1. Joe Dwan, MS Ed, RRT-NPS-SDS, PACT Chair Tony Garberg RRT, co-chair & OSRC President Tim Hutchison, BA, RRT, HOD Cathy Melero, BSRT RRT, Past President Renee Angstrom RRT, Central Regional Director Special Thanks to Cheryl West

2. Conflict of Interest Kettering National Seminars Sleep Exam Review seminar

3. Drivers of PSG Licensure Patient Safety Protecting the Public Quality of Care

4. Drivers of PSG Licensure Violation of RT Licensure Act Patient was violated in sleep lab Healthcare community driven Sleep or RT initiated

5. Legislative Options Sleep techs Licensed under Separate Sleep Licensing Board General Licensing Board (eg Board of Health, BME) Sleep & RT combined into one Board Registration

6. Problems Legislative barriers Opposition Ntl Sleep organizations BPRT & AASM Sleep Techs & RTs Politicians opposing regulation on business MD Sleep Lab Owners Independent labs poorly staffed with unqualified/minimally qualified PSG staff Fly-by-Night labs

7. Joe’s Irish Pub and Sleep Lab Sleep it Off here…

8. AASM Opposition Promoting Physician owned sleep labs Registered Sleep Technician exam by AASM Registered Sleep Tech (RST) Expect them to fly a rep to your state to attend meetings Expect them to bring local AASM physicians to attend all meetings Public Comments

9. Board of Registered Polysomnographic Technologists (BPRT) Turf issues Initial distrust of RT community & RT motivation BPRT will support PSG licensure, in theory

10. Your State Sleep tech Organization(s) Initial distrust of RT community No Turf war Develop trust through communication and inclusion

11. Hot Issues Mechanical ventilation ABGs by sleep techs drawing and running ABGs BiPAP with rates CEUs Match RTs CEU number/year Rural Sleep services Formal Sleep training: are schools available Will your state RT programs offer PSG certification programs On-line accredited programs

12. Hotter Issues Physician owned vs hospital sleep labs vs private company Money & Business of $leep Labor costs Recruitment costs Impact on profits Will increased costs close labs?

13. RT Exemption to PSG License Licensed RTs working in sleep should NOT have to obtain a second PSG license Licensed RTs should be able to supervise sleep labs, sleep techs and sleep tech students without a PSG license (CRT-SDS or RRT-SDS in Oregon) Write the RT exemption with specifics into your state law!

14. Rural Sleep Opposition Pts won’t drive great distances to PSG labs Recruitment Wages OJTs training to become RPSGT or SDS MDs, RNs, RTs, HCWs do not have exemptions for less qualified practitioners in Rural areas

15. Licensure Act & Admin Rules Think like a Lawyer Definitions Every Word, Every Line Scope of Practice RT Exemption: dual licensure Supervision of sleep techs/students Allow RT supervisors Remote supervision

16. Licensure Act & Admin Rules Think like a Lawyer Credentials: RPSGT, SDS, CPSGT, RST Pathways Grandfathering Temporary license

17. Licensure Act & Admin Rules Think like a Lawyer Site of Service Cost of Licensure CEUs Medical Direction MDs, DOs, PA/NPs, Dentists

18. Devil in the Details: Administrative Rules Be at the table! Have a knowledgeable resource attend Respond to every “Comment Period” Show of Force Act like a Lawyer Every Public Comment Period

19. PSG Licensure Coming Licensed PSG: NM, ND, ID, DC, LA, NJ, MD, OR, TN, VA, DL Registration: CA, GA, NC Drafted Language: KY, CN, CA Not If, but When will PSG licensure come to your state

20. jdwan@ketteringseminars.com