BILL REQ. #:  S-4052.1 

Read first time 01/15/08.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to the practice of health care assistants; amending RCW 18.135.010, 18.135.020, and 18.135.065; and adding a new section to chapter 18.135 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 18.135.010 and 1984 c 281 s 1 are each amended to read as follows:
     It is in the public interest that limited authority to: (1) Administer skin tests and subcutaneous, intradermal, intramuscular, and intravenous injections ((and to)); (2) perform minor invasive procedures to withdraw blood in this state; and (3) administer vaccines and immunizations in accordance with section 4 of this act be granted to health care assistants who are not so authorized under existing licensing statutes, subject to such regulations as will ((assure)) ensure the protection of the health and safety of the patient.

Sec. 2   RCW 18.135.020 and 2001 c 22 s 2 are each amended to read as follows:
     ((As used in this chapter:)) The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Secretary" means the secretary of health.
     (2) "Health care assistant" means an unlicensed person who assists a licensed health care practitioner in providing health care to patients pursuant to this chapter. However persons trained by a federally approved end-stage renal disease facility who perform end-stage renal dialysis in the home setting are exempt from certification under this chapter.
     (3) "Health care practitioner" means:
     (a) A physician licensed under chapter 18.71 RCW;
     (b) An osteopathic physician or surgeon licensed under chapter 18.57 RCW; or
     (c) Acting within the scope of their respective licensure, a podiatric physician and surgeon licensed under chapter 18.22 RCW, a registered nurse or advanced registered nurse practitioner licensed under chapter 18.79 RCW, ((or)) a naturopath licensed under chapter 18.36A RCW, a physician assistant licensed under chapter 18.71A RCW, or an osteopathic physician's assistant licensed under chapter 18.57A RCW.
     (4) "Supervision" means supervision of procedures permitted pursuant to this chapter by a health care practitioner who is physically present and is immediately available in the facility during the administration of injections, vaccines, or immunizations as defined in this chapter, but need not be present during procedures to withdraw blood.
     (5) "Health care facility" means any hospital, hospice care center, licensed or certified health care facility, health maintenance organization regulated under chapter 48.46 RCW, federally qualified health maintenance organization, renal dialysis center or facility federally approved under 42 C.F.R. 405.2100, blood bank federally licensed under 21 C.F.R. 607, or clinical laboratory certified under 20 C.F.R. 405.1301-16.
     (6) "Delegation" means direct authorization granted by a licensed health care practitioner to a health care assistant to perform the functions authorized in this chapter which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee.

Sec. 3   RCW 18.135.065 and 1991 c 3 s 276 are each amended to read as follows:
     (1) Each delegator, as defined under RCW 18.135.020(6), shall maintain a list of: (a) Specific medications, diagnostic agents, and the route of administration of each that he or she has authorized for injection; and (b) the vaccines and immunizations that he or she has authorized for administration. Both the delegator and delegatee shall sign the above list, indicating the date of each signature. The signed list shall be forwarded to the secretary of the department of health and shall be available for review.
     (2) Delegatees are prohibited from administering any controlled substance as defined in RCW 69.50.101(d), any experimental drug, and any cancer chemotherapy agent unless a delegator is physically present in the immediate area where the drug is administered.

NEW SECTION.  Sec. 4   A new section is added to chapter 18.135 RCW to read as follows:
     The administration of vaccines and immunizations by a health care assistant is restricted to the following types of vaccines and immunizations:
     (1) A vaccine or immunization that is administered by injection and that has been approved by the United States food and drug administration; or
     (2) A vaccine or immunization that is administered orally or topically, including nasal administration, and that has been recommended by the advisory committee on immunization practices.