WSR 25-06-053
PROPOSED RULES
DEPARTMENT OF HEALTH
[Filed February 28, 2025, 10:43 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 24-15-100.
Title of Rule and Other Identifying Information: Establishing the medical assistant-EMT credential. The department of health (department) is proposing new rule sections to chapter 246-827 WAC and proposing an amendment to WAC 246-827-990 to implement this new credential type.
Hearing Location(s): On April 8, 2025, at 9:00 a.m. Register in advance for this webinar at https://us02web.zoom.us/webinar/register/WN__TMIvAFsT_ixNYYTIg9cMQ. After registering, you will receive a confirmation email containing information about joining the webinar.
Date of Intended Adoption: April 15, 2025.
Submit Written Comments to: Becky McElhiney, P.O. Box 47852, Olympia, WA 98504-7852, email medical.assistants@doh.wa.gov, https://fortress.wa.gov/doh/policyreview, beginning the date and time of this filing, by April 8, 2025, at 11:59 p.m.
Assistance for Persons with Disabilities: Contact Becky McElhiney, phone 360-236-4766, TTY 711, email medical.assistants@doh.wa.gov, by March 25, 2025.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: In 2024, the legislature passed SSB 5940 (chapter 217, Laws of 2024), which created a new medical assistant credential type in chapter
18.360 RCW for individuals holding a current emergency medical technician (EMT), advanced EMT, or paramedic credential in good standing. The new credential is referred to as medical assistant-EMT (MA-EMT). The amendments made by SSB 5940 allow individuals who hold an MA-EMT to work under the supervision of a health care practitioner in a hospital environment if the duties are within the scope, training, and endorsements of their EMT, advanced EMT, or paramedic credential.
The department is proposing the following new sections to chapter 246-827 WAC that establish regulations for the new MA-EMT credential: WAC 246-827-0530 Medical assistant-EMT—Application, 246-827-0540 Medical assistant-EMT—Qualifications and activities allowed and prohibited, and 246-827-0550 Medical assistant-EMT—Administering medications and injections.
The proposed new sections outline the requirements related to the MA-EMT credential application process, outline qualifications needed for the MA-EMT credential, establish permitted activities in accordance with statutory guidelines, and specify the conditions for medication administration. The department is also proposing an amendment to WAC 246-827-990 Medical assistant—Fees and renewal cycle, to establish the new MA-EMT credential fees. The proposed rules are needed to establish enforceable licensing requirements to implement the new credential.
Reasons Supporting Proposal: The intent of SSB 5940 is to creatively address workforce shortage challenges all over the state by creating a new pathway to a medical assistant certification, specific to individuals who hold an emergency medical services (EMS) credential. The goal is to address the workforce shortages, especially in rural areas where there may not be enough funding to employ EMS providers. This new MA-EMT certification will utilize already trained EMS personnel to fill these gaps in medical services, keep EMS personnel in the region, ensure communities have continued access to EMS, and help meet the demand for medical assistants that is already expanding rapidly.
The proposed rules implement the intent of the MA statute and the MA-EMT certification as they provide clear regulatory information and references individuals seeking to be licensed as an MA-EMT. The proposed rules ensure that individuals performing the specialized functions under the MA-EMT credential are trained, supervised, and function in a manner that will not pose an undue risk to patient safety.
Statutory Authority for Adoption: SSB 5940 (chapter 217, Laws of 2024), codified under chapter
18.360 RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, governmental.
Name of Agency Personnel Responsible for Drafting: Becky McElhiney, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4766; Implementation and Enforcement: James Chaney, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2831.
A school district fiscal impact statement is not required under RCW
28A.305.135.
A cost-benefit analysis is required under RCW
34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Becky McElhiney, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4766, fax 360-236-2850, TTY 711, email
medical.assistants@doh.wa.gov.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Explanation of exemptions: The proposed rules impact individual licensees and not small businesses.
Scope of exemption for rule proposal:
Is fully exempt.
February 28, 2025
Kristin Peterson, JD
Chief of Policy
for Jessica Todorovich, MS
Acting Secretary of Health
RDS-5635.5
NEW SECTION
WAC 246-827-0530Medical assistant-EMT—Application.
An applicant for a medical assistant-EMT credential shall meet the following requirements:
(1) Submit a completed application on forms provided by the department;
(2) Submit proof of completion of high school education or its equivalent;
(3) Show proof of a credential in good standing as an emergency medical technician under chapter
18.73 RCW, advanced emergency medical technician under chapter
18.71 RCW, or paramedic under chapter
18.71 RCW;
(4) Pay any fee required in WAC 246-827-990; and
(5) Submit fingerprint cards for national fingerprint based background check pursuant to RCW
18.130.064(2), if requested by the department.
NEW SECTION
WAC 246-827-0540Medical assistant-EMT—Qualifications and activities allowed and prohibited.
(1) Any person with an emergency medical technician, advanced emergency medical technician, or paramedic certification in good standing is eligible for a medical assistant-EMT certification with no additional training or examination requirements.
(2) A medical assistant-EMT may perform functions authorized in RCW
18.350.050 (5)(a) under the delegation and supervision of a health care practitioner described in WAC 246-827-0110. The delegation and direction must be for functions within the scope, training, and endorsement of the medical assistant-EMT'S underlying emergency medical technician, advanced emergency medical technician, or paramedic certification.
(3) A person certified as a medical assistant-EMT certification may only practice in a hospital licensed under chapter
70.41 RCW and may not practice in any other health care setting such as clinics, urgent care facilities, free standing emergency departments, or any other health care facility.
NEW SECTION
WAC 246-827-0550Medical assistant-EMT—Administering medications and injections.
A medical assistant-EMT shall be deemed competent by the delegating health care practitioner prior to administering any medication authorized in this section. Medications must be administered under a valid written order from the delegating health care practitioner and shall be within the delegating health care practitioner's scope of practice. The order must be in written form or contained in the patient's electronic health care record.
(1) Medication administration shall not be delegated when:
(a) The medication may cause life-threatening consequences or the danger of immediate and serious harm to the patient; or
(b) Complex observations or critical decisions are required.
(2) To administer medications, the delegating health care practitioner shall ensure a medical assistant-EMT receives training concerning: Dosage, technique, acceptable route(s) of administration, appropriate anatomic sites, expected reactions, possible adverse reactions, appropriate intervention for adverse reaction, and risk to the patient. The delegating health care practitioner must ensure a medical assistant-EMT is competent to administer the medication.
(3) A medical assistant-EMT may only administer medications if the medications are:
(a) Administered only by unit or single dosage, or by a dosage calculated and verified by a health care practitioner. For purposes of this subsection, a combination or multidose vaccine shall be considered a unit dose; and
(b) Limited to vaccines, opioid antagonists, and oral glucose, as authorized by the delegating health care practitioner under the scope of their license.
(4) A medical assistant-EMT may:
(a) Start an intravenous line for diagnostic or therapeutic purposes under the immediate supervision of a health care practitioner; and
(b) Interrupt an intravenous line and restart at the same rate under the immediate supervision of a health care practitioner.
AMENDATORY SECTION(Amending WSR 17-24-014 and 17-22-088, filed 11/27/17 and 10/27/17, effective 3/1/18)
WAC 246-827-990Medical assistant—Fees and renewal cycle.
(1) Credentials must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC((, Part 2)).
(2) The following nonrefundable fees will be charged for medical assistant-certified, medical assistant-hemodialysis technician, ((and)) medical assistant-phlebotomist, and medical assistant-EMT credentials:
Title of Fee | Fee |
Initial credential | $145.00 |
Renewal | 145.00 |
| Late renewal penalty | 75.00 |
Expired credential reissuance | 55.00 |
Verification of credential | 25.00 |
Duplicate credential | 10.00 |
(3) The following nonrefundable fees will be charged for a medical assistant-registered credential:
Title of Fee | Fee |
Initial credential | $115.00 |
Renewal | 110.00 |
| Late renewal penalty | 60.00 |
Expired credential reissuance | 40.00 |
Verification of credential | 25.00 |
Duplicate credential | 10.00 |