(Podiatric Medical Board)
Preproposal statement of inquiry was filed as WSR 06-07-020.
Title of Rule and Other Identifying Information: Podiatric medicine, WAC 246-922-001 Scope of practice. This will include certified registered nurse anesthetists (CRNA) as appropriate practitioners to independently administer general or spinal anesthetic to podiatric patients.
Hearing Location(s): Clarion Hotel, 3000 South 176th Street, SeaTac, WA 98188, on January 18, 2007, at 9:00 a.m.
Date of Intended Adoption: January 18, 2007.
Submit Written Comments to: Arlene A. Robertson, P.O. Box 47866, Olympia, WA 98504-7866, web site http://www3.doh.wa.gov/policyreivew/, fax (360) 236-2406, by January 12, 2007.
Assistance for Persons with Disabilities: Contact Arlene Robertson by January 12, 2007, TTY (800) 833-6388 or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposal identifies which practitioners may provide anesthesia services for surgical patients of podiatric physicians.
Reasons Supporting Proposal: The current rule only allows for administration of general or spinal anesthetic to podiatric patients by or under the supervision of a physician authorized under chapter 18.71 or 18.57 RCW. It does not allow for a CRNA to administer anesthesia independently under RCW 18.79.240 (1)(r). Amending the rule is the only option to allow a CRNA to administer anesthesia independently to podiatric patients.
Statutory Authority for Adoption: RCW 18.22.015.
Statute Being Implemented: RCW 18.22.035.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, podiatric medical board, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Arlene Robertson, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4945.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department did not complete a small business economic impact statement under RCW 19.85.030(1) because the rule does not impose costs to businesses within the industry.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Arlene Robertson, Program Manager, P.O. Box 47866, Olympia, WA 98504-7866, phone (360) 236-4945, fax (360) 236-2406, e-mail firstname.lastname@example.org.
December 4, 2006
Blake T. Maresh
AMENDATORY SECTION(Amending Order 158B, filed 4/25/91, effective 5/26/91)
WAC 246-922-001 Scope of practice. (1) An "ailment of the human foot" as set forth in RCW 18.22.010 is defined as any condition, symptom, disease, complaint, or disability involving the functional foot. The functional foot includes the anatomical foot and any muscle, tendon, ligament, or other soft tissue structure directly attached to the anatomical foot and which impacts upon or affects the foot or foot function and osseous structure up to and including the articulating surfaces of the ankle joint.
(2) In diagnosing or treating the ailments of the functional foot, a podiatric physician and surgeon is entitled to utilize medical, surgical, mechanical, manipulative, radiological, and electrical treatment methods and the diagnostic procedure or treatment method may be utilized upon an anatomical location other than the functional foot. The diagnosis and treatment of the foot includes diagnosis and treatment necessary for preventive care of the well foot.
(3) A podiatric physician and surgeon may examine, diagnose, and commence treatment of ailments for which differential diagnoses include an ailment of the human foot. Upon determination that the condition presented is not an ailment of the human foot, the podiatric physician and surgeon shall obtain an appropriate consultation or make an appropriate referral to a licensed health care practitioner authorized by law to treat systemic conditions. The podiatric physician and surgeon may take emergency actions as are reasonably necessary to protect the patient's health until the intervention of a licensed health care practitioner authorized by law to treat systemic conditions.
(4) A podiatric physician and surgeon may diagnose or treat an ailment of the human foot caused by a systemic condition provided an appropriate consultation or referral for the systemic condition is made to a licensed health care practitioner authorized by law to treat systemic conditions.
(5) A podiatric physician and surgeon shall not
administer a general or spinal anesthetic, however, a
podiatric physician and surgeon may treat ailments of the
human foot when the treatment requires use of a general or
spinal anesthetic provided that the administration of the
general or spinal anesthetic is by ((
or under the supervision
of)) a physician authorized under chapter 18.71 or 18.57 RCW;
or a certified registered nurse anesthetist authorized under
chapter 18.79 RCW.
[Statutory Authority: RCW 18.22.015. 91-10-041 (Order 158B), § 246-922-001, filed 4/25/91, effective 5/26/91; 91-03-095 (Order 118B), recodified as § 246-922-001, filed 1/18/91, effective 2/18/91; 87-09-045 (Order PM 643), § 308-31-025, filed 4/14/87; 87-04-050 (Order PM 638), § 308-31-025, filed 2/3/87.]