AN ACT Relating to developing a process to allow pilot programs for health care professionals to learn new skills or roles, use existing skills in new circumstances, and accelerate training; adding a new chapter to Title 18 RCW; and creating a new section.

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

(1) "Approved project" means an educational or training program approved by the department that does any of the following on a pilot program basis:

(a) Teaches new skills to existing categories of health care personnel;

(b) Uses existing skills in new circumstances or settings;

(c) Accelerates the training of existing categories of health care personnel; or

(d) Teaches new health care roles and skills to previously trained persons whose skills or license is not recognized within the state.

(2) "Department" means the department of health.

(3) "Health care services" means, within the scope of an approved project and the supervisor's scope of practice, the skills of a supervisor which may be taught to a trainee.

(4) "Sponsoring organization" means an organization such as a hospital, clinic, nonprofit educational institution, or government agency engaged in health or education activities that chooses to sponsor a project.

(5) "Supervisor" means, within the scope of an approved project and the individual's scope of practice, the person designated by the sponsoring organization who possesses the skills to be taught to or used by trainees and who is certified or licensed in Washington to perform the health care services involving the skills.

(6) "Trainee" means a person who, within the scope of the approved project, will be learning to perform health care tasks involving skills taught by a supervisor.

(a) The aim of the project;

(b) The intended impact on patient care, access to services, and cost;

(c) The category of person to be trained;

(d) The tasks to be taught;

(e) The numbers of trainees and supervisors who will participate in the project;

(f) A description of the health care facilities to be used for training students; and

(g) A description of the types of patients likely to be seen or treated.

(2) The application for a project must contain a description of the following:

(a) The evaluation process to be used in assessing project outcomes;

(b) The baseline data and information to be collected;

(c) The nature of program data that will be collected and the methods for collecting and analyzing the data;

(d) Provision for protecting the safety of patients seen or treated in the project; and

(e) A statement of previous experience in providing related health care services.

(2) The department may designate an innovative health workforce project as an approved project only where the project is submitted by a sponsoring organization. Individual supervisors and trainees may not sponsor a project and must collaborate with a sponsoring organization. Nothing in this section precludes approved projects from utilizing hospitals or clinics and the offices of physicians, dentists, pharmacists, and other clinical settings as training sites.

(3) The department may set a reasonable application fee for project submissions.

(4) The department shall consult appropriate professional societies, appropriate regulatory entities, and other relevant experts prior to designating approved projects.

(5) The department shall give priority for approval to projects operating in high need areas, such as health provider shortage areas, central city areas, and disproportionate share hospitals.

(6) The department may not approve a project for a period lasting more than twenty-four months, unless the department determines that the project is likely to contribute substantially to the availability of high quality health services in the state or a region or more time is needed to obtain valid and reliable study results.

(a) Define certain tasks or patient care functions that a supervisor may delegate to a trainee to perform under direct supervision and with the appropriate training; and

(b) Identify the amount and types of liability insurance to be provided by the participating parties.

(2) A trainee is held to the same standard of care as an individual otherwise legally qualified to perform the health care service or services performed by the trainee or supervisor. While the trainee and supervisor are responsible for their own individual actions, under the collaborative work agreement the sponsoring organization and the supervisor retain overall accountability for patient care. Participation in an approved project by a trainee or supervisor does not constitute unlicensed practice or unprofessional conduct under chapter 18.130 RCW.

(3) Any patient being seen or treated by a trainee must be apprised of that fact and must be given the opportunity to refuse treatment. If a patient is not competent to grant informed consent, then a trainee may not provide treatment unless consent is obtained from a person authorized to provide consent on behalf of the patient pursuant to RCW 7.70.065. Consent to treatment does not constitute assumption of the risk.

(2) The sponsoring organization shall report to the department on a predetermined basis. Reports must include, at a minimum, the following:

(a) Confirmation that the sponsoring organization, supervisor, and trainee are abiding by the standards and guidelines set by the department;

(b) Information pertaining to quality and patient safety including:

(i) Confirmation that quality of care and patient safety have not been compromised; and

(ii) Outcomes for selected quality metrics; and

(c) Confirmation that the sponsoring organization, supervisor, and trainee are on target to complete the approved project by the identified completion date.

(1) The aim of the project;

(2) Whether the aim was achieved;

(3) The degree to which the approved project had an impact on patient care, access to services, and cost;

(4) Recommendations based on approved project outcomes;

(5) The quality of care and patient acceptance of the project;

(6) The new health skills taught or the extent that existing skills have been reallocated;

(7) The implication of the project for existing licensure laws, including suggestions for changes in the law where appropriate;

(8) The implications of the project for health services curricula and for the health care delivery systems;

(9) The teaching methods used in the project; and

(10) The extent that persons with the new skills could find employment in the sponsoring organization or similar health care systems or facilities, assuming laws were changed to incorporate their skill.

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