Oregon Bulletin

June 1, 2011


Oregon Health Licensing Agency
Chapter 331

Rule Caption: Exempt sleep labs from the definition of respiratory care if certain standards and guidelines are met.

Adm. Order No.: HLA 4-2011(Temp)

Filed with Sec. of State: 5-10-2011

Certified to be Effective: 5-10-11 thru 11-4-11

Notice Publication Date:

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.

Rules Coordinator: Samantha Patnode—(503) 373-1917


Sleep Lab Exemption

(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 breathing patients;

(b) Supplemental low-flow oxygen therapy during polysomnogram (up to 6 liters per minute);

(c) Capnography during polysomnogram;

(d) Cardiopulmonary resuscitation;

(e) Pulse oximetry;

(f) Electrocardiography;

(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 apnea;

(l) Maintenance of nasal and oral airways that do not extend into the trachea;

(m) The use of continuous positive airway pressure and bi-level modalities;

(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 medical director.

(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.

Stat. Auth.: ORS 676.606, 676.607, 676.611, 676.615 & 688.830

Stats. Implemented: ORS 688.800 & 688.605

Hist.: HLA 4-2011(Temp), f. & cert. ef. 5-10-11 thru 11-4-11

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