HOUSE BILL REPORT
ESHB 1073
As Passed Legislature
Title: An act relating to medical assistants.
Brief Description: Concerning medical assistants.
Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Harris, Tharinger, Ryu, Leavitt, Macri, Caldier, Santos and Ormsby).
Brief History:
Committee Activity:
Health Care & Wellness: 1/20/23, 1/27/23 [DPS].
Floor Activity:
Passed House: 2/15/23, 98-0.
Passed Senate: 4/6/23, 47-0.
Passed Legislature.
Brief Summary of Engrossed Substitute Bill
  • Extends the expiration of a medical assistant-certified interim permit to the issuance of a medical assistant-certified certification.
  • Allows an applicant for a medical assistant-phlebotomist credential or a medical assistant-hemodialysis technician credential who has completed the training program to work, under the level of supervision required for the training program, for a period of up to 180 days after filing their application.
  • Makes changes to the authorized duties of a medical assistant-certified and a medical assistant-registered.
HOUSE COMMITTEE ON HEALTH CARE & WELLNESS
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass.Signed by 14 members:Representatives Riccelli, Chair; Bateman, Vice Chair; Hutchins, Assistant Ranking Minority Member; Barnard, Bronoske, Davis, Harris, Macri, Maycumber, Mosbrucker, Orwall, Simmons, Stonier and Tharinger.
Minority Report: Without recommendation.Signed by 2 members:Representatives Schmick, Ranking Minority Member; Graham.
Staff: Emily Poole (786-7106).
Background:

The Department of Health licenses several different types of medical assistants, including medical assistants-certified and medical assistants-phlebotomist.


Certification.
A person meets the qualifications for certification as a medical assistant-certified if they satisfactorily complete a medical assistant training program approved by the Secretary of Health (Secretary), pass an examination approved by the Secretary, and meet any additional qualifications established by the Secretary in rule.  A person who has completed the other requirements but has not passed the examination may practice as a medical assistant-certified under an interim permit.  The permit expires upon passage of the examination or after one year, whichever occurs first, and may not be renewed.


A person meets the qualifications for certification as a medical assistant-phlebotomist if they meet the qualifications adopted by the Secretary in rule.


Authorized Duties and Supervision.
A medical assistant-certified may perform authorized duties only when delegated by, and under the supervision of, a health care practitioner.  For tasks requiring supervision, the supervising health care practitioner must generally be physically present and immediately available in the facility.  When administering intravenous injections for diagnostic or therapeutic agents, a medical assistant-certified must be under the direct visual supervision of a health care practitioner and meet certain minimum standards established by the Secretary in rule.

 

A medical assistant-registered may perform authorized duties only when delegated by, and under the supervision of, a health care practitioner.  Authorized duties include preparing patients for, and assisting with, routine and specialty examinations, procedures, treatments, and minor office surgeries utilizing no more than local anesthetic.   

Summary of Engrossed Substitute Bill:

Certification.

An interim permit for a medical assistant-certified expires upon passage of the examination and issuance of a certification, or after one year, whichever occurs first.


An applicant for a medical assistant-phlebotomist credential or a medical assistant-hemodialysis technician credential who has completed their training program is allowed to work, under the level of supervision required for the training program, for a period of up to 180 days after filing their application.


Authorized Duties and Supervision.

A supervising health care practitioner is not required to be present during procedures to administer vaccines or obtain specimens for or perform diagnostic testing.

 

A medical assistant-certified may establish intravenous lines for diagnostic or therapeutic purposes, without administering medications, under the supervision of a health care practitioner if the medical assistant-certified meets minimum standards established by the Secretary in rule.  

 

A medical assistant-registered may perform diagnostic testing and electrocardiography and prepare patients for, and assist with, routine and specialty examinations, procedures, treatments, and minor office surgeries, including those with minimal sedation.  A medical-assistant registered may also administer intramuscular injections for diagnostic or therapeutic agents under the immediate supervision of a health care practitioner if the medical assistant-registered meets minimum standards established by the Secretary.  A medical assistant-registered may administer medications for intramuscular injections if the drugs are:

  • administered only by unit or single dosage, or by a dosage calculated and verified by a health care practitioner;
  • limited to legend drugs, vaccines, and Schedule III through V controlled substances as authorized by a health care practitioner; and
  • administered pursuant to a written order from a health care practitioner.
Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill contains an emergency clause and takes effect immediately.
Staff Summary of Public Testimony:

(In support) This bill will help reduce discrepancies in supervision and licensing requirements between Washington and Oregon and help improve access to medical care.  Medicine today is a team sport, and all practitioners need to be able to operate at the highest level.  This bill will help have more people available to do important jobs, like drawing blood, administering intravenous injections, and giving medications.  It is more efficient for physician assistants to be able to complete certain tasks without direct visual supervision.  Medical assistants-phlebotomist serve a very important role.

 

(Opposed) None.


(Other) The bill makes concerning changes to the ability of medical assistants to administer drugs via intravenous lines.  There is some worry from physicians about the ability of medical assistants to determine when the supervising health care practitioner needs to be retrieved.

Persons Testifying: (In support) Representative Paul Harris, prime sponsor; and Mark Zeitzer, ZoomCare.
(Other) Sean Graham, Washington State Medical Association.
Persons Signed In To Testify But Not Testifying: None.