WSR 05-17-048

PROPOSED RULES

DEPARTMENT OF HEALTH


(Denturist)

[ Filed August 9, 2005, 1:36 p.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 04-12-120.

     Title of Rule and Other Identifying Information: Denturist, WAC 246-812-020 Continuing competency requirement.

     Hearing Location(s): Department of Health, Point Plaza East, Room 202, 310 Israel Road S.E., Tumwater, WA 98501, on September 30, 2005, at 9:30 a.m.

     Date of Intended Adoption: September 30, 2005.

     Submit Written Comments to: Vicki Brown, P.O. Box 47867, Olympia, WA 98504-7867, e-mail http://www3.doh.wa.gov/policyreview, fax (360) 236-4865 by September 16, 2005.

     Assistance for Persons with Disabilities: Contact Vicki Brown by September 16, 2005, TTY (800) 833-6388 or (360) 236-4865.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule implements RCW 18.30.065 (HB 2309, section 5, chapter 160, Laws of 2002) which required the denturist board to adopt rules for continuing competency requirements as a condition of license renewal. The proposed rules will clarify what activities and coursework the board will accept to fulfill the continuing competency requirements. The proposal does not affect existing rules.

     Reasons Supporting Proposal: The proposed rule is necessary to implement law. Additionally, the proposed rule will help the denturist stay current with technology and improve the practice of the denturist.

     Statutory Authority for Adoption: RCW 18.30.065.

     Statute Being Implemented: Chapter 18.30 RCW.

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

     Name of Proponent: Department of Health, Board of Denturists, governmental.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Vicki Brown, Program Manager, Department of Health, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4865.

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

Small Business Economic Impact Statement

     1. Briefly describe the proposed rule: The proposed rule seeks to set the minimum hours of continuing competency as a prerequisite for the renewal of a denturist license There is no current rule language to provide any specific details for continued competency. The proposed rule language describes the acceptable continuing competency activities in detail and the obligations of practitioners to maintain appropriate documentation of these activities as follows:

Add language for continuing competency requirements.
Requires a minimum of thirty hours of continuing competency every two years.
Requires a minimum of thirty hours of continuing competency to be related to the practice of denturism.
Required thirty contact hours are to be obtained through two or more of the activities from a specific list of options.
Require documentation from the individual or organization responsible for the continuing competency to provide certificates of attendance or documentation of attendance to the participants. The documentation is to include the licensee's name, date of activity, and number of hours.
Lists both practicing and professional continuing education activities that will fulfill continuing competency requirements.
     2. Is a small business economic impact statement (SBEIS) required for this rule? Yes, the Department of Health (DOH) has reviewed this proposal and has determined that an SBEIS is required. However, the majority of the rule will impose minimal costs to affected parties. The proposed rule generates minimal costs.

     3. Which industries are affected by this rule? In preparing this SBEIS, the DOH used the following SIC codes:


SIC Description Minor Impact Threshold ($)
8049

8051

8052

8059

8062

8069

8082

8093

8099

Offices of health practitioners, nec

Skilled nursing care facilities

Intermediate care facilities

Nursing and personal care, nec

General medical & surgical hospital

Specialty hospitals exc. psychiatrist

Home health care services

Specialty outpatient clinics, nec

Health and allied services, nec

66.10

195.64

66.10

66.10

396.57

237.94

122.94

116.33

66.10


     It is important to note that the majority of affected parties are self-employed.

     4. What are the costs of complying with this rule for small businesses (those with fifty or fewer employees) and for the largest 10% of businesses affected? The associated cost for each practitioner is the costs of requirement to complete at least two continuing competency activities from the list. With reference to the list, twelve hours of "preparing an article(s)", (number 4f in the list) and eight hours of "lecturing for an approved program", (number 4d in the list) can be completed on practitioners' own time at no costs. The remaining ten hours can be completed through "article review and testing", (number 4c in the list) at a cost of $150.00. This course is available from the DART on-line self instruction program from the Academy of Dentistry.

     The cost to both large and small businesses is the requirement of each practitioner to complete at least two continuing competency activities. Practitioners will be impacted by the associated costs of increased time to schedule, attend and complete at least two continuing competency activities. Some of the costs associated with attending a seminar that are not included in the projections are for: Lodging, meals and travel expenses.

     The problem is the huge combination of possible pairs that constitutes the selection universe. Estimating the costs is not easy because the continuing competency activities can be selected from a wide list of possible pairs. The costs, therefore, depend upon the costs associated with the choice of activity.

     A sample of the courses, hours and costs (in 2005) are represented below:


Practitioner 1
Category 4a Denturist Assn. Conference 10 hours $450.00
Category 4c Article Review & Testing 10 hours $150.00
Category 4f Preparing an article 12 hours $100.00
TOTAL HOURS AND COST 32 hours $700.00
Practitioner 2
Category 4f Preparing an article 12 hours $ 0.00
Category 4d Lecturer for an approved program 8 hours $ 0.00
Category 4b Adult CPR and First Aid 8 hours $44.50
Category 4c Article Review & Testing 2 hours $30.00
TOTAL HOURS AND COST 30 hours $74.50
Practitioner 3
Category 4 Correspondence course 36 hours $298.30
TOTAL HOURS AND COST 36 hours $298.30
Practitioner 4
Category 4b OSHA training 10 hours $150.00
Category 4b CPR/First Aid 8 hours $ 0.00
Category 4b Bloodborne Pathogens by L & I 4 hours $ 0.00
Category 4c Online Dental Didactic Courses 8 hours $64.00
TOTAL HOURS AND COST 30 hours $214.00

     5. Does the rule impose a disproportionate impact on small businesses? Assuming each licensed practitioner is responsible for the costs of his/her continued competency, the proposed rule does not impose a disproportionate impact on small businesses. However, the possibility of a disproportionate impact on small businesses can still exist if large businesses pay the costs of continuing competency education for their practitioners.

     The cost of taking a continuing competency course and not being open for practice, results in a loss of income. The range of income per hour for a denturist is $20.00 to $50.00. The loss of income for attending a sixteen hour seminar ranges from $320.00 to $800.00. The costs for a seminar or course can range from free for CPR/First Aid to $450.00 for a sixteen hour seminar.

     6. How are small businesses involved in the development of this rule? The DOH held three open public rules workshops (one in Yakima, one in Tumwater and one in SeaTac.) All one hundred forty-six active state licensees were surveyed by mail for input.

     A copy of the statement may be obtained by contacting Vicki Brown, Department of Health, Denturist Program, P.O. Box 47867, Olympia, WA 98504-7867, phone (360) 236-4865, fax (360) 664-9077, e-mail vicki.brown@doh.wa.gov.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Vicki Brown, Department of Health, Denturist Program, P.O. Box 47867, Olympia, WA 98504-7867, phone (360) 236-4865, fax (360) 664-9077, e-mail vicki.brown@doh.wa.gov.

July 12, 2005

Bruce C. Anderson

Chair, Board of Denturists

OTS-7861.2


NEW SECTION
WAC 246-812-020   Continuing competency requirements.   (1) Purpose. The board in agreement with the secretary of the department of health has determined that the public health, safety and welfare of the citizens of the state will be served by requiring all denturists, licensed under chapter 18.30 RCW, to continue their professional development via continuing competency after receiving their licenses.

     (2) Effective date. The effective date for the continuing competency requirements for denturists is January 1, 2006. The reporting cycle for verifying completion of continuing competency hours will begin on January 1, 2008, and each renewal date thereafter.

     (3) Requirements. A licensed denturist must complete thirty clock hours of continuing competency, every two years, prior to his or her biennial renewal date. The licensee must sign a declaration attesting to the completion of the required number of hours as part of the biennial renewal requirement. The department of health may randomly audit up to twenty-five percent of practitioners for compliance with these rules, after the credential is renewed as allowed by chapter 246-12 WAC, Part 7.

     (4) Acceptable continuing competency -- Qualification of courses for continuing competency credit. The board will not authorize or approve specific continuing competency courses. Continuing competency course work must contribute to the professional knowledge and development of the practitioner, or enhance services provided to clients.

     For the purposes of this chapter, acceptable continuing competency means courses offered or authorized by industry recognized state, local, private, national and international organizations, agencies or institutions of higher learning. Examples of sponsors or types of continuing competency courses include, but are not limited to:

     (a) Courses offered or sponsored by the Washington State Denturist Association.

     (b) Basic first aid, cardio pulmonary resuscitation, basic life support, advanced cardiac life support, or emergency related training such as courses offered or authorized by the American Heart Association, the American Cancer Society; training offered or sponsored by Occupational Safety and Health Administration (OSHA) or Washington Industrial Safety and Health Act (WISHA); or any other organizations or agencies.

     (c) All forms of educational media related to denturism, available through internet, mail or independent reading, that include an assessment tool upon completion, may not exceed ten hours for the two-year period.

     (d) A licensee who serves as a teacher or who lectures in continuing competency programs and/or courses, that contribute to the professional competence of a licensed denturist may accumulate the same number of hours obtained by licensed denturists attending the program and/or course may not exceed sixteen hours for the two-year period.

     (e) Attendance at a continuing competency program with a featured speaker(s) may not exceed sixteen hours for the two-year period.

     (f) Time spent preparing an original technical or clinical article for a professional publication may not exceed twelve hours for the two-year period.

     (g) Nonclinical courses relating to denturist practice organization and management, patient management, or methods of health delivery may not exceed eight hours for the two-year period.

     (h) Estate planning, financial planning, investments, and personal health courses are not acceptable.

     (5) The board may disallow any claim of credit for a continuing competency course that does not meet the requirements of subsection (4) of this section.

     (6) Failure to complete the continued competency requirements by time of license renewal, or failure to provide adequate documentation of completion, is grounds for denying renewal of his or her license until such time as the licensee demonstrates compliance.

     (7) Documentation required. Credit for a continuing competency course may not be claimed by a licensee unless the course organizer provides the licensee with documentation of course attendance.

     (8) Exceptions. The following are exceptions from the continuing competency requirements:

     Upon a showing of good cause by the licensee, the board may waive the licensee from any, all, or part of the continuing competency requirements in this chapter or may grant additional time for the licensee to complete the requirements. Good cause includes, but is not limited to:

     (a) Illness;

     (b) Medical necessity or family emergency;

     (c) Hardship to practice; or

     (d) Other extenuating circumstances.

     (9) The requirements of this section are in addition to the requirements in chapter 246-12 WAC, Part 7, related to continuing competency.

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