Nurse Licensure.
The Nursing Care Quality Assurance Commission (Commission) is the licensing and disciplining authority for registered nurses, advanced registered nurse practitioners, and licensed practical nurses in Washington. Applicants for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse are required to submit a written application, an official transcript demonstrating successful completion of an approved program, and any other official records specified by the Commission.
The Uniform Disciplinary Act governs unlicensed practice, the issuance and denial of licenses, and the discipline of health professionals in Washington, including registered nurses, advanced registered nurse practitioners, and licensed practical nurses.
Temporary Practice Permits.
Under the Uniform Disciplinary Act, the Secretary of the Department of Health (Department) is required to establish requirements for each applicant for an initial license to obtain a state background check through the Washington State Patrol prior to the issuance of any license. The Secretary is required to specify situations where an applicant for an initial license must obtain an electronic fingerprint-based national background check through the Washington State Patrol and the Federal Bureau of Investigation. Situations where a fingerprint-based national background check may be required include instances where an applicant has recently lived out of state or where the applicant has a criminal record in Washington.
If an individual licensed in another state that has licensing standards substantially equivalent to Washington applies for a license, the disciplining authority shall issue a temporary practice permit authorizing the applicant to practice the profession pending completion of documentation that the applicant meets the requirements for a license. The temporary permit may reflect statutory limitations on the scope of practice. The permit may be issued only upon the disciplining authority receiving verification from the states in which the applicant is licensed that the applicant is currently licensed and is not subject to charges or disciplinary action for unprofessional conduct or impairment.
As established by the Department in rule, a temporary practice permit issued by the Commission expires when a license is granted, a notice of decision on application is mailed to the applicant, or 180 days after the temporary practice permit is issued. If, at the expiration of the original temporary practice permit, the Department has not received information from the fingerprint-based national background check, the Commission may renew the temporary practice permit for an additional 180 days.
Reciprocity.
The Department is required to issue a license by endorsement without examination to practice as a registered nurse or as a licensed practical nurse to a person who is licensed as a registered nurse or licensed practical nurse under the laws of another state, and who meets all other qualifications for licensing. Other qualifications for licensing, as set out in rule, include submitting required documents, including a completed licensure application, an official transcript, and a verification of the applicant's original license from the state of original licensure.
Applicants for interstate endorsement as an advanced registered nurse practitioner must comply with additional requirements as set out in rule, including applying for and being granted a registered nurse license.
The Department is required to issue an expedited temporary license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse to a person who:
An expedited temporary license permits a person to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse in Washington, pending the results of the fingerprint-based national background check, to the extent allowed by rules adopted by the Commission and the Department. An expedited temporary license expires after two years or as of the date that the person's authorization issued by the licensing board in California, Idaho, or Oregon expires, whichever is earlier. An expedited temporary license is not renewable.
The substitute bill strikes provisions allowing all out-of-state health care providers to practice in Washington upon submission of certain information by a health care entity to the Department.
The substitute bill requires the Department to issue an expedited temporary license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse to a person who:
The substitute bill establishes that a person who is issued an expedited temporary license may practice pending the results of the fingerprint-based national background check, to the extent allowed by rules adopted by the Commission and the Department.
The substitute bill also establishes that an expedited temporary license is not renewable and expires after two years or as of the date that the person's authorization issued by the licensing board in California, Idaho, or Oregon expires, whichever is earlier.
(In support) There is a severe health care worker shortage in Washington that began before the pandemic. The shortage causes an overflow in emergency rooms and puts strain on nurses. This bill should open up a larger conversation about the shortage, because there needs to be a long-term solution.
(Opposed) The bill raises concerns about liability and discipline, because the out-of-state health care providers would not be subject to the Uniform Disciplinary Act. The bill takes authority away from the Commission. There would be no mechanism for the state to discipline out-of-state health care providers under this bill or for a provider's home state to learn about discipline in Washington. The bill cedes authority to other states and their licensing processes. If the intent of the bill is to address nurses, the bill should be narrowed to only address nurses. Reciprocity and interstate compacts are a better solution. This bill would allow a health care provider to practice beyond their scope of practice as established in Washington.