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- Why do we have licensure of respiratory therapists_
- This is very important consumer protection legislation. The unregulated practice of
respiratory care has been demonstrated to significantly harm the public when practiced by poorly trained,
incompetent, or negligent practitioners. This licensure Act will establish a scope of practice for respiratory
therapists, and it will specify minimum levels of education, training, and clinical competence for
practitioners. In addition, this licensure Act establishes a process to screen applicants, and to
discipline license holders for negligence or incompetence, among other offenses, after due process
investigations.
- What is the effective date of licensure in Michigan_
- July 1, 2004.
- Who is required to apply for a state license as a respiratory therapist_
- Any individual engaging in the practice of respiratory care, or providing or offering
respiratory services, must apply for a license as a respiratory therapist, unless they are in certain groups
that are specifically exempted. These various groups (currently licensed health professionals, RT techs,
diagnostic techs, etc.) are discussed in more detail in the following FAQs.
- Who controls licensing of respiratory therapists_
- The State of Michigan Department of Community Health, Bureau of Health Professions, is
responsible for licensing health professionals, including respiratory therapists. The MSRC, AARC, and NBRC
do NOT control licensure of respiratory therapists.
- How does the licensing process work_
- Initially, a database is developed of all persons with job titles of respiratory
therapist or respiratory care practitioner, and all persons with a CRT or RRT credential. Applications
for licensure are mailed to these persons. Please review the licensure flow chart
(138 kb .doc) to see what
pathway you will take for licensure. Once the applications are completed and returned with the
requested documentation, the application is reviewed against the licensure criteria. A license or
temporary license is either issued at that time, or the applicant may be asked to provide additional
information, or the applicant may be denied licensure for cause.
- What will be the scope of practice of a licensed respiratory therapist_
- The scope of practice of respiratory care services is intentionally broad and
comprehensive. It covers all preventative, diagnostic, therapeutic, and rehabilitative services to any person
with a disorder, disease, or abnormality of the cardiopulmonary system, as diagnosed by a physician.
Specific activities include, but are not limited to, patient assessment, administration of
medications and agents related to respiratory care services, collection and analysis of blood
specimens and other bodily fluids and tissues related to respiratory care services, development
and modification of respiratory care treatment plans, management of mechanical ventilation and
other means of life support, and certain approved emergency procedures.
- Will licensed respiratory therapists be able to take verbal orders in all settings_
- Yes. Effective July 1, 2004, licensed respiratory therapists will be formally approved to
take written, verbal, and telecommunicated orders in all health care settings. This includes
verbal orders in skilled nursing facilities without nursing countersignature.
- In what health care settings does licensure apply_
- All health care settings in Michigan. This includes, but is not limited to, inpatient or
outpatient services or departments within health facilities (hospitals, clinics, long term
care/nursing homes, skilled nursing facilities, etc.), home care agencies, durable medical
equipment companies, and educational programs.
- Do you need a Medical Director to get licensed_
- No.
- Can a licensed respiratory therapist delegate his or her duties to another individual_
- Generally, a licensed respiratory therapist may delegate to a licensed or unlicensed individual
(who is otherwise qualified by education, training, or experience) the performance of selected acts,
tasks, or functions, where the acts, tasks, or functions fall within the scope of practice of
respiratory care and will be performed under the licensed respiratory therapist's supervision.
A licensed respiratory therapist cannot delegate when the act, task, or function, under standards
of acceptable and prevailing practice, requires the level of education, skill, and judgment required
of the licensed respiratory therapist.
- What happens to me if I choose not to apply for my license_
- If you do not apply for licensure, you cannot practice as a respiratory therapist or
respiratory care practitioner in Michigan. You can, however, officially change your job title through your Human
Resources Department to Respiratory Technician, and continue to work in that capacity. Your job description,
however, cannot include unsupervised performance of any procedures listed in the respiratory therapist
scope of practice.
- What are the general requirements for licensure as a respiratory therapist_
- 1) Successful completion of an accredited respiratory therapist program, and
2) Have at least a 2 year Associates Degree from an accredited college or university, and
3) Be credentialed as a Certified Respiratory Therapist (CRT) or as Registered Respiratory Therapist (RRT) by the NBRC.
- What about individuals who received their CRT or RRT credential before the requirement for an Associates
Degree, or individuals who went through an alternative credentialing pathway years ago_
- Any individual who has either the CRT or RRT credential on or before July 1, 2004 is eligible
for licensure, provided that they apply for licensure by June 30, 2005.
- Will currently working, non-credentialed practitioners who were trained on-the-job, or who didn't
pass their CRT exam, be licensed_
- Because neither the State of Michigan nor the MSRC wants to force working practitioners out of their
jobs, provisions have been made for a temporary license for individuals who have the job title of
respiratory therapist, but do not meet the criteria for licensing of respiratory therapists.
This temporary license is renewable for up to 4 years. In order to apply for a temporary license,
the individual must: 1) have been employed full time with a job title of 'respiratory therapist' for
the 4 years immediately preceding their application; and 2) provide a letter of recommendation from
their medical director attesting to their clinical competence as a respiratory therapist; and 3) pay
the application and licensing fees (same as regular license fees); and 4) apply by June 30, 2005.
- What happens to individuals with a temporary license, after the 4 years is up_
- If these individuals pass the national board exams and have a CRT or RRT credential from the NBRC
before their 4-year temporary license period expires, they may apply for a full license. If not,
they will be prohibited from practicing as a respiratory therapist or respiratory care practitioner
after their 4-year temporary license window expires. These individuals may still work as a respiratory
therapy technician, aide, or assistant. They may, at any time thereafter, apply for licensure if
they meet all three licensure criteria listed above.
- What are the fees for licensure_ How often are they paid_
- The license application fee is a one-time fee of $20. The licensing fee is $75 per year. That
means that a therapist will pay $170 initially for licensure, which will be in effect for 2 years.
After that, renewal of the license will occur on a (probable) 2-year cycle at a cost of $150 for
each 2-year renewal.
- What are the consequences if an individual does not pay the licensure fees_ Are they able to continue
to practice in the state_
- If an individual does not pay the license application fee, and the license or temporary license fees,
they will not be issued a license or temporary license, and, therefore, would be prohibited from practicing
as a Respiratory Therapist or Respiratory Care Practitioner. They could still work as an RT Tech, Aide,
or Assistant, but only under the supervision of a licensed respiratory therapist.
- Is there any title protection by being licensed_
- Only licensed respiratory therapists can use the titles of "respiratory therapist", "licensed
respiratory therapist", "respiratory care practitioner", "licensed respiratory care
practitioner", "rt", "rcp", "lrt", "lrcp", or similar words or acronyms that indicate that the
individual is a respiratory therapist.
- Are there any continuing education requirements to maintain licensure_
- The Public Health Code permits the Michigan Board for Respiratory Care to establish continuing
education requirements as a condition of license renewal.
- How does licensure of respiratory therapists affect respiratory therapy technicians, aides, and assistants,
and other non-licensed individuals performing respiratory care procedures_
- Respiratory therapy technicians, aides, and assistants, and other non-licensed assistive personnel,
are not subject to licensure in Michigan, and will not be issued a temporary or limited license. However,
they can perform respiratory care procedures (as listed in the scope of practice) only under the supervision
of a licensed respiratory therapist, and they cannot call themselves respiratory therapists or respiratory
care practitioners.
- How does licensure affect other licensed health professions in Michigan_
- Licensure of respiratory therapists does not prevent other licensed health professions (physicians,
nurses, physical therapists, etc.) from performing respiratory care procedures if those procedures
are within that profession's scope of practice, and if they do not use the title of respiratory therapist
or respiratory care practitioner.
- What about respiratory therapy students_ How does licensure affect them_
- Respiratory therapy students are not subject to licensure, and will not be issued a temporary or
limited license. They can, however, perform respiratory care procedures, but only under the
supervision of a licensed respiratory therapist. In addition, they must be clearly identified as a
student, and can not call themselves respiratory therapists or respiratory care practitioners.
- What about individuals working in respiratory care-related diagnostics, such as in a PFT lab,
sleep lab, blood gas lab, etc._ How does licensure affect them_
- Non-respiratory therapists performing respiratory care diagnostic procedures (PFT,
sleep studies, blood gases, etc.) are not subject to licensure in Michigan, and will not be issued a
temporary or limited license. They may continue performing these studies provided that they possess a level
of training approved by the Board, are credentialed in their specialty (e.g. NSCPT, C-PFT, R-PFT, R.Psg.T., Med Techs,
etc.), and do not call themselves respiratory therapists or respiratory care practitioners. There is no
requirement for supervision of these individuals by a licensed respiratory therapist.
- Can respiratory therapists from other states or from Canada practice in Michigan_
- There are specific reciprocity arrangements already established in the Public Health
Code to permit the licensing and practice of respiratory care by therapists relocating
from other states, or therapists on a work visa from Canada.
- How can a manager determine whether or not a practitioner is licensed in Michigan_
- The Michigan Department of Community Health will maintain the practitioner database.
- What is the Michigan Board for Respiratory Care_
- The Michigan Board for Respiratory Care establishes rules and regulations for licensure,
reviews applications, reviews and recommends disciplinary actions, and establishes continuing
education criteria. It is comprised of four licensed respiratory therapists, one licensed
physician medical director, and two public members.
- What kind of certificate will I get to prove I am licensed as a respiratory therapist_
- The Michigan Department of Community Health will issue a hard copy license document and a wallet-size
license card to each applicant issued a license as a respiratory therapist.
- How will I know when it is time to renew my license_
- The Michigan Department of Community Health will mail license renewal forms
to you prior to your license expiration date.
- Are there any obligations that need to be taken care of at the hospital or workplace level_
- The greatest issues are to ensure that 1) all respiratory therapists and respiratory
care practitioners are accounted for and are fully informed of the mandatory licensure
requirements; 2) all RT and RCP job descriptions will need to be reviewed and revised
per the licensure requirements (minimum education & training, NBRC credential, scope of
practice, etc.) through your facility Human Resources Department; and 3) current license
status must be verified by your facility HR Department initially (within the 1 year grace
period) and every 2 years (if that is our renewal cycle). In addition, it is advisable
that supervisors maintain records and copies of each of their staff's licenses.
- Why are the licensure fees for respiratory therapists higher than what nurses pay_
- The reason is that, according to the Bureau of Labor Statistics, there are close to 80,000 nurses in
Michigan and only about 3,200 respiratory therapists. If you divide the costs of managing licensure
by 80,000 nurses compared to 3,200 therapists, respiratory therapists are getting a bargain.
Nationally, RT licensure fees range from a high of $125 (AZ) - $150 (CT) per year to a low of
$15 (PA) - $30 (MT, VT) per year. Fees in Michigan are in the midrange of fees nationally.
- Are there any infractions that may prevent me from getting my license or renewal_
- It is important, in order to protect the public, that complaints against applicants and licensed
practitioners be investigated by the Board. Issues may include negligence or failure to exercise
due care; personal disqualifications such as incompetence, mental or physical inability to practice,
conviction of certain misdemeanors, or felony convictions; commission of prohibited acts, such as
fraud and practicing outside the scope of the license; unethical business practices; and disciplinary
actions in another state.
- Are the licensure fees connected in anyway to MSRC, AARC, or NBRC annual dues, or do we still
pay those dues in addition to licensure fees_
- The licensure fees are not connected in any way to professional membership dues. The licensure
fees are paid to the State of Michigan. It is highly encouraged to continue to be an active member
of the MSRC, AARC, and NBRC, because these organizations are your professional voice. It is the MSRC
that got you licensed! It's a very small price to pay, given the benefits to the patient and to you, the therapist.
Congratulations, Licensed Respiratory Therapist!
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