Brief Description: Repealing the expiration provision in the act authorizing nurse practitioners to treat those covered by industrial insurance.

Sponsors: Representatives Green, Conway, Morrell, Cody, Ormsby, Schual-Berke, Moeller and Simpson.

Hearing Date: 2/8/07

Staff: Sarah Beznoska (786-7109).

Background:

Industrial Insurance Act

A worker who, in the course of employment, is injured or suffers disability from occupational disease may be entitled to benefits under the Industrial Insurance Act (Act). These benefits include proper and necessary medical and surgical services from a physician of the worker's choice. The Act contains many provisions specifying the roles and responsibilities of physicians. For example, a physician who fails to provide necessary assistance to injured workers or file required reports is subject to civil penalties. Also, a physician may be required to testify as to an injured worker's examination or treatment before the Department of Labor and Industries or the Board of Industrial Insurance Appeals.

The Department of Labor and Industries' rules define "physician" as a person licensed to practice medicine and surgery or osteopathic medicine and surgery. The rules also define "doctor" to include persons licensed to practice medicine and surgery, osteopathic medicine and surgery, chiropractic, naturopathic physician, podiatry, dentistry, and optometry. Doctors may sign accident report forms for injured workers and time loss authorizations.

Advanced Registered Nurse Practitioners

The Department of Health's rules provide that an "advanced registered nurse practitioner" (ARNP) is a registered nurse prepared to assume primary responsibility for management of a broad range of patient care. According to the rules, their practice "incorporates the use of independent judgment as well as collaborative interaction with other health care professionals."

Advanced Registered Nurse Practitioners and Industrial Insurance

The Department of Labor and Industries' rules permit ARNPs to provide nursing care for injured workers. The rules require that ARNPs be recognized as ARNPs and have a system of obtaining physician consultations. In 2004, the Legislature expanded the authority of ARNPs under the Act. Until June 30, 2007, the health services available to injured workers include health services provided by ARNPs within their scope of practice. ARNPs are recognized as independent practitioners. Generally, ARNPs have the same roles and responsibilities as physicians, except that ARNPs may not conduct special medical examinations.

The Department of Labor and Industries reported to the House Commerce and Labor Committee on December 1, 2006, on the implementation of these provisions, including the effects on injured worker outcomes, claim costs, and disputed claims. The report generally determined that implementation the 2004 law was not associated with any negative impact on costs, claim disputes, or time loss duration, and appeared to positively affect provider enrollment, availability of authorized attending providers in rural areas, and administrative efficiency.

Summary of Bill:

The expanded authority of advanced registered nurse practitioners (ARNPs) under the Industrial Insurance Act is made permanent. The health services available to injured workers include health services provided by ARNPs within their scope of practice. ARNPs are recognized as independent practitioners. Generally, ARNPs have the same roles and responsibilities as physicians, except that ARNPs may not conduct special medical examinations.

Rules Authority: The bill does not address the rule making authority of an agency.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill contains an emergency clause and takes effect immediately.