Passed by the Senate February 13, 2012 YEAS 46   ________________________________________ President of the Senate Passed by the House February 27, 2012 YEAS 97   ________________________________________ Speaker of the House of Representatives | I, Thomas Hoemann, Secretary of the Senate of the State of Washington, do hereby certify that the attached is ENGROSSED SECOND SUBSTITUTE SENATE BILL 5620 as passed by the Senate and the House of Representatives on the dates hereon set forth. ________________________________________ Secretary | |
Approved ________________________________________ Governor of the State of Washington | Secretary of State State of Washington |
State of Washington | 62nd Legislature | 2012 Regular Session |
READ FIRST TIME 01/10/12.
AN ACT Relating to the certification of dental anesthesia assistants; amending RCW 18.130.040, 18.32.030, and 18.120.020; and adding a new chapter to Title 18 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "Close supervision" has the same meaning as in RCW 18.260.010.
(2) "Commission" means the dental quality assurance commission
established in RCW 18.32.0351.
(3) "Department" means the department of health.
(4) "Direct visual supervision" means supervision by an oral and
maxillofacial surgeon or dental anesthesiologist by verbal command and
under direct line of sight.
(5) "Oral and maxillofacial surgeon" has the same meaning as in RCW
18.32.020.
(6) "Secretary" means secretary of health.
NEW SECTION. Sec. 2 (1) No person may practice or represent
himself or herself as a certified dental anesthesia assistant by use of
any title or description without being certified by the commission as
having met the standards established for certification under this
chapter.
(2) A certified dental anesthesia assistant may not practice or
represent himself or herself as a registered dental assistant without
being registered by the commission as having met the standards for
registration under chapter 18.260 RCW.
NEW SECTION. Sec. 3 (1) Each applicant for certification as a
dental anesthesia assistant must submit to the department:
(a) An application, on a form provided by the department, with the
applicant's name, address, and name and location of the oral and
maxillofacial surgeon or dental anesthesiologist where the assistant
will be performing his or her services;
(b) An application fee, as determined by the secretary of health as
provided in RCW 43.70.250 and 43.70.280; and
(c) Satisfactory evidence of:
(i) Completion of a commission-approved dental anesthesia assistant
training course, to include intravenous access or phlebotomy. This
training must include experience starting and maintaining intravenous
lines;
(ii) Completion of a commission-approved basic life support/cardiac
pulmonary resuscitation course; and
(iii) The valid general anesthesia permit of the oral and
maxillofacial surgeon or dental anesthesiologist where the assistant
will be performing his or her services.
(2) The commission may adopt rules for the requirements for renewal
of the certification, including continuing education requirements
consistent with national oral and maxillofacial surgery requirements.
(3) The secretary shall establish the administrative procedures,
administrative requirements, and fees for renewal of certifications as
provided in RCW 43.70.250 and 43.70.280.
NEW SECTION. Sec. 4 (1) Any dental anesthesia assistant
certified pursuant to this chapter shall perform the functions
authorized in this chapter only by delegation of authority from the
oral and maxillofacial surgeon or dental anesthesiologist and under the
supervision, as described in subsections (2) and (3) of this section,
of the oral and maxillofacial surgeon or dental anesthesiologist acting
within the scope of his or her license. The responsibility for
monitoring a patient and determining the selection of the drug, dosage,
and timing of all anesthetic medications rests solely with the oral and
maxillofacial surgeon or dental anesthesiologist.
(2) Under close supervision, the dental anesthesia assistant may:
(a) Initiate and discontinue an intravenous line for a patient
being prepared to receive intravenous medications, sedation, or general
anesthesia; and
(b) Adjust the rate of intravenous fluids infusion only to maintain
or keep the line patent or open.
(3) Under direct visual supervision, the dental anesthesia
assistant may:
(a) Draw up and prepare medications;
(b) Follow instructions to deliver medications into an intravenous
line upon verbal command;
(c) Adjust the rate of intravenous fluids infusion beyond a keep
open rate;
(d) Adjust an electronic device to provide medications, such as an
infusion pump;
(e) Administer emergency medications to a patient in order to
assist the oral and maxillofacial surgeon or dental anesthesiologist in
an emergency.
(4) Any oral and maxillofacial surgeon or dental anesthesiologist
delegating duties under this section must have a valid general
anesthesia permit and, if the dental anesthesia assistant does not
possess advanced cardiac life support training, must be current in such
training.
NEW SECTION. Sec. 5 The uniform disciplinary act, chapter 18.130
RCW, governs unlicensed practice, the issuance and denial of
certification, and the discipline of certified dental anesthesia
assistants under this chapter.
Sec. 6 RCW 18.130.040 and 2011 c 41 s 11 are each amended to read
as follows:
(1) This chapter applies only to the secretary and the boards and
commissions having jurisdiction in relation to the professions licensed
under the chapters specified in this section. This chapter does not
apply to any business or profession not licensed under the chapters
specified in this section.
(2)(a) The secretary has authority under this chapter in relation
to the following professions:
(i) Dispensing opticians licensed and designated apprentices under
chapter 18.34 RCW;
(ii) Midwives licensed under chapter 18.50 RCW;
(iii) Ocularists licensed under chapter 18.55 RCW;
(iv) Massage operators and businesses licensed under chapter 18.108
RCW;
(v) Dental hygienists licensed under chapter 18.29 RCW;
(vi) East Asian medicine practitioners licensed under chapter 18.06
RCW;
(vii) Radiologic technologists certified and X-ray technicians
registered under chapter 18.84 RCW;
(viii) Respiratory care practitioners licensed under chapter 18.89
RCW;
(ix) Hypnotherapists and agency affiliated counselors registered
and advisors and counselors certified under chapter 18.19 RCW;
(x) Persons licensed as mental health counselors, mental health
counselor associates, marriage and family therapists, marriage and
family therapist associates, social workers, social work associates -- advanced, and social work associates -- independent clinical under
chapter 18.225 RCW;
(xi) Persons registered as nursing pool operators under chapter
18.52C RCW;
(xii) Nursing assistants registered or certified under chapter
18.88A RCW;
(xiii) Health care assistants certified under chapter 18.135 RCW;
(xiv) Dietitians and nutritionists certified under chapter 18.138
RCW;
(xv) Chemical dependency professionals and chemical dependency
professional trainees certified under chapter 18.205 RCW;
(xvi) Sex offender treatment providers and certified affiliate sex
offender treatment providers certified under chapter 18.155 RCW;
(xvii) Persons licensed and certified under chapter 18.73 RCW or
RCW 18.71.205;
(xviii) Denturists licensed under chapter 18.30 RCW;
(xix) Orthotists and prosthetists licensed under chapter 18.200
RCW;
(xx) Surgical technologists registered under chapter 18.215 RCW;
(xxi) Recreational therapists [under chapter 18.230 RCW];
(xxii) Animal massage practitioners certified under chapter 18.240
RCW;
(xxiii) Athletic trainers licensed under chapter 18.250 RCW;
(xxiv) Home care aides certified under chapter 18.88B RCW; and
(xxv) Genetic counselors licensed under chapter 18.290 RCW.
(b) The boards and commissions having authority under this chapter
are as follows:
(i) The podiatric medical board as established in chapter 18.22
RCW;
(ii) The chiropractic quality assurance commission as established
in chapter 18.25 RCW;
(iii) The dental quality assurance commission as established in
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW
((and)), licenses and registrations issued under chapter 18.260 RCW,
and certifications issued under chapter 18.--- RCW (the new chapter
created in section 9 of this act);
(iv) The board of hearing and speech as established in chapter
18.35 RCW;
(v) The board of examiners for nursing home administrators as
established in chapter 18.52 RCW;
(vi) The optometry board as established in chapter 18.54 RCW
governing licenses issued under chapter 18.53 RCW;
(vii) The board of osteopathic medicine and surgery as established
in chapter 18.57 RCW governing licenses issued under chapters 18.57 and
18.57A RCW;
(viii) The board of pharmacy as established in chapter 18.64 RCW
governing licenses issued under chapters 18.64 and 18.64A RCW;
(ix) The medical quality assurance commission as established in
chapter 18.71 RCW governing licenses and registrations issued under
chapters 18.71 and 18.71A RCW;
(x) The board of physical therapy as established in chapter 18.74
RCW;
(xi) The board of occupational therapy practice as established in
chapter 18.59 RCW;
(xii) The nursing care quality assurance commission as established
in chapter 18.79 RCW governing licenses and registrations issued under
that chapter;
(xiii) The examining board of psychology and its disciplinary
committee as established in chapter 18.83 RCW;
(xiv) The veterinary board of governors as established in chapter
18.92 RCW; and
(xv) The board of naturopathy established in chapter 18.36A RCW.
(3) In addition to the authority to discipline license holders, the
disciplining authority has the authority to grant or deny licenses.
The disciplining authority may also grant a license subject to
conditions.
(4) All disciplining authorities shall adopt procedures to ensure
substantially consistent application of this chapter, the uniform
disciplinary act, among the disciplining authorities listed in
subsection (2) of this section.
Sec. 7 RCW 18.32.030 and 2007 c 269 s 15 are each amended to read
as follows:
The following practices, acts, and operations are excepted from the
operation of the provisions of this chapter:
(1) The rendering of dental relief in emergency cases in the
practice of his or her profession by a physician or surgeon, licensed
as such and registered under the laws of this state, unless the
physician or surgeon undertakes to or does reproduce lost parts of the
human teeth in the mouth or to restore or to replace in the human mouth
lost or missing teeth;
(2) The practice of dentistry in the discharge of official duties
by dentists in the United States federal services on federal
reservations, including but not limited to the armed services, coast
guard, public health service, veterans' bureau, or bureau of Indian
affairs;
(3) Dental schools or colleges approved under RCW 18.32.040, and
the practice of dentistry by students in accredited dental schools or
colleges approved by the commission, when acting under the direction
and supervision of Washington state-licensed dental school faculty;
(4) The practice of dentistry by licensed dentists of other states
or countries while appearing as clinicians at meetings of the
Washington state dental association, or component parts thereof, or at
meetings sanctioned by them, or other groups approved by the
commission;
(5) The use of roentgen and other rays for making radiographs or
similar records of dental or oral tissues, under the supervision of a
licensed dentist or physician;
(6) The making, repairing, altering, or supplying of artificial
restorations, substitutions, appliances, or materials for the
correction of disease, loss, deformity, malposition, dislocation,
fracture, injury to the jaws, teeth, lips, gums, cheeks, palate, or
associated tissues or parts; providing the same are made, repaired,
altered, or supplied pursuant to the written instructions and order of
a licensed dentist which may be accompanied by casts, models, or
impressions furnished by the dentist, and the prescriptions shall be
retained and filed for a period of not less than three years and shall
be available to and subject to the examination of the secretary or the
secretary's authorized representatives;
(7) The removal of deposits and stains from the surfaces of the
teeth, the application of topical preventative or prophylactic agents,
and the polishing and smoothing of restorations, when performed or
prescribed by a dental hygienist licensed under the laws of this state;
(8) A qualified and licensed physician and surgeon or osteopathic
physician and surgeon extracting teeth or performing oral surgery
pursuant to the scope of practice under chapter 18.71 or 18.57 RCW;
(9) The performing of dental operations or services by registered
dental assistants and licensed expanded function dental auxiliaries
holding a credential issued under chapter 18.260 RCW when performed
under the supervision of a licensed dentist, or by other persons not
licensed under this chapter if the person is licensed pursuant to
chapter 18.29, 18.57, 18.71, or 18.79 RCW as it applies to registered
nurses and advanced registered nurse practitioners, each while acting
within the scope of the person's permitted practice under the person's
license: PROVIDED HOWEVER, That such persons shall in no event perform
the following dental operations or services unless permitted to be
performed by the person under this chapter or chapters 18.29, 18.57,
18.71, 18.79 as it applies to registered nurses and advanced registered
nurse practitioners, and 18.260 RCW:
(a) Any removal of or addition to the hard or soft tissue of the
oral cavity;
(b) Any diagnosis of or prescription for treatment of disease,
pain, deformity, deficiency, injury, or physical condition of the human
teeth or jaws, or adjacent structure;
(c) Any administration of general or injected local anaesthetic of
any nature in connection with a dental operation, including intravenous
sedation;
(d) Any oral prophylaxis;
(e) The taking of any impressions of the teeth or jaw or the
relationships of the teeth or jaws, for the purpose of fabricating any
intra-oral restoration, appliance, or prosthesis; and
(10) The performing of dental services described in section 4 of
this act by dental anesthesia assistants certified under chapter 18.---RCW (the new chapter created in section 9 of this act) when working
under the supervision and direction of an oral and maxillofacial
surgeon or dental anesthesiologist.
Sec. 8 RCW 18.120.020 and 2010 c 286 s 14 are each amended to
read as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Applicant group" includes any health professional group or
organization, any individual, or any other interested party which
proposes that any health professional group not presently regulated be
regulated or which proposes to substantially increase the scope of
practice of the profession.
(2) "Certificate" and "certification" mean a voluntary process by
which a statutory regulatory entity grants recognition to an individual
who (a) has met certain prerequisite qualifications specified by that
regulatory entity, and (b) may assume or use "certified" in the title
or designation to perform prescribed health professional tasks.
(3) "Grandfather clause" means a provision in a regulatory statute
applicable to practitioners actively engaged in the regulated health
profession prior to the effective date of the regulatory statute which
exempts the practitioners from meeting the prerequisite qualifications
set forth in the regulatory statute to perform prescribed occupational
tasks.
(4) "Health professions" means and includes the following health
and health-related licensed or regulated professions and occupations:
Podiatric medicine and surgery under chapter 18.22 RCW; chiropractic
under chapter 18.25 RCW; dental hygiene under chapter 18.29 RCW;
dentistry under chapter 18.32 RCW; denturism under chapter 18.30 RCW;
dental anesthesia assistants under chapter 18.--- RCW (the new chapter
created in section 9 of this act); dispensing opticians under chapter
18.34 RCW; hearing instruments under chapter 18.35 RCW; naturopaths
under chapter 18.36A RCW; embalming and funeral directing under chapter
18.39 RCW; midwifery under chapter 18.50 RCW; nursing home
administration under chapter 18.52 RCW; optometry under chapters 18.53
and 18.54 RCW; ocularists under chapter 18.55 RCW; osteopathic medicine
and surgery under chapters 18.57 and 18.57A RCW; pharmacy under
chapters 18.64 and 18.64A RCW; medicine under chapters 18.71 and 18.71A
RCW; emergency medicine under chapter 18.73 RCW; physical therapy under
chapter 18.74 RCW; practical nurses under chapter 18.79 RCW;
psychologists under chapter 18.83 RCW; registered nurses under chapter
18.79 RCW; occupational therapists licensed under chapter 18.59 RCW;
respiratory care practitioners licensed under chapter 18.89 RCW;
veterinarians and veterinary technicians under chapter 18.92 RCW;
health care assistants under chapter 18.135 RCW; massage practitioners
under chapter 18.108 RCW; East Asian medicine practitioners licensed
under chapter 18.06 RCW; persons registered under chapter 18.19 RCW;
persons licensed as mental health counselors, marriage and family
therapists, and social workers under chapter 18.225 RCW; dietitians and
nutritionists certified by chapter 18.138 RCW; radiologic technicians
under chapter 18.84 RCW; and nursing assistants registered or certified
under chapter 18.88A RCW.
(5) "Inspection" means the periodic examination of practitioners by
a state agency in order to ascertain whether the practitioners'
occupation is being carried out in a fashion consistent with the public
health, safety, and welfare.
(6) "Legislative committees of reference" means the standing
legislative committees designated by the respective rules committees of
the senate and house of representatives to consider proposed
legislation to regulate health professions not previously regulated.
(7) "License," "licensing," and "licensure" mean permission to
engage in a health profession which would otherwise be unlawful in the
state in the absence of the permission. A license is granted to those
individuals who meet prerequisite qualifications to perform prescribed
health professional tasks and for the use of a particular title.
(8) "Professional license" means an individual, nontransferable
authorization to carry on a health activity based on qualifications
which include: (a) Graduation from an accredited or approved program,
and (b) acceptable performance on a qualifying examination or series of
examinations.
(9) "Practitioner" means an individual who (a) has achieved
knowledge and skill by practice, and (b) is actively engaged in a
specified health profession.
(10) "Public member" means an individual who is not, and never was,
a member of the health profession being regulated or the spouse of a
member, or an individual who does not have and never has had a material
financial interest in either the rendering of the health professional
service being regulated or an activity directly related to the
profession being regulated.
(11) "Registration" means the formal notification which, prior to
rendering services, a practitioner shall submit to a state agency
setting forth the name and address of the practitioner; the location,
nature and operation of the health activity to be practiced; and, if
required by the regulatory entity, a description of the service to be
provided.
(12) "Regulatory entity" means any board, commission, agency,
division, or other unit or subunit of state government which regulates
one or more professions, occupations, industries, businesses, or other
endeavors in this state.
(13) "State agency" includes every state office, department, board,
commission, regulatory entity, and agency of the state, and, where
provided by law, programs and activities involving less than the full
responsibility of a state agency.
NEW SECTION. Sec. 9 Sections 1 through 5 of this act constitute
a new chapter in Title