HOUSE BILL REPORT

SHB 1304

As Passed House:

February 14, 2011

Title: An act relating to administration of drugs by health care assistants.

Brief Description: Concerning the administration of drugs by health care assistants.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Jinkins, Harris, Green, Cody, Van De Wege, Kelley, Schmick, Bailey, Clibborn, Moeller, Hinkle and Reykdal).

Brief History:

Committee Activity:

Health Care & Wellness: 1/26/11, 2/3/11 [DPS].

Floor Activity:

Passed House: 2/14/11, 93-1.

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 11 members: Representatives Cody, Chair; Jinkins, Vice Chair; Schmick, Ranking Minority Member; Hinkle, Assistant Ranking Minority Member; Bailey, Clibborn, Green, Harris, Kelley, Moeller and Van De Wege.

Staff: Jim Morishima (786-7191).

Background:

A certified health care assistant is authorized to provide assistance to certain licensed health care practitioners, such as physicians, nurses, and naturopaths. A licensed health practitioner may delegate certain functions to the health care assistant such as administering skin tests, injections, and performing blood withdrawals.

Each health care assistant is certified by the facility in which they are employed, or by the practitioner who delegates functions to the health care assistant, pursuant to standards adopted by the Department of Health (DOH) in rule. The facility or practitioner must submit a roster of certified health care assistants to the DOH.

Health care assistants are divided into seven different categories based on differing educational, training, and experiential requirements. The different tasks each category of health care assistant may perform are as follows (all health care assistants may administer vaccines):

• Category A: venous and capillary invasive procedures for blood withdrawal;

• Category B: arterial invasive procedures for blood withdrawal;

• Category C: intradermal, subcutaneous, and intramuscular injections for diagnostic agents and the administration of skin tests;

• Category D: intravenous injections for diagnostic agents;

• Category E: intradermal, subcutaneous, and intramuscular injections and the administration of skin tests;

• Category F: intravenous injections for therapeutic agents; and

• Category G: hemodialysis.

In 2009 the Legislature authorized health care assistants to administer certain over-the-counter drugs (e.g., Benadryl, acetaminophen, ibuprofen, aspirin, Neosporin) and certain legend drugs (e.g., kenalog, hydrocortisone cream, raglan, compazine). The administration of these drugs is limited to oral, topical, rectal, otic, ophthalmic, or inhaled routes and must be pursuant to a written order of a supervising health care practitioner. Only category C or E health care assistants may administer oral drugs.

The provisions allowing health care assistants to administer drugs expire on July 1, 2013.

Summary of Substitute Bill:

Only category C or E health care assistants may administer over-the-counter drugs and legend drugs (as opposed to "oral" over-the-counter and legend drugs). The DOH must adopt any rules necessary to implement this limitation.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) This bill is a technical fix to resolve a drafting error. The bill makes sure that the people authorized to administer these medications have the training to do so. Category C and E health care assistants not only have the training and education, but also practice in the settings where these medications are likely to be administered.

(Opposed) None.

Persons Testifying: Representative Jinkins, prime sponsor; Carl Nelson, Western State Medical Association; and Sofia Aragon, Washington State Nurses Association.

Persons Signed In To Testify But Not Testifying: None.