Monthly Briefing February 2026

In November last year, a Florida-based respiratory therapist and lapsed CHT filed a petition with the Florida Department of Health Board of Respiratory Care, seeking a declaratory statement that would serve to restrict the operation of hyperbaric chambers in that state to respiratory therapists. This individual argued, among other things, that only respiratory therapists are trained and licensed to deliver oxygen, and the hyperbaric chamber is simply another form of oxygen delivery, adding ”HBO therapy is a respiratory therapy modality”. In his lengthy brief he further argued that “private certifications” (referring the CHT, CHS and by extension CHRNs) are sometimes treated as mandatory requirements; proposed a Florida Hyperbaric Operator Endorsement restricted to RTs (which his company Deep Breathe Institute would help train); complained that hospitals increasingly deny RTs access to hyperbaric operations unless they hold one of these private certifications; expressed dissatisfaction with what he considered to be the diminishing presence of RTs within the hyperbaric field “therefore increasing staffing costs”, and that patient safety would be restored if chamber operations were restricted to RTs, along with several other arguments in his 71 page document.

Not surprisingly, this alarmed many within the hyperbaric community. It prompted several organizations and individuals, including the National Board, to submit rebuttals in advance of a January 9 meeting of the Board of Respiratory Care. The National Board’s counter argument is linked below. The BNA kindly permitted their Position Statement to be linked here as well, (thanks Heather Wheaton!) as did Andrew Melnyczenko, Technical and Safety Director at the Mayo’s Hyperbaric and Altitude Medicine Program, in Rochester, MN.

The January meeting offered an opportunity for oral input, and I had planned to add some additional comments. As it turned out, counsel for the Board of Respiratory Care determined that the petition was not lawful/beyond their jurisdiction, so its hearing was denied by unanimous vote. I typed up what I intended to say and added it below.

“I assume that the Board’s members had an opportunity to read my letter written on behalf of the National Board of Diving & Hyperbaric Medical Technology, one that serves to oppose the proposal that Florida-based hyperbaric chambers be only operated by respiratory therapists. I will take a few minutes of your time to add several additional comments.

To argue, as this petitioner does, that hospitals unjustly exclude respiratory therapists from positions within their hyperbaric programs because they lack training and certification in the practice of hyperbaric medicine defies logic and borders on the absurd. More so given that the petitioner argues elsewhere for enhanced hyperbaric safety, and in doing references unique dangers and physiological emergencies that mostly fall beyond the scope of a respiratory therapist’s training. That hospitals deny RT’s hyperbaric positions unless they have acquired specialized training is precisely how to mitigate the referenced dangers and strengthen management of associated emergencies. To their credit, hospitals know this and rightly insist on it.

And to further argue there should be a safety model that is aligned with NFPA and CMS principles fails to grasp reality. This is precisely what decades of hyperbaric training & certification are designed to address and entirely consistent with NFPA expectations.

Equally important here is that the respiratory therapy discipline continues to be well represented within the CHT community. Throughout the National Board’s history, 522, or 11% of the 4,943 health care professionals from eight eligible pathways who qualified as CHTs were indeed respiratory therapists. 

When looking at currently practicing CHTs, RTs hold an even higher representation, at 16%. In recent years, the newly certified respiratory therapist CHT has been increasingly commonplace. In 2023 they constituted 21% (or one in five) of all new certifications, 12% in 2024 and 18% last year. So, there is nothing to support the petitioner’s contention of dwindling representation, and everything to indicate the opposite is true. 

To conclude, the National Board of Diving & Hyperbaric Medical Technology firmly opposes any initiative that would eliminate formally trained and nationally certified hyperbaric personnel from chamber operations, in Florida or elsewhere. That said the National Board has long recognized and valued respiratory therapy as a key qualifying vocation”.

We may not have heard that last from this gentleman, but you should be encouraged by the robust counter arguments that would be heard if this petition were to reappear in a different forum.

Dick Clarke, President

National Board of Diving & Hyperbaric Medical Technology

NBDHMT Rebuttal

BNA Position Statement

Andrew Melnyczenko Rebuttal