BILL REQ. #: Z-0559.3
| State of Washington | 60th Legislature | 2007 Regular Session |
Read first time 02/14/2007. Referred to Committee on Health Care & Wellness.
AN ACT Relating to the consolidation and elimination of certain boards and commissions; amending RCW 70.168.020, 18.73.030, 18.73.050, 70.168.060, 18.135.030, 43.41.220, and 43.41.230; reenacting and amending RCW 18.71.205; repealing RCW 77.12.690, 28B.04.085, 28B.115.050, 28A.600.130, 28B.12.040, 70.96A.070, and 18.73.040; and providing an effective date.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 70.168.020 and 2000 c 93 s 20 are each amended to read
as follows:
(1) There is hereby created an emergency medical services and
trauma care steering committee composed of representatives of
individuals knowledgeable in emergency medical services and trauma
care, including emergency medical providers such as physicians, nurses,
hospital personnel, emergency medical technicians, paramedics,
ambulance services, a member of the emergency medical services
licensing and certification advisory committee, local government
officials, state officials, consumers, and persons affiliated
professionally with health science schools. The governor shall appoint
members of the steering committee. Members shall be appointed for a
period of three years. The department shall provide administrative
support to the committee. All appointive members of the committee, in
the performance of their duties, may be entitled to receive travel
expenses as provided in RCW 43.03.050 and 43.03.060. The governor may
remove members from the committee who have three unexcused absences
from committee meetings. The governor shall fill any vacancies of the
committee in a timely manner. The terms of those members representing
the same field shall not expire at the same time.
The committee shall elect a chair and a vice-chair whose terms of
office shall be for one year each. The chair shall be ineligible for
reelection after serving four consecutive terms.
The committee shall meet on call by the governor, the secretary, or
the chair.
(2) The emergency medical services and trauma care steering
committee shall:
(a) Advise the department regarding emergency medical services and
trauma care needs throughout the state.
(b) Review the regional emergency medical services and trauma care
plans and recommend changes to the department before the department
adopts the plans.
(c) Review proposed departmental rules for emergency medical
services and trauma care, including licensing and certification of
emergency medical services.
(d) Recommend modifications in rules regarding emergency medical
services and trauma care.
Sec. 2 RCW 18.71.205 and 1996 c 191 s 55 and 1996 c 178 s 6 are
each reenacted and amended to read as follows:
(1) The secretary of the department of health, in conjunction with
the advice and assistance of the ((emergency medical services licensing
and certification advisory committee as prescribed in RCW 18.73.050,
and the)) commission, shall prescribe:
(a) Practice parameters, training standards for, and levels of,
physician trained emergency medical service intermediate life support
technicians and paramedics;
(b) Minimum standards and performance requirements for the
certification and recertification of physician's trained emergency
medical service intermediate life support technicians and paramedics;
and
(c) Procedures for certification, recertification, and
decertification of physician's trained emergency medical service
intermediate life support technicians and paramedics.
(2) Initial certification shall be for a period established by the
secretary pursuant to RCW 43.70.250 and 43.70.280.
(3) Recertification shall be granted upon proof of continuing
satisfactory performance and education, and shall be for a period
established by the secretary pursuant to RCW 43.70.250 and 43.70.280.
(4) As used in chapters 18.71 and 18.73 RCW, "approved medical
program director" means a person who:
(a) Is licensed to practice medicine and surgery pursuant to
chapter 18.71 RCW or osteopathic medicine and surgery pursuant to
chapter 18.57 RCW; and
(b) Is qualified and knowledgeable in the administration and
management of emergency care and services; and
(c) Is so certified by the department of health for a county, group
of counties, or cities with populations over four hundred thousand in
coordination with the recommendations of the local medical community
and local emergency medical services and trauma care council.
(5) The uniform disciplinary act, chapter 18.130 RCW, governs
uncertified practice, the issuance and denial of certificates, and the
disciplining of certificate holders under this section. The secretary
shall be the disciplining authority under this section. Disciplinary
action shall be initiated against a person credentialed under this
chapter in a manner consistent with the responsibilities and duties of
the medical program director under whom such person is responsible.
(6) Such activities of physician's trained emergency medical
service intermediate life support technicians and paramedics shall be
limited to actions taken under the express written or oral order of
medical program directors and shall not be construed at any time to
include free standing or nondirected actions, for actions not
presenting an emergency or life-threatening condition.
Sec. 3 RCW 18.73.030 and 2005 c 193 s 2 are each amended to read
as follows:
((Unless a different meaning is plainly required by the context,
the following words and phrases as used in this chapter shall have the
meanings indicated.)) The definitions in this section apply throughout
this chapter unless the context clearly requires otherwise.
(1) "Secretary" means the secretary of the department of health.
(2) "Department" means the department of health.
(3) "Committee" means the emergency medical services ((licensing
and certification advisory)) and trauma care steering committee created
in RCW 70.168.020.
(4) "Ambulance" means a ground or air vehicle designed and used to
transport the ill and injured and to provide personnel, facilities, and
equipment to treat patients before and during transportation.
(5) "Aid vehicle" means a vehicle used to carry aid equipment and
individuals trained in first aid or emergency medical procedure.
(6) "Emergency medical technician" means a person who is authorized
by the secretary to render emergency medical care pursuant to RCW
18.73.081.
(7) "Ambulance service" means an organization that operates one or
more ambulances.
(8) "Aid service" means an organization that operates one or more
aid vehicles.
(9) "Emergency medical service" means medical treatment and care
which may be rendered at the scene of any medical emergency or while
transporting any patient in an ambulance to an appropriate medical
facility, including ambulance transportation between medical
facilities.
(10) "Communications system" means a radio and landline network
which provides rapid public access, coordinated central dispatching of
services, and coordination of personnel, equipment, and facilities in
an emergency medical services and trauma care system.
(11) "Prehospital patient care protocols" means the written
procedure adopted by the emergency medical services medical program
director which direct the out-of-hospital emergency care of the
emergency patient which includes the trauma care patient. These
procedures shall be based upon the assessment of the patient's medical
needs and what treatment will be provided for emergency conditions.
The protocols shall meet or exceed statewide minimum standards
developed by the department in rule as authorized in chapter 70.168
RCW.
(12) "Patient care procedures" means written operating guidelines
adopted by the regional emergency medical services and trauma care
council, in consultation with the local emergency medical services and
trauma care councils, emergency communication centers, and the
emergency medical services medical program director, in accordance with
statewide minimum standards. The patient care procedures shall
identify the level of medical care personnel to be dispatched to an
emergency scene, procedures for triage of patients, the level of trauma
care facility to first receive the patient, and the name and location
of other trauma care facilities to receive the patient should an
interfacility transfer be necessary. Procedures on interfacility
transfer of patients shall be consistent with the transfer procedures
in chapter 70.170 RCW.
(13) "Emergency medical services medical program director" means a
person who is an approved medical program director as defined by RCW
18.71.205(4).
(14) "Council" means the local or regional emergency medical
services and trauma care council as authorized under chapter 70.168
RCW.
(15) "Basic life support" means noninvasive emergency medical
services requiring basic medical treatment skills as defined in chapter
18.73 RCW.
(16) "Advanced life support" means invasive emergency medical
services requiring advanced medical treatment skills as defined by
chapter 18.71 RCW.
(17) "First responder" means a person who is authorized by the
secretary to render emergency medical care as defined by RCW 18.73.081.
(18) "Stretcher" means a cart designed to serve as a litter for the
transportation of a patient in a prone or supine position as is
commonly used in the ambulance industry, such as wheeled stretchers,
portable stretchers, stair chairs, solid backboards, scoop stretchers,
basket stretchers, or flexible stretchers. The term does not include
personal mobility aids that recline at an angle or remain at a flat
position, that are owned or leased for a period of at least one week by
the individual using the equipment or the individual's guardian or
representative, such as wheelchairs, personal gurneys, or banana carts.
Sec. 4 RCW 18.73.050 and 1990 c 269 s 7 are each amended to read
as follows:
The ((emergency medical services licensing and certification
advisory)) committee shall:
(1) Review all administrative rules pertaining to licensing and
certification of emergency medical services proposed for adoption by
the department under this chapter or under RCW 18.71.205 and advise the
department of its recommendations.
(2) Assist the department, at the department's request, to fulfill
any duty or exercise any power under this chapter pertaining to
emergency medical services licensing and certification.
Sec. 5 RCW 70.168.060 and 1990 c 269 s 8 are each amended to read
as follows:
The department, in consultation with and having solicited the
advice of the emergency medical services and trauma care steering
committee, shall:
(1) Establish the following on a statewide basis:
(a) By September 1990, minimum standards for facility, equipment,
and personnel for level I, II, III, IV, and V trauma care services;
(b) By September 1990, minimum standards for facility, equipment,
and personnel for level I, I-pediatric, II, and III trauma-related
rehabilitative services;
(c) By September 1990, minimum standards for facility, equipment,
and personnel for level I, II, and III pediatric trauma care services;
(d) By September 1990, minimum standards required for verified
prehospital trauma care services, including equipment and personnel;
(e) Personnel training requirements and programs for providers of
trauma care. The department shall design programs which are accessible
to rural providers including on-site training;
(f) Statewide emergency medical services and trauma care system
objectives and priorities;
(g) Minimum standards for the development of facility patient care
protocols and prehospital patient care protocols and patient care
procedures;
(h) By July 1991, minimum standards for an effective emergency
medical communication system;
(i) Minimum standards for an effective emergency medical services
transportation system; and
(j) By July 1991, establish a program for emergency medical
services and trauma care research and development;
(2) Establish statewide standards, personnel training requirements
and programs, system objectives and priorities, protocols and
guidelines as required in subsection (1) of this section, by utilizing
those standards adopted in the report of the Washington trauma advisory
committee as authorized by chapter 183, Laws of 1988. In establishing
standards for level IV or V trauma care services the department may
adopt similar standards adopted for services provided in rural health
care facilities authorized in chapter 70.175 RCW. The department may
modify standards, personnel training requirements and programs, system
objectives and priorities, and guidelines in rule if the department
determines that such modifications are necessary to meet federal and
other state requirements or are essential to allow the department and
others to establish the system or should it determine that public
health considerations or efficiencies in the delivery of emergency
medical services and trauma care warrant such modifications;
(3) Designate emergency medical services and trauma care planning
and service regions as provided for in this chapter;
(4) By July 1, 1992, establish the minimum and maximum number of
hospitals and health care facilities in the state and within each
emergency medical services and trauma care planning and service region
that may provide designated trauma care services based upon approved
regional emergency medical services and trauma care plans;
(5) By July 1, 1991, establish the minimum and maximum number of
prehospital providers in the state and within each emergency medical
services and trauma care planning and service region that may provide
verified trauma care services based upon approved regional emergency
medical services and trauma care plans;
(6) By July 1993, begin the designation of hospitals and health
care facilities to provide designated trauma care services in
accordance with needs identified in the statewide emergency medical
services and trauma care plan;
(7) By July 1990, adopt a format for submission of the regional
plans to the department;
(8) By July 1991, begin the review and approval of regional
emergency medical services and trauma care plans;
(9) By July 1992, prepare regional plans for those regions that do
not submit a regional plan to the department that meets the
requirements of this chapter;
(10) By October 1992, prepare and implement the statewide emergency
medical services and trauma care system plan incorporating the regional
plans;
(11) Coordinate the statewide emergency medical services and trauma
care system to assure integration and smooth operation between the
regions;
(12) ((Facilitate coordination between the emergency medical
services and trauma care steering committee and the emergency medical
services licensing and certification advisory committee;)) Monitor the statewide emergency medical services and trauma
care system;
(13)
(((14))) (13) Conduct a study of all costs, charges, expenses, and
levels of reimbursement associated with providers of trauma care
services, and provide its findings and any recommendations regarding
adequate and equitable reimbursement to trauma care providers to the
legislature by July 1, 1991;
(((15))) (14) Monitor the level of public and private payments made
on behalf of trauma care patients to determine whether health care
providers have been adequately reimbursed for the costs of care
rendered such persons;
(((16))) (15) By July 1991, design and establish the statewide
trauma care registry as authorized in RCW 70.168.090 to (a) assess the
effectiveness of emergency medical services and trauma care delivery,
and (b) modify standards and other system requirements to improve the
provision of emergency medical services and trauma care;
(((17))) (16) By July 1991, develop patient outcome measures to
assess the effectiveness of emergency medical services and trauma care
in the system;
(((18))) (17) By July 1993, develop standards for regional
emergency medical services and trauma care quality assurance programs
required in RCW 70.168.090;
(((19))) (18) Administer funding allocated to the department for
the purpose of creating, maintaining, or enhancing the statewide
emergency medical services and trauma care system; and
(((20))) (19) By October 1990, begin coordination and development
of trauma prevention and education programs.
Sec. 6 RCW 18.135.030 and 1999 c 151 s 201 are each amended to
read as follows:
(1) ((The secretary or the secretary's designee may appoint members
of the health care assistant profession and other health care
practitioners, as defined in RCW 18.135.020(3), to serve in an ad hoc
capacity to assist in carrying out the provisions of this chapter. The
members shall provide advice on matters specifically identified and
requested by the secretary. The members shall be reimbursed for travel
expenses under RCW 43.03.050 and 43.03.060.)) In addition to any other authority provided by law, the
secretary shall adopt rules necessary to:
(2)
(a) Administer, implement, and enforce this chapter;
(b) Establish the minimum requirements necessary for a health care
facility or health care practitioner to certify a health care assistant
capable of performing the functions authorized in this chapter; and
(c) Establish minimum requirements for each and every category of
health care assistant.
(((3))) (2) The rules shall be adopted after fair consideration of
input from representatives of each category. These requirements shall
ensure that the public health and welfare are protected and shall
include, but not be limited to, the following factors:
(a) The education and occupational qualifications for the health
care assistant category;
(b) The work experience for the health care assistant category;
(c) The instruction and training provided for the health care
assistant category; and
(d) The types of drugs or diagnostic agents which may be
administered by injection by health care assistants working in a
hospital or nursing home. The rules established under this subsection
shall not prohibit health care assistants working in a health care
facility other than a nursing home or hospital from performing the
functions authorized under this chapter.
Sec. 7 RCW 43.41.220 and 1994 sp.s. c 9 s 873 are each amended to
read as follows:
(1) The ((governor)) joint legislative audit and review committee
shall conduct a review of all of the boards and commissions identified
under RCW 43.41.230 ((and, by January 8th of every odd-numbered year,))
over a six-year period, and submit to the legislature a report
recommending which boards and commissions should be terminated or
consolidated based upon the criteria set forth in subsection (3) of
this section. The report must state which of the criteria ((were)) the
joint legislative audit and review committee relied upon with respect
to each recommendation. ((The governor shall submit an executive
request bill by January 8th of every odd-numbered year to implement the
recommendations by expressly terminating the appropriate boards and
commissions and by providing for the transfer of duties and obligations
under this section. The governor shall accept and review with special
attention recommendations made, not later than June 1st of each even-numbered year, by the standing committees of the legislature in
determining whether to include any board or commission in the report
and bill required by this section.))
(2) In addition to terminations and consolidations under subsection
(1) of this section, the ((governor)) joint legislative audit and
review committee may recommend the transfer of duties and obligations
from a board or commission to another existing state entity.
(3) ((In preparing his or her report and legislation, the
governor)) The joint legislative audit and review committee shall make
an evaluation based upon answers to the questions set forth in this
subsection. The ((governor)) joint legislative audit and review
committee shall give these criteria priority in the order listed.
(a) Has the mission of the board or commission been completed or
ceased to be critical to effective state government?
(b) ((Does the work of the board or commission directly affect
public safety, welfare, or health)) Is the entity complying with its
legislative intent?
(c) Can the work of the board or commission be effectively done by
another state agency without adverse impact on public safety, welfare,
or health?
(d) ((Will termination of the board or commission have a
significant adverse impact on state revenue because of loss of federal
funds)) Is the entity meeting its performance measures?
(e) Will termination ((of the board or commission save revenues, be
cost neutral, or result in greater expenditures)) or consolidation of
the board or commission result in fiscal or other efficiencies?
(f) Is the work of the board or commission being done by another
board, commission, or state agency?
(g) Could the work of the board or commission be effectively done
by a nonpublic entity?
(h) ((Will termination of the board or commission result in a
significant loss of expertise to state government?)) Could the work of the board or commission be done by an ad
hoc committee?
(i) Will termination of the board or commission result in
operational efficiencies that are other than fiscal in nature?
(j)
Sec. 8 RCW 43.41.230 and 1994 sp.s. c 9 s 874 are each amended to
read as follows:
The boards and commissions to be reviewed by the ((governor)) joint
legislative audit and review committee must be all entities that are
required to be included in the list prepared by the office of financial
management under RCW 43.88.505, other than entities established under:
(1) Constitutional mandate; (2) court order or rule; (3) requirement of
federal law; or (4) requirement as a condition of the state or a local
government receiving federal financial assistance if, in the judgment
of the ((governor)) joint legislative audit and review committee, no
other state agency, board, or commission would satisfy the requirement.
NEW SECTION. Sec. 9 The following acts or parts of acts are each
repealed:
(1) RCW 77.12.690 (Migratory waterfowl art committee -- Duties--Deposit and use of funds -- Audits) and 1998 c 245 s 158, 1998 c 191 s
33, 1987 c 506 s 55, & 1985 c 243 s 6;
(2) RCW 28B.04.085 (Displaced homemaker program advisory committee)
and 2004 c 275 s 32 & 1987 c 230 s 2;
(3) RCW 28B.115.050 (Planning committee -- Criteria for selecting
participants) and 2004 c 275 s 70, 1991 c 332 s 18, & 1989 1st ex.s. c
9 s 719;
(4) RCW 28A.600.130 (Washington scholars' program -- Planning
committee -- Composition -- Duties) and 2006 c 263 s 916, 1995 1st sp.s. c
5 s 1, 1990 c 33 s 500, 1985 c 370 s 33, & 1981 c 54 s 4;
(5) RCW 28B.12.040 (Board to develop and administer program--Agreements authorized, limitation -- Work study advisory committee) and
1994 c 130 s 4, 1993 c 385 s 3, 1985 c 370 s 58, & 1974 ex.s. c 177 s
4;
(6) RCW 70.96A.070 (Citizens advisory council -- Qualifications--Duties -- Rules and policies) and 1994 c 231 s 2, 1989 c 270 s 9, 1973
1st ex.s. c 155 s 1, & 1972 ex.s. c 122 s 7; and
(7) RCW 18.73.040 (Emergency medical services licensing and
certification advisory committee) and 1990 c 269 s 6, 1984 c 279 s 55,
1981 c 338 s 13, 1979 ex.s. c 261 s 2, 1975-'76 2nd ex.s. c 34 s 43, &
1973 1st ex.s. c 208 s 4.
NEW SECTION. Sec. 10 This act takes effect July 1, 2008.