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I know in florida that Hyperbaric are covered for certain things. However my

freind that works at the Hospital has to have a Dr. there when the paitent

goes down and we the paitent goes comes up. That is the only way they can be

reimbursed for the treatment. THis is at Forida Medical center's Hyperbaric

unit. Hope this helps some.

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,

1. Who " wrote " this law--and why?

2. Does this specifically apply to hyperbaric clinics and only hyperbaric

clinics?

3. Can you post here a copy of the entire law?

>In North Carolina, a new law goes into effect which will require us to

>have a Licensed Respiratory Therapist on premises at all times.

>Considering the fact there is a major shortage of respiratory therapists

>here this will put us out of business. Even if we could find one, the

>cost would be so prohibitive that we could no longer operate as a

>cooperative. The law takes effect Oct. 1 of this year. I plan on

>appealing and applying for an exemption so does anyone have any

>information pertaining to other states which may give us some teeth. I do

>not need suggestions on what you may think should apply, I need actual

>facts which may have merit in our case.

>

> Hartsoe

>www.miraclemountain.org

>

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

" Delight yourself in the LORD and he will give you the desires of your heart. "

[Psalm 37:4]

Freels

2948 Windfield Circle

Tucker, GA 30084-6714

770/491-6776 (phone and fax)

509/275-1618 (efax, sends fax as email attachment)

mailto:dfreels@...

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Dear ,

and ,

the NC law (HOUSE BILL 1340), applies to respiratory care practice.

The part that defines the scope of RCP is inclusive of hyperbaric oxygen

therapy, flat...

.................................................................

(10) Practice of respiratory care. -- As

defined by the written order of a physician licensed under

Article 1 of this Chapter, the observing and monitoring of

signs and symptoms, general behavior, and general physical

response to respiratory care treatment and diagnostic

testing, including the determination of whether such signs,

symptoms, reactions, behavior, or general response exhibit

abnormal characteristics, and the performance of diagnostic

testing and therapeutic application of:

a. Medical gases, humidity, and

aerosols including the maintenance of associated

apparatus, except for the purpose of anesthesia.

b. Pharmacologic agents related to

respiratory care procedures, including those agents

necessary to perform hemodynamic monitoring.

c. Mechanical or physiological

ventilatory support.

d. Cardiopulmonary resuscitation and

maintenance of natural airways, the insertion and

maintenance of artificial airways under the direct

supervision of a recognized medical director in a

health care environment which identifies these services

within the scope of practice by the facility's

governing board.

e. Hyperbaric oxygen therapy.

f. Nontraditional cardiopulmonary

support techniques in appropriately identified

environments and under the training and practice

guidelines established by the appropriate professional

associations.

The term also means the interpretation and

implementation of a physician's written or verbal order

pertaining to the acts described in this subdivision.

(11) Respiratory care. -- As defined by

the written order of a physician licensed under Article 1 of

Chapter 90, the treatment, management, diagnostic testing,

and care of patients with deficiencies and abnormalities

associated with the cardiopulmonary system.

(12) Respiratory care practitioner. -- A

person who has been licensed by the Board to engage in the

practice of respiratory care.

(13) Support activities. -- Procedures

that do not require formal academic training, including the

delivery, setup, and maintenance of apparatus. The term also

includes giving instructions on the use, fitting, and

application of apparatus, but does not include therapeutic

evaluation and assessment.

In full, at:

http://www.geocities.com/timfultz/Pages/css/license.html

A physician in charge, or any unlicensed but qualified individuals should be

able to perform the duties.

Extrapolating from " Pennsylvania State Board of Medicine Interprets Respiratory

Care Practice Ac On April 28, 1998 : " .....the Medical Practice Act at section

13a exempts from certification persons executing medical orders pursuant to the

lawful delegation by a physician. Physicians may delegate tasks

to unlicensed persons where the physician ensured that the person performing the

task is qualified through documented

education and training. Additionally, the physician remains responsible for the

performance of the procedure and for the safety of the patient. "

It may apply, but it doesn´t help much:

either a physician or a RCP...

Are they qualified for HBO at all?

Not a word about CHTs.

Best regards,

Ignacio Fojgel, M.D.

Buenos Aires, Argentina

Freels wrote:

> ,

>

> 1. Who " wrote " this law--and why?

>

> 2. Does this specifically apply to hyperbaric clinics and only hyperbaric

> clinics?

>

> 3. Can you post here a copy of the entire law?

>

> >In North Carolina, a new law goes into effect which will require us to

> >have a Licensed Respiratory Therapist on premises at all times.

> >Considering the fact there is a major shortage of respiratory therapists

> >here this will put us out of business. Even if we could find one, the

> >cost would be so prohibitive that we could no longer operate as a

> >cooperative. The law takes effect Oct. 1 of this year. I plan on

> >appealing and applying for an exemption so does anyone have any

> >information pertaining to other states which may give us some teeth. I do

> >not need suggestions on what you may think should apply, I need actual

> >facts which may have merit in our case.

> >

> > Hartsoe

> >www.miraclemountain.org

> >

>

> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> " Delight yourself in the LORD and he will give you the desires of your heart. "

> [Psalm 37:4]

>

> Freels

> 2948 Windfield Circle

> Tucker, GA 30084-6714

> 770/491-6776 (phone and fax)

> 509/275-1618 (efax, sends fax as email attachment)

> mailto:dfreels@...

>

>

> _._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.

>

> Free downloads of nearly 50 pdf files on HBOT efficacy

medicaid/files/

>

> Download your state EPSDT program here

http://www.hcfa.gov/medicaid/stateplan/Map.asp by doing a search on the word

" ameliorate " . State Medicaid websites

http://www.medi-cal.ca.gov/RelSites_Oth_States.asp . State Medicaid waiver

programs: http://www.geocities.com/HotSprings/Villa/1029/medicaid.html

>

> Hyperbaric Oxygen Therapy (HBOT) can save billions of dollars and millions of

heartaches. Subscribe to this discussion group by sending an email now to

mailto:medicaid-subscribe

>

> Click here to unsubscribe mailto:medicaid-unsubscribe .

>

>

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>Dear ,

>and ,

>the NC law (HOUSE BILL 1340), applies to respiratory care practice.

>The part that defines the scope of RCP is inclusive of hyperbaric oxygen

>therapy, flat...

> c. Mechanical or physiological

> ventilatory support.

This is interesting that this should be included as a mandatory as well.

When Paragraph 5 of the EPSDT statute was originally introduced it was so

that brain-injured children who were ventilator-dependent* could stay at

home instead of being hooked up to a ventilator in the hospital.

This documentation can be downloaded from

medicaid/files/Legislative_intent_Par._5.PD

F

Under this new NC law it appears that it would be illegal to have a

ventilator-dependent child hooked up to a ventilator at home without a

respiratory therapist present.

Hmmm.

Of course, the brain-injured child could be weaned off a ventilator with

Hyperbaric Oxygen Therapy.

*i.e., so that brain-injured children could get more oxygen

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

" Delight yourself in the LORD and he will give you the desires of your heart. "

[Psalm 37:4]

Freels

2948 Windfield Circle

Tucker, GA 30084-6714

770/491-6776 (phone and fax)

509/275-1618 (efax, sends fax as email attachment)

mailto:dfreels@...

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Guest guest

The NC law also states:

" § 90-664. Persons and practices not affected.

The requirements of this Article shall not apply to:

(1) Any person registered, certified,

credentialed, or licensed to engage in another profession or

occupation or any person working under the supervision of a

person registered, certified, credentialed, or licensed to

engage in another profession or occupation in this State who

is performing work incidental to the practice of that

profession or occupation and does not represent himself or

herself as a respiratory care practitioner. "

So though HBO is considered a respiratory care procedure under the

act, it doesn't seem to prohibit otherwise " registered, certified,

credentialed, or licensed " professionals from performing RC

procedures, so long as they don't represent themselves as RCPs.

Steve " RCP in a past life " Wood

>

> > ,

> >

> > 1. Who " wrote " this law--and why?

> >

> > 2. Does this specifically apply to hyperbaric clinics and only

hyperbaric

> > clinics?

> >

> > 3. Can you post here a copy of the entire law?

> >

> > >In North Carolina, a new law goes into effect which will require

us to

> > >have a Licensed Respiratory Therapist on premises at all times.

> > >Considering the fact there is a major shortage of respiratory

therapists

> > >here this will put us out of business. Even if we could find

one, the

> > >cost would be so prohibitive that we could no longer operate as a

> > >cooperative. The law takes effect Oct. 1 of this year. I plan

on

> > >appealing and applying for an exemption so does anyone have any

> > >information pertaining to other states which may give us some

teeth. I do

> > >not need suggestions on what you may think should apply, I need

actual

> > >facts which may have merit in our case.

> > >

> > > Hartsoe

> > >www.miraclemountain.org

> > >

> >

> > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> > " Delight yourself in the LORD and he will give you the desires of

your heart. "

> >

[Psalm 37:4]

> >

> > Freels

> > 2948 Windfield Circle

> > Tucker, GA 30084-6714

> > 770/491-6776 (phone and fax)

> > 509/275-1618 (efax, sends fax as email attachment)

> > mailto:dfreels@m...

> >

> >

> >

_._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.

_._.

> >

> > Free downloads of nearly 50 pdf files on HBOT efficacy

medicaid/files/

> >

> > Download your state EPSDT program here

http://www.hcfa.gov/medicaid/stateplan/Map.asp by doing a search on

the word " ameliorate " . State Medicaid websites http://www.medi-

cal.ca.gov/RelSites_Oth_States.asp . State Medicaid waiver programs:

http://www.geocities.com/HotSprings/Villa/1029/medicaid.html

> >

> > Hyperbaric Oxygen Therapy (HBOT) can save billions of dollars and

millions of heartaches. Subscribe to this discussion group by sending

an email now to mailto:medicaid-subscribe@y...

> >

> > Click here to unsubscribe mailto:medicaid-

unsubscribe@y... .

> >

> >

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Guest guest

Dear Dr. Spiegel,

Thank you for your input and you present a powerful voice as a neurologist,

one that most of the naysayers will not be able to counter. And those of us

like myself feel so inadequate in trying to deal with the establishment since

there does not appear to be much money in HBOT. I tried for months to

interest Washington Hospital in putting in an HBO Chamber but the top

neurologist at Washington said it would no be economic to do so and told

the nurses advocating same that it was a non issue. Capt. Manson USN

Ret.

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Contrary to your remarks,there is no shortage of respiratory therapist.If

anything there is a glut. The medicare system has down graded the

reimbursement for many of the procedures they used to do. The hospitals have

fired many in the last 3-4 years. Where I'm from in Florida, you can hire

one for $12-14 per hour. This is a desirable job for them as they do not

have to work nights or weekends.My first HBO tech was a respiratory

therapist who crossed trained in hyperbarics

Allan Spiegel

[ ] new law

> In North Carolina, a new law goes into effect which will require us to

have a Licensed Respiratory Therapist on premises at all times. Considering

the fact there is a major shortage of respiratory therapists here this will

put us out of business. Even if we could find one, the cost would be so

prohibitive that we could no longer operate as a cooperative. The law takes

effect Oct. 1 of this year. I plan on appealing and applying for an

exemption so does anyone have any information pertaining to other states

which may give us some teeth. I do not need suggestions on what you may

think should apply, I need actual facts which may have merit in our case.

>

> Hartsoe

> www.miraclemountain.org

>

>

>

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Guest guest

There is a shortage in NC. In fact, this new law has made it worse.

I would be happy to hire one so if anyone knows any respiratory

therapists running around unemployed, send them my way.

Hartsoe

> Contrary to your remarks,there is no shortage of respiratory

therapist.If

> anything there is a glut. The medicare system has down graded the

> reimbursement for many of the procedures they used to do. The

hospitals have

> fired many in the last 3-4 years. Where I'm from in Florida, you

can hire

> one for $12-14 per hour. This is a desirable job for them as they do

not

> have to work nights or weekends.My first HBO tech was a respiratory

> therapist who crossed trained in hyperbarics

> Allan Spiegel

> [ ] new law

>

>

> > In North Carolina, a new law goes into effect which will require

us to

> have a Licensed Respiratory Therapist on premises at all times.

Considering

> the fact there is a major shortage of respiratory therapists here

this will

> put us out of business. Even if we could find one, the cost would

be so

> prohibitive that we could no longer operate as a cooperative. The

law takes

> effect Oct. 1 of this year. I plan on appealing and applying for an

> exemption so does anyone have any information pertaining to other

states

> which may give us some teeth. I do not need suggestions on what you

may

> think should apply, I need actual facts which may have merit in our

case.

> >

> > Hartsoe

> > www.miraclemountain.org

> >

> >

> >

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