February 10, 2006 Board Meeting Minutes

BOARD MEETING
PUBLIC SESSION MINUTES

February 10, 2006

State Capitol
10th & L Street, Senate Room 112
Sacramento, CA

CALL TO ORDER

The Public Session was called to order at 9:05 a.m. by President Renner. A quorum was present. President Renner introduced and welcomed the Board's newest member, Murray Olson.

APPROVAL OF NOVEMBER 14, 2005 PUBLIC SESSION MINUTES

Mr. Stern moved to approve the November 14, 2006 public Session Minutes as written.

M/Stern/S/Sheldon
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

NOVEMBER 14, 2005: UNFINISHED BUSINESS

Proposed Outreach Expenditures

Ms. Nunez explained that the action plans within Objectives 1.1 and 1.3 of the current Strategic Plan, include public outreach to promote public awareness. Accordingly, Ms. Nunez requested that the Board allocate funds to participate as an exhibitor at various outreach and career events, including the California State Fair.

Ms. Nunez advised the Board that staff has projected outreach expenditures for 2006 would range from $90,000 to $125,000. These projections include the cost of printing various materials/brochures, exhibitor/vendor fees, and for the purchasing of promotional items.

Dr. Sheldon moved to proceed with the proposed outreach and expenditures suggested by Ms. Nunez.

M/Sheldon/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Election of Officers

President Renner opened the nominations for President.

Ms. Stenson nominated Larry Renner.

M/Stenson/S/Sheldon

Dr. Sheldon moved to close nominations for President.

M/Sheldon/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

President Renner opened the nominations for Vice-President and nominated Gary Stern.

M/Renner/S/Sheldon
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

PPRESENTATION: DRUG COMPOUNDING IN CALIFORNIA
(Dennis Ming, Supervising Inspector, Board of Pharmacy)

Mr. Dennis Ming thanked the Board for inviting him to speak. Mr. Ming distributed an overview of the current Board of Pharmacy laws related to drug compounding, and addressed the Board's concerns relating to the compounding of respiratory care medications.

Mr. Ming advised that the Board of Pharmacy is currently sponsoring AB 595 (Negrete McLeod). He explained that, as proposed, AB 595 will amend the Pharmacy Act to define drug compounding and to clarify the point at which a pharmacy becomes a drug manufacturer. Mr. Ming requested the Board's support for this bill.

Mr. Ming entertained questions from the Board.

Dr. Sheldon suggested that, due to the potential risks associated with the compounding of respiratory medications, the Board continue to monitor, and provide insight and suggestions where appropriate, on future proposals related to drug compounding.

President Renner thanked Mr. Ming for his presentation.

LAW & PROFESSIONAL ETHICS COURSE IMPLEMENTATION UPDATE
(Barbara M. Stenson, RCP)

Ms. Stenson reported that although the implementation date for the Law & Professional Ethics Course was January 1, 2006, it was first made available on January 23, 2006. She reported that as of February 9th, the following registrants have enrolled in the ethics course:

1. *20 individuals registered for the CSRC's course (1/3 were students)
2. *22 have registered for the AARC's course (14 have passed and 8 are still in the process of completing the course)

Ms. Stenson added that ethics course information will be included in upcoming issues of the Board's newsletter, and is now distributed with renewed licenses and application packets. Ms. Stenson also advised that notification letters would also be sent to all program directors.

She added that Ms. Molina will be attending the CSRC's Greater Bay Area Conference in March where the first version of the "live" ethics course would be held. Staff will also be attending the CSRC's June Conference where the "live" version will also be offered.

Dr. Sheldon asked if it would be wise to incorporate the ethics course into the existing respiratory program curriculum. Ms. Stenson replied that she is unfamiliar with each programs' course content, but added that the CSRC and AARC have established discount rates for applicants and have been in contact with the various California programs regarding the new requirement.

Ms. Molina stated that a program director from the last board meeting discussed possibly working with the CSRC and administering the course on campus.

In closing, Ms. Stenson thanked Liane for her assistance throughout the implementation process.

EXECUTIVE OFFICER'S REPORT
(Stephanie Nunez)

Conference attendance

As requested at a previous meeting, Ms. Nunez provided reports for confrerences she recently attended.

National Organization for Competency Assurance (NOCA): Ms. Nunez informed the Board that in November she attended the NOCA conference. Although the conference was heavily geared for testing and credentialing agencies, she did learn that there continues to be a movement toward demonstrating competence at regular intervals, rather than just upon licensure. The goal is to have states pass laws that require health care practitioners to demonstrate continuing competency as a condition for licensure renewal, using various methods and pathways.

Dr. Sheldon recommended that a letter be sent to the NBRC stating that the Board is aware of and supports the continued competency movement.

Dr. Sheldon moved that the Board's President draft a letter to the NBRC indicating its support for ongoing competency evaluation for respiratory care practitioners.

M/Sheldon/S/Stenson

Mr. Olson agreed with Dr. Sheldon's motion but requested that AARC and CoARC be provided a copy of the letter.

Public comments were received at this time.

Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern

MOTION PASSED

Federal Association for Respiratory Boards (FARB):
Ms. Nunez explained that this conference is specifically geared toward regulatory boards. She added that the conference was very informative and allowed her to network with other Executive Officers. Ms. Nunez also noted that Charlene Zettel, DCA Director, was the opening speaker.

AB 1825 - Sexual Harassment Prevention Training

This item was tabled until the next meeting.

Unlicensed Personnel Regulations

Ms. Nunez informed the Board that this regulation package has been filed, and a hearing on the matter has been scheduled for March. She advised the Board that following the written comment period and the hearing, the proposal would be brought back to the Board for consideration of final approval.

The Board convened into Closed Session.

Public Session reconvened at 2:05 p.m.

RESPIRATORY CARE WORKFORCE STUDY

Presentation: Workforce Study Proposal
(Ernest L. Cowles, Ph.D., Director and Sandra Sutherland, Research Specialist, Instute for Social Research, California State University, Sacramento)

President Renner explained that Ernest Cowles, Ph.D. and Sandra Sutherland had been invited to present a proposal to the Board as part of the Board's Strategic Plan.

Dr. Cowles presented the ISR's workforce study proposal, and entertained questions from the Board.

Public comments were received at this time.

Jeff Espinoza, Chair, Advanced Practice Commission, CSRC: Mr. Espinoza expressed some concerns, and asked if the Advanced Practice Commission could follow up with a letter that would include some recommendations related to the proposed workforce study groups.

Ms. Nunez advised Mr. Espinoza that she was willing to work with him to ensure that, as appropriate, the workforce study groups be properly represented.

President Renner moved that this project be assigned to the Executive Committee.

M/Renner/S/Chaturvedi
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Consideration to Approve Proposal

President Renner moved that the Board proceed with executing the contract with CSUS for the performance of the proposed workforce study.

M/Renner/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

EXECUTIVE COMMITTEE REPORT
(Larry L. Renner, RCP, President)

Application Process for Persons Displaced by Hurricane Katrina

President Renner asked for input regarding how long the Board should continue to offer an expedited application process for those individuals displaced as a result of Hurricane Katrina.

Mr. Stern moved that the expedite process for those displaced by Hurricane Katrina remain in place through August 2006, allowing the process to remain in place for an entire year.

M/Stern/S/Sheldon
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Consideration to Establish a Formal Policy to Expedite the Application Process for Persons Affected by Declared Disasters

A question was presented as to whether the Board should consider establishing a formal policy to expedite the application process for persons affected by declared disasters.

Mr. Stern stated that he does not believe that a formal policy is needed at this time. Instead, the Board should act on an ad hoc, as needed basis, to respond to issues presented in the future. He added that many federal and state disasters have been declared over the RCB's history, not requiring a formal policy. The Board's response to Hurricane Katrina was based on the incomparable fact that RCPs were facing long-term displacement from their jobs, and the expedited process offered by the Board assisted those individuals to relocate and resume their careers.

President Renner moved that the Board not establish a formal policy based upon previous discussion.

M/Renner/S/Chaturvedi
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

UNLICENSED PERSONNEL TASK FORCE
(Larry L. Renner, Gary N. Stern, Esq)

Home Care Recommendations: Proposed Legislation and Regulatory Language and Consideration to Present Recommendations to the Department of Health Services

President Renner explained that the Joint Sunset Committee has agreed to carry the Board recommended legislative language this year, to exempt unlicensed personnel from specific respiratory tasks as defined by the RCB.

President Renner moved that the Unlicensed Personnel Task Force be given the authority to make any necessary non-substantive changes to the legislative language, and that staff move forward accordingly.

M/Renner/S/Stern

Discussion ensued.

President Renner clarified that his motion was in reference to Home Care only.

Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

In reference to the Department of Health Services (DHS), President Renner moved that staff meet with appropriate DHS staff to convey the Board's recommendations.

M/Renner/S/Sheldon
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Polysomnography Recommendations: consideration to Complete Sunrise Questionnaire

Legislative staff has directed the Board to complete a Sunrise questionnaire, and submit it as part of the sunset review process, to request consideration to establish Polysomnography licensure.

President Renner moved that staff move forward with completing the Sunrise questionnaire for inclusion with the Board's next Sunset Review Report.

M/Renner/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Pulmonary Function Testing Recommendations: Consideration to Present Recommendations to the Medical Board of California (MBC)

Ms. Nunez informed the Board that Legislative staff has recommended that the Board meet with the MBC to discuss the proposed training requirements for unlicensed personnel performing spirometry testing. Legislative staff expressed concern that this requirement may be impeding on the MBC's regulatory authority as it relates to Medical Assistants. Accordingly, the legislative staff has asked the Board to revisit this issue with them after meeting with the MBC.

President Renner moved that staff meet with MBC staff regarding this issue and report back to the Board.

M/Renner/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

Hyperbaric Oxygen Therapy: Consideration to Present Recommendations to the Department of Health Services (DHS)

Legislative staff recommended that the Board approach the DHS with its recommendations to regulate facilities.

President Renner moved that staff meet with the appropriate DHS staff to convey the Board's recommendation and report back.

M/Renner/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

LEGISLATIVE/LEGAL AFFAIRS COMMITTEE REPORT
(Gary N. Stern, Esq., Chair; Scott J. Svonkin, Member)

2006 Legislation of Interest

Mr. Stern provided a review of the legislation of interest for 2006 and stated the Board's positions.

1. *AB 704 - Geriatric Health Care Assistant: Licensing (Support if Amended)
2. *AB 859 - Medical Assistants: Authorized Activities (Watch)
3. *AB 1656 - Automated External Defibrillators (Watch)
4. *SB 162 - State Department of Public Health (Support if Amended)

In response to the earlier presentation provided by Dennis Ming of the Pharmacy Board, Mr. Stern moved that the Board support AB 595.

M/Stern/S/Renner
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

REVISED STRATEGIC PLAN

Ms. Nunez explained that Goal 3, Objective 3.1, #1 of the Strategic Plan included an action plan item for the Board to explore resources that would enable it to accept alternative payment methods and process licensure renewal applications via the Internet. Ms. Nunez reported that she was informed that a budget change proposal has been sent to the Department of Finance that would place monies in our budget for this purpose. Therefore, she requested that this section be modified accordingly.

Ms. Powell expressed her concern with Goal 1, Objective 1.5, as it relates to student background checks. Currently, when an individual is fingerprinted in California, subsequent criminal information is sent if the person re-offends. Under this, the Board would continue to receive subsequent information even if it no longer has an interest in the individual. In addition, the Board would have to provide the individual with an administrative hearing, requiring statutory changes which may face a substantial amount of resistance.

President Renner provided some background information and explained that the Board has been contemplating the student perspective and when a background check should be required. At a prior meeting, Dr. Sheldon mentioned that schools are now wrestling with the issue of hospitals inquiring what level of background or safety checks they have performed prior to allowing students to begin clinical practice at their facilities.

Ms. Powell recommended that the Board gather background information on the different processes/systems other licensing entities and hospitals have used, then report the findings to the Board and proceed accordingly.

President Renner moved approval of the Strategic Plan, to include the changes noted to Goal 1, Objective 1.5, and Goal 3, Objective 3.1.

M/Renner/S/Stern
Unanimous: Chaturvedi, Olson, Renner, Sheldon, Stenson, Stern
MOTION PASSED

PUBLIC COMMENTS ON ITEMS NOT ON THE AGENDA

Terry Lyle, Program Director, Modesto: Mr. Lyle addressed the Board regarding the applicant work permit process, an emergency contingency plan, and concerns with clinical practice requirements.

Mark Goldstein, President Elect, CSRC: Mr. Goldstein commended the Board for its research on the issues of home care, polysomnography, pulmonary function testing, and hyperbaric oxygen therapy.

ADJOURNMENT

The Public Session Meeting was adjourned at 3:30 p.m. by President Renner