AN ACT
Relating to acupuncture; amending RCW 4.24.240, 4.24.290, 7.70.020, 18.06.010,
18.06.020, 18.06.045, 18.06.080, 18.06.090, 18.06.110, 18.06.120, 18.06.130,
18.06.140, 18.06.190, 18.06.200, and 18.120.020; and reenacting and amending
RCW 18.130.040.
BE IT ENACTED BY THE LEGISLATURE
OF THE STATE OF WASHINGTON:
Sec.
1. RCW
4.24.240 and 1985 c 326 s 25 are each amended to read as follows:
(1)(a)
A person licensed by this state to provide health care or related services,
including, but not limited to, a ((certified)) licensed
acupuncturist, a physician, osteopathic physician, dentist, nurse, optometrist,
((podiatrist)) podiatric physician and surgeon, chiropractor,
physical therapist, psychologist, pharmacist, optician, physician's assistant,
osteopathic physician's assistant, nurse practitioner, including, in the event
such person is deceased, his or her estate or personal representative;
(b) An
employee or agent of a person described in subparagraph (a) of this subsection,
acting in the course and scope of his or her employment, including, in
the event such employee or agent is deceased, his or her estate or
personal representative; or
(c) An
entity, whether or not incorporated, facility, or institution employing one or
more persons described in subparagraph (a) of this subsection, including, but
not limited to, a hospital, clinic, health maintenance organization, or nursing
home; or an officer, director, trustee, employee, or agent thereof acting in
the course and scope of his or her employment, including in the event
such officer, director, employee, or agent is deceased, his or her
estate or personal representative;
shall be
immune from civil action for damages arising out of the good faith performance
of their duties on such committees, where such actions are being brought by or
on behalf of the person who is being evaluated.
(2) No
member, employee, staff person, or investigator of a professional review
committee shall be liable in a civil action as a result of acts or omissions
made in good faith on behalf of the committee; nor shall any person be so
liable for filing charges with or supplying information or testimony in good
faith to any professional review committee; nor shall a member, employee, staff
person, or investigator of a professional society, of a professional examining
or licensing board, of a professional disciplinary board, of a governing board
of any institution, or of any employer of professionals be so liable for good
faith acts or omissions made in full or partial reliance on recommendations or
decisions of a professional review committee or examining board.
Sec.
2. RCW
4.24.290 and 1994 sp.s. c 9 s 702 are each amended to read as follows:
In any
civil action for damages based on professional negligence against a hospital
which is licensed by the state of Washington or against the personnel of any
such hospital, or against a member of the healing arts including, but not
limited to, an acupuncturist ((certified)) licensed under chapter
18.06 RCW, a physician licensed under chapter 18.71 RCW, an osteopathic
physician licensed under chapter 18.57 RCW, a chiropractor licensed under
chapter 18.25 RCW, a dentist licensed under chapter 18.32 RCW, a podiatric
physician and surgeon licensed under chapter 18.22 RCW, or a nurse licensed
under chapter 18.79 RCW, the plaintiff in order to prevail shall be required to
prove by a preponderance of the evidence that the defendant or defendants
failed to exercise that degree of skill, care, and learning possessed at that
time by other persons in the same profession, and that as a proximate result of
such failure the plaintiff suffered damages, but in no event shall the
provisions of this section apply to an action based on the failure to obtain
the informed consent of a patient.
Sec.
3. RCW
7.70.020 and 1985 c 326 s 27 are each amended to read as follows:
As
used in this chapter "health care provider" means either:
(1) A
person licensed by this state to provide health care or related services,
including, but not limited to, a ((certified)) licensed
acupuncturist, a physician, osteopathic physician, dentist, nurse, optometrist,
((podiatrist)) podiatric physician and surgeon, chiropractor,
physical therapist, psychologist, pharmacist, optician, physician's assistant,
midwife, osteopathic physician's assistant, nurse practitioner, or physician's
trained mobile intensive care paramedic, including, in the event such person is
deceased, his or her estate or personal representative;
(2) An
employee or agent of a person described in part (1) above, acting in the course
and scope of his employment, including, in the event such employee or agent is
deceased, his or her estate or personal representative; or
(3) An
entity, whether or not incorporated, facility, or institution employing one or
more persons described in part (1) above, including, but not limited to, a
hospital, clinic, health maintenance organization, or nursing home; or an
officer, director, employee, or agent thereof acting in the course and scope of
his or her employment, including in the event such officer, director,
employee, or agent is deceased, his or her estate or personal
representative.
Sec.
4. RCW
18.06.010 and 1992 c 110 s 1 are each amended to read as follows:
The
following terms in this chapter shall have the meanings set forth in this
section unless the context clearly indicates otherwise:
(1)
"Acupuncture" means a health care service based on ((a traditional))
an Oriental system of medical theory utilizing Oriental diagnosis and
treatment to promote health and treat organic or functional disorders by
treating specific acupuncture points or meridians. Acupuncture includes ((but
is not necessarily limited to)) the following techniques:
(a)
Use of acupuncture needles to stimulate acupuncture points and meridians;
(b)
Use of electrical, mechanical, or magnetic devices to stimulate acupuncture
points and meridians;
(c)
Moxibustion;
(d)
Acupressure;
(e)
Cupping;
(f)
Dermal friction technique;
(g)
Infra-red;
(h)
Sonopuncture;
(i)
Laserpuncture;
(j) ((Dietary
advice based on traditional Oriental medical theory; and
(k))) Point
injection therapy (aquapuncture); and
(k)
Dietary advice based on Oriental medical theory provided in conjunction with
techniques under (a) through (j) of this subsection.
(2)
"Acupuncturist" means a person ((certified)) licensed
under this chapter.
(3)
"Department" means the department of health.
(4)
"Secretary" means the secretary of health or the secretary's
designee.
Sec.
5. RCW
18.06.020 and 1991 c 3 s 5 are each amended to read as follows:
(1) No
one may hold themselves out to the public as an acupuncturist or ((certified))
licensed acupuncturist or any derivative thereof which is intended to or
is likely to lead the public to believe such a person is an acupuncturist or ((certified))
licensed acupuncturist unless ((certified)) licensed as
provided for in this chapter.
(2) A
person may not practice acupuncture if the person is not licensed under this
chapter.
(3)
No one may use any configuration of letters after their name (including Ac.)
which indicates a degree or formal training in acupuncture unless ((certified))
licensed as provided for in this chapter.
(((3)))
(4) The secretary may by rule proscribe or regulate advertising and
other forms of patient solicitation which are likely to mislead or deceive the
public as to whether someone is ((certified)) licensed under this
chapter.
Sec.
6. RCW
18.06.045 and 1992 c 110 s 2 are each amended to read as follows:
Nothing
in this chapter shall be construed to prohibit or restrict:
(1)
The practice (([by an individual] licensed, certified, or registered)) by
an individual credentialed under the laws of this state and performing
services within such individual's 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 is pursuant to a
regular course of instruction or assignments from an instructor and under the
general supervision of the instructor;
(4)
The practice of acupuncture by any person ((licensed or certified)) credentialed
to perform acupuncture in any other jurisdiction where such person is doing so
in the course of regular instruction of a school of acupuncture approved by the
secretary or in an educational seminar by a professional organization of
acupuncture, provided that in the latter case, the practice is supervised
directly by a person ((certified pursuant to)) licensed under
this chapter or licensed under any other healing art whose scope of practice
includes acupuncture.
Sec.
7. RCW
18.06.080 and 1994 sp.s. c 9 s 502 are each amended to read as follows:
(1)
The secretary is hereby authorized and empowered to execute the provisions of
this chapter and shall offer examinations in acupuncture at least twice a year
at such times and places as the secretary may select. The examination shall be
a written examination and may include a practical examination.
(2)
The secretary shall develop or approve a ((certification)) licensure
examination in the subjects that the secretary determines are within the scope
of and commensurate with the work performed by ((certified)) licensed
acupuncturists and shall include but not necessarily be limited to anatomy,
physiology, microbiology, biochemistry, pathology, hygiene, and acupuncture.
All application papers shall be deposited with the secretary and there retained
for at least one year, when they may be destroyed.
(3) If
the examination is successfully passed, the secretary shall confer on such
candidate the title of ((Certified)) Licensed Acupuncturist.
(4)
The secretary may appoint members of the profession to serve in an ad hoc
advisory capacity to the secretary in carrying out this chapter. The members
will serve for designated times and provide advice on matters specifically
identified and requested by the secretary. The members shall be compensated in
accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW
43.03.040 and 43.03.060.
(5)
The secretary, ad hoc committee members, or individuals acting in their behalf
are immune from suit in a civil action based on any certification or
disciplinary proceedings or other official acts performed in the course of
their duties.
Sec.
8. RCW
18.06.090 and 1985 c 326 s 9 are each amended to read as follows:
Before
((certification)) licensure, each applicant shall demonstrate
sufficient fluency in reading, speaking, and understanding the English language
to enable the applicant to communicate with other health care providers and
patients concerning health care problems and treatment.
Sec.
9. RCW
18.06.110 and 1991 c 3 s 11 are each amended to read as follows:
The
uniform disciplinary act, chapter 18.130 RCW, governs uncertified practice, the
issuance and denial of ((certificates)) licenses, and the
disciplining of ((certificate)) license holders under this
chapter. The secretary shall be the disciplining authority under this chapter.
Sec.
10. RCW
18.06.120 and 1992 c 110 s 4 are each amended to read as follows:
(1)
Every person ((certified)) licensed in acupuncture shall register
with the secretary annually and pay an annual renewal ((registration))
fee determined by the secretary as provided in RCW 43.70.250 on or before the
((certificate)) license holder's birth anniversary date. The ((certificate))
license of the person shall be renewed for a period of one year or
longer in the discretion of the secretary. A person whose practice is
exclusively out-of-state or who is on sabbatical shall be granted an inactive
((certification)) licensure status and pay a reduced ((registration))
fee. The reduced fee shall be set by the secretary under RCW 43.70.250.
(2)
Any failure to register and pay the annual renewal ((registration)) fee
shall render the ((certificate)) license invalid. The ((certificate))
license shall be reinstated upon: (a) Written application to the
secretary; (b) payment to the state of a penalty fee determined by the
secretary as provided in RCW 43.70.250; and (c) payment to the state of all
delinquent annual ((certificate)) license renewal fees.
(3)
Any person who fails to renew his or her ((certification)) license
for a period of three years shall not be entitled to renew ((such
certification)) the licensure under this section. Such person, in
order to obtain a ((certification)) licensure in acupuncture in
this state, shall file a new application under this chapter, along with the
required fee, and shall meet examination or continuing education requirements
as the secretary, by rule, provides.
(4)
All fees collected under this section and RCW 18.06.070 shall be credited to
the health professions account as required under RCW 43.70.320.
Sec.
11. RCW
18.06.130 and 1991 c 3 s 13 are each amended to read as follows:
The
secretary shall develop a form to be used by an acupuncturist to inform the
patient of the acupuncturist's scope of practice and qualifications. All ((certificate))
license holders shall bring the form to the attention of the patients in
whatever manner the secretary, by rule, provides.
Sec.
12. RCW
18.06.140 and 1991 c 3 s 14 are each amended to read as follows:
Every
((certified)) licensed acupuncturist shall develop a written plan
for consultation, emergency transfer, and referral to other health care
practitioners operating within the scope of their authorized practices. The
written plan shall be submitted with the initial application for ((certification))
licensure as well as annually thereafter with the ((certificate))
license renewal fee to the department. The department may withhold ((certification))
licensure or renewal of ((certification)) licensure if the
plan fails to meet the standards contained in rules ((promulgated)) adopted
by the secretary.
When
the acupuncturist sees patients with potentially serious disorders such as
cardiac conditions, acute abdominal symptoms, and such other conditions, the
acupuncturist shall immediately request a consultation or recent written
diagnosis from a physician licensed under chapter 18.71 or 18.57 RCW. In the
event that the patient with the disorder refuses to authorize such consultation
or provide a recent diagnosis from such physician, acupuncture treatment shall
not be continued.
Sec.
13. RCW
18.06.190 and 1991 c 3 s 18 are each amended to read as follows:
The
secretary may ((certify)) license a person without examination if
such person is ((licensed or certified)) credentialed as an
acupuncturist in another jurisdiction if, in the secretary's judgment, the
requirements of that jurisdiction are equivalent to or greater than those of
Washington state.
Sec.
14. RCW
18.06.200 and 1985 c 326 s 20 are each amended to read as follows:
Nothing
in this chapter may be construed to require that individual or group policies
or contracts of an insurance carrier, health care service contractor, or health
maintenance organization provide benefits or coverage for services and supplies
provided by a person ((registered or certified)) licensed under
this chapter.
Sec.
15. RCW
18.120.020 and 1994 sp.s. c 9 s 718 are each amended to read as follows:
The
definitions contained in this section shall apply throughout this chapter
unless the context clearly requires otherwise.
(1)
"Applicant group" includes any health professional group or
organization, any individual, or any other interested party which proposes that
any health professional group not presently regulated be regulated or which
proposes to substantially increase the scope of practice of the profession.
(2)
"Certificate" and "certification" mean a voluntary process
by which a statutory regulatory entity grants recognition to an individual who
(a) has met certain prerequisite qualifications specified by that regulatory
entity, and (b) may assume or use "certified" in the title or
designation to perform prescribed health professional tasks.
(3)
"Grandfather clause" means a provision in a regulatory statute
applicable to practitioners actively engaged in the regulated health profession
prior to the effective date of the regulatory statute which exempts the
practitioners from meeting the prerequisite qualifications set forth in the
regulatory statute to perform prescribed occupational tasks.
(4)
"Health professions" means and includes the following health and
health-related licensed or regulated professions and occupations: Podiatric
medicine and surgery under chapter 18.22 RCW; chiropractic under chapter 18.25 RCW;
dental hygiene under chapter 18.29 RCW; dentistry under chapter 18.32 RCW;
dispensing opticians under chapter 18.34 RCW; hearing aids under chapter 18.35
RCW; naturopaths under chapter 18.36A RCW; embalming and funeral directing
under chapter 18.39 RCW; midwifery under chapter 18.50 RCW; nursing home
administration under chapter 18.52 RCW; optometry under chapters 18.53 and
18.54 RCW; ocularists under chapter 18.55 RCW; osteopathy and osteopathic
medicine and surgery under chapters 18.57 and 18.57A RCW; pharmacy under
chapters 18.64 and 18.64A RCW; medicine under chapters 18.71 and 18.71A RCW;
emergency medicine under chapter 18.73 RCW; physical therapy under chapter
18.74 RCW; practical nurses under chapter 18.79 RCW; psychologists under
chapter 18.83 RCW; registered nurses under chapter 18.79 RCW; occupational
therapists licensed under chapter 18.59 RCW; respiratory care practitioners
certified under chapter 18.89 RCW; veterinarians and animal technicians under
chapter 18.92 RCW; health care assistants under chapter 18.135 RCW; massage
practitioners under chapter 18.108 RCW; acupuncturists ((certified)) licensed
under chapter 18.06 RCW; persons registered or certified under chapter 18.19
RCW; dietitians and nutritionists certified by chapter 18.138 RCW; radiologic
technicians under chapter 18.84 RCW; and nursing assistants registered or
certified under chapter 18.88A RCW.
(5)
"Inspection" means the periodic examination of practitioners by a
state agency in order to ascertain whether the practitioners' occupation is
being carried out in a fashion consistent with the public health, safety, and
welfare.
(6)
"Legislative committees of reference" means the standing legislative
committees designated by the respective rules committees of the senate and
house of representatives to consider proposed legislation to regulate health
professions not previously regulated.
(7)
"License," "licensing," and "licensure" mean
permission to engage in a health profession which would otherwise be unlawful
in the state in the absence of the permission. A license is granted to those
individuals who meet prerequisite qualifications to perform prescribed health
professional tasks and for the use of a particular title.
(8)
"Professional license" means an individual, nontransferable
authorization to carry on a health activity based on qualifications which
include: (a) Graduation from an accredited or approved program, and (b)
acceptable performance on a qualifying examination or series of examinations.
(9)
"Practitioner" means an individual who (a) has achieved knowledge and
skill by practice, and (b) is actively engaged in a specified health
profession.
(10)
"Public member" means an individual who is not, and never was, a
member of the health profession being regulated or the spouse of a member, or
an individual who does not have and never has had a material financial interest
in either the rendering of the health professional
service
being regulated or an activity directly related to the profession being
regulated.
(11)
"Registration" means the formal notification which, prior to
rendering services, a practitioner shall submit to a state agency setting forth
the name and address of the practitioner; the location, nature and operation of
the health activity to be practiced; and, if required by the regulatory entity,
a description of the service to be provided.
(12)
"Regulatory entity" means any board, commission, agency, division, or
other unit or subunit of state government which regulates one or more
professions, occupations, industries, businesses, or other endeavors in this
state.
(13)
"State agency" includes every state office, department, board,
commission, regulatory entity, and agency of the state, and, where provided by
law, programs and activities involving less than the full responsibility of a
state agency.
Sec.
16. RCW
18.130.040 and 1994 sp.s. c 9 s 603 and 1994 c 17 s 19 are each reenacted and
amended to read as follows:
(1)
This chapter applies only to the secretary and the boards and commissions
having jurisdiction in relation to the professions licensed under the chapters
specified in this section. This chapter does not apply to any business or
profession not licensed under the chapters specified in this section.
(2)(a)
The secretary has authority under this chapter in relation to the following
professions:
(i)
Dispensing opticians licensed under chapter 18.34 RCW;
(ii)
Naturopaths licensed under chapter 18.36A RCW;
(iii)
Midwives licensed under chapter 18.50 RCW;
(iv)
Ocularists licensed under chapter 18.55 RCW;
(v)
Massage operators and businesses licensed under chapter 18.108 RCW;
(vi)
Dental hygienists licensed under chapter 18.29 RCW;
(vii)
Acupuncturists ((certified)) licensed under chapter 18.06 RCW;
(viii)
Radiologic technologists certified and x-ray technicians registered under
chapter 18.84 RCW;
(ix)
Respiratory care practitioners certified under chapter 18.89 RCW;
(x)
Persons registered or certified under chapter 18.19 RCW;
(xi)
Persons registered as nursing pool operators under chapter 18.52C RCW;
(xii)
Nursing assistants registered or certified under chapter 18.79 RCW;
(xiii)
Health care assistants certified under chapter 18.135 RCW;
(xiv)
Dietitians and nutritionists certified under chapter 18.138 RCW;
(xv)
Sex offender treatment providers certified under chapter 18.155 RCW; and
(xvi)
Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205.
(b)
The boards and commissions having authority under this chapter are as follows:
(i)
The podiatric medical board as established in chapter 18.22 RCW;
(ii)
The chiropractic quality assurance commission as established in chapter 18.25
RCW;
(iii)
The dental quality assurance commission as established in chapter 18.32 RCW;
(iv)
The board on fitting and dispensing of hearing aids as established in chapter
18.35 RCW;
(v)
The board of examiners for nursing home administrators as established in
chapter 18.52 RCW;
(vi)
The optometry board as established in chapter 18.54 RCW governing licenses
issued under chapter 18.53 RCW;
(vii)
The board of osteopathic medicine and surgery as established in chapter 18.57
RCW governing licenses issued under chapters 18.57 and 18.57A RCW;
(viii)
The board of pharmacy as established in chapter 18.64 RCW governing licenses
issued under chapters 18.64 and 18.64A RCW;
(ix)
The medical quality assurance commission as established in chapter 18.71 RCW
governing licenses and registrations issued under chapters 18.71 and 18.71A
RCW;
(x)
The board of physical therapy as established in chapter 18.74 RCW;
(xi)
The board of occupational therapy practice as established in chapter 18.59 RCW;
(xii)
The nursing care quality assurance commission as established in chapter 18.79
RCW governing licenses issued under that chapter;
(xiii)
The examining board of psychology and its disciplinary committee as established
in chapter 18.83 RCW;
(xiv)
The veterinary board of governors as established in chapter 18.92 RCW.
(3)
In addition to the authority to discipline license holders, the disciplining
authority has the authority to grant or deny licenses based on the conditions
and criteria established in this chapter and the chapters specified in subsection
(2) of this section. This chapter also governs any investigation, hearing, or
proceeding relating to denial of licensure or issuance of a license
conditioned on the applicant's compliance with an order entered pursuant to RCW
18.130.160 by the disciplining authority.
