BP BHEAD INT H

AN ACT Relating to registration of surgical technologists; amending RCW 18.71.030 and 18.57.040; adding new sections to chapter 18.71 RCW; and adding new sections to chapter 18.57 RCW.

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

Sec. 1. RCW 18.71.030 and 1995 c 65 s 1 are each amended to read as follows:

Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer; nor shall anything in this chapter be construed to prohibit:

(1) The furnishing of medical assistance in cases of emergency requiring immediate attention;

(2) The domestic administration of family remedies;

(3) The administration of oral medication of any nature to students by public school district employees or private elementary or secondary school employees as provided for in chapter 28A.210 RCW;

(4) The practice of dentistry, osteopathy, osteopathy and surgery, nursing, chiropractic, podiatric medicine and surgery, optometry, naturopathy, or any other healing art licensed under the methods or means permitted by such license;

(5) The practice of medicine in this state by any commissioned medical officer serving in the armed forces of the United States or public health service or any medical officer on duty with the United States veterans administration while such medical officer is engaged in the performance of the duties prescribed for him or her by the laws and regulations of the United States;

(6) The practice of medicine by any practitioner licensed by another state or territory in which he or she resides, provided that such practitioner shall not open an office or appoint a place of meeting patients or receiving calls within this state;

(7) The practice of medicine by a person who is a regular student in a school of medicine approved and accredited by the commission, however, the performance of such services be only pursuant to a regular course of instruction or assignments from his or her instructor, or that such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(8) The practice of medicine by a person serving a period of postgraduate medical training in a program of clinical medical training sponsored by a college or university in this state or by a hospital accredited in this state, however, the performance of such services shall be only pursuant to his or her duties as a trainee;

(9) The practice of medicine by a person who is regularly enrolled in a physician assistant program approved by the commission, however, the performance of such services shall be only pursuant to a regular course of instruction in said program and such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(10) The practice of medicine by a licensed physician assistant which practice is performed under the supervision and control of a physician licensed pursuant to this chapter;

(11) The practice of medicine, in any part of this state which shares a common border with Canada and which is surrounded on three sides by water, by a physician licensed to practice medicine and surgery in Canada or any province or territory thereof;

(12) The administration of nondental anesthesia by a dentist who has completed a residency in anesthesiology at a school of medicine approved by the commission, however, a dentist allowed to administer nondental anesthesia shall do so only under authorization of the patient's attending surgeon, obstetrician, or psychiatrist, and the commission has jurisdiction to discipline a dentist practicing under this exemption and enjoin or suspend such dentist from the practice of nondental anesthesia according to this chapter and chapter 18.130 RCW;

(13) Emergency lifesaving service rendered by a physician's trained emergency medical service intermediate life support technician and paramedic, as defined in RCW 18.71.200, if the emergency lifesaving service is rendered under the responsible supervision and control of a licensed physician;

(14) The provision of clean, intermittent bladder catheterization for students by public school district employees or private school employees as provided for in RCW 18.79.290 and 28A.210.280;

(15) The practice of surgical technology under the supervision and control of a physician licensed under this chapter by a person registered as a "surgical technologist" under sections 2 through 6 of this act.

NEW SECTION. Sec. 2. (1) No person may practice or represent himself or herself as a surgical technologist without being registered as a surgical technologist under sections 2 through 6 of this act.

(2) No surgical technologist may be employed or supervised by a hospital or physician without a practice arrangement approved by the commission. The supervising physician and surgical technologist are professionally and personally responsible for any act performed by the surgical technologist that constitutes the practice of medicine under this chapter.

(3) The commission and the board of osteopathic medicine and surgery shall consult in the adoption of uniform rules to implement the provisions of this chapter.

NEW SECTION. Sec. 3. (1) "Surgical technologist" means a person registered under sections 2 through 6 of this act to practice surgical assisting only under the supervision and control of a physician licensed under this chapter.

(2) The "practice of surgical assisting" consists of the preparation of the operating room and the instruments, equipment and supplies, passing instruments, sutures, and sponges to the surgeon at sterile field and assist in circulating and positioning and preparing the patient for surgery, under the direct supervision of a registered nurse. It involves those tasks which assist the surgeon in the opening and closing of incisions and other related technical functions under the supervision and control of the surgeon, including other tasks determined by the commission by rule.

NEW SECTION. Sec. 4. (1) The commission shall approve applicants for registration who meet the requirements of sections 2 through 6 of this act. The commission may require an approved practice arrangement plan before a surgical technologist may be employed or supervised by a hospital or physician. The commission shall require AIDS prevention training of registrants and may adopt requirements for continuing education.

(2) An applicant for registration must demonstrate to the satisfaction of the commission that he or she has successfully completed an educational program accredited by a national accrediting organization approved by the commission and has been certified by a national certifying organization in surgical technology determined by the commission. No examination is required for registration, however the commission may require any examination it deems necessary to determine the applicant's physical or mental capability to safely practice as a surgical technologist.

(3) The commission shall adopt rules to implement the registration of surgical technologists under sections 2 through 6 of this act.

NEW SECTION. Sec. 5. (1) Upon the approval of the commission, the secretary shall issue a registration to any applicant who submits, on forms provided by the secretary, the applicant's name, address, name and place of business or employer, and other information required by the commission under sections 2 through 6 of this act. The registration must be renewed annually.

(2) The secretary shall determine registration and application fees pursuant to RCW 43.70.250.

NEW SECTION. Sec. 6. The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of registration, unauthorized practice, and the discipline of persons registered under sections 2 through 6 of this act. The commission is the disciplining authority under sections 2 through 6 of this act.

Sec. 7. RCW 18.57.040 and 1991 c 160 s 5 are each amended to read as follows:

Nothing in this chapter shall be construed to prohibit:

(1) Service in the case of emergency;

(2) The domestic administration of family remedies;

(3) The practice of midwifery as permitted under chapter 18.50 RCW;

(4) The practice of osteopathic medicine and surgery by any commissioned medical officer in the United States government or military service or by any osteopathic physician and surgeon employed by a federal agency, in the discharge of his or her official duties;

(5) Practice by a dentist licensed under chapter 18.32 RCW when engaged exclusively in the practice of dentistry;

(6) Practice by any osteopathic physician and surgeon from any other state or territory in which he or she resides: PROVIDED, That such practitioner shall not open an office or appoint a place of meeting patients or receive calls within the limits of this state;

(7) Practice by a person who is a student enrolled in an accredited school of osteopathic medicine and surgery approved by the board: PROVIDED, That the performance of such services be only pursuant to a course of instruction or assignments from his or her instructor or school, and such services are performed only under the supervision of a person licensed pursuant to this chapter or chapter 18.71 RCW;

(8) Practice by an osteopathic physician and surgeon serving a period of clinical postgraduate medical training in a postgraduate program approved by the board: PROVIDED, That the performance of such services be only pursuant to a course of instruction in said program, and said services are performed only under the supervision and control of a person licensed pursuant to this chapter or chapter 18.71 RCW; ((or))

(9) Practice by a person who is enrolled in a physician assistant program approved by the board who is performing such services only pursuant to a course of instruction in said program: PROVIDED, That such services are performed only under the supervision and control of a person licensed pursuant to this chapter or chapter 18.71 RCW; or

(10) The practice of surgical technology under the supervision and control of a physician licensed under this chapter by a person registered as a "surgical technologist" under sections 9 through 12 of this act.

This chapter shall not be construed to apply in any manner to any other system or method of treating the sick or afflicted or to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer.

NEW SECTION. Sec. 8. (1) No person may practice or represent himself or herself as a surgical technologist without being registered as a surgical technologist under sections 8 through 12 of this act.

(2) No surgical technologist may be employed or supervised by a hospital or physician without a practice arrangement approved by the board. The supervising physician and surgical technologist are professionally and personally responsible for any act performed by the surgical technologist that constitutes the practice of medicine under this chapter.

(3) The commission and the board of osteopathic medicine and surgery shall consult in the adoption of uniform rules to implement the provisions of this chapter.

NEW SECTION. Sec. 9. (1) "Surgical technologist" means a person registered under sections 8 through 12 of this act to practice surgical assisting only under the supervision and control of a physician licensed under this chapter.

NEW SECTION. Sec. 10. (1) The board shall approve applicants for registration who meet the requirements of sections 8 through 12 of this act. The board may require an approved practice arrangement plan before a surgical technologist may be employed or supervised by a hospital or physician. The board shall require AIDS prevention training of registrants and may adopt requirements for continuing education.

(2) An applicant for registration must demonstrate to the satisfaction of the board that he or she has successfully completed an educational program accredited by a national accrediting organization approved by the board and has been certified by a national certifying organization in surgical technology determined by the board. No examination is required for registration, however the board may require any examination it deems necessary to determine the applicant's physical or mental capability to safely practice as a surgical technologist.

(3) The board shall adopt rules to implement the registration of surgical technologists under sections 8 through 12 of this act.

NEW SECTION. Sec. 11. (1) Upon the approval of the board, the secretary shall issue a registration to any applicant who submits, on forms provided by the secretary, the applicant's name, address, name and place of business or employer, and other information required by the board under sections 8 through 12 of this act. The registration must be renewed annually.

(2) The secretary shall determine registration and application fees pursuant to RCW 43.70.250.

NEW SECTION. Sec. 12. The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of registration, unauthorized practice, and the discipline of persons registered under sections 8 through 12 of this act. The board is the disciplining authority under sections 8 through 12 of this act.

NEW SECTION. Sec. 13. (1) Sections 2 through 6 of this act are each added to chapter 18.71 RCW.

(2) Sections 8 through 12 of this act are each added to chapter 18.57 RCW.