PROPOSED RULES
Original Notice.
Preproposal statement of inquiry was filed as WSR 97-17-016.
Title of Rule: Uniform procedures for complaint resolution.
Purpose: These rules establish time periods for initial assessment, investigation, charging, discovery, settlement and adjudication of complaints against credentialed health care providers and applicants for credentials. The rules also provide for management oversight and oversight by the presiding officer as enforcement mechanisms for the time periods.
Other Identifying Information: WAC 246-14-010, 246-14-020, 246-14-030, 246-14-040, 246-14-050, 246-14-060, 246-14-070, 246-14-080, 246-14-090, 246-14-100, 246-14-110, and 246-14-120.
Statutory Authority for Adoption: RCW 18.130.095(1).
Statute Being Implemented: RCW 18.130.095(1).
Summary: These rules establish basic time periods within which the steps of complaint review, investigation, disposition, and adjudication must occur. If good cause exists, the time periods may be extended by department management prior to a statement of charges being issued. The presiding officer may continue the adjudication process after a statement of charges has been issued. If an extension or continuance is granted, the person granting more time imposes and maintains heightened oversight of the case.
Reasons Supporting Proposal: These rules assure that complaints will be promptly addressed and resolved, while assuring appropriate scrutiny of the matter.
Name of Agency Personnel Responsible for Drafting: Margaret Gilbert, Staff Attorney, 1300 S.E. Quince Street, Olympia, (360) 236-4913; Implementation and Enforcement: Sue Shoblom, Acting Director, 1300 S.E. Quince Street, Olympia, (360) 236-4995.
Name of Proponent: Department of Health, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: These rules fulfill the mandate of RCW 18.130.095(1) to establish time periods for completion of initial assessment, investigation, charging and adjudication of complaints. The rules establish basic time periods within which the steps of the process must be completed. The basic time periods can be extended for good cause. If a time period is extended, the case is given heightened management oversight.
The rules are anticipated to assure timely resolution of complaints against credential health care providers and applicants for credentials by tracking progress of the complaint through the steps of initial assessment, investigation, charging and adjudication.
Proposal does not change existing rules. These are new rules.
A small business economic impact statement has been prepared under chapter 19.85 RCW.
A copy of the statement may be obtained by writing to Becky Egolf, Department of Health, P.O. Box 47860, Olympia, WA 98504-7860, phone (360) 236-4983, fax (360) 753-0657.
RCW 34.05.328 does not apply to this rule adoption. These rules do not subject a violator to a penalty, they do not create a qualification for a license, and they do not make a significant amendment to a program.
Hearing Location: First Floor Conference Room, 1102 S.E. Quince Street, Olympia, WA, on January 5, 2000, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Becky Egolf by December 29, 1999, TDD (800) 833-6388, or (360) 236-4983.
Submit Written Comments to: Margaret Gilbert, fax (360) 236-4930, by December 29, 1999.
Date of Intended Adoption: January 6, 2000.
November 1, 1999
Eric Slagle
for Mary C. Selecky
Secretary
OTS-3397.2
UNIFORM PROCEDURES FOR COMPLAINT RESOLUTION
These rules establish basic time periods for processing and resolving complaints against credentialed health care providers and applicants. The rules also provide for extensions of the basic time periods and enforcement mechanisms to ensure timely disposition of complaints and adjudicative proceedings. The department of health does not anticipate that the basic time period will be used in all cases. These rules are adopted as required by RCW 18.130.095(1). The intent is to promote timely protection of the public and fairness to credential holders, applicants, and complainants, without sacrificing public safety.
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(1) A "report" is information received by the department of health which raises concern about conduct, acts or conditions related to a credential holder or applicant or about the credential holder or applicant's ability to practice with reasonable skill and safety. If the disciplining authority determines a report warrants an investigation, the report becomes a "complaint."
(2) Basic time periods may be extended for "good cause." Good cause is determined on a case-by-case basis, balancing all relevant factors. Some examples of relevant factors may be circumstances not within the control of the department or the disciplining authority, need for expert review not available within the department or the disciplining authority, and activities which cannot be completed within the time period despite effort to do so.
(3) "Days" are calendar days unless indicated. If a time period would end on a Saturday, Sunday, or state holiday, that time period will end on the next business day.
(4) "Management oversight" is enhanced direction of a case imposed by department management as an enforcement mechanism when an extension is granted. The person granting the extension will assure the case moves through the stage promptly. Some examples of enhanced direction may be staffing changes, resource reallocation, and work planning.
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If a basic time period expires, the case cannot continue in its current stage unless an extension is granted. Department staff and a board or commission member, if applicable, are responsible for seeking an extension or moving the case to another stage. Extensions may be granted retroactively for good cause, but such extensions must meet all otherwise applicable criteria.
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(1) Initial assessment is the process of determining whether a report warrants an investigation and becomes a complaint. The complainant and credential holder or applicant will be notified as soon as possible after the initial assessment is complete.
(2) For the first year these rules are effective, the basic time period for initial assessment is twenty-one days. After one year, the basic time period for initial assessment is fourteen days.
(3) All reports will be reviewed for imminent danger within two working days. If imminent danger is identified, the report will be immediately forwarded for processing.
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(1) Investigation is the process of gathering information which examines the complaint and the situation surrounding the complaint.
(2) The basic time period for investigation is one hundred seventy days.
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(1) Case disposition is the process of deciding whether to issue a statement of charges on a complaint, to take informal action, or to close the complaint without action. It includes the processes necessary to implement the decision.
(2) The basic time period for case disposition is one hundred forty days.
(3) If a complaint returns to the case disposition stage because a stipulation to informal disposition has been rejected, there is a new basic period of sixty days.
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(1) If good cause exists, limited extensions of the basic time periods may be granted by the executive director of the program for initial assessment, investigation, and case disposition stages. Each first and second limited extension may be granted only one time for each report or complaint.
(2) The maximum lengths for limited extensions are
| Stage | First extension |
Second extension |
| Initial assessment | 7 days | none |
| Investigation | 30 days | 60 days |
| Case disposition decision | 20 days | 40 days |
| Case disposition decision if informal disposition is rejected | 7 days | 7 days |
(4) Requests for limited extensions must be submitted to the assigned executive director. The reason(s) for the request and for the decision will be documented in the file.
(5) If a limited extension is granted, the executive director will take appropriate steps to supervise the work through the extension period.
(6) If a request for limited extension is denied, the denial may be appealed to the director.
(7) If department staff believe a limited extension will not be sufficient to complete a particular stage, an extension with management oversight may be requested.
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(1) If good cause exists, the division director or the assistant secretary may grant extensions with management oversight. Extensions with oversight may be requested for the initial assessment, investigation, and case disposition stages. There is no maximum length for an extension with management oversight, but the time granted must be based on the request.
(2) A request for extension with management oversight should document the reason(s) for the request. If the disciplining authority is a board or commission, the member of the board or commission assigned to review the case may make recommendations. Those recommendations will be included in the request for extension and given consideration by the division director or assistant secretary. If the recommendation is based on professional expertise, it will be given substantial deference.
(3) Requests for an extension with management oversight must be submitted to the division director or the assistant secretary. The reason(s) for the request and the decision will be documented in the file.
(4) If an extension with oversight is granted, the division director or assistant secretary will impose management oversight to assure that there is a plan for progress in the case and that progress is actually being made. Time limits may be imposed and progress reports may be required.
(5) If a request for extension with oversight is denied, the decision may be appealed to the secretary.
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(1) Procedures for adjudication of statements of charges are contained in chapters 246-10 and 246-11 WAC. Those rules provide for twenty days to file an answer, with a sixty-day extension for good cause, and thirty days to issue a scheduling order. They also provide for continuances.
(2) The basic time period for settlement, discovery, and commencement of hearing is one hundred eighty days or less, to be set in the scheduling order.
(3) The basic time period for issuing an order is forty-five days from the end of the hearing. The secretary may grant a forty-five day limited extension.
(4) If no answer is filed or default occurs during the adjudication, a proposed final order of default will be submitted to the disciplining authority within sixty days of notice of failure to respond or notice of default. A final order will be issued within forty-five days of the submission.
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(1) If a statement of allegations is issued, the respondent will have fourteen days to make an initial response. The attorney handling the case for the program may grant a limited extension of fourteen days. If no response is made, the attorney may determine informal disposition has been rejected. The case will be returned to case disposition.
(2) If a response is made, the basic period for completion of informal resolution is sixty days. If informal resolution has not been reached within that time, the case will return to case disposition to determine appropriate action.
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If a case returns to a prior stage, any unused basic time period days or extensions in the prior stage may be used. If additional time is needed, extensions may be requested as in any other circumstance.
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(1) Affected credential holders, applicants, and complainants will be notified of applicable time periods and the possibility of extensions as soon as possible consistent with effective case management.
(2) Other information about applicable time periods and extensions will be released according to public records law.
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