DEPARTMENT OF HEALTH

(Nursing Care Quality Assurance Commission)

[Filed January 17, 2020, 11:02 a.m.]

Preproposal statement of inquiry was filed as WSR 19-15-093.

Title of Rule and Other Identifying Information: WAC 246-840-342 and 246-840-360 pertaining to advanced registered nurse practitioner (ARNP) clinical practice hour requirements. The nursing care quality assurance commission (commission) is proposing amendments to ARNP clinical practice hour requirements for license renewal and licensure by endorsement.

Hearing Location(s): On March 13, 2020, at 9:00 a.m., at the Department of Health, Town Center 2, Conference Room 166 and 167, 111 Israel Road S.E., Tumwater, WA 98501.

Date of Intended Adoption: March 13, 2020.

Submit Written Comments to: Brandon Williams, P.O. Box 47864, Olympia, WA 98504, email https://fortress.wa.gov/doh/policyreview, fax 360-236-4738, 360-236-4239, by March 4, 2020.

Assistance for Persons with Disabilities: Contact Brandon Williams, phone 360-236-4239, fax 360-236-4738, TTY 360-833-6388 or 711, email brandon.williams@doh.wa.gov, by March 4, 2020.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The commission is proposing amendments to WAC 246-840-342 and 246-840-360 pertaining to ARNP clinical practice hour requirements for license renewal and licensure by interstate endorsement. The advanced practice subcommittee (APSC) completed a literature review and determined that the requirement for ARNPs to submit proof of two hundred fifty clinical practice hours upon license renewal or initial interstate endorsement is not necessary due to other requirements for license renewal or initial interstate endorsement.

The proposed amendments remove the requirements for the applicant to complete a minimum of two hundred fifty [hours] of advanced clinical practice for each designation in the ARNP role within the last two years. The amendment removes requirements in both the rule language for ARNP licensure renewal, and ARNP applications by interstate endorsement.

Reasons Supporting Proposal: For an individual to maintain an active ARNP license in Washington state, the commission requires proof of an active national certification by one of the approved certifying bodies listed in WAC 246-840-302. Because these certifying bodies have continuing education and practice hour requirements, the current rule is redundant to the requirements of certifying bodies and may create additional barriers to practice.

Statutory Authority for Adoption: RCW 18.79.110, 18.79.160.

Statute Being Implemented: RCW 18.79.110, 18.79.160.

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

Name of Proponent: Washington state nursing care quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting and Implementation: Brandon Williams, 111 Israel Road S.E., Tumwater, WA 98504, 360-236-4239; and Enforcement: Catherine Woodard, 111 Israel Road S.E., Tumwater, WA 98504, 360-236-4757.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Brandon Williams, P.O. Box 47864, Olympia, WA 98504, phone 360-236-4239, fax 360-236-4738, TTY 360-833-6388 or 711, email brandon.williams@doh.wa.gov.

The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The proposed rules do not impact businesses, the proposed rules only impact provider licensing requirements.

Paula R. Meyer, MSN, RN, FRE

Nursing Care Quality Assurance Commission

AMENDATORY SECTION(Amending WSR 19-08-031, filed 3/27/19, effective 4/27/19)

WAC 246-840-342Licensure for ARNP applicants by interstate endorsement.

(1) An applicant for interstate endorsement for Washington state licensure as an ARNP shall meet the following requirements:

(a) Have an active RN and ARNP license, or recognition in another state or jurisdiction, as practicing in an advanced practice role, without sanctions or restrictions;

(b) Have a graduate degree from an advanced nursing education program as identified in WAC 246-840-340 (1)(b); and

(d) Have been performing advanced clinical practice as defined in WAC 246-840-010(1) as a licensed ARNP, or in the role of an advanced practice nurse as defined in WAC 246-840-010(2), for at least two hundred fifty hours within the two years prior to the date of application)).

(2) An applicant for an ARNP license through interstate endorsement shall:

(a) Apply for and be granted a Washington state RN license as identified in WAC 246-840-090;

(b) Submit a completed ARNP application for licensure to the commission;

(d) Request the certifying body, as identified in WAC 246-840-302, to send official documentation of certification directly to the commission;

(e) Request the advanced nursing educational program to send an official transcript directly to the commission showing courses, grades, degree or certificate granted, official seal and appropriate registrar; and

(f) Submit nursing education program objectives and course descriptions when requested by the commission((; and

(g) Submit evidence of at least two hundred fifty hours of advanced clinical practice as an ARNP, or at an advanced nursing practice level, within the two years prior to the date of application. The two hundred fifty hours may include teaching advanced nursing practice if providing direct patient care as a faculty member or serving as a preceptor in a clinical setting.

(3) An ARNP applicant who does not meet practice requirements shall complete two hundred fifty hours of supervised advanced clinical practice for every two years the applicant may have been out of practice, not to exceed one thousand hours.

(4) An ARNP applicant needing to complete the supervised advanced clinical practice shall obtain an ARNP interim permit consistent with the requirements for supervised practice defined in WAC 246-840-340 (4) and (5))).

AMENDATORY SECTION(Amending WSR 19-08-031, filed 3/27/19, effective 4/27/19)

WAC 246-840-360Renewal of ARNP licensure.

(1) An applicant applying for ARNP license renewal, shall have:

(a) An active Washington state RN license, without sanctions or restrictions;

(b) Current certification from a certifying body as identified in WAC 246-840-302; and

(c) Thirty contact hours of continuing education obtained during the renewal period in each ARNP designation. An ARNP who has certification in more than one area of practice may count the continuing education hours for more than one certification when applicable to each area of practice((; and

(d) At least two hundred fifty hours in advanced clinical practice for each ARNP designation within the two-year licensing renewal cycle. The two hundred fifty hours may include teaching advanced nursing practice only when the faculty member is providing patient care or serving as a preceptor in a clinical setting)).

(2) An applicant for ARNP licensure renewal shall comply with the requirements of chapter 246-12 WAC, Part 2 and submit:

(a) The renewal license fee as specified in WAC 246-840-990;

(b) Evidence of current certification by the commission approved certifying body for each designation;

(c) A written declaration, on forms provided by the commission attesting to: (((i))) Completion of thirty contact hours of continuing education during the renewal period for each ARNP designation; and

(((ii) Completion of a minimum of two hundred fifty hours of advanced clinical practice for each designation in the ARNP role within the last two years.))

(d) Evidence of completion of continuing education contact hours and advanced clinical practice hours when requested by the commission.

(((3) An applicant for ARNP licensure renewal who does not meet advanced clinical practice requirements shall complete two hundred fifty hours of supervised advanced clinical practice for every two years the applicant may have been out of practice, not to exceed one thousand hours.

(4) An applicant for ARNP licensure renewal needing to complete supervised advanced clinical practice shall obtain an ARNP interim permit consistent with the requirements for supervised practice defined in WAC 246-840-340 (4) and (5).))