1399.365. Basic Respiratory Tasks and Services

On June 5, 2025, the Office of Administrative Law (OAL) approved the Respiratory Care Board’s (RCB) regulations related to Basic Respiratory Tasks and Services codified at California Code of Regulations, title 16, section 1399.365. The regulation will become effective on October 1, 2025.

This regulation clearly defines which respiratory tasks may be performed without assessment or evaluation, providing clarity to Respiratory Care Practitioners (RCPs), other healthcare personnel, employers, and patients. The regulation promotes public safety while enabling non-RCP personnel to provide supportive care within clearly defined limits.

Regulatory Language

1399.365. Basic Respiratory Tasks and Services

(a) For purposes of this section, “assessment” means making an analysis or judgment and making recommendations concerning the management, diagnosis, treatment, or care of a patient or as a means to perform any task in regard to the care of a patient. Assessment as used in this section is beyond documenting observations, and gathering and reporting data to a licensed respiratory care practitioner, registered nurse, or physician.

(b) For purposes of subdivision (a) of section 3702.5 of the B&P, basic respiratory tasks and services do not require a respiratory assessment and include the following:

Patient data collection.
Application and monitoring of a pulse oximeter.
Medication administration by aerosol that does not require manipulation of an invasive or non-invasive mechanical ventilator.
Heat moisture exchanger (HME) and oxygen tank replacement for patients who are using non-invasive mechanical ventilation.
Hygiene care including replacement of tracheostomy ties and gauze and cleaning of the stoma sites.
Use of a manual resuscitation device and other cardio-pulmonary resuscitation technical skills (basic life support level) in the event of an emergency.
Documentation of care provided, which includes data retrieved from performing a breath count or transcribing data from an invasive or non-invasive ventilator interface.
Observing and gathering data from chest auscultation, palpation, and percussion.

(c) For purposes of subdivision (a) of section 3702.5 of the B&P, basic respiratory tasks and services do not include the following:

Manipulation of an invasive or non-invasive ventilator.
Assessment or evaluation of observed and gathered data from chest auscultation, palpation, and percussion.
Pre-treatment or post-treatment assessment.
Use of medical gas mixtures other than oxygen.
Preoxygenation, or endotracheal or nasal suctioning.
Initial setup, change out, or replacement of a breathing circuit or adjustment of oxygen liter flow or oxygen concentration.
Tracheal suctioning, cuff inflation/deflation, use or removal of an external speaking valve, or removal and replacement of the tracheostomy tube or inner cannula.

While this regulation only applies to basic respiratory tasks and services, the RCB is actively working on a separate regulatory package to establish exemptions that would allow Licensed Vocational Nurses (LVNs) to perform additional respiratory tasks when employed in home health agencies or in specific home and community-based settings pursuant to Business and Professions Code sections 3765(i) and (j). More information on those proposed regulations will be shared as the development process progresses.

Background and Development

March 28, 2024: The Board was presented with, and approved, text to begin the rulemaking process.
June 5, 2024: RCB staff filed the initial rulemaking package, and the 45-day public comment period began on June 21, 2024, with a closing date of August 6, 2024.
August 7, 2024: A public hearing was held. The Board received six (6) timely comment letters addressing 35 separate issues, and 15 additional untimely letters/emails after the public comment deadline.
October 14, 2024: The Board reviewed all comments, timely and untimely, and directed staff to revise the regulation and issue a Notice of Modified Text.
October 15, 2024: Staff issued a Notice of Availability of Modified Text. Changes included:
- Definition of "assessment": Clarified that it involves analysis and judgment, not mere data collection.
- Subdivision (b) Revisions: Reorganized for clarity and moved non-basic tasks to a new subdivision (c).
- New Subdivision (c): Created to list tasks excluded from the definition of basic respiratory tasks.
- Non-substantive edits: Reformatted text and clarified language.
The 15-day public comment period ran through October 31, 2024, and the Board received 44 additional timely comments identifying 20 distinct issues.
March 13, 2025: The Board considered all public comments and adopted the proposed regulation text without further changes.
June 5, 2025: The Office of Administrative Law approved the regulation and filed it with the Secretary of State. The regulation becomes effective October 1, 2025.