Nursing assistant regulation

AN ACT Relating to consolidating regulatory authority for nursing 1
assistants; amending RCW 18.79.070, 18.79.070, 18.88A.020, 2
18.88A.030, 18.88A.040, 18.88A.050, 18.88A.060, 18.88A.080, 3
18.88A.082, 18.88A.085, 18.88A.087, 18.88A.088, 18.88A.090, 4
18.88A.110, 18.88A.120, 18.88A.150, 18.88A.210, and 18.88B.060; 5
reenacting and amending RCW 18.130.040; repealing RCW 18.88A.100; 6
providing effective dates; and providing an expiration date.7
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:8
Sec. 1. RCW 18.79.070 and 2022 c 240 s 32 are each amended to 9
read as follows: 10
(1) The state ((nursing care quality assurance commission )) board 11
of nursing is established, consisting of ((fifteen)) 17 members to be 12
appointed by the governor to four-year terms. The governor shall 13
consider nursing members who are recommended for appointment by the 14
appropriate professional associations in the state. No person may 15
serve as a member of the ((commission)) board for more than two 16
consecutive full terms. 17
(2) There must be seven registered nurse members, two advanced 18
registered nurse practitioner members, ((three)) two licensed 19
practical nurse members, two certified nursing assistant members, a 20
registered nurse or licensed practical nurse member, and three public 21
Z-0181.1
HOUSE BILL 1792
State of Washington 69th Legislature 2025 Regular Session
By Representatives Obras, Stonier, Parshley, Wylie, and Reed; by
request of Washington State Board of Nursing
Read first time 02/03/25. Referred to Committee on Health Care &
Wellness.
p. 1 HB 1792
members on the ((commission)) board. Each member of the 1
((commission)) board must be a resident of this state.2
(3)(a) Registered nurse members of the ((commission)) board must:3
(i) Be licensed as registered nurses under this chapter; and4
(ii) Have had at least three years' experience in the active 5
practice of nursing and have been engaged in that practice within two 6
years of appointment. 7
(b) In addition: 8
(i) At least one member must be on the faculty at a four-year 9
university nursing program; 10
(ii) At least one member must be on the faculty at a two-year 11
community college nursing program; 12
(iii) At least two members must be staff nurses providing direct 13
patient care; and 14
(iv) At least one member must be a nurse manager or a nurse 15
executive. 16
(4) Advanced registered nurse practitioner members of the 17
((commission)) board must: 18
(a) Be licensed as advanced registered nurse practitioners under 19
this chapter; and 20
(b) Have had at least three years' experience in the active 21
practice of advanced registered nursing and have been engaged in that 22
practice within two years of appointment. 23
(5) Licensed practical nurse members of the ((commission)) board 24
must: 25
(a) Be licensed as licensed practical nurses under this chapter; 26
and 27
(b) Have had at least three years' actual experience as a 28
licensed practical nurse and have been engaged in practice as a 29
practical nurse within two years of appointment. 30
(6) Certified nursing assistant members of the board must:31
(a) Be currently employed as certified nursing assistants, 32
licensed under chapter 18.88A RCW; and33
(b) Have at least two years' experience as a certified nursing 34
assistant.35
(7) The registered nurse or licensed practical nurse member must 36
be currently either a program director or educator in an approved 37
nursing assistant training program.38
(8) Public members of the ((commission)) board may not be a 39
member of any other health care licensing board or commission, or 40
p. 2 HB 1792
have a fiduciary obligation to a facility rendering health services 1
regulated by the ((commission)) board, or have a material or 2
financial interest in the rendering of health services regulated by 3
the ((commission)) board. 4
((In appointing the initial members of the *commission, it is the 5
intent of the legislature that, to the extent possible, the governor 6
appoint the existing members of the board of nursing and the board of 7
practical nursing repealed under chapter 9, Laws of 1994 sp. sess. 8
The governor may appoint initial members of the commission to 9
staggered terms of from one to four years. Thereafter, all members 10
shall be appointed to full four-year terms. )) Members of the 11
((commission)) board hold office until their successors are 12
appointed. 13
When the secretary appoints pro tem members, reasonable efforts 14
shall be made to ensure that at least one pro tem member is a 15
registered nurse who is currently practicing and, in addition to 16
meeting other minimum qualifications, has graduated from an associate 17
or baccalaureate nursing program within three years of appointment.18
Sec. 2. RCW 18.79.070 and 2024 c 239 s 5 are each amended to 19
read as follows: 20
(1) The state board (([of nursing] )) of nursing is established, 21
consisting of ((fifteen)) 17 members to be appointed by the governor 22
to four-year terms. The governor shall consider nursing members who 23
are recommended for appointment by the appropriate professional 24
associations in the state. No person may serve as a member of the 25
board for more than two consecutive full terms. 26
(2) There must be seven registered nurse members, two advanced 27
practice registered nurse members, ((three)) two licensed practical 28
nurse members, two certified nursing assistant members, a registered 29
nurse or licensed practical nurse member, and three public members on 30
the board. Each member of the board must be a resident of this state.31
(3)(a) Registered nurse members of the board must:32
(i) Be licensed as registered nurses under this chapter; and33
(ii) Have had at least three years' experience in the active 34
practice of nursing and have been engaged in that practice within two 35
years of appointment. 36
(b) In addition: 37
(i) At least one member must be on the faculty at a four-year 38
university nursing program; 39
p. 3 HB 1792
(ii) At least one member must be on the faculty at a two-year 1
community college nursing program; 2
(iii) At least two members must be staff nurses providing direct 3
patient care; and 4
(iv) At least one member must be a nurse manager or a nurse 5
executive. 6
(4) Advanced practice registered nurse members of the board must:7
(a) Be licensed as advanced practice registered nurses under this 8
chapter; and 9
(b) Have had at least three years' experience in the active 10
practice of advanced practice registered nursing and have been 11
engaged in that practice within two years of appointment.12
(5) Licensed practical nurse members of the board must:13
(a) Be licensed as licensed practical nurses under this chapter; 14
and 15
(b) Have had at least three years' actual experience as a 16
licensed practical nurse and have been engaged in practice as a 17
practical nurse within two years of appointment. 18
(6) Certified nursing assistant members of the board must:19
(a) Be currently employed as certified nursing assistants, 20
licensed under chapter 18.88A RCW; and21
(b) Have at least two years' experience as a certified nursing 22
assistant.23
(7) The registered nurse or licensed practical nurse member must 24
be currently either a program director or educator in an approved 25
nursing assistant training program.26
(8) Public members of the board may not be a member of any other 27
health care licensing board or commission, or have a fiduciary 28
obligation to a facility rendering health services regulated by the 29
board, or have a material or financial interest in the rendering of 30
health services regulated by the board. 31
Members of the board hold office until their successors are 32
appointed. 33
When the secretary appoints pro tem members, reasonable efforts 34
shall be made to ensure that at least one pro tem member is a 35
registered nurse who is currently practicing and, in addition to 36
meeting other minimum qualifications, has graduated from an associate 37
or baccalaureate nursing program within three years of appointment.38
p. 4 HB 1792
Sec. 3. RCW 18.88A.020 and 2018 c 201 s 9008 are each amended to 1
read as follows: 2
Unless the context clearly requires otherwise, the definitions in 3
this section apply throughout this chapter. 4
(1) "Alternative training" means a nursing assistant-certified 5
program meeting criteria adopted by the ((commission)) board under 6
RCW 18.88A.087 to meet the requirements of a state-approved nurse 7
aide competency evaluation program consistent with 42 U.S.C. Sec. 8
1395i-3(e) and (f) of the federal social security act.9
(2) "Approved training program" means a nursing assistant-10
certified training program approved by the ((commission)) board to 11
meet the requirements of a state-approved nurse aide training and 12
competency evaluation program consistent with 42 U.S.C. Sec. 13
1395i-3(e) and (f) of the federal social security act. For community 14
college, vocational-technical institutes, skill centers, and 15
secondary school as defined in chapter 28B.50 RCW, nursing assistant-16
certified training programs shall be approved by the ((commission)) 17
board in cooperation with the board for community and technical 18
colleges or the superintendent of public instruction.19
(3) (("Commission" means the Washington nursing care quality 20
assurance commission )) "Board" means the Washington state board of 21
nursing. 22
(4) "Competency evaluation" means the measurement of an 23
individual's knowledge and skills as related to safe, competent 24
performance as a nursing assistant. 25
(5) "Department" means the department of health.26
(6) "Executive director" means the executive director of the 27
board hired pursuant to RCW 18.79.390.28
(7) "Health care facility" means a nursing home, hospital 29
licensed under chapter 70.41 or 71.12 RCW, hospice care facility, 30
home health care agency, hospice agency, licensed or certified 31
service provider under chapter 71.24 RCW other than an individual 32
health care provider, or other entity for delivery of health care 33
services as defined by the ((commission)) board. 34
(((7))) (8) "Medication assistant" means a nursing assistant-35
certified with a medication assistant endorsement issued under RCW 36
18.88A.082 who is authorized, in addition to his or her duties as a 37
nursing assistant-certified, to administer certain medications and 38
perform certain treatments in a nursing home under the supervision of 39
a registered nurse under RCW 18.88A.082. 40
p. 5 HB 1792
(((8))) (9) "Nursing assistant" means an individual, regardless 1
of title, who, under the direction and supervision of a registered 2
nurse or licensed practical nurse, assists in the delivery of nursing 3
and nursing-related activities to patients in a health care facility 4
or an individual, regardless of title, who uses their nursing 5
assistant credential to work as a long-term care worker as allowed by 6
RCW 18.88B.041(1) (a) or (b). The two levels of nursing assistants 7
are: 8
(a) "Nursing assistant-certified," an individual certified under 9
this chapter; and 10
(b) "Nursing assistant-registered," an individual registered 11
under this chapter. 12
(((9))) (10) "Nursing home" means a nursing home licensed under 13
chapter 18.51 RCW. 14
(((10))) (11) "Secretary" means the secretary of health.15
Sec. 4. RCW 18.88A.030 and 2021 c 203 s 16 are each amended to 16
read as follows: 17
(1)(a) A nursing assistant may assist in the care of individuals 18
as delegated by and under the direction and supervision of a licensed 19
(registered) nurse or licensed practical nurse or work as a long-term 20
care worker as allowed by RCW 18.88B.041(1) (a) or (b).21
(b) A health care facility shall not assign a nursing assistant-22
registered to provide care until the nursing assistant-registered has 23
demonstrated skills necessary to perform competently all assigned 24
duties and responsibilities. 25
(c) Nothing in this chapter shall be construed to confer on a 26
nursing assistant the authority to administer medication unless 27
delegated as a specific nursing task pursuant to this chapter or to 28
practice as a licensed (registered) nurse or licensed practical nurse 29
as defined in chapter 18.79 RCW. 30
(2)(a) A nursing assistant employed in a nursing home must have 31
successfully obtained certification through: (i) An approved training 32
program and the competency evaluation within a period of time 33
determined in rule by the ((commission)) board; or (ii) alternative 34
training and the competency evaluation prior to employment.35
(b) Certification is voluntary for nursing assistants working in 36
health care facilities other than nursing homes unless otherwise 37
required by state or federal law or regulation. 38
p. 6 HB 1792
(3) The ((commission)) board may adopt rules to implement the 1
provisions of this chapter. 2
Sec. 5. RCW 18.88A.040 and 2012 c 208 s 4 are each amended to 3
read as follows: 4
(1) No person may practice or represent himself or herself as a 5
nursing assistant-registered by use of any title or description 6
without being registered by the ((department)) board pursuant to this 7
chapter. 8
(2) ((After October 1, 1990, no )) No person may by use of any 9
title or description, practice or represent himself or herself as a 10
nursing assistant-certified without applying for certification, 11
meeting the qualifications, and being certified by the ((department)) 12
board pursuant to this chapter. 13
(3) ((After July 1, 2013, no )) No person may practice, or 14
represent himself or herself by any title or description, as a 15
medication assistant without a medication assistant endorsement 16
issued under RCW 18.88A.082. 17
Sec. 6. RCW 18.88A.050 and 2012 c 208 s 5 are each amended to 18
read as follows: 19
In addition to any other authority provided by law, the secretary 20
has the authority to: 21
(1) Set all nursing assistant certification, registration, 22
medication assistant endorsement, and renewal fees in accordance with 23
RCW 43.70.250 and to collect and deposit all such fees in the health 24
professions account established under RCW 43.70.320; and25
(2) ((Establish forms, procedures, and the competency evaluation 26
necessary to administer this chapter;27
(3) Hire clerical, administrative, and investigative staff as 28
needed to implement this chapter;29
(4) Issue a nursing assistant registration to any applicant who 30
has met the requirements for registration;31
(5) After January 1, 1990, issue a nursing assistant certificate 32
to any applicant who has met the training, competency evaluation, and 33
conduct requirements for certification under this chapter;34
(6) Issue a medication assistant endorsement to any applicant who 35
has met the requirements of RCW 18.88A.082;36
p. 7 HB 1792
(7) Maintain the official record for the department of all 1
applicants and persons with registrations, certificates, and 2
medication assistant endorsements under this chapter;3
(8) Exercise disciplinary authority as authorized in chapter 4
18.130 RCW;5
(9) Deny registration to any applicant who fails to meet 6
requirement for registration as a nursing assistant;7
(10) Deny certification to applicants who do not meet the 8
training, competency evaluation, and conduct requirements for 9
certification as a nursing assistant; and10
(11) Deny medication assistant endorsement to applicants who do 11
not meet the requirements of RCW 18.88A.082)) Employ staff that are 12
hired and managed by the executive director provided that nothing 13
contained in this section may be construed to alter any existing 14
collective bargaining unit or the provisions of any existing 15
collective bargaining agreement. 16
Sec. 7. RCW 18.88A.060 and 2012 c 208 s 6 are each amended to 17
read as follows: 18
In addition to any other authority provided by law, the 19
((commission)) board may: 20
(1) Determine minimum nursing assistant education requirements 21
and approve training programs; 22
(2) Approve education and training programs and examinations for 23
medication assistants as provided in RCW 18.88A.082;24
(3) Define the prescriber-ordered treatments a medication 25
assistant is authorized to perform under RCW 18.88A.082;26
(4) Prepare, grade, and administer, or determine the nature of, 27
and supervise the grading and administration of, the competency 28
evaluation for applicants for nursing assistant certification, using 29
the same competency evaluation for all applicants, whether qualifying 30
to take the competency evaluation under an approved training program 31
or alternative training; 32
(5) Establish forms and procedures for evaluation of an 33
applicant's alternative training under criteria adopted pursuant to 34
RCW 18.88A.087; 35
(6) Define and approve any experience requirement for nursing 36
assistant certification; 37
(7) Adopt rules implementing a continuing competency evaluation 38
program for nursing assistants; ((and))39
p. 8 HB 1792
(8) Establish forms, procedures, and the competency evaluation 1
necessary to administer this chapter;2
(9) Issue a nursing assistant registration to any applicant who 3
has met the requirements for registration;4
(10) Maintain the official record for the department of all 5
applicants and persons with registrations, certificates, and 6
medication assistant endorsements under this chapter;7
(11) Exercise disciplinary authority as authorized in chapter 8
18.130 RCW;9
(12) Deny registration to any applicant who fails to meet 10
requirements for registration as a nursing assistant;11
(13) Deny certification to applicants who do not meet the 12
training, competency evaluation, and conduct requirements for 13
certification as a nursing assistant;14
(14) Deny medication assistant endorsement to applicants who do 15
not meet the requirements of RCW 18.88A.082;16
(15) Issue a medication assistant endorsement to any applicant 17
who has met the requirements of RCW 18.88A.082;18
(16) Delegate certain disciplinary functions to staff where no 19
clinical expertise or standard of care issues are involved;20
(17) Issue a nursing assistant certificate to any applicant who 21
has met the training, competency evaluation, and conduct requirements 22
for certification under this chapter; and23
(18) Adopt rules to enable it to carry into effect the provisions 24
of this chapter. 25
Sec. 8. RCW 18.88A.080 and 1994 sp.s. c 9 s 711 are each amended 26
to read as follows: 27
(1) The ((secretary)) board shall issue a registration to any 28
applicant who pays any applicable fees and submits, on forms provided 29
by the ((secretary)) board, the applicant's name, address, and other 30
information as determined by the ((secretary)) board, provided there 31
are no grounds for denial of registration or issuance of a 32
conditional registration under this chapter or chapter 18.130 RCW.33
(2) Applicants must file an application with the ((commission)) 34
board for registration within three days of employment.35
Sec. 9. RCW 18.88A.082 and 2012 c 208 s 3 are each amended to 36
read as follows: 37
p. 9 HB 1792
(1) ((Beginning July 1, 2013, the secretary )) The board shall 1
issue a medication assistant endorsement to any nursing assistant-2
certified who meets the following requirements: 3
(a) Ongoing certification as a nursing assistant-certified in 4
good standing under this chapter; 5
(b) Completion of a minimum number of hours of documented work 6
experience as a nursing assistant-certified in a long-term care 7
setting as defined in rule by the ((commission)) board;8
(c) Successful completion of an education and training program 9
approved by the ((commission)) board by rule, such as the model 10
medication assistant-certified curriculum adopted by the national 11
council of state boards of nursing. The education and training 12
program must include training on the specific tasks listed in 13
subsection (2) of this section as well as training on identifying 14
tasks that a medication assistant may not perform under subsection 15
(4) of this section; 16
(d) Passage of an examination approved by the ((commission)) 17
board by rule, such as the medication aide competency examination 18
available through the national council of state boards of nursing; 19
and 20
(e) Continuing competency requirements as defined in rule by the 21
((commission)) board. 22
(2) Subject to subsection (3) of this section, a medication 23
assistant may perform the following additional tasks:24
(a) The administration of medications orally, topically, and 25
through inhalation; 26
(b) The performance of simple prescriber-ordered treatments, 27
including blood glucose monitoring, noncomplex clean dressing 28
changes, pulse oximetry reading, and oxygen administration, to be 29
defined by the ((commission)) board by rule; and 30
(c) The documentation of the tasks in this subsection (2) on 31
applicable medication or treatment forms. 32
(3) A medication assistant may only perform the additional tasks 33
in subsection (2) of this section: 34
(a) In a nursing home; 35
(b) Under the direct supervision of a designated registered nurse 36
who is on-site and immediately accessible during the medication 37
assistant's shift. The registered nurse shall assess the resident 38
prior to the medication assistant administering medications or 39
treatments and determine whether it is safe to administer the 40
p. 10 HB 1792
medications or treatments. The judgment and decision to administer 1
medications or treatments is retained by the registered nurse; and2
(c) If, while functioning as a medication assistant, the primary 3
responsibility of the medication assistant is performing the 4
additional tasks. The ((commission)) board may adopt rules regarding 5
the medication assistant's primary responsibilities and limiting the 6
duties, within the scope of practice of a nursing assistant-7
certified, that a nursing assistant-certified may perform while 8
functioning as a medication assistant. 9
(4) A medication assistant may not: 10
(a) Accept telephone or verbal orders from a prescriber;11
(b) Calculate medication dosages; 12
(c) Inject any medications; 13
(d) Perform any sterile task; 14
(e) Administer medications through a tube; 15
(f) Administer any Schedule I, II, or III controlled substance; 16
or 17
(g) Perform any task that requires nursing judgment.18
(5) Nothing in this section requires a nursing home to employ a 19
nursing assistant-certified with a medication assistant endorsement.20
(6) A medication assistant is responsible and accountable for his 21
or her specific functions. 22
(7) A medication assistant's employer may limit or restrict the 23
range of functions permitted under this section, but may not expand 24
those functions. 25
Sec. 10. RCW 18.88A.085 and 2010 c 169 s 7 are each amended to 26
read as follows: 27
(1) ((After January 1, 1990, the secretary )) The board shall 28
issue a nursing assistant certificate to any applicant who 29
demonstrates to the ((secretary's)) board's satisfaction that the 30
following requirements have been met: 31
(a) Successful completion of an approved training program or 32
successful completion of alternative training meeting established 33
criteria adopted by the ((commission)) board under RCW 18.88A.087; 34
and 35
(b) Successful completion of the competency evaluation.36
(2) In addition, applicants shall be subject to the grounds for 37
denial of certification under chapter 18.130 RCW. 38
p. 11 HB 1792
Sec. 11. RCW 18.88A.087 and 2021 c 203 s 17 are each amended to 1
read as follows: 2
(1) The ((commission)) board shall adopt criteria for evaluating 3
an applicant's alternative training to determine the applicant's 4
eligibility to take the competency evaluation for nursing assistant 5
certification. At least one option adopted by the ((commission)) 6
board must allow an applicant to take the competency evaluation if he 7
or she: 8
(a)(i) Is a certified home care aide pursuant to chapter 18.88B 9
RCW; or 10
(ii) Is a certified medical assistant pursuant to a certification 11
program accredited by a national medical assistant accreditation 12
organization and approved by the ((commission)) board; and13
(b) Has successfully completed at least twenty-four hours of 14
training that the ((commission)) board determines is necessary to 15
provide training equivalent to approved training on topics not 16
addressed in the training specified for certification as a home care 17
aide or medical assistant, as applicable. In the ((commission's)) 18
board's discretion, a portion of these hours may include clinical 19
training. 20
(2)(a) The ((commission)) board, in consultation with the 21
secretary, the department of social and health services, and 22
consumer, employer, and worker representatives, shall adopt rules to 23
implement this section and to provide for a program of credentialing 24
reciprocity to the extent required by this section between home care 25
aide and medical assistant certification and nursing assistant 26
certification. The secretary shall also adopt such rules as may be 27
necessary to implement this section and the credentialing reciprocity 28
program. 29
(b) Rules adopted under this section must be consistent with 30
requirements under 42 U.S.C. Sec. 1395i-3 (e) and (f) of the federal 31
social security act relating to state-approved competency evaluation 32
programs for certified nurse aides. 33
(((3) The secretary, in consultation with the commission, shall 34
report annually by December 1st to the governor and the appropriate 35
committees of the legislature on the progress made in achieving 36
career advancement for certified home care aides and medical 37
assistants into nursing practice.))38
p. 12 HB 1792
Sec. 12. RCW 18.88A.088 and 2011 c 32 s 10 are each amended to 1
read as follows: 2
An applicant with military training or experience satisfies the 3
training or experience requirements of this chapter unless the 4
((commission)) board determines that the military training or 5
experience is not substantially equivalent to the standards of this 6
state. 7
Sec. 13. RCW 18.88A.090 and 2010 c 169 s 8 are each amended to 8
read as follows: 9
(1) The ((commission)) board shall examine each applicant, by a 10
written or oral and a manual component of competency evaluation. The 11
competency evaluation shall be limited to the purpose of determining 12
whether the applicant possesses the minimum skill and knowledge 13
necessary to practice competently. 14
(2) Any applicant failing to make the required grade in the first 15
competency evaluation may take up to three subsequent competency 16
evaluations as the applicant desires upon prepaying a fee determined 17
by the secretary under RCW 43.70.250 for each subsequent competency 18
evaluation. Upon failing four competency evaluations, the secretary 19
may invalidate the original application and require such remedial 20
education before the person may take future competency evaluations.21
The ((commission)) board may approve a competency evaluation 22
prepared or administered by a private testing agency or association 23
of licensing agencies for use by an applicant in meeting the 24
credentialing requirements. 25
Sec. 14. RCW 18.88A.110 and 2010 c 169 s 9 are each amended to 26
read as follows: 27
An applicant holding a credential in another state may be 28
certified by endorsement to practice in this state without the 29
competency evaluation if the ((secretary)) board determines that the 30
other state's credentialing standards are substantially equivalent to 31
the standards in this state. 32
Sec. 15. RCW 18.88A.120 and 2012 c 208 s 7 are each amended to 33
read as follows: 34
Applications for registration, certification, and medication 35
assistant endorsement shall be submitted on forms provided by the 36
((secretary)) board. The ((secretary)) board may require any 37
p. 13 HB 1792
information and documentation that reasonably relates to the need to 1
determine whether the applicant meets the criteria for registration, 2
certification, and medication assistant endorsement credentialing 3
provided for in this chapter and chapter 18.130 RCW. Each applicant 4
shall comply with administrative procedures, administrative 5
requirements, and fees determined by the secretary under RCW 6
43.70.250 and 43.70.280. 7
Sec. 16. RCW 18.88A.150 and 2012 c 208 s 9 are each amended to 8
read as follows: 9
The uniform disciplinary act, chapter 18.130 RCW, governs 10
unregistered, uncertified, or unendorsed practice, issuance of 11
certificates, registrations, and medication assistant endorsements, 12
and the discipline of persons registered or with certificates under 13
this chapter. The ((secretary)) board shall be the disciplinary 14
authority under this chapter. 15
Sec. 17. RCW 18.88A.210 and 2008 c 146 s 12 are each amended to 16
read as follows: 17
(1) A nursing assistant meeting the requirements of this section 18
who provides care to individuals in community-based care settings or 19
in-home care settings, as defined in RCW 18.79.260(3), may accept 20
delegation of nursing care tasks by a registered nurse as provided in 21
RCW 18.79.260(3). 22
(2) For the purposes of this section, "nursing assistant" means a 23
nursing assistant-registered or a nursing assistant-certified. 24
Nothing in this section may be construed to affect the authority of 25
nurses to delegate nursing tasks to other persons, including licensed 26
practical nurses, as authorized by law. 27
(3)(a) Before commencing any specific nursing care tasks 28
authorized under this chapter, the nursing assistant must (i) provide 29
to the delegating nurse a certificate of completion issued by the 30
department of social and health services indicating the completion of 31
basic core nurse delegation training, (ii) be regulated by the 32
department of health pursuant to this chapter, subject to the uniform 33
disciplinary act under chapter 18.130 RCW, and (iii) meet any 34
additional training requirements identified by the ((nursing care 35
quality assurance commission )) board. Exceptions to these training 36
requirements must adhere to RCW 18.79.260(3)(e) (vi).37
p. 14 HB 1792
(b) In addition to meeting the requirements of (a) of this 1
subsection, before commencing the care of individuals with diabetes 2
that involves administration of insulin by injection, the nursing 3
assistant must provide to the delegating nurse a certificate of 4
completion issued by the department of social and health services 5
indicating completion of specialized diabetes nurse delegation 6
training. The training must include, but is not limited to, 7
instruction regarding diabetes, insulin, sliding scale insulin 8
orders, and proper injection procedures. 9
Sec. 18. RCW 18.88B.060 and 2012 c 164 s 303 are each amended to 10
read as follows: 11
(1) The department has the authority to: 12
(a) Establish forms, procedures, and examinations necessary to 13
certify home care aides pursuant to this chapter; 14
(b) Hire clerical, administrative, and investigative staff as 15
needed to implement this section; 16
(c) Issue certification as a home care aide to any applicant who 17
has successfully completed the home care aide examination, and renew 18
such certificates; 19
(d) Maintain the official record of all applicants and persons 20
with certificates; 21
(e) Exercise disciplinary authority as authorized in chapter 22
18.130 RCW, except that the state board of nursing has disciplinary 23
authority over nursing assistants licensed under chapter 18.88A RCW 24
working as long-term care workers under this chapter; and25
(f) Deny certification to applicants who do not meet training, 26
competency examination, and conduct requirements, including 27
background checks, for certification. 28
(2) The department shall adopt rules that establish the 29
procedures, including criteria for reviewing an applicant's state and 30
federal background checks, and examinations necessary to implement 31
this section. 32
Sec. 19. RCW 18.130.040 and 2024 c 362 s 8, 2024 c 217 s 7, and 33
2024 c 50 s 5 are each reenacted and amended to read as follows:34
(1) This chapter applies only to the secretary and the boards and 35
commissions having jurisdiction in relation to the professions 36
licensed under the chapters specified in this section. This chapter 37
p. 15 HB 1792
does not apply to any business or profession not licensed under the 1
chapters specified in this section. 2
(2)(a) The secretary has authority under this chapter in relation 3
to the following professions: 4
(i) Dispensing opticians licensed and designated apprentices 5
under chapter 18.34 RCW; 6
(ii) Midwives licensed under chapter 18.50 RCW;7
(iii) Ocularists licensed under chapter 18.55 RCW;8
(iv) Massage therapists and businesses licensed under chapter 9
18.108 RCW; 10
(v) Dental hygienists licensed under chapter 18.29 RCW;11
(vi) Acupuncturists or acupuncture and Eastern medicine 12
practitioners licensed under chapter 18.06 RCW; 13
(vii) Radiologic technologists certified and X-ray technicians 14
registered under chapter 18.84 RCW; 15
(viii) Respiratory care practitioners licensed under chapter 16
18.89 RCW; 17
(ix) Hypnotherapists registered, agency affiliated counselors 18
registered, certified, or licensed, and advisors and counselors 19
certified under chapter 18.19 RCW; 20
(x) Persons licensed as mental health counselors, mental health 21
counselor associates, marriage and family therapists, marriage and 22
family therapist associates, social workers, social work associates — 23
advanced, and social work associates — independent clinical under 24
chapter 18.225 RCW; 25
(xi) Persons registered as nursing pool operators under chapter 26
18.52C RCW; 27
(xii) ((Nursing assistants registered or certified or medication 28
assistants endorsed under chapter 18.88A RCW;29
(xiii))) Dietitians and nutritionists certified under chapter 30
18.138 RCW; 31
(((xiv))) (xiii) Substance use disorder professionals, substance 32
use disorder professional trainees, or co-occurring disorder 33
specialists certified under chapter 18.205 RCW; 34
(((xv))) (xiv) Sex offender treatment providers and certified 35
affiliate sex offender treatment providers certified under chapter 36
18.155 RCW; 37
(((xvi))) (xv) Persons licensed and certified under chapter 18.73 38
RCW or RCW 18.71.205; 39
p. 16 HB 1792
(((xvii))) (xvi) Orthotists and prosthetists licensed under 1
chapter 18.200 RCW; 2
(((xviii))) (xvii) Surgical technologists registered under 3
chapter 18.215 RCW; 4
(((xix))) (xviii) Recreational therapists under chapter 18.230 5
RCW; 6
(((xx))) (xix) Animal massage therapists certified under chapter 7
18.240 RCW; 8
(((xxi))) (xx) Athletic trainers licensed under chapter 18.250 9
RCW; 10
(((xxii))) (xxi) Home care aides certified under chapter 18.88B 11
RCW; 12
(((xxiii))) (xxii) Genetic counselors licensed under chapter 13
18.290 RCW; 14
(((xxiv))) (xxiii) Reflexologists certified under chapter 18.108 15
RCW; 16
(((xxv))) (xxiv) Medical assistants-certified, medical 17
assistants-hemodialysis technician, medical assistants-phlebotomist, 18
forensic phlebotomist, medical assistant-EMT, and medical assistants-19
registered certified and registered under chapter 18.360 RCW;20
(((xxvi))) (xxv) Behavior analysts, assistant behavior analysts, 21
and behavior technicians under chapter 18.380 RCW;22
(((xxvii))) (xxvi) Birth doulas certified under chapter 18.47 23
RCW; 24
(((xxviii))) (xxvii) Music therapists licensed under chapter 25
18.233 RCW; 26
(((xxix))) (xxviii) Behavioral health support specialists 27
certified under chapter 18.227 RCW; and 28
(((xxx))) (xxix) Certified peer specialists and certified peer 29
specialist trainees under chapter 18.420 RCW. 30
(b) The boards and commissions having authority under this 31
chapter are as follows: 32
(i) The podiatric medical board as established in chapter 18.22 33
RCW; 34
(ii) The chiropractic quality assurance commission as established 35
in chapter 18.25 RCW; 36
(iii) The dental quality assurance commission as established in 37
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW, 38
licenses and registrations issued under chapter 18.260 RCW, licenses 39
p. 17 HB 1792
issued under chapter 18.265 RCW, and certifications issued under 1
chapter 18.350 RCW; 2
(iv) The board of hearing and speech as established in chapter 3
18.35 RCW; 4
(v) The board of examiners for nursing home administrators as 5
established in chapter 18.52 RCW; 6
(vi) The optometry board as established in chapter 18.54 RCW 7
governing licenses issued under chapter 18.53 RCW; 8
(vii) The board of osteopathic medicine and surgery as 9
established in chapter 18.57 RCW governing licenses issued under 10
chapter 18.57 RCW; 11
(viii) The pharmacy quality assurance commission as established 12
in chapter 18.64 RCW governing licenses issued under chapters 18.64 13
and 18.64A RCW; 14
(ix) The Washington medical commission as established in chapter 15
18.71 RCW governing licenses and registrations issued under chapters 16
18.71, 18.71A, and 18.71D RCW; 17
(x) The board of physical therapy as established in chapter 18.74 18
RCW; 19
(xi) The board of occupational therapy practice as established in 20
chapter 18.59 RCW; 21
(xii) The board of nursing as established in chapter 18.79 RCW 22
governing licenses and registrations issued under that chapter and 23
under chapter 18.80 RCW, and nursing assistants registered or 24
certified or medication assistants endorsed under chapter 18.88A RCW;25
(xiii) The examining board of psychology and its disciplinary 26
committee as established in chapter 18.83 RCW; 27
(xiv) The veterinary board of governors as established in chapter 28
18.92 RCW; 29
(xv) The board of naturopathy established in chapter 18.36A RCW, 30
governing licenses and certifications issued under that chapter; and31
(xvi) The board of denturists established in chapter 18.30 RCW.32
(3) In addition to the authority to discipline license holders, 33
the disciplining authority has the authority to grant or deny 34
licenses. The disciplining authority may also grant a license subject 35
to conditions, which must be in compliance with chapter 18.415 RCW.36
(4) All disciplining authorities shall adopt procedures to ensure 37
substantially consistent application of this chapter, the uniform 38
disciplinary act, among the disciplining authorities listed in 39
subsection (2) of this section. 40
p. 18 HB 1792
NEW SECTION. Sec. 20. RCW 18.88A.100 (Waiver of examination for 1
initial applications) and 1994 sp.s. c 9 s 714 are each repealed.2
NEW SECTION. Sec. 21. (1) Sections 1 and 3 through 20 of this 3
act take effect July 1, 2026.4
(2) Section 2 of this act takes effect June 30, 2027.5
NEW SECTION. Sec. 22. Section 1 of this act expires June 30, 6
2027.7
--- END ---
p. 19 HB 1792