BILL REQ. #:  Z-0811.1 

Read first time 12/01/11.   Referred to Committee on Ways & Means.

     AN ACT Relating to fees for emergency medical service providers; amending RCW 18.71.205, 18.73.081, and 43.70.110; and providing an effective date.

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

Sec. 1   RCW 18.71.205 and 2010 1st sp.s. c 7 s 24 are each amended to read as follows:
     (1) The secretary of the department of health 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; and
     (d) Appropriate certification, recertification, and decertification fees under RCW 43.70.110 for 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 freestanding or nondirected actions, for actions not presenting an emergency or life-threatening condition.

Sec. 2   RCW 18.73.081 and 1993 c 254 s 1 are each amended to read as follows:
     In addition to other duties prescribed by law, the secretary shall:
     (1) Prescribe minimum requirements for:
     (a) Ambulance, air ambulance, and aid vehicles and equipment;
     (b) Ambulance and aid services; and
     (c) Minimum emergency communication equipment;
     (2) Adopt procedures for services that fail to perform in accordance with minimum requirements;
     (3) Prescribe minimum standards for first responder and emergency medical technician training including:
     (a) Adoption of curriculum and period of certification;
     (b) Procedures for certification, recertification, decertification, or modification of certificates;
     (c) Adoption of requirements for ongoing training and evaluation, as approved by the county medical program director, to include appropriate evaluation for individual knowledge and skills. The first responder, emergency medical technician, or emergency medical services provider agency may elect a program of continuing education and a written and practical examination instead of meeting the ongoing training and evaluation requirements;
     (d) Procedures for reciprocity with other states or national certifying agencies;
     (e) Review and approval or disapproval of training programs; and
     (f) Adoption of standards for numbers and qualifications of instructional personnel required for first responder and emergency medical technician training programs;
     (4) Adopt appropriate credentialing fees under RCW 43.70.110 for first responders and emergency medical technicians and ambulance and aid services, vehicles, and equipment;
     (5) Prescribe minimum requirements for liability insurance to be carried by licensed services except that this requirement shall not apply to public bodies; and
     (((5))) (6) Certify emergency medical program directors.

Sec. 3   RCW 43.70.110 and 2011 c 35 s 1 are each amended to read as follows:
     (1) The secretary shall charge fees to the licensee for obtaining a license. Physicians regulated pursuant to chapter 18.71 RCW who reside and practice in Washington and obtain or renew a retired active license are exempt from such fees. ((After June 30, 1995, municipal corporations providing emergency medical care and transportation services pursuant to chapter 18.73 RCW shall be exempt from such fees, provided that such other emergency services shall only be charged for their pro rata share of the cost of licensure and inspection, if appropriate.)) The secretary may waive the fees when, in the discretion of the secretary, the fees would not be in the best interest of public health and safety, or when the fees would be to the financial disadvantage of the state.
     (2) Except as provided in subsection (3) of this section, fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection.
     (3) License fees shall include amounts in addition to the cost of licensure activities in the following circumstances:
     (a) For registered nurses and licensed practical nurses licensed under chapter 18.79 RCW, support of a central nursing resource center as provided in RCW 18.79.202, until June 30, 2013;
     (b) For all health care providers licensed under RCW 18.130.040, the cost of regulatory activities for retired volunteer medical worker licensees as provided in RCW 18.130.360; and
     (c) For physicians licensed under chapter 18.71 RCW, physician assistants licensed under chapter 18.71A RCW, osteopathic physicians licensed under chapter 18.57 RCW, osteopathic physicians' assistants licensed under chapter 18.57A RCW, naturopaths licensed under chapter 18.36A RCW, podiatrists licensed under chapter 18.22 RCW, chiropractors licensed under chapter 18.25 RCW, psychologists licensed under chapter 18.83 RCW, registered nurses licensed under chapter 18.79 RCW, optometrists licensed under chapter 18.53 RCW, mental health counselors licensed under chapter 18.225 RCW, massage therapists licensed under chapter 18.108 RCW, clinical social workers licensed under chapter 18.225 RCW, midwives licensed under chapter 18.50 RCW((;)), licensed marriage and family therapists under chapter 18.225 RCW((;)), and East Asian medicine practitioners licensed under chapter 18.06 RCW, the license fees shall include up to an additional twenty-five dollars to be transferred by the department to the University of Washington for the purposes of RCW 43.70.112.
     (4) Department of health advisory committees may review fees established by the secretary for licenses and comment upon the appropriateness of the level of such fees.

NEW SECTION.  Sec. 4   This act takes effect July 1, 2012.