AN ACT Relating to the certification and registration of nursing assistants; amending RCW 18.88A.010, 18.88A.020, 18.88A.030, 18.88A.040, 18.88A.050, 18.88A.060, 18.88A.070, 18.88A.080, and 18.88A.100; adding new sections to chapter 18.88A RCW; and repealing RCW 18.52A.010, 18.52A.020, 18.52A.030, 18.52A.040, 18.52A.050, 18.52B.050, 18.52B.080, 18.52B.110, 18.52B.120, 18.52B.150, 18.52B.160, 18.52B.900, and 18.52B.901.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 18.88A.010 and 1989 c 300 s 3 are each amended to read as follows:

The legislature takes special note of the contributions made by nursing assistants in health care facilities whose tasks are arduous and whose working conditions may be contributing to the high and often critical turnover among the principal cadre of health care workers who provide for the basic needs of patients. The legislature also recognizes the growing shortage of nurses as the proportion of the elderly population grows and as the acuity of patients in hospitals and nursing homes becomes generally more severe.

The legislature finds and declares that occupational nursing assistants should have a formal system of educational and experiential qualifications leading to career mobility and advancement. The establishment of such a system should bring about a more stabilized work force in health care facilities, as well as provide a valuable resource for recruitment into licensed nursing practice.

The legislature finds that the quality of patient care in health care facilities is dependent upon the competence of the personnel who staff their facilities. To assure the availability of trained personnel in health care facilities the legislature recognizes the need for training programs for nursing assistants.

The legislature declares that the registration of nursing assistants and providing for voluntary certification of those who wish to seek higher levels of qualification is in the interest of the public health, safety, and welfare.

Sec. 2. RCW 18.88A.020 and 1989 c 300 s 4 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Department" means the department of ((~~licensing~~)) health.

(2) "((~~Director~~)) Secretary" means the ((~~director of licensing or the director's designee~~)) secretary of health.

(3) "Board" means the Washington state board of nursing.

(4) ((~~"Nursing assistant--certified" means an individual certified under this chapter.~~

~~(5) "Nursing assistant--registered" means an individual registered under this chapter~~)) "Nursing assistant" means an individual, regardless of title, who, under the direction and supervision of a registered nurse or licensed practical nurse, assists in the delivery of nursing and nursing-related activities to patients in a health care facility. The two levels of nursing assistants are (a) "nursing assistant-certified," an individual certified under this chapter, (b) "nursing assistant-registered," an individual registered under this chapter.

((~~(6)~~)) (5) "Committee" means the Washington state nursing assistant advisory committee.

(((7) "Certification program" means an educational program approved by the superintendent of public instruction or the state board for community college education in consultation with the board, and offered by or under the administration of an accredited educational institution, either at a school site or a health care facility site. A program shall be offered at or near a health care facility site only if the health care facility can provide adequate classroom and clinical facilities.

~~(8)~~)) (6) "Approved training program" means a nursing assistant-certified training program approved by the board. For community college, vocational-technical institutes, skill centers, and secondary school as defined in chapter 28B.50 RCW, nursing assistant-certified training programs shall be approved by the board in cooperation with the board for community college education or the superintendent of public instruction.

(7) "Health care facility" means a nursing home, hospital, hospice care facility, home health care agency, hospice agency, or other entity for delivery of health care services as defined by the board.

(8) "Competency evaluation" means the measurement of an individual's knowledge and skills as related to safe, competent performance as a nursing assistant.

Sec. 3. RCW 18.88A.030 and 1989 c 300 s 5 are each amended to read as follows:

(1) A nursing assistant may assist in the care of ((~~patients~~)) individuals as delegated by and under the direction and supervision of a licensed (registered) nurse or licensed practical nurse((, provided that a health care facility shall not assign an assistant to provide patient care until the assistant has demonstrated skill necessary to perform assigned duties and responsibilities competently. Nothing in this chapter shall be construed as conferring on a nursing assistant the authority to administer medication or to practice as a licensed (registered) nurse or licensed practical nurse.

(2) A nursing assistant--certified may assist in the care of the ill, injured, or infirm under the direction and supervision of a licensed (registered) nurse or licensed practical nurse except that a nursing assistant--certified may not administer medication or practice as a licensed (registered) nurse as defined in chapter 18.88 RCW or licensed practical nurse as defined in chapter 18.78 RCW)).

(2) A health care facility shall not assign a nursing assistant-registered to provide care until the nursing assistant-registered has demonstrated skills necessary to perform competently all assigned duties and responsibilities.

(3) Nothing in this chapter shall be construed to confer on a nursing assistant the authority to administer medication or to practice as a licensed (registered) nurse as defined in chapter 18.88 RCW or licensed practical nurse as defined in chapter 18.78 RCW.

(4) Certification is voluntary for nursing assistants working in health care facilities other than nursing homes unless otherwise required by state or federal law or regulation.

(5) The board of nursing shall have the authority to adopt rules to implement the provisions of this chapter.

Sec. 4. RCW 18.88A.040 and 1989 c 300 s 6 are each amended to read as follows:

(1) No person may practice or represent himself or herself as a nursing assistant-registered by use of any title or description without being registered by the department pursuant to this chapter((~~, unless exempt under RCW 18.52B.050~~)).

(2) After ((~~January~~)) October 1, 1990, no person may by use of any title or description, practice or represent himself or herself as a nursing assistant-((-))certified without applying for certification, meeting the qualifications, and being certified by the department pursuant to this chapter.

NEW SECTION. Sec. 5. A new section is added to chapter 18.88A RCW to read as follows:

Nothing in this chapter may be construed to prohibit or restrict:

(1) The practice by an individual licensed, certified, or registered under the laws of this state and performing services within their authorized scope of practice;

(2) The practice by an individual employed by the government of the United States while engaged in the performance of duties prescribed by the laws of the United States;

(3) The practice by a person who is a regular student in an educational program approved by the secretary, and whose performance of services pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor.

Sec. 6. RCW 18.88A.050 and 1989 c 300 s 7 are each amended to read as follows:

In addition to any other authority provided by law, the ((~~director~~)) secretary has the authority to:

(1) Set all certification, registration, and renewal fees in accordance with RCW ((~~43.24.086~~)) 43.70.250 and to collect and deposit all such fees in the health professions account established under RCW ((~~43.24.072~~)) 43.70.320;

(2) Establish forms ((~~and~~)), procedures, and examinations necessary to administer this chapter;

(3) Hire clerical, administrative, and investigative staff as needed to implement this chapter;

(4) Issue a registration to any applicant who has met the requirements for registration;

(5) After January 1, 1990, issue a certificate to any applicant who has met the education, training, and conduct requirements for certification;

(6) Maintain the official record for the department of all applicants and persons with registrations and certificates;

(7) ((Conduct a hearing on an appeal of a denial of a registration or a certificate based on the applicant's failure to meet the minimum qualifications for certification. The hearing shall be conducted under chapter 34.05 RCW;

(8) Issue subpoenas, statements of charges, statements of intent to deny certification, and orders and to delegate in writing to a designee the authority to issue subpoenas, statements of charges, and statements of intent to deny certification.

The uniform disciplinary act, chapter 18.130 RCW, governs unregistered or uncertified practice, issuance of certificates and registration, and the discipline of persons registered or with certificates under this chapter. The director shall be the disciplinary authority under this chapter)) Exercise disciplinary authority as authorized in chapter 18.130 RCW;

(8) Deny registration to any applicant who fails to meet requirement for registration;

(9) Deny certification to applicants who do not meet the education, training, competency evaluation, and conduct requirements for certification.

NEW SECTION. Sec. 7. A new section is added to chapter 18.88A RCW to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs unregistered or uncertified practice, issuance of certificates and registrations, and the discipline of persons registered or with certificates under this chapter. The secretary shall be the disciplinary authority under this chapter.

Sec. 8. RCW 18.88A.060 and 1989 c 300 s 8 are each amended to read as follows:

In addition to any other authority provided by law, the state board of nursing has the authority to:

(1) Determine minimum education requirements and approve ((~~certification~~)) training programs;

(2) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, examinations of training and competency for applicants for certification;

(3) Determine whether alternative methods of training are equivalent to ((~~formal education~~)) approved training programs, and establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take any qualifying examination for certification;

(4) Define and approve any experience requirement for certification;

(5) Adopt rules implementing a continuing competency evaluation program;

(6) Adopt rules to enable it to carry into effect the provisions of this chapter.

Sec. 9. RCW 18.88A.070 and 1989 c 300 s 9 are each amended to read as follows:

(1) The ((~~director~~)) secretary has the authority to appoint an advisory committee to the state board of nursing and the department to further the purposes of this chapter. The committee shall be composed of ten members, two members initially appointed for a term of one year, three for a term of two years, and four for a term of three years. Subsequent appointments shall be for terms of three years. No person may serve as a member of the committee for more than two consecutive terms. The committee shall consist of: A nursing assistant certified under this chapter, a representative of nursing homes, a representative of the office of the superintendent of public instruction, a representative of the state board ((of)) for community college education, a representative of the department of social and health services responsible for aging and adult services in nursing homes, a consumer of nursing assistant services who shall not be or have been a member of any other licensing board or committee; nor a licensee of any health occupation board, an employee of any health care facility, nor derive primary livelihood from the provision of health services at any level of responsibility, a representative of an acute care hospital, a representative of home health care, and one member who is a licensed (registered) nurse and one member who is a licensed practical nurse.

(2) The ((~~director~~)) secretary may remove any member of the advisory committee for cause as specified by rule. In the case of a vacancy, the ((~~director~~)) secretary shall appoint a person to serve for the remainder of the unexpired term.

(3) The advisory committee shall meet at the times and places designated by the ((~~director~~)) secretary or the board and shall hold meetings during the year as necessary to provide advice to the ((~~director~~)) secretary.

Sec. 10. RCW 18.88A.080 and 1989 c 300 s 10 are each amended to read as follows:

(1) The ((~~director~~)) secretary shall issue a registration to any applicant who pays any applicable fees and submits, on forms provided by the ((~~director~~)) secretary, the applicant's name, address, and other information as determined by the ((~~director, including information necessary to determine whether~~)) secretary, provided there are no grounds for denial of registration or issuance of a conditional registration under this chapter or chapter 18.130 RCW.

(2) ((~~After January 1, 1990, the director shall issue a certificate to any applicant who demonstrates to the director's satisfaction that the following requirements have been met:~~

~~(a) Completion of an educational program approved by the board or successful completion of alternate training meeting established criteria approved by the board;~~

~~(b) Successful completion of an approved examination; and~~

~~(c) Successful completion of any experience requirement established by the board.~~

~~(3) In addition, applicants shall be subject to the grounds for denial of registration or certificate under chapter 18.130 RCW~~)) Applicants must file an application with the board for registration within three days of employment.

NEW SECTION. Sec. 11. A new section is added to chapter 18.88A RCW to read as follows:

(1) After January 1, 1990, the secretary shall issue a certificate to any applicant who demonstrates to the secretary's satisfaction that the following requirements have been met:

(a) Completion of an approved training program or successful completion of alternate training meeting established criteria approved by the board; and

(b) Successful completion of a competency evaluation.

(2) In addition, applicants shall be subject to the grounds for denial of certification under chapter 18.130 RCW.

Sec. 12. RCW 18.88A.100 and 1989 c 300 s 12 are each amended to read as follows:

The ((~~director~~)) secretary shall waive the competency ((~~examination~~)) evaluation and certify a person ((~~authorized~~)) to practice within the state of Washington if the board determines that the person meets commonly accepted standards of education and experience for the nursing assistants. This section applies only to those individuals who file an application for waiver ((~~within one year of the establishment of the authorized practice on January 1, 1990~~)) by December 31, 1991.

NEW SECTION. Sec. 13. A new section is added to chapter 18.88A RCW to read as follows:

An applicant holding a credential in another state may be certified by endorsement to practice in this state without examination if the secretary determines that the other state's credentialing standards are substantially equivalent to the standards in this state.

NEW SECTION. Sec. 14. A new section is added to chapter 18.88A RCW to read as follows:

Applications for registration and certification shall be submitted on forms provided by the secretary. The secretary may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for registration and certification credentialing provided for in this chapter and chapter 18.120 RCW. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250. The fee shall accompany the application.

NEW SECTION. Sec. 15. A new section is added to chapter 18.88A RCW to read as follows:

The secretary shall establish by rule the procedural requirements and fees for renewal of a registration or certificate. Failure to renew shall invalidate the credential and all privileges granted by the credential. If a certificate has lapsed for a period longer than three years, the person shall demonstrate competence to the satisfaction of the board by taking continuing education courses, or meeting other standards determined by the board.

NEW SECTION. Sec. 16. The following acts or parts of acts are each repealed:

(1) RCW 18.52A.010 and 1979 c 114 s 1;

(2) RCW 18.52A.020 and 1989 c 300 s 13, 1988 c 267 s 19, 1985 c 284 s 5, & 1979 c 114 s 2;

(3) RCW 18.52A.030 and 1989 c 300 s 1, 1988 c 267 s 20, 1987 c 476 s 7, 1985 c 284 s 6, & 1979 c 114 s 3;

(4) RCW 18.52A.040 and 1989 c 300 s 2 & 1979 c 114 s 4;

(5) RCW 18.52A.050 and 1979 c 114 s 5;

(6) RCW 18.52B.050 and 1988 c 267 s 5;

(7) RCW 18.52B.080 and 1988 c 267 s 8;

(8) RCW 18.52B.110 and 1988 c 267 s 11;

(9) RCW 18.52B.120 and 1988 c 267 s 14;

(10) RCW 18.52B.150 and 1988 c 267 s 16;

(11) RCW 18.52B.160 and 1988 c 267 s 17;

(12) RCW 18.52B.900 and 1988 c 267 s 18; and

(12) RCW 18.52B.901 and 1988 c 267 s 25.

NEW SECTION. Sec. 17. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.