Compare versions

--- version:Introduced
+++ version:(document, no version)
@@ -1,1138 +1,15 @@
-HB299 INTRODUCED
-Page 0
-HB299
-XDIF5EE-1
-By Representative Oliver
-RFD: Health
-First Read: 21-Jan-26
-1
-2
-3
-4
-5
-XDIF5EE-1 10/10/2025 ZAK (L)ma 2025-2995
+FN-V7EU4LV-1
 Page 1
-First Read: 21-Jan-26
-SYNOPSIS:
-Under existing law, the Alabama State Board of
-Respiratory Therapy regulates the practice of
-respiratory therapy in this state.
-This bill would authorize respiratory therapists
-to practice under the direction of an advanced practice
-healthcare provider in addition to a physician.
-This bill would revise the requirements that
-must be satisfied by an individual to be licensed by
-the board.
-This bill would add a member to the board.
-This bill would further provide for the issuance
-and privileges of temporary licenses.
-This bill would also provide criminal penalties
-for fraudulently obtaining a license or holding one's
-self out as a licensed respiratory therapist without a
-license.
-A BILL
-TO BE ENTITLED
-AN ACT
-Relating to the Alabama State Board of Respiratory
-1
-2
-3
-4
-5
-6
-7
-8
-9
-10
-11
-12
-13
-14
-15
-16
-17
-18
-19
-20
-21
-22
-23
-24
-25
-26
-27
-28
-HB299 INTRODUCED
-Page 2
-Relating to the Alabama State Board of Respiratory
-Therapy; to amend Sections 34-27B-2, 34-27B-3, 34-27B-4,
-34-27B-5 , 34-27B-7, 34-27B-8, 34-27B-9, and 34-27B-11, Code of
-Alabama 1975, to authorize respiratory therapists to practice
-under certain advanced practice health care providers; to
-further provide for and revise requirements for licensure; to
-further provide for the duties and composition of the board;
-to further provide for temporary licenses; to add Section
-34-27B-8.1 to the Code of Alabama 1975, to  provide criminal
-penalties for certain actions;  and to repeal Section
-34-27B-12, Code of Alabama 1975,  requiring the board to
-provide notice of regulations to respiratory therapists
-practicing on May 17, 2004 .
-BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
-Section 1.  Sections 34-27B-2, 34-27B-3, 34-27B-4,
-34-27B-5, 34-27B-7, 34-27B-8, 34-27B-9, and 34-27B-11, Code of
-Alabama 1975, are amended to read as follows:
-"§34-27B-2
-As used in this chapter, the following terms  shall  have
-the following meanings:
-(1) BOARD. The Alabama State Board of Respiratory
-Therapy.
-(2) DIRECT CLINICAL SUPERVISION. A situation where a
-licensed respiratory therapist or physician is available for
-the purpose of communication, consultation, and assistance.
-(3) HEALTHCARE  HEALTH CARE  FACILITY. The  definition
-shall be the  same  meaning  as in Section 22-21-260.
-(4) LICENSED ADVANCED PRACTICE PROVIDER. A health care
-professional who undergoes specialized education, training,
-29
-30
-31
-32
-33
-34
-35
-36
-37
-38
-39
-40
-41
-42
-43
-44
-45
-46
-47
-48
-49
-50
-51
-52
-53
-54
-55
-56
-HB299 INTRODUCED
-Page 3
-professional who undergoes specialized education, training,
-and certification to provide services such as medical
-diagnosis and treatment. The term includes a physician
-assistant, certified registered nurse practitioner, or
-certified registered nurse anesthetist with prescribing
-authority.
-(4)(5) MEDICALLY APPROVED PROTOCOL. A detailed plan for
-taking specific diagnostic or treatment actions, or both,
-authorized by the treating physician of the patient,  all of
-which actions shall be  which is :
-a. In a hospital or other inpatient health care
-facility, approved by the supervising physician of the
-respiratory therapist or in an outpatient treatment setting
-approved by the supervising physician of the respiratory
-therapist .;
-b. Except in cases of medical emergency, instituted
-following an evaluation of the patient by a physician or
-otherwise directed by the supervising physician of the
-respiratory therapist .; and
-c. Consistent with the definition of the scope of
-practice of respiratory therapy, as established by this
-chapter.
-(5)(6) PHYSICIAN.  A person  An individual  who is a
-doctor of medicine or a doctor of osteopathy licensed to
-practice in this state.
-(6)(7) RESPIRATORY THERAPIST.  A person  An individual
-licensed by the board to administer respiratory therapy and
-who has the knowledge and skills necessary to administer
-respiratory therapy, monitor patient responses, modify
-57
-58
-59
-60
-61
-62
-63
-64
-65
-66
-67
-68
-69
-70
-71
-72
-73
-74
-75
-76
-77
-78
-79
-80
-81
-82
-83
-84
-HB299 INTRODUCED
-Page 4
-respiratory therapy, monitor patient responses, modify
-respiratory therapy based upon patient response, provide
-information and education to patients about deficiencies or
-disorders of the cardiopulmonary system, and supervise others
-in the delivery of appropriate respiratory therapy procedures.
-(7)(8) RESPIRATORY THERAPY OR CARE. Therapy,
-management, rehabilitation, diagnostic evaluation, and care of
-patients with deficiencies and abnormalities of the
-cardiopulmonary system and associated aspects of other
-systems' functions, given by a  health care professional
-respiratory therapist  under the direction of a physician  or
-licensed advanced practice provider . The term includes , but is
-not limited to,  the following activities conducted upon
-written prescription, verbal order, or medically approved
-protocol:
-a. Direct and indirect pulmonary care services that are
-safe, aseptic, preventive, or restorative to the patient.
-b. Direct and indirect respiratory therapy services,
-including , but not limited to,  the administration of
-pharmacologic, diagnostic, and therapeutic agents related to
-respiratory therapy procedures necessary to implement a
-treatment, disease prevention, pulmonary rehabilitative, or
-diagnostic regimen prescribed by a physician  or a licensed
-advanced practice provider .
-c. Observation and monitoring of signs and symptoms,
-general behavior, and general physical response to respiratory
-therapy treatment and diagnostic testing and determination of
-whether  such  these  signs, symptoms, reactions, behavior, or
-general responses exhibit abnormal characteristics , and
-85
-86
-87
-88
-89
-90
-91
-92
-93
-94
-95
-96
-97
-98
-99
-100
-101
-102
-103
-104
-105
-106
-107
-108
-109
-110
-111
-112
-HB299 INTRODUCED
-Page 5
-general responses exhibit abnormal characteristics , and
-implementation, based on observed abnormalities, of
-appropriate reporting or referral practices or prescribed and
-medically approved respiratory therapy protocols or
-appropriate changes in a treatment regimen, pursuant to a
-prescription by a physician  or a licensed advanced practice
-provider , or the initiation of emergency procedures.
-d. The diagnostic and therapeutic use of any of the
-following, in accordance with the prescription of a physician
-or a licensed advanced practice provider :
-1. Administration of medical gases,  exclusive of  not
-including  general anesthesia.
-2. Aerosols.
-3. Humidification.
-4. Environmental control systems and hyperbaric
-therapy.
-5. Pharmacologic agents related to respiratory therapy
-procedures.
-6. Mechanical or physiological ventilatory support.
-7. Bronchopulmonary hygiene.
-8. Cardiopulmonary resuscitation.
-9. Maintenance of the natural airways.
-10. Insertion without cutting tissues and maintenance
-of artificial airways.
-11. Diagnostic and testing techniques required for
-implementation of respiratory therapy protocols.
-12. Collections of specimens of blood and other body
-fluids including specimens from the respiratory tract.
-13. Collection of inspired and expired gas samples.
-113
-114
-115
-116
-117
-118
-119
-120
-121
-122
-123
-124
-125
-126
-127
-128
-129
-130
-131
-132
-133
-134
-135
-136
-137
-138
-139
-140
-HB299 INTRODUCED
-Page 6
-13. Collection of inspired and expired gas samples.
-14. Analysis of blood, gases, and respiratory
-secretions.
-15. Measurements of ventilatory volumes, pressures, and
-flows.
-16. Pulmonary function testing.
-17. Hemodynamic and other related physiologic
-measurements of the cardiopulmonary system.
-18. Respiratory telecommunications.
-19. Cardiopulmonary disease management.
-20. Tobacco cessation.
-e. The transcription and implementation of the written
-and verbal orders of a physician  or licensed advanced practice
-provider  pertaining to the practice of respiratory therapy.
-f. Institution of known and medically approved
-protocols relating to respiratory therapy in emergency
-situations in the absence of immediate direction by a
-physician  or licensed advanced practice provider  and
-institution of specific procedures and diagnostic testing
-related to respiratory therapy as ordered by a physician  to
-assist in diagnosis, monitoring, treatment, and medical
-research.
-g. Delivery of respiratory therapy procedures,
-instruction, and education of patients in the proper methods
-of self-care and prevention of cardiopulmonary diseases and
-other conditions requiring the use of respiratory therapy
-equipment or techniques."
-"§34-27B-3
-(a) Except as provided in Section 34-27B-7, no  person
-141
-142
-143
-144
-145
-146
-147
-148
-149
-150
-151
-152
-153
-154
-155
-156
-157
-158
-159
-160
-161
-162
-163
-164
-165
-166
-167
-168
-HB299 INTRODUCED
-Page 7
-(a) Except as provided in Section 34-27B-7, no  person
-individual  shall hold himself or herself out to be, or
-function as, a respiratory therapist in this state unless
-licensed in accordance with this chapter.
-(b) In order to obtain a respiratory therapist license,
-an applicant shall demonstrate to the board that he or she :
-(i) is a citizen of the United States or, if not a citizen of
-the United States,  a person  an individual  who is legally
-present in the United States with appropriate documentation
-from the federal government ,; (ii) is  at least 18 years of
-age,; (iii)  is a high school graduate , or has the equivalent
-of a high school diploma ,; (iv) demonstrates good moral
-character;  and  (v)  meets one of the following requirements:
-(1) Holds and maintains credentials as a registered
-respiratory therapist (RRT) or a certified respiratory
-therapist (CRT), as granted by the National Board for
-Respiratory Care or its successor organization.
-(2) Holds a temporary license issued under  subsection
-(d) of  Section 34-27B-7 and passes the examination leading to
-the CRT or RRT credential.
-(3) Has a valid respiratory therapist license from
-another state, the District of Columbia, or a territory of the
-United States , whose requirements for licensure are considered
-by the board as substantially similar to those of  Alabama  this
-state  and who otherwise meets the reciprocity requirements
-established by the board.
-(4) Meets the requirements of subdivision (2) of
-subsection (d) of Section 34-27B-7.
-(5)(4) Has been approved by the board as otherwise
-169
-170
-171
-172
-173
-174
-175
-176
-177
-178
-179
-180
-181
-182
-183
-184
-185
-186
-187
-188
-189
-190
-191
-192
-193
-194
-195
-196
-HB299 INTRODUCED
-Page 8
-(5)(4) Has been approved by the board as otherwise
-qualified by special training and has passed the licensure
-examination established by the board in subsection (c).
-(c) The board shall arrange for the administration of a
-licensure examination administered by the state or a national
-agency approved by the board. The examination shall be
-validated and nationally recognized as testing respiratory
-care competencies. The board may enter into agreements or
-contracts, consistent with state law, with outside
-organizations for the purpose of developing, administering,
-grading, and reporting the results of licensure examinations.
-Such  These  organizations shall be capable of meeting the
-standards of the National Commission for Health Certifying
-Agencies, or its equivalent or successor organization. The
-board shall establish criteria for satisfactory performance on
-the examination.
-(d) The board may request a criminal history background
-check of an applicant for the purpose of determining an
-applicant's suitability for a license to practice respiratory
-therapy. If requested by the board, the applicant shall submit
-a full set of fingerprints to the board for the purpose of
-obtaining a state and national criminal history background
-check.
-(2) Fingerprints obtained pursuant to subdivision (1)
-may be exchanged by the board, the Alabama State Law
-Enforcement Agency, or any successor entity thereof, or any
-channeler approved by the board, with the Federal Bureau of
-Investigation for the purpose of obtaining a state and
-national criminal history background check.
-197
-198
-199
-200
-201
-202
-203
-204
-205
-206
-207
-208
-209
-210
-211
-212
-213
-214
-215
-216
-217
-218
-219
-220
-221
-222
-223
-224
-HB299 INTRODUCED
-Page 9
-national criminal history background check.
-(3) The applicant shall be responsible for all costs
-associated with the submission of his or her fingerprints and
-obtaining a state and national criminal history background
-check. The board may incorporate those costs into the cost of
-licensing or may charge the applicant a separate fee, which
-may be payable to the board, the Alabama State Law Enforcement
-Agency, or any successor entity thereof, or the approved
-channeler, as appropriate.
-(4) Information received by the board pursuant to a
-state and national criminal history background check shall be
-confidential and shall not be a public record, except that any
-information received by and relied upon by the board in
-denying the issuance of a license may be disclosed as
-necessary to support the denial. "
-"§34-27B-4
-(a) The board shall perform  all of  the following
-functions:
-(1) Set respiratory therapy licensure fees, including ,
-but not limited to,  application, initial, renewal,  and
-reinstatement fees.
-(2) Establish and publish minimum standards of
-continuing education of respiratory therapy in accordance with
-those standards developed and accepted by the profession.
-(3) Examine for, approve, deny, revoke, suspend, and
-renew licensure of duly qualified applicants.
-(4) Promulgate  Adopt  and publish rules in accordance
-with the Administrative Procedure Act to administer this
-chapter.
-225
-226
-227
-228
-229
-230
-231
-232
-233
-234
-235
-236
-237
-238
-239
-240
-241
-242
-243
-244
-245
-246
-247
-248
-249
-250
-251
-252
-HB299 INTRODUCED
-Page 10
-chapter.
-(5) Conduct hearings on charges calling for the denial,
-suspension, revocation, or refusal to renew a license.
-(6) Maintain an up-to-date list of every  person
-individual  licensed to practice respiratory therapy pursuant
-to this chapter. The list shall include the last known place
-of residence and the state license number of the licensee.
-(7) Maintain an up-to-date list of  persons  individuals
-whose licenses have been suspended, revoked, or denied. The
-list shall include the name, Social Security number, type,
-date, and cause of action, penalty incurred, and the length of
-the penalty. The information on the list, except for Social
-Security numbers, shall be available for public inspection
-during reasonable business hours and the information may be
-shared with others as deemed necessary and acceptable by the
-board.
-(b) The board, by rule, shall prorate fees as
-appropriate and shall provide applicants and licensees with
-verification of receipt of fees. "
-"§34-27B-5
-(a)(1) The Alabama State Board of Respiratory Therapy
-is created to implement and administer this chapter and shall
-be composed of  six  seven  members appointed by the Governor.
-Three  Four  of the members shall be respiratory therapists, one
-member shall be the chief executive officer of a hospital, one
-member shall be a physician, and one member shall be a
-consumer.
-(2) The respiratory therapist members of the board
-appointed by the Governor shall be selected from a list of
-253
-254
-255
-256
-257
-258
-259
-260
-261
-262
-263
-264
-265
-266
-267
-268
-269
-270
-271
-272
-273
-274
-275
-276
-277
-278
-279
-280
-HB299 INTRODUCED
-Page 11
-appointed by the Governor shall be selected from a list of
-names submitted by the Alabama Society for Respiratory Care.
-The list shall include two names for each appointed position
-to be filled. The respiratory therapist members appointed to
-the board shall be registered or certified by the National
-Board for Respiratory Care or its successor organization .
-Respiratory therapists appointed to the initial board must be
-eligible to obtain a license under this chapter. Respiratory
-therapists selected for subsequent appointments must  and  be
-licensed by the  state  board .
-(3) The hospital member shall be selected from a list
-of two names submitted by the Alabama Hospital Association.
-(4) The physician member appointed shall be duly
-licensed to practice medicine in Alabama and shall be a member
-of at least one of the following: The American Thoracic
-Society, the American College of Chest Physicians, the
-American Society of Anesthesiologists, or the American Academy
-of Pediatrics. The physician member of the board appointed by
-the Governor shall be selected from a list of two names
-submitted by the Medical Association of the State of Alabama.
-(5) The consumer member appointed by the Governor shall
-be selected from one of the names submitted by the American
-Lung Association in Alabama, the Alabama Chapter of the Cystic
-Fibrosis Foundation, and the Alabama Asthma Coalition. Each
-entity shall submit one name for consideration.
-(b) All board members shall be residents of Alabama and
-all appointing authorities shall coordinate their appointments
-so that diversity of gender, race, and geographical areas is
-reflective of the makeup  to assure the board's membership is
-281
-282
-283
-284
-285
-286
-287
-288
-289
-290
-291
-292
-293
-294
-295
-296
-297
-298
-299
-300
-301
-302
-303
-304
-305
-306
-307
-308
-HB299 INTRODUCED
-Page 12
-reflective of the makeup  to assure the board's membership is
-inclusive and reflects the racial, gender, geographic, urban,
-rural, and economic diversity  of this state.
-(c) The Governor shall make the appointments for all
-positions for members of the board within 90 days of the date
-the position becomes available, including initial
-appointments, vacancies, and replacements at the end of the
-term of service.  All members shall continue to serve until a
-successor is appointed.
-(d) Members of the board shall have the same immunities
-from personal liability as state employees for actions taken
-in the performance of their official duties.
-(e) The term of office of those members first appointed
-shall be as follows: Two respiratory therapists and the
-hospital member, as determined by the Governor, shall serve
-for terms of two years, and one respiratory therapist and the
-physician member shall serve for terms of four years.  The
-additional respiratory therapist member appointed after
-October 1, 2026, shall serve an initial term of not more than
-four years as determined by the Governor.  Thereafter, the term
-of all members, including the consumer member, shall be for
-four years. No member shall be appointed for more than three
-consecutive full terms. A vacancy in an unexpired term shall
-be filled in the manner of the original appointment. The board
-shall elect a chair and vice chair annually.
-(f) The board shall meet at least twice each year at a
-time and place determined by the chair. A majority of the
-members of the board shall constitute a quorum for the
-309
-310
-311
-312
-313
-314
-315
-316
-317
-318
-319
-320
-321
-322
-323
-324
-325
-326
-327
-328
-329
-330
-331
-332
-333
-334
-335
-HB299 INTRODUCED
-Page 13
-members of the board shall constitute a quorum for the
-transaction of business.
-(g) Each member shall serve without compensation, but
-shall be reimbursed for travel expenses incurred in attendance
-at meetings of the board and any other expenses incurred on
-business of the board at its discretion. Board members shall
-also receive a per diem allowance following the guidelines for
-state employees. The reimbursement for expenses and per diem
-shall be paid from funds derived from the Alabama State Board
-of Respiratory Therapy Fund."
-"§34-27B-7
-(a) The board shall issue a respiratory therapist
-license to any  person  individual  who meets the qualifications
-required by this chapter and who pays the license fee
-established herein .
-(b) Any  person  individual  who is issued a regular or
-temporary respiratory therapy license  as a respiratory
-therapist  under this chapter may use the words "licensed
-respiratory therapist" or the letters "L .R.T." in connection
-with his or her name to denote his or her license.
-(c) A license issued under this chapter shall be
-subject to  biennial  renewal  every two years .
-(d)(1) The board may issue a six-month temporary
-license as a respiratory therapist to  persons  individuals  who
-have graduated from a respiratory therapy educational program
-accredited by the Council on Allied Health Education Programs
-(CAHEP) in collaboration with the Committee on Accreditation
-for Respiratory Care (CoARC), or their successor
-organizations, and who have applied for and are awaiting
-336
-337
-338
-339
-340
-341
-342
-343
-344
-345
-346
-347
-348
-349
-350
-351
-352
-353
-354
-355
-356
-357
-358
-359
-360
-361
-362
-363
-HB299 INTRODUCED
-Page 14
-organizations, and who have applied for and are awaiting
-competency examination.  The temporary license shall be
-renewable only once for an additional six-month period if the
-applicant fails the examination. Exceptions may be made at the
-discretion of the board based upon an appeal identifying
-extenuating circumstances.  The holder of a temporary license
-may only provide respiratory therapy or care activities,
-services, and procedures as defined in Section 34-27B-2 under
-the direct clinical supervision of a licensed onsite
-respiratory therapist  or physician .
-(2) The board shall grant a license as a respiratory
-therapist to other persons who do not meet the qualifications
-for licensure pursuant to Section 34-27B-3, but who, on the
-effective date of the adoption of the rules and regulations of
-the board, are currently employed in the administration of
-respiratory therapy under the direction of a physician in the
-State of Alabama. The opportunity to apply for a respiratory
-therapy license issued under this subdivision shall expire 365
-days after implementation of the rules of the board. Holders
-of these licenses shall be eligible to renew their licenses as
-are any other licensed respiratory therapists under this
-chapter. "
-"§34-27B-8
-(a) The board may refuse to renew a license, may
-suspend or revoke a license, may impose probationary
-conditions, or may impose an administrative fine not to exceed
-five hundred dollars ($500) per violation, as disciplinary
-actions if a licensee or applicant for licensure has been
-found guilty of unprofessional conduct that has endangered, or
-364
-365
-366
-367
-368
-369
-370
-371
-372
-373
-374
-375
-376
-377
-378
-379
-380
-381
-382
-383
-384
-385
-386
-387
-388
-389
-390
-391
-HB299 INTRODUCED
-Page 15
-found guilty of unprofessional conduct that has endangered, or
-is likely to endanger, the health, welfare, or safety of the
-public. Unprofessional conduct includes , but is not limited
-to, each of  the following:
-(1) Obtaining a license by means of fraud,
-misrepresentation, or concealment of material facts.
-(2) Being found guilty of unprofessional conduct as
-defined by the rules established by the board, or violating
-the code of ethics adopted and published by the American
-Association for Respiratory Care or its successor
-organization.
-(3) Conviction of a crime, other than a minor offense,
-in any court if the offense has a direct bearing on whether
-the person should be entrusted to serve the public in the
-capacity of a respiratory therapist.
-(b) The board, after a hearing, may exercise the
-disciplinary actions authorized in subsection (a). The board
-shall adopt policies for the conduct of the hearings. One year
-after the date of the revocation of a license, application may
-be made to the board for reinstatement. The board shall hold a
-hearing to consider any application for reinstatement.
-(c) The board may  establish  adopt  rules regarding the
-disciplinary actions authorized in subsection (a) in
-accordance with the Administrative Procedure Act.
-(d) A suspended license is subject to expiration during
-the suspension period.
-(e) The board may subpoena any person or document and
-take testimony to carry out this chapter.
-(f) The board shall promote the early identification,
-392
-393
-394
-395
-396
-397
-398
-399
-400
-401
-402
-403
-404
-405
-406
-407
-408
-409
-410
-411
-412
-413
-414
-415
-416
-417
-418
-419
-HB299 INTRODUCED
-Page 16
-(f) The board shall promote the early identification,
-intervention, treatment, and rehabilitation of respiratory
-therapy licensees who may be impaired by reason of illness,
-inebriation, excessive use of drugs, narcotics, alcohol,
-chemicals, or other substances, or as a result of any physical
-or mental condition. If the board has reasonable cause to
-believe that a respiratory therapy licensee is impaired, the
-board may refer that licensee to a treatment program. "
-"§34-27B-9
-(a) A person  An individual  who does not hold a license
-or a temporary license as a respiratory therapist or whose
-license or temporary license has been suspended or revoked may
-not do any of the following:
-(1) Use in connection with the  person's  individual's
-practice the words "respiratory care professional,"
-"respiratory therapist," "respiratory care practitioner,"
-"certified respiratory care practitioner," "licensed
-respiratory therapist," "inhalation therapist," or
-"respiratory therapy technician"; or use the letters "R.C.P."
-or "L.R.T."; or use any other words, letters, abbreviations,
-or insignia indicating or implying that the  person  individual
-is a respiratory therapist.
-(2) Directly or by implication represent in any way
-that the  person  individual  is a respiratory therapist.
-(b) A person who holds a license or a temporary license
-to practice respiratory therapy under this chapter may use the
-title "respiratory therapist" and the abbreviation "L.R.T."
-"§34-27B-11
-Nothing in this chapter shall be construed as
-420
-421
-422
-423
-424
-425
-426
-427
-428
-429
-430
-431
-432
-433
-434
-435
-436
-437
-438
-439
-440
-441
-442
-443
-444
-445
-446
-447
-HB299 INTRODUCED
-Page 17
-Nothing in this chapter shall be construed as
-preventing or restricting the practice, services, or
-activities of any of the following:
-(1) Any  person  individual  who is licensed in  Alabama
-this state  or certified by an organization accredited by the
-National Commission for Certifying Agencies and acceptable to
-the state from engaging in the profession or occupation for
-which the  person  individual  is licensed or certified.
-(2) Any  person  individual  employed by the United States
-government who provides respiratory therapy solely under the
-direction or control of the United States government agency or
-organization.
-(3) Any  person  individual  receiving clinical training
-while pursuing a course of study leading to registry or
-certification in a respiratory therapy educational program
-accredited by the Council on Allied Health Education Programs
-in collaboration with the Committee on Accreditation for
-Respiratory Care or their successor organizations. This  person
- will  individual shall  be under direct supervision and be
-designated by a title clearly indicating his or her status as
-a student or trainee.
-(4) Any emergency medical technician licensed by the
-Alabama  State Board  Department  of  Public  Health who is
-providing care to a patient at the scene of an emergency, or
-during transport of the patient in a licensed ground
-ambulance, provided that such care may not exceed the scope of
-care permissible under the rules of the Alabama  State Board
-Department  of  Public  Health.
-(5) The delivery of respiratory therapy of sick or
-448
-449
-450
-451
-452
-453
-454
-455
-456
-457
-458
-459
-460
-461
-462
-463
-464
-465
-466
-467
-468
-469
-470
-471
-472
-473
-474
-475
-HB299 INTRODUCED
-Page 18
-(5) The delivery of respiratory therapy of sick or
-disabled  persons  individuals  by family members or domestic
-servants or the care of  non-institutionalized persons
-noninstitutionalized individuals  by a surrogate family member
-as long as the  persons  individuals  do not represent themselves
-as, or hold themselves out to be, respiratory therapists.
-(6) Any individual who has demonstrated competency in
-one or more areas covered by this chapter as long as the
-individual performs only those functions that he or she is
-qualified by examination to perform. The standards of the
-National Commission for Certifying Agencies, or its
-equivalent, shall serve as a standard with which to evaluate
-those examinations and examining organizations.
-(7) Any  person  individual  performing respiratory
-services or care not licensed as a respiratory therapist in
-accordance with this chapter who is employed in a diagnostic
-laboratory, physician's office, clinic, or outpatient
-treatment facility and whose function is to administer
-treatment or perform diagnostic procedures confined to that
-laboratory, office, clinic, or outpatient facility under the
-direction of a licensed physician.
-(8) Any respiratory therapy student who performs
-limited respiratory therapy procedures as an employee of  any  a
-health care provider organization while enrolled in a
-respiratory therapy educational program accredited by the
-Council on Allied Health Education Programs in collaboration
-with the Committee on Accreditation for Respiratory Care or
-their successor organizations , provided any procedure
-performed by a respiratory therapy student is a procedure that
-476
-477
-478
-479
-480
-481
-482
-483
-484
-485
-486
-487
-488
-489
-490
-491
-492
-493
-494
-495
-496
-497
-498
-499
-500
-501
-502
-503
-HB299 INTRODUCED
-Page 19
-performed by a respiratory therapy student is a procedure that
-the student has previously studied and completed in clinical
-training . The employee shall be designated by title as a
-student or trainee and shall work under direct supervision  of
-a licensed respiratory therapist. The board shall maintain a
-list of all such students .
-(9) Any individual employed by a durable medical
-equipment or home medical equipment company who delivers, sets
-up, or maintains respiratory equipment, but not including
-assessment , treatment,  or evaluation of the patient.
-(10) Any individual employed as a polysommagraphic
-technologist working in a sleep center or diagnostic sleep
-clinic.
-(11) Any licensed respiratory therapist performing
-advances in the art and techniques of respiratory therapy
-learned through special training acceptable to the board."
-Section 2.  Section 34-27B-8.1 is added to the Code of
-Alabama 1975, to read as follows:
-An individual shall be guilty of a Class B misdemeanor
-if he or she does any of the following:
-(1) Sells or fraudulently obtains or furnishes, or aids
-or abets in selling or fraudulently obtaining, any license
-issued pursuant to this chapter.
-(2) Practices respiratory therapy, uses the title
-respiratory therapist, or uses in connection with his or her
-name any designation tending to imply that he or she is a
-respiratory therapist without a valid and active license
-issued pursuant to this chapter.
-Section 3.  Section 34-27B-12, Code of Alabama 1975,
-504
-505
-506
-507
-508
-509
-510
-511
-512
-513
-514
-515
-516
-517
-518
-519
-520
-521
-522
-523
-524
-525
-526
-527
-528
-529
-530
-531
-HB299 INTRODUCED
-Page 20
-Section 3.  Section 34-27B-12, Code of Alabama 1975,
-requiring the Alabama State Board of Respiratory Therapy to
-provide notice of regulations to respiratory therapists
-practicing on May 17, 2004 , is repealed.
-Section 4.  This act shall become effective on October
-1, 2026.
-532
-533
-534
-535
-536
-537
+FISCAL NOTE
+House Bill 299
+Committee: Health Sponsor: Representative Ed Oliver
+Analyst: Tiffany Weaver Date: 03/09/2026
+House Bill 299 as introduced would increase the obligations of the Alabama State Board of
+Respiratory Therapy by an estimated $1,080 annually for per diem and travel expenses of the
+one additional member added to the board by this bill.
+This bill could also decrease receipts of the board by a board-estimated maximum of $500
+annually by no longer allowing a temporary respiratory therapist license to be renewed.
+Finally, this bill could also increase the administrative obligations of the board for any criminal
+history background checks requested by the board for license applicants, the cost of which
+would borne by the applicant, per the provisions of this bill, through either a separate fee to the
+applicant or incorporating the cost into the license cost.