Editor
Bill Pruitt, RRT
Mobile, AL
(251) 434-3405 

House of Delegates Officers:
Frank Salvatore, Jr., BS, RRT, FAARC
Speaker
Danbury, CT
(203) 797-7984

Camden McLaughlin, BS, RRT, CPFT
Speaker-elect
Blacksburg, VA
(540) 230-7023

Dawn Rost, BS, RRT/ Secretary
Plainfield, IL

Joe Horn, BS, RRT/ Treasurer
Arlington, TX
(817) 461-6543

Debbie Fox, MBA, RRT/ Speaker
Wichita, KS
(316) 688-2992

Editor’s Remarks

Bill Pruitt
Editor

March 2008

Wow! Since Orlando, I have been working with the Publications committee to pull together articles for the HOD Record. We decided to go after more material and diversify into new sources to make the Record bring more to the table. Well ... this Record sets a record for me ... I have 28 pages of information and articles on my computer to send to the AARC and put out to the HOD! I urge all of you to read this issue and consider the information, ideas and suggestions offered.

To start things off, we have our HOD officers well represented in articles from Frank Salvatore, Speaker; Cam McLaughlin, Speaker-elect; Dawn Rost, Secretary; Debbie Fox, Past-speaker; Joe Horn, Treasurer; and Ken Thigpen, Parliamentarian.

Marie Fenske is next in the line-up with the results of the Effectiveness Survey from the HOD meeting in Orlando this past December. After Marie, Jenny Bush has provided a review of HOD resolutions to reflect their status - we have many that are still "open" and need some follow-up to see about getting them addressed and "closed". Debra Marckese (Delaware) has a brief note about a recovering member of the HOD - Helen Oldham (also Delaware). We have a reflection from Deborah Hendrickson (Wisconsin) about being a new member of the HOD, followed by a commentary and suggestion for resolution by Dan Maddalino (Florida). We asked Tom Lamphere (Pennsylvania), chair of the AARC membership committee for an update, and we received a very kind and gracious note from a special guest RT student who visited with the HOD in Orlando. Her letter is followed-up by a comment on our future as it is tied to students from Sandra McCleaster (New Jersey)

Finally, we have two articles regarding the powerhouses in the AARC - one from Tom Kallstrom, our Chief Operating Officer, and the other regarding Sam Giordano, the AARC Executive Director (written by Suzanne Bollig from Kansas).

I want to thank my hard-working committee for completing this big undertaking and we want to hear back from you…tell us your impressions of this Record. You know what they say, "Feedback is worth a thousand words".

Thanks,
Bill Pruitt (Alabama)
Editor, HOD Record

PS - get those letters running off to Washington…the 435 plan is at work and the PACT teams need us to make contact with Congress. The more that our representatives in D.C. hear from us, the more they will respond to help us in our cause of better lung health for America.

PSS - if you want to see past copies of the Record (and other great resources for the HOD) go to http://www.aarc.org/aarc_hod and look around. [Top]

Speaker’s Report

Frank Salvatore, Jr., BS, RRT, FAARC
Speaker

Once again, let me thank you for the honor and privilege to serve as your House of Delegates Speaker. As I stated in my first record article in 2007, this year is going to be a very busy year. At this time I am preparing to attend both the AARC PACT Meeting in Washington DC on March 9-12, 2008 and the Board of Directors meeting with the rest of the House officers in Dallas on March 27-30, 2008. Also as I did last year, let me take this time to list out my goals and objectives so that you are aware of them.

Speaker Goals and Objectives for 2008:

1. Work with the Chartered Affiliates to improve the lines of communication to the grass-roots member when it comes to advocacy for our profession and/or our patients.
2. Strengthen the HOD role in the governance of the AARC through an improved resolution process.
3. Strengthen the lines of communication between the Chartered Affiliates and the AARC through an efficient and effective HOD.
4. Maintain an open line of communication and collaborative working relationship with the AARC President, AARC-BOD, and Executive office.
5. Complete all General HOD Officer Charges.

1. Submit an article for each issue of the AARC Record.

1. You are reading the March issue.

2. Participate in the HOD orientation sessions.
3. Provide a written report, addressing the status of each pertinent charge, for inclusion in agenda book for each HOD meeting.
4. Perform other duties as assigned by the Speaker.
5. Notify Speaker of an absence that will prevent communication with officers of greater than one week.
6. Prepare a Summary of Activities for office to be passed on to next officer to assist in transition to that office.

Before I close, I would like to apologize to all of you for my less than auspicious ascension to the speaker's role. Most of you know that I was having knee problems that forced me to become "scooter boy". But what most of you didn't know was I needed to take dilaudid every four hours in order to get around. When the end of day two came and it was time to pass the gavel, I had planned a more emotional (teary-eyed) send off for Madame speaker. You all know how great of a communicator and speaker she was; well she was a great mentor for me. I want to publicly thank her once again…with a clearer head; for all that she did last year. The House was turned over a stronger and more united body because of her. Thank you again for the opportunity. If you need to get hold of me, please feel free to contact me at anytime. You can reach me at frank.salvatore@danhosp.org or you can call me at (203) 739-7984. Thank you again, and I look forward to seeing all of you in Phoenix. [Top]

Speaker-Elect’s Report

Camden J. McLaughlin, BS, RRT, CPFT
Speaker-Elect

I am still in awe of the honor of being elected as Speaker-Elect of our House of Delegates. An honor and privilege are words that do not seem to really do justice to such an incredible experience. Please know that I am very thankful and assure you that I will do my very best to not only meet my charges as noted below but to work with Frankie, my fellow officers, and each of you, our House of Delegates, to "take care of business".

AARC House of Delegates

Speaker Elect Charges 2008

1. Assume the duties of the Speaker in the event of the Speaker's absence, disability or resignation.
2. Participate in the AARC Budget process by serving as a member of the AARC Finance Committee and Chair of the Audit Sub-committee.
   An active committee with a BOD directive left over from 2007, report to follow. The Auditors will review and have a report prepared for the March BOD meeting in Dallas
3. In collaboration with the HOD Officers and Committee Chairs, review and make recommendations for changes in the HOD Rules at the fall meeting.
4. Prepare a roster of Committee Chairs, member appointments and committee charges for 2009, for ratification at fall meeting.
   Please begin to think about your role on HOD committees. For the new delegates see the HOD Handbook for descriptions and for you veterans consider where your talents will be best served along with thoughts for chairing a HOD committee. I will be sending a reminder prior to our summer meeting in AZ.
5. Participate in other committee functions at the discretion of the AARC President.
6. Work with the Parliamentarian to review the Delegate Handbook. Make recommendations for changes or revisions, if needed, by the fall meeting.
7. Complete all General HOD Officer Charges:
   1. Submit an article for each issue of the AARC Record.
   2. Participate in the HOD orientation sessions.
   3. Provide a written report, addressing the status of each pertinent charge, for inclusion in agenda book for each HOD meeting.
   4. Perform other duties as assigned by the Speaker.
   5. Notify Speaker of an absence that will prevent communication with officers of greater than one week.
   6. Prepare a Summary of Activities for office to be passed on to next officer to assist in transition to that office

Probably one of the most important unwritten charges is "learning from Frankie" and "learning from you". I am looking forward to your direction and ideas! From the heart, thank you again for this honor, and I can't wait to work with each of you.

ATTITUDE: Our lives are not determined by what happens to us; but how we react to what happens; not by what life brings to us; but by the attitude we bring to life. A positive attitude causes a chain reaction of positive thoughts, events, and outcomes. It's a catalyst....a spark that creates extraordinary results. [Top]

Secretary’s Report

Dawn Rost, BS, RRT
Secretary

Invaluable Resources

Throughout our community, not unlike any other, we are encouraged to reduce, reuse, and recycle to conserve many of our valuable resources. Both fresh air to breath, and clean water to drink are of utmost importance for us and for the generations that are to follow behind us. I have done my part by collecting and separating recyclable items, using reusable grocery bags and even car-pooling with the kids to and from swim practice.

Yet another valuable resource I have come to cherish is the many friends and colleagues I have met throughout my profession as a respiratory therapist. Being a part of my state society allowed me to gain much needed experience prior to being fast-tracked to the HOD as Delegate to substitute for Claude during the year that he was elected Speaker-Elect. It was over the next couple of years that I came to understand Denise Johnson's meaning behind the acronym AARC- "It's All About Relationships Claude".

At this time in my life as I embark on one of the biggest changes I will likely go through, I think of the valuable resources within the AARC and other state affiliates that I have available to me. Over the next few months my husband, two children and I will relocate to Naperville, Illinois. One of the most challenging and scary times in my life has been put somewhat at ease knowing that I have a contact somewhere out there, really no matter where I look. Knowing how many professionals I encounter at each and every meeting I attend is reassurance enough for me to look forward to this move. Moving means leaving behind lifelong friends, many family members, a great job with wonderful team members, and a very supportive state society.

I thank each and every one of you for being such an invaluable resource for everyone; new society members, new HOD Delegates, new graduates into our profession, and especially for me. I hope to carry on with my endeavors with the AARC HOD, and perhaps I will be a "recycled" Delegate from North Dakota now residing in Illinois. [Top]

Past Speaker’s Report

Debbie Fox, MBA, RRT-NPS
Past Speaker

Creating a Vision for Respiratory Care in 2015 and Beyond

As you know from discussion in Orlando, the AARC is sponsoring a series of three conferences that will define how respiratory therapy services will be delivered in the future and identify the skills clinicians will need to acquire in order to provide these services. This important project is being co-chaired by Charles G. Durbin, MD, FCCM, FAARC and John Walton MBA, RRT, FAARC. I have been asked to attend the first conference scheduled for March 3-5 in Dallas as your representative of the House of Delegates. Frank Salvatore, our esteemed Speaker was scheduled to attend but since he's still on his scooter, I was asked to serve as substitute.

I have reviewed the Agenda and the list of topics and presenting faculty is quite impressive. The following is a brief excerpt from the prospectus that I received

Ultimately, the process will produce a road map detailing how the current system will be modified to produce individuals with the needed skills, attributes, and competencies necessary to provide optimal care in this envisioned future.

To propel us through this change process we envision three conferences. This first conference, "Creating a Vision for Respiratory Care in 2015 and Beyond" will create a foundation for the next two conferences by answering the following critical questions:

• How will the changing health care delivery system respond to patient health care needs within the context of diagnosis, treatment, and management of patients with acute and chronic respiratory disorders?
• What current and new capabilities must respiratory therapists possess in order to assure adequate patient access to, achieve improved efficiency of and guarantee quality of respiratory services?
• What additional responsibilities can respiratory therapists assume that will result in more efficient utilization of respiratory care resources and assure more effective management of patients with chronic respiratory diseases?

The AARC has invited organizations representing employers, insurers, professional organizations, foundations, state and federal government agencies, the education community, patients and consumers, accrediting and credentialing agencies and other relevant organizations all have an important vested interest in the outcome of this process. The conference is structured to facilitate input from the stakeholder organizations. The presentation of each topic will be followed by a discussion session in which invited attendees can participate. All proceedings will be recorded and summarized for public distribution.

I am excited to attend this conference as your representative. I will provide you with a detailed report after the proceedings are concluded. If anyone is interested in receiving a copy of the agenda, you can send me an email and I will forward you a copy electronically.

March is turning out to be a busy month. In addition to attending the 2015 & Beyond Conference, I will also be attending the Washington PACT Meeting as the Kansas PACT Co-Leader and later in the month will join my fellow House Officers at the March AARC Board of Directors Meeting. I hope everyone is doing well and surviving the winter respiratory surges. I also want to extend continued best wishes to Helen Oldham, our Delegate from Delaware for her ongoing recovery.

I look forward to serving you as Past Speaker and please let me know if you have any questions or concerns. [Top]

Treasurer's Report

Joe Horn, BS, RRT
Treasurer

I wanted to take a moment to express to the entire House of Delegates how honored I am to be given this opportunity to serve as the House of Delegates Treasurer once again. It is my intent to do the very best job I can for you.

In reviewing the financial performance for 2007, there were several revenue related events worth mentioning.

1. Membership increase of 8%
2. Education revenue exceeded budget by $9K.
3. Convention revenue exceeded budget by 48%.

Overall, I think that it is fair to state that the financial performance of the AARC remains strong even in a time of an uncertain stock market.

This time last year, I had already started working with the sub-audit committee. That should be just around the corner. I will let you know more as we begin our work.

The following is a list of the HOD Treasurer charges:

• The responsibility of the Treasurer is to prepare the budget for the upcoming year, and monitor the House budget.
• Serve as a member of the AARC Finance Committee, and participate in preparing the AARC budget.
• The treasurer provides input into the AARC budget from a HOD perspective.
• Updates the HOD of the financial status regarding the AARC and serve on the Delegates Assistance Committee.
• Provide a financial impact resolutions report requested by the Resolution Committee.
• Any additional duties assigned by the speaker, the treasurer will perform.      

I will keep you informed of the status of each of these charges via House reports. The next one should be my July report. If you need anything from me, please don't hesitate to call me at (817) 461-6543. My email address is jhorn@irgstaffing.com. I look forward to working with each of you this coming year.

Thank you again for this tremendous opportunity to serve the House of Delegates and the American Association for Respiratory Care. [Top]

Parliamentarian’s Report

Ken Thigpen, BS, RRT
Parliamentarian

John Denver once sang a song, "Ain't it good, to be back home again?" ... That says a lot about the way I feel having the privilege of serving as your HOD Parliamentarian for 2008. I am absolutely looking forward to reconnecting with folks I may not have seen in a while and making lots of new friends as well. I think you'll find that 2008 is going to be an action-packed year and that the HOD Leadership that you elected is more than capable of meeting the challenges we may meet head-on!

The older I get, the more I find security in surrounding myself with people who "get it" and the House is full of 'em! I want to challenge each of you to bring your "A-Game" to the AARC, the HOD and our profession this year. We need your help, we need your support, and we need your passion.

For those of you who may be newcomers to the House this year, please know that we will do our dead-level best to give you a soft place to land! You will find your experience in the House to very likely be one of the most, if not the most, rewarding experiences of your professional career.

I want to encourage you to avoid the rush, to look for opportunities to get involved early, and make a difference!

Let's get on board and get strapped in - Frank is going to lead us on a great ride!

See you in Phoenix before you know it. It's 125 degrees, but really, it's okay ... It's a dry heat. [Top]

HOD Effectiveness Survey Winter 2007 - Orlando

Submitted by the Progress and Transition Committee
           Marie A. Fenske, Ed.D., RRT, Chair

Here are the results of the Effectiveness Survey completed at the 2008 winter meeting of the House of Delegates in Orlando, Florida:

HOD Effectiveness Survey
Progress & Transition Committee
Winter 2007-Orlando, Florida

4=strongly agree   3=somewhat agree   2=somewhat disagree  1=strongly disagree

80 surveys returned

Comments:

With the delegates' other work and family obligations it is difficult to find/make time to fully review the HOD information package when it arrives a week before the assembly of the HOD. I would like to suggest that the agenda be mailed at least two weeks in advance of assembly.

Great meeting.

Need informal social-organized before hand for networking. If not organized beforehand, members make other evening plans.

With the addition of a blog for the pre-resolution process, I'll be better prepared.

The HOD has been a welcoming group of people who have extended themselves to us, as incoming delegates. It's a great learning experience for me and I look forward to continuing to participate more fully.

This session was excellent!

Sometimes we dwell too long on minor issues due to some delegate's personal belief or agenda - not sure how to fix this process.

The "3" ratings (that I marked) are primarily the result of issues that are brought about by the occasional "minority" voice that I perceive as not the "voice of reason" but (at times) merely a negative opinion. The resolution process, open mic and HOD committee work all have the potential of being very effective processes. However, the true effectiveness lies with the one leading the process (i.e. we have the responsibility to make the process effective.)

Making progress w/communications (HOD/AARC BOD)

Professional, collegiate body of dedicated volunteers and leaders!

Proud to be a part.

Great job this year. Denise did a great job of reporting BOD activity.

More discussion and financial background info is needed.

I was expecting more dialogue on the CRT vs RRT credentialing system and greater discussion of BS degree for RCPs.

I am a new delegate so it remains to be seen if the resolution process will be effective for me. I do not yet have a basis for comparison.

Thank you for another great meeting.

I function better if less cold.

Very efficient meeting!

Please keep in mind discussion time after resolutions.

Nicely run meeting. Good flow of information. Reports all concise and timely. My only issue revolves around resolution ... they just don't seem to move us forward in a timely manner. 

Well run meeting. Good presentations from the AARC to the HOD.

Being a fairly new member, it is obvious there is a lack of trust with the AARC BOD that does not create an environment of unity.

A great group of professional. I appreciate the cooperation between the HOD and BOD.

The AARC, NBRC, CoARC need to seriously prepare a plan to move forward on the educational requirements to be considered a profession. The CRT level is out of date, no matter what "spin" you put on it! [Top]

Resolutions Followup

Jenny Bush, BS, RRT-NPS, RPFT, CCM
Nebraska Society for Respiratory Care

Progress of Resolutions

#04-07-23
Resolved that the HOD will receive the proposed AARC budget on the first day of fall HOD meeting. On the next day of the meeting the HOD will vote regarding the proposed budget.(Presented by Alabama, and co-sponsored by Florida and Louisiana.)
This was an amended motion and the amended motion carried.

#94-07-24
Resolved that the AARC develop a list of suggested competencies and equipment that respiratory therapy departments may use as a guideline in order to prepare for pandemic or mass casualty situations. (Presented by Virginia)

#94-07-25
Resolved that the AARC provide a discussion "blog" on the website for the purpose of posting relative and important information to submitted resolutions in advance of the HOD meetings. (Presented by Minnesota)

In July 2007 the HOD considered the following resolutions

#21-07-01
Resolved that the AARC work with the credentialed sleep specialists and their organizations to avoid adversity between the groups. Also resolved that non-RT sleep specialists be encouraged to join the AARC as associate members and to join the sleep membership section. (Presented and withdrawn by Michigan)

#29-06-18
Resolved that the AARC request that the NBRC change testing qualifications to allow the RRT examination to be taken by qualified candidates without prior CRT examination.
Amended: Resolved that the AARC request that the NBRC change testing qualifications to allow the RRT examinations to be taken by qualified candidates without prior CRT examination. Upon successful completion of the RRT exam, the candidate will be issued both the RRT and CRT credential. Amended motion carried. (Alabama moved to postpone resolutions. Motion carried and Wisconsin withdrew this resolution.

#29-07-07
Resolved that the AARC create and charge an ad hoc committee to investigate the issues surrounding transition from two NBRC (CRT & RRT) credentialing examinations to one NBRC (RRT) exam for qualified applicants. (Presented by Vermont-New Hampshire) Nevada amended resolution to substitute HOD for AARC. Amendment was withdrawn by Nevada.
Wisconsin amended the original resolution to state Resolved that the AARC create and charge an ad hoc committee to include several members of the HOD to investigate the issues surrounding transition from two NBRC (CRT & RRT) credentialing examinations to one NBRC (RRT) exam for qualified applicants. Amended motion carried.

Project 2012 will address this, a steering group has been appointed and it will be up to this group to include members from the HOD and others as appropriate.

2006 Resolution #29-06-18 from Wisconsin
Resolved that the AARC request that the NBRC change testing qualifications to allow the RRT examination to be taken by qualified candidates without prior CRT examination. Upon successful completion of the RRT exam, the candidate will be issued both the RRT and CRT credential.

See resolutions #29-07-07 above.

2006 Resolutions #94-06-19 from Virginia.
Be it resolved that the AARC develop the process for the Chartered Affiliates to have the option of an online voting for state (chartered affiliate) elections.

2006 Resolutions #94-06-22 from Ohio
The AARC investigate the feasibility of providing Internet domain to each affiliate for the purpose of setting up and maintaining their web sites for the affiliate.

2005 Resolutions #00-05-17 from Tennessee
Resolved that the AARC recommend to the Veteran's Health Administration that they amend the qualification standard for respiratory therapists to include language stating that respiratory therapists in Veteran Administration Hospitals should meet licensure requirements of that particular state, if applicable.

2003 Resolution #572003-29 by North Dakota
Resolved that the AARC adopt the following revenue sharing model: We propose a plan that will encourage state affiliates to actively promote membership by financial reward. The program is two tiered and bonuses would be annual and calculated at year-end based on yearly average affiliate AARC active and associate membership numbers.

• Establish a sliding base rate using the AARC active and associate membership numbers.
• State affiliate bonus based on annual affiliate AARC active and associate membership increase.

2003 Resolutions #42003-21 from Mississippi
Resolved that in the event that the AARC membership does not reach 35,000 by Dec 31, 2003 but does reach 33,000 that revenue sharing would decrease to decrease to $11 instead of $10.

2003 Resolution #492003-3 Tennessee
Resolved that a reduced registration fee for AARC retired therapists who are AARC members that have reached the age of 62 that do not CEU's but would like to attend the AARC annual convention and go through exhibits and social functions.

2001 Resolution #62001-24 from Kentucky
Resolved that the AARC BOD offer a credit card billing process that would offer the member to pay the membership dues over a three month period, with the transaction cost passed on to the member.

2001 Resolution 772001-8 New Jersey
Resolved that the AARC implement a program which recognizes health care facilities providing exceptional respiratory care services.

2001 Resolution 432001-5 Mississippi
Resolved that the AARC produce a film showing testimonies of AARC accomplishments, therapist passion for their profession and patient's appreciation for the therapist and profession that takes care of them. This film is to be made available to each affiliate to encourage new members to join the AARC.

2001 Resolution 62001-4 Mississippi
Resolved that the AARC offer multi-year memberships at discounted rates to its members beginning January 2002. (Example. 3-year membership $250 etc…)

2001 Resolution #252001-2 Ohio
Resolved that the AARC appoint a task force to develop a standard protocol for therapists transporting patients across lines where each state has licensure requirements.

Recommendation.
I would like to suggest the following regarding the open resolutions.

• Resolutions that are more than 3 years old be retired instead of closed with explanation by executive office or board and reported back to the HOD.
•  Resolutions more than 3 years old and should remain open as determined by the board have an action plan along with rationale for delay reported to HOD.
• Resolutions should have appropriate action and conclusion within 2-3 years of submission. Add this evaluation and measure to the resolutions committee of the HOD.

Thanks for your consideration and review of the current and past resolutions. [Top]

General HOD

Debra Marckese
HOD Delaware

Delaware's Junior Delegate Helen Oldham had a brain aneurysm on Dec. 7th which ruptured. She was near death but has made a unbelievable recovery. She is home now doing outpatient rehabilitation and making remarkable progress. She is not able to return to work and not sure when that day will come. Unfortunately Helen has had to resign her House of Delegate position with the DSRC.

I know Helen would want to thank everyone who has sent her well wishes while she was in the hospital. Anyone who would like to send Helen well wishes may do so at her home:

Helen Oldham
105 Wordsworth Dr.
Wilmington, De 19808.
Thank you
Debbie Marckese RRT, NPS
Respiratory Care Clinical Instructor
A.I. duPont Hospital for Children
Wilmington, De
302-651-5117 [Top]

New HOD Member Musings

Deborah Hendrickson BS, RRT
HOD Wisconsin

What a privilege it is to be a member of the AARC House of Delegates! As a newly elected member from Wisconsin, I was not certain what I could expect from the HOD, but more importantly, what would the HOD expect from me? I attended my first meeting as a Delegate in Orlando, but had been fortunate enough to attend the Summer HOD in Reno as a guest. From the beginning, I could tell that this was a group of people I would be proud to be associated with. The support for each other and from each other filled the room. As Denise Johnson said in her October 2007 Past Speaker's Update, "It IS all about relationships!"

And I was fortunate enough to learn a lot from Denise in the short time I could spend with her. My co-delegate from Wisconsin, Bill Pupanek, has made things as smooth as possible for me and I know there are about 50 more of you out there who are doing the same thing for your junior delegate. Thanks so much to all of you! Each contact I had with the rest of you gave me something that I hope I can repay someday. I eagerly look forward to learning from all of you in the next few years.

With your support (and maybe some of the rest of the "newbies" will agree with this), I feel confident enough to take on whatever the AARC HOD will bring and I will try to do so with as much grace and energy as you have already shown to me.

Thank you very much.

NBRC Fees Remain Too High

Dan Maddalino, RPFT, RRT-NPS
HOD Florida

All state licensing boards for respiratory care, including Florida's, require the CRT credential to obtain their license. True, a few including Florida have a dual level licensing system identifying the RRT as a separate and distinct title. However, it remains a fact that all that is needed to get that legal permit and go to work is the CRT credential.

So you graduated, got your CRT, got your license, and got your job. So why have so many of you stopped there? Why have so many studied and prepared for the RRT credential and never completed it? Many cite the lack of incentives. No pay differential, no academic environment to induce continued preparation, and no psychological support from peers are often offered as excuses for giving up. However, none of these are the number one cited reason for not attempting to achieve RRT status. No, the number one reason given for not taking the NBRC's Advanced Practitioner exam is the cost! First time candidates must pay $390 to sit for the examinations. To some new graduates carrying educational debt, this amount represents up to 48% of one week's pay!

It has been years since the NBRC has had to rent testing space, organize test site staffing, print and mail test materials to and from each examination venue, manually handle the test booklets, answer sheets, and review outliers. Here in the twenty-first century this is all done on line and testing is computer software controlled. No more paper and pencil forms and no more waiting weeks for the test results. So why does it still cost $390 to take the RRT examinations?

It is $190 to take the CRT exam and another $190 to take the same test again, ramped up and called the "RRT Written". Then another $200 to take a clinical simulation test that was developed over 27 years ago and translated to electronic format. Sure, there are maintenance costs and continued test question development costs. Especially if you are going to include questions about calculating the evaporation rate of nebulized aerosol solutions during the inspiratory phase of a small volume nebulizer as proposed in the August issue of Respiratory Care. But hasn't technology reduced the real costs of administering these examinations? I think so.

Isn't it time to address reducing the true barrier to potential RRT candidates? Isn't it appropriate to ask our AARC to engage the NBRC in discussions to provide better access for candidates by substantially reducing test application fees for the RRT examination? Indeed it is!

Sounds like a Resolution to me. [Top]

Membership Committee

Tom Lamphere BS, RRT, RPFT
2008 AARC Membership Committee Chair/
PSRC Delegate & Membership Chair

Membership ....YES, It's THAT Important!

Over the past 60 years, the AARC has grown to include over 42,000 members and 50 state affiliates. During that time period a lot of good work has been done for the respiratory therapy profession and for the patients we serve. Research, education, patient advocacy, patient care and more that are all part of what we do and no one does it better.

Yet for all of the wonderful things we've done well, there's one thing we haven't done well. Although we're proud to have over 42,000 members, the sobering fact is that this number represents approximately 1/3 of all respiratory therapists in the U.S! Although we've grown tremendously over the past 60 years, we still have a lot of work ahead of us and the number one area that needs our immediate and constant attention is membership!

We all know that membership is important. Many of the state societies rely on the revenue sharing checks they receive from the AARC to stay in business and these checks are based on the number of members in the respective states. We rely on members to fill the AARC and state society Board of Directors and House of Delegates. We also count on members for our 435 Plan and to man volunteer activities like the Mobile Spirometry Unit and High School Career Project.

The bottom line is that membership is THE most important aspect of the AARC and state affiliates! Simply put….membership drives everything and without it, neither the AARC or state affiliates exist.

Unfortunately, while most everyone would agree that membership is important, there are many state affiliates don't make it a priority. Several states, for example, don't have a Membership Committee Chair. Finding ambitious and energetic people to fill this committee and chair position should be the TOP priority for every state affiliate!

Want to increase membership in the AARC and your state society? Follow these steps to get started towards making that goal a reality!

Step ONE is to ensure you have a membership committee chair who is committed to working hard to increase membership in your state. If you don't have this person in this position, go find one! If you already have that person identified, then make sure they're the right person for the job. You need someone who is willing to make increasing membership their TOP priority and, in some cases, their only priority!

Step TWO is to make sure AARC has the contact information for your membership committee chair.

Step THREE is to give your membership committee chair some freedom to do their job. Make sure the membership list is sent monthly to your membership committee chair as this will be the most important tool. Ask your state affiliate's Board of Directors for approval to open an online account with the United States Postal Service to allow for much easier (and cheaper) mailing of membership related items.

Step FOUR is to take part in the AARC Group Membership program. Details of the program area available at www.aarc.org/marketplace/media_kit/group_membership.html

If you follow the above steps, your state affiliate will be well on their way to increasing the number of AARC and state affiliate members! [Top]

Student Insight

Amy Otsuka

My name is Amy Otsuka and I'm a third year student in the Respiratory Care Program at Kapiolani Community College, Hawaii. In November, 2007, I attended the House of Delegates meeting as a guest. When this opportunity presented itself, I immediately jumped on it. I was very excited to go to a H.O.D. meeting, but I'll admit, even on the plane ride to Orlando, I had only a vague idea of what I was about to experience.

The House of Delegates opened my eyes to so many more aspects of the profession than I ever knew existed. I was surprised to learn that I was the first (one of the first?) students to sit in the H.O.D. Sitting in the meeting, I remember being so amazed. I looked around and thought to myself how wonderful it was to see all of these people gathered together from all across the country, so dedicated to the profession. Not only were these people colleagues, but friends too. In school we're drilled with equations, values, and physiology. However, what I experienced at the H.O.D. meeting, can't be taught by any instructor. It has to be experienced. You can't be taught to be passionate about Respiratory Care, and you can't be taught the drive that it's going to take to move this profession forward. You have to feel it, and I definitely felt it. I felt it being in the room shaking the hands of other state representatives and listening to their experiences in the field, and I felt it listening to Toni Rodriguez speak with so much enthusiasm and passion. At that moment, I thought that every respiratory therapist in the world needed to be where I was. Surely, amazing things would happen.

It was initially Steve Wehrman's idea, the director of our Respiratory Care Program, to send me to the House of Delegates. It wasn't a cheap trip, but the Hawaii State Society for Respiratory Care (HSRC), along with school and personal scholarships, funded my trip. I was also fortunate enough to attend the conference as well. My classmates were very supportive of me going. When I talked to them about it, nobody really knew what the House of Delegates was or who was on it. I did my best explaining to them what the H.O.D. was and what was going on in the meetings, but it's just something they have to experience for themselves. They were impressed to learn about the PACT and were unaware of such a committee dedicated to passing bills in Congress specifically for the profession of respiratory care. I did my best to encourage them to become AARC members when we graduate and to get involved. I wished that I could have brought my whole class with me; it was a true honor.

I will graduate from the program this summer and I'm currently working on my baccalaureate degree in respiratory also. I know I want to be a neonatal/pediatric respiratory therapist. I also serve as a student member on the HSRC board. After I gain experience in the field, I hope to teach and I can definitely see myself becoming involved and being a delegate or PACT member.

So all the way across the ocean, as Ed Borza (Hawaii delegate and clinical director) said, "We challenge every state to bring a student to the H.O.D. next year and the years to come." Returning to school and sharing my experience with my classmates, I realized that, as students, we take the AARC for granted. Our eye is mostly on graduation. However, I feel that there needs to be something else for students to get involved, or else we'll all graduate never feeling the need to get involved in the field.  I will never forget this experience and it has inspired me to get involved and get others involved! Thank you to everybody who made me feel so welcome, making this such a great experience! [Top]

Comment on Student's visit to the HOD

Sandra McCleaster
HOD New Jersey

Students Are Our Collective Future

This most recent AARC House of Delegates meeting in Orlando had a refreshing twist. Although students aren't usually in attendance in the HOD, Amy Otsuka, a respiratory care student from Kapiolani Community College in Hawaii was front and center on the guest list.

The idea to send a student intern to the HOD came from her program director, Steve Wehrman. Steve's been thinking a lot lately about securing the future of Respiratory Care. Steve recognizes, (as most of us graying educators do) that students are our collective future. He knows that the professoriate is aging and that we need to cultivate younger practitioners to take our places. Steve says that he's struggled with how exactly, to turn his thoughts into reality. One of Steve's ideas involved getting students to the AARC International Congress and to observe the House of Delegates in action.  And so it happened. But it wasn't easy. Steve had to move a little of Hawaii's heaven on earth to fund such a trip, but after all was said and done, Amy Otsuka became the student selected by her program faculty and classmates to fly to Orlando.  She was accompanied by her Director of Clinical Education, Ed Borza, who is also Hawaii's senior delegate to the House.

Educators are always looking for ways to transition students to becoming active engaged professionals. Being a "fly on the wall" at the HOD meeting had to have been somewhat of a transformative event for Amy, one that brought the bigger organizational picture into view. I asked Amy for her impression of the trip and of her overall experience. Her answer, in her own words, accompanies this article. Read it and I think you'll foresee as I did, ten or twelve years from now Amy herself as President of the HSRC or even perhaps, participating in the HOD as state delegate.

Steve thinks that every state should do this. He says "Imagine 50 of our best students meeting with those delegates and with each other. The chemistry would be magic. Do this for a couple of years and the future leadership of the respiratory care profession will be assured."

Steve, I think I can speak on behalf of educators. Please know that we are all inspired by your vision and by the fact that while many of us "talk the talk", you have indeed "walked the walk." The Respiratory Care profession will reap what you have sown. [Top]

AARC spotlight: COO—Tom Kallstrom

Tom Kallstrom, RRT, AE-C, FAARC
AARC Chief Operating Officer

Personal and Professional Reflections

My title at the American Association for Respiratory Care (AARC) is Chief Operating Officer. I have been at the AARC since July of 2006. Respiratory therapy has been my only career for the past 30 years and I have loved every minute of it. I entered the profession at The University of Minnesota Hospitals, but the bulk of my experience was at University Hospitals of Cleveland's Rainbow Babies and Children's Hospital and before arriving at the AARC from the Cleveland Clinic Health Care System's Fairview Hospital in Cleveland. Through the years I moved up through the ranks of bedside caregiver to manager to administrative director.

Throughout my career I have focused my efforts primarily in pediatrics as well as management. Homecare has also been a part of my career that has been particularly gratifying as well.
My current responsibilities as Chief Operating Officer are many. I oversee the day-to-day operations of a dedicated and energized group of professionals. Our membership, which consists of more than 46,000 respiratory therapists have high expectations of the only professional association that represents the interest of our members and patients. As a result, it is essential that we represent their ongoing interests to the fullest capacity. I also represent that AARC to the National Heart Lung and Blood Institute's (NHLBI) National Asthma Education and Prevention Program. That is the group that writes the Guidelines for the Diagnosis and Management of Asthma, which was recently released.

2007 has been a successful year. Areas where we are seeing great strides are in broadening our issues to our elected and governmental officials. We have been able to draft language and gain sponsorship for a Medicare Part B initiative for respiratory care outside of the acute care hospital. We have also been granted recognition of respiratory therapists in the Public Health Service who now can be granted officer status. In April, 2007 the AARC celebrated its 60th birthday. As we recognize our longevity and successes we also realize that there is much to do.

We have a mission to educate patients as well. This can be seen at our website, yourlunghealth.org. Here we provide free information that is vetted by recognized professionals in pulmonary care. Included is an Ask Dr. Tom column where Thomas Petty MD (a world renowned pulmonologist and pioneer in pulmonary medicine) answers respiratory related questions posed by patients on the website. We also offer an electronic magazine called Asthma and Allergy Health. Because COPD is the fourth leading cause of death in the United States we have teamed up with the COPD Foundation and the NHLBI to work with the public. Our current project is the Mobile Spirometry Unit. It is through this project that we travel to community heath events across the country to educate and perform spirometry tests for the public. We are especially eager to screen people over the age of 40 with a history of smoking. They are prime targets for COPD. We started in February 2007 and we have we been to more than 25 cities and screened over 8,000 people. We are excited about this and expect to see this program grow in 2008.

There are so many developments today. I remember even 10 years ago managing open-heart patients on the ventilator for days. Now because of therapist driven protocols the benchmark is 3-4 hours of post-op ventilation. This makes a huge difference in post-op length of stay. We have seen major changes in ventilatory management of premature babies. Again the prognosis is much better because of a better understanding of the interface of machine and patient as well as the infusion of better pharmacotherapy. Another area is home care. Patients who are on oxygen can now be very mobile. Now there are portable oxygen concentrators that generate their own electricity and are lightweight. This has made a huge impact on oxygen-dependant patients.

There has been other research that illustrates that protocol-driven therapy in asthma care can reduce length of stay in the hospital and even reduce admission from the emergency department when a respiratory therapist is part of the process.

I feel strongly that the best promotion of respiratory health is being proactive and must continue our role as patient educators. As we look to the future we will see in the next ten years that COPD will move from the 4th to the 3rd leading cause of death. We will need more respiratory therapists as well. This is a profession that we are actively touting to middle and high school level students as a viable and rewarding health care profession, which will be in demand for years to come. [Top]

AARC spotlight: A Moment with Sam Giordano

Suzanne Bollig
HOD Kansas

The month of February in the mid-western states can be anything but pleasant. Temperatures can be low enough to make your teeth ache. Winds can be strong enough to take your breath away. For those who make their living outside in the elements, it can be a time of reflection on other employment opportunities. Such was the case with Sam Giordano.

In February of 1963, Sam was attending college in Kansas City and working as a gas station attendant. Back then, gas stations were "full service" meaning you sat in your car and the attendant stood outside in the elements cleaning your windows while your tank filled. Sam remembers thinking that there had to be a better place to work and keep warm. Luckily, he had done some work at St. Mary's Hospital and shortly thereafter, he had secured a job in the Inhalation Therapy Department. Like many others that began their careers in the sixties and seventies, Sam started as an OJT but after just one short year, he was sold on a new career. Sam credits his transition from OJT to respiratory therapy professional to the series of exceptional mentors and hospital experiences he had in Kansas City, St. Louis, Chicago, and Kansas City once again in 1973.

Interestingly enough, I met Sam Giordano in 1979 at St. Luke's in Kansas City where he was the Director of Respiratory and Biomedical Services. I was in the midst of a student's clinical rotation and even now almost thirty years later, I still remember the day. When you meet someone who strikes you as a professional with strong convictions and an evident passion for their work, it makes for a long-lasting impression.

Sam followed the same professional path many of us are on today. He served in the HOD as a Delegate representing Illinois and Missouri, and in 1980 Sam was elected as President of the AARC. In January 1981, he was asked to take the position of Chief Executive Officer of the AARC. While most of us have a hard time imagining the Executive Office without Sam Giordano, he relates it was not an easy decision to make at the time. After all, what had fueled his professional passion for so long were the patient contacts, the feeling of doing something good, and the challenge of learning. Sam told me he would not have made the decision for any other organization as he continues to miss the patients and his clinical work every day.

The AARC has come a long way since 1981 when Sam became the CEO and it boasted a membership of 13,000. It is now 60 years old with over 45,000 members, but is it time to rest? "Not so", says Sam, "we must continue to focus on the respiratory patient who for all practical purposes is not treated as well by the healthcare system as patients with other diseases. We need to help our patients go to the next step. We need to be a loud voice led by consumers. Why should a patient receiving hip surgery automatically qualify for rehabilitation services and yet the pulmonary patient not get the rehabilitation they need?"

Sam has a big goal for our profession. He wants us to do whatever it takes to bring about appropriate medical access to all healthcare resources for our patients. He challenges us to find any successful model of progress on a major agenda that did not require a strong community involvement. "Organizational unity is the key," he states, "and we must always remember our value is tied to the patient."

The change from clinician to executive office may have been a difficult decision to make at the time, but as I listened to Sam, one thing was clear to me. His professional passion for the patient contacts, the feeling of doing something good, and the challenge of learning is still fueling his actions today. As I sit in the same Midwestern state in the cold month of February that led Sam to his decision to make a move into healthcare so many years ago, I think that maybe for the RT profession and the patients it serves, the cold weather was not so bad after all.

Writing based on a personal conversation between Sam Giordano and Suzanne Bollig January 24, 2008. [Top]

Membership Figures

(as of 3/10/08)

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For Your Information

A Calendar of Events can be found in both the Delegate Handbook and the Chartered Affiliate Handbook, located at: http://www.aarc.org/aarc_hod/

Review this site for other HOD information as well. [Top]