California Code of Regulations, Title 16, Division 13.6

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California Code of Regulations
Title 16, Division 13.6

Article 1. General Provisions

§1399.300. Citation.

These regulations shall be cited and referred to as the "Respiratory Care Regulations."

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3722, Business and Professions Code.

§1399.301. Location of Office.

The principal office of the Respiratory Care Board of California is located at 444 North 3rd Street, Suite 270, Sacramento, CA 95814.

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3722, Business and Professions Code.

§1399.302. Definitions.

Unless the context otherwise requires, the following definitions shall apply:

(a) "Board" means the Respiratory Care Board of California.
(b) "B&PC" means the Business and Professions Code.
(c) "Act" means the Respiratory Care Practice Act.
(d) "Direct Supervision" means assigned to a currently licensed respiratory care practitioner who is on duty and immediately available in the assigned patient area.
(e) "Employer" means any company, corporation, partnership, health maintenance organization, or any other entity or person that employs one or more respiratory care practitioners.
(f) "Licensed Home Care Employer" means a Home Medical Device Retail Facility, Home Health Agency, or any home care provider licensed by the Department of Health Services or its successor.
(g) "Regulations" means Division 13.6 of Title 16 of the California Code of Regulations.
(h) "Unlicensed Personnel" means an individual not otherwise authorized or exempt to provide respiratory care services except as provided for in Article 6.

NOTE: Authority cited: Sections 3704 and 3722, Business and Professions Code. Reference: Sections 3704 and 3722, Business and Professions Code.

§1399.303. Delegation of Authority.

(a) Except for those powers reserved exclusively for the "agency itself" under the Administrative Procedure Act (Section 11500 et seq. of the Government Code), the board delegates and confers upon the executive officer of the board, or in his or her absence, the president of the board, the power and discretion to receive and file accusations; issue notices of hearings, statements to respondents and statements of issues; receive and file notices of defense; determine the time and place of hearings under Section 11508 of the Government Code; issue subpoenas and subpoenas duces tecum; calendar cases for hearing and perform other functions necessary to the businesslike dispatch of the business of the board in connection with proceedings under the provisions of Sections 11500 through 11528 of the Government Code, prior to the hearing of such proceedings; and the certification and delivery or mailing of copies of decisions under Section 11518 of said code.
(b) The executive officer is further authorized, subject to the approval of the board, to investigate and evaluate each applicant for licensure under the Act, and to issue or deny a license in conformance with the provisions of the B&PC, the Act, this chapter, and disciplinary guidelines.

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Sections 3716 and 3753, Business and Professions Code.

§1399.304. Filing of Address.

Each person holding a license as a respiratory care practitioner or any person with an application for licensure pending, shall file, in writing, with the board his or her proper and current mailing address, and shall give written notice within 14 days, to the board at its Sacramento office of any and all changes of address, giving both the old and new address.

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3774, Business and Professions Code.

§1399.305. Officers.

(a) The election of a president and vice president shall be held annually at the last regularly-scheduled meeting of the board during the calendar year. The newly-elected officers shall assume office on the first day of the calendar year following the election.
(b) In the case of a vacancy occurring in either of the offices, the vacancy may be filled at any regular or specially-called meeting. The member filling the vacancy shall serve the remainder of the one year term.

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3712, Business and Professions Code.

Article 2. Applications

§1399.320. Applications.

(a) Documentation related to the initial application process shall not be submitted more than 30 days prior to the receipt of an initial application. If an application is not received within 30 days, the submitted material will be destroyed.

Note: Authority cited: Section 3730, Business and Professions Code. Reference: Section 3732, 3733, 3735, 3735.3, 3735.5, 3740, Business and Professions Code.

§1399.321. Abandonment of Applications.

Each applicant shall have one year from the time his or her initial application is received by the Board to meet licensure requirements and complete the application and initial licensure process. If the application and initial licensure process is not completed within the one-year period, the application shall be deemed abandoned.

Note: Authority cited: Sections 3722 and 3730, Business and Professions Code. Reference: Sections 3730, 3732, 3735, 3735.3, 3735.5, 3740, Business and Professions Code.

§1399.327. Satisfactory Completion of Law and Professional Ethics Course Prerequisite to License

Every applicant shall successfully complete a course in law and professional ethics as provided in section 1399.352.7 of this division, prior to initial licensure.

Note: Authority cited: Sections 3719.5 and 3722, Business and Professions Code. Reference cited: Sections 3719.5 and 3730, Business and Professions Code.

Article 3. Education and Experience.

§1399.330. Education Waiver Criteria.

(a) The Board may waive the education requirements in section 3740 of the B&PC if an applicant for licensure
(1) Either successfully completed a minimum of a one-year respiratory care program supported by the Committee on Accreditation for Respiratory Care or its predecessor, prior to July 1, 2004 or previously held a license in good standing issued by the board and
(A) Holds a current valid license in good standing in another state, United States territory or Canadian province and has practiced respiratory care in that jurisdiction for a minimum of two years full time within the three years immediately preceding filing and application for licensure in this state; or
(B) Has practiced respiratory care in another state or United States territory, for a minimum of three years full time within the four years immediately preceding filing an application for licensure in this state, and that state or territory does not regulate the practice of respiratory care at the time the application for licensure is filed.
(2) Has not completed a respiratory care program described in subdivision (1) above but either
(A) Holds a current valid license in good standing in another state, United States territory or Canadian province and has competently practiced respiratory care in that state, United States territory of Canadian province for a minimum of four years full time within the five years immediately preceding filing an application for licensure in this state; or
(B) Has practiced respiratory care in another state or United States territory, for a minimum of five years full time within the six years immediately preceding filing an application for licensure in this state, and that state or territory does not license the practice of respiratory care at the time the application for licensure is filed.
(b) As used in this section, "good standing" means the applicant
(1) is not currently under investigation;
(2) has not been charged with an offense for any act substantially related to the practice of respiratory care by any public agency;
(3) has not entered into any consent agreement or been subject to an administrative disciplinary decision including and voluntary surrender of license; and
(4) has not been the subject of an adverse judgment or arbitration award resulting from a claim or action for damages for death or personal injury caused by that person's negligence, error or omission in the practice or respiratory care.
(c) An applicant must provide sufficient documentary evidence to establish to the satisfaction of the board, that the applicant meets each requirement in the pathway under which the applicant is attempting to qualify. An applicant shall sign a release authorizing the board to obtain copies of personnel records or any other documentation that establishes the applicants qualifications for a waiver of the educational requirements.
(d) This section shall not be construed to require the board to waive education requirements.

Note: Authority cited: Sections 3722 and 3740, Business and Professions Code. Reference cited: Section 3740, Business and Professions Code.

Article 4. Examinations

§1399.340. Failure on Examinations.

For purposes of B&PC section 3739, the "next available examination" shall mean the board's state licensing examination, or the National Board for Respiratory Care, Inc. entry level certification examination for respiratory therapy. Failure of either examination, or failure to take either examination as scheduled except for due cause, shall result in termination of the privilege to work as a "respiratory care practitioner applicant."

Note: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3739, Business and Professions Code.

Article 5. Continuing Education

§1399.349. Continuing Education Defined.

"Continuing Education" means the variety of forms of learning experiences, including, but not limited to, lectures, conferences, academic studies, in-service education, institutes, seminars, home study, internet courses, and workshops, taken by respiratory care practitioners for licensure renewal. These learning experiences are meant to enhance the knowledge of the respiratory care practitioner in the practice of respiratory care in direct and indirect patient care. Continuing education does not include basic education or training needed to become a licensed RCP.

Note: Authority cited: Sections 3719 and 3722, Business and Professions code. Reference: Sections 3719 and 3740, Business and Professions Code.

§1399.350. Continuing Education Required.

(a) Each respiratory care practitioner (RCP) is required to complete 15 hours of approved continuing education (CE) every 2 years. At least two-thirds of the required CE hours shall be directly related to clinical practice.
(b) To renew the license, each RCP shall report compliance with the CE requirement. Supporting documentation, showing evidence of compliance with each requirement under this Article, shall be submitted if requested by the board.
(c) CE supporting documentation shall be retained by the licensee for a period of four years.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code.

§1399.350.5 Law and Professional Ethics Course.

(a) As Part of required continuing education, every person licensed under this chapter shall successfully complete a course in law and professional ethics as provided in section 1399.352.7 of this division, during every other license renewal cycle.
(b) Continuing education units earned in accordance with this section shall represent three units toward the non-clinical practice requirements set forth in section 1399.350(a). However, the course may be taken for continuing education credit only once during any renewal period.

Note: Authority cited: Sections 3719.5 and 3722, Business and Professions Code. Reference cited: Section 3719 and 3719.5, Business and Professions Code.

§1399.351. Approved CE Programs.

(a) Any course or program meeting the criteria set forth in this Article will be accepted by the board for CE credit.
(b) Passing an official credentialing or proctored self-evaluation examination shall be approved for CE as follows:
(1) Registered Respiratory Therapist (RRT) - 15 CE hours if not taken for licensure;
(2) Certified Pulmonary Function Technologist (CPFT) - 15 CE hours;
(3) Registered Pulmonary Function Technologist (RPFT) - 15 CE hours;
(4) Neonatal/Pediatric Respiratory Care Specialist (NPS) - 15 CE hours;
(5) Advanced Cardiac Life Support (ACLS) - number of CE hours to be designated by the provider;
(6) Neonatal Resuscitation Program (NRP) - number of CE hours to be designated by the provider; and
(7) Pediatrics Advanced Life Support (PALS) - number of CE hours to be designated by the provider.
(8) Advanced Trauma Life Support (ATLS) - number of CE hours to be designated by the provider
(c) Examinations listed in subdivisions (b)(1) through (b)4 of this section shall be those offered by the National Board for Respiratory Care and each successfully completed examination may be counted only once for credit.
(d) Successful completion of each examination listed in subdivisions (b)(5) through (b)(8) of this section may be counted only once for credit and must be for the initial certification. See section 1399.352 for re-certification CE. These programs and examinations shall be provided by an approved entity listed in subdivision (h) of Section 1399.352.
(e) The board shall have the authority to audit programs offering CE for compliance with the criteria set forth in this Article.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Section 3719, Business and Professions Code.

§1399.352. Criteria for Acceptability of Courses.

Acceptable courses and programs shall meet the following criteria:

(a) The content of the course or program shall be relevant to the scope of practice of respiratory care. Credit may be given for a course that is not directly related to clinical practice if the content of the course or program relates to any of the following:
(1) Those activities relevant to specialized aspects of respiratory care, which activities include education, supervision, and management.
(2) Health care cost containment or cost management.
(3) Preventative health services and health promotion.
(4) Required abuse reporting.
(5) Other subject matter which is directed by legislation to be included in CE for licensed healing arts practitioners.
(6) Re-certification for ACLS, NRP, PALS, and ATLS.
(7) Review and/or preparation courses for credentialing examinations provided by the National Board for Respiratory Care, excluding those courses for entry-level respiratory therapy certification.
(b) The faculty shall be knowledgeable in the subject matter as evidenced by:
(1) A degree from an accredited college or university and verifiable experience in the subject matter, or
(2) Teaching and/or clinical experience in the same or similar subject matter.
(c) Educational objectives shall be listed.
(d) The teaching methods shall be described, e.g., lecture, seminar, audio-visual, simulation.
(e) Evaluation methods shall document that the objectives have been met.
(f) Each course must be provided in accordance with this Article.
(g) Each course or provider shall hold approval from one of the entities listed in subdivision (h) from the time the course is distributed or instruction is given through the completion of the course.
(h) Each course must be provided or approved by one of the following entities. Courses that are provided by one of the following entities must be approved by the entity's president, director, or other appropriate personnel:
(1) Any post-secondary institution accredited by a regional accreditation agency or association recognized by the United States Department of Education.
(2) A hospital or health-care facility licensed by the California Department of Health Services.
(3) The American Association for Respiratory Care.
(4) The California Society for Respiratory Care (and all other state societies directly affiliated with the American Association for Respiratory Care).
(5) The American Medical Association.
(6) The California Medical Association.
(7) The California Thoracic Society.
(8) The American College of Surgeons.
(9) The American College of Chest Physicians.
(10) Any entity approved or accredited by the California Board of Registered Nursing or the Accreditation Council for Continuing Medical Education.
(i) Course organizers shall maintain a record of attendance of participants, documentation of participant's completion, and evidence of course approval for four years.
(j) All program information by providers of CE shall state: "This course meets the requirements for CE for RCPs in California."
(k) All course providers shall provide documentation to course participants that includes participants name, RCP number, course title, course approval identifying information, number of hours of CE, date(s), and name and address of course provider.
(l) For quarter or semester-long courses (or their equivalent), completed at any post-secondary institution accredited by a regional accreditation agency or association recognized by the United States Department of Education, an official transcript showing successful completion of the course accompanied by the catalog's course description shall fulfill the requirements in subdivisions (i), (j) and (k).
(m) The board may audit providers offering CE for compliance with the criteria set forth in this Article.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Section 3719, Business and Professions Code.

§1399.352.5 CE Hours

The board will accept hours of approved CE as follows:

(a) The number of hours designated by those entities identified in subdivision (h) of Section 1399.352 as it pertains to their own course or a course approved by them.
(b) Notwithstanding subdivision (a), one (1) academic quarter unit is equal to ten (10) CE hours and one (1) academic semester unit is equal to fifteen (15) CE hours.
(c) Providers may not grant partial credit for any CE course. Partial credit is defined as any time segment less than the total designated course duration or time period.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Section 3719, Business and Professions Code.

§1399.352.7 Law and Professional Ethics Course Criteria

An acceptable course in law and professional ethics shall meet the following criteria and be approved by the board:

(a) The course shall be provided by the American Association for Respiratory Care or the California Society for Respiratory Care.
(b) The course shall be three hours in length.
(c) The content of the course shall consist of the following subject areas:
(1) Obligations of licensed respiratory care practitioners to patients under their care;
(2) Responsibilities of respiratory care practitioners to report illegal activities occurring in the work place; and
(3) Acts that jeopardize licensure and licensure status.
(d) One hour of instruction shall consist of not less than 50 minutes of actual classroom time or actual time spent by the licensee completing the coursework on the internet.

Note: Authority cited: Sections 3719.5 and 3722, Business and Professions Code. Reference cited: Section 3719.5, Business and Professions Code.

§1399.353. Audit and Sanctions for Noncompliance.

(a) The board shall audit a random sample of RCPs for compliance with the CE requirements.
(b) If documentation of the CE requirement is improper or inadequate, or the licensee fails to provide the requested documentation within 30 days, the license becomes inactive. The practice of respiratory care, or representation that one is an RCP, is prohibited while the license is inactive. Practice on an inactive license shall constitute grounds for appropriate disciplinary action pursuant to the B&PC.
(c) Notwithstanding subdivision (b), if the Board determines that through no fault of the licensee the CE completed does not meet the criteria set forth in this Article, the Board may grant an extension, not to exceed six months, for the licensee to complete approved CE.
(d) Misrepresentation of compliance shall constitute grounds for disciplinary action.
(e) Documentation supporting compliance with CE requirements shall be available to the board upon request during the four year period following relicensure.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Sections 3719 and 3750, Business and Professions Code.

§1399.354. Waiver of Requirements.

At the time of making application for renewal of a license, an RCP may request a waiver from completion of the CE requirements. The board shall grant a waiver only if the RCP verifies in writing that, during the two-year period immediately prior to the expiration date of the license, he or she:

(a) Has been absent from California for at least one year because of military service reasonably preventing completion of the CE requirements; or
(b) Has been prevented from completing the CE requirements for reasons of health or other good cause which includes:
(1) Total medical disability of the RCP for at least one year; or
(2) Total medical disability of an immediate family member for at least one year where the RCP has total responsibility for the care of that family member. Verification of the disability under subsection (b) shall be verified in writing by a licensed physician and surgeon.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Section 3719, Business and Professions Code.

§1399.355. Renewal After Inactive or Delinquent Status.

(a) For the renewal of an expired license more than two year and within three years from the date of expiration, the applicant shall provide documentation of completion of the required 30 hours of CE during the four-year period preceding the application for renewal.
(b) For the renewal of an expired license two years or less from the expiration date, the applicant shall provide documentation of completion of the required 15 hours of CE during the two-year period preceding the application for renewal.
(c) After a license has been expired for three years, it will be cancelled and the applicant must make application just as for an initial license and meet all the current criteria required for licensure.

Note: Authority cited: Sections 3719 and 3722, Business and Professions Code. Reference: Sections 3719 and 3774, Business and Professions Code.

§1399.356. License Status.

A licensee may request, in writing, to change the status of his/her license as follows:

(a) To change the status of a license from active to inactive, the licensee shall make application to the board for such a change.
(b) To change the status of a license from inactive to active, the licensee shall request such in writing, pay all current, delinquent and accrued renewal fees, and provide documentation of completion of 15 hours of CE during the two-year period preceding the request for active status.

Note: Authority cited: Sections 701, 704, 3719 and 3722, Business and Professions Code. Reference: Sections 3719, 3774 and 3775, Business and Professions Code.

Article 6. Scope of Practice.

§1399.360. Unlicensed Personnel Services; Home Care

(a) Unlicensed personnel (UP) may perform limited and basic respiratory care or respiratory care related services identified in subdivisions (b) and (c) in the home setting or for the purposes of patient transfer to the home setting, provided the following conditions are met:
(1) The UP is providing services through his or her employment with a Licensed Home Care employer (LHCE);
(2) The UP has been provided initial training, ongoing in-service education, and periodic competency testing specific to each service and equipment-type by either a California licensed respiratory care practitioner (RCP) or other qualified licensed personnel, in accordance with his or her scope of practice, and documentation of such training, education and testing is maintained by the LHCE for a period of four years, and
(3) The LHCE ensures that the patient, the patient's family, or the patient's caregiver(s) are advised prior to or at the time equipment or supplies are delivered, that a RCP or other qualified licensed personnel, in accordance with his or her scope of practice, shall provide follow up checks, by telephone or in-person as appropriate, at the request of the patient or the patient's family, caregiver, or physician, or any person who has had contact with the patient, or as otherwise directed by a plan of care, and such services are provided accordingly.
(b) In accordance with this section and as it relates to:

positive airway pressure (with or without a back-up rate) devices and supplies;
intermittent positive pressure breathing devices and supplies;
ventilatory devices and supplies;
nasotracheal or tracheal suctioning devices and supplies;
apnea monitors and alarms and supplies;
tracheostomy care devices and supplies;
respiratory diagnostic testing devices and supplies, including but not limited to pulse oximetry, CO2 monitoring,and spirometry devices and supplies;
pulse-dose type or demand conserving oxygen delivery devices or high flow oxygen systems beyond the capabilities of a simple mask or cannula or requiring particulate or molecular therapy in conjunction with oxygen, and
any other respiratory care equipment and supplies not identified in subdivisions (b) and (c),

(1) UP may:
(A) Deliver equipment and supplies;
(B) Instruct the patient, the patient's family or the patient's caregiver(s) on how to order equipment and supplies and the telephone number to call 24 hours a day, 7 days a week, in case of emergency in which a live person will be available to respond;
(C) Set up equipment to the extent that the set-up is not dependent upon or influenced by any written or oral communication with the patient or the patient's family, caregiver(s) or physician (with the exception of identifying a physical location in the home for set-up), and
(D) Provide instruction to the patient, the patient's family or the patient's caregiver(s) limited to the mechanical operation of the equipment (e.g. switch, knob, and dial locations) or the general use of equipment or supplies.
(2) UP are prohibited from:
(A) Setting up equipment to an extent that it constitutes patient care such as applying any device to the patient or making any adjustment or taking any action that requires or is dependent upon or influenced by any written or oral communication with the patient or the patient's family, caregiver(s) or physician;
(B) Providing any instruction to an extent that it constitutes patient care, such as instruction in the operation or use of the equipment for the purpose of deriving an intended medical benefit or instruction in the clinical application of equipment and/or supplies;
(C) Performing any level of clinical assessment of the patient;
(D) Directly engaging in any discussion of clinical care plans, therapy, prescriptions, or clinical application;
(E) Touching the patient for the purposes of making an assessment or placing any device upon the patient, and
(F) Providing any service that is not expressly authorized by this section.
(c) In accordance with this section and as it relates to oxygen delivery systems and prefilled cylinders, with the exception of pulse-dose or demand conserving oxygen systems and high flow oxygen systems beyond the capabilities of a simple mask or cannula or requiring particulate or molecular therapy in conjunction with oxygen,
(1) UP may:
(A) Deliver equipment and supplies;
(B) Instruct the patient, the patient's family or the patient's caregiver(s) on how to order oxygen equipment and supplies and the telephone number to call 24 hours a day, 7 days a week, in case of emergency in which a live person will be available to respond;
(C) Instruct the patient, the patient's family or the patient's caregiver(s) in the proper and safe operation of oxygen equipment including:
(i) equipment set-up for the purpose of making the equipment patient-ready;
(ii) connecting disposable tubing, cannulas, and masks;
(iii) verification of oxygen flow;
(iv) demonstration to the patient of prescribed flow rate(s);
(v) connection and cleaning of oxygen humidifying equipment and devices;
(vi) use of portable back-up oxygen cylinders and equipment, and
(vii) removal and disposition of disposable tubing, cannulas, and masks, and
(D) Use a mock, self-demonstration as a method of instruction for subdivision (c)(1)(C).
(E) Conduct regular in-home evaluations and gather information from the patient and home setting pertaining to the set-up, instruction, and provision of information as described in this subdivision for the use of the prescribing physician.
(2) UP are prohibited from:
(A) Direct administration of home oxygen;
(B) Handling or adjusting home oxygen equipment while it is in use by the patient or on the patient;
(C) Touching the patient or placing any device upon the patient while engaged in the set-up and instruction of equipment, including, but not limited to, applying a cannula or performing an oximetry evaluation or oxygen saturation test, and
(D) Directly engaging in any discussion of clinical care plans, oxygen therapy or any modifications of physician prescribe equipment, dosages, or instructions or clinical applications.

Authority: Business and Professions Code, Section 3722 and 3765. Reference: Business and Professions Code Sections 3701, 3702, 3703, 3704, 3717, and 3760 and Health and Safety Code Sections 109948.1, and 111656.3.

Article 7. Miscellaneous.

§1399.370. Substantial Relationship Criteria

For the purposes of denial, suspension, or revocation of a license, a crime or act shall be considered to be substantially related to the qualifications, functions or duties of a respiratory care practitioner, if it evidences present or potential unfitness of a licensee to perform the functions authorized by his or her license or in a manner inconsistent with the public health, safety, or welfare. Such crimes or acts include but are not limited to those involving the following:

(a) Violating or attempting to violate, directly or indirectly, or assisting or abetting the violation of or conspiring to violate any provision or term of the Act.
(b) Conviction of a crime involving fiscal dishonesty, theft or larceny.
(c) Conviction of a crime involving driving under the influence or reckless driving while under the influence.
(d) Conviction of a crime involving harassment or stalking as defined by the Penal Code.
(e) Conviction of a crime involving lewd conduct, prostitution or solicitation thereof, or pandering and/or indecent exposure, as defined by the Penal Code.

NOTE: Authority cited: Section 481, Business and Professions Code. Reference: Sections 481, 3750, 3750.5, 3752.5, 3752.6 and 3752.7, Business and Professions Code; and Sections 266, 288, 314, 646.9, 647, 1203.097, 11414, 13519.6 and 13519.7, Penal Code.

§1399.372. Rehabilitation Criteria for Suspensions or Revocations.

When considering the denial, petition for reinstatement, modification of probation, suspension or revocation of an RCP license the board will consider the following criteria in evaluating the rehabilitation of such person and his or her eligibility for a license:

(a) The nature and severity of the act(s) or offense(s).
(b) The total criminal record.
(c) The time that has elapsed since the commission of the act(s) or offense(s).
(d) Compliance with any terms of parole, probation, restitution, or any other sanctions lawfully imposed against such person.
(e) Evidence of any subsequent act(s) or crime(s) committed.
(f) Any other evidence of rehabilitation submitted that is acceptable to the board, including:
(1) Successful completion of respiratory care courses with a "C" or better, as determined by the institution;
(2) Active continued attendance or successful completion of rehabilitative programs such as 12-step recovery programs or psychotherapy counseling;
(3) Letters relating to the quality of practice signed under penalty of perjury from licensed health care providers responsible for the supervision of his/her work.
(g) Statements, letters, attestations of good moral character, or references relating to character, reputation, personality, marital/family status, or habits shall not be considered rehabilitation unless they relate to quality of practice as listed in section (f).

Note: Authority cited: Sections 482 and 3722, Business and Professions Code. Reference: Sections 482, 3750, 3751 and 3753, Business and Professions Code.

§1399.372.5 Satisfactory Completion of a Law and Professional Ethics Course Prerequisite to Reinstatement.

Every petitioner for reinstatement shall successfully complete a course in law and professional ethics as provided in section 1399.352.7 of this division, within 6 months prior to the date a petition for reinstatement is filed with the board.

Note: Authority cited: Sections 3719.5 and 3722, Business and Professions Code. Reference cited: Sections 3719.5 and 3751, Business and Professions Code.

§1399.373. Permit Processing Times.

"Permit" as defined by the Permit Reform Act of 1981 means any license, registration permit or any other form of authorization required by a state agency to engage in a particular activity or act. Processing times for the board's respiratory care practitioner program are set forth below. The actual processing times apply to those applicants who have passed all appropriate examinations.

Program	Maximum time for notifying the applicant, in writing, that the application is complete and accepted for filing, or that the application is deficient and what specific information is required	Maximum time after receipt of a complete application to issue or deny license	ACTUAL PROCESSING TIMES FOR ISSUANCE OF A LICENSE BASED ON PRIOR TWO YEARS
			Minimum	Median	Maximum
Respiratory Care Practitioner	30 days	150 days	70 days	242 days	344 days

Note: Authority cited: Section 3722, Business and Professions Code; Section 15376, Government Code. Reference: Section 15376, Government Code.

§1399.374. Disciplinary Guidelines

In reaching a decision on the disciplinary action under the Administrative Procedure Act (Government Code Section 11400 et seq.), the board shall consider the disciplinary guidelines entitled "Disciplinary Guidelines" [3/02 Edition] which are hereby incorporated by reference. Deviation from these guidelines and orders, including the standard terms of probation, is appropriate where the board in its sole discretion determines that the facts of the particular case warrant such a deviation-for example: the presence of mitigating factors; the age of the case; evidentiary problems.

NOTE: Authority cited: Sections 3718, 3722 and 3750, Business and Professions Code; and Sections 11400.20 and 11400.21, Government Code. Reference: Sections 11400.20 and 11425.50(e), Govt. Code.

Article 8. Citations and Fines

§1399.376. Citation Review.

(a) The person cited may, within 30 calendar days after the date of service of the citation, notify the executive officer, in writing, of his or her request for a citation review by the executive officer or a designated committee of the board regarding the acts charged in the citation. Notification shall be through the United States Postal Service by certified or registered mail.
(b) The executive officer or committee shall hold, within 240 calendar days from the receipt of the request, a citation review with the person cited or his or her legal counsel or other authorized representative. At the conclusion of the citation review, the committee may affirm, modify or dismiss the citation, including any fine levied. The executive officer or committee shall state in writing the reasons for the action and serve a copy of its findings and decision on the person cited within 30 calendar days of the date of the citation review. This decision shall be deemed to be a final order of the board with regard to the citation issued, including the fine levied.

NOTE: Authority cited: Section 3722, Business and Professions Code. Reference: Section 3761, Business and Profession Code.

§1399.380. Citations.

(a)The executive officer of the board or his or her designee is authorized to issue a citation to any person who holds a permit, certificate or license from the board for a violation of any provision of the Act or any regulation adopted by the board.
(b) Each citation shall be in writing and shall describe with particularity the nature and facts of each violation specified in the citation, including a reference to the statute or regulation alleged to have been violated.
(c) Each citation may contain an assessment of an administrative fine, payable within a time period designated by the board, not to exceed 365 days, an order of abatement fixing a reasonable time for abatement of the violation, or both, for each alleged violation.
(d) Each citation shall inform the cited person of his or her right to a hearing and that such a request for a hearing be made in writing within 30 calendar days from the issuance date of the citation.
(e) Each citation shall be served upon the individual by certified mail at the last address of record.
(f) In assessing an administrative fine or issuing an order of correction or abatement, due consideration shall be given to the following factors:
1) the gravity of the violation
2) the good or bad faith exhibited by the cited person
3) the history of previous violations
4) the extent to which the cited person has cooperated with the board's investigation
(g) The sanctions authorized under this section shall be separate from and in addition to any other administrative discipline, civil remedies, or criminal penalties.
(h) Every citation that is issued pursuant to this article is a public record.
(i) Once a fine is paid to satisfy an assessment based on the finding of a violation, the payment of the fine becomes public record.

NOTE: Authority cited: Sections 125.9 and 3722, Business and Professions Code. Reference: Section 125.9, Business and Professions Code.

§1399.381. Fines.

(a) Fines shall be assessed in accordance with the following schedule, provided, however, in no case shall the total exceed $2,500 for each violation.

B&PC	Description	Range of Fines
480	Grounds for denial of an application for licensure/certificate	$100 to $2,500
3731	Title Used by Licensee	$25 to $2,500
3739	Practice During License Process	$100 to $2,500
3750(a)	Advertising	$250 to $2,500
3750(b)	Fraud in the procurement of any license	$1,000 to $2,500
3750(c)	Knowingly employing unlicensed persons	$100 to $2,500
3750(d)	Conviction of Crime	$100 to$500
3750(e)	Impersonating an applicant in any examination	$1,500 to $2,500
3750(f)	Negligence	$100 to$2,500
3750(g)	Conviction of a violation of any provision of Division 2	$100 to$2,500
3750(h)	Aiding/Abetting person to violate this chapter	$1000 to $2,500
3750(i)	Aiding/abetting person to engage in unlawful practice	$1000 to $2,500
3750(j)	Commission of any fraudulent, dishonest or corrupt act	$100 to$2,500
3750(k)	Falsifying/ incorrect/ inconsistent entries in record	$500 to$2,500
3750(l)	Changing prescription/falsifying orders for treatment	$1000 to $2,500
3750(m)	Discipline taken by another agency	$100 to$2,500
3750(n)	Knowing failure to protect patients-infection control	$1000 to$2,500
3750(o)	Incompetence	$500 to$2,500
3750(p)	Pattern of substandard care	$1000 to $2,500
3750.5	Obtained/Possessed/Use of Drugs	$100 to$2,500
3750.6	Production of Work Permit or Pocket License for Inspection	$25 to $100
3753.1	Probation Monitoring Costs	Actual +$25 to $500
3753.5	Cost Recovery	Actual +$25 to $500
3754.5	Licensee who obtains license by fraud or misrepresentation	$1000 to $2,500
3755	Unprofessional Conduct	$250 to $2,500
3758.5	RCP to report any known violation made by other RCP	$250 to $2,500
3760(a)	Practice without a License	$50 to $2,500
3761(a)	Misrepresentation in claim of license to practice	$100 to $1,000
3761(b)	Knowingly employ unlicensed personnel	$100 to $2,500
3773(a)	License renewal - notice of conviction	$100 to $2,500
3773(b)	License renewal - identification of current employer(s)	$100 to $2,500

Regulations	Description	Range of Fines
1399.304	Current address	$25 to $250
1399.350	CE requirements	$50 to $1,500

(b) Administrative fines collected pursuant to this section shall be deposited into the board's special fund.

NOTE: Authority cited: Sections 125.9 and 3722, Business and Professions Code. Reference: Sections 125.9, 136, 480, 3731, 3739, 3750, 3750.5, 3750.6, 3753.1, 3753.5, 3754.5, 3755, 3758.5, 3758.6, 3760, and 3773, Business and Professions Code; and Sections 1399.304 and 1399.350, Title 16 California Code of Regulations.

§1399.382. Appeals.

(a) Any person served with a citation may contest the citation by appealing to the board in writing, within 30 calendar days of the issuance of the citation.
(b) If the cited person fails to notify the board of his or her intent to contest the citation, the citation shall be deemed a final order of the board.
(c) If a cited person notifies the board that he or she intends to contest a citation, the board shall afford an opportunity for a citation review in accordance with section 1399.376 of the board's regulations or a hearing in accordance with the provisions of Chapter 5 (commencing with section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) The failure of a cited person who has appealed to the board to appear at the time and place of the citation review or hearing shall be deemed a withdrawal of his or her appeal, and the citation shall constitute a final order of the board.

NOTE: Authority cited: Sections 125.9 and 3722, Business and Professions Code. Reference: Sections 125.9 and 3753.5, Business and Professions Code, Section 1399.376 Title 16 California Code of Regulations, and Sections 11500, etc., Government Code.

§1399.383. Failure to Comply with Citation.

The failure to comply with a citation containing an assessment of an administrative fine or an order of abatement or both after the citation is final and has been properly served shall result in one or more of the following:

a) the non renewal of a license.
b) referral to collection entities to collect the fine.
c) the pursuit of further legal action by the board to collect the fine.

NOTES: Authority cited: Sections 125.9 and 3722, Business and Professions Code. Reference: Section 125.9, Business and Professions Code.

§1399.384. Licensee Reporting.

Information required to be disclosed by any person issued a license to practice respiratory care, whether that license is valid or invalid, as provided in Section 3758.5 of the B&PC shall be disclosed to the board within 10 calendar days from the date the person knows or should have reasonably known of a violation or probable violation has occurred.

NOTE: Authority cited: Sections 3722 and 3758, Business and Professions Code. Reference: Section 3758, Business and Professions Code.

§1399.385. Employer Reporting.

Information required to be disclosed by any employer of a respiratory care practitioner as provided in Sections 3758 and 3758.6 of the B&PC shall be disclosed to the board within 10 calendar days from the date of suspension or termination, whichever occurs first.

Authority cited: Sections 3722 and 3758, Business and Professions Code. Reference: Section 3758, Business and Professions Code.

§1399.387. Citations-Employer.

(a) The he executive officer of the board or his or her designee is authorized to issue a citation to any employer for a violation of sections 3717, 3758 and 3758.6 of the B&PC or Section 1399.385 of the regulations.
(b) Each citation shall be in writing and shall describe with particularity the nature and facts of each violation specified in the citation, including a reference to the statute or regulation alleged to have been violated.
(c) Each citation may contain an assessment of an administrative fine, payable within a time period designated by the board, not to exceed 365 days, an order of abatement fixing a reasonable time for abatement of the violation, or both, for each alleged violation.
(d) Each citation shall inform the cited employer of its right to a hearing and that such a request for a hearing be made in writing within 30 days from the issuance date of the citation.
(e) Each citation shall be served upon the employer by certified mail at the last address of record.
(f) In assessing an administrative fine or issuing an order of correction or abatement, due consideration shall be given to the following factors:
1) the gravity of the violation
2) the good or bad faith exhibited by the employer
3) the history of previous violations
4) the extent to which the employer has cooperated with the board’s investigation
(g) The sanctions authorized under this section shall be separate from and in addition to any other administrative discipline, civil remedies, or criminal penalties.
(h) Every citation that is issued pursuant to this article is a public record.
(i) Once a fine is paid to satisfy an assessment based on the finding of a violation, the payment of the fine becomes a public record.

Authority cited: Sections 125.9, 3722, 3758, and 3758.6, Business and Professions Code. Reference: Section 125.9, 3717, 3758, and 3758.6, Business and Professions Code.

§1399.388. Fines-Employer.

(a) Failure of an employer to provide reports or records or allow inspections as required by Section 3717 of the B&PC shall be punishable by an administrative fine ranging from $250 to $2,500.
(b) Failure of an employer to make a report required by Section 3758 of the B&PC shall be punishable by an administrative fine ranging from $2,500 to $10,000.
(c) Failure of an employer to make a report as required by Section 3758.6 of the B&PC shall be punishable by an administrative fine ranging from $500 to $2,500.
(d) Administrative fines collected pursuant to this section shall be deposited into the board's special fund.

NOTE: Authority cited: Sections 3722 and 3758 of the Business and Professions Code. Reference: Sections 3717, 3758, and 3758.6 of the Business and Professions Code.

§1399.389. Appeals-Employer.

(a) Any employer served with a citation, may contest the citation by appealing to the board in writing, within 30 calendar days of the issuance of the citation.
(b) If the cited employer fails to notify the board of his or her intent to contest the citation, the citation shall be deemed a final order of the board and shall not be subject to administrative review.
(c) If a cited employer notifies the board that it intends to contest a citation, the board shall afford an opportunity for a hearing. The board shall thereafter issue a decision based on findings of fact, affirming, modifying or vacating the citation or penalty or both, or directing other appropriate relief. The proceedings under this section shall be conducted in accordance with the provisions of Chapter 5 (commencing with section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.
(d) The failure of a cited employer that has appealed to the board to appear at the time and place of the hearing shall be deemed a withdrawal of its appeal, and the citation shall constitute a final order of the board and shall not be subject to administrative review.

NOTE: Authority cited: Sections 125.9 and 3722 of the Business and Professions Code. Reference: Sections 125.9 and 3753.5 of the Business and Professions Code and Sections 11500, etc. of the Government Code.

§1399.390. Failure to Comply with Citation-Employer.

NOTE: Authority cited: Sections 3722 and 3758 of the Business and Professions Code. Reference: Section 3758 of the Business and Professions Code.

§1399.391. Citation and Fine - Unlicensed Personnel

(a) The executive officer or his or her designee is authorized to determine when and against whom a citation will be issued and to issue a citation to any person, or employer of a person, who acts in the capacity of or engages in the business of a respiratory care practitioner in this state without having a license in good standing pursuant to the Act and who is not otherwise exempted from the provisions of the Act. Each citation for unlicensed activity shall contain an order of abatement, and shall be in writing and state with particularity the basis of the citation. "Employer," as used in this section, means any entity or person that employs or contracts with one or more persons who are acting in the capacity of, or engaged in the business of, a respiratory care practitioner, including but not limited to, any person, facility, company, corporation, partnership, organization or health maintenance organization.
(b) An administrative fine shall be paid within the time period designated in the citation, not to exceed 365 days. The amount of an administrative fine shall be separate from section 1399.381 and in accordance with section 3767(b)(2) of the B&PC.
(c) A citation shall inform the cited person or employer of his or her right to a hearing and that such a request for a hearing be made in writing within 15 calendar days after service of the citation. A citation shall be served upon the individual or employer by certified mail.
(d) In assessing an administrative fine and issuing an order of abatement, due consideration shall be given to the following factors for each violation:
1) the gravity of the violation;
2) the good or bad faith exhibited by the cited person or employer;
3) the history of previous violations;
4) the extent to which the cited person or employer has cooperated with the board's investigation.
(e) A cited person or employer who wishes to contest the citation may serve a written appeal on the board, within 15 calendar days after service of the citation, through the United States Postal Service by certified or registered mail.
(f) If the cited person or employer notifies the board that he/she/it intends to contest a citation, the board shall afford an opportunity for a hearing. The board shall thereafter issue a decision based on findings of fact, affirming, modifying or vacating the citation with its fine or order of abatement, or directing other appropriate relief. The proceedings under this section shall be conducted in accordance with the provisions of Chapter 5 (commencing with section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.
(g) The failure of a cited person or employer to appear at the time and place of the hearing shall be deemed a withdrawal of the appeal, and the citation shall constitute a final order of the board and shall not be subject to further administrative review.

NOTE: Authority cited: Sections 3722, 3760, 3761, 3766, and 3767, Business and Professions Code. Reference: Section 3760, 3761, 3766, and 3767, Business and Professions Code.

§1399.395. Fee Schedule.

The following schedule of fees is hereby adopted pursuant to Sections 3775 and 3775.5 of the Business and Professions Code:

List of Application	Application Type	Fees
(a)	Application fee	$ 200
(b)	Application fee [pursuant to Section 3740(c)]	$ 250
(c)	Examination fee	$ 190
(d)	Re-examination fee	$ 150
(e)	Initial license fee (fee is prorated based on the length of the initial license period)	$ 200
(f)	Renewal fee for licenses expiring on or after January 1, 2002	$ 230
(g)	Delinquency fee (not more than 2 years after expiration)	$ 230
(h)	Delinquency fee (after 2 years but not more than 3years after expiration)	$ 460
(i)	Inactive license fee.	$ 230
(j)	Duplicate license fee	$ 25
(k)	Endorsement fee	$ 75

Note: Authority cited: Sections 3722, 3775 and 3775.5, Business and Professions Code. Reference: Sections 3775 and 3775.5, Business and Professions Code.

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