North Carolina 2025-2026 Regular Session

North Carolina House Bill H71 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		GENERAL ASSEMBLY OF NORTH CAROLINA
2	2		SESSION 2025
3		-	H 2
	3	+	H 1
4	4		HOUSE BILL 71
5		-	~~Committee Substitute Favorable 3/11/25~~
	5	+
6	6
7	7		Short Title: Respiratory Care Modernization Act. (Public)
8		-	Sponsors:
9		-	Referred to:
	8	+	Sponsors: Representatives Moss and Huneycutt (Primary Sponsors).
	9	+	For a complete list of sponsors, refer to the North Carolina General Assembly web site.
	10	+	Referred to: Health, if favorable, Regulatory Reform, if favorable, Rules, Calendar, and
	11	+	Operations of the House
10	12		February 11, 2025
11		-	H71-v-2
	13	+	H71-v-1
12	14		A BILL TO BE ENTITLED 1
13	15		AN ACT TO UPDATE THE GENERAL STATUTES OF NORTH CAROLINA GOVE RNING 2
14	16		THE PRACTICE OF RESPIRATORY CARE TO BETTER REFLECT THE CHANGES IN 3
15	17		EDUCATION, EXPERIENCE, AND PRACTICE OF THE PROFESSION IN ORDER TO 4
16	18		ENHANCE THE HEALTH A ND WELFARE OF NORTH CAROLINA CITIZENS. 5
17	19		Whereas, it is the intention of the North Carolina General Assembly to promote the 6
18	20		health and welfare of the citizens of this State; and 7
19	21		Whereas, the COVID-19 pandemic has placed increasing demands on all health care 8
20	22		professionals; and 9
21	23		Whereas, it is the intention of the North Carolina General Assembly that statutes 10
22	24		governing the profession of respiratory care reflect current practices, improvements, and other 11
23	25		developments that have occurred in the profession; and 12
24	26		Whereas, the current statutory language does not fully encompass current practices, 13
25	27		improvements, and other developments; Now, therefore, 14
26	28		The General Assembly of North Carolina enacts: 15
27	29		SECTION 1. Article 38 of Chapter 90 of the General Statutes reads as rewritten: 16
28	30		"Article 38. 17
29	31		"Respiratory Care Practice Act. 18
30	32		… 19
31	33		"§ 90-648. Definitions. 20
32	34		The following definitions apply in this Article: 21
33	35		(1) Advanced respiratory care practitioner (ARCP). – A person licensed in this 22
34	36		State who has gained additional specialized knowledge, skills, and experience 23
35	37		through a postgraduate advanced practice respiratory therapy program of 24
36	38		study as defined by the Board and is authorized to perform advanced 25
37	39		respiratory therapy practices under the supervision of a physician licensed to 26
38	40		practice medicine in accordance with Article 1 of this Chapter. 27
39	41		(1a) Advanced respiratory care procedures. – Procedures that require additional 28
40	42		competency training in accordance with rules adopted by the Board. 29
41	43		(1)(1b) Board. – The North Carolina Respiratory Care Board. 30
42	44		(2) Diagnostic testing. – Cardiopulmonary procedures and tests performed on the 31
43	45		written order of a physician licensed under Article 1 of this Chapter that 32
44		-	provide information to the physician to formulate a diagnosis of the patient's 33
45		-	condition. The tests and procedures may include pulmonary function testing, 34
46		-	electrocardiograph testing, cardiac stress testing, and sleep related testing. 35 General Assembly Of North Carolina Session 2025
47		-	Page 2 House Bill 71-Second Edition
48		-	(3) Direct supervision. – The authority and responsibility to direct the 1
49		-	performance of activities as established by policies and procedures for safe 2
50		-	and appropriate completion of services. 3
51		-	(3a) Endorsement. – A designation issued by the Board recognizing the person 4
52		-	named on the endorsement as having met the requirements to perform 5
53		-	advanced respiratory care procedures as defined by rules adopted by the 6
54		-	Board. 7
55		-	(4) Individual. – A human being. 8
56		-	(4a) Invasive diagnostic and therapeutic procedure. – Any test or treatment that 9
57		-	uses instruments to cut, puncture, or otherwise enter the body. 10
58		-	(5) License. – A certificate issued by the Board recognizing the person named 11
59		-	therein as having met the requirements to practice respiratory care as defined 12
60		-	in this Article.Article as a respiratory care practitioner or advanced respiratory 13
61		-	care practitioner. 14
62		-	(6) Licensee. – A person who has been issued a license under this Article. 15
63		-	(7) Medical director. – An appointed physician who is licensed under Article 1 of 16
64		-	this Chapter and a member of the entity's medical staff, and who is granted 17
65		-	the authority and responsibility for assuring and establishing policies and 18
66		-	procedures and that the provision of such is provided to the quality, safety, 19
67		-	and appropriateness standards as recognized within the defined scope of 20
68		-	practice for the entity. 21
69		-	(8) Person. – An individual, corporation, partnership, association, unit of 22
70		-	government, or other legal entity. 23
71		-	(9) Physician. – A doctor of medicine An individual licensed to practice medicine 24
72		-	by the State of North Carolina in accordance with Article 1 of this Chapter. 25
73		-	(9a) Practice of advanced practice respiratory therapy. – The scope of practice as 26
74		-	determined by the supervising physician at the practice level in any health care 27
75		-	setting authorized by the supervising physician and the Board. It shall not 28
76		-	include (i) medical diagnosis; (ii) prescribing; (iii) interpretation of medical 29
77		-	diagnostic imaging studies; (iv) final interpretation of sleep studies or 30
78		-	pulmonary function tests; (v) surgery; (vi) delivery of anesthesia; and (vii) 31
79		-	unless a physician is physically present to supervise the advanced practice 32
80		-	respiratory care therapist or the procedure is provided pursuant to subdivision 33
81		-	(10) of this section, the ordering or performance of diagnostic and therapeutic 34
82		-	procedures that are more than minimally invasive and have known 35
83		-	complications that involve serious injury and death. The advanced respiratory 36
84		-	care practitioner may perform acts, tasks, or functions in any health care 37
85		-	setting for which the physician is responsible, and which are as follows: 38
86		-	a. Related to the care of persons with problems affecting the 39
87		-	cardiovascular and cardiopulmonary systems. 40
88		-	b. Delegated by a supervising physician. 41
89		-	c. Appropriate to the advanced respiratory care practitioner's education, 42
90		-	training, experience, and level of competence. 43
91		-	(10) Practice of respiratory care. – As defined by the written order of a physician 44
92		-	licensed under Article 1 of this Chapter, Chapter for respiratory care 45
93		-	practitioners, the observing and monitoring of signs and symptoms, general 46
94		-	behavior, and general physical response to respiratory care treatment and 47
95		-	diagnostic testing, including the determination of whether such signs, 48
96		-	symptoms, reactions, behavior, or general response exhibit abnormal 49
97		-	characteristics, and the performance of diagnostic testing and therapeutic 50
98		-	application of: 51 General Assembly Of North Carolina Session 2025
99		-	House Bill 71-Second Edition Page 3
100		-	a. Medical gases, humidity, and aerosols including the maintenance use 1
101		-	of associated apparatus, respiratory care equipment, except for the 2
102		-	purpose of anesthesia. 3
103		-	b. Pharmacologic agents related to respiratory care procedures, including 4
104		-	those agents necessary to perform hemodynamic monitoring. 5
105		-	c. Mechanical or physiological ventilatory support. 6
106		-	d. Cardiopulmonary resuscitation and maintenance of natural airways, 7
107		-	the insertion and maintenance of artificial airways under the direct 8
108		-	supervision of a recognized medical director in a health care 9
109		-	environment which identifies these services within the scope of 10
110		-	practice by the facility's governing board. 11
111		-	e. Hyperbaric oxygen therapy. 12
112		-	f. New and innovative respiratory care and related support activities in 13
113		-	appropriately identified environments and under the training and 14
114		-	practice guidelines established by the American Association of 15
115		-	Respiratory Care. 16
116		-	The term also means the interpretation and implementation of a 17
117		-	physician's written or verbal order pertaining to the acts described in 18
118		-	this subdivision. 19
119		-	(11) Respiratory care. – As defined by the written order of a physician licensed 20
120		-	under Article 1 of Chapter 90, the treatment, management, diagnostic testing, 21
121		-	and care of patients with deficiencies and abnormalities associated with the 22
122		-	cardiopulmonary system. 23
123		-	(12) Respiratory care practitioner. – A person who has been licensed by the Board 24
124		-	to engage in the practice of respiratory care. 25
125		-	(12a) Serious injury. – An injury that creates a substantial risk of impairment of any 26
126		-	bodily function that requires immediate medical attention or hospitalization. 27
127		-	(12b) Supervising physician. – A physician with the competencies and authority to 28
128		-	supervise advanced respiratory care practitioners. 29
129		-	(13) Support activities. – Procedures Tasks that do not require formal academic 30
130		-	training, including the delivery, setup, and routine maintenance and repair of 31
131		-	apparatus. respiratory care equipment. The term also includes giving 32
132		-	instructions on the use, fitting, and application of apparatus, respiratory care 33
133		-	equipment but does not include therapeutic evaluation and 34
134		-	assessment.assessment for an individual patient as defined in rules adopted by 35
135		-	the Board. 36
136		-	"§ 90-649. North Carolina Respiratory Care Board; creation. 37
137		-	(a) The North Carolina Respiratory Care Board is created. The Board shall consist of 10 38
138		-	members as follows: 39
139		-	(1) Two members shall be respiratory care practitioners. 40
140		-	(2) Four members shall be physicians licensed to practice in North Carolina, and 41
141		-	whose primary practice is Pulmonology, Anesthesiology, Critical Care 42
142		-	Medicine, or whose specialty is Cardiothoracic Disorders. 43
143		-	(3) One member shall represent the North Carolina Hospital Association. 44
144		-	(4) One member member, who is a resident of this State, shall represent the North 45
145		-	Carolina Association of Atlantic Coast Medical Equipment Services.Services 46
146		-	Association. 47
147		-	(5) Two members shall represent the public at large. 48
148		-	… 49
149		-	"§ 90-650. Appointments and removal of Board members; terms and compensation. 50
150		-	(a) The members of the Board shall be appointed as follows: 51 General Assembly Of North Carolina Session 2025
151		-	Page 4 House Bill 71-Second Edition
152		-	… 1
153		-	(7) The North Carolina Association of Atlantic Coast Medical Equipment 2
154		-	Services Association shall appoint the member described in 3
155		-	G.S. 90-649(a)(4). 4
156		-	… 5
157		-	"§ 90-652. Powers and duties of the Board. 6
158		-	The Board shall have the power and duty to: 7
159		-	(1) Determine the qualifications and fitness of applicants for licensure, renewal 8
160		-	of licensure, and reciprocal licensure. The Board shall, in its discretion, 9
161		-	investigate the background of an applicant to determine the applicant's 10
162		-	qualifications with due regard given to the applicant's competency, honesty, 11
163		-	truthfulness, and integrity. The State Bureau of Investigation may provide a 12
164		-	criminal record check to the Board for a person who has applied for a license 13
165		-	through the Board. The Board shall provide to the State Bureau of 14
166		-	Investigation, along with the request, the fingerprints of the applicant, any 15
167		-	additional information required by the State Bureau of Investigation, and a 16
168		-	form signed by the applicant consenting to the check of the criminal record 17
169		-	and to the use of the fingerprints and other identifying information required 18
170		-	by the State or national repositories. Investigation. The applicant's fingerprints 19
171		-	shall be used by the State Bureau of Investigation for a search of the State's 20
172		-	criminal history record file, and the State Bureau of Investigation shall 21
173		-	forward a set of the fingerprints to the Federal Bureau of Investigation for a 22
174		-	national criminal history check. The Board shall keep all information pursuant 23
175		-	to this subdivision privileged, in accordance with applicable State law and 24
176		-	federal guidelines, and the information shall be confidential and shall not be a 25
177		-	public record under Chapter 132 of the General Statutes. The Board shall 26
178		-	collect any fees required by the State Bureau of Investigation and shall remit 27
179		-	the fees to the State Bureau of Investigation for expenses associated with 28
180		-	conducting the criminal history record check. 29
181		-	… 30
182		-	(14) Establish and adopt rules defining the education and credential requirements 31
183		-	for persons seeking endorsement under this Article. 32
184		-	"§ 90-653. Licensure requirements; examination. 33
185		-	(a) Each applicant for licensure a respiratory care practitioner license under this Article 34
186		-	shall meet the following requirements:do all of the following: 35
187		-	(1) Submit a completed application as required by the Board.Board, which shall 36
188		-	include a form signed by the applicant consenting to the check of the 37
189		-	applicant's criminal record and to the use of the applicant's fingerprints and 38
190		-	other identifying information required by the State and national repositories. 39
191		-	(2) Submit any fees required by the Board. 40
192		-	(3) Submit to the Board written evidence, verified by oath, that the applicant has 41
193		-	successfully completed the minimal entry-level degree requirements of a 42
194		-	respiratory care education program as approved by the Commission for 43
195		-	Accreditation of Allied Health Educational Programs, or the Canadian 44
196		-	Council on on Accreditation for Respiratory Therapy Education.Care 45
197		-	(CoARC) or its successor by arranging for the applicant's respiratory care 46
198		-	education program to submit an official transcript confirming successful 47
199		-	completion of the respiratory care education program directly to the Board. 48
200		-	(4) Submit to the Board written evidence, verified by oath, that the applicant has 49
201		-	successfully completed the minimal requirements for Basic Cardiac Life 50 General Assembly Of North Carolina Session 2025
202		-	House Bill 71-Second Edition Page 5
203		-	Support as recognized by the American Heart Association, the American Red 1
204		-	Cross, or the American Safety and Health Institute. 2
205		-	(5) Pass Submit to the Board written evidence, verified by oath, that the 3
206		-	entry-level applicant passed the examination requirements as defined by the 4
207		-	rules adopted by the Board given by the National Board for Respiratory Care, 5
208		-	Inc.Inc., or its successor, for entry-level respiratory care practitioners. 6
209		-	(b) At least three times each year, the Board shall cause the examination required in 7
210		-	subdivision (5) of subsection (a) of this section to be given to applicants at a time and place to be 8
211		-	announced by the Board. Any applicant who fails to pass the first examination may take 9
212		-	additional examinations in accordance with rules adopted pursuant to this Article. 10
213		-	(c) Each applicant for an advanced respiratory care practitioner license under this Article 11
214		-	shall do all of the following: 12
215		-	(1) Submit a completed application as required by the Board, including a form 13
216		-	signed by the applicant consenting to the check of the applicant's criminal 14
217		-	record and to the use of the applicant's fingerprints and other identifying 15
218		-	information required by the State and national repositories. 16
219		-	(2) Submit any fees required by the Board. 17
220		-	(3) Submit to the Board written evidence, verified by oath, that the applicant has 18
221		-	successfully completed the postgraduate degree requirements of respiratory 19
222		-	care education for the advanced practice respiratory therapist as approved by 20
223		-	the Commission on Accreditation for Respiratory Care (CoARC) or its 21
224		-	successor by arranging for the applicant's respiratory care education program 22
225		-	to submit an official transcript confirming successful completion of the 23
226		-	advanced respiratory care education program directly to the Board. 24
227		-	(4) Submit to the Board written evidence, verified by oath, that the applicant has 25
228		-	successfully completed the minimal requirements for Basic Cardiac Life 26
229		-	Support as recognized by the American Heart Association, the American Red 27
230		-	Cross, and the American Safety and Health Institute. 28
231		-	(5) Submit to the Board written evidence, verified by oath, that the applicant 29
232		-	passed the examination requirements as defined by Board rules pursuant to 30
233		-	this Article given by the National Board for Respiratory Care, Inc., or its 31
234		-	successor, for advanced-level respiratory care practitioners and defined by 32
235		-	Board rules pursuant to this Article. 33
236		-	(d) When issuing a license, the Board shall state the terms and conditions of use of the 34
237		-	license to the licensee. 35
238		-	… 36
239		-	"§ 90-660. Expenses; fees. 37
	46	+	provide information to the physician to formulate a diagnosis of the patient's 33 General Assembly Of North Carolina Session 2025
	47	+	Page 2 House Bill 71-First Edition
	48	+	condition. The tests and procedures may include pulmonary function testing, 1
	49	+	electrocardiograph testing, cardiac stress testing, and sleep related testing. 2
	50	+	(3) Direct supervision. – The authority and responsibility to direct the 3
	51	+	performance of activities as established by policies and procedures for safe 4
	52	+	and appropriate completion of services. 5
	53	+	(3a) Endorsement. – A designation issued by the Board recognizing the person 6
	54	+	named on the endorsement as having met the requirements to perform 7
	55	+	advanced respiratory care procedures as defined by rules adopted by the 8
	56	+	Board. 9
	57	+	(4) Individual. – A human being. 10
	58	+	(4a) Invasive diagnostic and therapeutic procedure. – Any test or treatment that 11
	59	+	uses instruments to cut, puncture, or otherwise enter the body. 12
	60	+	(5) License. – A certificate issued by the Board recognizing the person named 13
	61	+	therein as having met the requirements to practice respiratory care as defined 14
	62	+	in this Article.Article as a respiratory care practitioner or advanced respiratory 15
	63	+	care practitioner. 16
	64	+	(6) Licensee. – A person who has been issued a license under this Article. 17
	65	+	(7) Medical director. – An appointed physician who is licensed under Article 1 of 18
	66	+	this Chapter and a member of the entity's medical staff, and who is granted 19
	67	+	the authority and responsibility for assuring and establishing policies and 20
	68	+	procedures and that the provision of such is provided to the quality, safety, 21
	69	+	and appropriateness standards as recognized within the defined scope of 22
	70	+	practice for the entity. 23
	71	+	(8) Person. – An individual, corporation, partnership, association, unit of 24
	72	+	government, or other legal entity. 25
	73	+	(9) Physician. – A doctor of medicine An individual licensed to practice medicine 26
	74	+	by the State of North Carolina in accordance with Article 1 of this Chapter. 27
	75	+	(9a) Practice of advanced practice respiratory therapy. – The scope of practice as 28
	76	+	determined by the supervising physician at the practice level in any health care 29
	77	+	setting authorized by the supervising physician and the Board. It shall not 30
	78	+	include (i) medical diagnosis; (ii) prescribing; (iii) interpretation of medical 31
	79	+	diagnostic imaging studies; (iv) final interpretation of sleep studies or 32
	80	+	pulmonary function tests; (v) surgery; (vi) delivery of anesthesia; and (vii) 33
	81	+	ordering or performing diagnostic and therapeutic procedures that are more 34
	82	+	than minimally invasive and have known complications that involve serious 35
	83	+	injury and death, unless a physician is physically present to supervise the 36
	84	+	advanced practice respiratory care therapist or the procedure is provided 37
	85	+	pursuant to subdivision (10) of this section. The advanced respiratory care 38
	86	+	practitioner may perform acts, tasks, or functions in any health care setting for 39
	87	+	which the physician is responsible, and which are as follows: 40
	88	+	a. Related to the care of persons with problems affecting the 41
	89	+	cardiovascular and cardiopulmonary systems. 42
	90	+	b. Delegated by a supervising physician. 43
	91	+	c. Appropriate to the advanced respiratory care practitioner's education, 44
	92	+	training, experience, and level of competence. 45
	93	+	(10) Practice of respiratory care. – As defined by the written order of a physician 46
	94	+	licensed under Article 1 of this Chapter, Chapter for respiratory care 47
	95	+	practitioners, the observing and monitoring of signs and symptoms, general 48
	96	+	behavior, and general physical response to respiratory care treatment and 49
	97	+	diagnostic testing, including the determination of whether such signs, 50
	98	+	symptoms, reactions, behavior, or general response exhibit abnormal 51 General Assembly Of North Carolina Session 2025
	99	+	House Bill 71-First Edition Page 3
	100	+	characteristics, and the performance of diagnostic testing and therapeutic 1
	101	+	application of: 2
	102	+	a. Medical gases, humidity, and aerosols including the maintenance use 3
	103	+	of associated apparatus, respiratory care equipment, except for the 4
	104	+	purpose of anesthesia. 5
	105	+	b. Pharmacologic agents related to respiratory care procedures, including 6
	106	+	those agents necessary to perform hemodynamic monitoring. 7
	107	+	c. Mechanical or physiological ventilatory support. 8
	108	+	d. Cardiopulmonary resuscitation and maintenance of natural airways, 9
	109	+	the insertion and maintenance of artificial airways under the direct 10
	110	+	supervision of a recognized medical director in a health care 11
	111	+	environment which identifies these services within the scope of 12
	112	+	practice by the facility's governing board. 13
	113	+	e. Hyperbaric oxygen therapy. 14
	114	+	f. New and innovative respiratory care and related support activities in 15
	115	+	appropriately identified environments and under the training and 16
	116	+	practice guidelines established by the American Association of 17
	117	+	Respiratory Care. 18
	118	+	The term also means the interpretation and implementation of a 19
	119	+	physician's written or verbal order pertaining to the acts described in 20
	120	+	this subdivision. 21
	121	+	(11) Respiratory care. – As defined by the written order of a physician licensed 22
	122	+	under Article 1 of Chapter 90, the treatment, management, diagnostic testing, 23
	123	+	and care of patients with deficiencies and abnormalities associated with the 24
	124	+	cardiopulmonary system. 25
	125	+	(12) Respiratory care practitioner. – A person who has been licensed by the Board 26
	126	+	to engage in the practice of respiratory care. 27
	127	+	(12a) Serious injury. – An injury that creates a substantial risk of impairment of any 28
	128	+	bodily function that requires immediate medical attention or hospitalization. 29
	129	+	(12b) Supervising physician. – A physician with the competencies and authority to 30
	130	+	supervise advanced respiratory care practitioners. 31
	131	+	(13) Support activities. – Procedures Tasks that do not require formal academic 32
	132	+	training, including the delivery, setup, and routine maintenance and repair of 33
	133	+	apparatus. respiratory care equipment. The term also includes giving 34
	134	+	instructions on the use, fitting, and application of apparatus, respiratory care 35
	135	+	equipment but does not include therapeutic evaluation and 36
	136	+	assessment.assessment for an individual patient as defined in rules adopted by 37
	137	+	the Board. 38
	138	+	"§ 90-649. North Carolina Respiratory Care Board; creation. 39
	139	+	(a) The North Carolina Respiratory Care Board is created. The Board shall consist of 10 40
	140	+	members as follows: 41
	141	+	(1) Two members shall be respiratory care practitioners. 42
	142	+	(2) Four members shall be physicians licensed to practice in North Carolina, and 43
	143	+	whose primary practice is Pulmonology, Anesthesiology, Critical Care 44
	144	+	Medicine, or whose specialty is Cardiothoracic Disorders. 45
	145	+	(3) One member shall represent the North Carolina Hospital Association. 46
	146	+	(4) One member member, who is a resident of this State, shall represent the North 47
	147	+	Carolina Association of Atlantic Coast Medical Equipment Services.Services 48
	148	+	Association. 49
	149	+	(5) Two members shall represent the public at large. 50
	150	+	… 51 General Assembly Of North Carolina Session 2025
	151	+	Page 4 House Bill 71-First Edition
	152	+	"§ 90-650. Appointments and removal of Board members; terms and compensation. 1
	153	+	(a) The members of the Board shall be appointed as follows: 2
	154	+	… 3
	155	+	(7) The North Carolina Association of Atlantic Coast Medical Equipment 4
	156	+	Services Association shall appoint the member described in 5
	157	+	G.S. 90-649(a)(4). 6
	158	+	… 7
	159	+	"§ 90-652. Powers and duties of the Board. 8
	160	+	The Board shall have the power and duty to: 9
	161	+	(1) Determine the qualifications and fitness of applicants for licensure, renewal 10
	162	+	of licensure, and reciprocal licensure. The Board shall, in its discretion, 11
	163	+	investigate the background of an applicant to determine the applicant's 12
	164	+	qualifications with due regard given to the applicant's competency, honesty, 13
	165	+	truthfulness, and integrity. The State Bureau of Investigation may provide a 14
	166	+	criminal record check to the Board for a person who has applied for a license 15
	167	+	through the Board. The Board shall provide to the State Bureau of 16
	168	+	Investigation, along with the request, the fingerprints of the applicant, any 17
	169	+	additional information required by the State Bureau of Investigation, and a 18
	170	+	form signed by the applicant consenting to the check of the criminal record 19
	171	+	and to the use of the fingerprints and other identifying information required 20
	172	+	by the State or national repositories. Investigation. The applicant's fingerprints 21
	173	+	shall be used by the State Bureau of Investigation for a search of the State's 22
	174	+	criminal history record file, and the State Bureau of Investigation shall 23
	175	+	forward a set of the fingerprints to the Federal Bureau of Investigation for a 24
	176	+	national criminal history check. The Board shall keep all information pursuant 25
	177	+	to this subdivision privileged, in accordance with applicable State law and 26
	178	+	federal guidelines, and the information shall be confidential and shall not be a 27
	179	+	public record under Chapter 132 of the General Statutes. The Board shall 28
	180	+	collect any fees required by the State Bureau of Investigation and shall remit 29
	181	+	the fees to the State Bureau of Investigation for expenses associated with 30
	182	+	conducting the criminal history record check. 31
	183	+	… 32
	184	+	(14) Establish and adopt rules defining the education and credential requirements 33
	185	+	for persons seeking endorsement under this Article. 34
	186	+	"§ 90-653. Licensure requirements; examination. 35
	187	+	(a) Each applicant for licensure a respiratory care practitioner license under this Article 36
	188	+	shall meet the following requirements:do all of the following: 37
	189	+	(1) Submit a completed application as required by the Board.Board, which shall 38
	190	+	include a form signed by the applicant consenting to the check of the 39
	191	+	applicant's criminal record and to the use of the applicant's fingerprints and 40
	192	+	other identifying information required by the State and national repositories. 41
	193	+	(2) Submit any fees required by the Board. 42
	194	+	(3) Submit to the Board written evidence, verified by oath, that the applicant has 43
	195	+	successfully completed the minimal entry-level degree requirements of a 44
	196	+	respiratory care education program as approved by the Commission for 45
	197	+	Accreditation of Allied Health Educational Programs, or the Canadian 46
	198	+	Council on on Accreditation for Respiratory Therapy Education.Care 47
	199	+	(CoARC) or its successor by arranging for the applicant's respiratory care 48
	200	+	education program to submit an official transcript confirming successful 49
	201	+	completion of the respiratory care education program directly to the Board. 50 General Assembly Of North Carolina Session 2025
	202	+	House Bill 71-First Edition Page 5
	203	+	(4) Submit to the Board written evidence, verified by oath, that the applicant has 1
	204	+	successfully completed the minimal requirements for Basic Cardiac Life 2
	205	+	Support as recognized by the American Heart Association, the American Red 3
	206	+	Cross, or the American Safety and Health Institute. 4
	207	+	(5) Pass Submit to the Board written evidence, verified by oath, that the 5
	208	+	entry-level applicant passed the examination requirements as defined by the 6
	209	+	rules adopted by the Board given by the National Board for Respiratory Care, 7
	210	+	Inc.Inc., or its successor, for entry-level respiratory care practitioners. 8
	211	+	(b) At least three times each year, the Board shall cause the examination required in 9
	212	+	subdivision (5) of subsection (a) of this section to be given to applicants at a time and place to be 10
	213	+	announced by the Board. Any applicant who fails to pass the first examination may take 11
	214	+	additional examinations in accordance with rules adopted pursuant to this Article. 12
	215	+	(c) Each applicant for an advanced respiratory care practitioner license under this Article 13
	216	+	shall do all of the following: 14
	217	+	(1) Submit a completed application as required by the Board, including a form 15
	218	+	signed by the applicant consenting to the check of the applicant's criminal 16
	219	+	record and to the use of the applicant's fingerprints and other identifying 17
	220	+	information required by the State and national repositories. 18
	221	+	(2) Submit any fees required by the Board. 19
	222	+	(3) Submit to the Board written evidence, verified by oath, that the applicant has 20
	223	+	successfully completed the postgraduate degree requirements of respiratory 21
	224	+	care education for the advanced practice respiratory therapist as approved by 22
	225	+	the Commission on Accreditation for Respiratory Care (CoARC) or its 23
	226	+	successor by arranging for the applicant's respiratory care education program 24
	227	+	to submit an official transcript confirming successful completion of the 25
	228	+	advanced respiratory care education program directly to the Board. 26
	229	+	(4) Submit to the Board written evidence, verified by oath, that the applicant has 27
	230	+	successfully completed the minimal requirements for Basic Cardiac Life 28
	231	+	Support as recognized by the American Heart Association, the American Red 29
	232	+	Cross, and the American Safety and Health Institute. 30
	233	+	(5) Submit to the Board written evidence, verified by oath, that the applicant 31
	234	+	passed the examination requirements as defined by Board rules pursuant to 32
	235	+	this Article given by the National Board for Respiratory Care, Inc., or its 33
	236	+	successor, for advanced-level respiratory care practitioners and defined by 34
	237	+	Board rules pursuant to this Article. 35
	238	+	(d) When issuing a license, the Board shall state the terms and conditions of use of the 36
	239	+	license to the licensee. 37
240	240		… 38
241		-	(b) All monies received by the Board pursuant to this Article shall be deposited in an 39
242		-	account for the Board and shall be used for the administration and implementation of this Article. 40
243		-	The Board shall establish fees in amounts to cover the cost of services rendered for the following 41
244		-	purposes: 42
245		-	(1) For an initial application, a fee not to exceed fifty dollars ($50.00). 43
246		-	(2) For examination or reexamination, a fee not to exceed two hundred dollars 44
247		-	($200.00). 45
248		-	… 46
249		-	(6) For a license with a provisional or temporary endorsement, a fee not to exceed 47
250		-	fifty dollars ($50.00). 48
251		-	… 49
252		-	"§ 90-661. Requirement of license. 50
253		-	It shall be unlawful for any person who is not currently licensed under this Article to: 51 General Assembly Of North Carolina Session 2025
254		-	Page 6 House Bill 71-Second Edition
255		-	(1) Engage in the practice of respiratory care. 1
256		-	(2) Use the title "respiratory care practitioner".practitioner" or "advanced 2
257		-	respiratory care practitioner." 3
258		-	(3) Use the letters "RCP", "RTT", "RT", "ARCP", or any facsimile or 4
259		-	combination in any words, letters, abbreviations, or insignia. 5
260		-	(4) Imply orally or in writing or indicate in any way that the person is a respiratory 6
261		-	care practitioner practitioner, advanced respiratory care practitioner, or is 7
262		-	otherwise licensed under this Article. 8
263		-	(5) Employ or solicit for employment unlicensed persons to practice respiratory 9
264		-	care. 10
265		-	… 11
266		-	"§ 90-667. Confidentiality of Board investigative information. 12
267		-	(a) All records, papers, investigative information, and other documents containing 13
268		-	information that the Board, its members, or its employees possess, gather, or receive as a result 14
269		-	of investigations, inquiries, assessments, or interviews conducted in connection with a licensing 15
270		-	complaint, appeal, assessment, potential impairment matter, or disciplinary matter shall not be 16
271		-	considered public records within the meaning of Chapter 132 of the General Statutes and are 17
272		-	privileged, confidential, not subject to discovery, subpoena, or any means of legal compulsion 18
273		-	for release to anyone other than the Board, its employees, or consultants involved in the 19
274		-	application for license, impairment assessment, or discipline of the licensee, except as provided 20
275		-	in subsection (b) of this section. For the purposes of this section, "investigative information" 21
276		-	means investigative files and reports, information relating to the identity and report of a physician 22
277		-	or other professional performing an expert review for the Board, and any of the Board's 23
278		-	investigative materials that are not admitted into evidence. 24
279		-	(b) The Board shall provide the licensee or applicant for license access to all information 25
280		-	in its possession that the Board intends to offer into evidence at the licensee's or applicant's 26
281		-	hearing. The Board shall not be required to produce (i) information subject to attorney-client 27
282		-	privilege or (ii) investigative information that the Board will not offer into evidence and is related 28
283		-	to advice, opinions, or recommendations of the Board's staff, consultants, or agents. 29
284		-	(c) Any licensee's notice of statement of charges, notice of hearing, and all information 30
285		-	contained in those documents shall be public records under Chapter 132 of the General Statutes. 31
286		-	(d) If the Board, its employees, or its agents possess investigative information indicating 32
287		-	a crime may have been committed, the Board may report the information to the appropriate law 33
288		-	enforcement agency or district attorney of the district in which the offense was committed. The 34
289		-	Board shall cooperate with and assist any law enforcement agency or district attorney conducting 35
290		-	a criminal investigation or prosecution of a licensee by providing relevant information. This 36
291		-	information shall be confidential under G.S. 132-1.4 and shall remain confidential after 37
292		-	disclosure to a law enforcement agency or district attorney. 38
293		-	(e) All licensees shall self-report to the Board any of the following within 30 days of their 39
294		-	arrest or indictment: 40
295		-	(1) Any felony or arrest or indictment. 41
296		-	(2) Any arrest for driving while impaired or driving under the influence. 42
297		-	(3) Any arrest or indictment for the possession, use, or sale of any controlled 43
298		-	substance. 44
299		-	(f) The Board, its members, or its staff may release confidential information concerning 45
300		-	the denial, annulment, suspension, or revocation of a license to any other health care licensing 46
301		-	board in this State, other state, or country, or authorized Department of Health and Human 47
302		-	Services personnel who are charged with the enforcement or investigative responsibilities of 48
303		-	licensure. If the Board releases this confidential information, the Board shall notify and provide 49
304		-	a summary of the information to the licensee within 60 days after the information is transmitted. 50
305		-	The licensee may make a written request that the Board provide the licensee a copy of all 51 General Assembly Of North Carolina Session 2025
306		-	House Bill 71-Second Edition Page 7
307		-	information transmitted within 30 days of receiving notice of the initial transmittance. The Board 1
308		-	shall not provide the information if the information relates to an ongoing criminal investigation 2
309		-	by any law enforcement agency or authorized Department of Health and Human Services 3
310		-	personnel with enforcement or investigative responsibilities. 4
311		-	(g) Notwithstanding the provisions of this section, the Board shall withhold the identity 5
312		-	of a patient, including information relating to dates and places of treatment, or any other 6
313		-	information that would tend to identify the patient, in any proceeding, record of a hearing, and in 7
314		-	the notice of charges against any licensee, unless the patient or the patient's representative 8
315		-	expressly consents to the public disclosure. 9
316		-	"§ 90-668. Limitations on advanced respiratory care practitioners. 10
317		-	(a) Individuals who are licensed under this Article as advanced respiratory care 11
318		-	practitioners may use the title "advanced respiratory care practitioner." Individuals who hold 12
319		-	themselves out as advanced respiratory care practitioners without being licensed are in violation 13
320		-	of this Article. 14
321		-	(b) Individuals who are licensed under this Article as advanced respiratory care 15
322		-	practitioners may practice advanced respiratory care under the supervision of a physician 16
323		-	licensed under Article 1 of this Chapter and within the scope of rules adopted by the Board." 17
324		-	SECTION 2. The North Carolina Respiratory Care Board shall adopt rules to 18
325		-	implement and administer the provisions of this act no later than October 1, 2025. 19
326		-	SECTION 3. Section 1 of this act becomes effective on October 1, 2025. Except as 20
327		-	otherwise provided, this act is effective when it becomes law. 21
	241	+	"§ 90-660. Expenses; fees. 39
	242	+	… 40
	243	+	(b) All monies received by the Board pursuant to this Article shall be deposited in an 41
	244	+	account for the Board and shall be used for the administration and implementation of this Article. 42
	245	+	The Board shall establish fees in amounts to cover the cost of services rendered for the following 43
	246	+	purposes: 44
	247	+	(1) For an initial application, a fee not to exceed fifty dollars ($50.00). 45
	248	+	(2) For examination or reexamination, a fee not to exceed two hundred dollars 46
	249	+	($200.00). 47
	250	+	… 48
	251	+	(6) For a license with a provisional or temporary endorsement, a fee not to exceed 49
	252	+	fifty dollars ($50.00). 50
	253	+	… 51 General Assembly Of North Carolina Session 2025
	254	+	Page 6 House Bill 71-First Edition
	255	+	"§ 90-661. Requirement of license. 1
	256	+	It shall be unlawful for any person who is not currently licensed under this Article to: 2
	257	+	(1) Engage in the practice of respiratory care. 3
	258	+	(2) Use the title "respiratory care practitioner".practitioner" or "advanced 4
	259	+	respiratory care practitioner." 5
	260	+	(3) Use the letters "RCP", "RTT", "RT", "ARCP", or any facsimile or 6
	261	+	combination in any words, letters, abbreviations, or insignia. 7
	262	+	(4) Imply orally or in writing or indicate in any way that the person is a respiratory 8
	263	+	care practitioner practitioner, advanced respiratory care practitioner, or is 9
	264	+	otherwise licensed under this Article. 10
	265	+	(5) Employ or solicit for employment unlicensed persons to practice respiratory 11
	266	+	care. 12
	267	+	… 13
	268	+	"§ 90-667. Confidentiality of Board investigative information. 14
	269	+	(a) All records, papers, investigative information, and other documents containing 15
	270	+	information that the Board, its members, or its employees possess, gather, or receive as a result 16
	271	+	of investigations, inquiries, assessments, or interviews conducted in connection with a licensing 17
	272	+	complaint, appeal, assessment, potential impairment matter, or disciplinary matter shall not be 18
	273	+	considered public records within the meaning of Chapter 132 of the General Statutes and are 19
	274	+	privileged, confidential, not subject to discovery, subpoena, or any means of legal compulsion 20
	275	+	for release to anyone other than the Board, its employees, or consultants involved in the 21
	276	+	application for license, impairment assessment, or discipline of the licensee, except as provided 22
	277	+	in subsection (b) of this section. For the purposes of this section, "investigative information" 23
	278	+	means investigative files and reports, information relating to the identity and report of a physician 24
	279	+	or other professional performing an expert review for the Board, and any of the Board's 25
	280	+	investigative materials that are not admitted into evidence. 26
	281	+	(b) The Board shall provide the licensee or applicant for license access to all information 27
	282	+	in its possession that the Board intends to offer into evidence at the licensee's or applicant's 28
	283	+	hearing. The Board shall not be required to produce (i) information subject to attorney-client 29
	284	+	privilege or (ii) investigative information that the Board will not offer into evidence and is related 30
	285	+	to advice, opinions, or recommendations of the Board's staff, consultants, or agents. 31
	286	+	(c) Any licensee's notice of statement of charges, notice of hearing, and all information 32
	287	+	contained in those documents shall be public records under Chapter 132 of the General Statutes. 33
	288	+	(d) If the Board, its employees, or its agents possess investigative information indicating 34
	289	+	a crime may have been committed, the Board may report the information to the appropriate law 35
	290	+	enforcement agency or district attorney of the district in which the offense was committed. The 36
	291	+	Board shall cooperate with and assist any law enforcement agency or district attorney conducting 37
	292	+	a criminal investigation or prosecution of a licensee by providing relevant information. This 38
	293	+	information shall be confidential under G.S. 132-1.4 and shall remain confidential after 39
	294	+	disclosure to a law enforcement agency or district attorney. 40
	295	+	(e) All licensees shall self-report to the Board any of the following within 30 days of their 41
	296	+	arrest or indictment: 42
	297	+	(1) Any felony or arrest or indictment. 43
	298	+	(2) Any arrest for driving while impaired or driving under the influence. 44
	299	+	(3) Any arrest or indictment for the possession, use, or sale of any controlled 45
	300	+	substance. 46
	301	+	(f) The Board, its members, or its staff may release confidential information concerning 47
	302	+	the denial, annulment, suspension, or revocation of a license to any other health care licensing 48
	303	+	board in this State, other state, or country, or authorized Department of Health and Human 49
	304	+	Services personnel who are charged with the enforcement or investigative responsibilities of 50
	305	+	licensure. If the Board releases this confidential information, the Board shall notify and provide 51 General Assembly Of North Carolina Session 2025
	306	+	House Bill 71-First Edition Page 7
	307	+	a summary of the information to the licensee within 60 days after the information is transmitted. 1
	308	+	The licensee may make a written request that the Board provide the licensee a copy of all 2
	309	+	information transmitted within 30 days of receiving notice of the initial transmittance. The Board 3
	310	+	shall not provide the information if the information relates to an ongoing criminal investigation 4
	311	+	by any law enforcement agency or authorized Department of Health and Human Services 5
	312	+	personnel with enforcement or investigative responsibilities. 6
	313	+	(g) Notwithstanding the provisions of this section, the Board shall withhold the identity 7
	314	+	of a patient, including information relating to dates and places of treatment, or any other 8
	315	+	information that would tend to identify the patient, in any proceeding, record of a hearing, and in 9
	316	+	the notice of charges against any licensee, unless the patient or the patient's representative 10
	317	+	expressly consents to the public disclosure. 11
	318	+	"§ 90-668. Limitations on advanced respiratory care practitioners. 12
	319	+	(a) Individuals who are licensed under this Article as advanced respiratory care 13
	320	+	practitioners may use the title "advanced respiratory care practitioner." Individuals who hold 14
	321	+	themselves out as advanced respiratory care practitioners without being licensed are in violation 15
	322	+	of this Article. 16
	323	+	(b) Individuals who are licensed under this Article as advanced respiratory care 17
	324	+	practitioners may practice advanced respiratory care under the supervision of a physician 18
	325	+	licensed under Article 1 of this Chapter and within the scope of rules adopted by the Board." 19
	326	+	SECTION 2. The North Carolina Respiratory Care Board shall adopt rules to 20
	327	+	implement and administer the provisions of this act no later than October 1, 2025. 21
	328	+	SECTION 3. Section 1 of this act becomes effective on October 1, 2025. Except as 22
	329	+	otherwise provided, this act is effective when it becomes law. 23