SENATE BILL REPORT

EHB 1691

As of February 17, 2004

Title: An act relating to authorizing advanced registered nurse practitioners to examine, diagnose, and treat injured workers covered by industrial insurance.

Brief Description: Authorizing advanced registered nurse practitioners to examine, diagnose, and treat injured workers covered by industrial insurance.

Sponsors: Representatives Grant, Conway, Campbell, Wood, Kenney, Morrell, Crouse, Rockefeller, Holmquist, McCoy and Pflug.

Brief History:

Committee Activity: Commerce & Trade: 4/2/03, 4/3/03 [DPA]; 2/19/04.

SENATE COMMITTEE ON COMMERCE & TRADE

Staff: Jennifer Strus (786-7316)

Background: The Workers' Compensation Act (Act) provides that an injured worker is entitled to proper and necessary medical care from a physician of the worker's choice. The Act contains many provisions specifying the roles and responsibilities of physicians.

The Department of Labor and Industries' (L&I) rules define "physician" as a person licensed to practice medicine and surgery or osteopathic medicine and surgery. The rules also define "doctor" to include persons licensed to practice medicine and surgery, osteopathic medicine and surgery, podiatry, dentistry, and optometry. "Doctor" also includes chiropractors and naturopathic physicians. Doctors may sign accident report forms for injured workers and time loss cards.

The Department of Health's rules provide that an "advanced registered nurse practitioner" (ARNP) is a registered nurse prepared to assume primary responsibility for management of a broad range of patient care. According to the rules, their practice "incorporates the use of independent judgment, as well as collaborative interaction with other health care professionals." L&I's rules permit ARNPs to provide nursing care for injured workers. The rules require that the ARNPs be recognized as ARNPs, and have a system of obtaining physician consultations. ARNPs may not sign accident report forms or time loss cards.

Current law authorizes the department to approve or deny applications to participate as a provider of services for injured workers and to terminate or suspend eligibility to participate as a provider of services for injured workers.

Summary of Bill: The health services available to injured workers include health services provided by ARNPs within their scope and practice. ARNPs are recognized as independent practitioners and have the same roles and responsibilities as physicians, except that ARNPs may not conduct special medical examinations. These provisions expire June 30, 2007.

L&I must report to the Senate Commerce and Trade Committee and the House Commerce and Labor Committee by December 1, 2006, on the implementation of the act. The report must include information regarding the effects of the act on injured workers, claim costs, and disputed claims.

Appropriation: None.

Fiscal Note: Not requested.

Effective Date: The bill takes effect on July 1, 2004.