WSR 99-06-092

PROPOSED RULES

DEPARTMENT OF HEALTH


(Nursing Care Quality Assurance Commission)

[ Filed March 3, 1999, 9:20 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 98-21-082.

Title of Rule: WAC 246-840-020 Documents which indicate authorization to practice nursing in Washington.

Purpose: This rule describes the documents which are issued to nurses in Washington.

Statutory Authority for Adoption: RCW 18.79.110.

Statute Being Implemented: RCW 18.79.110.

Summary: The proposed amendments include changing the title to make it more clear of the kinds of documents that are issued, to clarify that these documents are issued to all nurses and clarifying that a limited educational license does not authorize practice.

Reasons Supporting Proposal: During a public rules review process it was identified that this rule is not as clear as it could be. These proposed changes should make the rule more understandable to the public and to nurses.

Name of Agency Personnel Responsible for Drafting: Joan Reilly, Ph.D., P.O. Box 47864, Olympia, WA 98504, (360) 236-4709; Implementation and Enforcement: Terry J. West, P.O. Box 47864, Olympia, WA 98504, (360) 236-4712.

Name of Proponent: Nursing Care Quality Assurance Commission, governmental.

Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: These amendments will enhance the language of the current rule.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The purpose of this rule is to list the documents issued to nurses by the Nursing Care Quality Assurance Commission. The amendments will clarify the title to make it more clear what this rule addresses, includes an amendment to make it clear that this rule pertains to all nurses and that issuance of a limited educational license does not authorize practice. The anticipated effect is that this rule will be easier to understand.

Proposal Changes the Following Existing Rules: The amendments will clarify the title to make it more clear what this rule addresses, includes an amendment to make it clear that this rule pertains to all nurses and that issuance of a limited educational license does not authorize practice. The anticipated effect is that this rule will be easier to understand.

A small business economic impact statement has been prepared under chapter 19.85 RCW.

Small Business Economic Impact Statement

and

Economic Impact Analysis



Background: This rule describes the documents which are issued to nurses in Washington and a brief description of each document. During a public rules review process this rule was identified as needing amendment to make it more clear and understandable. During the public meeting the exact language was also discussed so a separate rule-writing workshop was not held.

Necessity of Amendments to Nursing Rules: The proposed amendments include changing the title to make it more clear of the types of documents that are issued, to clarify that these documents are issued to all nurses and clarifying that a limited educational license does not authorize practice.

Costs to a Business: There are no new additional costs to a business to comply with these proposed amendments. This rule defines all of the different types of documents issued by the Nursing Care Quality Assurance Commission and includes a brief explanation of each document. These amendments do not require any additional areas of completion nor do they require any additional expense.

DOH Costs to Administer the Regulation: There are no new additional costs to the Department of Health to regulate these amendments. This rule simply defines some documents. These proposed amendments add no additional requirements, no additional forms, no additional review time and no additional analyses.

Magnitude of Amendments to Rule: All of these proposed amendments would not necessitate any additional requirements, would not require additional documentation and would not require any additional course work. On the contrary, these amendments clarify to applicants and licensees the kinds of documents issued by the Nursing Care Quality Assurance Commission and include descriptive paragraphs.

Small Business Economic Impact Statement: In preparing this small business economic impact statement (SBEIS), the department used SIC Code 809 Miscellaneous Health & Allied Services, Not Elsewhere Classified which has a minor impact threshold of $53.00. The estimated cost to health care practitioners for amending these rules is zero.

Therefore, there is no disproportionate cost for small businesses.

A copy of the statement may be obtained by writing to Terry J. West, Department of Health, P.O. Box 47864, Olympia, WA 98504, phone (360) 236-4712, fax (360) 236-4738.

RCW 34.05.328 does not apply to this rule adoption. This rule is not significant because it does not require anything of a licensee. This rule is informational and lists all of the documents issued by the Nursing Care Quality Assurance Commission and a short explanation of each document.

Hearing Location: Airport Ramada, Spokane International Airport, Spokane, WA 99219, on April 9, 1999, at 9:00 a.m.

Assistance for Persons with Disabilities: Contact Terry J. West by March 26, 1999, TDD (360) 664-0064, or (360) 236-4712.

Submit Written Comments to: Terry J. West, P.O. Box 47864, Olympia, WA 98504, fax (360) 236-4738, by April 5, 1999.

Date of Intended Adoption: April 9, 1999.

February 24, 1999

Paula R. Meyer, RN, MSN

Executive Director

OTS-2528.1


AMENDATORY SECTION(Amending WSR 98-05-060, filed 2/13/98, effective 3/16/98)

WAC 246-840-020
Documents ((which indicate authorization to practice nursing)) issued to nurses in Washington.

The following documents are the only documents ((that indicate legal authorization to practice as a licensed practical nurse or registered nurse)) issued to nurses in Washington.

(1) Active license.  A license is issued upon completion of all requirements for licensure, confers the right to use the title licensed practical nurse or licensed registered nurse and the use of its abbreviation, L.P.N. or R.N., and to practice as a licensed practical nurse or registered nurse in the state of Washington.

A student who has graduated from a basic professional nursing course and who is pursuing a baccalaureate degree in nursing, an advanced degree in nursing or an advanced certification in nursing shall hold an active Washington RN license before participating in the practice of nursing as required to fulfill the learning objectives in a clinical course.

Exception to this requirement may be granted by the commission on an individual basis upon a petition submitted by the dean or director of a school of nursing, on a case-by-case basis.

(a) The exception allows the student to practice in a clinical setting only under the direct supervision of an RN faculty member.  The commission requires that any RN faculty member supervising these students meet the requirements of direct supervision as defined in WAC 246-840-010 (13)(c)(ii) and, in addition, that supervising faculty document that all clients under the care of the student be assessed by the RN faculty each clinical day.

(b) The dean or director of the school of nursing shall ensure that each faculty member who supervises these students be provided a copy of these rules and be assigned in a manner that allows for direct supervision.

(c) Nursing students who participate in clinical courses under this section are not eligible for the nursing technician role.

(2) Inactive license.  A license issued to a person previously holding an active license in this state, is in good standing and does not practice in Washington state.  Refer to chapter 246-12 WAC, Part 4.

(3) Limited educational license.  A limited educational license may be issued to a person who has been on inactive or lapsed status for three years or more and who wishes to return to active status. A limited educational license does not authorize practice for employment.

(4) Advanced registered nurse practitioner (ARNP) recognition document.  An ARNP recognition document may be issued to any person who meets the requirements of the commission as contained in WAC 246-840-300.  Only persons holding this recognition document shall have the right to use the title "advanced registered nurse practitioner" or the abbreviation "ARNP" or any title or abbreviation which may indicate that the person is entitled to practice at an advanced and specialized level as a nurse practitioner, a specialized nurse practitioner, a nurse midwife, or a nurse anesthetist.  This document authorizes the ARNP to engage in the scope of practice allowed for his or her specialty area and is valid only with a current registered nurse license.

(5) ARNP interim permit.  An interim permit may be issued following satisfactory completion of an advanced formal education program, registration for the first certification examination of an approved program following completion of the education and filing of an application, fee and requested documentation.  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.

(6) ARNP prescriptive authorization.  A notation of prescriptive authorization may be placed on the ARNP recognition document issued to any person who meets the requirements of the commission as contained in WAC 246-840-410.  This authorizes the ARNP to prescribe drugs within his or her scope of practice and is valid only with a current registered nurse license.

[Statutory Authority: RCW 43.70.280.  98-05-060, 246-840-020, filed 2/13/98, effective 3/16/98.  Statutory Authority: Chapter 18.79 RCW.  97-13-100, 246-840-020, filed 6/18/97, effective 7/19/97.]

Washington State Code Reviser's Office