WSR 19-08-087
PROPOSED RULES
DEPARTMENT OF HEALTH
[Filed April 3, 2019, 10:05 a.m.]
Original Notice.
Title of Rule and Other Identifying Information: WAC 246-808-990 Chiropractic fees and renewal cycle, 246-830-990 Massage fees and renewal cycle, 246-841-990 Nursing assistant—Fees and renewal cycle, and 246-940-990 Certified animal massage therapist—Fees and renewal cycle. Proposing to increase application fees and active renewal fees, and update late renewal penalties for all chiropractors, chiropractic X-ray technicians, massage therapists, nursing assistants, and animal massage therapists.
Hearing Location(s): On May 7, 2019, at 1:00 p.m., at the Department of Health, Town Center 2, Room #158, 111 Israel Road S.E., Tumwater, WA 98501.
Date of Intended Adoption: May 17, 2019.
Submit Written Comments to: Nancy Elliott, Department of Health, P.O. Box 47850, Olympia, WA 98504-7850, email https://fortress.wa.gov/doh/policyreview, by May 7, 2019.
Assistance for Persons with Disabilities: Contact Nancy Elliott, phone 360-236-4878, TTY 360-833-6388 or 711, email nancy.elliott@doh.wa.gov, by April 24, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Current fees are not generating sufficient revenue to keep the chiropractic, massage, nursing assistant, and animal massage programs self-supporting. The fund balances for these programs have fallen below the desired levels and are projected to descend into a deficit of -$2.0 million for chiropractic, -$4.8 million for massage, -$4.4 million for nursing assistants, and -$129,500 for animal massage by 2025. The department of health (department), in coordination with the chiropractic quality assurance commission and board of massage as appropriate, has set a fund balance for these programs, while allowing for a reserve for unanticipated expenditures like costly disciplinary cases. Professions need to maintain a reserve that is based on level of risk including revenue stability, disciplinary trends, and size of the profession, in order to cover unanticipated costs. In addition to funding adequate reserves, the proposed fee increases are projected to bring licensing revenues in alignment with the actual costs of regulating these professions and maintain a positive program fund balance within six years. The department is also proposing adjustments to bring the late renewal penalty in line with agency standards for health professions.
Department policy and office of financial management guidelines that require professions to have a sufficient reserve to cover unexpected costs, were also used.
Reasons Supporting Proposal: RCW
43.70.250 requires the cost of each licensing program to be fully borne by the profession's members and licensing fees to be based on the licensing program's costs. To date, animal massage licensee growth rate is slower than predicted; there has been a large increase in chiropractic program staffing and discipline; the massage program has seen a high increase in disciplinary cost; and the nursing assistants program is experiencing high credentialing and disciplinary costs. Without the proposed fee increases, these programs cannot remain self-supporting. These program budgets are not currently maintaining the necessary fund balances, which are projected to fall into a large deficit starting June 2019 through 2025.
In addition, the state auditor's office published their performance audit report, "Aligning Healthcare Professional Fees with Licensing Costs," in November 2018, to examine if the department aligns the fees it charges to health care professions with the costs of licensing. In response, the department is developing processes to review fees more consistently and enhance transparency of fund balances and fee setting.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Nancy Elliott, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4878.
A school district fiscal impact statement is not required under RCW
28A.305.135.
A cost-benefit analysis is not required under RCW
34.05.328. The agency did not complete a cost-benefit analysis under RCW
34.05.328. RCW
34.05.328 (5)(b)(vi) exempts rules that set or adjust fees or rates pursuant to legislative standards.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Is exempt under RCW
19.85.025(3) as the rules set or adjust fees under the authority of RCW
19.02.075 or that set or adjust fees or rates pursuant to legislative standards, including fees set or adjusted under the authority of RCW
19.80.045.
April 3, 2019
John Wiesman, DrPH, MPH
Secretary
AMENDATORY SECTION(Amending WSR 17-08-061, filed 3/31/17, effective 8/1/17)
WAC 246-808-990Chiropractic fees and renewal cycle.
(1) Licenses and registrations must be renewed on the practitioner's birthday every year as provided in chapter 246-12 WAC, Part 2.
(2) The following nonrefundable fees will be charged for chiropractic licensure:
Title of Fee | Fee |
Original application | |
| Application | $((330.00)) 625.00 |
| Jurisprudence examination and reexamination | 100.00 |
| UW online access fee (HEAL-WA) | 16.00 |
Temporary practice permit | |
| 90-day permit | 105.00 |
Preceptorship - Initial and renewal | 155.00 |
Active license renewal | |
| Renewal | ((380.00)) 550.00 |
| Late renewal penalty | ((190.00)) 225.00 |
| Expired license reissuance | 302.00 |
| UW online access fee (HEAL-WA) | 16.00 |
Inactive license renewal | |
| Renewal | 257.00 |
| Expired license reissuance | 157.00 |
Duplicate license | 30.00 |
Verification of license | 30.00 |
(3) The following nonrefundable fees will be charged for chiropractic X-ray technician registration:
Title of Fee | Fee |
Application | ((47.00)) 135.00 |
Original registration | 47.00 |
Renewal | ((62.00)) 90.00 |
Late renewal penalty | ((62.00)) 50.00 |
Expired registration reissuance | 62.00 |
Duplicate registration | 30.00 |
Verification of registration | 30.00 |
AMENDATORY SECTION(Amending WSR 16-15-013, filed 7/8/16, effective 10/1/16)
WAC 246-830-990Massage fees and renewal cycle.
(1) Licenses must be renewed every year 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 |
Original application | |
| Application and initial license | ((125.00)) $210.00 |
| UW online access fee (HEAL-WA) | 16.00 |
Active license renewal | |
| Renewal | ((90.00)) 150.00 |
| Late renewal penalty | ((50.00)) 75.00 |
| Expired license reissuance | 50.00 |
| UW online access fee (HEAL-WA) | 16.00 |
Inactive license renewal | |
| Inactive license renewal | 50.00 |
| Expired inactive license reissuance | 50.00 |
| UW online access fee (HEAL-WA) | 16.00 |
Verification of license | 10.00 |
Duplicate license | 10.00 |
Intraoral massage endorsement | 25.00 |
AMENDATORY SECTION(Amending WSR 16-15-013, filed 7/8/16, effective 10/1/16)
WAC 246-841-990Nursing assistant—Fees and renewal cycle.
(1) Credentials must be renewed every year on the practitioner's birthday as provided in chapter 246-12 WAC, Part 2.
(2) The following nonrefundable fees will be charged for registration credentials:
Title of Fee | Fee |
Application - Registration | $((65.00)) 85.00 |
Renewal of registration | ((70.00)) 95.00 |
Duplicate registration | 10.00 |
Registration late penalty | 50.00 |
Expired registration reissuance | 52.00 |
(3) The following nonrefundable fees will be charged for certification credentials:
Title of Fee | Fee |
Application for certification | $((65.00)) 85.00 |
Certification renewal | ((70.00)) 95.00 |
Duplicate certification | 10.00 |
Certification late penalty | 50.00 |
Expired certification reissuance | 52.00 |
(4) The following nonrefundable fees will be charged for medication assistant endorsement credentials:
Title of Fee | Fee |
Application for endorsement | $25.00 |
Endorsement renewal | 10.00 |
AMENDATORY SECTION(Amending WSR 17-11-058, filed 5/16/17, effective 7/1/17)
WAC 246-940-990Certified animal massage therapist—Fees and renewal cycle.
(1) Certification must be renewed every year on or before the animal massage therapist's birthday as provided in chapter 246-12 WAC, Part 2.
(2) The following nonrefundable fees will be charged for certification:
Title of Fee | Fee |
Application for large animal certification | $((250.00)) 440.00 |
Application for small animal certification | ((250.00)) 440.00 |
Renewal of certification for large animal certification | ((190.00)) 335.00 |
Renewal of certification for small animal certification | ((190.00)) 335.00 |
Late renewal penalty fee per certification | ((95.00)) 170.00 |
Expired credential reissuance fee per certification | 95.00 |
Duplicate credential per certification | 30.00 |
Verification of credential per certification | 30.00 |