Original Notice.

Preproposal statement of inquiry was filed as WSR 98-08-114.

Title of Rule: Chapter 246-928 WAC, Respiratory care practitioners.

Purpose: Proposed amendments are to provide clarification and to incorporate SHB 1536, chapter 334, Laws of 1997 into chapter 18.89 RCW, that mandates the licensure of respiratory care practitioners who were formerly certified by the Department of Health (DOH) and requires that applicants complete programs with a two-year curriculum.

Statutory Authority for Adoption: RCW 18.89.050(1).

Statute Being Implemented: Chapter 18.89 RCW.

Summary: The statute specifically requires that applicants complete programs with a two-year curriculum. It directs DOH to establish the minimum educational qualifications so credentialed providers comply with the statute and rule. The statute also allows DOH to approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the licensure examination. In addition, the statute requires DOH to establish temporary practice, reciprocity, and/or temporary permit qualifications and requirements for respiratory care practitioners.

Reasons Supporting Proposal: The proposed amendments eliminate unnecessary regulations, implement legislation, clarify existing language and make housekeeping changes.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Tracy Hansen, 1300 S.E. Quince Street, Olympia, WA 98504, (360) 236-4940.

Name of Proponent: Department of Health, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The proposed rules will provide clarification and implement 1997 legislation. Chapter 18.89 RCW specifically requires that applicants complete programs with a two-year curriculum. It directs DOH to establish the minimum educational qualifications so credentialed providers comply with the statute and rule. The statute also allows DOH to approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the licensure examination. In addition, the statute requires DOH to establish temporary practice, reciprocity, and/or temporary permit qualifications and requirements for respiratory care practitioners.

Proposal Changes the Following Existing Rules: Amendments are to provide clarification and to incorporate the 1997 legislative changes to chapter 18.89 RCW, that mandates licensure of respiratory care practitioners who were formerly certified by DOH and requires applicants to complete programs with a two-year curriculum.

A small business economic impact statement has been prepared under chapter 19.85 RCW.

The following rules are old statute requirements: WAC 246-928-420, 246-928-430, 246-928-450, 246-928-510, 246-928-540, 246-928-550, 246-928-610, 246-928-620, 246-928-630, 246-928-640, 246-928-650, 246-928-660, and 246-928-990.

The following rules are new statute requirements: WAC 246-928-410, 246-928-520, 246-928-530, and 246-928-560.

The following rules are old rule requirements: WAC 246-928-246-928-420, 246-928-430, 246-928-450, 246-928-520, 246-928-530, 246-928-540, 246-928-550, 246-928-560, 246-928-610, 246-928-620, 246-928-630, 246-928-640, 246-928-650, 246-928-660, and 246-928-990.

The following rules are new rule requirements: WAC 246-928-246-928-410, 246-928-510, 246-928-520, 246-928-530, and 246-928-560.

The "more than minor" threshold varies by industry. The standard industrial code classifications used to determine the threshold for more than minor impact were: 806 and 809.

STANDARD INDUSTRIAL CODE	ECONOMIC ACTIVITY	MINOR COST THRESHOLD
806	Hospitals	50.00
809	Misc. Health	53.00

Costs Required To Comply.

Does the cost of the proposed rule exceed the threshold where an SBEIS is required?

The following WACs are below the minor cost threshold so an SBEIS is not required:

WAC 246-928-410, this rule explains who must be licensed and who is exempt form [from] licensure and required by RCW 19.89.040 [18.89.040]. No change in requirements. No new costs to comply.

WAC 246-928-420, licensure is required by RCW 18.89.050 [(1)](c). Applications for licensure are required by RCW 18.89.120. No change in requirement. No new costs to comply.

WAC 246-928-430, renewal for licensure is required by RCW 18.89.050 [(1)](c). Applications for renewal are required by RCW 18.89.140. No change in requirement. No new costs to comply.

WAC 246-928-450, reinstate of an expired license is required by RCW 18.89.050 [(1)](c). Applications for reinstatement of an expired license are required by RCW 18.89.140. No change in requirement. No new costs to comply.

WAC 246-928-510, this rule is an overview of the qualifications for licensure as required by RCW 18.89.50 [18.89.050(1)] (d) and (f) and 18.89.090. No change in requirements. No new costs to comply.

WAC 246-928-530, temporary practice qualifications for licensure is required by RCW 18.89.050 [(1)](c) and 18.89.090(2). The Department of Health will check applicant's eligibility for the next available examination through the National Board for Respiratory Care. No new costs to comply.

WAC 246-928-540, examination for licensure is required by RCW 18.89.050 [(1)](d) and 18.89.090. No change in requirement. No new costs to comply.

WAC 246-928-550, AIDS education for licensure is required by RCW 18.89.050 [(1)](d) and 70.24.270. No change in requirement. No new costs to comply.

WAC 246-928-610, requirements for mandatory reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-620, requirements for health care institution reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-630, requirements for associations or societies reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-640, requirements for professional liability carriers reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-650, requirements for courts reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-660, requirements for state and federal agencies reporting of unprofessional conduct in accordance with RCW 18.130.080. No change in requirement. No new costs to comply.

WAC 246-928-990, fees for application/licensure, temporary practice permit, renewal, reinstatement, duplicate and verification of licensure is required by RCW 19.89.050 [18.89.050 (1)](b). No new costs to comply.

The following WACs are new costs and exceed the threshold so an SBEIS is required:

WAC 246-928-520, minimum education qualifications for licensure is required by RCW 18.89.050 [(1)](d) and (f), and 18.89.090. The new statute requires two-year programs as evidence of fulfillment of the required education. Costs are associated with the educational programs.

WAC 246-928-560, a person holding a license in another state or jurisdiction may apply for licensure and/or temporary permit as required by RCW 18.89.050 [(1)](f) and (i), 18.89.090, 18.89.150, and 18.130.075. The new statute requires two-year programs as evidence of fulfillment of the required education. Costs are associated with the educational programs.

Does the proposed rule affect both large and small businesses? The Regulatory Fairness Act defines a business as any "entity, including a sole proprietorship, corporation, partnership, or other legal entity, that is owned and operated independently from all other businesses, that has the purpose of making a profit." The act defines a small business as one that employs less than fifty individuals.

The Department of Health estimates that 2,000 practitioners will be subject to the requirements of the proposed rules. Each practitioner must obtain a separate, individual credential. Since the proposed rule will only affect individuals, from the perspective of the Regulatory Fairness Act, all affected businesses are small.

Does the proposed rule impose disproportionate cost on small businesses? Since all practitioners affected by the proposed rules meet the definition of small business, the rule cannot impose disproportionate costs. Therefore, the department is not obligated to provide regulatory relief.

How did the department involve the public in the development of the proposed rule? Public involvement was solicited through two open public meetings in August 1997 to solicit comment regarding the drafting of rules to implement SHB 1536 Licensure of Respiratory Care Practitioners. The current rules and new legislative mandates that may require amendments, repeals, and/or new sections to current rules were discussed. Proposed draft rules were mailed to approximately five hundred thirty certified respiratory care practitioners, educators, the Medical Quality Assurance Commission, the Board of Osteopathic Medicine, the Podiatric Board, the Board of Pharmacy, various related associations, and the general public.

On March 20, 1998, program staff held an open public meeting on the rules development. Approximately twenty certified respiratory care practitioners were in attendance, to include educators and members of the Respiratory Care Society of Washington. Department staff involved in review [of] proposed language for rules were: Director, executive director, assistant attorney general, health policy and constituent relations, Respiratory Care Ad Hoc Committee, health professions operations and support services.

As a part of the revision process, DOH is required under the Administrative Procedure Act to conduct an analysis of the proposed changes (RCW 34.05.328). However, there are certain exemptions from this requirement. One exemption is when the proposed regulation adopts without material change "Washington state statutes." The proposed regulation contains several requirements that are clearly mandated by state statute. The department prepared cost-benefit and other analyses for those areas that were not otherwise exempt from the significant analysis. Finally, some parts of the significant analysis lend themselves broad answers that apply to the entire proposal, while others require more specific section by section analysis.

I. Clearly state the general goals and specific objectives of the statute that the rule implements (RCW 34.05.328 (1)(a)): In 1997, the legislature enacted SHB 1536, chapter 18.89 RCW. This law mandated the licensure of respiratory care practitioners who were formerly certified by the Department of Health. The objective of this legislation, as stated in the findings section is "to safeguard life, health, and to promote public welfare." The statute requires that a person practicing or offering to practice respiratory care must "submit evidence that he or she is qualified to practice." The statute specifically requires that applicants complete programs with a two-year curriculum. It directs DOH to establish the minimum educational qualifications so credentialed providers comply with the statute and rule. (WAC 246-928-520 describes the minimum educational qualifications for licensure as a respiratory care practitioner.) The statute also allows DOH to approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the licensure examination. In addition, the statute requires DOH to establish temporary practice, reciprocity, and/or temporary permit qualifications and requirements for respiratory care practitioners.

II. Determine that the rule is needed to achieve the general goals and specific objectives of the authorizing statute. Include an analysis of alternatives to rule making and the consequences of not adopting rules (RCW 34.05.328 (1)(b)): The proposed rule is needed to carry out the directives of the authorizing statute. The statute clearly requires DOH to issue regulations governing the licensure of respiratory care practitioners. The department's rule-making discretion is limited to establishing the qualifications for licensure such as minimum educational requirements and approved educational institutions.

III. Determine that the probable benefits of the rules are greater than the probable costs. Consider both the qualitative and quantitative benefits and costs (RCW 24.05.328 [34.05.328] (1)(c)): The department has regulatory discretion on four parts of the proposed rules: (1) The minimum educational qualifications; (2) the eligible requirements for temporary practice for new graduates who have completed an approved two-year program; (3) the qualifications and requirements for credentialing out-of-state individuals; and, (4) application/licensure, temporary practice permit, renewal, reinstatement, duplicate and verification of licensure fees as required by RCW 19.89.050 [18.89.050](b).

The proposal would also repeal the examination application and examination retake fees relating to alternative training. The state established alternative training rules in 1989. No person has ever applied for credentialing via alternative training. In addition, practitioners who have obtained the optional national certification will be able to qualify for licensure under the proposed state requirements. Therefore, the state determined that the alternative training rules provide no benefit and is proposing their repeal.

Education Requirements:

Benefits: The proposed minimum education standards for licensure of respiratory care practitioners provide several types of benefits. First, the proposed rules protect public health by making certain that the respiratory care practitioner has the education needed to provide consumers quality care. Moreover, practitioners meeting the proposed standards should have the capability of performing assessments and making decisions without constant supervision. An additional benefit arising from the proposed rule is avoided cost. The department expects that the expected improvement in care will accelerate the patient's return to work and may enhance the patient's productivity and employment.

In addition to the educational standards, the credentialing examination provides the benefit of consistency and will ensure competency. To pass the examination, practitioners will have to demonstrate a minimum level of knowledge, skill and experience necessary to safely practice respiratory care. In addition, the examination will test the applicant's knowledge of underlying protocols, and help ensure that practitioners will practice within these boundaries.

Another type of benefit accrues to practitioners. By utilizing current national standards rather than requiring state specific qualifications practitioners may more easily move from state to state. The department developed the proposed education standards for licensure to be substantially equivalent to the qualification standards set by the two primary national certifying bodies (although the requirements for formal training and experience vary slightly) and standards commonly accepted in the fields of respiratory care. This should help improve the mobility of practitioners entering and leaving the state.

Costs: The department does not anticipate any added costs as a result of adding the proposed educational requirements. The authorizing statute clearly requires that the department establish education standards. So the only potential cost attributable to these regulations is from standards so restrictive that they exclude a significant proportion of current practitioners and educational institutions.

Cost - Benefit Comparison: After carefully considering the potential benefits and costs, DOH finds that the proposed minimum educational requirements have benefits in excess of costs. The department finds minimal potential costs and significant potential benefits. Moreover, the department believes that costs may even go down because of the substantially lower risk that an incompetent person is practicing.

Credentialing of Out-of-State Practitioners: Current regulations require out-of-state practitioners to complete a two-year curriculum. Under the proposed regulation DOH would check the applicant's eligibility for the next available examination through the National Board for Respiratory Care. In addition, out-of-state practitioners would have to meet the same educational requirements as in-state practitioners (specified at WAC 246-928-520).

Benefits: This proposal would clarify for out-of-state practitioners the process they would have to go through to become eligible to sit for the National Board for Respiratory Care examination. The proposal would also ensure that all respiratory practitioners operating in this state have met the same minimum education requirements.

Costs: The department does not anticipate any added costs as a result of adding the proposed educational requirements. The proposed rule simply outlines the eligibility requirements and process out-of-state practitioners must follow to become licensed in Washington state.

Cost - Benefit Comparison: After carefully considering the potential benefits and costs, DOH finds that the proposed minimum regulatory revisions have benefits in excess of costs.

The proposal also includes specific qualifications and requirements. The state alternative training rules were established April 7, 1989. No person has ever applied for credentialing via alternative training. In addition, practitioners who have obtained the optional national certification will be able to qualify for licensure under the state requirements. Therefore, a repeal of the alternative training rules is appropriate, as there is no benefit.

Licensure Fees: The significant change in licensing fees (WAC 246-928-990) is the repeal of the examination application and examination retake fees relating to alternative training.

Benefits: As stated above, the alternative training approach to licensing has never been used and so the department determined that it provided no benefit and could potentially confuse applicants. Eliminating this requirement and its associated specified fees reduces the risk of public confusion.

Costs: The department expects that this change would not impose any costs.

Cost - Benefit Comparison: The department concludes that the probable benefits of this proposed change exceed the probable costs.

IV. Determine, after considering alternative versions of the rule that the proposed rule is the least burdensome alternative for those required to comply with it (RCW 34.05.328 (1)(d)): These rules were written to impose the least burden possible while fulfilling the goals and objectives of the statute. The statue requires respiratory care practitioners have a two-year degree and pass an exam. The department chose the National Board for Respiratory Care's entry level examination to meet this requirement. The department also used the national accreditation organizations for respiratory care to designate acceptable educational programs.

DOH maintained open contact with stakeholders during the course of the rules development. This open contact has been with a variety of stakeholders, such as: Respiratory care professional ad hoc committee members, educators, Medical Quality Assurance Commission, Board of Osteopathic Medicine, Podiatric Board, Board of Pharmacy, various related associations, the general public, and individuals credential under chapter 18.89 RCW. The department did not receive any opposition during this rule development. This collaborative effort has produced clear descriptive rules for applicants and licensees.

V. Will compliance with these rules cause a practitioner to violate another state or federal law (RCW 34.05.328 (1)(e))? No.

VI. Will the rules impose more stringent requirements on private entities than public entities (RCW 34.05.328 (1)(f))? No.

VII. Does any federal statute or regulation regulate the same activities? If yes, do they differ from the proposed rules (RCW 34.05.328 (1)(g))? No.

VIII. Coordinate the rule, to the maximum extent practicable, with other federal, state and local laws applicable to the same activity or subject matter. Not applicable.

A copy of the statement may be obtained by writing to Tracy Hansen, Program Manager, Respiratory Care Practitioners Program, P.O. Box 47870, Olympia, WA 98504-7870, phone (360) 236-4940, fax (360) 586-0745.

RCW 34.05.328 applies to this rule adoption. These rules are significant because they alter qualifications for the issuance of a license and adopt new requirements.

Hearing Location: Department of Health Conference Center, 1101 South Eastside Street, Olympia, WA 98504, on April 24, 2001, at 9:00 a.m.

Assistance for Persons with Disabilities: Contact Tracy Hansen by April 10, 2001, TDD (800) 833-6388, or (360) 236-4940.

Submit Written Comments to: Tracy Hansen, fax (360) 586-0745, by April 23, 2001.

Date of Intended Adoption: April 30, 2001.

March 19, 2001

M. C. Selecky

Secretary

OTS-2553.3

NEW SECTION
WAC 246-928-310   Introduction.   This chapter explains the requirements for respiratory care practitioner licensure. These rules, which implement the provisions of chapter 18.89 RCW, are divided into four parts:

Part I explains the definitions for and the process to become licensed as a respiratory care practitioner;

Part II specifies the requirements for licensure including educational and examination criteria;

Part III explains the grandfather clause for individuals who held a current or expired certification as respiratory care practitioner prior to July 1, 1998;

Part IV lists the fees for licensure and renewal cycle for respiratory care practitioners.

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(1) "Respiratory care practitioner" means a person licensed by the department of health, who is authorized under chapter 18.89 RCW and these rules to practice respiratory therapy. WAC 246-928-410 explains who must be licensed as a respiratory care practitioner.

(2) "Applicant" means a person whose application for licensure as a respiratory care practitioner is being submitted to the department of health.

(3) "Department" means the Washington state department of health.

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DEFINITIONS AND PROCEDURES FOR LICENSING AS A RESPIRATORY CARE PRACTITIONER
NEW SECTION
WAC 246-928-410   Who must be licensed as a respiratory care practitioner with the department.   This section identifies who must be licensed as a respiratory care practitioner with the department and who is exempt from licensure.

(1) Any person performing or offering to perform the functions authorized in RCW 18.89.040 must be licensed as a respiratory care practitioner. A certification, registration or other credential issued by a professional organization does not substitute for licensure as a respiratory care practitioner in Washington state.

(2) The following individuals are exempt from licensure as a respiratory care practitioner with the department:

(a) Any person performing or offering to perform the functions authorized in RCW 18.89.040, if that person already holds a current licensure, certification or registration that authorizes these functions;

(b) Any person employed by the United States government who is practicing respiratory care as a performance of the duties prescribed for him or her by the laws of and rules of the United States;

(c) Any person who is pursuing a supervised course of study leading to a degree or certificate in respiratory care, if the person is designated by a title that clearly indicates his or her status as a student or trainee and limited to the extent of demonstrated proficiency of completed curriculum, and under direct supervision;

(d) Any person who is licensed as a registered nurse under chapter 18.79 RCW;

(e) Any person who is practicing respiratory care without compensation for a family member.

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(1) The department shall provide forms for use by an applicant for licensure as a respiratory care practitioner. All applications for licensure must be submitted on these forms, with the appropriate fee required in WAC 246-928-990. The specific requirements and process for licensure is set forth in WAC 246-12-020.

(2) The applicant shall certify that all information on the application forms is accurate. The applicant is subject to investigation and discipline by the department for any apparent violation of chapters 18.130 and 18.89 RCW, or this chapter.

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(1) Applications for renewal of the license for respiratory care practitioner shall be submitted on forms provided by the department, with the appropriate fee required in WAC 246-928-990. The specific requirements and process for renewal of a license is set forth in WAC 246-12-030.

(2) Renewal fees must be postmarked on or before the renewal date or the department will charge a late renewal penalty fee and licensure reissuance fee.

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REQUIREMENTS FOR LICENSURE AS A RESPIRATORY CARE PRACTITIONER
NEW SECTION
WAC 246-928-510   Overview of the qualifications required for licensure as a respiratory care practitioner.   This section provides an overview of the qualifications required for licensure as a respiratory care practitioner.

The requirements for licensure are intended to ensure the minimum level of knowledge, skill and experience necessary to practice safely as a respiratory care practitioner. Licensure requires applicants to submit proof to the department that they have satisfied educational and examination requirements in this chapter. Individuals who were certified in good standing on July 1, 1998, and who apply within one year of the effective date of July 1, 1998, are eligible for licensure without additional education or reexamination as required by RCW 18.89.090. The specific requirements and procedures for grandfathering are explained in WAC 246-928-610 and 246-928-620.

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(1) To meet the educational requirements required by RCW 18.89.090, an applicant must be a graduate of a two-year respiratory therapy educational program. Programs must be:

Accredited by the Committee On Accreditation for Respiratory Care (COARC) or accredited by the American Medical Association's (AMA) Committee on Allied Health Education and Accreditation (CAHEA), or its successor, the Commission on Accreditation of Allied Health Education Program (CAAHEP).

(2) An official transcript indicating completion of a two-year program must be provided as evidence of fulfillment of the required education.

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(a) Submit the application and fee as required in WAC 246-928-990;

(b) Sit for the examination within ninety days of graduation as required in WAC 246-928-560; and

(c) Be under the supervision of a licensed respiratory care practitioner.

Temporary practice may begin from the time the application and fee is submitted to the department.

(2) An applicant shall request examination results be submitted directly to the department from National Board for Respiratory Care.

(3) An applicant who receives notification that he or she successfully passed the examination may continue to practice under the supervision of a licensed respiratory care practitioner until the department has issued a license to the applicant.

(4) An applicant who receives notification of failure to pass the examination shall cease practice immediately. Resumption of practice may occur only after successfully passing the examination and becoming licensed as a respiratory care practitioner by the department.

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An applicant who has taken and passed the National Board for Respiratory Care(NBRC) entry level examination, has met the minimum examination requirements of RCW 18.89.090 (1)(b). Applicants shall request the NBRC to verify to the department that the applicant has successfully passed the NBRC examination.

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Applicants must complete seven hours of AIDS education as required in chapter 246-12 WAC, Part 8.

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(1) An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. Applicants must submit the following documentation to be considered for licensure:

(a) An application fee and forms as specified in WAC 246-928-420 and 246-928-990; and

(b) Written verification directly from all states in which the applicant is or was credentialed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment; and

(c) Verification of completion of the required education and examination as specified in WAC 246-928-520.

(2) Applicants who have completed a two-year program recognized by the Canadian Society of Respiratory Therapists (CSRT) in their current list, or any previous lists, and are eligible to sit for the CSRT registry examination; or have been issued a registration by the CSRT are considered to have met the educational and examination requirements in this chapter. Canadian applicants are required to submit verification directly from CSRT, as well as all of the information listed above for applicants licensed in another jurisdiction.

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(1) An applicant who is currently or was previously credentialed in another state or jurisdiction may qualify for licensure in Washington state. Applicants must submit the following documentation to be considered for a temporary practice permit:

(a) A completed application on forms provided by the department with the request for a temporary practice permit indicated;

(b) An application fee and a temporary practice permit fee as specified in WAC 246-928-990;

(c) Written verification directly from all states or jurisdictions in which the applicant is or was licensed, attesting that the applicant has or had a license in good standing and is not subject to charges or disciplinary action for unprofessional conduct or impairment; and

(d) Verification of completion of the required education and examination as specified in WAC 246-928-520.

(2) The department shall issue a one-time-only temporary practice permit unless the department determines a basis for denial of the license or issuance of a conditional license.

(3) The temporary permit shall expire upon the issuance of a license by the department, or within three months, whichever occurs first. The permit shall not be extended beyond the expiration date.

(4) Issuance of a temporary practice permit does not ensure that the department will grant a full license. Temporary permit holders are subject to the same education and examination requirements as set forth in WAC 246-928-520 and 246-928-550.

(5) The following situations are not considered substantially equal for Washington state licensure:

(a) Certification of persons credentialed out-of-state through a state-constructed examination; or

(b) Grandfathering provisions where proof of education and examination was not required.

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GRANDFATHER CLAUSE AND PROCEDURES

Note:

The following rules in Part III explain the requirements and procedures for grandfathering of individuals who were respiratory care practitioners prior to July 1, 1998. The provisions of WAC 246-928-610 and 246-928-620 do not apply to applicants who have never been credentialed in the state of Washington as a respiratory care practitioner.

NEW SECTION
WAC 246-928-610   "Grandfathering" of currently certified practitioners to licensure.   Individuals who are currently certified as a Washington state respiratory care practitioner in good standing on the effective date of chapter 18.89 RCW are eligible to become licensed as respiratory care practitioners without having to complete the two-year curriculum required by RCW 18.89.050 (1)(f) and without having to retake the examination. The department may issue a license to all practitioners who are in good standing prior to July 1, 1998.

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(1) Prior to July 1, 1999, a respiratory care practitioner who was previously certified with the department as a respiratory care practitioner may become licensed without having to complete the two-year curriculum required by RCW 18.89.050 (1)(f) and without having to retake the examination. The practitioner must follow the reinstatement procedures outlined in WAC 246-12-040.

(2) After July 1, 1999, a respiratory care practitioner whose Washington state certification expired on or before July 1, 1998, must meet the current criteria for licensure required by RCW 18.89.050 (1)(f) and (g).

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REQUIREMENTS FOR REPORTING UNPROFESSIONAL CONDUCT
NEW SECTION
WAC 246-928-710   Mandatory reporting.   (1) All reports required by this chapter shall be submitted to the department as soon as possible, but no later than twenty days after a determination is made.

(2) A report should contain the following information if known:

(a) The name, address, and telephone number of the person making the report.

(b) The name, address, and telephone numbers of the respiratory care practitioner being reported.

(c) The case number of any patient whose treatment is a subject of the report.

(d) A brief description or summary of the facts which prompted the issuance of the report, including dates of occurrences.

(e) If court action is involved, the name of the court in which the action is filed along with the date of filing and docket number.

(f) Any further information which would aid in the evaluation of the report.

(3) Mandatory reports shall be exempt from public inspection and copying to the extent permitted under RCW 42.17.310 or to the extent that public inspection or copying of the report or any portion of the report would invade or violate a person's right to privacy as set forth in RCW 42.17.255.

(4) A person is immune from civil liability, whether direct or derivative, for providing information to the department pursuant to RCW 18.130.070.

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RESPIRATORY CARE PRACTITIONER LICENSING AND RENEWAL FEES
AMENDATORY SECTION(Amending WSR 98-05-060 [99-05-101], filed 2/13/98 [4/6/99], effective 3/16/98 [7/1/99])

WAC 246-928-990   Respiratory care fees and renewal cycle.   (1) Certificates must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.

(2) The following nonrefundable fees will be charged:

Title of Fee	Fee
Application	$ ((85.00)) 70.00
Temporary practice permit	((50.00)) 35.00
((Examination application	110.00
Examination retake	25.00))
Duplicate license	15.00
((Certification of certificate Verification of licensure	25.00)) 15.00
Renewal	((80.00)) 50.00
Late renewal penalty	50.00
Expired ((certificate)) license reissuance	50.00

[Statutory Authority: RCW 43.70.280. 98-05-060, 246-928-990, filed 2/13/98, effective 3/16/98. Statutory Authority: Chapter 18.89 RCW and RCW 43.70.040. 95-18-019, 246-928-990, filed 8/24/95, effective 9/24/95. Statutory Authority: RCW 43.70.250. 92-15-032 (Order 285), 246-928-990, filed 7/7/92, effective 8/7/92. Statutory Authority: RCW 18.89.050 and 43.70.250. 92-02-018 (Order 224), 246-928-990, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as 246-928-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.24.086. 88-17-099 (Order PM 741), 308-195-110, filed 8/23/88.]

Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.

Reviser's note: The bracketed material preceding the section above was supplied by the code reviser's office.
REPEALER

     The following sections of the Washington Administrative Code are repealed:

WAC 246-928-015	Scope of practice -- Allowed procedures.
WAC 246-928-020	Recognized educational programs -- Respiratory care practitioners.
WAC 246-928-030	State examination -- Examination waiver -- Examination application deadline.
WAC 246-928-040	Examination eligibility.
WAC 246-928-050	Definition of "commonly accepted standards for the profession."
WAC 246-928-060	Grandfather -- Verification of practice.
WAC 246-928-080	Reciprocity -- Requirements for certification.
WAC 246-928-085	Temporary permits -- Issuance and duration.
WAC 246-928-110	General provisions.
WAC 246-928-120	Mandatory reporting.
WAC 246-928-130	Health care institutions.
WAC 246-928-140	Respiratory care practitioner associations or societies.
WAC 246-928-150	Professional liability carriers.
WAC 246-928-160	Courts.
WAC 246-928-170	State and federal agencies.
WAC 246-928-180	Cooperation with investigation.
WAC 246-928-190	AIDS prevention and information education requirements.
WAC 246-928-200	Temporary practice.
WAC 246-928-210	Definitions -- Alternative training respiratory care practitioners.
WAC 246-928-220	Alternative training requirements.

Washington State Code Reviser's Office