Health care administrators

AN ACT Relating to licensure of health care administrators; 1
reenacting and amending RCW 18.130.040; and adding a new chapter to 2
Title 18 RCW. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. The definitions in this section apply 5
throughout this chapter unless the context clearly requires 6
otherwise.7
(1) "Department" means the department of health.8
(2) "Health care administrator" means a person employed by a 9
hospital who is a: 10
(a) Nonclinical hospital manager with direct supervisory 11
authority over clinical health care providers who is responsible for 12
one or more of the following activities: 13
(i) Hiring, scheduling, evaluating, and providing direct 14
supervision of clinical health care providers; 15
(ii) Monitoring activities for compliance with state or federal 16
regulatory requirements; or 17
(iii) Developing fiscal reports for clinical units or the 18
hospital as a whole; or 19
(b) Nonclinical hospital director, officer, or executive who does 20
not have direct supervisory authority over health care providers, but 21
H-0670.1
HOUSE BILL 1567
State of Washington 69th Legislature 2025 Regular Session
By Representatives Stonier, Fosse, Salahuddin, Macri, Mena, Berry,
Obras, Taylor, Reed, Stearns, Nance, Gregerson, Ortiz-Self, Hill,
Scott, Farivar, Peterson, Ryu, Parshley, Cortes, Simmons, Ormsby,
Doglio, and Pollet
Read first time 01/24/25. Referred to Committee on Health Care &
Wellness.
p. 1 HB 1567
has direct or indirect supervisory authority for nonclinical hospital 1
managers described in (a) of this subsection, for one or more of the 2
following activities: 3
(i) Hiring and supervising those nonclinical hospital managers in 4
(a) of this subsection; 5
(ii) Providing oversight of operations for the hospital or any of 6
its departments; 7
(iii) Developing policies and procedures establishing the 8
standards of patient care; 9
(iv) Providing oversight of budgetary and financial decisions 10
related to operations and the delivery of patient care for the 11
hospital or any of its departments; and 12
(v) Ensuring that hospital policies comply with state and federal 13
regulatory requirements. 14
(3) "Hospital" means a hospital licensed under chapter 70.41 RCW 15
or a psychiatric hospital licensed under chapter 71.12 RCW.16
(4) "Secretary" means the secretary of the department.17
NEW SECTION. Sec. 2. In addition to any other authority, the 18
secretary has the authority to:19
(1) Adopt rules under chapter 34.05 RCW necessary to implement 20
this chapter; 21
(2) Establish all initial licensing and renewal fees for health 22
care administrators in accordance with RCW 43.70.110 and 43.70.250;23
(3) Establish forms and procedures necessary to administer this 24
chapter; 25
(4) Issue licenses to applicants who have met the requirements 26
for obtaining an initial license or renewal license, as established 27
under section 5 or 6 of this act, and to deny a license to applicants 28
who do not meet the requirements; 29
(5) Establish and administer requirements for continuing 30
education necessary for renewal of a license; 31
(6) Establish practice parameters consistent with the definition 32
of the health care administration activities; 33
(7) Prepare, grade, and administer, or supervise the grading and 34
administration of written examinations for obtaining a license;35
(8) Conduct audits of hospitals for the purpose of determining 36
the compliance of licensed health care administrators with this 37
chapter; and 38
(9) Adopt rules implementing continuing education requirements.39
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NEW SECTION. Sec. 3. Beginning January 1, 2027, any person who 1
is employed as a health care administrator at a hospital in 2
Washington must be licensed as a health care administrator under this 3
chapter. The licensing requirement only applies to health care 4
administrators employed by a hospital in Washington.5
NEW SECTION. Sec. 4. Nothing in this chapter shall be construed 6
to require a health care administrator employed by the United States 7
armed services or any other branch of the federal government to 8
obtain a license under this chapter.9
NEW SECTION. Sec. 5. The secretary shall issue an initial 10
health care administrator license to any applicant who demonstrates 11
to the satisfaction of the secretary that the applicant meets the 12
following requirements:13
(1) Successful completion of an approved examination that 14
addresses the topics identified in section 7 of this act;15
(2) Completion of an application form with necessary information 16
to allow for appropriate licensing of the applicant, including 17
information about the applicant's employer and the types of health 18
care administration activities that the applicant performs and 19
requires licensure; 20
(3) Payment of the appropriate fee determined by the secretary 21
under RCW 43.70.250; and 22
(4) Completion of other requirements established by the 23
secretary. 24
NEW SECTION. Sec. 6. A health care administrator license must 25
be renewed annually. The secretary shall establish, by rule, the 26
requirements and fees for renewal of a license, including proof of 27
the successful completion of approved continuing education, as 28
established by the secretary.29
NEW SECTION. Sec. 7. (1) The secretary shall develop and 30
administer examinations to demonstrate the applicant's knowledge of 31
relevant health care laws and regulatory standards, patient safety 32
protocols, and health-related ethical guidelines. The department may 33
approve the use of the examinations that it has developed or approve 34
an examination developed and administered by a private organization.35
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(2) The date and location of examinations must be established by 1
the secretary. Applicants who have been found by the secretary to 2
meet the other requirements for obtaining a license must be scheduled 3
for the next examination following the filing of the application. The 4
secretary shall establish by rule the examination application 5
deadline. 6
(3) The secretary or the secretary's designees shall examine each 7
applicant, by means determined most effective, on subjects 8
appropriate to the scope of practice, as applicable. The examinations 9
must be limited to the purpose of determining whether the applicant 10
possesses the minimum skill and knowledge necessary to practice 11
competently. 12
(4) The examination papers, all grading of the papers, and the 13
grading of any practical work shall be preserved for a period of not 14
less than one year after the secretary has made and published the 15
decisions. All examinations must be conducted under fair and wholly 16
impartial methods. 17
(5) Any applicant failing to make the required grade in the first 18
examination may take up to three subsequent examinations as the 19
applicant desires upon prepaying a fee determined by the secretary 20
under RCW 43.70.250 for each subsequent examination. Upon failing 21
four examinations, the secretary may invalidate the original 22
application and require remedial education before the person may take 23
future examinations. 24
NEW SECTION. Sec. 8. (1) The uniform disciplinary act, chapter 25
18.130 RCW, governs the unlicensed practice as a health care 26
administrator, the issuance and denial of licenses, and the 27
discipline of health care administrators under this chapter.28
(2) In addition to those acts described in RCW 18.130.180, the 29
term "unprofessional conduct," as applied to health care 30
administrators, includes: 31
(a) Fiscal or operational decisions which result in injury to a 32
patient or create an unreasonable risk that a patient may be harmed;33
(b) A violation by a licensed health care provider of a state or 34
federal statute or administrative rule regulating a profession, as 35
provided in RCW 18.130.180(7), when the licensed health care 36
administrator was responsible for the oversight of the licensed 37
health care provider; 38
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(c) Aiding or abetting a licensed health care provider to 1
practice their health care profession after a patient complaint or 2
adverse event has been reported to the hospital employing the 3
licensed health care administrator, the department, or the 4
appropriate disciplining authority, while the complaint or adverse 5
event is being investigated, and if harm, disability, or death of a 6
patient occurred after the complaint or report of the adverse event;7
(d) Failure to adequately supervise licensed clinical staff and 8
nonclinical staff to the extent that a consumer's health or safety is 9
at risk; 10
(e) Any administrative, operational, or fiscal decision that 11
impedes a clinical licensed health care provider from adhering to 12
standards of practice or leads to patient harm, disability, or death; 13
and 14
(f) Fiscal or operational decisions resulting in the inability of 15
clinical licensed health care providers to practice with reasonable 16
skill and safety, regardless of the occurrence of patient harm, 17
disability, or death. 18
(3) When issuing sanctions under RCW 18.130.160, the disciplining 19
authority shall give consideration to the extent to which the 20
licensed health care administrator who is the subject of the 21
disciplinary matter had the ability to exercise control within the 22
hospital's operational structure regulating the policies and 23
financial decisions that resulted in the act of unprofessional 24
conduct. As appropriate, the disciplining authority may consider it 25
to be a mitigating factor if a licensed health care administrator had 26
limited authority or discretion to act regarding hospital policies 27
and financial decisions. 28
Sec. 9. RCW 18.130.040 and 2024 c 362 s 8, 2024 c 217 s 7, and 29
2024 c 50 s 5 are each reenacted and amended to read as follows:30
(1) This chapter applies only to the secretary and the boards and 31
commissions having jurisdiction in relation to the professions 32
licensed under the chapters specified in this section. This chapter 33
does not apply to any business or profession not licensed under the 34
chapters specified in this section. 35
(2)(a) The secretary has authority under this chapter in relation 36
to the following professions: 37
(i) Dispensing opticians licensed and designated apprentices 38
under chapter 18.34 RCW; 39
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(ii) Midwives licensed under chapter 18.50 RCW;1
(iii) Ocularists licensed under chapter 18.55 RCW;2
(iv) Massage therapists and businesses licensed under chapter 3
18.108 RCW; 4
(v) Dental hygienists licensed under chapter 18.29 RCW;5
(vi) Acupuncturists or acupuncture and Eastern medicine 6
practitioners licensed under chapter 18.06 RCW; 7
(vii) Radiologic technologists certified and X-ray technicians 8
registered under chapter 18.84 RCW; 9
(viii) Respiratory care practitioners licensed under chapter 10
18.89 RCW; 11
(ix) Hypnotherapists registered, agency affiliated counselors 12
registered, certified, or licensed, and advisors and counselors 13
certified under chapter 18.19 RCW; 14
(x) Persons licensed as mental health counselors, mental health 15
counselor associates, marriage and family therapists, marriage and 16
family therapist associates, social workers, social work associates — 17
advanced, and social work associates — independent clinical under 18
chapter 18.225 RCW; 19
(xi) Persons registered as nursing pool operators under chapter 20
18.52C RCW; 21
(xii) Nursing assistants registered or certified or medication 22
assistants endorsed under chapter 18.88A RCW; 23
(xiii) Dietitians and nutritionists certified under chapter 24
18.138 RCW; 25
(xiv) Substance use disorder professionals, substance use 26
disorder professional trainees, or co-occurring disorder specialists 27
certified under chapter 18.205 RCW; 28
(xv) Sex offender treatment providers and certified affiliate sex 29
offender treatment providers certified under chapter 18.155 RCW;30
(xvi) Persons licensed and certified under chapter 18.73 RCW or 31
RCW 18.71.205; 32
(xvii) Orthotists and prosthetists licensed under chapter 18.200 33
RCW; 34
(xviii) Surgical technologists registered under chapter 18.215 35
RCW; 36
(xix) Recreational therapists under chapter 18.230 RCW;37
(xx) Animal massage therapists certified under chapter 18.240 38
RCW; 39
(xxi) Athletic trainers licensed under chapter 18.250 RCW;40
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(xxii) Home care aides certified under chapter 18.88B RCW;1
(xxiii) Genetic counselors licensed under chapter 18.290 RCW;2
(xxiv) Reflexologists certified under chapter 18.108 RCW;3
(xxv) Medical assistants-certified, medical assistants-4
hemodialysis technician, medical assistants-phlebotomist, forensic 5
phlebotomist, medical assistant-EMT, and medical assistants-6
registered certified and registered under chapter 18.360 RCW;7
(xxvi) Behavior analysts, assistant behavior analysts, and 8
behavior technicians under chapter 18.380 RCW; 9
(xxvii) Birth doulas certified under chapter 18.47 RCW;10
(xxviii) Music therapists licensed under chapter 18.233 RCW;11
(xxix) Behavioral health support specialists certified under 12
chapter 18.227 RCW; ((and))13
(xxx) Certified peer specialists and certified peer specialist 14
trainees under chapter 18.420 RCW; and15
(xxxi) Licensed health care administrators under chapter 18.--- 16
RCW (the new chapter created in section 10 of this act).17
(b) The boards and commissions having authority under this 18
chapter are as follows: 19
(i) The podiatric medical board as established in chapter 18.22 20
RCW; 21
(ii) The chiropractic quality assurance commission as established 22
in chapter 18.25 RCW; 23
(iii) The dental quality assurance commission as established in 24
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW, 25
licenses and registrations issued under chapter 18.260 RCW, licenses 26
issued under chapter 18.265 RCW, and certifications issued under 27
chapter 18.350 RCW; 28
(iv) The board of hearing and speech as established in chapter 29
18.35 RCW; 30
(v) The board of examiners for nursing home administrators as 31
established in chapter 18.52 RCW; 32
(vi) The optometry board as established in chapter 18.54 RCW 33
governing licenses issued under chapter 18.53 RCW;34
(vii) The board of osteopathic medicine and surgery as 35
established in chapter 18.57 RCW governing licenses issued under 36
chapter 18.57 RCW; 37
(viii) The pharmacy quality assurance commission as established 38
in chapter 18.64 RCW governing licenses issued under chapters 18.64 39
and 18.64A RCW; 40
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(ix) The Washington medical commission as established in chapter 1
18.71 RCW governing licenses and registrations issued under chapters 2
18.71, 18.71A, and 18.71D RCW; 3
(x) The board of physical therapy as established in chapter 18.74 4
RCW; 5
(xi) The board of occupational therapy practice as established in 6
chapter 18.59 RCW; 7
(xii) The board of nursing as established in chapter 18.79 RCW 8
governing licenses and registrations issued under that chapter and 9
under chapter 18.80 RCW; 10
(xiii) The examining board of psychology and its disciplinary 11
committee as established in chapter 18.83 RCW; 12
(xiv) The veterinary board of governors as established in chapter 13
18.92 RCW; 14
(xv) The board of naturopathy established in chapter 18.36A RCW, 15
governing licenses and certifications issued under that chapter; and16
(xvi) The board of denturists established in chapter 18.30 RCW.17
(3) In addition to the authority to discipline license holders, 18
the disciplining authority has the authority to grant or deny 19
licenses. The disciplining authority may also grant a license subject 20
to conditions, which must be in compliance with chapter 18.415 RCW.21
(4) All disciplining authorities shall adopt procedures to ensure 22
substantially consistent application of this chapter, the uniform 23
disciplinary act, among the disciplining authorities listed in 24
subsection (2) of this section. 25
NEW SECTION. Sec. 10. Sections 1 through 8 of this act 26
constitute a new chapter in Title 18 RCW.27
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