AN
ACT Relating to making technical corrections to statutes administered by the
department of health; amending 1995 1st sp.s. c 18 553 (uncodified); reenacting
and amending RCW 18.71.210, 18.130.040, 18.35.060, and 18.35.080; reenacting
RCW 18.35.090; adding a new section to chapter 43.03 RCW; creating new
sections; and providing an expiration date.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec.
1. RCW
18.71.210 and 1995 c 65 s 4 and 1995 c 103 s 1 are each reenacted and amended
to read as follows:
No
act or omission of any physician's trained emergency medical service
intermediate life support technician and paramedic, as defined in RCW 18.71.200,
or any emergency medical technician or first responder, as
defined in RCW 18.73.030, done or omitted in good faith while rendering
emergency medical service under the responsible supervision and control of a
licensed physician or an approved medical program director or delegate(s) to a
person who has suffered illness or bodily injury shall impose any liability
upon:
(1)
The physician's trained emergency medical service intermediate life support
technician and paramedic, emergency medical technician, or first responder;
(2)
The medical program director;
(3)
The supervising physician(s);
(4)
Any hospital, the officers, members of the staff, nurses, or other employees of
a hospital;
(5)
Any training agency or training physician(s);
(6)
Any licensed ambulance service; or
(7)
Any federal, state, county, city or other local governmental unit or employees
of such a governmental unit.
This
section shall apply to an act or omission committed or omitted in the
performance of the actual emergency medical procedures and not in the
commission or omission of an act which is not within the field of medical
expertise of the physician's trained emergency medical service intermediate
life support technician and paramedic, emergency medical technician, or first
responder, as the case may be.
This
section shall apply also, as to the entities and personnel described in
subsections (1) through (7) of this section, to any act or omission committed
or omitted in good faith by such entities or personnel in rendering services at
the request of an approved medical program director in the training of
emergency medical service ((medical)) personnel for certification
or recertification pursuant to this chapter.
This
section shall not apply to any act or omission which constitutes either gross
negligence or willful or wanton misconduct.
Sec.
2. RCW
18.130.040 and 1996 c 200 s 32 and 1996 c 81 s 5 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 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)) 18.88A
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;
(xvi)
Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;
(xvii)
Persons registered as adult family home providers and resident managers under
RCW 18.48.020; and
(xviii)
Denturists licensed under chapter 18.30 RCW.
(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 of hearing and speech 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; and
(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.
(4)
All disciplining authorities shall adopt procedures to ensure substantially
consistent application of this chapter, the Uniform Disciplinary Act, among the
disciplining authorities listed in subsection (2) of this section.
Sec.
3. RCW
18.35.060 and 1996 c 200 s 7 and 1996 c 191 s 19 are each reenacted and amended
to read as follows:
(1)
The department shall issue a hearing instrument fitting/dispensing permit to
any applicant who has shown to the satisfaction of the department that the
applicant:
(a)
Is at least twenty-one years of age;
(b)
If issued a hearing instrument fitter/dispenser permit, would be employed and
directly supervised in the fitting and dispensing of hearing instruments by a
person licensed or certified in good standing as a hearing instrument
fitter/dispenser or audiologist for at least two years unless otherwise
approved by the board;
(c)
Has complied with administrative procedures, administrative requirements, and
fees determined as provided in RCW 43.70.250 and 43.70.280;
(d)
Has not committed unprofessional conduct as specified by the uniform disciplinary
act; and
(e)
Is a high school graduate or the equivalent.
The
provisions of RCW 18.35.030, 18.35.110, and 18.35.120 shall apply to any person
issued a hearing instrument fitter/dispenser permit. Pursuant to the
provisions of this section, a person issued a hearing instrument
fitter/dispenser permit may engage in the fitting and dispensing of hearing
instruments without having first passed the hearing instrument fitter/dispenser
examination provided under this chapter.
(2)
The hearing instrument fitter/dispenser permit shall contain the names of the
employer and the licensed or certified supervisor under this chapter who are
employing and supervising the hearing instrument fitter/dispenser permit holder
and those persons shall execute an acknowledgment of responsibility for all
acts of the hearing instrument fitter/dispenser permit holder in connection
with the fitting and dispensing of hearing instruments.
(3)
A hearing instrument fitter/dispenser permit holder may fit and dispense
hearing instruments, but only if the hearing instrument fitter/dispenser permit
holder is under the direct supervision of a licensed hearing instrument
fitter/dispenser or certified audiologist under this chapter in a capacity
other than as a hearing instrument fitter/dispenser permit holder. Direct
supervision by a licensed hearing instrument fitter/dispenser or certified
audiologist shall be required whenever the hearing instrument fitter/dispenser
permit holder is engaged in the fitting or dispensing of hearing instruments
during the hearing instrument fitter/dispenser permit holder's employment. The
board shall develop and adopt guidelines on any additional supervision or
training it deems necessary.
(4)
((No individual may hold a hearing instrument fitter/dispenser permit for
more than two years.)) The hearing instrument fitter/dispenser permit
expires one year from the date of its issuance except that on recommendation of
the board the permit may be reissued for one additional year only.
(5)
No certified audiologist or licensed hearing instrument fitter/dispenser under
this chapter may assume the responsibility for more than one hearing instrument
fitter/dispenser permit holder at any one time.
(6)
The department, upon approval by the board, shall issue an interim permit
authorizing an applicant for speech-language pathologist certification or
audiologist certification who, except for the postgraduate professional
experience and the examination requirements, meets the academic and practicum
requirements of RCW 18.35.040 to practice under interim permit supervision by a
certified speech-language pathologist or certified audiologist. The interim
permit is valid for a period of one year from date of issuance. The board
shall determine conditions for the interim permit.
Sec.
4. RCW
18.35.080 and 1996 c 200 s 9 and 1996 c 191 s 20 are each reenacted and amended
to read as follows:
(1)
The department shall license or certify each qualified applicant who
satisfactorily completes the required examinations for his or her profession
and complies with administrative procedures and administrative requirements
established pursuant to RCW 43.70.250 and 43.70.280.
(2)
The board shall waive the examination and grant a speech-language pathology
certificate to a person engaged in the profession of speech-language pathology
in this state on June 6, 1996, if the board determines that the person meets
commonly accepted standards for the profession, as defined by rules adopted by
the board. Persons eligible for certification under this subsection must apply
for a certificate before July 1, 1997.
(3)
The board shall waive the examinations and grant an audiology certificate to a
person engaged in the profession of audiology in this state on June 6, 1996, if
the board determines that the person meets the commonly accepted standards for
the profession and has passed the hearing instrument fitter/dispenser
examination. Persons eligible for certification under this subsection must
apply for a certificate before July 1, 1997.
(4)
The board shall grant an audiology certificate to a person engaged in the
profession of audiology, who has not been licensed as a hearing ((aid
[instrument])) instrument fitter/dispenser, but who meets the
commonly accepted standards for the profession of audiology and graduated from
a board-approved program after January 1, 1993, and has passed sections of the
examination pertaining to RCW 18.35.070 (3), (4), and (5). Persons eligible
for certification under this subsection must apply for a certificate before
July 1, 1997.
(5)
Persons engaged in the profession of audiology who meet the commonly accepted
standards for the profession of audiology and graduated from a board-approved
program prior to January 1, 1993, and who have not passed the hearing
instrument fitter/dispenser examination shall be granted a temporary audiology
certificate (nondispensing) for a period of two years from June 6, 1996, during
which time they must pass sections of the hearing instrument fitter/dispenser
examination pertaining to RCW 18.35.070 (1)(c), (2)(e) and (f), (3), (4), and
(5). The board may extend the term of the temporary certificate upon review.
Persons eligible for certification under this subsection must apply for a
certificate before July 1, 1997.
Sec.
5. RCW
18.35.090 and 1996 c 200 s 11 and 1996 c 191 s 21 are each reenacted to read as
follows:
Each
person who engages in practice under this chapter shall comply with
administrative procedures and administrative requirements established under RCW
43.70.250 and 43.70.280 and shall keep the license, certificate, or permit
conspicuously posted in the place of business at all times. The secretary may
establish mandatory continuing education requirements and/or continued
competency standards to be met by licensees or certificate or permit holders as
a condition for license, certificate, or permit renewal.
Sec.
6. RCW
18.88A.230 and 1995 1st sp.s. c 18 s 48 are each amended to read as follows:
(1)
The nurse and nursing assistant shall be accountable for their own individual
actions in the delegation process. Nurses acting within the protocols of their
delegation authority shall be immune from liability for any action performed in
the course of their delegation duties. Nursing assistants following written
delegation instructions from registered nurses performed in the course of their
accurately written, delegated duties shall be immune from liability.
(2)
No person may coerce a nurse into compromising patient safety by requiring the
nurse to delegate if the nurse determines it is inappropriate to do so. Nurses
shall not be subject to any employer reprisal or disciplinary action by the
Washington nursing care quality assurance commission for refusing to delegate
tasks or refusing to provide the required training for delegation if the nurse
determines delegation may compromise patient safety. Nursing assistants shall
not be subject to any employer reprisal or disciplinary action by the nursing
care quality assurance commission for refusing to accept delegation of a
nursing task based on patient safety issues. No community residential
program, adult family home, or boarding home contracting to provide
assisted-living services may discriminate or retaliate in any manner against a
person because the person made a complaint or cooperated in the investigation
of a complaint.
(3)
The department of social and health services shall impose a civil fine of not
less than two hundred fifty dollars nor more than one thousand dollars on a
community residential program, adult family home, or boarding home under
chapter 18, Laws of 1995 1st sp. sess. that knowingly permits an employee to
perform a nursing task except as delegated by a nurse pursuant to chapter 18,
Laws of 1995 1st sp. sess.
Sec.
7.
1995 1st sp.s. c 18 s 53 (uncodified) is amended to read as follows:
The
secretary of health in consultation with the Washington nursing care quality
assurance commission and the department of social and health services shall
monitor the implementation of sections 45 through 54 of this act and shall make
an interim report by December 31, 1996, and a final report by December 31, ((1997))
1998, to the legislature with any recommendations for improvements. As
part of the monitoring process, the secretary of health and the secretary of
social and health services, in consultation with the University of Washington
school of nursing, shall conduct a study to be completed by September 30, ((1997))
1998, which shall be a part of the final report to be submitted to the
legislature by December 31, ((1997)) 1998. The study shall include
consideration of the protection of health and safety of persons with
developmental disabilities and residents of adult family homes and boarding
homes providing assisted living services, including the appropriateness of the
tasks allowed for delegation, level and type of training and regulation of
nursing assistants. The report shall include direct observation,
documentation, and interviews, and shall specifically include data on the
following:
(1)
Patient, nurse, and nursing assistant satisfaction;
(2)
Medication errors, including those resulting in hospitalization;
(3)
Compliance with required training;
(4)
Compliance with nurse delegation protocols;
(5)
Incidence of harm to patients, including abuse and neglect;
(6)
Impact on access to care;
(7)
Impact on patient quality of life; and
(8)
Incidence of coercion in the nurse-delegation process.
Sec.
8. RCW
18.74.010 and 1991 c 12 s 1 are each amended to read as follows:
Unless
the context otherwise requires, the definitions in this section apply
throughout this chapter.
(1)
"Board" means the board of physical therapy created by RCW 18.74.020.
(2)
"Department" means the department of health.
(3)
"Physical therapy" means the treatment of any bodily or mental condition
of any person by the use of the physical, chemical, and other properties of
heat, cold, air, light, water, electricity, sound, massage, and therapeutic
exercise, which includes posture and rehabilitation procedures; the performance
of tests and measurements of neuromuscular function as an aid to the diagnosis
or treatment of any human condition; performance of treatments on the basis of
test findings after consultation with and periodic review by an authorized
health care practitioner except as provided in RCW 18.74.012; supervision of
selective forms of treatment by trained supportive personnel; and provision of
consultative services for health, education, and community agencies. The use
of Roentgen rays and radium for diagnostic and therapeutic purposes, the use of
electricity for surgical purposes, including cauterization, and the use of
spinal manipulation or manipulative mobilization of the spine and its immediate
articulations, are not included under the term "physical therapy" as
used in this chapter.
(4)
"Physical therapist" means a person who practices physical therapy as
defined in this chapter but does not include massage operators as defined in
RCW 18.108.010.
(5)
"Secretary" means the secretary of health.
(6)
Words importing the masculine gender may be applied to females.
(7)
"Authorized health care practitioner" means and includes licensed
physicians, osteopathic physicians, chiropractors, naturopaths, ((podiatrists,
and)) podiatric physicians and surgeons, dentists, and advanced
registered nurse practitioners: PROVIDED, HOWEVER, That nothing herein
shall be construed as altering the scope of practice of such practitioners as
defined in their respective licensure laws.
*NEW
SECTION. Sec. 9.
The department of social and health services
shall not impose civil fines authorized in RCW 18.88A.230 on facilities
licensed under chapter 70.128 RCW.
This
section does not affect any other fines or disciplinary actions authorized to
be imposed by the department for facilities licensed under chapter 70.128 RCW.
This
section expires July 1, 1999.
*Sec. 9 was vetoed. See message at end of chapter.
*NEW
SECTION. Sec. 10.
A new section is added to chapter 43.03 RCW to read as follows:
(1)
Any part-time commission that has rule-making authority, performs
quasi-judicial functions, has responsibility for the policy direction of a
health profession credentialing program, and performs regulatory and licensing
functions with respect to a health care profession licensed under Title 18 RCW
shall be identified as a class five group for purposes of compensation.
(2)
Except as otherwise provided in this section, each member of a class five group
is eligible to receive compensation in an amount not to exceed two hundred
fifty dollars for each day during which the member attends an official meeting
of the group or performs statutorily prescribed duties approved by the
chairperson of the group. A person shall not receive compensation for a day of
service under this section if the person (a) occupies a position, normally
regarded as full-time in nature, in any agency of the federal government,
Washington state government, or Washington state local government; and (b)
receives any compensation from such government for working that day.
(3)
Compensation may be paid a member under this section only if it is necessarily
incurred in the course of authorized business consistent with the responsibilities
of the commission established by law.
*Sec. 10 was vetoed. See message at end of chapter.
NEW
SECTION. Sec. 11. The
department of health shall study the feasibility of updating, designing, and
expanding the comprehensive hospital abstract reporting system to include
ambulatory and outpatient data. The department shall submit a preliminary
report to the legislature by December 31, 1997, and a final report July 1,
1998. The report shall be done in conjunction with potential and current data
providers and shall include a cost/benefit analysis, data standards and
reporting requirements, financing alternatives, data access and dissemination
requirements, prioritization of data needs, and proposed implementation phases.
