Effective Date of Rule: Thirty-one days after filing.

     Purpose: WAC 246-826-100 is being adopted to allow only health care assistants certified in categories C or E to administer certain over-the-counter and prescription drugs. The adopted rule reflects the change in the law.

     Citation of Existing Rules Affected by this Order: Amending WAC 246-826-100.

     Statutory Authority for Adoption: Chapter 18.135 RCW, SHB 1304 (chapter 43, Laws of 2011).

      Adopted under notice filed as WSR 11-18-033 on August 30, 2011.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

     Date Adopted: November 18, 2011.

Mary C. Selecky

Secretary

OTS-4123.4

AMENDATORY SECTION(Amending WSR 10-19-044, filed 9/13/10, effective 10/14/10)

WAC 246-826-100   Health care assistant classification.   (1) There are seven categories of health care assistants. The table in this subsection outlines the tasks authorized for each category of health care assistant. ((The administration of drugs under RCW 18.135.130 expires on July 1, 2013.))

Categories	A	B	C	D	E	F	G
May perform:	Venous and capillary invasive procedures for blood withdrawal	Arterial ((invasion)) invasive procedures for blood withdrawal	Intradermal, subcutaneous and intramuscular injections for diagnostic agents and administer skin tests	Intravenous injections for diagnostic agents	Intradermal, subcutaneous and intramuscular injections for therapeutic agents and administer skin tests	Intravenous injections for therapeutic agents	Hemodialysis
Injection	Not authorized	Not authorized	V, I	I	V, I	I	***
Oral	V	V	D, V	V	D, V	V	V
Topical	((D,)) V	((D,)) V	D, V	((D,)) V	D, V	((D,)) V	((D,)) V, ***
Nasal	((D,)) V	((D,)) V	D, V	((D,)) V	D, V	((D,)) V	((D,)) V, ****
Rectal	((D)) Not authorized	((D)) Not authorized	D	((D)) Not authorized	D	((D)) Not authorized	((D)) Not authorized
Otic	((D)) Not authorized	((D)) Not authorized	D	((D)) Not authorized	D	((D)) Not authorized	((D)) Not authorized
Ophthalmic	((D)) Not authorized	((D)) Not authorized	D	((D)) Not authorized	D	((D)) Not authorized	((D)) Not authorized
Inhaled	((D)) Not authorized	((D)) Not authorized	D	((D)) Not authorized	D	((D)) Not authorized	((D))****

	D - Drugs administered under RCW 18.135.130.
	I - Drugs by injection under WAC 246-826-200.
	V - Vaccines administered under RCW 18.135.120.
	*** - Drugs by injection listed under WAC 246-826-303 (2)(c).
	**** - Oxygen administration listed under WAC 246-826-303 (3)(a).

     (2) ((A written order from a supervising health care practitioner authorizing the administration of drugs listed in RCW 18.135.130 must be provided to the health care assistant.)) The administration of drugs under RCW 18.135.130 expires on July 1, 2013, and only applies to a health care assistant certified in category C or E.

     (3) A health care assistant certified in category C or E must have a written order from a supervising health care practitioner authorizing the administration of drugs listed in RCW 18.135.130.

     (4) A health care assistant((s)) may perform supervised delegated functions as provided under WAC 246-826-020 and 246-826-030.

     (((4))) (5) A health care assistant((s)) certified in category C or E must be able to demonstrate initial and ongoing competency to the supervisor or delegator on the administration of authorized drugs listed in RCW 18.135.130. Competency may be demonstrated by:

     (a) Practicing techniques in a simulated situation; or

     (b) Observing and performing procedures on patients until the health care assistant demonstrates proficiency to administer authorized drugs identified in the table in subsection (1) of this section; or

     (c) Documenting all training on a checklist appropriate to the facility of the administration of drugs by the health care assistant. The health care assistant must complete and sign the form, have the form signed by the supervisor and the delegator, and have the form placed in their employee personnel file; or

     (d) Other methods determined by the delegator.

     (((5))) (6) The supervisor or delegator is responsible for the patient's care. The tasks delegated to any category of health care assistant must be based on the health care assistant's individual education and training.

[Statutory Authority: RCW 18.135.030 and 2009 c 43. 10-19-044, § 246-826-100, filed 9/13/10, effective 10/14/10. Statutory Authority: RCW 18.135.030, 2008 c 58. 09-02-081, § 246-826-100, filed 1/7/09, effective 2/7/09. Statutory Authority: RCW 18.135.030 and 18.135.020. 02-06-115, § 246-826-100, filed 3/6/02, effective 4/6/02. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-826-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.135.030. 87-23-022 (Order PM 689), § 308-175-075, filed 11/12/87.]

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