WSR 11-18-033

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed August 30, 2011, 1:20 p.m. ]

Original Notice.

Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

Title of Rule and Other Identifying Information: WAC 246-826-100 amending the scope of practice for health care assistants to limit the administration of drugs listed in RCW 18.135.130 to health care assistants certified in categories C or E.

Hearing Location(s): Department of Health, Point Plaza East, Room 152, 310 Israel Road S.E., Tumwater, WA 98501, on October 14, 2011, at 9:00 a.m.

Date of Intended Adoption: October 19, 2011.

Submit Written Comments to: Erin Obenland, P.O. Box 47852, Olympia, WA 98504-7852, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2901, by October 14, 2011.

Assistance for Persons with Disabilities: Contact Erin Obenland by October 7, 2011, TTY (800) 833-6388 or 711.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: SHB 1304 (chapter 43, Laws of 2011) allows only health care assistants certified in categories C or E to administer certain over-the-counter and prescription drugs. The rules need to be amended to reflect the change in the law.

Reasons Supporting Proposal: SHB 1304 amends the scope of practice for health care assistants so that only health care assistants certified in categories C or E can administer the drugs that are listed in RCW 18.135.130. The current rule needs to be amended to specify that no other categories but those health care assistants certified in C or E can administer the drugs outlined in the law.

Statutory Authority for Adoption: Chapter 18.135 RCW, SHB 1304 (chapter 43, Laws of 2011).

Statute Being Implemented: Chapter 18.135 RCW, SHB 1304 (chapter 43, Laws of 2011).

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of health, health care assistant program, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Erin Obenland, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4945.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry.

A cost-benefit analysis is not required under RCW 34.05.328. The agency did not complete a cost-benefit analysis under RCW 34.05.328. RCW 34.05.328 (5)(b)(iii) exempts rules that adopt or incorporate by reference without material change federal statutes or regulations, Washington state law, the rules of other Washington state agencies, or national consensus codes that generally establish industry standards.

August 30, 2011

Mary C. Selecky

Secretary

OTS-4123.4


AMENDATORY SECTION(Amending WSR 10-19-044, filed 9/13/10, effective 10/14/10)

WAC 246-826-100   Health care assistant classification.   (1) There are seven categories of health care assistants. The table in this subsection outlines the tasks authorized for each category of health care assistant. ((The administration of drugs under RCW 18.135.130 expires on July 1, 2013.))


Categories A B C D E F G
May perform: Venous and capillary invasive procedures for blood withdrawal Arterial ((invasion)) invasive procedures for blood withdrawal Intradermal, subcutaneous and intramuscular injections for diagnostic agents and administer skin tests Intravenous injections for diagnostic agents Intradermal, subcutaneous and intramuscular injections for therapeutic agents and administer skin tests Intravenous injections for therapeutic agents Hemodialysis
Injection Not authorized Not authorized V, I I V, I I ***
Oral V V D, V V D, V V V
Topical ((D,)) V ((D,)) V D, V ((D,)) V D, V ((D,)) V ((D,)) V, ***
Nasal ((D,)) V ((D,)) V D, V ((D,)) V D, V ((D,)) V ((D,)) V, ****
Rectal ((D)) Not authorized ((D)) Not authorized D ((D)) Not authorized D ((D)) Not authorized ((D)) Not authorized
Otic ((D)) Not authorized ((D)) Not authorized D ((D)) Not authorized D ((D)) Not authorized ((D)) Not authorized
Ophthalmic ((D)) Not authorized ((D)) Not authorized D ((D)) Not authorized D ((D)) Not authorized ((D)) Not authorized
Inhaled ((D)) Not authorized ((D)) Not authorized D ((D)) Not authorized D ((D)) Not authorized ((D))****

D - Drugs administered under RCW 18.135.130.
I - Drugs by injection under WAC 246-826-200.
V - Vaccines administered under RCW 18.135.120.
*** - Drugs by injection listed under WAC 246-826-303 (2)(c).
**** - Oxygen administration listed under WAC 246-826-303 (3)(a).

(2) ((A written order from a supervising health care practitioner authorizing the administration of drugs listed in RCW 18.135.130 must be provided to the health care assistant.)) The administration of drugs under RCW 18.135.130 expires on July 1, 2013, and only applies to a health care assistant certified in category C or E.

(3) A health care assistant certified in category C or E must have a written order from a supervising health care practitioner authorizing the administration of drugs listed in RCW 18.135.130.

(4) A health care assistant((s)) may perform supervised delegated functions as provided under WAC 246-826-020 and 246-826-030.

(((4))) (5) A health care assistant((s)) certified in category C or E must be able to demonstrate initial and ongoing competency to the supervisor or delegator on the administration of authorized drugs listed in RCW 18.135.130. Competency may be demonstrated by:

(a) Practicing techniques in a simulated situation; or

(b) Observing and performing procedures on patients until the health care assistant demonstrates proficiency to administer authorized drugs identified in the table in subsection (1) of this section; or

(c) Documenting all training on a checklist appropriate to the facility of the administration of drugs by the health care assistant. The health care assistant must complete and sign the form, have the form signed by the supervisor and the delegator, and have the form placed in their employee personnel file; or

(d) Other methods determined by the delegator.

(((5))) (6) The supervisor or delegator is responsible for the patient's care. The tasks delegated to any category of health care assistant must be based on the health care assistant's individual education and training.

[Statutory Authority: RCW 18.135.030 and 2009 c 43. 10-19-044, 246-826-100, filed 9/13/10, effective 10/14/10. Statutory Authority: RCW 18.135.030, 2008 c 58. 09-02-081, 246-826-100, filed 1/7/09, effective 2/7/09. Statutory Authority: RCW 18.135.030 and 18.135.020. 02-06-115, 246-826-100, filed 3/6/02, effective 4/6/02. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as 246-826-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.135.030. 87-23-022 (Order PM 689), 308-175-075, filed 11/12/87.]

Washington State Code Reviser's Office