- Email: [email protected]
Washington
WASHINGTON
Since June 1977, CNMs in Washington have practiced under the Nurse Practice Act as certified registered nurses (CRNs). To qualify as a CRN, an applicant must have a current Washington RN license and a “certification credential for specialized and advanced nursing practice granted by a national certifying body” approved by the Board of Nursing. The scope of practice for CRNs is determined by the relevant certifying agency. After July 1, 1984, the state will only recognize applicants whose formal program of study is at least one academic year in length. Since August 1979, CRNs have been able to apply for a Prescriptive Authorization Document if they have one year of clinical experience and 30 contact hours in pharmacology and clinical management of drug therapy. The contact hours must have occurred within the previous four years, with eight of the contact hours in the previous year. If a CRN qualifies, she/he can sign prescriptions with the initials CRN and an identification number. CRNs may not prescribe controlled substances. The Prescriptive Authorization must be renewed every two years with evidence of eight hours of continuing education in pharmacology. In 1981, Washington passed a law requiring mandatory reimbursement to nurses for all services also reimbursed to physicians. Medicaid also reimburses CNMs. Washington also has had a statute providing for licensure of graduates of midwifery schools on the books since 1917. However, until 1975, no one had been licensed under the law because CNMs were practicing under the Nurse Practice Act and there were no other schools for midwifery in the United States. In the late 197Os, as the homebirth movement Journal of Nurse-Midwifery
grew, several foreign-trained midwives applied for licensure, and the state decided to update the old statute with a new law that became effective on January 15, 1982. The new midwifery statute exempts CNMs from its provisions. Applicants for licensure must present a diploma from a midwifery school whose curriculum includes three years of study for those who are not RNs and no less than two years of study for RNs or those who have practical midwifery experience. The applicant must have cared for 50 women in each of the antepartum, intrapartum, and postpartum periods and pass the licensure examination before she can receive a temporary permit. The applicant then can practice under supervision and must observe another 50 intrapartum cases before receiving licensure. Licensed midwives are allowed to obtain and administer opthalmic prophylactics, postpartum oxytoxics, and local anesthetics and may administer other medications as prescribed by an MD. With the annual renewal of licensure, the midwife must submit a written plan for medical consultation, and emergency transfer and transport of patients. A Midwifery Advisory Committee, consisting of one obstetrician, one other physician, one CNM, three midwives, and one public member, advises the Department of Licensing on matters pertaining to midwifery regulation. Birth centers have been licensed by the state since April 1980.
tice: Recognition document as certified registered nurse (CRN) Frequency of renewal of legal authorization: Euey two years CNM named in statute: No CNM named in regulations: No ACNM certification recognized: Yes RN license required: Yes Written evidence of collaboration agreement required: No Prescriptiue authority: Yes Can CNMs sign birth certificates: Yes Third-party reimbursement dated: Yes
man-
Medicaid reimbursement status: Regulations In place Can graduate nurse-midwives practice before ACNM certification: No CEUs required for CNM: Yes CEUs required for RN: No
ADDRESS AGENCY
OF REGULATORY
State Board of Nursing Division of Professional Licensing Box 9649 Olympia, WA 98504 ADDRESS
OF MEDICAID OFFICE
Department of Social and Health Services Box 9248 MSLG-11 Olympia, WA 98504 ESSENTIAL LEGAL CITATIONS
Are CNMs practicing in the jurisdiction: Yes Authorizing law: Nurse Practice Act Regulated by: Board
ofNursing
Form of legal authorization to prac-
o Vol. 29, No. 2, March/April 1984
Copyright 0 1984 by the American College of Nurse-Midwives
Practice statute: Revised Code of Washington Annotated, Section 18.88 Practice regulations: Washington Administrative Code, Section 308120 161 0091-2182/84/$03.00
Prescriptive authority: Revised Code of Washington Annotated, Section 18.64.011; Washington Administrative Code, Section 30%120400 Private reimbursement statute: Revised Code of Washington Annotated, Section 48.44290
162
Medicaid regulations: Department of Social and Health Services, Division of Medical Assistance, Office of Provider Services, “Certified Registered Nurse Schedule of Maximum Allowances,” July 1983 Birth center licensure: Washington Administrative Code, Section 24829
Other midwifery statute: Revised Code of Washington Annotated, Section 18.50 Medical practice act: Revised Code of Washington Annotated, Section 18.71 Birth certificates: Revised Code of Washington Annotated, Section 70.58.080
Journal of Nurse-Midwifery
?? Vol.
29, No. 2, March/April 1984
Since June 1977, CNMs in Washington have practiced under the Nurse Practice Act as certified registered nurses (CRNs). To qualify as a CRN, an applicant must have a current Washington RN license and a “certification credential for specialized and advanced nursing practice granted by a national certifying body” approved by the Board of Nursing. The scope of practice for CRNs is determined by the relevant certifying agency. After July 1, 1984, the state will only recognize applicants whose formal program of study is at least one academic year in length. Since August 1979, CRNs have been able to apply for a Prescriptive Authorization Document if they have one year of clinical experience and 30 contact hours in pharmacology and clinical management of drug therapy. The contact hours must have occurred within the previous four years, with eight of the contact hours in the previous year. If a CRN qualifies, she/he can sign prescriptions with the initials CRN and an identification number. CRNs may not prescribe controlled substances. The Prescriptive Authorization must be renewed every two years with evidence of eight hours of continuing education in pharmacology. In 1981, Washington passed a law requiring mandatory reimbursement to nurses for all services also reimbursed to physicians. Medicaid also reimburses CNMs. Washington also has had a statute providing for licensure of graduates of midwifery schools on the books since 1917. However, until 1975, no one had been licensed under the law because CNMs were practicing under the Nurse Practice Act and there were no other schools for midwifery in the United States. In the late 197Os, as the homebirth movement Journal of Nurse-Midwifery
grew, several foreign-trained midwives applied for licensure, and the state decided to update the old statute with a new law that became effective on January 15, 1982. The new midwifery statute exempts CNMs from its provisions. Applicants for licensure must present a diploma from a midwifery school whose curriculum includes three years of study for those who are not RNs and no less than two years of study for RNs or those who have practical midwifery experience. The applicant must have cared for 50 women in each of the antepartum, intrapartum, and postpartum periods and pass the licensure examination before she can receive a temporary permit. The applicant then can practice under supervision and must observe another 50 intrapartum cases before receiving licensure. Licensed midwives are allowed to obtain and administer opthalmic prophylactics, postpartum oxytoxics, and local anesthetics and may administer other medications as prescribed by an MD. With the annual renewal of licensure, the midwife must submit a written plan for medical consultation, and emergency transfer and transport of patients. A Midwifery Advisory Committee, consisting of one obstetrician, one other physician, one CNM, three midwives, and one public member, advises the Department of Licensing on matters pertaining to midwifery regulation. Birth centers have been licensed by the state since April 1980.
tice: Recognition document as certified registered nurse (CRN) Frequency of renewal of legal authorization: Euey two years CNM named in statute: No CNM named in regulations: No ACNM certification recognized: Yes RN license required: Yes Written evidence of collaboration agreement required: No Prescriptiue authority: Yes Can CNMs sign birth certificates: Yes Third-party reimbursement dated: Yes
man-
Medicaid reimbursement status: Regulations In place Can graduate nurse-midwives practice before ACNM certification: No CEUs required for CNM: Yes CEUs required for RN: No
ADDRESS AGENCY
OF REGULATORY
State Board of Nursing Division of Professional Licensing Box 9649 Olympia, WA 98504 ADDRESS
OF MEDICAID OFFICE
Department of Social and Health Services Box 9248 MSLG-11 Olympia, WA 98504 ESSENTIAL LEGAL CITATIONS
Are CNMs practicing in the jurisdiction: Yes Authorizing law: Nurse Practice Act Regulated by: Board
ofNursing
Form of legal authorization to prac-
o Vol. 29, No. 2, March/April 1984
Copyright 0 1984 by the American College of Nurse-Midwives
Practice statute: Revised Code of Washington Annotated, Section 18.88 Practice regulations: Washington Administrative Code, Section 308120 161 0091-2182/84/$03.00
Prescriptive authority: Revised Code of Washington Annotated, Section 18.64.011; Washington Administrative Code, Section 30%120400 Private reimbursement statute: Revised Code of Washington Annotated, Section 48.44290
162
Medicaid regulations: Department of Social and Health Services, Division of Medical Assistance, Office of Provider Services, “Certified Registered Nurse Schedule of Maximum Allowances,” July 1983 Birth center licensure: Washington Administrative Code, Section 24829
Other midwifery statute: Revised Code of Washington Annotated, Section 18.50 Medical practice act: Revised Code of Washington Annotated, Section 18.71 Birth certificates: Revised Code of Washington Annotated, Section 70.58.080
Journal of Nurse-Midwifery
?? Vol.
29, No. 2, March/April 1984