WSR 24-03-103
PROPOSED RULES
DEPARTMENT OF HEALTH
(Board of Nursing)
[Filed January 18, 2024, 3:58 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 23-11-143.
Title of Rule and Other Identifying Information: Initial licensure via an out-of-state traditional nursing education program approved by another United States nursing board and applicants applying via interstate endorsement. The Washington state board of nursing (board) is proposing amendments to WAC 246-840-030 and 246-840-090 to clarify specific licensing requirements for out-of-state registered nurse (RN) and licensed practical nurse (LPN) applicants.
Hearing Location(s): On March 8, 2024, at 1:15 p.m., at the Department of Health, Town Center 2, Room 166/167, 111 Israel Road S.E., Tumwater, WA 98501; or virtually via Zoom. Please follow this link to register for the virtual hearing which will give you instructions to either join the meeting on a device or call in to the meeting on the phone, https://us02web.zoom.us/meeting/register/tZwodOyrrTsoHNEiRA6XBdIyqCc4Yzstsa5A. After registering, you will receive a confirmation email containing information about joining the webinar.
Date of Intended Adoption: March 8, 2024.
Submit Written Comments to: Bonnie King, P.O. Box 47864, Olympia, WA 98504-7864, email https://fortress.wa.gov/doh/policyreview/, fax 360-236-4738, by February 27, 2024.
Assistance for Persons with Disabilities: Contact Bonnie King, phone 564-669-9721, fax 360-236-4738, TTY 711, email WABONRules@doh.wa.gov, by February 27, 2024.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The board is proposing amendments to WAC 246-840-030 and 246-840-090 to clarify specific licensing requirements for RN and LPN applicants. The proposal amends licensing requirements for RN and LPN applicants applying for initial licensure via an out-of-state traditional nursing education program approved by another United States nursing board, and applicants applying via interstate endorsement.
The current rules state that a nurse who has graduated from another state's approved nursing program or from a substantially equivalent program may be licensed. The board is aware that certain nursing programs in Florida and elsewhere have programs fraudulently granting diplomas. The board is proposing amendments to clarify that the Washington state board of nursing determines if another state's board-approved nursing program substantially meets Washington state requirements. Other clarifying amendments are also proposed for readability without changing the existing requirements.
On May 5, 2023, the board filed emergency rules to amend WAC 246-840-030 and 246-840-090 as WSR 23-11-015. The emergency rules were extended on September 1, 2023, as WSR 23-18-064, and later on December 29, 2023, as WSR 24-02-059. Emergency rules are intended to be in place until permanent rules are adopted.
The amendments clarify that RN and LPN applicants applying by interstate endorsement or for initial licensure educated in a traditional nursing education program approved by another United States nursing board must successfully complete a nursing education program in another United States state, which is approved by the nursing board in that state and substantially meets requirements for nursing education approved in Washington state as determined by the Washington State Board of Nursing.
This rule-making proposal, if adopted, will reflect standards currently adopted in the emergency rules.
Reasons Supporting Proposal: The board must protect the people of Washington by only licensing qualified, properly trained nurses. The board is proposing to amend these rules to ensure that only programs that meet Washington state standards are accepted. The intent of the proposed rule is to ensure that they cannot be interpreted to mean a fraudulent nursing program or program not meeting Washington state standards as approved by another state must be accepted as qualifying RNs and LPNs for licensure in Washington state.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Washington state board of nursing, governmental.
Name of Agency Personnel Responsible for Drafting: Bonnie King, 111 Israel Road S.E., Tumwater, WA 98504, 564-669-9721; Implementation: Amber Zawislak, 111 Israel Road S.E., Tumwater, WA 98504, 360-236-4785; 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 Bonnie King, P.O. Box 47864, Olympia, WA 98504-7864, phone 564-669-9721, fax 360-236-4738, TTY 711, email
WABONRules@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.
January 18, 2024
Alison Bradywood, DNP, MPH, RN, NHA, NEA-BC
Executive Director
Washington State Board of Nursing
OTS-4435.6
AMENDATORY SECTION(Amending WSR 21-04-016, filed 1/22/21, effective 2/22/21)
WAC 246-840-030Initial licensure for registered nurses and practical nurses—Out-of-state traditional nursing education program approved by another United States nursing board.
(1) Registered ((nursing))nurse and practical ((nursing))nurse applicants educated in a traditional nursing education program approved by another United States nursing board and applying for initial licensure ((must))shall:
(((1)))(a) Successfully complete a ((board approved)) nursing education program in another U.S. state, which:
(i) Is approved by the nursing board in that state; and
(ii) Substantially meets requirements for nursing education approved in Washington state. The board retains authority to evaluate and determine the sufficiency of academic preparation for all applicants.
((Applicants from a board approved registered nurse program who are applying for a practical nurse license:
(a) Complete all course work required of board approved practical nurse programs as listed in WAC 246-840-575(2). Required courses not included in the registered nurse program may be accepted if the courses were obtained through a commission approved program.
(b) Be deemed as capable to safely practice within the scope of practice of a practical nurse by the nurse administrator of the applicant's nursing education program.
(2)))(b) Successfully pass the ((commission))board-approved licensure examination as provided in WAC 246-840-050.
(((3)))(c) Submit the following documents:
(((a)))(i) A completed licensure application with the required fee as defined in WAC 246-840-990.
(((b)))(ii) An official transcript sent directly from the applicant's nursing education program to the ((commission))board. The transcript must include course names and credits accepted from other programs. The transcript must show:
(((i)))(A) The applicant has graduated from an approved nursing program or has successfully completed the prelicensure portion of an approved graduate-entry registered nursing program; or
(((ii)))(B) That the applicant has completed all course work required in a ((commission))board-approved practical nurse program as listed in WAC ((246-840-575(2)))246-840-539.
(((c) Applicants))(iii) An applicant from a board-approved registered nurse program who ((are))is applying for a practical nurse license ((must))shall also submit an attestation sent from the nurse administrator of the applicant's nursing education program indicating that the applicant is capable to safely practice within the scope of practice of a practical nurse.
(2) An applicant from an out-of-state board-approved registered nurse program who is applying for a practical nurse license shall:
(a) Complete all course work required of board-approved practical nurse programs as listed in WAC 246-840-539. Required courses not included in the registered nurse program may be accepted if the courses were obtained through a board-approved program.
(b) Be deemed as capable to safely practice within the scope of practice of a practical nurse by the nurse administrator of the applicant's nursing education program.
AMENDATORY SECTION(Amending WSR 21-04-016, filed 1/22/21, effective 2/22/21)
WAC 246-840-090Licensure for nurses by interstate endorsement.
Registered nurse and practical nurse applicants for interstate endorsement may be issued a license without examination provided the applicant meets the following requirements:
(1) The applicant graduated and holds a degree from:
(a) A ((commission or)) state board-approved program preparing candidates for licensure as a nurse, which substantially meets requirements for nursing education approved in Washington state, as determined by the board; or
(b) A nursing program that is equivalent to ((commission))board-approved nursing education in Washington state at the time of graduation as determined by the ((commission))board.
(2) The applicant holds a current active nursing license in another state or territory, or holds an inactive or expired license in another state or territory and successfully completes a ((commission))board-approved refresher course.
(a) An applicant whose license was inactive or expired must be issued a limited education authorization by the ((commission))board to enroll in the clinical portion of the refresher course.
(b) The limited education authorization is valid only while working under the direct supervision of a preceptor and is not valid for employment as a registered nurse.
(3) The applicant was originally licensed to practice as a nurse in another state or territory after passing the National Council Licensure Examination (NCLEX).
(4) ((Applicants))An applicant graduating from a nursing program((s)) outside the U.S. ((must))shall demonstrate English proficiency by:
(a) Passing a ((commission))board-approved English proficiency test if the nursing education is not in one of the following countries: Canada (except for Quebec), United Kingdom, Ireland, Australia, New Zealand, American Samoa, Guam, Northern Mariana Islands, and U.S. Virgin Islands((, or complete one thousand)); or
(b) Completing 1,000 hours of employment as a licensed nurse in another state((, or provide)). The 1,000 hours of employment must be in the same licensed role as the nurse is applying for licensure in Washington state. Proof of employment must be submitted to the board; or
(c) Providing evidence directly from the ((school))program of earning a high school diploma or college degree from a United States institution.
((The one thousand hours of employment must be in the same licensed role as the nurse is applying for licensure in Washington state. Proof of employment must be submitted to the commission.))
(5) For RNs: If the applicant is a graduate of a nontraditional nursing education program and:
(a) Was licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant ((must submit evidence of two hundred hours of preceptorship in the role of a registered nurse as defined in WAC 246-840-035, or at least one thousand hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory))shall meet the requirements defined in WAC 246-840-048.
(b) Was not licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant ((must))shall submit evidence of at least ((one thousand))1,000 hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory.
(6) All applicants must submit the following documents:
(a) A completed licensure application with the required fee as defined in WAC 246-840-990.
(b) An official transcript sent directly from the applicant's nursing education program to the ((commission))board if the education cannot be verified from the original board of nursing, or ((commission))board-approved evaluation agency.
(i) The transcript must contain adequate documentation demonstrating that the applicant graduated from an approved nursing program or successfully completed the prelicensure portion of an approved graduate-entry registered nursing program.
(ii) The transcripts ((shall))must include course names and credits accepted from other programs.
(c) Verification of an original registered or practical nurse license from the state or territory of original licensure. The verification must identify that issuance of the original licensure included passing the NCLEX.
(d) For an applicant((s)) educated outside the United States and in territories or countries not listed in subsection (4)(a) of this section, successful results of a ((commission))board-approved English proficiency exam, or, evidence of ((one thousand))1,000 hours worked as a nurse.
(e) For RNs: If the applicant is a graduate of a nontraditional program in nursing and:
(i) Was licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant ((must))shall submit ((documentation of two hundred hours of preceptorship in the role of a registered nurse as defined in WAC 246-840-035 or at least one thousand hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory))the requirements outlined in WAC 246-840-048.
(ii) Was not licensed as a practical/vocational nurse prior to licensure as a registered nurse, the applicant ((must))shall submit documentation of at least ((one thousand))1,000 hours of practice as a registered nurse without discipline of the registered nurse license by any other state or territory.