Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 2110
Brief Description: Concerning personnel for ambulance service interfacility specialty care transports.
Sponsors: Representatives Schmick, Tharinger, Engell, Parshley, Davis, Stuebe, Marshall and Simmons.
Brief Summary of Bill
  • Allows a registered nurse without emergency medical technician (EMT) certification to provide patient care during an interfacility specialty care transport by ambulance when no paramedic or nurse with EMT certification is available.
Hearing Date: 1/13/26
Staff: Alison Ryan (786-7296).
Background:

The Department of Health (DOH)   certifies four types of emergency medical services (EMS) professionals:  emergency medical responders (EMRs), emergency medical technicians (EMTs), advanced EMTs, and paramedics.

 

The DOH also licenses ambulance services and requires ambulances to meet specified minimum staffing requirements.  All ambulances must include at least one EMT, but other staffing requirements differ depending on the level of care provided by the ambulance service.  Levels of care include basic life support, intermediate life support, advanced life support, and specialty care transport.  Specialty care transports provide care for patients who are critically injured or ill and require care by a physician, registered nurse, or paramedic with special training.  Specialty care transports are interfacility, meaning the patient moves from one medical facility to another medical facility.

 

Department of Health regulations require that an ambulance service providing interfacility specialty care transports includes a minimum of two certified or licensed health care providers on each transport.  One of these providers must be either a paramedic or a registered nurse certified as an EMT.  The other provider must be a registered nurse, respiratory therapist, EMT, advanced EMT, paramedic, or another appropriate specialist as appointed by the physician director of the ambulance service. 
Summary of Bill:

When no paramedic or registered nurse with EMT certification is available, a registered nurse without an EMT certification may fulfill the provider requirement during an interfacility specialty care transport under the following circumstances:

  • there is a certified emergency medical service provider in the ambulance;
  • the nurse has appropriate competencies to provide care to the patient;
  • the ambulance service does not have a paramedic available; and
  • the sending hospital does not have a nurse with EMT certification available.

 

"Specialty care transport" means the level of care or service needed during an interfacility transport for a patient who is critically injured or ill and whose condition requires care by a physician, registered nurse with appropriate competencies, or a paramedic who has received special training and approval of the medical program director.

 

"Interfacility transport" means medical transport of a patient between recognized medical treatment facilities requested by a licensed health care provider. 
Appropriation: None.
Fiscal Note: Requested on January 5, 2026.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.