HOUSE BILL REPORT
SHB 1893
As Passed Legislature
Title: An act relating to allowing emergency medical technicians to provide medical evaluation, testing, and vaccines outside of an emergency in response to a public health agency request.
Brief Description: Allowing emergency medical technicians to provide medical evaluation, testing, and vaccines outside of an emergency in response to a public health agency request.
Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Donaghy, Riccelli, Leavitt, Simmons, Slatter, Tharinger, Berg, Taylor, Frame, Macri, Harris-Talley and Pollet; by request of Department of Health).
Brief History:
Committee Activity:
Health Care & Wellness: 1/27/22, 1/31/22 [DPS].
Floor Activity:
Passed House: 2/10/22, 88-5.
Senate Amended.
Passed Senate: 3/3/22, 47-0.
House Concurred.
Passed House: 3/7/22, 92-6.
Passed Legislature.
Brief Summary of Substitute Bill
  • Modifies the definition of "emergency medical technician" (EMT) to allow EMTs to provide collaborative medical care.
  • Creates a provisional emergency services provider certification and establishes eligibility criteria and certain corresponding restrictions on employment.
HOUSE COMMITTEE ON HEALTH CARE & WELLNESS
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass.Signed by 15 members:Representatives Cody, Chair; Bateman, Vice Chair; Schmick, Ranking Minority Member; Caldier, Assistant Ranking Minority Member; Bronoske, Davis, Harris, Macri, Maycumber, Riccelli, Rude, Simmons, Stonier, Tharinger and Ybarra.
Staff: Emily Poole (786-7106).
Background:

There are several types of emergency medical services (EMS) providers licensed by the Department of Health (DOH), including emergency medical technicians (EMTs), advanced EMTs, and paramedics.

 

Applicants for certification as EMS providers must meet minimum education and training requirements and be recommended for certification by the physician medical program director of the county in which the applicant will be working.  Applicants must also be associated with a licensed aid or ambulance service, a law enforcement agency, a business with an organized industrial safety team, or senior EMS instructors or coordinators teaching at emergency service training programs who are unable to be associated with another approved entity.

 

Certified EMS providers are only authorized to provide patient care when performing in a prehospital emergency setting or during interfacility ambulance transport, for a licensed EMS agency or an organization recognized by the Secretary of Health, and within a scope of care that meets defined criteria.


An EMT is a person who is authorized by the Secretary of Health to render emergency medical care or, under the supervision and direction of an approved medical program director, to participate in a community assistance referral and education services program.

 

In 2020 the DOH adopted a policy statement regarding EMS providers and emergency vaccinations.  In compliance with Washington's EMS scope of practice, the DOH authorized EMTs to administer vaccines under certain conditions when there is a state or local declaration of emergency.
Summary of Substitute Bill:

A provisional emergency services provider certification is created to be issued by the Department of Health (DOH).  To be eligible for a provisional emergency services provider certification, an applicant must: 

  • be currently licensed or certified in another state and be in good standing with the emergency medical services (EMS) board of that state or hold a current EMS provider certification from a national certifying agency approved by the DOH; 
  • be employed or have a valid employment offer from a Washington EMS agency; and 
  • be approved for provisional status from the medical program director of the county in which the applicant is or will be employed.

 

The number of persons holding a provisional emergency services provider certification an employer or host agency may employ is limited as follows: 

  • If the employer or host agency has fewer than 25 employees holding an emergency medical technician or paramedic credential, up to 20 percent of those employees, rounded up to the next whole number, may participate under a provisional emergency services provider certification.
  • If the employer or host agency has 25 or more employees holding an emergency medical technician or paramedic credential, up to 10 percent of those employees, rounded up to the next whole number, may participate under a provisional emergency services provider certification.

 

The 2020 Department of Health policy allowing emergency medical technicians (EMTs) to administer vaccines under certain conditions is codified and expanded to include communicable disease response outside of a state of emergency.

 

The definition of "emergency medical technician" is modified to allow EMTs to provide collaborative medical care.  Collaborative medical care means medical treatment and care provided pursuant to agreements with local, regional, or state public health agencies to control and prevent the spread of communicable diseases, which is rendered separately from emergency medical service.  The provision of collaborative medical care may not exceed the EMT's training and certification.
Appropriation: None.
Fiscal Note: Not requested.
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 will help prevent the spread of communicable diseases.  Emergency medical technicians (EMTs) have played a critical role in the response to the pandemic.  Emergency medical technicians should be able to administer vaccines and conduct testing after the COVID state of emergency is over.  Emergency medical technicians are trained to provide these services, but the law limits them to prehospital settings.  This bill will help increase access to health care, including in rural areas.  The bill will also increase equity in response to vulnerable populations, such as the elderly and people experiencing homelessness, who often bear a disproportionate burden of the impact of communicable diseases. 

 

(Opposed) None.

 

(Other) There should be an amendment limiting EMTs to providing collaborative medical care pursuant to agreements with public health agencies. 
Persons Testifying: (In support) Representative Brandy Donaghy, prime sponsor; Kristin Reichl, Washington State Department of Health; and Joe Kunzler.
(Other) Sean Graham, Washington State Medical Association.
Persons Signed In To Testify But Not Testifying: None.