House Bill 1792 amends and reorganizes existing law to consolidate regulatory authority over nursing assistants under the Washington State Board of Nursing. It replaces prior references to a commission, defines terms (including two levels of nursing assistant, medication assistant, approved and alternative training, competency evaluation), sets the board composition, appointment process, qualifications, four-year terms and a two-term limit, and gives the board rulemaking authority. The bill also amends many RCWs governing certification, registration, medication assistant endorsements, approved and alternative training pathways, competency evaluations, reciprocity with home care aide and medical assistant credentials, fee collection, and delegation of nursing tasks. The bill makes procedural and regulatory changes rather than creating new criminal offenses. Key procedural changes include new requirements for certification and registration (for example, nursing home employees must obtain certification through approved or alternative training and a competency evaluation before employment), limits on practicing without registration/certification/endorsement, standards and exam retake limits (up to three additional competency evaluations with fee; after four failures the secretary may invalidate the application and require remedial education), criteria for military training equivalency, endorsement by reciprocity if another state’s standards are substantially equivalent, specified permitted and prohibited functions for medication assistants and supervision requirements, and assignment rules for nursing assistant-registered. It also designates the board as the disciplining authority under the Uniform Disciplinary Act and clarifies the Department of Health and Department of Social and Health Services roles for home care aide certification and nurse delegation training certificates. The act repeals RCW 18.88A.100, reenacts and amends RCW 18.130.040, and sets effective dates and a limited expiration: most sections take effect July 1, 2026; one section takes effect June 30, 2027; Section 1 expires June 30, 2027. Important implementation details are not present in the extracted facts: several amended RCWs are referenced but their full texts are not included here, numeric values for some requirements (for example the minimum hours of work experience for medication assistant endorsement) are left to board rulemaking and are not specified, and one provision was truncated in the provided material so its remainder is uncertain.

If enacted, the bill centralizes regulation of nursing assistants under the Washington State Board of Nursing, reshapes who sits on that board, and tightens who can be called a nursing assistant, nursing assistant-certified, nursing assistant-registered, or medication assistant. Employers in nursing homes and other licensed health facilities will need to verify that nursing assistants are certified or registered before assigning care, and medication assistants must meet specified training, work-experience, exam, and on-site RN supervision requirements. The board gets rulemaking and disciplinary authority, the governor appoints board members with new term limits and qualification rules, and DSHS and the Department of Health play roles for delegation training and background checks. Practically this will likely raise compliance work and some costs for workers and employers: applicants and employers can expect fees for registration, certification, endorsements and retake exams; nursing assistants may need extra training (including 24 hours for some reciprocity paths), supervisors must ensure competency demonstrations before assignment, and failing multiple competency exams can lead to required remedial education. Key details that affect exact costs and timelines—fee amounts, the minimum documented work hours for medication assistants, specific board rules, and certain truncated provisions—are not provided in the text, so total fiscal and operational impacts remain uncertain.