CAHSAH Advocates for Protecting LVNs Scope of Practice

Over the past few months, CAHSAH has increased its advocacy to ensure continuity of care for patients who are ventilator-dependent and receive care from LVNs in the home and school setting. Back in 2019, we successfully worked with the California Board of Vocational Nursing and Psychiatric Technicians (BVNPT) and the Respiratory Care Board of California (RCB) and were able to get a joint statement issued from both of these boards which clarified the roles of respiratory therapists and LVNs who care for patients on mechanical ventilators. As we reported in our September edition of the Bulletin, this scope of practice issue has resurfaced because the RCB wants to define basic respiratory tasks that may be performed by an LVN. The BVNPT is heavily involved and is working diligently along with CAHSAH and other health care organizations. Our goal is to help the RCB understand why it is crucial that LVNs continue providing their current scope of practice which they have been trained, tested and licensed to perform. 

The RCB held a hearing on October 14, 2024 to finalize regulations on this scope of practice issue. CAHSAH organized representation from our home health agency members as we quickly learned that the RCB was not going to permit virtual testimony at that hearing.  We extend our sincere gratitude to those owners, administrators and nurses who took time away from their agencies to travel to Sacramento and testify in-person at the RCB meeting. The RCB permitted three minutes of testimony from each presenter and heard many reasons why the proposed regulations should not be finalized without including the amendments that CAHSAH and the BVNPT recommended.   

By the end of the hearing, we had learned that the RCB was going to submit the regulations again for a 15-day comment period to modify the text, but that text would not include the amendments that the BVNPT and CAHSAH requested. The RCB Notice of Availability of Modified Text and modified text have been publicly noticed on their website. Additionally, we have been told that the RCB is exempting home health agencies from this set of regulations, but they intend to work on a separate package of regulations for LVNs who provide respiratory care in the home setting which will not be effective until 2028.  

While this may seem a reprieve for home health, LVNs who provide care in other settings will be crucially impacted by the RCB’s regulations that seek to limit the basic respiratory tasks that may be performed by an LVN.  Please watch for future updates on this important scope of practice issue.   

Thank you for your advocacy!