Brief Description: Regarding the scope of practice of health care assistants.

Sponsors: Representative Cody.

Hearing Date:

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. 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 Bill:

The authority for licensed health care practitioners to delegate to health care assistants the administration of vaccines and immunizations is modified and made subject to the following:

• When administered by injection, the vaccine or immunization must be approved by the FDA.
• When administered orally or topically, including nasal administration, the vaccine or immunization must be recommended by the ACIP.

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.

Appropriation: None.

Fiscal Note: Not requested.

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