H-0670.1

HOUSE BILL 1567

ByRepresentatives Stonier, Fosse, Salahuddin, Macri, Mena, Berry, Obras, Taylor, Reed, Stearns, Nance, Gregerson, Ortiz-Self, Hill, Scott, Farivar, Peterson, Ryu, Parshley, Cortes, Simmons, Ormsby, Doglio, and Pollet

AN ACT Relating to licensure of health care administrators; reenacting and amending RCW 18.130.040; and adding a new chapter to Title 18 RCW.

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

(1) "Department" means the department of health.

(2) "Health care administrator" means a person employed by a hospital who is a:

(a) Nonclinical hospital manager with direct supervisory authority over clinical health care providers who is responsible for one or more of the following activities:

(i) Hiring, scheduling, evaluating, and providing direct supervision of clinical health care providers;

(ii) Monitoring activities for compliance with state or federal regulatory requirements; or

(iii) Developing fiscal reports for clinical units or the hospital as a whole; or

(b) Nonclinical hospital director, officer, or executive who does not have direct supervisory authority over health care providers, but has direct or indirect supervisory authority for nonclinical hospital managers described in (a) of this subsection, for one or more of the following activities:

(i) Hiring and supervising those nonclinical hospital managers in (a) of this subsection;

(ii) Providing oversight of operations for the hospital or any of its departments;

(iii) Developing policies and procedures establishing the standards of patient care;

(iv) Providing oversight of budgetary and financial decisions related to operations and the delivery of patient care for the hospital or any of its departments; and

(v) Ensuring that hospital policies comply with state and federal regulatory requirements.

(3) "Hospital" means a hospital licensed under chapter 70.41 RCW or a psychiatric hospital licensed under chapter 71.12 RCW.

(4) "Secretary" means the secretary of the department.

(1) Adopt rules under chapter 34.05 RCW necessary to implement this chapter;

(2) Establish all initial licensing and renewal fees for health care administrators in accordance with RCW 43.70.110 and 43.70.250;

(3) Establish forms and procedures necessary to administer this chapter;

(4) Issue licenses to applicants who have met the requirements for obtaining an initial license or renewal license, as established under section 5 or 6 of this act, and to deny a license to applicants who do not meet the requirements;

(5) Establish and administer requirements for continuing education necessary for renewal of a license;

(6) Establish practice parameters consistent with the definition of the health care administration activities;

(7) Prepare, grade, and administer, or supervise the grading and administration of written examinations for obtaining a license;

(8) Conduct audits of hospitals for the purpose of determining the compliance of licensed health care administrators with this chapter; and

(9) Adopt rules implementing continuing education requirements.

(1) Successful completion of an approved examination that addresses the topics identified in section 7 of this act;

(2) Completion of an application form with necessary information to allow for appropriate licensing of the applicant, including information about the applicant's employer and the types of health care administration activities that the applicant performs and requires licensure;

(3) Payment of the appropriate fee determined by the secretary under RCW 43.70.250; and

(4) Completion of other requirements established by the secretary.

(2) The date and location of examinations must be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for obtaining a license must be scheduled for the next examination following the filing of the application. The secretary shall establish by rule the examination application deadline.

(3) The secretary or the secretary's designees shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice, as applicable. The examinations must be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(4) The examination papers, all grading of the papers, and the grading of any practical work shall be preserved for a period of not less than one year after the secretary has made and published the decisions. All examinations must be conducted under fair and wholly impartial methods.

(5) Any applicant failing to make the required grade in the first examination may take up to three subsequent examinations as the applicant desires upon prepaying a fee determined by the secretary under RCW 43.70.250 for each subsequent examination. Upon failing four examinations, the secretary may invalidate the original application and require remedial education before the person may take future examinations.

(2) In addition to those acts described in RCW 18.130.180, the term "unprofessional conduct," as applied to health care administrators, includes:

(a) Fiscal or operational decisions which result in injury to a patient or create an unreasonable risk that a patient may be harmed;

(b) A violation by a licensed health care provider of a state or federal statute or administrative rule regulating a profession, as provided in RCW 18.130.180(7), when the licensed health care administrator was responsible for the oversight of the licensed health care provider;

(c) Aiding or abetting a licensed health care provider to practice their health care profession after a patient complaint or adverse event has been reported to the hospital employing the licensed health care administrator, the department, or the appropriate disciplining authority, while the complaint or adverse event is being investigated, and if harm, disability, or death of a patient occurred after the complaint or report of the adverse event;

(d) Failure to adequately supervise licensed clinical staff and nonclinical staff to the extent that a consumer's health or safety is at risk;

(e) Any administrative, operational, or fiscal decision that impedes a clinical licensed health care provider from adhering to standards of practice or leads to patient harm, disability, or death; and

(f) Fiscal or operational decisions resulting in the inability of clinical licensed health care providers to practice with reasonable skill and safety, regardless of the occurrence of patient harm, disability, or death.

(3) When issuing sanctions under RCW 18.130.160, the disciplining authority shall give consideration to the extent to which the licensed health care administrator who is the subject of the disciplinary matter had the ability to exercise control within the hospital's operational structure regulating the policies and financial decisions that resulted in the act of unprofessional conduct. As appropriate, the disciplining authority may consider it to be a mitigating factor if a licensed health care administrator had limited authority or discretion to act regarding hospital policies and financial decisions.

Sec. 9. RCW 18.130.040 and 2024 c 362 s 8, 2024 c 217 s 7, and 2024 c 50 s 5 are each reenacted and amended to read as follows:

(1) This chapter applies only to the secretary and the boards and commissions having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.

(2)(a) The secretary has authority under this chapter in relation to the following professions:

(i) Dispensing opticians licensed and designated apprentices under chapter 18.34 RCW;

(ii) Midwives licensed under chapter 18.50 RCW;

(iii) Ocularists licensed under chapter 18.55 RCW;

(iv) Massage therapists and businesses licensed under chapter 18.108 RCW;

(v) Dental hygienists licensed under chapter 18.29 RCW;

(vi) Acupuncturists or acupuncture and Eastern medicine practitioners licensed under chapter 18.06 RCW;

(vii) Radiologic technologists certified and X-ray technicians registered under chapter 18.84 RCW;

(viii) Respiratory care practitioners licensed under chapter 18.89 RCW;

(ix) Hypnotherapists registered, agency affiliated counselors registered, certified, or licensed, and advisors and counselors certified under chapter 18.19 RCW;

(x) Persons licensed as mental health counselors, mental health counselor associates, marriage and family therapists, marriage and family therapist associates, social workers, social work associates—advanced, and social work associates—independent clinical under chapter 18.225 RCW;

(xi) Persons registered as nursing pool operators under chapter 18.52C RCW;

(xii) Nursing assistants registered or certified or medication assistants endorsed under chapter 18.88A RCW;

(xiii) Dietitians and nutritionists certified under chapter 18.138 RCW;

(xiv) Substance use disorder professionals, substance use disorder professional trainees, or co-occurring disorder specialists certified under chapter 18.205 RCW;

(xv) Sex offender treatment providers and certified affiliate sex offender treatment providers certified under chapter 18.155 RCW;

(xvi) Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;

(xvii) Orthotists and prosthetists licensed under chapter 18.200 RCW;

(xviii) Surgical technologists registered under chapter 18.215 RCW;

(xix) Recreational therapists under chapter 18.230 RCW;

(xx) Animal massage therapists certified under chapter 18.240 RCW;

(xxi) Athletic trainers licensed under chapter 18.250 RCW;

(xxii) Home care aides certified under chapter 18.88B RCW;

(xxiii) Genetic counselors licensed under chapter 18.290 RCW;

(xxiv) Reflexologists certified under chapter 18.108 RCW;

(xxv) Medical assistants-certified, medical assistants-hemodialysis technician, medical assistants-phlebotomist, forensic phlebotomist, medical assistant-EMT, and medical assistants-registered certified and registered under chapter 18.360 RCW;

(xxvi) Behavior analysts, assistant behavior analysts, and behavior technicians under chapter 18.380 RCW;

(xxvii) Birth doulas certified under chapter 18.47 RCW;

(xxviii) Music therapists licensed under chapter 18.233 RCW;

(xxix) Behavioral health support specialists certified under chapter 18.227 RCW; ((and))

(xxx) Certified peer specialists and certified peer specialist trainees under chapter 18.420 RCW; and

(xxxi) Licensed health care administrators under chapter 18.--- RCW (the new chapter created in section 10 of this act).

(b) The boards and commissions having authority under this chapter are as follows:

(i) The podiatric medical board as established in chapter 18.22 RCW;

(ii) The chiropractic quality assurance commission as established in chapter 18.25 RCW;

(iii) The dental quality assurance commission as established in chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW, licenses and registrations issued under chapter 18.260 RCW, licenses issued under chapter 18.265 RCW, and certifications issued under chapter 18.350 RCW;

(iv) The board of hearing and speech as established in chapter 18.35 RCW;

(v) The board of examiners for nursing home administrators as established in chapter 18.52 RCW;

(vi) The optometry board as established in chapter 18.54 RCW governing licenses issued under chapter 18.53 RCW;

(vii) The board of osteopathic medicine and surgery as established in chapter 18.57 RCW governing licenses issued under chapter 18.57 RCW;

(viii) The pharmacy quality assurance commission as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;

(ix) The Washington medical commission as established in chapter 18.71 RCW governing licenses and registrations issued under chapters 18.71, 18.71A, and 18.71D RCW;

(x) The board of physical therapy as established in chapter 18.74 RCW;

(xi) The board of occupational therapy practice as established in chapter 18.59 RCW;

(xii) The board of nursing as established in chapter 18.79 RCW governing licenses and registrations issued under that chapter and under chapter 18.80 RCW;

(xiii) The examining board of psychology and its disciplinary committee as established in chapter 18.83 RCW;

(xiv) The veterinary board of governors as established in chapter 18.92 RCW;

(xv) The board of naturopathy established in chapter 18.36A RCW, governing licenses and certifications issued under that chapter; and

(xvi) The board of denturists established in chapter 18.30 RCW.

(3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses. The disciplining authority may also grant a license subject to conditions, which must be in compliance with chapter 18.415 RCW.

(4) All disciplining authorities shall adopt procedures to ensure substantially consistent application of this chapter, the uniform disciplinary act, among the disciplining authorities listed in subsection (2) of this section.

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