AB 2096 amends Section 3765 to carve out additional exceptions to prohibitions on respiratory care and to authorize licensed vocational nurses (LVNs) to perform specified respiratory tasks in non‑acute, community and home‑based settings when they meet employer training and certification conditions. The bill directs the respiratory care board to issue guidelines in collaboration with the Board of Vocational Nursing and Psychiatric Technicians (BVNPT) and preserves other narrow exceptions (students, emergency responders, research, certain school and child‑care personnel).
This change is primarily about workforce flexibility: it moves a subset of respiratory tasks out of the exclusive province of credentialed respiratory care practitioners and into the hands of trained LVNs in limited settings. For compliance officers, home‑care providers, and regulators the bill raises immediate implementation issues — who documents competency, what the approved tasks are, how liability and payer rules will adapt — while also creating new operational opportunities for small residential providers and home health agencies.
At a Glance
What It Does
The bill permits LVNs to perform respiratory tasks identified by the respiratory care board provided the nurse completes patient‑specific employer training and holds a current competency certification recognized by the board. It authorizes the board to publish employer training guidelines in collaboration with BVNPT and establishes specific exceptions for students, paramedics, researchers, and certain facility staff.
Who It Affects
Licensed vocational nurses, home health agencies, small licensed congregate and family homes, adult and pediatric day health programs, private duty nurses, and the boards that regulate respiratory care and vocational nursing. Respiratory care practitioners and insurers will also be affected by shifts in who delivers lower‑acuity respiratory services.
Why It Matters
The bill creates a predictable path to expand LVN responsibilities in community settings, potentially increasing access and reducing costs for routine respiratory support while concentrating regulatory responsibility on boards and employers to set training, certification, and oversight standards.
More articles like this one.
A weekly email with all the latest developments on this topic.
What This Bill Actually Does
AB 2096 rewrites the exception language in Section 3765 to permit LVNs to deliver certain respiratory care tasks outside hospitals when the LVN has employer‑satisfied, patient‑specific training and holds a recognized competency certificate. The bill keeps intact a broad list of non‑prohibitions — such as clinical training for respiratory students, emergency interventions by trained paramedics, informal family care, and cardiopulmonary research — but creates an explicit pathway for LVNs to shoulder particular respiratory duties in community contexts.
Implementation relies on two parallel elements: employer training and third‑party certification. Until the board issues model guidelines, employers must provide patient‑specific training that the employer deems adequate; after the board and BVNPT publish joint guidelines, employer training must follow those standards.
Certification recognition is delegated to the board: it names specific organizations (for example trade and professional respiratory groups) whose certificates will qualify, but it also leaves space for other entities the board may later identify.The bill confines the expanded LVN role to a set of lower‑acuity, non‑acute settings — small congregate living and intermediate care facilities (six beds or fewer), adult and pediatric day health/respite centers, small family homes, employment by home health agencies or as individual nurse providers, and private duty nursing during transport or community activities. The bill also includes narrow, local exceptions: experienced Los Angeles County hospital staff may continue to perform pulmonary function testing if they have a long tenure, and credentialed school nurses may supervise LVN suctioning and basic respiratory tasks in schools under Education Code references.Operationally, compliance will hinge on documentation: employers must track patient‑specific training, ensure certificates remain current for each task, and align supervision and delegation with existing statutes for home health and facility licensure.
Boards will face a rulemaking workload to define acceptable training content, minimum competency standards, approved certifying bodies, and enforcement mechanisms. The text sets an operative date for the LVN permission to take effect, giving regulators and employers limited runway to prepare.
The Five Things You Need to Know
The LVN authorization becomes operative on January 1, 2028, creating a deadline for employers and boards to prepare.
Before January 1, 2028, employers must provide patient‑specific training that the employer finds satisfactory; on or after that date, employer training must follow board guidelines developed jointly with BVNPT.
An LVN must hold a current competency certificate for each respiratory task from either the California Association of Medical Product Suppliers, the California Society for Respiratory Care, or other organizations the respiratory care board designates.
The allowed settings are tightly circumscribed and include small licensed congregate living or intermediate care facilities (six beds or fewer), adult and pediatric day health centers, small family homes (six beds or fewer), home health agency employment or individual nurse providers in residences, and private duty nursing during transport and community activities.
The bill preserves narrow exemptions: long‑tenured Los Angeles County hospital staff (15+ years) may continue pulmonary function testing, and LVNs may perform suctioning under the supervision of credentialed school nurses per Education Code cross‑references.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Existing and preserved exceptions (students, emergencies, research, child‑care staff)
These subsections enumerate activities the act does not prohibit and remain largely unchanged: respiratory care performed as part of approved educational programs, self‑care and unpaid family care, emergency interventions by trained paramedics, temporary measures during epidemics or disasters, cardiopulmonary research, and inhaled medication administration by trained child‑care staff. Practically, this preserves clinical flexibility for training, public health response, and non‑commercial caregiving while the bill narrows its substantive change to licensed provider scope in community settings.
Home medical device retail and home health agency staff: limited authorized services
Subsection (h) allows persons employed by home medical device retail facilities or state‑licensed home health agencies to perform specific, limited respiratory care services if the respiratory care board authorizes those services. That delegation creates a compliance checkpoint: the board must identify which low‑risk tasks can be safely delegated to non‑respiratory‑care staff, and employers must ensure task‑specific training and supervision are in place.
LVN authorization: patient‑specific training, certification, and timeline
These paragraphs create the core change: the board may identify respiratory tasks LVNs may perform if the LVN completes patient‑specific training and holds task‑specific competency certification. The bill sets a two‑phase training rule—employer‑satisfactory patient training until January 1, 2028, and board‑guideline‑aligned training thereafter—and directs the respiratory care board to develop those guidelines in collaboration with BVNPT by that same date. The provision also requires certification for each task from specified professional or trade organizations or others approved by the board, and it makes the LVN authorization operable beginning January 1, 2028.
Where LVNs may perform respiratory services
The bill lists the limited settings where an LVN may use this authority: congregate living health and intermediate care facilities designated as six beds or fewer, adult and pediatric day health centers, small family homes licensed by social services (six beds or fewer), employment by a home health agency or as an individual nurse provider in a residence, and private duty nursing during transport and community activities. By restricting locations and facility size, the statute aims to limit LVN respiratory work to lower‑acuity, community contexts rather than inpatient or larger institutional settings.
Local and school exceptions: pulmonary function testing and suctioning
Subsection (k) preserves a narrow, vocationally specific exception allowing current Los Angeles County hospital employees with at least 15 years' experience to perform pulmonary function testing. Subsection (l) authorizes LVNs to do suctioning and other basic respiratory tasks under the supervision of a credentialed school nurse, tied to Education Code supervisory provisions. These carveouts reflect localized workforce realities and educational settings where supervision models differ from community care.
This bill is one of many.
Codify tracks hundreds of bills on Healthcare across all five countries.
Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Patients receiving home‑ and community‑based care: More providers will be available to deliver routine respiratory supports, potentially improving access for patients who cannot easily reach hospitals or specialty clinics.
- Home health agencies and small residential providers: They can deploy LVNs to deliver defined respiratory tasks, reducing reliance on traveling respiratory therapists for lower‑acuity services and improving operational flexibility.
- Licensed vocational nurses: LVNs gain expanded responsibilities and career scope in community settings, paired with clear certification and training pathways to document competency.
Who Bears the Cost
- Respiratory care boards and BVNPT: They must develop joint training guidelines, identify acceptable certifying organizations, and oversee rulemaking and enforcement without dedicated funding identified in the text.
- Employers (home health agencies, small facilities, private duty employers): Employers must design and deliver patient‑specific training, document competencies, and maintain records of certification—an administrative and training cost.
- Respiratory care practitioners and associations: They may see shifts in task allocation and possible competitive or professional boundary disputes, requiring engagement in board rulemaking and potential advocacy or legal challenges.
Key Issues
The Core Tension
The central dilemma is straightforward: expand the workforce to improve access and lower costs for routine respiratory care versus the risk of variable training, inconsistent competency, and blurred professional boundaries; the bill solves the first by delegating standards-setting to boards and employers but shifts the burden of assuring safe, uniform practice into administrative rulemaking and employer processes that are neither prescriptive nor funded.
AB 2096 advances a targeted scope‑of‑practice expansion but leaves several implementation pivots unresolved. The bill relies heavily on boards and employers to operationalize safe practice: it does not prescribe minimum hours, curricula, or assessment standards for the patient‑specific training that employers must provide before the board issues guidelines, nor does it define the content or validity period for the accepted competency certificates.
That open delegation creates a window where employers’ standards could vary widely, producing uneven competency across settings.
The statute attempts to balance access and safety by limiting settings and tying authority to certification, but it does not address overlapping federal or payer rules (for example Medicare conditions of participation or durable medical equipment supplier requirements) that may constrain who can bill for or be reimbursed for respiratory services. Liability and scope‑of‑practice enforcement remain practical risks: employers and LVNs will need clearer supervisory rules and documentation expectations to manage malpractice exposure and licensing complaints.
Finally, the bill delegates key technical decisions to administrative rulemaking without earmarking resources, which could delay guidance and leave stakeholders operating under transitional, inconsistent practices.
Try it yourself.
Ask a question in plain English, or pick a topic below. Results in seconds.