WSR 25-13-095
PERMANENT RULES
DEPARTMENT OF HEALTH
[Filed June 17, 2025, 1:02 p.m., effective August 1, 2025]
Effective Date of Rule: August 1, 2025.
Purpose: Establishing the medical assistant (MA) - emergency medical technician (EMT) credential. The department of health (department) has adopted new rule sections to chapter 246-827 WAC and adopted an amendment to WAC 246-827-990 to implement this new credential type.
In 2024, the legislature passed SSB 5940 (chapter 217, Laws of 2024), that created a new medical assistant credential type in chapter
18.360 RCW for individuals holding a current EMT, advanced EMT, or paramedic credential in good standing. The new credential is referred to as MA-EMT. The amendments made by SSB 5940 allow individuals who hold an MA-EMT to work under the supervision of a healthcare practitioner in a hospital environment if the duties are within the scope, training, and endorsements of their EMT, advanced EMT, or paramedic credential.
The department has adopted the following new sections to chapter 246-827 WAC that establish regulations for the new MA-EMT credential: WAC 246-827-0530 Medical assistant-EMT—Application, 246-827-0540 Medical assistant-EMT—Qualifications and activities allowed and prohibited, and 246-827-0550 Medical assistant-EMT—Administering medications and injections.
The new sections of rule outline the requirements related to the MA-EMT credential application process, outline qualifications needed for the MA-EMT credential, establish permitted activities in accordance with statutory guidelines, and specify the conditions for medication administration. The department also adopted an amendment to WAC 246-827-990 Medical assistant—Fees and renewal cycle, to establish the new MA-EMT credential fees.
To account for changes to the credentialing system, the department is delaying the effective date to August 1, 2025.
Citation of Rules Affected by this Order: New WAC 246-827-0530, 246-827-0540, and 246-827-0550; and amending WAC 246-827-990.
Adopted under notice filed as WSR 25-06-053 on February 28, 2025.
Changes Other than Editing from Proposed to Adopted Version:
WAC 246-827-0540(2), corrected an incorrect citation from RCW
18.350.050 to 18.360.050.
WAC 246-827-0540(3), removed the word "certification" from "certified medical assistant - EMT certification."
WAC 246-827-0550 introductory paragraph, removed the word "written" from "valid written order."
WAC 246-827-0540(3), the department made an amendment to the language that clarifies that a person who is certified as an MA-EMT may only practice in a hospital licensed under chapter
70.41 RCW and may not practice in any other health care setting or an emergency department, unless that emergency department operates under the parent license of a hospital that is licensed under chapter
70.41 RCW.
WAC 246-827-0550 (4)(c), the department added subsection (4)(c) that includes that an MA-EMT may remove an intravenous line under the immediate supervision of a health care practitioner to align the rule closely with statute and to be consistent with other medical assistant medication administration rules.
A final cost-benefit analysis is available by contacting Becky McElhiney, P.O. Box 47852, [Olympia,] WA 98504-7852, phone 360-236-4766, TTY 711, email Medical.assistants@doh.wa.gov.
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 3, Amended 1, Repealed 0.
Number of Sections Adopted at the 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 3, Amended 1, Repealed 0.
Date Adopted: June 17, 2025.
Kristin Peterson, JD
Chief of Policy
for Jessica Todorovich, MS
Acting Secretary of Health
RDS-5635.6
NEW SECTION
WAC 246-827-0530Medical assistant-EMT—Application.
An applicant for a medical assistant-EMT credential shall meet the following requirements:
(1) Submit a completed application on forms provided by the department;
(2) Submit proof of completion of high school education or its equivalent;
(3) Show proof of a credential in good standing as an emergency medical technician under chapter
18.73 RCW, advanced emergency medical technician under chapter
18.71 RCW, or paramedic under chapter
18.71 RCW;
(4) Pay any fee required in WAC 246-827-990; and
(5) Submit fingerprint cards for national fingerprint based background check pursuant to RCW
18.130.064(2), if requested by the department.
NEW SECTION
WAC 246-827-0540Medical assistant-EMT—Qualifications and activities allowed and prohibited.
(1) Any person with an emergency medical technician, advanced emergency medical technician, or paramedic certification in good standing is eligible for a medical assistant-EMT certification with no additional training or examination requirements.
(2) A medical assistant-EMT may perform functions authorized in RCW
18.360.050 (5)(a) under the delegation and supervision of a health care practitioner described in WAC 246-827-0110. The delegation and direction must be for functions within the scope, training, and endorsement of the medical assistant-EMT'S underlying emergency medical technician, advanced emergency medical technician, or paramedic certification.
(3) A person certified as a medical assistant-EMT may only practice in a hospital licensed under chapter
70.41 RCW and may not practice in any other health care setting, unless it is an emergency department that operates under the parent license of a hospital licensed under chapter
70.41 RCW.
NEW SECTION
WAC 246-827-0550Medical assistant-EMT—Administering medications and injections.
A medical assistant-EMT shall be deemed competent by the delegating health care practitioner prior to administering any medication authorized in this section. Medications must be administered under a valid order from the delegating health care practitioner and shall be within the delegating health care practitioner's scope of practice. The order must be in written form or contained in the patient's electronic health care record.
(1) Medication administration shall not be delegated when:
(a) The medication may cause life-threatening consequences or the danger of immediate and serious harm to the patient; or
(b) Complex observations or critical decisions are required.
(2) To administer medications, the delegating health care practitioner shall ensure a medical assistant-EMT receives training concerning: Dosage, technique, acceptable route(s) of administration, appropriate anatomic sites, expected reactions, possible adverse reactions, appropriate intervention for adverse reaction, and risk to the patient. The delegating health care practitioner must ensure a medical assistant-EMT is competent to administer the medication.
(3) A medical assistant-EMT may only administer medications if the medications are:
(a) Administered only by unit or single dosage, or by a dosage calculated and verified by a health care practitioner. For purposes of this subsection, a combination or multidose vaccine shall be considered a unit dose; and
(b) Limited to vaccines, opioid antagonists, and oral glucose, as authorized by the delegating health care practitioner under the scope of their license.
(4) A medical assistant-EMT may:
(a) Start an intravenous line for diagnostic or therapeutic purposes under the immediate supervision of a health care practitioner;
(b) Interrupt an intravenous line and restart at the same rate under the immediate supervision of a health care practitioner; and
(c) Remove an intravenous line under the immediate supervision of a health care practitioner.
AMENDATORY SECTION(Amending WSR 17-24-014 and 17-22-088, filed 11/27/17 and 10/27/17, effective 3/1/18)
WAC 246-827-990Medical assistant—Fees and renewal cycle.
(1) Credentials must be renewed every two years on the practitioner's birthday as provided in chapter 246-12 WAC((, Part 2)).
(2) The following nonrefundable fees will be charged for medical assistant-certified, medical assistant-hemodialysis technician, ((and)) medical assistant-phlebotomist, and medical assistant-EMT credentials:
Title of Fee | Fee |
Initial credential | $145.00 |
Renewal | 145.00 |
| Late renewal penalty | 75.00 |
Expired credential reissuance | 55.00 |
Verification of credential | 25.00 |
Duplicate credential | 10.00 |
(3) The following nonrefundable fees will be charged for a medical assistant-registered credential:
Title of Fee | Fee |
Initial credential | $115.00 |
Renewal | 110.00 |
| Late renewal penalty | 60.00 |
Expired credential reissuance | 40.00 |
Verification of credential | 25.00 |
Duplicate credential | 10.00 |