§ 4701. Definitions
As used in this chapter:
(1) “Advisor” means an advisor appointed to give advice to the Director of the Office
of Professional Regulation under section 4705 of this title.
(2) “Consultation by telecommunications” means a respiratory care practitioner renders
professional or expert opinion or advice via telecommunications or computer technology
from another location. The term includes the transfer of data or exchange of educational
or related information by any means of audio, video, or data communications.
(3) “Direct supervision” means a respiratory care practitioner licensed in this State
is physically present and is immediately available to direct and supervise tasks related
to patient management.
(4) “Director” means the Director of the Office of Professional Regulation.
(5) “Disciplinary action” includes any action taken by the Director or by an administrative
law officer established by 3 V.S.A. § 129(j) against a respiratory care practitioner or applicant premised on a finding that he
or she has engaged in unprofessional conduct. The term includes all sanctions of any
kind, refusing to grant or renew licensure, suspending or revoking licensure, and
issuing warnings, reprimands, administrative penalties, and conditions.
(6) “Indirect supervision” means a respiratory care practitioner licensed in this State
is immediately available for consultation, direction, or supervision regarding the
practice or performance of respiratory care.
(7) “Performance of respiratory care” means respiratory care in accordance with the prescription
of a licensed physician, licensed osteopath, certified physician assistant, certified
anesthesiologist assistant, or licensed nurse practitioner, including the diagnostic
and therapeutic use of the following:
(A) Medical gases (except for the purpose of anesthesia), aerosols, and humidification.
(B) Pharmacologic agents.
(C) Mechanical or physiological ventilatory support.
(D) Bronchopulmonary hygiene.
(E) Cardiopulmonary resuscitation.
(F) Insertion and maintenance of artificial airways.
(G) Specific diagnostic and testing techniques employed in the medical management of patients
to assist in diagnosis, monitoring, treatment, and research of pulmonary abnormalities,
including measurements of ventilatory volumes, pressures, and flows, collection and
analysis of specimens of blood and blood gases and specimens from the respiratory
tract, expired and inspired gas samples, respiratory secretions, and pulmonary function
testing and hemodynamic and other related physiologic measurements of the cardiopulmonary
system.
(H) Insertion and maintenance of arterial and venous catheters.
(8) “Practice of respiratory care” means:
(A) Direct and indirect respiratory care services, including the administration of pharmacologic,
diagnostic, and therapeutic agents necessary to implement a treatment, disease prevention,
pulmonary rehabilitative, or diagnostic regimen by a licensed physician, physician
assistant, anesthesiologist assistant, or nurse practitioner.
(B) Transcription and implementation of written or verbal orders of a licensed physician,
physician assistant, anesthesiologist assistant, or nurse practitioner that pertains
to the practice of respiratory care.
(C) Observing and monitoring signs and symptoms, general behavior, general physical response
to respiratory care treatment and diagnostic testing, including determination of whether
such signs, symptoms, reactions, behavior, or general response exhibits abnormal characteristics.
(D) Implementing report, referral, and respiratory care protocols or changes in treatment,
based on observed abnormalities, pursuant to a physician, physician assistant, anesthesiologist
assistant, or nurse practitioner’s prescription.
(E) Initiating emergency procedures pursuant to rules adopted by the Director or as otherwise
provided under this chapter.
(F) Respiratory care may be practiced in any clinic, hospital, skilled nursing facility,
private dwelling, or other place deemed appropriate or necessary by the Director and
in accordance with the prescription or verbal orders of a licensed physician, physician
assistant, anesthesiologist assistant, or nurse practitioner.
(9) “Respiratory care” means the allied health profession responsible for the treatment,
management, diagnostic testing, control, and care of patients with deficiencies and
abnormalities associated with cardiopulmonary systems under the direction of a physician,
physician assistant, anesthesiologist assistant, or nurse practitioner. Respiratory
care also includes inhalation therapy and respiratory therapy.
(10) “Respiratory care educational program” means a program accredited by the Committee
on Accreditation for Respiratory Care (CoARC) or by the Commission on Accreditation
of Allied Health Education Programs (CAAHEP), or their successor organizations. To
qualify for the student respiratory therapist’s license, the applicant must be actively
enrolled, and in good standing, in a program accredited by one of the agencies listed
in this subdivision.
(11) “Respiratory care practitioner” means a person:
(A) employed in the practice or performance of respiratory care who has the knowledge
and skill necessary to administer the functions defined in subdivision (8) of this
section;
(B) capable of serving as a resource in relation to the clinical and technical aspects
of respiratory care as to the safe and effective methods for administering respiratory
care modalities;
(C) able to function in situations of unsupervised patient contact requiring individual
judgment;
(D) capable of supervising, directing, or teaching less skilled personnel in the provision
of respiratory care services.
(12) “Supervisor of record” means a respiratory care practitioner licensed in this State
who has been practicing actively as a respiratory care practitioner for at least two
years prior to becoming a supervisor of record and is employed by the same employer
as the person being supervised. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4702. Prohibition; offenses
(a) No person shall practice or attempt to practice respiratory care or hold himself or
herself out as being able to do so in this State without first having obtained a license.
(b) No person shall use in connection with the person’s name any letters, words, or insignia
indicating or implying that the person is a respiratory care practitioner unless licensed
in accordance with this chapter.
(c) No person shall practice or attempt to practice respiratory care while his or her
license has been revoked or suspended.
(d) A person who violates a provision of this section shall be subject to the penalties
provided in 3 V.S.A. § 127(c). (Added 2003, No. 139 (Adj. Sess.), § 2; amended 2005, No. 148 (Adj. Sess.), § 50; 2007, No. 29, § 74.)
§ 4703. Professional identification
(a) A person holding a license to practice respiratory care in this State shall use the
title “respiratory care practitioner” and the abbreviation “R.C.P.”
(b) A licensee shall show his or her license when requested.
(c) A person matriculated in an accredited respiratory education program shall use the
title “student respiratory therapist” and the abbreviation “S.R.T.” (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4704. Director of the Office of Professional Regulation; duties
(a) The Director shall:
(1) provide general information to applicants for licensure as respiratory care practitioners;
(2) administer fees as provided for under 3 V.S.A. § 125(b);
(3) explain appeal procedures to respiratory care practitioners and applicants and explain
complaint procedures to the public;
(4) receive applications for licensure, license applicants under this chapter, and renew
licenses;
(5) refer all disciplinary matters to an administrative law officer;
(6) revoke, suspend, reinstate, or condition licenses as ordered by an administrative
law officer;
(7) issue reprimands or impose administrative penalties as ordered by an administrative
law officer.
(b) The Director of the Office of Professional Regulation, with the advice of the advisor
appointees, may adopt rules necessary to perform the duties provided under this chapter. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4705. Advisor appointees
(a) The Secretary of State shall appoint two respiratory care practitioners to serve as
advisors in matters relating to respiratory care. They shall be appointed for staggered
five-year terms and serve at the pleasure of the Secretary. One of the initial appointments
shall be for less than a five-year term.
(b) Each appointee shall have at least three years of experience as a respiratory care
practitioner during the period immediately preceding appointment and shall be actively
practicing respiratory care in Vermont and remain in good standing during incumbency.
(c) The Director shall seek the advice of the respiratory care practitioners appointed
under this section in carrying out the provisions of this chapter. These appointees
shall be entitled to compensation and necessary expenses in the amounts provided in
32 V.S.A. § 1010 for attendance at any meeting called by the Director for this purpose. (Added 2003, No. 139 (Adj. Sess.), § 2; amended 2005, No. 27, § 114.)
§ 4706. Application
To apply for licensure as a respiratory care practitioner, a person shall apply to
the Director on a form furnished by the Director. The application shall be accompanied
by payment of the specified fee and evidence of eligibility as requested by the Director. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4707. Eligibility
To be eligible for licensure as a respiratory care practitioner, an applicant shall:
(1) have completed a respiratory care educational program as defined in subdivision 4701(10) of this title; and
(2) pass a standardized national examination approved by the Director. (Added 2003, No. 139 (Adj. Sess.), § 2; amended 2007, No. 163 (Adj. Sess.), § 43.)
§ 4708. Examination
Examinations shall be conducted under this chapter by a nationally recognized credentialing
body approved by the Director. Examinations administered and the procedures of administration
shall be fair and reasonable and shall be designed and implemented to ensure that
all applicants are granted licensure if they demonstrate that they possess the minimal
occupational qualifications that are necessary for the protection of the public health,
safety, and welfare. The examination shall not be designed or implemented for the
purpose of limiting the number of licensees. The Director may authorize the use of
independent testing services or other services to assist in the administration of
examinations. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4709. Licensure without examination; endorsement
(a) The Director may issue a license to practice respiratory care by endorsement and without
examination to an applicant who is currently licensed to practice respiratory care
under the laws of another state, territory, or country, and who is in good standing
to practice respiratory care in that jurisdiction, and, in the opinion of the Director,
the standards and qualifications required for regulation of respiratory care in that
state or territory are currently at least equal to those required by this chapter.
(b) An applicant for licensure by endorsement may practice under the indirect supervision
and responsibility of a licensed respiratory care practitioner in this State, providing
the applicant obtains a temporary license and the following are met:
(1) A current supervisor of record form is on file with the Director.
(2) The application is complete, except the Director may be waiting for validation of
out-of-state licenses. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4710. Temporary licensure
(a) A temporary license without examination for practice under the direction of a respiratory
care practitioner licensed in Vermont may be issued to a person who applies for the
first time to practice respiratory care in this State as a respiratory care practitioner
and meets all other qualifications of section 4707 of this title.
(b) A temporary license may be issued only for the purpose of allowing a qualified applicant
to practice as a respiratory care practitioner until:
(1) The applicant takes the next examination provided by the Director and a determination
is made of the applicant’s qualification to practice in this State.
(2) The necessary data for licensure without examination are collected and ruled on by
the Director.
(c) Temporary licenses shall be issued on payment of the specified fee for a fixed period
of time to be determined by the Director by rule and shall not be renewed, except
by petitioning the Director, subject to proof of an exceptional cause shown by the
applicant. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4711. Temporary licensure for student respiratory therapists
(a) Respiratory care services may be performed without a license by a student currently
enrolled in a respiratory care educational program when these services are incidental
to the clinical aspect of a student’s course of study.
(b) A student enrolled in a respiratory care educational program who is employed in an
organized health care system shall apply for a temporary student license from the
Director prior to performing respiratory care services. Students who have obtained
a temporary license may render respiratory care services only under the direct supervision
of a licensed respiratory care practitioner for a limited period of time and under
conditions specified by the Director by rule. The scope of practice of the student
respiratory therapist is limited to those activities for which there is documented
evidence of competency. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4712. Exemptions from licensure
(a) A person shall not practice respiratory care or represent himself or herself to be
a respiratory care practitioner unless he or she is licensed under this chapter, except
that this chapter shall not prohibit:
(1) A person matriculated in an education program approved by the Director who is pursuing
a degree in respiratory care or respiratory therapy from satisfying supervised clinical
education requirements related to the person’s respiratory care education while under
direct supervision of a respiratory care practitioner or physician.
(2) A respiratory care practitioner from practicing in the U.S. Armed Services, U.S. Public
Health Services, or the Department of Veterans Affairs, pursuant to federal regulations
of health care providers.
(3) A respiratory care practitioner who is licensed in another jurisdiction of the United
States from providing consultation by telecommunications.
(4) A respiratory care practitioner who is licensed in another jurisdiction of the United
States, or foreign educated respiratory care practitioner credentialed in another
country, from practicing respiratory care in conjunction with teaching or participating
in an educational seminar of no more than 60 days in a calendar year.
(5) Those individuals meeting the aide/assistant classification or those working under
medical supervision in a pulmonary function testing or research facility.
(6) Respiratory care rendered in an emergency.
(7) Self care by a patient or gratuitous care by family members or friends who do not
represent themselves as respiratory care practitioners.
(8) A respiratory care practitioner who is licensed in another jurisdiction of the United
States or a foreign educated respiratory care practitioner credentialed in another
country from practicing respiratory care in conjunction with the interfacility transport
of a critically ill patient.
(9) A home care medical equipment dealer from performing services related to delivery,
setup, instruction, or maintenance of durable medical equipment, including home respiratory
equipment. This exemption does not include therapeutic evaluation or assessment.
(10) [Expired.]
(11) A polysomnographic technologist, technician, or trainee from performing activities
within the scope of practice adopted by the association of polysomnographic technologists,
while under the direction of a Vermont licensed physician who has training in sleep
medicine.
(12) A perfusionist from performing those activities contained within the perfusion scope
of practice adopted by the American Society of Extracorporeal Technologists, or its
successor organization, while under the supervision of a licensed physician.
(b) This chapter does not restrict a person licensed or certified under any other law
of this State from engaging in the profession or practice for which that person is
licensed or certified if that person does not represent, imply, or claim that he or
she is a respiratory care practitioner or a provider of respiratory care. This chapter
does not expand the scope of practice of any other profession or occupation referred
to in this chapter. (Added 2003, No. 139 (Adj. Sess.), § 2; 2019, No. 178 (Adj. Sess.), § 24, eff. Oct. 1, 2020.)
§ 4713. Renewals; continuing education
(a) Licenses shall be renewed every two years upon payment of the required fee, provided
the person applying for renewal completes at least 12 hours of continuing education
requirements, approved by the Director, during the preceding two-year period.
(b) The Director, with the advice of the advisor appointees, shall establish, by rule,
guidelines and criteria for continuing education credit.
(c) Biennially, the Director shall forward a renewal form to each licensee. Upon receipt
of the completed form, renewal fee, and evidence of eligibility, the Director shall
issue a new license.
(d) Any application for renewal of a license that has expired shall be accompanied by
the renewal fee and late fee. A person shall not be required to pay renewal fees for
years during which the license was lapsed.
(e) If a respiratory care practitioner’s license has lapsed for more than five consecutive
years, that person shall pay all applicable renewal and reinstatement fees and shall
demonstrate competence to the Director’s satisfaction by one or more of the following,
as determined by the Director:
(1) documenting licensed practice in another state;
(2) completing a remedial course;
(3) completing continuing education requirements; or
(4) passing an examination approved by the Director. (Added 2003, No. 139 (Adj. Sess.), § 2; amended 2005, No. 27, § 115; 2007, No. 163 (Adj. Sess.), § 44.)
§ 4714. Unprofessional conduct
(a) A person licensed under this chapter or a person applying for a license shall not
engage in unprofessional conduct.
(b) Unprofessional conduct means the following conduct in addition to the conduct set
forth in 3 V.S.A.§ 129a:
(1) Failure to keep written respiratory care records justifying a course of treatment
for a patient, including patient history, examination results, and test results.
(2) Performing professional services that have not been authorized by the patient or his
or her legal representative.
(3) Performing any procedure or prescribing any therapy that, by the prevailing standards
of respiratory care practice, would constitute experimentation on a human subject
without first obtaining full, informed written consent.
(4) Sexual harassment of a patient.
(5) Engaging in a sexual act as defined in 13 V.S.A. § 3251 with a patient under the care of the person licensed under this chapter.
(c) In connection with a disciplinary action, the Office of Professional Regulation may
refuse to accept the return of a license tendered by the subject of a disciplinary
investigation.
(d) The burden of proof in a disciplinary action shall be on the State to show by a preponderance
of the evidence that the person has engaged in unprofessional conduct.
(e) After hearing and upon a finding of unprofessional conduct or upon approval of a negotiated
agreement, an administrative law officer may take disciplinary action against the
licensee or applicant. That action may include any of the following conditions or
restrictions, which may be in addition to or in lieu of a warning, reprimand, administrative
penalty, suspension, or revocation:
(1) A requirement that the person submit to care or counseling.
(2) A restriction that a licensee practice only under supervision of a named individual
or an individual with specified credentials.
(3) A requirement that a licensee participate in continuing education as directed by the
administrative law officer in order to overcome specified deficiencies.
(4) A requirement that the licensee’s scope of practice be restricted to a specified extent.
(f) The administrative law officer may reinstate a revoked license on terms and conditions
he or she deems proper. (Added 2003, No. 139 (Adj. Sess.), § 2.)
§ 4715. Repealed. 2007, No. 163 (Adj. Sess.), § 45.