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Chapter 246-928 WAC

Last Update: 10/13/23

RESPIRATORY CARE PRACTITIONERS

WAC Sections

HTMLPDF246-928-320General definitions.
HTMLPDF246-928-410Licensure requirements for a respiratory care practitioner.
HTMLPDF246-928-420Respiratory care practitioner application requirements.
HTMLPDF246-928-430Respiratory care practitioner license renewal.
HTMLPDF246-928-442Continuing education.
HTMLPDF246-928-443Verification of continuing education.
HTMLPDF246-928-445Health equity training standards.
HTMLPDF246-928-450Expired respiratory care practitioner license.
HTMLPDF246-928-520Minimum educational qualifications for licensure as a respiratory care practitioner.
HTMLPDF246-928-540Examination requirements for licensure as a respiratory care practitioner.
HTMLPDF246-928-560Licensure for persons credentialed out-of-state.
HTMLPDF246-928-570Temporary practice permits for applicants credentialed out-of-state.
HTMLPDF246-928-580Education and training requirements for extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS).
HTMLPDF246-928-590Training requirements for the administration of nitrous oxide.
HTMLPDF246-928-710Mandatory reporting.
HTMLPDF246-928-990Respiratory care fees and renewal cycle.
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
246-928-015Scope of practice—Allowed procedures. [Statutory Authority: Chapter 18.89 RCW and RCW 43.70.040. WSR 95-18-019, § 246-928-015, filed 8/24/95, effective 9/24/95.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-020Recognized educational programs—Respiratory care practitioners. [Statutory Authority: RCW 18.89.050. WSR 92-15-032 (Order 285), § 246-928-020, filed 7/7/92, effective 8/7/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-020, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-020, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-030State examination—Examination waiver—Examination application deadline. [Statutory Authority: RCW 18.89.050. WSR 92-02-018 (Order 224), § 246-928-030, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 89-09-006 (Order PM 832), § 308-195-030, filed 4/7/89; WSR 88-10-015 (Order 724), § 308-195-030, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-040Examination eligibility. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-040, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-040, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-050Definition of "commonly accepted standards for the profession." [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-050, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-060Grandfather—Verification of practice. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-060, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-060, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-070Grandfather—Examination dates. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-070, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-23-001 (Order PM 787), § 308-195-070, filed 11/3/88; WSR 88-10-015 (Order 724), § 308-195-070, filed 4/27/88.] Repealed by WSR 92-02-018 (Order 224), filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 18.89.050.
246-928-080Reciprocity—Requirements for certification. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-080, filed 4/27/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-085Temporary permits—Issuance and duration. [Statutory Authority: RCW 18.130.050 and [18.130].075. WSR 92-15-032 (Order 285), § 246-928-085, filed 7/7/92, effective 8/7/92.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-090Certification renewal registration date. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-090, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-090, filed 4/27/88.] Repealed by WSR 98-05-060, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.280.
246-928-100Rural hospital exemption. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 88-10-015 (Order 724), § 308-195-100, filed 4/27/88.] Repealed by WSR 92-02-018 (Order 224), filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 18.89.050.
246-928-110General provisions. [Statutory Authority: RCW 18.89.050, 18.130.050 and 18.130.070. WSR 92-02-018 (Order 224), § 246-928-110, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-110, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-120, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-120Mandatory reporting. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-120, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-130, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-130Health care institutions. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-130, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-140, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-140Respiratory care practitioner associations or societies. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-140, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-150, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-150Professional liability carriers. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-150, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-160, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-160Courts. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-160, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-170, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-170State and federal agencies. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-170, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-180, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-180Cooperation with investigation. [Statutory Authority: RCW 18.89.050, 18.130.050 and 18.130.070. WSR 92-02-018 (Order 224), § 246-928-180, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-180, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. WSR 89-14-092 (Order PM 842), § 308-195-190, filed 6/30/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-190AIDS prevention and information education requirements. [Statutory Authority: RCW 43.70.280. WSR 98-05-060, § 246-928-190, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.89.050 and 70.24.270. WSR 92-02-018 (Order 224), § 246-928-190, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-190, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.24.270. WSR 88-22-077 (Order PM 786), § 308-195-200, filed 11/2/88.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-200Temporary practice. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-200, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 89-09-006 (Order PM 832), § 308-195-210, filed 4/7/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-210Definitions—Alternative training respiratory care practitioners. [Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-210, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 89-09-006 (Order PM 832), § 308-195-220, filed 4/7/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-220Alternative training requirements. [Statutory Authority: RCW 18.89.050. WSR 92-02-018 (Order 224), § 246-928-220, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-220, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.89.050. WSR 89-09-006 (Order PM 832), § 308-195-230, filed 4/7/89.] Repealed by WSR 01-11-165, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 18.89.050(1).
246-928-310Introduction. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-310, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-440Continuing education requirements. [Statutory Authority: RCW 18.89.050(1) and 18.89.140. WSR 01-21-136, § 246-928-440, filed 10/24/01, effective 11/24/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-441Implementation. [Statutory Authority: RCW 18.89.050(1) and 18.89.140. WSR 01-21-136, § 246-928-441, filed 10/24/01, effective 11/24/01.] Repealed by WSR 15-24-095, filed 11/30/15, effective 12/31/15. Statutory Authority: RCW 18.89.050 and 19.89.140 [ 18.89.140].
246-928-510Overview of the qualifications required for licensure as a respiratory care practitioner. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-510, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-530How new graduates may qualify for temporary practice and what is required. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-530, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-550Education and training in AIDS prevention is required for licensure as a respiratory care practitioner. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-550, filed 5/23/01, effective 6/23/01.] Repealed by WSR 21-02-002, filed 12/23/20, effective 1/23/21. Statutory Authority: RCW 18.19.050, 18.29.130, 18.29.210, 18.34.120, 18.46.060, 18.55.095, 18.84.040, 18.88B.060, 18.89.050, 18.130.050, 18.138.070, 18.155.040, 18.200.050, 18.205.060, 18.215.040, 18.230.040, 18.240.050, 18.250.020, 18.290.020, 18.360.030, 18.360.070, 70.41.030, 70.230.020, 71.12.670, and 18.108.085.
246-928-720Health care institutions. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-720, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-730Respiratory care practitioner associations or societies. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-730, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-740Professional liability carriers. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-740, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-750Courts. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-750, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.
246-928-760State and federal agencies. [Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-760, filed 5/23/01, effective 6/23/01.] Repealed by WSR 22-11-013, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 2021 c 114.


PDF246-928-320

General definitions.

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Analgesia" means providing pain relief or loss of physical sensation without the total loss of consciousness or physical movement, and which allows the patient to respond to verbal commands and tactile stimulation.
(2) "Applicant" means a person whose application for licensure as a respiratory care practitioner is being submitted to the department.
(3) "Department" means the Washington state department of health.
(4) "Respiratory care practitioner" means a person licensed by the department, who is authorized under chapter 18.89 RCW and these rules to practice respiratory therapy. WAC 246-928-410 explains who must be licensed as a respiratory care practitioner.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-320, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-320, filed 5/23/01, effective 6/23/01.]



PDF246-928-410

Licensure requirements for a respiratory care practitioner.

This section identifies who must be licensed as a respiratory care practitioner with the department and who is exempt from licensure.
(1) Any person performing or offering to perform the functions authorized in RCW 18.89.040 must be licensed as a respiratory care practitioner. A certification, registration or other credential issued by a professional organization does not substitute for licensure as a respiratory care practitioner in Washington state.
(2) The following individuals are exempt from licensure as a respiratory care practitioner:
(a) Any person performing or offering to perform the functions authorized in RCW 18.89.040, who is either registered, certified, licensed, or similarly regulated under the laws of this state and is performing services within the person's authorized scope of practice;
(b) Any person employed by the United States government who is practicing respiratory care as a performance of the duties prescribed for him or her by the laws of and rules of the United States;
(c) Any person who is pursuing a supervised course of study leading to a degree or certificate in respiratory care, if the person is designated by a title that clearly indicates their status as a student or trainee and limited to the extent of demonstrated proficiency of completed curriculum, and under direct supervision;
(d) Any person who is licensed as a registered nurse under chapter 18.79 RCW;
(e) Any person who is practicing respiratory care without compensation for a family member.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-410, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-410, filed 5/23/01, effective 6/23/01.]



PDF246-928-420

Respiratory care practitioner application requirements.

To become licensed as a respiratory care practitioner, an applicant shall:
(1) Submit to the department:
(a) A completed application as provided by the department;
(b) Proof of meeting the education requirements in WAC 246-928-520;
(c) The appropriate fee required in WAC 246-928-990; and
(d) Any other information determined necessary by the department; and
(2) Comply with the examination requirements in WAC 246-928-540.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-420, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-420, filed 5/23/01, effective 6/23/01.]



PDF246-928-430

Respiratory care practitioner license renewal.

(1) To renew a license a respiratory care practitioner shall submit a renewal form provided by the department, with the appropriate fee required in WAC 246-928-990.
(2) The specific requirements and process for renewal of a license are in WAC 246-12-030.
(3) Renewal fees must be postmarked on or before the renewal date or the department will charge a late renewal penalty fee and licensure reissuance fee.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-430, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-430, filed 5/23/01, effective 6/23/01.]



PDF246-928-442

Continuing education.

To renew a respiratory care practitioner license, the licensee shall acquire 30 credit hours of respiratory care continuing education every two years as required in RCW 18.89.140. Licensees shall meet the continuing education requirements outlined in this section and report completed continuing education as required in WAC 246-12-170 through 246-12-240.
(1) The following are categories of required continuing education activities for licensed respiratory care practitioners:
(a) A minimum of 10 credit hours of continuing education during each two-year reporting cycle must be earned in courses approved by the American Association for Respiratory Care (AARC).
(b) Beginning January 1, 2024, a respiratory care practitioner must complete two hours of health equity training each reporting cycle, as specified in WAC 246-928-445.
(c) The remaining 18 hours of continuing education during each two-year reporting cycle may be in any of the following areas:
(i) Sponsored courses. Continuing education courses sponsored or approved by entities listed in subsection (2) of this section;
(ii) Certifications and examinations. Completing professional certifications or examinations listed in subsection (3) of this section;
(iii) Education and instruction. Completing or instructing coursework as described in subsection (4) of this section; and
(iv) Related studies. Completing up to 10 hours per reporting cycle of activities listed in subsection (5) of this section.
(2) Sponsored courses. Eligible courses are sponsored or approved by the:
(a) American Academy of Pediatrics;
(b) American Academy of Physician Assistants;
(c) American Association of Critical Care Nurses;
(d) American Association for Respiratory Care;
(e) American College of Chest Physicians;
(f) American College of Emergency Physicians;
(g) American College of Physicians;
(h) American Medical Association;
(i) American Nurses Association;
(j) American Osteopathic Association;
(k) American Thoracic Society;
(l) Society of Critical Care Medicine;
(m) Washington academy of physician assistants;
(n) Washington osteopathic medicine association;
(o) Washington state medical association;
(p) Washington state nurses association;
(q) Extracorporeal life support organization; or
(r) American Society of Extracorporeal Technology.
(3) Certifications and examinations. The following certifications and examinations are valid for continuing education credit:
(a) Ten credit hours each may be claimed for the following initial or renewal certifications:
(i) Advanced cardiac life support (also known as ACLS);
(ii) Neonatal advanced life support (also known as NALS, or neonatal resuscitation program or NRP); and
(iii) Pediatric advanced life support (also known as PALS).
(b) Five credit hours may be claimed for initial or renewal certification in basic life support (also known as BLS).
(c) Ten credit hours each may be claimed for passing either of the following National Board of Respiratory Care (NBRC) advanced practitioner examinations:
(i) The NBRC therapist multiple-choice examination combined with the clinical simulation examination that awards NBRC registration; or
(ii) Registered pulmonary function technologist.
(d) Five credit hours each may be claimed for passing any of the following:
(i) The NBRC therapist multiple-choice examination that awards NBRC certification;
(ii) Any NBRC specialty examination;
(iii) The NBRC self-assessment competency examination with a minimum score of 75; or
(iv) National Asthma Educator Certification Board certified asthma educator examination.
(4) Education and instruction. A licensee may claim continuing education credit for:
(a) Courses completed at a regionally accredited college, university, or institute of higher education. Such courses must focus on the clinical practice of respiratory care or education related to the cardiopulmonary system. Credit hours for such courses may be claimed as either:
(i) Actual semester contact hours (such as 15 semester contact hours shall be equal to 15 continuing education credits); or
(ii) An academic credit formula that multiplies the academic credits by a factor of three (such as four academic credits shall be equal to 12 continuing education credits).
(b) Respiratory care educational offerings provided by hospitals or health organizations.
(c) Serving as an instructor of educational offerings in respiratory care provided by hospitals or health organizations; or at a regionally accredited college, university, or institute of higher education. Such educational offerings must include learning objectives. The number of credit hours claimed for serving as an instructor shall be the same number as those earned by attendees. The credit hours for presenting a specific topic, lecture, or education course may only be used for continuing education once during each reporting cycle.
(5) Related studies. Up to 10 credit hours of continuing education during a two-year reporting cycle may be in any of the following areas:
(a) Self-study. Journal reading of publications related to respiratory care;
(b) Practice related topics. Formal, internet-based, or video-format courses offered by organizations not listed in (b) of this subsection including, but not limited to, the American Association of Cardiovascular and Pulmonary Rehabilitation, the Association for the Treatment of Tobacco Use and Dependence, or the Council for Tobacco Treatment Training Programs; or
(c) Nonclinical practice topics. Courses or activities including, but not limited to, health promotion, health care cost management, mandatory reporting, professional ethics, and regulatory affairs.
(6) Documentation requirements. A licensee is responsible for acquiring and maintaining all acceptable documentation of their continuing education activities, as required in WAC 246-12-170 through 246-12-240. Acceptable documentation must include transcripts, letters from course instructors, or certificates of completion or other formal certifications provided by hospitals, course instructors, and health organizations. In all cases other than transcripts, the documentation must show the participant's name, activity title, number of continuing education credit hours, date(s) of activity, instructor's name(s) and degree and the signature of the verifying individual program sponsor.
[Statutory Authority: RCW 18.89.050, 18.89.140, and 2021 c 276. WSR 23-21-076, § 246-928-442, filed 10/13/23, effective 1/1/24. Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-442, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050 and 19.89.140 [ 18.89.140]. WSR 15-24-095, § 246-928-442, filed 11/30/15, effective 12/31/15. Statutory Authority: RCW 18.89.050(1) and 18.89.140. WSR 01-21-136, § 246-928-442, filed 10/24/01, effective 11/24/01.]



PDF246-928-443

Verification of continuing education.

(1) The licensee shall:
(a) Verify on renewal forms provided by the department, that the minimum continuing education has been completed within the two-year renewal cycle prior to the licensee's renewal date; and
(b) Keep records for four years as required in WAC 246-12-200.
(2) The department may conduct random compliance audits of continuing education records in compliance with WAC 246-12-170 through 246-12-240.
(3) In certain emergency situations, the department may excuse all or part of the continuing education requirement in compliance with WAC 246-12-210. The department may require verification of the emergency.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-443, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1) and 18.89.140. WSR 01-21-136, § 246-928-443, filed 10/24/01, effective 11/24/01.]



PDF246-928-445

Health equity training standards.

(1) Beginning on January 1, 2024, a respiratory care practitioner must complete training in health equity as a part of their continuing education requirements. The respiratory care practitioner must complete at least two hours of health equity training every two-year renewal cycle. The training must meet the minimum standards under RCW 43.70.613 and comply with course requirements in WAC 246-12-800 through 246-12-830.
(2) Health equity continuing education counts toward the 30 total hours of continuing education required under WAC 246-928-442.
[Statutory Authority: RCW 18.89.050, 18.89.140, and 2021 c 276. WSR 23-21-076, § 246-928-445, filed 10/13/23, effective 1/1/24.]



PDF246-928-450

Expired respiratory care practitioner license.

To return an expired license to active status, the applicant shall meet the requirements in WAC 246-12-040.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-450, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-450, filed 5/23/01, effective 6/23/01.]



PDF246-928-520

Minimum educational qualifications for licensure as a respiratory care practitioner.

(1) To meet the educational requirements required by RCW 18.89.090, an applicant must be a graduate of at least a two-year respiratory therapy educational program. The program must be accredited by:
(a) The Committee on Accreditation for Respiratory Care (CoARC);
(b) The American Medical Association's (AMA) Committee on Allied Health Education and Accreditation (CAHEA); or
(c) The Commission on Accreditation of Allied Health Education Program (CAAHEP).
(2) An official transcript indicating completion of at least a two-year program must be provided as evidence of fulfillment of the required education.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-520, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-520, filed 5/23/01, effective 6/23/01.]



PDF246-928-540

Examination requirements for licensure as a respiratory care practitioner.

(1) An applicant who has taken and passed both the therapist multiple choice examination and the clinical simulation examination for the registered respiratory therapist credential provided by the National Board for Respiratory Care (NBRC), has met the minimum examination requirements of RCW 18.89.090 (1)(b). Applicants shall request the NBRC verify to the department that the applicant has successfully passed the NBRC examinations.
(2) An active registered respiratory therapist credential with NBRC is considered proof of meeting the minimum examination requirements.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-540, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-540, filed 5/23/01, effective 6/23/01.]



PDF246-928-560

Licensure for persons credentialed out-of-state.

An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. To be considered for licensure:
(1) The applicant shall submit to the department:
(a) A completed application on forms provided by the department;
(b) Proof of meeting the education requirements in WAC 246-928-520 or subsection (4) of this section; and
(c) A fee as specified in WAC 246-928-990.
(2) The applicant shall comply with the examination requirements in WAC 246-928-540 or subsection (4) of this section.
(3) The applicant shall request written verification directly from all states in which the applicant is or was credentialed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment.
(4) Applicants who have completed at least a two-year program recognized by the Canadian Society of Respiratory Therapists (CSRT) in their current list, or any previous lists, and have passed the CSRT registry examination; or have been issued a registration by the CSRT are considered to have met the educational and examination requirements in this chapter. Canadian applicants are required to submit verification directly from CSRT, as well as all of the information listed above for applicants licensed in another jurisdiction.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-560, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-560, filed 5/23/01, effective 6/23/01.]



PDF246-928-570

Temporary practice permits for applicants credentialed out-of-state.

(1) An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. Applicants must submit the following documentation to be considered for a temporary practice permit:
(a) A completed application on forms provided by the department with the request for a temporary practice permit indicated;
(b) An application fee and a temporary practice permit fee as specified in WAC 246-928-990;
(c) Written verification directly from all states or jurisdictions in which the applicant is or was licensed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment; and
(d) Verification of completion of the required education and examination as specified in WAC 246-928-520.
(2) The department shall issue a one-time-only temporary practice permit unless the department determines a basis for denial of the license or issuance of a conditional license.
(3) The temporary permit shall expire upon the issuance of a license by the department, or within 90 days, whichever occurs first. The permit shall not be extended beyond the expiration date.
(4) Issuance of a temporary practice permit does not ensure that the department will grant a full license. Temporary permit holders are subject to the same education and examination requirements as set forth in WAC 246-928-520 and 246-928-550.
(5) The following situations are not considered substantially equal for Washington state licensure:
(a) Certification of persons credentialed out-of-state through a state-constructed examination; or
(b) Legacy provisions where proof of education and examination was not required.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-570, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-570, filed 5/23/01, effective 6/23/01.]



PDF246-928-580

Education and training requirements for extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS).

(1) In order to provide extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS), a respiratory care practitioner shall first complete education and hands-on experience specific to this treatment. The education must meet the guidelines in the 2010 Extracorporeal Life Support Organization (ELSO) Guidelines for Training and Continuing Education of ECMO Specialists and must include:
(a) Didactic sessions of at least 24 hours;
(b) Hands-on proficiencies, also known as water drills, including:
(i) Basic session with a discussion and demonstration of the equipment; and
(ii) Emergency session to address failure of the equipment and corrections;
(c) High-fidelity simulation or animal sessions; and
(d) Preceptor training, also known as bedside training, of at least 16 hours.
(2) An ECMO or ECLS training program which meets the standards set by ELSO meets the training requirements of this section. This includes, but is not limited to, institutes and facilities that employ respiratory care practitioners.
(3) A respiratory care practitioner who provides ECMO or ECLS shall meet any annual training and certification requirements of their institute or facility, which may include, but are not limited to, examinations, evaluations, or continuing education requirements.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-580, filed 5/9/22, effective 7/1/22.]



PDF246-928-590

Training requirements for the administration of nitrous oxide.

(1) A respiratory care practitioner shall follow the training requirements and protocols of the hospital or facility in which they are employed when providing nitrous oxide for analgesia.
(2) To provide nitrous oxide for analgesia, a respiratory care practitioner shall complete training that includes, but is not limited to, the following components:
(a) Nitrous oxide training which provides education specific to administering nitrous oxide for analgesia;
(b) In-service competency which includes hands-on proficiency in the administration of nitrous oxide for analgesia; and
(c) Observed competency requirement of at least one successful, independent administration of nitrous oxide observed by a licensed individual currently qualified to provide this treatment.
(3) Respiratory care practitioners may only administer nitrous oxide for analgesia under direct supervision of a health care practitioner as defined in RCW 18.89.020 who is on-site and physically present in the treatment operatory.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-590, filed 5/9/22, effective 7/1/22.]



PDF246-928-710

Mandatory reporting.

Individuals and other entities must report unprofessional conduct in compliance with the Uniform Disciplinary Act in chapter 18.130 RCW and the standards of professional conduct in chapter 246-16 WAC.
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-710, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-710, filed 5/23/01, effective 6/23/01.]



PDF246-928-990

Respiratory care fees and renewal cycle.

(1) Licenses must be renewed every two years on the practitioner's birthday as provided in WAC 246-12-030.
(2) The following nonrefundable fees will be charged:
Title of Fee
Fee
Application
$140.00
Temporary practice permit
50.00
Duplicate license
15.00
Verification of licensure
15.00
Renewal
110.00
Late renewal penalty
55.00
Expired license reissuance
65.00
[Statutory Authority: RCW 18.89.050 and 2021 c 114. WSR 22-11-013, § 246-928-990, filed 5/9/22, effective 7/1/22. Statutory Authority: RCW 43.70.280. WSR 15-19-149, § 246-928-990, filed 9/22/15, effective 1/1/16. Statutory Authority: RCW 43.70.110, 43.70.250, and 2010 c 37. WSR 10-19-071, § 246-928-990, filed 9/16/10, effective 10/15/10. Statutory Authority: RCW 43.70.110, 43.70.250 and 2008 c 329. WSR 08-16-008, § 246-928-990, filed 7/24/08, effective 7/25/08. Statutory Authority: RCW 43.70.250, [43.70.]280 and 43.70.110. WSR 05-12-012, § 246-928-990, filed 5/20/05, effective 7/1/05. Statutory Authority: RCW 18.89.050(1). WSR 01-11-165, § 246-928-990, filed 5/23/01, effective 6/23/01. Statutory Authority: RCW 43.70.250. WSR 99-08-101, § 246-928-990, filed 4/6/99, effective 7/1/99. Statutory Authority: RCW 43.70.280. WSR 98-05-060, § 246-928-990, filed 2/13/98, effective 3/16/98. Statutory Authority: Chapter 18.89 RCW and RCW 43.70.040. WSR 95-18-019, § 246-928-990, filed 8/24/95, effective 9/24/95. Statutory Authority: RCW 43.70.250. WSR 92-15-032 (Order 285), § 246-928-990, filed 7/7/92, effective 8/7/92. Statutory Authority: RCW 18.89.050 and 43.70.250. WSR 92-02-018 (Order 224), § 246-928-990, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-928-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.24.086. WSR 88-17-099 (Order PM 741), § 308-195-110, filed 8/23/88.]