PLANO When respiratory therapist Nicky Cope rolls a mechanical ventilator into a room, the situation is already life and death.

'I help the doctor put a breathing tube down into the patient's airway and put the patient on life-support,' she said.

A new recommendation from the Texas Sunset Advisory Commission would deregulate her profession, along with 18 others including X-ray technicians and medical physicists who calibrate MRI machines and other radiologic equipment.

The commission was established in 1977 to evaluate state agencies and make fundamental changes to their missions or operations, if needed. Seventy-nine agencies have been abolished since 1977, saving Texas an estimated $945.6 million.

In a report released by the commission, the system that provides licensing for these medical professions is under-funded and understaffed. The commission believes hospital and private agency oversight would protect patient safety.

But Mark Barch, president of the Texas Society for Respiratory Care, disagrees with that assessment. 'The biggest danger is to patient safety and patient health,' he said, adding that therapists would not have guaranteed training or background checks before walking into a patient's room or their home.

In recent years, home health care has become a booming business for respiratory care therapists.

'These are vulnerable patients, so if you're not licensing people and doing criminal background checks on them every two years which is what's currently happening you have no idea whether they've committed crimes, sexual assaults,' Barch said.

Respiratory therapists are responsible for directly managing technical mechanical ventilators for patients who are unable to sustain life on their own. They must also understand the indications, hazards, contraindications, and dosages of medications patients are taking while on the ventilator.

Barch said respiratory care therapists who are incompetent, engaged in criminal activity, or have lost their license in another state would be able to work in Texas without any screening.

According to the Texas Department of State Health Services, 180 individuals have received disciplinary action or denial for a license in Texas.

'How would you like me to put one of your family on life-support and not have licensure to do it?' Nicky Cope asked. 'I would be very scared.'

The Advisory Commission will meet Tuesday and Wednesday in Austin to take public comment. The 12-member commission is not commenting before a decision is announced in August.

An agency typically undergoes a sunset review once every 12 years.

E-mail jstjames@wfaa.com

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