1399.365. Basic Respiratory Tasks and Services

On June 5, 2025, the Office of Administrative Law (OAL) approved the Respiratory Care Board’s (RCB) regulation related to Basic Respiratory Tasks and Services codified at California Code of Regulations, title 16, section 1399.365. The regulation became effective on October 1, 2025.

Emergency Amendment (Effective January 12, 2026)

An emergency amendment approved by the Office of Administrative Law on January 12, 2026 added subsection (d) to clarify that section 1399.365 does not apply to licensed vocational nurses (LVNs) performing respiratory care services identified by the Respiratory Care Board while working in, and under the conditions specified for, certain home and community-based exempt settings listed in subdivisions (i) and (j) of section 3765 of the Business and Professions Code.

Regulatory Language

1399.365. Basic Respiratory Tasks and Services.

(a) For purposes of this section, “assessment” means making an analysis or judgment and making recommendations concerning the management, diagnosis, treatment, or care of a patient or as a means to perform any task in regard to the care of a patient. Assessment as used in this section is beyond documenting observations, and gathering and reporting data to a licensed respiratory care practitioner, registered nurse, or physician.

(b) For purposes of subdivision (a) of section 3702.5 of the B&P, basic respiratory tasks and services do not require a respiratory assessment and include the following:

Patient data collection.
Application and monitoring of a pulse oximeter.
Medication administration by aerosol that does not require manipulation of an invasive or non-invasive mechanical ventilator.
Heat moisture exchanger (HME) and oxygen tank replacement for patients who are using non-invasive mechanical ventilation.
Hygiene care including replacement of tracheostomy ties and gauze and cleaning of the stoma sites.
Use of a manual resuscitation device and other cardiopulmonary resuscitation technical skills (basic life support level) in the event of an emergency.
Documentation of care provided, including data retrieved from performing a breath count or transcribing data from an invasive or non-invasive ventilator interface.
Observing and gathering data from chest auscultation, palpation, and percussion.

(c) For purposes of subdivision (a) of section 3702.5 of the B&P, basic respiratory tasks and services do not include the following:

Manipulation of an invasive or non-invasive ventilator.
Assessment or evaluation of observed and gathered data from chest auscultation, palpation, and percussion.
Pre-treatment or post-treatment assessment.
Use of medical gas mixtures other than oxygen.
Preoxygenation, or endotracheal or nasal suctioning.
Initial setup, change out, or replacement of a breathing circuit or adjustment of oxygen liter flow or oxygen concentration.
Tracheal suctioning, cuff inflation or deflation, use or removal of an external speaking valve, or removal and replacement of the tracheostomy tube or inner cannula.

(d) This section does not apply to licensed vocational nurses performing respiratory care services identified by the Board while working in any of the exempt settings listed, and under the conditions specified, in subdivisions (i) and (j) of section 3765 of the B&P.

Background and Rulemaking History

March 28, 2024: The Board reviewed and approved proposed regulatory text to begin the formal rulemaking process.
June 5, 2024: RCB staff filed the initial rulemaking package with the Office of Administrative Law (OAL). A 45-day public comment period opened on June 21, 2024 and closed on August 6, 2024.
August 7, 2024: A public hearing was held, and the Board received written and oral public comments.
October 14, 2024: The Board reviewed public comments and directed staff to issue modified text.
October 15, 2024: A Notice of Availability of Modified Text was issued, followed by a 15-day public comment period.
March 13, 2025: After considering all public comments, the Board adopted the regulation.
June 5, 2025: OAL approved the regulation and filed it with the Secretary of State. The regulation became effective October 1, 2025.
January 12, 2026: OAL approved an emergency amendment adding subsection (d) to clarify the application of section 1399.365 in exempt settings.

Exempt Settings – Statutory Authority and Rulemaking Status

California law includes statutory exemptions under Business and Professions Code section 3765, subdivisions (i) and (j), which identify certain home and community-based exempt settings where licensed vocational nurses (LVNs) may perform respiratory care services that are identified by the Respiratory Care Board, subject to specific statutory conditions.

At its November 14, 2025 Board Meeting (Agenda Item 3), the Board approved proposed regulatory text identifying the respiratory care tasks and services that LVNs may perform in these exempt settings. Staff is continuing the formal rulemaking process with the Office of Administrative Law.

To receive updates as this process moves forward, you may join the RCB’s email subscription list:
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School-Only Exemption – SB 389 (Effective January 1, 2026)

Senate Bill 389 (SB 389) added Business and Professions Code section 3765(l). This provision authorizes licensed vocational nurses (LVNs), when working under the supervision of a credentialed school nurse, to perform suctioning and other basic respiratory tasks and services for students as part of their school-day care.

Effective Date: January 1, 2026

For additional information, see the RCB’s SB 389 information page.

Note for Speech-Language Pathologists (SLPs)

Under Business and Professions Code section 2530.2(d)(4), speech-language pathologists are authorized to perform suctioning when it is within their scope of practice and when facility training requirements are met.

Professional Qualifications Committee Guidance

The Respiratory Care Board’s Professional Qualifications Committee (PQC) has issued guidance to help clarify how suctioning activities are evaluated under CCR section 1399.365. This guidance reflects discussion from the PQC’s January 23, 2026 public meeting.

Professional Qualifications Committee – Guidance on Suctioning Activities (PDF)

Frequently Asked Questions

Common questions about CCR section 1399.365 are addressed below:

Basic Respiratory Tasks & Services – Frequently Asked Questions

How This Regulation Affects You

Each page provides explanations and role-specific information tailored to each group.

If you have any questions, please contact the RCB at (916) 999-2190 or rcbinfo@dca.ca.gov.