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I sent the following letter to the Washington Department of Fish and Wildlife on March 17th:

 

Dear WDFW legal counsel:

 

I am a physician assistant (my license number) licensed to practice medicine in Washington State.  Completing paperwork on behalf of my patients is a substantial part of my regular duties in both family and occupational medicine.  In the scope of my practice, I attest to current worker disability status for the Department of Labor and Industries, certify data on deceased Washington residents for the Department of Health’s Electronic Death Reporting System (the modern equivalent of ‘signing a death certificate’), and attest to disability status for disabled parking permits for the Department of Licensing.

 

All of these other departments comply with both the spirit and letter of the RCW governing physician assistant practice, specifically the clause on documentation completion, RCW 18.71A.090, which states:

 

"A physician assistant may sign and attest to any certificates, cards, forms, or other required documentation that the physician assistant's supervising physician or physician group may sign, provided that it is within the physician assistant's scope of practice and is consistent with the terms of the physician assistant's practice arrangement plan as required by this chapter."

 

 

I note specifically the legislative intent from 2007, as documented on that web page: 

 

"The legislature finds that some state agencies and departments do not accept the signature of physician assistants on certain certificates, reports, and other documents that their supervising physician is permitted to sign, notwithstanding the fact that the signing of such documents is within the physician assistant's scope of practice, covered under their practice arrangement plan, and permitted pursuant to WAC 246-918-140.

 

"It is therefore the intent of the legislature to clarify in statute what was adopted by rule in WAC 246-918-140, that a physician assistant may sign and attest to any document that might ordinarily be signed by the supervising physician and that is consistent with the terms of the practice arrangement plan.”

 

By requiring only a physician’s signature on a Washington State Disabled Hunter/Fisher application, the department appears to be in direct violation of RCW 18.71A.090. Attached is a copy of a recent letter sent back to my patient, with personally identifying info redacted, demonstrating that rejecting physician assistant certification of disability status is both current, and sufficiently common that there is a corresponding box on the attendant form letter.

 

Please educate me as to a specific RCW which exempts the Disabled Hunter/Fisher application process from RCW 18.71A.090, or amend the department’s current practices to match the decade-old law.

 

Cordially,

(me)


I got a written letter from the WDFW Disabilities section the next week, saying essentially "yes, we know". And then yesterday, I got a nice letter back from WAPA (whom I had CC:'ed on the initial email) confirming that WDFW, after correspondence with the responsible state assistant attorneys general, had agreed to revise the practice.  Oh, and I helped win one for the NP's, too, as they were also previously prohibited from certifying residents as disabled for the purpose of hunting/fishing licenses... :-)

 

Moral of the story?  Know your laws, argue politely but directly, and bring up the impact on real patients in real situations rather than theoretical problems.

 

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