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                                          SUBSTITUTE HOUSE BILL NO. 1495

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                                                                            C 115 L 86

State of Washington                              49th Legislature                              1986 Regular Session

By House Committee on Social & Health Services (originally sponsored by Representative Brekke)

Read first time 2/3/86 and passed to Committee on Rules.

AN ACT Relating to health care assistants; and amending RCW 18.135.060 and 18.135.020.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  Section 6, chapter 281, Laws of 1984 and RCW 18.135.060 are each amended to read as follows:

          Any health care assistant certified pursuant to this chapter shall perform the functions authorized in this chapter only by delegation of authority from the health care practitioner and under the supervision of a health care practitioner acting within the scope of his or her license.  In the case of subcutaneous, intradermal and intramuscular and intravenous injections, a health care assistant may perform such functions only under the supervision of a health care practitioner having authority, within the scope of his or her license, to order such procedures:  PROVIDED, That a health care assistant trained by a federally approved end-stage renal disease facility may perform venipuncture for blood withdrawal, administration of oxygen as necessary by cannula or mask, venipuncture for placement of fistula needles, intravenous administration of heparin and sodium chloride solutions as an integral part of dialysis treatment, and intradermal, subcutaneous, or topical administration of local anesthetics in conjunction with placement of fistula needles, and intrapertoneal administration of sterile electrolyte solutions and heparin for peritoneal dialysis, in the center or health care facility or in the patient's home if a registered nurse licensed under chapter 18.88 RCW is physically present and immediately available in such health care facility for patients dialyzing in the health care facility or center or for patients dialyzing at home if a physician and a registered nurse are available for consultation during the dialysis.

        Sec. 2.  Section 2, chapter 281, Laws of 1984 and RCW 18.135.020 are each amended to read as follows:

          As used in this chapter:

          (1) "Director" means the director of licensing.

          (2) "Health care assistant" means an unlicensed person who assists a licensed health care practitioner in providing health care to patients pursuant to this chapter.

          (3) "Health care practitioner" means:

(a) A physician licensed under chapter 18.71 RCW((,));

(b) An osteopathic physician or surgeon licensed under chapter 18.57 RCW((,)); or((,))

(c) Acting within the scope of their respective licensures, a podiatrist licensed under chapter 18.22 RCW or a registered nurse licensed under chapter 18.88 RCW.

          (4) "Supervision" means supervision of procedures permitted pursuant to this chapter by a health care practitioner who is physically present and is immediately available in the facility during the administration of injections, as defined in this chapter, but need not be present during procedures to withdraw blood.

          (5) "Health care facility" means any hospital, hospice care center, licensed or certified health care facility, health maintenance organization regulated under chapter 48.46 RCW, federally qualified health maintenance organization, renal dialysis center or facility federally approved under 42 C.F.R. 405.2100, ((or)) blood bank federally licensed under 21 C.F.R. 607, or clinical laboratory certified under 20 C.F.R. 405.1301-16.

          (6) "Delegation" means direct authorization granted by a licensed health care practitioner to a health care assistant to perform the functions authorized in this chapter which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee.                                                                                                               Passed the House March 8, 1986.

Speaker of the House.

Passed the Senate March 4, 1986.

President of the Senate.