Title: An act relating to eliminating credentialing barriers for health professions.

Sponsors: Representatives Morrell, Benson, Darneille, Campbell and Bush; by request of Department of Health.

Brief Summary of Substitute Bill

• Amends initial licensing requirements for acupuncturists, dispensing opticians, registered nurses, and psychologists with regard to courses, clinical training, citizenship, examinations, temporary practice permits, and transcripts.

• Allows dental hygienists who have not passed an examination in restorations to practice dental hygiene with a renewable temporary license.

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 13 members: Representatives Cody, Chair; Morrell, Vice Chair; Bailey, Ranking Minority Member; Alexander, Benson, Campbell, Clibborn, Darneille, Edwards, Moeller, Rodne, Schual-Berke and Skinner.

In 2002 the Workforce Training and Education Coordinating Board convened a task force to examine the extent of the shortage of trained health care providers in Washington and to develop recommendations for increasing the number of health care workers. The task force's final report identified shortages of health care providers in numerous fields including nurses, medical aides, dental hygienists, billers and coders, laboratory personnel, pharmacists, physicians, and radiology technologists. Several of those health care providers are regulated by the Department of Health (Department).

The Department and the various health profession boards and commissions issue credentials to 57 types of health care providers in this state. General qualifications that providers in these health care fields must meet are established in statute. The Department and the boards and commissions are responsible for developing more specific minimum standards to determine entrance into a profession based upon these statutory requirements.

Changes are made to the licensing requirements for the following categories of health care providers.

The clinical training provisions requiring that applicants demonstrate the completion of a combination of quarter credits and patient contacts and treatments is eliminated and replaced with a flat 500 hours of approved clinical training.

A dental hygienist may renew a temporary license if he or she has met all of the licensure requirements except for passing the examination for restorations. A renewed temporary license allows a dental hygienist to perform all dental hygiene functions except for placing restorations or carving, contouring, or adjusting contacts or the occlusion of the restoration. Dental hygiene students may practice dental hygiene when under the direction and supervision of instructors who are licensed dentists or dental hygienists.

The requirement that applicants for the state dispensing optician exam certify under oath that they are United States citizens or intending to become citizens is eliminated.

The requirement that applicants for a nursing license provide evidence of a diploma from a school of nursing is changed to a transcript demonstrating an applicant's graduation and successful completion of a nursing program. Active licensed practical nurses who have completed an approved nontraditional registered nurse program can meet their supervised clinical experience requirement by acquiring the experience: (1) under the supervision of a registered nurse preceptor with an unrestricted license and at least two years of experience in the same type of practice setting as where the preceptorship will occur; and (2) within six months of completing the nontraditional program.

An applicant for a license to practice psychology must pass an exam, however, the requirement that there be both a written and oral exam is eliminated. The right to discuss exam performance with the Board of Psychology is eliminated. The requirement that one of the two years of supervised experience required for a license be obtained after receiving the doctoral degree is removed. A temporary practice permit may be granted to an applicant who is a member of a professional organization and holds a certificate that the Board of Psychology finds to meet the profession's standards. A license may be granted without oral examination if the applicant is a member of a professional organization and holds a certificate that the Board of Psychology finds meets the profession's standards.

The limited license for dental hygienists that do not perform activities related to restoratives and the nonrenewal provisions for temporary dental hygiene licenses are removed. In order to renew a temporary dental hygiene license, the applicant must show that he or she has passed the dental hygienist examination for administering local anesthetic and nitrous oxide/oxygen analgesia. Dental hygienists with a renewed temporary license may not perform restorative activities.

The provision for licensed practical nurses in a nontraditional registered nursing program to obtain clinical experience under the supervision of a registered nurse preceptor is removed as it pertains to those students who have not yet completed the nursing program.

Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of session in which bill is passed.

Testimony For: This bill eliminates barriers to entering a profession without compromising public protection. This bill will bring more dental hygienists into Washington.

Testimony Against: Restorative functions are not a barrier to dental hygiene practice and should not be covered in the bill.

Persons Testifying: (In support) Ron Weaver, Department of Health; and David Henion, Washington State Dental Association.

(Concerns) Anne Piazza, Washington State Nurses Association; and Sharon Ness, United Food and Commercial Workers.