Advocacy Updates: RCIC Next Steps to Implementation

In this episode of the AARC Perspectives Podcast, Miriam O'Day, AARC Senior Vice President of Government Affairs, speaks with Ron Pasewald, BS, RRT, and Lexie Caraway, MBA, RRT, RRT-NPS, RRT-ACCS, AE-C, RPFT, Co-Chairs of the AARC Respiratory Care Interstate Compact (RCIC) Task Force. They discuss the recent activation of the RCIC following the passage of legislation in more than 12 states, and the next steps for implementation that will benefit all respiratory therapists by easing interstate practice and increasing access to care.

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Transcript

Miriam O'Day 0:04

Welcome to today's episode of the AARC Perspectives Podcast. I'm Miriam Oday, AARC Senior Vice President of Government Affairs, and I'm joined today by Ron Pasewald and Lexie Caraway. They're co-chairs of the AARC Respiratory Care Interstate Compact Task Force, and we'll be sharing some answers to frequently asked questions about the next steps in the RCIC process and why the Compact is critical to the growth of the respiratory therapy profession. Thanks, Ron and Lexie, for joining me today. We have a list of questions that we're going to go through, and I'd like to start with you, Ron. What role did AARC play in getting the RCIC started and implemented?

Ron Pasewald 0:46

Yeah, good question. So the American Association for Respiratory Care has been the driving force behind the RCIC from the very beginning. First and foremost, the AARC obtained a grant from the Department of Defense who were interested in professional licensure portability to help military spouses who move frequently across the country. So the AARC partnered with the Council of State Governments to develop the compact language and implementation framework. The AARC also conducted and coordinated legislative strategies, stakeholder education, advocacy support, and implementation planning with state societies, regulators, legislators, and national partners. The AARC identified interstate licensure portability as a major workforce and patient access issue and worked with stakeholders across the country to build support for a compact model. The task force that Lexi and I chair has offered leadership and peer support to the state societies to keep the project rolling. This truly has been a collaborative effort between the AARC, state societies, the council state governments, the Department of Defense, and respiratory therapists around the country.

Miriam O'Day 2:01

That's really great answer, Ron, and thank you for highlighting the role of our state affiliates because without the local respiratory therapists, we would not succeed in getting this legislation introduced and passed. Lexie, what's the timeline for the RCIC to be implemented now that we have the number of states needed?

Lexie Caraway 2:21

Now that the threshold number of states has enacted the compact, the next major step is the formation of the RCIC Commission. The commission will include representatives appointed by participating states and will be responsible for adopting bylaws, rules, operational procedures, and the technical infrastructure needed to administer the compact. The first commission meeting is currently scheduled for October 2026 in Washington, D.C. Following that meeting, there will be additional work to finalize operational systems, application processes, and data sharing mechanisms before compact privileges can officially be issued. Implementation is moving ahead very quickly compared to many other interstate compacts.

Miriam O'Day 3:05

Terrific. Thank you. It is a question that's frequently asked about when practitioners will be able to obtain their compact privileges. And so I'm glad that we'll be addressing that. Thank you for talking a little bit more about the process. Ron, when can ssRT start applying for the compact license?

Ron Pasewald 3:24

Yeah, so respiratory therapists cannot apply quite yet because the operational operational systems and rules must first be finalized by the RCIC commission. Once the commission completes its organizational regulatory work, participating states will begin opening the application process for compact privileges. At this point, we anticipate additional updates after the first commission meeting in October. The AARC and participating states will communicate broadly with members and licensees as soon as the application timeline are finalized. So respiratory therapists may be able to obtain the compact license in participating states as early as next fall in 2027.

Miriam O'Day 4:09

Lexi, can individuals apply for a compact or a multi-state privilege for a state they don't live in because they want to travel there.

Lexie Caraway 4:20

Yes, that is one of the primary benefits of the compact. Under the RCIC, a respiratory therapist holds a home state license in the state where they primarily reside. If that home state is a participating compact state, the therapist may then apply for compact privileges in other participating states. This allows therapists to practice in additional compact states without having to obtain a separate license in every single state. It is especially helpful for traveling therapists, telehealth services, military families, and providers who practice near state borders. However, therapists must still apply, comply with the laws and regulations of the state where they are practicing.

Miriam O'Day 5:01

You know, thank you for that explanation because I think that it's important that respiratory therapists understand that they will only be able to obtain a compact license if their state is a member of the compact, which is why it's so important now that we have 12 states that we move on and that your task force is continuing to do outreach to the states that have not introduced or passed the legislation because we'd like to have as many states participating as possible. So we really appreciate your good work on the task force, Lexie and Ron. Ron, another question that's been asked is how can someone become a commissioner for the RCIC?

Ron Pasewald 5:43

Yeah, so each participating state will appoint its own commissioner according to the processes established in that state's compact legislation and regulatory structure. In many cases, commissioners may come from the state licensing board or be a state regulatory official. The exact process may vary somewhat by state. Individuals who are interested in serving should stay engaged with their state respiratory care board, state society, and the AARC led leadership so they are aware of opportunities as appointments are made.

Miriam O'Day 6:18

What can an individual respiratory therapist do to help the movement towards compact licensure in their state if the legislation has not yet been passed?

Lexie Caraway 6:30

The most important thing people can do is to stay engaged and be in touch with their state affiliates who are leading the processes and their state. Respiratory therapists can participate in the state respiratory care society. They can share real-world examples involving staff shortages, border practice issues, military spouse mobility, telehealth, or emergency response issues. They can also respond to AARC action alerts and advocacy campaigns, and they can help to educate colleagues and policymakers about what the Compact does and what it does not do. Legislators respond strongly to hearing directly from practicing respiratory therapists in their home districts. Grassroots engagement continue to be one of the most important factors in moving the RCIC legislation forward.

Miriam O'Day 7:19

Thank you for reinforcing the need for grassroots advocacy and for respiratory therapists who are in practice weighing in on the RCIC legislation once it's introduced in their state. Is there anything that I know the both of you have been very engaged with respiratory therapists on the ground and also with the state respiratory societies or the task force? Is there anything that we didn't ask that you think it's important at this point as we move from a concept to implementation of the RCIC that that either one of you would like to add for the edification of our listening public?

Ron Pasewald 8:02

I think one of the important things is if you're not part of the compact and you haven't had that past, it's really important that you reach out to your state society leadership, to the AARC to try to get engagement in the process. You know, we want to get as many states involved as possible. And one way you can do that is by making noise. And how you make noise is contacting your state society, which can contact us, and then we can get meetings set up so you can learn more about the process and get things rolling.

Speaker 2 8:34

Thank you both so much, Ron and Lexie, for joining me today for this discussion about the next steps for the RCIC. And thank you really for your leadership on the task force and the good work that you've done there and the good work that you continue to do to do outreach to our affiliates. For additional details and updates, keep an eye out on the AARC website at aarc.org. And if you want to, you can search Respiratory Care Interstate Compact. Remember to subscribe to this podcast wherever you listen, and be sure to share with your colleagues. Have a great day.