ISRC Board members: I recently took a promotion at the DME I have been working at for the last 5 years.  Due to downsizing I was offered this promotion with cut in pay or loss of job.  Since taking this promotion the company has continued to downsize even as we grow and become busier.  Therefore I have not been able to give the attention, any attention, to my job as the ISRC President.  I am therefore putting in my resignation as the ISRC President, which will allow the next person the opportunity to give more attention to ISRC business as needed.  I believe the President-elect takes on that job and if that is correct I will turn the items I have been given as President to him.  Thank you for everyone’s efforts and time and I am sorry that I have not been more available to serve. 

David Blakeman

How does this bill affect me if I am an RCP working in a sleep disorder center (SDC) or if I want to seek employment in a sleep disorder center? If you are and RCP currently working in a SDC you are not affected at all as long as you maintain your RCP license in Idaho. If you choose you could apply and pay for a polysomnography permit. If you want to seek employment in a SDC and you hold a current Idaho Respiratory Therapy license you may practice all respiratory care and polysomnography procedures that you have been trained for. 

Does this mean that a polysomnographer can practice respiratory care? Did we “give up” some of our practice? The language grants a very specific, and very limited scope of practice to polysomnographers. Some may say we gave up some of our practice but in fact, the emergence of the profession of polysomnography necessitated some “sharing” of practice. The bill defines “polysomnography related respiratory care services" as the limited practice of respiratory care in the provision of polysomnography services, under the supervision of an Idaho licensed physician, by a person at a sleep disorder center or laboratory who holds a permit issued by the board as a registered   polysomnographic technologist, polysomnographic technician or a polysomnographic trainee, or who is otherwise licensed as a respiratory care practitioner or who is exempt from licensure or permitting pursuant to section 54-4308, Idaho Code. Polysomnography related respiratory care services include therapeutic and diagnostic use of oxygen, noninvasive ventilatory assistance of spontaneously breathing patients and cardiopulmonary resuscitation and maintenance of nasal and oral airways that do not extend into the trachea, as ordered by an Idaho licensed physician or by written procedures and protocols of the associated sleep disorder center or laboratory as approved by an Idaho licensed physician and which do not violate a rule adopted by the board.  This chapter does not in any way authorize the practice of medicine or any of its branches by any person not so licensed by the board. Further, licensed respiratory practitioners, and those exempt from licensure pursuant to section 54-4308, Idaho Code, are not limited in their scope of practice of provision of respiratory care which they may provide, including in connection with the provision of polysomnography services.”  Whew, that is a lot of legal language. In essence we still get to do all we do as RCP’s and we agree to share a small portion of what we do with the polysomnographers.

Will the cost of my license increase? Did this legislation cost the ISRC any money? The cost of your license will not increase as a result of this legislation. The cost of the polysomnography permit will cover costs associated with rules writing, and regulation. The total cost to the ISRC was $150. The ISRC did seek legal council to review the proposed legislation and ensure that our best interests were represented. 

Will the polysomnography permit have similar entry-level requirements and continuing education requirements?  Three levels of polysomnographic personnel are defined in the bill:  Registered polysomnographic technologist, Polysomnographic technician, and Polysomnographic trainee. Because polysomnography is a relatively new field the entry-level requirements for the technician and trainee are lower than those for a RCP but they reflect the national standards, just as the RCP requirements reflect the national standard. Polysomnographers in Idaho will have the same continuing education and accountability standards as RCPs. 

What happens to the Respiratory Therapy Licensure Board (RTL Board)? Previously, three board members were RCPs. Now, one member must be dual credentialed as an RCP and as a Registered Polysomnographic Technologist. The board will now deal with issues relating to the practice of RCP and the practice of polysomnography related respiratory care. 

Was the AARC consulted regarding this matter? As you can imagine, several states are dealing with the issue of polysomnographers practice of respiratory care without a license. The AARC for the most part supports exemption of polysomnographers as the solution. Representatives of the ISRC explored this option but the Idaho Board of Medicine correctly determined that exemption provides no mechanisms for protection of the public. Exemption has no process for people harmed by the incorrect practice of polysomnography or for persons aware of inappropriate practice to report such situations. Additionally, exemption has no mechanisms for penalizing such persons.  The legislative representative for the AARC reviewed our legislation and essentially gave us her blessing. 
Why should we congratulate ourselves? Enactment of this legislation turns a bad situation into a good one. The public (that includes us) has a mechanism to report the inappropriate practice of polysomnography and the RTL board can determine if penalties are warranted. Additionally, Idaho becomes the first state to set entry-level requirements and continuing education requirements for polysomnographers. 

Why didn’t I have more input into the process? Given the nature legislation and the Idaho legislature, the process moved fairly quickly. Drafts of the legislation were circulated to ISRC board members for their comments and concerns. Drafts were not circulated to all RCPs in the state because they were just that, drafts. The language of the initial legislation only vaguely resembled that of the final legislation. Ultimately, most things were still undetermined until February and then moved very quickly. Leaving anyone out was not intentional. Indeed, the ISRC functioned as it should have to represent your best interested given the circumstances of the situation.

If you have further questions regarding this please do not hesitate to contact me. Jody Lester (208)426-3672 or Jlester@kickedbythecow@yahoo.com.

• Special Topics: Polysomnography and Sleep Disorder Breathing
• Scheduled Wednesdays from 9:30-12:30, June 9th – July 13th
• Lectures will be videotaped, and accompanying Powerpoint presentations will be placed on Boise State University’s Blackboard site so that those who cannot attend lectures can virtually attend class via the world wide web.
• Exams will be given via Blackboard, outside of class.

Lectures will be provided by local physicians who specialize in sleep medicine, and by registered polysomnographic technologists.  Topics include effects of sleep disordered breathing, related disease states, technical aspects of sleep studies, and interpretation of polysomnography data. 

Attendees who successfully complete the course will be eligible to pursue internship opportunities during the remainder of the summer, and possibly during the next academic year.
 

In following the progression of the recent changes to the Respiratory Act and all that was involved with this, I would like to commend Jodi Lester for all of her work. Jodi was asked to step in and help guide this issue through, and she did an exemplary job. All of the members of the Board of Medicine were impressed with the diligence, expertise and professionalism Jodi put into this issue. As an Idaho RT and as a member of the BOM--thank you, Jodi.

I would like to introduce myself as the new Mountain Air editor.  I am a pulmonary technologist at St. Luke’s Regional Medical Center in Boise and am a longtime member of the ISRC and AARC.  The overall organization of the newsletter is in great shape thanks to the fine efforts of our past President and newsletter editor, Nancy Roberts.  I invite any contributions to the Mountain Air whether it be regional or local news about Respiratory Care or RCPs, brief articles about clinical or political topics, or just a request for me to find out the state of any particular area of interest. Contact me at SLRMC, 190 E Bannock St., Boise, 
ID 83712; phone (208) 381-2153; FAX (208) 381-3498; gablet@slrmc.org.

Another opportunity for asthmatic kids is a new concept this year:  “Asthma Day Camp.”  The first of these is scheduled on June 19th, from 8:30 to 5:00 in Boise’s Municipal Park.  Call Paula Bermudo at 208-424-0249 for more information.

President David Blakeman called the meeting to order.

The minutes of the previous meeting were read and approved.

Treasurer’s report:  David will contact Nancy Roberts to get the books transferred to the new treasurer. 

PACT:  A motion was passed to send two people to the PACT meeting in March.  David will contact Renie to see if she is still interested.  If she is not David will e-mail the board to send him nominations within a week.  Conrad is the other person going.

Committee Reports:

• Newsletter:  Tom Gable volunteered to take over this job.  It was discussed about putting the conference registration in the summer newsletter and sending this one out to all the  RT’s in the state and the other newsletters to only members of the ISRC.  This will be decided by Tom and David.
• Bylaws:  Tom reported that Nolan cannot be a delegate because of holding an elected office.  He is already included in the delegation by being the President elect.  The vacated spot can remain unfilled.
• Annual Conference:  Idaho Falls is planning on having it this year.  Nolan Bybee and Terry Hale are co-chairs.  There is talk of having the conference split between Thursday and half of Friday.  No date has been set yet, but will be sometime in August.

• COPD awareness:  Con will contact the governor’s office to get this done this year.
• Credit card:  It was decided not to get one, since the president and treasurer are in the same part of the state these next two years.

• Con reported on the following.  Debbie Hill, a congresswoman wants to propose a $1.00 per pack cigarette tax increase.  The plan for this money will be 1-Getting a tobacco control plan. 2-Providing financial relief for prescription’s for the elderly. 3-Getting more Idaho children covered under health insurance (CHIP).  4-Replenishing the tobacco fund, so that the interest will maintain the programs.  The AARP, American Heart Association and the American Lung Association have endorsed the following statement:  The following organizations endorse a significant increase in the Idaho tobacco tax with the majority of the revenue being dedicated to programs that improve the health of Idaho’s citizens.  It was decided that the ISRC would also endorse this statement.
• SueAnn Reese from the Coalition for a Healthy Idaho gave a presentation on what CHI is and what it does and can do.  She asked if the ISRC as a group would become members.  Someone would need to attend the quarterly meetings and there maybe a chance to serve on ad hoc committees.  A motion was passed to have the ISRC  become a member and we will discuss at the next meeting what our role will be in this organization.

Respectfully submitted,

Ramona Sailor
ISRC Secretary Elect