WSR 23-17-150
PROPOSED RULES
DEPARTMENT OF HEALTH
[Filed August 22, 2023, 12:36 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 23-08-014.
Title of Rule and Other Identifying Information: Health equity continuing education (CE) for the athletic trainer profession, WAC 246-916-060. The department of health (department) is proposing an amendment in rule to establish health equity CE requirements to implement ESSB 5229 (chapter 276, Laws of 2021).
Hearing Location(s): On September 26, 2023, at 11:00 a.m. The department will provide a virtual-only hearing. Please register in advance for this webinar https://us02web.zoom.us/webinar/register/WN_F1CXDc_4TvWypsA4y-QmXg. After registering, you will receive a confirmation email containing information about joining the webinar.
Date of Intended Adoption: October 3, 2023.
Submit Written Comments to: Allyson McIver, Program Manager, P.O. Box 47877, Olympia, WA 98504-7877, email https://fortress.wa.gov/doh/policyreview, by September 26, 2023.
Assistance for Persons with Disabilities: Contact Allyson McIver, program manager, phone 360-236-2878, fax 360-236-2901, TTY 711, email allyson.mciver@doh.wa.gov, by September 19, 2023.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: RCW
43.70.613 (3)(b) directs the rule-making authority for each health profession licensed under Title
18 RCW that is subject to CE to adopt rules requiring a licensee to complete health equity CE training at least once every four years. The statute also directs the department to create model rules establishing the minimum standards for health equity CE programs. The department filed model rules for health equity CE minimum standards on November 23, 2022, under WSR 22-23-167. Any rules developed for the athletic trainer profession must meet or exceed the minimum standards [of] the model rules in WAC 246-12-800 through 246-12-830.
The department is proposing an amendment to WAC 246-916-060 to implement ESSB 5229. The proposal will adopt and meet the health equity model rules, WAC 246-12-800 through 246-12-830, for the athletic trainer profession to comply with RCW
43.70.613. The proposed rules add one hour of health equity education to be completed as part of the current CE requirements every two years. This meets the two hours of health equity education to be completed every four years required in the model rules. No additional topics are being added to the model rules requirements.
Reasons Supporting Proposal: The goal of health equity CE is to equip health care workers with the skills to recognize and reduce health inequities in their daily work. The content of health equity trainings include implicit bias trainings to identify strategies to reduce bias during assessment and diagnosis in an effort to address structural factors, such as bias, racism, and poverty, that manifest as health inequities.
The department believes in the importance of health equity training and that meeting the requirement of one hour every two years (equaling two hours every four years) allows individuals to develop a strong foundation in health equity with a more immediate positive impact on the professional's interaction with those receiving care. Health equity training enables health care professionals to care effectively for patients from diverse cultures, groups, and communities, varying race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity.
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: Allyson McIver, Program Manager, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2878.
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 Allyson McIver, Program Manager, P.O. Box 47877, Olympia, WA 98504-7877, phone 360-236-2878, fax 360-236-2901, email
allyson.mciver@doh.wa.gov.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Scope of exemption for rule proposal:
Is fully exempt.
August 22, 2023
Kristin Peterson, JD
Chief of Policy
for Umair A. Shah, MD, MPH
Secretary
OTS-4750.3
AMENDATORY SECTION(Amending WSR 16-11-053, filed 5/13/16, effective 6/13/16)
WAC 246-916-060Continuing education.
The goal of continuing education is to promote continued competence, development of current knowledge and skills, and enhancement of professional skills and judgment. Continuing education activities must focus on increasing knowledge, skills, and abilities related to the practice of athletic training.
(1) A licensed athletic trainer shall complete a minimum of ((fifty))50 hours of continuing education every two years. At least ((ten))10 of those hours must include evidence-based practice as outlined in subsection (((3)))(4) of this section. The remaining hours may be in categories listed in subsection (((4)))(5) of this section.
(2) A licensed athletic trainer must complete one hour of health equity continuing education every two years. The goal of health equity continuing education is to equip health care workers with the skills to recognize and address health inequities in their daily work.
The minimum standards include instruction on skills to address the structural factors, such as bias, racism, and poverty, that manifest as health inequities. These skills include individual level and system-level intervention, and self-reflection to assess how the licensee's social position can influence their relationship with patients and their communities. These skills enable a health care professional to care effectively for patients from diverse cultures, groups, and communities, varying in race, ethnicity, gender identity, sexuality, religion, age, ability, socioeconomic status, and other categories of identity.
(a) This training must be completed by the end of the first full continuing education reporting period after January 1, 2024, or during the first full continuing education reporting period after initial licensure, whichever is later.
(b) Training must include content as listed in WAC 246-12-830 and RCW 43.70.613. (c) The hours spent completing the training in health equity under this section will count toward meeting applicable continuing education requirements for athletic trainer license renewal.
(3) A licensed athletic trainer may alternatively meet the requirement of ((fifty))50 hours of continuing education if they hold a current certification from the board of certification for the athletic trainer (BOC). The required documentation is proof of certification during the two-year period.
(((3)))(4) At least ((ten))10 hours of evidence-based practice must be obtained during the two-year reporting period through any of the following activities:
(a) Complete BOC approved workshops, seminars, conferences, webinars, or home study courses. The required documentation for this activity is a certificate of completion.
(b) Graduate from a Commission on Accreditation of Athletic Training Education (CAATE) accredited post-professional athletic training graduate program. A maximum of ((ten))10 hours may be applied in the two-year period. The required documentation for this activity is an official transcript indicating graduation within the two-year period.
(c) Graduate from a PhD, EdD, DSc program if dissertation has a narrow focus of athletic training. A maximum of ((ten))10 hours may be applied in the two-year period. The required documentation for this activity is an official transcript indicating graduation within the reporting period and a copy of the dissertation.
(d) Present a BOC approved evidence-based practice program. A maximum of ((ten))10 hours per evidence-based practice topic may be applied in the two-year period. The required documentation for this activity is a letter of acknowledgment that includes the date, title, and intended audience from the conference coordinator.
(e) Complete a CAATE accredited athletic trainer residency or fellowship. A maximum of ((twenty))20 hours per year may be applied in the two-year period. The required documentation for this activity is a letter from the residency or fellowship director.
(f) Any other evidence-based practice activity as approved by the secretary.
(((4)))(5) Remaining hours may be obtained through any of the following activities:
(a) BOC approved workshops, seminars, conferences, webinars, or home study courses. The required documentation for this activity is a certificate of completion.
(b) Professional activities.
(i) Speaker at a conference or seminar for health care providers. A maximum of ((ten))10 hours may be applied per topic in the two-year period. The required documentation for this activity is a letter of acknowledgment that includes the date, title, and intended audience from the conference coordinator.
(ii) Panelist at a conference or seminar for health care providers. A maximum of five hours may be applied per topic in the two-year period. The required documentation for this activity is a letter of acknowledgment that includes the date, title, and intended audience from the conference coordinator.
(iii) Primary author of an article in a nonrefereed journal. A maximum of five hours may be applied per article in the two-year period. The required documentation for this activity is a copy of the article.
(iv) Author of an article in a refereed journal. A maximum of ((fifteen))15 hours may be applied per article in the two-year period for primary authors. A maximum of ((ten))10 hours may be applied per article in the two-year period for secondary authors. The required documentation for this activity is a copy of the article.
(v) Author of an abstract in a refereed journal. A maximum of ((ten))10 hours may be applied per abstract in the two-year period for primary authors. A maximum of five hours may be applied per abstract in the two-year period for secondary authors. The required documentation for this activity is a copy of the abstract.
(vi) Author of a published textbook. A maximum of ((forty))40 hours may be applied per book in the two-year reporting period for primary authors. A maximum of ((twenty))20 hours may be applied per book in the two-year reporting period for secondary authors. The required documentation for this activity is a copy of the title page with the publication date.
(vii) Contributing author of a published textbook. A maximum of ((ten))10 hours may be applied per book in the two-year period. The required documentation for this activity is a copy of the title page with the publication date and list of contributors.
(viii) Author of a peer-reviewed or refereed poster presentation. A maximum of ((ten))10 hours may be applied per presentation in the two-year period for primary authors. A maximum of five hours may be applied per presentation in the two-year period for secondary authors. The required documentation for this activity is a letter of acknowledgment that includes the date and title of the presentation from the conference coordinator.
(ix) Primary author of published multimedia material, including CD, audio, or video. A maximum of ((ten))10 hours may be applied per publication in the two-year period. The required documentation for this activity is a copy of the publication.
(x) Participating member of clinical research study team. A maximum of ((ten))10 hours may be applied in the two-year period. The required documentation for this activity is a letter from the principal investigator or a copy of the institutional review board approval with investigators listed.
(xi) Primary author of a home study course. A maximum of ((ten))10 hours may be applied per course in the two-year reporting period. The required documentation for this activity is a letter of approval.
(xii) Reviewer of a refereed publication. A maximum of five hours may be applied per review, with a limit of ((twenty))20 hours applied per two-year period. The required documentation for this activity is a disposition letter.
(xiii) Exam item writer for BOC exam or other health care professional exams. A maximum of five hours may be applied per year of active item writing. The required documentation for this activity is a letter of acknowledgment from the exam company.
(c) Post certification college or university course work. A maximum of ((ten))10 continuing education hours per credit hour may be applied during the two-year period. The required documentation for this activity is an official transcript from an accredited college or university.
(d) Activities by non-BOC approved providers.
(i) Workshops, seminars, conferences, webinars that are directly related to athletic training. The required documentation for this activity is verification of attendance.
(ii) Videos, DVDs, audiotapes, multimedia, webinars, home study courses. Each activity must have an examination. The required documentation for this activity is documentation verifying completion.
(((5)))(6) A licensed athletic trainer shall comply with the requirements of ((chapter 246-12 WAC, Part 7))WAC 246-12-170 through 246-12-240.