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Board Meeting News
July 8, 2010
At its regularly scheduled meeting the Board:
Approved a Position Statement on Respiratory Care Protocols.
Approved a Position Statement on Respiratory Care Management.
Referred to the Practice Committee a proposed Position Statement on Respiratory Care Equipment for Home Care.
Referred to the Practice Committee a proposed Position Statement on Delivery of Respiratory Therapy Services in Skilled Nursing Facilities Providing Ventilator and / or High Acuity Respiratory Care.
At the request of George Young, RCP, the Board approved an Interpretative Letter concerning RCP's administering Lexiscan and Aminophylline during cardiac stress testing.
Rescinded the Declaratory Ruling for Respiratory Care Assistants effective August 31, 2011. A RCP Student may apply for Respiratory Care Assistant registration until August 31, 2011. The registration will expire upon graduation or withdrawal or dismissal from the Respiratory Care Education program.
Referred to the Education Committee to review and make recommendations to improve compliance with the Respiratory Care Assistant declaratory ruling until its ending effective date of August 31, 2011.
Adopted the proposed amendments to Board Rules 21 NCAC 61 .0204, 21 NCAC 61 .0302, 21 NCAC 61 .0308 and 21 NCAC 61 .0401. Board Rule 21 NCAC 61 .0103 was adopted with changes approved by Board resolution.
Board Meeting News
April 8, 2010
At its regularly scheduled meeting the Board:
Approved a Resolution endorsing the COPD Community Chronic Care Model.
Referred to the Practice Committee a proposed Position Statement on Respiratory Care Management.
Referred to the Practice Committee a proposed Position Statement on Respiratory Care Protocols.
Referred to the Education Committee for review and recommendations concerning RCP Student co-signing orders, review of the Respiratory Care Assistant Ruling, request for CE approval at Board Meetings, and CE specific content.
At the request of William Mashburn, RCP the Board approved an Interpretative Letter concerning RCP's writing orders supported by Respiratory Care Protocols.
At the request of Judy Hilton, RCP the Board approved an Interpretative Letter concerning RCP's starting IV's and removing sutures from tracheostomy.
Approved changes to Board Rules 21 NCAC 61 .0103, .0204, .0302, .0308 and .0401. The proposed amendments will be published in the NC Register on May 3, 2010.
Board Approves Position Statement "Chronic Disease Management"
January 14, 2010
At its regularly scheduled meeting the Board:
Approved a Position Statement on Chronic Disease Management.
Introduced new Board members:
Dr. Edward Bratzke, MD, appointed by the President Pro Tem of the Senate. His term will expire October 31, 2012.
Dr. Joseph Coyle, MD, appointed by the Speaker of the House. His term will expire October 31, 2012.
Dan Grady, RCP, appointed by the NC Hospital Association. His term will expire October 31, 2012.
Kimberly Clark, RCP, appointed by the Speaker of the House. Her term will expire October 31, 2012.
Tim Safley, RCP, reappointed by the NC Association of Medical Equipment Services. His term will expire October 31, 2012.
Elected Officers for 2010:
Chairman- Joseph. Coyle, MD.
Vice-Chairman- Dan Grady, RCP
Secretary- Sherry Samuels
Treasurer- Tim. Safley, RCP
Board Chair assigned the following Committee Members:
Ethics Committee: Kim Roseman (Chair), Arnold Frazier, MD, and Floyd Boyer, RCP (ex officio)
Rules Committee: Tim Safley, RCP (Chair), Edward Bratzke, MD, Sherry Samuels, and Floyd Boyer, RCP (ex officio)
Investigation and Informal Settlement Committee: Sherry Samuels (Chair), Tim Safley, RCP, Dan Grady, RCP, Floyd Boyer, RCP (ex officio), and Judy Green, RCP (ex officio)
Practice Committee: Joseph Coyle, MD (Chair), Ralph Webb, RCP, Arnold Frazier, MD, and Floyd Boyer, RCP (ex officio)
Education Committee: Kimberly Clark, RCP (Chair), Ralph Webb, RCP, Bob Campbell, RCP, and Floyd Boyer, RCP (ex officio)
Board Approves Declaratory Ruling Concerning Sleep Related Testing
October 8, 2009
At its regularly scheduled meeting the Board:
Approved a Practice Committee recommendation to approve a Declaratory Ruling concerning Sleep Related Testing and to rescind all previous Declaratory Rulings concerning Sleep Technology. To view the ruling click Sleep Related Testing.
Approved a resolution from the Board stating that providing flu vaccine injections and subcutaneous Xolair is within the scope of practice of Respiratory Care Practitioners. The RCP must have documented training and competency review in the procedures. The RCP must have approval of the health care facility and have written policies and procedures
Approved a resolution from the Board stating the use of lasers is not within the scope of practice for Respiratory Care Practitioners in North Carolina.
Approved the Audit Report from Koone, Wooten and Haywood, LLP.
Awarded Service Plagues to outgoing Board Members:
Bill Croft, RCP- December 20, 2002 – October 31, 2009
Peggy Mitchell, RCP- December 20, 2002 – October 31, 2009
Karl Karlson, MD- November 1, 2006 – October 31, 2009
Tom Goodin, MD- November 1, 2003 – October 31, 2009
Wayne Beauford, MD- November 1, 2003 – October 31, 2009
Board Approves Polysomnography Practice Act Position Statement
May 18, 2009
At a special meeting, the Board approved a Position Statement supporting House Bill 819 and Senate Bill 892 as an important first step in the regulation of this field. The Position Statement may be viewed by clicking Position Statement.
Board Approves Change in License Expiration Date
April 9, 2009
At its regularly scheduled meeting the Board:
Approved a Practice Committee recommendation to change the expiration dates of licenses to the end of the month as they are renewed (Note: the expiration date does not change on your current license card. The date will change to the end of the month upon renewal for the renewal period April 9, 2009 to April 8, 2010). The change in expiration date will be phased in over the next year (April 9, 2009 to April 8, 2010). The approved policy change reads as follows:
The license will expire annually on the last day of the month in which it was issued (except for February 29). The license may be renewed only during the month of expiration.
Took no action on a request from the NC Council of State to change board policy or rules to amend or waive licensing requirements for Guards and Reservists while deployed. Current Board policy will meet the Council's requests.
Approved the Board apply for membership in the Citizen Advocacy Center.
Sent to the Practice Committee for further study, a request from Terry Smith of the NCSRC to look into standards for managing Respiratory Care Departments.
Approved a motion that the Board recommend to the General Assembly that a study commission be enacted to study the practice of polysomnography and come up with a bill that interested stakeholders could approve.
Board Approves Revised Declaratory Ruling Concerning Sleep Technology
January 8, 2009
At its regularly scheduled meeting the Board:
Approved a Practice Committee recommendation to approve a revised Declaratory Ruling concerning Sleep Technology. To view the ruling click Sleep Technology.
Approved a motion that the Board supports the scope of practice in all hospitals in the state of North Carolina that only licensed individuals may take verbal orders from physicians.
The Board referred a request from the State Auditor to the Rules Committee to enact Rules to offer relief to Guard and Reservists in order to maintain their licenses while on deployment,
Board Approves Position Statement Concerning Sleep Disorders Testing
October 9 , 2008
At its regularly scheduled meeting the Board:
Approved a Position Statement "Diagnostic Testing and Treatment of Sleep Related Disorders".
Sent back to committee for further study, a request from Wendy Yates of Respironics to allow RCP’s licensed in other states to perform orientation and competency evaluations of North Carolina licensed RCP’s without being licensed in North Carolina.
Approved a Declaratory Ruling allowing Chris Howard, RCP of Carolinas Medical Center-Pineville, NC to provide advanced practices during cardiac stress testing.
Took no position on a request from Recbecca Williams, RCP of Forsyth Medical Center concerning home care ventialtors in the hosptial setting.
Endorsed the AARC's Postion Statement "Inhaled Medication Administration Schedules" as the official position of the Board.
Board Endorses AARC's Uniform Reporting Manual
July 10, 2008
The Board approved a request from Dan Grady, RCP and The NC Respiratory Care Manager Group to endorse the AARC's Uniform Reporting Manual as an official position of the Board. The manual will help Respiratory Care Departments determine proper staffing requirements.
Board Rescinds Position Statement
July 10, 2008
The Board rescinded the Position Statement “The Provision Of Respiratory Care and Its Relationship to the Provision of Respiratory Care Equipment in the Home”, that was approved at its April 10, 2008 Board Meeting. The Board returned the statement to committee for further review.
In other action the Board sent back to the Practice Committee for further review, a request from the NC Hospital Association to endorse the AARC's Position Statement concerning Polysomnography certification requirements.
The Board approved a request from Tammy Creed, RCP and Laurie Hunt, RCP to modifying the declaratory ruling of January 6, 2005 to allow RCP's to administer atropine and Lopressor during stress testing. Click Ruling to review the revised document.
The Board sent back to committee for further study a request from Wendy Yates of Respironics to allow RCP’s licensed in other states to perform orientation and competency evaluations of North Carolina licensed RCP’s without being licensed in North Carolina.
Home Care Subcommittee Meeting for Public Comment
June 18 , 2008
The Board's Home Care Subcommittee met for the purpose of soliciting public comment to the Position Statement “The Provision Of Respiratory Care and Its Relationship to the Provision of Respiratory Care Equipment in the Home” that was approved by the Board at its April 10, 2008 meeting.
Board Approves Position Statement
April 10, 2008
The Board approved a Position Statement “The Provision Of Respiratory Care and Its Relationship to the Provision of Respiratory Care Equipment in the Home”. The Position Statement defines the support activities that are permitted in the home care setting with oversight by a licensed Respiratory Care Practitioner or other appropriately licensed health care provider. Click Position Statement to view the approved document.
In other action the Board sent back to the Practice Committee for further review, a request for a Position Statement concerning Polysomnography certification requirements.
The Education Committee presented information concerning the BSRT degree program at UNC-Charlotte. For information click BSRT Program.
Changes to Board Rules
Effective March 1, 2008 and April 1, 2008
Board Rules 21 NCAC 61 .0204 and 21 NCAC 61 .0305 have been amended and became effective March 1, 2008. Board Rule 21 NCAC 61 .0201 has been amended and became effective April 1, 2008.
21 NCAC 61 .0201 APPLICATION PROCESS
(a) Each applicant for a respiratory care practitioner license shall complete an application form provided by the Board. This form shall be submitted to the Board and shall be accompanied by:
(1) one head and shoulders passport type photograph of the applicant of acceptable quality for identification, two inches by two inches in size;
(2) the fee established in Rule .0204 of this Chapter;
(3) evidence, verified by oath, that the applicant has successfully completed the minimum requirements of a respiratory care education program approved by the Commission for Accreditation of Allied Health Educational Programs or the Canadian Council on Accreditation for Respiratory Therapy Education;
(4) evidence, verified by oath, that the applicant has successfully completed the requirements for certification in Basic Life Support which includes Adult, Child and Infant Cardiopulmonary Resuscitation (CPR), the Heimlich Maneuver, and Automatic External Defibrillator (AED) use by the American Heart Association, the American Red Cross or the American Safety and Health Institute; and
(5) evidence from the National Board for Respiratory Care (NBRC) of successful completion of the Certified Respiratory Therapist (CRT) examination administered by it.(b) Applicants for initial licensure in North Carolina, who have been inactive and who have not practiced respiratory care for a period of time greater than one year, must complete the following requirements in addition to the requirements in Paragraph (a) of this Rule:
(1) for applicants who have not practiced respiratory care for a period of time greater than one year, but less than five years, the applicant must provide evidence of twelve hours of continuing education, that meet the requirements of 21 NCAC 61 .0401, for each full year of inactivity; and
(2) for applicants who have not practiced respiratory care for a period of time greater than five years, the applicant must provide evidence of either:
(A) sixty hours of continuing education that meet the requirements of 21 NCAC 61 .0401 and evidence from the National Board for Respiratory Care (NBRC) of successful completion of the Certified Respiratory Therapist (CRT) examination taken as an assessment examination within the 90-day period before issuance of a license, or
(B) completion of a Respiratory Care refresher course offered through a Respiratory Care Education program accredited by the Commission for the Accreditation of Allied Health Educational Programs.History Note: Authority G.S. 90 652 (1), (2) and (13); 90-653(a);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. April 1, 2007; November 1, 2004; March 1, 2004.21 NCAC 61 .0204 FEES
(a) Fees are as follows:
(1) For an initial application, a fee of fifty dollars ($50.00);
(2) For issuance of an active license, a fee of one hundred twenty-five dollars ($125.00);
(3) For the renewal of an active license, a fee of sixty five dollars ($65.00);
(4) For the late renewal of any license, an additional late fee of seventy- five dollars ($75.00);
(5) For a license with a provisional or temporary endorsement, a fee of fifty dollars ($50.00);
(6) For official verification of license status, a fee of twenty dollars ($20.00);(b) Fees shall be nonrefundable and shall be paid in the form of a cashier's check, certified check or money order made payable to the North Carolina Respiratory Care Board. However, personal checks shall be accepted for payment of renewal fees.
History Note: Authority G.S. 90-652(2);(9); 90-660;
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. March 1, 2007; March 1, 2004.
21 NCAC 61 .0305 INACTIVE STATUS(a) A licensee who wishes to retain a license but who will not be practicing respiratory care may obtain inactive status by indicating this intention on the annual renewal and payment of a fee of twenty dollars ($20.00). An individual licensed on inactive status may not practice respiratory care during the period in which he or she remains on inactive status.
(b) An individual licensed on inactive status may convert his or her license to active status by submission of a renewal application and payment of the renewal fee and late fee. The renewal application must contain evidence of the completion of a minimum of twelve hours of continuing education that meets the requirements of 21 NCAC 61 .0401 for each full year of inactivity.
(c) In no case may an individual remain on inactive status for more than 60 months.History Note: Authority G.S 90 652(1),(2),(4);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002;
Amended Eff. March 1, 2007; June 1, 2005.Board Adopts Proposed Rule Changes
January 10, 2008
Amendments to Board Rules 21 NCAC 61 .0201, 21 NCAC 61 .0204 and 21 NCAC 61 .0305 were adopted by the Board. The proposed changes were reviewed at a Public Hearing on November 15, 2007. The deadline for written comments ended on December 31, 2007. The adopted Rules changes have been submitted to the Rules Review Coommission. Click Rule Changes Pages 912-913 to review the proposed changes.
In other actions the Board elected Ralph Webb, RCP as the Board Chair, Karl Karlson, MD as the Board Vice Chair and Sherry Samuels as the Board Secretary and Treasurer. The Ad Hoc Committee to study CPAP setups in the home and new technology for home based sleep studies is still working on a Position Statement or Declaratory Ruling concerning these procedures. The committee is to report back to the Practice Committee before the next Board meeting.
The Sleep Technology Subcommittee reported on CMS Rules changes concerning sleep studies and individuals that may perform the studies. The committee also gave the Board proposed language for a Polysomnographic Technologist Licensure Bill.
Board Approves Proposed Rule Changes
October 11, 2007
Amendments to Board Rules 21 NCAC 61 .0201, 21 NCAC 61 .0204 and 21 NCAC 61 .0305 were approved by the Board. Click Rule Changes Pages 912-913 to review the proposed changes.
In other actions the Board Chair appointed an Ad Hoc Committee to study changes to the current Positon Statement concerning CPAP setups in the home and new technology for home based sleep studies. The committee is to report back to the Board at its January meeting.
Board Approves Resolutions
July 12, 2007
The NCRCB approved a resolution to endorse the AARC's White Paper on Concurrent Therapy as the official position of the Board. The position statement may be viewed and downloaded at Concurrent Therapy.
In other actions the Board:
April 12, 2007
The NCRCB approved a resolution to support of Allied Health Funding and a resolution to support House Bill 267 and Senate Bill 125 to add ethyl alcohol as a substance specifically named as a toxic vapor and make illegal any instrument that can be used to atomize or introduce a toxic vapor in to body unless it is a device used to deliver a prescription medication or an approved over-the-counter medication.
In other actions the Board:
Board Approves Proposed Bills
January 11, 2007
The NCRCB approved moving forward with a proposed Bill to license polysomnographic technologists. The Board also approved changes to the Respiratory Care Practice Act to increase fees and provide for Advanced Practice Endorsement.
In other actions the Board approved a Practice Committee recommendation to withdraw a proposed Position Statement concerning Support Technicians.
Changes to Board Rules
Effective October 13, 2006
Amendments to Board Rule 21 NCAC 61 .0103 was adopted by the Board. Amendments to Board Rule 21 NCAC 61 .0401 was approved by the Board.
Declaratory Ruling on Respiratory Care Assistants
Effective July 13, 2006
The Board approved changes to the Declaratory Ruling for Respiratory Care Assistants by requiring the applicant to complete competency evaluations, which includes laboratory and clinical evaluations. The revised ruling may be viewed at RC Assistant Ruling.
Declaratory Ruling on Respiratory Care Assistants
Effective April 13, 2006
The Board approved changes to the Declaratory Ruling for Respiratory Care Assistants by adding the following to the approved tasks list: Devices designed to augment airway clearance, e.g. EzPAP, Flutter, etc.
Sleep Technology Guidance
Effective January 12, 2006
The Board approved guidance statements and representative forms to give indivuduals guidance on compliance with the ruling on sleep labs approved October 6, 2005. The guidance statements and forms may be viewed and downloaded at Sleep Guidance.
Position Statment of Financial Relationships and Referral Incentives
Effective January 12, 2006
The Board approved a position statement to give indivuduals guidance on financial relationshios and referral incentives. The positon statement may be viewed and downloaded at Position Statement.
Declaratory Rulings on Advanced Practice
Effective October 6, 2005
The Board approved changes to the Declaratory Ruling for Advanced Practice for RCP's relating to ECMO. The ruling may be viewed at Advanced Practice-ECMO.
The Board approved changes to the Declaratory Ruling for Advanced Practice for RCP's relating to EMS Services. The ruling may be viewed at Advanced Practice for RCP's.
Changes to Board Rules
Effective October 6, 2005
Board Rule 21 NCAC 61 .0103 and 21 NCAC 61 .0202 was approved by the Board for amendment. A public hearing will be held at the Board office on November 17, 2005.
Changes to Declaratory Ruling on Sleep Labs
Effective October 6, 2005
The Board approved changes to the Declaratory Ruling on Sleep Labs. The revised ruling adds the technician level provider and certification requirements. The revised ruling may be viewed at Sleep Lab Ruling.
Changes to Declaratory Ruling on Sleep Labs
Effective July 7, 2005
The Board approved changes to the Declaratory Ruling on Sleep Labs. The revised ruling adds the technician level provider and certification requirements. The revised ruling may be viewed at Sleep Lab Ruling.
Changes to Board Rules
Effective July 1, 2005
Board Rule 21 NCAC 61 .0308 has been amended and became effective June 1, 2005.
21 NCAC 61 .0308 CONTINUING DUTY TO REPORT
(a) All licensed respiratory care practitioners and provisional licensees are under a continuing duty to report to the Board any and all:
(1) convictions of, or pleas of guilty or nolo contendere to:
(A) any felony;
(B) any misdemeanor or other offense, such as fraud, when an element of the crime involves conduct by the licensee which indicates a lack of honesty, integrity, or competence directly relating to the licensee’s delivery of respiratory care, including crimes whose elements include violations of Rule .0307 (2), (5), (7), (10), (19), (21), (22), (23), (24) and (25) of this Chapter; and
(2) the existence of any civil suit which arises out of or is related to the licensee's practice of respiratory care.(b) All supervising respiratory care practitioners are under a continuing duty to report to the Board any and all:
(1) terminations of any respiratory care practitioner for violations of the practice act or Board rules; and
(2) violations of the practice act or Board rules by any respiratory care practitioner under his or her supervision.(c) The reports required by this rule must be made within 15 days of the occurrence.
History Note: Authority G.S. 90 652(2);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002,;
Amended Eff. July 1, 2005.
Effective June 1, 2005
Board Rule 21 NCAC 61 .0305 has been amended and became effective June 1, 2005.
21 NCAC 61 .0305 INACTIVE STATUS
(a) A licensee who wishes to retain a license but who will not be practicing respiratory care may obtain inactive status by indicating this intention on the annual renewal and payment of a fee of twenty dollars ($20.00). An individual licensed on inactive status may not practice respiratory care during the period in which he or she remains on inactive status.
(b) An individual licensed on inactive status may convert his or her license to active status by submission of a renewal application and payment of the renewal fee and late fee. The renewal application must contain evidence of the completion of a minimum of 10 hours of continuing education that meets the requirements of 21 NCAC .0401 for each full year of inactivity.
(c) In no case may an individual remain on inactive status for more than 60 months.History Note: Authority G.S 90 652(1),(2),(4);
Temporary Adoption Eff. October 15, 2001;
Eff. August 1, 2002,:
Amended Eff. June 1, 2005.Declaratory Rulings on Advanced Practice
Effective April 7, 2005
The Board approved a Declaratory Ruling for Advanced Practice for RCP's relating to ECMO. The ruling may be viewed at Advanced Practice-ECMO.
The Board approved changes to the Declaratory Ruling for Advanced Practice for RCP's relating to EMS Services. The ruling may be viewed at Advanced Practice for RCP's.
New Sleep Technology Subcommittee Appointed
Board Chair Joseph Coyle, MD, appointed a subcommittee of the Board's Practice Committee to look into issues concerning the practice of polysomnography in the state. The committtee meet on April 17, 2005 and discussed the Board's Declaratory Ruling on Sleep Labs and other concerns. The committee will meet again on April 28, 2005 at the Board office.
Changes to Discipline Manual
Effective January 6, 2005
The Board approved changes to the Discipline Manual which became effective January 6, 2005. The manual may be reviewed at Discipline Policy Manual. It is suggested that all RCP's review the manual for Board policies. The Board has changed the policy for RCP supervisors concerning disclosure of persons under their supervision that might practice without a license. The policy now reads as follows:
A Respiratory Care Practitioner who accepts a respiratory care administration position supervising other respiratory care personnel is accountable for ensuring that all such personnel are properly licensed, and will do the following:
• Immediately upon assuming responsibilities of the position, verify that a system exists to verify licensure of practitioners supervised by the position.
• Within fourteen (14) days of assuming responsibilities of the position, verify the licenses of all supervised respiratory care personnel.
• Thereafter, assure that the licenses of all supervised respiratory care personnel are current and valid. The supervisor must report to the Board any RCP found practicing with a lapsed license within 72 hours of the discovery. The Board authorizes the Executive Director to waive sanctioning of the supervisor if he/she reports the lapsed licensee within 14 days of the violation.Declaratory Ruling on Drug Administration for Cardiac Stress Test
Effective January 6, 2005
The Board approved a Declaratory Ruling on the administration of certain drugs by RCP's during cardiac stress tests. The ruling may be viewed at Stress Test Ruling.
Changes to Board Rules
Effective November 1, 2004
Board Rules 21 NCAC 61 .0201 and 21 NCAC 61 .0302 have been amended and became effective November 1, 2004. The amendment to Rule 21 NCAC 61 .0201 establishes additional requirements for licensure for applicants who have been out of practice for more than 1 year. The amendment to Rule 21 NCAC 61 .0302 adds language concerning the BLS requirements for renewal of a RCP license. The latest Board Rules may be downloaded for review and printing at Chapter 61 Rules.
New Verification Policy
If a RCP has renewed his/her license and hasn’t received the license card in the mail, his/her supervisor may print off the license verification from the website. Print off two copies, one for your records and one to be given to the RCP to be used in lieu of the wallet card. The copy of the verification of licensure will be acceptable for a period not to exceed seven days. After receipt of the license card the RCP must present the card to his/her supervisor. The supervisor must either file or display a copy of the renewal card at the practice site so as to be available for inspection. The RCP must keep a copy of the license wallet card available for inspection to anyone on request in the course of delivering services. If the RCP has not received the wallet card in the mail within the seven day period, he/she must contact the Board office at (919) 878-5595.
Grace Period for Continuing Education
Effective October 7, 2004
The Board approved a request to allow a grace period of one month for earning CE's for those RCP's that renew their licenses early. Therefore, if a RCP renews his/her license within the month prior to the expiration date of the license, he/she may then count any CE's earned in the time between the renewal date and his/her expiration date towards the next year's CE requirement.
Declaratory Ruling on RCP Advanced Practice Amended
Effective October 7, 2004
The Board approved an amendment to the RCP Advanced Practice Declaratory Ruling. Click RCP Advanced Practice Ruling to read the revised ruling. All RCP's providing Advanced Practice through the Office of Emergency Medical Services System must comply with this ruling. The ruling requires the RCP to complete and submit additional CE related to advanced practice.
