Washington State
House of Representatives
Office of Program Research
Postsecondary Education & Workforce Committee
E2SSB 5582
Brief Description: Reducing barriers and expanding educational opportunities to increase the supply of nurses in Washington.
Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Holy, Randall, Rivers, Robinson, Dozier, King, Conway, Shewmake, Padden, Lovick, Gildon, Muzzall, Lovelett, Mullet, Nobles, Salda?a, Valdez, Van De Wege, Wellman, Wilson, C. and Wilson, L.).
Brief Summary of Engrossed Second Substitute Bill
  • Directs the State Board for Community and Technical Colleges (College Board) to develop a plan to train more nurses over the next four years.
  • Requires development of an online Licensed Practical Nurse program at two community or technical colleges.
  • Directs the College Board to conduct a nurse educator compensation salary survey.
  • Modifies program approval and training requirements under the Nursing Care Quality Assurance Commission.
  • Modifies the Student Nurse Preceptor Grant Program.
  • Creates a marketing plan to advertise available nurse training opportunities and jobs in Washington.
  • Creates the Home Care Aide to Licensed Practical Nurse Apprenticeship Pathway Pilot Program.
  • Creates a grant program for health science Career and Technical Education programs.
  • Creates at least two High School Student Certified Nursing Assistant Pilot Projects.
Hearing Date: 3/22/23
Staff: Saranda Ross (786-7068)

Registered nurses (RN), licensed practical nurses (LPN), and certified nursing assistants (CNA) continuously rank among the most in-demand careers in Washington with exceptionally long vacancies.  From 2019 to 2021 the average length of time it took to fill an RN vacancy in Washington hospitals increased by 54 percent — from 74 to 114 days.  In 2021 hospitals alone needed 6,100 licensed RNs to fill their open positions.  From 2014-2020, an average of 3,200 qualified nursing program applicants were turned away annually due to insufficient capacity in RN programs.

The Nursing Care Quality Assurance Commission (NCQAC) regulates the nursing profession in Washington by establishing, monitoring, and enforcing licensing, consistent standards of practice, continuing competency mechanisms, and discipline.


The NCQAC is currently making the following efforts to address the nursing workforce demands:

  • operating the LPN apprenticeship program, which is funded by a planning grant provided by the Legislature to NCQAC to implement the program in at least three geographically disparate areas of the state experiencing high levels of long-term care workforce shortages;
  • expanding the nursing workforce in long-term care with funding by the Legislature to continue to implement virtual nursing assistant training and testing modalities, creating an apprenticeship pathway into nursing for nursing assistants, implementing rule changes to support a career path for nursing assistants, and collaborating with the Workforce Training and Education Coordinating Board on a pilot project to transform the culture and practice in long term care settings; and
  • operating the Washington State Student Nurse Preceptor Grant Program, which is currently funded at $3 million annually and funds nurses who precept nursing students in healthcare settings including advanced registered nurse practitioner, RN, and LPN programs.


Skill Centers are regional career and technical education (CTE) instructional venues established and operated by a host school district to provide access to comprehensive, industry-defined CTE programs that prepare high school students for careers, employment, apprenticeships, and postsecondary education.  There are 17 Skill Centers in Washington. About 7,000 students attend Washington Skills Centers from high schools in approximately 85 school districts annually.

Summary of Bill:

Expanding Nursing Credential OpportunitiesState Board for Community and Technical Colleges.  Subject to appropriations, the community and technical colleges must develop a plan to train more nurses over the next four years with an emphasis on shortage areas such as rural communities.  In developing the plan, the State Board for Community and Technical Colleges (College Board) must consult with health care employers, local workforce development councils, and exclusive bargaining representatives of nursing professions.  The plan must prioritize expanding existing programs or creating new ones that:  (a) create new capacity for training, (b) expand training opportunities for rural and underserved students, (c) demonstrate long-term sustainability, and (d) expand partnerships between employers and exclusive bargaining representatives.  A report detailing the plan is due to the Legislature by December 1, 2024.

Subject to appropriations, the College Board must select two community or technical colleges, one on either side of the Cascade Mountains, to develop and implement an online LPN program.  The curriculum may include use of a mobile skills lab or other innovative approaches to serve rural students.

The College Board must contract with a firm that has expertise in human resources consulting and health care to conduct a salary survey on nurse educator compensation.  Results of the survey are due to the Legislature by December 1, 2025.

Workforce Training and Education Coordinating Board.  Subject to appropriations, the Workforce Board must contract with a firm that has expertise in public relations and marketing to develop and execute a marketing plan about available training opportunities and jobs for CNAs, personal care aides, LPNs, licensed vocational nurses, and related nursing professions.  The marketing plan must include targeted outreach to serve workforce needs in rural and underserved communities, as well as long-term care facilities.

The Home Care Aide to Licensed Practical Nurse Apprenticeship Pathway Pilot Program (Pilot Program) is created.  The Pilot Program must be located in three geographically disparate sites during the 2023-2025 fiscal biennium.  The Workforce Board and the NCQAC jointly administers the Pilot Program in consultation with the Department of Labor and Industries.  A report detailing the status of the Pilot Program, options to expand, and barriers faced by current and prospective participants is due to the legislature by August 1, 2025.  

Eliminating Bottlenecks in Nurse TrainingNursing Care Quality Assurance Commission.  The NCQAC is permitted to grant approval to bachelor degrees in nursing programs where the nurse administrator holds a graduate degree with a major in nursing and sufficient experience as an RN but does not hold a doctoral degree.

The NCQAC must count one hour of simulated lab learning as two hours of clinical placement learning up to 50 percent of the required clinical hours for nurse licensure.

Subject to appropriations, the NCQAC must expand the Student Nurse Preceptor Grant Program to provide incentive pay to nursing candidate clinic supervisors with a focus on shortage areas such as rural and underserved communities and long-term care facilities.  Increased clinic opportunities must be achieved, in part, by reducing the required number of qualifying hours of precepting clinical instruction from 100 to 80.  A report on the outcomes of the grant program is due to the Office of Financial Management and the Legislature by September 30, 2025.

Growing Kindergarten through Grade 12 Pathways into Healthcare CredentialsCareer and Technical Education Grant Program.  Subject to appropriations, a competitive grant program to support high school Career and Technical Education programs in starting or expanding offerings in health science programs is created.  The grant program is established and administered by the Office of the Superintendent of Public Instruction, which must consult with the Workforce Board and the Washington State Apprenticeship and Training Council in developing award criteria.  Priority for grants is given to applications that include partnerships between employers and exclusive bargaining representatives as sponsors or cosponsors.  Grant funds may be used to purchase or improve curriculum, add additional staff, upgrade technology and equipment to meet industry standards, and for other purposes intended to initiate a new health science program or improve the rigor and quality of an existing health science program.

High School Certified Nursing Assistant Pilot Projects.  Subject to appropriations, at least two High School Certified Nursing Assitant Pilot Projects (Pilot Projects) are established at rural hospitals on either side of the Cascade Mountains to address the workforce shortages and promote nursing careers in rural hospitals.  The Pilot Projects utilize high school students who are training to become nursing assistant-certified or high school students who are nursing assistant-certified by, in part, providing information about related careers and educational and training opportunities including certified medical assistants, LPNs, and RNs.  The Pilot Projects are established by the NCQAC in collaboration with rural hospitals, relevant employer and exclusive bargaining unit partnerships, nursing assistant-certified training programs, the Department of Health, and the Department of Labor and Industries.  A report on the status of the Pilot Projects is due to the Legislature by December 1, 2024.

Appropriation: The bill contains a section or sections to limit implementation to the availability of amounts appropriated for that specific purpose.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.