Original Notice.

     Preproposal statement of inquiry was filed as WSR 07-17-156.

     Title of Rule and Other Identifying Information: WAC 296-23-241 Can advanced registered nurse practitioners independently perform the functions of an attending provider?

     Pursuant to HB 1666 (chapter 275, Laws of 2007) this rule repeals the sunset of the expansion of duties of advanced reregistered nurse practitioners (ARNP) under Title 51 RCW.

     Hearing Location(s): Department of Labor and Industries, 7273 Linderson Way, Tumwater Building, Room S117, on January 10, 2008, at 10:00 a.m.

     Date of Intended Adoption: January 22, 2008.

     Submit Written Comments to: Jami Lifka, Department of Labor and Industries, P.O. Box 44321, Olympia, WA 98504-4321, e-mail lifk235@lni.wa.gov, fax (360) 902-6315, by January 10, 2008.

     Assistance for Persons with Disabilities: Contact office of information and assistance, by December 31, 2007, TTY (360) 902-5797 or (360) 902-4941.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HB 1666 (chapter 275, Laws of 2007) from the 2007 legislature repealed the sunset of SHB 1691 (Laws of 2004) allowing advanced registered nurse practitioners (ARNPs) to permanently be attending providers. This is currently in effect via an emergency rule filed by the department. This rule making will be to permanently adopt this change in WAC 296-23-241 to establish that ARNPs may be the attending provider but may not rate permanent partial disabilities for workers' compensation purposes.

     Reasons Supporting Proposal: See above.

     Statutory Authority for Adoption: HB 1666 (chapter 275, Laws of 2007), RCW 51.04.020, 51.040.030 [51.04.030].

     Statute Being Implemented: HB 1666 (chapter 275, Laws of 2007).

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: , governmental.

     Name of Agency Personnel Responsible for Drafting: Jami Lifka, 7273 Linderson, Tumwater, WA, (360) 902-4941; Implementation: Gary Franklin, MD, MPH, Medical Director, (360) 902-5020; and Enforcement: Robert Malooly, Assistant Director of Insurance Services, (360) 902-4209.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule making is exempt under RCW 19.85.025(3), referring to RCW 34.05.310(4), namely RCW 34.05310 [34.05.310] (4)(b), (c), (d) and (e), because it adopts and implements HB 1666 (chapter 275, Laws of 2007) and otherwise clarifies language in the amended rules without changing its effect as a result of the change in law.

     A cost-benefit analysis is not required under RCW 34.05.328. This rule making is exempt under RCW 34.05.328 (5)(b)(iii), (iv) and (v) because it adopts and implements HB 1666 (chapter 275, Laws of 2007) without changing its effect as a result of the change in law.

December 4, 2007

Judy Schurke

Director

OTS-9732.3

AMENDATORY SECTION(Amending WSR 04-22-085, filed 11/2/04, effective 12/15/04)

WAC 296-23-241   Can advanced registered nurse practitioners independently perform the functions of an attending ((physician)) provider?   (1) Advanced registered nurse practitioners (ARNPs) may ((for the period of July 1, 2004, through June 30, 2007,)) independently perform the functions of an attending ((physician)) provider under the Industrial Insurance Act, with the exception of rating permanent impairment. These functions are referenced in the medical aid rules as those of ((a physician, attending physician, or attending doctor)) an attending or treating provider, and include, but are not limited to:

     • Completing and signing the report of accident or physician's initial report, where applicable;

     • Certifying time-loss compensation;

     • Completing and submitting all required or requested reports;

     • Referring workers for consultations;

     • Performing consultations;

     • Facilitating early return to work offered by and performed for the employer(s) of record;

     • Doing all that is possible to expedite the vocational process, including making an estimate of the worker's physical or mental capacities that affect the worker's employability.

     ARNPs can state whether a worker has permanent impairment, such as on the department's ((physician's final report (PFR))) activity prescription form (APF).

     ((ARNPs)) (2) Advanced registered nurse practitioners cannot:

     • Rate permanent impairment; or

     • Perform independent medical examinations (IMEs).

     ((WAC 296-23-241 expires on June 30, 2007.))

[Statutory Authority: 2004 c 65 and 2004 c 163. 04-22-085, § 296-23-241, filed 11/2/04, effective 12/15/04.]

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