Seattle registered counselor Devlin Crose advised an 11-year-old girl that she could have sex with anyone she wanted — including him, according to allegations filed by the state Department of Public Health.

Mercer Island gynecologist Charles Flake engaged in sexual affairs with three female patients, a board of professional peers ruled.

Snohomish nursing assistant Jerry Murry coerced a 16-year-old girl into sexual acts, according to state administrative charges.

These are among 60 sexual-misconduct cases the state has brought so far this year against Washington health-care professionals, up more than 50 percent over last year's total.

The state now has new rules that will make it easier to file charges and make them stick.

As of Sunday, patients are protected by a comprehensive set of rights, and practitioners are bound by detailed restrictions, which are among the toughest state standards nationally, research shows.

The state had lacked uniform rules to punish offenders, and as a result hundreds were returned to work, some of whom went on to offend again.

Some of the new rules include: patients must be afforded privacy when undressing; practitioners cannot solicit dates from patients, discuss their own sexual histories or describe fantasies; and practitioners must wear surgical gloves during genital exams.

Even the definition of a patient has changed to include any "key party" to health care, such as parents of young patients. In recent years, some practitioners, facing discipline, argued that mothers of patients were fair game for sexual pursuits.

The adoption of harsher standards was ordered by Gov. Christine Gregoire in response to a Seattle Times investigation, "License to Harm," published in April, which revealed how state officials and licensing boards often turned a blind eye to sexual misconduct by health-care practitioners.

The series found that the state Department of Health has failed to adequately investigate and punish the offenders by dismissing hundreds of sexual-misconduct complaints without making so much as a single telephone inquiry.

Even when the state handed out discipline, it often returned offenders to work under shoddy safeguards, the series found.

These new rules apply to 27 health-care professions directly overseen by the health department, such as nursing assistants and registered counselors. Fourteen other professions, including physicians and chiropractors, have already expanded sexual-misconduct rules.

But dentists and pharmacists are among the 16 health professions that have yet to adopt uniform rules. The goal is for all professions to be guided by similar rules by early 2007.

"It's a matter of getting up to speed," said health department spokesman Donn Moyer.

Flake acknowledged the three sexual relationships with patients and the Medical Quality Assurance Commission suspended his license. Neither Crose nor Murry has responded to the state's charges. They could not be reached.

The health department also is expected to strengthen standards to become a registered counselor. Currently, the state requires only a $40 application fee and attendance at a three-hour course on AIDS. No education or experience is required.

Since 1995, more registered counselors have been disciplined in Washington for sexual misconduct than any other health-care profession, The Times found.

Michael J. Berens: 206-464-2288 or mberens@seattletimes.com