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		<ns0:Id>20250SB__038996CHP</ns0:Id>
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				<ns0:ActionDate>2025-02-14</ns0:ActionDate>
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				<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
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				<ns0:ActionText>CHAPTERED</ns0:ActionText>
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				<ns0:ActionText>FILED</ns0:ActionText>
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		<ns0:LegislativeInfo>
			<ns0:SessionYear>2025</ns0:SessionYear>
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			<ns0:ChapterNum>582</ns0:ChapterNum>
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		<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Senator Ochoa Bogh</ns0:AuthorText>
		<ns0:AuthorText authorType="COAUTHOR_ORIGINATING">(Coauthor: Senator Dahle)</ns0:AuthorText>
		<ns0:Authors>
			<ns0:Legislator>
				<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
				<ns0:House>SENATE</ns0:House>
				<ns0:Name>Ochoa Bogh</ns0:Name>
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			<ns0:Legislator>
				<ns0:Contribution>COAUTHOR</ns0:Contribution>
				<ns0:House>SENATE</ns0:House>
				<ns0:Name>Dahle</ns0:Name>
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		<ns0:Title> An act to amend Section 3765 of the Business and Professions Code, and to amend Section 49423.5 of the Education Code, relating to pupil health.</ns0:Title>
		<ns0:RelatingClause>pupil health</ns0:RelatingClause>
		<ns0:GeneralSubject>
			<ns0:Subject>Pupil health: individuals with exceptional needs: respiratory services: licensed vocational nurses.</ns0:Subject>
		</ns0:GeneralSubject>
		<ns0:DigestText>
			<html:p>
				(1)
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				Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California to license and regulate the practice of respiratory care. The act authorizes, among other things, a licensed vocational nurse who is employed by a home health agency to perform respiratory tasks and services identified by the board, as specified.
			</html:p>
			<html:p>This bill would also authorize the performance of suctioning and other basic respiratory tasks and services by a licensed vocational nurse under the supervision of a credentialed school nurse.</html:p>
			<html:p>
				(2)
				<html:span class="EnSpace"/>
				Existing law authorizes an individual with exceptional needs who requires specialized physical health care services, as defined, during the regular schoolday, to be assisted by individuals meeting specified requirements.
			</html:p>
			<html:p>This bill would also authorize an individual with exceptional needs who requires specialized
			 physical health care services to be assisted by a licensed vocational nurse under the supervision of a credentialed school nurse for the above-described basic respiratory services.</html:p>
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			<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
			<ns0:Appropriation>NO</ns0:Appropriation>
			<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
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	<ns0:Bill id="bill">
		<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
		<ns0:BillSection id="id_3268B9A2-BDD7-422C-B7BE-74D5262AF685">
			<ns0:Num>SECTION 1.</ns0:Num>
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				Section 3765 of the 
				<ns0:DocName>Business and Professions Code</ns0:DocName>
				 is amended to read:
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					<ns0:Num>3765.</ns0:Num>
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							<html:p>This act does not prohibit any of the following activities:</html:p>
							<html:p>
								(a)
								<html:span class="EnSpace"/>
								The performance of respiratory care that is an integral part of the program of study by students enrolled in approved respiratory therapy training programs.
							</html:p>
							<html:p>
								(b)
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								Self-care by the patient or the gratuitous care by a friend or member of the family who does not represent or hold themselves out to be a respiratory care practitioner licensed under the provisions of this chapter.
							</html:p>
							<html:p>
								(c)
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								The respiratory care practitioner from performing advances in the art and techniques of respiratory care learned through formal or specialized training.
							</html:p>
							<html:p>
								(d)
								<html:span class="EnSpace"/>
								The performance of respiratory care in an emergency situation by paramedical personnel who have been formally trained in these modalities and are duly licensed under the provisions of an act pertaining to their specialty.
							</html:p>
							<html:p>
								(e)
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								Temporary performance, by other health care personnel, students, or groups, of respiratory care services, as identified and authorized by the board, in the event of an epidemic, pandemic, public disaster, or emergency.
							</html:p>
							<html:p>
								(f)
								<html:span class="EnSpace"/>
								Persons from engaging in cardiopulmonary research.
							</html:p>
							<html:p>
								(g)
								<html:span class="EnSpace"/>
								Formally trained licensees and staff of child day care facilities from administering to a child inhaled medication as defined in Section 1596.798 of the Health and Safety Code.
							</html:p>
							<html:p>
								(h)
								<html:span class="EnSpace"/>
								The performance by a person employed by a home medical device
						retail facility or by a home health agency licensed by the State Department of Public Health of specific, limited, and basic respiratory care or respiratory care-related services that have been authorized by the board.
							</html:p>
							<html:p>
								(i)
								<html:span class="EnSpace"/>
								The performance, by a vocational nurse licensed by the Board of Vocational Nursing and Psychiatric Technicians of the State of California who is employed by a home health agency licensed by the State Department of Public Health, of respiratory tasks and services identified by the board, if the licensed vocational nurse complies with the following:
							</html:p>
							<html:p>
								(1)
								<html:span class="EnSpace"/>
								Before January 1, 2028, the licensed vocational nurse has completed patient-specific training satisfactory to their employer.
							</html:p>
							<html:p>
								(2)
								<html:span class="EnSpace"/>
								On or after January 1, 2028, the licensed vocational nurse has completed patient-specific training by the employer in
						accordance with guidelines that shall be promulgated by the board no later than January 1, 2028, in collaboration with the Board of Vocational Nursing and Psychiatric Technicians of the State of California.
							</html:p>
							<html:p>
								(j)
								<html:span class="EnSpace"/>
								The performance of respiratory care services identified by the board by a licensed vocational nurse who satisfies the requirements in paragraph (1) in the settings listed in paragraph (2).
							</html:p>
							<html:p>
								(1)
								<html:span class="EnSpace"/>
								(A)
								<html:span class="EnSpace"/>
								The licensed vocational nurse is licensed pursuant to Chapter 6.5 (commencing with Section 2840).
							</html:p>
							<html:p>
								(B)
								<html:span class="EnSpace"/>
								The licensed vocational nurse has completed patient-specific training satisfactory to their employer.
							</html:p>
							<html:p>
								(C)
								<html:span class="EnSpace"/>
								The licensed vocational nurse holds a current and valid certification of competency for each respiratory task to be performed
						from the California Association of Medical Product Suppliers, the California Society for Respiratory Care, or another organization identified by the board.
							</html:p>
							<html:p>
								(2)
								<html:span class="EnSpace"/>
								A licensed vocational nurse may perform the respiratory care services identified by the board pursuant to this subdivision in the following settings:
							</html:p>
							<html:p>
								(A)
								<html:span class="EnSpace"/>
								At a congregate living health facility licensed by the State Department of Public Health that is designated as six beds or fewer.
							</html:p>
							<html:p>
								(B)
								<html:span class="EnSpace"/>
								At an intermediate care facility licensed by the State Department of Public Health that is designated as six beds or fewer.
							</html:p>
							<html:p>
								(C)
								<html:span class="EnSpace"/>
								At an adult day health care center licensed by the State Department of Public Health.
							</html:p>
							<html:p>
								(D)
								<html:span class="EnSpace"/>
								As an employee of a home health
						agency licensed by the State Department of Public Health or an individual nurse provider working in a residential home.
							</html:p>
							<html:p>
								(E)
								<html:span class="EnSpace"/>
								At a pediatric day health and respite care facility licensed by the State Department of Public Health.
							</html:p>
							<html:p>
								(F)
								<html:span class="EnSpace"/>
								At a small family home licensed by the State Department of Social Services that is designated as six beds or fewer.
							</html:p>
							<html:p>
								(G)
								<html:span class="EnSpace"/>
								As a private duty nurse as part of daily transportation and activities outside a patient’s residence or family respite for home- and community-based patients.
							</html:p>
							<html:p>
								(3)
								<html:span class="EnSpace"/>
								This subdivision is operative on January 1, 2028.
							</html:p>
							<html:p>
								(k)
								<html:span class="EnSpace"/>
								The performance of pulmonary function testing by persons who are currently employed by Los Angeles County hospitals and have
						performed pulmonary function testing for at least 15 years.
							</html:p>
							<html:p>
								(l)
								<html:span class="EnSpace"/>
								The performance of suctioning and other basic respiratory tasks and services by a vocational nurse licensed by the Board of Vocational Nursing and Psychiatric Technicians of the State of California under the supervision of a credentialed school nurse in accordance with Sections 49423.5 and 49426.5 of the Education Code.
							</html:p>
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			<ns0:Num>SEC. 2.</ns0:Num>
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				Section 49423.5 of the 
				<ns0:DocName>Education Code</ns0:DocName>
				 is amended to read:
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					<ns0:Num>49423.5.</ns0:Num>
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							<html:p>
								(a)
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								Notwithstanding Section 49422, an individual with exceptional needs who requires specialized physical health care services, during the regular schoolday, may be assisted by any of the following individuals:
							</html:p>
							<html:p>
								(1)
								<html:span class="EnSpace"/>
								Qualified persons who possess an appropriate credential issued pursuant to Section 44267 or 44267.5, or hold a valid certificate of public health nursing issued by the Board of Registered Nursing.
							</html:p>
							<html:p>
								(2)
								<html:span class="EnSpace"/>
								Qualified designated school personnel trained in the administration of specialized physical health care if they perform those services under the supervision, as defined by Section 3051.12 of Title 5 of the California Code of Regulations, of a credentialed school nurse, public health
						nurse, or licensed physician and surgeon and the services are determined by the credentialed school nurse or licensed physician and surgeon, in consultation with the physician treating the pupil, to be all of the following:
							</html:p>
							<html:p>
								(A)
								<html:span class="EnSpace"/>
								Routine for the pupil.
							</html:p>
							<html:p>
								(B)
								<html:span class="EnSpace"/>
								Pose little potential harm for the pupil.
							</html:p>
							<html:p>
								(C)
								<html:span class="EnSpace"/>
								Performed with predictable outcomes, as defined in the individualized education program of the pupil.
							</html:p>
							<html:p>
								(D)
								<html:span class="EnSpace"/>
								Do not require a nursing assessment, interpretation, or decisionmaking by the designated school personnel.
							</html:p>
							<html:p>
								(3)
								<html:span class="EnSpace"/>
								For basic respiratory services authorized by subdivision (l) of Section 3765 of the Business and
						Professions Code, a vocational nurse licensed by the Board of Vocational Nursing and Psychiatric Technicians of the State of California under the supervision of a credentialed school nurse.
							</html:p>
							<html:p>
								(b)
								<html:span class="EnSpace"/>
								Specialized health care or other services that require medically related training shall be provided pursuant to the procedures prescribed by Section 49423.
							</html:p>
							<html:p>
								(c)
								<html:span class="EnSpace"/>
								Persons providing specialized physical health care services shall also demonstrate competence in basic cardiopulmonary resuscitation and shall be knowledgeable of the emergency medical resources available in the community in which the services are performed.
							</html:p>
							<html:p>
								(d)
								<html:span class="EnSpace"/>
								“Specialized physical health care services,” as used in this section, includes catheterization, gastric tube feeding, suctioning, or other services that require medically related
						training.
							</html:p>
							<html:p>
								(e)
								<html:span class="EnSpace"/>
								Regulations necessary to implement this section shall be developed jointly by the State Department of Education and the State Department of Health Care Services, and adopted by the state board.
							</html:p>
							<html:p>
								(f)
								<html:span class="EnSpace"/>
								This section does not diminish or weaken any federal requirement for serving individuals with exceptional needs under the Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.), and its implementing regulations, and under Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sec. 794) and its implementing regulations.
							</html:p>
							<html:p>
								(g)
								<html:span class="EnSpace"/>
								This section does not affect current state law or regulation regarding medication administration.
							</html:p>
							<html:p>
								(h)
								<html:span class="EnSpace"/>
								It is the intent of the Legislature that this section not cause individuals with exceptional needs to
						be placed at schoolsites other than those they would attend but for their needs for specialized physical health care services.
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