READ FIRST TIME 02/06/04.   

     AN ACT Relating to eliminating credentialing barriers for health professions; amending RCW 18.06.050, 18.29.190, 18.29.180, 18.34.070, 18.79.160, 18.83.050, 18.83.070, 18.83.072, 18.83.082, 18.83.170, 18.89.050, and 18.89.110; adding a new section to chapter 18.79 RCW; creating a new section; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds that the health care work force shortage is contributing to the health care crisis. The legislature also finds that some unnecessary barriers exist that slow or prevent qualified applicants from becoming credentialed health care providers. The legislature further finds that eliminating these initial barriers to licensure will contribute to state initiatives directed toward easing the health care personnel shortage in Washington.

Sec. 2   RCW 18.06.050 and 1991 c 3 s 7 are each amended to read as follows:
     Any person seeking to be examined shall present to the secretary at least forty-five days before the commencement of the examination:
     (1) A written application on a form or forms provided by the secretary setting forth under affidavit such information as the secretary may require; and
     (2) Proof that the candidate has:
     (a) Successfully completed a course, approved by the secretary, of didactic training in basic sciences and acupuncture over a minimum period of two academic years. The training shall include such subjects as anatomy, physiology, ((bacteriology,)) microbiology, biochemistry, pathology, hygiene, and a survey of western clinical sciences. The basic science classes must be equivalent to those offered at the collegiate level. However, if the applicant is a licensed chiropractor under chapter 18.25 RCW or a naturopath licensed under chapter 18.36A RCW, the requirements of this subsection relating to basic sciences may be reduced by up to one year depending upon the extent of the candidate's qualifications as determined under rules adopted by the secretary;
     (b) Successfully completed ((a course, approved by the secretary,)) five hundred hours of clinical training in acupuncture ((over a minimum period of one academic year. The training shall include a minimum of: (i) Twenty-nine quarter credits of supervised practice, consisting of at least four hundred separate patient treatments involving a minimum of one hundred different patients, and (ii) one hundred hours or nine quarter credits of observation which shall include case presentation and discussion)) that is approved by the secretary.

Sec. 3   RCW 18.29.190 and 1993 c 323 s 2 are each amended to read as follows:
     (1) The department shall issue ((a temporary)) an initial limited license without the examination required by this chapter to any applicant who, as determined by the secretary:
     (a) Holds a valid license in another state that allows the scope of practice in subsection (3) (a) through (j) of this section;
     (b) Is currently engaged in active practice in another state. For the purposes of this section, "active practice" means five hundred sixty hours of practice in the preceding twenty-four months;
     (c) Files with the secretary documentation certifying that the applicant:
     (i) Has graduated from an accredited dental hygiene school approved by the secretary;
     (ii) Has successfully completed the dental hygiene national board examination; and
     (iii) Is licensed to practice in another state;
     (d) Provides information as the secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW;
     (e) Demonstrates to the secretary a knowledge of Washington state law pertaining to the practice of dental hygiene, including the administration of legend drugs;
     (f) Pays any required fees; and
     (g) Meets requirements for AIDS education.
     (2) The term of the ((temporary)) initial limited license issued under this section is eighteen months and it is ((nonrenewable)) renewable upon demonstration of successful passage of the examination for administering local anesthetic and nitrous oxide/oxygen analgesia.
     (3) A person practicing with ((a temporary)) an initial limited license granted under this section has the authority to perform hygiene procedures that are limited to:
     (a) Oral inspection and measuring of periodontal pockets;
     (b) Patient education in oral hygiene;
     (c) Taking intra-oral and extra-oral radiographs;
     (d) Applying topical preventive or prophylactic agents;
     (e) Polishing and smoothing restorations;
     (f) Oral prophylaxis and removal of deposits and stains from the surface of the teeth;
     (g) Recording health histories;
     (h) Taking and recording blood pressure and vital signs;
     (i) Performing subgingival and supragingival scaling; and
     (j) Performing root planing.
     (4)(a) A person practicing with ((a temporary)) an initial limited license granted under this section may not perform the following dental hygiene procedures unless authorized in (b) or (c) of this subsection:
     (i) Give injections of local anesthetic;
     (ii) Place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration;
     (iii) Soft tissue curettage; or
     (iv) Administer nitrous oxide/oxygen analgesia.
     (b) A person licensed in another state who can demonstrate substantively equivalent licensing standards in the administration of local anesthetic may receive a temporary endorsement to administer local anesthesia.
     (c) A person licensed in another state who can demonstrate substantively equivalent licensing standards in restorative procedures may receive a temporary endorsement for restorative procedures.
     (5)(a) A person practicing with a renewed limited license granted under this section may:
     (i) Perform hygiene procedures as provided under subsection (3) of this section;
     (ii) Give injections of local anesthetic;
     (iii) Perform soft tissue curretage; and
     (iv) Administer nitrous oxide/oxygen analgesia.
     (b) A person practicing with a renewed limited license granted under this section may not place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration.

Sec. 4   RCW 18.29.180 and 1991 c 3 s 57 are each amended to read as follows:
     The following practices, acts, and operations are excepted from the operation of this chapter:
     (1) The practice of dental hygiene in the discharge of official duties by dental hygienists in the United States armed services, coast guard, public health services, veterans' bureau, or bureau of Indian affairs;
     (2) Dental hygiene programs approved by the secretary and the practice of dental hygiene by students in dental hygiene programs approved by the secretary, when acting under the direction and supervision of persons licensed under chapter 18.29 or 18.32 RCW acting as instructors;
     (3) The practice of dental hygiene by students in accredited dental hygiene educational programs when acting under the direction and supervision of instructors licensed under chapter 18.29 or 18.32 RCW.

Sec. 5   RCW 18.34.070 and 1991 c 3 s 76 are each amended to read as follows:
     Any applicant for a license shall be examined if he or she pays an examination fee determined by the secretary as provided in RCW 43.70.250 and certifies under oath that he or she:
     (1) Is eighteen years or more of age; and
     (2) Has graduated from an accredited high school; and
     (3) ((Is a citizen of the United States or has declared his or her intention of becoming such citizen in accordance with law; and
     (4))) Is of good moral character; and
     (((5))) (4) Has either:
     (a) Had at least three years of apprenticeship training; or
     (b) Successfully completed a prescribed course in opticianry in a college or university approved by the secretary; or
     (c) Been principally engaged in practicing as a dispensing optician not in the state of Washington for five years.

Sec. 6   RCW 18.79.160 and 1994 sp.s. c 9 s 416 are each amended to read as follows:
     (1) An applicant for a license to practice as a registered nurse shall submit to the commission:
     (a) An attested written application on a department form;
     (b) ((Written)) An official ((evidence of a diploma from)) transcript demonstrating graduation and successful completion of an approved ((school)) program of nursing; and
     (c) Any other official records specified by the commission.
     (2) An applicant for a license to practice as an advanced registered nurse practitioner shall submit to the commission:
     (a) An attested written application on a department form;
     (b) ((Written)) An official ((evidence of)) transcript demonstrating graduation and successful completion of an advanced registered nurse practitioner ((training)) program meeting criteria established by the commission; and
     (c) Any other official records specified by the commission.
     (3) An applicant for a license to practice as a licensed practical nurse shall submit to the commission:
     (a) An attested written application on a department form;
     (b) Written official evidence that the applicant is over the age of eighteen;
     (c) ((Written official evidence of a high school diploma or general education development certificate or diploma;
     (d) Written)) An official ((evidence of completion of)) transcript demonstrating graduation and successful completion of an approved practical nursing program, or its equivalent; and
     (((e))) (d) Any other official records specified by the commission.
     (4) At the time of submission of the application, the applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse must not be in violation of chapter 18.130 RCW or this chapter.
     (5) The commission shall establish by rule the criteria for evaluating the education of all applicants.

NEW SECTION.  Sec. 7   A new section is added to chapter 18.79 RCW to read as follows:
     A licensed practical nurse with an active license who has completed the coursework of a nontraditional registered nurse program approved by the commission can obtain the required clinical experience when: (1) The experience is obtained under the immediate supervision of a registered nurse who agrees to act as the preceptor with the understanding that the licensed practical nurse is practicing under the preceptor's registered nurse license. The preceptor must have an unrestricted license with at least two years of clinical practice in the same type of practice setting where the preceptorship will occur; and (2) the experience is obtained within six months of completion of the approved nontraditional program.

Sec. 8   RCW 18.83.050 and 1994 c 35 s 2 are each amended to read as follows:
     (1) The board shall adopt such rules as it deems necessary to carry out its functions.
     (2) The board shall examine the qualifications of applicants for licensing under this chapter, to determine which applicants are eligible for licensing under this chapter and shall forward to the secretary the names of applicants so eligible.
     (3) The board shall administer examinations to qualified applicants on at least an annual basis. The board shall determine the subject matter and scope of the examination((s and shall require both written and oral examinations of each applicant)), except as provided in RCW 18.83.170. The board may allow applicants to take the ((written)) examination upon the granting of their doctoral degree before completion of their internship for supervised experience.
     (4) The board shall keep a complete record of its own proceedings, of the questions given in examinations, of the names and qualifications of all applicants, and the names and addresses of all licensed psychologists. The examination paper of such applicant shall be kept on file for a period of at least one year after examination.
     (5) The board shall, by rule, adopt a code of ethics for psychologists which is designed to protect the public interest.
     (6) The board may require that persons licensed under this chapter as psychologists obtain and maintain professional liability insurance in amounts determined by the board to be practicable and reasonably available.

Sec. 9   RCW 18.83.070 and 1995 c 198 s 11 are each amended to read as follows:
     An applicant for a license as "psychologist" must submit proof to the board that:
     (1) The applicant is of good moral character.
     (2) The applicant holds a doctoral degree from a regionally accredited institution, obtained from an integrated program of graduate study in psychology as defined by rules of the board.
     (3) The applicant has had no fewer than two years of supervised experience((, at least one of which shall have been obtained subsequent to the granting of the doctoral degree)). The board shall adopt rules defining the circumstances under which supervised experience shall qualify the candidate for licensure.
     (4) The applicant has passed the ((written or oral)) examination or examinations((, or both, as prescribed)) required by the board.
     Any person holding a valid license to practice psychology in the state of Washington on June 7, 1984, shall be considered licensed under this chapter.

Sec. 10   RCW 18.83.072 and 1996 c 191 s 65 are each amended to read as follows:
     (1) Examination of applicants shall be held in Olympia, Washington, or at such other place as designated by the secretary, at least annually at such times as the board may determine.
     (2) ((Any applicant shall have the right to discuss with the board his or her performance on the examination.
     (3))) Any applicant who fails to make a passing grade on the examination may be allowed to retake the examination. Any applicant who fails the examination a second time must obtain special permission from the board to take the examination again.
     (((4))) (3) The board may approve an examination prepared or administered by a private testing agency or association of licensing authorities.

Sec. 11   RCW 18.83.082 and 1996 c 191 s 67 are each amended to read as follows:
     A person, not licensed in this state, who wishes to perform practices under the provisions of this chapter for a period not to exceed ninety days within a calendar year, must petition the board for a temporary permit to perform such practices. If the person is licensed or certified in another state deemed by the board to have standards equivalent to this chapter, or if the person is a member of a professional organization and holds a certificate deemed by the board to meet standards equivalent to this chapter, a permit may be issued. No fee shall be charged for such temporary permit.

Sec. 12   RCW 18.83.170 and 1996 c 191 s 70 are each amended to read as follows:
     Upon compliance with administrative procedures, administrative requirements, and fees determined under RCW 43.70.250 and 43.70.280, the board may grant a license, without ((written)) oral examination, to any applicant who has not previously failed any examination held by the board of psychology of the state of Washington and furnishes evidence satisfactory to the board that the applicant:
     (1) Holds a doctoral degree with primary emphasis on psychology from an accredited college or university; and
     (2)(a) Is licensed or certified to practice psychology in another state or country in which the requirements for such licensing or certification are, in the judgment of the board, essentially equivalent to those required by this chapter and the rules and regulations of the board. Such individuals must have been licensed or certified in another state for a period of at least two years; or
     (((3))) (b) Is a diplomate in good standing of the American Board of Examiners in Professional Psychology; or
     (c) Is a member of a professional organization and holds a certificate deemed by the board to meet standards equivalent to this chapter.

Sec. 13   RCW 18.89.050 and 1997 c 334 s 5 are each amended to read as follows:
     (1) In addition to any other authority provided by law, the secretary may:
     (a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;
     (b) Set all license, examination, and renewal fees in accordance with RCW 43.70.250;
     (c) Establish forms and procedures necessary to administer this chapter;
     (d) Issue a license to any applicant who has met the education, training, and examination requirements for licensure;
     (e) Hire clerical, administrative, and investigative staff as needed to implement this chapter and hire individuals licensed under this chapter to serve as examiners for any practical examinations;
     (f) Approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the licensure examination, specifically requiring that applicants must have completed ((programs)) an accredited respiratory program with two-year curriculum;
     (g) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, examinations for applicants for licensure;
     (h) Determine whether alternative methods of training are equivalent to formal education and establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take the examination;
     (i) Determine which states have legal credentialing requirements equivalent to those of this state and issue licenses to individuals legally credentialed in those states without examination;
     (j) Define and approve any experience requirement for licensure; and
     (k) Appoint members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated times and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060.
     (2) The provisions of chapter 18.130 RCW shall govern the issuance and denial of licenses, unlicensed practice, and the disciplining of persons licensed under this chapter. The secretary shall be the disciplining authority under this chapter.

Sec. 14   RCW 18.89.110 and 1997 c 334 s 9 are each amended to read as follows:
     (1) The date and location of the examination shall be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for licensure shall be scheduled for the next examination following the filing of the application. However, the applicant shall not be scheduled for any examination taking place sooner than sixty days after the application is filed.
     (2) The secretary shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice. Such examinations shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently, and shall meet generally accepted standards of fairness and validity for licensure examinations.
     (3) All examinations shall be conducted by the secretary, and all grading of the examinations shall be under fair and wholly impartial methods.
     (4) Any applicant who fails to make the required grade in the first examination is entitled to take up to three subsequent examinations, upon compliance with administrative procedures, administrative requirements, and fees determined by the secretary under RCW 43.70.250 and 43.70.280 and such remedial education as is deemed necessary.
     (5) Applicants who meet the educational criteria as established by the national board for respiratory care to sit for the national board for respiratory care's advanced practitioner exams, or who have been issued the registered respiratory therapist credential by the national board for respiratory care, shall be considered to have met the educational criteria of this chapter, provided the criteria and credential continue to be recognized by the secretary as equal to or greater than the licensure standards in Washington. Applicants must have verification submitted directly from the national board for respiratory care to the department.
     (6) The secretary may approve an examination prepared and administered by a private testing agency or association of credentialing boards for use by an applicant in meeting the licensure requirement.

NEW SECTION.  Sec. 15   Sections 13 and 14 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and take effect immediately.