HOUSE BILL REPORT
HB 2475
This analysis was prepared by non-partisan legislative staff for the use of legislative members in
their deliberations. This analysis is not a part of the legislation nor does it constitute a
statement of legislative intent.
As Reported by House Committee On:
Health Care & Wellness
Title: An act relating to the practice of health care assistants.
Brief Description: Regarding the scope of practice of health care assistants.
Sponsors: Representatives Cody, Morrell and Green.
Brief History:
Health Care & Wellness: 1/14/08, 1/21/08 [DPS].
Brief Summary of Substitute Bill |
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HOUSE COMMITTEE ON HEALTH CARE & WELLNESS
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 13 members: Representatives Cody, Chair; Morrell, Vice Chair; Hinkle, Ranking Minority Member; Alexander, Assistant Ranking Minority Member; Barlow, Campbell, Condotta, DeBolt, Green, Moeller, Pedersen, Schual-Berke and Seaquist.
Staff: Chris Cordes (786-7103).
Background:
Health Care Assistants
Health care assistants are certified persons who assist a licensed health care practitioner, such
as physicians, registered nurses or advanced registered nurse practitioners, and naturopaths.
A licensed health care practitioner may delegate certain functions within the delegator's scope
of practice to a health care assistant, including administering skin tests and injections, and
performing blood withdrawal and certain other specified functions. The Department of
Health (DOH) rules provide for seven categories of health care assistants; only five of these
categories may administer injections.
Health care assistants are certified by the health care facility in which the services are
performed or by the health care practitioner who delegates functions to the health care
assistant. The facility or practitioner must submit to the DOH a roster of certified health care
assistants. The submittal must include a list of specific medications and diagnostic agents,
and the route of administration of each, that have been authorized for injection.
Vaccine Regulation
Vaccines are approved and licensed by the U.S. Food and Drug Administration (FDA). The
Advisory Committee on Immunization Practices (ACIP), a committee appointed by the
Secretary of the U.S. Department of Health and Human Services, provides advice to the
Secretary and to the Centers for Disease Control and Prevention (CDC) on the control of
vaccine-preventable diseases. The ACIP makes recommendations for the routine
administration of vaccines to children and adults, including age, dosage, and dosage interval
recommendations and precautions and contraindications.
The Rotavirus Vaccine
In February 2006 the FDA licensed an orally administered rotavirus vaccine for use among
infants to prevent gastroenteritis. According to the CDC, rotavirus is the most common cause
of severe diarrhea among children, with 55,000 children hospitalized each year in the United
States. In August 2006 the ACIP recommended routine three-dose administration of the oral
rotavirus vaccine to infants, beginning between the ages of six to 12 weeks, for the
prevention of rotavirus gastroenteritis in infants and children.
The DOH received funding in 2006 to distribute several new vaccines, including the oral
rotavirus vaccine. At that time, the DOH advised health care providers that health care
assistants are not among those who are allowed to administer oral vaccines, although they
may be allowed to administer vaccines by injection. The DOH explained that oral vaccines
may be administered only by those licensed practitioners authorized to prescribe or
administer oral vaccines and, when administration is appropriately delegated by those
licenced practitioners, to other licensed practitioners with a scope of practice that specifically
includes the administration of oral vaccines.
Summary of Substitute Bill:
The authority for licensed health care practitioners to delegate to health care assistants the
administration of vaccines is restricted to vaccines that are administered by injection, orally,
or topically, including nasal administration, and that are licensed by the U.S. Food and Drug
Administration.
A licensed health care practitioner delegating vaccine or immunization administration to a
health care assistant must submit a list to the DOH showing the vaccines and immunizations
that are authorized for administration.
Physician assistants and osteopathic physician assistants are added to the licensed health care
practitioners that may delegate authorized functions to health care assistants.
Substitute Bill Compared to Original Bill:
The substitute bill deletes the requirement for oral or topically administered vaccines to be
recommended by the ACIP before delegation to health care assistants is authorized, and adds
that delegation is authorized for health care assistants to administer vaccines that are injected
or administered orally or topically if the vaccine is licensed by the federal FDA.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of session in which bill is passed.
Staff Summary of Public Testimony:
(In support) This bill will help increase access to vaccines. The health care assistants play a
key role. When the funding for the oral rotavirus was provided, no one realized the
implications for health care assistants. The bill will help reduce inefficiencies in community
health centers and help small clinics in rural areas. Most health care assistants have been
trained to do this, but they cannot dispense any oral medicines now.
(Opposed) None.
Persons Testifying: Thomas E. Wolf, Washington State Society of Medical Assistants; Mary Selecky, Department of Health; Katherine White Tudor, Washington Association of Community and Migrant Health Centers; and Laurie Lippold, American Academy of Pediatrics, Washington Chapter.