BP BHEAD INT S

AN ACT Relating to the restructuring of boards, committees, commissions, and councils; amending RCW 18.25.005, 18.25.006, 18.25.019, 18.25.020, 18.25.025, 18.25.030, 18.25.035, 18.25.040, 18.25.070, 18.25.075, 18.25.180, 18.25.190, 18.32.010, 18.32.030, 18.32.040, 18.32.050, 18.32.100, 18.32.120, 18.32.160, 18.32.180, 18.32.190, 18.32.195, 18.32.215, 18.32.534, 18.32.640, 18.32.655, 18.32.665, 18.32.745, 18.32.755, 18.71.010, 18.71.017, 18.71.019, 18.71.050, 18.71.051, 18.71.055, 18.71.060, 18.71.070, 18.71.085, 18.71.090, 18.71.095, 18.71.205, 18.71.230, 18.71A.010, 18.71A.020, 18.71A.030, 18.71A.040, 18.71A.045, 18.71A.050, 18.71A.060, 18.71A.085, 18.72.155, 18.72.165, 18.72.265, 18.72.301, 18.72.306, 18.72.311, 18.72.316, 18.72.340, 18.72.345, 18.19.070, 18.06.080, 18.84.020, 18.84.040, 18.84.070, 18.84.090, 18.84.110, 18.89.020, 18.89.050, 18.89.080, 18.135.030, 18.138.070, 18.130.010, 18.130.020, 18.130.040, 18.130.300, 4.24.260, 4.24.290, 5.62.010, 18.32.030, 18.50.032, 18.50.040, 18.50.140, 18.50.115, 18.88A.020, 18.88A.030, 18.88A.060, 18.88A.080, 18.88A.085, 18.88A.090, 18.88A.130, 18.89.040, 18.100.140, 18.120.020, 18.135.020, 28A.210.260, 28A.210.280, 28A.210.290, 28C.10.030, 35.21.692, 35A.82.025, 36.32.122, 41.05.075, 41.05.180, 42.17.316, 43.70.220, 48.20.393, 48.20.411, 48.21.141, 48.21.225, 48.44.026, 48.44.290, 48.44.325, 48.46.275, 50.04.223, 69.41.030, 69.45.010, 69.50.101, 69.50.402, 70.02.030, 70.41.200, 70.41.210, 70.41.230, 70.127.250, 70.180.030, 71.24.025, 74.09.290, 74.42.010, 74.42.230, 74.42.240, 74.42.380, 74.46.020, 41.04.395, 43.19.558, 43.19.554, 70.148.030, 70.175.030, 78.52.010, 78.52.025, 78.52.030, 78.52.031, 78.52.032, 78.52.033, 78.52.035, 78.52.037, 78.52.040, 78.52.050, 78.52.070, 78.52.100, 78.52.120, 78.52.125, 78.52.140, 78.52.150, 78.52.155, 78.52.200, 78.52.205, 78.52.210, 78.52.220, 78.52.230, 78.52.240, 78.52.245, 78.52.250, 78.52.257, 78.52.260, 78.52.270, 78.52.280, 78.52.290, 78.52.300, 78.52.310, 78.52.320, 78.52.330, 78.52.335, 78.52.365, 78.52.460, 78.52.463, 78.52.467, 78.52.470, 78.52.480, 78.52.490, 78.52.530, 78.52.540, 90.48.366, and 90.54.190; reenacting and amending RCW 18.71.015, 18.71.030, 18.71.080, 18.71.030, 18.88A.100, 69.41.010, 71.05.210, and 75.30.050; adding new sections to chapter 18.25 RCW; adding new sections to chapter 18.32 RCW; adding new sections to chapter 18.71 RCW; adding a new section to chapter 75.30 RCW; adding new sections to chapter 88.46 RCW; creating new sections; adding new chapters to Title 18 RCW; recodifying RCW 18.25.130, 18.25.140, 18.25.150, 18.25.160, 18.25.170, 18.72.155, 18.72.165, 18.72.265, 18.72.301, 18.72.306, 18.72.311, 18.72.316, 18.72.340, 18.72.345, 18.72.010, and 18.72.321; repealing RCW 18.22.005, 18.22.010, 18.22.013, 18.22.014, 18.22.015, 18.22.018, 18.22.021, 18.22.025, 18.22.035, 18.22.040, 18.22.045, 18.22.060, 18.22.082, 18.22.083, 18.22.110, 18.22.120, 18.22.125, 18.22.191, 18.22.210, 18.22.220, 18.22.230, 18.22.900, 18.22.910, 18.22.911, 18.22.950, 18.36.035, 18.36A.010, 18.36A.020, 18.36A.030, 18.36A.040, 18.36A.050, 18.36A.060, 18.36A.070, 18.36A.080, 18.36A.090, 18.36A.100, 18.36A.110, 18.36A.120, 18.36A.130, 18.36A.140, 18.36A.900, 18.36A.901, 18.57.001, 18.57.003, 18.57.005, 18.57.011, 18.57.020, 18.57.031, 18.57.035, 18.57.040, 18.57.045, 18.57.050, 18.57.080, 18.57.130, 18.57.140, 18.57.145, 18.57.150, 18.57.160, 18.57.174, 18.57.245, 18.57.900, 18.57.910, 18.57.915, 18.57A.010, 18.57A.020, 18.57A.025, 18.57A.030, 18.57A.040, 18.57A.050, 18.57A.060, 18.57A.070, 18.25.015, 18.25.016, 18.25.017, 18.25.120, 18.26.010, 18.26.020, 18.26.028, 18.26.030, 18.26.040, 18.26.050, 18.26.060, 18.26.070, 18.26.080, 18.26.090, 18.26.110, 18.26.320, 18.26.330, 18.26.340, 18.26.350, 18.26.360, 18.26.370, 18.26.380, 18.26.390, 18.26.900, 18.32.035, 18.32.037, 18.32.042, 18.32.500, 18.32.510, 18.32.520, 18.32.560, 18.32.570, 18.32.580, 18.32.590, 18.32.600, 18.32.610, 18.32.620, 18.34.010, 18.34.020, 18.34.030, 18.34.050, 18.34.060, 18.34.070, 18.34.080, 18.34.110, 18.34.115, 18.34.120, 18.34.136, 18.34.141, 18.34.900, 18.53.005, 18.53.010, 18.53.021, 18.53.030, 18.53.035, 18.53.040, 18.53.050, 18.53.055, 18.53.060, 18.53.070, 18.53.100, 18.53.101, 18.53.140, 18.53.145, 18.53.150, 18.53.160, 18.53.165, 18.53.170, 18.53.175, 18.53.180, 18.53.185, 18.53.190, 18.53.200, 18.53.900, 18.53.901, 18.53.910, 18.53.911, 18.53.912, 18.53.920, 18.54.010, 18.54.020, 18.54.030, 18.54.040, 18.54.050, 18.54.060, 18.54.070, 18.54.076, 18.54.090, 18.54.130, 18.54.140, 18.54.150, 18.54.900, 18.54.910, 18.54.920, 18.72.020, 18.72.045, 18.72.090, 18.72.100, 18.72.110, 18.72.120, 18.72.130, 18.72.150, 18.72.154, 18.72.190, 18.72.380, 18.72.390, 18.72.400, 18.72.900, 18.72.910, 18.78.005, 18.78.010, 18.78.020, 18.78.030, 18.78.040, 18.78.050, 18.78.054, 18.78.055, 18.78.058, 18.78.060, 18.78.070, 18.78.072, 18.78.080, 18.78.090, 18.78.100, 18.78.160, 18.78.182, 18.78.225, 18.78.900, 18.78.901, 18.88.010, 18.88.020, 18.88.030, 18.88.050, 18.88.060, 18.88.070, 18.88.080, 18.88.086, 18.88.090, 18.88.100, 18.88.110, 18.88.120, 18.88.130, 18.88.140, 18.88.150, 18.88.160, 18.88.170, 18.88.175, 18.88.190, 18.88.200, 18.88.220, 18.88.270, 18.88.280, 18.88.285, 18.88.290, 18.88.295, 18.88.300, 18.88.900, 18.88A.070, 18.59.010, 18.59.020, 18.59.031, 18.59.040, 18.59.050, 18.59.060, 18.59.070, 18.59.080, 18.59.090, 18.59.100, 18.59.110, 18.59.120, 18.59.130, 18.59.141, 18.59.150, 18.59.900, 18.59.905, 18.74.005, 18.74.010, 18.74.012, 18.74.015, 18.74.020, 18.74.023, 18.74.025, 18.74.027, 18.74.029, 18.74.030, 18.74.035, 18.74.040, 18.74.050, 18.74.060, 18.74.065, 18.74.070, 18.74.075, 18.74.085, 18.74.090, 18.74.095, 18.74.120, 18.74.125, 18.74.130, 18.74.135, 18.74.140, 18.74.900, 18.74.910, 18.74.911, 18.06.170, 18.84.060, 18.89.070, 18.138.080, 18.85.500, 27.34.030, 27.34.040, 27.34.050, 43.19.1902, 43.19.556, 43.21A.170, 43.21A.180, 43.21A.190, 43.21A.200, 43.21A.210, 43.200.050, 43.230.010, 43.230.020, 43.230.030, 43.230.040, 48.17.135, 49.70.120, 49.70.130, 67.34.011, 67.34.021, 70.94.039, 73.40.020, 73.40.050, 78.52.020, 88.44.005, 88.44.010, 88.44.020, 88.44.030, 88.44.040, 88.44.080, 88.44.090, 88.44.100, 88.44.110, 88.44.120, 88.44.130, 88.44.140, 88.44.150, 88.44.160, 88.44.170, 88.44.180, 88.44.190, 88.44.200, 88.44.210, 88.44.220, 88.44.900, 88.44.901, 88.46.110, and 90.56.450; repealing 1984 c 286 s 13 (uncodified); and prescribing penalties.

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

ALLIED PHYSICIANS

NEW SECTION. Sec. 101. LEGISLATIVE FINDING‑-PURPOSE. The legislature finds that the conduct of podiatric physicians and surgeons, osteopathic physicians and surgeons, osteopathic physician assistants, and naturopathic physicians licensed to practice in this state plays a vital role in preserving the public health and well-being. The purpose of this chapter is to establish an effective public agency to regulate the practice of these professions for the protection and promotion of the public health, safety, and welfare and to act as a disciplinary body for the licensed podiatric and osteopathic physicians and surgeons and osteopathic physician assistants of this state and to ensure that only individuals who meet and maintain minimum standards of competence and conduct may obtain a license to provide these services to the public. It is the legislature's intent that the secretary of health will act as the disciplinary authority for naturopathic physicians licensed in this state.

It is the purpose of the commission established under section 103 of this act to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state.

NEW SECTION. Sec. 102. DEFINITIONS. As used in this chapter, the following terms have the meanings indicated unless the context clearly requires otherwise.

(1) "Podiatric physician and surgeon" means an individual licensed under this chapter for the diagnosis and the medical, surgical, mechanical, manipulative, and electrical treatment of ailments of the human foot.

(2) "Osteopathic physician and surgeon" means an individual licensed under this chapter for the use of any and all methods in the treatment of disease, injuries, deformities, and all other physical and mental conditions in and of human beings, including the use of osteopathic manipulative therapy. The term means the same as "osteopathy and surgery."

(3) "Osteopathic physician assistant" means a person who has satisfactorily completed a commission-approved training program designed to prepare persons to practice osteopathic medicine to a limited extent. "Practice medicine" has the meaning defined in subsection (2) of this section.

(4) "Naturopathic physician" or "naturopath" means an individual licensed under this chapter to practice the art and science of diagnosis, prevention, and treatment of disorders of the body by stimulation or support, or both, of the natural processes of the human body. The practice of naturopathic medicine includes manual manipulation (mechanotherapy), the prescription, administration, dispensing, and use, except for the treatment of malignancies or neoplastic disease, of nutrition and food science, physical modalities, homeopathy, certain medicines of mineral, animal, and botanical origin, hygiene, immunization, common diagnostic procedures, and suggestion; however, nothing in this chapter prohibits consultation and treatment of a patient in concert with a physician licensed under this chapter or chapter 18.-- RCW (sections 101 through 144 of this act).

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

(6) "Secretary" means the secretary of health or the secretary's designee.

(7) "Commission" means the Washington state allied physician quality assurance commission.

(8) "Allied physician" means an individual licensed under this chapter as either a podiatric physician and surgeon, an osteopathic physician and surgeon, an osteopathic physician assistant, or a naturopathic physician.

NEW SECTION. Sec. 103. COMMISSION ESTABLISHED‑-MEMBERS APPOINTED. The Washington state allied physicians quality assurance commission is established, consisting of eleven members each appointed by the governor to a four-year term. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, members of the previous boards and committees regulating these professions be appointed to the commission. Members of the commission hold office until their successors are appointed. Members of the initial commission may be appointed to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms.

NEW SECTION. Sec. 104. COMMISSION‑-REMOVAL OF MEMBERS‑-VACANCIES. The governor may remove a member of the commission for neglect of duty, misconduct, or malfeasance or misfeasance in office. Whenever the governor is satisfied that a member of the commission has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement to fill the remainder of the unexpired term.

NEW SECTION. Sec. 105. COMMISSION‑-QUALIFICATIONS FOR MEMBERS. Members must be citizens of the United States and residents of this state. Three members must be licensed podiatric physicians and surgeons for a period of five years before appointment; three members must be licensed osteopathic physicians and surgeons for a period of five years before appointment; and three members must be licensed naturopathic physicians for a period of five years before appointment. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

NEW SECTION. Sec. 106. COMMISSION--ORGANIZATION. The commission shall elect a chairperson, vice-chairperson, and secretary each year. Meetings of the commission are open to the public, except that the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

The commission may appoint members of panels. A quorum for transaction of any business is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

The members of the commission are immune from suit in an action, civil or criminal, based upon its disciplinary proceedings or other official acts performed in good faith as members of the committee.

The commission may, whenever the workload of the commission requires, request that the secretary appoint pro tempore members. While serving as members pro tempore persons have all the powers, duties, and immunities, and are entitled to the emoluments, including travel expenses, of the commission.

NEW SECTION. Sec. 107. COMMISSION‑-POWERS AND DUTIES. The commission has the following powers and duties:

(1) To administer examinations to applicants for licensing under this chapter, to determine examination dates, locations, and application deadlines, to determine examination requirements for applicants for licensing under this chapter, and to certify qualified applicants to the secretary for licensing;

(2) To adopt such rules as are not inconsistent with the laws of this state as may be deemed necessary or proper to carry out the purposes of this chapter;

(3) To establish and administer requirements for continuing professional education as may be necessary or proper to insure the public health and safety as a prerequisite to granting and renewing licenses under this chapter;

(4) To keep an official record of all its proceedings, which record shall be evidence of all proceedings of the commission that are set forth in this chapter;

(5) To approve curricula and establish criteria for minimum standards for schools preparing persons for licensing under this chapter. The commission shall establish criteria for proof of reasonable currency of knowledge and skill as a basis for safe practice after three years inactive or lapsed status. The commission shall establish criteria for licensing by endorsement.

NEW SECTION. Sec. 108. LICENSES REQUIRED. (1) It is unlawful for a person to practice or to offer to practice as a podiatric physician and surgeon in this state unless that person has been licensed as a podiatric physician and surgeon under this chapter. A person who holds a license to practice as a podiatric physician in this state may use the title "podiatric physician and surgeon" and the abbreviation "D.P.M." No other person may assume that title or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a podiatric physician and surgeon.

(2) It is unlawful for a person to practice or to offer to practice as an osteopathic physician and surgeon in this state unless that person has been licensed as an osteopathic physician and surgeon under this chapter. A person who holds a license to practice as an osteopathic physician and surgeon in this state may use the title "osteopathic physician and surgeon" and the abbreviation "D.O." No other person may assume that title or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is an osteopathic physician and surgeon.

(3) It is unlawful for a person to practice or to offer to practice as an osteopathic physician assistant in this state unless that person has been licensed as an osteopathic physician assistant under this chapter. A person who holds a license to practice as an osteopathic physician assistant in this state may use the title "osteopathic physician assistant" and the abbreviation "P.A." No other person may assume that title or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is an osteopathic physician assistant.

(4) It is unlawful for a person to practice or to offer to practice as a naturopath or naturopathic physician unless that person has been licensed as a naturopathic physician under this chapter. A person who holds a license to practice naturopathic medicine in this state may use the title "naturopathic physician" or "naturopath" or the abbreviation "N.D." No other person may assume those titles or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a naturopathic physician.

NEW SECTION. Sec. 109. EXAMINATIONS‑-WHEN TAKEN‑-REEXAMINATION. (1) An applicant who has met the requirements for examination under this chapter will be scheduled for the next examination after the filing of a completed application.

(2) An applicant who fails to pass an examination satisfactorily is entitled to reexamination upon the payment of a fee for each reexamination determined by the secretary under RCW 43.70.250.

NEW SECTION. Sec. 110. APPLICATION OF UNIFORM DISCIPLINARY ACT. The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter.

The secretary is the disciplining authority for naturopathic physicians. The secretary may delegate to the commission by rule any powers or duties granted under this chapter or by law.

NEW SECTION. Sec. 111. DISPLAY OF LICENSE. Every holder of a license under this chapter shall display the license in a conspicuous place in the holder's office or place of business.

NEW SECTION. Sec. 112. LICENSE RENEWAL. The commission shall establish by rule the requirements for renewal of licenses. The secretary shall establish a renewal and late renewal penalty fee under RCW 43.70.250, and the term for renewal of a license under RCW 43.70.280. Failure to renew invalidates the license and all privileges granted by it. The commission shall determine by rule when a license shall be canceled for failure to renew and shall establish prerequisites for relicensing.

NEW SECTION. Sec. 113. INACTIVE LICENSE. (1) An individual may place his or her license on inactive status. The holder of an inactive license shall not practice as an allied physician under this chapter in this state without first activating the license.

(2) The secretary shall establish the inactive renewal fee under RCW 43.70.250, but it may not exceed twenty-five percent of the active license renewal fee. Failure to renew an inactive license results in cancellation in the same manner as an active license.

(3) An inactive license may be placed in an active status upon compliance with the rules adopted by the commission.

(4) The provisions of this chapter relating to the denial, suspension, and revocation of a license are applicable to an inactive license, except that when proceedings to suspend or revoke an inactive license have been initiated, the license remains inactive until the proceedings have been completed.

NEW SECTION. Sec. 114. SECRETARY‑-POWERS AND DUTIES. The secretary shall adopt such rules as may be reasonable for the proper administration of this chapter. In addition to any other authority provided by law, the secretary may:

(1) Set all fees required in this chapter in accordance with RCW 43.70.250;

(2) Establish forms necessary to administer this chapter; and

(3) Maintain the official department record of all applicants and licensees.

NEW SECTION. Sec. 115. REGULATED PRACTICES. It is prima facie evidence of the practice of a profession regulated under this chapter or of holding oneself out as a practitioner within the meaning of this chapter for a person to:

(1) Treat in any manner ailments of the human foot by medical, surgical, or mechanical means or appliances, or to use the title "podiatrist," "podiatric physician and surgeon," or any other words or letters that designate or tend to designate to the public that the person so treating or holding himself or herself out to treat, is a podiatric physician and surgeon;

(2) Use any and all methods in the treatment of disease, injuries, deformities, and all other physical and mental conditions in and of human beings, including the use of osteopathic manipulative therapy, or to hold himself or herself out as an osteopathic physician and surgeon, or to use the title "osteopathic physician and surgeon" or other designation indicating that the person is an osteopathic physician or surgeon;

(3) Represent himself or herself as a naturopath or use a title or description of services that incorporates one or more of the following terms or designations: Naturopath or doctor of naturopathic medicine; or

(4) Represent himself or herself as an osteopathic physician assistant or to practice as an osteopathic physician assistant.

NEW SECTION. Sec. 116. PENALTY. A person violating or failing to comply with this chapter is guilty of a gross misdemeanor.

NEW SECTION. Sec. 117. EXCEPTIONS. The following practices, acts, and operations are excepted from this chapter:

(1) The practice of a profession by an allied physician employed by the government of the United States while the individual is engaged in the performance of duties prescribed by the laws and regulations of the United States;

(2) The practice of an allied physician while a student enrolled in a school approved by the commission. The performance of services must be pursuant to a course of instruction or assignments from an instructor and under the supervision of the instructor;

(3) The practice of an allied physician by licensed podiatric physicians and surgeons of other states or countries while appearing at educational seminars;

(4) The use of roentgen and other rays for making radiograms or similar records, under the supervision of a licensed allied physician;

(5) The performing of services of an allied physician by externs, interns, and residents in training programs approved by the commission;

(6) The performing of professional services by persons not licensed under this chapter when performed under the supervision of a licensed allied physician, if those services are authorized by commission rule or other law to be so performed;

(7) The domestic administration of family remedies or treatment by prayer or spiritual means in accordance with the creed or tenets of any well-recognized church or religious denomination.

NEW SECTION. Sec. 118. APPLICABILITY OF HEALTH REGULATIONS. Persons granted licenses or certificates under this chapter are subject to the state and municipal regulations relating to the control of contagious diseases, the reporting and certifying to births and deaths, and all matters pertaining to public health; and all such reports shall be accepted as legal.

NEW SECTION. Sec. 119. FALSIFICATION OF CERTIFICATE. A person falsely claiming himself or herself to be the person named in a certificate issued to another, or falsely claiming himself or herself to be the person entitled to the certificate, is guilty of a felony, and upon conviction, is subject to the penalties for forgery under RCW 9A.60.020.

NEW SECTION. Sec. 120. DUTY TO REPORT UNPROFESSIONAL CONDUCT‑-EXCEPTIONS. (1) An allied physician shall report to the commission when he or she has personal knowledge that an allied physician has either committed an act or acts that may constitute statutorily defined unprofessional conduct or that an allied physician may be unable to practice with reasonable skill and safety to patients by reason of illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material, or as a result of an impairing mental or physical condition.

(2) Reporting under this section is not required by:

(a) An appropriately appointed peer review committee member of a licensed hospital or by an appropriately designated professional review committee member of a professional society during the investigative phase of their respective operations if these investigations are completed in a timely manner; or

(b) A treating licensed health care professional of an allied physician currently involved in a treatment program as long as the allied physician patient actively participates in the treatment program and the allied physician patient's impairment does not constitute a clear and present danger to the public health, safety, or welfare.

(3) The appropriate disciplinary authority, whether the commission or the secretary, may impose disciplinary sanctions, including license suspension or revocation, on an allied physician subject to the jurisdiction of the commission who has failed to comply with this section.

NEW SECTION. Sec. 121. PODIATRIC PHYSICIANS AND SURGEONS. (1) A podiatric physician and surgeon is responsible for the quality of podiatric care.

(2) The practice of podiatric medicine and surgery is the diagnosis and the medical, surgical, mechanical, manipulative, and electrical treatments of ailments of the human foot.

(3) Podiatric physicians and surgeons may issue prescriptions valid at any pharmacy for any drug, including narcotics, necessary in the practice of podiatry.

(4) Podiatrists shall not:

(a) Amputate the foot;

(b) Administer spinal anesthetic or any anesthetic that renders the patient unconscious; or

NEW SECTION. Sec. 122. PODIATRIC PHYSICIANS AND SURGEONS‑-EXAMINATIONS. Before being issued a license to practice podiatric medicine and surgery, an applicant must successfully pass the examinations administered by the national board of podiatry examiners and an examination administered or approved by the commission to determine his or her professional qualifications. The examination administered by the commission must include the subject areas the commission may require by rule.

The commission may approve an examination prepared or administered, or both, by a private testing agency, other licensing authority, or association of licensing authorities.

The commission may by rule establish the passing grade for the examination.

All persons licensed under this section are subject to the jurisdiction of the commission as set forth in this chapter and chapter 18.130 RCW.

NEW SECTION. Sec. 123. PODIATRIC PHYSICIANS AND SURGEONS‑-APPLICATION FOR LICENSE EXAMINATION. Before a person may take an examination for the issuance of a podiatric physician and surgeon license, the applicant shall submit to the commission a completed application and a fee determined by the secretary under RCW 43.70.250. The applicant shall also furnish the commission with satisfactory proof that:

(1) The applicant has not engaged in unprofessional conduct as defined in chapter 18.130 RCW and is able to practice with reasonable skill and safety;

(2) The applicant has satisfactorily completed a course in an approved school of podiatric medicine and surgery; and

(3) The applicant has completed one year of postgraduate podiatric medical training in a program approved by the commission, except that applicants graduating before July 1, 1993, are exempt from the postgraduate training requirement.

NEW SECTION. Sec. 124. PODIATRIC PHYSICIANS AND SURGEONS‑-POSTGRADUATE LICENSE. The commission may grant approval to issue a license without examination to a podiatric physician and surgeon in a commission-approved postgraduate training program in this state if the applicant files an application and meets all the requirements for licensing set forth in this chapter other than completion of one year of postgraduate training. The secretary shall issue a postgraduate podiatric medicine and surgery license that permits the physician to practice podiatric medicine and surgery only in connection with his or her duties in the postgraduate training program. The postgraduate training license does not authorize the podiatric physician to engage in any other form of practice. Each podiatric physician and surgeon in postgraduate training may practice podiatric medicine and surgery only under the supervision of a podiatric physician licensed in this state under this chapter, but the supervision shall not be construed to necessarily require the personal presence of the supervising physician at the place where services are rendered.

NEW SECTION. Sec. 125. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-QUALIFICATIONS FOR LICENSE. In order to procure a license to practice osteopathic medicine and surgery, the applicant must provide the commission with evidence that a diploma has been issued to the applicant by an accredited school of osteopathic medicine and surgery, approved by the commission. The application must be made upon a form approved by the commission, and it must contain such information concerning the osteopathic medical instruction and the preliminary education of the applicant as the commission may require by rule. The commission shall reject an applicant who fails to meet these requirements.

An applicant for a license to practice osteopathic medicine and surgery must furnish evidence satisfactory to the commission that he or she has served for not less than one year in a postgraduate training program approved by the commission.

In addition, the applicant may be required to furnish evidence satisfactory to the commission that he or she is physically and mentally capable of safely carrying on the practice of osteopathic medicine and surgery. The commission may require an applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and mental capability to safely practice osteopathic medicine and surgery. The applicant shall also show that he or she has not been guilty of any conduct that would constitute grounds for denial, suspension, or revocation of the license under the laws of the state of Washington.

Nothing in this section prohibits the commission from requiring such additional information from applicants as it deems necessary.

Nothing in this chapter requires an applicant for licensing, or a licensee, as a requisite of retaining or renewing the license under this chapter, to be a member of any political or professional organization.

NEW SECTION. Sec. 126. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-POSTGRADUATE LICENSE. The commission may grant approval to issue a license without examination to an osteopathic physician and surgeon in a commission-approved postgraduate training program in this state if the applicant files an application and meets all the requirements for licensing set forth in this chapter other than completion of one year of postgraduate training. The secretary shall issue a postgraduate osteopathic medicine and surgery license that permits the physician in postgraduate training to practice osteopathic medicine and surgery only in connection with his or her duties as a physician in postgraduate training and does not authorize the physician to engage in any other form of practice. Each physician in postgraduate training may practice osteopathic medicine and surgery only under the supervision of a physician licensed in this state under this chapter or chapter 18.-- RCW (sections 101 through 144 of this act), but the supervision shall not be construed to necessarily require the personal presence of the supervising physician at the place where services are rendered.

All persons licensed under this section are subject to the jurisdiction of the commission as set forth in this chapter and chapter 18.130 RCW.

Persons applying for licensing under this section shall pay an application and renewal fee determined by the secretary under RCW 43.70.250. Licenses issued under this section may be renewed annually. A person who obtains a postgraduate license under this section may apply for regular licensing under this chapter, but shall submit a new application form and comply with all other licensing requirements of this chapter.

NEW SECTION. Sec. 127. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-DISCIPLINE‑-LICENSE RENEWAL. The commission may approve, deny, or take other disciplinary action upon the application for a license as provided in the Uniform Disciplinary Act, chapter 18.130 RCW. The license may be renewed on a periodic basis as determined by the secretary under RCW 43.70.280, upon payment of a fee determined by the secretary under RCW 43.70.250 and submission of a completed renewal application, in addition to any late renewal penalty fees as determined by the secretary under RCW 43.70.250.

NEW SECTION. Sec. 128. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-LICENSE QUALIFICATIONS. Applicants for a license to practice osteopathic medicine and surgery must successfully complete an examination prepared or approved by the commission. The examination must be conducted in the English language, must determine the applicant's fitness to practice osteopathic medicine and surgery, and may be in whole or in part in writing or by practical application on those general subjects and topics of which knowledge is commonly and generally required of applicants who have obtained the doctor of osteopathic medicine and surgery conferred by an accredited school of osteopathic medicine and surgery approved by the commission. If an examination does not encompass the subject of osteopathic principles and practice, the commission shall require the applicant to complete the commission-administered examination. The commission may prepare and administer or approve preparation and administration of examinations on such subjects as the commission deems advisable. The examination papers of an examination administered by the commission form a part of the applicant's records and must be retained as determined by the secretary for a period of not less than one year. All applicants for examination or reexamination shall pay a fee determined by the secretary under RCW 43.70.250.

NEW SECTION. Sec. 129. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-LICENSE BY ENDORSEMENT. An osteopathic physician and surgeon who meets the requirements of section 125 of this act and has been examined and licensed to practice osteopathic medicine and surgery by a state board of examiners of another state or the duly constituted authorities of another state authorized to issue licenses to practice osteopathic medicine and surgery upon examination, is, upon approval of the commission, entitled to receive a license to practice osteopathic medicine and surgery in this state. The applicant shall pay a fee determined by the secretary under RCW 43.70.250 to the state treasurer and file a copy of his or her license from the other state, certified by the authorities granting the license to be a full, true, and correct copy, and certifying also that the standard of requirements adopted by the authorities as provided by the law of that state is substantially equal to that provided for by this chapter. The commission shall not issue a license without examination to a person who has previously failed in an examination held in this state. The commission may revoke a license issued under this section for unprofessional conduct, in the same manner and upon the same grounds as if issued otherwise under this chapter. The commission may not permit anyone to practice surgery under this chapter who does not have a license to practice osteopathic medicine and surgery.

NEW SECTION. Sec. 130. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-USE OF TITLE. On all cards, signs, letterheads, envelopes, and billheads used by persons licensed under this chapter to practice osteopathy or osteopathy and surgery the word "osteopathic" must always immediately precede the word "physician," and if the word "surgeon" is used in connection with the person's name, the word "osteopathic" must also immediately precede the word "surgeon."

NEW SECTION. Sec. 131. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-USE OF DESIGNATIONS IN COMBINATION WITH NAME. No provision of this chapter or of any other law prevents a person who holds a valid, unrevoked certificate to practice osteopathic medicine and surgery from using in combination with his or her name the designation "Osteopathic Physician and Surgeon" or the abbreviation of his or her professional degree, Doctor of Osteopathy (D.O.), if he or she holds that professional degree, or any combination thereof upon his or her stationery, in professional lists or directories, or in other places where they may properly appear as permitted within the canons of ethics approved by the commission.

NEW SECTION. Sec. 132. OSTEOPATHIC PHYSICIANS AND SURGEONS‑-MALPRACTICE REPORTING. An institution or organization providing professional liability insurance to osteopathic physicians shall send a complete report to the commission of all malpractice settlements, awards, or payments in excess of twenty thousand dollars as a result of a claim or action for damages alleged to have been caused by an insured osteopathic physician's incompetency or negligence in the practice of osteopathic medicine. The institution or organization shall also report the award, settlement, or payment of three or more claims during a year as the result of the physician's alleged incompetence or negligence in the practice of medicine regardless of the dollar amount of the award or payment.

Reports required by this section must be made within sixty days of the date of the settlement or verdict. Failure to comply with this section is punishable by a civil penalty not to exceed two hundred fifty dollars.

NEW SECTION. Sec. 133. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-LICENSE QUALIFICATIONS. (1) The commission shall adopt rules fixing the qualifications and the educational and training requirements for licensing as an osteopathic physician assistant or for those enrolled in any physician assistant training program. The requirements must include completion of an accredited physician assistant training program approved by the commission and eligibility to take an examination approved by the commission, if the examination tests subjects substantially equivalent to the curriculum of an accredited physician assistant training program.

(2)(a) The commission shall also adopt rules governing the extent to which:

(i) Physician assistant students may practice medicine during training; and

(ii) Physician assistants may practice after successful completion of a training course.

(b) The rules must provide:

(i) That the practice of an osteopathic physician assistant is limited to the performance of those services for which he or she is trained; and

(ii) That each osteopathic physician assistant may practice osteopathic medicine only under the supervision and control of an osteopathic physician licensed in this state, but that the supervision and control shall not be construed to necessarily require the personal presence of the supervising physicians at the place where services are rendered. The commission may authorize the use of alternative supervisors who are licensed under chapter 18.71 RCW.

(3) Applicants for licensing shall file an application with the commission on a form approved by the commission, detailing the education, training, and experience of the physician assistant and such other information as the commission may require. The application must be accompanied by a fee determined by the secretary under RCW 43.70.250. Each applicant shall furnish proof satisfactory to the commission of the following:

(a) That the applicant has completed an accredited physician assistant program approved by the commission and is eligible to take the examination approved by the commission;

(b) That the applicant is of good moral character; and

(c) That the applicant is physically and mentally capable of practicing osteopathic medicine as an osteopathic physician assistant with reasonable skill and safety. The commission may require an applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and mental capability to safely practice as an osteopathic physician assistant.

(4) The commission may approve, deny, or take other disciplinary action upon the application for a license as provided in the Uniform Disciplinary Act, chapter 18.130 RCW. The license may be renewed on a periodic basis as determined by the secretary under RCW 43.70.280, upon payment of a fee determined by the secretary under RCW 43.70.250 and submission of a completed renewal application, in addition to any late renewal penalty fees as determined by the secretary under RCW 43.70.250.

NEW SECTION. Sec. 134. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-PRACTICE PLAN. An osteopathic physician assistant may practice osteopathic medicine in this state only with the approval of the practice arrangement plan by the commission and only to the extent permitted by the commission. An osteopathic physician assistant who has received a license but who has not received commission approval of the practice arrangement plan under section 135 of this act may not practice. An osteopathic physician assistant is subject to discipline by the commission under chapter 18.130 RCW.

NEW SECTION. Sec. 135. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-APPROVAL OF PRACTICE PLAN. (1) An osteopathic physician or physician group may not employ or supervise an osteopathic physician assistant practicing in this state without the approval of the commission.

(2) Before commencing practice, an osteopathic physician assistant licensed in this state shall apply to the commission for permission to be employed or supervised by an osteopathic physician or physician group. The practice arrangement plan shall be jointly submitted by the osteopathic physician or physician group and the osteopathic physician assistant. The secretary may charge a fee under RCW 43.70.250 to recover the cost for the plan review. The practice arrangement plan must delineate the manner and extent to which the physician assistant would practice and be supervised. Whenever an osteopathic physician assistant is practicing in a manner inconsistent with the approved practice arrangement plan, the commission may take disciplinary action under chapter 18.130 RCW.

NEW SECTION. Sec. 136. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-OSTEOPATHIC PHYSICIAN'S LIABILITY, RESPONSIBILITY. An osteopathic physician who supervises a licensed osteopathic physician assistant in accordance with and within the terms of any permission granted by the commission shall not be considered as aiding and abetting an unlicensed person to practice osteopathic medicine within the meaning of this chapter. However, the supervising osteopathic physician and the osteopathic physician assistant retain professional and personal responsibility for any act that constitutes the practice of osteopathic medicine as defined in this chapter when performed by the physician assistant.

NEW SECTION. Sec. 137. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-LIMITATIONS ON HEALTH CARE SERVICES. (1) An osteopathic physician assistant may not perform health care services under this chapter in any of the following areas:

(a) The measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses or frames for the aid of vision;

(b) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics;

(d) The practice of chiropractic as defined in chapter 18.-- RCW (sections 101 through 144 of this act), including the adjustment or manipulation of the articulations of the spine;

(e) The practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW, respectively. The exemptions set forth in RCW 18.32.030 (1) and (8) do not apply to a physician's assistant.

(2) Nothing in subsection (1)(a), (b), or (c) of this section precludes the performance of routine visual screening.

NEW SECTION. Sec. 138. OSTEOPATHIC PHYSICIAN ASSISTANTS‑-PERFORMANCE OF ACUPUNCTURE. (1) The performance of acupuncture for the purpose of demonstration, therapy, or the induction of analgesia by an osteopathic physician assistant is within the scope of practice authorized. However, an osteopathic physician assistant licensed to perform acupuncture under this section may do so only under the direct supervision of a licensed osteopathic physician.

(2) The commission shall determine the qualifications of a person authorized to perform acupuncture under subsection (1) of this section. In establishing a procedure for certification of acupuncture practitioners the commission shall consider a license or certificate that acknowledges that the person has the qualifications to practice acupuncture issued by the government of the Republic of China (Taiwan), the People's Republic of China, the British Crown Colony of Hong Kong, Korea, Great Britain, France, Germany, Italy, Japan, or any other country or state that has generally equivalent standards of practices for acupuncture as determined by the commission as evidence of the person's qualification.

(3) As used in this section "acupuncture" means the insertion of needles into the human body by piercing the skin of the body for the purpose of relieving pain, treating disease, or to produce analgesia, or as further defined by rules of the commission.

NEW SECTION. Sec. 139. NATUROPATHIC PHYSICIANS‑-DEFINITIONS. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter to any and all references to naturopathic physicians, naturopaths, or the practice of naturopathic medicine.

(1) "Naturopath" means an individual licensed under this chapter.

(2) "Educational program" means a program preparing persons for the practice of naturopathy.

(3) "Nutrition and food science" means the prevention and treatment of disease or other human conditions through the use of foods, water, herbs, roots, bark, or natural food elements.

(4) "Manual manipulation" or "mechanotherapy" means manipulation of a part or the whole of the body by hand or by mechanical means.

(5) "Physical modalities" means use of physical, chemical, electrical, and other noninvasive modalities including, but not limited to heat, cold, air, light, water in any of its forms, sound, massage, and therapeutic exercise.

(6) "Homeopathy" means a system of medicine based on the use of infinitesimal doses of medicines capable of producing symptoms similar to those of the disease treated, as listed in the homeopathic pharmacopoeia of the United States.

(7) "Medicines of mineral, animal, and botanical origin" means medicines derived from animal organs, tissues, and oils, minerals, and plants administered orally and topically, excluding legend drugs with the following exceptions: Vitamins, minerals, whole gland thyroid, and substances as exemplified in traditional botanical and herbal pharmacopoeia, and nondrug contraceptive devices excluding intrauterine devices. The use of intermuscular injections are limited to vitamin B‑12 preparations and combinations when clinical or laboratory evaluation has indicated vitamin B‑12 deficiency. The use of controlled substances regulated by chapter 69.50 RCW is prohibited.

(8) "Hygiene and immunization" means the use of such preventative techniques as personal hygiene, asepsis, public health, and immunizations, to the extent allowed by rule of the commission.

(9) "Minor office procedures" means care incident to treatment of superficial lacerations and abrasions, and the removal of foreign bodies located in superficial structures, not to include the eye, and the use of antiseptics and topical local anesthetics in connection with the procedures.

(10) "Common diagnostic procedures" means the use of venipuncture to withdraw blood, commonly used diagnostic modalities consistent with naturopathic practice, health history taking, physical examination, radiography, examination of body orifices excluding endoscopy, and laboratory medicine that obtains samples of human tissue products, including superficial scrapings but excluding procedures that would require surgical incision.

(11) "Suggestion" means techniques including but not limited to counseling, biofeedback, and hypnosis.

(12) "Radiography" means the ordering but not the interpretation of radiographic diagnostic studies and the taking and interpretation of standard radiographs.

NEW SECTION. Sec. 140. NATUROPATHIC PHYSICIANS‑-LICENSE REQUIREMENTS. The secretary shall issue a license to an applicant who meets the following requirements:

(1) Successful completion of an educational program approved by the commission, the minimum standard of which is the successful completion of a doctorate degree program in naturopathy or successful completion of equivalent alternate training that meets the criteria established by the commission;

(2) Successful completion of any equivalent experience requirement established by the commission;

(3) Successful completion of an examination administered or approved by the commission;

(4) Good moral character; and

(5) Not having engaged in unprofessional conduct and being able to practice with reasonable skill and safety.

The commission shall establish what constitutes adequate proof of meeting the requirements of this section. A person holding a valid license to practice drugless therapeutics under chapter 18.36 RCW upon January 1, 1988, is deemed to be licensed under this chapter.

NEW SECTION. Sec. 141. NATUROPATHIC PHYSICIANS‑-LICENSE REQUIRED. (1) No person may practice naturopathy or represent himself or herself as a naturopath without first applying for and receiving a license from the secretary to practice naturopathy.

(2) A person represents himself or herself as a naturopath when that person adopts or uses a title or a description of services that incorporates one or more of the following terms or designations: Naturopath or doctor of naturopathic medicine.

NEW SECTION. Sec. 142. NATUROPATHIC PHYSICIANS‑-PRACTICE DEFINED. Naturopathic medicine or naturopathy is the practice by naturopaths of the art and science of the diagnosis, prevention, and treatment of disorders of the body by stimulation or support, or both, of the natural processes of the human body. A naturopath is responsible and accountable to the consumer for the quality of naturopathic care rendered.

The practice of naturopathy includes manual manipulation (mechanotherapy), the prescription, administration, dispensing, and use, except for the treatment of malignancies or neoplastic disease, of nutrition and food science, physical modalities, homeopathy, certain medicines of mineral, animal, and botanical origin, hygiene and immunization, common diagnostic procedures, and suggestion; however, nothing in this chapter prohibits consultation and treatment of a patient in concert with an osteopathic physician and surgeon licensed under this chapter or a physician and surgeon licensed under chapter 18.71 RCW. No person licensed under this chapter may employ the term "chiropractic" to describe any services provided by a naturopathic physician under this chapter.

NEW SECTION. Sec. 143. NATUROPATHIC PHYSICIANS‑-EXCEPTIONS TO REGULATION. Nothing in this chapter prohibits or restricts:

(1) The practice of naturopathic medicine by students enrolled in a school approved by the commission. The performance of services must be under a course of instruction or assignments from an instructor and under the supervision of the instructor. The instructor must be a naturopath licensed under this chapter; or

(2) The practice of oriental medicine or oriental herbology, or the rendering of other dietary or nutritional advice.

NEW SECTION. Sec. 144. SAVINGS. The commission is the successor in interest of the board of podiatry, the board of osteopathic physicians, and the naturopathic practice advisory committee. All contracts, undertakings, agreements, rules, regulations, and policies continue in full force and effect on the effective date of this act, unless otherwise repealed or rejected by this chapter or by the commission.

NEW SECTION. Sec. 145. Sections 101 through 144 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 146. REPEALER. The following acts or parts of acts are each repealed:

(1) RCW 18.22.005 and 1990 c 147 s 1 & 1982 c 21 s 1;

(2) RCW 18.22.010 and 1990 c 147 s 2, 1982 c 21 s 2, 1973 c 77 s 1, 1955 c 149 s 1, 1941 c 31 s 1, 1921 c 120 s 1, & 1917 c 38 s 1;

(3) RCW 18.22.013 and 1990 c 147 s 3 & 1982 c 21 s 8;

(4) RCW 18.22.014 and 1990 c 147 s 4, 1984 c 287 s 26, & 1982 c 21 s 9;

(5) RCW 18.22.015 and 1990 c 147 s 5, 1986 c 259 s 18, & 1982 c 21 s 10;

(6) RCW 18.22.018 and 1987 c 150 s 10 & 1986 c 259 s 17;

(7) RCW 18.22.021 and 1987 c 150 s 11;

(8) RCW 18.22.025 and 1990 c 147 s 7;

(9) RCW 18.22.035 and 1990 c 147 s 6;

(10) RCW 18.22.040 and 1993 c 29 s 2, 1990 c 147 s 8, 1982 c 21 s 5, 1979 c 158 s 18, 1973 c 77 s 4, 1971 ex.s. c 292 s 19, 1955 c 149 s 2, 1935 c 48 s 3, 1921 c 120 s 3, & 1917 c 38 s 6;

(11) RCW 18.22.045 and 1993 c 29 s 1;

(12) RCW 18.22.060 and 1990 c 147 s 9, 1985 c 7 s 11, 1982 c 21 s 7, 1975 1st ex.s. c 30 s 16, 1973 c 77 s 6, 1965 c 97 s 1, & 1957 c 52 s 14;

(13) RCW 18.22.082 and 1990 c 147 s 10;

(14) RCW 18.22.083 and 1990 c 147 s 11 & 1982 c 21 s 13;

(15) RCW 18.22.110 and 1990 c 147 s 12, 1973 c 77 s 9, & 1957 c 52 s 15;

(16) RCW 18.22.120 and 1990 c 147 s 13, 1985 c 7 s 13, 1982 c 21 s 14, 1975 1st ex.s. c 30 s 18, 1973 c 77 s 10, 1971 ex.s. c 266 s 4, 1965 c 97 s 2, & 195 c 149 s 6;

(17) RCW 18.22.125 and 1990 c 147 s 14;

(18) RCW 18.22.191 and 1990 c 147 s 15 & 1955 c 149 s 13;

(19) RCW 18.22.210 and 1990 c 147 s 16, 1982 c 21 s 17, 1973 c 77 s 17, 1935 c 48 s 4, 1921 c 120 s 6, & 1917 c 38 s 10;

(20) RCW 18.22.220 and 1955 c 149 s 10 & 1917 c 38 s 21;

(21) RCW 18.22.230 and 1990 c 147 s 17, 1982 c 21 s 19, 1973 c 77 s 19, & 1955 c 149 s 12;

(22) RCW 18.22.900 and 1917 c 38 s 19;

(23) RCW 18.22.910 and 1955 c 149 s 16;

(24) RCW 18.22.911 and 1982 c 21 s 20;

(25) RCW 18.22.950 and 1990 c 147 s 19;

(26) RCW 18.36.035 and 1987 c 150 s 28;

(27) RCW 18.36A.010 and 1987 c 447 s 1;

(28) RCW 18.36A.020 and 1991 c 3 s 87 & 1987 c 447 s 4;

(29) RCW 18.36A.030 and 1991 c 3 s 88 & 1987 c 447 s 2;

(30) RCW 18.36A.040 and 1991 c 3 s 89, 1988 c 246 s 1, & 1987 c 447 s 3;

(31) RCW 18.36A.050 and 1991 c 3 s 90 & 1987 c 447 s 5;

(32) RCW 18.36A.060 and 1991 c 3 s 91 & 1987 c 447 s 6;

(33) RCW 18.36A.070 and 1991 c 3 s 92 & 1987 c 447 s 7;

(34) RCW 18.36A.080 and 1991 c 3 s 93 & 1987 c 447 s 8;

(35) RCW 18.36A.090 and 1991 c 3 s 94 & 1987 c 447 s 9;

(36) RCW 18.36A.100 and 1991 c 3 s 95 & 1987 c 447 s 10;

(37) RCW 18.36A.110 and 1991 c 3 s 96 & 1987 c 447 s 11;

(38) RCW 18.36A.120 and 1991 c 3 s 97 & 1987 c 447 s 12;

(39) RCW 18.36A.130 and 1991 c 3 s 98 & 1987 c 447 s 13;

(40) RCW 18.36A.140 and 1991 c 3 s 99 & 1987 c 447 s 14;

(41) RCW 18.36A.900 and 1987 c 447 s 20;

(42) RCW 18.36A.901 and 1987 c 447 s 25;

(43) RCW 18.57.001 and 1991 c 160 s 1, 1991 c 3 s 147, & 1979 c 117 s 1;

(44) RCW 18.57.003 and 1991 c 160 s 2, 1984 c 287 s 42, & 1979 c 117 s 2;

(45) RCW 18.57.005 and 1986 c 259 s 94 & 1979 c 117 s 3;

(46) RCW 18.57.011 and 1987 c 150 s 41 & 1986 c 259 s 92;

(47) RCW 18.57.020 and 1991 c 160 s 3, 1979 c 117 s 11, 1959 c 110 s 1, & 1919 c 4 s 4;

(48) RCW 18.57.031 and 1987 c 150 s 42;

(49) RCW 18.57.035 and 1991 c 160 s 9;

(50) RCW 18.57.040 and 1991 c 160 s 5 & 1919 c 4 s 19;

(51) RCW 18.57.045 and 1991 c 160 s 4;

(52) RCW 18.57.050 and 1991 c 160 s 6, 1985 c 7 s 55, 1979 c 117 s 12, 1975 1st ex.s. c 30 s 58, 1971 ex.s. c 266 s 11, & 1919 c 4 s 6;

(53) RCW 18.57.080 and 1991 c 160 s 7, 1979 c 117 s 13, & 1919 c 4 s 5;

(54) RCW 18.57.130 and 1991 c 160 s 10, 1991 c 3 s 151, 1985 c 7 s 56, 1979 c 117 s 15, 1975 1st ex.s. c 30 s 59, 1921 c 82 s 1, & 1919 c 4 s 17;

(55) RCW 18.57.140 and 1919 c 4 s 20;

(56) RCW 18.57.145 and 1991 c 160 s 8 & 1959 c 110 s 2;

(57) RCW 18.57.150 and 1919 c 4 s 18;

(58) RCW 18.57.160 and 1981 c 277 s 9 & 1919 c 4 s 15;

(59) RCW 18.57.174 and 1986 c 300 s 9;

(60) RCW 18.57.245 and 1986 c 300 s 10;

(61) RCW 18.57.900 and 1919 c 4 s 21;

(62) RCW 18.57.910 and 1919 c 4 s 22;

(63) RCW 18.57.915 and 1979 c 117 s 19;

(64) RCW 18.57A.010 and 1979 c 117 s 17 & 1971 ex.s. c 30 s 7;

(65) RCW 18.57A.020 and 1993 c 28 s 1, 1992 c 28 s 1, & 1971 ex.s. c 30 s 8;

(66) RCW 18.57A.025 and 1986 c 259 s 93;

(67) RCW 18.57A.030 and 1993 c 28 s 2, 1986 c 259 s 95, & 1971 ex.s. c 30 s 9;

(68) RCW 18.57A.040 and 1993 c 28 s 3 & 1991 c 3 s 152;

(69) RCW 18.57A.050 and 1993 c 28 s 4, 1986 c 259 s 97, & 1971 ex.s. c 30 s 11;

(70) RCW 18.57A.060 and 1973 c 77 s 20 & 1971 ex.s. c 30 s 12; and

(71) RCW 18.57A.070 and 1977 ex.s. c 233 s 1.

CHIROPRACTIC

NEW SECTION. Sec. 201. A new section is added to chapter 18.25 RCW to read as follows:

This chapter is enacted:

(1) In the exercise of the police power of the state and to provide an adequate public agency to act as a disciplinary body for the members of the chiropractic profession licensed to practice chiropractic in this state;

(2) Because the health and well-being of the people of this state are of paramount importance;

(3) Because the conduct of members of the chiropractic profession licensed to practice chiropractic in this state plays a vital role in preserving the health and well-being of the people of the state; and

(4) Because practicing other healing arts while licensed to practice chiropractic and while holding one's self out to the public as a chiropractor affects the health and welfare of the people of the state.

It is the purpose of the commission established under section 204 of this act to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state.

The legislature finds and declares that the costs of health care to the people are rising disproportionately to other costs and that there is a paramount concern that the right of the people to obtain access to health care in all its facets is being impaired thereby. For this reason, the reliance on the mechanism of health care service contractors, whether profit or nonprofit, is the only effective manner in which the large majority of the people can attain access to quality health care, and it is therefore declared to be in the public interest that health care service contractors be regulated to assure that all the people have access to health care to the greatest extent possible. RCW 18.25.130 through 18.25.170 (as recodified by this act), prohibiting discrimination against the legally recognized and licensed profession of chiropractic, are necessary in the interest of the public health, welfare, and safety.

Sec. 202. RCW 18.25.005 and 1992 c 241 s 2 are each amended to read as follows:

(1) Chiropractic is the practice of health care that deals with the diagnosis or analysis and care or treatment of the vertebral subluxation complex and its effects, articular dysfunction, and musculoskeletal disorders, all for the restoration and maintenance of health and recognizing the recuperative powers of the body.

(2) Chiropractic treatment or care includes the use of procedures involving spinal adjustments, and extremity manipulation insofar as any such procedure is complementary or preparatory to a chiropractic spinal adjustment. Chiropractic treatment also includes the use of heat, cold, water, exercise, massage, trigger point therapy, dietary advice and recommendation of nutritional supplementation except for medicines of herbal, animal, or botanical origin, the normal regimen and rehabilitation of the patient, first aid, and counseling on hygiene, sanitation, and preventive measures. Chiropractic care also includes such physiological therapeutic procedures as traction and light, but does not include procedures involving the application of sound, diathermy, or electricity.

(3) As part of a chiropractic differential diagnosis, a chiropractor shall perform a physical examination, which may include diagnostic x-rays, to determine the appropriateness of chiropractic care or the need for referral to other health care providers. The chiropractic ((~~disciplinary board~~)) quality assurance commission shall provide by rule for the type and use of diagnostic and analytical devices and procedures consistent with this chapter.

(4) Chiropractic care shall not include the prescription or dispensing of any medicine or drug, the practice of obstetrics or surgery, the use of x-rays or any other form of radiation for therapeutic purposes, colonic irrigation, or any form of venipuncture.

(5) Nothing in this chapter prohibits or restricts any other practitioner of a "health profession" defined in RCW 18.120.020(4) from performing any functions or procedures the practitioner is licensed or permitted to perform, and the term "chiropractic" as defined in this chapter shall not prohibit a practitioner licensed under chapter 18.71 RCW from performing medical procedures, except such procedures shall not include the adjustment by hand of any articulation of the spine.

Sec. 203. RCW 18.25.006 and 1992 c 241 s 3 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

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

(2) "Secretary" means the secretary of the department of health or the secretary's designee.

(3) "Chiropractor" means an individual licensed under this chapter.

(4) ((~~"Board" means the Washington state board of chiropractic examiners.~~)) "Commission" means the Washington state chiropractic quality assurance commission.

(5) "Vertebral subluxation complex" means a functional defect or alteration of the biomechanical and physiological dynamics in a joint that may cause neuronal disturbances, with or without displacement detectable by x-ray. The effects of the vertebral subluxation complex may include, but are not limited to, any of the following: Fixation, hypomobility, hypermobility, periarticular muscle spasm, edema, or inflammation.

(6) "Articular dysfunction" means an alteration of the biomechanical and physiological dynamics of a joint of the axial or appendicular skeleton.

(7) "Musculoskeletal disorders" means abnormalities of the muscles, bones, and connective tissue.

(8) "Chiropractic differential diagnosis" means a diagnosis to determine the existence of a vertebral subluxation complex, articular dysfunction, or musculoskeletal disorder, and the appropriateness of chiropractic care or the need for referral to other health care providers.

(9) "Chiropractic adjustment" means chiropractic care of a vertebral subluxation complex, articular dysfunction, or musculoskeletal disorder. Such care includes manual or mechanical adjustment of any vertebral articulation and contiguous articulations beyond the normal passive physiological range of motion.

(10) "Extremity manipulation" means a corrective thrust or maneuver applied to a joint of the appendicular skeleton. The use of extremity manipulation shall be complementary and preparatory to a chiropractic spinal adjustment to support correction of a vertebral subluxation complex and is considered a part of a spinal adjustment and shall not be billed separately from or in addition to a spinal adjustment.

NEW SECTION. Sec. 204. A new section is added to chapter 18.25 RCW to read as follows:

COMMISSION ESTABLISHED‑-MEMBERS APPOINTED BY THE GOVERNOR. The Washington state chiropractic quality assurance commission is established, consisting of fourteen members appointed by the governor to four-year terms, and including eleven practicing chiropractors and three public members. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, the governor appoint members of the previous boards and committees regulating this profession to the commission. Members of the commission hold office until their successors are appointed. The governor may appoint the members of the initial commissions to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. The governor may consider persons who are recommended for appointment by chiropractic associations of this state.

NEW SECTION. Sec. 205. A new section is added to chapter 18.25 RCW to read as follows:

COMMISSION‑-REMOVAL OF MEMBERS‑-VACANCIES. The governor may remove a member of the commission for neglect of duty, misconduct, or malfeasance or misfeasance in office. Whenever the governor is satisfied that a member of the commission has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement to fill the remainder of the unexpired term.

NEW SECTION. Sec. 206. A new section is added to chapter 18.25 RCW to read as follows:

COMMISSION‑-QUALIFICATIONS OF MEMBERS. Members must be citizens of the United States and residents of this state. Members must be licensed chiropractors for a period of five years before appointment. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

NEW SECTION. Sec. 207. A new section is added to chapter 18.25 RCW to read as follows:

COMMISSION‑-DUTIES AND POWERS. The commission shall elect a chairperson, vice-chairperson, and secretary each year. Meetings of the commission are open to the public, except that the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

The commission may appoint members of panels of at least three members. A quorum for transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

The members of the commission are immune from suit in an action, civil or criminal, based upon its disciplinary proceedings or other official acts performed in good faith as members of the commission.

The commission shall prepare or determine the nature of the examinations for applicants to practice chiropractic.

Sec. 208. RCW 18.25.019 and 1987 c 150 s 12 are each amended to read as follows:

The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice ((~~and~~)), the issuance and denial of licenses, and the discipline of licensees under this chapter.

Sec. 209. RCW 18.25.020 and 1991 c 3 s 38 are each amended to read as follows:

(1) Any person not now licensed to practice chiropractic in this state and who desires to practice chiropractic in this state, before it shall be lawful for him or her to do so, shall make application therefor to the secretary, upon such form and in such manner as may be adopted and directed by the secretary. Each applicant who matriculates to a chiropractic college after January 1, 1975, shall have completed not less than one-half of the requirements for a baccalaureate degree at an accredited and approved college or university and shall be a graduate of a chiropractic school or college accredited and approved by the ((~~board of chiropractic examiners~~)) commission and shall show satisfactory evidence of completion by each applicant of a resident course of study of not less than four thousand classroom hours of instruction in such school or college. Applications shall be in writing and shall be signed by the applicant in his or her own handwriting and shall be sworn to before some officer authorized to administer oaths, and shall recite the history of the applicant as to his or her educational advantages, his or her experience in matters pertaining to a knowledge of the care of the sick, how long he or she has studied chiropractic, under what teachers, what collateral branches, if any, he or she has studied, the length of time he or she has engaged in clinical practice; accompanying the same by reference therein, with any proof thereof in the shape of diplomas, certificates, and shall accompany said application with satisfactory evidence of good character and reputation.

(2) There shall be paid to the secretary by each applicant for a license, a fee determined by the secretary as provided in RCW 43.70.250 which shall accompany application and a fee determined by the secretary as provided in RCW 43.70.250, which shall be paid upon issuance of license. Like fees shall be paid for any subsequent examination and application.

Sec. 210. RCW 18.25.025 and 1980 c 51 s 3 are each amended to read as follows:

The ((~~board~~)) commission shall have authority to grant accreditation to chiropractic schools and colleges.

The ((~~board~~)) commission shall have authority to adopt educational standards which may include standards of any accreditation agency recognized by the office of education of the department of health and human services or its successor agency, or any portion of such standards, as the ((~~board's~~)) commission's standards: PROVIDED, That such standards, so adopted, shall contain, as a minimum of on-campus instruction in chiropractic, the following: Principles of chiropractic, two hundred hours; adjustive technique, four hundred hours; spinal roentgenology, one hundred seventy-five hours; symptomatology and diagnosis, four hundred twenty-five hours; clinic, six hundred twenty-five hours: PROVIDED FURTHER, That such standards shall not mandate, as a requirement for either graduation or accreditation, or include in the computation of hours of chiropractic instruction required by this section, instruction in the following: Mechanotherapy, physiotherapy, acupuncture, acupressure, or any other therapy.

The ((~~board~~)) commission shall approve and accredit chiropractic colleges and schools which apply for ((~~board~~)) commission accreditation and approval and which meet to the ((~~board's~~)) commission's satisfaction the educational standards adopted by the ((~~board~~)) commission. It shall be the responsibility of the college to apply for accreditation and approval, and of a student to ascertain whether a college or school has been accredited or approved by the ((~~board~~)) commission.

The ((~~board~~)) commission shall have authority to engage assistants in the giving of examinations called for under this chapter.

Sec. 211. RCW 18.25.030 and 1989 c 258 s 4 are each amended to read as follows:

Examinations for license to practice chiropractic shall be made by the ((~~board of chiropractic examiners~~)) commission according to the method deemed by it to be the most practicable and expeditious to test the applicant's qualifications. Such application shall be designated by a number instead of his or her name, so that the identity shall not be discovered or disclosed to the members of the ((~~examining committee~~)) commission until after the examination papers are graded.

All examinations shall be in whole or in part in writing, the subject of which shall be as follows: Anatomy, physiology, spinal anatomy, microbiology-public health, general diagnosis, neuromuscularskeletal diagnosis, x-ray, principles of chiropractic and adjusting, as taught by chiropractic schools and colleges. ((~~The board shall administer a practical examination to applicants which shall consist of diagnosis, principles and practice, x-ray, and adjustive technique consistent with chapter 18.25 RCW.~~)) A license shall be granted to all applicants whose score over each subject tested is seventy-five percent. The ((~~board~~)) commission may enact additional requirements for testing administered by the national board of chiropractic examiners.

Sec. 212. RCW 18.25.035 and 1971 ex.s. c 227 s 5 are each amended to read as follows:

The ((~~board~~)) commission may, in its discretion, waive any examination required by this chapter of persons applying for a license to practice chiropractic if, in its opinion, the applicant has successfully passed an examination conducted by the national board of chiropractic examiners of the United States that is of equal or greater difficulty than the examination being waived by the ((~~board~~)) commission.

Sec. 213. RCW 18.25.040 and 1991 c 320 s 8 are each amended to read as follows:

Persons licensed to practice chiropractic under the laws of any other state, territory of the United States, the District of Columbia, Puerto Rico, or province of Canada, having qualifications substantially equivalent to those required by this chapter, may, in the discretion of the ((~~board of chiropractic examiners~~)) commission, and after such examination as may be required by rule of the ((~~board~~)) commission, be issued a license to practice in this state without further examination, upon payment of a fee determined by the secretary as provided in RCW 43.70.250.

Sec. 214. RCW 18.25.070 and 1991 c 3 s 40 are each amended to read as follows:

(1) Every person practicing chiropractic shall, as a prerequisite to annual renewal of license, submit to the secretary at the time of application therefor, satisfactory proof showing attendance of at least twenty-five hours during the preceding twelve-month period, at one or more chiropractic symposiums which are recognized and approved by the ((~~board of chiropractic examiners: PROVIDED, That the board~~)) commission. The commission may, for good cause shown, waive said attendance. The following guidelines for such symposiums shall apply:

(a) The ((~~board~~)) commission shall set criteria for the course content of educational symposia concerning matters which are recognized by the state of Washington chiropractic licensing laws; it shall be the licensee's responsibility to determine whether the course content meets these criteria;

(b) The ((~~board~~)) commission shall adopt standards for distribution of annual continuing education credit requirements;

(c) Rules shall be adopted by the ((~~board~~)) commission for licensees practicing and residing outside the state who shall meet all requirements established by rule of the ((~~board by rules and regulations~~)) commission.

(2) Every person practicing chiropractic within this state shall pay on or before his or her birth anniversary date, after a license is issued to him or her as ((~~herein~~)) provided in this chapter, to ((~~said~~)) the secretary a renewal license fee to be determined by the secretary as provided in RCW 43.70.250. The secretary shall, thirty days or more before the birth anniversary date of each chiropractor in the state, mail to that chiropractor a notice of the fact that the renewal fee will be due on or before his or her birth anniversary date. Nothing in this chapter shall be construed so as to require that the receipts shall be recorded as original licenses are required to be recorded.

The failure of any licensed chiropractor to pay his or her annual license renewal fee within thirty days of license expiration shall work a forfeiture of his or her license. It shall not be reinstated except upon evidence that continuing educational requirements have been fulfilled and the payment of a penalty to be determined by the secretary as provided in RCW 43.70.250, together with all annual license renewal fees delinquent at the time of the forfeiture, and those for each year thereafter up to the time of reinstatement. ((~~Should the licentiate~~)) If the licensee allows his or her license to ((~~elapse~~)) lapse for more than three years, he or she may be reexamined as provided for in RCW 18.25.040 at the discretion of the ((~~board~~)) commission.

Sec. 215. RCW 18.25.075 and 1991 c 3 s 41 are each amended to read as follows:

(1) An individual may place his or her license on inactive status. The holder of an inactive license shall not practice chiropractic in this state without first activating the license.

(2) The inactive renewal fee shall be established by the secretary pursuant to RCW 43.70.250. Failure to renew an inactive license shall result in cancellation in the same manner as an active license.

(3) An inactive license may be placed in an active status upon compliance with the rules established by the ((~~board~~)) commission.

(4) The provisions relating to the denial, suspension, and revocation of a license shall be applicable to an inactive license, except that when proceedings to suspend or revoke an inactive license have been initiated, the license shall remain inactive until the proceedings have been completed.

NEW SECTION. Sec. 216. A new section is added to chapter 18.25 RCW to read as follows:

(1) In addition to those acts defined in chapter 18.130 RCW, the term "unprofessional conduct" as used in this chapter includes failing to differentiate chiropractic care from any and all other methods of healing at all times.

(2) Proceedings involving alleged unprofessional conduct shall be prosecuted by the attorney general upon the direction of the commission.

Sec. 217. RCW 18.25.180 and 1991 c 222 s 9 are each amended to read as follows:

(1) A chiropractor may employ a technician to operate x-ray equipment after the technician has registered with the ((~~board~~)) commission.

(2) The ((~~board~~)) commission may adopt rules necessary and appropriate to carry out the purposes of this section.

Sec. 218. RCW 18.25.190 and 1991 c 320 s 10 are each amended to read as follows:

Nothing in this chapter shall be construed to prohibit:

(1) The temporary practice in this state of chiropractic by any chiropractor licensed by another state, territory, or country in which he or she resides. However, the chiropractor shall not establish a practice open to the general public and shall not engage in temporary practice under this section for a period longer than thirty days. The chiropractor shall register his or her intention to engage in the temporary practice of chiropractic in this state with the ((~~board of chiropractic examiners~~)) commission before engaging in the practice of chiropractic, and shall agree to be bound by such conditions as may be prescribed by rule by the ((~~board~~)) commission.

(2) The practice of chiropractic, except the administration of a chiropractic adjustment, by a person who is a regular senior student in an accredited school of chiropractic approved by the ((~~board~~)) commission if the practice is part of a regular course of instruction offered by the school and the student is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the ((~~board~~)) commission.

(3) The practice of chiropractic by a person serving a period of postgraduate chiropractic training in a program of clinical chiropractic training sponsored by a school of chiropractic accredited in this state if the practice is part of his or her duties as a clinical postgraduate trainee and the trainee is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the ((~~board~~)) commission.

(4) The practice of chiropractic by a person who is eligible and has applied to take the next available examination for licensing offered by the ((~~board of chiropractic examiners~~)) commission, except that the unlicensed chiropractor must provide all services under the direct control and supervision of a licensed chiropractor approved by the ((~~board~~)) commission. The unlicensed chiropractor may continue to practice as provided by this subsection until the results of the next available examination are published, but in no case for a period longer than six months. The ((~~board~~)) commission shall adopt rules necessary to effectuate the intent of this subsection.

Any provision of chiropractic services by any individual under subsection (1), (2), (3), or (4) of this section shall be subject to the jurisdiction of the ((~~chiropractic disciplinary board~~)) commission as provided in chapters 18.26 and 18.130 RCW.

NEW SECTION. Sec. 219. A new section is added to chapter 18.25 RCW to read as follows:

The commission is the successor in interest of the board of chiropractic examiners, the chiropractic disciplinary board, and the chiropractic peer review committee. All contracts, undertakings, agreements, rules, regulations, and policies of those bodies continue in full force and effect on the effective date of this act, unless otherwise repealed or rejected by chapter . . ., Laws of 1994 (this act) or by the commission.

NEW SECTION. Sec. 220. RCW 18.25.130, 18.25.140, 18.25.150, 18.25.160, and 18.25.170 are each recodified within chapter 18.25 RCW between RCW 18.25.019 and 18.25.020.

NEW SECTION. Sec. 221. The following acts or parts of acts are each repealed:

(1) RCW 18.25.015 and 1989 c 258 s 1, 1984 c 279 s 49, 1980 c 51 s 1, 1965 ex.s. c 50 s 1, & 1959 c 53 s 1;

(2) RCW 18.25.016 and 1989 c 258 s 13;

(3) RCW 18.25.017 and 1991 c 3 s 37, 1986 c 259 s 23, 1984 c 287 s 27, 1975-'76 2nd ex.s. c 34 s 32, 1974 ex.s. c 97 s 8, & 1959 c 53 s 2;

(4) RCW 18.25.120 and 1974 ex.s. c 97 s 1;

(5) RCW 18.26.010 and 1989 c 258 s 7 & 1967 c 171 s 1;

(6) RCW 18.26.020 and 1991 c 3 s 43, 1989 c 258 s 8, & 1967 c 171 s 2;

(7) RCW 18.26.028 and 1987 c 150 s 13 & 1986 c 259 s 22;

(8) RCW 18.26.030 and 1986 c 259 s 25, 1979 ex.s. c 111 s 17, 1975 1st ex.s. c 39 s 1, 1974 ex.s. c 97 s 12, & 1967 c 171 s 3;

(9) RCW 18.26.040 and 1989 c 258 s 9 & 1980 c 46 s 1;

(10) RCW 18.26.050 and 1991 c 3 s 44, 1979 c 158 s 21, & 1967 c 171 s 5;

(11) RCW 18.26.060 and 1967 c 171 s 6;

(12) RCW 18.26.070 and 1991 c 3 s 45, 1984 c 287 s 28, & 1980 c 46 s 2;

(13) RCW 18.26.080 and 1967 c 171 s 8;

(14) RCW 18.26.090 and 1989 c 258 s 11 & 1967 c 171 s 9;

(15) RCW 18.26.110 and 1986 c 259 s 26, 1975 1st ex.s. c 39 s 2, & 1967 c 171 s 11;

(16) RCW 18.26.320 and 1991 c 320 s 1;

(17) RCW 18.26.330 and 1991 c 320 s 2;

(18) RCW 18.26.340 and 1991 c 320 s 3;

(19) RCW 18.26.350 and 1991 c 320 s 4;

(20) RCW 18.26.360 and 1991 c 320 s 5;

(21) RCW 18.26.370 and 1991 c 320 s 6;

(22) RCW 18.26.380 and 1991 c 320 s 7;

(23) RCW 18.26.390 and 1991 c 320 s 11; and

(24) RCW 18.26.900 and 1967 c 171 s 31.

DENTAL

NEW SECTION. Sec. 301. A new section is added to chapter 18.32 RCW to read as follows:

The legislature finds that the health and well-being of the people of this state are of paramount importance.

The legislature further finds that the conduct of members of the dental profession licensed to practice dentistry in this state plays a vital role in preserving the health and well-being of the people of the state.

The legislature further finds that there is no effective means of handling disciplinary proceedings against members of the dental profession licensed in this state when such proceedings are necessary for the protection of the public health.

Therefore, the legislature declares its intention to exercise the police power of the state to protect the public health, to promote the welfare of the state, and to provide a commission to act as a disciplinary and regulatory body for the members of the dental profession licensed to practice dentistry in this state.

It is the purpose of the commission established in section 304 of this act to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensure, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state.

Sec. 302. RCW 18.32.010 and 1991 c 3 s 58 are each amended to read as follows:

Words used in the singular in this chapter may also be applied to the plural of the persons and things; words importing the plural may be applied to the singular; words importing the masculine gender may be extended to females also; the term "((~~board~~)) commission" used in this chapter shall mean the Washington state ((~~board of dental examiners~~)) dental quality assurance commission; and the term "secretary" shall mean the secretary of health of the state of Washington.

Sec. 303. RCW 18.32.030 and 1991 c 3 s 59 are each amended to read as follows:

The following practices, acts, and operations are excepted from the operation of the provisions of this chapter:

(1) The rendering of dental relief in emergency cases in the practice of his or her profession by a physician or surgeon, licensed as such and registered under the laws of this state, unless the physician or surgeon undertakes to or does reproduce lost parts of the human teeth in the mouth or to restore or to replace in the human mouth lost or missing teeth;

(2) The practice of dentistry in the discharge of official duties by dentists in the United States federal services on federal reservations, including but not limited to the armed services, coast guard, public health service, veterans' bureau, or bureau of Indian affairs;

(3) Dental schools or colleges approved under RCW 18.32.040, and the practice of dentistry by students in Washington state dental schools or colleges approved by the ((~~board~~)) commission, when acting under the direction and supervision of Washington state-licensed dental school faculty;

(4) The practice of dentistry by licensed dentists of other states or countries while appearing as clinicians at meetings of the Washington state dental association, or component parts thereof, or at meetings sanctioned by them, or other groups approved by the ((~~board of dental examiners~~)) commission;

(5) The use of roentgen and other rays for making radiographs or similar records of dental or oral tissues, under the supervision of a licensed dentist or physician;

(6) The making, repairing, altering, or supplying of artificial restorations, substitutions, appliances, or materials for the correction of disease, loss, deformity, malposition, dislocation, fracture, injury to the jaws, teeth, lips, gums, cheeks, palate, or associated tissues or parts; providing the same are made, repaired, altered, or supplied pursuant to the written instructions and order of a licensed dentist which may be accompanied by casts, models, or impressions furnished by the dentist, and the prescriptions shall be retained and filed for a period of not less than three years and shall be available to and subject to the examination of the secretary or the secretary's authorized representatives;

(7) The removal of deposits and stains from the surfaces of the teeth, the application of topical preventative or prophylactic agents, and the polishing and smoothing of restorations, when performed or prescribed by a dental hygienist licensed under the laws of this state;

(8) A qualified and licensed physician and surgeon extracting teeth or performing oral surgery pursuant to the scope of practice under chapter 18.71 or 18.57 RCW;

(9) The performing of dental operations or services by persons not licensed under this chapter when performed under the supervision of a licensed dentist: PROVIDED HOWEVER, That such nonlicensed person shall in no event perform the following dental operations or services unless permitted to be performed by the person under this chapter or chapters 18.29, 18.57, 18.71, and 18.88 RCW:

(a) Any removal of or addition to the hard or soft tissue of the oral cavity;

(b) Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, or physical condition of the human teeth or jaws, or adjacent structure;

(c) Any administration of general or injected local anaesthetic of any nature in connection with a dental operation, including intravenous sedation;

(d) Any oral prophylaxis;

(e) The taking of any impressions of the teeth or jaw or the relationships of the teeth or jaws, for the purpose of fabricating any intra-oral restoration, appliance, or prosthesis.

NEW SECTION. Sec. 304. A new section is added to chapter 18.32 RCW to read as follows:

COMMISSION ESTABLISHED‑-MEMBERS APPOINTED. The Washington state dental quality assurance commission is established, consisting of fifteen members each appointed by the governor to a four-year term. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, members of the previous boards and committees regulating these professions be appointed to the commission. Members of the commission hold office until their successors are appointed. The governor may appoint members of the initial commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. Twelve members of the commission must be dentists, two members must be public members, and one nonvoting member must be a licensed dental hygienist.

NEW SECTION. Sec. 305. A new section is added to chapter 18.32 RCW to read as follows:

NEW SECTION. Sec. 306. A new section is added to chapter 18.32 RCW to read as follows:

COMMISSION‑-QUALIFICATIONS OF MEMBERS. Members must be citizens of the United States and residents of this state. Dentist members must be licensed dentists in the active practice of dentistry for a period of five years before appointment. Of the twelve dentists appointed to the commission, at least four must reside and engage in the active practice of dentistry east of the summit of the Cascade mountain range. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission. The dental hygienist member must be in the active practice of dental hygiene in this state for a period of five years before appointment to the commission, and at the time of initial appointment, be a member of the Washington state dental hygiene examining committee. No person is eligible to appointment to the commission who is in any way connected with a dental college or dental department of an institution of learning.

NEW SECTION. Sec. 307. A new section is added to chapter 18.32 RCW to read as follows:

COMMISSION‑-DUTIES AND POWERS. The commission shall elect a chairperson, vice-chairperson, and secretary each year. Meetings of the commission are open to the public, except the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

The commission may appoint members of panels consisting of not less than three members. A quorum for transaction of any business shall be a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

The commission shall prepare or determine the nature of the examinations for applicants to practice dentistry.

The attorney general shall advise the commission and represent it in all legal proceedings.

NEW SECTION. Sec. 308. A new section is added to chapter 18.32 RCW to read as follows:

Each member of the commission shall be compensated in accordance with RCW 43.03.240. Members shall be reimbursed for travel expenses incurred in the actual performance of their duties, as provided in RCW 43.03.050 and 43.03.060. Commission members shall be compensated and reimbursed for their activities in developing or administering a multistate licensing examination, as provided in this chapter.

NEW SECTION. Sec. 309. A new section is added to chapter 18.32 RCW to read as follows:

The commission may contract with competent persons on a temporary basis to assist in developing or administering examinations for licensure.

The commission may enter into compacts and agreements with other states and with organizations formed by several states, for the purpose of conducting multistate licensing examinations. The commission may enter into the compacts and agreements even though they would result in the examination of a candidate for a license in this state by an examiner or examiners from another state or states, and even though the compacts and agreements would result in the examination of a candidate or candidates for a license in another state or states by an examiner or examiners from this state.

NEW SECTION. Sec. 310. A new section is added to chapter 18.32 RCW to read as follows:

The commission may adopt rules in accordance with chapter 34.05 RCW to implement this chapter and chapter 18.130 RCW.

Sec. 311. RCW 18.32.040 and 1991 c 3 s 61 are each amended to read as follows:

The ((~~board~~)) commission shall require that every applicant for a license to practice dentistry shall:

(1) Present satisfactory evidence of graduation from a dental college, school, or dental department of an institution approved by the ((~~board~~)) commission;

(2) Submit, for the files of the ((~~board~~)) commission, a recent picture duly identified and attested; and

(3) Pass an examination prepared or approved by and administered under the direction of the ((~~board~~)) commission. The dentistry licensing examination shall consist of practical and written tests upon such subjects and of such scope as the ((~~board~~)) commission determines. The ((~~board~~)) commission may accept, in lieu of all or part of a written examination, a certificate granted by a national or regional testing organization approved by the ((~~board~~)) commission. The ((~~board~~)) commission shall set the standards for passing the examination. The secretary shall keep on file the examination papers and records of examination for at least one year. This file shall be open for inspection by the applicant or the applicant's agent unless the disclosure will compromise the examination process as determined by the ((~~board~~)) commission or is exempted from disclosure under RCW 42.17.250 through 42.17.340.

Sec. 312. RCW 18.32.050 and 1984 c 287 s 30 are each amended to read as follows:

((The members of the board shall each be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses incurred in attending the meetings of the board in accordance with RCW 43.03.050 and 43.03.060. Board)) Commission members shall be compensated and reimbursed pursuant to this section for their activities in administering a multi-state licensing examination pursuant to the ((~~board's~~)) commission's compact or agreement with another state or states or with organizations formed by several states((~~: PROVIDED, That any~~)). Compensation or reimbursement received by a ((~~board~~)) commission member from another state, or organization formed by several states, for such member's services in administering a multi-state licensing examination, shall be deposited in the state general fund.

Sec. 313. RCW 18.32.100 and 1991 c 3 s 62 are each amended to read as follows:

The applicant for a dentistry license shall file an application on a form furnished by the secretary, stating the applicant's name, age, place of residence, the name of the school or schools attended by the applicant, the period of such attendance, the date of the applicant's graduation, whether the applicant has ever been the subject of any disciplinary action related to the practice of dentistry, and shall include a statement of all of the applicant's dental activities. This shall include any other information deemed necessary by the ((~~board~~)) commission.

The application shall be signed by the applicant and sworn to by the applicant before some person authorized to administer oaths, and shall be accompanied by proof of the applicant's school attendance and graduation.

Sec. 314. RCW 18.32.120 and 1991 c 3 s 64 are each amended to read as follows:

When the application and the accompanying proof are found satisfactory, the secretary shall notify the applicant to appear before the ((~~board~~)) commission at a time and place to be fixed by the ((~~board~~)) commission.

The examination papers, and all grading thereon, and the grading of the practical work, shall be preserved for a period of not less than one year after the ((~~board~~)) commission has made and published its decisions thereon. All examinations shall be conducted by the ((~~board~~)) commission under fair and wholly impartial methods.

Any applicant who fails to make the required grade by his or her fourth examination may be reexamined only under rules adopted by the ((~~board~~)) commission.

Applicants for examination or reexamination shall pay a fee as determined by the secretary as provided in RCW 43.70.250.

Sec. 315. RCW 18.32.160 and 1991 c 3 s 65 are each amended to read as follows:

All licenses issued by the secretary on behalf of the ((~~board~~)) commission shall be signed by the secretary or chairperson and secretary of the ((~~board~~)) commission.

Sec. 316. RCW 18.32.180 and 1991 c 3 s 67 are each amended to read as follows:

(1) Every person licensed to practice dentistry in this state shall register with the secretary, and pay a renewal registration fee determined by the secretary as provided in RCW 43.70.250. Any failure to register and pay the renewal registration fee renders the license invalid, and the practice of dentistry shall not be permitted. The license shall be reinstated upon written application to the secretary and payment to the state of a penalty fee determined by the secretary as provided in RCW 43.70.250, together with all delinquent license renewal fees.

(2) A person who fails to renew the license for a period of three years may not renew the license under subsection (1) of this section. In order to obtain a license to practice dentistry in this state, such a person shall file an original application as provided for in this chapter, along with the requisite fees. The ((~~board~~)) commission, in its sole discretion, may permit the applicant to be licensed without examination, and with or without conditions, if it is satisfied that the applicant meets all the requirements for licensure in this state and is competent to engage in the practice of dentistry.

Sec. 317. RCW 18.32.190 and 1991 c 3 s 68 are each amended to read as follows:

Every person who engages in the practice of dentistry in this state shall cause his or her license to be, at all times, displayed in a conspicuous place, in his or her office wherein he or she shall practice such profession, and shall further, whenever requested, exhibit such license to any of the members of ((~~said board~~)) the commission, or its authorized agent, and to the secretary or his or her authorized agent. Every licensee shall notify the secretary of the address or addresses, and of every change thereof, where the licensee shall engage in the practice of dentistry.

Sec. 318. RCW 18.32.195 and 1992 c 59 s 1 are each amended to read as follows:

The ((~~board~~)) commission may, without examination, issue a license to persons who possess the qualifications set forth in this section.

(1) The ((~~board~~)) commission may, upon written request of the dean of the school of dentistry of the University of Washington, issue a license to practice dentistry in this state to persons who have been licensed or otherwise authorized to practice dentistry in another state or country and who have been accepted for employment by the school of dentistry as full-time faculty members. For purposes of this subsection, this means teaching members of the faculty of the school of dentistry of the University of Washington who are so employed on a one hundred percent of work time basis. Such license shall permit the holder thereof to practice dentistry within the confines of the university facilities for a period of one year while he or she is so employed as a full-time faculty member by the school of dentistry of the University of Washington. It shall terminate whenever the holder ceases to be such a full-time faculty member. Such license shall permit the holder thereof to practice dentistry only in connection with his or her duties in employment with the school of dentistry of the University of Washington. This limitation shall be stated on the license.

(2) The ((~~board~~)) commission may, upon written request of the dean of the school of dentistry of the University of Washington, issue a limited license to practice dentistry in this state to university residents in postgraduate dental education. The license shall permit the resident dentist to provide dental care only in connection with his or her duties as a university resident.

(3) The ((~~board~~)) commission may condition the granting of a license under this section with terms the ((~~board~~)) commission deems appropriate. All persons licensed under this section shall be subject to the jurisdiction of the ((~~dental disciplinary board~~)) commission to the same extent as other members of the dental profession, in accordance with this chapter, and in addition the licensee may be disciplined by the ((~~dental disciplinary board~~)) commission after a hearing has been held in accordance with the provisions set forth in this chapter, and determination by the ((~~dental disciplinary board~~)) commission that such licensee has violated any of the restrictions set forth in this section.

(4) Persons applying for licensure pursuant to this section shall pay the application fee determined by the secretary and, in the event the license applied for is issued, a license fee at the rate provided for licenses generally. After review by the ((~~board of dental examiners~~)) commission, licenses issued under this section may be renewed annually if the licensee continues to be employed as a full-time faculty member of the school of dentistry of the University of Washington, or a university resident in postgraduate dental education, and otherwise meets the requirements of the provisions and conditions deemed appropriate by the ((~~board of dental examiners~~)) commission. Any person who obtains a license pursuant to this section may, without an additional application fee, apply for licensure under this chapter, in which case the applicant shall be subject to examination and the other requirements of this chapter.

Sec. 319. RCW 18.32.215 and 1989 c 202 s 30 are each amended to read as follows:

An applicant holding a valid license and currently engaged in practice in another state may be granted a license without examination required by this chapter, on the payment of any required fees, if the ((~~board~~)) commission determines that the other state's licensing standards are substantively equivalent to the standards in this state((~~: PROVIDED, That~~)). The ((~~board~~)) commission may also require the applicant to: (1) File with the ((~~board~~)) commission documentation certifying the applicant is licensed to practice in another state; and (2) provide information as the ((~~board~~)) commission deems necessary pertaining to the conditions and criteria of the Uniform Disciplinary Act, chapter 18.130 RCW, and to demonstrate to the ((~~board~~)) commission a knowledge of Washington law pertaining to the practice of dentistry.

Sec. 320. RCW 18.32.534 and 1991 c 3 s 72 are each amended to read as follows:

(1) To implement an impaired dentist program as authorized by RCW 18.130.175, the ((~~dental disciplinary board~~)) commission shall enter into a contract with a voluntary substance abuse monitoring program. The impaired dentist program may include any or all of the following:

(a) Contracting with providers of treatment programs;

(b) Receiving and evaluating reports of suspected impairment from any source;

(d) Referring impaired dentists to treatment programs;

(e) Monitoring the treatment and rehabilitation of impaired dentists including those ordered by the ((~~board~~)) commission;

(f) Providing education, prevention of impairment, posttreatment monitoring, and support of rehabilitated impaired dentists; and

(g) Performing other related activities as determined by the ((~~board~~)) commission.

(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of up to fifteen dollars on each license issuance or renewal to be collected by the department of health from every dentist licensed under chapter 18.32 RCW. These moneys shall be placed in the health professions account to be used solely for the implementation of the impaired dentist program.

Sec. 321. RCW 18.32.640 and 1988 c 217 s 1 are each amended to read as follows:

(1) The ((~~board~~)) commission may adopt((~~, amend, and rescind~~)) such rules as it deems necessary to carry out this chapter.

(2) The ((~~board~~)) commission may adopt rules governing administration of sedation and general anesthesia by persons licensed under this chapter, including necessary training, education, equipment, and the issuance of any permits, certificates, or registration as required.

Sec. 322. RCW 18.32.655 and 1986 c 259 s 35 are each amended to read as follows:

The ((~~dental disciplinary board has the power and it shall be its duty to~~)) commission shall:

(1) Require licensed dentists to keep and maintain a copy of each laboratory referral instruction, describing detailed services rendered, for a period to be determined by the ((~~board~~)) commission but not more than three years, and ((to)) may require the production of all such records for examination by the ((~~board~~)) commission or its authorized representatives; and

(2) ((~~Promulgate~~)) Adopt reasonable rules ((~~and regulations~~)) requiring licensed dentists to make, maintain, and produce for examination by the ((~~board~~)) commission or its authorized representatives such other records as may be reasonable and proper in the performance of its duties and enforcing the provisions of this chapter.

Sec. 323. RCW 18.32.665 and 1986 c 259 s 36 are each amended to read as follows:

It shall be unlawful for any person, firm, or corporation to publish, directly or indirectly, or circulate any fraudulent, false, or misleading statements within the state of Washington as to the skill or method of practice of any person or operator; or in any way to advertise in print any matter with a view of deceiving the public, or in any way that will tend to deceive or defraud the public; or to claim superiority over neighboring dental practitioners; or to publish reports of cases or certificates of same in any public advertising media; or to advertise as using any anesthetic, drug, formula, medicine, which is either falsely advertised or misnamed; or to employ "capper" or "steerers" to obtain patronage; and any person committing any offense against any of the provisions of this section shall, upon conviction, be subjected to such penalties as are provided in this chapter: PROVIDED, That any person licensed under this chapter may announce credit, terms of credit or installment payments that may be made at periodical intervals to apply on account of any dental service rendered. The ((~~dental disciplinary board~~)) commission may adopt such rules as are necessary to carry out the intent of this section.

Sec. 324. RCW 18.32.745 and 1991 c 3 s 73 are each amended to read as follows:

No manager, proprietor, partnership, or association owning, operating, or controlling any room, office, or dental parlors, where dental work is done, provided, or contracted for, shall employ or retain any unlicensed person or dentist as an operator; nor shall fail, within ten days after demand made by the secretary of health((,)) or the ((~~state board of dental examiners, or the dental disciplinary board~~)) commission in writing sent by certified mail, addressed to any such manager, proprietor, partnership, or association at ((~~said~~)) the room, office, or dental parlor, to furnish the secretary of health((,)) or the ((~~state board of dental examiners, or the dental disciplinary board~~)) commission with the names and addresses of all persons practicing or assisting in the practice of dentistry in his or her place of business or under his or her control, together with a sworn statement showing by what license or authority ((~~said~~)) the persons are practicing dentistry.

The sworn statement shall not be used as evidence in any subsequent court proceedings, except in a prosecution for perjury connected with its execution.

Any violation of the provisions of this section ((~~shall constitute~~)) is improper, unprofessional, and dishonorable conduct; it ((~~shall~~)) also ((~~constitute~~)) is grounds for injunction proceedings as provided by this chapter, and in addition ((~~shall constitute~~)) is a gross misdemeanor, except that the failure to furnish the information as may be requested in accordance with this section ((~~shall constitute~~)) is a misdemeanor.

Sec. 325. RCW 18.32.755 and 1986 c 259 s 37 are each amended to read as follows:

Any advertisement or announcement for dental services must include for each office location advertised the names of all persons practicing dentistry at that office location.

Any violation of the provisions of this section ((~~shall constitute~~)) is improper, unprofessional, and dishonorable conduct; it ((~~shall~~)) also ((~~constitute~~)) is grounds for injunction proceedings as provided by RCW 18.130.190((~~(2)~~)) (4), and in addition ((~~shall constitute~~)) is a gross misdemeanor.

NEW SECTION. Sec. 326. A new section is added to chapter 18.32 RCW to read as follows:

The commission is the successor in interest of the board of dental examiners and the dental disciplinary board. All contracts, undertakings, agreements, rules, regulations, and policies continue in full force and effect on the effective date of this act, unless otherwise repealed or rejected by chapter ..., Laws of 1994 (this act) or by the commission.

NEW SECTION. Sec. 327. The following acts or parts of acts are each repealed:

(1) RCW 18.32.035 and 1989 c 202 s 14, 1984 c 279 s 50, 1979 c 38 s 1, 1975 c 49 s 1, 1953 c 93 s 2, 1941 c 92 s 1, & 1935 c 112 s 2;

(2) RCW 18.32.037 and 1991 c 3 s 60, 1989 c 202 s 15, & 1935 c 112 s 3;

(3) RCW 18.32.042 and 1989 c 202 s 28;

(4) RCW 18.32.500 and 1989 c 202 s 24, 1986 c 259 s 39, & 1977 ex.s. c 5 s 37;

(5) RCW 18.32.510 and 1977 ex.s. c 5 s 1;

(6) RCW 18.32.520 and 1991 c 3 s 71, 1989 c 202 s 25, 1986 c 259 s 40, 1979 c 158 s 36, & 1977 ex.s. c 5 s 2;

(7) RCW 18.32.560 and 1984 c 279 s 51 & 1977 ex.s. c 5 s 6;

(8) RCW 18.32.570 and 1977 ex.s. c 5 s 7;

(9) RCW 18.32.580 and 1977 ex.s. c 5 s 8;

(10) RCW 18.32.590 and 1977 ex.s. c 5 s 9;

(11) RCW 18.32.600 and 1984 c 287 s 31 & 1977 ex.s. c 5 s 10;

(12) RCW 18.32.610 and 1977 ex.s. c 5 s 11; and

(13) RCW 18.32.620 and 1984 c 279 s 62 & 1977 ex.s. c 5 s 12.

VISION CARE

NEW SECTION. Sec. 401. LEGISLATIVE INTENT. The legislature finds that vision care practitioners provide a vital service that affects the health and welfare of the people of this state and should be regulated in the public interest and to ensure that practitioners are limited to qualified persons licensed and authorized to practice under this chapter.

It is the purpose of the commission established under section 407 of this act to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state.

NEW SECTION. Sec. 402. DEFINITIONS. Unless the context clearly requires otherwise, the definitions set forth in this section apply throughout this chapter.

(1) "Apprentice" is a person registered by the secretary to a physician, optometrist, or dispensing optician for the purpose of obtaining training and direct supervision in the practice of a dispensing optician.

(2) "Commission" means the vision care quality assurance commission.

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

(4) "Dispensing optician" means a person licensed under this chapter to practice as a dispensing optician.

(5) "Optometrist" means a person licensed under this chapter to practice optometry.

(6) "Person" means an individual, corporation, government, governmental subdivision or agency, business trust, estate, trust, partnership, or association, or any other legal entity.

(7) "Physician" is a person licensed under chapter 18.57 or 18.71 RCW.

(8) "Secretary" means the secretary of health or the secretary's designee.

(9) "Vision care practitioner" means either a licensed dispensing optician or optometrist.

NEW SECTION. Sec. 403. OPTOMETRY‑-DEFINITION‑-SCOPE OF PRACTICE. (1) The practice of optometry is defined as the examination of the human eye, the examination and ascertaining any defects of the human vision system, and the analysis of the process of vision. The practice of optometry may include, but not necessarily be limited to, the following:

(a) The employment of objective or subjective means or methods including the use of drugs topically applied to the eye for diagnostic and therapeutic purposes by those licensed under this chapter and who meet the requirements of subsections (2) and (3) of this section, and the use of diagnostic instruments or devices for the examination or analysis of the human vision system, the measurement of the powers or range of human vision, or the determination of the refractive powers of the human eye or its functions in general;

(b) The prescription and provision of visual therapy, therapeutic aids, and other optical devices, and the treatment with topically applied drugs by those licensed under this chapter and who meet the requirements of subsections (2) and (3) of this section;

(d) The adaptation of prosthetic eyes.

(2) Those persons using drugs for diagnostic purposes in the practice of optometry must have a minimum of sixty hours of didactic and clinical instruction in general and ocular pharmacology as applied to optometry, and for therapeutic purposes, an additional minimum of seventy-five hours of didactic and clinical instruction as established by the commission and certification from an institution of higher learning, accredited by those agencies recognized by the United States office of education or the council on postsecondary accreditation to qualify for certification by the commission to use drugs for diagnostic and therapeutic purposes. The courses are the fiscal responsibility of the participating and attending optometrist.

(3) The commission shall establish a schedule of drugs for diagnostic and treatment purposes limited to the practice of optometry, and no person licensed under this chapter may prescribe, dispense, purchase, possess, or administer drugs except as authorized and to the extent permitted by the commission.

(4) The commission shall develop a means of identification and verification of optometrists certified to use therapeutic drugs for the purpose of issuing prescriptions as authorized by this section.

NEW SECTION. Sec. 404. DISPENSING OPTICIAN. A dispensing optician is a person who prepares duplication of, or prepares and dispenses lenses, spectacles, eyeglasses, or appurtenances to them on written prescriptions from physicians or optometrists, and in accordance with the prescriptions, measures, adapts, adjusts, and fabricates the lenses, spectacles, eyeglasses, or appurtenances to them to the human face for the aid or correction of visual or ocular anomalies of the human eye. However, contact lenses may be fitted only upon written prescription of a physician or optometrist.

NEW SECTION. Sec. 405. APPRENTICE. (1) A vision care practitioner shall not register more than two apprentices in the apprenticeship training program at one time.

(2) The vision care practitioner is responsible for the acts of his or her apprentices in the performance of their work in the apprenticeship program.

(3) An apprentice must complete the apprenticeship program within six years of the initial registration. An apprentice may request an extension from the secretary if the apprentice feels that unforeseen circumstances beyond his or her control prevented the apprentice from completing the program within the six-year period.

NEW SECTION. Sec. 406. EXEMPTIONS. Nothing in this chapter:

(1) Limits or restricts a duly licensed physician or optometrist or employees working under the personal supervision of a duly licensed physician or optometrist from the practices enumerated in this chapter that accrue to dispensing opticians licensed under this chapter, but this subsection does not permit a dispensing optician to practice optometry;

(2) Prohibits an unlicensed person from performing mechanical work upon inert matter in an optical office, laboratory, or shop;

(3) Prohibits an unlicensed person from engaging in the sale of spectacles, eyeglasses, magnifying glasses, goggles, sunglasses, telescopes, binoculars, or any such articles that are completely preassembled and sold only as merchandise;

(4) Authorizes or permits a dispensing optician to hold himself or herself out as being able to, or to offer to, or to undertake to attempt, by any manner of means, to examine or exercise the eyes, diagnose, treat, correct, relieve, operate, or prescribe for any human ailment, deficiency, deformity, disease, or injury.

NEW SECTION. Sec. 407. COMMISSION ESTABLISHED‑-MEMBERS APPOINTED. The Washington state vision care quality assurance commission is established, consisting of nine members each appointed by the governor to a four-year term. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, members of the previous boards and committees regulating these professions be appointed to the commission. Members of the commission hold office until their successors are appointed. The governor may appoint members of the initial commissions to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms.

NEW SECTION. Sec. 408. COMMISSION‑-REMOVAL OF MEMBERS‑-VACANCIES. The governor may remove a member of the commission for neglect of duty, misconduct, or malfeasance or misfeasance in office. Whenever the governor is satisfied that a member of the commission has been guilty of neglect of duty, misconduct, or malfeasance of misfeasance in office, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement to fill the remainder of the unexpired term.

NEW SECTION. Sec. 409. COMMISSION‑-QUALIFICATIONS FOR MEMBERS. Members must be citizens of the United States and residents of this state, and no commission member may have a connection with a school or college embracing the teaching of optometry or opticianry or with an optical supply business. Three members must be licensed practicing optometrists for a period of four years before appointment; three members must be licensed practicing dispensing opticians for a period of four years before appointment; two members must be public members; and one nonvoting member must be a licensed practicing ophthalmologist who is a physician holding certification in that specialty from the American Academy of Ophthalmology. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

NEW SECTION. Sec. 410. COMMISSION‑-DUTIES AND POWERS. The commission shall elect a chairperson, vice-chairperson, and secretary each year. Meetings of the commission are open to the public, except that the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

The commission may appoint members of panels consisting of not less than three members. A quorum for transaction of any business is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

The commission may, whenever the workload of the commission requires, request that the secretary appoint pro tempore members. While serving as members pro tempore, persons have all the powers, duties, and immunities, and are entitled to the emoluments, including travel expenses, of the commission.

The commission shall prepare or determine the nature of the examinations for applicants for optometrist and dispensing optician licenses.

NEW SECTION. Sec. 411. LICENSE APPLICATIONS‑-ELIGIBILITY‑-QUALIFICATIONS. (1) Persons applying for licensing under this chapter must:

(a) Submit a completed application on forms provided by the department;

(b) Pay an application fee as determined by the secretary as provided in RCW 43.70.250;

(d) Be a graduate of a state-accredited high school or its equivalent;

(e) Be of good moral character;

(f) Have no contagious or infectious disease;

(g) Successfully complete an examination prepared and administered or approved for administration, or both, by the commission.

(2) Optometrists applying for licensing must, in addition to the requirements of subsection (1) of this section, meet the following requirements: Have a diploma or other certificate of completion from an accredited college of optometry or school of optometry, maintaining a course of four scholastic years in addition to preprofessional college level studies, and teaching substantially all of the following subjects: General anatomy, anatomy of the eyes, physiology, physics, chemistry, pharmacology, biology, bacteriology, general pathology, ocular pathology, ocular neurology, ocular mechanics, clinical optometry, visual field charting and orthoptics, general laws of optics and refraction, and use of the ophthalmoscope, retinoscope, and other clinical instruments necessary in the practice of optometry.

(3) Dispensing opticians applying for licensing must, in addition to the requirements of subsection (1) of this section, have either:

(a) Had at least three years of apprenticeship training;

(b) Successfully completed a prescribed course in opticianry in a college or university approved by the secretary; or

NEW SECTION. Sec. 412. LICENSE REQUIRED. It is a violation of RCW 18.130.190 for a person to practice or represent himself or herself as a vision care practitioner in this state without first obtaining a license under this chapter from the secretary.

NEW SECTION. Sec. 413. ANNUAL RENEWAL‑-FEE‑-REINSTATEMENT‑-PENALTY‑-CONTINUING EDUCATION. Each licensee under this chapter shall pay an annual renewal registration fee determined by the secretary as provided in RCW 43.70.250, on the date prescribed by the secretary.

Failure to pay the annual renewal registration fee renders the license invalid, but the license shall be reinstated upon written application to the secretary as provided in RCW 43.70.250, together with all delinquent annual license renewal fees. In addition, the commission may adopt rules establishing mandatory continuing education or continuing competence requirements to be met by persons applying for license renewal.

NEW SECTION. Sec. 414. CREDENTIALING BY ENDORSEMENT. An applicant holding a credential in another state may be credentialed to practice in this state without examination if the commission determines that the other state's credentialing standards are substantially equivalent to the standards in this state.

NEW SECTION. Sec. 415. INTERIM PERMITS. The commission may, in its discretion, issue a permit to practice optometry during the interim between examinations, to a person who has filed an application for examination that has been accepted by the commission as admitting the applicant to the next examination. The permit is valid only until the date of the next examination and may not be issued sooner than thirty days after a regular examination. No permit may be issued to a person who has failed before the commission, nor where a certificate has been revoked.

NEW SECTION. Sec. 416. DISCIPLINING AUTHORITY. The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice, the issuance of licenses, and the discipline of licensees under this chapter.

The commission is the disciplining authority for optometrists licensed under this chapter. The secretary is the disciplining authority for dispensing opticians licensed under this chapter. The secretary may delegate by rule any powers or duties granted under this chapter or by law, to the commission.

NEW SECTION. Sec. 417. DISCIPLINARY ACTIONS‑-GROUNDS. The following are grounds for disciplinary action under chapter 18.130 RCW:

(1) Fraud or deceit used in securing a license;

(2) Unprofessional conduct of a nature likely to deceive or defraud the public;

(3) Employing either directly or indirectly a person or persons commonly known as "cappers" or "steerers" to obtain business;

(4) Employing a person to solicit from house to house, or to personally solicit from house to house;

(5) Placing or presenting an advertisement in which untruthful, improbable, or impossible statements are made regarding treatments, cures, or values; or

(6) Using the term "eye specialist" in connection with the name of the vision care practitioner.

NEW SECTION. Sec. 418. UNLAWFUL ACTS‑-OPTOMETRISTS. It is unlawful for an optometrist to:

(1) Sell or barter, or offer to sell or barter, a license issued by the secretary;

(2) Purchase or procure by barter a license with the intent to use it as evidence of the holder's qualification to practice optometry;

(3) Alter the license with fraudulent intent in a material regard; (4) Use or attempt to use a license that has been purchased, fraudulently issued, counterfeited, or materially altered as a valid license;

(5) Practice optometry under a false or assumed name, or as a representative or agent of a person, firm, or corporation with which the licensee has no connection; but nothing in this chapter makes it unlawful for a licensed optometrist or association of licensed optometrists to practice optometry under the name of a lawfully licensed optometrist who may transfer by inheritance or otherwise the right to use the name;

(6) Barter or give away as premiums either on his or her own account or as agent or representative, any eyeglasses, spectacles, lenses, or frames;

(7) Use drugs in the practice of optometry, except those topically applied for diagnostic or therapeutic purposes;

(8) Use advertising, whether printed, radio, display, or of any other nature, that is misleading or inaccurate in a material particular, or misrepresents goods or services (including but without limitation, its use, trademark, grade quality, size, origin, substance, character, nature, finish, material, content, or preparation) or credit terms, values, policies, services, or the nature or form of the business conducted;

(9) Advertise the "free examination of eyes," "free consultation," "consultation without obligation," "free advice," or use words or phrases of similar import that convey the impression to the public that eyes are examined free, or are of a character tending to deceive or mislead the public, or are in the nature of "bait advertising";

(10) Use an advertisement of a frame or mounting that is not truthful in describing the frame or mounting and all of its component parts, or advertise a frame or mounting at a price, unless the advertisement contains a statement immediately following or adjacent to the advertised price, in type as large as that used for the price, that the price is for frame or mounting only, and does not include lenses, eye examination, and professional services; or advertise lenses or complete glasses, such as frame or mounting with lenses included, at a price either alone or in conjunction with professional services; or

(11) Use advertising, whether printed, radio, display, or of any other nature, that:

(a) Inaccurately lays claim to a policy or continuing practice of generally underselling competitors; or

(b) Refers inaccurately in any material particular to competitors or their goods, prices, values, credit terms, policies, or services; or

(c) States a definite amount of money as "down payment" and a definite amount of money as a subsequent payment, whether daily, weekly, monthly, or at the end of a period of time.

NEW SECTION. Sec. 419. UNLAWFUL ADVERTISING OF INDEMNITY BENEFITS. It is unlawful for a person licensed under this chapter to advertise to the effect that benefits in the form of indemnity will accrue to subscribers of health care service contracts for services performed by the licensee for a subscriber when the licensee is neither a health care service contractor nor a participant. A violation of this section is punishable as provided in chapter 18.130 RCW.

NEW SECTION. Sec. 420. DISCRIMINATION PROHIBITED‑-LEGISLATIVE FINDING AND DECLARATION. The legislature finds and declares that the costs of health care to the people are rising disproportionately to other costs and that there is a paramount concern that the right of the people to obtain access to health care in all its facets is being impaired thereby. For this reason, the reliance on the mechanism of insurance, whether profit or nonprofit, is the only effective manner in which the large majority of the people can attain access to quality health care, and it is therefore declared to be in the public interest that health care insurance be regulated to assure that all the people have access to health care rendered by whatever means, and to the greatest extent possible. Sections 421 through 425 of this act, prohibiting discrimination against the legally recognized and vision care practitioners, are necessary in the interest of the public health, welfare, and safety.

NEW SECTION. Sec. 421. DISCRIMINATION PROHIBITED‑-ACCEPTANCE OF SERVICES BY STATE AGENCIES AND SUBDIVISIONS. Notwithstanding any other provision of law, the state and its political subdivisions shall accept the services of vision care practitioners for any service covered by their licenses with relation to any person receiving benefits, salaries, wages, or any other type of compensation from the state, its agencies, or subdivisions.

NEW SECTION. Sec. 422. DISCRIMINATION PROHIBITED‑-STATE AGENCIES AND SUBDIVISIONS‑-OFFICIALS AND EMPLOYEES. The state and its political subdivisions and all officials, agents, employees, or representatives of the state, are prohibited from discriminating against vision care practitioners in performing and receiving compensation for services covered by their licenses.

NEW SECTION. Sec. 423. DISCRIMINATION PROHIBITED‑-AGREEMENTS OR CONTRACTS BY STATE AND SUBDIVISIONS. Notwithstanding any other provision of law, the state and its political subdivisions, and all officials, agents, employees, or representatives of the state, are prohibited from entering into any agreement or contract with an individual, group, association, or corporation that discriminates against vision care practitioners in performing and receiving compensation for services covered by their licenses.

NEW SECTION. Sec. 424. DISCRIMINATION PROHIBITED‑-COSTS IMMATERIAL. Notwithstanding any other provision of law, for the purpose of sections 421 through 425 of this act it is immaterial whether the cost of a policy, plan agreement, or contract is additional compensation for services, or otherwise.

NEW SECTION. Sec. 425. DISCRIMINATION PROHIBITED‑-APPLICATION OF LAW. Sections 421 through 425 of this act apply to all agreements, renewals, or contracts issued on or after the effective date of this act. Health care service contracts having a participant agreement with a majority of the vision care practitioners within its service area may provide benefits to persons or groups of persons through contracts that allow a subscriber to use on an equal participation basis the services of any participant provided in the contract, and such contracts must not be discriminatory.

NEW SECTION. Sec. 426. PRIVILEGED COMMUNICATIONS. The information and records of a vision care practitioner pertaining to a patient are privileged communications, the same as now or hereafter may exist in the relationship of physician and patient and shall not be released or subjected to disclosure without the consent of the patient or as otherwise required by law.

NEW SECTION. Sec. 427. VIOLATIONS‑-PENALTY. A person violating this chapter is guilty of a misdemeanor.

NEW SECTION. Sec. 428. COMMISSION‑-RULES‑-CONTINUATION IN EFFECT. The commission may adopt rules that are not inconsistent with the laws of this state as it determines are necessary to carry out the purpose of this chapter. The commission may adopt rules in accordance with chapter 34.05 RCW to implement this chapter.

The commission is the successor in interest of the examining board of dispensing opticians and the optometry board. All contracts, undertakings, agreements, rules, regulations, and policies of those boards continue in full force and effect on the effective date of this act, unless otherwise repealed or rejected by this chapter or by the commission.

NEW SECTION. Sec. 429. LEGISLATIVE DIRECTIVE. Sections 401 through 428 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 430. REPEALER. The following acts or parts of acts are each repealed:

(1) RCW 18.34.010 and 1957 c 43 s 1;

(2) RCW 18.34.020 and 1991 c 3 s 74, 1979 c 158 s 37, & 1957 c 43 s 2;

(3) RCW 18.34.030 and 1991 c 3 s 75 & 1957 c 43 s 3;

(4) RCW 18.34.050 and 1984 c 287 s 32 & 1957 c 43 s 5;

(5) RCW 18.34.060 and 1957 c 43 s 6;

(6) RCW 18.34.070 and 1991 c 3 s 76, 1985 c 7 s 29, 1975 1st ex.s. c 30 s 34, 1971 ex.s. c 292 s 22, & 1957 c 43 s 7;

(7) RCW 18.34.080 and 1991 c 3 s 77 & 1957 c 43 s 8;

(8) RCW 18.34.110 and 1991 c 3 s 78 & 1957 c 43 s 11;

(9) RCW 18.34.115 and 1991 c 332 s 33;

(10) RCW 18.34.120 and 1991 c 3 s 79, 1984 c 279 s 52, 1975 1st ex.s. c 30 s 35, & 1957 c 43 s 12;

(11) RCW 18.34.136 and 1987 c 150 s 19 & 1986 c 259 s 45;

(12) RCW 18.34.141 and 1987 c 150 s 20;

(13) RCW 18.34.900 and 1957 c 43 s 16;

(14) RCW 18.53.005 and 1981 c 58 s 1 & 1975 1st ex.s. c 69 s 1;

(15) RCW 18.53.010 and 1989 c 36 s 1, 1981 c 58 s 2, 1975 1st ex.s. c 69 s 2, & 1919 c 144 s 1;

(16) RCW 18.53.021 and 1991 c 3 s 133 & 1987 c 150 s 38;

(17) RCW 18.53.030 and 1986 c 259 s 80 & 1919 c 144 s 8;

(18) RCW 18.53.035 and 1991 c 332 s 30;

(19) RCW 18.53.040 and 1975 1st ex.s. c 69 s 15, 1937 c 155 s 3, & 1919 c 144 s 15;

(20) RCW 18.53.050 and 1991 c 3 s 134, 1985 c 7 s 51, 1983 c 168 s 8, 1981 c 277 s 8, 1975 1st ex.s. c 30 s 56, 1971 ex.s. c 266 s 10, 1955 c 275 s 1, & 1919 c 144 s 13;

(21) RCW 18.53.055 and 1955 c 275 s 2;

(22) RCW 18.53.060 and 1991 c 3 s 135, 1975 1st ex.s. c 69 s 4, 1937 c 155 s 1, & 1919 c 144 s 5;

(23) RCW 18.53.070 and 1991 c 3 s 136, 1985 c 7 s 52, & 1981 c 260 s 5;

(24) RCW 18.53.100 and 1991 c 3 s 137, 1986 c 259 s 81, 1975 1st ex.s. c 69 s 6, & 1919 c 144 s 11;

(25) RCW 18.53.101 and 1987 c 150 s 36 & 1986 c 259 s 78;

(26) RCW 18.53.140 and 1991 c 3 s 138, 1989 c 36 s 2, 1986 c 259 s 82, 1981 c 58 s 3, 1979 c 158 s 47, 1975 1st ex.s. c 69 s 7, 1945 c 78 s 1, 1935 c 134 s 1, & 1919 c 144 s 7;

(27) RCW 18.53.145 and 1969 c 143 s 2;

(28) RCW 18.53.150 and 1986 c 259 s 83 & 1919 c 144 s 22;

(29) RCW 18.53.160 and 1949 c 149 s 1;

(30) RCW 18.53.165 and 1973 c 48 s 1;

(31) RCW 18.53.170 and 1973 c 48 s 2;

(32) RCW 18.53.175 and 1973 c 48 s 3;

(33) RCW 18.53.180 and 1973 c 48 s 4;

(34) RCW 18.53.185 and 1973 c 48 s 5;

(35) RCW 18.53.190 and 1975 1st ex.s. c 69 s 8 & 1973 c 48 s 6;

(36) RCW 18.53.200 and 1975 1st ex.s. c 69 s 14;

(37) RCW 18.53.900 and 1919 c 144 s 20;

(38) RCW 18.53.901 and 1973 c 48 s 7;

(39) RCW 18.53.910 and 1919 c 144 s 18;

(40) RCW 18.53.911 and 1975 1st ex.s. c 69 s 17;

(41) RCW 18.53.912 and 1981 c 58 s 4;

(42) RCW 18.53.920 and 1919 c 144 s 19;

(43) RCW 18.54.010 and 1963 c 25 s 1;

(44) RCW 18.54.020 and 1963 c 25 s 2;

(45) RCW 18.54.030 and 1984 c 279 s 54 & 1963 c 25 s 3;

(46) RCW 18.54.040 and 1963 c 25 s 4;

(47) RCW 18.54.050 and 1991 c 3 s 139, 1989 c 175 s 65, 1979 c 158 s 48, 1975 1st ex.s. c 69 s 9, & 1963 c 25 s 5;

(48) RCW 18.54.060 and 1963 c 25 s 6;

(49) RCW 18.54.070 and 1991 c 3 s 140, 1986 c 259 s 84, 1979 c 158 s 49, 1975 1st ex.s. c 69 s 10, & 1963 c 25 s 7;

(50) RCW 18.54.076 and 1987 c 150 s 37 & 1986 c 259 s 79;

(51) RCW 18.54.090 and 1963 c 25 s 9;

(52) RCW 18.54.130 and 1984 c 287 s 41, 1975-'76 2nd ex.s. c 34 s 39, 1967 c 188 s 3, & 1963 c 25 s 13;

(53) RCW 18.54.140 and 1991 c 3 s 141, 1983 c 168 s 9, 1979 c 158 s 50, 1975 1st ex.s. c 69 s 12, & 1963 c 25 s 14;

(54) RCW 18.54.150 and 1963 c 25 s 15;

(55) RCW 18.54.900 and 1963 c 25 s 16;

(56) RCW 18.54.910 and 1963 c 25 s 17; and

(57) RCW 18.54.920 and 1963 c 25 s 18.

MEDICAL

NEW SECTION. Sec. 501. A new section is added to chapter 18.71 RCW to read as follows:

It is the purpose of the medical quality assurance commission to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state of Washington.

Sec. 502. RCW 18.71.010 and 1991 c 3 s 158 are each amended to read as follows:

The following terms used in this chapter shall have the meanings set forth in this section unless the context clearly indicates otherwise:

(1) ((~~"Board" means the board of medical examiners~~)) "Commission" means the Washington state medical quality assurance commission.

(2) "Secretary" means the secretary of health.

(3) "Resident physician" means an individual who has graduated from a school of medicine which meets the requirements set forth in RCW 18.71.055 and is serving a period of postgraduate clinical medical training sponsored by a college or university in this state or by a hospital accredited by this state. For purposes of this chapter, the term shall include individuals designated as intern or medical fellow.

(4) "Emergency medical care" or "emergency medical service" has the same meaning as in chapter 18.73 RCW.

Sec. 503. RCW 18.71.015 and 1991 c 44 s 1 and 1991 c 3 s 159 are each reenacted and amended to read as follows:

((There is hereby created a board of medical examiners consisting of six individuals licensed to practice medicine in the state of Washington, one individual who is licensed as a physician assistant under chapter 18.71A RCW, and two individuals who are not physicians, to be known as the Washington state board of medical examiners.)) The Washington state medical quality assurance commission is established, consisting of thirteen individuals licensed to practice medicine in the state of Washington under this chapter, two individuals who are licensed as physician assistants under chapter 18.71A RCW, and four individuals who are members of the public. Each congressional district now existing or hereafter created in the state must be represented by at least one physician member of the commission. The terms of office of members of the commission are not affected by changes in congressional district boundaries. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

The ((~~board~~)) members of the commission shall be appointed by the governor. ((~~On expiration of the term of any member, the governor shall appoint for a period of five years an individual of similar qualifications to take the place of such member.~~)) Members of the initial commission may be appointed to staggered terms of one to four years, and thereafter all terms of appointment shall be for four years. The governor shall consider such physician and physician assistant members who are recommended for appointment by the appropriate professional associations in the state. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, the existing members of the board of medical examiners and medical disciplinary board repealed under section 536, chapter . . ., Laws of 1994 (this act) be appointed to the commission. No member may serve more than two consecutive full terms. Each member shall hold office until ((~~the expiration of the term for which such member is appointed or until~~)) a successor ((~~shall have been~~)) is appointed ((~~and shall have qualified~~)).

Each member of the ((~~board shall~~)) commission must be a citizen of the United States, must be an actual resident of this state, and, if a physician, must have been licensed to practice medicine in this state for at least five years.

The ((~~board~~)) commission shall meet as soon as practicable after appointment and elect a chair ((~~and~~)), a vice-chair, and a secretary from its members. Meetings shall be held at least four times a year and at such place as the ((~~board shall~~)) commission determines and at such other times and places as the ((~~board~~)) commission deems necessary. A majority of the ((~~board~~)) commission members appointed and serving ((~~shall~~)) constitutes a quorum for the transaction of ((~~board~~)) commission business.

((~~It shall require~~)) The affirmative vote of a majority of a quorum of the ((~~board~~)) commission is required to carry any motion or resolution, to adopt any rule, or to pass any measure. The commission may appoint panels consisting of at least three members. A quorum for the transaction of any business by a panel is a minimum of three members. A majority vote of ((~~the members appointed to a panel of the board shall constitute~~)) a quorum ((~~for~~)) of the panel is required to transact business delegated to it by the ((~~board~~)) commission.

Each member of the ((~~board~~)) commission shall be compensated in accordance with RCW 43.03.240 and in addition thereto shall be reimbursed for travel expenses incurred in carrying out the duties of the ((~~board~~)) commission in accordance with RCW 43.03.050 and 43.03.060. Any such expenses shall be paid from funds appropriated to the department of health.

((~~Any member of the board may be removed by the governor for~~)) Whenever the governor is satisfied that a member of a commission has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the statement of causes and order of removal to the last known post office address of the member.

Vacancies in the membership of the ((~~board~~)) commission shall be filled for the unexpired term by appointment by the governor.

The members of the commission are immune from suit in an action, civil or criminal, based on its disciplinary proceedings or other official acts performed in good faith as members of the commission.

Whenever the workload of the commission requires, the commission may request that the secretary appoint pro tempore members of the commission. When serving, pro tempore members of the commission have all of the powers, duties, and immunities, and are entitled to all of the emoluments, including travel expenses, of regularly appointed members of the commission.

Sec. 504. RCW 18.71.017 and 1961 c 284 s 11 are each amended to read as follows:

The board may ((~~make~~)) adopt such rules ((~~and regulations~~)) as are not inconsistent with the laws of this state as may be determined necessary or proper to carry out the purposes of this chapter. The commission is the successor in interest of the board of medical examiners and the medical disciplinary board. All contracts, undertakings, agreements, rules, regulations, and policies continue in full force and effect on the effective date of this act, unless otherwise repealed or rejected by this chapter or by the commission.

Sec. 505. RCW 18.71.019 and 1987 c 150 s 45 are each amended to read as follows:

The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice and the issuance and denial of licenses and discipline of licensees under this chapter.

Sec. 506. RCW 18.71.030 and 1990 c 196 s 12 and 1990 c 33 s 552 are each reenacted and amended to read as follows:

Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer; nor shall anything in this chapter be construed to prohibit:

(1) The furnishing of medical assistance in cases of emergency requiring immediate attention;

(2) The domestic administration of family remedies;

(3) The administration of oral medication of any nature to students by public school district employees or private elementary or secondary school employees as provided for in chapter 28A.210 RCW;

(4) The practice of dentistry, osteopathy, osteopathy and surgery, nursing, chiropractic, ((~~podiatry~~)) podiatric medicine and surgery, optometry, naturopathy, or any other healing art licensed under the methods or means permitted by such license;

(5) The practice of medicine in this state by any commissioned medical officer serving in the armed forces of the United States or public health service or any medical officer on duty with the United States veterans administration while such medical officer is engaged in the performance of the duties prescribed for him or her by the laws and regulations of the United States;

(6) The practice of medicine by any practitioner licensed by another state or territory in which he or she resides, provided that such practitioner shall not open an office or appoint a place of meeting patients or receiving calls within this state;

(7) The practice of medicine by a person who is a regular student in a school of medicine approved and accredited by the ((~~board~~)) commission, however, the performance of such services be only pursuant to a regular course of instruction or assignments from his or her instructor, or that such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(8) The practice of medicine by a person serving a period of postgraduate medical training in a program of clinical medical training sponsored by a college or university in this state or by a hospital accredited in this state, however, the performance of such services shall be only pursuant to his or her duties as a trainee;

(9) The practice of medicine by a person who is regularly enrolled in a physician assistant program approved by the ((~~board~~)) commission, however, the performance of such services ((~~[shall]~~)) shall be only pursuant to a regular course of instruction in said program and such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(10) The practice of medicine by a licensed physician assistant which practice is performed under the supervision and control of a physician licensed pursuant to this chapter;

(11) The practice of medicine, in any part of this state which shares a common border with Canada and which is surrounded on three sides by water, by a physician licensed to practice medicine and surgery in Canada or any province or territory thereof;

(12) The administration of nondental anesthesia by a dentist who has completed a residency in anesthesiology at a school of medicine approved by the ((~~board of medical examiners~~)) commission, however, a dentist allowed to administer nondental anesthesia shall do so only under authorization of the patient's attending surgeon, obstetrician, or psychiatrist, and the ((~~medical disciplinary board shall have~~)) commission has jurisdiction to discipline a dentist practicing under this exemption and enjoin or suspend such dentist from the practice of nondental anesthesia according to ((~~the provisions of chapter 18.72 RCW~~)) this chapter and chapter 18.130 RCW;

(13) Emergency lifesaving service rendered by a physician's trained mobile intravenous therapy technician, by a physician's trained mobile airway management technician, or by a physician's trained mobile intensive care paramedic, as defined in RCW 18.71.200, if the emergency lifesaving service is rendered under the responsible supervision and control of a licensed physician;

(14) The provision of clean, intermittent bladder catheterization for students by public school district employees or private school employees as provided for in RCW ((~~18.88.295~~)) 18.--.--- (section 629 of this act) and 28A.210.280.

Sec. 507. RCW 18.71.050 and 1991 c 3 s 161 are each amended to read as follows:

(1) Each applicant who has graduated from a school of medicine located in any state, territory, or possession of the United States, the District of Columbia, or the Dominion of Canada, shall file an application for licensure with the ((~~board~~)) commission on a form prepared by the secretary with the approval of the ((~~board~~)) commission. Each applicant shall furnish proof satisfactory to the ((~~board~~)) commission of the following:

(a) That the applicant has attended and graduated from a school of medicine approved by the ((~~board~~)) commission;

(b) That the applicant has completed two years of postgraduate medical training in a program acceptable to the ((~~board~~)) commission, provided that applicants graduating before July 28, 1985, may complete only one year of postgraduate medical training;

(d) That the applicant is physically and mentally capable of safely carrying on the practice of medicine. The ((~~board~~)) commission may require any applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical and/or mental capability to safely practice medicine.

(2) Nothing in this section shall be construed as prohibiting the ((~~board~~)) commission from requiring such additional information from applicants as it deems necessary. The issuance and denial of licenses are subject to chapter 18.130 RCW, the Uniform Disciplinary Act.

Sec. 508. RCW 18.71.051 and 1991 c 3 s 162 are each amended to read as follows:

Applicants for licensure to practice medicine who have graduated from a school of medicine located outside of the states, territories, and possessions of the United States, the District of Columbia, or the Dominion of Canada, shall file an application for licensure with the ((~~board~~)) commission on a form prepared by the secretary with the approval of the ((~~board~~)) commission. Each applicant shall furnish proof satisfactory to the ((~~board~~)) commission of the following:

(1) That he or she has completed in a school of medicine a resident course of professional instruction equivalent to that required in this chapter for applicants generally;

(2) That he or she meets all the requirements which must be met by graduates of the United States and Canadian school of medicine except that he or she need not have graduated from a school of medicine approved by the ((~~board~~)) commission;

(3) That he or she has satisfactorily passed the examination given by the educational council for foreign medical graduates or has met the requirements in lieu thereof as set forth in rules ((~~and regulations~~)) adopted by the ((~~board~~)) commission;

(4) That he or she has the ability to read, write, speak, understand, and be understood in the English language.

Sec. 509. RCW 18.71.055 and 1975 1st ex.s. c 171 s 8 are each amended to read as follows:

The ((~~board~~)) commission may approve any school of medicine which is located in any state, territory, or possession of the United States, the District of Columbia, or in the Dominion of Canada, provided that it:

(1) Requires collegiate instruction which includes courses deemed by the ((~~board~~)) commission to be prerequisites to medical education;

(2) Provides adequate instruction in the following subjects: Anatomy, biochemistry, microbiology and immunology, pathology, pharmacology, physiology, anaesthesiology, dermatology, gynecology, internal medicine, neurology, obstetrics, ((~~opthalmology~~)) ophthalmology, orthopedic surgery, otolaryngology, pediatrics, physical medicine and rehabilitation, preventive medicine and public health, psychiatry, radiology, surgery, and urology, and such other subjects determined by the ((~~board~~)) commission;

(3) Provides clinical instruction in hospital wards and out-patient clinics under guidance.

Approval may be withdrawn by the ((~~board~~)) commission at any time a medical school ceases to comply with one or more of the requirements of this section.

(4) Nothing in this section shall be construed to authorize the ((~~board~~)) commission to approve a school of osteopathy, osteopathy and surgery, or osteopathic medicine, for purposes of qualifying an applicant to be licensed under this chapter by direct licensure, reciprocity, or otherwise.

Sec. 510. RCW 18.71.060 and 1975 1st ex.s. c 171 s 9 are each amended to read as follows:

((~~Said board~~)) The commission shall keep an official record of all its proceedings, a part of which record shall consist of a register of all applicants for licensure under this chapter, with the result of each application. ((~~Said~~)) The record shall be evidence of all the proceedings of ((~~said board which~~)) the commission that are set forth ((~~therein~~)) in it.

Sec. 511. RCW 18.71.070 and 1985 c 322 s 3 are each amended to read as follows:

With the exception of those applicants granted licensure through the provisions of RCW 18.71.090 or 18.71.095, applicants for licensure must successfully complete an examination administered by the ((~~board~~)) commission to determine their professional qualifications. The ((~~board~~)) commission shall prepare and give, or approve the preparation and giving of, an examination which shall cover those general subjects and topics, a knowledge of which is commonly and generally required of candidates for the degree of doctor of medicine conferred by approved colleges or schools of medicine in the United States. Notwithstanding any other provision of law, the ((~~board shall have~~)) commission has the sole responsibility for determining the proficiency of applicants under this chapter, and, in so doing, may waive any prerequisite to licensure not set forth in this chapter.

The ((~~board~~)) commission may by rule establish the passing grade for the examination.

Examination results shall be part of the records of the ((~~board~~)) commission and shall be permanently kept with the applicant's file.

Sec. 512. RCW 18.71.080 and 1991 c 195 s 1 and 1991 c 3 s 163 are each reenacted and amended to read as follows:

Every person licensed to practice medicine in this state shall register with the secretary of health annually, and pay an annual renewal registration fee determined by the secretary as provided in RCW 43.70.250. The ((~~board~~)) commission may establish rules governing mandatory continuing education requirements which shall be met by physicians applying for renewal of licenses. The rules ((~~and regulations~~)) shall provide that mandatory continuing education requirements may be met in part by physicians showing evidence of the completion of approved activities relating to professional liability risk management. Any failure to register and pay the annual renewal registration fee shall render the license invalid, but such license shall be reinstated upon written application therefor to the secretary, and payment to the state of a penalty fee determined by the secretary as provided in RCW 43.70.250, together with all delinquent annual license renewal fees: PROVIDED, HOWEVER, That any person who fails to renew the license for a period of three years, shall in no event be entitled to renew the license under this section. Such a person in order to obtain a license to practice medicine in this state, shall file an original application as provided for in this chapter, along with the requisite fee therefor. The ((~~board~~)) commission, in its sole discretion, may permit such applicant to be licensed without examination if it is satisfied that such applicant meets all the requirements for licensure in this state, and is competent to engage in the practice of medicine.

Sec. 513. RCW 18.71.085 and 1991 c 44 s 2 are each amended to read as follows:

The ((~~board~~)) commission may adopt rules pursuant to this section authorizing an inactive license status.

(1) An individual licensed pursuant to chapter 18.71 RCW may place his or her license on inactive status. The holder of an inactive license shall not practice medicine and surgery in this state without first activating the license.

(3) An inactive license may be placed in an active status upon compliance with rules established by the ((~~board~~)) commission.

(4) Provisions relating to disciplinary action against a person with a license shall be applicable to a person with an inactive license, except that when disciplinary proceedings against a person with an inactive license have been initiated, the license shall remain inactive until the proceedings have been completed.

Sec. 514. RCW 18.71.090 and 1985 c 322 s 5 are each amended to read as follows:

Any applicant who meets the requirements of RCW 18.71.050 and has been licensed under the laws of another state, territory, or possession of the United States, or of any province of Canada, or an applicant who has satisfactorily passed examinations given by the national board of medical examiners may, in the discretion of the ((~~board~~)) commission, be granted a license without examination on the payment of the fees required by this chapter: PROVIDED, That the applicant must file with the ((~~board~~)) commission a copy of the license certified by the proper authorities of the issuing state to be a full, true copy thereof, and must show that the standards, eligibility requirements, and examinations of that state are at least equal in all respects to those of this state.

Sec. 515. RCW 18.71.095 and 1991 c 3 s 164 are each amended to read as follows:

The ((~~board~~)) commission may, without examination, issue a limited license to persons who possess the qualifications set forth herein:

(1) The ((~~board~~)) commission may, upon the written request of the secretary of the department of social and health services or the secretary of corrections, issue a limited license to practice medicine in this state to persons who have been accepted for employment by the department of social and health services or the department of corrections as physicians; who are licensed to practice medicine in another state of the United States or in the country of Canada or any province or territory thereof; and who meet all of the qualifications for licensure set forth in RCW 18.71.050.

Such license shall permit the holder thereof to practice medicine only in connection with patients, residents, or inmates of the state institutions under the control and supervision of the secretary of the department of social and health services or the department of corrections.

(2) The ((~~board~~)) commission may issue a limited license to practice medicine in this state to persons who have been accepted for employment by a county or city health department as physicians; who are licensed to practice medicine in another state of the United States or in the country of Canada or any province or territory thereof; and who meet all of the qualifications for licensure set forth in RCW 18.71.050.

Such license shall permit the holder thereof to practice medicine only in connection with his or her duties in employment with the city or county health department.

(3) Upon receipt of a completed application showing that the applicant meets all of the requirements for licensure set forth in RCW 18.71.050 except for completion of two years of postgraduate medical training, and that the applicant has been appointed as a resident physician in a program of postgraduate clinical training in this state approved by the ((~~board~~)) commission, the ((~~board~~)) commission may issue a limited license to a resident physician. Such license shall permit the resident physician to practice medicine only in connection with his or her duties as a resident physician and shall not authorize the physician to engage in any other form of practice. Each resident physician shall practice medicine only under the supervision and control of a physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physician at the place where services are rendered.

(4)(a) Upon nomination by the dean of the school of medicine at the University of Washington or the chief executive officer of a hospital or other appropriate health care facility licensed in the state of Washington, the ((~~board~~)) commission may issue a limited license to a physician applicant invited to serve as a teaching-research member of the institution's instructional staff if the sponsoring institution and the applicant give evidence that he or she has graduated from a recognized medical school and has been licensed or otherwise privileged to practice medicine at his or her location of origin. Such license shall permit the recipient to practice medicine only within the confines of the instructional program specified in the application and shall terminate whenever the holder ceases to be involved in that program, or at the end of one year, whichever is earlier. Upon request of the applicant and the institutional authority, the license may be renewed for no more than a total of two years.

(b) Upon nomination by the dean of the school of medicine of the University of Washington or the chief executive officer of any hospital or appropriate health care facility licensed in the state of Washington, the ((~~board~~)) commission may issue a limited license to an applicant selected by the sponsoring institution to be enrolled in one of its designated departmental or divisional fellowship programs provided that the applicant shall have graduated from a recognized medical school and has been granted a license or other appropriate certificate to practice medicine in the location of the applicant's origin. Such license shall permit the holder only to practice medicine within the confines of the fellowship program to which he or she has been appointed and, upon the request of the applicant and the sponsoring institution, the license may be renewed by the ((~~board~~)) commission for no more than a total of two years.

All persons licensed under this section shall be subject to the jurisdiction of the ((~~medical disciplinary board~~)) commission to the same extent as other members of the medical profession, in accordance with this chapter and chapter((~~s 18.72 and~~)) 18.130 RCW.

Persons applying for licensure pursuant to this section shall pay an application fee determined by the secretary as provided in RCW 43.70.250 and, in the event the license applied for is issued, a license fee at the rate provided for renewals of licenses generally. Licenses issued hereunder may be renewed annually pursuant to the provisions of RCW 18.71.080. Any person who obtains a limited license pursuant to this section may, without an additional application fee, apply for licensure under this chapter, but shall submit a new application form and comply with all other licensing requirements of this chapter.

Sec. 516. RCW 18.71.205 and 1992 c 128 s 1 are each amended to read as follows:

(1) The secretary of the department of health, in conjunction with the advice and assistance of the emergency medical services licensing and certification advisory committee as prescribed in RCW 18.73.050, and the ((~~board of medical examiners~~)) commission, shall prescribe:

(a) Minimum standards and performance requirements for the certification and recertification of physician's trained intravenous therapy technicians, airway management technicians, and mobile intensive care paramedics; and

(b) Procedures for certification, recertification, and decertification of physician's trained intravenous therapy technicians, airway management technicians, and mobile intensive care paramedics.

(2) Initial certification shall be for a period of three years.

(3) Recertification shall be granted upon proof of continuing satisfactory performance and education, and shall be for a period of three years.

(4) As used in chapters 18.71 and 18.73 RCW, "approved medical program director" means a person who:

(a) Is licensed to practice medicine and surgery pursuant to chapter 18.71 RCW or osteopathy and surgery pursuant to chapter 18.57 RCW; and

(b) Is qualified and knowledgeable in the administration and management of emergency care and services; and

(c) Is so certified by the department of health for a county, group of counties, or cities with populations over four hundred thousand in coordination with the recommendations of the local medical community and local emergency medical services and trauma care council.

(5) The Uniform Disciplinary Act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of certificates, and the disciplining of certificate holders under this section. The secretary shall be the disciplining authority under this section. Disciplinary action shall be initiated against a person credentialed under this chapter in a manner consistent with the responsibilities and duties of the medical program director under whom such person is responsible.

Sec. 517. RCW 18.71.230 and 1986 c 259 s 112 are each amended to read as follows:

A right to practice medicine and surgery by an individual in this state pursuant to RCW 18.71.030 (5) through (12) shall be subject to discipline by order of the ((~~board~~)) commission upon a finding by the ((~~board~~)) commission of an act of unprofessional conduct as defined in RCW 18.130.180 or that the individual is unable to practice with reasonable skill or safety due to a mental or physical condition as described in RCW 18.130.170. Such physician shall have the same rights of notice, hearing, and judicial review as provided licensed physicians generally ((~~pursuant to chapters 18.72 and~~)) under this chapter and chapter 18.130 RCW.

Sec. 518. RCW 18.71A.010 and 1990 c 196 s 1 are each amended to read as follows:

The definitions set forth in this section apply throughout this chapter.

(1) "Physician assistant" means a person who is licensed by the ((~~board~~)) commission to practice medicine to a limited extent only under the supervision of a physician as defined in chapter 18.71 RCW and who is academically and clinically prepared to provide health care services and perform diagnostic, therapeutic, preventative, and health maintenance services.

(2) "((~~Board~~)) Commission" means the ((~~board of medical examiners~~)) medical quality assurance commission.

(3) "Practice medicine" ((~~shall have~~)) has the meaning defined in RCW 18.71.011.

(4) "Secretary" means the secretary of health or the secretary's designee.

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

Sec. 519. RCW 18.71A.020 and 1993 c 28 s 5 are each amended to read as follows:

(1) The ((~~board~~)) commission shall adopt rules fixing the qualifications and the educational and training requirements for licensure as a physician assistant or for those enrolled in any physician assistant training program. The requirements shall include completion of an accredited physician assistant training program approved by the ((~~board~~)) commission and eligibility to take an examination approved by the ((~~board, provided such~~)) commission, if the examination tests subjects substantially equivalent to the curriculum of an accredited physician assistant training program. Physician assistants licensed by the board of medical examiners as of June 7, 1990, shall continue to be licensed.

(2)(a) The ((~~board~~)) commission shall adopt rules governing the extent to which:

(i) Physician assistant students may practice medicine during training; and

(ii) Physician assistants may practice after successful completion of a physician assistant training course.

(b) Such rules shall provide:

(i) That the practice of a physician assistant shall be limited to the performance of those services for which he or she is trained; and

(ii) That each physician assistant shall practice medicine only under the supervision and control of a physician licensed in this state, but such supervision and control shall not be construed to necessarily require the personal presence of the supervising physician or physicians at the place where services are rendered.

(3) Applicants for licensure shall file an application with the ((~~board~~)) commission on a form prepared by the secretary with the approval of the ((~~board~~)) commission, detailing the education, training, and experience of the physician assistant and such other information as the ((~~board~~)) commission may require. The application shall be accompanied by a fee determined by the secretary as provided in RCW 43.70.250. Each applicant shall furnish proof satisfactory to the ((~~board~~)) commission of the following:

(a) That the applicant has completed an accredited physician assistant program approved by the ((~~board~~)) commission and is eligible to take the examination approved by the ((~~board~~)) commission;

(b) That the applicant is of good moral character; and

(c) That the applicant is physically and mentally capable of practicing medicine as a physician assistant with reasonable skill and safety. The ((~~board~~)) commission may require an applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical or mental capability, or both, to safely practice as a physician assistant.

(4) The ((~~board~~)) commission may approve, deny, or take other disciplinary action upon the application for license as provided in the Uniform Disciplinary Act, chapter 18.130 RCW. The license shall be renewed on a periodic basis as determined by the secretary under RCW 43.70.280, upon payment of a fee determined by the secretary as provided in RCW 43.70.250, and submission of a completed renewal application, in addition to any late renewal penalty fees as determined by the secretary as provided in RCW 43.70.250. The ((~~board~~)) commission may authorize the use of alternative supervisors who are licensed either under chapter 18.57 or 18.71 RCW.

Sec. 520. RCW 18.71A.030 and 1993 c 28 s 6 are each amended to read as follows:

A physician assistant ((~~as defined in this chapter~~)) may practice medicine in this state only with the approval of the practice arrangement plan by the ((~~board~~)) commission and only to the extent permitted by the ((~~board~~)) commission. A physician assistant who has received a license but who has not received ((~~board~~)) commission approval of the practice arrangement plan under RCW 18.71A.040 may not practice. A physician assistant shall be subject to discipline under chapter 18.130 RCW.

Sec. 521. RCW 18.71A.040 and 1993 c 28 s 7 are each amended to read as follows:

(1) No physician assistant practicing in this state shall be employed or supervised by a physician or physician group without the approval of the ((~~board~~)) commission.

(2) Prior to commencing practice, a physician assistant licensed in this state shall apply to the ((~~board~~)) commission for permission to be employed or supervised by a physician or physician group. The practice arrangement plan shall be jointly submitted by the physician or physician group and physician assistant. The secretary may charge a fee as provided in RCW 43.70.250 to recover the cost for the plan review. The practice arrangement plan shall delineate the manner and extent to which the physician assistant would practice and be supervised. Whenever a physician assistant is practicing in a manner inconsistent with the approved practice arrangement plan, the medical disciplinary board may take disciplinary action under chapter 18.130 RCW.

Sec. 522. RCW 18.71A.045 and 1988 c 113 s 2 are each amended to read as follows:

Foreign medical school graduates shall not be eligible for ((~~registration~~)) licensing as physician assistants after July 1, 1989. ((Those applying on or before that date shall remain eligible to register as a physician assistant after July 1, 1989: PROVIDED, That the graduate does not violate chapter 18.130 RCW or the rules of the board. The board shall adopt rules regarding applications for registration. The rules shall include board approval of training as required in RCW 18.71.051(1) and receipt of original translated transcripts directly from the medical school.))

Sec. 523. RCW 18.71A.050 and 1993 c 28 s 8 are each amended to read as follows:

No physician who supervises a licensed physician assistant in accordance with and within the terms of any permission granted by the ((~~medical examining board shall be~~)) commission is considered as aiding and abetting an unlicensed person to practice medicine. The supervising physician and physician assistant shall retain professional and personal responsibility for any act which constitutes the practice of medicine as defined in RCW 18.71.011 when performed by the physician assistant.

Sec. 524. RCW 18.71A.060 and 1990 c 196 s 6 are each amended to read as follows:

No health care services may be performed under this chapter in any of the following areas:

(1) The measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses or frames for the aid thereof.

(2) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.

(3) The prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye.

(4) Nothing in this section shall preclude the performance of routine visual screening.

(5) The practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW respectively. The exemptions set forth in RCW 18.32.030((~~, paragraphs~~)) (1) and (8), shall not apply to a physician assistant.

(6) The practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulations of the spine.

(7) The practice of ((~~podiatry~~)) podiatric medicine and surgery as defined in chapter 18.22 RCW.

Sec. 525. RCW 18.71A.085 and 1990 c 196 s 10 are each amended to read as follows:

Any physician assistant acupuncturist currently licensed by the ((~~board~~)) commission may continue to perform acupuncture under the physician assistant license as long as he or she maintains licensure as a physician assistant.

Sec. 526. RCW 18.72.155 and 1991 c 3 s 168 are each amended to read as follows:

The secretary of the department of health shall appoint, from a list of three names supplied by the ((~~board~~)) commission, an executive ((~~secretary~~)) director who shall act to carry out the provisions of this chapter. The secretary shall also employ such additional staff including administrative assistants, investigators, and clerical staff as are required to enable the ((~~board~~)) commission to accomplish its duties and responsibilities. The executive ((~~secretary shall be~~)) director is exempt from the provisions of the civil service law, chapter 41.06 RCW, as now or hereafter amended.

Sec. 527. RCW 18.72.165 and 1986 c 300 s 5 are each amended to read as follows:

(1) A licensed health care professional licensed under this chapter ((~~18.71 RCW~~)) shall report to the ((~~medical disciplinary board~~)) commission when he or she has personal knowledge that a practicing physician has either committed an act or acts which may constitute statutorily defined unprofessional conduct or that a practicing physician may be unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material, or as a result of any mental or physical conditions.

(2) Reporting under this section is not required by:

(a) An appropriately appointed peer review committee member of a licensed hospital or by an appropriately designated professional review committee member of a county or state medical society during the investigative phase of their respective operations if these investigations are completed in a timely manner; or

(b) A treating licensed health care professional of a physician currently involved in a treatment program as long as the physician patient actively participates in the treatment program and the physician patient's impairment does not constitute a clear and present danger to the public health, safety, or welfare.

(3) The ((~~medical disciplinary board~~)) commission may impose disciplinary sanctions, including license suspension or revocation, on any health care professional subject to the jurisdiction of the ((~~board~~)) commission who has failed to comply with this section.

Sec. 528. RCW 18.72.265 and 1986 c 259 s 117 are each amended to read as follows:

(1) The contents of any report file under RCW 18.130.070 shall be confidential and exempt from public disclosure pursuant to chapter 42.17 RCW, except that it may be reviewed (a) by the licensee involved or his or her counsel or authorized representative who may submit any additional exculpatory or explanatory statements or other information, which statements or other information shall be included in the file, or (b) by a representative of the ((~~medical disciplinary board~~)) commission, or investigator thereof, who has been assigned to review the activities of a licensed physician.

Upon a determination that a report is without merit, the ((~~board's~~)) commission's records may be purged of information relating to the report.

(2) Every individual, medical association, medical society, hospital, medical service bureau, health insurance carrier or agent, professional liability insurance carrier, professional standards review organization, and agency of the federal, state, or local government shall be immune from civil liability, whether direct or derivative, for providing information to the ((~~board subsequent to~~)) commission under RCW 18.130.070, or for which an individual health care provider has immunity under the provisions of RCW 4.24.240, 4.24.250, or 4.24.260((~~, as now or hereafter amended~~)).

Sec. 529. RCW 18.72.301 and 1989 c 119 s 1 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 18.72.306 through 18.72.321 (as recodified by this act).

(1) ((~~"Board" means the medical disciplinary board of this state.~~

~~(2)~~)) "Committee" means a nonprofit corporation formed by physicians who have expertise in the areas of alcoholism, drug abuse, or mental illness and who broadly represent the physicians of the state and that has been designated to perform any or all of the activities set forth in RCW 18.72.306(1) (as recodified by this act) pursuant to rules adopted by the ((~~board~~)) commission under chapter 34.05 RCW.

((~~(3)~~)) (2) "Impaired" or "impairment" means the presence of the diseases of alcoholism, drug abuse, mental illness, or other debilitating conditions.

((~~(4)~~)) (3) "Impaired physician program" means the program for the prevention, detection, intervention, and monitoring of impaired physicians established by the ((~~board~~)) commission pursuant to RCW 18.72.306(1) (as recodified by this act).

((~~(5)~~)) (4) "Physician" means a person licensed under this chapter ((~~18.71 RCW~~)).

((~~(6)~~)) (5) "Treatment program" means a plan of care and rehabilitation services provided by those organizations or persons authorized to provide such services to be approved by the ((~~board~~)) commission for impaired physicians taking part in the impaired physician program created by RCW 18.72.306 (as recodified by this act).

Sec. 530. RCW 18.72.306 and 1991 c 3 s 169 are each amended to read as follows:

(1) The ((~~board~~)) commission shall enter into a contract with the committee to implement an impaired physician program. The impaired physician program may include any or all of the following:

(a) Contracting with providers of treatment programs;

(b) Receiving and evaluating reports of suspected impairment from any source;

(d) Referring impaired physicians to treatment programs;

(e) Monitoring the treatment and rehabilitation of impaired physicians including those ordered by the ((~~board~~)) commission;

(f) Providing post-treatment monitoring and support of rehabilitative impaired physicians;

(g) Performing such other activities as agreed upon by the ((~~board~~)) commission and the committee; and

(h) Providing prevention and education services.

(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of up to twenty-five dollars on each license renewal or issuance of a new license to be collected by the department of health from every physician and surgeon licensed under this chapter ((~~18.71 RCW~~)) in addition to other license fees ((~~and the medical discipline assessment fee established under RCW 18.72.380~~)). These moneys shall be placed in the health professions account to be used solely for the implementation of the impaired physician program.

Sec. 531. RCW 18.72.311 and 1987 c 416 s 3 are each amended to read as follows:

The committee shall develop procedures in consultation with the ((~~board~~)) commission for:

(1) Periodic reporting of statistical information regarding impaired physician activity;

(2) Periodic disclosure and joint review of such information as the ((~~board~~)) commission may deem appropriate regarding reports received, contacts or investigations made, and the disposition of each report: PROVIDED, That the committee shall not disclose any personally identifiable information except as provided in subsections (3) and (4) of this section;

(3) Immediate reporting to the ((~~board~~)) commission of the name and results of any contact or investigation regarding any impaired physician who is believed to constitute an imminent danger to the public;

(4) Reporting to the ((~~board~~)) commission, in a timely fashion, any impaired physician who refuses to cooperate with the committee, refuses to submit to treatment, or whose impairment is not substantially alleviated through treatment, and who, in the opinion of the committee, is unable to practice medicine with reasonable skill and safety. However, impairment, in and of itself, shall not give rise to a presumption of the inability to practice medicine with reasonable skill and safety;

(5) Informing each participant of the impaired physician program of the program procedures, the responsibilities of program participants, and the possible consequences of noncompliance with the program.

Sec. 532. RCW 18.72.316 and 1987 c 416 s 4 are each amended to read as follows:

If the ((~~board~~)) commission has reasonable cause to believe that a physician is impaired, the ((~~board~~)) commission shall cause an evaluation of such physician to be conducted by the committee or the committee's designee or the ((~~board's~~)) commission's designee for the purpose of determining if there is an impairment. The committee or appropriate designee shall report the findings of its evaluation to the ((~~board~~)) commission.

Sec. 533. RCW 18.72.340 and 1993 c 367 s 17 are each amended to read as follows:

(1) Every institution or organization providing professional liability insurance to physicians shall send a complete report to the ((~~medical disciplinary board~~)) commission of all malpractice settlements, awards, or payments in excess of twenty thousand dollars as a result of a claim or action for damages alleged to have been caused by an insured physician's incompetency or negligence in the practice of medicine. Such institution or organization shall also report the award, settlement, or payment of three or more claims during a five-year time period as the result of the alleged physician's incompetence or negligence in the practice of medicine regardless of the dollar amount of the award or payment.

(2) Reports required by this section shall be made within sixty days of the date of the settlement or verdict. Failure to comply with this section is punishable by a civil penalty not to exceed two hundred fifty dollars.

Sec. 534. RCW 18.72.345 and 1991 c 215 s 2 are each amended to read as follows:

To assist in identifying impairment related to alcohol abuse, the ((~~board~~)) commission may obtain a copy of the driving record of a physician or a physician assistant maintained by the department of licensing.

NEW SECTION. Sec. 535. (1) RCW 18.72.155, 18.72.165, 18.72.265, 18.72.301, 18.72.306, 18.72.311, 18.72.316, 18.72.340, and 18.72.345, as amended by this act, are each recodified as sections in chapter 18.71 RCW.

(2) RCW 18.72.010 and 18.72.321 are each recodified as sections in chapter 18.71 RCW.

NEW SECTION. Sec. 536. The following acts or parts of acts are each repealed:

(1) RCW 18.72.020 and 1986 c 259 s 115 & 1955 c 202 s 2;

(2) RCW 18.72.045 and 1991 c 215 s 1;

(3) RCW 18.72.090 and 1955 c 202 s 9;

(4) RCW 18.72.100 and 1991 c 3 s 166, 1984 c 287 s 45, 1979 ex.s. c 111 s 3, 1979 c 158 s 59, 1975-'76 2nd ex.s. c 34 s 42, & 1955 c 202 s 10;

(5) RCW 18.72.110 and 1955 c 202 s 11;

(6) RCW 18.72.120 and 1991 c 3 s 167 & 1955 c 202 s 12;

(7) RCW 18.72.130 and 1979 ex.s. c 111 s 4 & 1955 c 202 s 13;

(8) RCW 18.72.150 and 1986 c 259 s 116, 1979 ex.s. c 111 s 5, 1975 c 61 s 4, & 1955 c 202 s 15;

(9) RCW 18.72.154 and 1986 c 259 s 107;

(10) RCW 18.72.190 and 1989 c 373 s 18 & 1955 c 202 s 19;

(11) RCW 18.72.380 and 1993 c 367 s 18, 1991 c 3 s 170, 1985 c 7 s 62, & 1983 c 71 s 1;

(12) RCW 18.72.390 and 1991 sp.s. c 13 s 17, 1985 c 57 s 6, & 1983 c 71 s 2;

(13) RCW 18.72.400 and 1991 c 3 s 171 & 1983 c 71 s 3;

(14) RCW 18.72.900 and 1955 c 202 s 46; and

(15) RCW 18.72.910 and 1955 c 202 s 48.

NURSING CARE

NEW SECTION. Sec. 601. It is the purpose of the nursing care quality assurance commission to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state of Washington.

NEW SECTION. Sec. 602. Unless a different meaning is plainly required by the context, the definitions set forth in this section apply throughout this chapter.

(1) "Commission" means the Washington state nursing care quality assurance commission.

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

(3) "Secretary" means the secretary of health or the secretary's designee.

(4) "Diagnosis," in the context of nursing practice, means the identification of, and discrimination between, the person's physical and psycho-social signs and symptoms that are essential to effective execution and management of the nursing care regimen.

(5) "Diploma" means written official verification of completion of an approved nursing education program.

(6) "Nurse" or "nursing," unless otherwise specified as a practical nurse or practical nursing, means a registered nurse or registered nursing.

NEW SECTION. Sec. 603. (1) It is unlawful for a person to practice or to offer to practice as a registered nurse in this state unless that person has been licensed under this chapter. A person who holds a license to practice as a registered nurse in this state may use the title "registered nurse" and the abbreviation "R.N." No other person may assume that title or use the abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a registered nurse.

(2) It is unlawful for a person to practice or to offer to practice as an advanced registered nurse practitioner or as a nurse practitioner in this state unless that person has been licensed under this chapter. A person who holds a license to practice as an advanced registered nurse practitioner in this state may use the titles "advanced registered nurse practitioner" and "nurse practitioner" and the abbreviations "A.R.N.P." and "N.P." No other person may assume those titles or use those abbreviations or any other words, letters, signs, or figures to indicate that the person using them is an advanced registered nurse practitioner or nurse practitioner.

(3) It is unlawful for a person to practice or to offer to practice as a licensed practical nurse in this state unless that person has been licensed under this chapter. A person who holds a license to practice as a licensed practical nurse in this state may use the title "licensed practical nurse" and the abbreviation "L.P.N." No other person may assume that title or use that abbreviation or any other words, letters, signs, or figures to indicate that the person using them is a licensed practical nurse.

NEW SECTION. Sec. 604. (1) "Registered nursing practice" means the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in either:

(a) The observation, assessment, diagnosis, care or counsel, and health teaching of the ill, injured, or infirm, or in the maintenance of health or prevention of illness of others;

(b) The performance of such additional acts requiring education and training and that are recognized by the commission to be performed by registered nurses licensed under this chapter and that are authorized by the commission through its rules;

(c) The administration, supervision, delegation, and evaluation of nursing practice. However, nothing in this subsection affects the authority of a hospital, hospital district, medical clinic, or office, concerning its administration and supervision;

(d) The teaching of nursing;

(e) The executing of medical regimen as prescribed by a licensed physician and surgeon, dentist, osteopathic physician and surgeon, podiatric physician and surgeon, physician assistant, osteopathic physician assistant, or advanced registered nurse practitioner.

(2) Nothing in this section prohibits a person from practicing a profession for which a license has been issued under the laws of this state or specifically authorized by any other law of the state of Washington.

(3) This section does not prohibit (a) the nursing care of the sick, without compensation, by an unlicensed person who does not hold himself or herself out to be a registered nurse, or (b) the practice of licensed practical nursing by a licensed practical nurse.

NEW SECTION. Sec. 605. "Advanced registered nursing practice" means the performance of the acts of a registered nurse and the performance of an expanded role in providing health care services, the scope of which is defined by rule by the commission. Upon approval by the commission, an advanced registered nurse practitioner may prescribe legend drugs and controlled substances contained in Schedule V of the Uniform Controlled Substances Act, chapter 69.50 RCW.

Nothing in this section prohibits a person from practicing a profession for which a license has been issued under the laws of this state or specifically authorized by any other law of the state of Washington.

This section does not prohibit (1) the nursing care of the sick, without compensation, by an unlicensed person who does not hold himself or herself out to be an advanced registered nurse practitioner, or (2) the practice of registered nursing by a licensed registered nurse or the practice of licensed practical nursing by a licensed practical nurse.

NEW SECTION. Sec. 606. "Licensed practical nursing practice" means the performance of services requiring the knowledge, skill, and judgment necessary for carrying out selected aspects of the designated nursing regimen under the direction and supervision of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, physician assistant, osteopathic physician assistant, podiatric physician and surgeon, advanced registered nurse practitioner, or registered nurse.

This section does not prohibit the nursing care of the sick, without compensation, by an unlicensed person who does not hold himself or herself out to be a licensed practical nurse.

NEW SECTION. Sec. 607. (1) The state nursing care quality assurance commission is established, consisting of eleven members to be appointed by the governor to four-year terms. No person may serve as a member of the commission for more than two consecutive full terms.

(2) There must be three registered nurse members, two advanced registered nurse practitioner members, three licensed practical nurse members, two public members, and one nonvoting midwife member licensed under chapter 18.50 RCW, on the commission. Each member of the commission must be a citizen of the United States and a resident of this state.

(3) Registered nurse members of the commission must:

(a) Be licensed as registered nurses under this chapter; and

(b) Have had at least five years' experience in the active practice of nursing and have been engaged in that practice within two years of appointment.

(4) Advanced registered nurse practitioner members of the commission must:

(a) Be licensed as advanced registered nurse practitioners under this chapter; and

(b) Have had at least five years' experience in the active practice of advanced registered nursing and have been engaged in that practice within two years of appointment.

(5) Licensed practical nurse members of the commission must:

(a) Be licensed as licensed practical nurses under this chapter; and

(b) Have had at least five years' actual experience as a licensed practical nurse and have been engaged in practice as a practical nurse within two years of appointment.

(6) Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

(7) The nonvoting licensed midwife member of the commission must:

(a) Be licensed as a midwife under chapter 18.50 RCW; and

(b) Have had at least five years' actual experience as a licensed midwife and have been engaged in practice as a midwife within two years of appointment.

In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, the governor appoint the existing members of the board of nursing and the board of practical nursing repealed under chapter . . ., Laws of 1994 (this act). The governor may appoint initial members of the commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. Members of the commission hold office until their successors are appointed.

NEW SECTION. Sec. 608. The governor may remove a member of the commission for neglect of duty, misconduct, malfeasance or misfeasance in office, or for incompetency or unprofessional conduct as defined in chapter 18.130 RCW. Whenever the governor is satisfied that a member of the commission has been guilty of neglect of duty, misconduct, malfeasance or misfeasance in office, or of incompetency or unprofessional conduct, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the statement of causes and order of removal to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement member to fill the remainder of the unexpired term.

NEW SECTION. Sec. 609. Each commission member shall be compensated in accordance with RCW 43.03.240 and shall be paid travel expenses when away from home in accordance with RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 610. The commission shall annually elect from its members a chairperson, a vice-chairperson, and a secretary. The commission shall meet at least quarterly at times and places it designates. It shall hold such other meetings during the year as may be deemed necessary to transact its business. A majority of the commission members appointed and serving constitutes a quorum at a meeting. All meetings of the commission must be open and public, except that the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW.

Carrying a motion or resolution, adopting a rule, or passing a measure requires the affirmative vote of a majority of a quorum of the commission. The commission may appoint panels consisting of at least three members. A quorum for transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

NEW SECTION. Sec. 611. The commission shall keep a record of all of its proceedings and make such reports to the governor as may be required. The commission may adopt rules or issue advisory opinions in response to questions put to it by professional health associations, licensed nurses, and consumers in this state concerning the authority of various categories of licensed nurses to perform particular acts. The commission shall define by rule the criteria for granting to advanced registered nurse practitioners the authority to prescribe legend drugs and Schedule V controlled substances.

The commission shall approve curricula and shall establish criteria for minimum standards for schools preparing persons for licensing as registered nurses, advanced registered nurse practitioners, and licensed practical nurses under this chapter. The commission shall approve such schools of nursing as meet the requirements of this chapter and the commission, and the commission shall approve establishment of basic nursing education programs and shall establish criteria as to the need for and the size of a program and the type of program and the geographical location. The commission shall establish criteria for proof of reasonable currency of knowledge and skill as a basis for safe practice after three years' inactive or lapsed status. The commission shall establish criteria for licensing by endorsement. The commission shall determine examination requirements for applicants for licensing as registered nurses, advanced registered nurse practitioners, and licensed practical nurses under this chapter, and shall certify to the secretary for licensing duly qualified applicants.

The commission shall adopt such rules under chapter 34.05 RCW as are necessary to fulfill the purposes of this chapter.

The commission is the successor in interest of the board of nursing and the board of practical nursing. All contracts, undertakings, agreements, rules, regulations, decisions, orders, and policies of the former board of nursing or the board of practical nursing continue in full force and effect under the commission until the commission amends or rescinds those rules, regulations, decisions, orders, or policies.

The members of the commission are immune from suit in an action, civil or criminal, based on its disciplinary proceedings or other official acts performed in good faith as members of the commission.

NEW SECTION. Sec. 612. The Uniform Disciplinary Act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter.

NEW SECTION. Sec. 613. The secretary shall appoint, after consultation with the commission, an executive director who shall act to carry out this chapter. The secretary shall also employ such professional, secretarial, clerical, and other assistants as may be necessary to effectively administer this chapter. The secretary shall fix the compensation and provide for travel expenses for the executive director and all such employees, in accordance with RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 614. The executive director must be a graduate of an approved nursing education program and of a college or university, with a masters' degree, and currently licensed as a registered nurse under this chapter; have a minimum of eight years' experience in nursing in any combination of administration and nursing education; and have been actively engaged in the practice of registered nursing or nursing education within two years immediately before the time of appointment.

NEW SECTION. Sec. 615. An institution desiring to conduct a school of registered nursing or a school or program of practical nursing, or both, shall apply to the commission and submit evidence satisfactory to the commission that:

(1) It is prepared to carry out the curriculum approved by the commission for basic registered nursing or practical nursing, or both; and

(2) It is prepared to meet other standards established by law and by the commission.

The commission shall make, or cause to be made, such surveys of the schools and programs, and of institutions and agencies to be used by the schools and programs, as it determines are necessary. If in the opinion of the commission, the requirements for an approved school of registered nursing or a school or program of practical nursing, or both, are met, the commission shall approve the school or program.

NEW SECTION. Sec. 616. (1) An applicant for a license to practice as a registered nurse shall submit to the commission:

(a) An attested written application on a department form;

(b) Written official evidence of a diploma from an approved school of nursing; and

(2) An applicant for a license to practice as an advanced registered nurse practitioner shall submit to the commission:

(a) An attested written application on a department form;

(b) Written official evidence of completion of an advanced registered nurse practitioner training program meeting criteria established by the commission; and

(3) An applicant for a license to practice as a licensed practical nurse shall submit to the commission:

(a) An attested written application on a department form;

(b) Written official evidence that the applicant is over the age of eighteen;

(d) Written official evidence of completion of an approved practical nursing program, or its equivalent; and

(e) Any other official records specified by the commission.

(4) At the time of submission of the application, the applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse must not be in violation of chapter 18.130 RCW or this chapter.

(5) The commission shall establish by rule the criteria for evaluating the education of all applicants.

NEW SECTION. Sec. 617. An applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse must pass an examination in subjects determined by the commission. The examination may be supplemented by an oral or practical examination. The commission shall establish by rule the requirements for applicants who have failed the examination to qualify for reexamination.

NEW SECTION. Sec. 618. When authorized by the commission, the department shall issue an interim permit authorizing the applicant to practice registered nursing, advanced registered nursing, or licensed practical nursing, as appropriate, from the time of verification of the completion of the school or training program until notification of the results of the examination. Upon the applicant passing the examination, and if all other requirements established by the commission for licensing are met, the department shall issue the applicant a license to practice registered nursing, advanced registered nursing, or licensed practical nursing, as appropriate. If the applicant fails the examination, the interim permit expires upon notification to the applicant, and is not renewable. The holder of an interim permit is subject to chapter 18.130 RCW.

NEW SECTION. Sec. 619. Upon approval of the application by the commission, the department shall issue a license by endorsement without examination to practice as a registered nurse or as a licensed practical nurse to a person who is licensed as a registered nurse or licensed practical nurse under the laws of another state, territory, or possession of the United States, and who meets all other qualifications for licensing.

An applicant who has graduated from a school or program of nursing outside the United States and is licensed as a registered nurse or licensed practical nurse, or their equivalents, outside the United States must meet all qualifications required by this chapter and pass examinations as determined by the commission.

NEW SECTION. Sec. 620. An applicant for a license to practice as a registered nurse, advanced registered nurse practitioner, or licensed practical nurse shall pay a fee as determined by the secretary under RCW 43.70.250 to the state treasurer.

NEW SECTION. Sec. 621. A license issued under this chapter, whether in an active or inactive status, must be renewed, except as provided in this chapter. The licensee shall send the renewal form to the department with a renewal fee, as determined by the secretary under RCW 43.70.250, before the expiration date. Upon receipt of the renewal form and the appropriate fee, the department shall issue the licensee a license, which declares the holder to be a legal practitioner of registered nursing, advanced registered nursing practice, or licensed practical nursing, as appropriate, in either active or inactive status, for the period of time stated on the license.

NEW SECTION. Sec. 622. A person licensed under this chapter who allows his or her license to lapse by failing to renew the license, shall on application for renewal pay a penalty determined by the secretary under RCW 43.70.250. If the licensee fails to renew the license before the end of the current licensing period, the department shall issue the license for the next licensing period upon receipt of a written application and fee determined by the secretary under RCW 43.70.250. Persons on lapsed status for three or more years must provide evidence of knowledge and skill of current practice as required by the commission.

NEW SECTION. Sec. 623. A person licensed under this chapter who desires to retire temporarily from registered nursing practice, advanced registered nursing practice, or licensed practical nursing practice in this state shall send a written notice to the secretary.

Upon receipt of the notice the department shall place the name of the person on inactive status. While remaining on this status the person shall not practice in this state any form of nursing provided for in this chapter. When the person desires to resume practice, the person shall apply to the commission for renewal of the license and pay a renewal fee to the state treasurer. Persons on inactive status for three years or more must provide evidence of knowledge and skill of current practice as required by the commission or as provided in this chapter.

NEW SECTION. Sec. 624. (1) For persons licensed as registered nurses or advanced registered nurse practitioners, this chapter shall not be construed as:

(a) Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice registered nursing within the meaning of this chapter;

(b) Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;

(c) Prohibiting the practice of nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing aides;

(d) Prohibiting auxiliary services provided by persons carrying out duties necessary for the support of nursing services, including those duties that involve minor nursing services for persons performed in hospitals, nursing homes, or elsewhere under the direction of licensed physicians or the supervision of licensed registered nurses;

(e) Prohibiting the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a registered nurse licensed to practice in this state;

(f) Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in the practice of nursing as defined in this chapter;

(g) Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or a bureau, division, or agency thereof, while in the discharge of his or her official duties;

(h) Permitting the measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses for the aid thereof;

(i) Permitting the prescribing or directing the use of, or using, an optical device in connection with ocular exercises, visual training, vision training, or orthoptics;

(j) Permitting the prescribing of contact lenses for, or the fitting and adaptation of contact lenses to, the human eye;

(k) Prohibiting the performance of routine visual screening;

(l) Permitting the practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW, respectively;

(m) Permitting the practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulation of the spine;

(n) Permitting the practice of podiatric medicine and surgery as defined in chapter 18.-- RCW (sections 101 through 144 of this act);

(o) Permitting the performance of major surgery, except such minor surgery as the commission may have specifically authorized by rule adopted in accordance with chapter 34.05 RCW;

(p) Permitting the prescribing of controlled substances as defined in Schedules I through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, except as provided in (r) of this subsection;

(q) Prohibiting the determination and pronouncement of death;

(r) Prohibiting advanced registered nurse practitioners, approved by the commission as certified registered nurse anesthetists from selecting, ordering, or administering controlled substances as defined in Schedules II through IV of the Uniform Controlled Substances Act, chapter 69.50 RCW, consistent with their commission-recognized scope of practice; subject to facility-specific protocols, and subject to a request for certified registered nurse anesthetist anesthesia services issued by a physician licensed under chapter 18.71 RCW, an osteopathic physician and surgeon licensed under chapter 18.-- RCW (sections 101 through 144 of this act), a dentist licensed under chapter 18.32 RCW, or a podiatric physician and surgeon licensed under chapter 18.-- RCW (sections 101 through 144 of this act); the authority to select, order, or administer Schedule II through IV controlled substances being limited to those drugs that are to be directly administered to patients who require anesthesia for diagnostic, operative, obstetrical, or therapeutic procedures in a hospital, clinic, ambulatory surgical facility, or the office of a practitioner licensed under chapter 18.71, 18.-- (sections 101 through 144 of this act), or 18.32 RCW; "select" meaning the decision-making process of choosing a drug, dosage, route, and time of administration; and "order" meaning the process of directing licensed individuals pursuant to their statutory authority to directly administer a drug or to dispense, deliver, or distribute a drug for the purpose of direct administration to a patient, under instructions of the certified registered nurse anesthetist. "Protocol" means a statement regarding practice and documentation concerning such items as categories of patients, categories of medications, or categories of procedures rather than detailed case-specific formulas for the practice of nurse anesthesia.

(2) For persons licensed as licensed practical nurses, this chapter shall not be construed as:

(a) Prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers, so long as they do not practice practical nursing within the meaning of this chapter;

(b) Preventing a person from the domestic administration of family remedies or the furnishing of nursing assistance in case of emergency;

(c) Prohibiting the practice of practical nursing by students enrolled in approved schools as may be incidental to their course of study or prohibiting the students from working as nursing assistants;

(e) Prohibiting or preventing the practice of nursing in this state by a legally qualified nurse of another state or territory whose engagement requires him or her to accompany and care for a patient temporarily residing in this state during the period of one such engagement, not to exceed six months in length, if the person does not represent or hold himself or herself out as a licensed practical nurse licensed to practice in this state;

(f) Prohibiting nursing or care of the sick, with or without compensation, when done in connection with the practice of the religious tenets of a church by adherents of the church so long as they do not engage in licensed practical nurse practice as defined in this chapter;

(g) Prohibiting the practice of a legally qualified nurse of another state who is employed by the United States government or any bureau, division, or agency thereof, while in the discharge of his or her official duties.

NEW SECTION. Sec. 625. An advanced registered nurse practitioner under his or her license may perform for compensation nursing care, as that term is usually understood, of the ill, injured, or infirm, and in the course thereof, she or he may do the following things that shall not be done by a person not so licensed, except as provided in sections 626 and 627 of this act:

(1) Perform specialized and advanced levels of nursing as defined by the commission;

(2) Prescribe legend drugs and Schedule V controlled substances, as defined in the Uniform Controlled Substances Act, chapter 69.50 RCW, within the scope of practice defined by the commission;

(3) Perform all acts provided in section 626 of this act;

(4) Hold herself or himself out to the public or designate herself or himself as an advanced registered nurse practitioner or as a nurse practitioner.

NEW SECTION. Sec. 626. A registered nurse under his or her license may perform for compensation nursing care, as that term is usually understood, of the ill, injured, or infirm, and in the course thereof, she or he may do the following things that shall not be done by a person not so licensed, except as provided in section 627 of this act:

(1) At or under the general direction of a licensed physician and surgeon, dentist, osteopathic physician and surgeon, podiatric physician and surgeon, physician assistant, osteopathic physician assistant, or advanced registered nurse practitioner acting within the scope of his or her license, administer medications, treatments, tests, and inoculations, whether or not the severing or penetrating of tissues is involved and whether or not a degree of independent judgment and skill is required;

(2) Delegate to other persons engaged in nursing, the functions outlined in subsection (1) of this section;

(3) Instruct nurses in technical subjects pertaining to nursing;

(4) Hold herself or himself out to the public or designate herself or himself as a registered nurse.

NEW SECTION. Sec. 627. A licensed practical nurse under his or her license may perform nursing care, as that term is usually understood, of the ill, injured, or infirm, and in the course thereof may, under the direction of a licensed physician and surgeon, osteopathic physician and surgeon, dentist, podiatric physician and surgeon, physician assistant, osteopathic physician assistant, advanced registered nurse practitioner acting under the scope of his or her license, or at the direction and under the supervision of a registered nurse, administer drugs, medications, treatments, tests, injections, and inoculations, whether or not the piercing of tissues is involved and whether or not a degree of independent judgment and skill is required, when selected to do so by one of the licensed practitioners designated in this section, or by a registered nurse who need not be physically present; if the order given is reduced to writing within a reasonable time and made a part of the patient's record.

NEW SECTION. Sec. 628. It is not a violation of chapter 18.71 or 18.57 RCW for a registered nurse, at or under the general direction of a licensed physician and surgeon, or osteopathic physician and surgeon, to administer prescribed drugs, injections, inoculations, tests, or treatment whether or not the piercing of tissues is involved.

NEW SECTION. Sec. 629. (1) In accordance with rules adopted by the commission, public school districts and private schools that offer classes for any of grades kindergarten through twelve may provide for clean, intermittent bladder catheterization of students or assisted self-catheterization of students who are in the custody of the school district or private school at the time. After consultation with staff of the superintendent of public instruction, the commission shall adopt rules in accordance with chapter 34.05 RCW, that provide for the following and such other matters as the commission deems necessary to the proper implementation of this section:

(a) A requirement for a written, current, and unexpired request from a parent, legal guardian, or other person having legal control over the student that the school district or private school provide for the catheterization of the student;

(b) A requirement for a written, current, and unexpired request from a physician licensed under chapter 18.71 or 18.57 RCW that catheterization of the student be provided for during the hours when school is in session or the hours when the student is under the supervision of school officials;

(c) A requirement for written, current, and unexpired instructions from an advanced registered nurse practitioner or a registered nurse licensed under this chapter regarding catheterization that include (i) a designation of the school district or private school employee or employees who may provide for the catheterization, and (ii) a description of the nature and extent of any required supervision; and

(d) The nature and extent of acceptable training that shall (i) be provided by a physician, advanced registered nurse practitioner, or registered nurse licensed under chapter 18.71 or 18.57 RCW, or this chapter, and (ii) be required of school district or private school employees who provide for the catheterization of a student under this section, except that a licensed practical nurse licensed under this chapter is exempt from training.

(2) This section does not require school districts to provide intermittent bladder catheterization of students.

NEW SECTION. Sec. 630. The department, subject to chapter 34.05 RCW, the Washington Administrative Procedure Act, may adopt such reasonable rules as may be necessary to carry out the duties imposed upon it in the administration of this chapter.

NEW SECTION. Sec. 631. As of the effective date of this act, all rules, regulations, decisions, and orders of the board of nursing under chapter 18.88 RCW or the board of practical nursing under chapter 18.78 RCW continue to be in effect under the commission, until the commission acts to modify the rules, regulations, decisions, or orders.

NEW SECTION. Sec. 632. Sections 601 through 631 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 633. The following acts or parts of acts are each repealed:

(1) RCW 18.78.005 and 1991 c 84 s 1 & 1983 c 55 s 1;

(2) RCW 18.78.010 and 1991 c 84 s 13, 1991 c 3 s 185, 1983 c 55 s 2, 1967 c 79 s 1, 1963 c 15 s 1, & 1949 c 222 s 1;

(3) RCW 18.78.020 and 1991 c 84 s 2, 1983 c 55 s 3, 1967 c 79 s 2, & 1949 c 222 s 2;

(4) RCW 18.78.030 and 1991 c 84 s 3, 1983 c 55 s 4, & 1949 c 222 s 3;

(5) RCW 18.78.040 and 1991 c 84 s 4, 1984 c 287 s 47, 1983 c 55 s 5, 1975-'76 2nd ex.s. c 34 s 45, 1967 c 188 s 4, & 1949 c 222 s 4;

(6) RCW 18.78.050 and 1991 c 84 s 5, 1988 c 211 s 4, 1986 c 259 s 129, 1983 c 55 s 6, 1979 c 158 s 64, 1967 c 79 s 3, & 1949 c 222 s 5;

(7) RCW 18.78.054 and 1987 c 150 s 49 & 1986 c 259 s 128;

(8) RCW 18.78.055 and 1991 c 84 s 6 & 1983 c 55 s 7;

(9) RCW 18.78.058 and 1987 c 150 s 50;

(10) RCW 18.78.060 and 1991 c 84 s 7, 1988 c 212 s 1, 1983 c 55 s 8, 1971 ex.s. c 292 s 26, 1963 c 15 s 2, & 1949 c 222 s 6;

(11) RCW 18.78.070 and 1986 c 259 s 130, 1983 c 55 s 9, & 1949 c 222 s 7;

(12) RCW 18.78.072 and 1988 c 211 s 3;

(13) RCW 18.78.080 and 1991 c 84 s 8, 1985 c 7 s 65, 1979 c 158 s 65, 1975 1st ex.s. c 30 s 68, 1963 c 15 s 3, & 1949 c 222 s 9;

(14) RCW 18.78.090 and 1991 c 84 s 9, 1986 c 259 s 131, 1985 c 7 s 66, 1983 c 55 s 10, 1979 c 158 s 66, 1975 1st ex.s. c 30 s 69, 1971 ex.s. c 266 s 14, 1967 c 79 s 4, 1963 c 15 s 4, & 1949 c 222 s 10;

(15) RCW 18.78.100 and 1991 c 84 s 10, 1991 c 3 s 190, 1983 c 55 s 11, 1971 c 68 s 1, & 1949 c 222 s 11;

(16) RCW 18.78.160 and 1991 c 84 s 12, 1983 c 55 s 15, & 1949 c 222 s 17;

(17) RCW 18.78.182 and 1991 c 84 s 11, 1983 c 55 s 19, 1971 c 68 s 2, & 1967 c 79 s 6;

(18) RCW 18.78.225 and 1991 c 3 s 192 & 1988 c 211 s 12;

(19) RCW 18.78.900 and 1949 c 222 s 19;

(20) RCW 18.78.901 and 1983 c 55 s 22;

(21) RCW 18.88.010 and 1973 c 133 s 1 & 1949 c 202 s 1;

(22) RCW 18.88.020 and 1973 c 133 s 2 & 1949 c 202 s 2;

(23) RCW 18.88.030 and 1991 c 3 s 213, 1989 c 114 s 1, 1979 c 158 s 69, 1973 c 133 s 3, 1961 c 288 s 1, & 1949 c 202 s 4;

(24) RCW 18.88.050 and 1989 c 114 s 2, 1973 c 133 s 4, & 1949 c 202 s 5;

(25) RCW 18.88.060 and 1973 c 133 s 5, 1961 c 288 s 3, & 1949 c 202 s 6;

(26) RCW 18.88.070 and 1989 c 114 s 3, 1973 c 133 s 6, & 1949 c 202 s 7;

(27) RCW 18.88.080 and 1991 c 3 s 214, 1988 c 211 s 8, 1984 c 287 s 50, 1977 c 75 s 12, 1975-'76 2nd ex.s. c 34 s 50, 1973 c 133 s 7, 1961 c 288 s 4, & 1949 c 202 s 8;

(28) RCW 18.88.086 and 1987 c 150 s 57 & 1986 c 259 s 135;

(29) RCW 18.88.090 and 1991 c 3 s 215, 1975-'76 2nd ex.s. c 34 s 51, 1973 c 133 s 8, 1961 c 288 s 5, & 1949 c 202 s 9;

(30) RCW 18.88.100 and 1973 c 133 s 9, 1961 c 288 s 6, & 1949 c 202 s 10;

(31) RCW 18.88.110 and 1973 c 133 s 10 & 1949 c 202 s 11;

(32) RCW 18.88.120 and 1973 c 133 s 11 & 1949 c 202 s 12;

(33) RCW 18.88.130 and 1989 c 114 s 4, 1973 c 133 s 12, 1961 s 288 s 7, & 1949 c 202 s 13;

(34) RCW 18.88.140 and 1989 c 114 s 5, 1973 c 133 s 13, 1961 c 288 s 8, & 1949 c 202 s 14;

(35) RCW 18.88.150 and 1989 c 114 s 6, 1988 c 211 s 5, 1973 c 133 s 14, 1961 c 288 s 9, & 1949 c 202 s 15;

(36) RCW 18.88.160 and 1991 c 3 s 216, 1985 c 7 s 68, 1975 1st ex.s. c 30 s 77, 1973 c 133 s 15, 1961 c 288 s 10, & 1949 c 202 s 16;

(37) RCW 18.88.170 and 1973 c 133 s 16 & 1949 c 202 s 17;

(38) RCW 18.88.175 and 1991 c 3 s 217 & 1988 c 211 s 13;

(39) RCW 18.88.190 and 1991 c 3 s 218, 1988 c 211 s 9, 1985 c 7 s 69, 1979 ex.s. c 106 s 1, 1975 1st ex.s. c 30 s 78, 1973 c 133 s 18, 1971 ex.s. c 266 s 18, 1961 c 288 s 11, & 1949 c 202 s 19;

(40) RCW 18.88.200 and 1991 c 3 s 219, 1988 c 211 s 10, 1985 c 7 s 70, 1975 1st ex.s. c 30 s 79, 1973 c 133 s 19, 1961 c 288 s 12, & 1949 c 202 s 20;

(41) RCW 18.88.220 and 1991 c 3 s 220, 1988 c 211 s 11, 1973 c 133 s 20, & 1949 c 202 s 22;

(42) RCW 18.88.270 and 1986 c 259 s 136, 1973 c 133 s 26, & 1949 c 202 s 27;

(43) RCW 18.88.280 and 1993 c 225 s 1, 1989 c 114 s 7, 1988 c 37 s 1, 1973 c 133 s 27, 1961 c 288 s 13, & 1949 c 202 s 28;

(44) RCW 18.88.285 and 1989 c 114 s 8, 1973 c 133 s 28, 1967 c 79 s 9, & 1961 c 288 s 14;

(45) RCW 18.88.290 and 1955 c 62 s 1;

(46) RCW 18.88.295 and 1988 c 48 s 1;

(47) RCW 18.88.300 and 1973 c 133 s 29;

(48) RCW 18.88.900 and 1949 c 202 s 29; and

(49) RCW 18.88A.070 and 1991 c 16 s 9, 1991 c 3 s 223, 1989 c 300 s 9, & 1988 c 267 s 9.

PHYSICAL HEALTH THERAPIES

NEW SECTION. Sec. 701. PURPOSE. It is the purpose of the physical health therapies quality assurance commission to regulate the competency and quality of professional health care providers under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline. Rules, policies, and procedures developed by the commission must promote the delivery of quality health care to the residents of the state of Washington.

NEW SECTION. Sec. 702. DEFINITIONS. Unless the context otherwise requires, the definitions in this section apply throughout this chapter.

(1) "Commission" means the physical health therapies quality assurance commission created under section 703 of this act.

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

(3) "Secretary" means the secretary of health.

(4) Words importing the masculine gender may be applied to females.

(5) "Person" means an individual, partnership, unincorporated organization, or corporate body, except that only an individual may be licensed under this chapter.

(6) "Authorized health care practitioner" means licensed physicians, osteopathic physicians, chiropractors, naturopaths, podiatric physicians and surgeons, and dentists. Nothing in this chapter alters the scope of practice of those practitioners as defined in their respective licensing laws.

(7) "Physical therapy" means the treatment of a bodily or mental condition of a person by the use of the physical, chemical, and other properties of heat, cold, air, light, water, electricity, sound, massage, and therapeutic exercise, which includes posture and rehabilitation procedures; the performance of tests and measurements of neuromuscular function as an aid to the diagnosis or treatment of a human condition; performance of treatments on the basis of test findings after consultation with and periodic review by an authorized health care practitioner except as provided in section 707 of this act; supervision of selective forms of treatment by trained supportive personnel; and provision of consultative services for health, education, and community agencies. The use of roentgen rays and radium for diagnostic and therapeutic purposes, the use of electricity for surgical purposes, including cauterization, and the use of spinal manipulation or manipulative mobilization of the spine and its immediate articulations, are not included under the term "physical therapy" as used in this chapter.

(8) "Physical therapist" means a person licensed to practice physical therapy under this chapter but does not include massage practitioners.

(9) "Occupational therapy" is the scientifically based use of purposeful activity with individuals who are limited by physical injury or illness, psychosocial dysfunction, developmental or learning disabilities, or the aging process, in order to maximize independence, prevent disability, and maintain health. The practice encompasses evaluation, treatment, and consultation. Specific occupational therapy services include but are not limited to using specifically designed activities and exercises to enhance neurodevelopmental, cognitive, perceptual motor, sensory integrative, and psychomotor functioning; administering and interpreting tests such as manual muscle and sensory integration; teaching daily living skills; developing prevocational skills and play and avocational capabilities; designing, fabricating, or applying selected orthotic and prosthetic devices or selected adaptive equipment; and adapting environments for the handicapped. These services may be provided individually, in groups, or through social systems.

(10) "Occupational therapist" means a person licensed to practice occupational therapy under this chapter.

(11) "Occupational therapy assistant" means a person licensed to assist in the practice of occupational therapy under the supervision or with the regular consultation of an occupational therapist.

(12) "Occupational therapy aide" means a person who is trained to perform specific occupational therapy techniques under professional supervision as defined by the commission but who does not perform activities that require advanced training in the sciences or practices involved in the profession of occupational therapy.

(13) "Massage" and "massage therapy" mean a health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes. Massage therapy includes massage techniques such as methods of effleurage, petrissage, tapotement, tapping, compressions, vibration, friction, nerve stokes, and Swedish gymnastics or movements either by manual means, as they relate to massage, with or without the aids of superficial heat, cold, water, lubricants, or salts. Massage therapy does not include diagnosis or attempts to adjust or manipulate any articulations of the body or spine or mobilization of these articulations by the use of a thrusting force.

(14) "Massage practitioner" means an individual licensed under this chapter.

(15) "Massage business" means the operation of a business where massages are given.

NEW SECTION. Sec. 703. PHYSICAL HEALTH THERAPIES QUALITY ASSURANCE COMMISSION‑-GENERALLY. The Washington state physical health therapies quality assurance commission is established, consisting of eight members appointed by the governor. The governor may appoint the initial members of the commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. Members of the commission hold office until their successors are appointed. No person may serve as a member of the commission for more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, the governor appoint to the commission the existing members of the board of occupational therapy practice, the board of physical therapy, and board of massage repealed under chapter . . ., Laws of 1994 (this act).

Members of the commission must include two occupational therapists, two physical therapists, two massage practitioners, and two public members. The occupational therapist members, the physical therapist members, and the massage practitioner members must be citizens of the United States and residents of this state and have not less than five years' experience in the practice of their respective professions immediately before their appointments and must be actively engaged in the practice of their professions during their incumbency. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission.

The governor may remove a member of the commission for neglect of duty, misconduct, malfeasance or misfeasance in office, or for incompetency or unprofessional conduct as defined in chapter 18.130 RCW. Whenever the governor is satisfied that a member of a commission has been guilty of neglect of duty, misconduct, malfeasance or misfeasance in office, or of incompetency or unprofessional conduct, the governor shall file with the secretary of state a statement of the causes for and the order of removal from office, and the secretary shall forthwith send a certified copy of the statement of causes and order of removal to the last known post office address of the member. If a vacancy occurs on the commission, the governor shall appoint a replacement member to fill the remainder of the unexpired term.

The commission shall annually elect a chairperson, a vice-chairperson, and a secretary. The commission shall meet as called by the chairperson or the secretary. Meetings of the commission must be open and public, except the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW.

A majority of the commission members appointed and serving constitutes a quorum for the transaction of commission business. The affirmative vote of a majority of a quorum of the commission is required to carry a motion or resolution, to adopt a rule, or to pass a measure. The commission may appoint panels consisting of not less than three members. A quorum for transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

The members of the commission are immune from suit in an action, civil or criminal, based on its disciplinary proceedings or other official acts performed in good faith as members of the commission.

NEW SECTION. Sec. 704. POWERS AND DUTIES OF COMMISSION RELATED TO OCCUPATIONAL THERAPISTS AND PHYSICAL THERAPISTS‑-APPLICATION OF UNIFORM DISCIPLINARY ACT. (1) The commission has the following powers and duties:

(a) Administer examinations to applicants for physical therapist and occupational therapist licenses;

(b) Pass upon the qualifications of applicants for licensing and certify to the secretary qualified applicants;

(c) Make such rules not inconsistent with the laws of this state as may be deemed necessary or proper to carry out the purposes of this chapter;

(d) Establish and administer requirements for continuing competency;

(e) Keep an official record of all its proceedings, which record is evidence of all proceedings of the commission that are set forth in the record;

(f) Adopt rules not inconsistent with the laws of this state, when it deems appropriate, in response to questions put to it by professional health associations, massage practitioners, occupational therapists, physical therapists, and consumers in this state concerning the authority of occupational therapists, and physical therapists to perform particular acts; and recommend such rules related to massage practitioners for adoption by the secretary in areas under the authority of the secretary;

(g) Determine and approve definitions, evaluations, and designations of massage practitioner schools, programs, and apprenticeship programs including such areas as curriculum, faculty, and health, sanitation, and facility standards, from which graduation will be accepted as proof of a massage practitioner applicant's eligibility to take the massage practitioner licensing examination;

(h) Periodically review approved colleges, schools, and programs under its jurisdiction.

(2) The Uniform Disciplinary Act, chapter 18.130 RCW, governs the issuance and denial of licenses and the disciplining of persons under this chapter. The commission is the disciplining authority for occupational therapists and physical therapists under this chapter.

(3) The commission is the successor in interest of the board of occupational therapy practice and the board of physical therapy. All contracts, undertakings, agreements, rules, regulations, and policies continue is full force and effect on the effective date of this act, unless otherwise repealed or rejected by this chapter or by the commission.

NEW SECTION. Sec. 705. POWERS AND DUTIES OF SECRETARY RELATED TO MASSAGE PRACTITIONERS‑-APPLICATION OF UNIFORM DISCIPLINARY ACT. (1) In addition to any other authority provided by law, the secretary may:

(a) Adopt rules, in accordance with chapter 34.05 RCW necessary to implement the provisions of this chapter related to massage practitioners;

(b) Set all license, examination, and renewal fees for massage practitioners under RCW 43.70.250;

(d) Issue a license to an applicant who has met the education, training, and examination requirements for licensing as a massage practitioner; and

(e) Hire clerical, administrative, and investigative staff as necessary to implement this chapter, and hire individuals licensed as massage practitioners under this chapter to serve as examiners for any practical examinations for massage practitioner.

(2) The Uniform Disciplinary Act, chapter 18.130 RCW, governs the issuance and denial of licenses and the disciplining of persons under this chapter. The secretary is the disciplining authority for massage practitioners under this chapter.

(3) The secretary shall keep an official record of all proceedings under this section, a part of which record must consist of a register of all applicants for licensing under this chapter, with the result of each application.

(4) The commission is the successor in interest of the board of massage. All contracts, undertakings, agreements, rules, regulations, and policies continue is full force and effect on the effective date of this act, unless otherwise repealed or rejected by this chapter or by the commission.

(5) The secretary may by rule delegate to the commission the powers and duties granted under this section related to massage practitioners.

NEW SECTION. Sec. 706. POWERS AND DUTIES OF COMMISSION RELATED TO MASSAGE PRACTITIONERS. The commission has the following powers and duties:

(1) Prepare and administer examinations to applicants for licensing as massage practitioners under this chapter;

(2) Determine and approve definitions, evaluations, and designations of massage practitioner schools, programs, and apprenticeship programs including such areas as curriculum, faculty, and health, sanitation, and facility standards from which graduation will be accepted as proof of a massage practitioner applicant's eligibility to take the massage practitioner licensing examination. The determinations must apply equally to schools and training within the United States of America and those in foreign jurisdictions;

(3) Periodically review approved schools and programs;

(4) Determine which states have educational and licensing requirements equivalent to those of this state.

PHYSICAL THERAPISTS

NEW SECTION. Sec. 707. PHYSICAL THERAPIST CONSULTATION WITH HEALTH CARE PRACTITIONER NOT REQUIRED FOR CERTAIN TREATMENTS. Notwithstanding section 702(7) of this act, a consultation and periodic review by an authorized health care practitioner is not required for treatment of neuromuscular or musculoskeletal conditions. However, a physical therapist may only provide treatment using orthoses that support, align, prevent, or correct any structural problems intrinsic to the foot or ankle by referral or consultation from an authorized health care practitioner.

NEW SECTION. Sec. 708. PHYSICAL THERAPIST REFERRAL TO HEALTH CARE PRACTITIONERS‑-WHEN REQUIRED. (1) Physical therapists shall refer persons under their care to authorized health care practitioners if they have reasonable cause to believe symptoms or conditions are present that require services beyond the scope of their practice or for which physical therapy is contraindicated.

(2) A violation of this section is unprofessional conduct under this chapter and chapter 18.130 RCW.

NEW SECTION. Sec. 709. STANDARDS FOR APPROPRIATENESS OF PHYSICAL THERAPY CARE‑-VIOLATION. Under the commission's power in section 704 of this act, the commission shall adopt rules relating to standards for appropriateness of physical therapy care. Violation of the standards adopted under this section is unprofessional conduct under this chapter and chapter 18.130 RCW.

NEW SECTION. Sec. 710. QUALIFICATIONS OF PHYSICAL THERAPIST APPLICANTS. An applicant for a license as a physical therapist must have the following minimum qualifications:

(1) Be of good moral character; and

(2) Have obtained either (a) a baccalaureate degree in physical therapy from an institution of higher learning approved by the commission or (b) a baccalaureate degree from an institution of higher learning and a certificate or advanced degree from a school of physical therapy approved by the commission.

The applicant shall present proof of qualification to the commission in the manner and on the forms prescribed by it.

NEW SECTION. Sec. 711. PHYSICAL THERAPIST LICENSING EXAMINATIONS‑-SCOPE‑-TIME AND PLACE. The commission shall examine all qualified applicants for a license as a physical therapist at such time and place as the commission determines. The examination must embrace the following subjects: The applied sciences of anatomy, neuroanatomy, kinesiology, physiology, pathology, psychology, physics; physical therapy as applied to medicine, neurology, orthopedics, pediatrics, psychiatry, surgery; medical ethics; technical procedures in the practice of physical therapy; and such other subjects as the commission may deem useful to test the applicant's fitness to practice physical therapy, but not including the adjustment or manipulation of the spine or use of a thrusting force as mobilization. Examinations must be held within the state at least once a year, at such time and place as the commission determines. An applicant who fails an examination may apply for reexamination upon payment of a reexamination fee determined by the secretary.

NEW SECTION. Sec. 712. PHYSICAL THERAPIST LICENSES. The secretary shall license as a physical therapist, and shall furnish a license to each applicant, who successfully passes the examination for licensing as a physical therapist.

NEW SECTION. Sec. 713. PHYSICAL THERAPIST LICENSES‑-FEES. The secretary shall furnish a license upon the authority of the commission to any person who applies and who has qualified under this chapter. At the time of applying, the applicant shall pay to the state treasurer a fee determined by the secretary under RCW 43.70.250. No person registered or licensed on July 24, 1983, as a physical therapist may be required to pay an additional fee for a license under this chapter.

NEW SECTION. Sec. 714. PHYSICAL THERAPIST LICENSING BY ENDORSEMENT. Upon the recommendation of the commission, the secretary shall license as a physical therapist and shall furnish a license to a person who is a physical therapist registered or licensed under the laws of another state or territory, or the District of Columbia, if the qualifications for registration or license that were required of the applicant were substantially equal to the requirements under this chapter. At the time of applying for licensing by endorsement, the applicant shall pay to the state treasurer a fee determined by the secretary under RCW 43.70.250.

NEW SECTION. Sec. 715. PHYSICAL THERAPIST LICENSES‑-ISSUANCE TO PERSONS LICENSED OR REGISTERED BEFORE JULY 24, 1983. The secretary shall issue a license under this chapter to a person holding a valid license or certificate of registration to practice physical therapy issued by authority of this state before July 24, 1983.

NEW SECTION. Sec. 716. RENEWAL OF PHYSICAL THERAPIST LICENSE‑-LAPSED LICENSE‑-FEES. A licensed physical therapist shall apply to the secretary for a renewal of the license and pay to the state treasurer a fee determined by the secretary under RCW 43.70.250. The license of a physical therapist who fails to renew the license within thirty days of the date set by the secretary for renewal will automatically lapse. Within three years from the date of lapsing and upon the recommendation of the commission, the secretary may revive a lapsed license upon the payment of all past unpaid renewal fees and a penalty fee to be determined by the secretary. The commission may require reexamination of an applicant whose license has lapsed for more than three years and who has not continuously engaged in lawful practice in another state or territory, or waive reexamination in favor of evidence of continuing education satisfactory to the commission.

NEW SECTION. Sec. 717. PHYSICAL THERAPIST INTERIM PERMITS. (1) The department, upon approval by the commission, shall issue an interim permit authorizing an applicant for physical therapist licensing who meets the minimum qualifications of section 720 of this act to practice physical therapy under graduate supervision pending notification of the results of the first licensing examination for which the applicant is eligible, but not to exceed six months.

(2) For purposes of this section, "graduate supervision" means supervision of a holder of an interim permit by a licensed physical therapist who is on the premises at all times. Graduate supervision must include consultation regarding evaluation, treatment plan, treatment program, and progress of each assigned patient at appropriate intervals and be documented by cosignature of notes by the licensed physical therapist. Section 707 of this act does not apply to holders of interim permits.

(3) If the holder of the interim permit fails the examination, the permit expires upon notification and is not renewable.

NEW SECTION. Sec. 718. ADVERTISING BY PHYSICAL THERAPIST OF SPINAL MANIPULATION OR MOBILIZATION PROHIBITED. (1) Physical therapists shall not advertise that they perform spinal manipulation or manipulative mobilization of the spine.

(2) A violation of this section is unprofessional conduct under this chapter and chapter 18.130 RCW.

NEW SECTION. Sec. 719. FALSE ADVERTISING‑-USE OF NAME AND WORDS‑-LICENSE REQUIRED‑-PROSECUTIONS OF VIOLATIONS. A person who is not licensed with the secretary as a physical therapist under the requirements of this chapter shall not represent himself or herself as being so licensed and shall not use in connection with his or her name the words or letters "P.T.," "R.P.T.," "L.P.T.," "physical therapy," "physiotherapy," "physical therapist," or "physiotherapist," or any other letters, words, signs, numbers, or insignia indicating or implying that he or she is a physical therapist. No person may practice physical therapy without first having a valid license. The prosecuting attorney of each county shall prosecute all cases involving a violation of this chapter arising within that county. The attorney general may assist in the prosecution and shall appear at all hearings when requested to do so by the commission.

NEW SECTION. Sec. 720. FALSE ADVERTISING‑-INJUNCTIONS. If a person violates this chapter, the attorney general, prosecuting attorney, the secretary, the commission, or any citizen of the county where the violation occurred may maintain an action in the name of the state to enjoin the violator from practicing or holding himself or herself out as practicing physical therapy. The injunction does not relieve criminal prosecution, but the remedy of injunction is in addition to the liability of the offender for criminal prosecution and the suspension or revocation of his or her license.

NEW SECTION. Sec. 721. ACTIVITIES NOT PROHIBITED‑-USE OF LETTERS OR WORDS IN CONNECTION WITH NAME. Nothing in this chapter prohibits a person licensed in this state under any other law from engaging in the practice for which he or she is licensed. Nothing in this chapter prohibits a person who, at any time before January 1, 1961, was practicing a healing or manipulative art in the state of Washington and designating the practice as physical therapy or physiotherapy, from continuing to do so after the effective date of this act. However, no such person may represent himself or herself as being registered and may not use in connection with his or her name the words or letters "registered" or "licensed" or "R.P.T."

NEW SECTION. Sec. 722. PRACTICES AND SERVICES NOT REGULATED OR PROHIBITED BY PHYSICAL THERAPY PROVISIONS. This chapter does not prohibit or regulate:

(1) The practice of physical therapy by students enrolled in approved schools as may be incidental to their course of study so long as the activities do not go beyond the scope of practice defined by this chapter;

(2) Auxiliary services provided by physical therapy aides carrying out duties necessary for the support of physical therapy, including those duties that involve minor physical therapy services when performed under the direct supervision of licensed physical therapists so long as the activities do not go beyond the scope of practice defined by this chapter;

(3) The practice of physical therapy by licensed or registered physical therapists of other states or countries while appearing as clinicians of bona fide educational seminars sponsored by physical therapy, medical, or other healing art professional associations so long as the activities do not go beyond the scope of practice defined by this chapter;

(4) The practice of physical therapists in the armed services or employed by any other branch of the federal government.

NEW SECTION. Sec. 723. INSURANCE COVERAGE AND BENEFITS NOT MANDATED OR REGULATED. This chapter does not restrict the ability of an insurance entity regulated by Title 48 RCW, or a state agency or program, from limiting or controlling the use of physical therapy services through the use of a gatekeeper function; nor does it require or prohibit that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person licensed under this chapter. For the purpose of this chapter, "gatekeeper function" means a provision in a contract that establishes a threshold requirement, such as a recommendation from a case manager or a primary care provider, that must be satisfied before a covered person is eligible to receive benefits under the contract.

NEW SECTION. Sec. 724. PHYSICAL THERAPIST PRACTICE SETTING NOT RESTRICTED. Nothing in this chapter restricts the ability of physical therapists to work in the practice setting of their choice.

OCCUPATIONAL THERAPISTS

NEW SECTION. Sec. 725. OCCUPATIONAL THERAPIST LICENSE REQUIRED. No person may practice or represent himself or herself as an occupational therapist without first having a valid license to do so.

NEW SECTION. Sec. 726. PRACTICE, SERVICES, OR ACTIVITIES NOT PREVENTED OR RESTRICTED BY CHAPTER‑-LIMITED PERMITS. This chapter does not prevent or restrict the practice, services, or activities of:

(1) A person licensed in this state under any other law from engaging in the profession or occupation for which the person is licensed;

(2) A person employed as an occupational therapist or occupational therapy assistant by the government of the United States, if the person provides occupational therapy solely under the directions or control of the organization by which the person is employed;

(3) A person pursuing a course of study leading to a degree or certificate in occupational therapy in an accredited or approved educational program if the activities and services constitute a part of a supervised course of study, if the person is designated by a title that clearly indicates the person's status as a student or trainee;

(4) A person fulfilling the supervised fieldwork experience requirements of section 727 of this act, if the activities and services are a part of the experience necessary to meet the requirements of that section;

(5) A person performing occupational therapy services in this state, if the services are performed for no more than ninety working days and if:

(a) The person is licensed under the laws of another state that has licensing requirements at least as stringent as the requirements of this chapter, as determined by the commission; or

(b) The person has met commonly accepted standards for the practice of occupational therapy as specifically defined by the commission;

(6) A person employed by or supervised by an occupational therapist as an occupational therapy aide;

(7) A person with a limited permit. The commission may grant a limited permit to a person who has completed the education and experience requirements of this chapter, or education and experience requirements that the commission deems equivalent to those specified as requirements for licensing. The limited permit allows the applicant to practice in association with an occupational therapist. The limited permit is valid until the results of the next examination have been made public. The commission may grant one extension of this permit if the applicant has failed the examination, but during this period the person must be under the direct supervision of an occupational therapist;

(8) A person who teaches daily living skills, develops prevocational skills or play and avocational capabilities, adapts equipment or environments for the handicapped, or who does specific activities to enhance cognitive, perceptual motor, sensory integrative, and psychomotor skills, but who does not hold himself or herself out to the public by a title, initials, or description of services as being engaged in the practice of occupational therapy; or

(9) A person who designs, fabricates, or applies orthotic or prosthetic devices that are prescribed by a health care professional authorized by the laws of this state to prescribe the device or to direct the design, fabrication, or application of the device.

NEW SECTION. Sec. 727. OCCUPATIONAL THERAPIST LICENSES‑-APPLICATION‑-REQUIREMENTS‑-WAIVER. (1) An applicant for a license as an occupational therapist or an occupational therapy assistant shall file a written application on forms provided by the department showing to the satisfaction of the commission that the applicant meets the requirements of this subsection.

(a) The applicant must be of good moral character.

(b) The applicant shall present evidence satisfactory to the commission of having successfully completed the academic requirements of an educational program in occupational therapy recognized by the commission, with concentration in biological or physical science, psychology, sociology, and with education in selected manual skills.

(i) For an occupational therapist, the program must be nationally accredited and approved by rules of the commission.

(ii) For an occupational therapy assistant, the program must be nationally accredited and approved by rules of the commission.

(c) The applicant shall submit to the commission evidence of having successfully completed a period of supervised fieldwork experience at a recognized educational institution or a training program approved by the educational institution at which the applicant met the academic requirements.

(i) For an occupational therapist, a minimum of six months of supervised fieldwork experience is required.

(ii) For an occupational therapy assistant, a minimum of two months of supervised fieldwork experience is required.

(d) An applicant for licensure as an occupational therapist or as an occupational therapy assistant shall pass an examination as provided in section 728 of this act.

(2) The commission may waive the educational requirements specified under subsection (1)(b)(ii) of this section for an occupational therapy assistant who has met the experience and any other requirements established by the commission. Upon successful completion of the examination required of the occupational therapist, the commission shall grant the individual a license.

NEW SECTION. Sec. 728. OCCUPATIONAL THERAPIST LICENSING EXAMINATIONS. (1) A person applying for licensing shall demonstrate eligibility in accordance with section 727 of this act and shall apply for examination upon a form and in such a manner as the department prescribes. The application must be accompanied by the fee prescribed by section 733 of this act, which fee is not refundable. A person who fails an examination may apply for reexamination. The reexamination application must be accompanied by the prescribed fee.

(2) An applicant for licensing under this chapter shall be given a written examination to test the applicant's knowledge of the basic and clinical sciences relating to occupational therapy and occupational therapy theory and practice, including the applicant's professional skills of occupational therapy techniques and methods, and such other subjects as the commission deems useful to determine the applicant's fitness to practice. The commission shall approve the examination and establish standards for acceptable performance.

(3) Applicants for licensing shall be examined at a time and place and under such supervision as the commission may determine. The examination must be given at least twice each year at such places as the commission determines, and the commission shall give reasonable public notice of the examinations in accordance with its rules at least sixty days before the administration of the examination.

(4) Applicants may obtain their examination scores and may review their tests in accordance with rules of the commission.

NEW SECTION. Sec. 729. WAIVER OF OCCUPATIONAL THERAPIST EXAMINATION AND LICENSING REQUIREMENTS‑-APPLICANTS LICENSED IN OTHER STATES OR TERRITORIES. (1) The commission shall waive the examination and grant a license to a person engaged in the profession of an occupational therapist or an occupational therapy assistant on June 7, 1984, if the commission determines that the person meets commonly accepted standards for the profession, as established by rule of the commission. The commission may waive the examination, education, or experience requirements and grant a license to a person meeting the standards adopted by the commission under this section after June 7, 1984, if the commission considers the requirements for licensing in this chapter as having been met.

(2) The commission may grant a license to an applicant who presents proof of current licensing as an occupational therapist or occupational therapy assistant in another state, the District of Columbia, or a territory of the United States, that requires standards for licensing that the commission considers to be equivalent to the requirements for licensing under this chapter.

(3) The commission shall waive the education and experience requirements for licensing in section 727(1) (c) and (d) of this act for an applicant who presents evidence to the commission that he or she has been engaged in the practice of occupational therapy for the three years immediately before June 7, 1984. The applicant shall present proof of actual practice to the commission in the manner prescribed by rule of the commission. To obtain the waiver, an applicant shall file an application for examination no later than six months from June 7, 1984. An applicant who has filed for examination under this subsection is excused from the licensing requirement until the date the results of the examination are made public.

NEW SECTION. Sec. 730. LICENSE ISSUANCE‑-POSTING. The secretary shall issue a license to a person who meets the licensing requirements of this chapter upon payment of the prescribed license fee. The license must be posted in a conspicuous location at the person's work site.

NEW SECTION. Sec. 731. RENEWAL OF OCCUPATIONAL THERAPIST LICENSES‑-REINSTATEMENT OF SUSPENDED OR REVOKED LICENSES‑-INACTIVE STATUS. (1) Licenses under this chapter may be renewed at the time and in the manner determined by the secretary and with the payment of a renewal fee. The commission shall establish requirements for license renewal that provide evidence of continued competency. The secretary may provide for the late renewal of a license upon the payment of a late fee in accordance with commission rules. The rules may include additional continuing education or examination requirements.

(2) A suspended occupational therapist license is subject to expiration and may be renewed as provided in this section, but the renewal does not entitle the licensee, while the license remains suspended and until it is reinstated, to engage in the licensed activity, or in any other conduct or activity in violation of the order or judgment by which the license was suspended. If a license revoked on disciplinary grounds is reinstated, the licensee, as a condition of reinstatement, shall pay the renewal fee and any applicable late fee.

(3) An occupational therapist or occupational therapy assistant not practicing occupational therapy or providing services may place his or her license in an inactive status. The secretary may prescribe requirements for maintaining an inactive status and converting from an inactive or active status.

NEW SECTION. Sec. 732. DUTY TO REFER MEDICAL CASES. An occupational therapist shall, after evaluating a patient and if the case is a medical one, refer the case to a physician for appropriate medical direction if that direction is lacking. Treatment by an occupational therapist of such a medical case may take place only upon the referral of a physician or a podiatric physician and surgeon licensed to practice in this state.

NEW SECTION. Sec. 733. FEES. The secretary shall prescribe and publish occupational therapist fees in amounts determined by the secretary under RCW 43.70.250 for the following purposes:

(1) Application for examination;

(2) Initial license fee;

(3) Renewal of license fee;

(4) Late renewal fee; and

(5) Limited permit fee.

The secretary shall set the fees in amounts that will reimburse the state, to the extent feasible, for the cost of the services rendered.

MASSAGE PRACTITIONERS

NEW SECTION. Sec. 734. INTENT OF MASSAGE PRACTITIONERS REGULATION‑-HEALTH CARE INSURANCE NOT AFFECTED. The legislature finds it necessary to license the practice of massage and massage therapy in order to protect the public health and safety. It is the legislature's intent that only individuals who meet and maintain minimum standards of competence and conduct may provide services to the public. This chapter does not require or prohibit individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization from providing benefits or coverage for services and supplies provided by a person registered or certified under this chapter.

NEW SECTION. Sec. 735. MASSAGE PRACTITIONER LICENSE REQUIRED. (1) No person may practice or represent himself or herself as a massage practitioner without first applying for and receiving from the department a license to practice.

(2) A person represents himself or herself as a massage practitioner when the person adopts or uses any title or any description of services that incorporates one or more of the following terms or designations: Massage, massage practitioner, massage therapist, massage therapy, therapeutic massage, massage technician, massage technology, massagist, masseur, masseuse, myotherapist or myotherapy, touch therapist, reflexologist, acupressurist, body therapy or body therapist, or any derivation of those terms that implies a massage technique or method.

NEW SECTION. Sec. 736. ADVERTISING PRACTICE OF MASSAGE BY UNLICENSED PERSON UNLAWFUL. It is unlawful to advertise the practice of massage using the term massage or any other term that implies a massage technique or method in a public or private publication or communication by a person not licensed by the secretary as a massage practitioner. A person who holds a license to practice as a massage practitioner in this state may use the title "licensed massage practitioner" and the abbreviation "L.M.P." No other persons may assume that title or use that abbreviation or any other word, letters, signs, or figures to indicate that the person using the title is a licensed massage practitioner.

NEW SECTION. Sec. 737. EXEMPTIONS. This chapter does not apply to:

(1) An individual giving massage to members of his or her immediate family;

(2) The practice of a profession by individuals who are licensed, certified, or registered under other laws of this state and who are performing services within their authorized scope of practice;

(3) Massage practiced at the athletic department of an institution maintained by the public funds of the state, or any of its political subdivisions;

(4) Massage practiced at the athletic department of a school or college approved by the department by rule using recognized national professional standards.

NEW SECTION. Sec. 738. MASSAGE PRACTITIONER LICENSE‑-ISSUANCE‑-EXPIRATION‑-RENEWAL‑-FEES. Licenses issued under sections 739 through 742 of this act, unless otherwise provided, expire on the annual anniversary date of the individual's date of birth.

The secretary shall prorate the licensing fee for a massage practitioner based on one-twelfth of the annual license fee for each full calendar month between the issue date and the next anniversary of the applicant's birth date, a date used as the expiration date of the license.

An applicant for a license shall pay an examination fee determined by the secretary under RCW 43.70.250, which fee must accompany the application. Applications for licensing must be submitted on forms provided by the secretary.

An applicant granted a license under sections 739 through 742 of this act shall pay to the secretary a license fee determined by the secretary under RCW 43.70.250, before the issuance of the license, and an annual renewal fee determined by the secretary under RCW 43.70.250. Failure to renew invalidates the license and all privileges granted to the licensee, but the license may be reinstated upon written application to the secretary and payment to the state of all delinquent fees and penalties as determined by the secretary. If a license has lapsed for a period longer than three years, the licensee shall demonstrate competence to the satisfaction of the secretary by proof of continuing education or other standard determined by the secretary with the advice of the commission.

NEW SECTION. Sec. 739. QUALIFICATIONS FOR MASSAGE PRACTITIONER LICENSE. The secretary shall issue a massage practitioner's license to an applicant who demonstrates to the secretary's satisfaction that the following requirements have been met:

(1) Successful completion of a course of study in an approved massage program or approved apprenticeship program;

(2) Successful completion of an examination administered or approved by the commission; and

(3) Be eighteen years of age or older.

In addition, applicants are subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW.

The secretary may require information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria for licensing provided for in this section and chapter 18.130 RCW. The secretary shall establish by rule what constitutes adequate proof of meeting the criteria. The commission shall give an appropriate alternate form of examination for persons who cannot read or speak English to determine equivalent competency.

NEW SECTION. Sec. 740. MASSAGE PRACTITIONER LICENSE EXAMINATION. (1) The secretary shall establish the date and location of the examination. Applicants who demonstrate to the secretary's satisfaction that the following requirements have been met shall be scheduled for the next examination after the filing of the application:

(a) Successful completion of a course of study in an approved massage program; or

(b) Successful completion of an apprenticeship program established by the commission; and

In addition, completed and approved applications must be received sixty days before the scheduled examination.

(2) The commission or its designee shall examine each applicant in a written and practical examination determined most effective on subjects appropriate to the massage scope of practice. The subjects may include anatomy, kinesiology, physiology, pathology, principles of human behavior, massage theory and practice, hydrotherapy, hygiene, first aid, Washington law pertaining to the practice of massage, and such other subjects as the commission may deem useful to test the applicant's fitness to practice massage therapy. The examinations must be limited in purpose to determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(3) The commission shall preserve the examination papers, all grading of examinations, and the grading of any practical work for at least one year after the commission has made and published decisions upon them. The commission shall conduct all examinations under fair and impartial methods as determined by the secretary.

(4) An applicant who fails to make the required grade in the first examination is entitled to take up to two additional examinations upon the payment of a fee for each subsequent examination determined by the secretary under RCW 43.70.250. Upon failure of three examinations, the secretary may invalidate the original application and require such remedial education as is required by the commission before admission to future examinations.

(5) The commission may approve an examination prepared or administered, or both, by a private testing agency or association of licensing commissions for use by an applicant in meeting the licensing requirement.

NEW SECTION. Sec. 741. OUT-OF-STATE MASSAGE PRACTITIONER LICENSING APPLICANTS. The secretary may grant a Washington massage practitioner's license without examination to an applicant holding a license in another state or foreign jurisdiction if, in the opinion of the commission, the other state's or foreign jurisdiction's examination and educational requirements are substantially equivalent to Washington's and the applicant demonstrates to the satisfaction of the secretary a working knowledge of Washington law pertaining to the practice of massage. The applicant shall provide proof in a manner approved by the department that the examination and requirements are equivalent to Washington's.

NEW SECTION. Sec. 742. PERSONS LICENSED TO PRACTICE MASSAGE UNDER PRIOR LAW. A person holding a valid license to practice massage issued by authority of the state before the effective date of this act continues to be licensed as a massage practitioner under this chapter.

NEW SECTION. Sec. 743. INSPECTION OF MASSAGE PREMISES BY LAW ENFORCEMENT PERSONNEL. State and local law enforcement personnel may inspect massage premises at any time, including business hours.

NEW SECTION. Sec. 744. PROVISIONS RELATING TO LICENSING OF MASSAGE BUSINESSES NONEXCLUSIVE‑-AUTHORITY OF LOCAL POLITICAL SUBDIVISIONS. The provisions of this chapter relating to the registration and licensing of a massage business are not exclusive and any political subdivision of the state of Washington within whose jurisdiction the massage business is located may require any registrations or licenses, or charge any fee for the same or similar purpose; and nothing in this chapter limits or abridges the authority of a political subdivision to levy and collect a general and nondiscriminatory license fee levied upon all businesses, or to levy a tax based upon gross business conducted by a firm within that political subdivision.

NEW SECTION. Sec. 745. SAVINGS. This chapter does not affect any existing right acquired or liability or obligations incurred under the sections repealed in chapter . . ., Laws of 1994 (this act) or under any rule, regulation, or order adopted under those sections, nor as affecting any proceeding instituted under those sections.

NEW SECTION. Sec. 746. Sections 701 through 745 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 747. The following acts or parts of acts are each repealed:

(1) RCW 18.59.010 and 1984 c 9 s 2;

(2) RCW 18.59.020 and 1991 c 3 s 153 & 1984 c 9 s 3;

(3) RCW 18.59.031 and 1987 c 150 s 44;

(4) RCW 18.59.040 and 1985 c 296 s 1 & 1984 c 9 s 5;

(5) RCW 18.59.050 and 1984 c 9 s 6;

(6) RCW 18.59.060 and 1984 c 9 s 7;

(7) RCW 18.59.070 and 1984 c 9 s 8;

(8) RCW 18.59.080 and 1991 c 3 s 154 & 1984 c 9 s 9;

(9) RCW 18.59.090 and 1991 c 3 s 155, 1990 c 13 s 1, & 1984 c 9 s 10;

(10) RCW 18.59.100 and 1986 c 259 s 101 & 1984 c 9 s 11;

(11) RCW 18.59.110 and 1991 c 3 s 156, 1985 c 7 s 58, & 1984 c 9 s 12;

(12) RCW 18.59.120 and 1984 c 9 s 13;

(13) RCW 18.59.130 and 1986 c 259 s 102 & 1984 c 9 s 14;

(14) RCW 18.59.141 and 1987 c 150 s 43 & 1986 c 259 s 100;

(15) RCW 18.59.150 and 1991 c 3 s 157 & 1984 c 9 s 15;

(16) RCW 18.59.900 and 1984 c 9 s 1;

(17) RCW 18.59.905 and 1984 c 9 s 21;

(18) RCW 18.74.005 and 1983 c 116 s 1;

(19) RCW 18.74.010 and 1991 c 12 s 1, 1988 c 185 s 1, 1983 c 116 s 2, 1961 c 64 s 1, & 1949 c 239 s 1;

(20) RCW 18.74.012 and 1991 c 12 s 2, 1990 c 297 s 19, & 1988 c 185 s 2;

(21) RCW 18.74.015 and 1988 c 185 s 3;

(22) RCW 18.74.020 and 1991 c 3 s 174, 1984 c 287 s 46, 1983 c 116 s 3, 1979 c 158 s 62, 1975-'76 2nd ex.s. c 34 s 44, & 1949 c 239 s 2;

(23) RCW 18.74.023 and 1991 c 12 s 3, 1991 c 3 s 175, 1986 c 259 s 124, & 1983 c 116 s 4;

(24) RCW 18.74.025 and 1991 c 12 s 5;

(25) RCW 18.74.027 and 1983 c 116 s 5;

(26) RCW 18.74.029 and 1993 c 133 s 2, 1987 c 150 s 47, & 1986 c 259 s 123;

(27) RCW 18.74.030 and 1983 c 116 s 6, 1961 c 64 s 2, & 1949 c 239 s 3;

(28) RCW 18.74.035 and 1991 c 3 s 176, 1983 c 116 s 7, & 1961 c 64 s 3;

(29) RCW 18.74.040 and 1991 c 3 s 177, 1983 c 116 s 8, & 1949 c 239 s 4;

(30) RCW 18.74.050 and 1991 c 3 s 178, 1985 c 7 s 63, 1983 c 116 s 9, 1975 1st ex.s. c 30 s 65, 1961 c 64 s 4, & 1949 c 239 s 5;

(31) RCW 18.74.060 and 1991 c 3 s 179, 1985 c 7 s 64, 1983 c 116 s 10, 1975 1st ex.s. c 30 s 66, 1961 c 64 s 5, & 1949 c 239 s 6;

(32) RCW 18.74.065 and 1983 c 116 s 11;

(33) RCW 18.74.070 and 1991 c 3 s 180, 1983 c 116 s 12, 1975 1st ex.s. c 30 s 67, 1971 ex.s. c 266 s 13, 1961 c 64 s 6, & 1949 c 239 s 7;

(34) RCW 18.74.075 and 1993 c 133 s 1;

(35) RCW 18.74.085 and 1988 c 185 s 4;

(36) RCW 18.74.090 and 1991 c 3 s 181, 1987 c 150 s 48, 1986 c 259 s 125, 1983 c 116 s 18, 1961 c 64 s 8, & 1949 c 239 s 9;

(37) RCW 18.74.095 and 1991 c 3 s 182, 1983 c 116 s 19, & 1961 c 64 s 9;

(38) RCW 18.74.120 and 1991 c 3 s 183, 1983 c 116 s 21, 1979 c 158 s 63, 1977 c 75 s 11, & 1949 c 239 s 12;

(39) RCW 18.74.125 and 1961 c 64 s 10;

(40) RCW 18.74.130 and 1983 c 116 s 22;

(41) RCW 18.74.135 and 1988 c 185 s 5;

(42) RCW 18.74.140 and 1991 c 12 s 4;

(43) RCW 18.74.900 and 1949 c 239 s 13;

(44) RCW 18.74.910 and 1961 c 64 s 11; and

(45) RCW 18.74.911 and 1983 c 116 s 24.

MENTAL HEALTH CARE

Sec. 801. RCW 18.19.070 and 1991 c 3 s 22 are each amended to read as follows:

(1) ((Within sixty days of July 26, 1987, the secretary shall have authority to appoint advisory committees to further the purposes of this chapter. Each such committee shall be composed of five members, one member initially appointed for a term of one year, two for terms of two years, and two for terms of three years. No person may serve as a member of the committee for more than two consecutive terms.)) The Washington state mental health quality assurance council is created, consisting of nine members appointed by the secretary. All appointments shall be for a term of four years. No person may serve as a member of the council for more than two consecutive full terms.

Voting members of the council must include one social worker certified under RCW 18.19.110, one mental health counselor certified under RCW 18.19.120, one marriage and family therapist certified under RCW 18.19.130, one counselor registered under RCW 18.19.090, one hypnotherapist registered under RCW 18.19.090, and two public members. Nonvoting members of the council must include one psychiatrist licensed under chapter 18.71 RCW and one psychologist licensed under chapter 18.83 RCW. Each member of the council must be a citizen of the United States and a resident of this state. Public members of the council may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the council, or have a material or financial interest in the rendering of health services regulated by the council.

The secretary may appoint the initial members of the council to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. Members of the council hold office until their successors are appointed.

The secretary may remove any member of the ((~~advisory committees~~)) council for cause as specified by rule. In the case of a vacancy, the secretary shall appoint a person to serve for the remainder of the unexpired term.

(2) The ((~~advisory committees~~)) council shall ((~~each~~)) meet at the times and places designated by the secretary and shall hold meetings during the year as necessary to provide advice to the secretary.

Each member of ((~~an advisory committee~~)) the council shall be reimbursed for travel expenses as authorized in RCW 43.03.050 and 43.03.060. In addition, members of the ((~~committees~~)) council shall be compensated in accordance with RCW 43.03.240 when engaged in the authorized business of ((~~their committee.~~

(3) Members of an advisory committee shall be residents of this state. Each committee shall be composed of four individuals registered or certified in the category designated by the committee title, and one member who is a member of the public)) the council. The members of the council are immune from suit in an action, civil or criminal, based on their official acts performed in good faith as members of the council.

ACUPUNCTURE

Sec. 802. RCW 18.06.080 and 1992 c 110 s 3 are each amended to read as follows:

(1) The secretary is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in acupuncture at least twice a year at such times and places as the secretary may select. The examination shall be a written examination and may include a practical examination.

(2) The secretary shall develop or approve a certification examination in the subjects that the secretary determines are within the scope of and commensurate with the work performed by certified acupuncturists and shall include but not necessarily be limited to anatomy, physiology, microbiology, biochemistry, pathology, hygiene, and acupuncture. All application papers shall be deposited with the secretary and there retained for at least one year, when they may be destroyed.

(3) If the examination is successfully passed, the secretary shall confer on such candidate the title of Certified Acupuncturist.

(4) The secretary may appoint members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated times and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060.

(5) The secretary, ad hoc committee members, or individuals acting in their behalf are immune from suit in a civil action based on any certification or disciplinary proceedings or other official acts performed in the course of their duties.

NEW SECTION. Sec. 803. RCW 18.06.170 and 1991 c 3 s 16 & 1985 c 326 s 17 are each repealed.

RADIOLOGIC TECHNOLOGISTS

Sec. 804. RCW 18.84.020 and 1991 c 222 s 2 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

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

(2) "Secretary" means the secretary of health.

(3) "Licensed practitioner" means any licensed health care practitioner performing services within the person's authorized scope of practice.

(4) "Radiologic technologist" means an individual certified under this chapter, other than a licensed practitioner, who practices radiologic technology as a:

(a) Diagnostic radiologic technologist, who is a person who actually handles x-ray equipment in the process of applying radiation on a human being for diagnostic purposes at the direction of a licensed practitioner; or

(b) Therapeutic radiologic technologist, who is a person who uses radiation-generating equipment for therapeutic purposes on human subjects at the direction of a licensed practitioner; or

(c) Nuclear medicine technologist, who is a person who prepares radiopharmaceuticals and administers them to human beings for diagnostic and therapeutic purposes and who performs in vivo and in vitro detection and measurement of radioactivity for medical purposes at the direction of a licensed practitioner.

(5) ((~~"Advisory committee" means the Washington state radiologic technology advisory committee.~~

~~(6)~~)) "Approved school of radiologic technology" means a school of radiologic technology approved by the council on medical education of the American medical association or a school found to maintain the equivalent of such a course of study as determined by the department. Such school may be operated by a medical or educational institution, and for the purpose of providing the requisite clinical experience, shall be affiliated with one or more general hospitals.

((~~(7)~~)) (6) "Radiologic technology" means the use of ionizing radiation upon a human being for diagnostic or therapeutic purposes.

((~~(8)~~)) (7) "Radiologist" means a physician certified by the American board of radiology or the American osteopathic board of radiology.

((~~(9)~~)) (8) "Registered x-ray technician" means a person who is registered with the department, and who applies ionizing radiation at the direction of a licensed practitioner.

Sec. 805. RCW 18.84.040 and 1991 c 222 s 11 are each amended to read as follows:

(1) In addition to any other authority provided by law, the secretary may ((~~in consultation with the advisory committee~~)):

(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) Set all registration, certification, and renewal fees in accordance with RCW 43.70.250;

(d) Evaluate and designate those schools from which graduation will be accepted as proof of an applicant's eligibility to receive a certificate;

(e) Determine whether alternative methods of training are equivalent to formal education, and to establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to receive a certificate;

(f) Issue a certificate to any applicant who has met the education, training, and conduct requirements for certification; and

(g) Issue a registration to an applicant who meets the requirement for a registration.

(2) The secretary may hire clerical, administrative, and investigative staff as needed to implement this chapter.

(3) The Uniform Disciplinary Act, chapter 18.130 RCW, governs the issuance and denial of registrations and certifications, unregistered and uncertified practice, and the discipline of registrants and certificants under this chapter. The secretary is the disciplining authority under this chapter.

(4) The secretary may appoint ad hoc members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated times and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060.

Sec. 806. RCW 18.84.070 and 1991 c 3 s 208 are each amended to read as follows:

The secretary, ad hoc committee members ((~~of the committee~~)), or individuals acting on their behalf are immune from suit in any civil action based on any certification or disciplinary proceedings or other official acts performed in the course of their duties.

Sec. 807. RCW 18.84.090 and 1991 c 3 s 210 are each amended to read as follows:

The secretary((~~, in consultation with the advisory committee,~~)) shall establish by rule the standards and procedures for approval of schools and alternate training, and may contract with individuals or organizations having expertise in the profession or in education to assist in evaluating those applying for approval. The standards and procedures set shall apply equally to schools and training within the United States and those in foreign jurisdictions.

Sec. 808. RCW 18.84.110 and 1991 c 3 s 212 are each amended to read as follows:

The secretary((~~, in consultation with the advisory committee,~~)) shall establish by rule the requirements and fees for renewal of certificates. Failure to renew invalidates the certificate and all privileges granted by the certificate. In the event a certificate has lapsed for a period longer than three years, the certificant shall demonstrate competence to the satisfaction of the secretary by continuing education or under the other standards determined by the secretary.

NEW SECTION. Sec. 809. RCW 18.84.060 and 1991 c 3 s 207 & 1987 c 412 s 7 are each repealed.

RESPIRATORY CARE PRACTITIONERS

Sec. 810. RCW 18.89.020 and 1991 c 3 s 227 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) ((~~"Advisory committee" means the Washington state advisory respiratory care committee.~~

~~(2)~~)) "Department" means the department of health.

((~~(3)~~)) (2) "Secretary" means the secretary of health or the secretary's designee.

((~~(4)~~)) (3) "Respiratory care practitioner" means an individual certified under this chapter.

((~~(5)~~)) (4) "Physician" means an individual licensed under chapter 18.57 or 18.71 RCW.

((~~(6)~~)) (5) "Rural hospital" means a hospital located anywhere in the state except the following areas:

(a) The entire counties of Snohomish (including Camano Island), King, Kitsap, Pierce, Thurston, Clark, and Spokane;

(b) Areas within a twenty-mile radius of an urban area with a population exceeding thirty thousand persons; and

(c) Those cities or city-clusters located in rural counties but which for all practical purposes are urban. These areas are Bellingham, Aberdeen-Hoquiam, Longview-Kelso, Wenatchee, Yakima, Sunnyside, Richland-Kennewick-Pasco, and Walla Walla.

Sec. 811. RCW 18.89.050 and 1991 c 3 s 228 are each amended to read as follows:

(1) In addition to any other authority provided by law, the secretary((~~, in consultation with the advisory committee,~~)) may:

(a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;

(b) Set all certification, examination, and renewal fees in accordance with RCW 43.70.250;

(d) Issue a certificate to any applicant who has met the education, training, and examination requirements for certification;

(e) Hire clerical, administrative, and investigative staff as needed to implement this chapter and hire individuals certified under this chapter to serve as examiners for any practical examinations;

(f) Approve those schools from which graduation will be accepted as proof of an applicant's eligibility to take the certification examination;

(g) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, examinations for applicants for certification;

(h) Determine whether alternative methods of training are equivalent to formal education and establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take the examination;

(i) Determine which states have legal credentialing requirements equivalent to those of this state and issue certificates to individuals legally credentialed in those states without examination; ((~~and~~))

(j) Define and approve any experience requirement for certification; and

(k) Appoint members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated times and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060.

(2) The provisions of chapter 18.130 RCW shall govern the issuance and denial of certificates, uncertified practice, and the disciplining of persons certified under this chapter. The secretary shall be the disciplining authority under this chapter.

Sec. 812. RCW 18.89.080 and 1991 c 3 s 231 are each amended to read as follows:

The secretary, ad hoc committee members ((~~of the advisory committee~~)), or individuals acting on their behalf are immune from suit in any civil action based on any certification or disciplinary proceedings, or other official acts performed in the course of their duties.

NEW SECTION. Sec. 813. RCW 18.89.070 and 1991 c 3 s 230 & 1987 c 415 s 8 are each repealed.

HEALTH CARE ASSISTANTS

Sec. 814. RCW 18.135.030 and 1991 c 3 s 273 are each amended to read as follows:

The secretary((,)) or the secretary's designee((~~, with the advice of designees of the board of medical examiners, the board of osteopathic medicine and surgery, the podiatry board, and the board of nursing,~~)) shall adopt rules necessary to administer, implement, and enforce this chapter and establish the minimum requirements necessary for a health care facility or health care practitioner to certify a health care assistant capable of performing the functions authorized in this chapter. The rules shall establish minimum requirements for each and every category of health care assistant. Said rules shall be adopted after fair consideration of input from representatives of each category. These requirements shall ensure that the public health and welfare are protected and shall include, but not be limited to, the following factors:

(1) The education and occupational qualifications for the health care assistant category;

(2) The work experience for the health care assistant category;

(3) The instruction and training provided for the health care assistant category; and

(4) The types of drugs or diagnostic agents which may be administered by injection by health care assistants working in a hospital or nursing home. The rules established pursuant to this subsection shall not prohibit health care assistants working in a health care facility other than a nursing home or hospital from performing the functions authorized under this chapter.

DIETITIANS AND NUTRITIONISTS

Sec. 815. RCW 18.138.070 and 1991 c 3 s 284 are each amended to read as follows:

In addition to any other authority provided by law, the secretary may:

(1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;

(2) Establish forms necessary to administer this chapter;

(3) Issue a certificate to an applicant who has met the requirements for certification and deny a certificate to an applicant who does not meet the minimum qualifications;

(4) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and hire individuals, including those certified under this chapter, to serve as consultants as necessary to implement and administer this chapter;

(5) Maintain the official departmental record of all applicants and certificate holders;

(6) Conduct a hearing, pursuant to chapter 34.05 RCW, on an appeal of a denial of certification based on the applicant's failure to meet the minimum qualifications for certification;

(7) Investigate alleged violations of this chapter and consumer complaints involving the practice of persons representing themselves as certified dietitians or certified nutritionists;

(8) Issue subpoenas, statements of charges, statements of intent to deny certifications, and orders and delegate in writing to a designee the authority to issue subpoenas, statements of charges, and statements on intent to deny certifications;

(9) Conduct disciplinary proceedings, impose sanctions, and assess fines for violations of this chapter or any rules adopted under it in accordance with chapter 34.05 RCW;

(10) Set all certification, renewal, and late renewal fees in accordance with RCW 43.70.250; ((~~and~~))

(11) Set certification expiration dates and renewal periods for all certifications under this chapter; and

(12) Appoint members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated time and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060. The secretary, ad hoc committee members, or individuals acting in their behalf are immune from suit in a civil action based on any certification or disciplinary proceedings or other official acts performed in the course of their duties.

NEW SECTION. Sec. 816. RCW 18.138.080 and 1991 c 3 s 285 & 1988 c 277 s 8 are each repealed.

UNIFORM DISCIPLINARY ACT

Sec. 901. RCW 18.130.010 and 1991 c 332 s 1 are each amended to read as follows:

It is the intent of the legislature to strengthen and consolidate disciplinary and licensure procedures for the licensed health and health-related professions and businesses by providing a uniform disciplinary act with standardized procedures for the licensure of health care professionals and the enforcement of laws the purpose of which is to assure the public of the adequacy of professional competence and conduct in the healing arts.

It is also the intent of the legislature that all health and health-related professions newly credentialed by the state come under the uniform disciplinary act.

Further, the legislature declares that the addition of public members on all health care commissions and boards can give both the state and the public, which it has a statutory responsibility to protect, assurances of accountability and confidence in the various practices of health care.

Sec. 902. RCW 18.130.020 and 1989 1st ex.s. c 9 s 312 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Disciplining authority" means (((a) the board of medical examiners, the board of dental examiners, and the board of chiropractic examiners with respect to applicants for a license for the respective professions, (b) the medical disciplinary board, the dental disciplinary board, and the chiropractic disciplinary board with respect to holders of licenses for the respective professions, or (c))) the agency ((or)), board, or commission having the authority to take disciplinary action against a holder of, or applicant for, a professional or business license upon a finding of a violation of this chapter or a chapter specified under RCW 18.130.040.

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

(3) "Secretary" means the secretary of health or the secretary's designee.

(4) "Board" means any of those boards specified in RCW 18.130.040.

(5) "Commission" means any of the commissions specified in RCW 18.130.040.

(6) "Unlicensed practice" means:

(a) Practicing a profession or operating a business identified in RCW 18.130.040 without holding a valid, unexpired, unrevoked, and unsuspended license to do so; or

(b) Representing to a consumer, through offerings, advertisements, or use of a professional title or designation, that the individual is qualified to practice a profession or operate a business identified in RCW 18.130.040, without holding a valid, unexpired, unrevoked, and unsuspended license to do so.

((~~(6)~~)) (7) "Disciplinary action" means sanctions identified in RCW 18.130.160.

((~~(7)~~)) (8) "Practice review" means an investigative audit of records related to the complaint, without prior identification of specific patient or consumer names, to determine whether unprofessional conduct may have been committed.

((~~(8)~~)) (9) "Health agency" means city and county health departments and the department of health.

((~~(9)~~)) (10) "License," "licensing," and "licensure" shall be deemed equivalent to the terms "license," "licensing," "licensure," "certificate," "certification," and "registration" as those terms are defined in RCW 18.120.020.

Sec. 903. RCW 18.130.040 and 1993 c 367 s 4 are each 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 under chapter 18.34 RCW;

(ii) Naturopaths licensed under chapter 18.36A RCW;

(iii) Midwives licensed under chapter 18.50 RCW;

(iv) Ocularists licensed under chapter 18.55 RCW;

(v) Massage operators and businesses licensed under chapter 18.108 RCW;

(vi) Dental hygienists licensed under chapter 18.29 RCW;

(vii) Acupuncturists certified under chapter 18.06 RCW;

(viii) Radiologic technologists certified and x-ray technicians registered under chapter 18.84 RCW;

(ix) Respiratory care practitioners certified under chapter 18.89 RCW;

(x) Persons registered or certified under chapter 18.19 RCW;

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

(xii) Nursing assistants registered or certified under chapter ((~~18.88A~~)) 18.-- (sections 601 through 631 of this act) RCW;

(xiii) Health care assistants certified under chapter 18.135 RCW;

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

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

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

(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 ((~~disciplinary board~~)) quality assurance commission as established in chapter ((~~18.26 RCW governing licenses issued under chapter~~)) 18.25 RCW;

(iii) The dental ((~~disciplinary board~~)) quality assurance commission as established in chapter 18.32 RCW;

(iv) The ((~~council~~)) board on fitting and dispensing of hearing aids as established in chapter 18.35 RCW;

(v) The board of funeral directors and embalmers as established in chapter 18.39 RCW;

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

(vii) The ((~~optometry board~~)) vision care quality assurance commission as established in chapter ((~~18.54~~)) 18.-- RCW (sections 401 through 428 of this act) governing licenses issued under chapter 18.53 RCW;

(viii) The ((~~board of osteopathic medicine and surgery~~)) allied physicians quality assurance commission as established in chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act) governing licenses issued under ((~~chapters 18.57 and 18.57A RCW~~)) that chapter;

(ix) The board of pharmacy as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;

(x) The medical ((~~disciplinary board~~)) quality assurance commission as established in chapter ((~~18.72~~)) 18.71 RCW governing licenses and registrations issued under chapters 18.71 and 18.71A RCW;

(xi) The ((~~board of~~)) physical ((~~therapy~~)) health therapies quality assurance commission as established in chapter ((~~18.74~~)) 18.-- RCW (sections 701 through 745 of this act) governing licenses issued under that chapter;

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

~~(xiii) The board of practical~~)) The nursing care quality assurance commission as established in chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act) governing licenses issued under that chapter;

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

((~~(xv) The board of nursing as established in chapter 18.88 RCW; and~~

~~(xvi)~~)) (xiv) The veterinary board of governors as established in chapter 18.92 RCW.

(3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses based on the conditions and criteria established in this chapter and the chapters specified in subsection (2) of this section. ((However, the board of chiropractic examiners has authority over issuance and denial of licenses provided for in chapter 18.25 RCW, the board of dental examiners has authority over issuance and denial of licenses provided for in RCW 18.32.040, and the board of medical examiners has authority over issuance and denial of licenses and registrations provided for in chapters 18.71 and 18.71A RCW.)) This chapter also governs any investigation, hearing, or proceeding relating to denial of licensure or issuance of a license conditioned on the applicant's compliance with an order entered pursuant to RCW 18.130.160 by the disciplining authority.

Sec. 904. RCW 18.130.300 and 1993 c 367 s 10 are each amended to read as follows:

The secretary, members of the boards or commissions, or individuals acting on their behalf are immune from suit in any action, civil or criminal, based on any disciplinary proceedings or other official acts performed in the course of their duties.

CONFORMING AMENDMENTS

Sec. 1001. RCW 4.24.260 and 1975 1st ex.s. c 114 s 3 are each amended to read as follows:

Physicians licensed under chapter 18.71 RCW((~~[,]~~)), dentists licensed under chapter 18.32 RCW, and pharmacists licensed under chapter 18.64 RCW who, in good faith, file charges or present evidence against another member of their profession based on the claimed incompetency or gross misconduct of such person before the medical ((~~disciplinary board~~)) quality assurance commission established under chapter 18.72 RCW, in a proceeding under chapter 18.32 RCW, or to the board of pharmacy under RCW 18.64.160 shall be immune from civil action for damages arising out of such activities.

Sec. 1002. RCW 4.24.290 and 1985 c 326 s 26 are each amended to read as follows:

In any civil action for damages based on professional negligence against a hospital which is licensed by the state of Washington or against the personnel of any such hospital, or against a member of the healing arts including, but not limited to, an acupuncturist certified under chapter 18.06 RCW, a physician licensed under chapter 18.71 RCW, an osteopathic physician licensed under chapter 18.57 RCW, a chiropractor licensed under chapter 18.25 RCW, a dentist licensed under chapter 18.32 RCW, a ((~~podiatrist~~)) podiatric physician and surgeon licensed under chapter 18.22 RCW, or a nurse licensed under ((~~chapters 18.78 or 18.88~~)) chapter 18.-- RCW (sections 601 through 631 of this act), the plaintiff in order to prevail shall be required to prove by a preponderance of the evidence that the defendant or defendants failed to exercise that degree of skill, care, and learning possessed at that time by other persons in the same profession, and that as a proximate result of such failure the plaintiff suffered damages, but in no event shall the provisions of this section apply to an action based on the failure to obtain the informed consent of a patient.

Sec. 1003. RCW 5.62.010 and 1987 c 198 s 1 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Registered nurse" means a registered nurse or advanced nurse practitioner licensed under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act).

(2) "Protocol" means a regimen to be carried out by a registered nurse and prescribed by a licensed physician under chapter 18.71 RCW, or a licensed osteopathic physician under chapter 18.57 RCW, which is consistent with chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) and the rules adopted under that chapter ((~~18.88 RCW~~)).

(3) "Primary care" means screening, assessment, diagnosis, and treatment for the purpose of promotion of health and detection of disease or injury, as authorized by chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) and the rules adopted under that chapter ((~~18.88 RCW~~)).

Sec. 1004. RCW 18.32.030 and 1991 c 3 s 59 are each amended to read as follows:

The following practices, acts, and operations are excepted from the operation of the provisions of this chapter:

(3) Dental schools or colleges approved under RCW 18.32.040, and the practice of dentistry by students in Washington state dental schools or colleges approved by the board, when acting under the direction and supervision of Washington state-licensed dental school faculty;

(5) The use of roentgen and other rays for making radiographs or similar records of dental or oral tissues, under the supervision of a licensed dentist or physician;

(8) A qualified and licensed physician and surgeon extracting teeth or performing oral surgery pursuant to the scope of practice under chapter 18.71 or ((~~18.57~~)) 18.-- (sections 101 through 144 of this act) RCW;

(a) Any removal of or addition to the hard or soft tissue of the oral cavity;

(b) Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, or physical condition of the human teeth or jaws, or adjacent structure;

(c) Any administration of general or injected local anaesthetic of any nature in connection with a dental operation, including intravenous sedation;

(d) Any oral prophylaxis;

(e) The taking of any impressions of the teeth or jaw or the relationships of the teeth or jaws, for the purpose of fabricating any intra-oral restoration, appliance, or prosthesis.

Sec. 1005. RCW 18.50.032 and 1981 c 53 s 10 are each amended to read as follows:

Registered nurses and nurse midwives certified by the ((~~board of~~)) nursing care quality assurance commission under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) shall be exempt from the requirements and provisions of this chapter.

Sec. 1006. RCW 18.50.040 and 1991 c 3 s 106 are each amended to read as follows:

(1) Any person seeking to be examined shall present to the secretary, at least forty-five days before the commencement of the examination, a written application on a form or forms provided by the secretary setting forth under affidavit such information as the secretary may require and proof the candidate has received a high school degree or its equivalent; that the candidate is twenty-one years of age or older; that the candidate has received a certificate or diploma from a midwifery program accredited by the secretary and licensed under chapter 28C.10 RCW, when applicable, or a certificate or diploma in a foreign institution on midwifery of equal requirements conferring the full right to practice midwifery in the country in which it was issued. The diploma must bear the seal of the institution from which the applicant was graduated. Foreign candidates must present with the application a translation of the foreign certificate or diploma made by and under the seal of the consulate of the country in which the certificate or diploma was issued.

(2) The candidate shall meet the following conditions:

(a) Obtaining a minimum period of midwifery training for at least three years including the study of the basic nursing skills that the department shall prescribe by rule. However, if the applicant is a registered nurse or licensed practical nurse under chapter ((~~18.88 RCW, a licensed practical nurse under chapter 18.78 RCW~~)) 18.-- RCW (sections 601 through 631 of this act), or has had previous nursing education or practical midwifery experience, the required period of training may be reduced depending upon the extent of the candidate's qualifications as determined under rules adopted by the department. In no case shall the training be reduced to a period of less than two years.

(b) Meeting minimum educational requirements which shall include studying obstetrics; neonatal pediatrics; basic sciences; female reproductive anatomy and physiology; behavioral sciences; childbirth education; community care; obstetrical pharmacology; epidemiology; gynecology; family planning; genetics; embryology; neonatology; the medical and legal aspects of midwifery; nutrition during pregnancy and lactation; breast feeding; nursing skills, including but not limited to injections, administering intravenous fluids, catheterization, and aseptic technique; and such other requirements prescribed by rule.

(c) For a student midwife during training, undertaking the care of not less than fifty women in each of the prenatal, intrapartum, and early postpartum periods, but the same women need not be seen through all three periods. A student midwife may be issued a permit upon the satisfactory completion of the requirements in (a), (b), and (c) of this subsection and the satisfactory completion of the licensure examination required by RCW 18.50.060. The permit permits the student midwife to practice under the supervision of a midwife licensed under this chapter, a physician or a certified nurse-midwife licensed under the authority of chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act). The permit shall expire within one year of issuance and may be extended as provided by rule.

(d) Observing an additional fifty women in the intrapartum period before the candidate qualifies for a license.

(3) Notwithstanding subsections (1) and (2) of this section, the department shall adopt rules to provide credit toward the educational requirements for licensure before July 1, 1988, of nonlicensed midwives, including rules to provide:

(a) Credit toward licensure for documented deliveries;

(b) The substitution of relevant experience for classroom time; and

The training required under this section shall include training in either hospitals or alternative birth settings or both with particular emphasis on learning the ability to differentiate between low-risk and high-risk pregnancies.

Sec. 1007. RCW 18.50.140 and 1991 c 3 s 114 are each amended to read as follows:

The midwifery advisory committee is created.

The committee shall be composed of one physician who is a practicing obstetrician; one practicing physician; one certified nurse midwife licensed under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act); three midwives licensed under this chapter; and one public member, who shall have no financial interest in the rendering of health services. The committee may seek other consultants as appropriate, including persons trained in childbirth education and perinatology or neonatology.

The members are appointed by the secretary and serve at the pleasure of the secretary but may not serve more than five years consecutively. The terms of office shall be staggered. Members of the committee shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060 ((~~as now or hereafter amended~~)).

Sec. 1008. RCW 18.50.115 and 1991 c 3 s 112 are each amended to read as follows:

A midwife licensed under this chapter may obtain and administer prophylactic ophthalmic medication, postpartum oxytocic, vitamin K, Rho immune globulin (human), and local anesthetic and may administer such other drugs or medications as prescribed by a physician. A pharmacist who dispenses such drugs to a licensed midwife shall not be liable for any adverse reactions caused by any method of use by the midwife.

The secretary, after consultation with representatives of the midwife advisory committee, the board of pharmacy, and the ((~~board of~~)) medical ((~~examiners~~)) quality assurance commission, may ((~~issue regulations which~~)) adopt rules that authorize licensed midwives to purchase and use legend drugs and devices in addition to the drugs authorized in this chapter.

Sec. 1009. RCW 18.88A.020 and 1991 c 16 s 2 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

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

(2) "Secretary" means the secretary of health.

(3) "((~~Board~~)) Commission" means the Washington ((~~state board of~~)) nursing care quality assurance commission.

(4) "Nursing assistant" means an individual, regardless of title, who, under the direction and supervision of a registered nurse or licensed practical nurse, assists in the delivery of nursing and nursing-related activities to patients in a health care facility. The two levels of nursing assistants are (a) "nursing assistant-certified," an individual certified under this chapter, (b) "nursing assistant-registered," an individual registered under this chapter.

(5) ((~~"Committee" means the Washington state nursing assistant advisory committee.~~

~~(6)~~)) "Approved training program" means a nursing assistant-certified training program approved by the ((~~board~~)) commission. For community college, vocational-technical institutes, skill centers, and secondary school as defined in chapter 28B.50 RCW, nursing assistant-certified training programs shall be approved by the ((~~board~~)) commission in cooperation with the board for community and technical colleges ((~~education~~)) or the superintendent of public instruction.

((~~(7)~~)) (6) "Health care facility" means a nursing home, hospital, hospice care facility, home health care agency, hospice agency, or other entity for delivery of health care services as defined by the ((~~board~~)) commission.

((~~(8)~~)) (7) "Competency evaluation" means the measurement of an individual's knowledge and skills as related to safe, competent performance as a nursing assistant.

Sec. 1010. RCW 18.88A.030 and 1991 c 16 s 3 are each amended to read as follows:

(1) A nursing assistant may assist in the care of individuals as delegated by and under the direction and supervision of a licensed (registered) nurse or licensed practical nurse.

(2) A health care facility shall not assign a nursing assistant-registered to provide care until the nursing assistant-registered has demonstrated skills necessary to perform competently all assigned duties and responsibilities.

(3) Nothing in this chapter shall be construed to confer on a nursing assistant the authority to administer medication or to practice as a licensed (registered) nurse ((~~as defined in chapter 18.88 RCW~~)) or licensed practical nurse as defined in chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act).

(4) Certification is voluntary for nursing assistants working in health care facilities other than nursing homes unless otherwise required by state or federal law or regulation.

(5) The ((~~board of nursing shall have the authority to~~)) commission may adopt rules to implement the provisions of this chapter.

Sec. 1011. RCW 18.88A.060 and 1991 c 16 s 8 are each amended to read as follows:

In addition to any other authority provided by law, the ((~~state board of nursing has the authority to~~)) commission may:

(1) Determine minimum education requirements and approve training programs;

(2) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of, examinations of training and competency for applicants for certification;

(3) Determine whether alternative methods of training are equivalent to approved training programs, and establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take any qualifying examination for certification;

(4) Define and approve any experience requirement for certification;

(5) Adopt rules implementing a continuing competency evaluation program;

(6) Adopt rules to enable it to carry into effect the provisions of this chapter.

Sec. 1012. RCW 18.88A.080 and 1991 c 16 s 10 are each amended to read as follows:

(1) The secretary shall issue a registration to any applicant who pays any applicable fees and submits, on forms provided by the secretary, the applicant's name, address, and other information as determined by the secretary, provided there are no grounds for denial of registration or issuance of a conditional registration under this chapter or chapter 18.130 RCW.

(2) Applicants must file an application with the ((~~board~~)) commission for registration within three days of employment.

Sec. 1013. RCW 18.88A.085 and 1991 c 16 s 11 are each amended to read as follows:

(1) After January 1, 1990, the secretary shall issue a certificate to any applicant who demonstrates to the secretary's satisfaction that the following requirements have been met:

(a) Completion of an approved training program or successful completion of alternate training meeting established criteria approved by the ((~~board~~)) commission; and

(b) Successful completion of a competency evaluation.

(2) In addition, applicants shall be subject to the grounds for denial of certification under chapter 18.130 RCW.

Sec. 1014. RCW 18.88A.090 and 1991 c 3 s 225 are each amended to read as follows:

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

(2) The ((~~board~~)) commission shall examine each applicant, by a written or oral and a manual component of competency evaluation. Examinations shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(3) The examination papers, all grading of the papers, and the grading of skills demonstration shall be preserved for a period of not less than one year after the ((~~board~~)) commission has made and published the decisions. All examinations shall be conducted under fair and wholly impartial methods.

(4) 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 such remedial education before the person may take future examinations.

(5) The ((~~board~~)) commission may approve an examination prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the credentialing requirements.

Sec. 1015. RCW 18.88A.100 and 1991 c 16 s 12 and 1991 c 3 s 226 are each reenacted and amended to read as follows:

The secretary shall waive the competency evaluation and certify a person to practice within the state of Washington if the ((~~board~~)) commission determines that the person meets commonly accepted standards of education and experience for the nursing assistants. This section applies only to those individuals who file an application for waiver by December 31, 1991.

Sec. 1016. RCW 18.88A.130 and 1991 c 16 s 15 are each amended to read as follows:

The secretary shall establish by rule the procedural requirements and fees for renewal of a registration or certificate. Failure to renew shall invalidate the credential and all privileges granted by the credential. If a certificate has lapsed for a period longer than three years, the person shall demonstrate competence to the satisfaction of the ((~~board~~)) commission by taking continuing education courses, or meeting other standards determined by the ((~~board~~)) commission.

Sec. 1017. RCW 18.89.040 and 1987 c 415 s 5 are each amended to read as follows:

A respiratory care practitioner certified under this chapter is employed in the treatment, management, diagnostic testing, rehabilitation, and care of patients with deficiencies and abnormalities which affect the cardiopulmonary system and associated aspects of other systems, and is under the direct order and under the qualified medical direction of a physician. The practice of respiratory care includes, but is not limited to:

(1) The use and administration of medical gases, exclusive of general anesthesia;

(2) The use of air and oxygen administering apparatus;

(3) The use of humidification and aerosols;

(4) The administration of prescribed pharmacologic agents related to respiratory care;

(5) The use of mechanical or physiological ventilatory support;

(6) Postural drainage, chest percussion, and vibration;

(7) Bronchopulmonary hygiene;

(8) Cardiopulmonary resuscitation as it pertains to establishing airways and external cardiac compression;

(9) The maintenance of natural and artificial airways and insertion, without cutting tissues, of artificial airways, as ordered by the attending physician;

(10) Diagnostic and monitoring techniques such as the measurement of cardiorespiratory volumes, pressures, and flows; and

(11) The drawing and analyzing of arterial, capillary, and mixed venous blood specimens as ordered by the attending physician or an advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act).

Sec. 1018. RCW 18.100.140 and 1987 c 447 s 16 are each amended to read as follows:

Nothing in this chapter shall authorize a director, officer, shareholder, agent or employee of a corporation organized under this chapter, or a corporation itself organized under this chapter, to do or perform any act which would be illegal, unethical or unauthorized conduct under the provisions of the following acts: (1) ((~~Medical disciplinary act~~)) Physicians and surgeons, chapter ((~~18.72~~)) 18.71 RCW; (2) anti-rebating act, chapter 19.68 RCW; (3) state bar act, chapter 2.48 RCW; (4) professional accounting act, chapter 18.04 RCW; (5) professional architects act, chapter 18.08 RCW; (6) professional auctioneers act, chapter 18.11 RCW; (7) cosmetologists, barbers, and manicurists, chapter 18.16 RCW; (8) boarding homes act, chapter 18.20 RCW; (9) ((~~podiatry~~)) podiatric medicine and surgery, chapter 18.22 RCW; (10) chiropractic act, chapter 18.25 RCW; (11) registration of contractors, chapter 18.27 RCW; (12) debt adjusting act, chapter 18.28 RCW; (13) dental hygienist act, chapter 18.29 RCW; (14) dentistry, chapter 18.32 RCW; (15) dispensing opticians, chapter ((~~18.34~~)) 18.-- RCW (sections 401 through 428 of this act); (16) ((~~naturopathic act~~)) naturopathic physicians, chapter ((~~18.36A~~)) 18.-- RCW (sections 101 through 144 of this act); (17) embalmers and funeral directors, chapter 18.39 RCW; (18) engineers and land surveyors, chapter 18.43 RCW; (19) escrow agents registration act, chapter 18.44 RCW; (20) maternity homes, chapter 18.46 RCW; (21) midwifery, chapter 18.50 RCW; (22) nursing homes, chapter 18.51 RCW; (23) optometry, chapter ((~~18.53~~)) 18.-- RCW (sections 401 through 428 of this act; (24) ((~~osteopathy~~)) osteopathic physicians and surgeons, chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act); (25) pharmacists, chapter 18.64 RCW; (26) physical therapy, chapter 18.74 RCW; (27) registered nurses, advanced registered nurse practitioners, and practical nurses, chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act); (28) psychologists, chapter 18.83 RCW; (29) real estate brokers and salesmen, chapter 18.85 RCW; (30) ((~~registered professional nurses, chapter 18.88 RCW; (31)~~)) veterinarians, chapter 18.92 RCW.

Sec. 1019. RCW 18.120.020 and 1989 c 300 s 14 are each amended to read as follows:

The definitions contained in this section shall apply throughout this chapter unless the context clearly requires otherwise.

(1) "Applicant group" includes any health professional group or organization, any individual, or any other interested party which proposes that any health professional group not presently regulated be regulated or which proposes to substantially increase the scope of practice of the profession.

(2) "Certificate" and "certification" mean a voluntary process by which a statutory regulatory entity grants recognition to an individual who (a) has met certain prerequisite qualifications specified by that regulatory entity, and (b) may assume or use "certified" in the title or designation to perform prescribed health professional tasks.

(3) "Grandfather clause" means a provision in a regulatory statute applicable to practitioners actively engaged in the regulated health profession prior to the effective date of the regulatory statute which exempts the practitioners from meeting the prerequisite qualifications set forth in the regulatory statute to perform prescribed occupational tasks.

(4) "Health professions" means and includes the following health and health-related licensed or regulated professions and occupations: ((~~Podiatry~~)) Podiatric medicine and surgery under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act); chiropractic under chapter((s)) 18.25 ((~~and 18.26 RCW~~)); dental hygiene under chapter 18.29 RCW; dentistry under chapter 18.32 RCW; dispensing opticians under chapter ((~~18.34~~)) 18.-- RCW (sections 401 through 428 of this act); hearing aids under chapter 18.35 RCW; naturopaths under chapter ((~~18.36A~~)) 18.-- RCW (sections 101 through 144 of this act); embalming and funeral directing under chapter 18.39 RCW; midwifery under chapter 18.50 RCW; nursing home administration under chapter 18.52 RCW; optometry under chapter((~~s 18.53 and 18.54~~)) 18.-- RCW (sections 401 through 428 of this act); ocularists under chapter 18.55 RCW; osteopathy and osteopathic medicine and surgery under chapter((~~s 18.57 and 18.57A~~)) 18.-- RCW (sections 101 through 144 of this act); pharmacy under chapters 18.64 and 18.64A RCW; medicine under chapters 18.71((,)) and 18.71A((~~, and 18.72~~)) RCW; emergency medicine under chapter 18.73 RCW; physical therapy under chapter ((~~18.74~~)) 18.-- RCW (sections 701 through 745 of this act); practical nurses under chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act); psychologists under chapter 18.83 RCW; registered nurses under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act); occupational therapists licensed ((~~pursuant to~~)) under chapter ((~~18.59~~)) 18.-- RCW (sections 701 through 745 of this act); respiratory care practitioners certified under chapter 18.89 RCW; veterinarians and animal technicians under chapter 18.92 RCW; health care assistants under chapter 18.135 RCW; massage practitioners under chapter ((~~18.108~~)) 18.-- RCW (sections 701 through 745 of this act); acupuncturists certified under chapter 18.06 RCW; persons registered or certified under chapter 18.19 RCW; dietitians and nutritionists certified by chapter 18.138 RCW; radiologic technicians under chapter 18.84 RCW; and nursing assistants registered or certified under chapter 18.88A RCW.

(5) "Inspection" means the periodic examination of practitioners by a state agency in order to ascertain whether the practitioners' occupation is being carried out in a fashion consistent with the public health, safety, and welfare.

(6) "Legislative committees of reference" means the standing legislative committees designated by the respective rules committees of the senate and house of representatives to consider proposed legislation to regulate health professions not previously regulated.

(7) "License," "licensing," and "licensure" mean permission to engage in a health profession which would otherwise be unlawful in the state in the absence of the permission. A license is granted to those individuals who meet prerequisite qualifications to perform prescribed health professional tasks and for the use of a particular title.

(8) "Professional license" means an individual, nontransferable authorization to carry on a health activity based on qualifications which include: (a) Graduation from an accredited or approved program, and (b) acceptable performance on a qualifying examination or series of examinations.

(9) "Practitioner" means an individual who (a) has achieved knowledge and skill by practice, and (b) is actively engaged in a specified health profession.

(10) "Public member" means an individual who is not, and never was, a member of the health profession being regulated or the spouse of a member, or an individual who does not have and never has had a material financial interest in either the rendering of the health professional

service being regulated or an activity directly related to the profession being regulated.

(11) "Registration" means the formal notification which, prior to rendering services, a practitioner shall submit to a state agency setting forth the name and address of the practitioner; the location, nature and operation of the health activity to be practiced; and, if required by the regulatory entity, a description of the service to be provided.

(12) "Regulatory entity" means any board, commission, agency, division, or other unit or subunit of state government which regulates one or more professions, occupations, industries, businesses, or other endeavors in this state.

(13) "State agency" includes every state office, department, board, commission, regulatory entity, and agency of the state, and, where provided by law, programs and activities involving less than the full responsibility of a state agency.

Sec. 1020. RCW 18.135.020 and 1991 c 3 s 272 are each amended to read as follows:

As used in this chapter:

(1) "Secretary" means the secretary of health.

(2) "Health care assistant" means an unlicensed person who assists a licensed health care practitioner in providing health care to patients pursuant to this chapter.

(3) "Health care practitioner" means:

(a) A physician licensed under chapter 18.71 RCW;

(b) An osteopathic physician or surgeon licensed under chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act); or

(c) Acting within the scope of their respective licensure, a ((~~podiatrist~~)) podiatric physician and surgeon licensed under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act) or a registered nurse or advanced registered nurse practitioner licensed under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act).

(4) "Supervision" means supervision of procedures permitted pursuant to this chapter by a health care practitioner who is physically present and is immediately available in the facility during the administration of injections, as defined in this chapter, but need not be present during procedures to withdraw blood.

(5) "Health care facility" means any hospital, hospice care center, licensed or certified health care facility, health maintenance organization regulated under chapter 48.46 RCW, federally qualified health maintenance organization, renal dialysis center or facility federally approved under 42 C.F.R. 405.2100, blood bank federally licensed under 21 C.F.R. 607, or clinical laboratory certified under 20 C.F.R. 405.1301‑16.

(6) "Delegation" means direct authorization granted by a licensed health care practitioner to a health care assistant to perform the functions authorized in this chapter which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee.

Sec. 1021. RCW 28A.210.260 and 1982 c 195 s 1 are each amended to read as follows:

Public school districts and private schools which conduct any of grades kindergarten through the twelfth grade may provide for the administration of oral medication of any nature to students who are in the custody of the school district or school at the time of administration, but are not required to do so by this section, subject to the following conditions:

(1) The board of directors of the public school district or the governing board of the private school or, if none, the chief administrator of the private school shall adopt policies which address the designation of employees who may administer oral medications to students, the acquisition of parent requests and instructions, and the acquisition of dentist and physician requests and instructions regarding students who require medication for more than fifteen consecutive school days, the identification of the medication to be administered, the means of safekeeping medications with special attention given to the safeguarding of legend drugs as defined in chapter 69.41 RCW, and the means of maintaining a record of the administration of such medication;

(2) The board of directors shall seek advice from one or more licensed physicians or nurses in the course of developing the foregoing policies;

(3) The public school district or private school is in receipt of a written, current and unexpired request from a parent, or a legal guardian, or other person having legal control over the student to administer the medication to the student;

(4) The public school district or the private school is in receipt of (a) a written, current and unexpired request from a licensed physician or dentist for administration of the medication, as there exists a valid health reason which makes administration of such medication advisable during the hours when school is in session or the hours in which the student is under the supervision of school officials, and (b) written, current and unexpired instructions from such physician or dentist regarding the administration of prescribed medication to students who require medication for more than fifteen consecutive work days;

(5) The medication is administered by an employee designated by or pursuant to the policies adopted pursuant to subsection (1) of this section and in substantial compliance with the prescription of a physician or dentist or the written instructions provided pursuant to subsection (4) of this section;

(6) The medication is first examined by the employee administering the same to determine in his or her judgment that it appears to be in the original container and to be properly labeled; and

(7) The board of directors shall designate a professional person licensed pursuant to chapter 18.71 or ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) to train and supervise the designated school district personnel in proper medication procedures.

Sec. 1022. RCW 28A.210.280 and 1988 c 48 s 2 are each amended to read as follows:

(1) Public school districts and private schools that offer classes for any of grades kindergarten through twelve may provide for clean, intermittent bladder catheterization of students, or assisted self-catheterization of students pursuant to ((~~RCW 18.88.295: PROVIDED, That~~)) section 629 of this act, if the catheterization is provided for in substantial compliance with:

(a) Rules adopted by the state ((~~board of~~)) nursing care quality assurance commission and the instructions of a registered nurse or advanced registered nurse practitioner issued under such rules; and

(b) Written policies of the school district or private school which shall be adopted in order to implement this section and shall be developed in accordance with such requirements of chapters 41.56 and 41.59 RCW as may be applicable.

(2) This section does not require school districts to provide intermittent bladder catheterization of students.

Sec. 1023. RCW 28A.210.290 and 1990 c 33 s 209 are each amended to read as follows:

(1) In the event a school employee provides for the catheterization of a student pursuant to RCW ((~~18.88.295~~)) 18.--.--- (section 629 of this act) and 28A.210.280 in substantial compliance with (a) rules adopted by the state ((~~board of~~)) nursing care quality assurance commission and the instructions of a registered nurse or advanced registered nurse practitioner issued under such rules, and (b) written policies of the school district or private school, then the employee, the employee's school district or school of employment, and the members of the governing board and chief administrator thereof shall not be liable in any criminal action or for civil damages in their individual, marital, governmental, corporate, or other capacity as a result of providing for the catheterization.

(2) Providing for the catheterization of any student pursuant to RCW ((~~18.88.295~~)) 18.--.--- (section 629 of this act) and 28A.210.280 may be discontinued by a public school district or private school and the school district or school, its employees, its chief administrator, and members of its governing board shall not be liable in any criminal action or for civil damages in their individual, marital, governmental, corporate, or other capacity as a result of the discontinuance: PROVIDED, That the chief administrator of the public school district or private school, or his or her designee, has first provided actual notice orally or in writing in advance of the date of discontinuance to a parent or legal guardian of the student or other person having legal control over the student: PROVIDED FURTHER, That the public school district otherwise provides for the catheterization of the student to the extent required by federal or state law.

Sec. 1024. RCW 28C.10.030 and 1990 c 188 s 6 are each amended to read as follows:

This chapter does not apply to:

(1) Bona fide trade, business, professional, or fraternal organizations sponsoring educational programs primarily for that organization's membership or offered by that organization on a no-fee basis;

(2) Entities offering education that is exclusively avocational or recreational;

(3) Education not requiring payment of money or other consideration if this education is not advertised or promoted as leading toward educational credentials;

(4) Entities that are established, operated, and governed by this state or its political subdivisions under Title 28A, 28B, or 28C RCW;

(5) Degree-granting programs in compliance with the rules of the higher education coordinating board;

(6) Any other entity to the extent that it has been exempted from some or all of the provisions of this chapter under RCW 28C.10.100;

(7) Entities not otherwise exempt that are of a religious character, but only as to those educational programs exclusively devoted to religious or theological objectives and represented accurately in institutional catalogs or other official publications;

(8) Entities offering only courses certified by the federal aviation administration;

(9) Barber and cosmetology schools licensed under chapter 18.16 RCW;

(10) Entities which only offer courses approved to meet the continuing education requirements for licensure under chapter((s)) 18.04, ((~~18.78, 18.88~~)) 18.-- (sections 601 through 631 of this act), or 48.17 RCW; and

(11) Entities not otherwise exempt offering only workshops or seminars lasting no longer than three calendar days.

Sec. 1025. RCW 35.21.692 and 1991 c 182 s 1 are each amended to read as follows:

(1) A state licensed massage practitioner seeking a city or town license to operate a massage business must provide verification of his or her state massage license as provided for in RCW ((~~18.108.030~~)) 18.‑-.--- (section 735 of this act).

(2) The city or town may charge a licensing or operating fee, but the fee charged a state licensed massage practitioner shall not exceed the licensing or operating fee imposed on similar health care providers, such as physical therapists or occupational therapists, operating within the same city or town.

(3) A state licensed massage practitioner is not subject to additional licensing requirements not currently imposed on similar health care providers, such as physical therapists or occupational therapists.

Sec. 1026. RCW 35A.82.025 and 1991 c 182 s 2 are each amended to read as follows:

(1) A state licensed massage practitioner seeking a city license to operate a massage business must provide verification of his or her state massage license as provided for in RCW ((~~18.108.030~~ )) 18.‑-.---(section 735 of this act).

(2) The city may charge a licensing or operating fee, but the fee charged a state licensed massage practitioner shall not exceed the licensing or operating fee imposed on similar health care providers, such as physical therapists or occupational therapists, operating within the same city.

Sec. 1027. RCW 36.32.122 and 1991 c 182 s 3 are each amended to read as follows:

(1) A state licensed massage practitioner seeking a county license to operate a massage business must provide verification of his or her state massage license as provided for in RCW ((~~18.108.030~~)) 18.‑-.---(section 735 of this act).

(2) The county may charge a licensing or operating fee, but the fee charged a state licensed massage practitioner shall not exceed the licensing or operating fee imposed on similar health care providers, such as physical therapists or occupational therapists, operating within the same county.

Sec. 1028. RCW 41.05.075 and 1993 c 386 s 10 are each amended to read as follows:

(1) The administrator shall provide benefit plans designed by the board through a contract or contracts with insuring entities, through self-funding, self-insurance, or other methods of providing insurance coverage authorized by RCW 41.05.140.

(2) The administrator shall establish a contract bidding process that encourages competition among insuring entities, is timely to the state budgetary process, and sets conditions for awarding contracts to any insuring entity.

(3) The administrator shall establish a requirement for review of utilization and financial data from participating insuring entities on a quarterly basis.

(4) The administrator shall centralize the enrollment files for all employee and retired or disabled school employee health plans offered under chapter 41.05 RCW and develop enrollment demographics on a plan-specific basis.

(5) The administrator shall establish methods for collecting, analyzing, and disseminating to covered individuals information on the cost and quality of services rendered by individual health care providers.

(6) All claims data shall be the property of the state. The administrator may require of any insuring entity that submits a bid to contract for coverage all information deemed necessary to fulfill the administrator's duties as set forth in this chapter.

(7) All contracts with insuring entities for the provision of health care benefits shall provide that the beneficiaries of such benefit plans may use on an equal participation basis the services of practitioners licensed pursuant to chapters 18.22, 18.25, 18.32, ((~~18.53~~)) 18.-- (sections 401 through 428 of this act), ((~~18.57~~)) 18.-- (sections 101 through 144 of this act), 18.71, ((~~18.74~~)) 18.-- (sections 701 through 745 of this act), 18.83, and 18.88 RCW. However, nothing in this subsection may preclude the administrator from establishing appropriate utilization controls approved pursuant to RCW 41.05.065(2) (a)((~~(i)~~)), (b), and (d).

(8) Beginning in January 1990, and each January thereafter, the administrator shall publish and distribute to each school district a description of health care benefit plans available through the authority and the estimated cost if school district employees were enrolled.

Sec. 1029. RCW 41.05.180 and 1989 c 338 s 5 are each amended to read as follows:

Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after January 1, 1990, and that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) or physician(('s)) assistant pursuant to chapter 18.71A RCW.

This section shall not be construed to prevent the application of standard health plan provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of the state health care authority to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

Sec. 1030. RCW 42.17.316 and 1987 c 416 s 7 are each amended to read as follows:

The disclosure requirements of this chapter shall not apply to records of the committee obtained in an action under RCW 18.72.301 through 18.72.321 (as recodified by this act).

Sec. 1031. RCW 43.70.220 and 1989 1st ex.s. c 9 s 301 are each amended to read as follows:

The powers and duties of the department of licensing and the director of licensing under the following statutes are hereby transferred to the department of health and the secretary of health: Chapters 18.06, 18.19, ((~~18.22,~~)) 18.25, ((~~18.26,~~)) 18.29, 18.32, ((~~18.34,~~)) 18.35, ((~~18.36A,~~)) 18.50, 18.52, ((~~18.52A, 18.52B,~~)) 18.52C, ((~~18.53, 18.54,~~)) 18.55, ((~~18.57, 18.57A, 18.59~~)) 18.‑- (sections 101 through 144 of this act), 18.71, 18.71A, ((~~18.72, 18.74~~)) 18.‑- (sections 701 through 745 of this act), 18.78, 18.83, 18.84, 18.88, 18.89, 18.92, ((~~18.108~~)) 18.‑- (sections 701 through 745 of this act), 18.135, and 18.138 RCW. More specifically, the health professions regulatory programs and services presently administered by the department of licensing are hereby transferred to the department of health.

Sec. 1032. RCW 48.20.393 and 1989 c 338 s 1 are each amended to read as follows:

Each disability insurance policy issued or renewed after January 1, 1990, that provides coverage for hospital or medical expenses shall provide coverage for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) or physician(('s)) assistant pursuant to chapter 18.71A RCW.

This section shall not be construed to prevent the application of standard policy provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of an insurer to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

Sec. 1033. RCW 48.20.411 and 1973 1st ex.s. c 188 s 3 are each amended to read as follows:

Notwithstanding any provision of any disability insurance contract as provided for in this chapter, benefits shall not be denied thereunder for any health care service performed by a holder of a license for registered nursing practice or advanced registered nursing practice issued pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to chapter 18.71 RCW: PROVIDED, HOWEVER, That no provision of chapter 18.71 RCW shall be asserted to deny benefits under this section.

The provisions of this section are intended to be remedial and procedural to the extent they do not impair the obligation of any existing contract.

Sec. 1034. RCW 48.21.141 and 1973 1st ex.s. c 188 s 4 are each amended to read as follows:

Notwithstanding any provision of any group disability insurance contract or blanket disability insurance contract as provided for in this chapter, benefits shall not be denied thereunder for any health service performed by a holder of a license for registered nursing practice or advanced registered nursing practice issued pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to chapter 18.71 RCW: PROVIDED, HOWEVER, That no provision of chapter 18.71 RCW shall be asserted to deny benefits under this section.

The provisions of this section are intended to be remedial and procedural to the extent they do not impair the obligation of any existing contract.

Sec. 1035. RCW 48.21.225 and 1989 c 338 s 2 are each amended to read as follows:

Each group disability insurance policy issued or renewed after January 1, 1990, that provides coverage for hospital or medical expenses shall provide coverage for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) or physician(('s)) assistant pursuant to chapter 18.71A RCW.

Sec. 1036. RCW 48.44.026 and 1990 c 120 s 6 are each amended to read as follows:

Checks in payment for claims pursuant to any health care service contract for health care services provided by persons licensed or regulated under chapters ((~~18.22~~)) 18.-- (sections 101 through 144 of this act), 18.25, 18.29, 18.32, ((~~18.53~~)) 18.-- (sections 401 through 428 of this act), ((~~18.57~~)) 18.-- (sections 101 through 144 of this act), 18.64, 18.71, 18.73, ((~~18.74~~)) 18.‑- (sections 701 through 745 of this act), 18.83, or 18.88 RCW, where the provider is not a participating provider under a contract with the health care service contractor, shall be made out to both the provider and the enrolled participant with the provider as the first named payee, jointly, to require endorsement by each: PROVIDED, That payment shall be made in the single name of the enrolled participant if the enrolled participant as part of his or her claim furnishes evidence of prepayment to the health care service provider: AND PROVIDED FURTHER, That nothing in this section shall preclude a health care service contractor from voluntarily issuing payment in the single name of the provider.

Sec. 1037. RCW 48.44.290 and 1986 c 223 s 6 are each amended to read as follows:

Notwithstanding any provision of this chapter, for any health care service contract thereunder which is entered into or renewed after July 26, 1981, benefits shall not be denied under such contract for any health care service performed by a holder of a license for registered nursing practice or advanced registered nursing practice issued pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) if (1) the service performed was within the lawful scope of such person's license, and (2) such contract would have provided benefits if such service had been performed by a holder of a license issued pursuant to chapter 18.71 RCW: PROVIDED, HOWEVER, That no provision of chapter 18.71 RCW shall be asserted to deny benefits under this section.

The provisions of this section are intended to be remedial and procedural to the extent that they do not impair the obligation of any existing contract.

Sec. 1038. RCW 48.44.325 and 1989 c 338 s 3 are each amended to read as follows:

Each health care service contract issued or renewed after January 1, 1990, that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) or physician(('s)) assistant pursuant to chapter 18.71A RCW.

This section shall not be construed to prevent the application of standard contract provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of a contractor to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

Sec. 1039. RCW 48.46.275 and 1989 c 338 s 4 are each amended to read as follows:

Each health maintenance agreement issued or renewed after January 1, 1990, that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician or advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission pursuant to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) or physician(('s)) assistant pursuant to chapter 18.71A RCW.

All services must be provided by the health maintenance organization or rendered upon referral by the health maintenance organization. This section shall not be construed to prevent the application of standard agreement provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of a health maintenance organization to negotiate rates and contract with specific providers for the delivery of mammography services. This section shall not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

Sec. 1040. RCW 50.04.223 and 1993 c 167 s 1 are each amended to read as follows:

The term "employment" does not include services performed by a massage practitioner licensed under chapter ((~~18.108~~)) 18.‑- RCW (sections 701 through 745 of this act) in a massage business if the use of the business facilities is contingent upon compensation to the owner of the business facilities and the person receives no compensation from the owner for the services performed.

Sec. 1041. RCW 69.41.010 and 1989 1st ex.s. c 9 s 426 and 1989 c 36 s 3 are each reenacted and amended to read as follows:

As used in this chapter, the following terms ((~~has [have]~~)) have the ((~~meaning[s]~~)) meanings indicated unless the context clearly requires otherwise:

(1) "Administer" means the direct application of a legend drug whether by injection, inhalation, ingestion, or any other means, to the body of a patient or research subject by:

(a) A practitioner; or

(b) The patient or research subject at the direction of the practitioner.

(2) "Deliver" or "delivery" means the actual, constructive, or attempted transfer from one person to another of a legend drug, whether or not there is an agency relationship.

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

(4) "Dispense" means the interpretation of a prescription or order for a legend drug and, pursuant to that prescription or order, the proper selection, measuring, compounding, labeling, or packaging necessary to prepare that prescription or order for delivery.

(5) "Dispenser" means a practitioner who dispenses.

(6) "Distribute" means to deliver other than by administering or dispensing a legend drug.

(7) "Distributor" means a person who distributes.

(8) "Drug" means:

(a) Substances recognized as drugs in the official United States pharmacopoeia, official homeopathic pharmacopoeia of the United States, or official national formulary, or any supplement to any of them;

(b) Substances intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or animals;

(c) Substances (other than food, minerals or vitamins) intended to affect the structure or any function of the body of man or animals; and

(d) Substances intended for use as a component of any article specified in clause (a), (b), or (c) of this subsection. It does not include devices or their components, parts, or accessories.

(9) "Legend drugs" means any drugs which are required by state law or regulation of the state board of pharmacy to be dispensed on prescription only or are restricted to use by practitioners only.

(10) "Person" means individual, corporation, government or governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity.

(11) "Practitioner" means:

(a) A physician under chapter 18.71 RCW, an osteopathic physician or an osteopathic physician and surgeon under chapter ((~~18.57~~)) 18.-- (sections 101 through 144 of this act) RCW, a dentist under chapter 18.32 RCW, a ((~~podiatrist~~)) podiatric physician and surgeon under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act), a veterinarian under chapter 18.92 RCW, a registered nurse ((~~under chapter 18.88 RCW, a~~)), advanced registered nurse practitioner, or licensed practical nurse under chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act), an optometrist under chapter ((~~18.53~~)) 18.‑- RCW (sections 401 through 428 of this act) who is certified by the ((~~optometry board~~)) vision care quality assurance commission under ((~~RCW 18.53.010~~)) section 403 of this act, an osteopathic physician(('s)) assistant under chapter ((~~18.57A~~)) 18.-- RCW (sections 101 through 144 of this act), ((or)) a physician(('s)) assistant under chapter 18.71A RCW, or a pharmacist under chapter 18.64 RCW;

(b) A pharmacy, hospital, or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to, or to administer a legend drug in the course of professional practice or research in this state; and

(c) A physician licensed to practice medicine and surgery or a physician licensed to practice osteopathy and surgery in any state, or province of Canada, which shares a common border with the state of Washington.

(12) "Secretary" means the secretary of health or the secretary's designee.

Sec. 1042. RCW 69.41.030 and 1991 c 30 s 1 are each amended to read as follows:

It shall be unlawful for any person to sell, deliver, or possess any legend drug except upon the order or prescription of a physician under chapter 18.71 RCW, an osteopathic physician or an osteopathic physician and surgeon under chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act), a dentist under chapter 18.32 RCW, a podiatric physician and surgeon under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act), a veterinarian under chapter 18.92 RCW, a commissioned medical or dental officer in the United States armed forces or public health service in the discharge of his or her official duties, a duly licensed physician or dentist employed by the veterans administration in the discharge of his or her official duties, a registered nurse or advanced registered nurse practitioner under chapter ((~~18.88~~)) 18.‑- RCW (sections 601 through 631 of this act) when authorized by the ((~~board of~~)) nursing care quality assurance commission, an osteopathic physician(('s)) assistant under chapter ((~~18.57A~~)) 18.-- RCW (sections 101 through 144 of this act) when authorized by the ((~~committee of osteopathic examiners~~)) allied physicians quality assurance commission, a physician assistant under chapter 18.71A RCW when authorized by the ((~~board of~~)) medical ((~~examiners~~)) quality assurance commission, a physician licensed to practice medicine and surgery or a physician licensed to practice osteopathy and surgery, a dentist licensed to practice dentistry, a podiatric physician and surgeon licensed to practice podiatric medicine and surgery, or a veterinarian licensed to practice veterinary medicine, in any province of Canada which shares a common border with the state of Washington or in any state of the United States: PROVIDED, HOWEVER, That the above provisions shall not apply to sale, delivery, or possession by drug wholesalers or drug manufacturers, or their agents or employees, or to any practitioner acting within the scope of his or her license, or to a common or contract carrier or warehouseman, or any employee thereof, whose possession of any legend drug is in the usual course of business or employment: PROVIDED FURTHER, That nothing in this chapter or chapter 18.64 RCW shall prevent a family planning clinic that is under contract with the department of social and health services from selling, delivering, possessing, and dispensing commercially prepackaged oral contraceptives prescribed by authorized, licensed health care practitioners.

Sec. 1043. RCW 69.45.010 and 1989 1st ex.s. c 9 s 444 are each amended to read as follows:

The definitions in this section apply throughout this chapter.

(1) "Board" means the board of pharmacy.

(2) "Drug samples" means any federal food and drug administration approved controlled substance, legend drug, or products requiring prescriptions in this state, which is distributed at no charge to a practitioner by a manufacturer or a manufacturer's representative, exclusive of drugs under clinical investigations approved by the federal food and drug administration.

(3) "Controlled substance" means a drug, substance, or immediate precursor of such drug or substance, so designated under or pursuant to chapter 69.50 RCW, the uniform controlled substances act.

(4) "Deliver" or "delivery" means the actual, constructive, or attempted transfer from one person to another of a drug or device, whether or not there is an agency relationship.

(5) "Dispense" means the interpretation of a prescription or order for a drug, biological, or device and, pursuant to that prescription or order, the proper selection, measuring, compounding, labeling, or packaging necessary to prepare that prescription or order for delivery.

(6) "Distribute" means to deliver, other than by administering or dispensing, a legend drug.

(7) "Legend drug" means any drug that is required by state law or by regulations of the board to be dispensed on prescription only or is restricted to use by practitioners only.

(8) "Manufacturer" means a person or other entity engaged in the manufacture or distribution of drugs or devices, but does not include a manufacturer's representative.

(9) "Person" means any individual, corporation, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, or any other legal entity.

(10) "Practitioner" means a physician under chapter 18.71 RCW, an osteopathic physician or an osteopathic physician and surgeon under chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act), a dentist under chapter 18.32 RCW, a ((~~podiatrist~~)) podiatric physician and surgeon under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act), a veterinarian under chapter 18.92 RCW, a pharmacist under chapter 18.64 RCW, a commissioned medical or dental officer in the United States armed forces or the public health service in the discharge of his or her official duties, a duly licensed physician or dentist employed by the veterans administration in the discharge of his or her official duties, a registered nurse or advanced registered nurse practitioner under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) when authorized to prescribe by the ((~~board of~~)) nursing care quality assurance commission, an osteopathic ((~~physician's~~)) physician assistant under chapter ((~~18.57A~~)) 18.‑- RCW (sections 101 through 144 of this act) when authorized by the ((~~board of osteopathic medicine and surgery~~)) allied physicians quality assurance commission, or a ((~~physician's~~)) physician assistant under chapter 18.71A RCW when authorized by the ((~~board of~~)) medical ((~~examiners~~)) quality assurance commission.

(11) "Manufacturer's representative" means an agent or employee of a drug manufacturer who is authorized by the drug manufacturer to possess drug samples for the purpose of distribution in this state to appropriately authorized health care practitioners.

(12) "Reasonable cause" means a state of facts found to exist that would warrant a reasonably intelligent and prudent person to believe that a person has violated state or federal drug laws or regulations.

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

(14) "Secretary" means the secretary of health or the secretary's designee.

Sec. 1044. RCW 69.50.101 and 1993 c 187 s 1 are each amended to read as follows:

Unless the context clearly requires otherwise, definitions of terms shall be as indicated where used in this chapter:

(a) "Administer" means to apply a controlled substance, whether by injection, inhalation, ingestion, or any other means, directly to the body of a patient or research subject by:

(1) a practitioner authorized to prescribe (or, by the practitioner's authorized agent); or

(2) the patient or research subject at the direction and in the presence of the practitioner.

(b) "Agent" means an authorized person who acts on behalf of or at the direction of a manufacturer, distributor, or dispenser. It does not include a common or contract carrier, public warehouseperson, or employee of the carrier or warehouseperson.

(d) "Controlled substance" means a drug, substance, or immediate precursor included in Schedules I through V as set forth in federal or state laws, or federal or board rules.

(e)(1) "Controlled substance analog" means a substance the chemical structure of which is substantially similar to the chemical structure of a controlled substance in Schedule I or II and:

(i) that has a stimulant, depressant, or hallucinogenic effect on the central nervous system substantially similar to the stimulant, depressant, or hallucinogenic effect on the central nervous system of a controlled substance included in Schedule I or II; or

(ii) with respect to a particular individual, that the individual represents or intends to have a stimulant, depressant, or hallucinogenic effect on the central nervous system substantially similar to the stimulant, depressant, or hallucinogenic effect on the central nervous system of a controlled substance included in Schedule I or II.

(2) The term does not include:

(i) a controlled substance;

(ii) a substance for which there is an approved new drug application;

(iii) a substance with respect to which an exemption is in effect for investigational use by a particular person under Section 505 of the federal Food, Drug and Cosmetic Act, 21 U.S.C. Sec. 355, to the extent conduct with respect to the substance is pursuant to the exemption; or

(iv) any substance to the extent not intended for human consumption before an exemption takes effect with respect to the substance.

(f) "Deliver" or "delivery," means the actual or constructive transfer from one person to another of a substance, whether or not there is an agency relationship.

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

(h) "Dispense" means the interpretation of a prescription or order for a controlled substance and, pursuant to that prescription or order, the proper selection, measuring, compounding, labeling, or packaging necessary to prepare that prescription or order for delivery.

(i) "Dispenser" means a practitioner who dispenses.

(j) "Distribute" means to deliver other than by administering or dispensing a controlled substance.

(k) "Distributor" means a person who distributes.

(l) "Drug" means (1) a controlled substance recognized as a drug in the official United States pharmacopoeia/national formulary or the official homeopathic pharmacopoeia of the United States, or any supplement to them; (2) controlled substances intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in individuals or animals; (3) controlled substances (other than food) intended to affect the structure or any function of the body of individuals or animals; and (4) controlled substances intended for use as a component of any article specified in (1), (2), or (3) of this subsection. The term does not include devices or their components, parts, or accessories.

(m) "Drug enforcement administration" means the drug enforcement administration in the United States Department of Justice, or its successor agency.

(n) "Immediate precursor" means a substance:

(1) that the state board of pharmacy has found to be and by rule designates as being the principal compound commonly used, or produced primarily for use, in the manufacture of a controlled substance;

(2) that is an immediate chemical intermediary used or likely to be used in the manufacture of a controlled substance; and

(3) the control of which is necessary to prevent, curtail, or limit the manufacture of the controlled substance.

(o) "Isomer" means an optical isomer, but in RCW 69.50.101(r)(5), 69.50.204(a) (12) and (34), and 69.50.206(a)(4), the term includes any geometrical isomer; in RCW 69.50.204(a) (8) and (42), and 69.50.210(c) the term includes any positional isomer; and in RCW 69.50.204(a)(35), 69.50.204(c), and 69.50.208(a) the term includes any positional or geometric isomer.

(p) "Manufacture" means the production, preparation, propagation, compounding, conversion, or processing of a controlled substance, either directly or indirectly or by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, and includes any packaging or repackaging of the substance or labeling or relabeling of its container. The term does not include the preparation, compounding, packaging, repackaging, labeling, or relabeling of a controlled substance:

(1) by a practitioner as an incident to the practitioner's administering or dispensing of a controlled substance in the course of the practitioner's professional practice; or

(2) by a practitioner, or by the practitioner's authorized agent under the practitioner's supervision, for the purpose of, or as an incident to, research, teaching, or chemical analysis and not for sale.

(q) "Marijuana" or "marihuana" means all parts of the plant Cannabis, whether growing or not; the seeds thereof; the resin extracted from any part of the plant; and every compound, manufacture, salt, derivative, mixture, or preparation of the plant, its seeds or resin. The term does not include the mature stalks of the plant, fiber produced from the stalks, oil or cake made from the seeds of the plant, any other compound, manufacture, salt, derivative, mixture, or preparation of the mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of the plant which is incapable of germination.

(r) "Narcotic drug" means any of the following, whether produced directly or indirectly by extraction from substances of vegetable origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis:

(1) Opium, opium derivative, and any derivative of opium or opium derivative, including their salts, isomers, and salts of isomers, whenever the existence of the salts, isomers, and salts of isomers is possible within the specific chemical designation. The term does not include the isoquinoline alkaloids of opium.

(2) Synthetic opiate and any derivative of synthetic opiate, including their isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever the existence of the isomers, esters, ethers, and salts is possible within the specific chemical designation.

(3) Poppy straw and concentrate of poppy straw.

(4) Coca leaves, except coca leaves and extracts of coca leaves from which cocaine, ecgonine, and derivatives or ecgonine or their salts have been removed.

(5) Cocaine, or any salt, isomer, or salt of isomer thereof.

(6) Cocaine base.

(7) Ecgonine, or any derivative, salt, isomer, or salt of isomer thereof.

(8) Any compound, mixture, or preparation containing any quantity of any substance referred to in subparagraphs (1) through (7).

(s) "Opiate" means any substance having an addiction-forming or addiction-sustaining liability similar to morphine or being capable of conversion into a drug having addiction-forming or addiction-sustaining liability. The term includes opium, substances derived from opium (opium derivatives), and synthetic opiates. The term does not include, unless specifically designated as controlled under RCW 69.50.201, the dextrorotatory isomer of 3-methoxy-n-methylmorphinan and its salts (dextromethorphan). The term includes the racemic and levorotatory forms of dextromethorphan.

(t) "Opium poppy" means the plant of the species Papaver somniferum L., except its seeds.

(u) "Person" means individual, corporation, business trust, estate, trust, partnership, association, joint venture, government, governmental subdivision or agency, or any other legal or commercial entity.

(v) "Poppy straw" means all parts, except the seeds, of the opium poppy, after mowing.

(w) "Practitioner" means:

(1) A physician under chapter 18.71 RCW, a physician assistant under chapter 18.71A RCW, an osteopathic physician and surgeon under chapter ((~~18.57~~)) 18.-- RCW (sections 101 through 144 of this act), a dentist under chapter 18.32 RCW, a podiatric physician and surgeon under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act), a veterinarian under chapter 18.92 RCW, a registered nurse, advanced registered nurse practitioner, or licensed practical nurse under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 632 of this act), ((~~a licensed practical nurse under chapter 18.78 RCW,~~)) a pharmacist under chapter 18.64 RCW or a scientific investigator under this chapter, licensed, registered or otherwise permitted insofar as is consistent with those licensing laws to distribute, dispense, conduct research with respect to or administer a controlled substance in the course of their professional practice or research in this state.

(2) A pharmacy, hospital or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this state.

(3) A physician licensed to practice medicine and surgery, a physician licensed to practice osteopathy and surgery, a dentist licensed to practice dentistry, a podiatric physician and surgeon licensed to practice podiatric medicine and surgery, or a veterinarian licensed to practice veterinary medicine in any state of the United States.

(x) "Prescription" means an order for controlled substances issued by a practitioner duly authorized by law or rule in the state of Washington to prescribe controlled substances within the scope of his or her professional practice for a legitimate medical purpose.

(y) "Production" includes the manufacturing, planting, cultivating, growing, or harvesting of a controlled substance.

(z) "Secretary" means the secretary of health or the secretary's designee.

(aa) "State," unless the context otherwise requires, means a state of the United States, the District of Columbia, the Commonwealth of Puerto Rico, or a territory or insular possession subject to the jurisdiction of the United States.

(bb) "Ultimate user" means an individual who lawfully possesses a controlled substance for the individual's own use or for the use of a member of the individual's household or for administering to an animal owned by the individual or by a member of the individual's household.

Sec. 1045. RCW 69.50.402 and 1980 c 138 s 6 are each amended to read as follows:

(a) It is unlawful for any person:

(1) who is subject to Article III to distribute or dispense a controlled substance in violation of RCW 69.50.308;

(2) who is a registrant, to manufacture a controlled substance not authorized by his registration, or to distribute or dispense a controlled substance not authorized by his registration to another registrant or other authorized person;

(3) who is a practitioner, to prescribe, order, dispense, administer, supply, or give to any person:

(i) any amphetamine, including its salts, optical isomers, and salts of optical isomers classified as a schedule II controlled substance by the board of pharmacy pursuant to chapter 34.05 RCW; or

(ii) any nonnarcotic stimulant classified as a schedule II controlled substance and designated as a nonnarcotic stimulant by the board of pharmacy pursuant to chapter 34.05 RCW;

except for the treatment of narcolepsy or for the treatment of hyperkinesis, or for the treatment of drug-induced brain dysfunction, or for the treatment of epilepsy, or for the differential diagnostic psychiatric evaluation of depression, or for the treatment of depression shown to be refractory to other therapeutic modalities, or for the clinical investigation of the effects of such drugs or compounds, in which case an investigative protocol therefor shall have been submitted to and reviewed and approved by the state board of pharmacy before the investigation has been begun: PROVIDED, That the board of pharmacy, in consultation with the medical ((~~disciplinary board~~)) quality assurance commission and the ((~~osteopathic disciplinary board~~)) allied physicians quality assurance commission, may establish by rule, pursuant to chapter 34.05 RCW, disease states or conditions in addition to those listed in this subsection for the treatment of which Schedule II nonnarcotic stimulants may be prescribed, ordered, dispensed, administered, supplied, or given to patients by practitioners: AND PROVIDED, FURTHER, That investigations by the board of pharmacy of abuse of prescriptive authority by physicians, licensed pursuant to chapter 18.71 RCW, pursuant to subsection (a)(3) of this section shall be done in consultation with the medical ((~~disciplinary board~~)) quality assurance commission;

(4) to refuse or fail to make, keep or furnish any record, notification, order form, statement, invoice, or information required under this chapter;

(5) to refuse an entry into any premises for any inspection authorized by this chapter; or

(6) knowingly to keep or maintain any store, shop, warehouse, dwelling, building, vehicle, boat, aircraft, or other structure or place, which is resorted to by persons using controlled substances in violation of this chapter for the purpose of using these substances, or which is used for keeping or selling them in violation of this chapter.

(b) Any person who violates this section is guilty of a crime and upon conviction may be imprisoned for not more than two years, fined not more than two thousand dollars, or both.

Sec. 1046. RCW 70.02.030 and 1993 c 448 s 3 are each amended to read as follows:

(1) A patient may authorize a health care provider to disclose the patient's health care information. A health care provider shall honor an authorization and, if requested, provide a copy of the recorded health care information unless the health care provider denies the patient access to health care information under RCW 70.02.090.

(2) A health care provider may charge a reasonable fee for providing the health care information and is not required to honor an authorization until the fee is paid.

(3) To be valid, a disclosure authorization to a health care provider shall:

(a) Be in writing, dated, and signed by the patient;

(b) Identify the nature of the information to be disclosed;

(d) Except for third-party payors, identify the provider who is to make the disclosure; and

(e) Identify the patient.

(4) Except as provided by this chapter, the signing of an authorization by a patient is not a waiver of any rights a patient has under other statutes, the rules of evidence, or common law.

(5) A health care provider shall retain each authorization or revocation in conjunction with any health care information from which disclosures are made. This requirement shall not apply to disclosures to third-party payors.

(6) Except for authorizations given pursuant to an agreement with a treatment or monitoring program or disciplinary authority under chapter ((~~18.72~~)) 18.71 or 18.130 RCW or to provide information to third-party payors, an authorization may not permit the release of health care information relating to future health care that the patient receives more than ninety days after the authorization was signed. Patients shall be advised of the period of validity of their authorization on the disclosure authorization form. If the authorization does not contain an expiration date, it expires ninety days after it is signed.

Sec. 1047. RCW 70.41.200 and 1993 c 492 s 415 are each amended to read as follows:

(1) Every hospital shall maintain a coordinated quality improvement program for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice. The program shall include at least the following:

(a) The establishment of a quality improvement committee with the responsibility to review the services rendered in the hospital, both retrospectively and prospectively, in order to improve the quality of medical care of patients and to prevent medical malpractice. The committee shall oversee and coordinate the quality improvement and medical malpractice prevention program and shall insure that information gathered pursuant to the program is used to review and to revise hospital policies and procedures;

(b) A medical staff privileges sanction procedure through which credentials, physical and mental capacity, and competence in delivering health care services are periodically reviewed as part of an evaluation of staff privileges;

(c) The periodic review of the credentials, physical and mental capacity, and competence in delivering health care services of all persons who are employed or associated with the hospital;

(d) A procedure for the prompt resolution of grievances by patients or their representatives related to accidents, injuries, treatment, and other events that may result in claims of medical malpractice;

(e) The maintenance and continuous collection of information concerning the hospital's experience with negative health care outcomes and incidents injurious to patients, patient grievances, professional liability premiums, settlements, awards, costs incurred by the hospital for patient injury prevention, and safety improvement activities;

(f) The maintenance of relevant and appropriate information gathered pursuant to (a) through (e) of this subsection concerning individual physicians within the physician's personnel or credential file maintained by the hospital;

(g) Education programs dealing with quality improvement, patient safety, injury prevention, staff responsibility to report professional misconduct, the legal aspects of patient care, improved communication with patients, and causes of malpractice claims for staff personnel engaged in patient care activities; and

(h) Policies to ensure compliance with the reporting requirements of this section.

(2) Any person who, in substantial good faith, provides information to further the purposes of the quality improvement and medical malpractice prevention program or who, in substantial good faith, participates on the quality improvement committee shall not be subject to an action for civil damages or other relief as a result of such activity.

(3) Information and documents, including complaints and incident reports, created specifically for, and collected, and maintained by a quality improvement committee are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (e) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of health to be made regarding the care and treatment received.

(4) Each quality improvement committee shall, on at least a semiannual basis, report to the governing board of the hospital in which the committee is located. The report shall review the quality improvement activities conducted by the committee, and any actions taken as a result of those activities.

(5) The department of health shall adopt such rules as are deemed appropriate to effectuate the purposes of this section.

(6) The medical ((~~disciplinary board~~)) quality assurance commission or the ((~~board of osteopathic medicine and surgery~~)) allied physicians quality assurance commission, as appropriate, may review and audit the records of committee decisions in which a physician's privileges are terminated or restricted. Each hospital shall produce and make accessible to the ((~~board~~)) commission the appropriate records and otherwise facilitate the review and audit. Information so gained shall not be subject to the discovery process and confidentiality shall be respected as required by subsection (3) of this section. Failure of a hospital to comply with this subsection is punishable by a civil penalty not to exceed two hundred fifty dollars.

(7) Violation of this section shall not be considered negligence per se.

Sec. 1048. RCW 70.41.210 and 1986 c 300 s 7 are each amended to read as follows:

The chief administrator or executive officer of a hospital shall report to the ((~~board~~)) medical quality assurance commission when a physician's clinical privileges are terminated or are restricted based on a determination, in accordance with an institution's bylaws, that a physician has either committed an act or acts which may constitute unprofessional conduct. The officer shall also report if a physician accepts voluntary termination in order to foreclose or terminate actual or possible hospital action to suspend, restrict, or terminate a physician's clinical privileges. Such a report shall be made within sixty days of the date action was taken by the hospital's peer review committee or the physician's acceptance of voluntary termination or restriction of privileges. Failure of a hospital to comply with this section is punishable by a civil penalty not to exceed two hundred fifty dollars.

Sec. 1049. RCW 70.41.230 and 1993 c 492 s 416 are each amended to read as follows:

(1) Prior to granting or renewing clinical privileges or association of any physician or hiring a physician, a hospital or facility approved pursuant to this chapter shall request from the physician and the physician shall provide the following information:

(a) The name of any hospital or facility with or at which the physician had or has any association, employment, privileges, or practice;

(b) If such association, employment, privilege, or practice was discontinued, the reasons for its discontinuation;

(c) Any pending professional medical misconduct proceedings or any pending medical malpractice actions in this state or another state, the substance of the allegations in the proceedings or actions, and any additional information concerning the proceedings or actions as the physician deems appropriate;

(d) The substance of the findings in the actions or proceedings and any additional information concerning the actions or proceedings as the physician deems appropriate;

(e) A waiver by the physician of any confidentiality provisions concerning the information required to be provided to hospitals pursuant to this subsection; and

(f) A verification by the physician that the information provided by the physician is accurate and complete.

(2) Prior to granting privileges or association to any physician or hiring a physician, a hospital or facility approved pursuant to this chapter shall request from any hospital with or at which the physician had or has privileges, was associated, or was employed, the following information concerning the physician:

(a) Any pending professional medical misconduct proceedings or any pending medical malpractice actions, in this state or another state;

(b) Any judgment or settlement of a medical malpractice action and any finding of professional misconduct in this state or another state by a licensing or disciplinary board; and

(3) The medical ((~~disciplinary board~~)) quality assurance commission shall be advised within thirty days of the name of any physician denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.

(4) A hospital or facility that receives a request for information from another hospital or facility pursuant to subsections (1) and (2) of this section shall provide such information concerning the physician in question to the extent such information is known to the hospital or facility receiving such a request, including the reasons for suspension, termination, or curtailment of employment or privileges at the hospital or facility. A hospital, facility, or other person providing such information in good faith is not liable in any civil action for the release of such information.

(5) Information and documents, including complaints and incident reports, created specifically for, and collected, and maintained by a quality improvement committee are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (e) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of health to be made regarding the care and treatment received.

(6) Hospitals shall be granted access to information held by the medical ((~~disciplinary board~~)) quality assurance commission and the ((~~board of osteopathic medicine and surgery~~)) allied physicians quality assurance commission pertinent to decisions of the hospital regarding credentialing and recredentialing of practitioners.

(7) Violation of this section shall not be considered negligence per se.

Sec. 1050. RCW 70.127.250 and 1993 c 42 s 10 are each amended to read as follows:

(1) In addition to the rules consistent with RCW 70.127.005 adopted under RCW 70.127.120, the department shall adopt rules for home health agencies which address the following:

(a) Establishment of case management guidelines for acute and maintenance care patients;

(b) Establishment of guidelines for periodic review of the home health care plan of care and plan of treatment by appropriate health care professionals; and

(c) Maintenance of written policies regarding the delivery and supervision of patient care and clinical consultation as necessary by appropriate health care professionals.

(2) As used in this section:

(a) "Acute care" means care provided by a home health agency for patients who are not medically stable or have not attained a satisfactory level of rehabilitation. These patients require frequent monitoring by a health care professional in order to maintain their health status.

(b) "Maintenance care" means care provided by home health agencies that is necessary to support an existing level of health and to preserve a patient from further failure or decline.

(c) "Home health plan of care" means a written plan of care established by a home health agency by appropriate health care professionals that describes maintenance care to be provided. A patient or his or her representative shall be allowed to participate in the development of the plan of care to the extent practicable.

(d) "Home health plan of treatment" means a written plan of care established by a physician licensed under chapter ((~~18.57~~)) 18.-- (sections 101 through 144 of this act) or 18.71 RCW, a podiatric physician and surgeon licensed under chapter ((~~18.22~~)) 18.-- RCW (sections 101 through 144 of this act), or an advanced registered nurse practitioner as authorized by the ((~~board of~~)) nursing care quality assurance commission under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act), in consultation with appropriate health care professionals within the agency that describes medically necessary acute care to be provided for treatment of illness or injury.

Sec. 1051. RCW 70.180.030 and 1990 c 271 s 3 are each amended to read as follows:

(1) The department, in cooperation with ((~~[the]~~)) the University of Washington school of medicine, the state's registered nursing programs, the state's pharmacy programs, and other appropriate public and private agencies and associations, shall develop and keep current a register of physicians, physician assistants, pharmacists, and advanced registered nurse practitioners who are available to practice on a short-term basis in rural communities of the state. The department shall periodically screen individuals on the registry for violations of the Uniform Disciplinary Act as authorized in chapter 18.130 RCW. If a finding of unprofessional conduct has been made by the appropriate disciplinary authority against any individual on the registry, the name of that individual shall be removed from the registry and that person shall be made ineligible for the program. The department shall include a list of back-up physicians and hospitals who can provide support to health care providers in the pool. The register shall be compiled, published, and made available to all rural hospitals, public health departments and districts, rural pharmacies, and other appropriate public and private agencies and associations. The department shall coordinate with existing entities involved in health professional recruitment when developing the registry for the health professional temporary substitute resource pool.

(2) Eligible health care professionals are those licensed under chapters ((~~18.57, 18.57A~~)) 18.-- (sections 1 through 144 of this act), 18.64, 18.71, and 18.71A RCW and advanced registered nurse practitioners licensed under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act).

(3) Participating health care professionals shall receive:

(a) Reimbursement for travel to and from the rural community and for lodging at a rate determined under RCW 43.03.050 and 43.03.060;

(b) Medical malpractice insurance purchased by the department, or the department may reimburse participants for medical malpractice insurance premium costs for medical liability while providing health care services in the program, if the services provided are not covered by the participant's or local provider's existing medical malpractice insurance; and

(c) Information on back-up support from other physicians and hospitals in the area to the extent necessary and available.

(4) The department may require rural communities to participate in health professional recruitment programs as a condition for providing a temporary substitute health care professional if the community does not have adequate permanent health care personnel. To the extent deemed appropriate and subject to funding, the department may also require communities to participate in other programs or projects, such as the rural health system project authorized in chapter 70.175 RCW, that are designed to assist communities to reorganize the delivery of rural health care services.

(5) The department may require a community match for assistance provided in subsection (3) of this section if it determines that adequate community resources exist.

(6) The maximum continuous period of time a participating health professional may serve in a community is ninety days. The department may modify or waive this limitation should it determine that the health and safety of the community warrants a waiver or modification. The community shall be responsible for all salary expenses of participating health professionals.

Sec. 1052. RCW 71.05.210 and 1991 c 364 s 11 and 1991 c 105 s 4 are each reenacted and amended to read as follows:

Each person involuntarily admitted to an evaluation and treatment facility shall, within twenty-four hours of his or her admission, be examined and evaluated by a licensed physician who may be assisted by a physician assistant according to chapter 18.71A RCW or ((a)) an advanced registered nurse practitioner according to chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act) and a mental health professional as defined in this chapter, and shall receive such treatment and care as his or her condition requires including treatment on an outpatient basis for the period that he or she is detained, except that, beginning twenty-four hours prior to a court proceeding, the individual may refuse all but emergency life-saving treatment, and the individual shall be informed at an appropriate time of his or her right to such refusal of treatment. Such person shall be detained up to seventy-two hours, if, in the opinion of the professional person in charge of the facility, or his or her professional designee, the person presents a likelihood of serious harm to himself or herself or others, or is gravely disabled. A person who has been detained for seventy-two hours shall no later than the end of such period be released, unless referred for further care on a voluntary basis, or detained pursuant to court order for further treatment as provided in this chapter.

If, after examination and evaluation, the licensed physician and mental health professional determine that the initial needs of the person would be better served by placement in a chemical dependency treatment facility, then the person shall be referred to an approved treatment program defined under RCW 70.96A.020.

An evaluation and treatment center admitting any person pursuant to this chapter whose physical condition reveals the need for hospitalization shall assure that such person is transferred to an appropriate hospital for treatment. Notice of such fact shall be given to the court, the designated attorney, and the designated county mental health professional and the court shall order such continuance in proceedings under this chapter as may be necessary, but in no event may this continuance be more than fourteen days.

Sec. 1053. RCW 71.24.025 and 1991 c 306 s 2 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Acutely mentally ill" means a condition which is limited to a short-term severe crisis episode of:

(a) A mental disorder as defined in RCW 71.05.020(2) or, in the case of a child, as defined in RCW 71.34.020(12);

(b) Being gravely disabled as defined in RCW 71.05.020(1) or, in the case of a child, as defined in RCW 71.34.020(8); or

(c) Presenting a likelihood of serious harm as defined in RCW 71.05.020(3) or, in the case of a child, as defined in RCW 71.34.020(11).

(2) "Available resources" means those funds which shall be appropriated under this chapter by the legislature during any biennium for the purpose of providing community mental health programs under RCW 71.24.045. When regional support networks are established or after July 1, 1995, "available resources" means federal funds, except those provided according to Title XIX of the Social Security Act, and state funds appropriated under this chapter or chapter 71.05 RCW by the legislature during any biennium for the purpose of providing residential services, resource management services, community support services, and other mental health services. This does not include funds appropriated for the purpose of operating and administering the state psychiatric hospitals, except as negotiated according to RCW 71.24.300(1)(d).

(3) "Licensed service provider" means an entity licensed according to this chapter or chapter 71.05 RCW that meets state minimum standards or individuals licensed under chapter ((~~18.57~~)) 18.-- (sections 101 through 144 of this act), 18.71, 18.83, or ((~~18.88~~)) 18.-- (sections 601 through 631 of this act) RCW.

(4) "Child" means a person under the age of eighteen years.

(5) "Chronically mentally ill adult" means an adult who has a mental disorder and meets at least one of the following criteria:

(a) Has undergone two or more episodes of hospital care for a mental disorder within the preceding two years; or

(b) Has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding year; or

(c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than twelve months. "Substantial gainful activity" shall be defined by the department by rule consistent with Public Law 92‑603, as amended.

(6) "Severely emotionally disturbed child" means an infant or child who has been determined by the regional support network to be experiencing a mental disorder as defined in chapter 71.34 RCW, including those mental disorders that result in a behavioral or conduct disorder, that is clearly interfering with the child's functioning in family or school or with peers and who meets at least one of the following criteria:

(a) Has undergone inpatient treatment or placement outside of the home related to a mental disorder within the last two years;

(b) Has undergone involuntary treatment under chapter 71.34 RCW within the last two years;

(c) Is currently served by at least one of the following child-serving systems: Juvenile justice, child-protection/welfare, special education, or developmental disabilities;

(d) Is at risk of escalating maladjustment due to:

(i) Chronic family dysfunction involving a mentally ill or inadequate caretaker;

(ii) Changes in custodial adult;

(iii) Going to, residing in, or returning from any placement outside of the home, for example, psychiatric hospital, short-term inpatient, residential treatment, group or foster home, or a correctional facility;

(iv) Subject to repeated physical abuse or neglect;

(v) Drug or alcohol abuse; or

(vi) Homelessness.

(7) "Community mental health program" means all mental health services established by a county authority. After July 1, 1995, or when the regional support networks are established, "community mental health program" means all activities or programs using available resources.

(8) "Community support services" means services for acutely mentally ill persons, chronically mentally ill adults, and severely emotionally disturbed children and includes: (a) Discharge planning for clients leaving state mental hospitals, other acute care inpatient facilities, inpatient psychiatric facilities for persons under twenty-one years of age, and other children's mental health residential treatment facilities; (b) sufficient contacts with clients, families, schools, or significant others to provide for an effective program of community maintenance; and (c) medication monitoring. After July 1, 1995, or when regional support networks are established, for adults and children "community support services" means services authorized, planned, and coordinated through resource management services including, at least, assessment, diagnosis, emergency crisis intervention available twenty-four hours, seven days a week, prescreening determinations for mentally ill persons being considered for placement in nursing homes as required by federal law, screening for patients being considered for admission to residential services, diagnosis and treatment for acutely mentally ill and severely emotionally disturbed children discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program, investigation, legal, and other nonresidential services under chapter 71.05 RCW, case management services, psychiatric treatment including medication supervision, counseling, psychotherapy, assuring transfer of relevant patient information between service providers, other services determined by regional support networks, and maintenance of a patient tracking system for chronically mentally ill adults and severely emotionally disturbed children.

(9) "County authority" means the board of county commissioners, county council, or county executive having authority to establish a community mental health program, or two or more of the county authorities specified in this subsection which have entered into an agreement to provide a community mental health program.

(10) "Department" means the department of social and health services.

(11) "Mental health services" means community services pursuant to RCW 71.24.035(5)(b) and other services provided by the state for the mentally ill. When regional support networks are established, or after July 1, 1995, "mental health services" shall include all services provided by regional support networks.

(12) "Mentally ill persons" and "the mentally ill" mean persons and conditions defined in subsections (1), (5), (6), and (16) of this section.

(13) "Regional support network" means a county authority or group of county authorities recognized by the secretary that enter into joint operating agreements to contract with the secretary pursuant to this chapter.

(14) "Residential services" means a facility or distinct part thereof which provides food and shelter, and may include treatment services.

When regional support networks are established, or after July 1, 1995, for adults and children "residential services" means a complete range of residences and supports authorized by resource management services and which may involve a facility, a distinct part thereof, or services which support community living, for acutely mentally ill persons, chronically mentally ill adults, severely emotionally disturbed children, or seriously disturbed adults determined by the regional support network to be at risk of becoming acutely or chronically mentally ill. The services shall include at least evaluation and treatment services as defined in chapter 71.05 RCW, acute crisis respite care, long-term adaptive and rehabilitative care, and supervised and supported living services, and shall also include any residential services developed to service mentally ill persons in nursing homes. Residential services for children in out-of-home placements related to their mental disorder shall not include the costs of food and shelter, except for children's long-term residential facilities existing prior to January 1, 1991.

(15) "Resource management services" mean the planning, coordination, and authorization of residential services and community support services administered pursuant to an individual service plan for acutely mentally ill adults and children, chronically mentally ill adults, severely emotionally disturbed children, or seriously disturbed adults determined by the regional support network at their sole discretion to be at risk of becoming acutely or chronically mentally ill. Such planning, coordination, and authorization shall include mental health screening for children eligible under the federal Title XIX early and periodic screening, diagnosis, and treatment program. Resource management services include seven day a week, twenty-four hour a day availability of information regarding mentally ill adults' and children's enrollment in services and their individual service plan to county-designated mental health professionals, evaluation and treatment facilities, and others as determined by the regional support network.

(16) "Seriously disturbed person" means a person who:

(a) Is gravely disabled or presents a likelihood of serious harm to oneself or others as a result of a mental disorder as defined in chapter 71.05 RCW;

(b) Has been on conditional release status at some time during the preceding two years from an evaluation and treatment facility or a state mental health hospital;

(d) Exhibits suicidal preoccupation or attempts; or

(e) Is a child diagnosed by a mental health professional, as defined in RCW 71.05.020, as experiencing a mental disorder which is clearly interfering with the child's functioning in family or school or with peers or is clearly interfering with the child's personality development and learning.

(17) "Secretary" means the secretary of social and health services.

(18) "State minimum standards" means: (a) Minimum requirements for delivery of mental health services as established by departmental rules and necessary to implement this chapter, including but not limited to licensing service providers and services; (b) minimum service requirements for licensed service providers for the provision of mental health services as established by departmental rules pursuant to chapter 34.05 RCW as necessary to implement this chapter, including, but not limited to: Qualifications for staff providing services directly to mentally ill persons; the intended result of each service; and the rights and responsibilities of persons receiving mental health services pursuant to this chapter; (c) minimum requirements for residential services as established by the department in rule based on clients' functional abilities and not solely on their diagnoses, limited to health and safety, staff qualifications, and program outcomes. Minimum requirements for residential services are those developed in collaboration with consumers, families, counties, regulators, and residential providers serving the mentally ill. Minimum requirements encourage the development of broad-range residential programs, including integrated housing and cross-systems programs where appropriate, and do not unnecessarily restrict programming flexibility; and (d) minimum standards for community support services and resource management services, including at least qualifications for resource management services, client tracking systems, and the transfer of patient information between service providers.

Sec. 1054. RCW 74.09.290 and 1990 c 100 s 5 are each amended to read as follows:

The secretary of the department of social and health services or his authorized representative shall have the authority to:

(1) Conduct audits and investigations of providers of medical and other services furnished pursuant to this chapter, except that the Washington state medical ((~~disciplinary board~~)) quality assurance commission shall generally serve in an advisory capacity to the secretary in the conduct of audits or investigations of physicians. Any overpayment discovered as a result of an audit of a provider under this authority shall be offset by any underpayments discovered in that same audit sample. In order to determine the provider's actual, usual, customary, or prevailing charges, the secretary may examine such random representative records as necessary to show accounts billed and accounts received except that in the conduct of such examinations, patient names, other than public assistance applicants or recipients, shall not be noted, copied, or otherwise made available to the department. In order to verify costs incurred by the department for treatment of public assistance applicants or recipients, the secretary may examine patient records or portions thereof in connection with services to such applicants or recipients rendered by a health care provider, notwithstanding the provisions of RCW 5.60.060, 18.53.200, 18.83.110, or any other statute which may make or purport to make such records privileged or confidential: PROVIDED, That no original patient records shall be removed from the premises of the health care provider, and that the disclosure of any records or information by the department of social and health services is prohibited and shall be punishable as a class C felony according to chapter 9A.20 RCW, unless such disclosure is directly connected to the official purpose for which the records or information were obtained: PROVIDED FURTHER, That the disclosure of patient information as required under this section shall not subject any physician or other health services provider to any liability for breach of any confidential relationship between the provider and the patient, but no evidence resulting from such disclosure may be used in any civil, administrative, or criminal proceeding against the patient unless a waiver of the applicable evidentiary privilege is obtained: PROVIDED FURTHER, That the secretary shall destroy all copies of patient medical records in their possession upon completion of the audit, investigation or proceedings;

(2) Approve or deny applications to participate as a provider of services furnished pursuant to this chapter;

(3) Terminate or suspend eligibility to participate as a provider of services furnished pursuant to this chapter; and

(4) Adopt, promulgate, amend, and ((~~rescind~~)) repeal administrative rules ((~~and regulations~~)), in accordance with the Administrative Procedure Act, chapter 34.05 RCW, to carry out the policies and purposes of RCW 74.09.200 through 74.09.290.

Sec. 1055. RCW 74.42.010 and 1993 c 508 s 4 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Department" means the department of social and health services and the department's employees.

(2) "Facility" refers to a nursing home as defined in RCW 18.51.010.

(3) "Licensed practical nurse" means a person licensed to practice practical nursing under chapter ((~~18.78~~)) 18.-- RCW (sections 601 through 631 of this act).

(4) "Medicaid" means Title XIX of the Social Security Act enacted by the social security amendments of 1965 (42 U.S.C. Sec. 1396; 79 Stat. 343), as amended.

(5) "Nursing care" means that care provided by a registered nurse, an advanced registered nurse practitioner, a licensed practical nurse, or a nursing assistant in the regular performance of their duties.

(6) "Qualified therapist" means:

(a) An activities specialist who has specialized education, training, or experience specified by the department.

(b) An audiologist who is eligible for a certificate of clinical competence in audiology or who has the equivalent education and clinical experience.

(d) A mental retardation professional who is a qualified therapist or a therapist approved by the department and has specialized training or one year experience in treating or working with the mentally retarded or developmentally disabled.

(e) An occupational therapist who is a graduate of a program in occupational therapy or who has equivalent education or training.

(f) A physical therapist as defined in chapter ((~~18.74~~)) 18.-- RCW (sections 701 through 745 of this act).

(g) A social worker who is a graduate of a school of social work.

(h) A speech pathologist who is eligible for a certificate of clinical competence in speech pathology or who has equivalent education and clinical experience.

(7) "Registered nurse" means a person ((~~practicing~~)) licensed to practice registered nursing under chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act).

(8) "Resident" means an individual residing in a nursing home, as defined in RCW 18.51.010.

(9) "Physician(('s)) assistant" means a person practicing pursuant to chapters 18.57A and 18.71A RCW.

(10) "Nurse practitioner" means a person ((~~practicing such expanded acts of nursing as are authorized by the board of nursing pursuant to RCW 18.88.030~~)) licensed to practice advanced registered nursing under chapter 18.-- RCW (sections 601 through 631 of this act).

Sec. 1056. RCW 74.42.230 and 1982 c 120 s 2 are each amended to read as follows:

(1) The resident's attending or staff physician or authorized practitioner approved by the attending physician shall order all medications for the resident. The order may be oral or written and shall be limited by time. An "authorized practitioner," as used in this section, is a registered nurse under chapter ((~~18.88~~)) 18.‑- RCW (sections 601 through 631 of this act) when authorized by the ((~~board of~~)) nursing care quality assurance commission, an osteopathic physician(('s)) assistant under chapter ((~~18.57A~~)) 18.-- RCW (sections 101 through 144 of this act) when authorized by the ((~~committee of osteopathic examiners~~)) allied physicians quality assurance commission, or a physician(('s)) assistant under chapter 18.71A RCW when authorized by the ((~~board of~~)) medical ((~~examiners~~)) quality assurance commission.

(2) An oral order shall be given only to a licensed nurse, pharmacist, or another physician. The oral order shall be recorded and signed immediately by the person receiving the order. The attending physician shall sign the record of the oral order in a manner consistent with good medical practice.

Sec. 1057. RCW 74.42.240 and 1989 c 372 s 5 are each amended to read as follows:

(1) No staff member may administer any medication to a resident unless the staff member is licensed to administer medication: PROVIDED, That nothing herein shall be construed as prohibiting graduate nurses or student nurses from administering medications when permitted to do so under chapter ((~~18.88 or 18.78~~)) 18.-- RCW (sections 601 through 631 of this act) and rules adopted thereunder.

(2) The facility may only allow a resident to give himself or herself medication with the attending physician's permission.

(3) Medication shall only be administered to or used by the resident for whom it is ordered.

Sec. 1058. RCW 74.42.380 and 1989 c 372 s 6 are each amended to read as follows:

(1) The facility shall have a director of nursing services. The director of nursing services shall be a registered nurse or an advanced registered nurse practitioner.

(2) The director of nursing services is responsible for:

(a) Coordinating the plan of care for each resident;

(b) Permitting only licensed personnel to administer medications: PROVIDED, That nothing herein shall be construed as prohibiting graduate nurses or student nurses from administering medications when permitted to do so under chapter ((~~18.88 or 18.78~~)) 18.-- RCW (sections 601 through 631 of this act) and rules ((~~promulgated pursuant thereto~~)) adopted under it: PROVIDED FURTHER, That nothing herein shall be construed as prohibiting persons certified under chapter 18.135 RCW from practicing pursuant to the delegation and supervision requirements of chapter 18.135 RCW and rules ((~~promulgated pursuant thereto~~)) adopted under it; and

(c) Insuring that the licensed practical nurses ((~~comply with chapter 18.78 RCW,~~)) and the registered nurses comply with chapter ((~~18.88~~)) 18.-- RCW (sections 601 through 631 of this act), and persons certified under chapter 18.135 RCW comply with the provisions of that chapter and rules ((~~promulgated pursuant thereto~~)) adopted under it.

Sec. 1059. RCW 74.46.020 and 1993 sp.s. c 13 s 1 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Accrual method of accounting" means a method of accounting in which revenues are reported in the period when they are earned, regardless of when they are collected, and expenses are reported in the period in which they are incurred, regardless of when they are paid.

(2) "Ancillary care" means those services required by the individual, comprehensive plan of care provided by qualified therapists.

(3) "Appraisal" means the process of estimating the fair market value or reconstructing the historical cost of an asset acquired in a past period as performed by a professionally designated real estate appraiser with no pecuniary interest in the property to be appraised. It includes a systematic, analytic determination and the recording and analyzing of property facts, rights, investments, and values based on a personal inspection and inventory of the property.

(4) "Arm's-length transaction" means a transaction resulting from good-faith bargaining between a buyer and seller who are not related organizations and have adverse positions in the market place. Sales or exchanges of nursing home facilities among two or more parties in which all parties subsequently continue to own one or more of the facilities involved in the transactions shall not be considered as arm's-length transactions for purposes of this chapter. Sale of a nursing home facility which is subsequently leased back to the seller within five years of the date of sale shall not be considered as an arm's-length transaction for purposes of this chapter.

(5) "Assets" means economic resources of the contractor, recognized and measured in conformity with generally accepted accounting principles.

(6) "Bad debts" means amounts considered to be uncollectable from accounts and notes receivable.

(7) "Beds" means the number of set-up beds in the facility, not to exceed the number of licensed beds.

(8) "Beneficial owner" means:

(a) Any person who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise has or shares:

(i) Voting power which includes the power to vote, or to direct the voting of such ownership interest; and/or

(ii) Investment power which includes the power to dispose, or to direct the disposition of such ownership interest;

(b) Any person who, directly or indirectly, creates or uses a trust, proxy, power of attorney, pooling arrangement, or any other contract, arrangement, or device with the purpose or effect of divesting himself of beneficial ownership of an ownership interest or preventing the vesting of such beneficial ownership as part of a plan or scheme to evade the reporting requirements of this chapter;

(c) Any person who, subject to subparagraph (b) of this subsection, has the right to acquire beneficial ownership of such ownership interest within sixty days, including but not limited to any right to acquire:

(i) Through the exercise of any option, warrant, or right;

(ii) Through the conversion of an ownership interest;

(iii) Pursuant to the power to revoke a trust, discretionary account, or similar arrangement; or

(iv) Pursuant to the automatic termination of a trust, discretionary account, or similar arrangement;

except that, any person who acquires an ownership interest or power specified in subparagraphs (i), (ii), or (iii) of this subparagraph (c) with the purpose or effect of changing or influencing the control of the contractor, or in connection with or as a participant in any transaction having such purpose or effect, immediately upon such acquisition shall be deemed to be the beneficial owner of the ownership interest which may be acquired through the exercise or conversion of such ownership interest or power;

(d) Any person who in the ordinary course of business is a pledgee of ownership interest under a written pledge agreement shall not be deemed to be the beneficial owner of such pledged ownership interest until the pledgee has taken all formal steps necessary which are required to declare a default and determines that the power to vote or to direct the vote or to dispose or to direct the disposition of such pledged ownership interest will be exercised; except that:

(i) The pledgee agreement is bona fide and was not entered into with the purpose nor with the effect of changing or influencing the control of the contractor, nor in connection with any transaction having such purpose or effect, including persons meeting the conditions set forth in subparagraph (b) of this subsection; and

(ii) The pledgee agreement, prior to default, does not grant to the pledgee:

(A) The power to vote or to direct the vote of the pledged ownership interest; or

(B) The power to dispose or direct the disposition of the pledged ownership interest, other than the grant of such power(s) pursuant to a pledge agreement under which credit is extended and in which the pledgee is a broker or dealer.

(9) "Capitalization" means the recording of an expenditure as an asset.

(10) "Contractor" means an entity which contracts with the department to provide services to medical care recipients in a facility and which entity is responsible for operational decisions.

(11) "Department" means the department of social and health services (DSHS) and its employees.

(12) "Depreciation" means the systematic distribution of the cost or other basis of tangible assets, less salvage, over the estimated useful life of the assets.

(13) "Direct care supplies" means medical, pharmaceutical, and other supplies required for the direct nursing and ancillary care of medical care recipients.

(14) "Entity" means an individual, partnership, corporation, or any other association of individuals capable of entering enforceable contracts.

(15) "Equity" means the net book value of all tangible and intangible assets less the recorded value of all liabilities, as recognized and measured in conformity with generally accepted accounting principles.

(16) "Facility" means a nursing home licensed in accordance with chapter 18.51 RCW, excepting nursing homes certified as institutions for mental diseases, or that portion of a hospital licensed in accordance with chapter 70.41 RCW which operates as a nursing home.

(17) "Fair market value" means the replacement cost of an asset less observed physical depreciation on the date for which the market value is being determined.

(18) "Financial statements" means statements prepared and presented in conformity with generally accepted accounting principles including, but not limited to, balance sheet, statement of operations, statement of changes in financial position, and related notes.

(19) "Generally accepted accounting principles" means accounting principles approved by the Financial Accounting Standards Board (FASB).

(20) "Generally accepted auditing standards" means auditing standards approved by the American Institute of Certified Public Accountants (AICPA).

(21) "Goodwill" means the excess of the price paid for a business over the fair market value of all other identifiable, tangible, and intangible assets acquired.

(22) "Historical cost" means the actual cost incurred in acquiring and preparing an asset for use, including feasibility studies, architect's fees, and engineering studies.

(23) "Imprest fund" means a fund which is regularly replenished in exactly the amount expended from it.

(24) "Joint facility costs" means any costs which represent resources which benefit more than one facility, or one facility and any other entity.

(25) "Lease agreement" means a contract between two parties for the possession and use of real or personal property or assets for a specified period of time in exchange for specified periodic payments. Elimination (due to any cause other than death or divorce) or addition of any party to the contract, expiration, or modification of any lease term in effect on January 1, 1980, or termination of the lease by either party by any means shall constitute a termination of the lease agreement. An extension or renewal of a lease agreement, whether or not pursuant to a renewal provision in the lease agreement, shall be considered a new lease agreement. A strictly formal change in the lease agreement which modifies the method, frequency, or manner in which the lease payments are made, but does not increase the total lease payment obligation of the lessee, shall not be considered modification of a lease term.

(26) "Medical care program" means medical assistance provided under RCW 74.09.500 or authorized state medical care services.

(27) "Medical care recipient" or "recipient" means an individual determined eligible by the department for the services provided in chapter 74.09 RCW.

(28) "Net book value" means the historical cost of an asset less accumulated depreciation.

(29) "Net invested funds" means the net book value of tangible fixed assets employed by a contractor to provide services under the medical care program, including land, buildings, and equipment as recognized and measured in conformity with generally accepted accounting principles, plus an allowance for working capital which shall be five percent of the product of the per patient day rate multiplied by the prior calendar year reported total patient days of each contractor.

(30) "Operating lease" means a lease under which rental or lease expenses are included in current expenses in accordance with generally accepted accounting principles.

(31) "Owner" means a sole proprietor, general or limited partners, and beneficial interest holders of five percent or more of a corporation's outstanding stock.

(32) "Ownership interest" means all interests beneficially owned by a person, calculated in the aggregate, regardless of the form which such beneficial ownership takes.

(33) "Patient day" or "client day" means a calendar day of care which will include the day of admission and exclude the day of discharge; except that, when admission and discharge occur on the same day, one day of care shall be deemed to exist.

(34) "Professionally designated real estate appraiser" means an individual who is regularly engaged in the business of providing real estate valuation services for a fee, and who is deemed qualified by a nationally recognized real estate appraisal educational organization on the basis of extensive practical appraisal experience, including the writing of real estate valuation reports as well as the passing of written examinations on valuation practice and theory, and who by virtue of membership in such organization is required to subscribe and adhere to certain standards of professional practice as such organization prescribes.

(35) "Qualified therapist" means:

(a) An activities specialist who has specialized education, training, or experience as specified by the department;

(b) An audiologist who is eligible for a certificate of clinical competence in audiology or who has the equivalent education and clinical experience;

(d) A mental retardation professional who is either a qualified therapist or a therapist approved by the department who has had specialized training or one year's experience in treating or working with the mentally retarded or developmentally disabled;

(e) A social worker who is a graduate of a school of social work;

(f) A speech pathologist who is eligible for a certificate of clinical competence in speech pathology or who has the equivalent education and clinical experience;

(g) A physical therapist as defined by chapter ((~~18.74~~)) 18.‑- RCW (sections 701 through 745 of this act);

(h) An occupational therapist who is a graduate of a program in occupational therapy, or who has the equivalent of such education or training; and

(i) A respiratory care practitioner certified under chapter 18.89 RCW.

(36) "Questioned costs" means those costs which have been determined in accordance with generally accepted accounting principles but which may constitute disallowed costs or departures from the provisions of this chapter or rules and regulations adopted by the department.

(37) "Records" means those data supporting all financial statements and cost reports including, but not limited to, all general and subsidiary ledgers, books of original entry, and transaction documentation, however such data are maintained.

(38) "Related organization" means an entity which is under common ownership and/or control with, or has control of, or is controlled by, the contractor.

(a) "Common ownership" exists when an entity is the beneficial owner of five percent or more ownership interest in the contractor and any other entity.

(b) "Control" exists where an entity has the power, directly or indirectly, significantly to influence or direct the actions or policies of an organization or institution, whether or not it is legally enforceable and however it is exercisable or exercised.

(39) "Restricted fund" means those funds the principal and/or income of which is limited by agreement with or direction of the donor to a specific purpose.

(40) "Secretary" means the secretary of the department of social and health services.

(41) "Title XIX" or "Medicaid" means the 1965 amendments to the social security act, P.L. 89‑07, as amended.

(42) "Physical plant capital improvement" means a capitalized improvement that is limited to an improvement to the building or the related physical plant.

DISABILITY ACCOMMODATION REVOLVING FUND ADVISORY REVIEW BOARD

Sec. 1101. RCW 41.04.395 and 1987 c 9 s 2 are each amended to read as follows:

(1) The disability accommodation revolving fund is created in the custody of the state treasurer. Disbursements from the fund shall be on authorization of the director of the department of personnel or the director's designee. The fund is subject to the allotment procedure provided under chapter 43.88 RCW, but no appropriation is required for disbursements. The fund shall be used exclusively by state agencies to accommodate the unanticipated job site or equipment needs of persons of disability in state employ.

(2) The director of the department of personnel shall ((~~appoint an advisory review board to review and approve~~)) consult with the governor's committee on disability issues and employment regarding requests for disbursements from the disability accommodation revolving fund. The ((~~review board~~)) department shall establish application procedures, adopt criteria, and provide technical assistance to users of the fund.

(3) Agencies that receive moneys from the disability accommodation revolving fund shall return to the fund the amount received from the fund by no later than the end of the first month of the following fiscal biennium.

MOTOR VEHICLE ADVISORY COMMITTEE

Sec. 1102. RCW 43.19.558 and 1989 c 57 s 5 are each amended to read as follows:

The motor transport account shall be used to pay the costs of carrying out the programs provided for in RCW 43.19.550 through 43.19.558, unless otherwise specified by law. The director of general administration may recover the costs of the programs by billing agencies that own and operate passenger motor vehicles on the basis of a per vehicle charge. The director of general administration, after consultation with affected state agencies ((~~and recommendation of the motor vehicle advisory committee~~)), shall establish the rates. All rates shall be approved by the director of financial management. The proceeds generated by these charges shall be used solely to carry out RCW 43.19.550 through 43.19.558.

Sec. 1103. RCW 43.19.554 and 1990 c 75 s 1 are each amended to read as follows:

(1) To carry out the purposes of RCW 43.19.550 through 43.19.558 and 46.08.065, the director of general administration has the following powers and duties:

(a) To develop and implement a state-wide information system to collect, analyze, and disseminate data on the acquisition, operation, management, maintenance, repair, disposal, and replacement of all state-owned passenger motor vehicles. State agencies shall provide the department with such data as is necessary to implement and maintain the system. The department shall provide state agencies with information and reports designed to assist them in achieving efficient and cost-effective management of their passenger motor vehicle operations.

(b) To survey state agencies to identify the location, ownership, and condition of all state-owned fuel storage tanks.

(c) In cooperation with the department of ecology and other public agencies, to prepare a plan and funding proposal for the inspection and repair or replacement of state-owned fuel storage tanks, and for the clean-up of fuel storage sites where leakage has occurred. The plan and funding proposal shall be submitted to the governor no later than December 1, 1989.

(d) To develop and implement a state-wide motor vehicle fuel purchase, distribution, and accounting system to be used by all state agencies and their employees. The director may exempt agencies from participation in the system if the director determines that participation interferes with the statutory duties of the agency.

(e) To establish minimum standards and requirements for the content and frequency of safe driving instruction for state employees operating state-owned passenger motor vehicles, which shall include consideration of employee driving records. In carrying out this requirement, the department shall consult with other agencies that have expertise in this area.

(f) To develop a schedule, after consultation with ((~~the state motor vehicle advisory committee and~~)) affected state agencies, for state employees to participate in safe driving instruction.

(g) To require all state employees to provide proof of a driver's license recognized as valid under Washington state law prior to operating a state-owned passenger vehicle.

(h) To develop standards for the efficient and economical replacement of all categories of passenger motor vehicles used by state agencies and provide those standards to state agencies and the office of financial management.

(i) To develop and implement a uniform system and standards to be used for the marking of passenger motor vehicles as state-owned vehicles as provided for in RCW 46.08.065. The system shall be designed to enhance the resale value of passenger motor vehicles, yet ensure that the vehicles are clearly identified as property of the state.

(j) To develop and implement other programs to improve the performance, efficiency, and cost-effectiveness of passenger motor vehicles owned and operated by state agencies.

(k) To consult with state agencies and institutions of higher education in carrying out RCW 43.19.550 through 43.19.558.

(2) The director shall establish an operational unit within the department to carry out subsection (1) of this section. The director shall employ such personnel as are necessary to carry out RCW 43.19.550 through 43.19.558. Not more than three employees within the unit may be exempt from chapter 41.06 RCW.

(3) No later than December 31, 1992, the director shall report to the governor and appropriate standing committees of the legislature on the implementation of programs prescribed by this section, any cost savings and efficiencies realized by their implementation, and recommendations for statutory changes.

SOLID WASTE PLAN ADVISORY COMMITTEE

NEW SECTION. Sec. 1104. The director of ecology shall abolish the solid waste plan advisory committee effective July 1, 1994.

POLLUTION LIABILITY INSURANCE PROGRAM TECHNICAL ADVISORY COMMITTEE

Sec. 1105. RCW 70.148.030 and 1990 c 64 s 4 are each amended to read as follows:

(1) The Washington pollution liability insurance program is created as an independent agency of the state. The administrative head and appointing authority of the program shall be the director who shall be appointed by the governor, with the consent of the senate, and shall serve at the pleasure of the governor. The salary for this office shall be set by the governor pursuant to RCW 43.03.040. The director shall appoint a deputy director. The director, deputy director, and up to three other employees are exempt from the civil service law, chapter 41.06 RCW.

(2) The director shall employ such other staff as are necessary to fulfill the responsibilities and duties of the director. The staff is subject to the civil service law, chapter 41.06 RCW. In addition, the director may contract with third parties for services necessary to carry out its activities where this will promote economy, avoid duplication of effort, and make best use of available expertise. To the extent necessary to protect the state from unintended liability and ensure quality program and contract design, the director shall contract with an organization or organizations with demonstrated experience and ability in managing and designing pollution liability insurance and with an organization or organizations with demonstrated experience and ability in managing and designing pollution liability reinsurance. The director shall enter into such contracts after competitive bid but need not select the lowest bid. Any such contractor or consultant is prohibited from releasing, publishing, or otherwise using any information made available to it under its contractual responsibility without specific permission of the program director. The director may call upon other agencies of the state to provide technical support and available information as necessary to assist the director in meeting the director's responsibilities under this chapter. Agencies shall supply this support and information as promptly as circumstances permit.

(3) ((The governor shall appoint a standing technical advisory committee that is representative of the public, the petroleum marketing industry, business and local government owners of underground storage tanks, and insurance professionals. Individuals appointed to the technical advisory committee shall serve at the pleasure of the governor and without compensation for their services as members, but may be reimbursed for their travel expenses in accordance with RCW 43.03.050 and 43.03.060.

(4) A member of the technical advisory committee of the program is not civilly liable for any act or omission in the course and scope of his or her official capacity unless the act or omission constitutes gross negligence.)) The director may appoint ad hoc technical advisory committees to obtain expertise necessary to fulfill the purposes of this chapter.

OFFICE OF RURAL HEALTH ADVISORY COMMITTEE

Sec. 1106. RCW 70.175.030 and 1989 1st ex.s. c 9 s 703 are each amended to read as follows:

(1) The department shall establish the Washington rural health system project to provide financial and technical assistance to participants. The goal of the project is to help assure access to affordable health care services to citizens in the rural areas of Washington state.

(2) Administrative costs necessary to implement this project shall be kept at a minimum to insure the maximum availability of funds for participants.

(3) ((The secretary may appoint such technical or advisory committees as he or she deems necessary consistent with the provisions of RCW 43.70.040. In appointing an advisory committee the secretary should assure representation by health care professionals, health care providers, and those directly involved in the purchase, provision, or delivery of health care services as well as consumers, rural community leaders, and those knowledgeable of the issues involved with health care public policy. Individuals appointed to any technical advisory committee shall serve without compensation for their services as members, but may be reimbursed for their travel expenses pursuant to RCW 43.03.050 and 43.03.060.

~~(4)~~)) The secretary may contract with third parties for services necessary to carry out activities to implement this chapter where this will promote economy, avoid duplication of effort, and make the best use of available expertise.

((~~(5)~~)) (4) The secretary may apply for, receive, and accept gifts and other payments, including property and service, from any governmental or other public or private entity or person, and may make arrangements as to the use of these receipts, including the undertaking of special studies and other projects related to the delivery of health care in rural areas.

((~~(6)~~)) (5) In designing and implementing the project the secretary shall consider the report of the Washington rural health care commission established under chapter 207, Laws of 1988. Nothing in this chapter requires the secretary to follow any specific recommendation contained in that report except as it may also be included in this chapter.

FISHERIES ADVISORY REVIEW BOARDS

Sec. 1107. RCW 75.30.050 and 1993 c 376 s 9 and 1993 c 240 s 27 are each reenacted and amended to read as follows:

(1) The director shall appoint three-member advisory review boards to hear cases as provided in RCW 75.30.060. Members shall be from:

(a) ((~~The salmon charter boat fishing industry in cases involving salmon charter licenses or angler permits;~~

~~(b) The commercial salmon fishing industry in cases involving commercial salmon fishery licenses;~~

~~(c)~~)) The commercial crab fishing industry in cases involving dungeness crab‑-Puget Sound fishery licenses;

((~~(d)~~)) (b) The commercial herring fishery in cases involving herring fishery licenses;

((~~(e) The commercial Puget Sound whiting fishery in cases involving whiting‑-Puget Sound fishery licenses;~~

~~(f)~~)) (c) The commercial sea urchin fishery in cases involving sea urchin dive fishery licenses;

((~~(g)~~)) (d) The commercial sea cucumber fishery in cases involving sea cucumber dive fishery licenses; and

((~~(h)~~)) (e) The commercial ocean pink shrimp industry (Pandalus jordani) in cases involving ocean pink shrimp delivery licenses.

(2) Members shall serve at the discretion of the director and shall be reimbursed for travel expenses as provided in RCW 43.03.050, 43.03.060, and 43.03.065.

FISHERIES REGIONAL ADVISORY COMMITTEES

NEW SECTION. Sec. 1108. A new section is added to chapter 75.30 RCW to read as follows:

The director of the department of fish and wildlife shall abolish the department's regional advisory committees, effective July 1, 1994.

OIL AND GAS CONSERVATION COMMITTEE

Sec. 1109. RCW 78.52.010 and 1983 c 253 s 2 are each amended to read as follows:

For the purposes of this chapter, unless the text otherwise requires, the following terms shall have the following meanings:

(1) "Certificate of clearance" means a permit prescribed by the ((~~committee~~)) department for the transportation or the delivery of oil, gas, or product.

(2) "((~~Committee~~)) Department" means the ((~~oil and gas conservation committee~~)) department of natural resources.

(3) "Development unit" means the maximum area of a pool which may be drained efficiently and economically by one well.

(4) "Division order" means an instrument showing percentage of royalty or rental divisions among royalty owners.

(5) "Fair and reasonable share of the production" means, as to each separately-owned tract or combination of tracts, that part of the authorized production from a pool that is substantially in the proportion that the amount of recoverable oil or gas under the development unit of that separately-owned tract or tracts bears to the recoverable oil or gas or both in the total of the development units in the pool.

(6) "Field" means the general area which is underlaid by at least one pool and includes the underground reservoir or reservoirs containing oil or gas, or both. The words "field" and "pool" mean the same thing when only one underground reservoir is involved; however, "field," unlike "pool," may relate to two or more pools.

(7) "Gas" means all natural gas, all gaseous substances, and all other fluid or gaseous hydrocarbons not defined as oil in subsection (12) of this section, including but not limited to wet gas, dry gas, residue gas, condensate, and distillate, as those terms are generally understood in the petroleum industry.

(8) "Illegal oil" or "illegal gas" means oil or gas that has been produced from any well within the state in violation of this chapter or any rule or order of the ((~~committee~~)) department.

(9) "Illegal product" means any product derived in whole or part from illegal oil or illegal gas.

(10) "Interested person" means a person with an ownership, basic royalty, or leasehold interest in oil or gas within an existing or proposed development unit or unitized pool.

(11) "Lessee" means the lessee under an oil and gas lease, or the owner of any land or mineral rights who has the right to conduct or carry on any oil and gas development, exploration and operation thereon, or any person so operating for himself, herself, or others.

(12) "Oil" means crude petroleum, oil, and all hydrocarbons, regardless of gravity, that are in the liquid phase in the original reservoir conditions and are produced and recovered at the wellhead in liquid form.

(13) "Operator" means the person who operates a well or unit or who has been designated or accepted by the owners to operate the well or unit, and who is responsible for compliance with the ((~~committee's~~)) department's rules and policies.

(14) "Owner" means the person who has the right to develop, operate, drill into, and produce from a pool and to appropriate the oil or gas that he or she produces therefrom, either for that person or for that person and others.

(15) "Person" means any natural person, corporation, association, partnership, receiver, trustee, executor, administrator, guardian, fiduciary, or representative of any kind and includes any governmental or political subdivision or any agency thereof.

(16) "Pool" means an underground reservoir containing a common accumulation of oil or gas, or both. Each zone of a structure which is completely separated from any other zone in the same structure such that the accumulations of oil or gas are not common with each other is considered a separate pool and is covered by the term "pool" as used in this chapter.

(17) "Pooling" means the integration or combination of two or more tracts into an area sufficient to constitute a development unit of the size for one well as prescribed by the ((~~committee~~)) department.

(18) "Product" means any commodity made from oil or gas.

(19) "Protect correlative rights" means that the action or regulation by the ((~~committee~~)) department should afford a reasonable opportunity to each person entitled thereto to recover or receive without causing waste his or her fair and reasonable share of the oil and gas in this tract or tracts or its equivalent.

(20) "Royalty" means a right to or interest in oil or gas or the value from or attributable to production, other than the right or interest of a lessee, owner, or operator, as defined herein. Royalty includes, but is not limited to the basic royalty in a lease, overriding royalty, and production payments. Any such interest may be referred to in this chapter as "royalty" or "royalty interest." As used in this chapter "basic royalty" means the royalty reserved in a lease. "Royalty owner" means a person who owns a royalty interest.

(21) "Supervisor" means the state oil and gas supervisor.

(22) "Unitization" means the operation of all or part of a field or reservoir as a single entity for operating purposes.

(23) "Waste" in addition to its ordinary meaning, means and includes:

(a) "Physical waste" as that term is generally understood in the petroleum industry;

(b) The inefficient, excessive, or improper use of, or unnecessary dissipation of, reservoir energy, and the locating, spacing, drilling, equipping, operating, or producing of any oil or gas well in a manner which results or is probable to result in reducing the quantity of oil or gas to be recovered from any pool in this state under operations conducted in accordance with prudent and proper practices or that causes or tends to cause unnecessary wells to be drilled;

(c) The inefficient above-ground storage of oil, and the locating, spacing, drilling, equipping, operating, or producing of any oil or gas well in a manner causing or tending to cause unnecessary or excessive surface loss or destruction of oil or gas;

(d) The production of oil or gas in such manner as to cause unnecessary water channeling, or coning;

(e) The operation of an oil well with an inefficient gas-oil ratio;

(f) The drowning with water of any pool or part thereof capable of producing oil or gas, except insofar as and to the extent authorized by the ((~~committee~~)) department;

(g) Underground waste;

(h) The creation of unnecessary fire hazards;

(i) The escape into the open air, from a well producing oil or gas, of gas in excess of the amount which is reasonably necessary in the efficient development or production of the well;

(j) The use of gas for the manufacture of carbon black, except as provided in RCW 78.52.140;

(k) Production of oil and gas in excess of the reasonable market demand;

(l) The flaring of gas from gas wells except that which is necessary for the drilling, completing, or testing of the well; and

(m) The unreasonable damage to natural resources including but not limited to the destruction of the surface, soils, wildlife, fish, or aquatic life from or by oil and gas operations.

Sec. 1110. RCW 78.52.025 and 1983 c 253 s 3 are each amended to read as follows:

The ((~~committee~~)) department shall hold hearings or meetings at such times and places as may be found by the ((~~committee~~)) department to be necessary to carry out its duties. The ((~~committee~~)) department may establish its own rules for the conduct of public hearings or meetings consistent with other applicable law.

Sec. 1111. RCW 78.52.030 and 1951 c 146 s 6 are each amended to read as follows:

The ((~~committee shall have the authority and it shall be its duty to~~)) department shall employ all personnel necessary to carry out the provisions of this chapter.

Sec. 1112. RCW 78.52.031 and 1983 c 253 s 5 are each amended to read as follows:

The ((~~committee shall have the power to~~)) department may subpoena witnesses, ((to)) administer oaths, and ((to)) require the production of records, books, and documents for examination at any hearing or investigation conducted by it. No person shall be excused from attending and testifying, or from producing books, papers, and records before the ((~~committee~~)) department or a court, or from obedience to the subpoena of the ((~~committee~~)) department or a court, on the ground or for the reason that the testimony or evidence, documentary or otherwise, required of ((~~him~~)) the person may tend to incriminate ((~~him~~)) the person or subject ((~~him~~)) the person to a penalty or forfeiture: PROVIDED, That nothing herein contained shall be construed as requiring any person to produce any books, papers, or records, or to testify in response to any inquiry not pertinent to some question lawfully before ((~~such committee~~)) the department or court for determination. No person shall be subjected to criminal prosecution or to any penalty or forfeiture for or on account of any transaction, matter, or thing concerning which, in spite of his or her objection, he or she may be required to testify or produce evidence, documentary or otherwise before the ((~~committee~~)) department or court, or in obedience to its subpoena: PROVIDED, HOWEVER, That no person testifying shall be exempt from prosecution and punishment for perjury committed in so testifying.

Sec. 1113. RCW 78.52.032 and 1983 c 253 s 10 are each amended to read as follows:

In addition to the powers and authority, either express or implied, granted to the ((~~Washington oil and gas conservation committee~~)) department by virtue of the laws of this state, the ((~~committee~~)) department may, in prescribing its rules of order or procedure in connection with hearings or other proceedings before the ((~~committee~~)) department, provide for the appointment of one or more examiners to conduct a hearing or hearings with respect to any matter properly coming before the ((~~committee~~)) department and to make reports and recommendations to the ((~~committee~~)) department with respect thereto. Any ((~~member~~)) employee of the ((~~committee, or its staff~~)) department or any other person designated by the ((~~committee~~)) commissioner of public lands, or the supervisor when this power is so delegated, may serve as an examiner. The ((~~committee~~)) department shall adopt rules governing hearings to be conducted before examiners.

Sec. 1114. RCW 78.52.033 and 1951 c 146 s 8 are each amended to read as follows:

In case of failure or refusal on the part of any person to comply with a subpoena issued by the ((~~committee~~)) department or in case of the refusal of any witness to testify as to any matter regarding which ((he)) the witness may be interrogated, any superior court in the state, upon the application of the ((~~committee~~)) department, may compel ((~~him~~)) the person to comply with such subpoena, and to attend before the ((~~committee~~)) department and produce such records, books, and documents for examination, and to give his or her testimony and shall have the power to punish for contempt as in the case of disobedience to a like subpoena issued by the court, or for refusal to testify therein.

Sec. 1115. RCW 78.52.035 and 1951 c 146 s 9 are each amended to read as follows:

The attorney general shall be the attorney for the ((~~committee: PROVIDED, That~~)) department, but in cases of emergency, the ((~~committee~~)) department may call upon the prosecuting attorney of the county where the action is to be brought, or defended, to represent the ((~~committee~~)) department until such time as the attorney general may take charge of the litigation.

Sec. 1116. RCW 78.52.037 and 1983 c 253 s 4 are each amended to read as follows:

((The department of natural resources is the designated agent of the committee for the purpose of carrying out this chapter. It shall administer and enforce this chapter consistent with the policies adopted by the committee, together with all rules and orders which the committee may adopt and delegate, including but not limited to issuing permits, orders, enforcement actions, and other actions or decisions authorized to be made under this chapter.)) The department shall designate a state oil and gas supervisor who shall be charged with duties as may be delegated by the department. The department ((~~of natural resources~~)) may designate one or more deputy supervisors and employ all personnel necessary including the appointment of examiners as provided in RCW 78.52.032 to carry out this chapter and the rules and orders of the ((~~committee~~)) department.

Sec. 1117. RCW 78.52.040 and 1983 c 253 s 6 are each amended to read as follows:

((~~It shall be the duty of the committee to~~)) The department shall administer and enforce the provisions of this chapter by the adoption of policies, and all rules, regulations, and orders promulgated hereunder, and the ((~~committee is hereby vested with~~)) department has jurisdiction, power, and authority, over all persons and property, public and private, necessary to enforce effectively such duty.

Sec. 1118. RCW 78.52.050 and 1983 c 253 s 7 are each amended to read as follows:

The ((~~committee shall have authority to~~)) department may make such reasonable rules, regulations, and orders as may be necessary from time to time for the proper administration and enforcement of this chapter. Unless otherwise required by law or by this chapter or by rules of procedure made under this chapter, the ((~~committee~~)) department may make such rules, regulations, and orders, after notice, as the basis therefor. The notice may be given by publication in some newspaper of general circulation in the state in a manner and form which may be prescribed by the ((~~committee~~)) department by general rule. The public hearing shall be at the time and in the manner and at the place prescribed by the ((~~committee~~)) department, and any person having any interest in the subject matter of the hearing shall be entitled to be heard. In addition, written notice shall be mailed to all interested persons who have requested, in writing, notice of ((~~committee~~)) department hearings, rulings, policies, and orders. The ((~~committee~~)) department shall establish and maintain a mailing list for this purpose. Substantial compliance with these mailing requirements is deemed compliance with ((~~the provisions herewith~~)) this section.

Sec. 1119. RCW 78.52.070 and 1951 c 146 s 12 are each amended to read as follows:

Any interested person shall have the right to have the ((~~committee~~)) department call a hearing for the purpose of taking action with respect to any matter within the jurisdiction of the ((~~committee~~)) department by filing a verified written petition therefor, which shall state in substance the matter and reasons for and nature of the action requested. Upon receipt of any such request the ((~~committee~~)) department, if in its judgment a hearing is warranted and justifiable, shall promptly call a hearing thereon, and after such hearing, and with all convenient speed, and in any event within twenty days after the conclusion of such hearing, shall take such action with regard to the subject matter thereof as it may deem appropriate.

Sec. 1120. RCW 78.52.100 and 1983 c 253 s 8 are each amended to read as follows:

All rules, regulations, policies, and orders of the ((~~committee~~)) department, all petitions, copies of all notices and actions with affidavits of posting, mailing, or publications pertaining thereto, all findings of fact, and transcripts of all hearings shall be in writing and shall be entered in full by the ((~~committee~~)) department in the permanent official records of the office of the commissioner of public lands and shall be open for inspection at all times during reasonable office hours. A copy of any rule, regulation, policy, order, or other official records of the ((~~committee~~)) department, certified by the ((~~executive secretary of the committee~~)) commissioner of public lands, shall be received in evidence in all courts of this state with the same effect as the original. The ((~~committee~~)) department is hereby required to furnish to any person upon request, copies of all rules, regulations, policies, orders, and amendments thereof.

Sec. 1121. RCW 78.52.120 and 1983 c 253 s 11 are each amended to read as follows:

Any person desiring or proposing to drill any well in search of oil or gas, before commencing the drilling of any such well, shall apply to the ((~~committee~~)) department upon such form as the ((~~committee~~)) department may prescribe, and shall pay to the state treasurer a fee of the following amounts for each application:

(1) For each well the estimated depth of which is three thousand five hundred feet or less, two hundred fifty dollars;

(2) From three thousand five hundred one feet to seven thousand feet, five hundred dollars;

(3) From seven thousand one feet to twelve thousand feet, seven hundred fifty dollars; and

(4) From twelve thousand one feet and deeper, one thousand dollars.

In addition, as pertains to the tract upon which the well is proposed to be located, the applicant must notify the surface landowner, the landowner's tenant, and other surface users in the manner provided by regulations of the ((~~committee~~)) department that a drilling permit has been applied for by furnishing each such surface landowner, tenant, and other users with a copy of the application concurrent with the filing of the application. Within fifteen days of receipt of the application, each such surface landowner, the landowner's tenant, and other surface users have the right to inform the ((~~committee~~)) department of objections or comments as to the proposed use of the surface by the applicant, and the ((~~committee~~)) department shall consider the objections or comments.

The drilling of any well is prohibited until a permit is given and such fee has been paid as ((~~herein~~)) provided in this section. The ((~~committee shall have the authority to~~)) department may prescribe that the said form indicate the exact location of such well, the name and address of the owner, operator, contractor, driller, and any other person responsible for the conduct of drilling operations, the proposed depth of the well, the elevation of the well above sea level, and such other relevant and reasonable information as the ((~~committee~~)) department may deem necessary or convenient to effectuate the purposes of this chapter.

The ((~~committee~~)) department shall issue a permit if it finds that the proposed drilling will be consistent with this chapter, the rules((,)) and orders adopted under it, and is not detrimental to the public interest. The ((~~committee~~)) department shall impose conditions and restrictions as necessary to protect the public interest and to ensure compliance with this chapter, and the rules and orders adopted by the ((~~committee~~)) department. A person shall not apply to drill a well in search of oil or gas unless that person holds an ownership or contractual right to locate and operate the drilling operations upon the proposed drilling site. A person shall not be issued a permit unless that person prima facie holds an ownership or contractual right to drill to the proposed depth, or proposed horizon. Proof of prima facie ownership shall be presented to the ((~~committee~~)) department.

Sec. 1122. RCW 78.52.125 and 1971 ex.s. c 180 s 8 are each amended to read as follows:

Any person desiring or proposing to drill any well in search of oil or gas, when such drilling would be conducted through or under any surface waters of the state, shall prepare and submit an environmental impact statement upon such form as the department of ecology shall prescribe at least one hundred and twenty days prior to commencing the drilling of any such well. Within ninety days after receipt of such environmental statement the department of ecology shall prepare and submit to ((~~each member of the committee~~)) the department of natural resources a report examining the potential environmental impact of the proposed well and recommendations for ((~~committee~~)) department action thereon. If after consideration of the report the ((~~committee~~)) department determines that the proposed well is likely to have a substantial environmental impact the drilling permit for such well may be denied.

The ((~~committee~~)) department shall require sufficient safeguards to minimize the hazards of pollution of all surface and ground waters of the state. If safeguards acceptable to the ((~~committee~~)) department cannot be provided the drilling permit shall be denied.

Sec. 1123. RCW 78.52.140 and 1951 c 146 s 16 are each amended to read as follows:

The use of gas from a well producing gas only, or from a well which is primarily a gas well, for the manufacture of carbon black or similar products predominantly carbon, is declared to constitute waste prima facie, and such gas well shall not be used for any such purpose unless it is clearly shown, at a public hearing to be held by the ((~~committee~~)) department, on application of the person desiring to use such gas, that waste would not take place by the use of such gas for the purpose or purposes applied for, and that gas which would otherwise be lost is not available for such purpose or purposes, and that the gas to be used cannot be used for a more beneficial purpose, such as for light or fuel purposes, except at prohibitive cost, and that it would be in the public interest to grant such permit. If the ((~~committee~~)) department finds that the applicant has clearly shown a right to use such gas for the purpose or purposes applied for, it shall issue a permit upon such terms and conditions as may be found necessary in order to permit the use of the gas, and at the same time require compliance with the intent of this section.

Sec. 1124. RCW 78.52.150 and 1951 c 146 s 17 are each amended to read as follows:

The ((~~committee has authority, and it shall be its duty, to~~)) department shall make such investigations as it may deem proper to determine whether waste exists or is imminent or whether other facts exist which justify action by the ((~~committee~~)) department.

Sec. 1125. RCW 78.52.155 and 1983 c 253 s 9 are each amended to read as follows:

(1) The ((~~committee~~)) department shall make investigations as necessary to carry out this chapter.

(2) The ((~~committee and the~~)) department((~~, consistent with the committee's policies,~~)) shall require:

(a) Identification of ownership of oil or gas wells, producing leases, tanks, plants, structures, and facilities for the transportation or refining of oil or gas;

(b) The making and filing of well logs, core samples, directional surveys, and reports on well locations, drilling, and production;

(d) The drilling, casing, operating, and plugging of wells in such a manner as to prevent the escape of oil or gas out of the casings, or out of one pool into another, the intrusion of water into an oil or gas pool, and the pollution of freshwater supplies by oil, gas, or saltwater and to prevent blowouts, cavings, seepages, and fires;

(e) The furnishing of adequate security acceptable to the department, conditioned on the performance of the duty to plug each dry or abandoned well, the duty to reclaim and clean-up well drilling sites, the duty to repair wells causing waste, the duty to comply with all applicable laws and rules adopted by the ((~~committee~~)) department, orders of the ((~~committee and the~~)) department, all permit conditions, and this chapter;

(f) The operation of wells with efficient gas-oil and water-oil ratios and may fix these ratios and limit production from wells with inefficient gas-oil or water-oil ratios;

(g) The production of oil and gas from wells be accurately measured by means and upon standards prescribed by the ((~~committee~~)) department, and that every person who produces, sells, purchases, acquires, stores, transports, treats, or processes oil or gas in this state keeps and maintains for a period of five years within this state complete and accurate records thereof, which records shall be available for examination by the ((~~committee~~)) department or its agents at all reasonable times, and that every person file with the ((~~committee~~)) department such reports as it may prescribe with respect to the oil or gas; and

(h) Compliance with all applicable laws and rules of this state.

(3) The ((~~committee and the department, consistent with the committee's policies,~~)) department shall regulate:

(a) The drilling, producing, locating, spacing, and plugging of wells and all other operations for the production of oil or gas;

(b) The physical, mechanical, and chemical treatment of wells, and the perforation of wells;

(c) Operations to increase ultimate recovery such as cycling of gas, the maintenance of pressure, and the introduction of gas, water, or other substances into producing formations;

(d) Disposal of saltwater and oil field brines;

(e) The storage, processing, and treatment of natural gas and oil produced within this state; and

(f) Reclamation and clean-up of all well sites and any areas directly affected by the drilling, production, operation, and plugging of oil and gas wells.

(4) The ((~~committee~~)) department may limit and prorate oil and gas produced in this state and may restrict future production of oil and gas from any pool in such amounts as will offset and compensate for any production determined by the ((~~committee~~)) department to be in excess of or in violation of "oil allowable" or "gas allowable."

(5) The ((~~committee~~)) department shall classify wells as oil or gas wells for purposes material to the interpretation or enforcement of this chapter.

(6) The ((~~committee and the department, consistent with the committee's policies,~~)) department shall regulate oil and gas exploration and drilling activities so as to prevent or remedy unreasonable or excessive waste or surface destruction.

Sec. 1126. RCW 78.52.200 and 1983 c 253 s 12 are each amended to read as follows:

When necessary to prevent waste, to avoid the drilling of unnecessary wells, or to protect correlative rights including those of royalty owners, the ((~~committee~~)) department, upon its own motion or upon application of interested persons, shall establish development units covering any known pool. Development units shall be of uniform size and shape for the entire pool unless the ((~~committee~~)) department finds that it must make an exception due to geologic, geographic, or other factors. When necessary, the ((~~committee~~)) department may divide any pool into zones and establish development units for each zone, which units may differ in size and shape from those established in any other zone.

Sec. 1127. RCW 78.52.205 and 1983 c 253 s 13 are each amended to read as follows:

Within sixty days after the discovery of oil or gas in a pool not then covered by an order of the ((~~committee~~)) department, a hearing shall be held and the ((~~committee~~)) department shall issue an order prescribing development units for the pool. If sufficient geological or other scientific data from drilling operations or other evidence is not available to determine the maximum area that can be efficiently and economically drained by one well, the ((~~committee~~)) department may establish temporary development units to ensure the orderly development of the pool pending availability of the necessary data. A temporary order shall continue in force for a period of not more than twenty-four months at the expiration of which time, or upon the petition of an affected person, the ((~~committee~~)) department shall require the presentation of such geological, scientific, drilling, or other evidence as will enable it to determine the proper development units in the pool. During the interim period between the discovery and the issuance of the temporary order, permits shall not be issued for the drilling of direct offsets to a discovery well.

Sec. 1128. RCW 78.52.210 and 1983 c 253 s 14 are each amended to read as follows:

(1) The size and the shape of any development units shall be such as will result in the efficient and economical development of the pool as a whole, and the size shall not be smaller than the maximum area that can be efficiently and economically drained by one well as determined by competent geological, geophysical, engineering, drilling, or other scientific testimony, data, and evidence. The ((~~committee~~)) department shall fix a development unit of not more than one hundred sixty acres for any pool deemed by the ((~~committee~~)) department to be an oil reservoir, or of six hundred forty acres for any pool deemed by the ((~~committee~~)) department to be a gas reservoir, plus a ten percent tolerance in either case to allow for irregular sections. The ((~~committee~~)) department may, at its discretion, after notice and hearing, establish development units for oil and gas in variance of these limitations when competent geological, geophysical, engineering, drilling, or other scientific testimony, data, and evidence is presented and upon a finding that one well can efficiently and economically drain a larger or smaller area and is justified because of technical, economic, environmental, or safety considerations.

(2) The ((~~committee~~)) department may establish development units of different sizes or shapes for different parts of a pool or may grant exceptions to the size or shapes of any development unit or units. Where development units of different sizes or shapes exist in a pool, the ((~~committee~~)) department shall, if necessary, make such adjustments to the allowable production from the well or wells drilled thereon so that each operator in each development unit will have a reasonable opportunity to produce or receive his or her just and equitable share of the production.

Sec. 1129. RCW 78.52.220 and 1983 c 253 s 15 are each amended to read as follows:

An order establishing development units for a pool shall specify the size and shape of each area and the location of the permitted well thereon in accordance with a reasonable uniform spacing plan. Upon application and after notice and a hearing, if the ((~~committee~~)) department finds that a well drilled at the prescribed location would not produce in paying quantities, or that surface conditions would substantially add to the burden or hazard of drilling such well, the ((~~committee is authorized to~~)) department may enter an order permitting the well to be drilled pursuant to permit at a location other than that prescribed by such development order; however, the ((~~committee~~)) department shall include in the order suitable provisions to prevent the production from the development unit of more than its just and equitable share of the oil and gas in the pool.

Sec. 1130. RCW 78.52.230 and 1983 c 253 s 16 are each amended to read as follows:

An order establishing development units for a pool shall cover all lands determined or believed to be underlaid by such pool, and may be modified by the ((~~committee~~)) department from time to time to include additional areas determined to be underlaid by such pool. When the ((~~committee~~)) department determines that it is necessary for the prevention of waste, or to avoid the drilling of unnecessary wells, or to protect correlative rights, an order establishing development units in a pool may be modified by the ((~~committee~~)) department to increase or decrease the size of development units in the pool or to permit the drilling of additional wells on a reasonably uniform plan in the pool.

Sec. 1131. RCW 78.52.240 and 1983 c 253 s 17 are each amended to read as follows:

When two or more separately-owned tracts are embraced within a development unit, or when there are separately owned interests in all or a part of the development unit, then the owners and lessees thereof may pool their interests for the development and operation of the development unit. In the absence of this voluntary pooling, the ((~~committee~~)) department, upon the application of any interested person, shall enter an order pooling all interests, including royalty interests, in the development unit for the development and operation thereof. Each such pooling order shall be made after notice and hearing. The applicant or applicants shall have the burden of proving that all reasonable efforts have been made to obtain the consent of, or to reach agreement with, other owners.

Sec. 1132. RCW 78.52.245 and 1983 c 253 s 18 are each amended to read as follows:

A pooling order shall be upon terms and conditions that are fair and reasonable and that afford to each owner and royalty owner his or her fair and reasonable share of production. Production shall be allocated as follows:

(1) For the purpose of determining the portions of production owned by the persons owning interests in the pooled unit, the production shall be allocated to the respective tracts within the unit in the proportion that the surface acres in each tract bear to the number of surface acres included in the entire unit.

(2) Notwithstanding subsection (1) of this section, if the ((~~committee~~)) department finds that allocation on a surface acreage basis does not allocate to each tract its fair share, the ((~~committee~~)) department shall allocate the production so that each tract will receive its fair share.

Sec. 1133. RCW 78.52.250 and 1983 c 253 s 19 are each amended to read as follows:

(1) Each such pooling order shall make provision for the drilling and operation of a well on the development unit, and for the payment of the reasonable actual cost thereof by the owners of interests required to pay such costs in the development unit, plus a reasonable charge for supervision and storage facilities. Costs associated with production from the pooled unit shall be allocated in the same manner as is production in RCW 78.52.245. In the event of any dispute as to such costs the ((~~committee~~)) department shall determine the proper costs.

(2) As to each owner who fails or refuses to agree to bear his or her proportionate share of the costs of the drilling and operation of the well, the order shall provide for reimbursement of those persons paying for the drilling and operation of the well of the nonconsenting owner's share of the costs from, and only from, production from the unit representing that person's interest, excluding royalty or other interests not obligated to pay any part of the cost thereof. The ((~~committee~~)) department may provide that the consenting owners shall own and be entitled to receive all production from the well after payment of the royalty as provided in the lease, if any, applicable to each tract or interest, and obligations payable from production, until the consenting owners have been paid the amount due under the terms of the pooling order or order settling any dispute.

The order shall determine the interest of each owner in the unit and shall provide that each consenting owner is entitled to receive, subject to royalty or similar obligations, the share of the production of the well applicable to the owner's interest in the unit, and, unless the owner has agreed otherwise, his or her proportionate part of the nonconsenting owner's share of the production until costs are recovered as provided in this subsection. Each nonconsenting owner is entitled to receive, subject to royalty or similar obligations, the share of production from the well applicable to the owner's interest in the unit after the consenting owners have recovered from the nonconsenting owner's share of production the following:

(a) In respect to every such well, one hundred percent of the nonconsenting owner's share of the cost of surface equipment beyond the wellhead connections, including but not limited to, stock tanks, separators, treaters, pumping equipment, and piping, plus one hundred percent of the nonconsenting owner's share of the cost of operation of the well, commencing with first production and continuing until the consenting owners have recovered these costs, with the intent that the nonconsenting owner's share of these costs and equipment will be that interest which would have been chargeable to the nonconsenting owner had he or she initially agreed to pay his or her share of the costs of the well from the beginning of the operation;

(b) One hundred fifty percent of that portion of the costs and expenses of staking the location, well site preparation, rights of way, rigging-up, drilling, reworking, deepening or plugging back, testing, and completing, after deducting any cash contributions received by the consenting owners, and also one hundred fifty percent of that portion of the cost of equipment in the well, up to and including the wellhead connections; and

(c) If there is a dispute regarding the costs, the ((~~committee~~)) department shall determine the proper costs and their allocation among working interest owners after due notice to interested parties and a hearing on the costs.

(3) The operator of a well under a pooling order in which there are nonconsenting owners shall furnish the nonconsenting owners with monthly statements of all costs incurred, together with the quantity of oil or gas produced, and the amount of proceeds realized from the sale of this production during the preceding month. If and when the consenting owners recover from a nonconsenting owner's relinquished interest the amounts provided for in subsection (2) of this section, the relinquished interest of the nonconsenting owner shall automatically revert to him or her, and the nonconsenting owner shall own the same interest in the well and the production from it and be liable for the further costs of the operation as if he or she had participated in the initial drilling and operation.

(4) A nonconsenting owner of a tract in a development unit which is not subject to any lease or other contract for the development thereof for oil and gas shall elect within fifteen days of the issuance of the pooling order or such further time as the ((~~committee~~)) department shall, in the order, allow:

(a) To be treated as a nonconsenting owner as provided in subsections (2) and (3) of this section and is deemed to have a basic landowners' royalty of one-eighth, or twelve and one-half percent, of the production allocated to the tract, unless a higher basic royalty has been established in the development unit. If a higher royalty has been established, then the nonconsenting owner of a nonleased tract shall receive the higher basic royalty. This presumed royalty shall exist only during the time that costs and expenses are being recovered under subsection (2) of this section, and is intended to assure that the owner of a nonleased tract receive a basic royalty free of all costs at all times. Notwithstanding anything herein to the contrary, the owner shall at all times retain his or her entire ownership of the property, including the right to execute an oil and gas lease on any terms negotiated, and be entitled to all production subject to subsection (2) of this section; or

(b) To grant a lease to the operator at the current fair market value for that interest for comparable leases or interests at the time of the commencement of drilling; or

(c) To pay his or her pro rata share of the costs of the well or wells in the development unit and receive his or her pro rata share of production, if any.

A nonconsenting owner who does not make an election as provided in this subsection is deemed to have elected to be treated under (a) of this subsection.

Sec. 1134. RCW 78.52.257 and 1983 c 253 s 22 are each amended to read as follows:

(1) An order pooling a development unit shall automatically dissolve:

(a) One year after its effective date if there has been no production of commercial quantities or drilling operations on lands within the unit;

(b) Six months after completion of a dry hole on the unit; or

(c) Six months after cessation of production of commercial quantities from the unit, unless, prior to the expiration of such six-month period, the operator shall, in good faith, commence drilling or reworking operations in an effort to restore production.

(2) Upon the termination of a lease pooled by order of the ((~~committee~~)) department under authority granted in this chapter, interests covered by the lease are considered pooled as unleased mineral interests.

(3) Any party to a pooling order is entitled, after due notice to all parties, to a hearing to modify or terminate a previously entered pooling order upon presenting new evidence showing that the previous determination of reservoir conclusions are substantially incorrect.

(4) The ((~~committee, in its discretion~~)) department, after notice and hearing, may grant additional time, for good cause shown, before a pooling order is automatically dissolved as provided in subsection (1) of this section. In no case may such an extension be longer than six months.

Sec. 1135. RCW 78.52.260 and 1951 c 146 s 28 are each amended to read as follows:

Whenever the ((~~committee shall~~)) department requires the making and filing of well logs, directional surveys, or reports on the drilling of, subsurface conditions found in, or reports with respect to the substance produced, or capable of being produced from, a "wildcat" or "exploratory" well, as those terms are used in the petroleum industry, such logs, surveys, reports, or information shall be kept confidential by the ((~~committee~~)) department for a period of one year, if at the time of filing such logs, surveys, reports, or other information, the owner, lessee, or operator of such well requests that such information be kept confidential: PROVIDED, HOWEVER, That the ((~~committee shall have the right to~~)) department may divulge or use such information in a public hearing or suit when it is necessary for the enforcement of the provisions of this chapter or any rule, regulation, or order made hereunder.

Sec. 1136. RCW 78.52.270 and 1951 c 146 s 29 are each amended to read as follows:

Whenever the total amount of oil which all of the pools in this state can currently produce in accordance with good operating practices, exceeds the amount reasonably required to meet the reasonable market demand, the ((~~committee~~)) department shall limit the oil which may be currently produced in this state to an amount, designated the "oil allowable(("))." The ((~~committee~~)) department shall then prorate this "oil allowable" among the pools on a reasonable basis, avoiding undue discrimination among the pools, and so that waste will be prevented. In determining the "oil allowable(("))," and in prorating such "oil allowable" among the pools in the state, the ((~~committee~~)) department shall take into account the producing conditions and other relevant facts with respect to such pools, including the separate needs for oil and gas, and separate needs for oil of particular kinds or qualities, and shall formulate rules setting forth standards or a program for the determination of the "oil allowable(("))," and shall prorate the "oil allowable" in accordance with such standards or program, and where conditions in one pool or area are substantially similar to those in another pool or area, then the same standards or program shall be applied to such pools or areas so that as far as practicable a uniform program will be followed: PROVIDED, HOWEVER, That if the amount prorated to a pool as its share of the "oil allowable" is in excess of the amount which the pool can efficiently produce currently, then the ((~~committee~~)) department shall prorate to such pool the maximum amount which can be efficiently produced currently without waste.

Sec. 1137. RCW 78.52.280 and 1951 c 146 s 30 are each amended to read as follows:

The ((~~committee~~)) department shall not be required to determine the reasonable market demand applicable to any single pool of oil except in relation to all pools producing oil of similar kind and quality and in relation to the reasonable market demand. The ((~~committee~~)) department shall prorate the "allowable" in such manner as will prevent undue discrimination against any pool or area in favor of another or others resulting from selective buying or nomination by purchasers.

Sec. 1138. RCW 78.52.290 and 1951 c 146 s 31 are each amended to read as follows:

Whenever the total amount of gas which all of the pools in this state can currently produce in accordance with good operating practice exceeds the amount reasonably required to meet the reasonable market demand, the ((~~committee~~)) department shall limit the gas which may be currently produced to an amount, designated as the "gas allowable(("))," which will not exceed the reasonable market demand for gas. The ((~~committee~~)) department shall then prorate the "gas allowable" among the pools on a reasonable basis, avoiding undue discrimination among the pools, and so that waste will be prevented, giving due consideration to location of pipe lines, cost of interconnecting such pipe lines, and other pertinent factors, and insofar as applicable, the provisions of RCW 78.52.270 shall be followed in determining the "gas allowable" and in prorating such "gas allowable" among the pools therein: PROVIDED, HOWEVER, That in determining the reasonable market demand for gas as between pools, the ((~~committee~~)) department shall give due regard to the fact that gas produced from oil pools is to be regulated in a manner which will protect the reasonable use of gas energy for oil production and promote the most or maximum efficient recovery of oil from such pools.

Sec. 1139. RCW 78.52.300 and 1951 c 146 s 32 are each amended to read as follows:

Whenever the total amount of gas which may be currently produced from all of the pools in this state has not been limited as hereinabove provided, and the available production from any one pool containing gas only is in excess of the reasonable market demand or available transportation facilities for gas from such pool, the ((~~committee~~)) department shall limit the production of gas from such pool to that amount which does not exceed the reasonable market demand or transportation facilities for gas from such pool.

Sec. 1140. RCW 78.52.310 and 1951 c 146 s 33 are each amended to read as follows:

Whenever the ((~~committee~~)) department limits the total amount of oil or gas which may be produced from any pool to an amount less than that which the pool could produce if no restrictions were imposed (whether incidental to, or without, a limitation of the total amount of oil which may be produced in the state) the ((~~committee~~)) department shall prorate the allowable production for the pool among the producers in the pool on a reasonable basis, so that each producer will have opportunity to produce or receive his or her just and equitable share, subject to the reasonable necessities for the prevention of waste, giving where reasonable, under the circumstances, to each pool with small wells of settled production, allowable production which prevents the premature abandonment of wells in the pool.

All orders establishing the "oil allowable" and "gas allowable" for this state, and all orders prorating such allowables as herein provided, and any changes thereof, for any month or period shall be issued by the ((~~committee~~)) department on or before the fifteenth day of the month preceding the month for which such orders are to be effective, and such orders shall be immediately published in some newspaper of general circulation printed in Olympia, Washington. No orders establishing such allowables, or prorating such allowables, or any changes thereof, shall be issued without first having a hearing, after notice, as provided in this chapter: PROVIDED, HOWEVER, When in the judgment of the ((~~committee~~)) department, an emergency requiring immediate action is found to exist, the ((~~committee is authorized to~~)) department may issue an emergency order under this section which shall have the same effect and validity as if a hearing with respect to the same had been held after due notice. The emergency order permitted by this ((~~subsection~~)) section shall remain in force no longer than thirty days, and in any event it shall expire when the order made after due notice and hearing with respect to the subject matter of the emergency order becomes effective.

Sec. 1141. RCW 78.52.320 and 1951 c 146 s 34 are each amended to read as follows:

Whenever the production of oil or gas in this state or any pool therein is limited and the "oil allowable" or "gas allowable" is established and prorated by the ((~~committee~~)) department as provided in RCW 78.52.310, no person shall thereafter produce from any well, pool, lease, or property more than the production which is prorated thereto.

Sec. 1142. RCW 78.52.330 and 1951 c 146 s 35 are each amended to read as follows:

To assist in the development of oil and gas in this state and to further the purposes of this chapter, the persons owning interests in separate tracts of land, may validly agree to integrate their interests and manage, operate, and develop their land as a unit, subject to the approval of the ((~~committee~~)) department.

Sec. 1143. RCW 78.52.335 and 1983 c 253 s 23 are each amended to read as follows:

(1) The ((~~committee~~)) department shall upon the application of any interested person, or upon its own motion, hold a hearing to consider the need for the operation as a unit of one or more pools or parts of them in a field.

(2) The ((~~committee shall have the authority to~~)) department may enter an order providing for the unit operations if ((~~the committee~~)) it finds that:

(a) The unit operations are necessary for secondary recovery or enhanced recovery purposes. For purposes of this chapter secondary or enhanced recovery means that oil or gas or both are recovered by any method, artificial flowing or pumping, that may be employed to produce oil or gas, or both, through the joint use of two or more wells with an application of energy extrinsic to the pool or pools. This includes pressuring, cycling, pressure maintenance, or injections into the pool or pools of a substance or form of energy: PROVIDED, That this does not include the injection in a well of a substance or form of energy for the sole purpose of (i) aiding in the lifting of fluids in the well, or (ii) stimulation of the reservoir at or near the well by mechanical, chemical, thermal, or explosive means;

(b) The unit operations will protect correlative rights;

(c) The operations will increase the ultimate recovery of oil or gas, or will prevent waste, or will prevent the drilling of unnecessary wells; and

(d) The value of the estimated additional recovery of oil and/or gas exceeds the estimated additional cost incident to conducting these operations.

(3) The ((~~committee shall also have the authority to~~)) department may also enter an order providing for unit operations, after notice and hearing, only if the ((~~committee~~)) department finds that there is clear and convincing evidence that all of the following conditions are met:

(a) In the absence of unitization, the ultimate recovery of oil or gas, or both, will be substantially decreased because normal production techniques and methods are not feasible and will not result in the maximum efficient and economic recovery of oil or gas, or both;

(b) The unit operations will protect correlative rights;

(d) There has been a discovery of a commercial oil or gas field; and

(e) There has been sufficient exploration, drilling activity, and development to properly define the one or more pools or parts of them in a field proposed to be unitized.

(4) Notwithstanding any of the above, nothing in this chapter may be construed to prevent the voluntary agreement of all interested persons to any plan of unit operations. The ((~~committee~~)) department shall approve operations upon making a finding consistent with subsection((s)) (2) (b) and (c) of this section.

(5) The order shall be upon terms and conditions that are fair and reasonable and shall prescribe a plan for unit operations that includes:

(a) A description of the pool or pools or parts thereof to be so operated, termed the unitized area;

(b) A statement of the nature of the operations contemplated;

(c) An allocation of production and costs to the separately-owned tracts in the unitized area. The allocation shall be in accord with the agreement, if any, of the interested parties. If there is no agreement, production shall be allocated in a manner calculated to ensure that each owner's correlative rights are protected, and each separately-owned tract or combination of tracts receives its fair and reasonable share of production. Costs shall be allocated on a fair and reasonable basis;

(d) A provision, if necessary, prescribing fair, reasonable, and equitable terms and conditions as to time and rate of interest for carrying or otherwise financing any person who is unable to promptly meet his or her financial obligations in connection with the unit, such carrying and interest charges to be paid as provided by the ((~~committee~~)) department from the person's prorated share of production;

(e) A provision for the supervision and conduct of the unit operations, in respect to which each owner shall have a vote with a value corresponding to the percentage of the costs of unit operations chargeable against the owner's interest;

(f) The time when the unit operations shall commence, the timetable for development, and the manner and circumstances under which the unit operations shall terminate; and

(g) Additional provisions which are found to be appropriate for carrying out the unit operations and for the protection of correlative rights.

(6) No order of the ((~~committee~~)) department providing for unit operations may become effective until:

(a) The plan for unit operations approved by the ((~~committee~~)) department has been approved in writing by those persons who, under the ((~~committee's~~)) department's order, will be required to pay at least seventy-five percent of the costs of unit operations;

(b) The plan has been approved in writing by those persons such as royalty owners, overriding royalty owners, and production payment owners, who own at least seventy-five percent of the production or proceeds thereof that will be credited to interests that are free of costs; and

(c) The ((~~committee~~)) department has made a finding, either in the order providing for unit operations or in a supplemental order, that the plan for unit operations has been so approved. If the plan for unit operations has not been so approved at the time the order providing for unit operations is made, the ((~~committee~~)) department shall upon application and notice hold such supplemental hearings as may be required to determine if and when the plan for unit operations has been so approved. If the persons owning required percentages of interest in the unitized area do not approve the plan for unit operations within a period of six months from the date on which the order providing for unit operations is made, or within such additional period or periods of time as the ((~~committee~~)) department prescribes, the order will become unenforceable and shall be vacated by the ((~~committee~~)) department.

(7) An order providing for unit operations may be amended by an order made by the ((~~committee~~)) department in the same manner and subject to the same conditions as an original order, except as provided in subsection (8) of this section, providing for unit operations, but (a) if such an amendment affects only the rights and interests of the owners, the approval of the amendment by those persons who own interests that are free of costs is not required, and (b) no such amending order may change the percentage for the allocation of oil and gas as established for any separately-owned tract or combination of tracts by the original order, except with the consent of all persons owning oil and gas rights in the tract, and no such order may change the percentage for the allocation of cost as established for any separately-owned tract or combination of tracts by the original order, except with the consent of all persons owning an interest in the tract or combination of tracts. An amendment that provides for the expansion of the unit area shall comply with subsection (8) of this section.

(8) The ((~~committee~~)) department, by order, may provide for the unit operation of a reservoir or reservoirs or parts thereof that include a unitized area established by a previous order of the ((~~committee~~)) department. The order, in providing for the allocation of unit production, shall first treat the unitized area previously established as a single tract and the portion of the new unit production allocated thereto shall then be allocated among the separately-owned tracts included in the previously established unit area in the same proportions as those specified in the previous order.

(9) After the date designated by the ((~~committee~~)) department the unit plan shall be effective, oil and gas leases within the unit area, or other contracts pertaining to the development thereof, shall be changed only to the extent necessary to meet the requirements of the unit plan, and otherwise shall remain in full force. Operations carried on under and in accordance with the unit plan shall be regarded and considered as fulfillment of and compliance with all of the provisions, covenants, and conditions, expressed or implied, of the several oil and gas leases upon lands within the unit area, or other contracts pertaining to the development thereof, insofar as the leases or other contracts may relate to the pool or field subject to the unit plan. The amount of production apportioned and allocated under the unit plan to each separately-owned tract within the unit area, and only that amount, regardless of the location of the well within the unit area from which it may be produced, and regardless of whether it is more or less than the amount of production from the well, if any, on each separately-owned tract, shall for all purposes be regarded as production from the separately-owned tract. Lessees shall not be obligated to pay royalties or make other payments, required by the oil and gas leases or other contracts affecting each such separately-owned tract, on production in excess of that amount apportioned and allocated to the separately-owned tract under the unit plan.

(10) The portion of the unit production allocated to any tract and the proceeds from its sale are the property and income of the several persons to whom, or to whose credit, the portion and proceeds are allocated or payable under the order providing for unit operations.

(11) No division order or other contract relating to the sale, purchase, or production from a separately-owned tract or combination of tracts may be terminated by the order providing for unit operations but shall remain in force and shall apply to oil and gas allocated to the tract until terminated by an amended division order or contract in accordance with the order.

(12) Except to the extent that parties affected so agree, an order providing for unit operations shall not be construed to result in a transfer of all or any part of the title of any person to the oil and gas rights in any tract in the unit area. All property, whether real or personal, that may be acquired in the conduct of unit operations hereunder shall be acquired for the account of the owners within the unit area, and shall be the property of those owners in the proportion that the expenses of unit operations are charged.

(13) After the date designated by the order of the ((~~committee~~)) department that a unit plan shall become effective, the designation of one or more unit operators shall be by vote of the lessees of land in the unit area, in a manner to be provided in the unit plan, and any operations in conflict with such unit plan shall be unlawful and are prohibited.

(14) A certified copy of any order of the ((~~committee~~)) department entered under this section is entitled to be recorded in the auditor's office in the county or counties wherein all or any portion of the unit area is located and, if recorded, constitute notice thereof to all persons. A copy of this order shall be mailed by certified mail to all interested persons.

(15) No order for unitization may be construed to allow the drilling of a well on a tract within the unit which is not leased or under contract for oil and gas exploration or production.

Sec. 1144. RCW 78.52.365 and 1983 c 253 s 26 are each amended to read as follows:

The ((~~committee~~)) department may administer and enforce RCW 78.52.345 and 78.52.355 in accordance with the procedures in this chapter for its enforcement and with the rules and orders of the ((~~committee~~)) department.

Sec. 1145. RCW 78.52.460 and 1951 c 146 s 49 are each amended to read as follows:

No plan for the operation of a field or pool of oil or gas as a unit, either whole or in part, created or approved by the ((~~committee hereunder shall~~)) department under this chapter may be held to violate any of the statutes of this state prohibiting monopolies or acts, arrangements, agreements, contracts, combinations, or conspiracies in restraint of trade or commerce.

Sec. 1146. RCW 78.52.463 and 1989 c 175 s 167 are each amended to read as follows:

(1) Any operation or activity that is in violation of applicable laws, rules, orders, or permit conditions is subject to suspension by order of the ((~~committee~~)) department. The order may suspend the operations authorized in the permit in whole or in part. The order may be issued only after the ((~~committee~~)) department has first notified the operator or owner of the violations and the operator or owner has failed to comply with the directions contained in the notification within ten days of service of the notice: PROVIDED, That the ((~~committee~~)) department may issue the suspension order immediately without notice if the violations are or may cause substantial harm to adjacent property, persons, or public resources, or has or may result in the pollution of waters in violation of any state or federal law or rule. A suspension shall remain in effect until the violations are corrected or other directives are complied with unless declared invalid by the ((~~committee~~)) department after hearing or an appeal. The suspension order and notification, where applicable, shall specify the violations and the actions required to be undertaken to be in compliance with such laws, rules, orders, or permit conditions. The order and notification may also require remedial actions to be undertaken to restore, prevent, or correct activities or conditions which have resulted from the violations. The order and notification may be directed to the operator or owner or both.

(2) The suspension order constitutes a final and binding order unless the owner or operator to whom the order is directed requests a hearing before the ((~~committee~~)) department within fifteen days after service of the order. Such a request shall not in itself stay or suspend the order and the operator or owner shall comply with the order immediately upon service. The ((~~committee or its chairman have the authority to~~)) department may stay or suspend in whole or in part the suspension order pending a hearing if so requested. The hearing shall constitute an adjudicative proceeding under chapter 34.05 RCW, the Administrative Procedure Act.

Sec. 1147. RCW 78.52.467 and 1983 c 253 s 30 are each amended to read as follows:

(1) The sale, purchase, acquisition, transportation, refining, processing, or handling of illegal oil, gas, or product is prohibited. However, no penalty by way of fine may be imposed upon a person who sells, purchases, acquires, transports, refines, processes, or handles illegal oil, gas, or product unless (a) the person knows, or is put on notice of, facts indicating that illegal oil, illegal gas, or illegal product is involved, or (b) the person fails to obtain a certificate of clearance with respect to the oil, gas, or product if prescribed by rule or order of the ((~~committee~~)) department, or fails to follow any other method prescribed by an order of the ((~~committee~~)) department for the identification of the oil, gas, or product.

(2) Illegal oil, illegal gas, and illegal product are declared to be contraband and are subject to seizure and sale as provided in this section. Seizure and sale shall be in addition to all other remedies and penalties provided in this chapter for violations relating to illegal oil, illegal gas, or illegal product. If the ((~~committee~~)) department believes that any oil, gas, or product is illegal, the ((~~committee~~)) department acting through the attorney general, shall bring a civil action in rem in the superior court of the county in which the oil, gas, or product is found, to seize and sell the same, or the ((~~committee~~)) department may include such an action in rem in any suit brought for an injunction or penalty involving illegal oil, illegal gas, or illegal product. A person claiming an interest in oil, gas, or product affected by an action in rem has the right to intervene as an interested party.

(3) Actions for the seizure and sale of illegal oil, illegal gas, or illegal product shall be strictly in rem and shall proceed in the name of the state as plaintiff against the oil, gas, or product as defendant. No bond or similar undertaking may be required of the plaintiff. Upon the filing of the petition for seizure and sale, the clerk of the court shall issue a summons, with a copy of the petition attached thereto, directed to the sheriff of the county or to another officer or person whom the court may designate, for service upon all persons having or claiming any interest in the oil, gas, or product described in the petition. The summons shall command these persons to appear and answer within twenty days after the issuance and service of the summons. These persons need not be named or otherwise identified in the summons, and the summons shall be served by posting a copy of the summons, with a copy of the petition attached, on any public bulletin board or at the courthouse of a county where the oil, gas, or product involved is located, and by posting another copy at or near the place where the oil, gas, or product is located. The posting constitutes notice of the action to all persons having or claiming any interest in the oil, gas, or product described in the petition. In addition, if the court, on a properly verified petition, or affidavit or affidavits, or oral testimony, finds that grounds for seizure and for sale exist, the court shall issue an immediate order of seizure, describing the oil, gas, or product to be seized, and directing the sheriff of the county to take the oil, gas, or product into the sheriff's actual or constructive custody and to hold the same subject to further orders of the court. The court, in the order of seizure, may direct the sheriff to deliver the oil, gas, or product seized by him or her under the order to a court-appointed agent. The agent shall give bond in an amount and with such surety as the court may direct, conditioned upon compliance with the orders of the court concerning the custody and disposition of the oil, gas, or product.

(4) Any person having an interest in oil, gas, or product described in order of seizure and contesting the right of the state to seize and sell the oil, gas, or product may obtain its release prior to sale upon furnishing to the sheriff a bond approved by the court. The bond shall be in an amount equal to one hundred fifty percent of the market value of the oil, gas, or product to be released and shall be conditioned upon either redelivery to the sheriff of the released commodity or payment to the sheriff of its market value, if and when ordered by the court, and upon full compliance with further orders of the court.

(5) If the court, after a hearing upon a petition for the seizure and sale of oil, gas, or product, finds that the oil, gas, or product is contraband, the court shall order its sale by the sheriff in the same manner and upon the same notice of sale as provided by law for the sale of personal property on execution of judgment entered in a civil action, except that the court may order that the oil, gas, or product be sold in specified lots or portions and at specified intervals. Upon sale, title to the oil, gas, or product sold shall vest in the purchaser free of all claims, and it shall be legal oil, legal gas, or legal product in the hands of the purchaser.

(6) All proceeds, less costs of suit and expenses of sale, which are derived from the sale of illegal oil, illegal gas, or illegal product, and all amounts paid as penalties provided for by this chapter, shall be paid into the state treasury for the use of the ((~~committee~~)) department in defraying its expenses in the same manner as other funds provided by law for the use of the ((~~committee~~)) department.

Sec. 1148. RCW 78.52.470 and 1989 c 175 s 168 are each amended to read as follows:

Any person adversely affected by any order of the ((~~committee~~)) department may, within thirty days from the effective date of such order, apply for a hearing with respect to any matter determined therein. No cause for action arising out of any order of the ((~~committee shall~~)) department accrues in any court to any person unless the person makes application for a hearing as ((~~herein~~)) provided in this section. Such application shall set forth specifically the ground on which the applicant considers the order to be unlawful or unreasonable. No party shall, in any court, urge or rely upon any ground not set forth in said application. An order made in conformity to a decision resulting from a hearing which abrogates, changes, or modifies the original order shall have the same force and effect as an original. Such hearing shall constitute an adjudicative proceeding under chapter 34.05 RCW, the Administrative Procedure Act, and shall be conducted in accordance with its provisions.

Sec. 1149. RCW 78.52.480 and 1983 c 253 s 28 are each amended to read as follows:

In proceedings for review of an order or decision of the ((~~committee~~)) department, the ((~~committee~~)) department shall be a party to the proceedings and shall have all rights and privileges granted by this chapter to any other party to such proceedings.

Sec. 1150. RCW 78.52.490 and 1983 c 253 s 32 are each amended to read as follows:

Within thirty days after the application for a hearing is denied, or if the application is granted, then within thirty days after the rendition of the decision on the hearing, the applicant may apply to the superior court, at the petitioner's option, for (a) Thurston county, (b) the county of petitioner's residence or place of business, or (c) in any county where the property or property rights owned by the petitioner is located for a review of such rule, regulation, order, or decision. The application for review shall be filed in the office of the clerk of the superior court of Thurston county and shall specifically state the grounds for review upon which the applicant relies and shall designate the rule, regulation, order, or decision sought to be reviewed. The applicant shall immediately serve a certified copy of said application upon the ((~~executive secretary of the committee~~)) commissioner of public lands who shall immediately notify all parties who appeared in the proceedings before the ((~~committee~~)) department that such application for review has been filed. In the event the court determines the review is solely for the purpose of determining the validity of a rule or regulation of general applicability the court shall transfer venue to Thurston county for a review of such rule or regulation in the manner provided for in RCW ((~~34.05.538~~)) 34.05.570.

Sec. 1151. RCW 78.52.530 and 1951 c 146 s 56 are each amended to read as follows:

Whenever it shall appear that any person is violating any provisions of this chapter, or any rule, regulation, or order made by the ((~~committee hereunder~~)) department under this chapter, and if the ((~~committee~~)) department cannot, without litigation, effectively prevent further violation, the ((~~committee~~)) department may bring suit in the name of the state against such person in the superior court in the county of the residence of the defendant, or in the county of the residence of any defendant if there be more than one defendant, or in the county where the violation is alleged to have occurred, to restrain such person from continuing such violation. In such suit the ((~~committee~~)) department may without bond obtain injunctions prohibitory and mandatory, including temporary restraining orders and preliminary injunctions, as the facts may warrant.

Sec. 1152. RCW 78.52.540 and 1951 c 146 s 57 are each amended to read as follows:

((~~In the event the committee should~~)) If the department fails to bring suit within thirty days to enjoin any apparent violation of this chapter, or of any rule, regulation, or order made by the ((~~committee hereunder~~)) department under this chapter, then any person or party in interest adversely affected by such violation, who has requested the ((~~committee~~)) department in writing to sue, may, to prevent any or further violation, bring suit for that purpose in the superior court of any county where the ((~~committee~~)) department could have instituted such suit. If, in such suit, the court should hold that injunctive relief should be granted, then the state shall be made a party and shall be substituted for the person who brought the suit, and the injunction shall be issued as if the state had at all times been the complainant.

OIL SPILL CONTINGENCY PLAN CORPORATION

NEW SECTION. Sec. 1153. A new section is added to chapter 88.46 RCW to read as follows:

A nonprofit corporation that provides contingency plan coverage for any vessel in compliance with RCW 88.46.060 is entitled to liability protection as provided in this section. Obligations incurred by the corporation and any other liabilities or claims against the corporation may be enforced only against the assets of the corporation, and no liability for the debts or actions of the corporation exists against a director, officer, member, employee, incident commander, agent, contractor, or subcontractor of the corporation in his or her individual or representative capacity. Except as otherwise provided in this chapter, neither the directors, officers, members, employees, incident commander, or agents of the corporation, nor the business entities by whom they are regularly employed may be held individually responsible for discretionary decisions, errors in judgment, mistakes, or other acts, either of commission or omission, other than their own individual acts of dishonesty or crime. The corporation may insure and defend and indemnify the directors, officers, members, employees, incident commanders, and agents to the extent permitted by chapters 23B.08 and 24.03 RCW.

MARINE SAFETY COMMITTEES

NEW SECTION. Sec. 1154. A new section is added to chapter 88.46 RCW to read as follows:

The administrator may appoint ad hoc, advisory marine safety committees to solicit recommendations and technical advice concerning vessel traffic safety.

SCIENTIFIC ADVISORY BOARD FOR THE OIL SPILL COMPENSATION SCHEDULE

Sec. 1155. RCW 90.48.366 and 1992 c 73 s 28 are each amended to read as follows:

By July 1, 1991, the department, in consultation with the departments of fisheries, wildlife, and natural resources, and the parks and recreation commission, shall adopt rules establishing a compensation schedule for the discharge of oil in violation of this chapter and chapter 90.56 RCW. ((~~The department shall establish a scientific advisory board to assist in establishing the compensation schedule.~~)) The amount of compensation assessed under this schedule shall be no less than one dollar per gallon of oil spilled and no greater than fifty dollars per gallon of oil spilled. The compensation schedule shall reflect adequate compensation for unquantifiable damages or for damages not quantifiable at reasonable cost for any adverse environmental, recreational, aesthetic, or other effects caused by the spill and shall take into account:

(1) Characteristics of any oil spilled, such as toxicity, dispersibility, solubility, and persistence, that may affect the severity of the effects on the receiving environment, living organisms, and recreational and aesthetic resources;

(2) The sensitivity of the affected area as determined by such factors as: (a) The location of the spill; (b) habitat and living resource sensitivity; (c) seasonal distribution or sensitivity of living resources; (d) areas of recreational use or aesthetic importance; (e) the proximity of the spill to important habitats for birds, aquatic mammals, fish, or to species listed as threatened or endangered under state or federal law; (f) significant archaeological resources as determined by the office of archaeology and historic preservation; and (g) other areas of special ecological or recreational importance, as determined by the department. If the department has adopted rules for a compensation table prior to July 1, 1992, the sensitivity of significant archaeological resources shall only be included among factors to be used in the compensation table when the department revises the rules for the compensation table after July 1, 1992; and

(3) Actions taken by the party who spilled oil or any party liable for the spill that: (a) Demonstrate a recognition and affirmative acceptance of responsibility for the spill, such as the immediate removal of oil and the amount of oil removed from the environment; or (b) enhance or impede the detection of the spill, the determination of the quantity of oil spilled, or the extent of damage, including the unauthorized removal of evidence such as injured fish or wildlife.

TASK FORCE ON STATE-WIDE EVALUATION OF IRRIGATED AREAS

Sec. 1156. RCW 90.54.190 and 1989 c 348 s 11 are each amended to read as follows:

(1) ((The department of ecology may establish a task force to assist in a state-wide evaluation of irrigated areas, not to exceed six months in duration, to determine the associated impacts of efficiency measures, efficiency opportunities, and local interest.)) The department ((~~and the task force~~)) shall establish a list of basin and stream efficiency initiatives and select an irrigation area for a voluntary demonstration project.

(2) Prior to conducting conservation assessments and developing conservation plans, the department of ecology shall secure technical and financial assistance from the bureau of reclamation to reduce the costs to the state to the extent possible.

(3) A "conservation assessment" as described in this section shall be conducted before a demonstration project to increase the efficiency of irrigated agriculture is undertaken for an irrigated area, a basin, subbasin, or stream. The conservation assessment should:

(a) Evaluate existing patterns, including current reuse of return flows, and priorities of water use;

(b) Assess conflicting needs for future water allocations and claims to reserved rights;

(d) Assess alternative efficiency measures;

(e) Determine the likely net water savings of efficiency improvements including the amount and timing of water that would be saved and potential benefits and impacts to other water uses and resources including effects on artificial recharge of ground water and wetland impacts;

(f) Evaluate the full range of costs and benefits that would accrue from various measures; and

(g) Evaluate the potential for integrating conservation efforts with operation of existing or potential storage facilities.

(4) The conservation assessment shall be used as the basis for development of a demonstration conservation plan to rank conservation elements based on relative costs, benefits, and impacts. It shall also estimate the costs of implementing the plan and propose a specific basis for cost share distributions.

The demonstration conservation plan shall be developed jointly by the department and a conservation plan formulation committee consisting of representatives of a cross-section of affected local water users, members of the public, and tribal governments. Other public agencies with expertise in water resource management may participate as nonvoting committee members. A proposed demonstration conservation plan may be approved by the department and the committee only after public comment has been received.

(5) The department shall reimburse any members ((~~of the task force in subsection (2) [(1)] of this section or~~)) of the committee in subsection (4) of this section who are not representing governmental agencies or entities for their travel expenses in accordance with RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 1157. Broker's Trust Account Board. RCW 18.85.500 and 1987 c 513 s 8 are each repealed.

NEW SECTION. Sec. 1158. Washington State Heritage Council. The following acts or parts of acts are each repealed:

(1) RCW 27.34.030 and 1983 c 91 s 3;

(2) RCW 27.34.040 and 1993 c 101 s 11 & 1983 c 91 s 4; and

(3) RCW 27.34.050 and 1983 c 91 s 5.

NEW SECTION. Sec. 1159. Supply Management Advisory Board. RCW 43.19.1902 and 1979 c 151 s 97, 1975-'76 2nd ex.s. c 21 s 3, 1967 ex.s. c 104 s 3, & 1965 c 8 s 43.19.1902 are each repealed.

NEW SECTION. Sec. 1160. Motor Vehicle Advisory Committee. RCW 43.19.556 and 1989 c 57 s 4 are each repealed.

NEW SECTION. Sec. 1161. Ecological Commission. The following acts or parts of acts are each repealed:

(1) RCW 43.21A.170 and 1989 1st ex.s. c 9 s 217, 1988 c 36 s 15, 1985 c 466 s 50, 1979 c 141 s 68, & 1970 ex.s. c 62 s 17;

(2) RCW 43.21A.180 and 1984 c 287 s 76, 1975-'76 2nd ex.s. c 34 s 100, & 1970 ex.s. c 62 s 18;

(3) RCW 43.21A.190 and 1988 c 127 s 24 & 1970 ex.s. c 62 s 19;

(4) RCW 43.21A.200 and 1977 c 75 s 47 & 1970 ex.s. c 62 s 20; and

(5) RCW 43.21A.210 and 1970 ex.s. c 62 s 21.

NEW SECTION. Sec. 1162. Nuclear Waste Advisory Council. RCW 43.200.050 and 1989 c 322 s 4, 1984 c 161 s 6, & 1983 1st ex.s. c 19 s 5 are each repealed.

NEW SECTION. Sec. 1163. Athletic Health Care and Training Council. The following acts or parts of acts are each repealed:

(1) RCW 43.230.010 and 1990 c 33 s 583 & 1984 c 286 s 2;

(2) RCW 43.230.020 and 1984 c 286 s 3;

(3) RCW 43.230.030 and 1984 c 286 s 4;

(4) RCW 43.230.040 and 1984 c 286 s 5; and

(5) 1984 c 286 s 13 (uncodified).

NEW SECTION. Sec. 1164. Insurance Advisory Examining Board. RCW 48.17.135 and 1984 c 287 s 96, 1975-'76 2nd ex.s. c 34 s 142, & 1967 c 150 s 14 are each repealed.

NEW SECTION. Sec. 1165. Right-to-Know Advisory Council. The following acts or parts of acts are each repealed:

(1) RCW 49.70.120 and 1987 c 24 s 1, 1985 c 409 s 5, & 1984 c 289 s 17; and

(2) RCW 49.70.130 and 1984 c 289 s 18.

NEW SECTION. Sec. 1166. Winter Recreation Commission. The following acts or parts of acts are each repealed:

(1) RCW 67.34.011 and 1987 c 526 s 1; and

(2) RCW 67.34.021 and 1987 c 526 s 2.

NEW SECTION. Sec. 1167. Science Advisory Board. RCW 70.94.039 and 1991 c 199 s 314 are each repealed.

NEW SECTION. Sec. 1168. Korean War Veterans' Memorial Advisory Committee. The following acts or parts of acts are each repealed:

(1) RCW 73.40.020 and 1984 c 81 s 2; and

(2) RCW 73.40.050 and 1989 c 235 s 2.

NEW SECTION. Sec. 1169. Oil and Gas Conservation Committee. RCW 78.52.020 and 1988 c 128 s 49, 1983 c 253 s 31, 1971 ex.s. c 180 s 7, 1961 c 300 s 7, & 1951 c 146 s 4 are each repealed.

NEW SECTION. Sec. 1170. Washington State Maritime Commission. The following acts or parts of acts are each repealed, effective July 1, 1995:

(1) RCW 88.44.005 and 1990 c 117 s 1;

(2) RCW 88.44.010 and 1992 c 73 s 15, 1991 c 200 s 901, & 1990 c 117 s 2;

(3) RCW 88.44.020 and 1991 c 200 s 902 & 1990 c 117 s 3;

(4) RCW 88.44.030 and 1991 c 200 s 903 & 1990 c 117 s 4;

(5) RCW 88.44.040 and 1991 c 200 s 904 & 1990 c 117 s 5;

(6) RCW 88.44.080 and 1991 c 200 s 905 & 1990 c 117 s 9;

(7) RCW 88.44.090 and 1990 c 117 s 10;

(8) RCW 88.44.100 and 1992 c 73 s 16 & 1990 c 117 s 11;

(9) RCW 88.44.110 and 1992 c 73 s 17, 1991 c 200 s 906, & 1990 c 117 s 12;

(10) RCW 88.44.120 and 1990 c 117 s 13;

(11) RCW 88.44.130 and 1990 c 117 s 14;

(12) RCW 88.44.140 and 1990 c 117 s 15;

(13) RCW 88.44.150 and 1990 c 117 s 16;

(14) RCW 88.44.160 and 1991 c 200 s 907 & 1990 c 117 s 17;

(15) RCW 88.44.170 and 1990 c 117 s 18;

(16) RCW 88.44.180 and 1990 c 117 s 19;

(17) RCW 88.44.190 and 1990 c 117 s 20;

(18) RCW 88.44.200 and 1990 c 117 s 21;

(19) RCW 88.44.210 and 1990 c 117 s 22;

(20) RCW 88.44.220 and 1990 c 117 s 23;

(21) RCW 88.44.900 and 1990 c 117 s 24; and

(22) RCW 88.44.901 and 1990 c 117 s 25.

NEW SECTION. Sec. 1171. Regional Marine Safety Committees. RCW 88.46.110 and 1992 c 73 s 24 & 1991 c 200 s 424 are each repealed.

NEW SECTION. Sec. 1172. Marine Oversight Board. RCW 90.56.450 and 1992 c 73 s 40 & 1991 c 200 s 501 are each repealed.

NEW SECTION. Sec. 1173. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 1174. Headings and captions used in this act constitute no part of the law.

NEW SECTION. Sec. 1175. This act takes effect July 1, 1994.