BILL REQ. #:  H-4688.1 

READ FIRST TIME 01/26/10.   

     AN ACT Relating to pain management; adding a new section to chapter 18.22 RCW; adding a new section to chapter 18.32 RCW; adding a new section to chapter 18.54 RCW; adding a new section to chapter 18.57 RCW; adding a new section to chapter 18.71 RCW; adding a new section to 18.79 RCW; and creating a new section.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 18.22 RCW to read as follows:
     (1) By December 1, 2010, the board shall repeal its rules on pain management, WAC 246-922-510 through 246-922-540.
     (2) By December 1, 2010, the board shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids.
     (3) The board shall adopt the rules in consultation with the agency medical directors' group, the department of health, the university of Washington, and the Washington state medical association.
     (4) The rules adopted under this section do not apply to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 2   A new section is added to chapter 18.32 RCW to read as follows:
     (1) By December 1, 2010, the commission shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids.
     (2) The commission shall adopt the rules in consultation with the agency medical directors' group, the department of health, the University of Washington, and the Washington state medical association.
     (3) The rules adopted under this section do not apply to dentists providing palliative, hospice, or other end-of-life care or to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 3   A new section is added to chapter 18.54 RCW to read as follows:
     (1) By December 1, 2010, the board shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought; and
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids.
     (2) The board shall adopt the rules in consultation with the agency medical directors' group, the department of health, the University of Washington, and the Washington state medical association.
     (3) The rules adopted under this section do not apply to optometrists providing palliative, hospice, or other end-of-life care or to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 4   A new section is added to chapter 18.57 RCW to read as follows:
     (1) By December 1, 2010, the board shall repeal its rules on pain management, WAC 246-853-510 through 246-853-540 and 246-854-120 through 246-854-150.
     (2) By December 1, 2010, the board shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids, particularly in the emergency department.
     (3) The board shall adopt the rules in consultation with the agency medical directors' group, the department of health, the University of Washington, and the Washington state medical association.
     (4) The rules adopted under this section shall not apply to osteopathic physicians and surgeons or osteopathic physician assistants providing palliative, hospice, or other end-of-life care or to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 5   A new section is added to chapter 18.71 RCW to read as follows:
     (1) By December 1, 2010, the commission shall repeal its rules on pain management, WAC 246-919-800 through 246-919-830.
     (2) By December 1, 2010, the commission shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids, particularly in the emergency department.
     (3) The commission shall adopt the rules in consultation with the agency medical directors' group, the department of health, the University of Washington, and the Washington state medical association.
     (4) The rules adopted under this section do not apply to physicians providing palliative, hospice, or other end-of-life care or to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 6   A new section is added to chapter 18.79 RCW to read as follows:
     (1) By December 1, 2010, the commission shall adopt new rules on chronic, noncancer pain management that contain the following elements:
     (a) Dosing criteria based on the interagency guideline on opioid dosing for chronic noncancer pain developed by the agency medical directors' group;
     (b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
     (c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
     (d) Guidance on tracking the use of opioids, particularly in the emergency department.
     (2) The commission shall adopt the rules in consultation with the agency medical directors' group, the department of health, the University of Washington, and the Washington state medical association.
     (3) The rules adopted under this section do not apply to advanced registered nurse practitioners and certified registered nurse anesthetists providing palliative, hospice, or other end-of-life care or to the management of acute pain caused by an injury or a surgical procedure, except to the extent that special requirements are needed for opioid-dependent patients experiencing such acute pain.

NEW SECTION.  Sec. 7   The boards and commissions required to adopt rules on pain management under sections 1 through 6 of this act shall work collaboratively to ensure that the rules are as uniform as practicable.