Caption: Exempt sleep labs from the
definition of respiratory care if certain standards and guidelines are met.
Order No.: HLA 4-2011(Temp)
Filed with Sec. of
Certified to be
Effective: 5-10-11 thru 11-4-11
Rules Adopted: 331-705-0071
Subject: In November 2010 the Respiratory Therapist Licensing
board adopted temporary administrative rules regarding Sleep Lab Exemption, to
allow for certain respiratory care services (e.g. positive airway pressure) to
be performed by unlicensed individuals in sleep labs under a medical director.
The primary purpose for the temporary rule was to allow the 2011 Legislature
time to consider licensing polysomnographers or sleep technicians within the
Respiratory Therapist Licensing Board. The 2011 Legislative Assembly, Senate
Chamber introduced SB 723 which creates the Respiratory Therapist and
Polysomnographic Technologist Licensing Board. Currently the bill is moving
through the legislative process and is scheduled for a hearing in the Joint
Ways and Means, Education Committee. If SB 723 is adopted in law then the
permanent rulemaking process will begin in July.
(1) The following are exempt from the definition of Respiratory
Care Services under ORS 688.800 when performed in a sleep lab environment:
(a) Positive airway pressure titration on spontaneously
(b) Supplemental low-flow oxygen therapy during
polysomnogram (up to 6 liters per minute);
(c) Capnography during polysomnogram;
(d) Cardiopulmonary resuscitation;
(e) Pulse oximetry;
(g) Respiratory effort including thoriac and abdominal;
(h) Plethysmography blood flow;
(i) Nasal and oral airflow monitoring;
(j) Monitoring the effects positive airway pressure,
used to treat sleep-related breathing disorders, has on sleep patterns,
provided that the device does not extend into the trachea;
(k) Monitoring the effect on sleep patterns of an oral
device that does not extend into the trachea and that is used to treat sleep
(l) Maintenance of nasal and oral airways that do not
extend into the trachea;
(m) The use of continuous positive airway pressure and
(n) Set-up for use of durable medical equipment; and
(o) Long term follow-up care.
(2) For the purpose of this rule, “sleep lab” is:
(a) A physical space, including any commercial space,
used by a hospital for conducting sleep testing and under the supervision of a
medical director; or
(b) A facility accredited by the American Academy of
Sleep Medicine (AASM) for conducting sleep testing under the supervision of a
(c) A facility provisionally accredited by the AASM for
conducting sleep testing under the supervision of a medical director.
(3) For purpose of this rule, “medical director” means
the medical director of any inpatient or outpatient facility or department who
is a physician licensed by the State of Oregon and who has special interest and
knowledge in the diagnosis and treatment of sleep disorders.
(4) For the purpose of this rule, “sleep lab” does not
include the home environment.
(5) The exemption under this rule does not include
partial or full ventilatory support services involving tidal volume regulation
or which require the setting of respiratory back-up rates unless these services
are for the treatment of central and mixed sleep apnea.
(6) Sleep labs in operation on the effective date of
this rule and seeking exemption under (2)(b) of this rule must be accredited by
August 1, 2011. All sleep labs in the accreditation process must adhere to all
other requirements of this rule.
(7) All documentation and information regarding the
provisional accreditation or accreditation through the AASM must be made
available to the agency if requested.
(8) All policies, procedures and protocols for
unlicensed individuals related to positive airway pressure treatment and
titration including but not limited to central and mixed sleep apnea must be
made available to the agency if requested.
Hist.: HLA 4-2011(Temp), f. &
cert. ef. 5-10-11 thru 11-4-11
Notes 1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.