BILL REQ. #:  S-2373.1 

READ FIRST TIME 02/27/07.   

     AN ACT Relating to the consolidation and elimination of certain boards and commissions; amending RCW 70.168.020, 18.73.030, 18.73.050, 70.168.060, 18.135.030, 43.41.220, and 43.41.230; reenacting and amending RCW 18.71.205; repealing RCW 28B.04.085, 28B.115.050, 28A.600.130, 28B.12.040, and 18.73.040; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 70.168.020 and 2000 c 93 s 20 are each amended to read as follows:
     (1) There is hereby created an emergency medical services and trauma care steering committee composed of representatives of individuals knowledgeable in emergency medical services and trauma care, including emergency medical providers such as physicians, nurses, hospital personnel, emergency medical technicians, paramedics, ambulance services, a member of the emergency medical services licensing and certification advisory committee, local government officials, state officials, consumers, and persons affiliated professionally with health science schools. The governor shall appoint members of the steering committee. Members shall be appointed for a period of three years. The department shall provide administrative support to the committee. All appointive members of the committee, in the performance of their duties, may be entitled to receive travel expenses as provided in RCW 43.03.050 and 43.03.060. The governor may remove members from the committee who have three unexcused absences from committee meetings. The governor shall fill any vacancies of the committee in a timely manner. The terms of those members representing the same field shall not expire at the same time.
     The committee shall elect a chair and a vice-chair whose terms of office shall be for one year each. The chair shall be ineligible for reelection after serving four consecutive terms.
     The committee shall meet on call by the governor, the secretary, or the chair.
     (2) The emergency medical services and trauma care steering committee shall:
     (a) Advise the department regarding emergency medical services and trauma care needs throughout the state.
     (b) Review the regional emergency medical services and trauma care plans and recommend changes to the department before the department adopts the plans.
     (c) Review proposed departmental rules for emergency medical services and trauma care, including licensing and certification of emergency medical services.
     (d) Recommend modifications in rules regarding emergency medical services and trauma care.

Sec. 2   RCW 18.71.205 and 1996 c 191 s 55 and 1996 c 178 s 6 are each reenacted and amended to read as follows:
     (1) The secretary of the department of health, in conjunction with the advice and assistance of the ((emergency medical services licensing and certification advisory committee as prescribed in RCW 18.73.050, and the)) commission, shall prescribe:
     (a) Practice parameters, training standards for, and levels of, physician trained emergency medical service intermediate life support technicians and paramedics;
     (b) Minimum standards and performance requirements for the certification and recertification of physician's trained emergency medical service intermediate life support technicians and paramedics; and
     (c) Procedures for certification, recertification, and decertification of physician's trained emergency medical service intermediate life support technicians and paramedics.
     (2) Initial certification shall be for a period established by the secretary pursuant to RCW 43.70.250 and 43.70.280.
     (3) Recertification shall be granted upon proof of continuing satisfactory performance and education, and shall be for a period established by the secretary pursuant to RCW 43.70.250 and 43.70.280.
     (4) As used in chapters 18.71 and 18.73 RCW, "approved medical program director" means a person who:
     (a) Is licensed to practice medicine and surgery pursuant to chapter 18.71 RCW or osteopathic medicine and surgery pursuant to chapter 18.57 RCW; and
     (b) Is qualified and knowledgeable in the administration and management of emergency care and services; and
     (c) Is so certified by the department of health for a county, group of counties, or cities with populations over four hundred thousand in coordination with the recommendations of the local medical community and local emergency medical services and trauma care council.
     (5) The uniform disciplinary act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of certificates, and the disciplining of certificate holders under this section. The secretary shall be the disciplining authority under this section. Disciplinary action shall be initiated against a person credentialed under this chapter in a manner consistent with the responsibilities and duties of the medical program director under whom such person is responsible.
     (6) Such activities of physician's trained emergency medical service intermediate life support technicians and paramedics shall be limited to actions taken under the express written or oral order of medical program directors and shall not be construed at any time to include free standing or nondirected actions, for actions not presenting an emergency or life-threatening condition.

Sec. 3   RCW 18.73.030 and 2005 c 193 s 2 are each amended to read as follows:
     ((Unless a different meaning is plainly required by the context, the following words and phrases as used in this chapter shall have the meanings indicated.)) The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Secretary" means the secretary of the department of health.
     (2) "Department" means the department of health.
     (3) "Committee" means the emergency medical services ((licensing and certification advisory)) and trauma care steering committee created in RCW 70.168.020.
     (4) "Ambulance" means a ground or air vehicle designed and used to transport the ill and injured and to provide personnel, facilities, and equipment to treat patients before and during transportation.
     (5) "Aid vehicle" means a vehicle used to carry aid equipment and individuals trained in first aid or emergency medical procedure.
     (6) "Emergency medical technician" means a person who is authorized by the secretary to render emergency medical care pursuant to RCW 18.73.081.
     (7) "Ambulance service" means an organization that operates one or more ambulances.
     (8) "Aid service" means an organization that operates one or more aid vehicles.
     (9) "Emergency medical service" means medical treatment and care which may be rendered at the scene of any medical emergency or while transporting any patient in an ambulance to an appropriate medical facility, including ambulance transportation between medical facilities.
     (10) "Communications system" means a radio and landline network which provides rapid public access, coordinated central dispatching of services, and coordination of personnel, equipment, and facilities in an emergency medical services and trauma care system.
     (11) "Prehospital patient care protocols" means the written procedure adopted by the emergency medical services medical program director which direct the out-of-hospital emergency care of the emergency patient which includes the trauma care patient. These procedures shall be based upon the assessment of the patient's medical needs and what treatment will be provided for emergency conditions. The protocols shall meet or exceed statewide minimum standards developed by the department in rule as authorized in chapter 70.168 RCW.
     (12) "Patient care procedures" means written operating guidelines adopted by the regional emergency medical services and trauma care council, in consultation with the local emergency medical services and trauma care councils, emergency communication centers, and the emergency medical services medical program director, in accordance with statewide minimum standards. The patient care procedures shall identify the level of medical care personnel to be dispatched to an emergency scene, procedures for triage of patients, the level of trauma care facility to first receive the patient, and the name and location of other trauma care facilities to receive the patient should an interfacility transfer be necessary. Procedures on interfacility transfer of patients shall be consistent with the transfer procedures in chapter 70.170 RCW.
     (13) "Emergency medical services medical program director" means a person who is an approved medical program director as defined by RCW 18.71.205(4).
     (14) "Council" means the local or regional emergency medical services and trauma care council as authorized under chapter 70.168 RCW.
     (15) "Basic life support" means noninvasive emergency medical services requiring basic medical treatment skills as defined in chapter 18.73 RCW.
     (16) "Advanced life support" means invasive emergency medical services requiring advanced medical treatment skills as defined by chapter 18.71 RCW.
     (17) "First responder" means a person who is authorized by the secretary to render emergency medical care as defined by RCW 18.73.081.
     (18) "Stretcher" means a cart designed to serve as a litter for the transportation of a patient in a prone or supine position as is commonly used in the ambulance industry, such as wheeled stretchers, portable stretchers, stair chairs, solid backboards, scoop stretchers, basket stretchers, or flexible stretchers. The term does not include personal mobility aids that recline at an angle or remain at a flat position, that are owned or leased for a period of at least one week by the individual using the equipment or the individual's guardian or representative, such as wheelchairs, personal gurneys, or banana carts.

Sec. 4   RCW 18.73.050 and 1990 c 269 s 7 are each amended to read as follows:
     The ((emergency medical services licensing and certification advisory)) committee shall:
     (1) Review all administrative rules pertaining to licensing and certification of emergency medical services proposed for adoption by the department under this chapter or under RCW 18.71.205 and advise the department of its recommendations.
     (2) Assist the department, at the department's request, to fulfill any duty or exercise any power under this chapter pertaining to emergency medical services licensing and certification.

Sec. 5   RCW 70.168.060 and 1990 c 269 s 8 are each amended to read as follows:
     The department, in consultation with and having solicited the advice of the emergency medical services and trauma care steering committee, shall:
     (1) Establish the following on a statewide basis:
     (a) By September 1990, minimum standards for facility, equipment, and personnel for level I, II, III, IV, and V trauma care services;
     (b) By September 1990, minimum standards for facility, equipment, and personnel for level I, I-pediatric, II, and III trauma-related rehabilitative services;
     (c) By September 1990, minimum standards for facility, equipment, and personnel for level I, II, and III pediatric trauma care services;
     (d) By September 1990, minimum standards required for verified prehospital trauma care services, including equipment and personnel;
     (e) Personnel training requirements and programs for providers of trauma care. The department shall design programs which are accessible to rural providers including on-site training;
     (f) Statewide emergency medical services and trauma care system objectives and priorities;
     (g) Minimum standards for the development of facility patient care protocols and prehospital patient care protocols and patient care procedures;
     (h) By July 1991, minimum standards for an effective emergency medical communication system;
     (i) Minimum standards for an effective emergency medical services transportation system; and
     (j) By July 1991, establish a program for emergency medical services and trauma care research and development;
     (2) Establish statewide standards, personnel training requirements and programs, system objectives and priorities, protocols and guidelines as required in subsection (1) of this section, by utilizing those standards adopted in the report of the Washington trauma advisory committee as authorized by chapter 183, Laws of 1988. In establishing standards for level IV or V trauma care services the department may adopt similar standards adopted for services provided in rural health care facilities authorized in chapter 70.175 RCW. The department may modify standards, personnel training requirements and programs, system objectives and priorities, and guidelines in rule if the department determines that such modifications are necessary to meet federal and other state requirements or are essential to allow the department and others to establish the system or should it determine that public health considerations or efficiencies in the delivery of emergency medical services and trauma care warrant such modifications;
     (3) Designate emergency medical services and trauma care planning and service regions as provided for in this chapter;
     (4) By July 1, 1992, establish the minimum and maximum number of hospitals and health care facilities in the state and within each emergency medical services and trauma care planning and service region that may provide designated trauma care services based upon approved regional emergency medical services and trauma care plans;
     (5) By July 1, 1991, establish the minimum and maximum number of prehospital providers in the state and within each emergency medical services and trauma care planning and service region that may provide verified trauma care services based upon approved regional emergency medical services and trauma care plans;
     (6) By July 1993, begin the designation of hospitals and health care facilities to provide designated trauma care services in accordance with needs identified in the statewide emergency medical services and trauma care plan;
     (7) By July 1990, adopt a format for submission of the regional plans to the department;
     (8) By July 1991, begin the review and approval of regional emergency medical services and trauma care plans;
     (9) By July 1992, prepare regional plans for those regions that do not submit a regional plan to the department that meets the requirements of this chapter;
     (10) By October 1992, prepare and implement the statewide emergency medical services and trauma care system plan incorporating the regional plans;
     (11) Coordinate the statewide emergency medical services and trauma care system to assure integration and smooth operation between the regions;
     (12) ((Facilitate coordination between the emergency medical services and trauma care steering committee and the emergency medical services licensing and certification advisory committee;
     (13))) Monitor the statewide emergency medical services and trauma care system;
     (((14))) (13) Conduct a study of all costs, charges, expenses, and levels of reimbursement associated with providers of trauma care services, and provide its findings and any recommendations regarding adequate and equitable reimbursement to trauma care providers to the legislature by July 1, 1991;
     (((15))) (14) Monitor the level of public and private payments made on behalf of trauma care patients to determine whether health care providers have been adequately reimbursed for the costs of care rendered such persons;
     (((16))) (15) By July 1991, design and establish the statewide trauma care registry as authorized in RCW 70.168.090 to (a) assess the effectiveness of emergency medical services and trauma care delivery, and (b) modify standards and other system requirements to improve the provision of emergency medical services and trauma care;
     (((17))) (16) By July 1991, develop patient outcome measures to assess the effectiveness of emergency medical services and trauma care in the system;
     (((18))) (17) By July 1993, develop standards for regional emergency medical services and trauma care quality assurance programs required in RCW 70.168.090;
     (((19))) (18) Administer funding allocated to the department for the purpose of creating, maintaining, or enhancing the statewide emergency medical services and trauma care system; and
     (((20))) (19) By October 1990, begin coordination and development of trauma prevention and education programs.

Sec. 6   RCW 18.135.030 and 1999 c 151 s 201 are each amended to read as follows:
     (1) ((The secretary or the secretary's designee may appoint members of the health care assistant profession and other health care practitioners, as defined in RCW 18.135.020(3), to serve in an ad hoc capacity to assist in carrying out the provisions of this chapter. The members shall provide advice on matters specifically identified and requested by the secretary. The members shall be reimbursed for travel expenses under RCW 43.03.050 and 43.03.060.
     (2))) In addition to any other authority provided by law, the secretary shall adopt rules necessary to:
     (a) Administer, implement, and enforce this chapter;
     (b) Establish the minimum requirements necessary for a health care facility or health care practitioner to certify a health care assistant capable of performing the functions authorized in this chapter; and
     (c) Establish minimum requirements for each and every category of health care assistant.
     (((3))) (2) The rules shall be adopted after fair consideration of input from representatives of each category. These requirements shall ensure that the public health and welfare are protected and shall include, but not be limited to, the following factors:
     (a) The education and occupational qualifications for the health care assistant category;
     (b) The work experience for the health care assistant category;
     (c) The instruction and training provided for the health care assistant category; and
     (d) The types of drugs or diagnostic agents which may be administered by injection by health care assistants working in a hospital or nursing home. The rules established under this subsection shall not prohibit health care assistants working in a health care facility other than a nursing home or hospital from performing the functions authorized under this chapter.

Sec. 7   RCW 43.41.220 and 1994 sp.s. c 9 s 873 are each amended to read as follows:
     (1) The ((governor)) joint legislative audit and review committee shall conduct a review of all of the boards and commissions identified under RCW 43.41.230 ((and, by January 8th of every odd-numbered year,)) over a six-year period, and submit to the legislature a report recommending which boards and commissions should be terminated or consolidated based upon the criteria set forth in subsection (3) of this section. The report must state which of the criteria ((were)) the joint legislative audit and review committee relied upon with respect to each recommendation. ((The governor shall submit an executive request bill by January 8th of every odd-numbered year to implement the recommendations by expressly terminating the appropriate boards and commissions and by providing for the transfer of duties and obligations under this section. The governor shall accept and review with special attention recommendations made, not later than June 1st of each even-numbered year, by the standing committees of the legislature in determining whether to include any board or commission in the report and bill required by this section.))
     (2) In addition to terminations and consolidations under subsection (1) of this section, the ((governor)) joint legislative audit and review committee may recommend the transfer of duties and obligations from a board or commission to another existing state entity.
     (3) ((In preparing his or her report and legislation, the governor)) The joint legislative audit and review committee shall make an evaluation based upon answers to the questions set forth in this subsection. The ((governor)) joint legislative audit and review committee shall give these criteria priority in the order listed.
     (a) Has the mission of the board or commission been completed or ceased to be critical to effective state government?
     (b) ((Does the work of the board or commission directly affect public safety, welfare, or health)) Is the entity complying with its legislative intent?
     (c) Can the work of the board or commission be effectively done by another state agency without adverse impact on public safety, welfare, or health?
     (d) ((Will termination of the board or commission have a significant adverse impact on state revenue because of loss of federal funds)) Is the entity meeting its performance measures?
     (e) Will termination ((of the board or commission save revenues, be cost neutral, or result in greater expenditures)) or consolidation of the board or commission result in fiscal or other efficiencies?
     (f) Is the work of the board or commission being done by another board, commission, or state agency?
     (g) Could the work of the board or commission be effectively done by a nonpublic entity?
     (h) ((Will termination of the board or commission result in a significant loss of expertise to state government?
     (i) Will termination of the board or commission result in operational efficiencies that are other than fiscal in nature?
     (j))) Could the work of the board or commission be done by an ad hoc committee?

Sec. 8   RCW 43.41.230 and 1994 sp.s. c 9 s 874 are each amended to read as follows:
     The boards and commissions to be reviewed by the ((governor)) joint legislative audit and review committee must be all entities that are required to be included in the list prepared by the office of financial management under RCW 43.88.505, other than entities established under: (1) Constitutional mandate; (2) court order or rule; (3) requirement of federal law; or (4) requirement as a condition of the state or a local government receiving federal financial assistance if, in the judgment of the ((governor)) joint legislative audit and review committee, no other state agency, board, or commission would satisfy the requirement.

NEW SECTION.  Sec. 9   The following acts or parts of acts are each repealed:
     (1) RCW 28B.04.085 (Displaced homemaker program advisory committee) and 2004 c 275 s 32 & 1987 c 230 s 2;
     (2) RCW 28B.115.050 (Planning committee -- Criteria for selecting participants) and 2004 c 275 s 70, 1991 c 332 s 18, & 1989 1st ex.s. c 9 s 719;
     (3) RCW 28A.600.130 (Washington scholars' program -- Planning committee -- Composition -- Duties) and 2006 c 263 s 916, 1995 1st sp.s. c 5 s 1, 1990 c 33 s 500, 1985 c 370 s 33, & 1981 c 54 s 4;
     (4) RCW 28B.12.040 (Board to develop and administer program--Agreements authorized, limitation -- Work study advisory committee) and 1994 c 130 s 4, 1993 c 385 s 3, 1985 c 370 s 58, & 1974 ex.s. c 177 s 4; and
     (5) RCW 18.73.040 (Emergency medical services licensing and certification advisory committee) and 1990 c 269 s 6, 1984 c 279 s 55, 1981 c 338 s 13, 1979 ex.s. c 261 s 2, 1975-'76 2nd ex.s. c 34 s 43, & 1973 1st ex.s. c 208 s 4.

NEW SECTION.  Sec. 10   This act takes effect July 1, 2008.