SENATE BILL REPORT

SB 5144

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 of January 31, 2013

Title: An act relating to medical assistants.

Brief Description: Modifying medical assistant provisions.

Sponsors: Senators Keiser and Schlicher.

Brief History:

Committee Activity: Health Care: 1/31/13.

SENATE COMMITTEE ON HEALTH CARE

Staff: Edith Rice (786-7444)

Background: Medical assistants are personnel who perform administrative or clinical tasks under the supervision of other health care practitioners. Until last year, medical assistant positions were not a credentialed health profession in Washington. However, health care assistants have been credentialed in WA, and until last year, were certified by the facility in which they were employed or by a health care practitioner. The Department of Health (DOH) sets standards for health care assistants.

In 2011, the DOH completed a sunrise review of a proposal to credential medical assistants. DOH supported creating a credential for medical assistants and recommended clarifying the health care assistant credential. DOH also recommended blending the existing health care assistant categories with medical assistant certification.

ESSB 6237, enacted in 2012, created four categories of medical assistants which are:

The certification credentials for each category of medical assistant were spelled out in detail in ESSB 6237. A medical assistant-certified is a person who is certified by DOH and performs tasks under the supervision of a health care practitioner. Tasks that may be performed include fundamental procedures, clinical procedures, specimen collection, diagnostic testing, patient care, administering medications, and administering intravenous injections.

A medical assistant-hemodialysis technician is a person who performs hemodialysis when delegated and supervised by a health care practitioner. This category permits a person to administer drugs and oxygen to a patient. The qualifications adopted by the Secretary of DOH must be equivalent to the qualifications that currently exist for hemodialysis technicians.

A medical assistant-phlebotomist is a person who performs capillary, venous, and arterial invasive procedures for blood withdrawal and other functions when delegated and supervised by a health care practitioner.

A medical assistant-registered is a person who performs tasks under the supervision of a health care practitioner. Tasks that may be performed include fundamental procedures, clinical procedures, specimen collection, patient care, certain permitted tests, and administering vaccines.

New certifications for health care assistants are not to be issued after July 1, 2013. Specific categories of qualified health assistants are to be renewed as medical assistant-phlebotomists. Other categories of qualified health care assistants are to be renewed as medical assistants-certified and the remainder who qualify are to be renewed as medical assistant-hemodialysis technicians.

The Secretary of DOH was to develop recommendations regarding a career path plan for medical assistants, identifying barriers to career advancement and career ladder training initiatives with a report due to the Legislature by December 15, 2012.

There are federal standards for health care personnel who perform simple, moderate, and complex testing in health care settings. The standards for testing personnel qualifications and testing personnel responsibilities are found in 42 CFR sec. 493.

Summary of Bill: In addition to the duties already delegated to medical assistant-certified individuals by a health care practitioner, clinical procedures can include arterial blood withdrawal. Specimen collection can include arterial invasive procedures for blood withdrawal, and diagnostic testing can include moderate complexity tests if the medical assistant-certified individual meets standards for personnel qualifications and responsibilities in compliance with federal regulations for nonwaived testing.

It is clarified that the duties performed by a medical assistant-phlebotomist are delegated by and under the supervision of a health care practitioner. Additionally, a medical assistant-phlebotomist can perform tests waived under the federal clinical laboratory improvement amendments program after July 1, 2013, and moderate complexity tests if the medical assistant-phlebotomist meets standards for personnel qualification and responsibilities in compliance with federal regulations for nonwaived testing.

Added to the existing duties for a medical assistant-registered individual are moderate complexity tests if the medical assistant-registered meets standards for personnel qualifications and responsibilities in compliance with federal regulations for nonwaived testing.

A new section is added to the statutes governing medical assistants. It provides that an applicant for a medical assistant credential, who has completed a registered apprenticeship program administered by a Washington State agency, is deemed to have satisfied the requirements for the medical assistant credential, unless the Secretary of DOH determines that the apprenticeship program training or experience is not substantially equivalent to Washington State medical assistant standards.

Appropriation: None.

Fiscal Note: Not requested.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony: PRO: This bill addresses most of the concerns expressed from last year. We have some suggestions for additional language.

CON: We have patient safety concerns as well as scope of practice concerns. We are concerned about where medical assistants will gain experience; on the job training may not be adequate. We are concerned about the arterial blood withdrawal and patient safety.

OTHER: Some minor changes are needed. Identifying a career path is good. We will continue to discuss our concerns with the DOH.

Persons Testifying: PRO: Kristi Weeks, DOH.

CON: Nick Federici, Susan Gibbs, Respiratory Care Society of WA; Sofia Aragon, WA State Nurses Assn.

OTHER: Carl Nelson, WA State Medical Assn; Brad Tower, Optometric Physicians of WA; Gail McGaffick, WA State Podiatric Medical Assn.