Oregon Bulletin
Rule Caption: Exempt sleep labs from the definition of respiratory care if certain standards
and guidelines are met.
Adm. Order No.: HLA 13-2011(Temp)
Filed with Sec. of State: 11-22-2011
Certified to be Effective: 11-22-11 thru 5-10-12
Notice Publication Date:
Rules Adopted: 331-705-0072
Subject: in November 2010, the Respiratory Therapist
Licensing Board adopted temporary administrative rules regarding Sleep Lab
Exemption, to allow for certain respiratory care services (e.g. positive airway
pressure) to be performed by unlicensed individuals in sleep labs under a
medical doctor. The primary purpose for the temporary rule was to allow the
2011 Legislative Assembly time to consider licensing polysomnographers or sleep
technicians within the Respiratory Therapist Licensing Board. The 2011
Legislative Assembly passed SB 723 which created the Respiratory Therapist and
Polysomnographic Technologist Licensing Board. According to the bill, the
Oregon Health Licensing Agency can start licensing polysomnographic technicians
as of January 1, 2012. The bill also requires that all individuals practicing
polysomnography must be licenses by January 1, 2013. This temporary rule
continues to allow certain respiratory care services (e.g. positive airway
pressure) be performed by unlicensed individuals in sleep labs under a medical
doctor.
Rules Coordinator: Samantha Patnode—(503) 373-1917
331-705-0072
Sleep Lab
Exemption
This rule
is in effect through January 1, 2013, upon requirement for licensure for
polysomnographic technologists.
(1) The
following are exempt from the definition of Respiratory Care Services under ORS
688.800(7) when performed in a sleep lab environment:
(a)
Positive airway pressure titration on spontaneously breathing patients;
(b)
Supplemental low-flow oxygen therapy during polysomnogram (up to 6 liters per
minute);
(c)
Capnography during polysomnogram;
(d)
Cardiopulmonary resuscitation;
(e) Pulse
oximetry;
(f)
Electrocardiography;
(g)
Respiratory effort including thoriac and abdominal;
(h)
Plethysmography blood flow;
(i) Nasal
and oral airflow monitoring;
(j)
Monitoring the effects positive airway pressure, used to treat sleep-related
breathing disorders, has on sleep patterns, provided that the device does not
extend into the trachea;
(k)
Monitoring the effect on sleep patterns of an oral device that does not extend
into the trachea and that is used to treat sleep apnea;
(l)
Maintenance of nasal and oral airways that do not extend into the trachea;
(m) The use
of continuous positive airway pressure and bi-level modalities;
(n) Set-up
for use of durable medical equipment; and
(o) Long
term follow-up care.
(2) For the
purpose of this rule, “sleep lab” is:
(a) A
physical space, including any commercial space, used by a hospital for
conducting sleep testing and under the supervision of a medical director; or
(b) A
facility accredited by the American Academy of Sleep Medicine or the Joint
Commission for conducting sleep testing under the supervision of a medical
director.
(c) A
facility provisionally accredited by the AASM for conducting sleep testing
under the supervision of a medical director.
(3) For purpose of this rule, “medical
director” means the medical director of any inpatient or outpatient facility or
department who is a physician licensed by the State of Oregon and who has
special interest and knowledge in the diagnosis and treatment of sleep
disorders.
(4) For the
purpose of this rule, “sleep lab” does not include the home environment.
(5) The
exemption under this rule does not include partial or full ventilatory support
services involving tidal volume regulation or which require the setting of
respiratory back-up rates unless these services are for the treatment of
central and mixed sleep apnea.
(6) All
documentation and information regarding the provisional accreditation or
accreditation through the AASM must be made available to the agency if
requested.
(7) All
policies, procedures and protocols for unlicensed individuals related to
positive airway pressure treatment and titration including but not limited to
central and mixed sleep apnea must be made available to the agency if
requested.
Stat.
Auth.: ORS 676.606, 676.607, 676.611, 676.615, 688.830
Stats.
Implemented: ORS 688.800, 688.805
Hist.: HLA 13-2011(Temp),
f. & cert. ef. 11-22-11 thru 5-10-12
Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2011.
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