Z-0055.1

SENATE BILL 5051

BySenators Bateman and Riccelli; by request of Washington State Board of Nursing

AN ACT Relating to consolidating regulatory authority for nursing assistants; amending RCW 18.79.070, 18.79.070, 18.88A.020, 18.88A.030, 18.88A.040, 18.88A.050, 18.88A.060, 18.88A.080, 18.88A.082, 18.88A.085, 18.88A.087, 18.88A.088, 18.88A.090, 18.88A.110, 18.88A.120, 18.88A.150, 18.88A.210, and 18.88B.060; reenacting and amending RCW 18.130.040; repealing RCW 18.88A.100; providing effective dates; and providing an expiration date.

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

Sec. 1. RCW 18.79.070 and 2022 c 240 s 32 are each amended to read as follows:

(1) The state ((nursing care quality assurance commission))board of nursing is established, consisting of ((fifteen))17 members to be appointed by the governor to four-year terms. The governor shall consider nursing members who are recommended for appointment by the appropriate professional associations in the state. No person may serve as a member of the ((commission))board for more than two consecutive full terms.

(2) There must be seven registered nurse members, two advanced registered nurse practitioner members, ((three))two licensed practical nurse members, two certified nursing assistant members, a registered nurse or licensed practical nurse member, and three public members on the ((commission))board. Each member of the ((commission))board must be a resident of this state.

(3)(a) Registered nurse members of the ((commission))board must:

(i) Be licensed as registered nurses under this chapter; and

(ii) Have had at least three years' experience in the active practice of nursing and have been engaged in that practice within two years of appointment.

(b) In addition:

(i) At least one member must be on the faculty at a four-year university nursing program;

(ii) At least one member must be on the faculty at a two-year community college nursing program;

(iii) At least two members must be staff nurses providing direct patient care; and

(iv) At least one member must be a nurse manager or a nurse executive.

(4) Advanced registered nurse practitioner members of the ((commission))board must:

(a) Be licensed as advanced registered nurse practitioners under this chapter; and

(b) Have had at least three years' experience in the active practice of advanced registered nursing and have been engaged in that practice within two years of appointment.

(5) Licensed practical nurse members of the ((commission))board must:

(a) Be licensed as licensed practical nurses under this chapter; and

(b) Have had at least three years' actual experience as a licensed practical nurse and have been engaged in practice as a practical nurse within two years of appointment.

(6) Certified nursing assistant members of the board must:

(8) Public members of the ((commission))board may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the ((commission))board, or have a material or financial interest in the rendering of health services regulated by the ((commission))board.

((In appointing the initial members of the *commission, it is the intent of the legislature that, to the extent possible, the governor appoint the existing members of the board of nursing and the board of practical nursing repealed under chapter 9, Laws of 1994 sp. sess. The governor may appoint initial members of the commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms.)) Members of the ((commission))board hold office until their successors are appointed.

When the secretary appoints pro tem members, reasonable efforts shall be made to ensure that at least one pro tem member is a registered nurse who is currently practicing and, in addition to meeting other minimum qualifications, has graduated from an associate or baccalaureate nursing program within three years of appointment.

Sec. 2. RCW 18.79.070 and 2024 c 239 s 5 are each amended to read as follows:

(1) The state board (([of nursing]))of nursing is established, consisting of ((fifteen))17 members to be appointed by the governor to four-year terms. The governor shall consider nursing members who are recommended for appointment by the appropriate professional associations in the state. No person may serve as a member of the board for more than two consecutive full terms.

(2) There must be seven registered nurse members, two advanced practice registered nurse members, ((three))two licensed practical nurse members, two certified nursing assistant members, a registered nurse or licensed practical nurse member, and three public members on the board. Each member of the board must be a resident of this state.

(3)(a) Registered nurse members of the board must:

(i) Be licensed as registered nurses under this chapter; and

(ii) Have had at least three years' experience in the active practice of nursing and have been engaged in that practice within two years of appointment.

(b) In addition:

(i) At least one member must be on the faculty at a four-year university nursing program;

(ii) At least one member must be on the faculty at a two-year community college nursing program;

(iii) At least two members must be staff nurses providing direct patient care; and

(iv) At least one member must be a nurse manager or a nurse executive.

(4) Advanced practice registered nurse members of the board must:

(a) Be licensed as advanced practice registered nurses under this chapter; and

(b) Have had at least three years' experience in the active practice of advanced practice registered nursing and have been engaged in that practice within two years of appointment.

(5) Licensed practical nurse members of the board must:

(a) Be licensed as licensed practical nurses under this chapter; and

(b) Have had at least three years' actual experience as a licensed practical nurse and have been engaged in practice as a practical nurse within two years of appointment.

(6) Certified nursing assistant members of the board must:

(8) Public members of the board may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the board, or have a material or financial interest in the rendering of health services regulated by the board.

Members of the board hold office until their successors are appointed.

When the secretary appoints pro tem members, reasonable efforts shall be made to ensure that at least one pro tem member is a registered nurse who is currently practicing and, in addition to meeting other minimum qualifications, has graduated from an associate or baccalaureate nursing program within three years of appointment.

Sec. 3. RCW 18.88A.020 and 2018 c 201 s 9008 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Alternative training" means a nursing assistant-certified program meeting criteria adopted by the ((commission))board under RCW 18.88A.087 to meet the requirements of a state-approved nurse aide competency evaluation program consistent with 42 U.S.C. Sec. 1395i-3(e) and (f) of the federal social security act.

(2) "Approved training program" means a nursing assistant-certified training program approved by the ((commission))board to meet the requirements of a state-approved nurse aide training and competency evaluation program consistent with 42 U.S.C. Sec. 1395i-3(e) and (f) of the federal social security act. For community college, vocational-technical institutes, skill centers, and secondary school as defined in chapter 28B.50 RCW, nursing assistant-certified training programs shall be approved by the ((commission))board in cooperation with the board for community and technical colleges or the superintendent of public instruction.

(3) (("Commission" means the Washington nursing care quality assurance commission))"Board" means the Washington state board of nursing.

(4) "Competency evaluation" means the measurement of an individual's knowledge and skills as related to safe, competent performance as a nursing assistant.

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

(6) "Executive director" means the executive director of the board hired pursuant to RCW 18.79.390.

(7) "Health care facility" means a nursing home, hospital licensed under chapter 70.41 or 71.12 RCW, hospice care facility, home health care agency, hospice agency, licensed or certified service provider under chapter 71.24 RCW other than an individual health care provider, or other entity for delivery of health care services as defined by the ((commission))board.

(((7)))(8) "Medication assistant" means a nursing assistant-certified with a medication assistant endorsement issued under RCW 18.88A.082 who is authorized, in addition to his or her duties as a nursing assistant-certified, to administer certain medications and perform certain treatments in a nursing home under the supervision of a registered nurse under RCW 18.88A.082.

(((8)))(9) "Nursing assistant" means an individual, regardless of title, who, under the direction and supervision of a registered nurse or licensed practical nurse, assists in the delivery of nursing and nursing-related activities to patients in a health care facility or an individual, regardless of title, who uses their nursing assistant credential to work as a long-term care worker as allowed by RCW 18.88B.041(1) (a) or (b). The two levels of nursing assistants are:

(a) "Nursing assistant-certified," an individual certified under this chapter; and

(b) "Nursing assistant-registered," an individual registered under this chapter.

(((9)))(10) "Nursing home" means a nursing home licensed under chapter 18.51 RCW.

(((10)))(11) "Secretary" means the secretary of health.

Sec. 4. RCW 18.88A.030 and 2021 c 203 s 16 are each amended to read as follows:

(1)(a) A nursing assistant may assist in the care of individuals as delegated by and under the direction and supervision of a licensed (registered) nurse or licensed practical nurse or work as a long-term care worker as allowed by RCW 18.88B.041(1) (a) or (b).

(b) A health care facility shall not assign a nursing assistant-registered to provide care until the nursing assistant-registered has demonstrated skills necessary to perform competently all assigned duties and responsibilities.

(c) Nothing in this chapter shall be construed to confer on a nursing assistant the authority to administer medication unless delegated as a specific nursing task pursuant to this chapter or to practice as a licensed (registered) nurse or licensed practical nurse as defined in chapter 18.79 RCW.

(2)(a) A nursing assistant employed in a nursing home must have successfully obtained certification through: (i) An approved training program and the competency evaluation within a period of time determined in rule by the ((commission))board; or (ii) alternative training and the competency evaluation prior to employment.

(b) Certification is voluntary for nursing assistants working in health care facilities other than nursing homes unless otherwise required by state or federal law or regulation.

(3) The ((commission))board may adopt rules to implement the provisions of this chapter.

Sec. 5. RCW 18.88A.040 and 2012 c 208 s 4 are each amended to read as follows:

(1) No person may practice or represent himself or herself as a nursing assistant-registered by use of any title or description without being registered by the ((department))board pursuant to this chapter.

(2) ((After October 1, 1990, no))No person may by use of any title or description, practice or represent himself or herself as a nursing assistant-certified without applying for certification, meeting the qualifications, and being certified by the ((department))board pursuant to this chapter.

(3) ((After July 1, 2013, no))No person may practice, or represent himself or herself by any title or description, as a medication assistant without a medication assistant endorsement issued under RCW 18.88A.082.

Sec. 6. RCW 18.88A.050 and 2012 c 208 s 5 are each amended to read as follows:

In addition to any other authority provided by law, the secretary has the authority to:

(1) Set all nursing assistant certification, registration, medication assistant endorsement, and renewal fees in accordance with RCW 43.70.250 and to collect and deposit all such fees in the health professions account established under RCW 43.70.320; and

(2) ((Establish forms, procedures, and the competency evaluation necessary to administer this chapter;

(11) Deny medication assistant endorsement to applicants who do not meet the requirements of RCW 18.88A.082))Employ staff that are hired and managed by the executive director provided that nothing contained in this section may be construed to alter any existing collective bargaining unit or the provisions of any existing collective bargaining agreement.

Sec. 7. RCW 18.88A.060 and 2012 c 208 s 6 are each amended to read as follows:

In addition to any other authority provided by law, the ((commission))board may:

(1) Determine minimum nursing assistant education requirements and approve training programs;

(2) Approve education and training programs and examinations for medication assistants as provided in RCW 18.88A.082;

(3) Define the prescriber-ordered treatments a medication assistant is authorized to perform under RCW 18.88A.082;

(4) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, the competency evaluation for applicants for nursing assistant certification, using the same competency evaluation for all applicants, whether qualifying to take the competency evaluation under an approved training program or alternative training;

(5) Establish forms and procedures for evaluation of an applicant's alternative training under criteria adopted pursuant to RCW 18.88A.087;

(6) Define and approve any experience requirement for nursing assistant certification;

(7) Adopt rules implementing a continuing competency evaluation program for nursing assistants; ((and))

(8) Establish forms, procedures, and the competency evaluation necessary to administer this chapter;

(18) Adopt rules to enable it to carry into effect the provisions of this chapter.

Sec. 8. RCW 18.88A.080 and 1994 sp.s. c 9 s 711 are each amended to read as follows:

(1) The ((secretary))board shall issue a registration to any applicant who pays any applicable fees and submits, on forms provided by the ((secretary))board, the applicant's name, address, and other information as determined by the ((secretary))board, provided there are no grounds for denial of registration or issuance of a conditional registration under this chapter or chapter 18.130 RCW.

(2) Applicants must file an application with the ((commission))board for registration within three days of employment.

Sec. 9. RCW 18.88A.082 and 2012 c 208 s 3 are each amended to read as follows:

(1) ((Beginning July 1, 2013, the secretary))The board shall issue a medication assistant endorsement to any nursing assistant-certified who meets the following requirements:

(a) Ongoing certification as a nursing assistant-certified in good standing under this chapter;

(b) Completion of a minimum number of hours of documented work experience as a nursing assistant-certified in a long-term care setting as defined in rule by the ((commission))board;

(c) Successful completion of an education and training program approved by the ((commission))board by rule, such as the model medication assistant-certified curriculum adopted by the national council of state boards of nursing. The education and training program must include training on the specific tasks listed in subsection (2) of this section as well as training on identifying tasks that a medication assistant may not perform under subsection (4) of this section;

(d) Passage of an examination approved by the ((commission))board by rule, such as the medication aide competency examination available through the national council of state boards of nursing; and

(e) Continuing competency requirements as defined in rule by the ((commission))board.

(2) Subject to subsection (3) of this section, a medication assistant may perform the following additional tasks:

(a) The administration of medications orally, topically, and through inhalation;

(b) The performance of simple prescriber-ordered treatments, including blood glucose monitoring, noncomplex clean dressing changes, pulse oximetry reading, and oxygen administration, to be defined by the ((commission))board by rule; and

(c) The documentation of the tasks in this subsection (2) on applicable medication or treatment forms.

(3) A medication assistant may only perform the additional tasks in subsection (2) of this section:

(a) In a nursing home;

(b) Under the direct supervision of a designated registered nurse who is on-site and immediately accessible during the medication assistant's shift. The registered nurse shall assess the resident prior to the medication assistant administering medications or treatments and determine whether it is safe to administer the medications or treatments. The judgment and decision to administer medications or treatments is retained by the registered nurse; and

(c) If, while functioning as a medication assistant, the primary responsibility of the medication assistant is performing the additional tasks. The ((commission))board may adopt rules regarding the medication assistant's primary responsibilities and limiting the duties, within the scope of practice of a nursing assistant-certified, that a nursing assistant-certified may perform while functioning as a medication assistant.

(4) A medication assistant may not:

(a) Accept telephone or verbal orders from a prescriber;

(b) Calculate medication dosages;

(c) Inject any medications;

(d) Perform any sterile task;

(e) Administer medications through a tube;

(f) Administer any Schedule I, II, or III controlled substance; or

(g) Perform any task that requires nursing judgment.

(5) Nothing in this section requires a nursing home to employ a nursing assistant-certified with a medication assistant endorsement.

(6) A medication assistant is responsible and accountable for his or her specific functions.

(7) A medication assistant's employer may limit or restrict the range of functions permitted under this section, but may not expand those functions.

Sec. 10. RCW 18.88A.085 and 2010 c 169 s 7 are each amended to read as follows:

(1) ((After January 1, 1990, the secretary))The board shall issue a nursing assistant certificate to any applicant who demonstrates to the ((secretary's))board's satisfaction that the following requirements have been met:

(a) Successful completion of an approved training program or successful completion of alternative training meeting established criteria adopted by the ((commission))board under RCW 18.88A.087; and

(b) Successful completion of the competency evaluation.

(2) In addition, applicants shall be subject to the grounds for denial of certification under chapter 18.130 RCW.

Sec. 11. RCW 18.88A.087 and 2021 c 203 s 17 are each amended to read as follows:

(1) The ((commission))board shall adopt criteria for evaluating an applicant's alternative training to determine the applicant's eligibility to take the competency evaluation for nursing assistant certification. At least one option adopted by the ((commission))board must allow an applicant to take the competency evaluation if he or she:

(a)(i) Is a certified home care aide pursuant to chapter 18.88B RCW; or

(ii) Is a certified medical assistant pursuant to a certification program accredited by a national medical assistant accreditation organization and approved by the ((commission))board; and

(b) Has successfully completed at least twenty-four hours of training that the ((commission))board determines is necessary to provide training equivalent to approved training on topics not addressed in the training specified for certification as a home care aide or medical assistant, as applicable. In the ((commission's))board's discretion, a portion of these hours may include clinical training.

(2)(a) The ((commission))board, in consultation with the secretary, the department of social and health services, and consumer, employer, and worker representatives, shall adopt rules to implement this section and to provide for a program of credentialing reciprocity to the extent required by this section between home care aide and medical assistant certification and nursing assistant certification. The secretary shall also adopt such rules as may be necessary to implement this section and the credentialing reciprocity program.

(b) Rules adopted under this section must be consistent with requirements under 42 U.S.C. Sec. 1395i-3(e) and (f) of the federal social security act relating to state-approved competency evaluation programs for certified nurse aides.

(((3) The secretary, in consultation with the commission, shall report annually by December 1st to the governor and the appropriate committees of the legislature on the progress made in achieving career advancement for certified home care aides and medical assistants into nursing practice.))

Sec. 12. RCW 18.88A.088 and 2011 c 32 s 10 are each amended to read as follows:

An applicant with military training or experience satisfies the training or experience requirements of this chapter unless the ((commission))board determines that the military training or experience is not substantially equivalent to the standards of this state.

Sec. 13. RCW 18.88A.090 and 2010 c 169 s 8 are each amended to read as follows:

(1) The ((commission))board shall examine each applicant, by a written or oral and a manual component of competency evaluation. The competency evaluation shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(2) Any applicant failing to make the required grade in the first competency evaluation may take up to three subsequent competency evaluations as the applicant desires upon prepaying a fee determined by the secretary under RCW 43.70.250 for each subsequent competency evaluation. Upon failing four competency evaluations, the secretary may invalidate the original application and require such remedial education before the person may take future competency evaluations.

The ((commission))board may approve a competency evaluation prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the credentialing requirements.

Sec. 14. RCW 18.88A.110 and 2010 c 169 s 9 are each amended to read as follows:

An applicant holding a credential in another state may be certified by endorsement to practice in this state without the competency evaluation if the ((secretary))board determines that the other state's credentialing standards are substantially equivalent to the standards in this state.

Sec. 15. RCW 18.88A.120 and 2012 c 208 s 7 are each amended to read as follows:

Applications for registration, certification, and medication assistant endorsement shall be submitted on forms provided by the ((secretary))board. The ((secretary))board may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for registration, certification, and medication assistant endorsement credentialing provided for in this chapter and chapter 18.130 RCW. Each applicant shall comply with administrative procedures, administrative requirements, and fees determined by the secretary under RCW 43.70.250 and 43.70.280.

Sec. 16. RCW 18.88A.150 and 2012 c 208 s 9 are each amended to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs unregistered, uncertified, or unendorsed practice, issuance of certificates, registrations, and medication assistant endorsements, and the discipline of persons registered or with certificates under this chapter. The ((secretary))board shall be the disciplinary authority under this chapter.

Sec. 17. RCW 18.88A.210 and 2008 c 146 s 12 are each amended to read as follows:

(1) A nursing assistant meeting the requirements of this section who provides care to individuals in community-based care settings or in-home care settings, as defined in RCW 18.79.260(3), may accept delegation of nursing care tasks by a registered nurse as provided in RCW 18.79.260(3).

(2) For the purposes of this section, "nursing assistant" means a nursing assistant-registered or a nursing assistant-certified. Nothing in this section may be construed to affect the authority of nurses to delegate nursing tasks to other persons, including licensed practical nurses, as authorized by law.

(3)(a) Before commencing any specific nursing care tasks authorized under this chapter, the nursing assistant must (i) provide to the delegating nurse a certificate of completion issued by the department of social and health services indicating the completion of basic core nurse delegation training, (ii) be regulated by the department of health pursuant to this chapter, subject to the uniform disciplinary act under chapter 18.130 RCW, and (iii) meet any additional training requirements identified by the ((nursing care quality assurance commission))board. Exceptions to these training requirements must adhere to RCW 18.79.260(3)(e) (vi).

(b) In addition to meeting the requirements of (a) of this subsection, before commencing the care of individuals with diabetes that involves administration of insulin by injection, the nursing assistant must provide to the delegating nurse a certificate of completion issued by the department of social and health services indicating completion of specialized diabetes nurse delegation training. The training must include, but is not limited to, instruction regarding diabetes, insulin, sliding scale insulin orders, and proper injection procedures.

Sec. 18. RCW 18.88B.060 and 2012 c 164 s 303 are each amended to read as follows:

(1) The department has the authority to:

(a) Establish forms, procedures, and examinations necessary to certify home care aides pursuant to this chapter;

(b) Hire clerical, administrative, and investigative staff as needed to implement this section;

(c) Issue certification as a home care aide to any applicant who has successfully completed the home care aide examination, and renew such certificates;

(d) Maintain the official record of all applicants and persons with certificates;

(e) Exercise disciplinary authority as authorized in chapter 18.130 RCW, except that the state board of nursing has disciplinary authority over nursing assistants licensed under chapter 18.88A RCW working as long-term care workers under this chapter; and

(f) Deny certification to applicants who do not meet training, competency examination, and conduct requirements, including background checks, for certification.

(2) The department shall adopt rules that establish the procedures, including criteria for reviewing an applicant's state and federal background checks, and examinations necessary to implement this section.

Sec. 19. RCW 18.130.040 and 2024 c 362 s 8, 2024 c 217 s 7, and 2024 c 50 s 5 are each reenacted and 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 therapists and businesses licensed under chapter 18.108 RCW;

(v) Dental hygienists licensed under chapter 18.29 RCW;

(vi) Acupuncturists or acupuncture and Eastern 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 registered, agency affiliated counselors registered, certified, or licensed, 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 or medication assistants endorsed under chapter 18.88A RCW;

(xiii))) Dietitians and nutritionists certified under chapter 18.138 RCW;

(((xiv)))(xiii) Substance use disorder professionals, substance use disorder professional trainees, or co-occurring disorder specialists certified under chapter 18.205 RCW;

(((xv)))(xiv) Sex offender treatment providers and certified affiliate sex offender treatment providers certified under chapter 18.155 RCW;

(((xvi)))(xv) Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;

(((xvii)))(xvi) Orthotists and prosthetists licensed under chapter 18.200 RCW;

(((xviii)))(xvii) Surgical technologists registered under chapter 18.215 RCW;

(((xix)))(xviii) Recreational therapists under chapter 18.230 RCW;

(((xx)))(xix) Animal massage therapists certified under chapter 18.240 RCW;

(((xxi)))(xx) Athletic trainers licensed under chapter 18.250 RCW;

(((xxii)))(xxi) Home care aides certified under chapter 18.88B RCW;

(((xxiii)))(xxii) Genetic counselors licensed under chapter 18.290 RCW;

(((xxiv)))(xxiii) Reflexologists certified under chapter 18.108 RCW;

(((xxv)))(xxiv) Medical assistants-certified, medical assistants-hemodialysis technician, medical assistants-phlebotomist, forensic phlebotomist, medical assistant-EMT, and medical assistants-registered certified and registered under chapter 18.360 RCW;

(((xxvi)))(xxv) Behavior analysts, assistant behavior analysts, and behavior technicians under chapter 18.380 RCW;

(((xxvii)))(xxvi) Birth doulas certified under chapter 18.47 RCW;

(((xxviii)))(xxvii) Music therapists licensed under chapter 18.233 RCW;

(((xxix)))(xxviii) Behavioral health support specialists certified under chapter 18.227 RCW; and

(((xxx)))(xxix) Certified peer specialists and certified peer specialist trainees under chapter 18.420 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, licenses and registrations issued under chapter 18.260 RCW, licenses issued under chapter 18.265 RCW, and certifications issued under chapter 18.350 RCW;

(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 chapter 18.57 RCW;

(viii) The pharmacy quality assurance commission as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;

(ix) The Washington medical commission as established in chapter 18.71 RCW governing licenses and registrations issued under chapters 18.71, 18.71A, and 18.71D 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 board of nursing as established in chapter 18.79 RCW governing licenses and registrations issued under that chapter and under chapter 18.80 RCW, and nursing assistants registered or certified or medication assistants endorsed under chapter 18.88A RCW;

(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;

(xv) The board of naturopathy established in chapter 18.36A RCW, governing licenses and certifications issued under that chapter; and

(xvi) The board of denturists established in chapter 18.30 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, which must be in compliance with chapter 18.415 RCW.

(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.

(2) Section 2 of this act takes effect June 30, 2027.

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