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SB 160

Local Government, General - As enacted, requires TACIR to study the economic impact on local jurisdictions that are required to provide ambulance services and emergency and non-emergency transport reimbursement; requires TACIR to submit a report of the findings and recommendations. - Amends TCA Title 7, Chapter 61.

114th Regular Session (2025-2026) Introduced by Joey Hensley

SB 160 creates the Advanced Respiratory Care Practitioner license, under physician supervision, with Board endorsements for advanced tasks to expand patient care and access.

Pub. Ch. 413
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Bill Summary · SB 160

SB 160 — Respiratory Care Modernization Act (Introduced Jan 23, 2025)

Status: Passed 1st Reading

Main purpose

SB 160 updates North Carolina’s Respiratory Care Practice Act to align state law with modern respiratory-care education, training, and clinical practice. The bill creates a defined advanced-practice role for respiratory therapists, clarifies scopes of practice, and gives the Respiratory Care Board authority to set competency and endorsement requirements. The stated intent is to improve patient care and public health (particularly in light of demands arising from events such as the COVID‑19 pandemic).

Key provisions and changes

  • Defines a new license/classification: Advanced Respiratory Care Practitioner (ARCP) — a licensed respiratory therapist who has completed a postgraduate advanced-practice respiratory therapy program (as defined by the Board) and who may perform advanced respiratory therapy practices under physician supervision.
  • Establishes terms and limits:
    • Advanced respiratory care procedures require additional competency training and rule‑making by the Respiratory Care Board.
    • Endorsements — Board-issued recognitions permitting specific advanced procedures.
    • Supervising physician / medical director roles are defined; ARCPs practice under physician supervision and within duties delegated by that physician.
    • Clarifies that advanced respiratory practice does not include: making medical diagnoses, prescribing medications, interpreting diagnostic imaging, providing final interpretation of sleep studies or pulmonary function tests, performing surgery or anesthesia, or performing highly invasive procedures with high risk of serious injury or death — except where a physician is physically present or other narrow exceptions apply.
  • Expands and clarifies the statutory definition of the practice of respiratory care, listing permitted activities such as mechanical ventilatory support, cardiopulmonary resuscitation, inserting/maintaining artificial airways (under appropriate supervision), hyperbaric oxygen therapy, pharmacologic agents related to respiratory procedures (including agents used in hemodynamic monitoring), and certain diagnostic cardiopulmonary testing.
  • Distinguishes support activities (tasks not requiring formal academic training) from licensed respiratory‑care practice.
  • Reinforces Board authority to adopt rules governing training, competency, endorsements, and supervision.

Who is affected

  • Respiratory therapists in North Carolina (current and future) — potential new advanced‑practice pathway and broader delegated responsibilities for qualified individuals.
  • Supervising physicians, hospitals, clinics, and other employers — will need to define supervisory relationships, protocols, and credentialing for ARCPs.
  • The Respiratory Care Board — expanded rule‑making and endorsement responsibilities.
  • Patients — potential for expanded access to advanced respiratory services in varied care settings.

Practical effects and considerations

  • May improve access to specialized respiratory care (especially in intensive care, post‑acute, and rural settings) by enabling credentialed ARCPs to perform advanced tasks under defined supervision.
  • Implementation will depend on Board rule‑making (scope details, required postgraduate programs, endorsement processes, and competency standards).
  • Employers will need to update policies, supervision protocols, and credentialing processes; liability, reimbursement, and scope‑of‑practice interactions with other professions may require attention.
  • Training programs will need to align curricula to the Board’s postgraduate program standards.

Procedural / timeline notes

  • Introduced: Jan 23, 2025. Status shown as Passed 1st Reading.
  • If advanced by the legislature, the Board will promulgate implementing rules to define endorsements, competencies, and program criteria before full operationalization of the ARCP role.

If you’d like, I can:
- Extract likely regulatory tasks the Respiratory Care Board must complete next, or
- Draft a short implementation checklist for hospitals and outpatient providers.

Compiled from official sources — confirm details with the bill’s official record.

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