Under state law, each profession must be self-supporting through the fees that licensees pay. The department sets or changes fees through a formal rule-making process that includes opportunities for the public to give input.
- Which professions have had recent changes to their fees?
- Why does the department increase fees?
The Department of Health reviews how much income is received from licensing fees for each healthcare profession compared to ongoing costs of regulating that profession. Under state law, licensing fees must reflect these costs, and the costs must be shared by all members of the profession. When a profession's revenue and reserves don't support current or projected expenses, the department must increase fees for that profession.
- Why does the department reduce fees?
The Department of Health reviews how much income is received from licensing fees for each health care profession compared to ongoing costs of regulating that profession. Under state law, licensing fees must reflect these costs, and the costs must be shared by all members of the profession. When the department takes in more fee income than is needed (including reserves for unexpected expenses) the department may reduce the fees for that profession.
- If my profession will have a fee change, when do I have to start paying the new fee?
If your profession received a fee increase, fee decrease or a new fee, the new amount is due on your next credential renewal date. This is typically your birthday unless otherwise noted on the professions fee change information webpage.
- What is the HEAL-WA fee? Why do I have to pay it? And why doesn't everyone have to pay it?
State law requires members of certain professions to pay an annual fee to use an online healthcare resources library through the University of Washington's HEAL-WA portal. The portal gives access to professional journals, research and other clinical information at lower costs than practitioners would pay for these resources individually.
The law doesn't allow individual licensees to opt out of the paying the HEAL-WA fee. Also, the law doesn't allow individuals in other professions to pay the fee to gain access to the HEAL-WA portal.
Starting in 2012, some practitioners who hold licenses in multiple professions began paying only one HEAL-WA fee instead of two or more fees as in years past.
- How much is my fee changing?
To view the fee changes for your profession, find your profession on the department website.
To find out about proposed fee changes, see the professions fee change information webpage.
- Why does the department change fees?
State law requires that each profession be self-supporting. Fees must cover the costs to administer and regulate the profession, including reserves for unexpected expenses. The department must raise fees when the costs of regulating a profession are projected to exceed the projected revenue received from licensing fees.
- How does the department determine fees?
By law, the department must ensure that each profession is self-supporting. The department analyzes the revenue and expenses for each profession, considering growth in the number of licensees, past costs, and future needs to determine if a profession's fees will cover future costs.
When a profession's revenue and reserves don't support current or projected expenses, the department must ask the legislature for permission to increase fees. We must show the legislature why we must raise fees, and estimate what the new fee amount would be. If the legislature approves, the department starts the rule-making process to increase the fee.
- What does my fee pay for?
Licensing fees support the costs of administration and regulation of each profession and include, but are not limited to:
- Implementing standards set or changed by the legislature, including writing and adopting rules
- Disciplinary activities, including investigating complaints, hearings and related actions. Patient safety is the department's number one priority. Allowing unsafe providers to practice hurts the people of the state as well as the public's faith in the department and the profession.
- Licensing costs, including issuing and renewing credentials, reviewing applications, background checks, confirming education and training of applicants, responding to licensee questions and related customer service activities
- Administrative costs, including salaries and benefits, computer services, legal support, utilities, building rents, supplies, postage and related costs
- If the profession is regulated by a healthcare profession board or commission, members' time and travel, meeting costs, and related expenses.
- Why do fees increase for some professions, but not for others?
The department looks at costs to regulate each profession separately, including:
- The number of licensees in a profession. A profession with a high number of licensees can more likely spread costs over its members than a profession with a low number of licensees.
- Credentialing costs. These vary by profession. Whether the profession has a registered, certified or licensed credential greatly affects what it costs to process and issue new or renewal credentials. For example, a person applying for registered credential doesn't need to submit education and training information. On the other hand, a person applying for many of the licensed credentials must submit proof of education, training and clinical experience, and the department must verify them. Some credentialing costs, such as doing background checks, are generally the same for all credential types.
- Discipline history is a key factor. A high discipline rate usually means higher expenses for a profession. But, even professions with low discipline rates can have high costs depending on how complex cases have been, or how many members of profession there are to share these costs.
- Shouldn't more licensees in a profession mean lower fees?
Generally, yes. While there are more practitioners to share the costs, there may also be more costs to share. Some professions receive more complaints, require more investigations, and have higher rates of disciplinary action. Some professions receive fewer complaints; but the cases investigated may be more complex than another profession's cases.
- I make less money than another profession. Why are my fees higher?
By law, the department must consider costs to regulate each profession separately when setting fees. The department does not have the option to consider costs for other professions, nor can we spread the costs of regulating one profession to others. The department also cannot consider health profession licensing fees in other states.
- What are discipline costs and why do I have to pay them?
All licensees in a profession must share the costs of the profession. This includes discipline. The department has seen a dramatic increase in discipline activity in recent years for some professions. The following affect discipline costs:
- Complaints received.
- Background checks completed on applicants. A positive state or national background check adds to the disciplinary workload.
- Investigations on complaints received or positive results from a background check.
- Court cases have added requirements for how we collect evidence and have raised the level of proof necessary to move forward with discipline.
- Frequency and complexity of disciplinary cases continue to rise.
- Impaired provider programs costs have increased. These programs work with practitioners to prevent or reduce impaired practice.
- Why don't people pay for their own discipline costs instead of making innocent licensees pay?
State law requires that all licensees in a profession share equally in the cost for the profession. This includes discipline. In general, the department can assess specific fines; but these fines do not recover all of the discipline costs. With the exception of one profession, the laws don't allow the department to assess discipline costs against just the people involved. Legislation in 2009 authorized the department to assess additional costs against practitioners for just one profession; under specific requirements.
- Why are the renewals fees so high? It doesn't cost that much to print a card.
Renewal fees are one part of the overall revenue for a profession. All activities contribute to the costs for credentialing and renewal. Renewal costs include more than the work and costs to send out the renewal notices, and the work to process renewals. One activity associated with renewals is to verify practitioners complete required continuing education, if applicable. Another activity that occurs more frequently with existing practitioners is requests for information on a practitioner. People want to know if their practitioner is licensed and if the practitioner has any complaints.
- Why is my fee higher in Washington than another state?
Each state regulates healthcare professions based on their own laws and rules of the individual state. While there may be similarities, no two states do everything the same. The department must base licensing and other fees on the costs to regulate a profession according to the laws and rules of Washington State.
- Why is the time for public comment on a fee change so short?
Fee changes must be adopted in rule (also known as the Washington Administrative Code). State rule-making laws set a minimum length of time before a public hearing on the fee rule can be held. This must be at least 20 days after a proposed fee is published in the Washington State Register. However, the department typically lets the public know about proposed rules up to 34 days before the hearing date, and sometimes earlier.
We put information about proposed fee changes on the department rules comment website. You may also get rules information directly by selecting the green "Subscribe" button at the bottom of the page.
- What happens if fees are not raised?
Patient safety is threatened as many services might not occur in a timely manner:
- Investigating and resolving complaints about healthcare professionals may take longer.
- Providing the protection and level of service the public expects.
- Licensing, including conducting fingerprint-based federal background and other national databank checks, might become backlogged. This could result in significant delays in issuing new licenses and renewals.
- A growing backlog of disciplinary cases slows decisions. In some cases, incompetent or unethical health providers could continue to practice.
- Can I pay my renewal fees online?
Yes. All healthcare profession credentials can be renewed online, including paying renewal fees. See the department's online renewal webpage for details and instructions.
The department is in the process of making online applications available to applicants for initial (new) credentials, including paying fees online. See the online applications frequently asked questions webpage for current information.
- Can I pay part of the fee now and part later?
No. State law requires that practitioners must pay the full renewal fee to renew the credential and doesn't allow partial payments or installment payments.
- Is there a grace period to pay my fee?
No. The total fee is due on or before your credential expiration date. If the fee isn't paid, then a late penalty fee is assessed.
- Where may I get more information?
You may find more profession-specific information: