BILL REQ. #:  H-1042.2 

Read first time 01/31/2005.   Referred to Committee on Health Care.

     AN ACT Relating to meeting the health needs of children; amending RCW 28A.305.130 and 28A.150.260; adding a new section to chapter 28A.210 RCW; adding a new chapter to Title 18 RCW; creating new sections; making an appropriation; providing an expiration date; and declaring an emergency.

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

NEW SECTION.  Sec. 1   The legislature finds that the composition of today's student population continues to change in relation to the number, complexity, and acuity of medical and psychiatric problems with which students come to school daily. The legislature also finds that due to an emerging lack of access to routine health care for many children, the role of the school nurse in protecting children's health and improving their ability to achieve academically continues to grow.
The legislature also finds that student health is fundamental to the educational process, that access to school nursing services is a vital component of supporting student academic success, and that removing health barriers to learning is essential to the successful education of students.
     The legislature further finds that in response to the increasingly diverse needs that challenge school communities today, the nature and scope of school nursing services required to meet student needs continues to expand. The legislature recognizes that in addition to meeting the health care needs of the general student population by assessing student health status, identifying health problems that have an impact on learning, delivering emergency care, administering medications, performing health care procedures, and providing wellness programs, health counseling, and health education, school nurses also must meet the health needs of special student populations including, but not limited to, special education students, students with 504 plans, and students with mental or social concerns that impede learning.
     The legislature also finds that due to the growing complexity of student health needs, the delegation of nursing tasks to unlicensed and untrained school personnel compromises the health and safety of students, creates the potential for errors with life-threatening consequences, and exposes school districts to legal liability. The legislature acknowledges that the department of health, in its 2001 sunrise review of school health aides, recommended the state regulation of registered school health aides according to established nursing practice standards and the state's uniform professional accountability processes. The legislature declares that the training of registered school health aides is in the interest of public health and safety.
     The legislature intends to undertake a more comprehensive examination of overall student health care needs in the school setting to determine how school nursing services can be best integrated into existing efforts to raising student academic achievement.

NEW SECTION.  Sec. 2   The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Commission" means the nursing care quality assurance commission created in RCW 18.79.070.
     (2) "Department" means the department of health.
     (3) "School health aide" means a person registered under this chapter who performs health care tasks under training and supervision of a registered nurse licensed under RCW 18.79.040.
     (4) "Secretary" means the secretary of health.

NEW SECTION.  Sec. 3   (1) No certificated or noncertificated school district employee may practice or represent himself or herself as a school health aide by use of any title or description of services without being registered to practice by the department, unless otherwise exempted by this chapter.
     (2) Tasks delegated to a school health aide include those nursing procedures applicable to school districts under RCW 28A.210.260 and 28A.210.280.
     (3) This section shall not be construed to affect the scope of nursing procedures applicable to school districts as provided by law.

NEW SECTION.  Sec. 4   This chapter shall not be construed to prohibit or restrict:
     (1) The practice by an individual licensed, certified, or registered under the laws of this state and performing services within the authorized scope of practice;
     (2) The practice by an individual employed by the government of the United States while engaged in the performance of duties prescribed by the laws of the United States; or
     (3) The practice by a person who is a regular student in an educational program approved by the secretary, and whose performance of services is pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor.

NEW SECTION.  Sec. 5   In addition to any other authority provided by law, the secretary has the authority to:
     (1) Adopt rules under chapter 34.05 RCW necessary to implement this chapter;
     (2) Establish all registration, examination, and renewal fees in accordance with RCW 43.70.250;
     (3) Establish forms and procedures necessary to administer this chapter;
     (4) Register any applicants, and to deny registration to applicants who do not meet the minimum qualifications, except that proceedings concerning the denial of registration based upon unprofessional conduct or impairment shall be governed by the uniform disciplinary act, chapter 18.130 RCW; and
     (5) Hire clerical, administrative, investigative, and other staff as needed to implement this chapter, and hire individuals registered under this chapter to serve as examiners for any practical examinations.

NEW SECTION.  Sec. 6   The secretary shall keep an official record of all proceedings. A part of the record shall consist of a register of all applicants for registration under this chapter and the results of each application.

NEW SECTION.  Sec. 7   The secretary shall issue a registration to any applicant who completes an application that identifies the name and address of the applicant, the registration being requested, and information required by the secretary necessary to establish whether there are grounds for denial of a registration or issuance of a conditional registration under chapter 18.130 RCW.

NEW SECTION.  Sec. 8    The superintendent of public instruction shall establish by rule, in consultation with the commission, standards and procedures for approval of educational and alternative training programs.

NEW SECTION.  Sec. 9   Applications for registration shall be submitted on forms provided by the secretary. The secretary may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for registration provided for in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250. The fee shall accompany the application.

NEW SECTION.  Sec. 10   The secretary shall establish by rule the procedural requirements and fees for renewal of a registration. Failure to renew shall invalidate the registration and all privileges granted by the registration. If a registration has lapsed for a period longer than three years, the person shall demonstrate competence to the satisfaction of the secretary by taking continuing education courses, or meeting other standards determined by the secretary.

NEW SECTION.  Sec. 11   The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of registrations, unauthorized practice, and the discipline of persons registered under this chapter. The secretary is the disciplining authority under this chapter.

NEW SECTION.  Sec. 12   This chapter only applies to a business or profession regulated under the laws of this state if this chapter is specifically referenced in the laws regulating that business or profession.

NEW SECTION.  Sec. 13   (1) The joint legislative task force on student health is created. The task force shall consist of three members of each major caucus of the senate, representing the committees on health and long-term care, ways and means, and early learning, K-12 and higher education, appointed by the president of the senate; and three members of each major caucus of the house of representatives, representing the committees on education, appropriations, and health care, appointed by the speaker of the house of representatives. Every effort shall be made to ensure that members of the joint task force are appointed by the effective date of this section.
     (2) The task force, in consultation with the department of health and the office of the superintendent of public instruction, shall investigate the need for additional school nursing services by gathering data about current school nurse-to-student ratios, and assessing the demand for school nursing services by acuity levels and the necessary skills to meet those demands. The task force also shall recommend to the legislature best practices in school nursing services, including a dedicated, sustainable funding model that would best meet the current and future needs of Washington's schools and contribute to greater academic success of all students.
     (3) The task force shall report its findings and recommendations to the appropriate committees of the legislature by December 1, 2005.
     (4) This section expires July 1, 2006.

NEW SECTION.  Sec. 14   The school nurse account is created in the custody of the state treasurer. All receipts from gifts, grants, or endowments obtained under section 15 of this act must be deposited into the account.
     Expenditures from the account may be used only to increase the number of certificated educational staff associate school nurses in class I school districts. School districts with more than one thousand five hundred students for every school nurse shall receive priority for these funds. As used in this section, "school nurse" does not include nurses in the school nurse corps.
     Only the superintendent of public instruction or the superintendent's designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.

NEW SECTION.  Sec. 15   The office of the superintendent of public instruction may receive gifts, grants, or endowments from public or private sources that are made from time to time, in trust or otherwise, for the use and benefit of the purposes of section 14 of this act and spend gifts, grants, or endowments or income from the public or private sources to support the purpose in section 14 of this act, unless the receipt of the gifts, grants, or endowments violates RCW 42.17.710.

Sec. 16   RCW 28A.305.130 and 2002 c 205 s 3 are each amended to read as follows:
     In addition to any other powers and duties as provided by law, the state board of education shall:
     (1) Approve or disapprove the program of courses leading to teacher, school administrator, and school specialized personnel certification offered by all institutions of higher education within the state which may be accredited and whose graduates may become entitled to receive such certification. Program approval under this section shall require that the certification program include a requirement for the successful completion of a course in emergency first-aid and cardiopulmonary resuscitation training.
     (2) Conduct every five years a review of the program approval standards, including the minimum standards for teachers, administrators, and educational staff associates, to reflect research findings and assure continued improvement of preparation programs for teachers, administrators, and educational staff associates.
     (3) Investigate the character of the work required to be performed as a condition of entrance to and graduation from any institution of higher education in this state relative to such certification as provided for in subsection (1) of this section, and prepare a list of accredited institutions of higher education of this and other states whose graduates may be awarded such certificates.
     (4)(a) The state board of education shall adopt rules to allow a teacher certification candidate to fulfill, in part, teacher preparation program requirements through work experience as a classified teacher's aide in a public school or private school meeting the requirements of RCW 28A.195.010. The rules shall include, but are not limited to, limitations based upon the recency of the teacher preparation candidate's teacher aide work experience, and limitations based on the amount of work experience that may apply toward teacher preparation program requirements under this chapter.
     (b) The state board of education shall require that at the time of the individual's enrollment in a teacher preparation program, the supervising teacher and the building principal shall jointly provide to the teacher preparation program of the higher education institution at which the teacher candidate is enrolled, a written assessment of the performance of the teacher candidate. The assessment shall contain such information as determined by the state board of education and shall include: Evidence that at least fifty percent of the candidate's work as a classified teacher's aide was involved in instructional activities with children under the supervision of a certificated teacher and that the candidate worked a minimum of six hundred thirty hours for one school year; the type of work performed by the candidate; and a recommendation of whether the candidate's work experience as a classified teacher's aide should be substituted for teacher preparation program requirements. In compliance with such rules as may be established by the state board of education under this section, the teacher preparation programs of the higher education institution where the candidate is enrolled shall make the final determination as to what teacher preparation program requirements may be fulfilled by teacher aide work experience.
     (5) Supervise the issuance of such certificates as provided for in subsection (1) of this section and specify the types and kinds of certificates necessary for the several departments of the common schools by rule or regulation in accordance with RCW 28A.410.010.
     (6) Accredit, subject to such accreditation standards and procedures as may be established by the state board of education, all schools that apply for accreditation, and approve, subject to the provisions of RCW 28A.195.010, private schools carrying out a program for any or all of the grades kindergarten through twelve: PROVIDED, That no private school may be approved that operates a kindergarten program only: PROVIDED FURTHER, That no public or private schools shall be placed upon the list of accredited schools so long as secret societies are knowingly allowed to exist among its students by school officials: PROVIDED FURTHER, That the state board may elect to require all or certain classifications of the public schools to conduct and participate in such preaccreditation examination and evaluation processes as may now or hereafter be established by the board.
     (7) Make rules and regulations governing the establishment in any existing nonhigh school district of any secondary program or any new grades in grades nine through twelve. Before any such program or any new grades are established the district must obtain prior approval of the state board.
     (8) Prepare such outline of study for the common schools as the board shall deem necessary, and prescribe such rules for the general government of the common schools, as shall seek to secure regularity of attendance, prevent truancy, secure efficiency, and promote the true interest of the common schools.
     (9) Continuously reevaluate courses and adopt and enforce regulations within the common schools so as to meet the educational needs of students and articulate with the institutions of higher education and unify the work of the public school system.
     (10) Carry out board powers and duties relating to the organization and reorganization of school districts under chapter 28A.315 RCW ((28A.315.010 through 28A.315.680 and 28A.315.900)).
     (11) Hear and decide appeals as otherwise provided by law.
     The state board of education is given the authority to promulgate information and rules dealing with the prevention of child abuse for purposes of curriculum use in the common schools.

NEW SECTION.  Sec. 17   A new section is added to chapter 28A.210 RCW to read as follows:
     School building administrators and school district boards of directors are encouraged to provide ample opportunities for all school employees to receive training in emergency first aid and cardiopulmonary resuscitation, and to periodically attend refresher courses in these vital areas of preparedness necessary to provide assistance to students and other employees in emergency situations.

Sec. 18   RCW 28A.150.260 and 1997 c 13 s 2 are each amended to read as follows:
     The basic education allocation for each annual average full time equivalent student shall be determined in accordance with the following procedures:
     (1) The governor shall and the superintendent of public instruction may recommend to the legislature a formula based on a ratio of students to staff for the distribution of a basic education allocation for each annual average full time equivalent student enrolled in a common school. The distribution formula shall have the primary objective of equalizing educational opportunities and shall provide appropriate recognition of the following costs among the various districts within the state:
     (a) Certificated instructional staff and their related costs;
     (b) Certificated administrative staff and their related costs;
     (c) Classified staff and their related costs;
     (d) Registered nurses licensed under RCW 18.79.040;
     (e) Nonsalary costs;
     (((e))) (f) Extraordinary costs of remote and necessary schools and small high schools, including costs of additional certificated and classified staff; and
     (((f))) (g) The attendance of students pursuant to RCW 28A.335.160 and 28A.225.250 who do not reside within the servicing school district.
     (2)(a) This formula for distribution of basic education funds shall be reviewed biennially by the superintendent and governor. The recommended formula shall be subject to approval, amendment or rejection by the legislature. The formula shall be for allocation purposes only. While the legislature intends that the allocations for additional instructional staff be used to increase the ratio of such staff to students, nothing in this section shall require districts to reduce the number of administrative staff below existing levels.
     (b) The formula adopted by the legislature shall reflect the following ratios at a minimum: (i) Forty-nine certificated instructional staff to one thousand annual average full time equivalent students enrolled in grades kindergarten through three; (ii) forty-six certificated instructional staff to one thousand annual average full time equivalent students in grades four through twelve; (iii) four certificated administrative staff to one thousand annual average full time equivalent students in grades kindergarten through twelve; ((and)) (iv) sixteen and sixty-seven one-hundredths classified personnel to one thousand annual average full time equivalent students enrolled in grades kindergarten through twelve; and (v) one and thirty-three one-hundredths registered school nurse personnel to one thousand annual average full-time equivalent students enrolled in grades kindergarten through twelve.
     (c) In the event the legislature rejects the distribution formula recommended by the governor, without adopting a new distribution formula, the distribution formula for the previous school year shall remain in effect: PROVIDED, That the distribution formula developed pursuant to this section shall be for state apportionment and equalization purposes only and shall not be construed as mandating specific operational functions of local school districts other than those program requirements identified in RCW 28A.150.220 and 28A.150.100. The enrollment of any district shall be the annual average number of full time equivalent students and part time students as provided in RCW 28A.150.350, enrolled on the first school day of each month and shall exclude full time equivalent students with disabilities recognized for the purposes of allocation of state funds for programs under RCW 28A.155.010 through 28A.155.100. The definition of full time equivalent student shall be determined by rules of the superintendent of public instruction: PROVIDED, That the definition shall be included as part of the superintendent's biennial budget request: PROVIDED, FURTHER, That any revision of the present definition shall not take effect until approved by the house appropriations committee and the senate ways and means committee: PROVIDED, FURTHER, That the office of financial management shall make a monthly review of the superintendent's reported full time equivalent students in the common schools in conjunction with RCW 43.62.050.
     (3)(a) Certificated instructional staff shall include those persons employed by a school district who are nonsupervisory employees within the meaning of RCW 41.59.020(8): PROVIDED, That in exceptional cases, people of unusual competence but without certification may teach students so long as a certificated person exercises general supervision: PROVIDED, FURTHER, That the hiring of such classified people shall not occur during a labor dispute and such classified people shall not be hired to replace certificated employees during a labor dispute.
     (b) Certificated administrative staff shall include all those persons who are chief executive officers, chief administrative officers, confidential employees, supervisors, principals, or assistant principals within the meaning of RCW 41.59.020(4).

NEW SECTION.  Sec. 19   Sections 2 through 12 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION.  Sec. 20   The sum of forty-five thousand dollars, or as much thereof as may be necessary, is appropriated for the fiscal year ending June 30, 2006, from the general fund to the office of the superintendent of public instruction for the purpose of funding a position to pursue grants and obtain funds for the school nurse account.

NEW SECTION.  Sec. 21   If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION.  Sec. 22   This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately.