chapter 61 - north carolina respiratory care board
SECTION .0100 ORGANIZATION AND GENERAL PROVISIONS
21 NCAC 61 .0101purpose
It is the responsibility of the Board to license respiratory care practitioners and to see that the qualifications and activities of those engaged in respiratory care are in accord with law and in the best interest of the public. The Board shall issue and enforce standards for the licensure of respiratory care practitioners but the Board is not a Board of arbitration and has no jurisdiction to settle disputes between private parties.
History Note:Authority G.S. 90652(2);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0102BOARD OFFICE
The administrative offices of the North Carolina Respiratory Care Board (NCRCB) are located at:125 Edinburgh South Drive, Suite 100, Cary, NC 27511.Office hours are 8:00 a.m. until 4:00 p.m., Monday through Friday, except North Carolina state holidays.
History Note: Authority G.S. 90-652(2);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. October 1, 2014;
Expired Eff. September 1, 2015 pursuant to G.S. 150B-21.3A.
21 NCAC 61 .0103DEFINITIONS
The definitions of terms contained in G.S. 90-648 shall apply to the rules in this Chapter. In addition, the following definitions shall apply to the rules in this Chapter:
(1)"Assessment" means a clinical evaluation of an individual patient by a Respiratory Care Practitioner (RCP) or other licensed health care provider within their scope of practice to determine the ability and efficacy of a respiratory care procedure,protocol, or treatment, including an assessment of the suitability and efficacy of equipment for an individual patient if equipment is to be used in the procedure or treatment.
(2)"Respiratory care" means the health care discipline that specializes in the promotion of optimum cardiopulmonary function and health and wellness using scientific principles to identify, treat and prevent acute or chronic dysfunction of the cardiopulmonary system pursuant to G.S. 90-648(11) that is taught in accredited educational programs pursuant to G.S. 90-653(3) or in approved continuing education programs pursuant to the rules of this Chapter within the guidelines established by the American Association for RespiratoryCare,incorporated by reference including subsequent amendments andeditions, pursuant to G.S. 90-648(10)(f). Copies of the guidelines may be found at at no cost.
(3)"The practice of respiratory care" means the performance of assessments and diagnostic tests, and implementation of treatment procedures and protocols related to the cardiopulmonary system pursuant to G.S. 90-648(10) and the activities defined by the American Association of Respiratory Care clinicalguidelines,incorporated by reference including subsequent amendments andeditions, pursuant to G.S. 90-648(10)(f). Copies of the guidelines may be found at at no cost.
(4)"Medical gases" mean those inhaled gases used in the treatment of cardiopulmonary disease.
(5)"Humidity" means adding heat or moisture to an inhaled medical gas.
(6)"Aerosols" mean the suspension of particles dispersed in air or gas to deliver medication or humidity to the airways.
(7)"Pharmacologic agent" means a medication or medical gas delivered during a respiratory care procedure for the treatment of cardiopulmonary disease.
(8)"Hyperbaric oxygen therapy" means inhalation of high concentrations of oxygen at increased levels of atmospheric pressures within a total body chamber for the treatment of cardiopulmonary disorders orwounds.
(9)"Mechanical or physiological ventilatory support" means the provision of an apparatus to support gas exchange associated with cardiopulmonary dysfunction.
(10)"Hemodynamic monitoring" means a procedure required to monitor blood pressure invasively or noninvasively.
(11)"Diagnostic testing" means a procedure for assessing the function of the cardiopulmonary system and diagnosing cardiopulmonary disease or sleep related disorders.
(12)"Therapeutic application" means utilizing evidenced-based protocols, procedures, treatments, or modalities defined in this Chapter to maintain cardiopulmonary health or treat cardiopulmonary disease.
(13)"Active status" means a license issued to an individual after meeting the requirementsof G.S. 90-653.
(14) "Endorsement" means a license issued by the Board recognizing the person named on the certificate as having met the requirements to perform respiratory care procedures pursuant to the rules of this Chapter.
History Note:Authority G.S. 90-652; 90-648(2),(10), and (11);90-660;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. September 1, 2010; January 1, 2007; March 1, 2006;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015;
Amended Eff. July 1, 2018.
21 NCAC 61 .0104CODE OF ETHICS
(a) The American Association of Respiratory Care (AARC) Code of Ethics are incorporated by reference, including subsequent amendments and editions. A free copy may be obtained from the American Association of Respiratory Care online at
History Note:Authority G.S. 90-652(3);
Eff. July 1, 2018.
SECTION .0200 – APPLICATION FOR LICENSE
21 NCAC 61 .0201APPLICATION PROCESS
(a) Each applicant for a respiratory care practitioner license shall complete an application form provided by the Board. This form shall be submitted to the Board and shall be accompanied by:
(1)one head and shoulders passport type photograph of the applicant of acceptable quality for identification, two inches by two inches in size;
(2)the fee established in Rule .0204 of this Chapter;
(3)evidence, verified by oath, that the applicant has successfully completed the minimum requirements of a respiratory care education program approved by the Commission for Accreditation of Allied Health Educational Programs or the Canadian Council on Accreditation for Respiratory Therapy Education;
(4)evidence, verified by oath, that the applicant has successfully completed the requirements for certification in Basic Life Support which includes Adult, Child and Infant Cardiopulmonary Resuscitation (CPR), the Heimlich Maneuver, and Automatic External Defibrillator (AED) use by the American Heart Association, the American Red Cross or the American Safety and Health Institute; and
(5)evidence from the National Board for Respiratory Care (NBRC) of successful completion of the Certified Respiratory Therapist (CRT) examination administered by it.
(b) Applicants for initial licensure in North Carolina, who have been inactive and who have not practiced respiratory care for a period of time greater than one year, must complete the following requirements in addition to the requirements in Paragraph (a) of this Rule:
(1)for applicants who have not practiced respiratory care for a period of time greater than one year, but less than five years, the applicant must provide evidence of twelve hours of continuing education, that meet the requirements of 21 NCAC 61 .0401, for each full year of inactivity; and
(2)for applicants who have not practiced respiratory care for a period of time greater than five years, the applicant must provide evidence of either:
(A)sixty hours of continuing education that meet the requirements of 21 NCAC 61 .0401 and evidence from the National Board for Respiratory Care (NBRC) of successful completion of the Certified Respiratory Therapist (CRT) examination taken as an assessment examination within the 90-day period before issuance of a license, or
(B)completion of a Respiratory Care refresher course offered through a Respiratory Care Education program accredited by the Commission for the Accreditation of Allied Health Educational Programs.
History Note:Authority G.S. 90652 (1),(2) and (13); 90-653(a);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. April 1, 2008; November 1, 2004; March 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0202EXEMPTIONS
The Board shall exempt the following persons meeting the requirements of G.S. 90-664 from the requirement of obtaining a license. For the purposes of this Rule:
(1)For purposes of interpreting G.S. 90-664(2), direct supervision shall mean that a respiratory care practitioner licensed by the Board is present in the same facility to supervise a respiratory care student at any time while the student is engaged in the practice of respiratory care. The supervising respiratory care practitioner shall be specifically assigned to the particular student, but more than one practitioner may be assigned to a particular student. A respiratory care student shall not engage in the performance of respiratory care activities without direct supervision by a respiratory care practitioner licensed by the Board.
(2)For purposes of interpreting G.S. 90-664(4), support activities shall include instructions on the use, fitting,and application of the apparatus, including demonstrating its mechanical operation for the patient or caregiver, by unlicensed individuals who deliver, set up, and calibrate prescribed respiratory care equipment; but shall not include teaching, administration, or performance of respiratory care.Instructions to the patient or caregiver regarding the clinical use of the equipment and any patient monitoring, patient assessment, or other activities or procedures that are undertaken to assess the clinical effectiveness of an apparatus or to evaluate the effectiveness of the treatmentshall be performed by a respiratory care practitioner licensed by the Board or other licensed practitioner operating within their scope of practice.
History Note:Authority G.S. 90-648(13); 90652(2); 90-664;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Readopted Eff. July 1, 2016.
21 NCAC 61 .0203INTERVIEWS
If the Board has questions about the qualifications of an applicant, it may conduct interviews of the applicant, or of others with knowledge of an applicant's qualifications.
History Note:Authority G.S. 90652(2);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0204FEES
(a) Fees are as follows:
(1)For an initial application, a fee of fifty dollars ($50.00);
(2)For issuance of an active license, a fee of one hundred twenty-five dollars ($125.00);
(3)For the renewal of an active license, a fee of seventy-five dollars ($75.00);
(4)For the late renewal of any license, an additional late fee of seventy-five dollars ($75.00);
(5)For a license with a provisional or temporary endorsement, a fee of fifty dollars ($50.00);
(6)For official verification of license status, a fee of twenty dollars ($20.00);
(b) Fees shall be nonrefundable and shall be paid in the form of a cashier's check, certified check or money order made payable to the North Carolina Respiratory Care Board. However, personal checks shall be accepted for payment of renewal fees.
History Note: Authority G.S. 90-652(2);(9); 90-660;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. December 1, 2010: March 1, 2008; March 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 ncac 61 .0205BACKGROUND INVESTIGATION
(a) Every applicant for licensure shall submit to the Board a signed release form, completed Fingerprint Record Card, and such other form(s) as required to perform a criminal history check by the North Carolina Department of Justice at the time of the application. In all instances the applicant must make full and accurate disclosure of any felony convictions, any misdemeanor convictions (except for traffic violations), convictions of any crime directly related to the practice of respiratory care or any disciplinary action pending or ever been taken against any health care provider license / certificate the applicant has or has had.
(b) The applicant shall provide any additional information regarding any conviction as requested by the Board.
(c) Failure to make full and accurate disclosure shall be grounds for immediate application denial, or other disciplinary action applicable to licensure pursuant to G.S. 90-659.
(d) The Board shall determine if any conviction is related to the duties and responsibilities of a respiratory care practitioner. The Board shall consider the following factors:
(1)The nature and seriousness of the crime;
(2)The extent to which a license might offer an opportunity to engage in further criminal activity of the same type; and
(3)The relationship of the crime to the ability, capacity, or fitness required to perform the duties and discharge the responsibilities of a respiratory care practitioner.
(e) If the person's criminal activity is related to a history of chemical dependency, the Board shall also consider the person's efforts and success in achieving and maintaining recovery. Applicants with a history of chemical dependency shall demonstrate evidence of treatment or rehabilitation and at least two years of continuous recovery.
(f) An individual whose application is denied or whose license is suspended or revoked may request a hearing under the procedure established in G.S. 150B, Article 3A.
History Note:Authority G.S. 90-652(1);
Eff. April 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
SECTION .0300 – LICENSING
21 NCAC 61 .0301LICENSE NUMBER: DISPLAY OF lICENSE
(a) Each license issued by the Board shall be valid for a period of one year, except as otherwise provided in G.S. 90-654 and G.S. 93B-15.1.
(b) Each individual who is issued a license shall be issued a license number that shall be displayed on the Board's website. Should that number be retired for any reason, such as death, failure to renew the license, or any other reason, that number shall not be reissued. A web-based license verification displaying the status, credentials, degree level, dates for registration, renewal, and expiration shall be accessible by the licensee in their principal place of business so as to be available for inspection in a printed or electronic format.
(c) In accordance with the provisions of G.S. 90-640, whenever a licensee is providing respiratory care to a patient, the licensee shall wear identification that displays, in readily visible type, the licensee's name and the designation "RCP". Provisional license holders shall wear identification that displays, in readily visible type, the licensee's nameand the designation "RCP-Provisional." A licensee shall ensure any person working under his or hersupervision who is exempted byG.S. 90-664(2) and (4) is properly identified by wearing identification that designates the person's affiliation and position in readily visible type.
History Note:Authority G.S. 90652(2),(4); 90-658(b); 90-640;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. April 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015;
Amended Eff. July 1, 2018.
21 NCAC 61 .0302LICENSE RENEWAL
(a) Any licensee desiring the renewal of a license shall apply for renewal and shall submit the fee established in this Chapter.
(b) Any person whose license is lapsed or expired and who engages in the practice of respiratory care as defined in G.S. 90-648(10) is subject to the penalties prescribed in G.S. 90-659.
(c) Each applicant for renewal shall provide proof of completion of continuing education requirements as established in this Chapter.
(d) The licensee shall maintain current respiratory care credentials as issued by the National Board for Respiratory Care and shall provide proof of the credentials to the Board upon renewal and upon request.
(e) Each applicant for renewal shall provide a copy of current certification in Basic Life Support (BLS) which includes Adult, Child and Infant Cardiopulmonary Resuscitation (CPR); the Heimlich Maneuver; and Automatic External Defibrillator (AED) use by the American Heart Association, the American Red Cross or the American Safety and Health Institute. The board shall accept a copy of the applicant's BLS Instructor certificate or Advanced Cardiac Life Support (ACLS) certificate in lieu of the BLS certificate.
(f) Licenses lapsed in excess of 24 months shall not be renewable. Persons whose licenses have been lapsed in excess of 24 months and who desire to be licensed shall apply for a new license and shall meet all the requirements then existing.
(g) Members of the armed forces whose licenses are in good standing and to whom G.S. 105-249.2 grants an extension of time to file a tax return are granted that same extension of time to pay the license renewal fee and to complete the continuing education requirements prescribed in 21 NCAC 61 .0401. A copy of military orders or the extension approval by the Internal Revenue Service must be furnished to the Board. If approved, continuing education credits acquired during this extended time period shall not be utilized for future renewal purposes, but may be used for the current renewal.
History Note:Authority G.S. 90-652(1),(2),(4) and (13);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. June 1, 2011, September 1, 2010; November 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0303LICENSE WITH PROVISIONAL ENDORSEMENT
An applicant for a provisional license must have completed the educational requirements set out in G.S. 90-563(a)(3) and must have made application to take the certification exam administered by the NBRC and must have filed his application with the Board in accordance with G.S. 90656 and the rules in this Chapter. The supervising licensed respiratory care practitioner shall be in the same facility and readily available for supervision of and consultation with the provisional licensee at all times the provisional licensee is engaging in the practice of respiratory care.
History Note:Authority G.S 90652(2),(4); 90-656;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. March 1, 2004;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0304LICENSE WITH TEMPORARY ENDORSEMENT
History Note:Authority G.S 90652(1),(2),(4); 90-654;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. March 1, 2004;
Expired Eff. September 1, 2015 pursuant to G.S. 150B-21.3A.
21 NCAC 61 .0305inactive status
(a) A licensee who wishes to retain a license but who will not be practicing respiratory care may obtain inactive status by indicating this intention on the annual renewal and payment of a fee of twenty dollars ($20.00). An individual licensed on inactive status may not practice respiratory care during the period in which he or she remains on inactive status.
(b) An individual licensed on inactive status may convert his or her license to active status by submission of a renewal application and payment of the renewal fee and late fee. The renewal application must contain evidence of the completion of a minimum of 12 hours of continuing education that meets the requirements of 21 NCAC 61 .0401 for each full year of inactivity.
(c) In no case may an individual remain on inactive status for more than 60 months.
History Note:Authority G.S. 90652(1),(2),(4);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. March 1, 2008; June 1, 2005;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015.
21 NCAC 61 .0306LICENSE BY RECIPROCITY
When the Board determines that a license, certificate or registration issued by another state, political territory, or jurisdiction to a respiratory care practitioner was issued upon satisfaction of substantially the same requirements for licensure required by the North Carolina Respiratory Care Practice Act, the Board may issue a license to that respiratory care practitioner upon receipt of the initial application fee and license issuing fee.
History Note:Authority G.S. 90652(1),(2),(4); 90-655;