Washington State House of Representatives Office of Program Research	BILL ANALYSIS
Commerce & Labor Committee

2SSB 5797

Brief Description:  Authorizing advanced registered nurse practitioners to examine, diagnose, and treat injured workers covered by industrial insurance.

Sponsors:  Senate Committee on Health & Long‑Term Care (originally sponsored by Senators Prentice, Deccio, Fairley, Thibaudeau and Costa).

Brief Summary of Second Substitute Bill

$Makes health services provided by advanced registered nurse practitioners within their scope of practice available to injured workers.

Hearing Date:  2/27/02

Staff:  Jill Reinmuth (786‑7134).

Background:

The Workers' Compensation Act provides that an injured worker is entitled to proper and necessary medical care from a physician of the worker's choice.  The Act contains many provisions specifying the roles and responsibilities of physicians.  For example, a physician who fails to provide necessary assistance to injured workers or file required reports is subject to civil penalties.  Also, a physician may be required to testify as to an injured worker's examination or treatment before the Department of Labor and Industries or the Board of Industrial Insurance Appeals.

The Department of Labor and Industries' rules define "physician" as a person licensed to practice medicine and surgery or osteopathic medicine and surgery.  The rules also define "doctor" to include persons licensed to practice medicine and surgery, osteopathic medicine and surgery, chiropractic, naturopathic physician, podiatry, dentistry, and optometry.  Doctors may sign accident report forms for injured workers and time loss cards.

The Department of Health's rules provide that an "advanced registered nurse practitioner" (ARNP) is a registered nurse prepared to assume primary responsibility for management of a broad range of patient care.  According to the rules, their practice "incorporates the use of independent judgment as well as collaborative interaction with other health care professionals."  The Department of Labor and Industries' rules permit ARNPs to provide nursing care for injured workers.  The rules require that ARNPs be recognized as such, and have a system of obtaining physician consultations.  ARNPs may not sign accident report forms or time loss cards.

Summary of Bill:

The health services available to injured workers include health services provided by advanced registered nurse practitioners within their scope of practice.  ARNPs are recognized as independent practitioners.  Other provisions give ARNPs the same roles and responsibilities as physicians, except that ARNPs may not conduct special medical examinations.

Rules Authority:  The bill does not contain provisions addressing the rule‑making powers of an agency.

Appropriation:  None.

Fiscal Note:  Available for SSB 5797.

Effective Date:  Ninety days after adjournment of session in which bill is passed.