HOUSE BILL REPORT
ESHB 1530
BYHouse Committee on Health Care (originally sponsored by Representatives Brooks, Braddock, Brough, Cantwell, Sprenkle, Spanel, Wineberry, Day and Miller)
Certifying and registering nursing assistants.
House Committe on Health Care
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. (10)
Signed by Representatives Braddock, Chair; Day, Vice Chair; Bristow, Brooks, Cantwell, Lewis, Lux, D. Sommers, Sprenkle and Vekich.
House Staff:John Welsh (786-7133)
Rereferred House Committee on Ways & Means/Appropriations
Majority Report: The substitute bill by Committee on Health Care as amended by Committee on Ways & Means/Appropriations do pass. (23)
Signed by Representatives Locke, Chair; Belcher, Braddock, Brekke, Bristow, Brough, Butterfield, Ebersole, Fuhrman, Grant, Grimm, Hine, Holland, McLean, Nealey, Peery, Sayan, Silver, H. Sommers, Spanel, Sprenkle, Wang and B. Williams.
House Staff: David Knutson (786-7136)
AS PASSED HOUSE FEBRUARY 13, 1988
BACKGROUND:
Nursing assistants are health care workers employed in the nursing home setting who work under the direction and supervision of licensed nurses. They are required to complete a training program within six months of employment approved by the State Board of Nursing. The minimum curriculum consists of 25 classroom hours and 50 hours of supervised on-the-job clinical practice.
Nursing assistants are not included under the Uniform Disciplinary Act for the health professions currently.
There is evidence of a critical turnover of nursing assistants in nursing homes statewide, as high as 300 percent, as well as a growing shortage of nurses generally, especially in long-term care.
SUMMARY:
The Legislature declares that nursing assistants should be brought formally within the spectrum of professional nursing with recognized educational qualifications within an articulated nursing educational program, for the purpose of career mobility.
Nursing assistants are required to register with the Department of Licensing in order to practice and use the title "nursing assistant-registered". Those wishing to meet higher academic qualifications determined by the State Board of Nursing in consultation with the Board of Practical Nursing may elect to become certified, and may use the title "nursing assistant- certified". The Board may define by rule their scope of practice.
Exemptions from registration include other practitioners credentialed by the state, employees of the federal government and regularly enrolled students.
The director of licensing has authority to register and certify applicants, set fees, act as the disciplinary authority under the Uniform Disciplinary Act governing the discipline of those registered or certified, keep official records of all proceedings, and appoint an advisory committee to the department and board.
The State Board of Nursing has authority to determine minimum educational requirements and approve registration programs under Ch. 18.52A RCW, administer certification examinations and determine applicants' eligibility for examinations for certification, issue certificates by endorsement for out-of- state applicants, and adopt rules for continuing competency.
The director will issue a registration to applicants who submit their identity, address, and other background information. After January 1, 1989, the director will issue a certificate to any person who has completed a board-approved educational program, an exam, and any board-approved experience requirements. The board must establish by rule the standards for approving and revoking approval of educational programs, which must apply equally to foreign jurisdictions. The board is required to examine each applicant for certification for minimum skill to practice competently, and applicants may take the examination up to three times.
The director may waive the examination for applicants who apply within one year and who possess commonly accepted standards of education and experience. The director may certify applicants from other states without examination by endorsement who are credentialed under standards substantially equivalent there.
The director shall establish by rule procedural requirements for renewal of registration and certification.
EFFECT OF SENATE AMENDMENT(S): The effective date of the certification program for nursing assistants is extended from January 1, 1989 to January 1, 1990. The Board of Nursing is required to report to the Legislature by January 1, 1989 with proposed standards and procedures for meeting requirements of educational programs and alternative training for nursing assistants seeking certification.
Appropriation: $100,000 to the Department of Licensing.
Revenue: The bill has a revenue impact.
Fiscal Note: Requested January 28, 1988.
House Committee ‑ Testified For: (Health Care) Donna Hinrichs, Visiting Nurse Services; Beverly Jacobson, Seattle Area Hospital Council; Lorraine Overmyer, Washington State Board of Nursing; Hilke Faber, Nursing Home Coalition.
(Ways & Means/Appropriations) Cynthia Jones, Department of Licensing.
House Committee - Testified Against: (Health Care) None Presented.
(Ways & Means/Appropriations) None Presented.
House Committee - Testimony For: (Health Care) The establishment of a registration requirement for nursing assistants would be helpful in identifying the principal cadre of health care workers in the nursing home setting, and providing unprofessional conduct standards in a disciplinary process. This is now a federal requirement. Voluntary certification will enable the worker to progress to higher levels or qualification upon completing the educational and training program developed by the Board of Nursing. The opportunity for career development and advancement may help in retaining nursing assistants in nursing homes and reducing the 300 percent turnover. It would also add to the supply of candidates entering career nursing at the LPN and registered nurse level.
(Ways & Means/Appropriations) Registration of nursing assistants will provide a career ladder for individuals entering the health care field. It will also establish unprofessional conduct standards in a disciplinary process.
House Committee - Testimony Against: (Health Care) None Presented.
(Ways & Means/Appropriations) None Presented.
VOTE ON FINAL PASSAGE:
Yeas 91; Excused 7
Excused: Representatives Allen, Fuhrman, King P, Sanders, Schoon, Williams B, Wineberry