WSR 99-20-095

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed October 5, 1999, 11:03 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 98-01-160.

Title of Rule: WAC 246-843-130 Courses of study, 246-843-150 Continuing education requirements to meet the conditions of reregistration for license, and 246-843-125 Continuing education credit for preceptors for administrators-in-training programs.

Purpose: Continuing education is the tool available to the Board of Nursing Home Administrators (BNHA) to assure minimum competency among licensed nursing home administrators.

Other Identifying Information: The BNHA eliminated a requirement for examination on state law and the mandatory course on state law replaces that part of the exam for licensure. The mandatory CE course was developed in resolution of conflict with the long-term care ombudsman, Department of Social and Health Services residential care services and the legislature.

Statutory Authority for Adoption: Chapters 18.52, 34.05 RCW.

Statute Being Implemented: Chapter 18.52 RCW.

Summary: The rule on courses was amended to include a mandatory course on state law for newly licensed NHAs and provides for retroactive credit for AITs. A description of the state law CE is included to assist potential providers of the course. Amended language updates the topics of possible CE courses to match topics covered in the national examination. Rules clarify BNHA intent on approval of courses and moves existing language on CE credit for preceptors to a more appropriate section of WAC.

Reasons Supporting Proposal: The rule to require state law training is the result of work among people representing DSHS, long-term care ombudsman program, professional associations, associations that are advocates for residents of nursing homes, BNHA and DOH. The multi-dimensional viewpoints were considered and agreement was reached by the workgroup and approved by the BNHA.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Barbara Hayes, Department of Health, (360) 236-4921.

Name of Proponent: Board of Nursing Home Administrators, governmental.

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

Explanation of Rule, its Purpose, and Anticipated Effects: Rules on CE set a standard to assure the minimum continuing competency of licensed nursing home administrators.

Proposal Changes the Following Existing Rules: The BNHA eliminated the state law portion of its examination requirement and these rule changes impose a mandatory CE course for new licensees as a negotiated replacement of that second part of the examination for license.

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

Small Business Economic Impact Statement

There are approximately 485 active and 152 inactive licensed nursing home administrators (NHA) in Washington state. Active licensed NHAs are employed in approximately 280 DSHS licensed nursing homes in Washington state, which require one licensed NHA in "administrative charge." Approximately 57% of the active licensed NHAs are employed in nursing homes. Some of these nursing homes are for profit businesses.

There is no significant increase or reduction of cost to comply with these rules. The standard industrial code classifications used to determine the threshold for more than minor impact was:

STANDARD INDUSTRIAL CODE MINOR COST THRESHOLD
Miscellaneous Health $53.00

The cost of complying with the rules does not exceed the minor cost threshold; therefore mitigation is not necessary.

Opportunity for public involvement and written comment was provided during different stages of the development of the rules. A preproposal [statement] of inquiry, CR-101, was filed with the Code Reviser's Office December 22, 1997, for publication in the Washington State Register. A preliminary public input meeting notice for meetings on April 21 and 23, 1997, was mailed to 700 individuals (interested persons mailing list, active and inactive NHA licensees, candidates for NHA license). Board meeting agendas for meetings at which rules were a topic were mailed to the program's interested persons mailing list (approximately twenty-five individuals and organizations) for meetings on May 22, 1997, August 21, 1997, February 18-19, 1998, May 7-8, 1998, November 6, 1998, February 26, 1999, May 21, 1999, and August 20, 1999.

A copy of the statement may be obtained by writing to Barbara Hayes, P.O. Box 47868, Olympia, WA 98504-7868, phone (360) 236-4921, fax (360) 236-4922.

RCW 34.05.328 applies to this rule adoption. These rules are significant because they adopt new or make significant amendments to a regulatory program.

Hearing Location: Wesley Gardens Board Room, 815 South 216th, Des Moines, WA 98198, on November 19, 1999, at 3:00 p.m.

Assistance for Persons with Disabilities: Contact Erin Obenland, (360) 236-4920, by November 12, 1999, TDD (800) 525-0127, or (800) 833-6388.

Submit Written Comments to: Barbara Hayes, fax (360) 236-4922, by November 12, 1999.

Date of Intended Adoption: November 19, 1999.

September 30, 1999

Barbara A. Hayes

Program Manager

OTS-2399.3


AMENDATORY SECTION(Amending Order 217B, filed 11/27/91, effective 12/28/91)

WAC 246-843-130
Continuing education courses ((of study)).

A course ((of study)) provided to satisfy the continuing education requirement of licensed nursing home administrators shall meet the following conditions before ((approval)) being approved by the board ((will be considered)):

(1) ((Such course of study)) A request for approval shall be ((registered before being offered)) submitted on forms provided by the department at least one day prior to the start of the course;

(2) Such course of study shall consist of a minimum of one hour of organized instruction with the exception of board-approved ((correspondence courses of)) self-study courses;

(3) Such course of study may include the following general subject areas or their equivalents, and shall be oriented to the nursing home administrator and reasonably related to the ((administrator)) administration of nursing homes:

(a) ((Applicable standards of environmental health and safety

(b) Local health and safety regulations

(c) General administration

(d) Psychology of patient care

(e) Principles of medical care

(f) Personal and social care

(g) Therapeutic and supportive care and services in long-term care

(h) Departmental organization and management

(i) Community inter-relationships;)) Resident management;

(b) Personnel management;

(c) Financial management;

(d) Environmental management;

(e) Governance and management;

(f) Laws relating to Washington state nursing homes;

(4) Within one hundred eighty days after becoming licensed, nursing home administrators shall attend an approved course on laws relating to nursing homes in Washington. The board will grant retroactive credit to those licensees who obtain the required training as administrators-in-training under WAC 246-843-090. The board will approve state law training courses based on the following criteria.

A minimum of a six-hour program, with formal training objectives, that covers the following subjects: The requirements of chapter 18.52 RCW and essential areas of laws that apply to nursing homes regulated by the department of social and health services under chapter 388-97 WAC:

• Resident services, medical and social;

• Resident rights, including resident decision making, informed consent, advance directives and notices to residents;

• Enforcement;

• Criminal history inquiries;

• Differences between federal and state law.

(5) Such course of study shall issue certificates of attendance or other evidence satisfactory to the board((; and

(5) All courses of study for continuing education are subject to board approval)).

[Statutory Authority: RCW 18.52.100.  91-24-050 (Order 217B), § 246-843-130, filed 11/27/91, effective 12/28/91; 91-06-060 (Order 141B), recodified as § 246-843-130, filed 3/1/91, effective 4/1/91.  Statutory Authority: RCW 18.52.100(11).  88-23-038 (Order PM 791), § 308-54-130, filed 11/9/88.  Statutory Authority: RCW 18.52.100(14) and 18.52.110(2).  82-20-092 (Order PL 407), § 308-54-130, filed 10/6/82.  Statutory Authority: RCW 18.52.100(14) and 18.52.110.  80-01-057 (Order PL 328), § 308-54-130, filed 12/20/79; Order PL 265, § 308-54-130, filed 3/21/77; Order PL 260, § 308-54-130, filed 12/10/76; Order PL 107, § 308-54-130, filed 3/3/71.]


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

WAC 246-843-150
Continuing education requirements ((to meet the conditions of reregistration)) for renewal of license.

(1) Licensed nursing home administrators must demonstrate completion of fifty-four hours of continuing education every three years as provided in chapter 246-12 WAC, Part 7.

(2) ((Practitioners)) Licensees practicing ((only)) solely out of ((the state of)) Washington ((may petition the board for full recognition of the continuing education requirement through fulfillment of their state of practice's licensing and continuing education requirements with the condition that their state has equal hours of continuing education requirements)) state are exempt from WAC 246-843-130(1) and must meet all other requirements.

(3) A preceptor for an administrator-in-training program may be granted continuing education credit of one hour per month of the AIT program. Credit as a preceptor is limited to twenty-four hours of continuing education in any three-year period.

[Statutory Authority: RCW 43.70.280.  98-05-060, § 246-843-150, filed 2/13/98, effective 3/16/98.  Statutory Authority: RCW 18.52.100.  91-24-050 (Order 217B), § 246-843-150, filed 11/27/91, effective 12/28/91; 91-06-060 (Order 141B), recodified as § 246-843-150, filed 3/1/91, effective 4/1/91.  Statutory Authority: RCW 18.52.100(14) and 18.52.110(2).  84-07-051 (Order PL 461), § 308-54-150, filed 3/21/84.  Statutory Authority: RCW 18.52.110.  80-04-069 (Order 338), § 308-54-150, filed 3/26/80; Order PL 260, § 308-54-150, filed 12/10/76; Order PL 107, § 308-54-150, filed 3/3/71.]


REPEALER

     The following section of the Washington Administrative Code is repealed:
WAC 246-843-125 Continuing education credit for preceptors for administrators-in-training programs.

© Washington State Code Reviser's Office