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HB 49 and Board Consolidation

Below is a letter penned by Sue, Dave, and partly, myself to state representatives from Ohio regarding HB 49:

We are very disappointed that the House leadership has chosen to ignore the opponent testimony and calls from our professional association (Ohio Society for Respiratory Care) when crafting Sub. HB 49.

Sub. HB 49 abolishes the Ohio Respiratory Care Board (ORCB) and replaces it with an advisory council under the Ohio Medical Board.  We request that the ORCB budget be restored to full funding for both FY 2018 and 2019, and that it remain an independent board so that it can continue to provide meaningful regulation of respiratory care professionals (RCP’s) and protection of the public.

RCPs undergo extensive education and training in the assessment and treatment of respiratory and cardiac diseases. In fact, Registered Respiratory Therapists (RRTs)—those RCPs who have passed both a rigorous written and clinical simulation examination—have a well-defined scope of practice and have been identified by the Medical Board of the National Academy of Sciences as Type B Physician Assistants.  Type B Physician Assistants are expected to have more knowledge about their medical specialty than the average physician who is not board certified in that area. This has allowed RRTs to be considered the authorities in the operation of life-support equipment used in critical care areas, such as intensive care units and trauma centers.  The application of mechanical ventilation for critically ill patients in respiratory failure, such as babies with heart conditions, places an immense demand for continual training of RRTs. Furthermore, their critical thinking skills, coupled with an in-depth knowledge of the vast array of cardiopulmonary diseases, has allowed them to remain the go-to experts for assessing and recommending the appropriate therapies to non-physician providers, such as nurse practitioners.

As the number of licensed physicians continue to decline in the State of Ohio, protecting the quality of the profession that best compliments the growing demand for nurse practitioners and physician assistants in the assessment and treatment of cardiopulmonary disease is vital. Moreover, as return-to-hospital rates for Chronic Obstructive Pulmonary Disease (COPD), congestive heart failure (CHF), and pneumonia continue to cause heavy stress on the financial health of Ohio hospitals, protecting the quality of the profession that can best assist providers in the management of these diseases is crucial in protecting the health of the public and reducing healthcare costs.

If this bill passes, RCP’s may not have the appropriate level of representation on the Medical Board who will be regulating the profession. The current language only states the Medical Board will appoint respiratory care advisory council and “to make initial appointments” of “not more than 7 individuals knowledgeable in the area of respiratory care.  There is also no requirement for the council to actually meet and no mention of authority or responsibility to make re-appointments after the initial assignments – so it appears that the advisory council could disappear after the first 3 years of existence.

The language requiring meaningful qualifications for education, training, license or actual practice experience in pulmonary medicine or respiratory care for the proposed advisory council members has been removed.

The Medical Board is made up exclusively of physicians and consumer members who will be hearing RCP disciplinary cases and deciding their outcome.  The OSRC strongly feels that RCP licensees will be at a significant disadvantage when they appear before the board of doctors and public members who only have limited knowledge of the RCP’s scope of practice, education and procedures.

The OSRC is very concerned that merging the ORCB function under the Medical Board may reduce the efficiency of the ORCB staff in processing licenses, particularly without an Executive Director to specifically oversee and manage the ORCB operation. Current timeliness of ORCB response to requests and licensing is excellent.

The ORCB is fully funded by its licensee’s fees. Where is the value in this merger when current expenses are covered by the licensees who lose effectiveness professional regulation?  This is taxation without representation.

I want to thank Sue and Dave of the legislative committee for the work they’ve been putting into this endeavor to stop the language of HB49 that will place us under the Ohio State Medical Board. Please forward this important information to those within your individual networks, especially department directors who have influence over a large number of RCPs within the state. It’s important that we make as many people aware as possible, and ask them to contact their legislators. We fully expect to beat this; but if by chance this passes, at least we will be able to demonstrate to our state RCPs we did our best to stop it, and that their help with future issues is absolutely necessary.

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