Bill
HB 71
NC HB71 modernizes respiratory care laws by creating the Advanced Respiratory Care Practitioner (ARCP) role with supervised advanced procedures to expand access while ensuring safety
Status & Timeline
- Introduced: February 11, 2025 (House bill).
- Committee referrals: Health; if favorable, Regulatory Reform; then Rules/Calendar.
- Committee action: Committee substitute favorable (reported) March 11, 2025.
- Current status: Passed out of committee with substitute; awaiting further floor or Rules/Calendar action.
Purpose / Intent
- Modernize and clarify North Carolina statute (Article 38, Chapter 90) governing the practice of respiratory care so it reflects contemporary education, post‑graduate training, and clinical practice — including lessons from the COVID‑19 pandemic — and to better protect public health and safety.
Key Provisions and Changes
- New and clarified definitions: revises numerous statutory definitions in the Respiratory Care Practice Act (e.g., “Board,” “physician,” “license,” “respiratory care,” “invasive diagnostic and therapeutic procedure,” “support activities”).
- Creates Advanced Respiratory Care Practitioner (ARCP) role:
- Recognizes licensed practitioners who complete postgraduate advanced practice respiratory therapy programs as defined by the North Carolina Respiratory Care Board.
- ARCPs may perform “advanced respiratory care procedures” consistent with Board rules and under physician supervision.
- Establishes an endorsement mechanism through the Board to recognize ARCP competency for advanced procedures.
- Scope of practice clarifications:
- Defines the practice of respiratory care and of advanced practice respiratory therapy, including specific modalities (pulmonary function testing, sleep testing, ventilatory support, hyperbaric therapy, cardiopulmonary resuscitation, use/maintenance of respiratory equipment, certain pharmacologic agents).
- Explicitly lists activities excluded from ARCP authority (e.g., medical diagnosis, prescribing, interpretation of diagnostic imaging, final interpretation of PFTs or sleep studies, surgery, delivery of anesthesia).
- Allows performance of delegated physician tasks that are appropriate to the practitioner’s training, competence, and supervising‑physician authority.
- Supervision and medical oversight:
- Defines “supervising physician” and “medical director” responsibilities; advanced procedures that are more than minimally invasive or have major complication risk require physical physician supervision unless otherwise authorized.
- Regulatory authority:
- The North Carolina Respiratory Care Board is referenced to adopt rules establishing competency standards, endorsements, and training requirements for advanced practice functions.
- Miscellaneous:
- Clarifies “support activities” as tasks not requiring formal academic training (delivery, setup, routine maintenance of apparatus, etc.).
Who Is Affected
- Respiratory care practitioners and students (potential new pathway to ARCP status).
- Physicians and medical directors who will supervise ARCPs and delegate procedures.
- Health care facilities that employ respiratory practitioners (hospitals, clinics, home‑care providers) — may need updated policies, supervision protocols, and privileging processes.
- Patients: potential increased access to advanced respiratory services in varied settings.
Potential Impact / Considerations
- Clinical: May broaden the permitted clinical responsibilities of experienced respiratory practitioners, improving capacity for advanced respiratory care (notably in critical care, ventilator management, pulmonary diagnostics).
- Regulatory: Requires Board rulemaking to define advanced programs, endorsements, and supervision standards.
- Training/Workforce: May incentivize postgraduate advanced respiratory education and create new advanced practice career ladder.
- Fiscal: No fiscal note provided in the bill text; potential administrative costs for Board rulemaking and for employers implementing supervision/credentialing processes.
- Patient safety: The bill includes limits (prohibiting diagnosis/prescribing/surgical or anesthetic procedures) and supervision requirements intended to mitigate risks.
Next Steps
- Board rulemaking to define postgraduate programs, advanced procedures, and endorsement criteria.
- Further legislative action (Rules/Calendar and floor consideration) to advance or amend the substitute.
Compiled from official sources — confirm details with the bill’s official record.
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