SB 1226

SB1226:v99#DOCUMENT

Bill Start

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

Senate Bill

No. 1226

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.

LEGISLATIVE COUNSEL'S DIGEST

SB 1226, as introduced, Ochoa Bogh. Pupil health: individuals with exceptional needs: respiratory services.

Existing law, the Respiratory Care Practice Act, prohibits a person from engaging in the practice of respiratory care unless the person is a licensed respiratory care practitioner, except for specified respiratory care functions, including, among others, the performance of suctioning and other basic respiratory tasks and services by a licensed vocational nurse under the supervision of a credentialed school nurse, as provided.

Existing law authorizes individuals with specified qualifications and meeting certain requirements to assist an individual with exceptional needs who requires specialized physical health care services, as defined, during the regular schoolday. Existing law also authorizes a licensed vocational nurse, under the supervision of a credentialed school nurse, to assist an individual with exceptional needs who requires specialized physical health care with the basic respiratory services authorized by the Respiratory Care Practice Act.

This bill would repeal the authorization for a licensed vocational nurse, under the supervision of a credentialed school nurse, to assist an individual with exceptional needs with the above-described basic respiratory services authorized by the Respiratory Care Practice Act. The bill would instead authorize individuals, if they have the qualifications and meet the requirements referenced above for providing specialized physical health care services to an individual with exceptional needs, to provide a defined set of basic respiratory services to those individuals.

Digest Key

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

Section 3765 of the Business and Professions Code is amended to read:

3765.

This act does not prohibit any of the following activities:

(a) The performance of respiratory care that is an integral part of the program of study by students enrolled in approved respiratory therapy training programs.

(b) 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.

(c) The respiratory care practitioner from performing advances in the art and techniques of respiratory care learned through formal or specialized training.

(d) 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.

(e) 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.

(f) Persons from engaging in cardiopulmonary research.

(g) 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.

(h) 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.

(i) 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:

(1) Before January 1, 2028, the licensed vocational nurse has completed patient-specific training satisfactory to their employer.

(2) 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.

(j) 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).

(1) (A) The licensed vocational nurse is licensed pursuant to Chapter 6.5 (commencing with Section 2840).

(B) The licensed vocational nurse has completed patient-specific training satisfactory to their employer.

(C) 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.

(2) A licensed vocational nurse may perform the respiratory care services identified by the board pursuant to this subdivision in the following settings:

(A) At a congregate living health facility licensed by the State Department of Public Health that is designated as six beds or fewer.

(B) At an intermediate care facility licensed by the State Department of Public Health that is designated as six beds or fewer.

(C) At an adult day health care center licensed by the State Department of Public Health.

(D) 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.

(E) At a pediatric day health and respite care facility licensed by the State Department of Public Health.

(F) At a small family home licensed by the State Department of Social Services that is designated as six beds or fewer.

(G) 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.

(3) This subdivision is operative on January 1, 2028.

(k) 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.

(l) 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 basic respiratory services in accordance with Sections 49423.5 and 49426.5 of the Education Code.

SEC. 2.

Section 49423.5 of the Education Code is amended to read:

49423.5.

(a) (1)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:

(1)

(A) 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.

(2)

(B) 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:

(A)

(i) Routine for the pupil.

(B)

(ii) Pose little potential harm for the pupil.

(C)

(iii) Performed with predictable outcomes, as defined in the individualized education program of the pupil.

(D)

(iv) Do not require a nursing assessment, interpretation, or decisionmaking by the designated school personnel.

(3)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.

(2) Notwithstanding any other law, basic respiratory services may be provided by individuals pursuant to paragraph (1).

(b) Specialized health care or other services that require medically related training shall be provided pursuant to the procedures prescribed by Section 49423.

(c) 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.

(d) For purposes of this section, the following definitions apply:

(1) “Basic respiratory services” includes all of the following:(A) Suctioning.(B) Oxygen therapy as prescribed by the pupil’s physician.(C) Routine tracheostomy care.(D) In the event of an emergency, any procedure required to maintain or restore respiratory function until emergency personnel arrive.

(2) “Specialized physical health care services,” as used in this section, services” includes catheterization, gastric tube feeding, suctioning, basic respiratory services, or other services that require medically related training.

(e) 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.

(f) 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.

(g) This section does not affect current state law or regulation regarding medication administration.

(h) 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.