Effective October 1, 2019: New Disclosure Requirements Regarding Provider Sexual Misconduct

Change of Law: Hospital Action Required

To:                 Chief Medical Officers, Chief Nursing Officers, Legal Counsel and Government Affairs Staff
                       Please forward to risk managers

From:            Zosia Stanley, JD, MHA, Associate General Counsel | ZosiaS@wsha.org | (206) 216-2511

Subject:        Effective October 1, 2019: New Disclosure Requirements Regarding Provider Sexual Misconduct

Purpose

The purpose of this bulletin is to inform hospitals of a new requirement that health care providers disclose to patients if a disciplining authority has sanctioned the provider for unprofessional conduct involving sexual misconduct.  This requirement in SHB 1198 goes into effect on October 1, 2019.

Applicability/Scope

The disclosure requirement applies to all health care providers who are subject to the Uniform Disciplinary Act (chapter 18.130 RCW), other than veterinarians.  While the disclosure requirement applies to providers, rather than facilities, hospitals should ensure that a copy of the required disclosure is included in the patient’s file.

Overview

Substitute House Bill 1198 requires all health care providers subject to the Uniform Disciplinary Act to provide a disclosure to patients if the provider is sanctioned by the relevant disciplining authority for unprofessional conduct involving sexual misconduct.  This requirement applies to sanctions imposed on or after October 1, 2019.

The provider (or his or her designee) must provide the disclosure to any patient scheduled for an appointment with the provider during the time period when the disciplining authority’s order or stipulation is in effect. The disclosure is only required to be provided at or before the patient’s first visit with the provider.

The disclosure must include the following information:

1. A copy of the disciplining authority’s stipulation to informal disposition or public order, such as an agreed order, default order, final order, or reinstatement order (but not a summary restriction order);
2. A description of the sanctions imposed, including their duration;
3. The telephone number of the relevant disciplining authority; and
4. An explanation of how the patient can find more information about the provider on the disciplining authority’s license information website.

The patient or surrogate decision-maker must sign a copy of the disclosure, indicating that the patient received a copy of the order or stipulation and is aware that the provider was sanctioned for unprofessional conduct involving sexual misconduct.  A copy of the signed disclosure must be maintained in the patient’s file.

Recommendation & Next Steps

To implement SHB 1198, hospitals should:

• Be familiar with these new requirements and procedures and share this information with providers who provide services in the hospital.
• Create a sexual misconduct disclosure form. WSHA has provided a sample disclosure form that hospitals may wish to modify for their own use.
• Ensure that procedures are in place to maintain a signed copy of the disclosure in the patient’s file.
• Make any necessary updates to existing policies and procedures related to sexual misconduct by health care providers, including when and how the facility is notified of findings against health care providers.

Background and References

Credentialed health care providers are subject to professional discipline under the Uniform Disciplinary Act (UDA).  Depending on the profession, the disciplining authority may be the Secretary of Health or one of 16 different boards and commissions as stated in RCW 18.130.040. The relevant boards and commission

• The board of denturists;
• The board of examiners for nursing home administrators;
• The board of hearing and speech as established in chapter 18.35 RCW;
• The board of naturopathy;
• The board of occupational therapy practice;
• The board of osteopathic medicine and surgery;
• The board of physical therapy;
• The chiropractic quality assurance commission;
• The dental quality assurance commission;
• The examining board of psychology;
• The Washington medical commission;
• The nursing care quality assurance commission;
• The optometry board;
• The pharmacy quality assurance commission;
• The podiatric medical board;
• The veterinary board of governors (which is exempt from the sexual misconduct reporting requirements).

Each board and commission has promulgated regulations defining sexual misconduct, as required by Executive Order 06-03 from then Washington State Governor Gregoire. The relevant rules are in Title 246 WAC.

The UDA authorizes a disciplining authority to impose sanctions on a provider who has committed unprofessional conduct.  Unprofessional conduct is defined by statute to include a variety of acts, including sexual contact with or abuse of a patient, commission of an act involving moral turpitude, malpractice that injures a patient or creates an unreasonable risk of harm, and violation of the standard of care.

If a disciplining authority (the Secretary of Health or a board or commission) receives a complaint that a provider has engaged in unprofessional conduct, the disciplining authority investigates, holds a hearing, and imposes sanctions if the complaint is substantiated.  If a complaint alleges that a provider has committed unprofessional conduct involving sexual misconduct and the case does not involve clinical expertise or standard of care issues, the Secretary of Health serves as the sole disciplining authority during the disciplinary process.

Sanctions are intended to protect the public and, if possible, rehabilitate the provider.  In selecting sanctions, the disciplining authority must follow the standards and procedures outlined in Department of Health rules, which include sanction schedules for different categories of conduct.  Available sanctions include revocation or suspension of the license, restriction of the practice, completion of a program or treatment, monitoring, reprimand, probationary conditions, fines, corrective action, and a surrender of the license.  Sanctions begin on the effective date of the order and must be reported to the national database, professional organizations and associations, other states’ licensing authority, and the public.

SHB 1198
Uniform Disciplinary Act, chapter 18.130 RCW
WSHA Sample Patient Disclosure Regarding Health Care Provider Sexual Misconduct
Sanctions rules, WAC 246-16-800 through -890
Department of Health Provider Credential Search
Glossary of Terms applicable to health care provider regulation