Original Notice.

Preproposal statement of inquiry was filed as WSR 98-19-091.

Title of Rule: WAC 246-840-050 Licensing examination, 246-840-070 Failures--Repeat examination, and 246-840-090 Licensure by interstate endorsement.

Purpose: Amend WAC 246-840-050 to make it clearer that reexams are four attempts within two years of graduation; WAC 246-840-070 is being amended to clarify that repeat examinations shall be done within two years from completion of the nursing program; and WAC 246-840-090 is being amended to clarify for endorsement candidates that they have four attempts within two years of graduation from a nursing program.

Other Identifying Information: These amendments were identified during open public rules review meetings. These amendments should reduce confusion about the length of time a candidate has from the time they complete their nursing program to take the national examination.

Statutory Authority for Adoption: RCW 18.79.110 and 18.79.160(5).

Statute Being Implemented: RCW 18.79.110 and 18.79.160(5).

Summary: The proposed amendments include adding a clause to make it clear that the examination should be taken within four attempts or two years after completion of the nursing program. This is necessary to make it clear to applicants since the examination is no longer given only three times a year, but is instead given throughout the year by use of computerized testing on the date of their choice.

Reasons Supporting Proposal: During a public rules review process it was identified that these rules are not as clear as they could be since the timing of examinations have changed when the Nursing Commission adopted the national computerized testing with testing done throughout the year instead of only three times per year. These proposed changes should make the rules 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 rules.

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

Explanation of Rule, its Purpose, and Anticipated Effects: The purpose of these rules is to outline the requirements for testing for all candidates. This includes information such as which national examination is used, how the examination is conducted, procedures for appeal and repeat examinations. The anticipated effect is that these rules will be easier to understand since the change in the examination testing dates has made the rules unclear as they are currently written.

Proposal Changes the Following Existing Rules: The proposed amendments include adding a clause to make it clear that the examination should be taken within four attempts or two years after completion of the nursing program. This is necessary to make it clear to applicants since the examination is no longer given only three times a year, but is instead given throughout the year by use of computerized testing on the date of their choice.

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

Necessity of Amendments to Nursing Rules: These amendments will make it clear to the public and applicants that a person can test up to four times in the two-year period following graduation from their nursing program. Candidates are currently being informed that they should test within two years of graduation. This is not a change as the National Council only allows candidates to test every ninety days, but this will put candidates on notice in advance of the examination as to the number of times they can take the examination. In addition, the amendment will clarify that candidates should attempt to pass the examination within two years following completion of their nursing program while their clinical skills are good. These amendments will include the licensing examination rule, the rule addressing repeat examinations and the rule addressing applicants endorsing in from another state.

Costs to a Business: There are no new additional costs to a business to comply with these proposed amendments. These rules already required an applicant to take an examination, these amendments are not changing any of these requirements, only clarifying the number of times an applicant may take the examination. These amendments do not require any additional areas of completion nor do they require any additional expense. Candidates can only test every ninety days currently, so there is no change in procedure.

DOH Costs to Administer the Regulation: There are no new additional costs to the Department of Health to regulate these amendments. These rules currently require applicants to take and pass the national examination. 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 require any additional requirements, would not require additional documentation and would not require any additional course work. These amendments will make it clear to the public and applicants the number of times a candidate may take the national examination in the two-year period following completion of the nursing program.

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. These rules are not significant because they do not require anything new of a licensee. While these rules do contain requirements for licensees, none of the proposed changes alter the requirements. Instead, the proposed changes clarify the time period in which examinations and reexaminations can be completed.

Hearing Location: Lacey Community Center, 6729 Pacific Avenue S.E., Lacey, WA 98503, on May 21, 1999, at 9:00 a.m.

Assistance for Persons with Disabilities: Contact Terry J. West at (360) 236-4712, by May 14, 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 May 17, 1999.

Date of Intended Adoption: May 21, 1999.

March 23, 1999

Paula Q. Meyer, RN, MSN

Executive Director

OTS-2701.1

AMENDATORY SECTION(Amending WSR 97-13-100, filed 6/18/97, effective 7/19/97)

WAC 246-840-050
Licensing examination.

(1) The current series of the National Council of the State Boards of Nursing Registered Nurse or Practical Nurse Licensing Examination (NCLEX-RN or NCLEX-PN) Computerized Adaptive Test (NCLEX CAT) shall be the official examinations for nurse licensure.  In order to be licensed in this state, all nurse applicants shall take and pass the National Council Licensure Examination (NCLEX-RN or NCLEX-PN) within four attempts and within two years of completion of the nursing program.

(2) The NCLEX will consist of a Computerized Adaptive Test that will be individualized with the score for the examination reported as either pass or fail.  Specific parameters of the exam will be as prescribed by contract with National Council of State Boards of Nursing, Inc. (NCSBN).

(3) Examinations shall be conducted throughout the year.

(4) The executive director of the commission shall negotiate with NCSBN for the use of the NCLEX CAT.

(5) The examination shall be administered in accord with the NCSBN security measures and contract.  All appeals of examination results shall be managed in accord with policies in the NCSBN contract.

[Statutory Authority: Chapter 18.79 RCW.  97-13-100, § 246-840-050, filed 6/18/97, effective 7/19/97.]

(1) The retest may be scheduled no sooner than ninety days following the date of the last exam taken.

(2) Request to retake the exam must be submitted to the commission no less than forty-five days prior to the anticipated test date.

(3) Candidates who fail the examination will be permitted to retake the examination three times within the two-year period from the month of ((first examination taken)) completion of the nursing program.

(4) Candidates who fail to pass the examination within the time period specified in subsection (3) of this section shall be required to complete a program of study approved by the commission.  Upon successful completion of the approved program, the candidate shall be required to take the examination.

[Statutory Authority: Chapter 18.79 RCW.  97-13-100, § 246-840-070, filed 6/18/97, effective 7/19/97.]

A license to practice as a nurse in Washington may be issued without examination provided the applicant meets all of the following requirements:

FOR PRACTICAL NURSE PROGRAMS:

(1) The applicant has graduated and holds a credential from:

(a) A commission or state board approved program preparing candidates for licensure as a practical nurse; or

(b) Its equivalent as determined by the commission, which program must fulfill the minimum requirement for commission or state board approved practical nursing programs in Washington at the time of graduation.

(2) Applicants shall have passed a state board constructed test, the SBTPE (state board test pool examination), or NCLEX in their original state of licensure within four attempts and within two years of completion of the nursing program.

(3) The applicant held or currently holds a license to practice as a practical nurse in another state or territory.  If the license is lapsed or inactive for three years or more, the applicant must successfully complete a commission approved refresher course before an active Washington license is issued.

(4) That grounds do not exist for denial under chapter 18.130 RCW.

(5) The applicant shall:

(a) Submit a completed application with the required fee.  

(b) Applicants must complete seven clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.

FOR REGISTERED NURSE PROGRAMS:

(6) The applicant has graduated and holds a degree/diploma from a commission or state board approved school of nursing preparing candidates for licensure as a registered nurse provided such nursing program is equivalent to the minimum nursing educational standards prevailing for commission or state board approved schools of nursing in Washington at the time of the applicant's graduation.

(a) Applicants who were licensed prior to January 1, 1953, must have scored at least seventy-five percent on the commission or state board examination in the state of original licensure.

(i) Applicants licensed after January 1, 1953, but before June 1, 1982, must have passed the state board test pool examination for registered nurse licensure with a minimum standard score of 350 in each test.

(ii) Applicants licensed after July 1, 1982, must have passed with a minimum standard score as established by contract with the National Council of State Boards of Nursing.

(b) The applicant holds a valid current license to practice as a registered nurse in another state or territory.

(c) Applicants must complete seven clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.

(d) The application must be completed and notarized, the fee must be filed with the application.   A notarized copy of a valid current license shall be filed with the application.

(e) Verification of licensure by examination must be obtained from the state or territory of original licensure.  Any fee for verification required by the state or territory of original license must be paid by the applicant.

(7) Applicants from countries outside the United States who were granted a license in another United States jurisdiction or territory prior to December 31, 1971, and who were not required to pass the state board test pool examination must meet the following requirements:

(a) The nursing education program must meet the minimum approved standards prevailing for schools of nursing in Washington at the time of the applicant's graduation.

(b) The applicant holds a valid current license to practice as a registered nurse in another United States jurisdiction or territory.

(c) The applicant must submit to the commission:

(i) A complete notarized application.  The fee must be filed with the application.

(ii) Verification of original licensure obtained in the United States jurisdiction or territory.

(iii) Notarized copies of educational preparation and licensure by examination submitted directly from the country of original licensure or from the state commission or territory of original United States licensure.

(iv) Verification of current nursing practice for three years prior to application for Washington licensure.

(v) Applicants must complete seven clock hours of AIDS education as required in chapter 246-12 WAC, Part 8.

(d) The applicant shall meet all requirements of chapter 18.79 RCW and regulations of the commission.

[Statutory Authority: RCW 43.70.280.  98-05-060, § 246-840-090, filed 2/13/98, effective 3/16/98.  Statutory Authority: Chapter 18.79 RCW.  97-13-100, § 246-840-090, filed 6/18/97, effective 7/19/97.]

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