HOUSE BILL REPORT

HB 1328

As Reported by House Committee On:

Health Care

Title:  An act relating to requiring registration of a school health aide.

Brief Description:  Requiring the registration of certain school health personnel.

Sponsors:  Representatives Cody, Campbell, Conway, Schual‑Berke, Talcott, Keiser, Santos, Edwards, Kenney, Veloria, Lovick and Edmonds.

Brief History:

Committee Activity:

Health Care:  1/25/01, 2/22/01 [DPS].

  Brief Summary of Substitute Bill

$Establishes a registration program for school health assistant providing nursing tasks delegated by school nurses to students.

HOUSE COMMITTEE ON HEALTH CARE

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass. Signed by 14 members: Representatives Campbell, Republican Co‑Chair; Cody, Democratic Co‑Chair; Schual‑Berke, Democratic Vice Chair; Skinner, Republican Vice Chair; Alexander, Ballasiotes, Conway, Darneille, Edmonds, Edwards, Marine, McMorris, Pennington and Ruderman.

Staff:  John Welsh (786‑7133).

Background:

Registered nurses may delegate to school health personnel certain limited health care tasks provided to students in schools if they comply with delegation training and supervision requirements.  These health care tasks are specified by law and include the administration of oral medication and clean intermittent catheterization.  A report on school health services published by the Joint Legislative Audit and Review Committee found that school health personnel are also performing more complex duties, such as injections, central venous line care, replacing nasogastric tubes, and tracheal suctioning, which by law only nurses and other licensed health professionals may provide.

The Sunrise Review report by the Department of Health identified potential risks of harm in the delivery of health care tasks in schools as more students are requiring health services in school settings, compounded by a marked increase in the number of children with physical, emotional, or psychological challenges.

There is no monitoring mechanism or regulatory oversight provided by the Department of Health over school health personnel providing health care tasks to students in school settings.

Summary of  Substitute Bill:

There is a declaration of legislative intent that the training of school health aides or assistants for serving the health needs of students in the state=s school districts is necessary to counter the diminishing supply of school nurses.  In addition, the current practice of delegating nursing tasks to unlicensed and untrained school personnel, such as teachers, teacher=s assistants, and secretarial staff, is compromising the health of students and exposes school districts to legal liability.  Removing health barriers to learning by recognizing established nursing practice standards in the state school districts is essential to the successful education of students.

A school health assistant is a person who performs health care tasks under the training and supervision of a registered nurse.  Nursing tasks delegated to school health assistants include those nursing procedures applicable to school districts provided by law.

School health assistants are required to register with the Department of Health, and no school district employees may practice or represent themselves as school health aides without being registered.  No person may be coerced into registering as a school health assistant.

Registration of school health aides does not affect the practice of health care by other regulated health professionals, nor federal employees, nor students in approved educational programs.

The Secretary of Health is given authority to implement this act, including rule making authority, and the setting of registration fees to fund the program.

The Uniform Disciplinary Act for the regulated health professions provides procedures and sanctions for unprofessional conduct, and the secretary is the disciplining authority.

Substitute Bill Compared to Original Bill:

Chances title of "school health aide" to "school health assistant"; deletes references to training and supervision; deletes topical medication and clean dressing changes from scope of nursing tasks and limits tasks to those specified in current law; adds prohibition against employer reprisal or disciplinary action for refusing to accept delegated nursing tasks; deletes references to examination and continuing education; and adds technical section relating to the Uniform Disciplinary Act.

Appropriation:  None.

Fiscal Note:  Available.

Effective Date of Substitute Bill:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  The provision of health care services to students should be regularized.  Registration will bring accountability into the system.  The shortage of school nurses creates a compelling need to establish a cadre of health assistants available to serve the health needs of students.

Testimony Against:  None.

Testified:  (In support) Paula Meyer and Steve Boruchowitz, Department of Health; Jeff Larsen, Washington Academy of Physician Assistants, Washington Osteopathic Medical Association and Washington Association of Naturopathic Physicians; and Ann Simons and Jeanne Baranski, SNOW .

(Support with concerns) Greg Williamson and Judy Maire, Office of the Superintendent of Public Instruction; and Doug Nelson, Public School Employees.