Subject of Possible Rule Making: New sections in chapter 246-918 WAC, Safe and effective analgesia and anesthesia administration in office-based surgery settings, as it applies to physician assistants. The commission is considering rules regarding requirements for physician assistants who perform surgery in office-based settings.

     Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 18.71A.020 and 18.130.050.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: There are no regulations for surgeries performed in office-based settings by physicians or physician assistants. These rules will [be] on the same subject and coordinated with the physician's rule filed by CR-101 on January 24, 2007 - WSR 07-03-178 regarding the administration of sedation and anesthesia in office-based settings. Physician assistants can also perform minor surgeries in office-based settings and should have the same or similar requirements as physicians. The rules are needed to reduce the risk of substandard care, such as inappropriate anesthesia, unnecessary infections, and serious complications when surgeries are performed [by] physician assistants in an office-based setting. The rules will establish enforceable standards for the commission to take action against a physician assistant if minimum patient safety standards are not met.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The commission will coordinate its rules development with the board of osteopathic medicine and surgery, podiatric medical board and the nursing care quality assurance commission to include certified nurse anesthetists (CRNAs) for both physician and physician assistant rules. The commission will coordinate the physician assistant rules with the physician rules and will be developed and filed concurrently.

     Process for Developing New Rule: Collaborative rule making.

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication. In order for the commission to allow interested persons to provide input on proposed language, there will be public workshops in three areas of the state. The commission will notify via the listserv all those individuals and organizations that have expressed an interest in the commission's rules. Stakeholders may also submit written comments for consideration to Beverly A. Thomas, Program Manager, P.O. Box 47866, Olympia, WA 98504-7866, phone (360) 236-4788, fax (360) 236-4768 or by e-mail to beverly.thomas@doh.wa.gov.

November 20, 2007

Blake T. Maresh

Executive Director

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