SHB 2974 -
By Committee on Health & Long-Term Care
ADOPTED 03/03/2006
Strike everything after the enacting clause and insert the following:
"Sec. 1 RCW 18.130.060 and 2001 c 101 s 1 are each amended to
read as follows:
In addition to the authority specified in RCW 18.130.050, the
secretary has the following additional authority:
(1) To employ such investigative, administrative, and clerical
staff as necessary for the enforcement of this chapter;
(2) Upon the request of a board, to appoint pro tem members to
participate as members of a panel of the board in connection with
proceedings specifically identified in the request. Individuals so
appointed must meet the same minimum qualifications as regular members
of the board. Pro tem members appointed for matters under this chapter
are appointed for a term of no more than one year. No pro tem member
may serve more than four one-year terms. While serving as board
members pro tem, persons so appointed have all the powers, duties, and
immunities, and are entitled to the emoluments, including travel
expenses in accordance with RCW 43.03.050 and 43.03.060, of regular
members of the board. The chairperson of a panel shall be a regular
member of the board appointed by the board chairperson. Panels have
authority to act as directed by the board with respect to all matters
concerning the review, investigation, and adjudication of all
complaints, allegations, charges, and matters subject to the
jurisdiction of the board. The authority to act through panels does
not restrict the authority of the board to act as a single body at any
phase of proceedings within the board's jurisdiction. Board panels may
make interim orders and issue final decisions with respect to matters
and cases delegated to the panel by the board. Final decisions may be
appealed as provided in chapter 34.05 RCW, the administrative procedure
act;
(3) To establish fees to be paid for witnesses, expert witnesses,
and consultants used in any investigation and to establish fees to
witnesses in any agency adjudicative proceeding as authorized by RCW
34.05.446;
(4) To conduct investigations and practice reviews at the direction
of the disciplining authority and to issue subpoenas, administer oaths,
and take depositions in the course of conducting those investigations
and practice reviews at the direction of the disciplining authority;
(5) To have the health professions regulatory program establish a
system to recruit potential public members, to review the
qualifications of such potential members, and to provide orientation to
those public members appointed pursuant to law by the governor or the
secretary to the boards and commissions specified in RCW
18.130.040(2)(b), and to the advisory committees and councils for
professions specified in RCW 18.130.040(2)(a); and
(6) To adopt rules, in consultation with the disciplining
authorities, requiring every license holder to report information
identified in RCW 18.130.070.
Sec. 2 RCW 18.130.070 and 2005 c 470 s 2 are each amended to read
as follows:
(1)(a) The ((disciplining authority may)) secretary shall adopt
rules requiring ((any person, including, but not limited to, licensees,
corporations, organizations, health care facilities, impaired
practitioner programs, or voluntary substance abuse monitoring programs
approved by the disciplining authority and state or local governmental
agencies,)) every license holder to report to the appropriate
disciplining authority any conviction, determination, or finding that
((a)) another license holder has committed an act which constitutes
unprofessional conduct, or to report information to the disciplining
authority, an impaired practitioner program, or voluntary substance
abuse monitoring program approved by the disciplining authority, which
indicates that the other license holder may not be able to practice his
or her profession with reasonable skill and safety to consumers as a
result of a mental or physical condition.
(b) The secretary may adopt rules to require other persons,
including corporations, organizations, health care facilities, impaired
practitioner programs, or voluntary substance abuse monitoring programs
approved by a disciplining authority, and state or local government
agencies to report:
(i) Any conviction, determination, or finding that a license holder
has committed an act which constitutes unprofessional conduct; or
(ii) Information to the disciplining authority, an impaired
practitioner program, or voluntary substance abuse monitoring program
approved by the disciplining authority, which indicates that the
license holder may not be able to practice his or her profession with
reasonable skill and safety to consumers as a result of a mental or
physical condition.
(c) If a report has been made by a hospital to the department
pursuant to RCW 70.41.210, a report to the disciplining authority is
not required. To facilitate meeting the intent of this section, the
cooperation of agencies of the federal government is requested by
reporting any conviction, determination, or finding that a federal
employee or contractor regulated by the disciplining authorities
enumerated in this chapter has committed an act which constituted
unprofessional conduct and reporting any information which indicates
that a federal employee or contractor regulated by the disciplining
authorities enumerated in this chapter may not be able to practice his
or her profession with reasonable skill and safety as a result of a
mental or physical condition.
(d) Reporting under this section is not required by:
(i) Any entity with a peer review committee, quality improvement
committee or other similarly designated professional review committee,
or by a license holder who is a member of such committee, during the
investigative phase of the respective committee's operations if the
investigation is completed in a timely manner; or
(ii) An impaired practitioner program or voluntary substance abuse
monitoring program approved by a disciplining authority under RCW
18.130.175 if the license holder is currently enrolled in the treatment
program, so long as the license holder actively participates in the
treatment program and the license holder's impairment does not
constitute a clear and present danger to the public health, safety, or
welfare.
(2) If a person fails to furnish a required report, the
disciplining authority may petition the superior court of the county in
which the person resides or is found, and the court shall issue to the
person an order to furnish the required report. A failure to obey the
order is a contempt of court as provided in chapter 7.21 RCW.
(3) A person is immune from civil liability, whether direct or
derivative, for providing information to the disciplining authority
pursuant to the rules adopted under subsection (1) of this section.
(4)(a) The holder of a license subject to the jurisdiction of this
chapter shall report to the disciplining authority:
(i) Any conviction, determination, or finding that ((the licensee))
he or she has committed unprofessional conduct or is unable to practice
with reasonable skill or safety; and
(ii) Any disqualification from participation in the federal
medicare program, under Title XVIII of the federal social security act
or the federal medicaid program, under Title XIX of the federal social
security act.
(b) Failure to report within thirty days of notice of the
conviction, determination, ((or)) finding, or disqualification
constitutes grounds for disciplinary action.
NEW SECTION. Sec. 3 A new section is added to chapter 18.130 RCW
to read as follows:
Any individual who applies for a license or temporary practice
permit or holds a license or temporary practice permit and is
prohibited from practicing a health care profession in another state
because of an act of unprofessional conduct that is substantially
equivalent to an act of unprofessional conduct prohibited by this
chapter or any of the chapters specified in RCW 18.130.040 is
prohibited from practicing a health care profession in this state until
proceedings of the appropriate disciplining authority have been
completed under RCW 18.130.050.
Sec. 4 RCW 18.130.050 and 1995 c 336 s 4 are each amended to read
as follows:
The disciplining authority has the following authority:
(1) To adopt, amend, and rescind such rules as are deemed necessary
to carry out this chapter;
(2) To investigate all complaints or reports of unprofessional
conduct as defined in this chapter and to hold hearings as provided in
this chapter;
(3) To issue subpoenas and administer oaths in connection with any
investigation, hearing, or proceeding held under this chapter;
(4) To take or cause depositions to be taken and use other
discovery procedures as needed in any investigation, hearing, or
proceeding held under this chapter;
(5) To compel attendance of witnesses at hearings;
(6) In the course of investigating a complaint or report of
unprofessional conduct, to conduct practice reviews;
(7) To take emergency action ordering summary suspension of a
license, or restriction or limitation of the ((licensee's)) license
holder's practice pending proceedings by the disciplining authority.
Consistent with section 3 of this act, a disciplining authority shall
issue a summary suspension of the license or temporary practice permit
of a license holder prohibited from practicing a health care profession
in another state, federal, or foreign jurisdiction because of an act of
unprofessional conduct that is substantially equivalent to an act of
unprofessional conduct prohibited by this chapter or any of the
chapters specified in RCW 18.130.040. The summary suspension remains
in effect until proceedings by the Washington disciplining authority
have been completed;
(8) To use a presiding officer as authorized in RCW 18.130.095(3)
or the office of administrative hearings as authorized in chapter 34.12
RCW to conduct hearings. The disciplining authority shall make the
final decision regarding disposition of the license unless the
disciplining authority elects to delegate in writing the final decision
to the presiding officer;
(9) To use individual members of the boards to direct
investigations. However, the member of the board shall not
subsequently participate in the hearing of the case;
(10) To enter into contracts for professional services determined
to be necessary for adequate enforcement of this chapter;
(11) To contract with licensees or other persons or organizations
to provide services necessary for the monitoring and supervision of
licensees who are placed on probation, whose professional activities
are restricted, or who are for any authorized purpose subject to
monitoring by the disciplining authority;
(12) To adopt standards of professional conduct or practice;
(13) To grant or deny license applications, and in the event of a
finding of unprofessional conduct by an applicant or license holder, to
impose any sanction against a license applicant or license holder
provided by this chapter;
(14) To designate individuals authorized to sign subpoenas and
statements of charges;
(15) To establish panels consisting of three or more members of the
board to perform any duty or authority within the board's jurisdiction
under this chapter;
(16) To review and audit the records of licensed health facilities'
or services' quality assurance committee decisions in which a
licensee's practice privilege or employment is terminated or
restricted. Each health facility or service shall produce and make
accessible to the disciplining authority the appropriate records and
otherwise facilitate the review and audit. Information so gained shall
not be subject to discovery or introduction into evidence in any civil
action pursuant to RCW 70.41.200(3).
Sec. 5 RCW 18.130.080 and 1998 c 132 s 9 are each amended to read
as follows:
(1) A person, including but not limited to consumers, licensees,
corporations, organizations, health care facilities, impaired
practitioner programs, or voluntary substance abuse monitoring programs
approved by disciplining authorities, and state and local governmental
agencies, may submit a written complaint to the disciplining authority
charging a license holder or applicant with unprofessional conduct and
specifying the grounds therefor or to report information to the
disciplining authority, or voluntary substance abuse monitoring
program, or an impaired practitioner program approved by the
disciplining authority, which indicates that the license holder may not
be able to practice his or her profession with reasonable skill and
safety to consumers as a result of a mental or physical condition. If
the disciplining authority determines that the complaint merits
investigation, or if the disciplining authority has reason to believe,
without a formal complaint, that a license holder or applicant may have
engaged in unprofessional conduct, the disciplining authority shall
investigate to determine whether there has been unprofessional conduct.
In determining whether or not to investigate, the disciplining
authority shall consider any prior complaints received by the
disciplining authority, any prior findings of fact under RCW
18.130.110, any stipulations to informal disposition under RCW
18.130.172, and any comparable action taken by other state disciplining
authorities.
(2) Notwithstanding subsection (1) of this section, the
disciplining authority shall initiate an investigation in every
instance where the disciplining authority receives information that a
health care provider has been disqualified from participating in the
federal medicare program, under Title XVIII of the federal social
security act, or the federal medicaid program, under Title XIX of the
federal social security act.
(3) A person who files a complaint or reports information under
this section in good faith is immune from suit in any civil action
related to the filing or contents of the complaint.
Sec. 6 RCW 18.130.160 and 2001 c 195 s 1 are each amended to read
as follows:
Upon a finding, after hearing, that a license holder or applicant
has committed unprofessional conduct or is unable to practice with
reasonable skill and safety due to a physical or mental condition, the
disciplining authority may issue an order providing for one or any
combination of the following:
(1) Revocation of the license;
(2) Suspension of the license for a fixed or indefinite term;
(3) Restriction or limitation of the practice;
(4) Requiring the satisfactory completion of a specific program of
remedial education or treatment;
(5) The monitoring of the practice by a supervisor approved by the
disciplining authority;
(6) Censure or reprimand;
(7) Compliance with conditions of probation for a designated period
of time;
(8) Payment of a fine for each violation of this chapter, not to
exceed five thousand dollars per violation. Funds received shall be
placed in the health professions account;
(9) Denial of the license request;
(10) Corrective action;
(11) Refund of fees billed to and collected from the consumer;
(12) A surrender of the practitioner's license in lieu of other
sanctions, which must be reported to the federal data bank.
Any of the actions under this section may be totally or partly
stayed by the disciplining authority. Safeguarding the public's health
and safety is the paramount responsibility of every disciplining
authority and in determining what action is appropriate, the
disciplining authority must first consider what sanctions are necessary
to protect or compensate the public. Only after such provisions have
been made may the disciplining authority consider and include in the
order requirements designed to rehabilitate the license holder or
applicant. All costs associated with compliance with orders issued
under this section are the obligation of the license holder or
applicant.
The licensee or applicant may enter into a stipulated disposition
of charges that includes one or more of the sanctions of this section,
but only after a statement of charges has been issued and the licensee
has been afforded the opportunity for a hearing and has elected on the
record to forego such a hearing. The stipulation shall either contain
one or more specific findings of unprofessional conduct or inability to
practice, or a statement by the licensee acknowledging that evidence is
sufficient to justify one or more specified findings of unprofessional
conduct or inability to practice. The stipulation entered into
pursuant to this subsection shall be considered formal disciplinary
action for all purposes.
Sec. 7 RCW 18.130.175 and 2005 c 274 s 233 are each amended to
read as follows:
(1) In lieu of disciplinary action under RCW 18.130.160 and if the
disciplining authority determines that the unprofessional conduct may
be the result of substance abuse, the disciplining authority may refer
the license holder to a voluntary substance abuse monitoring program
approved by the disciplining authority.
The cost of the treatment shall be the responsibility of the
license holder, but the responsibility does not preclude payment by an
employer, existing insurance coverage, or other sources. Primary
alcoholism or other drug addiction treatment shall be provided by
approved treatment programs under RCW 70.96A.020 or by any other
provider approved by the entity or the commission. However, nothing
shall prohibit the disciplining authority from approving additional
services and programs as an adjunct to primary alcoholism or other drug
addiction treatment. The disciplining authority may also approve the
use of out-of-state programs. Referral of the license holder to the
program shall be done only with the consent of the license holder.
Referral to the program may also include probationary conditions for a
designated period of time. If the license holder does not consent to
be referred to the program or does not successfully complete the
program, the disciplining authority may take appropriate action under
RCW 18.130.160 which includes suspension of the license unless or until
the disciplining authority, in consultation with the director of the
voluntary substance abuse monitoring program, determines the license
holder is able to practice safely. The secretary shall adopt uniform
rules for the evaluation by the disciplinary authority of a relapse or
program violation on the part of a license holder in the substance
abuse monitoring program. The evaluation shall encourage program
participation with additional conditions, in lieu of disciplinary
action, when the disciplinary authority determines that the license
holder is able to continue to practice with reasonable skill and
safety.
(2) In addition to approving substance abuse monitoring programs
that may receive referrals from the disciplining authority, the
disciplining authority may establish by rule requirements for
participation of license holders who are not being investigated or
monitored by the disciplining authority for substance abuse. License
holders voluntarily participating in the approved programs without
being referred by the disciplining authority shall not be subject to
disciplinary action under RCW 18.130.160 for their substance abuse, and
shall not have their participation made known to the disciplining
authority, if they meet the requirements of this section and the
program in which they are participating.
(3) The license holder shall sign a waiver allowing the program to
release information to the disciplining authority if the licensee does
not comply with the requirements of this section or is unable to
practice with reasonable skill or safety. The substance abuse program
shall report to the disciplining authority any license holder who fails
to comply with the requirements of this section or the program or who,
in the opinion of the program, is unable to practice with reasonable
skill or safety. License holders shall report to the disciplining
authority if they fail to comply with this section or do not complete
the program's requirements. License holders may, upon the agreement of
the program and disciplining authority, reenter the program if they
have previously failed to comply with this section.
(4) The treatment and pretreatment records of license holders
referred to or voluntarily participating in approved programs shall be
confidential, shall be exempt from chapter 42.56 RCW, and shall not be
subject to discovery by subpoena or admissible as evidence except for
monitoring records reported to the disciplining authority for cause as
defined in subsection (3) of this section. Monitoring records relating
to license holders referred to the program by the disciplining
authority or relating to license holders reported to the disciplining
authority by the program for cause, shall be released to the
disciplining authority at the request of the disciplining authority.
Records held by the disciplining authority under this section shall be
exempt from chapter 42.56 RCW and shall not be subject to discovery by
subpoena except by the license holder.
(5) "Substance abuse," as used in this section, means the
impairment, as determined by the disciplining authority, of a license
holder's professional services by an addiction to, a dependency on, or
the use of alcohol, legend drugs, or controlled substances.
(6) This section does not affect an employer's right or ability to
make employment-related decisions regarding a license holder. This
section does not restrict the authority of the disciplining authority
to take disciplinary action for any other unprofessional conduct.
(7) A person who, in good faith, reports information or takes
action in connection with this section is immune from civil liability
for reporting information or taking the action.
(a) The immunity from civil liability provided by this section
shall be liberally construed to accomplish the purposes of this section
and the persons entitled to immunity shall include:
(i) An approved monitoring treatment program;
(ii) The professional association operating the program;
(iii) Members, employees, or agents of the program or association;
(iv) Persons reporting a license holder as being possibly impaired
or providing information about the license holder's impairment; and
(v) Professionals supervising or monitoring the course of the
impaired license holder's treatment or rehabilitation.
(b) The courts are strongly encouraged to impose sanctions on
clients and their attorneys whose allegations under this subsection are
not made in good faith and are without either reasonable objective,
substantive grounds, or both.
(c) The immunity provided in this section is in addition to any
other immunity provided by law.
NEW SECTION. Sec. 8 A new section is added to chapter 43.43 RCW
to read as follows:
(1) Upon a guilty plea or conviction of a person for any felony
crime involving homicide under chapter 9A.32 RCW, assault under chapter
9A.36 RCW, kidnapping under chapter 9A.40 RCW, or sex offenses under
chapter 9A.44 RCW, the prosecuting attorney shall notify the state
patrol of such guilty pleas or convictions.
(2) When the state patrol receives information that a person has
pled guilty to or been convicted of one of the felony crimes under
subsection (1) of this section, the state patrol shall transmit that
information to the department of health. It is the duty of the
department of health to identify whether the person holds a credential
issued by a disciplining authority listed under RCW 18.130.040, and
provide this information to the disciplining authority that issued the
credential to the person who pled guilty or was convicted of a crime
listed in subsection (1) of this section.
NEW SECTION. Sec. 9 A new section is added to chapter 18.130 RCW
to read as follows:
(1) When developing its biennial budget request for appropriation
of the health professions account created in RCW 43.70.320, beginning
in the 2007-2009 budget and continuing in subsequent biennia, the
department shall specify the number of full-time employees designated
as investigators and attorneys and the costs associated with supporting
their activities. The department shall also specify the additional
full-time employees designated as investigators and attorneys that are
required to achieve a staffing level that is able to respond promptly,
competently, and appropriately to the workload associated with health
professions disciplinary activities and the costs associated with
supporting disciplinary activities. In identifying the need for
additional staff, the department shall develop a formula based on its
prior experience with staff levels compared to the number of providers,
complaints, investigations, and other criteria that the department
determines is relevant to staffing level decisions. The department
must request additional funds for activities that most critically
impact public health and safety. The budget request must specify the
methodology used for each biennium.
(2) The joint legislative audit and review committee, in
consultation with the department, shall report to the legislature by
December 1, 2010, with recommendations for formulas for determining
appropriate staffing levels for investigators and attorneys at the
department of health involved in the health professions disciplinary
process to achieve prompt, competent, and appropriate responses to
complaints of unprofessional conduct. The report must be based upon
the department's prior experience with staff levels compared to the
number of providers, complaints, investigations, and other criteria
that the department finds are relevant to determining appropriate
staffing levels.
(3) This section expires July 1, 2011.
NEW SECTION. Sec. 10 The following acts or parts of acts are
each repealed:
(1) RCW 18.57.174 (Duty to report unprofessional conduct--Exceptions) and 2000 c 171 s 20 & 1986 c 300 s 9; and
(2) RCW 18.71.0193 (Duty to report unprofessional conduct--Exceptions) and 1994 sp.s. c 9 s 327 & 1986 c 300 s 5.
NEW SECTION. Sec. 11 Section 7 of this act takes effect July 1,
2006."
SHB 2974 -
By Committee on Health & Long-Term Care
ADOPTED 03/03/2006
On page 1, line 1 of the title, after "discipline;" strike the remainder of the title and insert "amending RCW 18.130.060, 18.130.070, 18.130.050, 18.130.080, 18.130.160, and 18.130.175; adding new sections to chapter 18.130 RCW; adding a new section to chapter 43.43 RCW; repealing RCW 18.57.174 and 18.71.0193; providing an effective date; and providing an expiration date."