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The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
"Department" means the department of health.
"Health care administrator" means a person employed by a hospital who is a:
Nonclinical hospital manager with direct supervisory authority over clinical health care providers who is responsible for one or more of the following activities:
Hiring, scheduling, evaluating, and providing direct supervision of clinical health care providers;
Monitoring activities for compliance with state or federal regulatory requirements; or
Developing fiscal reports for clinical units or the hospital as a whole; or
Nonclinical hospital director, officer, or executive who does not have direct supervisory authority over health care providers, but has direct or indirect supervisory authority for nonclinical hospital managers described in (a) of this subsection, for one or more of the following activities:
Hiring and supervising those nonclinical hospital managers in (a) of this subsection;
Providing oversight of operations for the hospital or any of its departments;
Developing policies and procedures establishing the standards of patient care;
Providing oversight of budgetary and financial decisions related to operations and the delivery of patient care for the hospital or any of its departments; and
Ensuring that hospital policies comply with state and federal regulatory requirements.
"Hospital" means a hospital licensed under chapter 70.41 RCW or a psychiatric hospital licensed under chapter 71.12 RCW.
"Secretary" means the secretary of the department.
In addition to any other authority, the secretary has the authority to:
Adopt rules under chapter 34.05 RCW necessary to implement this chapter;
Establish all initial licensing and renewal fees for health care administrators in accordance with RCW 43.70.110 and 43.70.250;
Establish forms and procedures necessary to administer this chapter;
Issue licenses to applicants who have met the requirements for obtaining an initial license or renewal license, as established under section 5 or 6 of this act, and to deny a license to applicants who do not meet the requirements;
Establish and administer requirements for continuing education necessary for renewal of a license;
Establish practice parameters consistent with the definition of the health care administration activities;
Prepare, grade, and administer, or supervise the grading and administration of written examinations for obtaining a license;
Conduct audits of hospitals for the purpose of determining the compliance of licensed health care administrators with this chapter; and
Adopt rules implementing continuing education requirements.
Beginning January 1, 2027, any person who is employed as a health care administrator at a hospital in Washington must be licensed as a health care administrator under this chapter. The licensing requirement only applies to health care administrators employed by a hospital in Washington.
Nothing in this chapter shall be construed to require a health care administrator employed by the United States armed services or any other branch of the federal government to obtain a license under this chapter.
The secretary shall issue an initial health care administrator license to any applicant who demonstrates to the satisfaction of the secretary that the applicant meets the following requirements:
Successful completion of an approved examination that addresses the topics identified in section 7 of this act;
Completion of an application form with necessary information to allow for appropriate licensing of the applicant, including information about the applicant's employer and the types of health care administration activities that the applicant performs and requires licensure;
Payment of the appropriate fee determined by the secretary under RCW 43.70.250; and
Completion of other requirements established by the secretary.
A health care administrator license must be renewed annually. The secretary shall establish, by rule, the requirements and fees for renewal of a license, including proof of the successful completion of approved continuing education, as established by the secretary.
The secretary shall develop and administer examinations to demonstrate the applicant's knowledge of relevant health care laws and regulatory standards, patient safety protocols, and health-related ethical guidelines. The department may approve the use of the examinations that it has developed or approve an examination developed and administered by a private organization.
The date and location of examinations must be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for obtaining a license must be scheduled for the next examination following the filing of the application. The secretary shall establish by rule the examination application deadline.
The secretary or the secretary's designees shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice, as applicable. The examinations must be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.
The examination papers, all grading of the papers, and the grading of any practical work shall be preserved for a period of not less than one year after the secretary has made and published the decisions. All examinations must be conducted under fair and wholly impartial methods.
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 remedial education before the person may take future examinations.
The uniform disciplinary act, chapter 18.130 RCW, governs the unlicensed practice as a health care administrator, the issuance and denial of licenses, and the discipline of health care administrators under this chapter.
In addition to those acts described in RCW 18.130.180, the term "unprofessional conduct," as applied to health care administrators, includes:
Fiscal or operational decisions which result in injury to a patient or create an unreasonable risk that a patient may be harmed;
A violation by a licensed health care provider of a state or federal statute or administrative rule regulating a profession, as provided in RCW 18.130.180(7), when the licensed health care administrator was responsible for the oversight of the licensed health care provider;
Aiding or abetting a licensed health care provider to practice their health care profession after a patient complaint or adverse event has been reported to the hospital employing the licensed health care administrator, the department, or the appropriate disciplining authority, while the complaint or adverse event is being investigated, and if harm, disability, or death of a patient occurred after the complaint or report of the adverse event;
Failure to adequately supervise licensed clinical staff and nonclinical staff to the extent that a consumer's health or safety is at risk;
Any administrative, operational, or fiscal decision that impedes a clinical licensed health care provider from adhering to standards of practice or leads to patient harm, disability, or death; and
Fiscal or operational decisions resulting in the inability of clinical licensed health care providers to practice with reasonable skill and safety, regardless of the occurrence of patient harm, disability, or death.
When issuing sanctions under RCW 18.130.160, the disciplining authority shall give consideration to the extent to which the licensed health care administrator who is the subject of the disciplinary matter had the ability to exercise control within the hospital's operational structure regulating the policies and financial decisions that resulted in the act of unprofessional conduct. As appropriate, the disciplining authority may consider it to be a mitigating factor if a licensed health care administrator had limited authority or discretion to act regarding hospital policies and financial decisions.
(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.