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Laws and Rules: Florida Respiratory Care Board

2.00 Contact Hours
A score of 80% correct answers on a test is required to successfully complete any course and attain a certificate of completion.
Author:    Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Outcomes

The purpose of this course is to prepare respiratory care providers licensed in Florida to practice within the perimeters of the Florida Laws and Rules governing the practice of respiratory care.

Objectives

After completing this course, the learner will be able to:

  1. Apply the Florida Board of Respiratory Care rules and regulations
  2. Identify the Board of Respiratory Care website
  3. Discuss continuing education requirements
  4. Discuss the scope of respiratory care practice
  5. Apply principles of ethics

Introduction

The Laws and Rules of Respiratory Practice are composed of (1) Statutes passed by the Florida State Legislature; and (2) Rules and Regulations passed by the Florida Board of Respiratory Care (BORC). Rules and Regulations clarify the Statues in the practice of respiratory care. Rules and regulations are administrative law.

The Laws and Rules grant the authority to regulate respiratory care applicants and licensure, provides broad statements of duties, and specifies of how board members are appointed. Your Respiratory Care practice is directly affected by your ability to make informed decisions, within the parameters of laws and rules. You need to know how the rules that apply to you and then apply them in your practice.

You can find the Statues plus Rules and Regulations by going to the Florida Board of Respiratory Care Renewal website at http://floridasrespiratorycare.gov/renewals/. Below is a screenshot of the renewal page showing links to the Statutes plus Rules and Regulations: 

Florida Board of Respiratory Care Renewal Website

Statutes and rules and regulations have complex numbering systems. You do not need to know that numbering system because you can always look up the information by the title of the section.

Check the website regularly to keep up with any changes or additions that will affect your practice. Make sure your contact information is up-to-date otherwise the license renewal notice will go to the wrong place.

The BORC represents the people of Florida by ensuring that licensed respiratory therapists meet minimum standards of safe practice. Licensure is a requirement to protect the people of Florida and ensure safe respiratory care. You cannot call yourself a Respiratory Therapist nor practice in the state of Florida without a license.

The BORC DOES NOT:

  • answer questions about employment issues such as salaries, staffing ratios, or other workplace concerns
  • regulate practice settings or environments
  • protect or advocate for respiratory therapists
  • make decisions for you

The BORC can help you understand how to practice safely and within the rules and regulations set up in the state of Florida.

Professional respiratory care associations DO:

  • represent their members in legislative, political, and policy matters
  • provide leadership in other areas, such as efforts to improve working conditions and benefits for respiratory therapists.

Florida Board of Respiratory Care

The BORC members are appointed by the governor. Membership includes1:

  1. A registered respiratory therapist.
  2. A certified respiratory therapist.
  3. A respiratory care professional from each of the following areas:
    1. Respiratory care education.
    2. Respiratory care management and supervision.
    3. Homecare/subacute.
  4. Two consumer members, who are residents of this state and have never been licensed as health care practitioners.

Each respiratory care professional on the board must have been actively engaged in the delivery of respiratory care services in this state for at least four consecutive years prior to appointment. The Governor shall, insofar as possible, appoint persons from different geographical areas.

License Requirements

In order to be eligible for licensure by the board, an applicant must be an active “certified respiratory therapist” or an active “registered respiratory therapist” as designated by the National Board for Respiratory Care. Licensure by endorsement is possible with verification by oath and submission of evidence satisfactory to the board that such credential is held.1 There are additional requirements for reactivating a lapsed or retired license. Specific instructions and requirements for licensure are available at http://floridasrespiratorycare.gov/licensing/.

Process steps for licensure application:

  • Request an official letter of verification from the National Board for Respiratory Care (NBRC) (www.nbrc.org) is sent directly to the respiratory care board office.
  • Request license verification(s) from all states in which you have ever held a license, if applicable. The verification must be sent directly to our board office.
  • Complete your Florida application online at http://flhealthsource.gov/mqa-services.
    • If applicants have any affirmative answers in the Criminal, Personal, or Disciplinary sections of the application, submission of the personal statement and supporting documentation can be emailed or faxed to our board office. Any affirmative answers on the initial application to the criminal, disciplinary or personal history sections will require a personal written statement and supporting documentation. This documentation is reviewed to determine if a personal appearance at a board meeting is required.

BORC contact

Email the BORC from http://floridasrespiratorycare.gov/contact/

Customer Contact Center
Monday – Friday
8:00 a.m. to 6:00 p.m. ET
(850) 488-0595

Board Office
8:00 a.m. to 5:00 p.m. ET
(850) 245-4373
FAX: 850-414-6860
Mailing Address:
Department of Health
Board of Respiratory Care
4052 Bald Cypress Way Bin C-05
Tallahassee, FL 32399-3257

Applications and Fees ONLY:
Department of Health
Board of Respiratory Care
P.O. Box 6330
Tallahassee, FL 32314-6330
 

Respiratory Care Practice

Respiratory care service includes1:

  • Evaluation and disease management.
  • Diagnostic and therapeutic use of respiratory equipment, devices, or medical gas.
  • Administration of drugs, as duly ordered or prescribed by a physician and in accordance with protocols, policies, and procedures established by a hospital or other health care provider or the board.
  • Initiation, management, and maintenance of equipment to assist and support ventilation and respiration.
  • Diagnostic procedures, research, and therapeutic treatment and procedures, including measurement of ventilatory volumes, pressures, and flows; specimen collection and analysis of blood for gas transport and acid/base determinations; pulmonary-function testing; and other related physiological monitoring of cardiopulmonary systems.
  • Cardiopulmonary rehabilitation.
  • Cardiopulmonary resuscitation, advanced cardiac life support, neonatal resuscitation, and pediatric advanced life support, or equivalent functions.
  • Insertion and maintenance of artificial airways and intravascular catheters.
  • Education of patients, families, the public, or other health care providers, including disease process and management programs and smoking prevention and cessation programs.
  • Initiation and management of hyperbaric oxygen.

Only licensed persons have the right to use the title1:

  • “Respiratory Care Practitioner” and the abbreviation “RCP.”
  • “Registered Respiratory Therapist” and the abbreviation “RRT”
  • “Certified Respiratory Therapist” and the abbreviation “CRT”

Continuing Education

The Legislature and the Board have determined that competency in delivery of respiratory care services is enhanced by continuous updating of knowledge and skills.2 Continuing education is required as a condition for renewal of licensure of all respiratory care licensees. During each biennium, each licensee must earn 24 hours of continuing education credit including those earned as provided in this rule. None of these hours can be obtained by taking Basic Life Support (BLS) training. No more than five (5) hours per biennium shall be awarded for completion of courses focusing on risk management.

As of August 3, 2016, home study/online courses are no longer limited to 12 hours starting the 2017 renewal biennium. All courses, including home study/online courses, must be completed by an approved respiratory care provider. Live courses are still acceptable, available and are not limited, but are not mandatory starting 2017 renewal biennium.

Each licensee shall submit proof satisfactory to the Board of participation in appropriate continuing education using the electronic reporting system CEBroker. Education providers approved by the BORC are required to report contact hours to CEBroker. CEUFast.com is a BORC provider and reports your contact hours automatically. Continuing education contact hours by non-BORC providers must be entered by the participant into CEBroker at www.CEBroker.com.

To ensure you receive your renewal notification from the department, your current mailing address must be on file. Failure to renew an active or inactive license by the expiration date will result in the license being placed in delinquent status. Failure by a delinquent licensee to renew before the expiration of the current licensure cycle renders the license null and void without any further action by the board or the department.

Continuing Education (CE/CEU) Requirements

http://floridasrespiratorycare.gov/renewals/

Required Subject AreaRequired Number of HoursImportant Information
General Hours20 
Medical Error2Mandatory for all licensees: 2 hours in a board-approved continuing education course pursuant to Rule 64B32-6.006, F.A.C.
Laws and Rules2

Mandatory for all licensees: 2 credit hours pursuant to subsection 64B32-6.001(5), F.A.C. Licensees may earn up to 8 continuing education hours per biennium by attending meetings of the Board of Respiratory Care, but no more than 2 of those hours will be credited to satisfying the Florida laws and rules requirement.

                               24 Total

A 3 hour HIV/AIDs course is mandatory for the initial renewal of all licensees and optional for subsequent renewals: The course must be taken within the last five (5) years prior to either initial licensure or first renewal.

One contact hour equals 50 minutes of education and 0.5 contact hours equals 25 minutes. A contact hour is not equivalent to a continuing education unit (CEU). Contact hour is the current term of measure for CNE. You might find the old term CEU used occasionally. One contact hour equals 0.1 CEU and 10 contact hours equals one CEU.

Reporting Violations and Patient Care Concerns.

The respiratory therapist has a responsibility to report breaches in practice. The Department of Health investigates complaints and reports involving health care practitioners regulated by the department and enforces appropriate Florida Statutes.3 The action which may be taken against health care practitioners is administrative in nature. That website is http://www.floridahealth.gov/licensing-and-regulation/enforcement/index.html.

Disciplinary Grounds

The following acts constitute grounds for denial of a license or disciplinary action, as specified in s. 456.072(2)1:

  1. Procuring, attempting to procure, or renewing a license as provided by this part by bribery, by fraudulent misrepresentation, or through an error of the department or the board.
  2. Having licensure, certification, registration, or other authority, by whatever name known, to deliver respiratory care services revoked, suspended, or otherwise acted against, including the denial of licensure, certification, registration, or other authority to deliver respiratory care services by the licensing authority of another state, territory, or country.
  3. Being convicted or found guilty of, or entering a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to respiratory care services or to the ability to deliver such services.
  4. Willfully making or filing a false report or record, willfully failing to file a report or record required by state or federal law, or willfully impeding or obstructing such filing or inducing another person to do so. Such reports or records include only those reports or records which require the signature of a respiratory care practitioner or respiratory therapist licensed.
  5. Circulating false, misleading, or deceptive advertising.
  6. Unprofessional conduct:
    1. Violating the confidentiality of information or knowledge concerning a patient.
    2. Falsely misrepresenting the facts on an application for employment as a respiratory therapist.
    3. Leaving a respiratory therapy assignment before properly advising appropriate supervisory personnel.
    4.  Providing false or incorrect information to an employer regarding the status of the certification, registration, or licensure.
    5. Failing to report another licensee in violation of the laws and/or rules pertaining to the profession.
    6. Using foul or abusive language in patient care or public areas.
  7. Engaging or attempting to engage in the possession, sale, or distribution of controlled substances, as set forth by law, for any purpose other than a legitimate purpose.
  8. Willfully failing to report any violation of this part.
  9. Violating a lawful order of the board or department previously entered in a disciplinary hearing.
  10. Engaging in the delivery of respiratory care services with a revoked, suspended, or inactive license.
  11. Permitting, aiding, assisting, procuring, or advising any person who is not licensed pursuant to this part, contrary to this part or to any rule of the department or the board.
  12. Failing to perform any statutory or legal obligation placed upon a respiratory care practitioner or respiratory therapist licensed pursuant to this part.
  13. Accepting and performing professional responsibilities which the licensee knows, or has reason to know, she or he is not competent to perform.
  14. Delegating professional responsibilities to a person when the licensee delegating such responsibilities knows, or has reason to know, that such person is not qualified by training, experience, or licensure to perform them.
  15. Gross or repeated malpractice or the failure to deliver respiratory care services with that level of care, skill, and treatment which is recognized by a reasonably prudent respiratory care practitioner or respiratory therapist with similar professional training as being acceptable under similar conditions and circumstances.
  16. Paying or receiving any commission, bonus, kickback, or rebate to or from, or engaging in any split-fee arrangement in any form whatsoever with, a person, organization, or agency, either directly or indirectly, for goods or services rendered to patients referred by or to providers of health care goods and services, including, but not limited to, hospitals, nursing homes, clinical laboratories, ambulatory surgical centers, or pharmacies. The provisions of this paragraph shall not be construed to prevent the licensee from receiving a fee for professional consultation services.
  17. Exercising influence within a respiratory care relationship for engaging a patient in sexual activity. A patient is presumed to be incapable of giving free, full, and informed consent to sexual activity with the patient’s respiratory care practitioner or respiratory therapist.
  18. Making deceptive, untrue, or fraudulent representations in the delivery of respiratory care services or employing a trick or scheme in the delivery of respiratory care services if such a scheme or trick fails to conform to the generally prevailing standards of other licensees within the community.
  19. Soliciting patients, either personally or through an agent, using fraud, deception, or otherwise misleading statements or through the exercise of intimidation or undue influence.
  20. Failing to keep written respiratory care records justifying the reason for the action taken by the licensee.
  21. Exercising influence on the patient in such a manner as to exploit the patient for the financial gain of the licensee or a third party, which includes, but is not limited to, the promoting or selling of services, goods, appliances, or drugs.
  22. Performing professional services which have not been duly ordered by a physician licensed pursuant to chapter 458 or chapter 459 and which are not in accordance with protocols established by the hospital, other health care provider, or the board, except as provided in ss. 743.064,766.103, and 768.13.
  23. Being unable to deliver respiratory care services with reasonable skill and safety to patients because of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material because of any mental or physical condition. In enforcing this paragraph, the department shall, upon probable cause, have authority to compel a respiratory care practitioner or respiratory therapist to submit to a mental or physical examination by physicians designated by the department. The cost of examination shall be borne by the licensee being examined. The failure of a respiratory care practitioner or respiratory therapist to submit to such an examination when so directed constitutes an admission of the allegations against her or him, upon which a default and a final order may be entered without the taking of testimony or presentation of evidence, unless the failure was due to circumstances beyond her or his control. A respiratory care practitioner or respiratory therapist affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that she or he can resume the competent delivery of respiratory care services with reasonable skill and safety to her or his patients. In any proceeding under this paragraph, neither the record of proceedings nor the orders entered by the board shall be used against a respiratory care practitioner or respiratory therapist in any other proceeding.
     

468.365 Disciplinary actions1

  1. The board may enter an order denying licensure or imposing any of the penalties in s.456.072(2) against any applicant for licensure or licensee who is found guilty of violating any provision of subsection (1) of this section or who is found guilty of violating any provision of s.456.072(1).
  2. The board shall not reinstate licensure, or cause a license to be issued to a person it has deemed unqualified, until it is satisfied that such person has complied with all the terms and conditions set forth in the final order and that the respiratory care practitioner or respiratory therapist is capable of safely engaging in the delivery of respiratory care services.
  3. The board may, by rule, establish guidelines for the disposition of disciplinary cases involving specific types of violations. Such guidelines may include minimum and maximum fines, periods of supervision on probation, or conditions upon probation or reissuance of a license.

468.366 Penalties for violations1

  1. It is a violation of law for any person, including any firm, association, or corporation, to:
    1. Sell or fraudulently obtain, attempt to obtain, or furnish to any person a diploma, license, or record, or aid or abet in the sale, procurement, or attempted procurement thereof.
    2. Deliver respiratory care services, as defined by this part or by rule of the board, under cover of any diploma, license, or record that was illegally or fraudulently obtained or signed or issued unlawfully or under fraudulent representation.
    3. Deliver respiratory care services, as defined by this part or by rule of the board, unless such person is duly licensed to do so under the provisions of this part or unless such person is exempted pursuant to s. 468.368.
    4. Use, in connection with his or her name, any designation tending to imply that he or she is a respiratory care practitioner or a respiratory therapist, duly licensed under the provisions of this part, unless he or she is so licensed. Advertise an educational program as meeting the requirements of this part, or conduct an educational program for the preparation of respiratory care practitioners or respiratory therapists, unless such program has been approved by the board.
    5. Knowingly employ unlicensed persons in the delivery of respiratory care services, unless exempted by this part.
    6. Knowingly conceal information relative to any violation of this part.
  2. Any violation of this section is a felony of the third degree, punishable as provided in s.775.082,

64B32-5.007 The following violations may be disposed of by citation with the specified penalty1

  1. Violations of continuing education requirements required by Section 468.361, F.S.: are to be completed within 90 days of the date of the filing of the final order. Licensee must submit certified documentation of completion of all the CE requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, licensee must document compliance with the CE requirements for the relevant period.
  2. Failure to document HIV/AIDS continuing education requirement the fine shall be $100.
  3. Documentation of some but not all of the 24 hours of continuing education for license renewal the fine shall be $50 for each hour not documented.
  4. Violation of any portion of Rule 64B32-5.003, F.A.C., for unprofessional conduct the fine shall be $300.
  5. Failure to notify the Board of current address as required by Rule 64B32-1.006, F.A.C. the fine shall be $50.
  6. Failure to keep written respiratory care records justifying the reason for the action taken on only one patient under Section 468.365(1)(t), F.S. the fine shall be $100.
  7. Circulating misleading advertising in violation of Section 468.365(1)(e), F.S., the fine shall be $500.
  8. Exercising influence on a patient to exploit the patient for financial gain by promoting or selling services, goods, appliances or drugs under Section 468.365(1)(u), F.S. the fine shall be $1,000.
  9. Failure to submit compliance documentation after receipt of the continuing education audit notification under Section 468.365(1)(x), F.S. the fine shall be $150.
  10. Failure to provide satisfaction including the costs incurred following receipt of the Department’s notification of a check dishonored for insufficient funds under Section 468.365(1)(l), F.S. the fine shall be $150.
  11. Failure to pay required fees and/or fines in a timely manner under Section 468.365(1)(i), F.S. the fine shall be $150.

64B32-5.001 Disciplinary Guidelines2

The Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the severity and repetition of the violations as set forth below. The mitigating or aggravating circumstances used to justify any deviation from the specified guidelines must be enunciated in the final order. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included. For applicants, any and all offenses listed herein are sufficient for refusal to certify an application for licensure. In addition to the penalty imposed, pursuant to Section 456.072(4), F.S., the Board shall recover the costs of the investigation and prosecution of the case. Additionally, if the Board makes a finding of pecuniary benefit or self-gain related to the violation, then the Board shall require refund of fees billed and collected from the patient or a third party on behalf of the patient.

VIOLATIONRECOMMENDED RANGE OF PENALTY

(a) Attempting to obtain a license by bribery, fraud or through an error of the Department or the Board.
(Sections 468.365(1)(a), 456.072(1)(h), F.S.)

First Offense

From one year probation with conditions to revocation and payment of a fine of $250 to $1,000.

Second Offense

From revocation with ability to reapply and a fine from $2,000 to $6,000.

Third Offense

From revocation with no ability to reapply and a fine from $6,000 to $10,000.

*However, if the violation is not through an error but is for fraud or making a false or fraudulent representation, the fine is increased to $10,000 per count or offense.

b) Actions taken against license by another jurisdiction. 
(Sections 468.365(1)(b), 456.072(l)(f), F.S.)

First Offense

From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation occurred in Florida to suspension of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken, and an administrative fine ranging from $300 to $1,000. Impaired practitioners working in this state may be ordered into the PRN.

Second Offense

Same as for a first offense except a fine shall range from $1,000 to $2,000.

Third Offense

Same minimum as for a first offense with a maximum penalty of revocation and a fine from $2,000 to $10,000.

(c) Guilt of crime directly relating to practice or ability to practice.  
(Sections 468.365(1)(c), 456.072(1)(c), F.S.)

First Offense

From a minimum of six months probation with conditions to revocation of the license and an administrative fine ranging from $300 to $1,000. Any Board ordered probation shall be for no less time than Court ordered sanctions.

Second Offense

From one year suspension and $5,000 fine to revocation and fine of $10,000.

(d) Willfully failing to file a report as required.
(Sections 468.365(1)(d), 456.072(1)(l), F.S.)

First Offense

From six months to one year probation with conditions, and an administrative fine from $300 to $1,000.

Second Offense

From one year probation with conditions to six months suspension and a fine from $500 to $3,000.

Third Offense

From one year suspension to revocation and a fine from $3,000 to $10,000.

*However, if the offense is for fraud or for willfully making a false or fraudulent report, the fine is increased to $10,000 per count or offense.

(e) False, deceptive, or misleading advertising.
(Section 468.365(1)(e), F.S.)

First Offense

From reprimand to one year suspension, and an administrative fine from $250 to $1,000.

Second Offense

From one year probation with conditions to one year suspension and a fine from $500 to $3,000.

Third Offense

From one year suspension to revocation and a fine from $3,000 to $10,000.

(f) Unprofessional conduct.
(Section 468.365(1)(f), F.S.)

First Offense

From a minimum of one year probation with conditions to revocation, and an administrative fine from $300 to $2,000.

Second Offense

From one year suspension to revocation and a fine from $2,000 to $10,000.

(g) Controlled substances.
(Section 468.365(1)(g), F.S.)

First Offense

From a minimum of six months probation with conditions to revocation of the license and an administrative fine ranging from $1,000 to $5,000. Any Board ordered probation shall be for no less time than Court ordered sanctions.

Second Offense

From one year suspension to revocation and a fine from $5,000 to $10,000.

(h) Failure to report another licensee in violation.  
(Sections 468.365(1)(h), 456.072(1)(i), F.S.)

First Offense

From a letter of concern to six months probation with conditions, and an administrative fine from $300 to $1,000.

Second Offense

From six months probation with conditions to one year suspension and a fine from $500 to $3,000.

Third Offense

From one year suspension to revocation and a fine from $3,000 to $10,000.

(i) Violation of order of the Board or Department or failure to comply with subpoena.
(Sections 468.365(1)(i), 456.072(1)(q), F.S.)

First Offense

From a reprimand to six months suspension, and an administrative fine from $300 to $1,000. For failure to comply with subpoena, $250 minimum fine and ninety day suspension and thereafter until compliance.

Second Offense

From one year suspension to revocation and a fine from $2,000 to $10,000.

(j) Unlicensed practice.  
(Section 468.365(1)(j), F.S.)

First Offense

A reprimand to six months suspension followed by one year, and probation with conditions, and an administrative fine from $500 to $1,000.

Second Offense

From six months suspension to revocation and a fine from $2,000 to $10,000.

Third Offense

Revocation with no ability to reapply and a fine from $5,000 to $10,000.

(k) Aiding unlicensed practice.  
(Sections 468.365(1)(k), 456.072(1)(j), F.S.)

First Offense

From a minimum of one year probation with conditions to six months suspension followed by one year of probation with conditions, and an administrative fine from $500 to $3,000.

Second Offense

From six months suspension followed by one year of probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From one year suspension followed by two years probation with conditions to revocation with no ability to reapply and a fine from $6,000 to $10,000.

(l) Failure to perform legal obligation.
(Sections 468.365(1)(l), 456.072(1)(k), F.S.)

First Offense

From a reprimand to revocation, and an administrative fine from $300 to $1,000.

Second Offense

From one year probation with conditions to six months suspension and a fine from $500 to $5,000.

Third Offense

From one year suspension to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(m) Practicing beyond competence level.
(Sections 468.365(1)(m), 456.072(1)(o), F.S.)

First Offense

From reprimand to one year suspension followed by two years probation and an administrative fine from $300 to $2,000.

Second Offense

From six months suspension followed by one year probation with conditions to revocation and a fine from $1,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(n) Delegation of professional responsibilities to unqualified person.  
(Sections 468.365(1)(n), 456.072(1)(p), F.S.)

First Offense

From one year probation with conditions to revocation, and an administrative fine from $300 to $1,000.

Second Offense

From six months suspension followed by one year of probation with conditions to revocation and a fine from $1,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(o) Malpractice.  
(Section 468.365(1)(o), F.S.)

First Offense

From one year probation with conditions to revocation, and an administrative fine from $500 to $2,000.

Second Offense

From two years probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(p) Kickbacks or split fee arrangements.
(Section 468.365(1)(p), F.S.)

First Offense

From refund of fees billed and six months suspension followed by at least one year probation with conditions to revocation, and administrative fine from $300 to $3,000.

Second Offense

From one year suspension followed by two years probation with conditions to revocation with no ability to reapply and a fine from $2,000 to $10,000.

q) Exercising influence or engage patient in sex.
(Sections 468.365(1)(q), 456.072(1)(v), F.S.)

First Offense

From one year suspension followed by at least one year probation with conditions and possible referral to the PRN to revocation, and an administrative fine from $500 to $2,000.

Second Offense

From one year suspension followed by at least one year probation with conditions to revocation with no ability to reapply and possible referral to PRN a fine from $1,000 to $10,000.

(r) Deceptive, untrue, or fraudulent representations in the practice of respiratory care.
(Sections 468.365(1)(r), 456.072(1)(a), (m), F.S.)

First Offense

From a minimum of one year probation with conditions to revocation, and an administrative fine from $10,000 per count or offense.

Second Offense

From two years of probation with conditions to revocation with no ability to reapply and a fine of $10,000 per count or offense.

(s) Improper solicitation of patients.  
(Section 468.365(1)(s), F.S.)

First Offense

From a minimum of one year probation with conditions to revocation, and an administrative fine from $300 to $1,000.

Second Offense

From two years probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

*However, if the violation is for fraud or soliciting patients by making a false or fraudulent representation, the fine is increased to $10,000 per count or offense.

(t) Failure to keep written medical records.  
(Section 468.365(1)(t), F.S.)

First Offense

From a letter of concern to one year suspension, followed by a minimum of one year probation with conditions and an administrative fine from $300 to $1,000.

Second Offense

From a reprimand to two years probation with conditions and a fine from $500 to $5,000.

Third Offense

From six months suspension followed by one year probation to revocation and a fine from $3,000 to $10,000.

u) Exercising influence on patient for financial gain.
(Sections 468.365(1)(u), 456.072(1)(n), F.S.)

First Offense

From refund of fees billed and a minimum of one year probation with conditions, to two years suspension and an administrative fine from $500 to $3,000.

Second Offense

From refund of fees billed and two years probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From refund of fees billed and one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(v) Performing professional services not authorized by physician.  
(Section 468.365(1)(v), F.S.)

First Offense

From a reprimand to one year suspension, followed by a minimum of one year probation with conditions and an administrative fine from $300 to $1,000.

Second Offense

From six months probation with conditions to revocation and a fine from $1,000 to $10,000.

Third Offense

From six months suspension followed by one year probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

w) Inability to practice respiratory care with skill and safety. (Sections 468.365(1)(w), 456.072(1)(z), F.S.)

First Offense

From referral to PRN for submission to a mental or physical examination directed towards the problem and/or one year probation with conditions, to revocation and an administrative fine from $100 to $1,000.

Second Offense 

From referral to PRN and/or two years of probation with conditions to revocation and a fine from $300 to $5,000.

(x) Violation of this chapter, Chapter 456, F.S., or any rules adopted pursuant thereto.  
(Sections 468.365(1)(x), 456.072(1)(b), (dd), F.S.)

First Offense

From a reprimand to revocation and a fine from $300 to $2,000.

Second Offense

From six months of probation with conditions to revocation and a fine from $1,000 to $10,000.

Third Offense

From one year of probation with conditions to revocation and a fine from $2,000 to $10,000.

(y) Improper interference with investigation, inspection or discipline.
(Section 456.072(1)(r), F.S.)

First Offense

From six months of probation with conditions to revocation and a fine from $500 to $5,000.

Second Offense

From six months suspension followed by one year probation with conditions to revocation with no ability to reapply and a fine from $1,000 to $10,000.

z) Failure to report conviction or plea.
(Section 456.072(1)(x), F.S.)

First Offense

From reprimand to six months suspension and a fine from $300 to $1,000.

Second Offense

From one year probation with conditions to revocation with no ability to reapply and a fine from $1,000 to $10,000.

aa) Wrong patient, wrong site, or wrong or unauthorized procedure.  
(Section 456.072(1)(bb), F.S.)

First Offense

From one year probation with conditions to revocation and a fine from $500 to $2,000.

Second Offense

From two years probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(bb) Leaving a foreign body in a patient.  
(Section 456.072(1)(bb), (cc), F.S.)

First Offense

From one year probation with conditions to revocation and a fine from $500 to $2,000.

Second Offense

From two years probation with conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

From one year suspension followed by two years probation to revocation with no ability to reapply and a fine from $3,000 to $10,000.

(cc) Testing positive in a pre-employer ordered drug screen. (Section 456.072(1)(aa), F.S.)

First Offense

From six months probation with referral to PRN to revocation employment condition and/or and a fine from $500 to $2,000.

Second Offense

From one year probation with conditions and referral to PRN to revocation and an administrative fine from $1,000 to $10,000.

(dd) Termination of PRN Contract.
(Section 456.072(1)(hh), F.S.)

Any Offense

Reprimand to revocation, plus an administrative fine from $250 to $2,000.

ee) Practicing with a delinquent, retired, or inactive status license.
(Section 456.072(1)(o), F.S.)

Any Offense

Reprimand to revocation, plus an administrative fine from $2,000 to $10,000. If fraud is shown, $10,000 fine per count.

*However, if fraud is shown, the fine is increased to $10,000 fine per count.

(ff) Failure to notify a patient through written or oral notice of the type of license the practitioner holds.
(Section 456.072(1)(t), F.S.)

First Offense

Read laws and rules and submit an affidavit attesting that the licensee has read the laws and rules

Second Offense

A fine from $100.00 to $500.00.

(gg) Any felony offense classified under Chapter 409, 817, 893, F.S., or 21 U.S.C ss. 801-970, or 42 U.S.C. ss. 1395-1396.
(Section 456.0635, F.S.)

Any Offense

The board is prohibited from issuing or renewing a license, certificate, or registration, unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application.

(hh) Terminated for cause from the Florida Medicaid program pursuant to Section 409.913, F.S.
(Section 456.0635, F.S.)

Any Offense

The board is prohibited from issuing or renewing a license, certificate, or registration, unless the applicant has been in good standing with the Florida Medicaid program for the most recent 5 years.

(ii) Terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program.
(Section 456.0635, F.S.)

Any Offense

The board is prohibited from issuing or renewing a license, certificate, or registration, unless the applicant has been in good standing with a state Medicaid program or the Federal Medicare program for the most recent 5 years and the termination occurred at least 20 years prior to the date of the application.

(jj) Willfully failing to comply with Section 627.64194 or 641.513, F.S., with such frequency as to indicate a general business practice.
(Section 456.072(1)(oo), F.S.)

First Offense

From refund of fees billed and a minimum of one year probation with conditions, to two years suspension and an administrative fine from $500 to $3,000.

Second Offense

From refund of fees billed and two years probation with Conditions to revocation and a fine from $2,000 to $10,000.

Third Offense

Refund of fees billed, revocation with no ability to reapply and a Fine from $3,000 to $10,000.

*However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

Child Abuse

Effective 7/1/17, HB 1121 permits hospitals and physicians’ offices to release patient records to the Florida Department of Children and Families (DCF) for investigative purposes. DCF agents or representatives can now obtain records without written permission from the patient, but only when the information will be used to investigate cases of abuse, neglect, or exploitation that impact children and/or vulnerable adults.4

Ethics

A respiratory therapist is in a trusted position, but the respiratory therapist is also human. That is why the respiratory therapist must be able to promptly and fully self-disclose facts, circumstances, events, errors, and omissions when such disclosure could enhance the health status of patients or the public, or could protect patients or the public from unnecessary risk of harm.

Respiratory therapists have a duty to the patient - that's the highest level of responsibility. Employers, other health care providers, and the respiratory therapist’s personal interests do not outweigh this very important responsibility. Respiratory therapists must be aware of their actions and feelings within the therapeutic relationship, identify the invisible boundaries, and act in the best interest of the patient.

A respiratory therapist is a position of power. It's important that we can practice respiratory care in an autonomous role with patients, their families, significant others, and members of the public during difficult times in their lives. Respiratory therapists can take advantage of vulnerable people and must guard against any abuse of trust.

A respiratory therapist has an important role in maintaining professional boundaries and must be able to know, recognize, and maintain professional boundaries of the respiratory therapist-client relationship. Violating professional boundaries of the respiratory therapist-client relationship includes but is not limited to physical, sexual, emotional, or financial exploitation of the client or the client's significant other.

Ethical Principles affecting Respiratory Care Practice

Autonomy

Self-governance
The right to make an informed decision
The right to determine the course

Beneficence

One ought to do or promote good
Positive benefits are what the health care providers are obligated to seek
Act for the good of the individual

Justice

Equal access
Equal, equitable distribution
Fair share of resources
Wide range in theories of fairness and veracity
Truthfulness
The duty of a respiratory therapist to tell the truth
Veracity
Truthfulness
The duty of the respiratory therapist to tell the truth

Fidelity

Doing one’s duty
Keeping one’s word
Faithfulness

Nonmaleficence

Do no harm
Avoid harm

Morality is social conventions about right and wrong agreed upon amongst the population.

Values include your beliefs, likes, dislikes, and preferences. Things that determine personal values are educational background, life experience, cultural beliefs, family beliefs, and religious beliefs. Different people have different values. Different cultures have different values, and values are different even within cultures. Values change over time and in different situations.

Personal ethics and values differ from professional ethics and values. Your personal ethics and values affect your practice. Value and ethical conflict occur if you fail to recognize that values and beliefs are different for individuals of different cultures and within culture.

Sources of professional values:

  • professional organizations
  • state respiratory therapist statutes and regulations

Case studies

Sue works the evening shift in an intensive care unit. At 3:30, Sue receives a call for her child’s care provider, and her child is sick. She asks the supervising respiratory therapists if she could check on her child. This is the conflict between Sue’s personal value of her child’s health and her professional ethical responsibility of Fidelity's in doing one’s duty. If the supervising respiratory therapist allows Sue to go home, this resolves her conflict. If the supervising respiratory therapist does not allow Sue to go home the conflict remains unresolved.

Mr. X’s physician has asked home health care to evaluate him. It is determined that Mr. X requires patient education and therapy related to managing his shortness of breath. Physical therapy is also order. Mr. X allows the physical therapist to come but refuses physical therapy. After Mr. X refuses to open the door for the physical therapist, the respiratory therapist and physical therapists arranged to come together. The respiratory therapist educates Mr. X on the benefit of physical therapy in increasing his exercise tolerance and decreasing his shortness of breath. Mr. X continues to refuse in participating with the physical therapy regimen. This is an ethical conflict between fidelity and beneficence in doing one’s duty to carry out a beneficial patient care order and the patient’s autonomy in his right to choose.

References

  1. Florida Statute, Chapter 468, Part V; Respiratory Care. Retrieved 7/23/17 from http://floridasrespiratorycare.gov/renewals/
  2. Florida Administrative Code, Chapter 64B32: Board of Respiratory Care, Florida Administrative Code. Retrieved 7/23/17 from http://floridasrespiratorycare.gov/renewals/
  3. Florid Healthcare Complaint Portal. http://www.floridahealth.gov/licensing-and-regulation/enforcement/index.html.
  4. HB 1121 Child Welfare Ch. 395, F.S. Retrieved 7/23/17 from http://www.flhealthsource.gov/2017-bills
     

This course is applicable for the following professions:

Respiratory Therapist (RT)

Topics:

Florida Requirements


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