RRTs are now able to independently authorize the Assistive Devices Program (ADP) Home Oxygen Applications, and their ability to do so comes from the 5^th authorized act – Administering a prescribed substance by inhalation (the “prescribed substance” in this case being oxygen). Therefore, only RRTs who can perform the 5^th act without restrictions are permitted to sign the ADP Home Oxygen Applications.

The following groups of Respiratory Therapists may have TCLs preventing them from authorizing the ADP Home Oxygen Application:

Graduate Respiratory Therapist (GRT)

Members with a Graduate Certificate of Registration are prohibited from performing any procedures under the 5^th authorized act, and therefore, are prohibited from authorizing ADP Home Oxygen Applications. In addition, GRTs have a standard TCL that requires them to only perform authorized acts under general supervision, and this also prohibits them from authorizing ADP Home Oxygen Applications.

Limited (Practical) Respiratory Therapists (PRT)

Member who holds a Limited Certificate of Registration are prohibited from performing any procedures under the 5^th authorized act, and therefore, are prohibited from authorizing ADP Home Oxygen Applications.

General Certificate of Registration with TCLs (RRT)

Some General Members of the CRTO have TCLs that limit what authorized acts they can perform, or stipulate the degree of supervision required to perform certain acts. These are often added when an RRT is re-issued a certificate of registration after being away from practice for a number of years. For example, an RRT may have a term that states they “shall only perform a controlled act, authorized to Respiratory Therapy, for the purpose of gaining competence in that procedure if performed under direct supervision”. This would prevent the RRT from authorizing Home Oxygen Applications. The same term requiring general supervision would also prevent an RRT from authorizing Home Oxygen Applications.

However, some RRTs with TCLs have exceptions to certain authorized acts (or specific portions of an act). For example, an RRT may require direct or general supervision for all authorized acts “with the exception of administering a substance by inhalation”. In this instance, the RRT would be able to authorize Home Oxygen Applications because they are permitted to perform the act without the requirement of supervision.

If you have any questions about how your TCLs pertain to the authorization of ADP Home Oxygen Applications, please contact Carole Hamp RRT, Deputy Registrar at hamp@crto.on.ca.

RRTs who work for home oxygen Vendors of Record are not permitted to authorize the home oxygen application forms. However, there are a number of hospitals that have joint venture arrangements which involve some but not all the RRTs who work for that organization. Therefore, the RRTs who are directly involved with the home oxygen need to recognize that their role puts them in a conflict of interest that prohibits them from authorizing the ADP home oxygen application forms. RRTs that work for hospital with joint venture arrangements but are not directly involved with the administration of that service are still permitted to authorize the ADP home oxygen application forms.

When an RRT authorizes a home oxygen application, they must provide the home care vendor with a copy of the prescriber’s order. Both a direct order and a properly constructed medical directive meet the criteria of a valid order, and either can be used as validation of the home oxygen order. For more information as to what constitutes a properly constructed medical directive, please see the CRTO’s position statement entitled Medical Directives and the Ordering of Controlled Acts.

No. You must not be employed by a Vendor of Record when signing the initial application. This ensures that there is no conflict of interest related to your employment and the needs of the patient.

Yes. You must have an Ontario contact number (i.e., business contact) ensuring that there is means to contact you to clarify information about the patient, if required. As well, you must not be employed by a Vendor of Record when signing the initial application. This ensures that there is no conflict of interest related to your employment and the needs of the patient.

Previously, all applications needed to be signed by the person who originally prescribed home oxygen (i.e., a physician or nurse practitioner). That step has been removed to improve the efficiency of the process and to speed up patient discharge and access to home oxygen. However, when an RRT signs the application, he/she is affirming that home oxygen is both indicated and appropriate for the patient. This assessment and affirmation can only be done by an RRT with the legislated authority to independently administer oxygen.

Two times per year, the CRTO sends a list to the Assistive Devices Program of all RRTs who meet the eligibility criteria. If your employment information has changed, be sure to update your file with the CRTO promptly to ensure that your most current status will be included with the next upload to ADP.

Yes. RRTs ability to complete and sign the application relates to both short-term and long-term funding applications. Please follow this link to find important information about this and other recent changes to ADP-funded home oxygen therapy.