nurse, or a certified midwife;
65		-	(d) Observation and monitoring of signs, symptoms, reactions,
66		-	general behavior, and general physical response to respiratory care
67		-	PAGE 2-HOUSE BILL 24-1253 treatment and diagnostic testing for:
68		-	(II) The implementation based on observed abnormalities of
69		-	appropriate reporting, referral, or respiratory care protocols or changes in
	109	+	A PHYSICIAN ASSISTANT, an advanced practice24
	110	+	registered nurse, or a certified midwife;25
	111	+	(d) Observation and monitoring of signs, symptoms, reactions,26
	112	+	general behavior, and general physical response to respiratory care27
	113	+	1253
	114	+	-3- treatment and diagnostic testing for:1
	115	+	(II) The implementation based on observed abnormalities of2
	116	+	appropriate reporting, referral, or respiratory care protocols or changes in3
70	117		treatment regimen pursuant to a prescription by a physician,
71		-	A PHYSICIAN
72		-	ASSISTANT
73		-	, an advanced practice registered nurse, or a certified midwife or
74		-	the initiation of emergency procedures;
75		-	(e) The diagnostic and therapeutic use of the following in
	118	+	A PHYSICIAN4
	119	+	ASSISTANT, an advanced practice registered nurse, or a certified midwife5
	120	+	or the initiation of emergency procedures;6
	121	+	(e) The diagnostic and therapeutic use of the following in7
76	122		accordance with the prescription of a physician,
77		-	A PHYSICIAN ASSISTANT, an
78		-	advanced practice registered nurse, or a certified midwife:
79		-	(I) Administration of medical gases, exclusive of general anesthesia;
80		-	(II) Aerosols;
81		-	(III) Humidification;
82		-	(IV) Environmental control systems and biomedical therapy;
83		-	(V) Pharmacologic agents related to respiratory care procedures;
84		-	(VI) Mechanical or physiological ventilatory support;
85		-	(VII) Bronchopulmonary hygiene;
86		-	(VIII) Respiratory protocol and evaluation;
87		-	(IX) Cardiopulmonary resuscitation;
88		-	(X) Maintenance of the natural airways;
89		-	(XI) Insertion and maintenance of artificial airways;
90		-	(XII) Diagnostic and testing techniques required for implementation
91		-	of respiratory care protocols;
92		-	(XIII) Collection of specimens from the respiratory tract; or
93		-	(XIV) Analysis of blood gases and respiratory secretions and
94		-	PAGE 3-HOUSE BILL 24-1253 participation in cardiopulmonary research; and
95		-	SECTION 4. In Colorado Revised Statutes, 12-300-112, amend
96		-	(1)(a)(III) as follows:
97		-	12-300-112. Exceptions. (1) This article 300 does not prohibit:
98		-	(a) (III) The practice of respiratory therapy by polysomnographic
99		-	technologists who are not registered by or do not hold credentials from a
100		-	nationally recognized organization, but those polysomnographic
101		-	technologists shall only practice under the supervision of a respiratory
102		-	therapist, a physician, or an individual exempted from the provisions of
103		-	this
104		-	article 300 pursuant to subsection (1)(g) of this section,
105		-	AND THOSE
106		-	POLYSOMNOGRAPHIC TECHNOLOGISTS
107		-	' SCOPE OF PRACTICE MUST NOT
108		-	EXCEED OXYGEN TITRATION WITH PULSE OXIMETRY AND NONINVASIVE
109		-	POSITIVE PRESSURE VENTILATION TITRATION
110		-	.
111		-	SECTION 5. In Colorado Revised Statutes, 12-300-107, amend (2)
112		-	as follows:
113		-	12-300-107. License - effectiveness - fee. (2) The director shall
114		-	issue a license to practice respiratory therapy to an applicant who otherwise
115		-	meets the qualifications set forth in this article 300 and who submits
116		-	satisfactory proof and certifies under penalty of perjury that the applicant
117		-	is either:
118		-	(a) Eligible for licensure by endorsement pursuant to the
	123	+	A PHYSICIAN ASSISTANT,8
	124	+	an advanced practice registered nurse, or a certified midwife:9
	125	+	(I) Administration of medical gases, exclusive of general10
	126	+	anesthesia;11
	127	+	(II) Aerosols;12
	128	+	(III) Humidification;13
	129	+	(IV) Environmental control systems and biomedical therapy;14
	130	+	(V) Pharmacologic agents related to respiratory care procedures;15
	131	+	(VI) Mechanical or physiological ventilatory support;16
	132	+	(VII) Bronchopulmonary hygiene;17
	133	+	(VIII) Respiratory protocol and evaluation;18
	134	+	(IX) Cardiopulmonary resuscitation;19
	135	+	(X) Maintenance of the natural airways;20
	136	+	(XI) Insertion and maintenance of artificial airways;21
	137	+	(XII) Diagnostic and testing techniques required for22
	138	+	implementation of respiratory care protocols;23
	139	+	(XIII) Collection of specimens from the respiratory tract; or24
	140	+	(XIV) Analysis of blood gases and respiratory secretions and25
	141	+	participation in cardiopulmonary research; and26
	142	+	SECTION 4. In Colorado Revised Statutes, 12-300-112, amend27
	143	+	1253
	144	+	-4- (1)(a)(III) as follows:1
	145	+	12-300-112. Exceptions. (1) This article 300 does not prohibit:2
	146	+	(a) (III) The practice of respiratory therapy by polysomnographic3
	147	+	technologists who are not registered by or do not hold credentials from a4
	148	+	nationally recognized organization, but those polysomnographic5
	149	+	technologists shall only practice under the supervision of a respiratory6
	150	+	therapist, a physician, or an individual exempted from the provisions of7
	151	+	this article 300 pursuant to subsection (1)(g) of this section,
	152	+	AND THOSE8
	153	+	POLYSOMNOGRAPHIC TECHNOLOGISTS ' SCOPE OF PRACTICE MUST NOT9
	154	+	EXCEED OXYGEN TITRATION WITH PULSE OXIMETRY AND NONINVASIVE10
	155	+	POSITIVE PRESSURE VENTILATION TITRATION .11
	156	+	SECTION 5. In Colorado Revised Statutes, 12-300-107, amend12
	157	+	(2) as follows:13
	158	+	12-300-107. License - effectiveness - fee. (2) The director shall14
	159	+	issue a license to practice respiratory therapy to an applicant who15
	160	+	otherwise meets the qualifications set forth in this article 300 and who16
	161	+	submits satisfactory proof and certifies under penalty of perjury that the17
	162	+	applicant is either:18
	163	+	(a) Eligible for licensure by endorsement pursuant to the19
119	164		occupational credential portability program;
120		-	OR
121		-	(b) Holding credentials conferred by a national respiratory ~~therapy~~
122		-	credentialing body, as determined by the director, which credentials ~~have~~
	165	+	OR20
	166	+	(b) Holding credentials conferred by a national respiratory therapy21
	167	+	credentialing body, as determined by the director, which credentials have22
123	168		not been suspended or revoked. or
124		-	(c) Functioning in the capacity of a respiratory therapist as of July
125		-	1, 2000, and has successfully passed, no later than July 1, 2001, the
126		-	certification or registration examination of a national respiratory therapy
127		-	credentialing body, as determined by the director.
128		-	SECTION 6. In Colorado Revised Statutes, amend 12-300-108 as
129		-	follows:
130		-	PAGE 4-HOUSE BILL 24-1253 12-300-108. Renewal of license. (1) At least sixty calendar days
131		-	prior to the expiration of a license, the director shall notify the licensee of
132		-	the pending expiration. The director shall make an expiration notice and a
133		-	renewal form available to the licensee. Before the expiration date, the
134		-	licensee shall complete the renewal form and return it to the division with
135		-	the renewal fee.
136		-	(2) Licenses issued pursuant to this article 300 are subject to the
137		-	renewal, expiration, reinstatement, and delinquency fee provisions specified
138		-	in section 12-20-202 (1) and (2). Any person whose license has expired
139		-	shall be
140		-	IS subject to the penalties provided in this article 300 or section
141		-	12-20-202 (1).
142		-	SECTION 7. Act subject to petition - effective date. This act
143		-	takes effect at 12:01 a.m. on the day following the expiration of the
144		-	ninety-day period after final adjournment of the general assembly; except
145		-	that, if a referendum petition is filed pursuant to section 1 (3) of article V
146		-	of the state constitution against this act or an item, section, or part of this act
147		-	within such period, then the act, item, section, or part will not take effect
148		-	unless approved by the people at the general election to be held in
149		-	PAGE 5-HOUSE BILL 24-1253 November 2024 and, in such case, will take effect on the date of the official
150		-	declaration of the vote thereon by the governor.
151		-	____________________________ ____________________________
152		-	Julie McCluskie Steve Fenberg
153		-	SPEAKER OF THE HOUSE PRESIDENT OF
154		-	OF REPRESENTATIVES THE SENATE
155		-	____________________________ ____________________________
156		-	Robin Jones Cindi L. Markwell
157		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
158		-	OF REPRESENTATIVES THE SENATE
159		-	APPROVED________________________________________
160		-	(Date and Time)
161		-	_________________________________________
162		-	Jared S. Polis
163		-	GOVERNOR OF THE STATE OF COLORADO
164		-	PAGE 6-HOUSE BILL 24-1253
	169	+	23
	170	+	(c) Functioning in the capacity of a respiratory therapist as of July24
	171	+	1, 2000, and has successfully passed, no later than July 1, 2001, the25
	172	+	certification or registration examination of a national respiratory therapy26
	173	+	credentialing body, as determined by the director.27
	174	+	1253
	175	+	-5- SECTION 6. In Colorado Revised Statutes, amend 12-300-1081
	176	+	as follows:2
	177	+	12-300-108. Renewal of license. (1) At least sixty calendar days3
	178	+	prior to the expiration of a license, the director shall notify the licensee of4
	179	+	the pending expiration. The director shall make an expiration notice and5
	180	+	a renewal form available to the licensee. Before the expiration date, the6
	181	+	licensee shall complete the renewal form and return it to the division with7
	182	+	the renewal fee.8
	183	+	(2) Licenses issued pursuant to this article 300 are subject to the9
	184	+	renewal, expiration, reinstatement, and delinquency fee provisions10
	185	+	specified in section 12-20-202 (1) and (2). Any person whose license has11
	186	+	expired shall be IS subject to the penalties provided in this article 300 or12
	187	+	section 12-20-202 (1).13
	188	+	SECTION 7. Act subject to petition - effective date. This act14
	189	+	takes effect at 12:01 a.m. on the day following the expiration of the15
	190	+	ninety-day period after final adjournment of the general assembly; except16
	191	+	that, if a referendum petition is filed pursuant to section 1 (3) of article V17
	192	+	of the state constitution against this act or an item, section, or part of this18
	193	+	act within such period, then the act, item, section, or part will not take19
	194	+	effect unless approved by the people at the general election to be held in20
	195	+	November 2024 and, in such case, will take effect on the date of the21
	196	+	official declaration of the vote thereon by the governor.22
	197	+	1253
	198	+	-6-