SENATE BILL REPORT
HB 1666
This analysis was prepared by non-partisan legislative staff for the use of legislative members in
their deliberations. This analysis is not a part of the legislation nor does it constitute a
statement of legislative intent.
As Reported By Senate Committee On:
Labor, Commerce, Research & Development, March 19, 2007
Title: An act relating to extending the authority of nurse practitioners to examine, diagnose, and treat injured workers covered by industrial insurance.
Brief Description: Repealing the expiration provision in the act authorizing nurse practitioners to treat those covered by industrial insurance.
Sponsors: Representatives Green, Conway, Morrell, Cody, Ormsby, Schual-Berke, Moeller and Simpson.
Brief History: Passed House: 2/28/07, 97-0.
Committee Activity: Labor, Commerce, Research & Development: 3/15/07, 3/19/07 [DP].
SENATE COMMITTEE ON LABOR, COMMERCE, RESEARCH & DEVELOPMENT
Majority Report: Do pass.Signed by Senators Kohl-Welles, Chair; Keiser, Vice Chair; Clements, Ranking Minority Member; Franklin, Hewitt, Holmquist and Prentice.
Staff: Jennifer Strus (786-7316)
Background: A worker who, in the course of employment, is injured or suffers disability from
occupational disease may be entitled to benefits under the Industrial Insurance Act (Act). These
benefits include proper and necessary medical and surgical services 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, chiropractic, naturopathic physician, podiatry, dentistry, and optometry. Doctors may
sign accident report forms for injured workers and time-loss authorizations.
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 rules permit ARNPs to provide nursing care for injured workers. The rules require that
ARNPs be recognized as ARNPs and have a system of obtaining physician consultations.
In 2004, the Legislature expanded the authority of ARNPs under the Act. Until June 30, 2007,
the health services available to injured workers include health services provided by ARNPs within
their scope of practice. The ARNPs are recognized as independent practitioners. Generally,
ARNPs have the same roles and responsibilities as physicians, except that ARNPs may not
conduct special medical examinations. In the fall of 2006, L&I issued a report on the impact of
the changes made in 2004. The report generally determined that implementation of the 2004 law
was not associated with any negative impact on costs, claim disputes, or time-loss duration, and
appeared to positively affect provider enrollment, availability of authorized attending providers
in rural areas, and administrative efficiency.
Summary of Bill: The expanded authority of ARNPs under the Act is made permanent. The health services available to injured workers include health services provided by ARNPs within their scope of practice. The ARNPs are recognized as independent practitioners. Generally, ARNPs have the same roles and responsibilities as physicians, except that ARNPs may not conduct special medical examinations.
Appropriation: None.
Fiscal Note: Available.
Committee/Commission/Task Force Created: No.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Staff Summary of Public Testimony: PRO: The ability of ARNPs to provide health care to injured workers has really improved access to health care for injured workers in rural areas of the state. The purpose of the study by L&I was to determine whether ARNPs could do a good job providing health care services to injured workers. The results of the study prove they can so the expiration date should be removed and the provisions made permanent.
Persons Testifying: PRO: Representative Green, prime sponsor; Nick Federici, Marty Couret, ARNPs United.