AN ACT Relating to the clarification and correction of statutes regarding the department of health; amending RCW 15.36.425, 16.70.010, 16.70.020, 18.06.010, 18.06.020, 18.06.030, 18.06.050, 18.06.060, 18.06.080, 18.06.110, 18.06.120, 18.06.130, 18.06.140, 18.06.160, 18.06.170, 18.06.180, 18.06.190, 18.19.020, 18.19.030, 18.19.050, 18.19.070, 18.19.080, 18.19.090, 18.19.100, 18.19.110, 18.19.120, 18.19.130, 18.19.140, 18.19.150, 18.19.160, 18.19.170, 18.19.180, 18.20.020, 18.22.010, 18.22.015, 18.22.040, 18.22.060, 18.22.081, 18.22.120, 18.22.130, 18.22.191, 18.25.006, 18.25.017, 18.25.020, 18.25.040, 18.25.070, 18.25.100, 18.26.020, 18.26.050, 18.26.070, 18.29.021, 18.29.045, 18.29.060, 18.29.071, 18.29.100, 18.29.110, 18.29.120, 18.29.130, 18.29.140, 18.29.150, 18.29.160, 18.29.180, 18.32.010, 18.32.030, 18.32.037, 18.32.040, 18.32.100, 18.32.110, 18.32.120, 18.32.160,18.32.170, 18.32.180, 18.32.190, 18.32.195, 18.32.220, 18.32.520, 18.32.534, 18.32.745, 18.34.020, 18.34.030, 18.34.070, 18.34.080, 18.34.110, 18.34.120, 18.35.010, 18.35.040, 18.35.060, 18.35.080, 18.35.090, 18.35.240, 18.35.250, 18.36A.020, 18.36A.030, 18.36A.040, 18.36A.050, 18.36A.060, 18.36A.070, 18.36A.080, 18.36A.090, 18.36A.100, 18.36A.110, 18.36A.120, 18.36A.130, 18.36A.140, 18.46.010, 18.50.005, 18.50.010, 18.50.020, 18.50.034, 18.50.040, 18.50.045, 18.50.050, 18.50.060, 18.50.102, 18.50.105, 18.50.115, 18.50.135, 18.50.140, 18.50.150, 18.52.020, 18.52.060, 18.52.070, 18.52.100, 18.52.110, 18.52.130, 18.52A.030, 18.52B.050, 18.52B.080, 18.52B.110, 18.52B.120, 18.52B.150, 18.52B.160, 18.52C.020, 18.52C.030, 18.52C.040, 18.53.021, 18.53.050, 18.53.060, 18.53.070, 18.53.100, 18.53.140, 18.54.050, 18.54.070, 18.54.140, 18.55.020, 18.55.030, 18.55.040, 18.55.050,18.55.060, 18.57.001, 18.57.020, 18.57.050, 18.57.080, 18.57.130, 18.59.020, 18.59.080, 18.59.090, 18.59.110, 18.59.150, 18.71.010, 18.71.040, 18.71.050, 18.71.051, 18.71.080, 18.71.095, 18.71.200, 18.71.205, 18.71.212, 18.71.215, 18.71A.070, 18.72.100, 18.72.120, 18.72.155, 18.72.306, 18.72.380, 18.72.400, 18.73.010, 18.73.030, 18.74.010, 18.74.020, 18.74.023, 18.74.035, 18.74.040, 18.74.050, 18.74.060, 18.74.070, 18.74.090, 18.74.095, 18.74.120, 18.76.020, 18.78.010, 18.78.080, 18.78.225, 18.83.010, 18.83.025, 18.83.045, 18.83.050, 18.83.060, 18.83.072, 18.83.080, 18.83.090, 18.83.105, 18.83.170, 18.83.190, 18.84.020, 18.84.040, 18.84.050, 18.84.060, 18.84.070, 18.84.080, 18.84.090, 18.84.100, 18.84.110, 18.88.030, 18.88.080, 18.88.090, 18.88.160, 18.88.175,18.88.190, 18.88.200, 18.88.220, 18.89.020, 18.89.050, 18.89.060, 18.89.070, 18.89.080, 18.89.090, 18.89.100, 18.89.110, 18.89.120, 18.89.130, 18.89.140, 18.92.015, 18.92.035, 18.92.040, 18.92.047, 18.92.070, 18.92.100, 18.92.115, 18.92.120, 18.92.130, 18.92.140, 18.92.145, 18.104.040, 18.104.080, 18.104.110, 18.108.010, 18.108.020, 18.108.025, 18.108.040, 18.108.060, 18.108.070, 18.108.073, 18.108.085, 18.135.020, 18.135.030, 18.135.050, 18.135.055, 18.135.065, 18.135.080, 18.138.010, 18.138.020, 18.138.030, 18.138.040, 18.138.050, 18.138.060, 18.138.070, 18.138.080, 18.138.090, 19.32.110, 28A.31.040, 28A.31.106, 28A.31.112, 28B.104.060, 43.03.028, 43.20B.110, 43.83B.380, 43.99D.025, 43.99E.025, 51.36.010, 69.30.010, 70.05.053, 70.05.054, 70.05.055, 70.05.060, 70.05.070, 70.05.080, 70.05.090, 70.05.100, 70.05.130, 70.08.050, 70.12.015, 70.12.070, 70.22.020, 70.22.030, 70.22.040, 70.22.050, 70.22.060,70.24.017, 70.24.100, 70.24.120, 70.24.130, 70.24.150, 70.24.280, 70.24.400, 70.24.410, 70.30.081, 70.33.010, 70.39.144, 70.40.020, 70.40.030, 70.40.150, 70.41.020, 70.41.200, 70.41.230, 70.41.240, 70.47.060, 70.50.010, 70.54.040, 70.54.140, 70.58.005, 70.58.107, 70.58.310, 70.58.320, 70.58.340, 70.62.210, 43.70.130, 70.83.020, 70.83.030, 70.83.040, 70.83B.020, 70.90.110, 70.90.130, 70.98.030, 70.98.050, 70.98.085, 70.104.010, 70.104.030,70.104.040, 70.104.050, 70.104.055, 70.104.057, 70.104.060, 70.104.080, 70.104.090, 70.116.010, 70.116.030, 70.118.020, 70.118.040, 70.119.020, 70.119.090, 70.119A.020, 70.119A.080, 70.121.020, 70.127.010, 70.142.020, 70.142.050, 80.50.030, 18.71.015, 18.71.030, 18.78.005, 18.78.020, 18.78.030, 18.78.040, 18.78.050, 18.78.055, 18.78.060, 18.78.080, 18.78.100, 70.38.025, and 70.38.111; reenacting and amending RCW 18.57A.040, 18.71A.040, 18.78.090, 42.17.2401, 70.39.050, and 70.39.070; and repealing RCW 18.78.110.

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

Sec. 1. Section 15.36.425, chapter 11, Laws of 1961 as last amended by section 20, chapter 354, Laws of 1989 and RCW 15.36.425 are each amended to read as follows:

The health authority or a physician authorized by him or her shall examine and take careful morbidity history of every person connected with a pasteurization plant, or about to be employed, whose work brings him or her in contact with the production, handling, storage, or transportation of milk, milk products, containers, or equipment. If such examination or history suggests that such person may be a carrier of or infected with the organisms of typhoid or paratyphoid fever or any other communicable diseases likely to be transmitted through milk, he or she shall secure appropriate specimens of body discharges and cause them to be examined in a laboratory approved by him or her or by the state department of ((~~social and health services~~)) health for such examinations, and if the results justify such persons shall be barred from such employment.

Such persons shall furnish such information, submit to such physical examinations, and submit such laboratory specimens as the health official may require for the purpose of determining freedom from infection.

Sec. 2. Section 1, chapter 72, Laws of 1971 and RCW 16.70.010 are each amended to read as follows:

The incidence of disease communicated to human beings by contact with pet animals has shown an increase in the past few years. The danger to human beings from such pets infected with disease communicable to humans has demonstrated the necessity for legislation to authorize the secretary of the department of ((~~social and health services~~)) health and the state board of health to take such action as is necessary to control the sale, importation, movement, transfer, or possession of such animals where it becomes necessary in order to protect the public health and welfare.

Sec. 3. Section 2, chapter 72, Laws of 1971 and RCW 16.70.020 are each amended to read as follows:

The following words or phrases as used in this chapter shall have the following meanings unless the context indicates otherwise:

(1) "Pet animals" means dogs (Canidae), cats (Felidae), monkeys and other similar primates, turtles, psittacine birds, skunks, or any other species of wild or domestic animals sold or retained for the purpose of being kept as a household pet.

(2) "Secretary" means the secretary of the department of ((~~social and health services~~)) health or his or her designee.

(3) "Department" means the department of ((~~social and health services~~)) health.

(4) "Board" means the Washington state board of health.

(5) "Person" means an individual, group of individuals, partnership, corporation, firm, or association.

(6) "Quarantine" means the placing and restraining of any pet animal or animals by direction of the secretary, either within a certain described and designated enclosure or area within this state, or the restraining of any such pet animal or animals from entering this state.

Sec. 4. Section 1, chapter 326, Laws of 1985 and RCW 18.06.010 are each amended to read as follows:

The following terms in this chapter shall have the meanings set forth in this section unless the context clearly indicates otherwise:

(1) "Acupuncture" means a health care service based on a traditional Oriental system of medical theory utilizing Oriental diagnosis and treatment to promote health and treat organic or functional disorders by treating specific acupuncture points or meridians. Acupuncture includes but is not necessarily limited to the following techniques:

(a) Use of acupuncture needles to stimulate acupuncture points and meridians;

(b) Use of electrical, mechanical, or magnetic devices to stimulate acupuncture points and meridians;

(d) Acupressure;

(e) Cupping;

(f) Dermal friction technique (gwa hsa);

(g) Infra-red;

(h) Sonopuncture;

(i) Laserpuncture;

(j) Dietary advice based on traditional Chinese medical theory; and

(k) Point injection therapy (aquapuncture).

(2) "Acupuncturist" means a person certified under this chapter.

(3) "Department" means the department of ((~~licensing~~)) health.

(4) ((~~"Director" means the director of licensing or the director's designee~~)) "Secretary" means the secretary of health or the secretary's designee.

Sec. 5. Section 2, chapter 326, Laws of 1985 and RCW 18.06.020 are each amended to read as follows:

(1) No one may hold themselves out to the public as an acupuncturist or certified acupuncturist or any derivative thereof which is intended to or is likely to lead the public to believe such a person is an acupuncturist or certified acupuncturist unless certified as provided for in this chapter.

(2) No one may use any configuration of letters after their name (including Ac.) which indicates a degree or formal training in acupuncture unless certified as provided for in this chapter.

(3) The ((~~director~~)) secretary may by rule proscribe or regulate advertising and other forms of patient solicitation which are likely to mislead or deceive the public as to whether someone is certified under this chapter.

Sec. 6. Section 3, chapter 326, Laws of 1985 and RCW 18.06.030 are each amended to read as follows:

Any person certified as provided for in this chapter may practice acupuncture irrespective of any other occupational licensing law. This authorization also extends to:

(1) The practice of acupuncture by a person who is a regular student in a school of acupuncture approved by the ((~~director: PROVIDED, HOWEVER, That~~)) secretary. The performance of such services must be pursuant only to a regular course of instruction or assignments from his or her instructor and ((~~that~~)) such services ((~~are~~)) may be performed only under the direct supervision and control of a person certified pursuant to this chapter or licensed under any other healing art whose scope of practice includes acupuncture; and

(2) The practice of acupuncture by any person licensed or certified to perform acupuncture in any other jurisdiction where such person is doing so in the course of regular instruction of a school of acupuncture approved by the ((~~director~~)) secretary or in an educational seminar sponsored by a professional organization of acupuncture((~~: PROVIDED, That~~)). In the latter case, the practice is supervised directly by a person certified pursuant to this chapter or licensed under any other healing art whose scope of practice includes acupuncture.

Sec. 7. Section 5, chapter 326, Laws of 1985 as amended by section 15, chapter 447, Laws of 1987 and RCW 18.06.050 are each amended to read as follows:

Any person seeking to be examined shall present to the ((~~director~~)) secretary at least forty-five days before the commencement of the examination:

(1) A written application on a form or forms provided by the ((~~director~~)) secretary setting forth under affidavit such information as the ((~~director~~)) secretary may require; and

(2) Proof that the candidate has:

(a) Successfully completed a course, approved by the ((~~director~~)) secretary, of didactic training in basic sciences and acupuncture over a minimum period of two academic years. The training shall include such subjects as anatomy, physiology, bacteriology, biochemistry, pathology, hygiene, and a survey of western clinical sciences. The basic science classes must be equivalent to those offered at the collegiate level. However, if the applicant is a licensed chiropractor under chapter 18.25 RCW or a naturopath licensed under chapter 18.36A RCW, the requirements of this subsection relating to basic sciences may be reduced by up to one year depending upon the extent of the candidate's qualifications as determined under rules adopted by the ((~~director~~)) secretary;

(b) Successfully completed a course, approved by the ((~~director~~)) secretary, of clinical training in acupuncture over a minimum period of one academic year. The training shall include a minimum of: (i) Twenty-nine quarter credits of supervised practice, consisting of at least four hundred separate patient treatments involving a minimum of one hundred different patients, and (ii) one hundred hours or nine quarter credits of observation which shall include case presentation and discussion.

Sec. 8. Section 6, chapter 326, Laws of 1985 and RCW 18.06.060 are each amended to read as follows:

The department shall consider for approval any school, program, apprenticeship, or tutorial which meets the requirements outlined in this chapter and provides the training required under RCW 18.06.050. Clinical and didactic training may be approved as separate programs or as a joint program. The process for approval shall be established by the ((~~director~~)) secretary by rule.

Sec. 9. Section 8, chapter 326, Laws of 1985 and RCW 18.06.080 are each amended to read as follows:

(1) The ((~~director of licensing~~)) secretary is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in acupuncture at least twice a year at such times and places as the ((~~director~~)) secretary may select. The examination shall be a written examination in English and may include a practical examination.

(2) The ((~~director~~)) secretary shall develop or approve a licensure examination in the subjects that the ((~~director~~)) secretary determines are within the scope of and commensurate with the work performed by certified acupuncturists and shall include but not necessarily be limited to anatomy, physiology, bacteriology, biochemistry, pathology, hygiene, and acupuncture. All application papers shall be deposited with the ((~~director~~)) secretary and there retained for ((~~a [at]~~)) at least one year, when they may be destroyed.

(3) If the examination is successfully passed, the ((~~director~~)) secretary shall confer on such candidate the title of Certified Acupuncturist.

Sec. 10. Section 11, chapter 326, Laws of 1985 as amended by section 9, chapter 150, Laws of 1987 and RCW 18.06.110 are each amended to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of certificates, and the disciplining of certificate holders under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

Sec. 11. Section 12, chapter 326, Laws of 1985 and RCW 18.06.120 are each amended to read as follows:

(1) Every person certified in acupuncture shall register with the ((~~director~~)) secretary annually and pay an annual renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 on or before the certificate holder's birth anniversary date. The certificate of the person shall be renewed for a period of one year or longer in the discretion of the ((~~director~~)) secretary.

(2) Any failure to register and pay the annual renewal registration fee shall render the certificate invalid. The certificate shall be reinstated upon: (a) Written application to the ((~~director~~)) secretary; (b) payment to the state of a penalty fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086; and (c) payment to the state of all delinquent annual certificate renewal fees.

(3) Any person who fails to renew his or her certification for a period of three years shall not be entitled to renew such certification under this section. Such person, in order to obtain a certification in acupuncture in this state, shall file a new application under this chapter, along with the required fee, and shall meet examination or continuing education requirements as the ((~~director~~)) secretary, by rule, provides.

(4) All fees collected under this section and RCW 18.06.060 shall be credited to the health professions account as required under RCW ((~~43.24.072~~)) 43.70.320.

Sec. 12. Section 13, chapter 326, Laws of 1985 and RCW 18.06.130 are each amended to read as follows:

The ((~~director~~)) secretary shall develop a form to be used by an acupuncturist to inform the patient of the acupuncturist's scope of practice and qualifications. All certificate holders shall bring the form to the attention of the patients in whatever manner the ((~~director~~)) secretary, by rule, provides.

Sec. 13. Section 14, chapter 326, Laws of 1985 and RCW 18.06.140 are each amended to read as follows:

Every certified acupuncturist shall develop a written plan for consultation, emergency transfer, and referral to other health care practitioners operating within the scope of their authorized practices. The written plan shall be submitted with the initial application for certification as well as annually thereafter with the certificate renewal fee to the department. The department may withhold certification or renewal of certification if the plan fails to meet the standards contained in rules promulgated by the ((~~director~~)) secretary.

When the acupuncturist sees patients with potentially serious disorders such as cardiac conditions, acute abdominal symptoms, and such other conditions, the acupuncturist shall immediately request a consultation or recent written diagnosis from a physician licensed under chapter 18.71 or 18.57 RCW. In the event that the patient with the disorder refuses to authorize such consultation or provide a recent diagnosis from such physician, acupuncture treatment shall not be continued.

Sec. 14. Section 16, chapter 326, Laws of 1985 and RCW 18.06.160 are each amended to read as follows:

The ((~~director~~)) secretary shall adopt rules in the manner provided by chapter 34.05 RCW as are necessary to carry out the purposes of this chapter.

Sec. 15. Section 17, chapter 326, Laws of 1985 and RCW 18.06.170 are each amended to read as follows:

(1) The acupuncture advisory committee is created. The committee shall be composed of one physician licensed under chapter 18.71 or 18.57 RCW, three acupuncturists certified under this chapter, and one public member, who does not have any financial interest in the rendering of health services.

(2) The ((~~director~~)) secretary shall appoint members to staggered terms so as to provide continuity in membership. Members shall serve at the pleasure of the ((~~director~~)) secretary but may not serve more than five years total. Members of the committee shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060.

(3) Each member of the committee shall receive fifty dollars for each day ((~~during which~~)) the member attends an official meeting of the group or performs statutorily prescribed duties approved by the ((~~director~~)) secretary.

(4) The committee shall meet only on the request of the ((~~director~~)) secretary and consider only those matters referred to it by the ((~~director~~)) secretary.

Sec. 16. Section 18, chapter 326, Laws of 1985 and RCW 18.06.180 are each amended to read as follows:

All persons registered as acupuncture assistants pursuant to chapter 18.71A or 18.57A RCW on July 28, 1985, shall be certified under this chapter by the ((~~director~~)) secretary without examination if they otherwise would qualify for certification under this chapter and apply for certification within one hundred twenty days of July 28, 1985.

Sec. 17. Section 19, chapter 326, Laws of 1985 and RCW 18.06.190 are each amended to read as follows:

The ((~~director~~)) secretary may certify a person without examination if such person is licensed or certified as an acupuncturist in another jurisdiction if, in the ((~~director's~~)) secretary's judgment, the requirements of that jurisdiction are equivalent to or greater than those of Washington state.

Sec. 18. Section 3, chapter 512, Laws of 1987 and RCW 18.19.020 are each amended to read as follows:

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

(1) "Certified marriage and family therapist" means a person certified to practice marriage and family therapy pursuant to RCW 18.19.130.

(2) "Certified mental health counselor" means a person certified to practice mental health counseling pursuant to RCW 18.19.120.

(3) "Certified social worker" means a person certified to practice social work pursuant to RCW 18.19.110.

(4) "Client" means an individual who receives or participates in counseling or group counseling.

(5) "Counseling" means employing any therapeutic techniques, including but not limited to social work, mental health counseling, marriage and family therapy, and hypnotherapy, for a fee that offer, assist or attempt to assist an individual or individuals in the amelioration or adjustment of mental, emotional, or behavioral problems, and includes therapeutic techniques to achieve sensitivity and awareness of self and others and the development of human potential. For the purposes of this chapter, nothing may be construed to imply that the practice of hypnotherapy is necessarily limited to counseling.

(6) "Counselor" means an individual, practitioner, therapist, or analyst who engages in the practice of counseling to the public for a fee, including for the purposes of this chapter, hypnotherapists.

(7) "Department" means the department of ((~~licensing~~)) health.

(8) ((~~"Director"~~)) "Secretary" means the ((~~director of the department~~)) secretary of health or the ((~~director's~~)) secretary's designee.

Sec. 19. Section 2, chapter 512, Laws of 1987 and RCW 18.19.030 are each amended to read as follows:

No person may, for a fee or as a part of his or her position as an employee of a state agency, practice counseling without being registered to practice by the department of ((~~licensing~~)) health under this chapter unless exempt under RCW 18.19.040. No person may represent himself or herself as a certified social worker, certified mental health counselor, or certified marriage and family therapist without being so certified by the department of ((~~licensing~~)) health under this chapter.

Sec. 20. Section 5, chapter 512, Laws of 1987 and RCW 18.19.050 are each amended to read as follows:

(1) In addition to any other authority provided by law, the ((~~director~~)) secretary has the following authority:

(a) To adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) To set all certification, registration, and renewal fees in accordance with RCW 43.24.086 and to collect and deposit all such fees in the health professions account established under RCW ((~~43.24.072~~)) 43.70.320;

(d) To hire clerical, administrative, and investigative staff as needed to implement this chapter;

(e) To issue a registration to any applicant who has met the requirements for registration;

(f) To set educational, ethical, and professional standards of practice for certification;

(g) To prepare and administer or cause to be prepared and administered an examination for all qualified applicants for certification;

(h) To establish criteria for evaluating the ability and qualifications of persons applying for a certificate, including standards for passing the examination and standards of qualification for certification to practice;

(i) To evaluate and designate those schools from which graduation will be accepted as proof of an applicant's eligibility to receive a certificate and to establish standards and procedures for accepting alternative training in lieu of such graduation;

(j) To issue a certificate to any applicant who has met the education, training, and conduct requirements for certification;

(k) To set competence requirements for maintaining certification; and

(l) To develop a dictionary of recognized professions and occupations providing counseling services to the public included under this chapter.

(2) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of certifications and registrations and the discipline of certified practitioners and registrants under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter. The absence of educational or training requirements for counselors registered under this chapter or the counselor's use of nontraditional nonabusive therapeutic techniques shall not, in and of itself, give the ((~~director~~)) secretary authority to unilaterally determine the training and competence or to define or restrict the scope of practice of such individuals.

(3) The department shall publish and disseminate information in order to educate the public about the responsibilities of counselors and the rights and responsibilities of clients established under this chapter. Solely for the purposes of administering this education requirement, the ((~~director~~)) secretary shall assess an additional fee for each registration and certification application and renewal, equal to five percent of the fee. The revenue collected from the assessment fee may be appropriated by the legislature for the department's use in educating consumers pursuant to this section. The authority to charge the assessment fee shall terminate on June 30, 1994.

Sec. 21. Section 7, chapter 512, Laws of 1987 and RCW 18.19.070 are each amended to read as follows:

(1) Within sixty days of July 26, 1987, the ((~~director~~)) secretary shall have authority to appoint advisory committees to further the purposes of this chapter. Each such committee shall be composed of five members, one member initially appointed for a term of one year, two for terms of two years, and two for terms of three years. No person may serve as a member of the committee for more than two consecutive terms.

The ((~~director~~)) secretary may remove any member of the advisory committees for cause as specified by rule. In the case of a vacancy, the ((~~director~~)) secretary shall appoint a person to serve for the remainder of the unexpired term.

(2) The advisory committees shall each meet at the times and places designated by the ((~~director~~)) secretary and shall hold meetings during the year as necessary to provide advice to the ((~~director~~)) secretary.

Each member of an advisory committee shall be reimbursed for travel expenses as authorized in RCW 43.03.050 and 43.03.060. In addition, members of the committees shall be compensated in accordance with RCW 43.03.240 when engaged in the authorized business of their committee.

(3) Members of an advisory committee shall be residents of this state. Each committee shall be composed of four individuals registered or certified in the category designated by the committee title, and one member who is a member of the public.

Sec. 22. Section 8, chapter 512, Laws of 1987 and RCW 18.19.080 are each amended to read as follows:

The ((~~director~~)) secretary shall keep an official record of all proceedings, a part of which record shall consist of a register of all applicants for registration or certification under this chapter, with the result of each application.

Sec. 23. Section 9, chapter 512, Laws of 1987 and RCW 18.19.090 are each amended to read as follows:

The ((~~director~~)) secretary shall issue a registration to any applicant who submits, on forms provided by the ((~~director~~)) secretary, the applicant's name, address, occupational title, name and location of business, and other information as determined by the ((~~director~~)) secretary, including information necessary to determine whether there are grounds for denial of registration or issuance of a conditional registration under this chapter or chapter 18.130 RCW. Applicants for registration shall register as counselors or may register as hypnotherapists if employing hypnosis as a modality. Applicants shall, in addition, provide in their titles a description of their therapeutic orientation, discipline, theory, or technique. Each applicant shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, which shall accompany the application.

Sec. 24. Section 10, chapter 512, Laws of 1987 and RCW 18.19.100 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the procedural requirements and fees for renewal of registrations. Failure to renew shall invalidate the registration and all privileges granted by the registration. Subsequent registration will require application and payment of a fee as determined by the ((~~director~~)) secretary under RCW 43.24.086.

Sec. 25. Section 12, chapter 512, Laws of 1987 and RCW 18.19.110 are each amended to read as follows:

(1) The department shall issue a certified social worker certificate to any applicant meeting the following requirements:

(a) A minimum of a master's degree from an accredited graduate school of social work approved by the ((~~director~~)) secretary;

(b) A minimum of two years of post-master's degree social work practice under the supervision of a social worker certified under this chapter or a person deemed acceptable to the ((~~director~~)) secretary, such experience consisting of at least thirty hours per week for two years or at least twenty hours per week for three years; and

(c) Successful completion of the examination in RCW 18.19.150, unless the applicant qualified under an exemption pursuant to subsection (2) of this section or RCW 18.19.160.

Applicants shall be subject to the grounds for denial or issuance of a conditional certificate in chapter 18.130 RCW.

(2) Except as provided in RCW 18.19.160, an applicant is exempt from the examination provisions of this chapter under the following conditions if application for exemption is made within twelve months after July 26, 1987:

(a) The applicant shall establish to the satisfaction of the ((~~director~~)) secretary that he or she has been engaged in the practice of social work as defined in this chapter for two of the previous four years; and

(b) The applicant has the following academic qualifications: (i) A doctorate or master's degree in social work from an accredited graduate school of social work or comparable and equivalent educational attainment as determined by the ((~~director~~)) secretary in consultation with the advisory committee; and (ii) two years of postgraduate social work experience under the supervision of a social worker who qualifies for certification under this chapter or under the supervision of any other professional deemed appropriate by the ((~~director~~)) secretary.

(3) Certified social work practice is that aspect of counseling that involves the professional application of social work values, principles, and methods by individuals trained in accredited social work graduate programs and requires knowledge of human development and behavior, knowledge of social systems and social resources, an adherence to the social work code of ethics, and knowledge of and sensitivity to ethnic minority populations. It includes, but is not limited to, evaluation, assessment, treatment of psychopathology, consultation, psychotherapy and counseling, prevention and educational services, administration, policy-making, research, and education directed toward client services.

Sec. 26. Section 13, chapter 512, Laws of 1987 and RCW 18.19.120 are each amended to read as follows:

(1) The department shall issue a certified mental health counselor certificate to any applicant meeting the following requirements:

(a) A master's or doctoral degree in mental health counseling or a related field from an approved school, or completion of at least thirty graduate semester hours or forty-five graduate quarter hours in the field of mental health counseling or the substantial equivalent in both subject content and extent of training;

(b) Postgraduate supervised mental health counseling practice that meets standards established by the ((~~director~~)) secretary;

(d) Twenty-four months of postgraduate professional experience working in a mental health counseling setting that meets the requirements established by the ((~~director~~)) secretary.

(2) No applicant may come before the ((~~director~~)) secretary for examination without the initial educational and supervisory credentials as required by this chapter, except that applicants completing a master's or doctoral degree program in mental health counseling or a related field from an approved graduate school before or within eighteen months of July 26, 1987, may qualify for the examination.

(3) For one year beginning on July 26, 1987, a person may apply for certification without examination. However, if the applicant's credentials are not adequate to establish competence to the ((~~director's~~)) secretary's satisfaction, the ((~~director~~)) secretary may require an examination of the applicant during the initial certification period. For the initial certification period, an applicant shall:

(a) Submit a completed application as required by the ((~~director~~)) secretary, who may require that the statements on the application be made under oath, accompanied by the application fee set by the ((~~director~~)) secretary in accordance with RCW 43.24.086;

(b) Have a master's or doctoral degree in counseling or a related field from an approved school; and

(c) Have submitted a completed application as required by the ((~~director~~)) secretary accompanied by the application fee set by the ((~~director~~)) secretary and a request for waiver from the requirements of (b) of this subsection, with documentation to show that the applicant has alternative training and experience equivalent to formal education and supervised experience required for certification.

(4) Certified mental health practice is that aspect of counseling that involves the rendering to individuals, groups, organizations, corporations, institutions, government agencies, or the general public a mental health counseling service emphasizing a wellness model rather than an illness model in the application of therapeutic principles, methods, or procedures of mental health counseling to assist the client in achieving effective personal, organizational, institutional, social, educational, and vocational development and adjustment and to assist the client in achieving independence and autonomy in the helping relationship.

Sec. 27. Section 14, chapter 512, Laws of 1987 and RCW 18.19.130 are each amended to read as follows:

(1) The department shall issue a certified marriage and family therapist certificate to any applicant meeting the following requirements:

(a)(i) A master's or doctoral degree in marriage and family therapy or its equivalent from an approved school that shows evidence of the following course work: (A) Marriage and family systems, (B) marriage and family therapy, (C) individual development, (D) assessment of psychopathology, (E) human sexuality, (F) research methods, (G) professional ethics and laws, and (H) a minimum of one year in the practice of marriage and family therapy under the supervision of a qualified marriage and family therapist;

(ii) Two years of postgraduate practice of marriage and family therapy under the supervision of a qualified marriage and family therapist; and

(iii) Passing scores on both written and oral examinations administered by the department for marriage and family therapists; or

(b) In the alternative, an applicant completing a master's or doctoral degree program in marriage and family therapy or its equivalent from an approved graduate school before or within eighteen months of July 26, 1987, may qualify for the examination.

(2) Except as provided in RCW 18.19.160, an applicant is exempt from the examination provisions of this section under the following conditions if application for exemption is made within twelve months after July 26, 1987:

(a) The applicant shall establish to the satisfaction of the ((~~director~~)) secretary that he or she has been engaged in the practice of marriage and family therapy as defined in this chapter for two of the previous four years; and

(b) The applicant has the following academic qualifications: (i) A doctorate or master's degree in marriage and family therapy or its equivalent from an approved graduate school; and (ii) two years of postgraduate experience under the supervision of a marriage and family therapist who qualifies for certification under this chapter or under the supervision of any other professional deemed appropriate by the ((~~director~~)) secretary.

(3) The practice of marriage and family therapy is that aspect of counseling that involves the assessment and treatment of impaired marriage or family relationships including, but not limited to, premarital and postdivorce relationships and the enhancement of marital and family relationships via use of educational, sociological, and psychotherapeutic theories and techniques.

Sec. 28. Section 17, chapter 512, Laws of 1987 and RCW 18.19.140 are each amended to read as follows:

Applications for certification shall be submitted on forms provided by the ((~~director~~)) secretary. The ((~~director~~)) secretary may require any information and documentation which reasonably relates to the need to determine whether the applicant meets the criteria for certification provided for in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, which shall accompany the application. The department shall not knowingly permit access to or use of its mailing list of certificate holders for commercial purposes.

Sec. 29. Section 16, chapter 512, Laws of 1987 and RCW 18.19.150 are each amended to read as follows:

(1) The date and location of the examinations required under this chapter shall be established by the ((~~director~~)) secretary. Applicants who have been found by the ((~~director~~)) secretary to meet the other requirements for certification will be scheduled for the next examination following the filing of the application. However, the applicant will not be scheduled for any examination taking place sooner than sixty days after the application is filed.

(2) The ((~~director~~)) secretary shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice. The examinations shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(3) The examination papers, all grading thereon, and the grading of any practical work shall be preserved for a period of not less than one year after the ((~~director~~)) secretary has published the results. All examinations shall be conducted by the ((~~director~~)) secretary by means of fair and wholly impartial methods.

(4) Any applicant who fails to make the required grade in the first examination is entitled to take up to three subsequent examinations as the applicant desires upon the prepayment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 for each subsequent examination. Upon failure of four examinations, the ((~~director~~)) secretary may invalidate the original application and require remedial education prior to admittance to future examinations.

(5) The ((~~director~~)) secretary may approve an examination prepared or administered, or both, by a private testing agency or association of licensing agencies for use by an applicant in meeting the licensing requirement.

Sec. 30. Section 19, chapter 512, Laws of 1987 and RCW 18.19.160 are each amended to read as follows:

(1) Upon receiving a written application, evidence of qualification and the required fee, the department shall issue a certificate for certification without examination to an applicant who is currently credentialed under the laws of another jurisdiction, if the requirements of the other jurisdiction are substantially equal to the requirements of this chapter.

(2) A person certified under this chapter who is or desires to be temporarily retired from practice in this state shall send written notice to the ((~~director~~)) secretary. Upon receipt of the notice, the person shall be placed upon the nonpracticing list. While on the list, the person is not required to pay the renewal fees and shall not engage in any such practice. In order to resume practice, application for renewal shall be made in the ordinary course with the renewal fee for the current period. Persons in a nonpracticing status for a period exceeding five years shall provide evidence of current knowledge or skill, by examination, as the ((~~director~~)) secretary may require.

Sec. 31. Section 15, chapter 512, Laws of 1987 and RCW 18.19.170 are each amended to read as follows:

A certificate issued under this chapter shall be renewed as determined by the ((~~director~~)) secretary who may establish rules governing continuing competence requirements. An additional fee may be set by the ((~~director~~)) secretary as a renewal requirement when certification has lapsed due to failure to renew prior to the expiration date.

Sec. 32. Section 11, chapter 512, Laws of 1987 and RCW 18.19.180 are each amended to read as follows:

An individual registered or certified under this chapter shall not disclose the written acknowledgment of the disclosure statement pursuant to RCW 18.19.060 nor any information acquired from persons consulting the individual in a professional capacity when that information was necessary to enable the individual to render professional services to those persons except:

(1) With the written consent of that person or, in the case of death or disability, the person's personal representative, other person authorized to sue, or the beneficiary of an insurance policy on the person's life, health, or physical condition;

(2) That a person registered or certified under this chapter is not required to treat as confidential a communication that reveals the contemplation or commission of a crime or harmful act;

(3) If the person is a minor, and the information acquired by the person registered or certified under this chapter indicates that the minor was the victim or subject of a crime, the person registered or certified may testify fully upon any examination, trial, or other proceeding in which the commission of the crime is the subject of the inquiry;

(4) If the person waives the privilege by bringing charges against the person registered or certified under this chapter;

(5) In response to a subpoena from a court of law or the ((~~director~~)) secretary. The ((~~director~~)) secretary may subpoena only records related to a complaint or report under chapter 18.130 RCW; or

(6) As required under chapter 26.44 RCW.

Sec. 33. Section 2, chapter 253, Laws of 1957 as last amended by section 1, chapter 329, Laws of 1989 and RCW 18.20.020 are each amended to read as follows:

As used in this chapter:

(1) "Aged person" means a person of the age sixty-five years or more, or a person of less than sixty-five years who by reason of infirmity requires domiciliary care.

(2) "Boarding home" means any home or other institution, however named, which is advertised, announced or maintained for the express or implied purpose of providing board and domiciliary care to three or more aged persons not related by blood or marriage to the operator. It shall not include facilities certified as group training homes pursuant to RCW 71A.22.040, nor any home, institution or section thereof which is otherwise licensed and regulated under the provisions of state law providing specifically for the licensing and regulation of such home, institution or section thereof. Nor shall it include any independent senior housing, independent living units in continuing care retirement communities, or other similar living situations including those subsidized by the department of housing and urban development.

(3) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.

(4) "Secretary" means the secretary of ((~~social and health services~~)) health.

(5) "Department" means the state department of ((~~social and health services~~)) health.

(6) "Authorized department" means any city, county, city-county health department or health district authorized by the secretary of ((~~social and health services~~)) health to carry out the provisions of this chapter.

Sec. 34. Section 1, chapter 38, Laws of 1917 as last amended by section 2, chapter 21, Laws of 1982 and RCW 18.22.010 are each amended to read as follows:

As used in this chapter, the following terms have the meanings indicated unless the context clearly requires otherwise.

(1) The practice of podiatry means the diagnosis and the medical, surgical, mechanical, manipulative, and electrical treatments of ailments of the human foot. A podiatrist is a podiatric physician and surgeon of the foot licensed to treat ailments of the foot, except:

(a) Amputation of the foot;

(b) The administration of a spinal anesthetic or any anesthetic, which renders the patient unconscious, or the administration and prescription of drugs including narcotics, other than required to perform the services authorized for the treatment of the feet; and

(2) "Board" means the Washington state podiatry board.

(3) "Department" means the department of ((~~licensing~~)) health.

(4) ((~~"Director"~~)) "Secretary" means the ((~~director of licensing~~)) secretary of health.

(5) "Approved school of podiatry" means a school approved by the board, which may consider official recognition of the Council of Education of the American Podiatry Association in determining the approval of schools of podiatry.

Sec. 35. Section 10, chapter 21, Laws of 1982 as amended by section 18, chapter 259, Laws of 1986 and RCW 18.22.015 are each amended to read as follows:

The board shall:

(1) Administer all laws placed under its jurisdiction;

(2) Prepare, grade, and administer or determine the nature, grading, and administration of examinations for applicants for podiatrist licenses;

(3) Examine and investigate all applicants for podiatrist licenses and certify to the ((~~director~~)) secretary all applicants it judges to be properly qualified.

The board may adopt any rules which it considers necessary or proper to carry out the purposes of this chapter.

Sec. 36. Section 6, chapter 38, Laws of 1917 as last amended by section 5, chapter 21, Laws of 1982 and RCW 18.22.040 are each amended to read as follows:

Before any person shall be permitted to take an examination for the issuance of a podiatry license, the applicant shall furnish the ((~~director of licensing~~)) secretary and the board with satisfactory proof that:

(1) The applicant is eighteen years of age or over;

(2) The applicant is of good moral character;

(3) The applicant has successfully completed a four-year course in a high school or its equivalent and a two-year college course leading toward the baccalaureate degree, not including correspondence courses, before beginning a course in podiatry in an approved school of podiatry; and

(4) The applicant has received a diploma or certificate of graduation from a legally incorporated, regularly established and approved school of podiatry.

Sec. 37. Section 14, chapter 52, Laws of 1957 as last amended by section 11, chapter 7, Laws of 1985 and RCW 18.22.060 are each amended to read as follows:

Every applicant for a license to practice podiatry shall pay to the state treasurer a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

An applicant who fails to pass an examination satisfactorily is entitled to reexamination at a meeting called for the examination of applicants, upon the payment of a fee for each reexamination determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 38. Section 3, chapter 97, Laws of 1965 as last amended by section 12, chapter 7, Laws of 1985 and RCW 18.22.081 are each amended to read as follows:

Any applicant who has been examined and licensed under the laws of another state which grants the holders of certificates from the proper authorities of this state the full privileges of practice within its borders or an applicant who has satisfactorily passed examinations given by the national board of podiatry examiners may, in the discretion of the board and after examination by the board in the clinical application of dermatology, bio-mechanics, surgery, medicine, podiatric medicine, radiology, pharmacology, laboratory procedures, and any other subjects the board may require by ((~~regulation~~)) rule, be granted a license on the payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 to the state treasurer if the applicant has not previously failed to pass an examination held in this state. If the applicant was licensed in another state, the applicant must file with the ((~~director~~)) secretary a copy of the license certified by the proper authorities of the issuing state to be a full and true copy thereof, and must show that the standards, eligibility requirements, and examinations of that state are at least equal in all respects to those of this state.

Sec. 39. Section 6, chapter 149, Laws of 1955 as last amended by section 13, chapter 7, Laws of 1985 and RCW 18.22.120 are each amended to read as follows:

Every person practicing podiatry must renew his or her license each year and pay a renewal fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Failure to register and pay the annual renewal fee invalidates the license, but it shall be reinstated upon written application to the ((~~director~~)) secretary and payment to the state of a penalty of ten dollars, together with all delinquent annual renewal fees((~~: PROVIDED, That~~)). A person who fails to renew his or her license for a period of three years is not entitled to renewal under this section but must file an original application as provided in this chapter, and pay the required fee. The board may permit an applicant whose license has lapsed in this manner to be licensed without examination if it determines that the applicant meets all the requirements for licensure in this state and is competent to engage in the practice of podiatry.

Sec. 40. Section 5, chapter 38, Laws of 1917 as amended by section 11, chapter 77, Laws of 1973 and RCW 18.22.130 are each amended to read as follows:

The ((~~director~~)) secretary shall keep in a book kept for that purpose, a record showing the name, age, place of residence, the time spent in the study and practice of podiatry, the time spent in schools of podiatry, and the date of graduation therefrom and the degree if any, and the date and number of the license issued to such applicant, and whether the same was issued upon or without examination; and the copy of such record certified by the ((~~director~~)) secretary shall be prima facie evidence of the facts therein stated in all courts and all actions and proceedings where proof of such facts is competent.

Sec. 41. Section 13, chapter 149, Laws of 1955 and RCW 18.22.191 are each amended to read as follows:

The ((~~director of licensing~~)) secretary of health shall have the power and duty to formulate and prescribe such rules ((~~and regulations~~)) as may be reasonable in the proper administration of this chapter.

Sec. 42. Section 12, chapter 258, Laws of 1989 and RCW 18.25.006 are each amended to read as follows:

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

(1) "Department" means the department of ((~~licensing~~)) health.

(2) ((~~"Director"~~)) "Secretary" means the ((~~director of the department of licensing~~)) secretary of health or the ((~~director's~~)) secretary's designee.

(3) "Chiropractor" means an individual licensed under this chapter.

(4) "Board" means the Washington state board of chiropractic examiners.

Sec. 43. Section 2, chapter 53, Laws of 1959 as last amended by section 23, chapter 259, Laws of 1986 and RCW 18.25.017 are each amended to read as follows:

The board shall meet as soon as practicable after appointment, and shall elect a chairman and a secretary from its members. Meetings shall be held at least once a year at such place as the ((~~director of licensing~~)) secretary shall determine, and at such other times and places as he or she deems necessary.

The board may make such rules ((~~and regulations~~)), not inconsistent with this chapter, as it deems necessary to carry out the provisions of this chapter.

Each member shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060, all to be paid out of the general fund on vouchers approved by the ((~~director~~)) secretary, but not to exceed in the aggregate the amount of fees collected as provided in this chapter.

Sec. 44. Section 5, chapter 5, Laws of 1919 as last amended by section 3, chapter 258, Laws of 1989 and RCW 18.25.020 are each amended to read as follows:

(1) Any person not now licensed to practice chiropractic in this state and who desires to practice chiropractic in this state, before it shall be lawful for him or her to do so, shall make application therefor to the ((~~director~~)) secretary, upon such form and in such manner as may be adopted and directed by the ((~~director~~)) secretary. Each applicant who matriculates to a chiropractic college after January 1, 1975, shall have completed not less than one-half of the requirements for a baccalaureate degree at an accredited and approved college or university and shall be a graduate of a chiropractic school or college accredited and approved by the board of chiropractic examiners and shall show satisfactory evidence of completion by each applicant of a resident course of study of not less than four thousand classroom hours of instruction in such school or college. Applications shall be in writing and shall be signed by the applicant in his or her own handwriting and shall be sworn to before some officer authorized to administer oaths, and shall recite the history of the applicant as to his or her educational advantages, his or her experience in matters pertaining to a knowledge of the care of the sick, how long he or she has studied chiropractic, under what teachers, what collateral branches, if any, he or she has studied, the length of time he or she has engaged in clinical practice; accompanying the same by reference therein, with any proof thereof in the shape of diplomas, certificates, and shall accompany said application with satisfactory evidence of good character and reputation.

(2) There shall be paid to the ((~~director~~)) secretary by each applicant for a license, a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 which shall accompany application and a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, which shall be paid upon issuance of license. Like fees shall be paid for any subsequent examination and application.

Sec. 45. Section 14, chapter 5, Laws of 1919 as last amended by section 15, chapter 7, Laws of 1985 and RCW 18.25.040 are each amended to read as follows:

Persons licensed to practice chiropractic under the laws of any other state having equal requirements of this chapter, may, in the discretion of the board of chiropractic examiners, and after examination by the board in principles of chiropractic, x-ray, and adjusting, as taught by chiropractic schools and colleges, be issued a license to practice in this state without further examination, upon payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 46. Section 10, chapter 5, Laws of 1919 as last amended by section 5, chapter 258, Laws of 1989 and RCW 18.25.070 are each amended to read as follows:

(1) Every person practicing chiropractic shall, as a prerequisite to annual renewal of license, submit to the ((~~director~~)) secretary at the time of application therefor, satisfactory proof showing attendance of at least twenty-five hours during the preceding twelve-month period, at one or more chiropractic symposiums which are recognized and approved by the board of chiropractic examiners((~~: PROVIDED, That~~)). The board may, for good cause shown, waive said attendance. The following guidelines for such symposiums shall apply:

(a) The board shall set criteria for the course content of educational symposia concerning matters which are recognized by the state of Washington chiropractic licensing laws; it shall be the licensee's responsibility to determine whether the course content meets these criteria;

(b) The board shall adopt standards for distribution of annual continuing education credit requirements;

(c) Rules shall be adopted by the board for licensees practicing and residing outside the state who shall meet all requirements established by the board by rules ((~~and regulations~~)).

(2) Every person practicing chiropractic within this state shall pay on or before his or her birth anniversary date, after a license is issued to him or her as herein provided, to said ((~~director~~)) secretary a renewal license fee to be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The ((~~director~~)) secretary shall, thirty days or more before the birth anniversary date of each chiropractor in the state, mail to that chiropractor a notice of the fact that the renewal fee will be due on or before his or her birth anniversary date. Nothing in this chapter shall be construed so as to require that the receipts shall be recorded as original licenses are required to be recorded.

The failure of any licensed chiropractor to pay his or her annual license renewal fee within thirty days of license expiration shall work a forfeiture of his or her license. It shall not be reinstated except upon evidence that continuing educational requirements have been fulfilled and the payment of a penalty to be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, together with all annual license renewal fees delinquent at the time of the forfeiture, and those for each year thereafter up to the time of reinstatement. Should the licentiate allow his or her license to elapse for more than three years, he or she may be reexamined as provided for in RCW 18.25.040 at the discretion of the board.

Sec. 47. Section 16, chapter 5, Laws of 1919 and RCW 18.25.100 are each amended to read as follows:

It shall be the duty of the several prosecuting attorneys of this state to prosecute all persons charged with the violation of any of the provisions of this chapter. It shall be the duty of the ((~~director of licensing~~)) secretary to aid said attorneys of this state in the enforcement of this chapter.

Sec. 48. Section 2, chapter 171, Laws of 1967 as amended by section 8, chapter 258, Laws of 1989 and RCW 18.26.020 are each amended to read as follows:

Terms used in this chapter shall have the meaning set forth in this section unless the context clearly indicates otherwise:

(1) "Board" means the chiropractic disciplinary board;

(2) "License" means a certificate of license to practice chiropractic in this state as provided for in chapter 18.25 RCW;

(3) "Members" means members of the chiropractic disciplinary board;

(4) "Department" means the department of ((~~licensing~~)) health;

(5) ((~~"Director"~~)) "Secretary" means the ((~~director~~)) secretary of the department of ((~~licensing~~)) health or the ((~~director's~~)) secretary's designee;

(6) "Chiropractor" means a person licensed under chapter 18.25 RCW.

Sec. 49. Section 5, chapter 171, Laws of 1967 as amended by section 21, chapter 158, Laws of 1979 and RCW 18.26.050 are each amended to read as follows:

Vacancies on the board shall be filled as provided for initially for the position for which a vacancy exists. The vacancy shall be filled within thirty days of the existence thereof and the ((~~director of licensing~~)) secretary shall be informed of the name and address of the person named to fill the vacancy.

Sec. 50. Section 2, chapter 46, Laws of 1980 as amended by section 28, chapter 287, Laws of 1984 and RCW 18.26.070 are each amended to read as follows:

Members of the board may be compensated in accordance with RCW 43.03.240 and may be paid their travel expenses while engaged in the business of the board in accordance with RCW 43.03.050 and 43.03.060, with such reimbursement to be paid out of the general fund on vouchers signed by the ((~~director of licensing~~)) secretary.

Sec. 51. Section 1, chapter 202, Laws of 1989 and RCW 18.29.021 are each amended to read as follows:

(1) The department shall issue a license to any applicant who, as determined by the ((~~director~~)) secretary:

(a) Has successfully completed an educational program approved by the ((~~director~~)) secretary. This educational program shall include course work encompassing the subject areas within the scope of the license to practice dental hygiene in the state of Washington;

(b) Has successfully completed an examination administered by the dental hygiene examining committee; and

(c) Has not engaged in unprofessional conduct or is not unable to practice with reasonable skill and safety as a result of a physical or mental impairment.

(2) Applications for licensure shall be submitted on forms provided by the department. The department may require any information and documentation necessary to determine if the applicant meets the criteria for licensure as provided in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The fee shall be submitted with the application.

Sec. 52. Section 29, chapter 202, Laws of 1989 and RCW 18.29.045 are each amended to read as follows:

An applicant holding a valid license and currently engaged in practice in another state may be granted a license without examination required by this chapter, on the payment of any required fees, if the ((~~director~~)) secretary in consultation with the advisory committee determines that the other state's licensing standards are substantively equivalent to the standards in this state((~~: PROVIDED, That~~)). The ((~~director~~)) secretary in consultation with the advisory committee may require the applicant to: (1) File with the ((~~director~~)) secretary documentation certifying the applicant is licensed to practice in another state; and (2) provide information as the ((~~director~~)) secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW and to demonstrate to the ((~~director~~)) secretary a knowledge of Washington law pertaining to the practice of dental hygiene.

Sec. 53. Section 31, chapter 16, Laws of 1923 as last amended by section 12, chapter 202, Laws of 1989 and RCW 18.29.060 are each amended to read as follows:

Upon passing an examination and meeting the requirements as provided in RCW 18.29.021, the ((~~director of licensing~~)) secretary of health shall issue to the successful applicant a license as dental hygienist. The license shall be displayed in a conspicuous place in the operation room where such licensee shall practice.

Sec. 54. Section 2, chapter 202, Laws of 1989 and RCW 18.29.071 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the requirements for renewal of licenses. The ((~~director~~)) secretary shall establish a renewal and late renewal penalty fee as provided in RCW 43.24.086. Failure to renew invalidates the license and all privileges granted by the license. The ((~~director~~)) secretary shall determine by rule whether a license shall be canceled for failure to renew and shall establish procedures and requirements for relicensure.

Sec. 55. Section 36, chapter 16, Laws of 1923 as amended by section 34, chapter 158, Laws of 1979 and RCW 18.29.100 are each amended to read as follows:

Any person who shall violate any provision of this chapter shall be guilty of a misdemeanor. It shall be the duty of the prosecuting attorney of each county to prosecute all cases involving a violation of this chapter arising within his county. The attorney general may assist in such prosecutions and shall appear at all hearings when requested to do so by the ((~~director of licensing~~)) secretary of health.

Sec. 56. Section 3, chapter 202, Laws of 1989 and RCW 18.29.110 are each amended to read as follows:

There shall be a dental hygiene examining committee consisting of three practicing dental hygienists and one public member appointed by the ((~~director~~)) secretary, to be known as the Washington dental hygiene examining committee. Each dental hygiene member shall be licensed and have been actively practicing dental hygiene for a period of not less than five years immediately before appointment and shall not be connected with any dental hygiene school. The public member shall not be connected with any dental hygiene program or engaged in any practice or business related to dental hygiene. Members of the committee shall be appointed by the ((~~director~~)) secretary to prepare and conduct examinations for dental hygiene licensure. Members shall be appointed to serve for terms of three years from October 1 of the year in which they are appointed. Terms of the members shall be staggered. Each member shall hold office for the term of his or her appointment and until his or her successor is appointed and qualified. Any member of the committee may be removed by the ((~~director~~)) secretary for neglect of duty, misconduct, malfeasance, or misfeasance in office, after being given a written statement of the charges against him or her and sufficient opportunity to be heard thereon. Members of the committee shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060.

Sec. 57. Section 4, chapter 202, Laws of 1989 and RCW 18.29.120 are each amended to read as follows:

The ((~~director~~)) secretary in consultation with the Washington dental hygiene examining committee shall:

(1) Adopt rules in accordance with chapter 34.05 RCW necessary to prepare and conduct examinations for dental hygiene licensure;

(2) Require an applicant for licensure to pass an examination consisting of written and practical tests upon such subjects and of such scope as the committee determines;

(3) Set the standards for passage of the examination;

(4) Administer at least two examinations each calendar year in conjunction with examinations for licensure of dentists under chapter 18.32 RCW. Additional examinations may be given as necessary; and

(5) Establish by rule the procedures for an appeal of an examination failure.

Sec. 58. Section 5, chapter 202, Laws of 1989 and RCW 18.29.130 are each amended to read as follows:

In addition to any other authority provided by law, the ((~~director~~)) secretary may:

(1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;

(2) Establish forms necessary to administer this chapter;

(3) Issue a license to any applicant who has met the education and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure. Proceedings concerning the denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;

(4) Employ clerical, administrative, and investigative staff as needed to implement and administer this chapter and hire individuals, including those licensed under this chapter, to serve as examiners or consultants as necessary to implement and administer this chapter;

(5) Maintain the official departmental record of all applicants and licensees;

(6) Establish, by rule, the minimum education requirements for licensure, including but not limited to approval of educational programs; and

(7) Establish and implement by rule a continuing education program.

Sec. 59. Section 6, chapter 202, Laws of 1989 and RCW 18.29.140 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the standards and procedures for approval of educational programs and may contract with individuals or organizations having expertise in the profession or in education to report to the ((~~director~~)) secretary information necessary for the ((~~director~~)) secretary to evaluate the educational programs. The ((~~director~~)) secretary may establish a fee for educational program evaluation. The fee shall be set to defray the administrative costs for evaluating the educational program, including, but not limited to, costs for site evaluation.

Sec. 60. Section 7, chapter 202, Laws of 1989 and RCW 18.29.150 are each amended to read as follows:

(1) The ((~~director~~)) secretary shall establish the date and location of the examination. Applicants who meet the education requirements for licensure shall be scheduled for the next examination following the filing of the application. The ((~~director~~)) secretary shall establish by rule the examination application deadline.

(2) The examination shall contain subjects appropriate to the scope of practice and on laws in the state of Washington regulating dental hygiene practice.

(3) The committee shall establish by rule the requirements for a reexamination if the applicant has failed the examination.

(4) The committee may approve an examination prepared or administered by a private testing agency or association of licensing authorities.

Sec. 61. Section 8, chapter 202, Laws of 1989 and RCW 18.29.160 are each amended to read as follows:

The ((~~director~~)) secretary, members of the committee, and individuals acting on their behalf are immune from suit in any action, civil or criminal, based on any acts performed in the course of their duties.

Sec. 62. Section 10, chapter 202, Laws of 1989 and RCW 18.29.180 are each amended to read as follows:

The following practices, acts, and operations are excepted from the operation of this chapter:

(1) The practice of dental hygiene in the discharge of official duties by dental hygienists in the United States armed services, coast guard, public health services, veterans' bureau, or bureau of Indian affairs;

(2) Dental hygiene programs approved by the ((~~director~~)) secretary and the practice of dental hygiene by students in dental hygiene programs approved by the ((~~director~~)) secretary, when acting under the direction and supervision of persons licensed under chapter 18.29 or 18.32 RCW acting as instructors.

Sec. 63. Section 1, chapter 112, Laws of 1935 and RCW 18.32.010 are each amended to read as follows:

Words used in the singular in this chapter may also be applied to the plural of the persons and things; words importing the plural may be applied to the singular; words importing the masculine gender may be extended to females also; the term "board" used in this chapter shall mean the Washington state board of dental examiners and the term ((~~"director"~~)) "secretary" shall mean the ((~~director of licensing~~)) secretary of health of the state of Washington.

Sec. 64. Section 1, chapter 130, Laws of 1951 as last amended by section 13, chapter 202, Laws of 1989 and RCW 18.32.030 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 Washington state dental schools or colleges approved by the board, 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 board of dental examiners;

(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 ((~~director of licensing~~)) secretary or the ((~~director's~~)) 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 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 persons not licensed under this chapter when performed under the supervision of a licensed dentist((~~: PROVIDED HOWEVER, That~~)). Such nonlicensed person 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, and 18.88 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.

Sec. 65. Section 3, chapter 112, Laws of 1935 as amended by section 15, chapter 202, Laws of 1989 and RCW 18.32.037 are each amended to read as follows:

The board shall designate one of its members as chairperson and one as secretary, and it shall meet at least once in each year, and more often if necessary, at the discretion of the ((~~director~~)) secretary of health or board, and at such times and places as the ((~~director~~)) secretary of health or the board deems proper. A majority of the members of the board currently serving constitutes a quorum for the transaction of the business of the board.

Sec. 66. Section 5, chapter 112, Laws of 1935 as last amended by section 16, chapter 202, Laws of 1989 and RCW 18.32.040 are each amended to read as follows:

The board shall require that every applicant for a license to practice dentistry shall:

(1) Present satisfactory evidence of graduation from a dental college, school, or dental department of an institution approved by the board;

(2) Submit, for the files of the board, a recent picture duly identified and attested; and

(3) Pass an examination prepared or approved by and administered under the direction of the board. The dentistry licensing examination shall consist of practical and written tests upon such subjects and of such scope as the board determines. The board may accept, in lieu of all or part of a written examination, a certificate granted by a national or regional testing organization approved by the board. The board shall set the standards for passing the examination. The ((~~director of licensing~~)) secretary of health shall keep on file the examination papers and records of examination for at least one year. This file shall be open for inspection by the applicant or the applicant's agent unless the disclosure will compromise the examination process as determined by the board or is exempted from disclosure under RCW 42.17.250 through 42.17.340.

Sec. 67. Section 4, chapter 112, Laws of 1935 as last amended by section 18, chapter 202, Laws of 1989 and RCW 18.32.100 are each amended to read as follows:

The applicant for a dentistry license shall file an application on a form furnished by the ((~~director~~)) secretary, stating the applicant's name, age, place of residence, the name of the school or schools attended by the applicant, the period of such attendance, the date of the applicant's graduation, whether the applicant has ever been the subject of any disciplinary action related to the practice of dentistry, and shall include a statement of all of the applicant's dental activities. This shall include any other information deemed necessary by the board.

The application shall be signed by the applicant and sworn to by the applicant before some person authorized to administer oaths, and shall be accompanied by proof of the applicant's school attendance and graduation.

Sec. 68. Section 29, chapter 52, Laws of 1957 as last amended by section 19, chapter 202, Laws of 1989 and RCW 18.32.110 are each amended to read as follows:

((~~Except as otherwise provided in RCW 18.32.210,~~)) Each applicant shall pay a fee determined by the ((~~director~~)) secretary of health as provided in RCW 43.24.086, which shall accompany the application.

Sec. 69. Section 5, chapter 93, Laws of 1953 as last amended by section 20, chapter 202, Laws of 1989 and RCW 18.32.120 are each amended to read as follows:

When the application and the accompanying proof are found satisfactory, the ((~~director~~)) secretary of health shall notify the applicant to appear before the board at a time and place to be fixed by the board.

The examination papers, and all grading thereon, and the grading of the practical work, shall be preserved for a period of not less than one year after the board has made and published its decisions thereon. All examinations shall be conducted by the board under fair and wholly impartial methods.

Any applicant who fails to make the required grade by his or her fourth examination may be reexamined only under rules adopted by the board.

Applicants for examination or reexamination shall pay a fee as determined by the ((~~director~~)) secretary of health as provided in RCW 43.24.086.

Sec. 70. Section 17, chapter 112, Laws of 1935 as last amended by section 21, chapter 202, Laws of 1989 and RCW 18.32.160 are each amended to read as follows:

All licenses issued by the ((~~director~~)) secretary of health on behalf of the board shall be signed by the ((~~director~~)) secretary of health or chairperson and secretary of the board.

Sec. 71. Section 25, chapter 52, Laws of 1957 as last amended by section 25, chapter 7, Laws of 1985 and RCW 18.32.170 are each amended to read as follows:

A fee determined by the ((~~director~~)) secretary of health as provided in RCW 43.24.086 shall be charged for every duplicate license issued by the ((~~director~~)) secretary of health.

Sec. 72. Section 24, chapter 112, Laws of 1935 as last amended by section 22, chapter 202, Laws of 1989 and RCW 18.32.180 are each amended to read as follows:

(1) Every person licensed to practice dentistry in this state shall register with the ((~~director of licensing~~)) secretary of health, and pay a renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Any failure to register and pay the renewal registration fee renders the license invalid, and the practice of dentistry shall not be permitted. The license shall be reinstated upon written application to the ((~~director~~)) secretary and payment to the state of a penalty fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, together with all delinquent license renewal fees.

(2) A person who fails to renew the license for a period of three years may not renew the license under subsection (1) of this section. In order to obtain a license to practice dentistry in this state, such a person shall file an original application as provided for in this chapter, along with the requisite fees. The board, in its sole discretion, may permit the applicant to be licensed without examination, and with or without conditions, if it is satisfied that the applicant meets all the requirements for licensure in this state and is competent to engage in the practice of dentistry.

Sec. 73. Section 7, chapter 112, Laws of 1935 as amended by section 7, chapter 277, Laws of 1981 and RCW 18.32.190 are each amended to read as follows:

Every person who engages in the practice of dentistry in this state shall cause his or her license to be, at all times, displayed in a conspicuous place, in his or her office wherein he or she shall practice such profession, and shall further, whenever requested, exhibit such license to any of the members of said board, or its authorized agent, and to the ((~~director~~)) secretary of health or his or her authorized agent. Every licensee shall notify the ((~~director~~)) secretary of health of the address or addresses, and of every change thereof, where the licensee shall engage in the practice of dentistry.

Sec. 74. Section 1, chapter 111, Laws of 1985 and RCW 18.32.195 are each amended to read as follows:

The board may, without examination, issue a license to persons who possess the qualifications set forth in this section.

(1) The board may, upon written request of the dean of the school of dentistry of the University of Washington, issue a license to practice dentistry in this state to persons who have been licensed or otherwise authorized to practice dentistry in another state or country and who have been accepted for employment by the school of dentistry as full-time faculty members. For purposes of this section, this means teaching members of the faculty of the school of dentistry of the University of Washington who are so employed on a one hundred percent of work time basis. Such license shall permit the holder thereof to practice dentistry within the confines of the university facilities for a period of one year while he or she is so employed as a full-time faculty member by the school of dentistry of the University of Washington. It shall terminate whenever the holder ceases to be such a full-time faculty member. Such license shall permit the holder thereof to practice dentistry only in connection with his or her duties in employment with the school of dentistry of the University of Washington. This limitation shall be stated on the license.

(2) The board may condition the granting of such license with terms the board deems appropriate. All persons licensed under this section shall be subject to the jurisdiction of the dental disciplinary board to the same extent as other members of the dental profession, in accordance with this chapter, and in addition the licensee may be disciplined by the dental disciplinary board after a hearing has been held in accordance with the provisions set forth in this chapter, and determination by the dental disciplinary board that such licensee has violated any of the restrictions set forth in this section.

(3) Persons applying for licensure pursuant to this section shall pay the application fee determined by the ((~~director~~)) secretary of health and, in the event the license applied for is issued, a license fee at the rate provided for licenses generally. After review by the board of dental examiners, licenses issued under this section may be renewed annually if the licensee continues to be employed as a full-time faculty member of the school of dentistry of the University of Washington and otherwise meets the requirements of the provisions and conditions deemed appropriate by the board of dental examiners. Any person who obtains a license pursuant to this section may, without an additional application fee, apply for licensure under this chapter, in which case the applicant shall be subject to examination and the other requirements of this chapter.

Sec. 75. Section 14, chapter 112, Laws of 1935 as amended by section 23, chapter 202, Laws of 1989 and RCW 18.32.220 are each amended to read as follows:

Anyone who is a licensed dentist in the state of Washington who desires to change residence to another state or territory, shall, upon application to the ((~~director~~)) secretary of health and payment of a fee as determined by the ((~~director~~)) secretary of health under RCW 43.24.086, receive a certificate over the signature of the ((~~director~~)) secretary of health or ((~~the director's~~)) his or her designee, which shall attest to the facts mentioned in this section, and giving the date upon which the dentist was licensed.

Sec. 76. Section 2, chapter 5, Laws of 1977 ex. sess. as last amended by section 25, chapter 202, Laws of 1989 and RCW 18.32.520 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions contained in this section shall apply throughout RCW 18.32.510 through 18.32.755.

(1) "Board" means the dental disciplinary board created in RCW 18.32.560.

(2) "License" means a certificate or license to practice dentistry in this state as provided for in this chapter.

(3) "Member" means member of the dental disciplinary board.

(4) "Secretary" means the secretary of the dental disciplinary board.

(5) ((~~"Director" means the director of licensing~~)) "Secretary of health" means the secretary of the department of health of the state of Washington.

(6) "To practice dentistry" means to engage in the practice of dentistry as defined in RCW 18.32.020.

Sec. 77. Section 1, chapter 125, Laws of 1989 and RCW 18.32.534 are each amended to read as follows:

(1) To implement an impaired dentist program as authorized by RCW 18.130.175, the dental disciplinary board shall enter into a contract with a voluntary substance abuse monitoring program. The impaired dentist program may include any or all of the following:

(a) Contracting with providers of treatment programs;

(b) Receiving and evaluating reports of suspected impairment from any source;

(d) Referring impaired dentists to treatment programs;

(e) Monitoring the treatment and rehabilitation of impaired dentists including those ordered by the board;

(f) Providing education, prevention of impairment, posttreatment monitoring, and support of rehabilitated impaired dentists; and

(g) Performing other related activities as determined by the board.

(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of up to fifteen dollars on each license issuance or renewal to be collected by the department of ((~~licensing~~)) health from every dentist licensed under chapter 18.32 RCW. These moneys shall be placed in the health professions account to be used solely for the implementation of the impaired dentist program.

Sec. 78. Section 7, chapter 93, Laws of 1953 as last amended by section 31, chapter 5, Laws of 1977 ex. sess. and RCW 18.32.745 are each amended to read as follows:

No manager, proprietor, partnership, or association owning, operating, or controlling any room, office, or dental parlors, where dental work is done, provided, or contracted for, shall employ or retain any unlicensed person or dentist as an operator; nor shall fail, within ten days after demand made by the ((~~director~~)) secretary of health, the state board of dental examiners, or the dental disciplinary board in writing sent by certified mail, addressed to any such manager, proprietor, partnership, or association at said room, office, or dental parlor, to furnish the ((~~director~~)) secretary of health, the state board of dental examiners, or the dental disciplinary board with the names and addresses of all persons practicing or assisting in the practice of dentistry in his or her place of business or under his or her control, together with a sworn statement showing by what license or authority said persons are practicing dentistry.

The sworn statement shall not be used as evidence in any subsequent court proceedings, except in a prosecution for perjury connected with its execution.

Any violation of the provisions of this section shall constitute improper, unprofessional, and dishonorable conduct; it shall also constitute grounds for injunction proceedings as provided by this chapter and in addition shall constitute a gross misdemeanor, except that the failure to furnish the information as may be requested in accordance with this section shall constitute a misdemeanor.

Sec. 79. Section 2, chapter 43, Laws of 1957 as amended by section 37, chapter 158, Laws of 1979 and RCW 18.34.020 are each amended to read as follows:

The term ((~~"director"~~)) "secretary" wherever used in this chapter shall mean the ((~~director of licensing~~)) secretary of health of the state of Washington. The term "apprentice" wherever used in this chapter shall mean a person who shall be designated an apprentice in the records of the ((~~director~~)) secretary at the request of a physician, registered optometrist or licensee hereunder, and who shall thereafter receive from such physician, registered optometrist or licensee hereunder training and direct supervision in the work of a dispensing optician.

Sec. 80. Section 3, chapter 43, Laws of 1957 and RCW 18.34.030 are each amended to read as follows:

No licensee hereunder may have more than two apprentices in training at one time((~~: PROVIDED, That~~)). The licensee shall be responsible for the acts of his or her apprentices in the performance of their work in the apprenticeship program((~~: PROVIDED FURTHER, That~~)). Apprentices shall complete their apprenticeship in six years and shall not work longer as an apprentice unless the ((~~director~~)) secretary determines, after a hearing, that the apprentice was prevented by causes beyond his or her control from completing his or her apprenticeship and becoming a licensee hereunder in six years.

Sec. 81. Section 7, chapter 43, Laws of 1957 as last amended by section 29, chapter 7, Laws of 1985 and RCW 18.34.070 are each amended to read as follows:

Any applicant for a license shall be examined if he or she pays an examination fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 and certifies under oath that he or she:

(1) ((He)) Is eighteen years or more of age; and

(2) ((He)) Has graduated from an accredited high school; and

(3) ((He)) Is a citizen of the United States or has declared his or her intention of becoming such citizen in accordance with law; and

(4) ((He)) Is of good moral character; and

(5) ((He)) Has either:

(a) Had at least three years of apprenticeship training; or

(b) Successfully completed a prescribed course in opticianry in a college or university approved by the ((~~director~~)) secretary; or

Sec. 82. Section 8, chapter 43, Laws of 1957 and RCW 18.34.080 are each amended to read as follows:

The examination shall determine whether the applicant has a thorough knowledge of the principles governing the practice of a dispensing optician which is hereby declared necessary for the protection of the public health. The ((~~director~~)) secretary shall license successful examinees and the license shall be conspicuously displayed in the place of business of the licensee.

Sec. 83. Section 11, chapter 43, Laws of 1957 and RCW 18.34.110 are each amended to read as follows:

The ((~~director~~)) secretary shall issue a license without examination to any person who makes application therefor within six months after ((~~the effective date of this chapter~~)) June 12, 1957, pays a fee of fifty dollars and certifies under oath that he or she is of good moral character and has been actually and principally engaged in the practice of a dispensing optician in the state of Washington for a period of not less than six months immediately preceding ((~~the effective date of this chapter~~)) June 12, 1957.

Sec. 84. Section 12, chapter 43, Laws of 1957 as last amended by section 52, chapter 279, Laws of 1984 and RCW 18.34.120 are each amended to read as follows:

Each licensee hereunder shall pay an annual renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, on or before the first day of July of each year, and thereupon the license of such person shall be renewed for a period of one year. Any failure to pay the annual renewal registration fee shall render the license invalid, but such license shall be reinstated upon written application therefor to the ((~~director~~)) secretary and payment of a penalty determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, together with all delinquent annual license renewal fees. In addition, the ((~~director of licensing~~)) secretary may adopt rules establishing mandatory continuing education requirements to be met by persons applying for license renewal.

Sec. 85. Section 1, chapter 106, Laws of 1973 1st ex. sess. as last amended by section 1, chapter 39, Laws of 1983 and RCW 18.35.010 are each amended to read as follows:

As used in this chapter, unless the context requires otherwise:

(1) "Department" means the department of ((~~licensing~~)) health.

(2) "Council" means the council on hearing aids.

(3) "Hearing aid" means any wearable prosthetic instrument or device designed for or represented as aiding, improving, compensating for, or correcting defective human hearing and any parts, attachments, or accessories of such an instrument or device, excluding batteries and cords and ear molds.

(4) "Fitting and dispensing of hearing aids" means the sale, lease, or rental or attempted sale, lease, or rental of hearing aids together with the selection and adaptation of hearing aids and the use of those tests and procedures essential to the performance of these functions. It includes the taking of impressions for ear molds for these purposes.

(5) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(6) "Establishment" means any facility engaged in the fitting and dispensing of hearing aids.

Sec. 86. Section 4, chapter 106, Laws of 1973 1st ex. sess. as last amended by section 2, chapter 198, Laws of 1989 and RCW 18.35.040 are each amended to read as follows:

An applicant for license shall be at least eighteen years of age and shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. An applicant shall not be issued a license under the provisions of this chapter unless the applicant:

(1) Satisfactorily completes the examination required by this chapter; or

(2) Holds a current, unsuspended, unrevoked license or certificate from a state or jurisdiction with which the department has entered into a reciprocal agreement, and shows evidence satisfactory to the department that the applicant is licensed in good standing in the other jurisdiction.

Sec. 87. Section 6, chapter 106, Laws of 1973 1st ex. sess. as last amended by section 31, chapter 7, Laws of 1985 and RCW 18.35.060 are each amended to read as follows:

(1) The department shall issue a trainee license to any applicant who has shown to the satisfaction of the department that:

(a) The applicant is at least eighteen years of age;

(b) If issued a trainee license, would be employed and directly supervised in the fitting and dispensing of hearing aids by a person licensed in good standing as a fitter-dispenser for at least one year unless otherwise approved by the council; and

(c) Has paid an application fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, to the department.

The provisions of RCW 18.35.030, 18.35.110, and 18.35.120 shall apply to any person issued a trainee license. Pursuant to the provisions of this section, a person issued a trainee license may engage in the fitting and dispensing of hearing aids without having first passed the examination provided under this chapter.

(2) The trainee license shall contain the name of the person licensed under this chapter who is employing and supervising the trainee and that person shall execute an acknowledgment of responsibility for all acts of the trainee in connection with the fitting and dispensing of hearing aids.

(3) A trainee may fit and dispense hearing aids, but only if the trainee is under the direct supervision of a person licensed under this chapter in a capacity other than as a trainee. Direct supervision by a licensed fitter-dispenser shall be required whenever the trainee is engaged in the fitting or dispensing of hearing aids during the trainee's first three months of full-time employment. The council shall develop and adopt guidelines on any additional supervision or training it deems necessary.

(4) The trainee license shall expire one year from the date of its issuance except that on recommendation of the council the license may be reissued for one additional year only.

(5) No person licensed under this chapter may assume the responsibility for more than two trainees at any one time, except that the department may approve one additional trainee if none of the trainees is within the initial ninety-day period of direct supervision and the licensee demonstrates to the department's satisfaction that adequate supervision will be provided for all trainees.

Sec. 88. Section 8, chapter 106, Laws of 1973 1st ex. sess. as last amended by section 4, chapter 198, Laws of 1989 and RCW 18.35.080 are each amended to read as follows:

The department shall license each applicant, without discrimination, who satisfactorily completes the required examination and, upon payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 to the department, shall issue to the applicant a license. If a person does not apply for a license within three years of the successful completion of the license examination, reexamination is required for licensure. The license shall be effective until the licensee's next birthday at which time it is subject to renewal. Subsequent renewal dates shall coincide with the licensee's birthday.

Sec. 89. Section 9, chapter 106, Laws of 1973 1st ex. sess. as last amended by section 5, chapter 198, Laws of 1989 and RCW 18.35.090 are each amended to read as follows:

Each person who engages in the fitting and dispensing of hearing aids shall as the department prescribes by rule, pay to the department a fee established by the ((~~director~~)) secretary under RCW 43.24.086 for a renewal of the license and shall keep the license conspicuously posted in the place of business at all times. Any person who fails to renew his or her license prior to the expiration date must pay a penalty fee in addition to the renewal fee and satisfy the requirements that may be set forth by rule promulgated by the ((~~director~~)) secretary for reinstatement. The ((~~director~~)) secretary may by rule establish mandatory continuing education requirements and/or continued competency standards to be met by licensees as a condition for license renewal.

Sec. 90. Section 18, chapter 39, Laws of 1983 as amended by section 10, chapter 198, Laws of 1989 and RCW 18.35.240 are each amended to read as follows:

(1) Every establishment engaged in the fitting and dispensing of hearing aids shall file with the department a surety bond in the sum of ten thousand dollars, running to the state of Washington, for the benefit of any person injured or damaged as a result of any violation by the establishment's employees or agents of any of the provisions of this chapter or rules adopted by the ((~~director~~)) secretary.

(2) In lieu of the surety bond required by this section, the establishment may file with the department a cash deposit or other negotiable security acceptable to the department. All obligations and remedies relating to surety bonds shall apply to deposits and security filed in lieu of surety bonds.

(3) If a cash deposit is filed, the department shall deposit the funds with the state treasurer. The cash or other negotiable security deposited with the department shall be returned to the depositor one year after the establishment has discontinued the fitting and dispensing of hearing aids if no legal action has been instituted against the establishment, its agents or employees, or the cash deposit or other security. The establishment owners shall notify the department if the establishment is sold or has discontinued the fitting and dispensing of hearing aids in order that the cash deposit or other security may be released at the end of one year from that date.

(4) A surety may file with the department notice of withdrawal of the bond of the establishment. Upon filing a new bond, or upon the expiration of sixty days after the filing of notice of withdrawal by the surety, the liability of the former surety for all future acts of the establishment terminates.

(5) Upon the filing with the department notice by a surety of withdrawal of the surety on the bond of an establishment or upon the cancellation by the department of the bond of a surety under this section, the department shall immediately give notice to the establishment by certified or registered mail with return receipt requested addressed to the establishment's last place of business as filed with the department.

(6) The department shall immediately cancel the bond given by a surety company upon being advised that the surety company's license to transact business in this state has been revoked.

Sec. 91. Section 20, chapter 39, Laws of 1983 as amended by section 11, chapter 198, Laws of 1989 and RCW 18.35.250 are each amended to read as follows:

(1) In addition to any other legal remedies, an action may be brought in any court of competent jurisdiction upon the bond, cash deposit, or security in lieu of a surety bond required by this chapter, by any person having a claim against a licensee, agent, or establishment for any violation of this chapter or any rule adopted under this chapter. The aggregate liability of the surety to all claimants shall in no event exceed the sum of the bond. Claims shall be satisfied in the order of judgment rendered.

(2) An action upon the bond shall be commenced by serving and filing the complaint within one year from the date of the cancellation of the bond. An action upon a cash deposit or other security shall be commenced by serving and filing the complaint within one year from the date of notification to the department of the change in ownership of the establishment or the discontinuation of the fitting and dispensing of hearing aids by that establishment. Two copies of the complaint shall be served by registered or certified mail, return receipt requested, upon the department at the time the suit is started. The service constitutes service on the surety. The ((~~director~~)) secretary shall transmit one copy of the complaint to the surety within five business days after the copy has been received.

(3) The ((~~director~~)) secretary shall maintain a record, available for public inspection, of all suits commenced under this chapter under surety bonds, or the cash or other security deposited in lieu of the surety bond. In the event that any final judgment impairs the liability of the surety upon a bond so furnished or the amount of the deposit so that there is not in effect a bond undertaking or deposit in the full amount prescribed in this section, the department shall suspend the license until the bond undertaking or deposit in the required amount, unimpaired by unsatisfied judgment claims, has been furnished.

(4) If a judgment is entered against the deposit or security required under this chapter, the department shall, upon receipt of a certified copy of a final judgment, pay the judgment from the amount of the deposit or security.

Sec. 92. Section 4, chapter 447, Laws of 1987 and RCW 18.36A.020 are each amended to read as follows:

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

(1) "Department" means the department of ((~~licensing~~)) health.

(2) ((~~"Director" means the director of licensing or the director's designee~~)) "Secretary" means the secretary of health or the secretary's designee.

(3) "Naturopath" means an individual licensed under this chapter.

(4) "Committee" means the Washington state naturopathic practice advisory committee.

(5) "Educational program" means a program preparing persons for the practice of naturopathy.

(6) "Nutrition and food science" means the prevention and treatment of disease or other human conditions through the use of foods, water, herbs, roots, bark, or natural food elements.

(7) "Manual manipulation" or "mechanotherapy" means manipulation of a part or the whole of the body by hand or by mechanical means.

(8) "Physical modalities" means use of physical, chemical, electrical, and other noninvasive modalities including, but not limited to heat, cold, air, light, water in any of its forms, sound, massage, and therapeutic exercise.

(9) "Homeopathy" means a system of medicine based on the use of infinitesimal doses of medicines capable of producing symptoms similar to those of the disease treated, as listed in the homeopathic pharmacopeia of the United States.

(10) "Medicines of mineral, animal, and botanical origin" means medicines derived from animal organs, tissues, and oils, minerals, and plants administered orally and topically, excluding legend drugs with the following exceptions: Vitamins, minerals, whole gland thyroid, and substances as exemplified in traditional botanical and herbal pharmacopoeia, and nondrug contraceptive devices excluding interuterine devices. The use of intermuscular injections are limited to vitamin B-12 preparations and combinations when clinical and/or laboratory evaluation has indicated vitamin B-12 deficiency. The use of controlled substances is prohibited.

(11) "Hygiene and immunization" means the use of such preventative techniques as personal hygiene, asepsis, public health, and immunizations, to the extent allowed by rule ((~~and regulation~~)).

(12) "Minor office procedures" means care incident thereto of superficial lacerations and abrasions, and the removal of foreign bodies located in superficial structures, not to include the eye; and the use of antiseptics and topical local anesthetics in connection therewith.

(13) "Common diagnostic procedures" means the use of venipuncture to withdraw blood, commonly used diagnostic modalities consistent with naturopathic practice, health history taking, physical examination, radiography, examination of body orifices excluding endoscopy, and laboratory medicine which obtains samples of human tissue products, including superficial scrapings but excluding procedures which would require surgical incision.

(14) "Suggestion" means techniques including but not limited to counseling, biofeedback, and hypnosis.

(15) "Radiography" means the ordering but not the interpretation of radiographic diagnostic studies and the taking and interpretation of standard radiographs.

Sec. 93. Section 2, chapter 447, Laws of 1987 and RCW 18.36A.030 are each amended to read as follows:

(1) No person may practice naturopathy or represent himself or herself as a naturopath without first applying for and receiving a license from the ((~~director~~)) secretary to practice naturopathy.

(2) A person represents himself or herself as a naturopath when that person adopts or uses any title or any description of services that incorporates one or more of the following terms or designations: Naturopath or doctor of naturopathic medicine.

Sec. 94. Section 3, chapter 447, Laws of 1987 as amended by section 1, chapter 246, Laws of 1988 and RCW 18.36A.040 are each amended to read as follows:

Naturopathic medicine or naturopathy is the practice by naturopaths of the art and science of the diagnosis, prevention, and treatment of disorders of the body by stimulation or support, or both, of the natural processes of the human body. A naturopath((s)) is responsible and accountable to the consumer for the quality of naturopathic care rendered.

The practice of naturopathy includes manual manipulation (mechanotherapy), the prescription, administration, dispensing, and use, except for the treatment of malignancies or neoplastic disease, of nutrition and food science, physical modalities, homeopathy, certain medicines of mineral, animal, and botanical origin, hygiene and immunization, common diagnostic procedures, and suggestion; however, nothing in this chapter shall prohibit consultation and treatment of a patient in concert with a practitioner licensed under chapter 18.57 or 18.71 RCW. No person licensed under this chapter may employ the term "chiropractic" to describe any services provided by a naturopath under this chapter.

((The state health coordinating council shall study and make recommendations on the qualifications of naturopaths in practicing manual manipulation (mechanotherapy), including the minimum educational standards comparable to the educational requirements of other health professions, and verification of qualifications by examination of applicants for naturopathic licensure. The report shall be presented to the legislature by January 1, 1989.))

Sec. 95. Section 5, chapter 447, Laws of 1987 and RCW 18.36A.050 are each amended to read as follows:

Nothing in this chapter shall be construed to prohibit or restrict:

(1) The practice of a profession by individuals who are licensed, certified, or registered under other laws of this state who are performing services within their authorized scope of practice;

(2) The practice of naturopathic medicine by an individual employed by the government of the United States while the individual is engaged in the performance of duties prescribed for him or her by the laws and regulations of the United States;

(3) The practice of naturopathic medicine by students enrolled in a school approved by the ((~~director~~)) secretary. The performance of services shall be pursuant to a course of instruction or assignments from an instructor and under the supervision of the instructor. The instructor shall be a naturopath licensed pursuant to this chapter; or

(4) The practice of oriental medicine or oriental herbology, or the rendering of other dietary or nutritional advice.

Sec. 96. Section 6, chapter 447, Laws of 1987 and RCW 18.36A.060 are each amended to read as follows:

(1) In addition to any other authority provided by law, the ((~~director~~)) secretary may:

(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) Set all license, examination, and renewal fees in accordance with RCW 43.24.086;

(d) Determine the minimum education and experience requirements for licensure in conformance with RCW 18.36A.090, including but not limited to approval of educational programs;

(e) Prepare and administer or approve the preparation and administration of examinations for licensure;

(f) Issue a license to any applicant who has met the education, training, and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure; except that denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;

(g) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and to hire individuals, including those licensed under this chapter, to serve as examiners or consultants as necessary to implement and administer this chapter;

(h) Maintain the official department record of all applicants and licensees;

(i) Determine whether alternative methods of training are equivalent to formal education, and establish forms, procedures, and criteria for evaluation of an applicant's equivalent alternative training to determine the applicant's eligibility to take the examination;

(j) Establish by rule the procedures for an appeal of examination failure;

(k) Conduct a hearing on an appeal of a denial of a license based on the applicant's failure to meet the minimum qualifications for licensure. The hearing shall be conducted pursuant to chapter 34.05 RCW; and

(l) Adopt rules implementing a continuing competency program.

(2) The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses and the discipline of licensees under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

Sec. 97. Section 7, chapter 447, Laws of 1987 and RCW 18.36A.070 are each amended to read as follows:

(1) There is hereby created the Washington state naturopathic advisory committee consisting of five members appointed by the ((~~director~~)) secretary who shall advise the ((~~director~~)) secretary concerning the administration of this chapter. Three members of the initial committee shall be persons who would qualify for licensing under this chapter. Their successors shall be naturopaths who are licensed under this chapter. Two members of the committee shall be individuals who are unaffiliated with the profession. For the initial committee, one unaffiliated member and one naturopath shall serve four-year terms, one unaffiliated member and one naturopath shall serve three-year terms, and one naturopath shall serve a two-year term. The term of office for committee members after the initial committee is four years. Any committee member may be removed for just cause including a finding of fact of unprofessional conduct, impaired practice, or more than three unexcused absences. The ((~~director~~)) secretary may appoint a new member to fill any vacancy on the committee for the remainder of the unexpired term.

No committee member may serve more than two consecutive terms, whether full or partial.

(2) Committee members shall be compensated in accordance with RCW 43.03.240 and reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060.

(3) The committee may elect annually a chair and vice-chair to direct the meetings of the committee. The committee shall meet at least once each year, and may hold additional meetings as called by the ((~~director~~)) secretary or the chair.

Sec. 98. Section 8, chapter 447, Laws of 1987 and RCW 18.36A.080 are each amended to read as follows:

The ((~~director~~)) secretary, members of the committee, or individuals acting on their behalf, are immune from suit in any civil action based on any act performed in the course of their duties.

Sec. 99. Section 9, chapter 447, Laws of 1987 and RCW 18.36A.090 are each amended to read as follows:

The department shall issue a license to any applicant who meets the following requirements:

(1) Successful completion of an educational program approved by the ((~~director~~)) secretary, the minimum standard of which shall be the successful completion of a doctorate degree program in naturopathy which includes a minimum of two hundred post-graduate hours in the study of mechanotherapy from an approved educational program, or successful completion of equivalent alternate training that meets the criteria established by the ((~~director~~)) secretary. The requirement for two hundred post-graduate hours in the study of mechanotherapy shall expire June 30, 1989;

(2) Successful completion of any equivalent experience requirement established by the ((~~director~~)) secretary;

(3) Successful completion of an examination administered or approved by the ((~~director~~)) secretary;

(4) Good moral character; and

(5) Not having engaged in unprofessional conduct or being unable to practice with reasonable skill and safety as a result of a physical or mental impairment.

The ((~~director~~)) secretary shall establish what constitutes adequate proof of meeting the above requirements. Any person holding a valid license to practice drugless therapeutics under chapter 18.36 RCW upon January 1, 1988, shall be deemed licensed pursuant to this chapter.

Sec. 100. Section 10, chapter 447, Laws of 1987 and RCW 18.36A.100 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the standards for approval of educational programs and alternate training and may contract with individuals or organizations having expertise in the profession and/or in education to report to the ((~~director~~)) secretary the information necessary for the ((~~director~~)) secretary to evaluate the educational programs. The standards for approval shall be based on the minimal competencies necessary for safe practice. The standards and procedures for approval shall apply equally to educational programs and equivalent alternate training within the United States and those in foreign jurisdictions. The ((~~director~~)) secretary may establish a fee for educational program evaluation. The fee shall be determined by the administrative costs for the educational program evaluation, including, but not limited to, costs for site evaluation.

Sec. 101. Section 11, chapter 447, Laws of 1987 and RCW 18.36A.110 are each amended to read as follows:

(1) The date and location of the examination shall be established by the ((~~director~~)) secretary. Applicants who have been found to meet the education and experience requirements for licensure shall be scheduled for the next examination following the filing of the application. The ((~~director~~)) secretary shall establish by rule the examination application deadline.

(2) The examination shall contain subjects appropriate to the standards of competency and scope of practice.

(3) The ((~~director~~)) secretary shall establish by rule the requirements for a reexamination if the applicant has failed the examination.

(4) The committee may recommend to the ((~~director~~)) secretary an examination prepared or administered, or both, by a private testing agency or association of licensing boards.

Sec. 102. Section 12, chapter 447, Laws of 1987 and RCW 18.36A.120 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the standards for licensure of applicants licensed in another jurisdiction. However, the standards for reciprocity of licensure shall not be less than required for licensure in the state of Washington.

Sec. 103. Section 13, chapter 447, Laws of 1987 and RCW 18.36A.130 are each amended to read as follows:

Applications for licensure shall be submitted on forms provided by the department. The department may require any information and documentation needed to determine if the applicant meets the criteria for licensure as provided in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The fee shall be submitted with the application.

Sec. 104. Section 14, chapter 447, Laws of 1987 and RCW 18.36A.140 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the requirements for renewal of licenses. The ((~~director~~)) secretary shall establish a renewal and late renewal penalty fee as provided in RCW 43.24.086. Failure to renew shall invalidate the license and all privileges granted by the license. The ((~~director~~)) secretary shall determine by rule whether a license shall be canceled for failure to renew and shall establish procedures and prerequisites for relicensure.

Sec. 105. Section 2, chapter 168, Laws of 1951 as last amended by section 8, chapter 213, Laws of 1985 and RCW 18.46.010 are each amended to read as follows:

(1) "Maternity home" means any home, place, hospital or institution in which facilities are maintained for the care of four or more women, not related by blood or marriage to the operator, during pregnancy or during or within ten days after delivery((~~: PROVIDED, HOWEVER, That~~)). This chapter shall not apply to any hospital approved by the American College of Surgeons, American Osteopathic Association or its successor.

(2) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.

(3) "Department" means the state department of ((~~social and health services~~)) health.

Sec. 106. Section 2, chapter 53, Laws of 1981 as amended by section 1, chapter 467, Laws of 1987 and RCW 18.50.005 are each amended to read as follows:

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

(1) "Department" means the department of ((~~licensing~~)) health.

(2) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(3) "Midwife" means a midwife licensed under this chapter.

(4) "Physician" means a physician licensed under chapter 18.57 or 18.71 RCW.

Sec. 107. Section 8, chapter 160, Laws of 1917 as last amended by section 2, chapter 467, Laws of 1987 and RCW 18.50.010 are each amended to read as follows:

Any person shall be regarded as practicing midwifery within the meaning of this chapter who shall render medical aid for a fee or compensation to a woman during prenatal, intrapartum, and postpartum stages or who shall advertise as a midwife by signs, printed cards, or otherwise. Nothing shall be construed in this chapter to prohibit gratuitous services. It shall be the duty of a midwife to consult with a physician whenever there are significant deviations from normal in either the mother or the infant.

((A study shall be conducted by the department of licensing in consultation with the department of social and health services and the midwifery advisory committee to determine maternal and neonatal outcome data by type of practitioner, including an analysis of births attended by nonlicensed practitioners. The study shall also determine the role of nonlicensed practitioners in the provision of maternity services in the state of Washington. The results of the study shall be reported to the legislature in January, 1988.))

Sec. 108. Section 1, chapter 160, Laws of 1917 and RCW 18.50.020 are each amended to read as follows:

Any person who shall practice midwifery in this state after July 1, 1917, shall first obtain from the ((~~director of licensing~~)) secretary of the state of Washington a license so to do, and the said ((~~director~~)) secretary is authorized to grant such license after examination of the applicant as hereinafter provided.

Sec. 109. Section 11, chapter 53, Laws of 1981 and RCW 18.50.034 are each amended to read as follows:

Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of midwifery by a person who is enrolled in a program of midwifery approved and accredited by the ((~~director: PROVIDED, That~~)) secretary. The performance of such services ((is)) may be only pursuant to a regular course of instruction or assignment from the student's instructor, and that such services are performed only under the supervision and control of a person licensed in the state of Washington to perform services encompassed under this chapter.

Sec. 110. Section 2, chapter 160, Laws of 1917 as last amended by section 3, chapter 467, Laws of 1987 and RCW 18.50.040 are each amended to read as follows:

(1) Any person seeking to be examined shall present to the ((~~director~~)) secretary, at least forty-five days before the commencement of the examination, a written application on a form or forms provided by the ((~~director~~)) secretary setting forth under affidavit such information as the ((~~director~~)) secretary may require and proof the candidate has received a high school degree or its equivalent; that the candidate is twenty-one years of age or older; that the candidate has received a certificate or diploma from a midwifery program accredited by the ((~~director~~)) secretary and licensed under chapter 28C.10 RCW, when applicable, or a certificate or diploma in a foreign institution on midwifery of equal requirements conferring the full right to practice midwifery in the country in which it was issued. The diploma must bear the seal of the institution from which the applicant was graduated. Foreign candidates must present with the application a translation of the foreign certificate or diploma made by and under the seal of the consulate of the country in which the certificate or diploma was issued.

(2) The candidate shall meet the following conditions:

(a) Obtaining a minimum period of midwifery training for at least three years including the study of the basic nursing skills that the department shall prescribe by rule. However, if the applicant is a registered nurse under chapter 18.88 RCW, a licensed practical nurse under chapter 18.78 RCW, or has had previous nursing education or practical midwifery experience, the required period of training may be reduced depending upon the extent of the candidate's qualifications as determined under rules adopted by the department. In no case shall the training be reduced to a period of less than two years.

(b) Meeting minimum educational requirements which shall include studying obstetrics; neonatal pediatrics; basic sciences; female reproductive anatomy and physiology; behavioral sciences; childbirth education; community care; obstetrical pharmacology; epidemiology; gynecology; family planning; genetics; embryology; neonatology; the medical and legal aspects of midwifery; nutrition during pregnancy and lactation; breast feeding; nursing skills, including but not limited to injections, administering intravenous fluids, catheterization, and aseptic technique; and such other requirements prescribed by rule.

(c) For a student midwife during training, undertaking the care of not less than fifty women in each of the prenatal, intrapartum, and early postpartum periods, but the same women need not be seen through all three periods. A student midwife may be issued a permit upon the satisfactory completion of the requirements in (a), (b), and (c) of this subsection and the satisfactory completion of the licensure examination required by RCW 18.50.060. The permit permits the student midwife to practice under the supervision of a midwife licensed under this chapter, a physician or a certified nurse-midwife licensed under the authority of chapter 18.88 RCW. The permit shall expire within one year of issuance and may be extended as provided by rule.

(d) Observing an additional fifty women in the intrapartum period before the candidate qualifies for a license.

(3) Notwithstanding subsections (1) and (2) of this section, the department shall adopt rules to provide credit toward the educational requirements for licensure before July 1, 1988, of nonlicensed midwives, including rules to provide:

(a) Credit toward licensure for documented deliveries;

(b) The substitution of relevant experience for classroom time; and

The training required under this section shall include training in either hospitals or alternative birth settings or both with particular emphasis on learning the ability to differentiate between low-risk and high-risk pregnancies.

Sec. 111. Section 7, chapter 53, Laws of 1981 and RCW 18.50.045 are each amended to read as follows:

The ((~~director~~)) secretary shall promulgate standards by rule under chapter 34.05 RCW for accrediting midwifery educational programs. The standards shall cover the provision of adequate clinical and didactic instruction in all subjects and noncurriculum matters under this section including, but not limited to, staffing and teacher qualifications. In developing the standards, the ((~~director~~)) secretary shall be advised by and receive the recommendations of the midwifery advisory committee.

Sec. 112. Section 3, chapter 160, Laws of 1917 as last amended by section 48, chapter 7, Laws of 1985 and RCW 18.50.050 are each amended to read as follows:

If the application is approved and the candidate shall have deposited an examination fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 with the ((~~director~~)) secretary, the candidate shall be admitted to the examination, and in case of failure to pass the examination, may be reexamined at any regular examination within one year without the payment of an additional fee, said fee to be retained by the ((~~director~~)) secretary after failure to pass the second examination.

Sec. 113. Section 4, chapter 160, Laws of 1917 as last amended by section 4, chapter 467, Laws of 1987 and RCW 18.50.060 are each amended to read as follows:

(1) The ((~~director of licensing~~)) secretary is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in midwifery at least twice a year at such times and places as the ((~~director~~)) secretary may select. The examinations shall be written and shall be in the English language.

(2) The ((~~director~~)) secretary, with the assistance of the midwifery advisory committee, shall develop or approve a licensure examination in the subjects that the ((~~director~~)) secretary determines are within the scope of and commensurate with the work performed by a licensed midwife. The examination shall be sufficient to test the scientific and practical fitness of candidates to practice midwifery. All application papers shall be deposited with the ((~~director~~)) secretary and there retained for at least one year, when they may be destroyed.

(3) If the examination is satisfactorily completed, the ((~~director~~)) secretary shall issue to such candidate a license entitling the candidate to practice midwifery in the state of Washington.

Sec. 114. Section 13, chapter 53, Laws of 1981 as amended by section 49, chapter 7, Laws of 1985 and RCW 18.50.102 are each amended to read as follows:

Every person licensed to practice midwifery shall register with the ((~~director of licensing~~)) secretary annually and pay an annual renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 on or before the licensee's birth anniversary date. The license of the person shall be renewed for a period of one year. Any failure to register and pay the annual renewal registration fee shall render the license invalid. The license shall be reinstated upon written application to the ((~~director~~)) secretary, payment to the state of a penalty fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, and payment to the state of all delinquent annual license renewal fees. Any person who fails to renew his or her license for a period of three years shall not be entitled to renew such license under this section. Such person, in order to obtain a license to practice midwifery in this state, shall file a new application under this chapter, along with the required fee. The ((~~director~~)) secretary, in the ((~~director's~~)) secretary's discretion, may permit the applicant to be licensed without examination if satisfied that the applicant meets all the requirements for licensure in this state and is competent to engage in the practice of midwifery.

Sec. 115. Section 12, chapter 53, Laws of 1981 and RCW 18.50.105 are each amended to read as follows:

The ((~~director~~)) secretary, with the advice of the midwifery advisory committee, shall develop a form to be used by a midwife to inform the patient of the qualifications of a licensed midwife.

Sec. 116. Section 6, chapter 467, Laws of 1987 and RCW 18.50.115 are each amended to read as follows:

A midwife licensed under this chapter may obtain and administer prophylactic ophthalmic medication, postpartum oxytocic, vitamin K, Rho immune globulin (human), and local anesthetic and may administer such other drugs or medications as prescribed by a physician. A pharmacist who dispenses such drugs to a licensed midwife shall not be liable for any adverse reactions caused by any method of use by the midwife.

The ((~~director~~)) secretary, after consultation with representatives of the midwife advisory committee, the board of pharmacy, and the board of medical examiners, may issue ((~~regulations~~)) rules which authorize licensed midwives to purchase and use legend drugs and devices in addition to the drugs authorized in this chapter.

Sec. 117. Section 15, chapter 53, Laws of 1981 and RCW 18.50.135 are each amended to read as follows:

The ((~~director~~)) secretary shall promulgate rules under chapter 34.05 RCW as are necessary to carry out the purposes of this chapter.

Sec. 118. Section 3, chapter 53, Laws of 1981 as amended by section 5, chapter 467, Laws of 1987 and RCW 18.50.140 are each amended to read as follows:

The midwifery advisory committee is created.

The committee shall be composed of one physician who is a practicing obstetrician; one practicing physician; one certified nurse midwife licensed under chapter 18.88 RCW; three midwives licensed under this chapter; and one public member, who shall have no financial interest in the rendering of health services. The committee may seek other consultants as appropriate, including persons trained in childbirth education and perinatology or neonatology.

The members are appointed by the ((~~director~~)) secretary and serve at the pleasure of the ((~~director~~)) secretary but may not serve more than five years consecutively. The terms of office shall be staggered. Members of the committee shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060 ((~~as now or hereafter amended~~)).

Sec. 119. Section 4, chapter 53, Laws of 1981 and RCW 18.50.150 are each amended to read as follows:

The midwifery advisory committee shall advise and make recommendations to the ((~~director~~)) secretary on issues including, but not limited to, continuing education, mandatory reexamination, and peer review. The ((~~director~~)) secretary shall transmit the recommendations to the social and health services committee of the senate and the human services committee of the house of representatives on an annual basis.

Sec. 120. Section 2, chapter 57, Laws of 1970 ex. sess. as amended by section 44, chapter 158, Laws of 1979 and RCW 18.52.020 are each amended to read as follows:

When used in this chapter, unless the context otherwise clearly requires:

(1) "Board" means the state board of examiners for the licensing of nursing home administrators representative of the professions and institutions concerned with the care of the chronically ill and infirm aged patients.

(2) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(3) "Nursing home" means any facility or portion thereof licensed under state law as a nursing home.

(4) "Nursing home administrator" means an individual in active administrative charge of nursing homes as defined herein, whether or not having an ownership interest in such homes, and although functions and duties may be shared with or delegated to other persons((~~: PROVIDED HOWEVER, That~~)). Nothing in this definition or this chapter shall be construed to prevent any person, so long as he or she is otherwise qualified, from obtaining and maintaining a license even though he or she has not administered or does not continue to administer a nursing home.

Sec. 121. Section 6, chapter 57, Laws of 1970 ex. sess. as last amended by section 40, chapter 287, Laws of 1984 and RCW 18.52.060 are each amended to read as follows:

The board shall elect from its membership a chairman, vice chairman, and secretary-treasurer, and shall adopt rules ((~~and regulations~~)) to govern its proceedings. The chairman or four board members by signed written request may call board meetings upon reasonable written notice to each member. Each member shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060. A full-time or part-time executive secretary for the board may be employed by the ((~~director~~)) secretary through the department of ((~~licensing~~)) health, and the ((~~director~~)) secretary through the department of ((~~licensing~~)) health shall provide the executive secretary and the board with such secretarial, administrative, and other assistance as may be required to carry out the purposes of this chapter. Employment of an executive secretary shall be subject to confirmation by the board. The position of executive secretary shall be exempt from the requirements of chapter 41.06 RCW.

Sec. 122. Section 7, chapter 57, Laws of 1970 ex. sess. as last amended by section 65, chapter 279, Laws of 1984 and RCW 18.52.070 are each amended to read as follows:

Upon the ((~~director's~~)) secretary's receipt of an application and examination fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, and completed application forms provided by the ((~~director~~)) secretary, a nursing home administrator's license shall be issued to any person who:

(1) Is at least twenty-one years of age and of good moral character.

(2) Has presented evidence satisfactory to the board of practical experience, education, and training which, when evaluated according to criteria developed by the board, is equivalent to two years of experience in the operation of a nursing home((~~: PROVIDED, That~~)). After January 1, 1980, no license shall be issued to any applicant unless such applicant has either successfully completed at least two years of formal education beyond the high school level or holds an associate degree from a recognized institution of higher learning((~~: PROVIDED FURTHER, That~~)). The educational degree required by this subsection may be waived for individuals who present evidence satisfactory to the board of sufficient practical experience.

(3) Has passed an examination administered by the board which shall be designed to test the candidate's competence to administer a nursing home on the basis of the candidate's formal instruction and training or actual experience((~~: PROVIDED HOWEVER, That~~)). Nothing in this chapter or the rules ((~~and regulations~~)) thereunder shall be construed to require an applicant for a license or provisional license as a nursing home administrator who is certified by any well established and generally recognized church or religious denomination which teaches reliance on spiritual means alone for healing as having been approved to administer institutions certified by such church or denomination for the care and treatment of the sick in accordance with its teachings, to demonstrate proficiency in any medical techniques or to meet any medical educational qualifications or medical standards not in accord with the remedial care and treatment provided in such institutions((~~: PROVIDED FURTHER, That~~)). Any such individual shall demonstrate in the process of application for the examination his or her membership in such church or religious denomination and his or her license shall indicate the limited extent of his or her authority to act as an administrator.

(4) The initial administrator members of the board shall be selected and appointed by the governor to meet the requirements of subsection (1) of this section and of RCW 18.52.040 and 18.52.050. The three nonadministrator members of the first board shall administer to the initial administrator members an appropriate examination, and the initial administrator members shall thereafter be issued their licenses under this chapter as nursing home administrators. The three nonadministrator members of the first board may exercise the powers of the board to carry out licensing of the initial administrator members, regardless of the normal quorum or procedural requirements for board action. The licensing of the initial administrator members of the first board shall be carried out within thirty days after appointment of the board, and in all events prior to April 1, 1970.

Sec. 123. Section 10, chapter 57, Laws of 1970 ex. sess. as last amended by section 33, chapter 150, Laws of 1987 and RCW 18.52.100 are each amended to read as follows:

The board with the assistance of the ((~~director~~)) secretary for administrative matters shall have the duty and responsibility within the limits provided in this chapter:

(1) To develop standards which must be met by individuals in order to receive a license as a nursing home administrator, which standards shall include criteria to evaluate the practical experience, education, and training of applicants for licenses to determine that applicants have the equivalent of two years of experience in the operation of a nursing home. The standards and criteria shall be designed to insure that nursing home administrators will be individuals who are of good character and are otherwise suitable, and who, by training or experience in the field of institutional administration, are qualified to serve as nursing home administrators as provided in this chapter.

(2) To develop appropriate techniques, including examinations and investigations to the extent necessary to determine whether an individual meets such standards for licensing.

(3) To develop, administer, and supervise an administrator-in-training program for applicants for licenses who are otherwise qualified but do not have the equivalent of two years experience in the operation of a nursing home at the time of application. Such program shall provide for supervision of each administrator-in-training by licensed nursing home administrators as preceptors. The board shall have the authority to do all acts necessary for the implementation of such a program, including, but not limited to, conducting education and training programs, establishing standards of qualification for preceptors, establishing criteria for creating and evaluating individual programs, and monitoring such programs to assure compliance with rules ((~~and regulations~~)) adopted by the board.

(4) To issue licenses to individuals determined by the board, after the application of such techniques, to meet such standards and to order the ((~~director~~)) secretary to deny licenses to individuals who do not meet such standards or who are in violation of this chapter or chapter 18.130 RCW.

(5) To conduct a continuing study and investigation of the licensing of administrators of nursing homes within the state with a view to the improvement of the standards imposed for the licensing of new administrators and of procedures and methods for the enforcement of such standards with respect to administrators of nursing homes who are to be licensed.

(6) To encourage qualified educational institutions and other qualified organizations to establish, provide, and conduct and continue such training and instruction courses and programs as will enable all otherwise qualified individuals to attain the qualifications necessary to meet the standards for licensing nursing home administrators.

(7) To establish and carry out procedures, if required, designed to insure that individuals licensed as nursing home administrators will, during any period that they serve as such, comply with the requirements and standards for licensing set forth in this chapter.

(8) To establish appropriate procedures for the issuance in unusual circumstances and without examination of temporary license permits as nursing home administrators. Such permits may be issued and renewed by the ((~~director~~)) secretary pursuant to rules ((~~and regulations~~)) which shall be established by the board. Such permits and renewals shall be subject to confirmation or rescission by order of the board upon review at the next board meeting. Any such permit or renewal thereof shall in all events expire six months from the date issued. Persons receiving such permits need not have passed the required examination but shall meet the other requirements of this chapter, except RCW 18.52.070(2). After hearing before the board and upon order of the board the board may take appropriate disciplinary action for the reasons provided in this chapter or chapter 18.130 RCW.

(9) To advise the relevant state agencies regarding receipt and administration of such federal funds as are made available to carry out the educational purposes of this chapter.

(10) To advise the ((~~director~~)) secretary regarding the application forms used by the ((~~director~~)) secretary under this chapter.

(11) To issue rules ((~~and regulations~~)) which are necessary to carry out the functions of the board specifically assigned to it by this chapter.

Sec. 124. Section 11, chapter 57, Laws of 1970 ex. sess. as last amended by section 69, chapter 279, Laws of 1984 and RCW 18.52.110 are each amended to read as follows:

(1) Every holder of a nursing home administrator's license shall reregister it annually with the ((~~director~~)) secretary on dates specified by the ((~~director~~)) secretary by making application for reregistration on forms provided by the ((~~director~~)) secretary. Such reregistration shall be granted automatically upon receipt of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. In the event that any license is not reregistered within thirty days after the date for reregistration specified by the ((~~director~~)) secretary, the ((~~director~~)) secretary shall, in accordance with rules prescribed by the board, give notice to the license holder, and may thereafter in accordance with rules prescribed by the board charge up to double the normal reregistration fee. In the event that the license of an individual is not reregistered within two years from the most recent date for reregistration it shall lapse and such individual must again apply for licensing and meet all requirements of this chapter for a new applicant. The board may prescribe rules for maintenance of a license at a reduced fee for temporary or permanent withdrawal or retirement from the active practice of nursing home administration.

(2) A condition of reregistration shall be the presentation of proof by the applicant that he or she has attended the number of classroom hours of approved educational programs, classes, seminars, or proceedings set by the board. The board shall have the power to approve programs, classes, seminars, or proceedings offered in this state or elsewhere by any accredited institution of higher learning or any national or local group or society if such programs, classes, seminars, or proceedings are reasonably related to the administration of nursing homes. The board shall establish rules ((~~and regulations~~)) providing that the applicant for reregistration may present such proofs yearly, or may obtain the cumulative number of required hours over a three year period and present such proofs over periods of three years. In no event shall the number of classroom hours required for any time period exceed the number of such board approved classroom hours reasonably available over such time period on an adult or continuing education basis to nonmatriculating participants in this state.

(3) An individual may obtain and reregister a license under this chapter although he or she does not actively engage in nursing home administration. The licensee shall meet requirements set by the board to ensure the individual's continued competency.

Sec. 125. Section 13, chapter 57, Laws of 1970 ex. sess. as last amended by section 50, chapter 7, Laws of 1985 and RCW 18.52.130 are each amended to read as follows:

Upon receipt of an application fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 and an annual license fee, the ((~~director~~)) secretary may issue a nursing home administrator's license, without examination, to any person who holds a current license as a nursing home administrator from another jurisdiction((~~: PROVIDED, That~~)) if the board finds that the standards for licensing in such other jurisdiction are at least the substantial equivalent of those prevailing in this state, and that the applicant is otherwise qualified. In the event that there is developed a nationally recognized standard for the licensing of nursing home administrators which is in fact utilized in licensing procedures on a reasonably uniform basis the board may by rule ((~~or regulation~~)) provide for granting reciprocal licensing on a showing of compliance with such standard.

Sec. 126. Section 3, chapter 114, Laws of 1979 as last amended by section 1, chapter 300, Laws of 1989 and RCW 18.52A.030 are each amended to read as follows:

(1) Any nursing assistant employed by a nursing home, who has satisfactorily completed a nursing assistant training program under this chapter, shall, upon application, be issued a verification of completion by the program provider.

(2) All nursing assistants employed by a nursing home shall be required to be registered with the department of ((~~licensing~~)) health and to show evidence of satisfactory completion of a nursing assistant training program, or that they are enrolled in and are progressing satisfactorily towards completion of a training program under standards promulgated by the board, which program must be completed within four months of employment. A nursing home may employ a person not currently enrolled if the employer within twenty days enrolls the person in an approved training program((~~: PROVIDED, That~~)). A nursing home shall not assign an assistant to provide resident care until the assistant has demonstrated skills necessary to perform assigned duties and responsibilities competently. All persons enrolled in a training program must satisfactorily complete the program within four months from the date of initial employment.

(3) Compliance with this section shall be a condition of licensure of nursing homes under chapter 18.51 RCW. Beginning January 1, 1986, compliance with this section shall be a condition of licensure of hospitals licensed under chapter 70.41 RCW with a wing certified to provide nursing home care under Title XVIII or Title XIX of the social security act. Any health provider of skilled nursing facility care or intermediate care facility care shall meet the requirements of this section.

Sec. 127. Section 5, chapter 267, Laws of 1988 and RCW 18.52B.050 are each amended to read as follows:

Nothing in this chapter may be construed to prohibit or restrict:

(1) The practice by an individual licensed, certified, or registered under the laws of this state and performing services within their authorized scope of practice;

(2) The practice by an individual employed by the government of the United States while engaged in the performance of duties prescribed by the laws of the United States;

(3) The practice by a person who is a regular student in an educational program approved by the ((~~director~~)) secretary, and whose performance of services is pursuant to a regular course of instruction or assignments from an instructor and under the general supervision of the instructor.

Sec. 128. Section 8, chapter 267, Laws of 1988 and RCW 18.52B.080 are each amended to read as follows:

The ((~~director~~)) secretary shall keep an official record of all proceedings. A part of the record shall consist of a register of all applicants for credentialing under this chapter and the results of each application.

Sec. 129. Section 11, chapter 267, Laws of 1988 and RCW 18.52B.110 are each amended to read as follows:

The board, in consultation with the board of practical nursing, shall establish by rule the standards and procedures for approval of educational programs and alternative training. The ((~~director~~)) secretary may use or contract with individuals or organizations having expertise in the profession or in education to assist in the evaluations. The board shall establish by rule the standards and procedures for revocation of approval of education programs. The standards and procedures set shall apply equally to educational programs and training in the United States and in foreign jurisdictions. The ((~~director~~)) secretary may establish a fee for educational program evaluations.

Sec. 130. Section 14, chapter 267, Laws of 1988 and RCW 18.52B.120 are each amended to read as follows:

Applications for certification shall be submitted on forms provided by the ((~~director~~)) secretary. The ((~~director~~)) secretary may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for credentialing provided for in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the ((~~director~~)) secretary under RCW 43.24.086. The fee shall accompany the application.

Sec. 131. Section 16, chapter 267, Laws of 1988 and RCW 18.52B.150 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 examination if the ((~~director~~)) secretary determines that the other state's credentialing standards are substantially equivalent to the standards in this state.

Sec. 132. Section 17, chapter 267, Laws of 1988 and RCW 18.52B.160 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the procedural requirements and fees for renewal of a registration or certificate. Failure to renew shall invalidate the credential and all privileges granted by the credential. If a certificate has lapsed for a period longer than three years, the person shall demonstrate competence to the satisfaction of the board by taking continuing education courses, or meeting other standards determined by the board.

Sec. 133. Section 2, chapter 243, Laws of 1988 and RCW 18.52C.020 are each amended to read as follows:

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

(1) ((~~"Director" means the director of the department of licensing~~)) "Secretary" means the secretary of health.

(2) "Health care facility" means a nursing home, hospital, hospice care facility, home health care agency, hospice agency, or other entity for the delivery of health care services.

(3) "Nursing home" means any nursing home facility licensed pursuant to chapter 18.52 RCW.

(4) "Nursing pool" means any person engaged in the business of providing, procuring, or referring health care personnel for temporary employment in health care facilities, such as licensed nurses or practical nurses, and nursing assistants. "Nursing pool" does not include an individual who only engages in providing his or her own services.

(5) "Person" includes an individual, firm, corporation, partnership, or association.

Sec. 134. Section 3, chapter 243, Laws of 1988 and RCW 18.52C.030 are each amended to read as follows:

A person who operates a nursing pool shall register the pool with the ((~~director~~)) secretary. Each separate location of the business of a nursing pool shall have a separate registration.

The ((~~director~~)) secretary, by rule, shall establish forms and procedures for the processing of nursing pool registration applications, including the payment of registration fees pursuant to RCW 43.24.086. An application for a nursing pool registration shall include at least the following information:

(1) The names and addresses of the owner or owners of the nursing pool; and

(2) If the owner is a corporation, copies of its articles of incorporation and current bylaws, together with the names and addresses of its officers and directors.

A registration issued by the ((~~director~~)) secretary in accordance with this section shall remain effective for a period of one year from the date of its issuance unless the registration is revoked or suspended pursuant to RCW 18.52C.040(4), or unless the nursing pool is sold or ownership or management is transferred, in which case the registration of the nursing pool shall be voided and the new owner or operator shall apply for a new registration.

Sec. 135. Section 4, chapter 243, Laws of 1988 and RCW 18.52C.040 are each amended to read as follows:

(1) The nursing pool shall document that each temporary employee or referred independent contractor provided or referred to health care facilities currently meets the minimum state credentialing requirements.

(2) The nursing pool shall not require, as a condition of employment or referral, that employees or independent contractors of the nursing pool recruit new employees or independent contractors for the nursing pool from among the permanent employees of the health care facility to which the nursing pool employee or independent contractor has been assigned or referred.

(3) The nursing pool shall carry professional and general liability insurance to insure against any loss or damage occurring, whether professional or otherwise, as the result of the negligence of its employees, agents or independent contractors for acts committed in the course of their employment with the nursing pool((~~: PROVIDED, That~~)). A nursing pool that only refers self-employed, independent contractors to health care facilities shall carry professional and general liability insurance to cover its own liability as a nursing pool which refers self-employed, independent contractors to health care facilities((~~: AND PROVIDED FURTHER, That it~~)). The nursing pool shall require, as a condition of referral, that self-employed, independent contractors carry professional and general liability insurance to insure against loss or damage resulting from their own acts committed in the course of their own employment by a health care facility.

(4) The uniform disciplinary act, chapter 18.130 RCW, shall govern the issuance and denial of registration and the discipline of persons registered under this chapter. The ((~~director~~)) secretary shall be the disciplinary authority under this chapter.

Sec. 136. Section 38, chapter 150, Laws of 1987 and RCW 18.53.021 are each amended to read as follows:

It is a violation of RCW 18.130.190 for any person to practice optometry in this state without first obtaining a license from the ((~~director of licensing~~)) secretary of health.

Sec. 137. Section 13, chapter 144, Laws of 1919 as last amended by section 51, chapter 7, Laws of 1985 and RCW 18.53.050 are each amended to read as follows:

Every registered optometrist shall annually or on the date specified by the ((~~director~~)) secretary pay to the state treasurer a renewal fee, to be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, and failure to pay such fee within the prescribed time shall cause the suspension of his or her certificate.

Sec. 138. Section 5, chapter 144, Laws of 1919 as last amended by section 4, chapter 69, Laws of 1975 1st ex. sess. and RCW 18.53.060 are each amended to read as follows:

From and after January 1, 1940, in order to be eligible for examination for registration, a person shall be a citizen of the United States of America, who shall have a preliminary education of or equal to four years in a state accredited high school and has completed a full attendance course in a regularly chartered school of optometry maintaining a standard which is deemed sufficient and satisfactory by the optometry board, who is a person of good moral character, who is not afflicted with any contagious or infectious disease, who has a visual acuity in at least one eye, of a standard known as 20/40 under correction((~~: PROVIDED, That~~)). From and after January 1, 1975, in order to be eligible for examination for a license, a person shall have the following qualifications:

(1) Be a graduate of a state accredited high school or its equivalent;

(2) Have a diploma or other certificate of completion from an accredited college of optometry or school of optometry, maintaining a standard which is deemed sufficient and satisfactory by the optometry board, conferring its degree of doctor of optometry or its equivalent, maintaining a course of four scholastic years in addition to preprofessional college level studies, and teaching substantially all of the following subjects: General anatomy, anatomy of the eyes, physiology, physics, chemistry, pharmacology, biology, bacteriology, general pathology, ocular pathology, ocular neurology, ocular myology, psychology, physiological optics, optometrical mechanics, clinical optometry, visual field charting and orthoptics, general laws of optics and refraction and use of the opthalmoscope, retinoscope and other clinical instruments necessary in the practice of optometry;

(3) Be of good moral character; and

(4) Have no contagious or infectious disease.

Such person shall file an application for an examination and license with said board at any time thirty days prior to the time fixed for such examination, or at a later date if approved by the board, and such application must be on forms approved by the board, and properly attested, and if found to be in accordance with the provisions of this chapter shall entitle the applicant upon payment of the proper fee, to take the examination prescribed by the board. Such examination shall not be out of keeping with the established teachings and adopted textbooks of the recognized schools of optometry, and shall be confined to such subjects and practices as are recognized as essential to the practice of optometry. All candidates without discrimination, who shall successfully pass the prescribed examination, shall be registered by the board and shall, upon payment of the proper fee, be issued a license. The optometry board, at its discretion, may waive all or a portion of the written examination for any applicant who has satisfactorily passed the examination given by the National Board of Examiners in Optometry. Any license to practice optometry in this state issued by the ((~~director~~)) secretary, and which shall be in full force and effect at the time of passage of this 1975 amendatory act, shall be continued.

Sec. 139. Section 5, chapter 260, Laws of 1981 as amended by section 52, chapter 7, Laws of 1985 and RCW 18.53.070 are each amended to read as follows:

The fees for application for examination and for issuing a certificate of registration shall be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, which shall be paid to the ((~~director~~)) secretary as he or she shall prescribe.

Sec. 140. Section 11, chapter 144, Laws of 1919 as last amended by section 81, chapter 259, Laws of 1986 and RCW 18.53.100 are each amended to read as follows:

The following constitutes grounds for disciplinary action under chapter 18.130 RCW:

(1) Any form of fraud or deceit used in securing a license; or

(2) Any unprofessional conduct, of a nature likely to deceive or defraud the public; or

(3) The employing either directly or indirectly of any person or persons commonly known as "cappers" or "steerers" to obtain business; or

(4) To employ any person to solicit from house to house, or to personally solicit from house to house; or

(5) Advertisement in any way in which untruthful, improbable or impossible statements are made regarding treatments, cures or values; or

(6) The use of the term "eye specialist" in connection with the name of such optometrist; or

(7) Inability to demonstrate, in a manner satisfactory to the ((~~director~~)) secretary or the board of optometry, their practical ability to perform any function set forth in RCW 18.53.010 which they utilize in their practice.

Sec. 141. Section 7, chapter 144, Laws of 1919 as last amended by section 2, chapter 36, Laws of 1989 and RCW 18.53.140 are each amended to read as follows:

It shall be unlawful for any person:

(1) To sell or barter, or offer to sell or barter any license issued by the ((~~director~~)) secretary; or

(2) To purchase or procure by barter any license with the intent to use the same as evidence of the holder's qualification to practice optometry; or

(3) To alter with fraudulent intent in any material regard such license; or

(4) To use or attempt to use any such license which has been purchased, fraudulently issued, counterfeited or materially altered as a valid license; or

(5) To practice optometry under a false or assumed name, or as a representative or agent of any person, firm or corporation with which the licensee has no connection((~~: PROVIDED,~~)). Nothing in this chapter nor in the optometry law shall make it unlawful for any lawfully licensed optometrist or association of lawfully licensed optometrists to practice optometry under the name of any lawfully licensed optometrist who may transfer by inheritance or otherwise the right to use such name; or

(6) To practice optometry in this state either for ((~~himself~~)) him or herself or any other individual, corporation, partnership, group, public or private entity, or any member of the licensed healing arts without having at the time of so doing a valid license issued by the director of licensing; or

(7) To in any manner barter or give away as premiums either on his or her own account or as agent or representative for any other purpose, firm or corporation, any eyeglasses, spectacles, lenses or frames; or

(8) To use drugs in the practice of optometry, except those topically applied for diagnostic or therapeutic purposes; or

(9) To use advertising whether printed, radio, display, or of any other nature, which is misleading or inaccurate in any material particular, nor shall any such person in any way misrepresent any goods or services (including but without limitation, its use, trademark, grade, quality, size, origin, substance, character, nature, finish, material, content, or preparation) or credit terms, values, policies, services, or the nature or form of the business conducted; or

(10) To advertise the "free examination of eyes," "free consultation," "consultation without obligation," "free advice," or any words or phrases of similar import which convey the impression to the public that eyes are examined free or of a character tending to deceive or mislead the public, or in the nature of "bait advertising;" or

(11) To use an advertisement of a frame or mounting which is not truthful in describing the frame or mounting and all its component parts. Or advertise a frame or mounting at a price, unless it shall be depicted in the advertisement without lenses inserted, and in addition the advertisement must contain a statement immediately following, or adjacent to the advertised price, that the price is for frame or mounting only, and does not include lenses, eye examination and professional services, which statement shall appear in type as large as that used for the price, or advertise lenses or complete glasses, viz.: frame or mounting with lenses included, at a price either alone or in conjunction with professional services; or

(12) To use advertising, whether printed, radio, display, or of any other nature, which inaccurately lays claim to a policy or continuing practice of generally underselling competitors; or

(13) To use advertising, whether printed, radio, display or of any other nature which refers inaccurately in any material particular to any competitors or their goods, prices, values, credit terms, policies or services; or

(14) To use advertising whether printed, radio, display, or of any other nature, which states any definite amount of money as "down payment" and any definite amount of money as a subsequent payment, be it daily, weekly, monthly, or at the end of any period of time.

Sec. 142. Section 5, chapter 25, Laws of 1963 as last amended by section 65, chapter 175, Laws of 1989 and RCW 18.54.050 are each amended to read as follows:

The board must meet at least once yearly or more frequently upon call of the chairman or the ((~~director of licensing~~)) secretary of health at such times and places as the chairman or the ((~~director of licensing~~)) secretary of health may designate by giving three days' notice or as otherwise required by RCW 42.30.075.

Sec. 143. Section 7, chapter 25, Laws of 1963 as last amended by section 84, chapter 259, Laws of 1986 and RCW 18.54.070 are each amended to read as follows:

The board has the following powers and duties:

(1) The board shall prepare the necessary lists of examination questions, conduct examinations, either written or oral or partly written and partly oral, and shall certify to the ((~~director of licensing~~)) secretary of health all lists, signed by all members conducting the examination, of all applicants for licenses who have successfully passed the examination and a separate list of all applicants for licenses who have failed to pass the examination, together with a copy of all examination questions used, and the written answers to questions on written examinations submitted by each of the applicants.

(2) The board shall adopt rules ((~~and regulations~~)) to promote safety, protection and the welfare of the public, to carry out the purposes of this chapter, to aid the board in the performance of its powers and duties, and to govern the practice of optometry.

Sec. 144. Section 14, chapter 25, Laws of 1963 as last amended by section 9, chapter 168, Laws of 1983 and RCW 18.54.140 are each amended to read as follows:

Notwithstanding any other provisions of law((,)) or rule ((~~or regulation~~)), the board may draw from the health professions account on vouchers approved by the ((~~director of licensing~~)) secretary of health, so much money as is necessary to carry into effect, to administer, and to enforce the provisions of this chapter.

Sec. 145. Section 2, chapter 101, Laws of 1980 and RCW 18.55.020 are each amended to read as follows:

The terms defined in this section shall have the meaning ascribed to them wherever appearing in this chapter, unless a different meaning is specifically used to such term in such statute.

(1) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(2) "Ocularist" means a person who designs, fabricates, and fits ocular prosthetic appliances. An ocularist is authorized to perform the necessary procedures to provide an ocular prosthetic service for the patient in the ocularist's office or laboratory on prescription of a physician. The ocularist is authorized to make judgment on the needed care, replacement, and use of an ocular prosthetic appliance. The ocularist is authorized to design, fabricate, and fit human prosthetics in the following categories:

(a) Stock and custom prosthetic eyes;

(b) Stock and custom therapeutic scleral shells;

(d) External orbital and facial prosthetics; and

(e) Ocular conformers((~~: PROVIDED, That~~)), however nothing herein shall be construed to allow the fitting or fabricating of contact lenses.

(3) "Apprentice" means a person designated an apprentice in the records of the ((~~director~~)) secretary at the request of a licensed ocularist, and who shall thereafter receive from such licensee training and direct supervision in the work of an ocularist.

Sec. 146. Section 3, chapter 101, Laws of 1980 and RCW 18.55.030 are each amended to read as follows:

Upon receipt of an application for a license and the license fee as determined by the ((~~director~~)) secretary, the ((~~director~~)) secretary shall issue a license if the applicant meets the requirements established under this chapter. The license, unless suspended or revoked, shall be renewed annually. All licenses issued under the provisions of this chapter shall expire on the 1st day of July.

Sec. 147. Section 4, chapter 101, Laws of 1980 as amended by section 53, chapter 7, Laws of 1985 and RCW 18.55.040 are each amended to read as follows:

(1) No applicant for a license shall be registered under this chapter until the applicant pays an examination fee as shall be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, and certifies under oath that the applicant:

(a) Is eighteen years or more of age;

(b) Has graduated from high school;

(d) Has either:

(i) Had at least five years of apprenticeship training under a licensed ocularist in the state of Washington; or

(ii) Successfully completed a prescribed course in ocularist training programs in a college, teaching facility, or university approved by the ((~~director~~)) secretary; or

(iii) Been principally engaged in practicing as an ocularist outside the state of Washington for eight years and shall have been employed by a licensed ocularist or physician for one year in the state of Washington; and

(iv) Successfully passes with a grade of at least seventy-five percent, an examination, conducted by the ((~~director~~)) secretary, which shall determine whether the applicant has a thorough knowledge of the principles governing the practice of an ocularist.

(2) The ((~~director~~)) secretary shall issue a license without examination to any person who makes application therefor within six months after June 12, 1980, pays a fee as determined by the ((~~director~~)) secretary, and certifies under oath that the applicant has been actually and principally engaged in the practice of an ocularist in the state of Washington for a period of not less than five years immediately preceding June 12, 1980.

(3) Any person who on June 12, 1980 (a) is employed as apprentice by a person who is principally engaged in the practice of an ocularist, (b) registers with the ((~~director~~)) secretary prior to one hundred twenty days after June 12, 1980, and (c) furnishes the ((~~director~~)) secretary a statement, under oath, and certified as correct by the employer, as to the length of time of such employment shall be given credit for such period towards compliance with the requirement for five years' apprenticeship.

Sec. 148. Section 7, chapter 101, Laws of 1980 as amended by section 54, chapter 7, Laws of 1985 and RCW 18.55.050 are each amended to read as follows:

Every licensee under this chapter shall pay an annual renewal registration fee determined by the ((~~director~~)) secretary, as provided by RCW 43.24.086, on or before the 1st day of July of each year, and thereupon the license of such person shall be renewed for a period of one year. An application for renewal shall be on the form provided by the ((~~director~~)) secretary and shall be filed with the department of ((~~licensing~~)) health not less than ten days prior to its expiration. Each application for renewal shall be accompanied by a license fee as shall be determined by the ((~~director~~)) secretary. Any license not renewed as provided in this section shall render the license invalid but such licensee shall be reinstated upon written application therefore to the ((~~director~~)) secretary and payment of a renewal fee to the ((~~director~~)) secretary as provided in RCW 43.24.086, together with all delinquent annual renewal license fees.

Sec. 149. Section 5, chapter 101, Laws of 1980 and RCW 18.55.060 are each amended to read as follows:

(1) No licensee under this chapter may have more than two apprentices in training at one time.

(2) The licensee shall be responsible for the acts of the apprentices in the performance of their work in the apprenticeship program.

(3) Apprentices shall complete their apprenticeship in eight years and shall not work longer as an apprentice unless the ((~~director~~)) secretary determines, after a hearing, that the apprentice was prevented by causes beyond his or her control from completing the apprenticeship and becoming a licensee hereunder in eight years.

Sec. 150. Section 1, chapter 117, Laws of 1979 and RCW 18.57.001 are each amended to read as follows:

As used in this chapter:

(1) "Board" means the Washington state board of osteopathic medicine and surgery;

(2) "Department" means the department of ((~~licensing~~)) health;

(3) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health; and

(4) "Osteopathic medicine and surgery" means the use of any and all methods in the treatment of disease, injuries, deformities, and all other physical and mental conditions in and of human beings, including the use of osteopathic manipulative therapy. The term means the same as "osteopathy and surgery".

Sec. 151. Section 4, chapter 4, Laws of 1919 as last amended by section 11, chapter 117, Laws of 1979 and RCW 18.57.020 are each amended to read as follows:

A license shall be issued by the ((~~director~~)) secretary authorizing the holder thereof to practice osteopathy or osteopathic medicine and surgery, including the use of internal medicine and drugs, and shall be the only type of license issued. All licenses to practice osteopathy or osteopathic medicine and surgery, including the use of internal medicine and drugs, heretofore issued shall remain in full force and effect((~~: PROVIDED, That~~)). A license to practice osteopathy and surgery shall be deemed to be the same as a license to practice osteopathic medicine and surgery, and the former license may be exchanged for the latter license at the option of the license holder.

In order to procure a license to practice osteopathic medicine and surgery, the applicant must file with the board satisfactory testimonials of good moral character and a diploma issued by some legally chartered school of osteopathic medicine and surgery, approved by the board, or satisfactory evidence of having possessed such diploma, and he or she must file with such diploma an application sworn to before some person authorized to administer oaths, and attested by the hand and seal of such officer, if he or she have a seal, stating that he or she is the person named in said diploma, that he or she is the lawful holder thereof, and that the same was procured in the regular course of instruction and examination, without fraud or misrepresentation. The said application shall be made upon a form prepared by the ((~~director~~)) secretary, with the approval of the board, and it shall contain such information concerning said osteopathic medical instruction and the preliminary education of the applicant as the board may by rule provide. Applicants who have failed to meet the requirements must be rejected.

An applicant for a license to practice osteopathic medicine and surgery must furnish evidence satisfactory to the board that he or she has served for not less than one year as intern or resident in a training program acceptable to the board.

In addition, the applicant may be required to furnish evidence satisfactory to the board that he or she is physically and mentally capable of safely carrying on the practice of osteopathic medicine and surgery. The board may require any applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and/or mental capability to safely practice osteopathic medicine and surgery. The applicant must also show that he or she has not been guilty of any conduct which would constitute grounds for denial, suspension, or revocation of such license under the laws of the state of Washington.

Nothing in this section shall be construed as prohibiting the board from requiring such additional information from applicants as it deems necessary.

Nothing in this chapter shall be construed to require any applicant for licensure, or any licensee, as a requisite of retaining or renewing licensure under this chapter, to be a member of any political and/or professional organization.

Sec. 152. Section 6, chapter 4, Laws of 1919 as last amended by section 55, chapter 7, Laws of 1985 and RCW 18.57.050 are each amended to read as follows:

Each applicant on making application shall pay the ((~~director~~)) secretary a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 which shall be paid to the state treasurer by said ((~~director~~)) secretary and used to defray the expenses and compensation of said ((~~director~~)) secretary. In case the applicant's credentials are insufficient, or in case he does not desire to take the examination, the sum of fifteen dollars shall be returned. All persons licensed to practice osteopathy or osteopathic medicine and surgery within this state who are engaged in active practice shall pay on or before the first day of May of each year to the ((~~director~~)) secretary a renewal license fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The board may establish rules ((~~and regulations~~)) governing mandatory continuing education requirements which shall be met by physicians applying for renewal of licenses. Licenses not so renewed will not be valid. The ((~~director~~)) secretary shall thirty days or more before May 1st of each year mail to all active practitioners of osteopathy or osteopathic medicine and surgery in this state at their last known address a notice of the fact that the renewal fee will be due on or before the first of May. Nothing in this chapter shall be construed so as to require that the receipt shall be recorded as original licenses are required to be recorded.

Sec. 153. Section 5, chapter 4, Laws of 1919 as amended by section 13, chapter 117, Laws of 1979 and RCW 18.57.080 are each amended to read as follows:

Applicants for a license must be personally examined by the board as to their qualifications. The examination shall be conducted in the English language, shall be practical in character and designed to discover the applicant's fitness to practice osteopathic medicine and surgery, and shall be in whole or in part in writing on the following fundamental subjects, to wit: Anatomy, histology, gynecology, pathology, bacteriology, chemistry, toxicology, physiology, obstetrics, general diagnosis, hygiene, principles and practice of osteopathic medicine, surgery, and the management of surgical cases (including anesthetics) and any other subjects that the board shall deem advisable. The examination papers shall form a part of the records of the ((~~director~~)) secretary and shall be kept on file by the board for a period of one year after examination. In said examination the applicant shall be known and designated by number only, and the name attached to the number shall be kept secret until final action by the board on such application.

Sec. 154. Section 17, chapter 4, Laws of 1919 as last amended by section 56, chapter 7, Laws of 1985 and RCW 18.57.130 are each amended to read as follows:

Any person who meets the requirements of RCW 18.57.020 ((~~as now or hereafter amended~~)) and has been examined and licensed to practice osteopathic medicine and surgery by a state board of examiners of another state or the duly constituted authorities of another state authorized to issue licenses to practice osteopathic medicine and surgery upon examination, shall upon approval of the board be entitled to receive a license to practice osteopathic medicine and surgery in this state upon the payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 to the state treasurer and filing a copy of his or her license in such other state, duly certified by the authorities granting the license to be a full, true, and correct copy thereof, and certifying also that the standard of requirements adopted by such authorities as provided by the law of such state is equal to that provided for by the provisions of this chapter((~~: PROVIDED, That~~)). No license shall issue without examination to any person who has previously failed in an examination held in this state((~~: PROVIDED, FURTHER, That~~)). All licenses herein mentioned may be revoked for unprofessional conduct, in the same manner and upon the same grounds as if issued under this chapter((~~: PROVIDED, FURTHER, That~~)). No one shall be permitted to practice surgery under this chapter who has not a license to practice osteopathic medicine and surgery.

Sec. 155. Section 10, chapter 30, Laws of 1971 ex. sess. as last amended by section 57, chapter 7, Laws of 1985 and by section 96, chapter 259, Laws of 1986 and RCW 18.57A.040 are each reenacted and amended to read as follows:

No osteopathic physician practicing in this state shall utilize the services of an osteopathic physician's assistant without the approval of the board.

Any osteopathic physician licensed in this state may apply to the board for permission to use the services of an osteopathic physician's assistant. The application shall be accompanied by a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, shall detail the manner and extent to which the physician's assistant would be used and supervised, shall detail the education, training, and experience of the osteopathic physician's assistant and shall provide such other information in such form as the board may require.

The board may approve or reject such applications. In addition, the board may modify the proposed utilization of the osteopathic physician's assistant, and approve the application as modified. No such approval shall extend for more than one year, but approval once granted may be renewed annually upon payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Whenever it appears to the board that an osteopathic physician's assistant is being utilized in a manner inconsistent with the approval granted, the board may withdraw such approval. In the event a hearing is requested upon the rejection of an application, or upon the withdrawal of an approval, a hearing shall be conducted in accordance with chapter 34.05 RCW.

Sec. 156. Section 3, chapter 9, Laws of 1984 and RCW 18.59.020 are each amended to read as follows:

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

(1) "Board" means the board of occupational therapy practice.

(2) "Occupational therapy" is the scientifically based use of purposeful activity with individuals who are limited by physical injury or illness, psychosocial dysfunction, developmental or learning disabilities, or the aging process in order to maximize independence, prevent disability, and maintain health. The practice encompasses evaluation, treatment, and consultation. Specific occupational therapy services include but are not limited to: Using specifically designed activities and exercises to enhance neurodevelopmental, cognitive, perceptual motor, sensory integrative, and psychomotor functioning; administering and interpreting tests such as manual muscle and sensory integration; teaching daily living skills; developing prevocational skills and play and avocational capabilities; designing, fabricating, or applying selected orthotic and prosthetic devices or selected adaptive equipment; and adapting environments for the handicapped. These services are provided individually, in groups, or through social systems.

(3) "Occupational therapist" means a person licensed to practice occupational therapy under this chapter.

(4) "Occupational therapy assistant" means a person licensed to assist in the practice of occupational therapy under the supervision or with the regular consultation of an occupational therapist.

(5) "Occupational therapy aide" means a person who is trained to perform specific occupational therapy techniques under professional supervision as defined by the board but who does not perform activities that require advanced training in the sciences or practices involved in the profession of occupational therapy.

(6) "Person" means any individual, partnership, unincorporated organization, or corporate body, except that only an individual may be licensed under this chapter.

(7) "Department" means the department of ((~~licensing~~)) health.

(8) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

Sec. 157. Section 9, chapter 9, Laws of 1984 and RCW 18.59.080 are each amended to read as follows:

The ((~~director~~)) secretary shall issue a license to a person who meets the licensing requirements of this chapter upon payment of the prescribed license fee. The license shall be posted in a conspicuous location at the person's work site.

Sec. 158. Section 10, chapter 9, Laws of 1984 and RCW 18.59.090 are each amended to read as follows:

(1) Licenses under this chapter shall be renewed at the time and in the manner determined by the ((~~director~~)) secretary and with the payment of a renewal fee. The board may establish requirements for license renewal which provide evidence of continued competency. The ((~~director~~)) secretary may provide for the late renewal of a license upon the payment of a late fee in accordance with its rules which may include additional continuing education or examination requirements.

(2) A suspended license is subject to expiration and may be renewed as provided in this section, but the renewal does not entitle the licensee, while the license remains suspended and until it is reinstated, to engage in the licensed activity, or in any other conduct or activity in violation of the order or judgment by which the license was suspended. If a license revoked on disciplinary grounds is reinstated, the licensee, as a condition of reinstatement, shall pay the renewal fee and any applicable late fee.

(3) Any occupational therapist or occupational therapy assistant licensed under this chapter not practicing occupational therapy or providing services may place his or her license in an inactive status. The ((~~director~~)) secretary may prescribe requirements for maintaining an inactive status and converting from an inactive or active status.

Sec. 159. Section 12, chapter 9, Laws of 1984 as amended by section 58, chapter 7, Laws of 1985 and RCW 18.59.110 are each amended to read as follows:

The ((~~director~~)) secretary shall prescribe and publish fees in amounts determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 for the following purposes:

(1) Application for examination;

(2) Initial license fee;

(3) Renewal of license fee;

(4) Late renewal fee; and

(5) Limited permit fee.

The fees shall be set in such an amount as to reimburse the state, to the extent feasible, for the cost of the services rendered.

Sec. 160. Section 15, chapter 9, Laws of 1984 and RCW 18.59.150 are each amended to read as follows:

The ((~~director~~)) secretary shall provide such administrative and investigative staff as are necessary for the board to carry out its duties under this chapter.

Sec. 161. Section 2, chapter 60, Laws of 1957 as last amended by section 1, chapter 104, Laws of 1988 and RCW 18.71.010 are each amended to read as follows:

The following terms used in this chapter shall have the meanings set forth in this section unless the context clearly indicates otherwise:

(1) "Board" means the board of medical examiners.

(2) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(3) "Resident physician" means an individual who has graduated from a school of medicine which meets the requirements set forth in RCW 18.71.055 and is serving a period of postgraduate clinical medical training sponsored by a college or university in this state or by a hospital accredited by this state. For purposes of this chapter, the term shall include individuals designated as intern or medical fellow.

(4) "Emergency medical care" or "emergency medical service" has the same meaning as in chapter 18.73 RCW.

Sec. 162. Section 1, chapter 322, Laws of 1985 and RCW 18.71.040 are each amended to read as follows:

Every applicant for a certificate to practice medicine and surgery shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 163. Section 3, chapter 60, Laws of 1957 as last amended by section 109, chapter 259, Laws of 1986 and RCW 18.71.050 are each amended to read as follows:

(1) Each applicant who has graduated from a school of medicine located in any state, territory or possession of the United States, the District of Columbia, or the Dominion of Canada, shall file an application for licensure with the board on a form prepared by the ((~~director~~)) secretary with the approval of the board. Each applicant shall furnish proof satisfactory to the board of the following:

(a) That the applicant has attended and graduated from a school of medicine approved by the board;

(b) That the applicant has completed two years of postgraduate medical training in a program acceptable to the board, provided that applicants graduating before July 28, 1985, may complete only one year of postgraduate medical training;

(d) That the applicant is physically and mentally capable of safely carrying on the practice of medicine. The board may require any applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and/or mental capability to safely practice medicine.

(2) Nothing in this section shall be construed as prohibiting the board from requiring such additional information from applicants as it deems necessary. The issuance and denial of licenses are subject to chapter 18.130 RCW, the uniform disciplinary act.

Sec. 164. Section 16, chapter 171, Laws of 1975 1st ex. sess. and RCW 18.71.051 are each amended to read as follows:

Applicants for licensure to practice medicine who have graduated from a school of medicine located outside of the states, territories and possessions of the United States, the District of Columbia, or the Dominion of Canada, shall file an application for licensure with the board on a form prepared by the ((~~director~~)) secretary with the approval of the board. Each applicant shall furnish proof satisfactory to the board of the following:

(1) That he or she has completed in a school of medicine a resident course of professional instruction equivalent to that required in this chapter for applicants generally;

(2) That he or she meets all the requirements which must be met by graduates of the United States and Canadian school of medicine except that he or she need not have graduated from a school of medicine approved by the board;

(3) That he or she has satisfactorily passed the examination given by the educational council for foreign medical graduates or has met the requirements in lieu thereof as set forth in rules ((~~and regulations~~)) adopted by the board;

(4) That he or she has the ability to read, write, speak, understand, and be understood in the English language.

Sec. 165. Section 4, chapter 322, Laws of 1985 and RCW 18.71.080 are each amended to read as follows:

Every person licensed to practice medicine in this state shall register with the ((~~director of licensing~~)) secretary of health annually, and pay an annual renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The board may establish rules ((~~and regulations~~)) governing mandatory continuing education requirements which shall be met by physicians applying for renewal of licenses. Any failure to register and pay the annual renewal registration fee shall render the license invalid, but such license shall be reinstated upon written application therefor to the ((~~director~~)) secretary, and payment to the state of a penalty fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, together with all delinquent annual license renewal fees((~~: PROVIDED, HOWEVER, That~~)). Any person who fails to renew the license for a period of three years, shall in no event be entitled to renew the license under this section. Such a person in order to obtain a license to practice medicine in this state, shall file an original application as provided for in this chapter, along with the requisite fee therefor. The board, in its sole discretion, may permit such applicant to be licensed without examination if it is satisfied that such applicant meets all the requirements for licensure in this state, and is competent to engage in the practice of medicine.

Sec. 166. Section 1, chapter 129, Laws of 1987 and RCW 18.71.095 are each amended to read as follows:

The board may, without examination, issue a limited license to persons who possess the qualifications set forth herein:

(1) The board may, upon the written request of the secretary of the department of ((~~social and health services~~)) health or the secretary of corrections, issue a limited license to practice medicine in this state to persons who have been accepted for employment by the department of social and health services or the department of corrections as physicians; who are licensed to practice medicine in another state of the United States or in the country of Canada or any province or territory thereof; and who meet all of the qualifications for licensure set forth in RCW 18.71.050.

Such license shall permit the holder thereof to practice medicine only in connection with patients, residents, or inmates of the state institutions under the control and supervision of the secretary of the department of social and health services or the department of corrections.

(2) The board may issue a limited license to practice medicine in this state to persons who have been accepted for employment by a county or city health department as physicians; who are licensed to practice medicine in another state of the United States or in the country of Canada or any province or territory thereof; and who meet all of the qualifications for licensure set forth in RCW 18.71.050.

Such license shall permit the holder thereof to practice medicine only in connection with his or her duties in employment with the city or county health department.

(3) Upon receipt of a completed application showing that the applicant meets all of the requirements for licensure set forth in RCW 18.71.050 except for completion of two years of postgraduate medical training, and that the applicant has been appointed as a resident physician in a program of postgraduate clinical training in this state approved by the board, the board may issue a limited license to a resident physician. Such license shall permit the resident physician to practice medicine only in connection with his or her duties as a resident physician and shall not authorize the physician to engage in any other form of practice. Each resident physician shall practice medicine only under the supervision and control of a physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physician at the place where services are rendered.

(4)(a) Upon nomination by the dean of the school of medicine at the University of Washington or the chief executive officer of a hospital or other appropriate health care facility licensed in the state of Washington, the board may issue a limited license to a physician applicant invited to serve as a teaching-research member of the institution's instructional staff if the sponsoring institution and the applicant give evidence that he or she has graduated from a recognized medical school and has been licensed or otherwise privileged to practice medicine at his or her location of origin. Such license shall permit the recipient to practice medicine only within the confines of the instructional program specified in the application and shall terminate whenever the holder ceases to be involved in that program, or at the end of one year, whichever is earlier. Upon request of the applicant and the institutional authority, the license may be renewed for no more than a total of two years.

(b) Upon nomination by the dean of the school of medicine of the University of Washington or the chief executive officer of any hospital or appropriate health care facility licensed in the state of Washington, the board may issue a limited license to an applicant selected by the sponsoring institution to be enrolled in one of its designated departmental or divisional fellowship programs provided that the applicant shall have graduated from a recognized medical school and has been granted a license or other appropriate certificate to practice medicine in the location of the applicant's origin. Such license shall permit the holder only to practice medicine within the confines of the fellowship program to which he or she has been appointed and, upon the request of the applicant and the sponsoring institution, the license may be renewed by the board for a total period of time not to exceed two calendar years.

All persons licensed under this section shall be subject to the jurisdiction of the medical disciplinary board to the same extent as other members of the medical profession, in accordance with chapters 18.72 and 18.130 RCW.

Persons applying for licensure pursuant to this section shall pay an application fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 and, in the event the license applied for is issued, a license fee at the rate provided for renewals of licenses generally. Licenses issued hereunder may be renewed annually pursuant to the provisions of RCW 18.71.080. Any person who obtains a limited license pursuant to this section may, without an additional application fee, apply for licensure under this chapter, but shall submit a new application form and comply with all other licensing requirements of this chapter.

Sec. 167. Section 2, chapter 305, Laws of 1971 ex. sess. as last amended by section 111, chapter 259, Laws of 1986 and RCW 18.71.200 are each amended to read as follows:

(1) As used in this chapter, a "physician's trained mobile intravenous therapy technician" means a person who:

(a) Has successfully completed an emergency medical technician course as described in chapter 18.73 RCW;

(b) Is trained under the supervision of an approved medical program director to administer intravenous solutions under written or oral authorization of an approved licensed physician; and

(c) Has been examined and certified as a physician's trained mobile intravenous therapy technician by the University of Washington's school of medicine or the department of ((~~social and health services~~)) health;

(2) As used in this chapter, a "physician's trained mobile airway management technician" means a person who:

(a) Has successfully completed an emergency medical technician course as described in chapter 18.73 RCW;

(b) Is trained under the supervision of an approved medical program director to perform endotracheal airway management and other authorized aids to ventilation under written or oral authorization of an approved licensed physician; and

(c) Has been examined and certified as a physician's trained mobile airway management technician by the University of Washington's school of medicine or the department of ((~~social and health services~~)) health; and

(3) As used in this chapter, a "physician's trained mobile intensive care paramedic" means a person who:

(a) Has successfully completed an emergency medical technician course as described in chapter 18.73 RCW;

(b) Is trained under the supervision of an approved medical program director:

(i) To carry out all phases of advanced cardiac life support;

(ii) To administer drugs under written or oral authorization of an approved licensed physician; and

(iii) To administer intravenous solutions under written or oral authorization of an approved licensed physician; and

(iv) To perform endotracheal airway management and other authorized aids to ventilation; and

(c) Has been examined and certified as a physician's trained mobile intensive care paramedic by the University of Washington's school of medicine or by the department of ((~~social and health services~~)) health.

Sec. 168. Section 3, chapter 55, Laws of 1977 as last amended by section 1, chapter 68, Laws of 1986 and RCW 18.71.205 are each amended to read as follows:

(1) The secretary of the department of ((~~social and health services~~)) health, in conjunction with the advice and assistance of the emergency medical services committee as prescribed in RCW 18.73.050, and the board of medical examiners, shall prescribe:

(a) Minimum standards and performance requirements for the certification and recertification of physician's trained intravenous therapy technicians, airway management technicians, and mobile intensive care paramedics; and

(b) Procedures for certification, recertification, and decertification of physician's trained intravenous therapy technicians, airway management technicians, and mobile intensive care paramedics.

(2) Initial certification shall be for a period of two years.

(3) Recertification shall be granted upon proof of continuing satisfactory performance and education, and shall be for a period of two years.

(4) As used in chapters 18.71 and 18.73 RCW, "approved medical program director" means a person who:

(a) Is licensed to practice medicine and surgery pursuant to chapter 18.71 RCW or osteopathy and surgery pursuant to chapter 18.57 RCW; and

(b) Is qualified and knowledgeable in the administration and management of emergency care and services; and

(c) Is so certified by the department of ((~~social and health services~~)) health for a county or group of counties in coordination with the recommendations of the local medical community and local emergency medical services council.

Sec. 169. Section 2, chapter 68, Laws of 1986 and RCW 18.71.212 are each amended to read as follows:

The secretary of the department of ((~~social and health services~~)) health, in conjunction with the state emergency medical services committee, shall evaluate, certify and terminate certification of medical program directors, and prescribe minimum standards defining duties and responsibilities and performance of duties and responsibilities.

Sec. 170. Section 4, chapter 112, Laws of 1983 as amended by section 5, chapter 68, Laws of 1986 and RCW 18.71.215 are each amended to read as follows:

The department of ((~~social and health services~~)) health shall defend and hold harmless approved medical program directors, delegates, or agents for any act or omission committed or omitted in good faith in the performance of his or her duties.

Sec. 171. Section 4, chapter 30, Laws of 1971 ex. sess. as last amended by section 61, chapter 7, Laws of 1985 and by section 113, chapter 259, Laws of 1986 and RCW 18.71A.040 are each reenacted and amended to read as follows:

No physician practicing in this state shall utilize the services of a physician's assistant without the approval of the board.

Any physician licensed in this state may apply to the board for permission to use the services of a physician's assistant. The application shall be accompanied by a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, shall detail the manner and extent to which the physician's assistant would be used and supervised, shall detail the education, training, and experience of the physician's assistant and shall provide such other information in such form as the board may require.

The board may approve or reject such applications. In addition, the board may modify the proposed utilization of the physician's assistant, and approve the application as modified. No such approval shall extend for more than one year, but approval once granted may be renewed annually upon payment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Whenever it appears to the board that a physician's assistant is being utilized in a manner inconsistent with the approval granted, the board may withdraw such approval. In the event a hearing is requested upon the rejection of an application, or upon the withdrawal of an approval, a hearing shall be conducted in accordance with chapter 18.130 RCW.

Sec. 172. Section 3, chapter 190, Laws of 1975 1st ex. sess. as amended by section 58, chapter 158, Laws of 1979 and RCW 18.71A.070 are each amended to read as follows:

There shall be appointed by the ((~~director of licensing~~)) secretary of health an agent whose title shall be "medical practice investigator", who shall have the duty and shall be authorized to enter the clinic, office, or premises where a physician's assistant is employed for the purpose of inspecting the registration and utilization of any physician's assistant employed therein. Said investigator may serve and execute any notice or process issued under the authority of this chapter and shall perform any other duty prescribed by the ((~~director~~)) secretary or the board, including assisting other agencies in enforcing the provisions of the law regulating the practice of medicine((~~: PROVIDED, That funds must be included in the department's 1975-77 operational budget for this program~~)).

Sec. 173. Section 10, chapter 202, Laws of 1955 as last amended by section 45, chapter 287, Laws of 1984 and RCW 18.72.100 are each amended to read as follows:

Members of the board shall be compensated in accordance with RCW 43.03.240 and shall be repaid their travel expenses while engaged in business of the board in accordance with RCW 43.03.050 and 43.03.060. Such compensation and reimbursement for expenses shall be paid out of the general fund on vouchers approved by the ((~~director of licensing~~)) secretary of health.

Sec. 174. Section 12, chapter 202, Laws of 1955 and RCW 18.72.120 are each amended to read as follows:

The first board shall be organized in this manner: Within ten days after the effective date of this chapter the ((~~director of licenses~~)) secretary of health shall appoint five holders of licenses to practice medicine and surgery in this state to serve as members of a temporary commission which shall, within ninety days thereafter, organize and hold the election to name the first members of the medical disciplinary board. The temporary commission shall adopt such rules ((~~and regulations~~)) as it deems necessary to govern the holding of the first election. After the election is completed and the first members of the board have qualified and taken office, the temporary commission shall be abolished and all of its records shall be turned over to the board.

Sec. 175. Section 6, chapter 111, Laws of 1979 ex. sess. and RCW 18.72.155 are each amended to read as follows:

The ((~~director~~)) secretary of the department of ((~~licensing~~)) health shall appoint, from a list of three names supplied by the board, an executive secretary who shall act to carry out the provisions of this chapter. The ((~~director~~)) secretary shall also employ such additional staff including administrative assistants, investigators, and clerical staff as are required to enable the board to accomplish its duties and responsibilities. The executive secretary shall be exempt from the provisions of the civil service law, chapter 41.06 RCW((~~, as now or hereafter amended~~)).

Sec. 176. Section 2, chapter 416, Laws of 1987 as amended by section 2, chapter 119, Laws of 1989 and RCW 18.72.306 are each amended to read as follows:

(1) The board shall enter into a contract with the committee to implement an impaired physician program. The impaired physician program may include any or all of the following:

(a) Contracting with providers of treatment programs;

(b) Receiving and evaluating reports of suspected impairment from any source;

(d) Referring impaired physicians to treatment programs;

(e) Monitoring the treatment and rehabilitation of impaired physicians including those ordered by the board;

(f) Providing post-treatment monitoring and support of rehabilitative impaired physicians;

(g) Performing such other activities as agreed upon by the board and the committee; and

(h) Providing prevention and education services.

(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of up to twenty-five dollars on each license renewal or issuance of a new license to be collected by the department of ((~~licensing~~)) health from every physician and surgeon licensed under chapter 18.71 RCW in addition to other license fees and the medical discipline assessment fee established under RCW 18.72.380. These moneys shall be placed in the health professions account to be used solely for the implementation of the impaired physician program.

Sec. 177. Section 1, chapter 71, Laws of 1983 as amended by section 62, chapter 7, Laws of 1985 and RCW 18.72.380 are each amended to read as follows:

There is hereby levied to be collected by the department of ((~~licensing~~)) health from every physician and surgeon licensed pursuant to chapter 18.71 RCW an annual medical disciplinary assessment equal to the license renewal fee established under RCW 43.24.086. The assessment levied pursuant to this ((~~subsection~~)) section is in addition to any license renewal fee established under RCW 43.24.086.

Sec. 178. Section 3, chapter 71, Laws of 1983 and RCW 18.72.400 are each amended to read as follows:

The ((~~director of licensing~~)) secretary of health shall allocate all appropriated funds to accomplish the purposes of this chapter.

Sec. 179. Section 1, chapter 208, Laws of 1973 1st ex. sess. as last amended by section 2, chapter 104, Laws of 1988 and RCW 18.73.010 are each amended to read as follows:

The legislature finds that a state-wide program of emergency medical care is necessary to promote the health, safety, and welfare of the citizens of this state. The intent of the legislature is that the secretary of the department of ((~~social and health services~~)) health develop and implement a system to promote immediate treatment for victims of motor vehicle accidents, suspected coronary illnesses, and other acute illness or trauma.

The legislature further recognizes that emergency medical care and transportation methods are constantly changing and conditions in the various regions of the state vary markedly. The legislature, therefore, seeks to establish a flexible method of implementation and regulation to meet those conditions.

Sec. 180. Section 3, chapter 208, Laws of 1973 1st ex. sess. as last amended by section 3, chapter 104, Laws of 1988 and RCW 18.73.030 are each amended to read as follows:

Unless a different meaning is plainly required by the context, the following words and phrases as used in this chapter shall have the meanings indicated.

(1) "Secretary" means the secretary of the department of ((~~social and health services~~)) health.

(2) "Department" means the department of ((~~social and health services~~)) health.

(3) "Committee" means the emergency medical services committee.

(4) "Ambulance" means a ground or air vehicle designed and used to transport the ill and injured and to provide personnel, facilities, and equipment to treat patients before and during transportation.

(5) " Aid vehicle" means a vehicle used to carry aid equipment and individuals trained in first aid or emergency medical procedure.

(6) "Emergency medical technician" means a person who is authorized by the secretary to render emergency medical care pursuant to RCW 18.73.081.

(7) "Ambulance operator" means a person who owns one or more ambulances and operates them as a private business.

(8) "Ambulance director" means a person who is a director of a service which operates one or more ambulances provided by a volunteer organization or governmental agency.

(9) "Aid vehicle operator" means a person who owns one or more aid vehicles and operates them as a private business.

(10) "Aid director" means a person who is a director of a service which operates one or more aid vehicles provided by a volunteer organization or governmental agency.

(11) "Emergency medical care" or "emergency medical service" means such medical treatment and care which may be rendered at the scene of any medical emergency or while transporting any patient in an ambulance to an appropriate medical facility, including ambulance transportation between medical facilities.

(12) "Communications system" means a radio and landline network which provides rapid public access, coordinated central dispatching of services, and coordination of personnel, equipment, and facilities in an emergency medical services system.

(13) "Emergency medical services region" means a region established by the secretary of the department of ((~~social and health services~~)) health pursuant to RCW 18.73.060((~~, as now or hereafter amended~~)).

(14) "Patient care protocols" means the written procedure adopted by the emergency medical services medical program director which direct the care of the emergency patient. These procedures shall be based upon the assessment of the patient's medical needs and what treatment will be provided for serious conditions.

(15) "Patient care guidelines" means written operating procedures adopted by the local or regional emergency medical services councils and the emergency medical services medical program director and may include which level of medical care personnel will be dispatched to an emergency scene, which hospital will first receive the patient and which hospitals are appropriate for transfer if necessary.

(16) "Emergency medical services medical program director" means a person who is an approved medical program director as defined by RCW 18.71.205(4).

(17) "Council" means the local or regional emergency medical services advisory council.

(18) "Basic life support" means emergency medical services.

(19) "Advanced life support" means emergency medical services requiring advanced medical treatment skills as defined by chapter 18.71 RCW.

(20) "System service area" means an emergency medical service area that develops because of trade, patient catchment, market, or other factors and may include county or multicounty boundaries.

(21) "First responder" means a person who is authorized by the secretary to render emergency medical care as defined by RCW 18.73.081.

Sec. 181. Section 1, chapter 239, Laws of 1949 as last amended by section 1, chapter 185, Laws of 1988 and RCW 18.74.010 are each amended to read as follows:

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

(1) "Board" means the board of physical therapy created by RCW 18.74.020.

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

(3) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(4) "Physical therapy" means the treatment of any bodily or mental condition of any person by the use of the physical, chemical, and other properties of heat, cold, air, light, water, electricity, sound, massage, and therapeutic exercise, which includes posture and rehabilitation procedures; the performance of tests and measurements of neuromuscular function as an aid to the diagnosis or treatment of any human condition; performance of treatments on the basis of test findings after consultation with and periodic review by an authorized health care practitioner except as provided in RCW 18.74.012 until June 30, 1991; supervision of selective forms of treatment by trained supportive personnel; and provision of consultative services for health, education, and community agencies. The use of Roentgen rays and radium for diagnostic and therapeutic purposes, the use of electricity for surgical purposes, including cauterization, and the use of spinal manipulation or manipulative mobilization of the spine and its immediate articulations, are not included under the term "physical therapy" as used in this chapter.

(5) "Physical therapist" means a person who practices physical therapy as defined in this chapter but does not include massage operators as defined in RCW 18.108.010.

(6) Words importing the masculine gender may be applied to females.

(7) "Authorized health care practitioner" means and includes licensed physicians, osteopathic physicians, chiropractors, naturopaths, podiatrists, and dentists: PROVIDED, HOWEVER, That nothing herein shall be construed as altering the scope of practice of such practitioners as defined in their respective licensure laws.

Sec. 182. Section 2, chapter 239, Laws of 1949 as last amended by section 46, chapter 287, Laws of 1984 and RCW 18.74.020 are each amended to read as follows:

The state board of physical therapy is hereby created. The board shall consist of five members who shall be appointed by the governor. Of the initial appointments, two shall be appointed for a term of two years, two for a term of three years, and one for a term of four years. Thereafter, all appointments shall be for terms of four years. Four members of the board shall be physical therapists licensed under this chapter and residing in this state, shall have not less than five years' experience in the practice of physical therapy, and shall be actively engaged in practice within two years of appointment. The fifth member shall be appointed from the public at large, shall have an interest in the rights of consumers of health services, and shall not be or have been a member of any other licensing board, a licensee of any health occupation board, an employee of any health facility nor derive his or her primary livelihood from the provision of health services at any level of responsibility. In the event that a member of the board for any reason cannot complete his or her term of office, another appointment shall be made by the governor in accordance with the procedure stated above to fill the remainder of the term. No member may serve for more than two successive four-year terms.

The ((~~director of licensing~~)) secretary of health shall furnish such secretarial, clerical and other assistance as the board may require. Each member of the board shall, in addition to travel expenses in accordance with RCW 43.03.050 and 43.03.060, be compensated in accordance with RCW 43.03.240.

Sec. 183. Section 4, chapter 116, Laws of 1983 as amended by section 124, chapter 259, Laws of 1986 and RCW 18.74.023 are each amended to read as follows:

The board has the following powers and duties:

(1) To administer examinations to applicants for a license under this chapter.

(2) To pass upon the qualifications of applicants for a license and to certify to the ((~~director~~)) secretary duly qualified applicants.

(3) To make such rules not inconsistent with the laws of this state as may be deemed necessary or proper to carry out the purposes of this chapter.

(4) To establish and administer requirements for continuing professional education as may be necessary or proper to ensure the public health and safety and which may be a prerequisite to granting and renewing a license under this chapter.

(5) To keep an official record of all its proceedings, which record shall be evidence of all proceedings of the board which are set forth therein.

(6) To adopt rules not inconsistent with the laws of this state, when it deems appropriate, in response to questions put to it by professional health associations, physical therapists, and consumers in this state concerning the authority of physical therapists to perform particular acts.

Sec. 184. Section 3, chapter 64, Laws of 1961 as amended by section 7, chapter 116, Laws of 1983 and RCW 18.74.035 are each amended to read as follows:

All qualified applicants for a license as a physical therapist shall be examined by the board at such time and place as the board may determine. The examination shall embrace the following subjects: The applied sciences of anatomy, neuroanatomy, kinesiology, physiology, pathology, psychology, physics; physical therapy, as defined in this chapter, applied to medicine, neurology, orthopedics, pediatrics, psychiatry, surgery; medical ethics; technical procedures in the practice of physical therapy as defined in this chapter; and such other subjects as the board may deem useful to test the applicant's fitness to practice physical therapy, but not including the adjustment or manipulation of the spine or use of a thrusting force as mobilization. Examinations shall be held within the state at least once a year, at such time and place as the board shall determine. An applicant who fails an examination may apply for reexamination upon payment of a reexamination fee determined by the ((~~director~~)) secretary.

Sec. 185. Section 4, chapter 239, Laws of 1949 as amended by section 8, chapter 116, Laws of 1983 and RCW 18.74.040 are each amended to read as follows:

The ((~~director of licensing~~)) secretary of health shall license as a physical therapist, and shall furnish a license to each applicant who successfully passes the examination for licensure as a physical therapist.

Sec. 186. Section 5, chapter 239, Laws of 1949 as last amended by section 63, chapter 7, Laws of 1985 and RCW 18.74.050 are each amended to read as follows:

The ((~~director~~)) secretary shall furnish a license upon the authority of the board to any person who applies and who has qualified under the provisions of this chapter. At the time of applying, the applicant shall pay to the state treasurer a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, provided no person registered or licensed on July 24, 1983, as a physical therapist shall be required to pay an additional fee for a license under this chapter.

Sec. 187. Section 6, chapter 239, Laws of 1949 as last amended by section 64, chapter 7, Laws of 1985 and RCW 18.74.060 are each amended to read as follows:

Upon the recommendation of the board, the ((~~director~~)) secretary shall license as a physical therapist and shall furnish a license to any person who is a physical therapist registered or licensed under the laws of another state or territory, or the District of Columbia, if the qualifications for such registration or license required of the applicant were substantially equal to the requirements under this chapter. At the time of making application, the applicant shall pay to the state treasurer a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 188. Section 7, chapter 239, Laws of 1949 as last amended by section 12, chapter 116, Laws of 1983 and RCW 18.74.070 are each amended to read as follows:

Every licensed physical therapist shall apply to the ((~~director~~)) secretary for a renewal of the license and pay to the state treasurer a fee determined by the ((~~director~~)) secretary as provided in RCW ((~~43.24.085 as now or hereafter amended~~)) 43.24.086. The license of a physical therapist who fails to renew the license within thirty days of the date set by the ((~~director~~)) secretary for renewal shall automatically lapse. Within three years from the date of lapse and upon the recommendation of the board, the ((~~director~~)) secretary may revive a lapsed license upon the payment of all past unpaid renewal fees and a penalty fee to be determined by the ((~~director~~)) secretary. The board may require reexamination of an applicant whose license has lapsed for more than three years and who has not continuously engaged in lawful practice in another state or territory, or waive reexamination in favor of evidence of continuing education satisfactory to the board.

Sec. 189. Section 9, chapter 239, Laws of 1949 as last amended by section 48, chapter 150, Laws of 1987 and RCW 18.74.090 are each amended to read as follows:

A person who is not licensed with the ((~~director of licensing~~)) secretary of health as a physical therapist under the requirements of this chapter shall not represent ((~~himself~~)) him or herself as being so licensed and shall not use in connection with his or her name the words or letters "P.T.", "R.P.T.", "L.P.T.", "physical therapy", "physiotherapy", "physical therapist" or "physiotherapist", or any other letters, words, signs, numbers, or insignia indicating or implying that he or she is a physical therapist. No person may practice physical therapy without first having a valid license. Nothing in this chapter prohibits any person licensed in this state under any other act from engaging in the practice for which he or she is licensed. It shall be the duty of the prosecuting attorney of each county to prosecute all cases involving a violation of this chapter arising within his or her county. The attorney general may assist in such prosecution and shall appear at all hearings when requested to do so by the board.

Sec. 190. Section 9, chapter 64, Laws of 1961 as amended by section 19, chapter 116, Laws of 1983 and RCW 18.74.095 are each amended to read as follows:

If any person violates the provisions of this chapter, the attorney general, prosecuting attorney, the ((~~director~~)) secretary, the board, or any citizen of the same county, may maintain an action in the name of the state to enjoin such person from practicing or holding himself or herself out as practicing physical therapy. The injunction shall not relieve criminal prosecution but the remedy by injunction shall be in addition to the liability of such offender for criminal prosecution and the suspension or revocation of his or her license.

Sec. 191. Section 12, chapter 239, Laws of 1949 as last amended by section 21, chapter 116, Laws of 1983 and RCW 18.74.120 are each amended to read as follows:

The ((~~director of licensing~~)) secretary of health shall keep a record of proceedings under this chapter and a register of all persons licensed under it. The register shall show the name of every living licensed physical therapist, his or her last known place of residence, and the date and number of his or her license as a physical therapist.

Sec. 192. Section 19, chapter 214, Laws of 1987 and RCW 18.76.020 are each amended to read as follows:

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

(1) "Department" means the department of ((~~social and health services~~)) health.

(2) "Poison information center medical director" means a person who: (a) Is licensed to practice medicine and surgery under chapter 18.71 RCW or osteopathy and surgery under chapter 18.57 RCW; (b) is certified by the secretary under standards adopted under RCW 18.76.050; and (c) provides services enumerated under RCW 18.76.030 and 18.76.040, and is responsible for supervision of poison information specialists.

(3) "Poison information specialist" means a person who provides services enumerated under RCW 18.76.030 and 18.76.040 under the supervision of a poison information center medical director and is certified by the secretary under standards adopted under RCW 18.76.050.

(4) "Secretary" means the secretary of ((~~social and health services~~)) health.

Sec. 193. Section 1, chapter 222, Laws of 1949 as last amended by section 2, chapter 55, Laws of 1983 and RCW 18.78.010 are each amended to read as follows:

Unless a different meaning is plainly required by the context, the following words and phrases as hereinafter used in this chapter shall have the following meanings:

(1) "Board" shall mean "Washington state board of practical nursing."

(2) "Curriculum" means the theoretical and practical studies which must be taught in order for students to meet the minimum standards of competency as determined by the board.

(3) ((~~"Director" shall mean "director of licensing."~~)) "Secretary" means the secretary of health.

(4) "Licensed practical nurse," abbreviated "L.P.N.," means a person licensed by the board to practice practical nursing.

(5) "Licensed practical nurse practice" shall mean the performance of services requiring the knowledge, skill, and judgment necessary for carrying out selected aspects of the designated nursing regimen under the direction of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, or podiatrist or at the direction and under the supervision of a registered nurse.

(6) "Supervision" shall mean the critical evaluation of acts performed with authority to take corrective action, but shall not be construed so as to require direct and bodily presence.

Sec. 194. Section 9, chapter 222, Laws of 1949 as last amended by section 65, chapter 7, Laws of 1985 and RCW 18.78.080 are each amended to read as follows:

All applicants applying for a license to practice as a licensed practical nurse with or without examination, as provided in this chapter, shall pay a license fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 to the department of ((~~licensing: PROVIDED, HOWEVER, That~~)) health. The applicant applying for a reexamination shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 195. Section 12, chapter 211, Laws of 1988 and RCW 18.78.225 are each amended to read as follows:

An individual may place his or her license on inactive status with proper notification to the department. The holder of an inactive license shall not practice practical nursing in this state. The inactive renewal fee shall be established by the ((~~director~~)) secretary pursuant to RCW 43.24.086. Failure to renew an inactive license shall result in cancellation in the same manner as an active license. An inactive license may be placed in an active status upon compliance with the rules established by the board.

The provisions relating to the denial, suspension, and revocation of a license shall be applicable to an inactive or lapsed license. When proceedings to suspend or revoke an inactive license have been initiated, the license shall not be reinstated until the proceedings have been completed.

Sec. 196. Section 1, chapter 305, Laws of 1955 as last amended by section 75, chapter 279, Laws of 1984 and RCW 18.83.010 are each amended to read as follows:

When used in this chapter:

(1) The "practice of psychology" means the application of established principles of learning, motivation, perception, thinking and emotional relationships to problems of evaluation, group relations and behavior adjustment, including but not limited to: (a) counseling and guidance; (b) use of psychotherapeutic techniques with clients who have adjustment problems in the family, at school, at work or in interpersonal relationships; (c) measuring and testing of personality, intelligence, aptitudes, emotions, public opinion, attitudes and skills.

This definition does not include the teaching of principles of psychology for accredited educational institutions, or the conduct of research in problems of human or animal behavior.

Nothing in this definition shall be construed as permitting the administration or prescribing of drugs or in any way infringing upon the practice of medicine and surgery as defined in chapter 18.71 RCW.

(2) ((~~"Director" means director of licensing~~)) "Secretary" means the secretary of health.

(3) "Board" means the examining board of psychology.

(4) "Committee" means the disciplinary committee established by the board.

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

Sec. 197. Section 87, chapter 279, Laws of 1984 and RCW 18.83.025 are each amended to read as follows:

The ((~~director~~)) secretary has the following authority:

(1) To hire such investigative, administrative, and clerical staff as necessary for the enforcement of this chapter;

(2) To establish fees to be paid for witnesses, expert witnesses, and consultants used in any investigation, hearing, or proceeding, and to reimburse the individuals for services provided.

Sec. 198. Section 77, chapter 279, Laws of 1984 and RCW 18.83.045 are each amended to read as follows:

The board shall meet at least once each year and at such other times as the board deems appropriate to properly discharge its duties. All meetings shall be held in Olympia, Washington, or such other places as may be designated by the ((~~director~~)) secretary. Five members of the board shall constitute a quorum, except that oral examinations may be conducted with only three psychologist members.

Sec. 199. Section 5, chapter 305, Laws of 1955 as last amended by section 3, chapter 27, Laws of 1986 and RCW 18.83.050 are each amended to read as follows:

(1) The board shall adopt such rules as it deems necessary to carry out its functions.

(2) The board shall examine the qualifications of applicants for licensing under this chapter, to determine which applicants are eligible for licensing under this chapter and shall forward to the ((~~director~~)) secretary the names of applicants so eligible.

(3) The board shall administer examinations to qualified applicants on at least an annual basis. The board shall determine the subject matter and scope of the examinations and shall require both written and oral examinations of each applicant, except as provided in RCW 18.83.170. The board may allow applicants to take the written examination upon the granting of their doctoral degree before completion of their internship for supervised experience.

(4) The board shall keep a complete record of its own proceedings, of the questions given in examinations, of the names and qualifications of all applicants, and the names and addresses of all licensed psychologists. The examination paper of such applicant shall be kept on file for a period of at least one year after examination.

(5) The board shall, by rule, adopt a code of ethics for psychologists which is designed to protect the public interest.

(6) The board shall create a disciplinary committee within the board for the purposes of hearing, examining, and ruling on complaints and evidence of unethical conduct or practices brought by the public, other psychologists, organizations, corporations, public or private agencies, or officers, agencies, or instrumentalities of state, county, or local governments.

(7) The board may require that persons licensed under this chapter as psychologists obtain and maintain professional liability insurance in amounts determined by the board to be practicable and reasonably available.

Sec. 200. Section 6, chapter 305, Laws of 1955 as last amended by section 79, chapter 279, Laws of 1984 and RCW 18.83.060 are each amended to read as follows:

Each applicant for a license shall file with the ((~~director~~)) secretary an application duly verified, in such form and setting forth such information as the board shall prescribe. An application fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 shall accompany each application.

Sec. 201. Section 20, chapter 70, Laws of 1965 as last amended by section 81, chapter 279, Laws of 1984 and RCW 18.83.072 are each amended to read as follows:

(1) Examination of applicants shall be held in Olympia, Washington, or at such other place as designated by the ((~~director~~)) secretary, at least annually at such times as the board may determine.

(2) Any applicant shall have the right to discuss with the board his or her performance on the examination.

(3) Any applicant who fails to make a passing grade on the examination may be allowed to retake the examination. Any applicant who fails the examination a second time must obtain special permission from the board to take the examination again.

(4) The reexamination fee shall be the same as the application fee set forth in RCW 18.83.060.

Sec. 202. Section 8, chapter 305, Laws of 1955 as last amended by section 4, chapter 27, Laws of 1986 and RCW 18.83.080 are each amended to read as follows:

Upon forwarding to the ((~~director~~)) secretary by the board of the name of each applicant entitled to a license under this chapter, the ((~~director~~)) secretary shall promptly issue to such applicant a license authorizing such applicant to use the title "psychologist" for a period of one year. Said license shall be in such form as the ((~~director~~)) secretary shall determine. Each licensed psychologist shall keep his or her license displayed in a conspicuous place in his or her principal place of business.

Sec. 203. Section 9, chapter 305, Laws of 1955 as last amended by section 83, chapter 279, Laws of 1984 and RCW 18.83.090 are each amended to read as follows:

The board shall establish rules governing mandatory continuing education requirements which shall be met by any psychologist applying for a license renewal. Each licensed psychologist shall pay to the health professions account, created in RCW ((~~43.24.072~~)) 43.70.320, annually, at such time as determined by the board, an annual license renewal fee determined by the ((~~director~~)) secretary under RCW 43.24.086. Upon receipt of the fee, the ((~~director~~)) secretary shall issue a certificate of renewal in such form as the ((~~director~~)) secretary shall determine.

Sec. 204. Section 22, chapter 70, Laws of 1965 as last amended by section 67, chapter 7, Laws of 1985 and RCW 18.83.105 are each amended to read as follows:

The board may issue certificates of qualification with appropriate title to applicants who meet all the licensing requirements except the possession of the degree of Doctor of Philosophy or its equivalent in psychology from an accredited educational institution. These certificates of qualification certify that the holder has been examined by the board and is deemed competent to perform certain functions within the practice of psychology under the periodic direct supervision of a psychologist licensed by the board. Such functions will be specified on the certificate issued by the board. Such applicant shall pay to the board of examiners a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 for certification in a single area of qualification and a fee for amendment of the certificate to include each additional area of qualification. Upon petition by a holder the board of examiners may grant authority to function without immediate supervision.

Sec. 205. Section 17, chapter 305, Laws of 1955 as last amended by section 92, chapter 279, Laws of 1984 and RCW 18.83.170 are each amended to read as follows:

Upon application accompanied by a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, the board may grant a license, without written examination, to any applicant who has not previously failed any examination held by the board of psychology of the state of Washington and furnishes evidence satisfactory to the board that the applicant:

(1) Holds a doctoral degree with primary emphasis on psychology from an accredited college or university; and

(2) Is licensed or certified to practice psychology in another state or country in which the requirements for such licensing or certification are, in the judgment of the board, essentially equivalent to those required by this chapter and the rules ((~~and regulations~~)) of the board. Such individuals must have been licensed or certified in another state for a period of at least two years; or

(3) Is a diplomate in good standing of the American Board of Examiners in Professional Psychology.

Sec. 206. Section 24, chapter 70, Laws of 1965 as amended by section 8, chapter 27, Laws of 1986 and RCW 18.83.190 are each amended to read as follows:

If any person represents himself or herself to be a psychologist, unless the person is exempt from the provisions of this chapter, without possessing a valid license, certificated qualification, or a temporary permit to do so, or if he or she violates any of the provisions of this chapter, any prosecuting attorney, the ((~~director~~)) secretary, or any citizen of the same county may maintain an action in the name of the state to enjoin such person from representing himself or herself as a psychologist. The injunction shall not relieve the person from criminal prosecution, but the remedy by injunction shall be in addition to the liability of such offender to criminal prosecution and to suspension or revocation of his or her license.

Sec. 207. Section 3, chapter 412, Laws of 1987 and RCW 18.84.020 are each amended to read as follows:

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

(1) "Department" means the department of ((~~licensing~~)) health.

(2) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(3) "Licensed practitioner" means a physician or osteopathic physician licensed under chapter 18.71 or 18.57 RCW, respectively; a registered nurse licensed under chapter 18.88 RCW; or a podiatrist licensed under chapter 18.22 RCW.

(4) "Radiologic technologist" means an individual certified under this chapter, other than a licensed practitioner, who practices radiologic technology as a:

(a) Diagnostic radiologic technologist, who is a person who actually handles x-ray equipment in the process of applying radiation on a human being for diagnostic purposes under the supervision of a licensed practitioner; or

(b) Therapeutic radiologic technologist, who is a person who uses radiation-generating equipment for therapeutic purposes on human subjects at the direction of a licensed practitioner; or

(c) Nuclear medicine technologist, who is a person who prepares radiopharmaceuticals and administers them to human beings for diagnostic and therapeutic purposes and who performs in vivo and in vitro detection and measurement of radioactivity for medical purposes under the supervision of a licensed practitioner.

(5) "Advisory committee" means the Washington state radiologic technology advisory committee.

(6) "Approved school of radiologic technology" means a school of radiologic technology approved by the council on medical education of the American medical association or a school found to maintain the equivalent of such a course of study as determined by the department. Such school may be operated by a medical or educational institution, and for the purpose of providing the requisite clinical experience, shall be affiliated with one or more general hospitals.

(7) "Radiologic technology" means the use of ionizing radiation upon a human being for diagnostic or therapeutic purposes.

(8) "Radiologist" means a physician certified by the American board of radiology or the American osteopathic board of radiology.

Sec. 208. Section 5, chapter 412, Laws of 1987 and RCW 18.84.040 are each amended to read as follows:

(1) In addition to any other authority provided by law, the ((~~director~~)) secretary may in consultation with the advisory committee:

(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) Set all certification and renewal fees in accordance with RCW 43.24.086;

(d) Evaluate and designate those schools from which graduation will be accepted as proof of an applicant's eligibility to receive a certificate;

(e) Determine whether alternative methods of training are equivalent to formal education, and to establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to receive a certificate;

(f) Issue a certificate to any applicant who has met the education, training, and conduct requirements for certification; and

(g) Hire clerical, administrative, and investigative staff as needed to implement this chapter.

(2) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of certifications, uncertified practice and the discipline of certificants under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

Sec. 209. Section 6, chapter 412, Laws of 1987 and RCW 18.84.050 are each amended to read as follows:

The ((~~director~~)) secretary shall keep an official record of all proceedings, a part of which record shall consist of a register of all applicants for certification under this chapter, with the result of each application.

Sec. 210. Section 7, chapter 412, Laws of 1987 and RCW 18.84.060 are each amended to read as follows:

(1) There is created a state radiologic technology advisory committee consisting of seven members appointed by the ((~~director~~)) secretary who shall advise the ((~~director~~)) secretary concerning the administration of this chapter. Three members of the committee shall be radiologic technologists who are certified under this chapter, except for the initial members of the committee, and who have been engaged in the practice of radiologic technology for at least five years. Two members shall be radiologists. Two members of the committee shall be individuals who are unaffiliated with the profession representing the public. The term of office for committee members is four years. The terms of the first committee members, however, shall be staggered to ensure an orderly succession of new committee members thereafter. Any committee member may be removed for just cause. The ((~~director~~)) secretary may appoint a new member to fill any vacancy on the committee for the remainder of the unexpired term. No committee member may serve more than two consecutive terms whether full or partial.

(2) Committee members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.050 and 43.03.060.

(3) The committee shall elect a chair and vice-chair annually to direct the meetings of the committee. The committee shall meet at least once each year, and may hold additional meetings as called by the ((~~director~~)) secretary or the chair. Four members of the committee shall constitute a quorum.

Sec. 211. Section 8, chapter 412, Laws of 1987 and RCW 18.84.070 are each amended to read as follows:

The ((~~director~~)) secretary, members of the committee, or individuals acting on their behalf are immune from suit in any civil action based on any certification or disciplinary proceedings or other official acts performed in the course of their duties.

Sec. 212. Section 9, chapter 412, Laws of 1987 and RCW 18.84.080 are each amended to read as follows:

(1) The ((~~director~~)) secretary shall issue a certificate to any applicant who demonstrates to the ((~~director's~~)) secretary's satisfaction, that the following requirements have been met:

(a) Graduation from an approved school or successful completion of alternate training that meets the criteria established by the ((~~director~~)) secretary; and

(b) Good moral character.

(2) Applicants shall be subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW.

(3) The ((~~director~~)) secretary shall establish by rule what constitutes adequate proof of meeting the requirements for certification and for designation of certification in a particular field of radiologic technology.

Sec. 213. Section 10, chapter 412, Laws of 1987 and RCW 18.84.090 are each amended to read as follows:

The ((~~director~~)) secretary, in consultation with the advisory committee, shall establish by rule the standards and procedures for approval of schools and alternate training, and may contract with individuals or organizations having expertise in the profession or in education to assist in evaluating those applying for approval. The standards and procedures set shall apply equally to schools and training within the United States and those in foreign jurisdictions.

Sec. 214. Section 11, chapter 412, Laws of 1987 and RCW 18.84.100 are each amended to read as follows:

Applications for certification must be submitted on forms provided by the ((~~director~~)) secretary. The ((~~director~~)) secretary may require any information and documentation that reasonably relates to the determination of whether the applicant meets the requirements for certification provided for in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 which shall accompany the application.

Sec. 215. Section 12, chapter 412, Laws of 1987 and RCW 18.84.110 are each amended to read as follows:

The ((~~director~~)) secretary, in consultation with the advisory committee, shall establish by rule the requirements and fees for renewal of certificates. Failure to renew invalidates the certificate and all privileges granted by the certificate. In the event a certificate has lapsed for a period longer than three years, the certificant shall demonstrate competence to the satisfaction of the ((~~director~~)) secretary by continuing education or under the other standards determined by the ((~~director~~)) secretary.

Sec. 216. Section 4, chapter 202, Laws of 1949 as last amended by section 1, chapter 114, Laws of 1989 and RCW 18.88.030 are each amended to read as follows:

Whenever used in this chapter, terms defined in this section shall have the meanings herein specified unless the context clearly indicates otherwise.

The practice of nursing means the performance of acts requiring substantial specialized knowledge, judgment and skill based upon the principles of the biological, physiological, behavioral and sociological sciences in either:

(1) The observation, assessment, diagnosis, care or counsel, and health teaching of the ill, injured or infirm, or in the maintenance of health or prevention of illness of others.

(2) The performance of such additional acts requiring education and training and which are recognized jointly by the medical and nursing professions as proper to be performed by nurses licensed under this chapter and which shall be authorized by the board of nursing through its rules ((~~and regulations~~)).

(3) The administration, supervision, delegation and evaluation of nursing practice((~~: PROVIDED, HOWEVER, That~~)). Nothing herein shall affect the authority of any hospital, hospital district, medical clinic or office, concerning its administration and supervision.

(4) The teaching of nursing.

(5) The executing of medical regimen as prescribed by a licensed physician, osteopathic physician, dentist, or podiatrist.

Nothing in this chapter shall be construed as prohibiting any person from practicing any profession for which a license shall have been issued under the laws of this state or specifically authorized by any other law of the state of Washington.

This chapter shall not be construed as prohibiting: The nursing care of the sick, without compensation, by any unlicensed person who does not hold herself or himself out to be a registered nurse, and ((~~further, this chapter shall not be construed as prohibiting~~)) the practice of practical nursing by any practical nurse, with or without compensation in either homes or hospitals.

The word "board" means the Washington state board of nursing.

The term "department" means the department of ((~~licensing~~)) health.

The word "diagnosis", in the context of nursing practice, means the identification of, and discrimination between, the person's physical and psycho-social signs and symptoms which are essential to effective execution and management of the nursing care regimen.

The term "diploma" means written official verification of completion of an approved nursing education program.

The term ((~~"director" means the director of licensing or the director's designee~~)) "secretary" means the secretary of health or the secretary's designee.

The terms "nurse" or "nursing" wherever they occur in this chapter, unless otherwise specified, for the purposes of this chapter shall mean a registered nurse or registered nursing.

Sec. 217. Section 8, chapter 202, Laws of 1949 as last amended by section 8, chapter 211, Laws of 1988 and RCW 18.88.080 are each amended to read as follows:

The board may adopt such rules ((~~and regulations~~)) not inconsistent with the law, as may be necessary to enable it to carry into effect the provisions of this chapter. The board shall approve curricula and shall establish criteria for minimum standards for schools preparing persons for licensure under this chapter. It shall keep a record of all its proceedings and make such reports to the governor as may be required. The board shall define by ((~~regulation~~)) rule what constitutes specialized and advanced levels of nursing practice as recognized by the medical and nursing professions. The board may adopt ((~~regulations~~)) rules or issue advisory opinions in response to questions put to it by professional health associations, nursing practitioners, and consumers in this state concerning the authority of various categories of nursing practitioners to perform particular acts.

The board shall approve such schools of nursing as meet the requirements of this chapter and the board, and the board shall approve establishment of basic nursing education programs and shall establish criteria as to the need for and the size of a program and the type of program and the geographical location. The board shall establish criteria for proof of reasonable currency of knowledge and skill as a basis for safe practice after three years inactive or lapsed status. The board shall establish criteria for licensure by endorsement. The board shall examine all applications for registration under this chapter, and shall certify to the ((~~director~~)) secretary for licensing duly qualified applicants.

The department shall furnish to the board such secretarial, clerical and other assistance as may be necessary to effectively administer the provisions of this chapter. Each member of the board shall, in addition to travel expenses in accordance with RCW 43.03.050 and 43.03.060 while away from home, be compensated in accordance with RCW 43.03.240.

Sec. 218. Section 9, chapter 202, Laws of 1949 as last amended by section 51, chapter 34, Laws of 1975-'76 2nd ex. sess. and RCW 18.88.090 are each amended to read as follows:

The ((~~director~~)) secretary shall appoint, after consultation with the board, an executive secretary who shall act to carry out the provisions of this chapter. The ((~~director~~)) secretary shall also employ such assistants licensed under the provisions of this chapter as shall be necessary to carry out the provisions of this chapter. The ((~~director~~)) secretary shall fix the compensation and provide for travel expenses in accordance with RCW 43.03.050 and 43.03.060 ((~~as now existing or hereafter amended~~)) for such appointee and all such employees.

Sec. 219. Section 16, chapter 202, Laws of 1949 as last amended by section 68, chapter 7, Laws of 1985 and RCW 18.88.160 are each amended to read as follows:

Each applicant for a license to practice as a registered nurse or a specialized or advanced registered nurse shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 to the state treasurer.

Sec. 220. Section 13, chapter 211, Laws of 1988 and RCW 18.88.175 are each amended to read as follows:

Upon approval by the board and following verification of satisfactory completion of an advanced formal education, the department of ((~~licensing~~)) health shall issue an interim permit authorizing the applicant to practice specialized and advanced nursing practice pending notification of the results of the first certification examination. If the applicant passes the examination, the department shall grant advanced registered nurse practitioner status. If the applicant fails the examination, the interim permit shall expire upon notification and is not renewable. The holder of the interim permit is subject to chapter 18.130 RCW.

Sec. 221. Section 19, chapter 202, Laws of 1949 as last amended by section 9, chapter 211, Laws of 1988 and RCW 18.88.190 are each amended to read as follows:

Every license issued under the provisions of this chapter, whether in an active or inactive status, shall be renewed, except as hereinafter provided. At least thirty days prior to expiration, the ((~~director~~)) secretary shall mail a notice for renewal of license to every person licensed for the current licensing period. The applicant shall return the notice to the department with a renewal fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 before the expiration date. Upon receipt of the notice and appropriate fee, the department shall issue to the applicant a license which shall render the holder thereof a legal practitioner of nursing in either active or inactive status for the period stated on the license.

Sec. 222. Section 20, chapter 202, Laws of 1949 as last amended by section 10, chapter 211, Laws of 1988 and RCW 18.88.200 are each amended to read as follows:

Any licensee who allows his or her license to lapse by failing to renew the license, shall upon application for renewal pay a penalty determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. If the applicant fails to renew the license before the end of the current licensing period, the license shall be issued for the next licensing period by the department upon written application and fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Persons on lapsed status for three or more years must provide evidence of knowledge and skill of current practice as required by the board.

Sec. 223. Section 22, chapter 202, Laws of 1949 as last amended by section 11, chapter 211, Laws of 1988 and RCW 18.88.220 are each amended to read as follows:

A person licensed under the provisions of this chapter desiring to retire temporarily from the practice of nursing in this state shall send a written notice to the ((~~director~~)) secretary.

Upon receipt of such notice the name of such person shall be placed on inactive status. While remaining on this status the person shall not practice nursing in the state as provided in this chapter. When such person desires to resume practice, application for renewal of license shall be made to the board and renewal fee payable to the state treasurer. Persons on inactive status for three years or more must provide evidence of knowledge and skill of current practice as required by the board or as hereinafter in this chapter provided.

Sec. 224. Section 2, chapter 415, Laws of 1987 and RCW 18.89.020 are each amended to read as follows:

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

(1) "Advisory committee" means the Washington state advisory respiratory care committee.

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

(3) ((~~"Director" means the director of licensing or the director's designee~~)) "Secretary" means the secretary of health or the secretary's designee.

(4) "Respiratory care practitioner" means an individual certified under this chapter.

(5) "Physician" means an individual licensed under chapter 18.57 or 18.71 RCW.

(6) "Rural hospital" means a hospital located anywhere in the state except the following areas:

(a) The entire counties of Snohomish (including Camano Island), King, Kitsap, Pierce, Thurston, Clark, and Spokane;

(b) Areas within a twenty-mile radius of an urban area with a population exceeding thirty thousand persons; and

(c) Those cities or city-clusters located in rural counties but which for all practical purposes are urban. These areas are Bellingham, Aberdeen-Hoquiam, Longview-Kelso, Wenatchee, Yakima, Sunnyside, Richland-Kennewick-Pasco, and Walla Walla.

Sec. 225. Section 6, chapter 415, Laws of 1987 and RCW 18.89.050 are each amended to read as follows:

(1) In addition to any other authority provided by law, the ((~~director~~)) secretary, in consultation with the advisory committee, may:

(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) Set all certification, examination, and renewal fees in accordance with RCW 43.24.086;

(d) Issue a certificate to any applicant who has met the education, training, and examination requirements for certification;

(e) Hire clerical, administrative, and investigative staff as needed to implement this chapter and hire individuals certified under this chapter to serve as examiners for any practical examinations;

(f) Approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the certification examination;

(g) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, examinations for applicants for certification;

(h) Determine whether alternative methods of training are equivalent to formal education and establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take the examination;

(i) Determine which states have legal credentialing requirements equivalent to those of this state and issue certificates to individuals legally credentialed in those states without examination; and

(j) Define and approve any experience requirement for certification.

(2) The provisions of chapter 18.130 RCW shall govern the issuance and denial of certificates, uncertified practice, and the disciplining of persons certified under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

Sec. 226. Section 7, chapter 415, Laws of 1987 and RCW 18.89.060 are each amended to read as follows:

Sec. 227. Section 8, chapter 415, Laws of 1987 and RCW 18.89.070 are each amended to read as follows:

(1) There is created a state respiratory care advisory committee consisting of five members appointed by the ((~~director~~)) secretary. Three members of the advisory committee shall be respiratory care practitioners who are certified under this chapter. The initial members, however, may be appointed to the advisory committee if they meet all the requirements for certification under this chapter and have been engaged in the practice of respiratory care for at least five years. One member of the advisory committee shall be an individual representing the public who is unaffiliated with the profession. One member of the advisory committee shall be a physician, who is a pulmonary specialist. Each member shall hold office for a term of four years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his or her predecessor was appointed shall be appointed for the remainder of such term and the terms of office of the members first taking office shall expire, as designated at the time of appointment, one at the end of the first year, one at the end of the second year, one at the end of the third year, and two at the end of the fourth year after the date of appointment. Thereafter all appointments shall be for four years. Any advisory committee member may be removed for just cause. The ((~~director~~)) secretary may appoint a new member to fill any vacancy on the advisory committee for the remainder of the unexpired term. No advisory committee member may serve more than two consecutive terms, whether full or partial.

(2) Advisory committee members shall be entitled to be compensated in accordance with RCW 43.03.240, and to be reimbursed for travel expenses under RCW 43.03.050 and 43.03.060.

(3) The advisory committee shall have the authority to elect annually a chairperson and vice-chairperson to direct the meetings of the advisory committee. The advisory committee shall meet at least once each year, and may hold additional meetings as called by the ((~~director~~)) secretary or the chairperson. Three members of the advisory committee constitute a quorum.

Sec. 228. Section 9, chapter 415, Laws of 1987 and RCW 18.89.080 are each amended to read as follows:

The ((~~director~~)) secretary, members of the advisory committee, or individuals acting on their behalf are immune from suit in any civil action based on any certification or disciplinary proceedings, or other official acts performed in the course of their duties.

Sec. 229. Section 10, chapter 415, Laws of 1987 and RCW 18.89.090 are each amended to read as follows:

The ((~~director~~)) secretary shall issue a certificate to any applicant who demonstrates to the ((~~director's~~)) secretary's satisfaction that the following requirements have been met:

(1) Graduation from a school approved by the ((~~director~~)) secretary or successful completion of alternate training which meets the criteria established by the ((~~director~~)) secretary;

(2) Successful completion of an examination administered or approved by the ((~~director~~)) secretary;

(3) Successful completion of any experience requirement established by the ((~~director~~)) secretary;

(4) Good moral character.

In addition, applicants shall be subject to the grounds for denial or issuance of a conditional certificate under chapter 18.130 RCW.

A person who meets the qualifications to be admitted to the examination for certification as a respiratory care practitioner may practice as a respiratory care practitioner under the supervision of a respiratory care practitioner certified under this chapter between the date of filing an application for certification and the announcement of the results of the next succeeding examination for certification if that person applies for and takes the first examination for which he or she is eligible.

The ((~~director~~)) secretary shall establish by rule what constitutes adequate proof of meeting the criteria.

Sec. 230. Section 11, chapter 415, Laws of 1987 and RCw 18.89.100 are each amended to read as follows:

The ((~~director~~)) secretary shall approve only those persons who have achieved the minimum level of competency as defined by the ((~~director~~)) secretary. The ((~~director~~)) secretary shall establish by rule the standards and procedures for approval of alternate training and shall have the authority to contract with individuals or organizations having expertise in the profession, or in education, to assist in evaluating those applying for approval. The standards and procedures set shall apply equally to schools and training within the United States and those in foreign jurisdictions.

Sec. 231. Section 12, chapter 415, Laws of 1987 and RCW 18.89.110 are each amended to read as follows:

(1) The date and location of the examination shall be established by the ((~~director~~)) secretary. Applicants who have been found by the ((~~director~~)) secretary to meet the other requirements for certification shall be scheduled for the next examination following the filing of the application. However, the applicant shall not be scheduled for any examination taking place sooner than sixty days after the application is filed.

(2) The ((~~director~~)) secretary shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice. Such examinations shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently, and shall meet generally accepted standards of fairness and validity for certification examinations.

(3) All examinations shall be conducted by the ((~~director~~)) secretary, and all grading of the examinations shall be under fair and wholly impartial methods.

(4) Any applicant who fails to make the required grade in the first examination is entitled to take up to three subsequent examinations, upon the prepayment of a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086 for each subsequent examination. Upon failure of four examinations, the ((~~director~~)) secretary may invalidate the original application and require such remedial education as is deemed necessary.

(5) The ((~~director~~)) secretary may approve an examination prepared and administered by a private testing agency or association of credentialing boards for use by an applicant in meeting the certification requirement.

Sec. 232. Section 13, chapter 415, Laws of 1987 and RCW 18.89.120 are each amended to read as follows:

Applications for certification shall be submitted on forms provided by the ((~~director~~)) secretary. The ((~~director~~)) secretary may require any information and documentation which reasonably relates to the need to determine whether the applicant meets the criteria for certification provided in this chapter and chapter 18.130 RCW. All applications shall be accompanied by a fee determined by the ((~~director~~)) secretary under RCW 43.24.086.

Sec. 233. Section 14, chapter 415, Laws of 1987 and RCW 18.89.130 are each amended to read as follows:

(1) The ((~~director~~)) secretary shall waive the examination and grant a certificate to a person engaged in the profession of respiratory care in this state on July 26, 1987, if the ((~~director~~)) secretary determines the person meets commonly accepted standards of education and experience for the profession and has previously achieved an acceptable grade on an approved examination administered by a private testing agency or respiratory care association as established by rule of the ((~~director~~)) secretary.

(2) If an individual is engaged in the practice of respiratory care on July 26, 1987, but has not achieved an acceptable grade on an approved examination administered by a private testing agency, the individual may apply to the ((~~director~~)) secretary for examination. This section shall only apply to those individuals who file an application within one year of July 26, 1987.

Sec. 234. Section 15, chapter 415, Laws of 1987 and RCW 18.89.140 are each amended to read as follows:

The ((~~director~~)) secretary shall establish by rule the requirements and fees for renewal of certificates. Failure to renew shall invalidate the certificate and all privileges granted by the certificate. In the event a certificate has lapsed for a period longer than three years, the certified respiratory care practitioner shall demonstrate competence to the satisfaction of the ((~~director~~)) secretary by continuing education or under the other standards determined by the ((~~director~~)) secretary.

Sec. 235. Section 21, chapter 71, Laws of 1941 as last amended by section 1, chapter 102, Laws of 1983 and RCW 18.92.015 are each amended to read as follows:

The term "board" used in this chapter shall mean the Washington state veterinary board of governors; and the term ((~~"director"~~)) "secretary" shall mean the ((~~director of licensing~~)) secretary of health of the state of Washington. "Animal technician" shall mean a person who has successfully completed an examination administered by the board and who has either successfully completed a post high school course approved by the board in the care and treatment of animals, or a person who has had five years practical experience acceptable to the board with a licensed veterinarian.

Sec. 236. Section 9, chapter 71, Laws of 1941 and RCW 18.92.035 are each amended to read as follows:

The board shall certify to the ((~~director~~)) secretary the names of all applicants who have successfully passed an examination and are entitled to a license to practice veterinary medicine, surgery and dentistry. The ((~~director~~)) secretary shall thereupon issue a license to practice veterinary medicine, surgery and dentistry to such applicant.

Sec. 237. Section 13, chapter 124, Laws of 1907 as last amended by section 51, chapter 287, Laws of 1984 and RCW 18.92.040 are each amended to read as follows:

Each member of the board shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060. No expense may be incurred by members of the board except in connection with board meetings without prior approval of the ((~~director~~)) secretary.

Sec. 238. Section 2, chapter 125, Laws of 1989 and RCW 18.92.047 are each amended to read as follows:

(1) To implement an impaired veterinarian program as authorized by RCW 18.130.175, the veterinary board of governors shall enter into a contract with a voluntary substance abuse monitoring program. The impaired veterinarian program may include any or all of the following:

(a) Contracting with providers of treatment programs;

(b) Receiving and evaluating reports of suspected impairment from any source;

(d) Referring impaired veterinarians to treatment programs;

(e) Monitoring the treatment and rehabilitation of impaired veterinarians including those ordered by the board;

(f) Providing education, prevention of impairment, posttreatment monitoring, and support of rehabilitated impaired veterinarians; and

(g) Performing other related activities as determined by the board.

(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of up to twenty-five dollars on each license issuance or renewal of a new license to be collected by the department of ((~~licensing~~)) health from every veterinarian licensed under chapter 18.92 RCW. These moneys shall be placed in the health professions account to be used solely for the implementation of the impaired veterinarian program.

Sec. 239. Section 6, chapter 71, Laws of 1941 as last amended by section 141, chapter 259, Laws of 1986 and RCW 18.92.070 are each amended to read as follows:

No person, unless registered or licensed to practice veterinary medicine, surgery, and dentistry in this state at the time this chapter shall become operative, shall begin the practice of veterinary medicine, surgery and dentistry without first applying for and obtaining a license for such purpose from the ((~~director~~)) secretary. In order to procure a license to practice veterinary medicine, surgery, and dentistry in the state of Washington, the applicant for such license shall file his or her application at least sixty days prior to date of examination upon a form furnished by the ((~~director of licensing~~)) secretary of health, which, in addition to the fee provided by this chapter, shall be accompanied by satisfactory evidence that he or she is at least eighteen years of age and of good moral character, and by official transcripts or other evidence of graduation from a veterinary college satisfactory to and approved by the board. Said application shall be signed by the applicant and sworn to by him or her before some person authorized to administer oaths. When such application and the accompanying evidence are found satisfactory, the ((~~director~~)) secretary shall notify the applicant to appear before the board for the next examination. In addition, applicants shall be subject to grounds for denial or issuance of a conditional license under chapter 18.130 RCW.

Nothing in this chapter shall preclude the board from permitting a person who has completed a portion of his or her educational program as determined by the board, in a veterinary college recognized by the board, to take the examination or any part thereof prior to satisfying the requirements for application for a license((~~: PROVIDED HOWEVER, That~~)). No license shall be issued to such applicant until such requirements are satisfied.

Sec. 240. Section 7, chapter 71, Laws of 1941 as last amended by section 6, chapter 50, Laws of 1967 ex. sess. and RCW 18.92.100 are each amended to read as follows:

Examinations for license to practice veterinary medicine, surgery and dentistry shall be held at least once each year at such times and places as the ((~~director~~)) secretary may authorize and direct. Said examination, which shall be conducted in the English language shall be, in whole or in part, in writing on the following subjects: Veterinary anatomy, surgery, obstetrics, pathology, chemistry, hygiene, veterinary diagnosis, materia medica, therapeutics, parasitology, physiology, sanitary medicine, and such other subjects which are ordinarily included in the curricula of veterinary colleges, as the board may prescribe. All examinees shall be tested by written examination, supplemented by such oral interviews and practical demonstrations as the board deems necessary. The board may accept the examinee's results on the National Board of Veterinary Examiners in lieu of the written portion of the state examination.

Sec. 241. Section 10, chapter 71, Laws of 1941 as last amended by section 71, chapter 7, Laws of 1985 and RCW 18.92.115 are each amended to read as follows:

Any applicant who shall fail to secure the required grade in his first examination may take the next regular veterinary examination. The fee for reexamination shall be determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

Sec. 242. Section 11, chapter 124, Laws of 1907 as last amended by section 142, chapter 259, Laws of 1986 and RCW 18.92.120 are each amended to read as follows:

Any person who shall make application for examination, as provided by RCW 18.92.070, and who has not previously failed to pass the veterinary examination, and whose application is found satisfactory by the ((~~director~~)) secretary, may be given a temporary certificate to practice veterinary medicine, surgery and dentistry valid only until the results of the next examination for licenses are available. In addition, applicants shall be subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW. No more than one temporary certificate may be issued to any applicant. Such permittee shall be employed by a licensed veterinary practitioner or by the state of Washington.

Sec. 243. Section 12, chapter 71, Laws of 1941 as amended by section 10, chapter 92, Laws of 1959 and RCW 18.92.130 are each amended to read as follows:

Any person who has been lawfully licensed to practice veterinary medicine, surgery, and dentistry in another state or territory which has and maintains a standard for the practice of veterinary medicine, surgery and dentistry which is substantially the same as that maintained in this state, and who has been lawfully and continuously engaged in the practice of veterinary medicine, surgery and dentistry for two years or more immediately before filing his or her application to practice in this state and who shall submit to the ((~~director~~)) secretary a duly attested certificate from the examining board of the state or territory in which he or she is registered, certifying to the fact of his or her registration and of his or her being a person of good moral character and of professional attainments, may upon the payment of the fee as provided herein, be granted a license to practice veterinary medicine, surgery and dentistry in this state, without being required to take an examination((~~: PROVIDED, HOWEVER, That~~)). No license shall be issued to any applicant, unless the state or territory from which such certificate has been granted to such applicant shall have extended a like privilege to engage in the practice of veterinary medicine, surgery and dentistry within its own borders to veterinarians heretofore and hereafter licensed by this state, and removing to such other state((~~: AND PROVIDED FURTHER, That~~)). The ((~~director of licensing~~)) secretary of health shall have power to enter into reciprocal relations with other states whose requirements are substantially the same as those provided herein. The board shall make recommendations to the ((~~director~~)) secretary upon all requests for reciprocity.

Sec. 244. Section 16, chapter 71, Laws of 1941 as last amended by section 72, chapter 7, Laws of 1985 and RCW 18.92.140 are each amended to read as follows:

Each person now qualified to practice veterinary medicine, surgery and dentistry or registered as an animal technician in this state or who shall hereafter be licensed or registered to engage in such practice, shall register with the ((~~director of licensing~~)) secretary of health annually or on the date prescribed by the ((~~director~~)) secretary and pay the renewal registration fee set by the ((~~director~~)) secretary as provided in RCW 43.24.086. A person who fails to renew a license or certificate prior to its expiration shall be subject to a late renewal fee equal to one-third of the regular renewal fee set by the ((~~director~~)) secretary.

Sec. 245. Section 19, chapter 71, Laws of 1941 as last amended by section 73, chapter 7, Laws of 1985 and RCW 18.92.145 are each amended to read as follows:

The ((~~director~~)) secretary shall determine the fees, as provided in RCW 43.24.086, for the issuance, renewal, or administration of the following licenses, certificates of registration, permits, duplicate licenses, renewals, or examination:

(1) For a license to practice veterinary medicine, surgery, and dentistry issued upon an examination given by the examining board;

(2) For a license to practice veterinary medicine, surgery, and dentistry issued upon the basis of a license issued in another state;

(3) For a certificate of registration as an animal technician;

(4) For a temporary permit to practice veterinary medicine, surgery, and dentistry. The temporary permit fee shall be accompanied by the full amount of the examination fee.

Sec. 246. Section 4, chapter 212, Laws of 1971 ex. sess. and RCW 18.104.040 are each amended to read as follows:

The department shall have the power:

(1) To issue, deny, suspend or revoke licenses pursuant to the provisions of this chapter;

(2) To enter upon lands for the purpose of inspecting any water well, drilled or being drilled, at all reasonable times;

(3) To call upon or receive professional or technical advice from any public agency or any person;

(4) To make such rules ((~~and regulations~~)) governing licensing hereunder and water well construction as may be appropriate to carry out the purposes of this chapter. Without limiting the generality of the foregoing, the department may in cooperation with the department of ((~~social and health services~~)) health make rules ((~~and regulations~~)) regarding:

(a) Standards for the construction and maintenance of water wells and their casings;

(b) Methods of sealing artesian wells and water wells to be abandoned or which may contaminate other water resources;

(c) Methods of artificial recharge of ground water bodies and of construction of wells which insure separation of individual water bearing formations;

(d) The manner of conducting and the content of examinations required to be taken by applicants for license hereunder;

(e) Reporting requirements of water well contractors;

(f) Limitations on water well construction in areas identified by the department as requiring intensive control of withdrawals in the interests of sound management of the ground water resource.

Sec. 247. Section 8, chapter 212, Laws of 1971 ex. sess. and RCW 18.104.080 are each amended to read as follows:

The examination, which is made a prerequisite for obtaining a license hereunder, shall be prepared to test knowledge and understanding of the following subjects:

(1) Washington ground water laws as they relate to well construction;

(2) Sanitary standards for water well drilling and construction of water wells;

(3) Types of water well construction;

(4) Drilling tools and equipment;

(5) Underground geology as it relates to water well construction; and

(6) Rules ((~~and regulations~~)) of the department and the department of ((~~social and health services~~)) health relating to water well construction.

Examinations shall be held at such times and places as may be determined by the department but not later than thirty days after an applicant has filed a completed application with the department. The department shall make a determination of the applicant's qualifications for a license within ten days after the examination.

Sec. 248. Section 11, chapter 212, Laws of 1971 ex. sess. and RCW 18.104.110 are each amended to read as follows:

In cases other than those relating to the failure of a licensee to renew a license, any license issued hereunder may be suspended or revoked by the director for any of the following reasons:

(1) For fraud or deception in obtaining the license;

(2) For fraud or deception in reporting under RCW 18.104.050;

(3) For violating the provisions of this chapter, or of any lawful rule ((~~or regulation~~)) of the department or the department of ((~~social and health services~~)) health.

No license shall be suspended for more than six months. No person whose license is revoked shall be eligible to apply for a license for one year from the effective date of the final order of revocation.

Sec. 249. Section 1, chapter 280, Laws of 1975 1st ex. sess. as last amended by section 2, chapter 443, Laws of 1987 and RCW 18.108.010 are each amended to read as follows:

In this chapter, unless the context otherwise requires, the following meanings shall apply:

(1) "Board" means the Washington state board of massage.

(2) "Massage" and "massage therapy" mean a health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes. Massage therapy includes massage techniques such as methods of effleurage, petrissage, tapotement, tapping, compressions, vibration, friction, nerve stokes, and Swedish gymnastics or movements either by manual means, as they relate to massage, with or without the aids of superficial heat, cold, water, lubricants, or salts. Massage therapy does not include diagnosis or attempts to adjust or manipulate any articulations of the body or spine or mobilization of these articulations by the use of a thrusting force.

(3) "Massage practitioner" means an individual licensed under this chapter.

(4) ((~~"Director" means the director of licensing or the director's designee~~)) "Secretary" means the secretary of health or the secretary's designee.

(5) Massage business means the operation of a business where massages are given.

Sec. 250. Section 9, chapter 443, Laws of 1987 and RCW 18.108.020 are each amended to read as follows:

The Washington state board of massage is hereby created. The board shall consist of four members who shall be appointed by the governor for a term of four years each. Members shall be residents of this state and shall have not less than three years experience in the practice of massage immediately preceding their appointment and shall be licensed under this chapter and actively engaged in the practice of massage during their incumbency.

In addition to the members specified in this section, the governor shall appoint a consumer member of the board, who shall serve for a term of four years. The consumer member of the board shall be an individual who does not derive his or her livelihood by providing health care services or massage therapy and is not a licensed health professional. The consumer member shall not be an employee of the state nor a present or former member of another licensing board.

In the event that a member cannot complete his or her term of office, another appointment shall be made by the governor in accordance with the procedures stated in this section to fill the remainder of the term. No member may serve more than two successive terms whether full or partial. The governor may remove any member of the board for neglect of duty, incompetence, or unprofessional or disorderly conduct as determined under chapter 18.130 RCW.

Each member of the board shall be compensated in accordance with RCW 43.03.240. Members shall be reimbursed for travel expenses incurred in the actual performance of their duties, as provided in RCW 43.03.050 and 43.03.060.

The board may annually elect a chairperson to direct the meetings of the board. The board shall meet as called by the chairperson or the ((~~director~~)) secretary. Three members of the board shall constitute a quorum of the board.

Sec. 251. Section 10, chapter 443, Laws of 1987 and RCW 18.108.025 are each amended to read as follows:

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

(1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter, subject to the approval of the ((~~director~~)) secretary;

(2) Define, evaluate, approve, and designate those schools, programs, and apprenticeship programs including all current and proposed curriculum, faculty, and health, sanitation, and facility standards from which graduation will be accepted as proof of an applicant's eligibility to take the licensing examination;

(3) Review approved schools and programs periodically;

(4) Prepare, grade, administer, and supervise the grading and administration of, examinations for applicants for licensure; and

(5) Determine which states have educational and licensing requirements equivalent to those of this state.

The board shall establish by rule the standards and procedures for approving courses of study and may contract with individuals or organizations having expertise in the profession or in education to assist in evaluating courses of study. The standards and procedures set shall apply equally to schools and training within the United States of America and those in foreign jurisdictions.

Sec. 252. Section 4, chapter 280, Laws of 1975 1st ex. sess. as amended by section 4, chapter 443, Laws of 1987 and RCW 18.108.040 are each amended to read as follows:

It shall be unlawful to advertise the practice of massage using the term massage or any other term that implies a massage technique or method in any public or private publication or communication by a person not licensed by the ((~~director~~)) secretary as a massage practitioner. Any person who holds a license to practice as a massage practitioner in this state may use the title "licensed massage practitioner" and the abbreviation "L.M.P.". No other persons may assume such title or use such abbreviation or any other word, letters, signs, or figures to indicate that the person using the title is a licensed massage practitioner.

Sec. 253. Section 6, chapter 280, Laws of 1975 1st ex. sess. as last amended by section 6, chapter 443, Laws of 1987 and RCW 18.108.060 are each amended to read as follows:

All licenses issued under the provisions of this chapter, unless otherwise provided shall expire on the annual anniversary date of the individual's date of birth.

The ((~~director~~)) secretary shall prorate the licensing fee for massage practitioner based on one-twelfth of the annual license fee for each full calendar month between the issue date and the next anniversary of the applicant's birth date, a date used as the expiration date of such license.

Every applicant for a license shall pay an examination fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, which fee shall accompany their application. Applications for licensure shall be submitted on forms provided by the ((~~director~~)) secretary.

Applicants granted a license under this chapter shall pay to the ((~~director~~)) secretary a license fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086, prior to the issuance of their license, and an annual renewal fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Failure to renew shall invalidate the license and all privileges granted to the licensee, but such license may be reinstated upon written application to the ((~~director~~)) secretary and payment to the state of all delinquent fees and penalties as determined by the ((~~director~~)) secretary. In the event a license has lapsed for a period longer than three years, the licensee shall demonstrate competence to the satisfaction of the ((~~director~~)) secretary by proof of continuing education or other standard determined by the ((~~director~~)) secretary with the advice of the board.

Sec. 254. Section 7, chapter 280, Laws of 1975 1st ex. sess. as amended by section 7, chapter 443, Laws of 1987 and RCW 18.108.070 are each amended to read as follows:

The ((~~director~~)) secretary shall issue a massage practitioner's license to an applicant who demonstrates to the ((~~director's~~)) secretary's satisfaction that the following requirements have been met:

(1) Effective June 1, 1988, successful completion of a course of study in an approved massage program or approved apprenticeship program;

(2) Successful completion of an examination administered or approved by the board; and

(3) Be eighteen years of age or older.

In addition, applicants shall be subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW.

The ((~~director~~)) secretary may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for licensure provided for in this chapter and chapter 18.130 RCW. The ((~~director~~)) secretary shall establish by rule what constitutes adequate proof of meeting the criteria. The board shall give an appropriate alternate form of examination for persons who cannot read or speak English to determine equivalent competency.

Sec. 255. Section 8, chapter 443, Laws of 1987 and RCW 18.108.073 are each amended to read as follows:

(1) The date and location of the examination shall be established by the ((~~director~~)) secretary. Applicants who demonstrate to the ((~~director's~~)) secretary's satisfaction that the following requirements have been met shall be scheduled for the next examination following the filing of the application:

(a) Effective June 1, 1988, successful completion of a course of study in an approved massage program; or

(b) Effective June 1, 1988, successful completion of an apprenticeship program established by the board; and

In addition, completed and approved applications shall be received sixty days before the scheduled examination.

(2) The board or its designee shall examine each applicant in a written and practical examination determined most effective on subjects appropriate to the massage scope of practice. The subjects may include anatomy, kinesiology, physiology, pathology, principles of human behavior, massage theory and practice, hydrotherapy, hygiene, first aid, Washington law pertaining to the practice of massage, and such other subjects as the board may deem useful to test applicant's fitness to practice massage therapy. Such examinations shall be limited in purpose to determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(3) The examination papers, all grading of examinations, and the grading of any practical work, shall be preserved for a period of not less than one year after the board has made and published decisions thereupon. All examinations shall be conducted by the board under fair and impartial methods as determined by the ((~~director~~)) secretary.

(4) An applicant who fails to make the required grade in the first examination is entitled to take up to two additional examinations upon the payment of a fee for each subsequent examination determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. Upon failure of three examinations, the ((~~director~~)) secretary may invalidate the original application and require such remedial education as is required by the board before admission to future examinations.

(5) The board may approve an examination prepared or administered, or both, by a private testing agency or association of licensing boards for use by an applicant in meeting the licensing requirement.

Sec. 256. Section 11, chapter 443, Laws of 1987 and RCW 18.108.085 are each amended to read as follows:

(1) In addition to any other authority provided by law, the ((~~director~~)) secretary may:

(a) Adopt rules, in accordance with chapter 34.05 RCW necessary to implement this chapter;

(b) Set all license, examination, and renewal fees in accordance with RCW 43.24.086;

(d) Issue a license to any applicant who has met the education, training, and examination requirements for licensure; and

(e) Hire clerical, administrative, and investigative staff as necessary to implement this chapter, and hire individuals licensed under this chapter to serve as examiners for any practical examinations.

(2) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of licenses and the disciplining of persons under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

(3) The ((~~director~~)) secretary shall keep an official record of all proceedings under this chapter, a part of which record shall consist of a register of all applicants for licensure under this chapter, with the result of each application.

Sec. 257. Section 2, chapter 281, Laws of 1984 as amended by section 2, chapter 115, Laws of 1986 and RCW 18.135.020 are each amended to read as follows:

As used in this chapter:

(1) ((~~"Director" means the director of licensing~~)) "Secretary" means the secretary of health.

(2) "Health care assistant" means an unlicensed person who assists a licensed health care practitioner in providing health care to patients pursuant to this chapter.

(3) "Health care practitioner" means:

(a) A physician licensed under chapter 18.71 RCW;

(b) An osteopathic physician or surgeon licensed under chapter 18.57 RCW; or

(c) Acting within the scope of their respective licensures, a podiatrist licensed under chapter 18.22 RCW or a registered nurse licensed under chapter 18.88 RCW.

(4) "Supervision" means supervision of procedures permitted pursuant to this chapter by a health care practitioner who is physically present and is immediately available in the facility during the administration of injections, as defined in this chapter, but need not be present during procedures to withdraw blood.

(5) "Health care facility" means any hospital, hospice care center, licensed or certified health care facility, health maintenance organization regulated under chapter 48.46 RCW, federally qualified health maintenance organization, renal dialysis center or facility federally approved under 42 C.F.R. 405.2100, blood bank federally licensed under 21 C.F.R. 607, or clinical laboratory certified under 20 C.F.R. 405.1301-16.

(6) "Delegation" means direct authorization granted by a licensed health care practitioner to a health care assistant to perform the functions authorized in this chapter which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee.

Sec. 258. Section 4, chapter 281, Laws of 1984 as amended by section 2, chapter 216, Laws of 1986 and RCW 18.135.030 are each amended to read as follows:

The ((~~director~~)) secretary, or the ((~~director's~~)) secretary's designee, with the advice of designees of the board of medical examiners, the board of osteopathic medicine and surgery, the podiatry board, and the board of nursing, shall adopt rules necessary to administer, implement, and enforce this chapter and establish the minimum requirements necessary for a health care facility or health care practitioner to certify a health care assistant capable of performing the functions authorized in this chapter. The rules shall establish minimum requirements for each and every category of health care assistant. Said rules shall be adopted after fair consideration of input from representatives of each category. These requirements shall ensure that the public health and welfare are protected and shall include, but not be limited to, the following factors:

(1) The education and occupational qualifications for the health care assistant category;

(2) The work experience for the health care assistant category;

(3) The instruction and training provided for the health care assistant category; and

(4) The types of drugs or diagnostic agents which may be administered by injection by health care assistants working in a hospital or nursing home. The rules established pursuant to this subsection shall not prohibit health care assistants working in a health care facility other than a nursing home or hospital from performing the functions authorized under this chapter.

Sec. 259. Section 5, chapter 281, Laws of 1984 and RCW 18.135.050 are each amended to read as follows:

(1) Any health care facility may certify a health care assistant to perform the functions authorized in this chapter in that health care facility; and any health care practitioner may certify a health care assistant capable of performing such services in any health care facility, or in his or her office, under a health care practitioner's supervision. Before certifying the health care assistant, the health care facility or health care practitioner shall verify that the health care assistant has met the minimum requirements established by the ((~~director~~)) secretary under this chapter. These requirements shall not prevent the certifying entity from imposing such additional standards as the certifying entity considers appropriate. The health care facility or health care practitioner shall provide the licensing authority with a certified roster of health care assistants who are certified.

(2) Certification of a health care assistant shall be effective for a period of two years. Recertification is required at the end of this period. Requirements for recertification shall be established by rule.

Sec. 260. Section 1, chapter 117, Laws of 1985 and RCW 18.135.055 are each amended to read as follows:

The health care facility or health care practitioner registering an initial or continuing certification pursuant to the provisions of this chapter shall pay a fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086.

All fees collected under this section shall be credited to the health professions account as required in RCW ((~~43.24.072~~)) 43.70.320.

Sec. 261. Section 4, chapter 216, Laws of 1986 and RCW 18.135.065 are each amended to read as follows:

(1) Each delegator, as defined under RCW 18.135.020(6) shall maintain a list of specific medications, diagnostic agents, and the route of administration of each that he or she has authorized for injection. Both the delegator and delegatee shall sign the above list, indicating the date of each signature. The signed list shall be forwarded to the ((~~director~~)) secretary of the department of ((~~licensing~~)) health and shall be available for review.

(2) Delegatees are prohibited from administering any controlled substance as defined in RCW ((~~69.50.101(2)(d)~~)) 69.50.101(d), any experimental drug, and any cancer chemotherapy agent unless a delegator is physically present in the immediate area where the drug is administered.

Sec. 262. Section 8, chapter 281, Laws of 1984 and RCW 18.135.080 are each amended to read as follows:

The ((~~director or the director's~~)) secretary or the secretary's designee shall decertify a health care assistant based on a finding that the assistant has obtained certification through misrepresentation or concealment of a material fact or has engaged in unsafe or negligent practices.

Sec. 263. Section 1, chapter 277, Laws of 1988 and RCW 18.138.010 are each amended to read as follows:

(1) "Dietetics" is the integration and application of scientific principles of food, nutrition, biochemistry, physiology, management, and behavioral and social sciences in counseling people to achieve and maintain health. Unique functions of dietetics include, but are not limited to:

(a) Assessing individual and community food practices and nutritional status using anthropometric, biochemical, clinical, dietary, and demographic data for clinical, research, and program planning purposes;

(b) Establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints;

(d) Developing, implementing, managing, and evaluating nutrition care systems; and

(e) Evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition care services.

(2) "General nutrition services" means the counseling and/or educating of groups or individuals in the selection of food to meet normal nutritional needs for health maintenance, which includes, but is not restricted to:

(a) Assessing the nutritional needs of individuals and groups by planning, organizing, coordinating, and evaluating the nutrition components of community health care services;

(b) Supervising, administering, or teaching normal nutrition in colleges, universities, clinics, group care homes, nursing homes, hospitals, private industry, and group meetings.

(3) "Certified dietitian" means any person certified to practice dietetics under this chapter.

(4) "Certified nutritionist" means any person certified to provide general nutrition services under this chapter.

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

(6) ((~~"Director" means the director of licensing or the director's designee~~)) "Secretary" means the secretary of health or the secretary's designee.

Sec. 264. Section 2, chapter 277, Laws of 1988 and RCW 18.138.020 are each amended to read as follows:

(1) No persons shall represent themselves as certified dietitians or certified nutritionists unless certified as provided for in this chapter.

(2) Persons represent themselves as certified dietitians or certified nutritionists when any title or any description of services is used which incorporates one or more of the following items or designations: "Certified dietitian," "certified dietician," "certified nutritionist," "D.," "C.D.," or "C.N."

Sec. 265. Section 3, chapter 277, Laws of 1988 and RCW 18.138.030 are each amended to read as follows:

(1) An applicant applying for certification as a certified dietitian or certified nutritionist shall file a written application on a form or forms provided by the ((~~director~~)) secretary setting forth under affidavit such information as the ((~~director~~)) secretary may require, and proof that the candidate has met qualifications set forth below in subsection (2) or (3) of this section.

(2) Any person seeking certification as a "certified dietitian" shall meet the following qualifications:

(a) Be eighteen years of age or older;

(b) Has satisfactorily completed a major course of study in human nutrition, foods and nutrition, dietetics, or food systems management, and has received a baccalaureate or higher degree from a college or university accredited by the Western association of schools and colleges or a similar accreditation agency or colleges and universities approved by the ((~~director~~)) secretary in rule;

(c) Demonstrates evidence of having successfully completed a planned continuous preprofessional experience in dietetic practice of not less than nine hundred hours under the supervision of a certified dietitian or a registered dietitian or demonstrates completion of a coordinated undergraduate program in dietetics, both of which meet the training criteria established by the ((~~director~~)) secretary;

(d) Has satisfactorily completed an examination for dietitians administered by a public or private agency or institution recognized by the ((~~director~~)) secretary as qualified to administer the examination; and

(e) Has satisfactorily completed courses of continuing education as currently established by the ((~~director~~)) secretary.

(3) An individual may be certified as a certified dietician if he or she provides evidence of meeting criteria for registration on June 9, 1988, by the commission on dietetic registration.

(4) Any person seeking certification as a "certified nutritionist" shall meet the following qualifications:

(a) Possess the qualifications required to be a certified dietitian; or

(b) Has received a master's degree or doctorate degree in one of the following subject areas: Human nutrition, nutrition education, foods and nutrition, or public health nutrition from a college or university accredited by the Western association of schools and colleges or a similar accrediting agency or colleges and universities approved by the ((~~director~~)) secretary in rule.

Sec. 266. Section 4, chapter 277, Laws of 1988 and RCW 18.138.040 are each amended to read as follows:

(1) If the applicant meets the qualifications as outlined in RCW 18.138.030(2), the ((~~director~~)) secretary shall confer on such candidates the title certified dietitian.

(2) If the applicant meets the qualifications as outlined in RCW 18.138.030(4), the ((~~director~~)) secretary shall confer on such candidates the title certified nutritionist.

(3) The application fee in an amount determined by the ((~~director~~)) secretary shall accompany the application for certification as a certified dietitian or certified nutritionist.

Sec. 267. Section 6, chapter 277, Laws of 1988 and RCW 18.138.050 are each amended to read as follows:

The ((~~director~~)) secretary may certify a person applying for the title "certified dietitian" without examination if such person is licensed or certified as a dietitian in another jurisdiction and if, in the ((~~director's~~)) secretary's judgment, the requirements of that jurisdiction are equivalent to or greater than those of Washington state.

Sec. 268. Section 7, chapter 277, Laws of 1988 and RCW 18.138.060 are each amended to read as follows:

(1) Every person certified as a certified dietitian or certified nutritionist shall pay a renewal registration fee determined by the ((~~director~~)) secretary as provided in RCW 43.24.086. The certificate of the person shall be renewed for a period of one year or longer at the discretion of the ((~~director~~)) secretary.

(2) Any failure to register and pay the annual renewal registration fee shall render the certificate invalid. The certificate shall be reinstated upon: (a) Written application to the ((~~director~~)) secretary; (b) payment to the state of a penalty fee determined by the ((~~director~~)) secretary; and (c) payment to the state of all delinquent annual certificate renewal fees.

(3) Any person who fails to renew his or her certification for a period of three years shall not be entitled to renew such certification under this section. Such person, in order to obtain a certification as a certified dietitian or certified nutritionist in this state, shall file a new application under this chapter, along with the required fee, and shall meet all requirements as the ((~~director~~)) secretary provides.

(4) All fees collected under this section shall be credited to the health professions account as required.

Sec. 269. Section 10, chapter 277, Laws of 1988 and RCW 18.138.070 are each amended to read as follows:

In addition to any other authority provided by law, the ((~~director~~)) secretary may:

(1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;

(2) Establish forms necessary to administer this chapter;

(3) Issue a certificate to an applicant who has met the requirements for certification and deny a certificate to an applicant who does not meet the minimum qualifications;

(4) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and hire individuals, including those certified under this chapter, to serve as consultants as necessary to implement and administer this chapter;

(5) Maintain the official departmental record of all applicants and certificate holders;

(6) Conduct a hearing, pursuant to chapter 34.05 RCW, on an appeal of a denial of certification based on the applicant's failure to meet the minimum qualifications for certification;

(7) Investigate alleged violations of this chapter and consumer complaints involving the practice of persons representing themselves as certified dietitians or certified nutritionists;

(8) Issue subpoenas, statements of charges, statements of intent to deny certifications, and orders and delegate in writing to a designee the authority to issue subpoenas, statements of charges, and statements on intent to deny certifications;

(9) Conduct disciplinary proceedings, impose sanctions, and assess fines for violations of this chapter or any rules adopted under it in accordance with chapter 34.05 RCW;

(10) Set all certification, renewal, and late renewal fees in accordance with RCW 43.24.086; and

(11) Set certification expiration dates and renewal periods for all certifications under this chapter.

Sec. 270. Section 8, chapter 277, Laws of 1988 and RCW 18.138.080 are each amended to read as follows:

(1) There is created a state advisory committee consisting of five members appointed by the ((~~director~~)) secretary who shall advise the ((~~director~~)) secretary concerning the administration of this chapter. Two members of the committee shall be certified dietitians who have been engaged in the practice of dietetics for at least five years immediately preceding their appointments. Two members of the committee shall be certified nutritionists who have been engaged in the provision of general nutrition services for at least five years preceding their appointments. These committee members shall at all times be certified under this chapter, except for the initial members of the committee, who shall fulfill the requirements for certification under this chapter. The remaining member of the committee shall be a member of the public with an interest in the rights of consumers of health services, but who does not have any financial interest in the rendering of health services.

(2) The term of office for committee members is four years. The terms of the first committee members however, shall be staggered to ensure an orderly succession of new committee members thereafter. Terms of office shall expire on December 31. Any committee member may be removed for just cause. The ((~~director~~)) secretary may appoint a new member to fill any vacancy on the committee for the remainder of the unexpired term. No committee member may serve more than two consecutive terms whether full or partial.

(3) Committee members shall be entitled to be compensated in accordance with RCW 43.03.240 and to be reimbursed for travel expenses under RCW 43.03.050 and 43.03.060.

(4) The committee shall have the authority to annually elect a chairperson and vice-chairperson to direct the meetings of the committee. The committee shall meet at least once each year, and may hold additional meetings as called by the ((~~director~~)) secretary or the chairperson. Three members of the committee shall constitute a quorum of the committee.

Sec. 271. Section 5, chapter 277, Laws of 1988 and RCW 18.138.090 are each amended to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of certificates, unauthorized practices, and the disciplining of certificate holders under this chapter. The ((~~director~~)) secretary shall be the disciplining authority under this chapter.

Sec. 272. Section 6, chapter 117, Laws of 1943 as amended by section 11, chapter 213, Laws of 1985 and RCW 19.32.110 are each amended to read as follows:

(1) No person afflicted with any contagious or infectious disease ((~~shall~~)) may work or be permitted to work in or about any refrigerated locker, nor in the handling, dealing nor processing of any human food in connection therewith.

(2) No person ((~~shall~~)) may work or be permitted to work in or about any refrigerated locker in the handling, processing or dealing in any human food or any ingredient thereof without holding a certificate from a physician, duly accredited for that purpose by the department of ((~~social and health services~~)) health, certifying that such person has been examined and found free from any contagious or infectious disease. The department of ((~~social and health services~~)) health may fix a maximum fee, not exceeding two dollars which may be charged by a physician for such examination. Such certificate shall be effective for a period of six months and thereafter must be renewed following proper physical examination as aforesaid. Where such certificate is required and provided under municipal ordinance upon examination deemed adequate by the department, certificates issued thereunder shall be sufficient under this chapter.

(3) Any such certificate shall be revoked by the department of ((~~social and health services~~)) health at any time the holder thereof is found, after proper physical examination, to be afflicted with any communicable or infectious disease. Refusal of any person employed in such premises to submit to proper and reasonable physical examination upon written demand by the department of ((~~social and health services~~)) health or of the director of agriculture shall be cause for revocation of that person's health certificate.

Sec. 273. Section 28A.31.040, chapter 223, Laws of 1969 ex. sess. as amended by section 3, chapter 32, Laws of 1971 and RCW 28A.31.040 are each amended to read as follows:

The person or persons completing the screening prescribed in RCW 28A.31.030 shall promptly prepare a record of the screening of each child found to have, or suspected of having, reduced visual and/or auditory acuity in need of attention, including the special education services provided by chapter 28A.13 RCW, and send copies of such records and recommendations to the parents or guardians of such children and shall deliver the original records to the appropriate school official who shall preserve such records and forward to the superintendent of public instruction and the secretary of ((~~social and health services~~)) health visual and auditory data as requested by such officials.

Sec. 274. Section 4, chapter 118, Laws of 1979 ex. sess. as amended by section 5, chapter 40, Laws of 1984 and RCW 28A.31.106 are each amended to read as follows:

Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.31.100 through 28A.31.120 upon the presentation of any one or more of the following, on a form prescribed by the department of ((~~social and health services~~)) health:

(1) A written certification signed by any physician licensed to practice medicine pursuant to chapter 18.71 or 18.57 RCW that a particular vaccine required by rule of the state board of health is, in his or her judgment, not advisable for the child((~~: PROVIDED, That~~)). However, when it is determined that this particular vaccine is no longer contraindicated, the child will be required to have the vaccine;

(2) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the religious beliefs of the signator are contrary to the required immunization measures; and

(3) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the signator has either a philosophical or personal objection to the immunization of the child.

Sec. 275. Section 7, chapter 118, Laws of 1979 ex. sess. and RCW 28A.31.112 are each amended to read as follows:

A child's proof of immunization or certification of exemption shall be presented to the chief administrator of the public or private school or day care center or to his or her designee for that purpose. The chief administrator shall:

(1) Retain such records pertaining to each child at the school or day care center for at least the period the child is enrolled in the school or attends such center;

(2) Retain a record at the school or day care center of the name, address, and date of exclusion of each child excluded from school or the center pursuant to RCW 28A.31.114 for not less than three years following the date of a child's exclusion;

(3) File a written annual report with the department of ((~~social and health services~~)) health on the immunization status of students or children attending the day care center at a time and on forms prescribed by the department of ((~~social and health services~~)) health; and

(4) Allow agents of state and local health departments access to the records retained in accordance with this section during business hours for the purposes of inspection and copying.

Sec. 276. Section 6, chapter 242, Laws of 1988 and RCW 28B.104.060 are each amended to read as follows:

(1) Participants in the conditional scholarship program incur an obligation to repay the conditional scholarship, with interest, unless they serve for five years in nurse shortage areas of the state of Washington. Nurse shortage areas may include geographical areas as a result of maldistribution, or specialty areas of nursing such as gerentology, critical care, or coronary care.

(2) The terms of the repayment, including deferral of the interest, shall be consistent with the terms of the federal guaranteed loan program.

(3) The period for repayment shall be five years, with payments accruing quarterly commencing nine months from the date the participant completes or discontinues the course of study.

(4) The entire principal and interest of each payment shall be forgiven for each payment period in which the participant serves in a nurse shortage area, as determined by the state health ((~~coordinating council~~)) department, until the entire repayment obligation is satisfied or the borrower ceases to so serve. Should the participant cease to serve in this state before the participant's repayment obligation is completed, payments on the unsatisfied portion of the principal and interest shall begin the next payment period and continue until the remainder of the participant's repayment obligation is satisfied.

(5) The board is responsible for collection of repayments made under this section and shall exercise due diligence in such collection, maintaining all necessary records to ensure that maximum repayments are made. Collection and servicing of repayments under this section shall be pursued using the full extent of the law, including wage garnishment if necessary, and shall be performed by entities approved for such servicing by the Washington student loan guaranty association or its successor agency. The board is responsible to forgive all or parts of such repayments under the criteria established in this section and shall maintain all necessary records of forgiven payments.

(6) Receipts from the payment of principal or interest or any other subsidies to which the board as administrator is entitled, which are paid by or on behalf of participants under this section, shall be deposited with the higher education coordinating board and shall be used to cover the costs of granting the conditional scholarships, maintaining necessary records, and making collections under subsection (5) of this section. The board shall maintain accurate records of these costs, and all receipts beyond those necessary to pay such costs shall be used to grant conditional scholarships to eligible students.

Sec. 277. Section 2, chapter 34, Laws of 1984 as last amended by section 2, chapter 158, Laws of 1989, section 22, chapter 279, Laws of 1989 and by section 812, chapter 9, Laws of 1989 1st ex. sess. and RCW 42.17.2401 are each reenacted and amended to read as follows:

For the purposes of RCW 42.17.240, the term "executive state officer" includes:

(1) The chief administrative law judge, the director of agriculture, the administrator of the Washington basic health plan, the director of the department of services for the blind, the director of the state system of community colleges, the director of community development, the secretary of corrections, the director of ecology, the commissioner of employment security, the chairman of the energy facility site evaluation council, the director of the energy office, the secretary of the state finance committee, the director of financial management, the director of fisheries, the executive secretary of the forest practices appeals board, the director of the gambling commission, the director of general administration, the secretary of health, the administrator of the Washington state health care authority, the executive secretary of the health care facilities authority, the executive secretary of the higher education facilities authority, the director of the higher education personnel board, the executive secretary of the horse racing commission, the executive secretary of the human rights commission, the executive secretary of the indeterminate sentence review board, the director of the department of information services, the director of the interagency committee for outdoor recreation, the executive director of the state investment board, the director of labor and industries, the director of licensing, the director of the lottery commission, the director of the office of minority and women's business enterprises, !sethe director of parks and recreation, the director of personnel, the executive director of the public disclosure commission, the director of retirement systems, the director of revenue, the secretary of social and health services, the chief of the Washington state patrol, the executive secretary of the board of tax appeals, the director of trade and economic development, the secretary of transportation, the secretary of the utilities and transportation commission, the director of veterans affairs, the director of wildlife, the president of each of the regional and state universities and the president of The Evergreen State College, each district and each campus president of each state community college;

(2) Each professional staff member of the office of the governor;

(3) Each professional staff member of the legislature; and

(4) Central Washington University board of trustees, board of trustees of each community college, each member of the state board for community college education, state convention and trade center board of directors, committee for deferred compensation, Eastern Washington University board of trustees, Washington economic development finance authority, The Evergreen State College board of trustees, forest practices appeals board, forest practices board, gambling commission, Washington health care facilities authority, ((~~state health coordinating council,~~)) higher education coordinating board, higher education facilities authority, higher education personnel board, horse racing commission, ((~~hospital commission,~~)) state housing finance commission, human rights commission, indeterminate sentence review board, board of industrial insurance appeals, information services board, interagency committee for outdoor recreation, state investment board, liquor control board, lottery commission, oil and gas conservation committee, Pacific Northwest electric power and conservation planning council, parks and recreation commission, personnel appeals board, personnel board, pollution control hearings board, public disclosure commission, public pension commission, shorelines hearing board, state employees' benefits board, board of tax appeals, transportation commission, University of Washington board of regents, utilities and transportation commission, Washington public power supply system executive board, Washington State University board of regents, Western Washington University board of trustees, and wildlife commission.

Sec. 278. Section 9, chapter 167, Laws of 1988 and RCW 43.03.028 are each amended to read as follows:

(1) There is hereby created a state committee on agency officials' salaries to consist of seven members, or their designees, as follows: The president of the University of Puget Sound; the chairperson of the council of presidents of the state's four-year institutions of higher education; the chairperson of the State Personnel Board; the president of the Association of Washington Business; the president of the Pacific Northwest Personnel Managers' Association; the president of the Washington State Bar Association; and the president of the Washington State Labor Council. If any of the titles or positions mentioned in this subsection are changed or abolished, any person occupying an equivalent or like position shall be qualified for appointment by the governor to membership upon the committee.

(2) The committee shall study the duties and salaries of the directors of the several departments and the members of the several boards and commissions of state government, who are subject to appointment by the governor or whose salaries are fixed by the governor, and of the chief executive officers of the following agencies of state government:

The arts commission; the human rights commission; the board of accountancy; ((~~the board of pharmacy;~~)) the capitol historical association and museum; the eastern Washington historical society; the Washington state historical society; the interagency committee for outdoor recreation; the criminal justice training commission; the department of personnel; the state finance committee; the state library; the traffic safety commission; the horse racing commission; the advisory council on vocational education; the public disclosure commission; ((~~the hospital commission;~~)) the state conservation commission; the commission on Hispanic affairs; the commission on Asian-American affairs; the state board for volunteer ((~~firemen~~)) fire fighters; the transportation improvement board; the public employees relations commission; the forest practices appeals board; and the energy facilities site evaluation council.

The committee shall report to the governor or the chairperson of the appropriate salary fixing authority at least once in each fiscal biennium on such date as the governor may designate, but not later than seventy-five days prior to the convening of each regular session of the legislature during an odd-numbered year, its recommendations for the salaries to be fixed for each position.

(3) Committee members shall be reimbursed by the department of personnel for travel expenses under RCW 43.03.050 and 43.03.060.

Sec. 279. Section 2, chapter 201, Laws of 1982 as last amended by section 216, chapter 9, Laws of 1989 1st ex. sess. and RCW 43.20B.110 are each amended to read as follows:

(1) The secretary shall charge fees to the licensee for obtaining a license. The secretary may waive the fees when, in the discretion of the secretary, the fees would not be in the best interest of public health and safety, or when the fees would be to the financial disadvantage of the state.

(2) Fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection.

(3) Department of social and health services advisory committees may review fees established by the secretary for licenses and comment upon the appropriateness of the level of such fees.

(4) ((~~For~~)) Fees associated with the licensing or regulation of health professions or health facilities administered by the department of health((,)) shall be established and reviewed in accordance with RCW 43.70.110 and 43.70.250.

Sec. 280. Section 17, chapter 1, Laws of 1977 ex. sess. and RCW 43.83B.380 are each amended to read as follows:

There is hereby appropriated to the department of ((~~social and health services~~)) health the sum of nine million seven hundred thirty-seven thousand dollars, or so much thereof as may be necessary, for the biennium ending June 30, 1977, from the general fund--state and local improvements revolving account--water supply facilities for the purposes authorized in RCW 43.83B.300 through 43.83B.345 and 43.83B.210 ((~~as now or hereafter amended~~)) relating to the emergency water conditions arising from the drought forecast for the summer and fall of 1977 affecting municipal and industrial water supply distribution facilities. Prior to the expenditure of funds for projects approved by the department, the department shall file a listing of the approved projects with the senate ways and means committee and the house appropriations committee.

(2) There is hereby appropriated to the department of ((~~social and health services~~)) health the sum of five million three hundred twenty-seven thousand dollars, or so much thereof as may be necessary, for the biennium ending June 30, 1977, from the general fund--state and local improvements revolving account--water supply facilities to be expended for municipal and industrial water supply and distribution facility projects for which applications are in progress on March 25, 1977 and have arisen from the drought forecast for the summer and fall of 1977. Prior to the expenditure of funds for projects approved by the department, the department shall file a listing of the approved projects with the senate ways and means committee and the house appropriations committee.

The municipal and industrial water supply and distribution facilities receiving funds from the appropriations contained in this section shall comply with the eligible costs criteria, health and design standards, and contract performance requirements of the municipal and industrial funding program under chapter 43.83B RCW. All projects shall be evaluated by applying the said chapter's evaluation and prioritization criteria to insure that only projects related to water shortage problems receive funding. The projects funded shall be limited to those projects providing interties with adjacent utilities, an expanded source of supply, conservation projects which will conserve or maximize efficiency of the existing supply, or a new source of supply. No obligation to provide a grant for a project authorized under this section shall be incurred after June 30, 1977.

Sec. 281. Section 4, chapter 258, Laws of 1979 ex. sess. and RCW 43.99D.025 are each amended to read as follows:

The proceeds from the sale of the bonds deposited in the state and local improvements revolving account‑-water supply facilities of the general fund under the terms of this chapter shall be administered by the state department of ((~~social and health services~~)) health subject to legislative appropriation. The department may use or permit the use of any funds derived from the sale of bonds authorized under this chapter to accomplish the purpose for which the bonds are issued by direct expenditures and by grants or loans to public bodies, including grants to public bodies as matching funds in any case where federal, local, or other funds are made available on a matching basis for improvements within the purposes of this chapter.

Sec. 282. Section 4, chapter 234, Laws of 1979 ex. sess. and RCW 43.99E.025 are each amended to read as follows:

(1) Seventy-five million dollars, or so much thereof as may be required, shall be used for domestic, municipal, and industrial water supply facilities; and

(2) Fifty million dollars, or so much thereof as may be required, shall be used for water supply facilities for agricultural use alone or in combination with fishery, recreational, or other beneficial uses of water.

The share of seventy-five million dollars shall be administered by the department of ((~~social and health services~~)) health and the share of fifty million dollars shall be administered by the department of ecology, subject to legislative appropriation. The administering departments may use or permit the use of any funds derived from the sale of bonds authorized under this chapter to accomplish the purpose for the issuance of the bonds by direct expenditures and by grants or loans to public bodies, including grants to public bodies as matching funds in any case where federal, local, or other funds are made available on a matching basis for improvements within the purposes of this chapter.

Sec. 283. Section 51.36.010, chapter 23, Laws of 1961 as last amended by section 6, chapter 58, Laws of 1986 and RCW 51.36.010 are each amended to read as follows:

Upon the occurrence of any injury to a worker entitled to compensation under the provisions of this title, he or she shall receive proper and necessary medical and surgical services at the hands of a physician of his or her own choice, if conveniently located, and proper and necessary hospital care and services during the period of his or her disability from such injury, but the same shall be limited in point of duration as follows:

In the case of permanent partial disability, not to extend beyond the date when compensation shall be awarded him or her, except when the worker returned to work before permanent partial disability award is made, in such case not to extend beyond the time when monthly allowances to him or her shall cease; in case of temporary disability not to extend beyond the time when monthly allowances to him or her shall cease((~~: PROVIDED, That~~)). After any injured worker has returned to his or her work his or her medical and surgical treatment may be continued if, and so long as, such continuation is deemed necessary by the supervisor of industrial insurance to be necessary to his or her more complete recovery; in case of a permanent total disability not to extend beyond the date on which a lump sum settlement is made with him or her or he or she is placed upon the permanent pension roll((~~: PROVIDED, HOWEVER, That~~)). The supervisor of industrial insurance, solely in his or her discretion, may authorize continued medical and surgical treatment for conditions previously accepted by the department when such medical and surgical treatment is deemed necessary by the supervisor of industrial insurance to protect such worker's life or provide for the administration of medical and therapeutic measures including payment of prescription medications, but not including those controlled substances currently scheduled by the state board of pharmacy as Schedule I, II, III, or IV substances under chapter 69.50 RCW, which are necessary to alleviate continuing pain which results from the industrial injury. In order to authorize such continued treatment the written order of the supervisor of industrial insurance issued in advance of the continuation shall be necessary.

The supervisor of industrial insurance, the supervisor's designee, or a self-insurer, in his or her sole discretion, may authorize inoculation or other immunological treatment in cases in which a work-related activity has resulted in probable exposure of the worker to a potential infectious occupational disease. Authorization of such treatment does not bind the department or self-insurer in any adjudication of a claim by the same worker or the worker's beneficiary for an occupational disease.

Sec. 284. Section 1, chapter 144, Laws of 1955 as last amended by section 1, chapter 200, Laws of 1989 and RCW 69.30.010 are each amended to read as follows:

When used in this chapter, the following terms shall have the following meanings:

(1) "Shellfish" means all varieties of fresh and frozen oysters, mussels, and clams, either shucked or in the shell, and any fresh or frozen edible products thereof.

(2) "Sale" means to sell, offer for sale, barter, trade, deliver, consign, hold for sale, consignment, barter, trade, or delivery, and/or possess with intent to sell or dispose of in any commercial manner.

(3) "Shellfish growing areas" means the lands and waters in and upon which shellfish are grown for harvesting in commercial quantity or for sale for human consumption.

(4) "Establishment" means the buildings, together with the necessary equipment and appurtenances, used for the storage, culling, shucking, packing and/or shipping of shellfish in commercial quantity or for sale for human consumption.

(5) "Person" means any individual, partnership, firm, company, corporation, association, or the authorized agents of any such entities.

(6) "Department" means the state department of ((~~social and health services~~)) health.

(7) "Secretary" means the secretary of ((~~social and health services~~)) health or his or her authorized representatives.

(8) "Commercial quantity" means any quantity exceeding: (a) Forty pounds of mussels; (b) one hundred oysters; (c) fourteen horseclams; (d) six geoducks; or (e) fifty pounds of hard or soft shell clams.

Sec. 285. Section 3, chapter 114, Laws of 1969 ex. sess. as last amended by section 3, chapter 39, Laws of 1983 1st ex. sess. and RCW 70.05.053 are each amended to read as follows:

A person holding a license required by RCW 70.05.050 but not meeting any of the requirements for qualification prescribed by RCW 70.05.051 may be appointed by the board or official responsible for appointing the local health officer under RCW 70.05.050 as a provisionally qualified local health officer for a maximum period of three years upon the following conditions and in accordance with the following procedures:

(1) He or she shall participate in an in-service orientation to the field of public health as provided in RCW 70.05.054, and

(2) He or she shall satisfy the secretary of ((~~social and health services~~)) health pursuant to the periodic interviews prescribed by RCW 70.05.055 that he or she has successfully completed such in-service orientation and is conducting such program of good health practices as may be required by the jurisdictional area concerned.

Sec. 286. Section 4, chapter 114, Laws of 1969 ex. sess. as amended by section 77, chapter 141, Laws of 1979 and RCW 70.05.054 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health shall provide an in-service public health orientation program for the benefit of provisionally qualified local health officers.

Such program shall consist of‑-

(1) A three months course in public health training conducted by the secretary either in the state department of ((~~social and health services~~)) health, in a county and/or city health department, in a local health district, or in an institution of higher education; or

(2) An on-the-job, self-training program pursuant to a standardized syllabus setting forth the major duties of a local health officer including the techniques and practices of public health principles expected of qualified local health officers((~~: PROVIDED, That~~)). Each provisionally qualified local health officer may choose which type of training he or she shall pursue.

Sec. 287. Section 5, chapter 114, Laws of 1969 ex. sess. as amended by section 78, chapter 141, Laws of 1979 and RCW 70.05.055 are each amended to read as follows:

Each year, on a date which shall be as near as possible to the anniversary date of appointment as provisional local health officer, the secretary of ((~~social and health services~~)) health or his or her designee shall personally visit such provisional officer's office for a personal review and discussion of the activity, plans, and study being carried on relative to the provisional officer's jurisdictional area((~~: PROVIDED, That~~)). The third such interview shall occur three months prior to the end of the three year provisional term. A standardized checklist shall be used for all such interviews, but such checklist shall not constitute a grading sheet or evaluation form for use in the ultimate decision of qualification of the provisional appointee as a public health officer.

Copies of the results of each interview shall be supplied to the provisional officer within two weeks following each such interview.

Following the third such interview, the secretary ((~~of social and health services~~)) shall evaluate the provisional local health officer's in-service performance and shall notify such officer by certified mail of his or her decision whether or not to qualify such officer as a local public health officer. Such notice shall be mailed at least sixty days prior to the third anniversary date of provisional appointment. Failure to so mail such notice shall constitute a decision that such provisional officer is qualified.

Sec. 288. Section 10, chapter 51, Laws of 1967 ex. sess. as last amended by section 6, chapter 25, Laws of 1984 and RCW 70.05.060 are each amended to read as follows:

Each local board of health shall have supervision over all matters pertaining to the preservation of the life and health of the people within its jurisdiction and shall:

(1) Enforce through the local health officer or the administrative officer appointed under RCW 70.05.040, if any, the public health statutes of the state and rules ((~~and regulations~~)) promulgated by the state board of health and the secretary of ((~~social and health services~~)) health;

(2) Supervise the maintenance of all health and sanitary measures for the protection of the public health within its jurisdiction;

(3) Enact such local rules and regulations as are necessary in order to preserve, promote and improve the public health and provide for the enforcement thereof;

(4) Provide for the control and prevention of any dangerous, contagious or infectious disease within the jurisdiction of the local health department;

(5) Provide for the prevention, control and abatement of nuisances detrimental to the public health;

(6) Make such reports to the state board of health through the local health officer or the administrative officer as the state board of health may require; and

(7) Establish fee schedules for issuing or renewing licenses or permits or for such other services as are authorized by the law and the rules ((~~and regulations~~)) of the state board of health((~~: PROVIDED, That~~)). Such fees for services shall not exceed the actual cost of providing any such services.

Sec. 289. Section 12, chapter 51, Laws of 1967 ex. sess. as last amended by section 7, chapter 25, Laws of 1984 and RCW 70.05.070 are each amended to read as follows:

The local health officer, acting under the direction of the local board of health or under direction of the administrative officer appointed under RCW 70.05.040, if any, shall:

(1) Enforce the public health statutes of the state, rules ((~~and regulations~~)) of the state board of health and the secretary of ((~~social and health services~~)) health, and all local health rules, regulations and ordinances within his or her jurisdiction;

(2) Take such action as is necessary to maintain health and sanitation supervision over the territory within his or her jurisdiction;

(3) Control and prevent the spread of any dangerous, contagious or infectious diseases that may occur within his or her jurisdiction;

(4) Inform the public as to the causes, nature, and prevention of disease and disability and the preservation, promotion and improvement of health within his or her jurisdiction;

(5) Prevent, control or abate nuisances which are detrimental to the public health;

(6) Attend all conferences called by the secretary of ((~~social and health services~~)) health or his or her authorized representative;

(7) Collect such fees as are established by the state board of health or the local board of health for the issuance or renewal of licenses or permits or such other fees as may be authorized by law or by the rules ((~~and regulations~~)) of the state board of health.

(8) Take such measures as he or she deems necessary in order to promote the public health, to participate in the establishment of health educational or training activities, and to authorize the attendance of employees of the local health department or individuals engaged in community health programs related to or part of the programs of the local health department.

Sec. 290. Section 13, chapter 51, Laws of 1967 ex. sess. as last amended by section 4, chapter 39, Laws of 1983 1st ex. sess. and RCW 70.05.080 are each amended to read as follows:

If the local board of health or other official responsible for appointing a local health officer under RCW 70.05.050 refuses or neglects to appoint a local health officer after a vacancy exists, the secretary of ((~~social and health services~~)) health may appoint a local health officer and fix the compensation. The local health officer so appointed shall have the same duties, powers and authority as though appointed under RCW 70.05.050. Such local health officer shall serve until a qualified individual is appointed according to the procedures set forth in RCW 70.05.050. The board or official responsible for appointing the local health officer under RCW 70.05.050 shall also be authorized to appoint an acting health officer to serve whenever the health officer is absent or incapacitated and unable to fulfill his or her responsibilities under the provisions of chapter 70.05 RCW and RCW 70.46.020 through 70.46.090.

Sec. 291. Section 14, chapter 51, Laws of 1967 ex. sess. as amended by section 82, chapter 141, Laws of 1979 and RCW 70.05.090 are each amended to read as follows:

Whenever any physician shall attend any person sick with any dangerous contagious or infectious disease, or with any diseases required by the state board of health to be reported, he or she shall, within twenty-four hours, give notice thereof to the local health officer within whose jurisdiction such sick person may then be or to the state department of ((~~social and health services~~)) health in Olympia.

Sec. 292. Section 15, chapter 51, Laws of 1967 ex. sess. as amended by section 83, chapter 141, Laws of 1979 and RCW 70.05.100 are each amended to read as follows:

In case of the question arising as to whether or not any person is affected or is sick with a dangerous, contagious or infectious disease, the opinion of the local health officer shall prevail until the state department of ((~~social and health services~~)) health can be notified, and then the opinion of the executive officer of the state department of ((~~social and health services~~)) health, or any physician he or she may appoint to examine such case, shall be final.

Sec. 293. Section 18, chapter 51, Laws of 1967 ex. sess. as amended by section 84, chapter 141, Laws of 1979 and RCW 70.05.130 are each amended to read as follows:

All expenses incurred by the state, health district, or county in carrying out the provisions of chapter 70.05 RCW and RCW 70.46.020 through 70.46.090 or any other public health law, or the rules ((~~and regulations~~)) of the state department of ((~~social and health services~~)) health enacted under such laws, shall be paid by the county or city by which or in behalf of which such expenses shall have been incurred and such expenses shall constitute a claim against the general fund as provided herein.

Sec. 294. Section 8, chapter 46, Laws of 1949 as amended by section 85, chapter 141, Laws of 1979 and RCW 70.08.050 are each amended to read as follows:

Nothing in this chapter shall prohibit the director of public health as provided herein from acting as health officer for any other city or town within the county, nor from acting as health officer in any adjoining county or any city or town within such county having a contract or agreement as provided in RCW 70.08.090((~~: PROVIDED, HOWEVER, That~~)). Before being appointed health officer for such adjoining county, the secretary of ((~~social and health services~~)) health shall first give his or her approval thereto.

Sec. 295. Section 2, chapter 191, Laws of 1939 as amended by section 86, chapter 141, Laws of 1979 and RCW 70.12.015 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health is hereby authorized to apportion and expend such sums as he or she shall deem necessary for public health work in the counties of the state, from the appropriations made to the state department of ((~~social and health services~~)) health for county public health work.

Sec. 296. Section 5, chapter 190, Laws of 1943 as amended by section 87, chapter 141, Laws of 1979 and RCW 70.12.070 are each amended to read as follows:

The public health pool fund shall be subject to audit by the division of departmental audits and shall be subject to check by the state department of ((~~social and health services~~)) health.

Sec. 297. Section 2, chapter 283, Laws of 1961 as amended by section 88, chapter 141, Laws of 1979 and RCW 70.22.020 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health is hereby authorized and empowered to make or cause to be made such inspections, investigations, studies and determinations as he or she may from time to time deem advisable in order to ascertain the effect of mosquitoes as a health hazard, and, to the extent to which funds are available, to provide for the control or elimination thereof in any or all parts of the state.

Sec. 298. Section 3, chapter 283, Laws of 1961 as amended by section 89, chapter 141, Laws of 1979 and RCW 70.22.030 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health shall coordinate plans for mosquito control work which may be projected by any county, city or town, municipal corporation, taxing district, state department or agency, federal government agency, or any person, group or organization, and arrange for cooperation between any such districts, departments, agencies, persons, groups or organizations.

Sec. 299. Section 4, chapter 283, Laws of 1961 as amended by section 90, chapter 141, Laws of 1979 and RCW 70.22.040 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health is authorized and empowered to receive funds from any county, city or town, municipal corporation, taxing district, the federal government, or any person, group or organization to carry out the purpose of this chapter. In connection therewith the secretary is authorized and empowered to contract with any such county, city, or town, municipal corporation, taxing district, the federal government, person, group or organization with respect to the construction and maintenance of facilities and other work for the purpose of effecting mosquito control or elimination, and any such county, city or town, municipal corporation, or taxing district obligated to carry out the provisions of any such contract entered into with the secretary ((~~of social and health services~~)) is authorized, empowered and directed to appropriate, and if necessary, to levy taxes for and pay over such funds as its contract with the secretary may from time to time require.

Sec. 300. Section 5, chapter 283, Laws of 1961 as last amended by section 25, chapter 11, Laws of 1989 and RCW 70.22.050 are each amended to read as follows:

To carry out the purpose of this chapter, the secretary of ((~~social and health services~~)) health may:

(1) Abate as nuisances breeding places for mosquitoes as defined in RCW 17.28.170;

(2) Acquire by gift, devise, bequest, lease, or purchase, real and personal property necessary or convenient for carrying out the purpose of this chapter;

(3) Make contracts, employ engineers, health officers, sanitarians, physicians, laboratory personnel, attorneys, and other technical or professional assistants;

(4) Publish information or literature; and

(5) Do any and all other things necessary to carry out the purpose of this chapter((~~: PROVIDED, That~~)). No program shall be permitted nor any action taken in pursuance thereof which may be injurious to the life or health of game or fish.

Sec. 301. Section 6, chapter 283, Laws of 1961 as amended by section 92, chapter 141, Laws of 1979 and RCW 70.22.060 are each amended to read as follows:

Each state department, agency, and political subdivision shall cooperate with the secretary of ((~~social and health services~~)) health in carrying out the purposes of this chapter.

Sec. 302. Section 101, chapter 206, Laws of 1988 and RCW 70.24.017 are each amended to read as follows:

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

(1) "Acquired immunodeficiency syndrome" or "AIDS" means the clinical syndrome of HIV-related illness as defined by the board of health by rule.

(2) "Board" means the state board of health.

(3) "Department" means the department of ((~~social and health services~~)) health, or any successor department with jurisdiction over public health matters.

(4) "Health care provider" means any person who is a member of a profession under RCW 18.130.040 or other person providing medical, nursing, psychological, or other health care services regulated by the department of ((~~licensing or the department of social and health services~~)) health.

(5) "Health care facility" means a hospital, nursing home, neuropsychiatric or mental health facility, home health agency, hospice, child care agency, adult family home, group care facility, family foster home, clinic, blood bank, blood center, sperm bank, laboratory, or other social service or health care institution regulated or operated by the department of ((~~social and health services~~)) health.

(6) "HIV-related condition" means any medical condition resulting from infection with HIV including, but not limited to, seropositivity for HIV.

(7) "Human immunodeficiency virus" or "HIV" means all HIV and HIV-related viruses which damage the cellular branch of the human immune or neurological systems and leave the infected person immunodeficient or neurologically impaired.

(8) "Test for a sexually transmitted disease" means a test approved by the board by rule.

(9) "Legal guardian" means a person appointed by a court to assume legal authority for another who has been found incompetent or, in the case of a minor, a person who has legal custody of the child.

(10) "Local public health officer" means the officer directing the county health department or his or her designee who has been given the responsibility and authority to protect the health of the public within his or her jurisdiction.

(11) "Person" includes any natural person, partnership, association, joint venture, trust, public or private corporation, or health facility.

(12) "Release of test results" means a written authorization for disclosure of any sexually transmitted disease test result which is signed, dated, and which specifies to whom disclosure is authorized and the time period during which the release is to be effective.

(13) "Sexually transmitted disease" means a bacterial, viral, fungal, or parasitic disease, determined by the board by rule to be sexually transmitted, to be a threat to the public health and welfare, and to be a disease for which a legitimate public interest will be served by providing for regulation and treatment. The board shall designate chancroid, gonorrhea, granuloma inguinale, lymphogranuloma venereum, genital herpes simplex, chlamydia, nongonococcal urethritis (NGU), trachomitis, genital human papilloma virus infection, syphilis, acquired immunodeficiency syndrome (AIDS), and human immunodeficiency virus (HIV) infection as sexually transmitted diseases, and shall consider the recommendations and classifications of the centers for disease control and other nationally recognized medical authorities in designating other diseases as sexually transmitted.

(14) "State public health officer" means the secretary of ((~~social and health services~~)) health or an officer appointed by the secretary.

Sec. 303. Section 2, chapter 165, Laws of 1939 as amended by section 95, chapter 141, Laws of 1979 and RCW 70.24.100 are each amended to read as follows:

A standard serological test shall be a laboratory test for syphilis approved by the secretary of ((~~social and health services~~)) health and shall be performed either by a laboratory approved by the secretary of ((~~social and health services~~)) health for the performance of the particular serological test used or by the state department of ((~~social and health services~~)) health, on request of the physician free of charge.

Sec. 304. Section 1, chapter 59, Laws of 1977 as amended by section 913, chapter 206, Laws of 1988 and RCW 70.24.120 are each amended to read as follows:

Sexually transmitted disease case investigators, upon specific authorization from a physician, are hereby authorized to perform venipuncture or skin puncture on a person for the sole purpose of withdrawing blood for use in sexually transmitted disease tests.

The term "sexually transmitted disease case investigator" shall mean only those persons who:

(1) Are employed by public health authorities; and

(2) Have been trained by a physician in proper procedures to be employed when withdrawing blood in accordance with training requirements established by the department of ((~~social and health services~~)) health; and

(3) Possess a statement signed by the instructing physician that the training required by subsection (2) of this section has been successfully completed.

The term "physician" means any person licensed under the provisions of chapters 18.57 or 18.71 RCW.

Sec. 305. Section 915, chapter 206, Laws of 1988 and RCW 70.24.130 are each amended to read as follows:

The board shall adopt such rules as are necessary to implement and enforce this chapter. Rules may also be adopted by the department of ((~~social and health services or the department of licensing~~)) health for the purposes of this chapter. The rules may include procedures for taking appropriate action, in addition to any other penalty under this chapter, with regard to health care facilities or health care providers which violate this chapter or the rules adopted under this chapter. The rules shall prescribe stringent safeguards to protect the confidentiality of the persons and records subject to this chapter. The procedures set forth in chapter 34.05 RCW apply to the administration of this chapter, except that in case of conflict between chapter 34.05 RCW and this chapter, the provisions of this chapter shall control.

Sec. 306. Section 918, chapter 206, Laws of 1988 and RCW 70.24.150 are each amended to read as follows:

Members of the state board of health and local boards of health, public health officers, and employees of the department of ((~~social and health services~~)) health and local health departments are immune from civil action for damages arising out of the good faith performance of their duties as prescribed by this chapter, unless such performance constitutes gross negligence.

Sec. 307. Section 605, chapter 206, Laws of 1988 and RCW 70.24.280 are each amended to read as follows:

The state board of ((~~-pharmacy~~)) health shall adopt rules that require appropriate education and training for licensees on the prevention, transmission, and treatment of AIDS. The board shall work with the office on AIDS under RCW 70.24.250 to develop the training and educational material necessary for health professionals.

Sec. 308. Section 801, chapter 206, Laws of 1988 and RCW 70.24.400 are each amended to read as follows:

The department shall establish a state-wide system of regional acquired immunodeficiency syndrome (AIDS) service networks as follows:

(1) The secretary of ((~~social and health services~~)) health shall direct that all state or federal funds, excluding those from federal Title XIX for services or other activities authorized in this chapter, shall be allocated to the office on AIDS established in RCW 70.24.250. The secretary shall further direct that all funds for services and activities specified in subsection (3) of this section shall be provided to lead counties through contractual agreements based on plans developed as provided in subsection (2) of this section, unless direction of such funds is explicitly prohibited by federal law, federal regulation, or federal policy. The department shall deny funding allocations to lead counties only if the denial is based upon documented incidents of nonfeasance, misfeasance, or malfeasance. However, the department shall give written notice and thirty days for corrective action in incidents of misfeasance or nonfeasance before funding may be denied. The department shall designate six AIDS service network regions encompassing the state. In doing so, the department shall use the boundaries of the regional structures in place for the community services administration on January 1, 1988.

(2) The department shall request that a lead county within each region, which shall be the county with the largest population, prepare, through a cooperative effort of local health departments within the region, a regional organizational and service plan, which meets the requirements set forth in subsection (3) of this section. Efforts should be made to use existing plans, where appropriate. The plan should place emphasis on contracting with existing hospitals, major voluntary organizations, or health care organizations within a region that have in the past provided quality services similar to those mentioned in subsection (3) of this section and that have demonstrated an interest in providing any of the components listed in subsection (3) of this section. If any of the counties within a region do not participate, it shall be the lead county's responsibility to develop the part of the plan for the nonparticipating county or counties. If all of the counties within a region do not participate, the department shall assume the responsibility.

(3) The regional AIDS service network plan shall include the following components:

(a) A designated single administrative or coordinating agency;

(b) A complement of services to include:

(i) Voluntary and anonymous counseling and testing;

(ii) Mandatory testing and/or counseling services for certain individuals, as required by law;

(iii) Notification of sexual partners of infected persons, as required by law;

(iv) Education for the general public, health professionals, and high-risk groups;

(v) Intervention strategies to reduce the incidence of HIV infection among high-risk groups, possibly including needle sterilization and methadone maintenance;

(vi) Related community outreach services for runaway youth;

(vii) Case management;

(viii) Strategies for the development of volunteer networks;

(ix) Strategies for the coordination of related agencies within the network; and

(x) Other necessary information, including needs particular to the region;

(i) Case management services; and

(ii) A community-based continuum-of-care model encompassing both medical, mental health, and social services with the goal of maintaining persons with AIDS in a home-like setting, to the extent possible, in the least-expensive manner; and

(d) Budget, caseload, and staffing projections.

(4) Efforts shall be made by both the counties and the department to use existing service delivery systems, where possible, in developing the networks.

(5) The University of Washington health science program, in cooperation with the office on AIDS may, within available resources, establish a center for AIDS education, which shall be linked to the networks. The center for AIDS education is not intended to engage in state-funded research related to HIV infection, AIDS, or HIV-related conditions. Its duties shall include providing the office on AIDS with the appropriate educational materials necessary to carry out that office's duties.

(6) The department shall implement this section, consistent with available funds, by October 1, 1988, by establishing six regional AIDS service networks whose combined jurisdictions shall include the entire state.

(a) Until June 30, 1991, available funding for each regional AIDS service network shall be allocated as follows:

(i) Seventy-five percent of the amount provided for regional AIDS service networks shall be allocated per capita based on the number of persons residing within each region, but in no case less than one hundred fifty thousand dollars for each regional AIDS service network per fiscal year. This amount shall be expended for testing, counseling, education, case management, notification of sexual partners of infected persons, planning, coordination, and other services required by law, except for those enumerated in (ii) of this subsection.

(ii) Twenty-five percent of the amount provided for regional AIDS service networks shall be allocated for intervention strategies specifically addressing groups that are at a high risk of being infected with the human immunodeficiency virus. The allocation shall be made by the office on AIDS based on documented need as specified in regional AIDS network plans.

(b) After June 30, 1991, the funding shall be allocated as provided by law. By December 15, 1990, the department shall report to the appropriate committees of the legislature on proposed methods of funding regional AIDS service networks.

(7) The regional AIDS service networks shall be the official state regional agencies for AIDS information education and coordination of services. The state public health officer, as designated by the secretary of ((~~social and health services~~)) health, shall make adequate efforts to publicize the existence and functions of the networks.

(8) If the department is not able to establish a network by an agreement solely with counties, it may contract with nonprofit agencies for any or all of the designated network responsibilities.

(9) The department, in establishing the networks, shall study mechanisms that could lead to reduced costs and/or increased access to services. The methods shall include capitation.

(10) The department shall reflect in its departmental biennial budget request the funds necessary to implement this section.

(11) The department shall submit an implementation plan to the appropriate committees of the legislature by July 1, 1988.

(12) The use of appropriate materials may be authorized by regional AIDS service networks in the prevention or control of HIV infection.

Sec. 309. Section 803, chapter 206, Laws of 1988 and RCW 70.24.410 are each amended to read as follows:

To assist the secretary of ((~~social and health services~~)) health in the development and implementation of AIDS programs, the governor shall appoint an AIDS advisory committee. Among its duties shall be a review of insurance problems as related to persons with AIDS. The committee shall terminate on June 30, 1991.

Sec. 310. Section 4, chapter 143, Laws of 1972 ex. sess. and RCW 70.30.081 are each amended to read as follows:

All hospitals established or maintained for the treatment of persons suffering from tuberculosis shall be subject to annual inspection, or more frequently if required by federal law, by agents of the department of ((~~social and health services~~)) health, and the medical director shall admit such agents into every part of the facility and its buildings, and give them access on demand to all records, reports, books, papers, and accounts pertaining to the facility.

Sec. 311. Section 15, chapter 277, Laws of 1971 ex. sess. as amended by section 171, chapter 3, Laws of 1983 and RCW 70.33.010 are each amended to read as follows:

The following words and phrases shall have the designated meanings in this chapter and RCW 70.32.010, 70.32.050, and 70.32.060 unless the context clearly indicated otherwise:

(1) "Department" means the department of ((~~social and health services~~)) health;

(2) "Secretary" means the secretary of the department of ((~~social and health services~~)) health or his or her designee;

(3) "Tuberculosis hospital" and "tuberculosis hospital facility" refer to hospitals for the care of persons suffering from tuberculosis;

(4) "Tuberculosis control" refers to the procedures administered in the counties for the control and prevention of tuberculosis, but does not include hospitalization.

Sec. 312. Section 1, chapter 262, Laws of 1988 and RCW 70.39.144 are each amended to read as follows:

(1) The commission shall exempt a hospital from the rate review and approval provisions of RCW 70.39.140 if:

(a) The hospital is located within fifteen miles of one or more hospitals located in a jurisdiction that is not subject to RCW 70.39.140; and

(b) The hospital or hospitals not subject to RCW 70.39.140 have the existing capacity to absorb twenty-five percent or more of the patients served by the hospital exempted under this section.

(2) The exemption provided by this section shall not affect the exempted hospital's responsibility to make on a timely basis all filings required by the commission pursuant to this chapter. In addition, an exempted hospital shall provide on a timely basis other pertinent data that may be requested from time to time by the commission.

(3) This section shall expire June 30, ((~~1991~~)) 1990.

Sec. 313. Section 2, chapter 197, Laws of 1949 as last amended by section 96, chapter 141, Laws of 1979 and RCW 70.40.020 are each amended to read as follows:

As used in this chapter:

(1) "Secretary" means the secretary of the state department of ((~~social and health services~~)) health;

(2) "The federal act" means Title VI of the public health service act, as amended, or as hereafter amended by congress;

(3) "The surgeon general" means the surgeon general of the public health service of the United States;

(4) "Hospital" includes public health centers and general, tuberculosis, mental, chronic disease, and other types of hospitals, and related facilities, such as laboratories, outpatient departments, nurses' home and training facilities, and central service facilities operated in connection with hospitals;

(5) "Public health center" means a publicly owned facility for the provision of public health services, including related facilities such as laboratories, clinics, and administrative offices operated in connection with public health centers;

(6) "Nonprofit hospital" and "nonprofit medical facility" means any hospital or medical facility owned and operated by a corporation or association, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual;

(7) "Medical facilities" means diagnostic or diagnostic and treatment centers, rehabilitation facilities and nursing homes as those terms are defined in the federal act.

Sec. 314. Section 3, chapter 197, Laws of 1949 as last amended by section 97, chapter 141, Laws of 1979 and RCW 70.40.030 are each amended to read as follows:

There is hereby established in the state department of ((~~social and health services~~)) health a "section of hospital and medical facility survey and construction" which shall be administered by a full time salaried head under the supervision and direction of the secretary. The state department of ((~~social and and health services~~)) health, through such section, shall constitute the sole agency of the state for the purpose of:

(1) Making an inventory of existing hospitals and medical facilities, surveying the need for construction of hospitals and medical facilities, and developing a program of hospital and medical facility construction; and

(2) Developing and administering a state plan for the construction of public and other nonprofit hospitals and medical facilities as provided in this chapter.

Sec. 315. Section 15, chapter 197, Laws of 1949 as last amended by section 31, chapter 106, Laws of 1973 and RCW 70.40.150 are each amended to read as follows:

The secretary is hereby authorized to receive federal funds in behalf of, and transmit them to, such applicants or to approve applicants for federal funds and authorize the payment of such funds directly to such applicants as may be allowed by federal law. To achieve that end there is hereby established, separate and apart from all public moneys and funds of this state, a trust fund to be known as the "hospital and medical facility construction fund", of which the state treasurer shall ex officio be custodian. Moneys received from the federal government for construction projects approved by the surgeon general shall be deposited to the credit of this fund, shall be used solely for payments due applicants for work performed, or purchases made, in carrying out approved projects. Vouchers covering all payments from the hospital and medical facility construction fund shall be prepared by the department of ((~~social and health services~~)) health and shall bear the signature of the secretary or his or her duly authorized agent for such purpose, and warrants therefor shall be signed by the state treasurer.

Sec. 316. Section 2, chapter 267, Laws of 1955 as last amended by section 16, chapter 213, Laws of 1985 and RCW 70.41.020 are each amended to read as follows:

Unless the context clearly indicates otherwise, the following terms, whenever used in this chapter, shall be deemed to have the following meanings:

(1) "Department" means the Washington state department of ((~~social and health services~~)) health;

(2) "Hospital" means any institution, place, building, or agency which provides accommodations, facilities and services over a continuous period of twenty-four hours or more, for observation, diagnosis, or care, of two or more individuals not related to the operator who are suffering from illness, injury, deformity, or abnormality, or from any other condition for which obstetrical, medical, or surgical services would be appropriate for care or diagnosis. "Hospital" as used in this chapter does not include hotels, or similar places furnishing only food and lodging, or simply domiciliary care; nor does it include clinics, or physician's offices where patients are not regularly kept as bed patients for twenty-four hours or more; nor does it include nursing homes, as defined and which come within the scope of chapter 18.51 RCW; nor does it include maternity homes, which come within the scope of chapter 18.46 RCW; nor does it include psychiatric hospitals, which come within the scope of chapter 71.12 RCW; nor any other hospital, or institution specifically intended for use in the diagnosis and care of those suffering from mental illness, mental retardation, convulsive disorders, or other abnormal mental condition. Furthermore, nothing in this chapter or the rules ((~~and regulations~~)) adopted pursuant thereto shall be construed as authorizing the supervision, regulation, or control of the remedial care or treatment of residents or patients in any hospital conducted for those who rely primarily upon treatment by prayer or spiritual means in accordance with the creed or tenets of any well recognized church or religious denominations;

(3) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.

Sec. 317. Section 4, chapter 300, Laws of 1986 as amended by section 5, chapter 269, Laws of 1987 and RCW 70.41.200 are each amended to read as follows:

(1) Every hospital shall maintain a coordinated program for the identification and prevention of medical malpractice. The program shall include at least the following:

(a) The establishment of a quality assurance committee with the responsibility to review the services rendered in the hospital in order to improve the quality of medical care of patients and to prevent medical malpractice. The committee shall oversee and coordinate the medical malpractice prevention program and shall insure that information gathered pursuant to the program is used to review and to revise hospital policies and procedures. At least one member of the committee shall be a member of the governing board of the hospital who is not otherwise affiliated with the hospital in an employment or contractual capacity;

(b) A medical staff privileges sanction procedure through which credentials, physical and mental capacity, and competence in delivering health care services are periodically reviewed as part of an evaluation of staff privileges;

(c) The periodic review of the credentials, physical and mental capacity, and competence in delivering health care services of all persons who are employed or associated with the hospital;

(d) A procedure for the prompt resolution of grievances by patients or their representatives related to accidents, injuries, treatment, and other events that may result in claims of medical malpractice;

(e) The maintenance and continuous collection of information concerning the hospital's experience with negative health care outcomes and incidents injurious to patients, patient grievances, professional liability premiums, settlements, awards, costs incurred by the hospital for patient injury prevention, and safety improvement activities;

(f) The maintenance of relevant and appropriate information gathered pursuant to (a) through (e) of this subsection concerning individual physicians within the physician's personnel or credential file maintained by the hospital;

(g) Education programs dealing with patient safety, injury prevention, staff responsibility to report professional misconduct, the legal aspects of patient care, improved communication with patients, and causes of malpractice claims for staff personnel engaged in patient care activities; and

(h) Policies to ensure compliance with the reporting requirements of this section.

(2) Any person who, in substantial good faith, provides information to further the purposes of the medical malpractice prevention program or who, in substantial good faith, participates on the quality assurance committee shall not be subject to an action for civil damages or other relief as a result of such activity.

(3) Information and documents, including complaints and incident reports, created, collected, and maintained about health care providers arising out of the matters that are under review or have been evaluated by a review committee conducting quality assurance reviews are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or board shall be permitted or required to testify in any civil action as to the content of such proceedings. This subsection does not preclude: (a) In any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (b) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality assurance committees regarding such health care provider; (c) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any; or (d) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of ((~~social and health services~~)) health to be made regarding the care and treatment received.

(4) The department of ((~~social and health services~~)) health shall adopt such rules as are deemed appropriate to effectuate the purposes of this section.

(5) The medical disciplinary board or the board of osteopathic medicine and surgery, as appropriate, may review and audit the records of committee decisions in which a physician's privileges are terminated or restricted. Each hospital shall produce and make accessible to the board the appropriate records and otherwise facilitate the review and audit. Information so gained shall not be subject to the discovery process and confidentiality shall be respected as required by subsection (3) of this section. Failure of a hospital to comply with this subsection is punishable by a civil penalty not to exceed two hundred fifty dollars.

(6) Violation of this section shall not be considered negligence per se.

Sec. 318. Section 11, chapter 300, Laws of 1986 as amended by section 6, chapter 269, Laws of 1987 and RCW 70.41.230 are each amended to read as follows:

(1) Prior to granting or renewing clinical privileges or association of any physician or hiring a physician, a hospital or facility approved pursuant to this chapter shall request from the physician and the physician shall provide the following information:

(a) The name of any hospital or facility with or at which the physician had or has any association, employment, privileges, or practice;

(b) If such association, employment, privilege, or practice was discontinued, the reasons for its discontinuation;

(c) Any pending professional medical misconduct proceedings or any pending medical malpractice actions in this state or another state, the substance of the allegations in the proceedings or actions, and any additional information concerning the proceedings or actions as the physician deems appropriate;

(d) The substance of the findings in the actions or proceedings and any additional information concerning the actions or proceedings as the physician deems appropriate;

(e) A waiver by the physician of any confidentiality provisions concerning the information required to be provided to hospitals pursuant to this subsection; and

(f) A verification by the physician that the information provided by the physician is accurate and complete.

(2) Prior to granting privileges or association to any physician or hiring a physician, a hospital or facility approved pursuant to this chapter shall request from any hospital with or at which the physician had or has privileges, was associated, or was employed, the following information concerning the physician:

(a) Any pending professional medical misconduct proceedings or any pending medical malpractice actions, in this state or another state;

(b) Any judgment or settlement of a medical malpractice action and any finding of professional misconduct in this state or another state by a licensing or disciplinary board; and

(3) The medical disciplinary board shall be advised within thirty days of the name of any physician denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.

(4) A hospital or facility that receives a request for information from another hospital or facility pursuant to subsections (1) and (2) of this section shall provide such information concerning the physician in question to the extent such information is known to the hospital or facility receiving such a request, including the reasons for suspension, termination, or curtailment of employment or privileges at the hospital or facility. A hospital, facility, or other person providing such information in good faith is not liable in any civil action for the release of such information.

(5) Information and documents, including complaints and incident reports, created, collected, and maintained about health care providers arising out of the matters that are under review or have been evaluated by a review committee conducting quality assurance reviews are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or board shall be permitted or required to testify in any civil action as to the content of such proceedings. This subsection does not preclude: (a) In any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (b) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality assurance committees regarding such health care provider; (c) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any; or (d) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of ((~~social and health services~~)) health to be made regarding the care and treatment received.

(6) Hospitals shall be granted access to information held by the medical disciplinary board and the board of osteopathic medicine and surgery pertinent to decisions of the hospital regarding credentialing and recredentialing of practitioners.

(7) Violation of this section shall not be considered negligence per se.

Sec. 319. Section 3, chapter 207, Laws of 1988 and RCW 70.41.240 are each amended to read as follows:

The department of ((~~social and health services~~)) health shall compile and make available to the public information regarding medicare health care facility certification options available to hospitals licensed under this title that desire to convert to nonhospital health care facilities. The information provided shall include standards and requirements for certification and procedures for acquiring certification.

Sec. 320. Section 8, chapter 5, Laws of 1987 1st ex. sess. and RCW 70.47.060 are each amended to read as follows:

The administrator has the following powers and duties:

(1) To design and from time to time revise a schedule of covered basic health care services, including physician services, inpatient and outpatient hospital services, and other services that may be necessary for basic health care, which enrollees in any participating managed health care system under the Washington basic health plan shall be entitled to receive in return for premium payments to the plan. The schedule of services shall emphasize proven preventive and primary health care, shall include all services necessary for prenatal, postnatal, and well-child care, and shall include a separate schedule of basic health care services for children, eighteen years of age and younger, for those enrollees who choose to secure basic coverage through the plan only for their dependent children. In designing and revising the schedule of services, the administrator shall consider the guidelines for assessing health services under the mandated benefits act of 1984, RCW 48.42.080, and such other factors as the administrator deems appropriate.

(2) To design and implement a structure of periodic premiums due the administrator from enrollees that is based upon gross family income, giving appropriate consideration to family size as well as the ages of all family members. The enrollment of children shall not require the enrollment of their parent or parents who are eligible for the plan.

(3) To design and implement a structure of nominal copayments due a managed health care system from enrollees. The structure shall discourage inappropriate enrollee utilization of health care services, but shall not be so costly to enrollees as to constitute a barrier to appropriate utilization of necessary health care services.

(4) To design and implement, in concert with a sufficient number of potential providers in a discrete area, an enrollee financial participation structure, separate from that otherwise established under this chapter, that has the following characteristics:

(a) Nominal premiums that are based upon ability to pay, but not set at a level that would discourage enrollment;

(b) A modified fee-for-services payment schedule for providers;

(c) Coinsurance rates that are established based on specific service and procedure costs and the enrollee's ability to pay for the care. However, coinsurance rates for families with incomes below one hundred twenty percent of the federal poverty level shall be nominal. No coinsurance shall be required for specific proven prevention programs, such as prenatal care. The coinsurance rate levels shall not have a measurable negative effect upon the enrollee's health status; and

(d) A case management system that fosters a provider-enrollee relationship whereby, in an effort to control cost, maintain or improve the health status of the enrollee, and maximize patient involvement in her or his health care decision-making process, every effort is made by the provider to inform the enrollee of the cost of the specific services and procedures and related health benefits.

The potential financial liability of the plan to any such providers shall not exceed in the aggregate an amount greater than that which might otherwise have been incurred by the plan on the basis of the number of enrollees multiplied by the average of the prepaid capitated rates negotiated with participating managed health care systems under RCW 70.47.100 and reduced by any sums charged enrollees on the basis of the coinsurance rates that are established under this subsection.

(5) To limit enrollment of persons who qualify for subsidies so as to prevent an overexpenditure of appropriations for such purposes. Whenever the administrator finds that there is danger of such an overexpenditure, the administrator shall close enrollment until the administrator finds the danger no longer exists.

(6) To adopt a schedule for the orderly development of the delivery of services and availability of the plan to residents of the state, subject to the limitations contained in RCW 70.47.080.

In the selection of any area of the state for the initial operation of the plan, the administrator shall take into account the levels and rates of unemployment in different areas of the state, the need to provide basic health care coverage to a population reasonably representative of the portion of the state's population that lacks such coverage, and the need for geographic, demographic, and economic diversity.

Before July 1, 1988, the administrator shall endeavor to secure participation contracts with managed health care systems in discrete geographic areas within at least five congressional districts.

(7) To solicit and accept applications from managed health care systems, as defined in this chapter, for inclusion as eligible basic health care providers under the plan. The administrator shall endeavor to assure that covered basic health care services are available to any enrollee of the plan from among a selection of two or more participating managed health care systems. In adopting any rules or procedures applicable to managed health care systems and in its dealings with such systems, the administrator shall consider and make suitable allowance for the need for health care services and the differences in local availability of health care resources, along with other resources, within and among the several areas of the state.

(8) To receive periodic premiums from enrollees, deposit them in the basic health plan operating account, keep records of enrollee status, and authorize periodic payments to managed health care systems on the basis of the number of enrollees participating in the respective managed health care systems.

(9) To accept applications from individuals residing in areas served by the plan, on behalf of themselves and their spouses and dependent children, for enrollment in the Washington basic health plan, to establish appropriate minimum-enrollment periods for enrollees as may be necessary, and to determine, upon application and at least annually thereafter, or at the request of any enrollee, eligibility due to current gross family income for sliding scale premiums. An enrollee who remains current in payment of the sliding-scale premium, as determined under subsection (2) of this section, and whose gross family income has risen above twice the federal poverty level, may continue enrollment unless and until the enrollee's gross family income has remained above twice the poverty level for six consecutive months, by making payment at the unsubsidized rate required for the managed health care system in which he or she may be enrolled. No subsidy may be paid with respect to any enrollee whose current gross family income exceeds twice the federal poverty level or, subject to RCW 70.47.110, who is a recipient of medical assistance or medical care services under chapter 74.09 RCW. If a number of enrollees drop their enrollment for no apparent good cause, the administrator may establish appropriate rules or requirements that are applicable to such individuals before they will be allowed to re-enroll in the plan.

(10) To require that prospective enrollees who may be eligible for categorically needy medical coverage under RCW 74.09.510 or whose income does not exceed the medically needy income level under RCW 74.09.700 apply for such coverage, but the administrator shall enroll the individuals in the plan pending the determination of eligibility under chapter 74.09 RCW.

(11) To determine the rate to be paid to each participating managed health care system in return for the provision of covered basic health care services to enrollees in the system. Although the schedule of covered basic health care services will be the same for similar enrollees, the rates negotiated with participating managed health care systems may vary among the systems. In negotiating rates with participating systems, the administrator shall consider the characteristics of the populations served by the respective systems, economic circumstances of the local area, the need to conserve the resources of the basic health plan trust account, and other factors the administrator finds relevant.

(12) To monitor the provision of covered services to enrollees by participating managed health care systems in order to assure enrollee access to good quality basic health care, to require periodic data reports concerning the utilization of health care services rendered to enrollees in order to provide adequate information for evaluation, and to inspect the books and records of participating managed health care systems to assure compliance with the purposes of this chapter. In requiring reports from participating managed health care systems, including data on services rendered enrollees, the administrator shall endeavor to minimize costs, both to the managed health care systems and to the administrator. The administrator shall coordinate any such reporting requirements with other state agencies, such as the insurance commissioner and the ((~~hospital commission~~)) department of health, to minimize duplication of effort.

(13) To monitor the access that state residents have to adequate and necessary health care services, determine the extent of any unmet needs for such services or lack of access that may exist from time to time, and make such reports and recommendations to the legislature as the administrator deems appropriate.

(14) To evaluate the effects this chapter has on private employer-based health care coverage and to take appropriate measures consistent with state and federal statutes that will discourage the reduction of such coverage in the state.

(15) To develop a program of proven preventive health measures and to integrate it into the plan wherever possible and consistent with this chapter.

(16) To provide, consistent with available resources, technical assistance for rural health activities that endeavor to develop needed health care services in rural parts of the state.

Sec. 321. Section 1, chapter 23, Laws of 1945 as amended by section 108, chapter 141, Laws of 1979 and RCW 70.50.010 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health shall appoint and employ an otologist skilled in diagnosis of diseases of the ear and defects in hearing, especially for school children with an impaired sense of hearing, and shall fix the salary of such otologist in a sum not exceeding the salary of the secretary.

Sec. 322. Section 3, chapter 208, Laws of 1909 as amended by section 109, chapter 141, Laws of 1979 and RCW 70.54.040 are each amended to read as follows:

The commissioners of any county or the mayor of any city may call upon the secretary of ((~~social and health services~~)) health for advice relative to improving sanitary conditions or disposing of garbage and sewage or obtaining a pure water supply, and when so called upon the secretary ((~~of social and health services~~)) shall either personally or by an assistant make a careful examination into the conditions existing and shall make a full report containing his or her advice ((~~thereon~~)) to the county or city making such request.

Sec. 323. Section 2, chapter 122, Laws of 1977 ex. sess. and RCW 70.54.140 are each amended to read as follows:

No hospital or health facility may interfere with the physician/patient relationship by restricting or forbidding the use of amygdalin (Laetrile) when prescribed or administered by a physician licensed pursuant to chapter 18.57 or 18.71 RCW and requested by a patient under his/her care who has requested the substance after having been given sufficient information in writing to make an informed decision.

For the purposes of RCW 70.54.130 through 70.54.150, the ((~~state board of pharmacy~~)) department of health shall provide for the certification as to the identity of amygdalin (Laetrile) by random sample testing or other testing procedures, and shall promulgate rules ((~~and regulations~~)) necessary to implement and enforce its authority under this section.

Sec. 324. Section 1, chapter 223, Laws of 1987 and RCW 70.58.005 are each amended to read as follows:

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

(1) "Department" means the department of ((~~social and health services~~)) health.

(2) "Vital records" means records of birth, death, fetal death, marriage, dissolution, annulment, and legal separation, as maintained under the supervision of the state registrar of vital statistics.

Sec. 325. Section 3, chapter 223, Laws of 1987 as amended by section 1, chapter 40, Laws of 1988 and RCW 70.58.107 are each amended to read as follows:

The department of ((~~social and health services~~)) health shall charge a fee of eleven dollars for certified copies of records and for copies or information provided for research, statistical, or administrative purposes, and eight dollars for a search of the files or records when no copy is made. The department shall prescribe by ((~~regulation~~)) rule fees to be paid for preparing sealed files and for opening sealed files.

No fee may be demanded or required for furnishing certified copies of a birth, death, fetal death, marriage, divorce, annulment, or legal separation record for use in connection with a claim for compensation or pension pending before the veterans administration.

The ((~~state~~)) department ((~~of social and health services~~)) shall keep a true and correct account of all fees received and turn the fees over to the state treasurer on a weekly basis.

Local registrars shall charge the same fees as the state as hereinabove provided and as prescribed by department ((~~regulation~~)) rule, except that local registrars shall charge eleven dollars for the first copy of a death certificate and six dollars for each additional copy of the same death certificate when the additional copies are ordered at the same time as the first copy. All such fees collected, except for three dollars of each fee for the issuance of a certified copy, shall be paid to the jurisdictional health department.

All local registrars in cities and counties shall keep a true and correct account of all fees received under this section for the issuance of certified copies and shall turn three dollars of the fee over to the state treasurer on or before the first day of January, April, July, and October.

Three dollars of each fee imposed for the issuance of certified copies, except for copies suitable for display issued under RCW 70.58.085, at both the state and local levels shall be held by the state treasurer in the death investigations account established by RCW 43.79.445.

Sec. 326. Section 2, chapter 177, Laws of 1959 as amended by section 110, chapter 141, Laws of 1979 and RCW 70.58.310 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health, through the state registrar of vital statistics, shall establish and maintain a registry for handicapped children.

Sec. 327. Section 3, chapter 177, Laws of 1959 as last amended by section 1, chapter 156, Laws of 1984 and RCW 70.58.320 are each amended to read as follows:

Whenever the attending physician discovers that a newborn child has a sentinel defect, and whenever a physician discovers upon treating a child under the age of fourteen years that such child has a partial or complete disability or a condition which may lead to partial or complete disability, such fact shall be reported to the local registrar and to the parents, or legal guardians of the child, upon a form to be provided by the secretary of ((~~social and health services~~)) health. No report shall be required if the disabling condition has been previously reported or the condition is not one required to be reported by the secretary ((~~of social and health services~~)). Sentinel defects shall be reported at the same time as birth certificates are required to be filed. Each physician shall make a report as to disabling conditions within thirty days after discovery thereof. If a child with sentinel birth defects is born outside the hospital, the person filling out the birth certificate shall make a report to the department.

The forms to be provided by the secretary ((~~of social and health services~~)) for this purpose shall require such information as the secretary deems necessary to carry out the purpose of RCW 70.58.300 through 70.58.350.

Sec. 328. Section 5, chapter 177, Laws of 1959 as amended by section 112, chapter 141, Laws of 1979 and RCW 70.58.340 are each amended to read as follows:

The secretary of ((~~social and health services~~)) health and any local health officer is authorized to cooperate with and to promote the aid of any medical, health, nursing, welfare, or other private groups or organizations, and with any state agency or political subdivision to furnish statistical data in furtherance of the purpose of RCW 70.58.300 through 70.58.350. The secretary or any local health officer may accept contributions or gifts in cash or otherwise from any person, group, or governmental agency to further the purpose of RCW 70.58.300 through 70.58.350.

Sec. 329. Section 2, chapter 239, Laws of 1971 ex. sess. and RCW 70.62.210 are each amended to read as follows:

The following terms whenever used or referred to in this chapter shall have the following respective meanings for the purposes of this chapter, except in those instances where the context clearly indicates otherwise:

(1) The term "transient accommodation" shall mean any facility such as a hotel, motel, condominium, resort, or any other facility or place offering three or more lodging units to travelers and transient guests.

(2) The term "person" shall mean any individual, firm, partnership, corporation, company, association or joint stock association, and the legal successor thereof.

(3) The term "secretary" shall mean the secretary of the Washington state department of ((~~social and health services~~)) health and any duly authorized representative thereof.

(4) The term "board" shall mean the Washington state board of health.

(5) The term "department" shall mean the Washington state department of ((~~social and health services~~)) health.

(6) The term "lodging unit" shall mean one self-contained unit designated by number, letter or some other method of identification.

Sec. 330. Section 43.20.010, chapter 8, Laws of 1965 as last amended by section 251, chapter 9, Laws of 1989 1st ex. sess. and RCW 43.70.130 are each amended to read as follows:

The secretary of health shall:

(1) Exercise all the powers and perform all the duties prescribed by law with respect to public health ((~~and~~)), vital statistics, and health data pursuant to chapter 43.70 RCW and other specified chapters of the Revised Code of Washington;

(2) Investigate and study factors relating to the preservation, promotion, and improvement of the health of the people, the causes of morbidity and mortality, and the effects of the environment and other conditions upon the public health, and report the findings to the state board of health for such action as the board determines is necessary;

(3) Strictly enforce all laws for the protection of the public health and the improvement of sanitary conditions in the state, and all rules, regulations, and orders of the state board of health;

(4) Enforce the public health laws of the state and the rules and regulations promulgated by the department or the board of health in local matters, when in its opinion an emergency exists and the local board of health has failed to act with sufficient promptness or efficiency, or is unable for reasons beyond its control to act, or when no local board has been established, and all expenses so incurred shall be paid upon demand of the secretary of ((~~the department of~~)) health by the local health department for which such services are rendered, out of moneys accruing to the credit of the municipality or the local health department in the current expense fund of the county;

(5) Investigate outbreaks and epidemics of disease that may occur and advise local health officers as to measures to be taken to prevent and control the same;

(6) Encourage public awareness and understanding of the department and its programs and services;

(7) Exercise general supervision over the work of all local health departments and establish uniform reporting systems by local health officers to the state department of health;

((~~(7)~~)) (8) Have the same authority as local health officers, except that the secretary shall not exercise such authority unless the local health officer fails or is unable to do so, or when in an emergency the safety of the public health demands it;

((~~(8)~~)) (9) Cause to be made from time to time, personal health and sanitation inspections at state owned or contracted institutions and facilities to determine compliance with sanitary and health care standards as adopted by the department, and require the governing authorities thereof to take such action as will conserve the health of all persons connected therewith, and report the findings to the governor;

((~~(9)~~)) (10) Take such measures as the secretary deems necessary in order to promote the public health, to address primary health risks affecting youth occasioning high death rates, premature death, and illness or injury as result of coronary heart disease, cancer, chronic lung disease, and other debilitating chronic diseases, to establish or participate in the establishment of health educational or training activities, and to provide funds for and to authorize the attendance and participation in such activities of employees of the state or local health departments and other individuals engaged in programs related to or part of the public health programs of the local health departments or the state department of health. The secretary is also authorized to accept any funds from the federal government or any public or private agency made available for health education training purposes and to conform with such requirements as are necessary in order to receive such funds; and

((~~(10)~~)) (11) Establish and maintain laboratory facilities and services as are necessary to carry out the responsibilities of the department in chapter 43.70 RCW and other specified chapters of the Revised Code of Washington.

Sec. 331. Section 2, chapter 82, Laws of 1967 as amended by section 1, chapter 27, Laws of 1975-'76 2nd ex. sess. and RCW 70.83.020 are each amended to read as follows:

It shall be the duty of the department of ((~~social and health services~~)) health to require screening tests of all newborn infants before they are discharged from the hospital for the detection of phenylketonuria and other heritable or metabolic disorders leading to mental retardation or physical defects as defined by the state board of health((~~: PROVIDED, That~~)). No such tests shall be given to any newborn infant whose parents or guardian object thereto on the grounds that such tests conflict with their religious tenets and practices.

Sec. 332. Section 3, chapter 82, Laws of 1967 as amended by section 113, chapter 141, Laws of 1979 and RCW 70.83.030 are each amended to read as follows:

Laboratories, attending physicians, hospital administrators, or other persons performing or requesting the performance of tests for phenylketonuria shall report to the department of ((~~social and health services~~)) health all positive tests. The state board of health by rule ((~~and regulation~~)) shall, when it deems appropriate, require that positive tests for other heritable and metabolic disorders covered by this chapter be reported to the state department of ((~~social and health services~~)) health by such persons or agencies requesting or performing such tests.

Sec. 333. Section 4, chapter 82, Laws of 1967 as amended by section 114, chapter 141, Laws of 1979 and RCW 70.83.040 are each amended to read as follows:

When notified of positive screening tests, the state department of ((~~social and health services~~)) health shall offer the use of its services and facilities, designed to prevent mental retardation or physical defects in such children, to the attending physician, or the parents of the newborn child if no attending physician can be identified.

The services and facilities of the ((~~state~~)) department ((~~of social and health services~~)), and other state and local agencies cooperating with the department ((~~of social and health services~~)) in carrying out programs of detection and prevention of mental retardation and physical defects shall be made available to the family and physician to the extent required in order to carry out the intent of this chapter and within the availability of funds.

Sec. 334. Section 2, chapter 276, Laws of 1988 and RCW 70.83B.020 are each amended to read as follows:

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

(1) "Department" means the department of ((~~social and health services~~)) health.

(2) "Laboratory" means a private or public agency or organization performing prenatal tests for congenital and heritable disorders.

(3) "Prenatal tests" means any test that predicts congenital or heritable disorders which: (a) As determined by the state board of health can by improper utilization clearly harm or endanger the health, safety, or welfare of the public, and the potential harm is easily recognizable and not remote or dependent upon tenuous argument, and (b) are enumerated by the department by rule.

(4) "Secretary" means the secretary of ((~~social and health services~~)) health.

Sec. 335. Section 2, chapter 236, Laws of 1986 as amended by section 2, chapter 222, Laws of 1987 and RCW 70.90.110 are each amended to read as follows:

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

(1) "Water recreation facility" means any artificial basin or other structure containing water used or intended to be used for recreation, bathing, relaxation, or swimming, where body contact with the water occurs or is intended to occur and includes auxiliary buildings and appurtenances. The term includes, but is not limited to:

(a) Conventional swimming pools, wading pools, and spray pools;

(b) Recreational water contact facilities as defined in this chapter;

(d) Any area designated for swimming in natural waters with artificial boundaries within the waters.

(2) "Recreational water contact facility" means an artificial water associated facility with design and operational features that provide patron recreational activity which is different from that associated with a conventional swimming pool and purposefully involves immersion of the body partially or totally in the water, and that includes but is not limited to, water slides, wave pools, and water lagoons.

(3) "Local health officer" means the health officer of the city, county, or city-county department or district or a representative authorized by the local health officer.

(4) "Secretary" means the secretary of ((~~social and health services~~)) health.

(5) "Person" means an individual, firm, partnership, co-partnership, corporation, company, association, club, government entity, or organization of any kind.

(6) "Department" means the department of ((~~social and health services~~)) health.

(7) "Board" means the state board of health.

Sec. 336. Section 4, chapter 236, Laws of 1986 and RCW 70.90.130 are each amended to read as follows:

(1) A recreational water contact facility advisory committee is established and shall be appointed by the board which shall consist of the following members:

(a) A representative of the board of health;

(b) A private operator of a recreational water contact facility;

(d) A representative from the department of ((~~social and health services~~)) health;

(e) A representative of the county health departments;

(f) A representative from those who engage in the construction or design of recreational water contact facilities; and

(g) A representative from those who engage in the manufacturing or design of goods or services for recreational water contact facilities.

(2) The advisory committee shall have the following powers and duties:

(a) To assist in reviewing and drafting proposed rules regarding the design or operation of any recreational water contact facility which recommendations shall be transmitted to the board;

(b) To provide technical assistance regarding the review of new products, equipment and procedures, and periodic program review; and

(3) The committee may appoint subcommittees as it deems necessary.

Sec. 337. Section 3, chapter 207, Laws of 1961 as last amended by section 9, chapter 19, Laws of 1983 1st ex. sess. and RCW 70.98.030 are each amended to read as follows:

(1) "Byproduct material" means any radioactive material (except special nuclear material) yielded in or made radioactive by exposure to the radiation incident to the process of producing or utilizing special nuclear material.

(2) "Ionizing radiation" means gamma rays and x-rays, alpha and beta particles, high-speed electrons, neutrons, protons, and other atomic or subatomic particles; but not sound or radio waves, or visible, infrared, or ultraviolet light.

(3) (a) "General license" means a license effective pursuant to ((~~regulations~~)) rules promulgated by the state radiation control agency, without the filing of an application, to transfer, acquire, own, possess, or use quantities of, or devices or equipment utilizing, byproduct, source, special nuclear materials, or other radioactive material occurring naturally or produced artificially.

(b) "Specific license" means a license, issued after application to use, manufacture, produce, transfer, receive, acquire, own, or possess quantities of, or devices or equipment utilizing byproduct, source, special nuclear materials, or other radioactive materials occurring naturally or produced artificially.

(4) "Person" means any individual, corporation, partnership, firm, association, trust, estate, public or private institution, group, agency, political subdivision of this state, any other state or political subdivision or agency thereof, and any legal successor, representative, agent, or agency of the foregoing, other than the United States Atomic Energy Commission, or any successor thereto, and other than federal government agencies licensed by the United States Atomic Energy Commission, or any successor thereto.

(5) "Source material" means (a) uranium, thorium, or any other material which is determined by the United States Nuclear Regulatory Commission or its successor pursuant to the provisions of section 61 of the United States Atomic Energy Act of 1954, as amended (42 U.S.C. Sec. 209) to be source material; or (b) ores containing one or more of the foregoing materials, in such concentration as the commission may by regulation determine from time to time.

(6) "Special nuclear material" means (a) plutonium, uranium enriched in the isotope 233 or in the isotope 235, and any other material which the United States Nuclear Regulatory Commission or its successor, pursuant to the provisions of section 51 of the United States Atomic Energy Act of 1954, as amended (42 U.S.C. Sec. 2071), determines to be special nuclear material, but does not include source material; or (b) any material artificially enriched by any of the foregoing, but does not include source material.

(7) "Registration" means registration with the state department of ((~~social and health services~~)) health by any person possessing a source of ionizing radiation in accordance with rules((~~, regulations and standards~~)) adopted by the department of ((~~social and health services~~)) health.

(8) "Radiation source" means any type of device or substance which is capable of producing or emitting ionizing radiation.

Sec. 338. Section 5, chapter 207, Laws of 1961 as last amended by section 132, chapter 175, Laws of 1989 and RCW 70.98.050 are each amended to read as follows:

(1) The department of ((~~social and health services~~)) health is designated as the state radiation control agency, hereinafter referred to as the agency, and shall be the state agency having sole responsibility for administration of the regulatory, licensing, and radiation control provisions of this chapter.

(2) The secretary of ((~~social and health services~~)) health shall be director of the agency, hereinafter referred to as the secretary, who shall perform the functions vested in the agency pursuant to the provisions of this chapter.

(3) The agency shall appoint a state radiological control officer, and in accordance with the laws of the state, fix his compensation and prescribe his or her powers and duties.

(4) The agency shall for the protection of the occupational and public health and safety:

(a) Develop programs for evaluation of hazards associated with use of ionizing radiation;

(b) Develop a state-wide radiological baseline beginning with the establishment of a baseline for the Hanford reservation;

(c) Implement an independent state-wide program to monitor ionizing radiation emissions from radiation sources within the state;

(d) Develop programs with due regard for compatibility with federal programs for regulation of byproduct, source, and special nuclear materials;

(e) Conduct environmental radiation monitoring programs which will determine the presence and significance of radiation in the environment and which will verify the adequacy and accuracy of environmental radiation monitoring programs conducted by the federal government at its installations in Washington and by radioactive materials licensees at their installations;

(f) Formulate, adopt, promulgate, and repeal ((~~codes,~~)) rules ((~~and regulations~~)) relating to control of sources of ionizing radiation;

(g) Advise, consult, and cooperate with other agencies of the state, the federal government, other states and interstate agencies, political subdivisions, and with groups concerned with control of sources of ionizing radiation;

(h) Have the authority to accept and administer loans, grants, or other funds or gifts, conditional or otherwise, in furtherance of its functions, from the federal government and from other sources, public or private;

(i) Encourage, participate in, or conduct studies, investigations, training, research, and demonstrations relating to control of sources of ionizing radiation, including the collection of statistical data and epidemiological research, where available, on diseases that result from exposure to sources of ionizing radiation;

(j) Collect and disseminate information relating to control of sources of ionizing radiation; including:

(i) Maintenance of a file of all license applications, issuances, denials, amendments, transfers, renewals, modifications, suspensions, and revocations;

(ii) Maintenance of a file of registrants possessing sources of ionizing radiation requiring registration under the provisions of this chapter and any administrative or judicial action pertaining thereto; and

(iii) Maintenance of a file of all rules ((~~and regulations~~)) relating to regulation of sources of ionizing radiation, pending or promulgated, and proceedings thereon;

(k) In connection with any adjudicative proceeding as defined by RCW 34.05.010 or any other administrative proceedings as provided for in this chapter, have the power to issue subpoenas in order to compel the attendance of necessary witnesses and/or the production of records or documents.

(5) In order to avoid duplication of efforts, the agency may acquire the data requested under this section from public and private entities that possess this information.

Sec. 339. Section 3, chapter 383, Laws of 1985 as last amended by section 1, chapter 106, Laws of 1989 and RCW 70.98.085 are each amended to read as follows:

(1) The agency is empowered to suspend and reinstate site use permits consistent with current regulatory practices and in coordination with the department of ecology, for generators, packagers, or brokers using the Hanford low-level radioactive waste disposal facility.

(2) The agency shall collect a surveillance fee as an added charge on each cubic foot of low level radioactive waste disposed of at the disposal site in this state which shall be set at a level that is sufficient to fund completely the radiation control activities of the agency directly related to the disposal site, including but not limited to the management, licensing, monitoring, and regulation of the site. The surveillance fee shall not exceed four percent of the basic minimum fee charged by an operator of a low-level radioactive waste disposal site in this state. The basic minimum fee consists of the disposal fee for the site operator, the fee for the perpetual care and maintenance fund administered by the state, the fee for the state closure fund, and the tax collected pursuant to chapter 82.04 RCW. Site use permit fees and surcharges collected under chapter 43.200 RCW are not part of the basic minimum fee. The fee shall also provide funds to the Washington state patrol for costs incurred from inspection of low-level radioactive waste shipments entering this state. Disbursements for this purpose shall be by authorization of the secretary of the department of ((~~social and health services~~)) health or the secretary's designee.

The agency may adopt such rules as are necessary to carry out its responsibilities under this section.

Sec. 340. Section 1, chapter 41, Laws of 1971 ex. sess. and RCW 70.104.010 are each amended to read as follows:

The department of ((~~social and health services~~)) health has responsibility to protect and enhance the public health and welfare. As a consequence, it must be concerned with both natural and artificial environmental factors which may adversely affect the public health and welfare. Dangers to the public health and welfare related to the use of pesticides require specific legislative recognition of departmental authority and responsibility in this area.

Sec. 341. Section 3, chapter 41, Laws of 1971 ex. sess. as amended by section 71, chapter 380, Laws of 1989 and RCW 70.104.030 are each amended to read as follows:

(1) The department of ((~~social and health services~~)) health shall investigate all suspected human cases of pesticide poisoning and such cases of suspected pesticide poisoning of animals that may relate to human illness. The department shall establish time periods by rule to determine investigation response time. Time periods shall range from immediate to forty-eight hours to initiate an investigation, depending on the severity of the case or suspected case of pesticide poisoning.

In order to adequately investigate such cases, the department ((~~of social and health services~~)) shall have the power to:

(a) Take all necessary samples and human or animal tissue specimens for diagnostic purposes: PROVIDED, That tissue, if taken from a living human, shall be taken from a living human only with the consent of a person legally qualified to give such consent;

(b) Secure any and all such information as may be necessary to adequately determine the nature and causes of any case of pesticide poisoning.

(2) The ((~~state~~)) department ((~~of social and health services~~)) shall, by rule ((~~and regulation~~)) adopted pursuant to the Administrative Procedure Act, chapter 34.05 RCW, ((~~as it now exists or is hereafter amended, and, in any event,~~)) with due notice and a hearing for the adoption of permanent rules, establish procedures for the prevention of any recurrence of poisoning and the department shall immediately notify the department of agriculture, the department of labor and industries, and other appropriate agencies of the results of its investigation for such action as the other departments or agencies deem appropriate. The notification of such investigations and their results may include recommendations for further action by the appropriate department or agency.

Sec. 342. Section 4, chapter 41, Laws of 1971 ex. sess. as amended by section 178, chapter 3, Laws of 1983 and RCW 70.104.040 are each amended to read as follows:

(1) In any case where an emergency relating to pesticides occurs that represents a hazard to the public due to toxicity of the material, the quantities involved or the environment in which the incident takes place, such emergencies including but not limited to fires, spillage, and accidental contamination, the person or agent of such person having actual or constructive control of the pesticides involved shall immediately notify the department of ((~~social and health services~~)) health by telephone or the fastest available method.

(2) Upon notification or discovery of any pesticide emergency the department of ((~~social and health services~~)) health shall:

(a) Make such orders and take such actions as are appropriate to assume control of the property and to dispose of hazardous substances, prevent further contamination, and restore any property involved to a nonhazardous condition. In the event of failure of any individual to obey and carry out orders pursuant to this section, the department ((~~of social and health services~~)) shall have all power and authority to accomplish those things necessary to carry out such order. Any expenses incurred by the department ((~~of social and health services~~)) as a result of intentional failure of any individual to obey its lawful orders shall be charged as a debt against such individual.

(3) In any case where the department of ((~~social and health services~~)) health has assumed control of property pursuant to this chapter, such property shall not be reoccupied or used until such time as written notification of its release for use is received from the secretary of the department ((~~of social and health services~~)) or his or her designee. Such action shall take into consideration the economic hardship, if any, caused by having the department assume control of property, and release shall be accomplished as expeditiously as possible. Nothing in this chapter shall prevent a farmer from continuing to process his or her crops and/or animals provided that ((it)) the processing does not endanger the public health.

(4) The department shall recognize the pesticide industry's responsibility and active role in minimizing the effect of pesticide emergencies and shall provide for maximum utilization of these services.

(5) Nothing in this chapter shall be construed in any way to infringe upon or negate the authority and responsibility of the department of agriculture in its application and enforcement of the Washington Pesticide Control Act, chapter 15.58 RCW and the Washington Pesticide Application Act, chapter 17.21 RCW. The department of ((~~social and health services~~)) health shall work closely with the department of agriculture in the enforcement of this chapter and shall keep it appropriately advised.

Sec. 343. Section 5, chapter 41, Laws of 1971 ex. sess. and RCW 70.104.050 are each amended to read as follows:

The department of ((~~social and health services~~)) health shall investigate human exposure to pesticides, and in order to carry out such investigations shall have authority to secure and analyze appropriate specimens of human tissue and samples representing sources of possible exposure.

Sec. 344. Section 72, chapter 380, Laws of 1989 and RCW 70.104.055 are each amended to read as follows:

(1) Any attending physician or other health care provider recognized as primarily responsible for the diagnosis and treatment of a patient or, in the absence of a primary health care provider, the health care provider initiating diagnostic testing or therapy for a patient shall report a case or suspected case of pesticide poisoning to the department of ((~~social and health services~~)) health in the manner prescribed by, and within the reasonable time periods established by, rules of the state board of health. Time periods established by the board shall range from immediate reporting to reporting within seven days depending on the severity of the case or suspected case of pesticide poisoning. The reporting requirements shall be patterned after other board rules establishing requirements for reporting of diseases or conditions. Confidentiality requirements shall be the same as the confidentiality requirements established for other reportable diseases or conditions. The board rules shall determine what information shall be reported. Reports shall be made on forms provided to health care providers by the department of ((~~social and health services~~)) health. For purposes of any oral reporting, the department of ((~~social and health services~~)) health shall make available a toll-free telephone number.

(2) Within a reasonable time period as established by board rules, the department of ((~~social and health services~~)) health shall investigate the report of a case or suspected case of pesticide poisoning to document the incident. The department shall report the results of the investigation to the health care provider submitting the original report.

(3) Cases or suspected cases of pesticide poisoning shall be reported by the department of ((~~social and health services~~)) health to the pesticide reporting and tracking review panel within the time periods established by state board of health rules.

(4) Upon request of the primary health care provider, pesticide applicators or employers shall make available to that provider any available information on pesticide applications which may have affected the health of the provider's patient. This information is to be used only for the purposes of providing health care services to the patient.

(5) Any failure of the primary health care provider to make the reports required under this section may be cause for the department of ((~~social and health services~~)) health to submit information about such nonreporting to the applicable disciplining authority for the provider under RCW 18.130.040.

(6) No cause of action shall arise as the result of: (a) The failure to report under this section; or (b) any report submitted to the department of ((~~social and health services~~)) health under this section.

(7) For the purposes of this section, a suspected case of pesticide poisoning is a case in which the diagnosis is thought more likely than not to be pesticide poisoning.

Sec. 345. Section 73, chapter 380, Laws of 1989 and RCW 70.104.057 are each amended to read as follows:

The department of ((~~social and health services~~)) health, after seeking advice from the state board of health, local health officers, and state and local medical associations, shall develop a program of medical education to alert physicians and other health care providers to the symptoms, diagnosis, treatment, and reporting of pesticide poisonings.

Sec. 346. Section 6, chapter 41, Laws of 1971 ex. sess. and RCW 70.104.060 are each amended to read as follows:

In order effectively to prevent human illness due to pesticides and to carry out the requirements of this chapter, the department of ((~~social and health services~~)) health is authorized to provide technical assistance and consultation regarding health effects of pesticides to physicians and other agencies, and is authorized to operate an analytical chemical laboratory and may provide analytical and laboratory services to physicians and other agencies to determine pesticide levels in human and other tissues, and appropriate environmental samples.

Sec. 347. Section 68, chapter 380, Laws of 1989 and RCW 70.104.080 are each amended to read as follows:

(1) There is hereby created a pesticide incident reporting and tracking review panel consisting of the following members:

(a) The directors, secretaries, or designees of the departments of labor and industries, agriculture, natural resources, wildlife, and ecology;

(b) The director of the department of ((~~social and health services~~)) health or his or her designee, who shall serve as the coordinating agency for the review panel;

(d) The pesticide coordinator and specialist of the cooperative extension at Washington State University or his or her designee;

(e) A representative of the Washington poison control center network;

(f) A practicing toxicologist and a member of the general public, who shall each be appointed by the governor for terms of two years and may be appointed for a maximum of four terms at the discretion of the governor. The governor may remove either member prior to the expiration of his or her term of appointment for cause. Upon the death, resignation, or removal for cause of a member of the review panel, the governor shall fill such vacancy, within thirty days of its creation, for the remainder of the term in the manner herein prescribed for appointment to the review panel.

(2) The review panel shall be chaired by the secretary of the department of ((~~social and health services~~)) health, or designee. The members of the review panel shall meet at least monthly at a time and place specified by the chair, or at the call of a majority of the review panel.

Sec. 348. Section 69, chapter 380, Laws of 1989 and RCW 70.104.090 are each amended to read as follows:

The responsibilities of the review panel shall include, but not be limited to:

(1) Establishing guidelines for centralizing the receipt of information relating to actual or alleged health and environmental incidents involving pesticides;

(2) Reviewing and making recommendations for procedures for investigation of pesticide incidents, which shall be implemented by the appropriate agency unless a written statement providing the reasons for not adopting the recommendations is provided to the review panel;

(3) Monitoring the time periods required for response to reports of pesticide incidents by the departments of agriculture, ((~~social and health services~~)) health, and labor and industries;

(4) At the request of the chair or any panel member, reviewing pesticide incidents of unusual complexity or those that cannot be resolved;

(5) Identifying inadequacies in state and/or federal law that result in insufficient protection of public health and safety, with specific attention to advising the appropriate agencies on the adequacy of pesticide reentry intervals established by the federal environmental protection agency and registered pesticide labels to protect the health and safety of farmworkers. The panel shall establish a priority list for reviewing reentry intervals, which considers the following criteria:

(a) Whether the pesticide is being widely used in labor-intensive agriculture in Washington;

(b) Whether another state has established a reentry interval for the pesticide that is longer than the existing federal reentry interval;

(d) Whether the pesticide has been identified by a federal or state agency or through a scientific review as presenting a risk of cancer, birth defects, genetic damage, neurological effects, blood disorders, sterility, menstrual dysfunction, organ damage, or other chronic or subchronic effects; and

(e) Whether reports or complaints of ill effects from the pesticide have been filed following worker entry into fields to which the pesticide has been applied; and

(6) Reviewing and approving an annual report prepared by the department of ((~~social and health services~~)) health to the governor, agency heads, and members of the legislature, with the same available to the public. The report shall include, at a minimum:

(a) A summary of the year's activities;

(b) A synopsis of the cases reviewed;

(c) A separate descriptive listing of each case in which adverse health or environmental effects due to pesticides were found to occur;

(d) A tabulation of the data from each case;

(e) An assessment of the effects of pesticide exposure in the workplace;

(f) The identification of trends, issues, and needs; and

(g) Any recommendations for improved pesticide use practices.

Sec. 349. Section 1, chapter 142, Laws of 1977 ex. sess. and RCW 70.116.010 are each amended to read as follows:

The legislature hereby finds that an adequate supply of potable water for domestic, commercial, and industrial use is vital to the health and well-being of the people of the state. Readily available water for use in public water systems is limited and should be developed and used efficiently with a minimum of loss or waste.

In order to maximize efficient and effective development of the state's public water supply systems, the department of ((~~social and health services~~)) health shall assist water purveyors by providing a procedure to coordinate the planning of the public water supply systems.

Sec. 350. Section 3, chapter 142, Laws of 1977 ex. sess. and RCW 70.116.030 are each amended to read as follows:

Unless the context clearly requires otherwise, the following terms when used in this chapter shall be defined as follows:

(1) "Coordinated water system plan" means a plan for public water systems within a critical water supply service area which identifies the present and future needs of the systems and sets forth means for meeting those needs in the most efficient manner possible. Such a plan shall include provisions for subsequently updating the plan. In areas where more than one water system exists, a coordinated plan may consist of either: (a) A new plan developed for the area following its designation as a critical water supply service area; or (b) a compilation of compatible water system plans existing at the time of such designation and containing such supplementary provisions as are necessary to satisfy the requirements of this chapter. Any such coordinated plan must include provisions regarding: Future service area designations; assessment of the feasibility of shared source, transmission, and storage facilities; emergency inter-ties; design standards; and other concerns related to the construction and operation of the water system facilities.

(2) "Critical water supply service area" means a geographical area which is characterized by a proliferation of small, inadequate water systems, or by water supply problems which threaten the present or future water quality or reliability of service in such a manner that efficient and orderly development may best be achieved through coordinated planning by the water utilities in the area.

(3) "Public water system" means any system providing water intended for, or used for, human consumption or other domestic uses. It includes, but is not limited to, the source, treatment for purifying purposes only, storage, transmission, pumping, and distribution facilities where water is furnished to any community, or number of individuals, or is made available to the public for human consumption or domestic use, but excluding water systems serving one single family residence. However, systems existing on September 21, 1977 which are owner operated and serve less than ten single family residences or which serve only one industrial plant shall be excluded from this definition and the provisions of this chapter.

(4) "Purveyor" means any agency or subdivision of the state or any municipal corporation, firm, company, mutual or cooperative association, institution, partnership, or person or any other entity, that owns or operates for wholesale or retail service a public water system. It also means the authorized agents of any such entities.

(5) "Secretary" means the secretary of the department of ((~~social and health services~~)) health or the secretary's authorized representative.

(6) "Service area" means a specific geographical area serviced or for which service is planned by a purveyor.

Sec. 351. Section 2, chapter 133, Laws of 1977 ex. sess. and RCW 70.118.020 are each amended to read as follows:

As used in this chapter, the terms defined in this section shall have the meanings indicated unless the context clearly indicates otherwise.

(1) "Nonwater-carried sewage disposal devices" means any device that stores and treats nonwater-carried human urine and feces.

(2) "Alternative methods of effluent disposal" means systems approved by the department of ((~~social and health services~~)) health, including at least, mound systems, alternating drain fields, anaerobic filters, evapotranspiration systems, and aerobic systems.

(3) "Failure" means: (a) Effluent has been discharged on the surface of the ground prior to approved treatment; or (b) effluent has percolated to the surface of the ground; or (c) effluent has contaminated or threatens to contaminate a ground water supply.

Sec. 352. Section 4, chapter 133, Laws of 1977 ex. sess. and RCW 70.118.040 are each amended to read as follows:

With the advice of the secretary of the department of ((~~social and health services~~)) health, local boards of health are hereby authorized to waive applicable sections of local plumbing and/or building codes that might prohibit the use of an alternative method for correcting a failure.

Sec. 353. Section 2, chapter 99, Laws of 1977 ex. sess. as amended by section 2, chapter 292, Laws of 1983 and RCW 70.119.020 are each amended to read as follows:

As used in this chapter unless context requires another meaning:

(1) "Board" means the board established pursuant to RCW 70.95B.070 which shall be known as the water and waste water operator certification board of examiners.

(2) "Certificate" means a certificate of competency issued by the secretary stating that the operator has met the requirements for the specified operator classification of the certification program.

(3) "Department" means the department of ((~~social and health services~~)) health.

(4) "Distribution system" means that portion of a public water supply system which stores, transmits, pumps and distributes water to consumers.

(5) "Nationally recognized association of certification authorities" shall mean an organization which serves as an information center for certification activities, recommends minimum standards and guidelines for classification of potable water treatment plants, water distribution systems and waste water facilities and certification of operators, facilitates reciprocity between state programs and assists authorities in establishing new certification programs and updating existing ones.

(6) "Certified operator" means an individual employed or appointed by any county, water district, municipality, public or private corporation, company, institution, person, or the state of Washington who is designated by the employing or appointing officials as the person responsible for active daily technical operation.

(7) "Public water supply system" means any water supply system intended or used for human consumption or other domestic uses, including source, treatment, storage, transmission and distribution facilities where water is furnished to any community or group of individuals, or is made available to the public for human consumption or domestic use, but excluding all water supply systems serving one single family residence.

(8) "Purification plant" means that portion of a public water supply system which treats or improves the physical, chemical or bacteriological quality of the system's water to bring the water into compliance with state board of health standards.

(9) "Secretary" means the secretary of the department of ((~~social and health services~~)) health.

Sec. 354. Section 9, chapter 99, Laws of 1977 ex. sess. as amended by section 7, chapter 292, Laws of 1983 and RCW 70.119.090 are each amended to read as follows:

Certificates shall be issued without examination under the following conditions:

(1) Certificates shall be issued without application fee to operators who, on January 1, 1978, hold certificates of competency attained under the voluntary certification program sponsored jointly by the state department of ((~~social and health services~~)) health, health services division, and the Pacific Northwest section of the American water works association.

(2) Certification shall be issued to persons certified by a governing body or owner of a public water supply system to have been the operators of a purification plant or distribution system on January 1, 1978, but only to those who are required to be certified under RCW 70.119.030(1). A certificate so issued shall be valid for operating any plant or system of the same classification and same type of water source.

(3) A nonrenewable certificate, temporary in nature, may be issued to an operator for a period not to exceed twelve months to fill a vacated position required to have a certified operator. Only one such certificate may be issued subsequent to each instance of vacation of any such position.

Sec. 355. Section 2, chapter 271, Laws of 1986 as amended by section 2, chapter 422, Laws of 1989 and RCW 70.119A.020 are each amended to read as follows:

Unless the context clearly requires otherwise, the following definitions apply throughout this chapter:

(1) "Department" means the department of ((~~social and health services~~)) health.

(2) "Local board of health" means the city, town, county, or district board of health.

(3) "Local health jurisdiction" means an entity created under chapter 70.05, 70.08, or 70.46 RCW which provides public health services to persons within the area.

(4) "Public water system" means any system, excluding a system serving only one single-family residence, which provides piped water for human consumption, including:

(a) Any collection, treatment, storage, and distribution facilities under control of the purveyor and used primarily in connection with such system; and

(b) Any collection or pretreatment storage facilities not under control of the purveyor which are primarily used in connection with such system.

(5) "Order" means a written direction to comply with a provision of the ((~~regulations~~)) rules adopted under RCW 43.20.050(2)(a) or 70.119.050 or to take an action or a series of actions to comply with the ((~~regulations~~)) rules.

(6) "Purveyor" means any agency or subdivision of the state or any municipal corporation, firm, company, mutual((,)) or cooperative association, institution, partnership, or person or any other entity, that owns or operates a public water system. It also means the authorized agents of any such entities.

(7) "Regulations" means rules adopted to carry out the purposes of this chapter.

(8) "Federal safe drinking water act" means the federal safe drinking water act, 42 U.S.C. Sec. 300f et seq., as now in effect or hereafter amended.

(9) "Local health officer" means the legally qualified physician who has been appointed as the health officer for the city, town, county, or district public health department.

(10) "Person" includes, but is not limited to, natural persons, municipal corporations, governmental agencies, firms, companies, mutual or cooperative associations, institutions, and partnerships. It also means the authorized agents of any such entities.

(11) "Public health emergency" means a declaration by an authorized health official of a situation in which either illness, or exposure known to cause illness, is occurring or is imminent.

(12) "Secretary" means the secretary of the department of ((~~social and health services~~)) health.

(13) "State board of health" is the board created by RCW 43.20.030.

Sec. 356. Section 5, chapter 422, Laws of 1989 and RCW 70.119A.080 are each amended to read as follows:

(1) The department shall administer a drinking water program which includes, but is not limited to, those program elements necessary to assume primary enforcement responsibility for part B, and section 1428 of part C of the federal safe drinking water act. No rule ((~~or regulation~~)) promulgated or implemented by the department of ((~~social and health services~~)) health or the state board of health for the purpose of compliance with the requirements of the federal safe drinking water act, 42 U.S.C. Sec. 300f et seq., shall be applicable to public water systems to which that federal law is not applicable, unless the department or the state board determines that such rule ((~~or regulation~~)) is necessary for the protection of public health.

(2) The department shall enter into an agreement of administration with the department of ecology and any other appropriate agencies, to administer the federal safe drinking water act.

(3) The department is authorized to accept federal grants for the administration of a primary program.

Sec. 357. Section 2, chapter 110, Laws of 1979 ex. sess. as last amended by section 1, chapter 184, Laws of 1987 and RCW 70.121.020 are each amended to read as follows:

Unless the context clearly requires a different meaning, the definitions in this section apply throughout this chapter.

(1) "Department" means the department of ((~~social and health services~~)) health.

(2) "Secretary" means the secretary of ((~~social and health services~~)) health.

(3) "Site" means the restricted area as defined by the United States nuclear regulatory commission.

(4) "Tailings" means the residue remaining after extraction of uranium or thorium from the ore whether or not the residue is left in piles, but shall not include ore bodies nor ore stock piles.

(5) "License" means a radioactive materials license issued under chapter 70.98 RCW and the rules adopted under chapter 70.98 RCW.

(6) "Termination of license" means the cancellation of the license after permanent cessation of operations. Temporary interruptions or suspensions of production due to economic or other conditions are not a permanent cessation of operations.

(7) "Milling" means grinding, cutting, working, or concentrating ore which has been extracted from the earth by mechanical (conventional) or chemical (in situ) processes.

(8) "Obligor-licensee" means any person who obtains a license to operate a uranium or thorium mill in the state of Washington or any person who owns the property on which the mill operates and who owes money to the state for the licensing fee, for reclamation of the site, for perpetual surveillance and maintenance of the site, or for any other obligation owed the state under this chapter.

(9) "Statement of claim" means the document recorded or filed pursuant to this chapter, which names an obligor-licensee, names the state as obligee, describes the obligation owed to the state, and describes property owned by the obligor-licensee on which a lien will attach for the benefit of the state, and which creates the lien when filed.

Sec. 358. Section 2, chapter 245, Laws of 1988 and RCW 70.127.010 are each amended to read as follows:

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

(1) "Branch office" means a location or site from which a home health, hospice, or home care agency provides services within a portion of the total geographic area served by the parent agency. The branch office is part of the agency and is located sufficiently close to share administration, supervision, and services.

(2) "Department" means the department of ((~~social and health services~~)) health.

(3) "Home care agency" means a private or public agency or organization that administers or provides home care services directly or through a contract arrangement to ill, disabled, or infirm persons in places of temporary or permanent residence.

(4) "Home care services" means personal care services, homemaker services, respite care services, or any other nonmedical services provided to ill, disabled, or infirm persons which services enable these persons to remain in their own residences consistent with their desires, abilities, and safety.

(5) "Home health agency" means a private or public agency or organization that administers or provides home health aide services or two or more home health services directly or through a contract arrangement to ill, disabled, or infirm persons in places of temporary or permanent residence.

(6) "Home health services" means health or medical services provided to ill, disabled, or infirm persons. These services may be of an acute or maintenance care nature, and include but are not limited to nursing services, home health aide services, physical therapy services, occupational therapy services, speech therapy services, respiratory therapy services, nutritional services, medical social services, and medical supplies or equipment services.

(7) "Home health aide services" means services provided by a home health agency or a hospice under the supervision of a registered nurse, physical therapist, occupational therapist, or speech therapist. Such care includes ambulation and exercise, assistance with self-administered medications, reporting changes in patients' conditions and needs, completing appropriate records, and personal care or homemaker services needed to achieve medically desired results.

(8) "Homemaker services" means services that assist ill, disabled, or infirm persons with household tasks essential to achieving adequate household and family management.

(9) "Hospice agency" means a private or public agency or organization administering or providing hospice care directly or through a contract arrangement to terminally ill persons in places of temporary or permanent residence by using an interdisciplinary team composed of at least nursing, social work, physician, and pastoral or spiritual counseling.

(10) "Hospice care" means: (a) Palliative care provided to a terminally ill person in a place of temporary or permanent residence that alleviates physical symptoms, including pain, as well as alleviates the emotional and spiritual discomfort associated with dying; and (b) bereavement care provided to the family of a terminally ill person that alleviates the emotional and spiritual discomfort associated with the death of a family member. Hospice care may include health and medical services and personal care, respite, or homemaker services. Family means individuals who are important to and designated by the patient, and who need not be relatives.

(11) "Ill, disabled, or infirm persons" means persons who need home health, hospice, or home care services in order to maintain themselves in their places of temporary or permanent residence.

(12) "Personal care services" means services that assist ill, disabled, or infirm persons with dressing, feeding, and personal hygiene to facilitate self-care.

(13) "Respite care services" means services that assist or support the primary care giver on a scheduled basis.

Sec. 359. Section 2, chapter 187, Laws of 1984 and RCW 70.142.020 are each amended to read as follows:

The state board of health shall conduct public hearings and establish by rule monitoring requirements for chemical contaminants in public water supplies. Results of tests conducted pursuant to such requirements shall be submitted to the department of ((~~social and health services~~)) health and to the local health department. The state board of health may review and revise monitoring requirements for chemical contaminants.

Sec. 360. Section 4, chapter 187, Laws of 1984 and RCW 70.142.050 are each amended to read as follows:

Public water supply systems as defined by RCW 70.119.020 that the state board of health or local health department determines do not comply with the water quality standards applicable to the system shall immediately initiate preparation of a corrective plan designed to meet or exceed the minimum standards for submission to the department of ((~~social and health services~~)) health. The owner of such system shall within one year take any action required to bring the water into full compliance with the standards((~~: PROVIDED, That~~)). The department of ((~~social and health services~~)) health may require compliance as promptly as necessary to abate an immediate public health threat or may extend the period of compliance if substantial new construction is required((~~: PROVIDED FURTHER, That~~)). The extension shall be granted only upon a determination by the department, after a public hearing, that the extension will not pose an imminent threat to public health. Each such system shall include a notice identifying the water quality standards exceeded, and the amount by which the water tested exceeded the standards, in all customer bills mailed after such determination. The notification shall continue until water quality tests conducted in accordance with this chapter establish that the system meets or exceeds the minimum standards.

Sec. 361. Section 51, chapter 266, Laws of 1986 as amended by section 60, chapter 36, Laws of 1988 and RCW 80.50.030 are each amended to read as follows:

(1) There is created and established the energy facility site evaluation council.

(2) (a) The chairman of the council shall be appointed by the governor with the advice and consent of the senate, shall have a vote on matters before the council, shall serve for a term coextensive with the term of the governor, and is removable for cause. The chairman may designate a member of the council to serve as acting chairman in the event of the chairman's absence. The salary of the chairman shall be determined under RCW 43.03.040. The chairman is a "state employee" for the purposes of chapter 42.18 RCW.

(b) The chairman is the chief executive officer of the council and shall, with the concurrence of the council, execute all official documents, contracts, and other materials on behalf of the council. The chairman shall appoint an executive secretary to serve at the pleasure of the chairman. The chairman may appoint a confidential secretary to serve at the pleasure of the chairman. The chairman shall appoint and prescribe the duties of such clerks, employees, and agents as may be necessary to carry out this chapter((~~: PROVIDED, That such~~)). Persons shall be employed pursuant to chapter 41.06 RCW.

(3) The council shall consist of the directors, administrators, or their designees, of the following departments, agencies, commissions, and committees or their statutory successors:

(a) Department of ecology;

(b) Department of fisheries;

(d) Parks and recreation commission;

(e) Department of ((~~social and health services~~)) health;

(f) State energy office;

(g) Department of trade and economic development;

(h) Utilities and transportation commission;

(i) Office of financial management;

(j) Department of natural resources;

(k) Department of community development;

(l) Department of agriculture;

(m) Department of transportation.

(4) The appropriate county legislative authority of every county wherein an application for a proposed site is filed shall appoint a member or designee as a voting member to the council. The member or designee so appointed shall sit with the council only at such times as the council considers the proposed site for the county which he or she represents, and such member or designee shall serve until there has been a final acceptance or rejection of the proposed site((;)).

(5) The city legislative authority of every city within whose corporate limits an energy plant is proposed to be located shall appoint a member or designee as a voting member to the council. The member or designee so appointed shall sit with the council only at such times as the council considers the proposed site for the city which he or she represents, and such member or designee shall serve until there has been a final acceptance or rejection of the proposed site.

(6) For any port district wherein an application for a proposed port facility is filed subject to this chapter, the port district shall appoint a member or designee as a nonvoting member to the council. The member or designee so appointed shall sit with the council only at such times as the council considers the proposed site for the port district which he or she represents, and such member or designee shall serve until there has been a final acceptance or rejection of the proposed site. The provisions of this subsection shall not apply if the port district is the applicant, either singly or in partnership or association with any other person.

Sec. 362. Section 2, chapter 284, Laws of 1961 as last amended by section 1, chapter 116, Laws of 1987 and RCW 18.71.015 are each amended to read as follows:

There is hereby created a board of medical examiners consisting of six individuals licensed to practice medicine in the state of Washington, one individual who is registered as a ((~~physician's~~)) physician assistant under chapter 18.71A RCW ((~~who shall be entitled to vote only on matters directly related to physicians' assistants~~)), and ((~~one individual who is not a physician~~)) two individuals who are not physicians, to be known as the Washington state board of medical examiners.

The board shall be appointed by the governor. ((The members of the first board shall be appointed within thirty days after March 21, 1961, to serve the following terms: One member for one year, one member for two years, one member for three years, one member for four years, one member for five years, and the physician's assistant for a term of five years, from the date of their appointment, or until their successors are duly appointed and qualified.)) On expiration of the term of any member, the governor shall appoint for a period of five years an individual of similar qualifications to take the place of such member. Each member shall hold office until the expiration of the term for which such member is appointed or until a successor shall have been appointed and shall have qualified.

Each member of the board shall be a citizen of the United States, must be an actual resident of this state, and, if a physician, must have been licensed to practice medicine in this state for at least five years.

The board shall meet as soon as practicable after appointment and elect a ((~~chairman~~)) chair and a ((~~secretary~~)) vice-chair from its members. Meetings shall be held at least four times a year and at such place as the board shall determine and at such other times and places as the board deems necessary. A majority of the board members serving shall constitute a quorum for the transaction of board business.

It shall require the affirmative vote of a majority of ((~~the members~~)) a quorum of the board to carry any motion or resolution, to adopt any rule, to pass any measure, or to authorize or deny the issuance of any certificate.

Each member of the board shall be compensated in accordance with RCW 43.03.240 and in addition thereto shall be reimbursed for travel expenses incurred in carrying out the duties of the board in accordance with RCW 43.03.050 and 43.03.060. Any such expenses shall be paid from funds appropriated to the department ((~~of licensing~~)).

Any member of the board may be removed by the governor for neglect of duty, misconduct, or malfeasance or misfeasance in office.

Vacancies in the membership of the board shall be filled for the unexpired term by appointment by the governor.

Sec. 363. Section 1, chapter 2, Laws of 1983 as last amended by section 4, chapter 48, Laws of 1988 and RCW 18.71.030 are each amended to read as follows:

Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer; nor shall anything in this chapter be construed to prohibit:

(1) The furnishing of medical assistance in cases of emergency requiring immediate attention;

(2) The domestic administration of family remedies;

(3) The administration of oral medication of any nature to students by public school district employees or private elementary or secondary school employees as provided for in chapter 28A.31 RCW, as now or hereafter amended;

(4) The practice of dentistry, osteopathy, osteopathy and surgery, nursing, chiropractic, podiatry, optometry, naturopathy or any other healing art licensed under the methods or means permitted by such license;

(5) The practice of medicine in this state by any commissioned medical officer serving in the armed forces of the United States or public health service or any medical officer on duty with the United States veterans administration while such medical officer is engaged in the performance of the duties prescribed for him or her by the laws and regulations of the United States;

(6) The practice of medicine by any practitioner licensed by another state or territory in which he or she resides, provided that such practitioner shall not open an office or appoint a place of meeting patients or receiving calls within this state;

(7) The practice of medicine by a person who is a regular student in a school of medicine approved and accredited by the board((~~: PROVIDED, HOWEVER, That~~)), however, the performance of such services be only pursuant to a regular course of instruction or assignments from his or her instructor, or that such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(8) The practice of medicine by a person serving a period of postgraduate medical training in a program of clinical medical training sponsored by a college or university in this state or by a hospital accredited in this state((~~: PROVIDED, That~~)), however, the performance of such services shall be only pursuant to his or her duties as a trainee;

(9) The practice of medicine by a person who is regularly enrolled in a ((~~physician's~~)) physician assistant program approved by the board((~~: PROVIDED, HOWEVER, That~~)), however, the performance of such services be only pursuant to a regular course of instruction in said program((~~: AND PROVIDED FURTHER, That~~)) and such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(10) The practice of medicine by a registered ((~~physician's~~)) physician assistant which practice is performed under the supervision and control of a physician licensed pursuant to this chapter;

(11) The practice of medicine, in any part of this state which shares a common border with Canada and which is surrounded on three sides by water, by a physician licensed to practice medicine and surgery in Canada or any province or territory thereof;

(12) The administration of nondental anesthesia by a dentist who has completed a residency in anesthesiology at a school of medicine approved by the board of medical examiners((~~: PROVIDED, That~~)), however, a dentist allowed to administer nondental anesthesia shall do so only under authorization of the patient's attending surgeon, obstetrician, or psychiatrist((~~: AND PROVIDED FURTHER, That~~)) and the medical disciplinary board shall have jurisdiction to discipline a dentist practicing under this exemption and enjoin or suspend such dentist from the practice of nondental anesthesia according to the provisions of chapter 18.72 RCW and chapter 18.130 RCW;

(13) Emergency lifesaving service rendered by a physician's trained mobile intravenous therapy technician, by a physician's trained mobile airway management technician, or by a physician's trained mobile intensive care paramedic, as defined in RCW 18.71.200, if the emergency lifesaving service is rendered under the responsible supervision and control of a licensed physician;

(14) The provision of clean, intermittent bladder catheterization for students by public school district employees or private school employees as provided for in RCW 18.88.295 and 28A.31.160.

Sec. 364. Section 1, chapter 55, Laws of 1983 and RCW 18.78.005 are each amended to read as follows:

The purpose of this chapter is to protect the health of the general public and to provide for the establishment and enforcement of standards for licensing practical nurses. Any person offering to practice as a licensed practical nurse or using any title, representation, sign, or device to indicate that the person is practicing as a practical nurse or licensed practical nurse in this state shall submit evidence that he or she is qualified to practice and shall be licensed as provided in this chapter.

Sec. 365. Section 2, chapter 222, Laws of 1949 as last amended by section 3, chapter 55, Laws of 1983 and RCW 18.78.020 are each amended to read as follows:

There is hereby created a board to be known and designated as the "Washington state board of practical nursing." The board of practical nursing shall be composed of five members, appointed by the governor as follows:

(1) Two members shall be licensed practical nurses who shall have had not less than five years' actual experience as a licensed practical nurse and who have practiced as a practical nurse within two years of appointment;

(2) Two members shall be licensed registered nurses who have no less than five years' experience in the practice of nursing, one of whom shall be a registered nurse actively engaged in instructing in an approved practical nursing course, and one of whom shall be a registered nurse supervisor of licensed practical nurses;

((~~(2)~~)) (3) There shall be one public member who does not derive his or her livelihood primarily from the provision of health services and is not:

(a) A present or former member of another licensing board;

(b) A licensed health professional; or

(((3) Two members shall be licensed practical nurses who shall have had not less than five years' actual experience as a licensed practical nurse and who have practiced as a practical nurse within two years of appointment.))

Sec. 366. Section 3, chapter 222, Laws of 1949 as amended by section 4, chapter 55, Laws of 1983 and RCW 18.78.030 are each amended to read as follows:

((~~On July 24, 1983, the members of the board shall be appointed to serve as follows:~~

~~(1) One licensed practical nurse for a term of five years;~~

~~(2) One registered nurse for a term of four years;~~

~~(3) One licensed practical nurse for a term of three years;~~

~~(4) One registered nurse for a term of two years; and~~

~~(5) One public member for a term of one year.~~

~~Thereafter all appointments shall be for terms of five years each.~~)) Vacancies occurring on the board shall be filled for the unexpired term by appointment of the governor, who also may remove any member from the board for neglect of duty required by law, ((or)) for incompetency, or for unprofessional ((~~or disorderly~~)) conduct as defined in chapter 18.130 RCW. All appointments shall be for terms of five years each. No person may serve as a member of the board for more than two consecutive terms, except that a member who is filling less than one-half of an uncompleted term shall be eligible for two full terms in addition to the uncompleted term. Board members shall serve until a successor is appointed.

The board shall meet at least quarterly at times and places it designates. It shall hold such other meetings during the year as may be deemed necessary to transact its business. A majority of the board currently serving shall constitute a quorum at any meeting.

Sec. 367. Section 4, chapter 222, Laws of 1949 as last amended by section 47, chapter 287, Laws of 1984 and RCW 18.78.040 are each amended to read as follows:

Each board member shall be compensated in accordance with RCW 43.03.240 and shall be paid travel expenses while away from home in accordance with RCW 43.03.050 and 43.03.060. The ((~~members of the~~)) board shall appoint ((~~a chairman and a secretary from among its entire members, who shall serve until his or her successor is appointed by the board~~)) officers annually.

Sec. 368. Section 5, chapter 222, Laws of 1949 as last amended by section 4, chapter 211, Laws of 1988 and RCW 18.78.050 are each amended to read as follows:

The board shall conduct examinations for all applicants for licensure under this chapter and shall certify qualified applicants for licensure to the department ((~~of licensing for licensing~~)). The board in consultation with the state board for community college education and the superintendent of public instruction shall also determine and formulate what constitutes the curriculum for ((an)) approved practical nursing ((~~program~~)) schools/programs and shall establish criteria for minimum standards for schools/programs preparing persons for licensure under this chapter. The board shall establish criteria for licensure by endorsement.

The board may adopt rules or issue advisory opinions in response to questions from professional health associations, health care practitioners, and consumers in this state concerning licensed practical nurse practice. The board shall establish criteria for proof of reasonable currency of knowledge and skill as a basis for safe practice ((~~after three years inactive or lapsed status~~)) of practical nursing.

The board shall adopt such rules as are necessary to fulfill the purposes of this chapter pursuant to chapter ((~~34.04~~)) 34.05 RCW.

Sec. 369. Section 7, chapter 55, Laws of 1983 and RCW 18.78.055 are each amended to read as follows:

An institution desiring to conduct a school/program of practical nursing shall apply to the board and submit evidence satisfactory to the board that: (1) It is prepared to carry out the approved curriculum for an approved practical nursing school/program; and (2) it is prepared to meet other standards established by this chapter and by the board.

If in the opinion of the board ((~~the curriculum of a program of~~)) a school/program of practical nursing meets the requirements of this chapter and the board, the program shall be approved.

All approved practical nursing ((~~programs~~)) schools/programs in the state shall be surveyed and the board shall review written reports of each survey. The surveys shall be conducted periodically as determined by the board. If the board determines that an approved practical nursing ((~~program~~)) school/program is not maintaining the curriculum standards or other standards required ((~~for approval, the board shall give~~)) by the board written notice shall be given specifying the deficiencies. Failure to correct the deficiencies within a period of time specified by the board shall result in the suspension of the program's approval.

Sec. 370. Section 6, chapter 222, Laws of 1949 as last amended by section 1, chapter 212, Laws of 1988 and RCW 18.78.060 are each amended to read as follows:

An applicant for a license to practice nursing as a licensed practical nurse shall submit to the board written evidence, on a form provided by the board, verified under oath, that the applicant:

(1) Is at least eighteen years of age;

(2) Is of good moral character;

(3) Is of good physical and mental health;

(4) Has completed at least a tenth grade course or its equivalent, as determined by the board;

(5) Has completed an approved program ((~~of not less than nine months~~)) for the education of practical nurses, or its equivalent, as determined by the board((.));

(6) Has provided written information or completed other requirements of the board;

(7) The applicant at the time of such submission shall not be in violation of chapter 18.130 RCW or any provisions of this chapter.

To be licensed as a practical nurse, each applicant shall be required to pass an examination in such subjects as the board may determine within the scope of and commensurate with the work to be performed by a licensed practical nurse. Upon approval by the board, the department shall issue an interim permit authorizing the applicant to practice nursing as authorized under this chapter pending notification of the results of the first licensing examination following verification of satisfactory completion of an approved program of practical nursing. Any applicant failing to pass ((~~such an~~)) the examination may apply for reexamination. If the applicant fails the examination, the interim permit expires upon notification and is not renewable. Upon passing ((~~such~~)) the examination ((~~as determined by the board, the director shall issue~~)) a license shall be issued to the applicant ((~~a license~~)) to practice as a licensed practical nurse, providing the license fee is paid by the applicant and the applicant meets all other requirements of the board.

Sec. 371. Section 9, chapter 222, Laws of 1949 as last amended by section 65, chapter 7, Laws of 1985 and RCW 18.78.080 are each amended to read as follows:

((~~All~~)) Applicants applying for a license to practice as a licensed practical nurse, with or without examination((~~, as provided in this chapter,~~)), or for reexamination, shall pay ((~~a license~~)) fees determined by the ((~~director~~)) secretary as provided in ((~~RCW 43.24.086~~)) section 319, chapter 9, Laws of 1989 1st ex. sess. to the department ((~~of licensing: PROVIDED, HOWEVER, That the applicant applying for a reexamination shall pay a fee determined by the director as provided in RCW 43.24.086~~)).

Sec. 372. Section 10, chapter 222, Laws of 1949 as last amended by section 66, chapter 7, Laws of 1985 and by section 131, chapter 259, Laws of 1986 and RCW 18.78.090 are each reenacted and amended to read as follows:

Every licensed practical nurse in this state shall renew the license with the department ((~~of licensing and~~)), shall pay a fee determined by the ((~~director~~)) secretary as provided in ((~~RCW 43.24.086~~)) section 319, chapter 9, Laws of 1989 1st ex. sess., and shall provide evidence of knowledge and skill in current practice as required by the board. Any failure to register ((~~and~~)), pay the renewal registration fee, or meet the requirements of the board shall render the license ((~~invalid, but such~~)) lapsed. The lapsed license shall be reinstated ((~~upon written application therefor and~~)) upon payment to the state of ((a)) renewal and penalty fees determined by the ((~~director~~)) secretary as provided in RCW ((~~43.24.086~~)) 43.70.250 and upon compliance with the rules established by the board.

Sec. 373. Section 11, chapter 222, Laws of 1949 as last amended by section 11, chapter 55, Laws of 1983 and RCW 18.78.100 are each amended to read as follows:

After consultation with the board, the ((~~director~~)) secretary shall appoint an executive secretary of the board to carry out the provisions of this chapter ((~~who shall have the following qualifications:~~

~~(1) Be a registered nurse in the state of Washington;~~

~~(2) Be the holder of a baccalaureate degree from an accredited four-year institution of higher education;~~

~~(3) Have not less than five years' experience in the field of nursing; and~~

~~(4) Have not less than two years' experience in nursing education~~)).

The board and secretary shall determine the qualifications required to be employed as the executive secretary.

Sec. 374. Section 2, chapter 161, Laws of 1979 ex. sess. as last amended by section 602, chapter 9, Laws of 1989 1st ex. sess. and RCW 70.38.025 are each amended to read as follows:

When used in this chapter, the terms defined in this section shall have the meanings indicated.

(1) "Board of health" means the state board of health created pursuant to chapter 43.20 RCW.

(2) "Capital expenditure" is an expenditure, including a force account expenditure (i.e., an expenditure for a construction project undertaken by a nursing home facility as its own contractor) which, under generally accepted accounting principles, is not properly chargeable as an expense of operation or maintenance. Where a person makes an acquisition under lease or comparable arrangement, or through donation, which would have required review if the acquisition had been made by purchase, such expenditure shall be deemed a capital expenditure. Capital expenditures include donations of equipment or facilities to a nursing home facility which if acquired directly by such facility would be subject to certificate of need review under the provisions of this chapter and transfer of equipment or facilities for less than fair market value if a transfer of the equipment or facilities at fair market value would be subject to such review. The cost of any studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the acquisition, improvement, expansion, or replacement of any plant or equipment with respect to which such expenditure is made shall be included in determining the amount of the expenditure.

(3) "Continuing care retirement community" means an entity which provides shelter and services under continuing care contracts with its members and which sponsors or includes a health care facility or a health service. A "continuing care contract" means a contract to provide a person, for the duration of that person's life or for a term in excess of one year, shelter along with nursing, medical, health-related, or personal care services, which is conditioned upon the transfer of property, the payment of an entrance fee to the provider of such services, or the payment of periodic charges for the care and services involved. A continuing care contract is not excluded from this definition because the contract is mutually terminable or because shelter and services are not provided at the same location.

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

(5) "Expenditure minimum" means, for the purposes of the certificate of need program, one million dollars adjusted by the department by rule to reflect changes in the United States department of commerce composite construction cost index; or a lesser amount required by federal law and established by the department by rule.

(6) "Health care facility" means hospices, hospitals, psychiatric hospitals, nursing homes, kidney disease treatment centers, ambulatory surgical facilities, ((~~continuing care retirement communities,~~)) and home health agencies, and includes such facilities when owned and operated by a political subdivision or instrumentality of the state and such other facilities as required by federal law and implementing regulations, but does not include Christian Science sanatoriums operated, listed, or certified by the First Church of Christ Scientist, Boston, Massachusetts. In addition, the term does not include any nonprofit hospital: (a) Which is operated exclusively to provide health care services for children; (b) which does not charge fees for such services; and (c) if not contrary to federal law as necessary to the receipt of federal funds by the state. ((In addition, the term does not include a continuing care retirement community which: (i) Offers services only to contractual members; and (ii) provides its members a contractually guaranteed range of services from independent living through skilled nursing, including some form of assistance with activities of daily living; and (iii) contractually assumes responsibility for costs of services exceeding the member's financial responsibility as stated in contract, so that, with the exception of insurance purchased by the retirement community or its members, no third party, including the medicaid program, is liable for costs of care even if the member depletes his or her personal resources; and (iv) has offered continuing care contracts and operated a nursing home continuously since January 1, 1988, or has obtained a certificate of need to establish a nursing home; and (v) maintains a binding agreement with the department of social and health services assuring that financial liability for services to members, including nursing home services, shall not fall upon the department of social and health services; and (vi) does not operate, and has not undertaken, a project which would result in a number of nursing home beds in excess of one for every four living units operated by the continuing care retirement community, exclusive of nursing home beds; and (vii) has undertaken no increase in the total number of nursing home beds after January 1, 1988, unless a professional review of pricing and long-term solvency was obtained by the retirement community within the prior five years and fully disclosed to members.))

(7) "Health maintenance organization" means a public or private organization, organized under the laws of the state, which:

(a) Is a qualified health maintenance organization under Title XIII, section 1310(d) of the Public Health Services Act; or

(b)(i) Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services: Usual physician services, hospitalization, laboratory, x-ray, emergency, and preventive services, and out-of-area coverage; (ii) is compensated (except for copayments) for the provision of the basic health care services listed in (b)(i) to enrolled participants by a payment which is paid on a periodic basis without regard to the date the health care services are provided and which is fixed without regard to the frequency, extent, or kind of health service actually provided; and (iii) provides physicians' services primarily (A) directly through physicians who are either employees or partners of such organization, or (B) through arrangements with individual physicians or one or more groups of physicians (organized on a group practice or individual practice basis).

(8) "Health services" means clinically related (i.e., preventive, diagnostic, curative, rehabilitative, or palliative) services and includes alcoholism, drug abuse, and mental health services and as defined in federal law.

(9) "Health service area" means a geographic region appropriate for effective health planning which includes a broad range of health services.

(10) "Person" means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies, and insurance companies), the state, or a political subdivision or instrumentality of the state, including a municipal corporation or a hospital district.

(11) "Provider" generally means a health care professional or an organization, institution, or other entity providing health care but the precise definition for this term shall be established by rule of the department, consistent with federal law.

(12) "Public health" means the level of well-being of the general population; those actions in a community necessary to preserve, protect, and promote the health of the people for which government is responsible; and the governmental system developed to guarantee the preservation of the health of the people.

(13) "Secretary" means the secretary of health or the secretary's designee.

(14) "Tertiary health service" means a specialized service that meets complicated medical needs of people and requires sufficient patient volume to optimize provider effectiveness, quality of service, and improved outcomes of care.

(15) "Hospital" means any health care institution which is required to qualify for a license under RCW 70.41.020(2); or as a psychiatric hospital under chapter 71.12 RCW.

Sec. 375. Section 9, chapter 139, Laws of 1980 as last amended by section 604, chapter 9, Laws of 1989 1st ex. sess. and RCW 70.38.111 are each amended to read as follows:

(1) The department shall not require a certificate of need for the offering of an inpatient tertiary health service by:

(a) A health maintenance organization or a combination of health maintenance organizations if (i) the organization or combination of organizations has, in the service area of the organization or the service areas of the organizations in the combination, an enrollment of at least fifty thousand individuals, (ii) the facility in which the service will be provided is or will be geographically located so that the service will be reasonably accessible to such enrolled individuals, and (iii) at least seventy-five percent of the patients who can reasonably be expected to receive the tertiary health service will be individuals enrolled with such organization or organizations in the combination;

(b) A health care facility if (i) the facility primarily provides or will provide inpatient health services, (ii) the facility is or will be controlled, directly or indirectly, by a health maintenance organization or a combination of health maintenance organizations which has, in the service area of the organization or service areas of the organizations in the combination, an enrollment of at least fifty thousand individuals, (iii) the facility is or will be geographically located so that the service will be reasonably accessible to such enrolled individuals, and (iv) at least seventy-five percent of the patients who can reasonably be expected to receive the tertiary health service will be individuals enrolled with such organization or organizations in the combination; or

(c) A health care facility (or portion thereof) if (i) the facility is or will be leased by a health maintenance organization or combination of health maintenance organizations which has, in the service area of the organization or the service areas of the organizations in the combination, an enrollment of at least fifty thousand individuals and, on the date the application is submitted under subsection (2) of this section, at least fifteen years remain in the term of the lease, (ii) the facility is or will be geographically located so that the service will be reasonably accessible to such enrolled individuals, and (iii) at least seventy-five percent of the patients who can reasonably be expected to receive the tertiary health service will be individuals enrolled with such organization;

if, with respect to such offering or obligation by a nursing home, the department has, upon application under subsection (2) of this section, granted an exemption from such requirement to the organization, combination of organizations, or facility.

(2) A health maintenance organization, combination of health maintenance organizations, or health care facility shall not be exempt under subsection (1) of this section from obtaining a certificate of need before offering a tertiary health service unless:

(a) It has submitted at least thirty days prior to the offering of services reviewable under RCW 70.38.105(4)(d) an application for such exemption; and

(b) The application contains such information respecting the organization, combination, or facility and the proposed offering or obligation by a nursing home as the department may require to determine if the organization or combination meets the requirements of subsection (1) of this section or the facility meets or will meet such requirements; and

(c) The department approves such application. The department shall approve or disapprove an application for exemption within thirty days of receipt of a completed application. In the case of a proposed health care facility (or portion thereof) which has not begun to provide tertiary health services on the date an application is submitted under this subsection with respect to such facility (or portion), the facility (or portion) shall meet the applicable requirements of subsection (1) of this section when the facility first provides such services. The department shall approve an application submitted under this subsection if it determines that the applicable requirements of subsection (1) of this section are met.

(3) A health care facility (or any part thereof) with respect to which an exemption was granted under subsection (1) of this section may not be sold or leased and a controlling interest in such facility or in a lease of such facility may not be acquired and a health care facility described in (1)(c) which was granted an exemption under subsection (1) of this section may not be used by any person other than the lessee described in (1)(c) unless:

(a) The department issues a certificate of need approving the sale, lease, acquisition, or use; or

(b) The department determines, upon application, that (i) the entity to which the facility is proposed to be sold or leased, which intends to acquire the controlling interest, or which intends to use the facility is a health maintenance organization or a combination of health maintenance organizations which meets the requirements of (1)(a)(i), and (ii) with respect to such facility, meets the requirements of (1)(a) (ii) or (iii) or the requirements of (1)(b) (i) and (ii).

(4) In the case of a health maintenance organization, an ambulatory care facility, or a health care facility, which ambulatory or health care facility is controlled, directly or indirectly, by a health maintenance organization or a combination of health maintenance organizations, the department may under the program apply its certificate of need requirements only to the offering of inpatient tertiary health services and then only to the extent that such offering is not exempt under the provisions of this section.

(5)(a) The department shall not require a certificate of need for the construction, development, or other establishment of a nursing home or the addition of beds to an existing nursing home by a continuing care retirement community that:

(i) Offers services only to contractual members;

(ii) Provides its members a contractually guaranteed range of services from independent living through skilled nursing, including some assistance with daily living activities;

(iii) Contractually assumes responsibility for costs of services exceeding the member's financial responsibility as stated in contract, so that, with the exception of insurance purchased by the retirement community or its members, no third party, including the medicaid program, is liable for costs of care even if the member depletes his or her personal resources;

(iv) Has offered continuing care contracts and operated a nursing home continuously since January 1, 1988, or has obtained a certificate of need to establish a nursing home;

(v) Maintains a binding agreement with the department of social and health services assuring that financial liability for services to members, including nursing home services, shall not fall upon the department of social and health services;

(vi) Does not operate, and has not undertaken a project that would result in a number of nursing home beds in excess of one for every four living units operated by the continuing care retirement community, exclusive of nursing home beds; and

(vii) Has obtained a professional review of pricing and long-term solvency within the prior five years which was fully disclosed to members.

(b) A continuing care retirement community shall not be exempt under this subsection from obtaining a certificate of need unless:

(i) It has submitted an application for exemption at least thirty days prior to commencing construction of, submitting an application for the licensure of, or commencing operation of a nursing home, whichever comes first; and

(ii) The application documents to the department that the continuing care retirement community qualifies for exemption.

(c) The sale, lease, acquisition, or use of part or all of a continuing care retirement community nursing home that qualifies for exemption under this subsection shall require prior certificate of need approval unless the department determines such sale, lease, acquisition, or use is by a continuing care retirement community that meets the conditions of (a) of this subsection.

NEW SECTION. Sec. 376. Section 12, chapter 222, Laws of 1949, section 46, chapter 34, Laws of 1975-'76 2nd ex. sess., section 12, chapter 55, Laws of 1983 and RCW 18.78.110 are each repealed.