HOUSE BILL REPORT

SSB 6283

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 Passed House - Amended:

March 13, 2014

Title: An act relating to clarifying the practice of a phlebotomist.

Brief Description: Clarifying the practice of a phlebotomist.

Sponsors: Senate Committee on Health Care (originally sponsored by Senators Becker, Bailey and Keiser).

Brief History:

Committee Activity:

Health Care & Wellness: 2/24/14, 2/26/14 [DPA].

Floor Activity:

Passed House - Amended: 3/13/14, 96-1.

Brief Summary of Substitute Bill

(As Amended by House)

  • Allows a medical assistant-phlebotomist to perform tests categorized as moderate or high complexity or waived under the Clinical Laboratory Improvement Amendments of 1988.

  • Allows a medical assistant-phlebotomist to perform electrocardiograms.

HOUSE COMMITTEE ON HEALTH CARE & WELLNESS

Majority Report: Do pass as amended. Signed by 14 members: Representatives Cody, Chair; Riccelli, Vice Chair; Schmick, Ranking Minority Member; Harris, Assistant Ranking Minority Member; Green, G. Hunt, Jinkins, Manweller, Morrell, Rodne, Ross, Short, Tharinger and Van De Wege.

Staff: Jim Morishima (786-7191).

Background:

I. Laboratory Testing.

The federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) established standards for clinical laboratory tests performed on humans. Under the CLIA, tests are grouped into one of three categories based on complexity: high complexity, moderate complexity, and waived tests. Laboratory test sites are licensed and regulated by the state.

II. Medical Assistant-Phlebotomists.

In 2012 four new professions were created to replace the existing health care assistant credential: medical assistant-registered, medical assistant-phlebotomist, medical assistant-certified, and medical assistant-hemodialysis technician.

A person may be licensed as a medical assistant-phlebotomist if he or she:

A medical assistant-phlebotomist may perform capillary, venous, or arterial invasive procedures for blood withdrawal when delegated and supervised by a health care practitioner. A medical assistant-phlebotomist is not authorized to perform tests categorized as moderate complexity or waived under the CLIA.

Tests categorized as moderate complexity or waived under the CLIA may be performed by a medical assistant-certified or a medical assistant-registered. In order to perform moderate complexity tests, the medical assistant-certified or medical assistant-registered must meet standards for personnel qualifications and responsibilities in compliance with federal regulation for non-waived testing. The Department of Health (DOH) must update the list of CLIA-waived tests periodically based on changes in federal law.

Summary of Bill:

A medical assistant-phlebotomist may perform tests waived under the CLIA. The DOH must update the list of waived tests periodically based on changes in federal law. A medical assistant-phlebotomist may perform moderate or high complexity tests if he or she meets standards for personnel qualifications and responsibilities in compliance with federal regulation for non-waived testing.

A medical assistant-phlebotomist may perform electrocardiograms.

Appropriation: None.

Fiscal Note: Available.

Effective Date of Amended Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) This bill is a technical fix of changes that were made last year. People are currently having to pay double fees to do their jobs. The state transitioned from health care assistants to medical assistants with carefully crafted scopes of practice. The transition has gone well, but a few cleanup issues have surfaced. Currently, medical assistant-phlebotomists may draw blood, but not perform tests. This bill corrects this error.

(In support with amendments) Testing sites and the personnel who can perform tests are regulated by federal and state law. Testing personnel perform a range of testing from waived to high complexity. The current medical assistant system is in conflict with federal law. Medical assistant-phlebotomists should be allowed to perform waived, moderate, and high complexity tests. Medical assistant-phlebotomists should be allowed to perform electrocardiograms.

(Opposed) None.

Persons Testifying: (In support) Senator Becker, prime sponsor; Kristi Weeks, Washington Department of Health; and Carl Nelson, Washington State Medical Association.

(In support with amendments) Rosella Ray, Group Health Cooperative.

Persons Signed In To Testify But Not Testifying: None.