House Bill 71, the Respiratory Care Modernization Act, updates North Carolina’s Respiratory Care Practice Act to reflect current education, training, and practice standards in the profession. The bill creates and defines a new advanced respiratory care practitioner category, along with related concepts such as advanced respiratory care procedures, endorsements, supervising physician, and invasive diagnostic and therapeutic procedures. It also revises definitions and scope-of-practice language for respiratory care practitioners, including diagnostic testing, respiratory therapy services, and support activities.
The bill expands and clarifies the licensing framework for respiratory care practitioners and advanced respiratory care practitioners. It sets out application requirements, including criminal background checks, educational credentials, basic life support certification, and examination requirements, and it authorizes the Respiratory Care Board to establish rules for endorsements and advanced practice requirements. The bill also updates board composition, board powers, fee authority, confidentiality rules for investigative records, and penalties for unauthorized use of respiratory care titles and credentials. It directs the Board to adopt implementing rules by October 1, 2025, and makes the substantive changes effective on that date.
The bill’s impact is to modernize Chapter 90, Article 38 of the General Statutes governing respiratory care, while preserving physician oversight for advanced practice. It affects respiratory care practitioners, advanced respiratory care practitioners, physicians who supervise them, hospitals, and other health care settings where respiratory therapy services are provided. It also gives the North Carolina Respiratory Care Board broader authority to regulate licensure, endorsements, discipline, confidentiality, and fees, and it updates statutory references to current accrediting and testing bodies.
The general sentiment around the bill appears strongly favorable. The bill passed second reading in the House by a wide margin, 113-4, suggesting broad bipartisan support for updating the profession’s regulatory framework. The findings in the bill emphasize the COVID-19 pandemic and the need to align the law with modern respiratory care practice, which likely contributed to the positive reception.
The main points of contention, based on the bill text, are likely to center on the creation of an advanced practice category and the scope of authority delegated to the Board and supervising physicians. The bill limits advanced respiratory care practitioners from independently performing diagnosis, prescribing, interpreting imaging, or carrying out certain invasive procedures without physician supervision, which may reflect concerns about patient safety and professional boundaries. Another possible issue is the expanded regulatory burden, including background checks, endorsement requirements, and confidentiality provisions for Board investigations, though no specific opposition was recorded in the provided materials.
The bill amends Article 38 of Chapter 90 of the North Carolina General Statutes, which governs respiratory care practice. It adds new statutory definitions and licensing categories, revises scope-of-practice provisions, updates Board membership and authority, and strengthens rules for licensure, endorsements, discipline, confidentiality, and title protection. It also requires the Respiratory Care Board to adopt implementing rules by October 1, 2025, with the substantive statutory changes taking effect on that date.
The available voting history indicates strong support for the bill, with a 113-4 second-reading vote in the House. The bill’s stated purpose—to modernize respiratory care law in light of current practice and post-pandemic demands—suggests a broadly favorable reception among lawmakers, and no committee transcript material was provided showing organized opposition or significant amendment debate.
The most likely areas of disagreement are the bill’s creation of an advanced respiratory care practitioner role and the extent to which those practitioners may perform advanced procedures under physician supervision. Some stakeholders may also scrutinize the Board’s expanded authority over licensure, endorsements, criminal background checks, and confidential investigations, as well as the limits the bill places on independent practice, diagnosis, prescribing, and invasive procedures. The bill text suggests an effort to balance modernization and workforce flexibility with physician oversight and patient safety.