Re-Elect Jim Moeller

2009-2010 Session

Summary

By June 30, 2011, the MQAC, the BOMS, and the PMB must repeal their rules on pain management. By June 30, 2011, the MQAC, the BOMS, the PMB, the Dental Quality

Assurance Commission, and the Nursing Care Quality Assurance Commission must all adopt new rules on chronic, non-cancer pain management. The new rules must contain the following elements:

• dosing criteria, including a dosage amount that may not be exceeded without
• consultation with a pain management specialist, and exigent or special circumstances
• under which the dosage amount may be exceeded without a consultation. The rules
• regarding consultation with a pain management specialist must, to the extentpracticable, take into account:
• circumstances under which repeated consultations would not be necessary or
• appropriate for a patient undergoing a stable, ongoing course of treatment for pain management;
• minimum training and experience that is sufficient to exempt a provider from
• the consultation requirement;
• methods for enhancing the availability of consultations;
• allowing the efficient use of resources; and
• minimizing the burden on practitioners and patients;
• guidance on when to seek specialty consultation and ways in which electronic
• specialty consultations may be sought;
• guidance on tracking clinical progress by using assessment tools focusing on pain
• interference, physical function, and overall risk for poor outcome; and
• guidance on tracking the use of opioids.

The rules do not apply to:

• palliative, hospice, or other end-of-life care; or

the management of acute pain caused by an injury or a surgical procedure.

2005-2006 Session

Summary:

The Department of Health (Department) is directed to establish and maintain a statewide registry of health care declarations submitted by Washington residents on a secure web site.

The Department may contract with another entity to perform these registry functions. The health care declarations that may be submitted include advance directives, durable powers of attorney for health care, mental health advance directives, and forms establishing physician orders for emergency medical service personnel.Residents may either send the health care declarations to the Department to place in the registry or they may submit them directly to the registry in a digital format. The Departmentis not responsible for determining whether or not the health care declarations have been properly executed.

Individuals must have access to their health care declarations and the ability to revoke them at all times. Personal representatives, health care facilities, attending physicians, ARNPs, and health care providers acting under the direction of a physician or ARNP must have access to

the registry at all times.

A health care declaration that is stored in the registry may be revoked by standard statutory methods or according to a method developed by the Department. Revocation of a health care declaration stored in the registry by means of a standard statutory method is valid even if the Department is not notified of the revocation.

Physicians, ARNPs, health care providers acting under the direction of a physician or ARNP, health care facilities and their employees who, in good faith and without negligence, act  reliance on a declaration in the registry, are immune from civil and criminal liability and professional sanctions in specified circumstances. These circumstances include when they provide, do not provide, withdraw, or withhold treatment and: (1) there was no actual knowledge that there was a declaration in the registry; (2) there was no actual knowledge that the declaration had been revoked; (3) the declaration is subsequently determined to have been invalid; or (4) the procedure is in accordance with the declaration that is stored in the registry.

The Department is immune from civil liability for its administration and operation of the registry except in cases of gross negligence, willful misconduct, or intentional wrongdoing.

The stated intent of the act is that the electronic registry improve access to advance directives and mental health advance directives, but not supplant the current system of using these documents. The intent is also stated to be that health care providers consult the registry in all situations where there may be a question about the patient’s wishes for periods of incapacity and the existence of a document of the patient’s intentions except where it would affect the emergency care of the patient.

The Health Care Declarations Registry Account (Account) is created for the purpose of creating and maintaining the registry and educating the public about the registry. The

Account is appropriated and is to be funded through donations and appropriations.

By December 1, 2008, the Department must report to the Legislature on the number of registry participants, number and type of health care declarations submitted, number and type of revocations, number and type of providers and facilities with access to the registry, costs of operating the registry, and donations received for the Account.

2003-2004

Summary

Students in accredited dental schools approved by the Dental Quality Assurance Commission may practice dentistry under the direction and supervision of a dentist licensed in Washington who is a faculty member at a dental school