AN ACT Relating to surgeons' assistants; amending RCW 18.71A.010, 18.71A.020, 18.71A.030, and 18.71A.070; and adding a new section to chapter 18.71A RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. Section 1, chapter 30, Laws of 1971 ex. sess. as amended by section 1, chapter 190, Laws of 1975 1st ex. sess. and RCW 18.71A.010 are each amended to read as follows:

(1) "Physician's assistant" means:

(a) A person who is enrolled in, or who has satisfactorily completed, a board approved training program designed to prepare persons to practice medicine to a limited extent; or

(b) A person who is a university medical graduate of a foreign medical school or college.

(2) "Surgeon's assistant" means a person who is certified under this chapter to perform surgical assisting.

(3) "Board" means the board of medical examiners.

((~~(3)~~)) (4) "Practice medicine" shall have the meaning defined in RCW ((~~18.71.010~~)) 18.71.011.

(5) "Surgical assisting" includes: (a) Positioning or assisting in positioning patients for surgery, (b) assisting surgeons in opening and closing of patients, (c) retracting and exposing tissue, (d) controlling bleeding by clamping and tying of blood vessels, (e) suturing of designated tissue, (f) suctioning and sponging operative site, (g) tying of closing sutures in peritoneum, fascia, and subcutaneous tissues, (h) applying surgical dressing if requested by surgeon, and (i) any other duties requested by a surgeon to assist in a patient's surgery.

Sec. 2. Section 2, chapter 30, Laws of 1971 ex. sess. and RCW 18.71A.020 are each amended to read as follows:

(1) The board shall adopt rules and regulations fixing the qualifications and the educational and training requirements for persons who may be employed as physician's assistants or who may be enrolled in any physician's assistant training program.

The board shall, in addition, adopt rules and regulations governing the extent to which physician's assistants may practice medicine during training and after successful completion of a training course. Such regulations shall provide:

((~~(1)~~)) (a) That the practice of a physician's assistant shall be limited to the performance of those services for which he is trained; and

((~~(2)~~)) (b) That each physician's assistant shall practice medicine only under the supervision and control of a physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physician at the place where services are rendered; and

(2) The board shall adopt rules governing the issuance and annual renewal of surgeon's assistants certifications. Applicants for certification shall provide the following:

(a) Letters of reference from six practicing surgeons licensed in the state of Washington; and

(b) Letters of reference from the hospital where the applicant trained; and

(d) Evidence of three years experience in surgical assisting; or

(e) Evidence of military training in surgical assisting.

Each applicant for initial certification shall provide proof of formal training in anatomy, physiology, surgical procedures, ethics, medical-legal issues, cardiopulmonary resuscitation, and sterile technique. Applicants for certification renewals shall provide proof of the annual completion of at least fifteen hours of continuing education approved by the board.

The board may deny, suspend, or revoke any certification issued under this subsection for any cause it deems appropriate. The board shall not issue an initial or renewed certification to any person convicted of a felony.

Sec. 3. Section 3, chapter 30, Laws of 1971 ex. sess. and RCW 18.71A.030 are each amended to read as follows:

((A)) Physician's assistants and surgeon's assistants as defined in this chapter may practice medicine in this state only after authorization by the board and only to the extent permitted by the board under this chapter. ((A)) Physician's assistants and surgeon's assistants shall be subject to discipline under chapter 18.72 RCW.

Sec. 4. Section 3, chapter 190, Laws of 1975 1st ex. sess. as amended by section 58, chapter 158, Laws of 1979 and RCW 18.71A.070 are each amended to read as follows:

There shall be appointed by the director of licensing an agent whose title shall be "medical practice investigator", who shall have the duty and shall be authorized to enter the clinic, office, or premises where a physician's assistant or surgeon's assistant is employed for the purpose of inspecting the registration or certification and utilization of any physician's assistant or surgeon's assistant employed therein. Said investigator may serve and execute any notice or process issued under the authority of this chapter and shall perform any other duty prescribed by the director or the board, including assisting other agencies in enforcing the provisions of the law regulating the practice of medicine((~~: PROVIDED, That funds must be included in the department's 1975-77 operational budget for this program~~)).

NEW SECTION. Sec. 5. A new section is added to chapter 18.71A RCW to read as follows:

Nothing in this chapter shall be construed as prohibiting or limiting the practice of nursing as authorized under chapter 18.88 RCW and rules promulgated thereunder.