Title: An act relating to authorizing advanced registered nurse practitioners to examine, diagnose, and treat injured workers covered by industrial insurance.

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

Sponsors: By House Committee on Commerce & Labor (originally sponsored by Representatives Grant, Conway, Campbell, Wood, Kenney, Morrell, Crouse, Rockefeller, Holmquist, McCoy and Pflug).

Brief Summary of Substitute Bill

• For workers' compensation purposes, gives advanced registered nurse practitioners nearly the same roles and responsibilities as physicians, including authority to sign accident report forms and time loss cards.

• Requires the Department of Labor and Industries to report to specified legislative committees by December 1, 2006, on the implementation of the act.

• Provides that substantive provisions of the act to expire June 30, 2007.

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 8 members: Representatives Conway, Chair; McMorris, Ranking Minority Member; Condotta, Assistant Ranking Minority Member; Crouse, Holmquist, Hudgins, Kenney and McCoy.

The Workers' Compensation Act (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 ARNPs, and have a system of obtaining physician consultations. ARNPs may not sign accident report forms or time loss cards.

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. These provisions expire June 30, 2007.

The Department of Labor and Industries must report to the Senate Commerce and Trade Committee and the House Commerce and Labor Committee by December 1, 2006, on the implementation of the act, including the effects of the act on injured worker outcomes, claim costs, and disputed claims.