DOH administrative adjudications's independence and impartiality eroded by "Index of Significant Decisions"

The Department of Health maintains an “Index of Significant Decisions,” which are decisions from disciplinary hearings that “include an analysis or decision of substantial importance to the department in carrying out its duties.”  WAC 246-08-480(1).   Health Law Judges (HLJs) frequently treat these decisions as binding authority even though no statute or case law addresses the question of what precedential weight these “significant decisions” carry in subsequent administrative adjudications. This practice risks the possibility of life-altering (potentially career-ending) decisions being guided by reasoning that may actually be contrary to Washington law.Chapter 18.130 of the Revised Code of Washington (RCW), or the “Uniform Disciplinary Act” governs all licensed healthcare providers in Washington State.  Under Title 246 of the Washington Administrative Code (WAC), DOH has promulgated thousands of additional regulations ranging in subjects from the sanitary control of shellfish to sewer systems to professional standards and licensing for healthcare providers.  Alleged violations of DOH professional standards and licensing rules subjects Washington providers to administrative disciplinary action pursuant to the Uniform Disciplinary Act.  A vast number of healthcare provider disciplinary proceedings have reached the Washington Court of Appeals and Supreme Court.  All of the published decisions from these appellate cases are, by definition, binding on lower courts and administrative tribunals.  The legislature and the Department, under its delegated authority, decide what rules healthcare providers in this state must follow.  The Constitution leaves it to the courts to decide genuine disputes regarding the interpretation of those rules. Allowing Department HLJs to rely on their own prior decisions, which have never been subject to judicial or legislative review, in interpreting important legal questions erodes the independence and impartiality of DOH administrative adjudications.