SENATE BILL REPORT
SB 5181
As of January 11, 2023
Title: An act relating to medical assistants.
Brief Description: Concerning medical assistants.
Sponsors: Senators Cleveland, Rivers and Dhingra.
Brief History:
Committee Activity: Health & Long Term Care: 1/12/23.
Brief Summary of Bill
  • Allows an applicant applying for certification as a medical assistant-phlebotomist or a medical assistant-hemodialysis technician to work for 180 days after the applicant's application has been filed. 
  • Expands the authorized duties for medical assistant-registered to include using electrocardiography for diagnostic testing and administering certain medications for intramuscular injections.
  • Amends the supervision level required from physically present and immediately available in the facility to immediately available for medical assistants during certain procedures involving administering vaccines, and obtaining specimens for or performing diagnostic testing.
SENATE COMMITTEE ON HEALTH & LONG TERM CARE
Staff: Julie Tran (786-7283)
Background:

Medical Assistants.  There are several types of medical assistants (MAs) certified and registered by the Department of Health (DOH) including MA-certified, MA-registered, MA-phlebotomist, and MA-hemodialysis technician.  Each type of MA must be supervised by a health care practitioner, including a physician, an osteopathic physician, a podiatric physician, a registered nurse, an advanced registered nurse practitioner, a naturopath, a physician assistant, or an optometrist.  In most cases, the health care practitioner must be physically present and immediately available.  The health care practitioner does not need to be present during procedures to withdraw blood, but must be immediately available

A MA-certified and a MA-registered may sterilize equipment, take vital signs, and maintain records.  A MA-registered may only perform the medical tasks listed in his or her current attestation of endorsement.
 
A MA-hemodialysis technician performs hemodialysis when delegated and supervised by a qualified health care practitioner.
 
A MA-phlebotomist may perform capillary, venous, or arterial invasive procedures for blood withdrawal under the general supervision of a qualified health care practitioner.
 
Credentialing for Medical Assistants.  To become certified as a MA-hemodialysis technician, an applicant must complete a training program or hold a national credential that is the equivalent of the training program.  The applicant must also have a high school education; the ability to read, write, and converse in English; basic math skills; and cardiopulmonary resuscitation certification.
 
To become certified as a MA-phlebotomist, an applicant must complete a phlebotomy program through a postsecondary school or college accredited by a regional or national accrediting organization recognized by the U.S. Department of Education, or a phlebotomy training program as attested by the phlebotomy training program's supervising health care practitioner.
 
To be issued a registration as a MA-registered, an individual must have a current endorsement from a health care practitioner, clinic, or group practice.  To be endorsed, an individual must have a current attestation of their endorsement to perform specific medical tasks signed by a supervising health care practitioner filed with DOH and be endorsed by a qualifying health care practitioner, clinic, or group practice.  A registration based on an endorsement by a health care practitioner, clinic, or group practice is not transferable to another health care practitioner, clinic, or group practice.

 

An applicant for registration as a MA-registered who applies to DOH within seven days of employment by the endorsing health care practitioner, clinic, or group practice may work as a MA-registered for up to 60 days while the application is processed.  The applicant must stop working on the 60th day of employment if registration has not been granted for any reason.

 

For MA-certified, an individual who has completed the training program and met all the qualifications except for the passage of the exam, may obtain an interim certification. The interim permit expires upon passage of the examination or after one year, whichever occurs first, and may not be renewed.

 

Proclamation 20-32.  In February 29, 2020, Governor Jay Inslee issued Proclamation 20-05, which declared a state of emergency throughout Washington as a result of the COVID-19 pandemic.  The Governor has since exercised emergency powers through a number of proclamations that prohibit certain activities and waive or suspend certain laws and regulations.  These emergency orders include Proclamation 20-32, concerning continuing education, training, license renewals, retired active credential renewals, and delegation agreements for certain health care professionals, as well as supervision of certain medical assistants.
 
Proclamation 20-32 waived and suspended statutes and rules relating to the administrative requirements to license health care providers to increase the availability of health care workers.  The statutes and rules that were waived and suspended include:

  • the requirement for a supervising health care practitioner to be physically present in the facility;
  • the automatic expiration of the MA-certified interim permit after one year; and
  • the requirement for applicants applying for registration as a MA-registered to stop working on the 60th day if DOH has not approved their registration application within 60 days.


Proclamation 20-32 also allowed for the renewal of MA-certified's interim certification and for medical assistants to administer, deliver, distribute, and dispense COVID-19 tests and vaccines.  Proclamation 20-32 expired on October 27, 2022.

Summary of Bill:

A healthcare practitioner does not need to be physically present but must be immediately available when MAs perform procedures involving administering vaccines, or obtaining specimens for or performing diagnostic testing.

 

The authorized duties for MA-registered may include using electrocardiography to conduct diagnostic testing and administer certain medications for intramuscular injections.

 

Credentialing for Medical Assistants.  The MA-certified interim permit expires upon either both the passage of the exam and issuance of certification or the one-year period, whichever occurs first.

 

To facilitate patient continuity of care and to allow sufficient time for application processing, an applicant for certification as a MA-hemodialysis technician who has completed the training program may continue to work at a dialysis facility under the level of supervision required for the training program for 180 days after the application is filed. 

 

To facilitate access to services and to allow sufficient time for application processing, an applicant for certification as a MA-phlebotomist who has completed the training program may work under the level of supervision required for the training program for 180 days after the application is filed.

Appropriation: None.
Fiscal Note: Requested on January 7, 2023.
Creates Committee/Commission/Task Force that includes Legislative members: No.
Effective Date: The bill contains an emergency clause and takes effect immediately.