The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
  (1) AARC--The American Association for Respiratory Care.
  (2) Act--The Respiratory Care Practitioners Act, Texas Occupations Code Annotated, Title 3, Subtitle K, Chapter 604 as amended.
  (3) Active duty--A person who is currently serving as full-time military service member in the armed forces of the United States or active duty military service as a member of the Texas military forces, as defined by §437.001, Government Code, or similar military service of another state.
  (4) Address of record--The mailing address of each certificate holder or applicant as provided to the agency pursuant to the Act.
  (5) Advisory Board or Board--The Texas Board of Respiratory Care, an advisory board to the Texas Medical Board.
  (6) APA--The Administrative Procedure Act, Texas Government Code, Chapter 2001 as amended.
  (7) Applicant--A party seeking a certificate or temporary permit from the Texas Board of Respiratory Care.
  (8) Certificate--A respiratory care practitioner certificate issued by the Texas Board of Respiratory Care.
  (9) Delegated Authority--As defined in the Texas Medical Practice Act, Texas Occupations Code, Chapter 157 and the rules pertaining thereto adopted by the Texas Medical Board.
  (10) Directing physician--A physician licensed by the Medical Board who has an active and unrestricted license in good standing with the Texas Medical Board that directs a Texas state-certified respiratory care practitioner in the practice of respiratory care.
  (11) Diagnostic--Of or relating to or used in the art or act of identifying a disease or disorder.
  (12) Educational accrediting body--Commission on Accreditation for Respiratory Care (CoARC), or other such organization approved by the advisory board in accordance with §604.054 of the Occupations Code.
  (13) Executive Director--The Executive Director of the Texas Medical Board or the authorized designee of the Executive Director.
  (14) Formally trained--Completion of an organized educational activity which:
    (A) includes supervised and directed instruction specific to the respiratory care procedures to be performed by the individual;
    (B) includes specific objectives, activities, and an evaluation of competency; and
    (C) is supervised and directed by another individual qualified to provide the training and supervision.
  (15) Good professional character--An applicant for certification must not be in violation of or committed any act described in the Respiratory Care Practitioners Act, §§604.302 - 604.304, Texas Occupations Code Annotated.
  (16) Medical Board--The Texas Medical Board.
  (17) Medical Practice Act--Texas Occupations Code Annotated, Title 3, Subtitle B, as amended.
  (18) Military service member--A person who is currently serving in the armed forces of the United States, in a reserve component of the armed forces of the United States, including the National Guard, or in the state military service of any state.
  (19) Military spouse--A person who is married to a military service member who is currently on active duty.
  (20) Military veteran--A person who served on active duty in the army, navy, air force, marine corps, or coast guard of the United States, or in an auxiliary service of one of those branches of the armed forces and who was discharged or released from active duty under conditions other than dishonorable.
  (21) NBRC--The National Board for Respiratory Care, Inc.
  (22) Open Meetings Act--Texas Government Code Annotated, Chapter 551 as amended.
  (23) Palliative--Serving to moderate the intensity of pain or other disease process.
  (24) Party--The respiratory care practitioner board and each person named or admitted as a party in a hearing before the State Office of Administrative Hearings.
  (25) Practice--Engaging in respiratory care as a clinician, educator, or consultant.
  (26) Presiding Officer--The person appointed by the Governor to serve as the presiding officer of the board.
  (27) Protocols--For purposes of this chapter, respiratory care-related policies, procedures, and protocols developed or approved by a licensed health facility or a physician through collaboration with administrators, certified respiratory care practitioners, or other health professionals.
  (28) Qualified medical director--A physician licensed and in good standing with the Texas Medical Board, and who has special interest and knowledge in the diagnosis and treatment of respiratory care problems and who is actively engaged in the practice of medicine. This physician must be a member of the active medical staff of a health care facility, agency or organization who supervises the provision of respiratory care.
  (29) Respiratory care--The treatment, management, control, diagnostic evaluation, and care of inpatients or outpatients who have deficiencies and abnormalities associated with the cardiorespiratory system, in conjunction with the provisions of §604.003 of the Act. Respiratory care does not include the delivery, assembly, set up, testing, and demonstration of respiratory care equipment upon the order of a licensed physician. Demonstration is not to be interpreted here as the actual patient assessment and education, administration, or performance of the respiratory care procedure(s).
  (30) Respiratory care education program--
    (A) a program in respiratory care approved by the educational accrediting body;
    (B) a program approved by an appropriate education agency and working toward becoming an approved program in respiratory care. A program will qualify as a respiratory care education program under this subparagraph only for a period of one year from the date of the first class offered by the program; after that one year, the program must be an approved program in respiratory care; or
    (C) a program accredited by the Canadian Medical Association and whose graduates are eligible to take the national registry exam given by the Canadian Board of Respiratory Care.
  (31) Respiratory care practitioner--A person holding a certificate or temporary permit to practice respiratory care issued by the Texas Board of Respiratory Care.
  (32) Respiratory care procedure--Respiratory care provided by the therapeutic and diagnostic use of medical gases, humidifiers, and aerosols, the administration of drugs and medications to the cardiorespiratory system, ventilatory assistance and ventilatory control, postural drainage, chest drainage, chest percussion or vibration (physiotherapy), breathing exercises, cardiopulmonary rehabilitation resuscitation (including cardiopulmonary resuscitation), the maintenance of natural airways, and the insertion and maintenance of artificial airways. The term includes a technique as ordered by a patient's physician, and according to and including standing orders or protocols, used to assist in diagnosis, monitoring, treatment, and research. Examples include:
    (A) the measurement of ventilatory volumes, pressures and flows;
    (B) the specimen collection of blood and other materials;
    (C) pulmonary function testing; and
    (D) hemodynamic and other related physiological forms of monitoring or treating the cardiorespiratory system.
  (33) State--Any state, territory, or insular possession of the United States and the District of Columbia.
  (34) Submit--The term used to indicate that a completed item has been actually received and date-stamped by the board along with all required documentation and fees, if any.
  (35) Supervising respiratory care practitioner--A respiratory care practitioner who holds an active and unrestricted certificate from the advisory board; has not been the subject of a disciplinary order, unless the disciplinary order was administrative in nature; and is not a relative or family member of the temporary permit holder supervised. The supervising practitioner assumes responsibility and legal liability for the services rendered by the supervised temporary permit holder.
  (36) Supervision--Overseeing the activities of, and accepting responsibility for, the respiratory care services rendered by a temporary permit holder. Supervision does not require the constant physical presence of the supervising respiratory care practitioner but includes a situation where a supervising respiratory care practitioner and the person being supervised are, or can easily be, in contact with one another by radio, telephone, or another telecommunication device.
  (37) Temporary Permit--A permit issued in accordance with §186.7 of this chapter (relating to Temporary Permit).
  (38) TSRC--Texas Society for Respiratory Care.
  (39) Therapeutic--Of or relating to the treatment of disorders by remedial agents or methods.
  (40) Under the direction--Assuring that established policies are carried out; monitoring and evaluating the quality, safety, and appropriateness of respiratory care services and taking action based on findings; and providing consultation whenever required, particularly on patients receiving continuous ventilatory or oxygenation support.
  (41) Voluntary Charity Care--Respiratory care provided for no compensation to indigent populations, in medically underserved areas, or for a disaster relief organization. As used in this definition, compensation means direct or indirect payment of anything of monetary value, except payment or reimbursement of reasonable, necessary, and actual travel and related costs.

Source Note: The provisions of this §186.2 adopted to be effective April 3, 2017, 42 TexReg 1758; amended to be effective April 15, 2018, 43 TexReg 2147