SENATE BILL REPORT
SB 6739
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 Amended by House, March 4, 2008
Title: An act relating to psychiatric advanced registered nurse practitioners.
Brief Description: Granting authority to psychiatric advanced registered nurse practitioners.
Sponsors: Senators Franklin, Prentice, Marr and Jacobsen.
Brief History:
Committee Activity: Health & Long-Term Care: 2/6/08, 2/7/08 [DP].
Passed Senate: 2/18/08, 45-0.
SENATE COMMITTEE ON HEALTH & LONG-TERM CARE
Majority Report: Do pass.Signed by Senators Keiser, Chair; Franklin, Vice Chair; Pflug, Ranking Minority Member; Carrell, Fairley, Kastama, Kohl-Welles and Marr.
Staff: Edith Rice (786-7444)
Background: Advanced registered nurse practitioners (ARNPs) are registered nurses with
additional formal specialized training in areas such as pediatrics, midwifery, geriatrics
anesthesiology, and psychiatry. ARNPs function more independently than registered nurses and
assume primary responsibility and accountability for care of their patients. An ARNP can
examine patients and establish medical diagnoses, admit patients to health care facilities, order
and interpret lab tests, implement a plan of care for patients, prescribe medications and refer
clients to other health care practitioners or facilities.
The Washington Nursing Care Quality Assurance Commission recognizes a specialty designation
for psychiatric nurse practitioners or clinical specialists in psychiatric-mental health nursing.
Individuals suffering from mental illness who are found to be gravely disabled or present a
likelihood of serious harm have the right to refuse anti-psychotic medication unless it is
determined that the failure to medicate may result in a likelihood of serious harm or substantial
deterioration or substantially prolong the length of involuntary commitment and there is no less
intrusive course of treatment than medication in the best interest of the person. The Department
of Social and Health Services (department) must adopt rules to address these issues which include
an attempt to gain the informed consent of the patient, and the right to refuse anti-psychotic
medications for up to 30 days unless there is an additional concurring medical opinion approving
medication.
A court can appoint a psychiatrist, psychologist, or physician to examine and testify on behalf of
a person who is involuntarily detained. A court must appoint a psychiatrist, psychologist, or
physician to testify on behalf of a person involuntarily detained where an order for
electroconvulsant therapy is being sought.
Summary of Bill: An advanced nurse practitioner is permitted to admit a person to be examined
or treated as a patient in a hospital. A psychiatrist, psychiatric advanced registered nurse
practitioner, or physician in consultation with a mental health professional with prescriptive
authority can provide the concurring medical opinion allowing for administration of anti-psychotic medication when a patient has the right to refuse such medication. A psychiatric
advanced registered nurse practitioner can, as an alternative to a physician, offer an opinion as
to whether a person's condition constitutes an emergency requiring treatment prior to obtaining
a second medical opinion.
A psychiatric advanced registered nurse practitioner is added to the list of health professionals
from which a court can appoint, to examine and testify on behalf of a person who is involuntarily
detained. A psychiatric advanced registered nurse practitioner is added to the same list of health
professionals from which a court must appoint, to testify if an order for electroconvulsant therapy
is sought.
Appropriation: None.
Fiscal Note: Not requested.
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: When psychiatrists are in short supply it slows the process down to have to wait for the appropriate professional opinion or signature. Allowing advanced practice psychiatric nurses to provide this will save time and cost. This is not a scope of practice issue. It is clearly within their scope of practice.
Persons Testifying: PRO: Leslie Emerick, Association of Advanced Practice Psychiatric Nurses; Lisa Trig, AAPPN; Donna Poole, AAPPN.
House Amendment(s): A reference to "advanced nurse practitioner" is changed to "psychiatric advanced registered nurse practitioner" to conform to the rest of the bill.