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Hospitals and nursing facilities urge changes to respiratory-care bill over LVN scope exclusions
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Summary
Supporters of SB 1304 urged extending the Respiratory Care Board’s sunset and clarified training for expanded LVN respiratory tasks; hospitals, skilled nursing facilities and provider groups opposed the bill unless it includes SNFs and hospitals where LVNs already perform basic respiratory care.
The Senate Business and Professions Committee heard extended debate over SB 1304, the sunset-extension bill for the Respiratory Care Board, as hospitals and nursing-home groups pressed the author to amend the measure to include certain licensed health facilities among settings where licensed vocational nurses may perform basic respiratory-care tasks.
The author said SB 1304 would extend the board’s operations through Jan. 1, 2031, consolidate examinations, update exempt practice settings and revise fee structures. "The safety of medically fragile individuals is my utmost concern," the author said, and described the bill as a work in progress.
Catherine Pitt, introduced as Assistant Executive Director of the Respiratory Care Board, told the committee regulators were focused on patient acuity and that the board plans additional training, especially for higher-acuity settings such as hospitals and skilled nursing facilities. "A patient in a hospital or a SNF is at a higher acuity level, so they require more technical respiratory services," she said, adding that regulation would require patient-specific additional training for LVNs.
Opponents from the California Association of Health Facilities and the California Hospital Association said the bill’s current language would exclude SNFs and many hospitals from being settings where trained LVNs can provide basic respiratory care, creating care disruptions and added costs in areas with severe staffing shortages. "Establishing a more restrictive scope of practice for LVNs working in health facilities than for LVNs working in a non-health care facility is contrary to the State's goals for patient safety and public protection," a CAF representative told the committee.
A representative of respiratory therapists argued that the LVN role already includes routine tasks such as light suctioning and mask adjustments and suggested that training permitted in community settings should be allowed in health-care settings as well.
Committee members asked technical questions about what ‘‘advanced’’ respiratory services would include; Pitt said specific service lists would be provided as part of the regulation package and identified examples including oxygen management and ventilator-related tasks.
After the public exchange and committee questions, the committee moved SB 1304 as amended toward the Senate Appropriations Committee for further work and stakeholder negotiations.
The committee’s next steps include clarifying whether and how hospitals and SNFs will be included and the specific training and supervision requirements for LVNs listed in forthcoming regulatory language.
