HOUSE BILL REPORT

HB 1726

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Reported by House Committee On:

Health Care & Wellness

Title: An act relating to services provided by health care professional students.

Brief Description: Concerning services provided by health care professional students.

Sponsors: Representatives Riccelli, Schmick, Robinson, Walsh, Thai, Stonier, Macri and Pollet.

Brief History:

Committee Activity:

Health Care & Wellness: 2/19/19, 2/20/19 [DP].

Brief Summary of Bill

  • Permits pharmacy students, allopathic and osteopathic medical students, and nursing students to perform tasks under the supervision of a licensed pharmacist, licensed allopathic or osteopathic physician, registered nurse, or advanced registered nurse practitioner, so long as those tasks fall within the scope of practice of both the student and the supervisor and certain other conditions are met.

HOUSE COMMITTEE ON HEALTH CARE & WELLNESS

Majority Report: Do pass. Signed by 14 members: Representatives Cody, Chair; Macri, Vice Chair; Schmick, Ranking Minority Member; Caldier, Assistant Ranking Minority Member; Chambers, Davis, Harris, Jinkins, Maycumber, Riccelli, Robinson, Stonier, Thai and Tharinger.

Staff: Kim Weidenaar (786-7120).

Background:

Scopes of Practice.

Pharmacists are licensed by the Pharmacy Quality Assurance Commission. The practice of pharmacy includes: interpreting prescriptions; compounding, dispensing, labeling, administering, distributing, and storing drugs and devices; monitoring drug therapy; initiating or modifying drug therapy in accordance with written guidelines; participating in drug utilization reviews and product selection; and providing information on legend drugs.

Physicians are licensed by the Medical Quality Assurance Commission (Medical Commission). The practice of medicine is defined as: offering or undertaking to diagnose, cure, advise, or prescribe for any human disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real or imaginary, by any means or instrumentality; administering or prescribing drugs or medicinal preparations; and severing or penetrating the tissues of human beings.

Osteopathic physicians are licensed by the Board of Osteopathic Medicine and Surgery (Osteopathic Board). The practice of osteopathic medicine and surgery is defined as using any method in the treatment of disease, injuries, deformities, and other physical and mental conditions of human beings.

Registered nurses and advanced registered nurse practitioners are licensed by the Nursing Quality Assurance Commission (Nursing Commission). The practice of advanced registered nursing means performing the acts of a registered nurse and performing an expanded role in providing health care services, as defined by the Nursing Commission, including prescribing legend drugs and controlled substances contained in Schedules II through V.

The practice of registered nursing is defined as performing acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in, among other things: observing, assessing, diagnosing, caring or counseling, and health teaching of individuals with illnesses, injuries, or disabilities, or in the maintenance of health or prevention of illness; administering, supervising, delegating, and evaluating nursing practice; and executing a prescribed medical regimen. An unlicensed person may provide nursing care to the sick if he or she is uncompensated and does not hold himself or herself out to be a registered nurse.

Practice of Medicine, Nursing, and Pharmacy by Students.

Students enrolled in a school of medicine that is approved and accredited by the Medical Commission may practice medicine pursuant to their coursework or under the supervision and control of a licensed physician. Students enrolled in a school of osteopathic medicine and surgery that is accredited and approved by the Osteopathic Board may practice pursuant to their coursework and under the supervision of a licensed osteopathic physician. Nursing students enrolled in approved schools may practice registered nursing or advanced registered nursing so long as it is incidental to their course of study. Pharmacy students must apply for registration as a pharmacy intern to obtain pharmacy internship experience.

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Summary of Bill:

A pharmacy student registered as a pharmacy intern may practice pharmacy, a nursing student may practice registered nursing or advanced registered nursing, an allopathic medical student may practice medicine, and an osteopathic medical student may practice osteopathic medicine if:

The Pharmacy Commission may adopt rules to implement these requirements.

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Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) Currently, a pharmacy student that provides services at a health fair or outreach program must be supervised by a pharmacist, even when doing tasks other health care professionals like nurses and doctors could perform.  Often health fairs and other outreach programs struggle to find preceptors for all health care professions, so those students miss out on the experience and fewer health needs are met. These restrictions are unnecessary.

Under the bill, a pharmacy student, nursing student, or medical student could be supervised by a pharmacist, nurse, or physician, when they are acting within the professional's scope.  This would expand the number of opportunities open to health care professional students, increase the care they can provide, and create additional opportunities for inter-professional training and education, which is important in today's health care system.  All of the professional associations have worked together on this bill and are in full support.

(Opposed) None.

Persons Testifying: Representative Riccelli, prime sponsor; Brandy Seignemartin and Johanna Pantig, Associated Students of Washington State University Health Sciences; Jennifer Robinson, Washington State University College of Pharmacy; and Gloria Brighsm, Washington State Nurses Association.

Persons Signed In To Testify But Not Testifying: None.