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

Sponsors: By Senate Committee on Health & Long-Term Care (originally sponsored by Senators Franklin, Parlette, Keiser, Winsley and Thibaudeau; by request of Department of Health).

Brief Summary of Engrossed Substitute Bill

(As Amended by House)

• Amends initial licensing requirements for acupuncturists, dispensing opticians, registered nurses, respiratory therapists, and psychologists with regard to education, 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 limited license.

Majority Report: Do pass as amended. Signed by 12 members: Representatives Cody, Chair; Morrell, Vice Chair; Bailey, Ranking Minority Member; Alexander, Benson, Campbell, Clibborn, Darneille, 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 professions 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 health professions 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 are eliminated and replaced with a flat 500 hours of approved clinical training.

An applicant for a dental hygiene license may obtain an initial limited license without examination that is valid for 18 months if he or she holds a dental hygiene license in another state and has met other licensure requirements. An initial limited license allows a dental hygienist to perform all dental hygiene functions except for administering injections of local anesthetic; performing soft tissue curettage; administering nitrous oxide/oxygen analgesia; or placing restorations or carving, contouring, or adjusting contacts or the occlusion of the restoration. The limited license may be renewed upon demonstration of successful passage of the examination for administering local anesthetic and nitrous oxide/oxygen analgesia. A renewed limited 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 find to meet the profession's standards.

An applicant for the respiratory care licensure examination must have completed an accredited respiratory program. The educational criteria required for licensure may be satisfied by meeting the requirements for taking the National Board for Respiratory Care's advanced practitioners' exams. Alternatively, an applicant may satisfy the educational criteria if he or she has been credentialed as a registered respiratory therapist by the national board.

Effective Date of Amended Bill: The bill takes effect 90 days after adjournment of session in which bill is passed, except for sections 13 and 14, relating to respiratory therapists, which take effect immediately.

Testimony For: This bill reduces unnecessary barriers to obtaining health care professional licenses without compromising patient care. The bill will increase access to care.

Persons Testifying: (In support) Senator Franklin, prime sponsor; Ron Weaver, Department of Health; Mark Walker, Washington State Dental Association; and Melissa Johnson, Washington State Dental Hygienists Association.

Persons Signed In To Testify But Not Testifying: (In support) Nick Federici, Respiratory Care Society of Washington.