Midwife supervision

AN ACT Relating to midwife supervision of medical assistants and 1
lactation consultants; amending RCW 18.50.160 and 18.360.010; 2
reenacting and amending RCW 18.360.010; providing an effective date; 3
and providing an expiration date. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
Sec. 1. RCW 18.50.160 and 2014 c 187 s 4 are each amended to 6
read as follows: 7
A licensed midwife may delegate to a registered nurse ((or a )), 8
licensed practical nurse , medical assistant, or international board 9
certified lactation consultant selected acts, tasks, or procedures 10
that constitute the practice of midwifery but do not exceed the 11
education and scope of practice of the nurse , medical assistant, or 12
lactation consultant. 13
Sec. 2. RCW 18.360.010 and 2024 c 248 s 2 and 2024 c 217 s 1 are 14
each reenacted and amended to read as follows: 15
The definitions in this section apply throughout this chapter 16
unless the context clearly requires otherwise. 17
(1) "Administer" means the retrieval of medication, and its 18
application to a patient, as authorized in RCW 18.360.050.19
H-2786.1
HOUSE BILL 2329
State of Washington 69th Legislature 2026 Regular Session
By Representatives Barnard, Ramel, Ormsby, and Marshall
Prefiled 01/08/26. Read first time 01/12/26. Referred to Committee
on Health Care & Wellness.
p. 1 HB 2329
(2) "Delegation" means direct authorization granted by a licensed 1
health care practitioner to a medical assistant to perform the 2
functions authorized in this chapter which fall within the scope of 3
practice of the health care provider and the training and experience 4
of the medical assistant. 5
(3) "Department" means the department of health.6
(4) "Forensic phlebotomist" means a police officer, law 7
enforcement officer, or employee of a correctional facility or 8
detention facility, who is certified under this chapter and meets any 9
additional training and proficiency standards of his or her employer 10
to collect a venous blood sample for forensic testing pursuant to a 11
search warrant, a waiver of the warrant requirement, or exigent 12
circumstances. 13
(5) "Health care practitioner" means: 14
(a) A physician licensed under chapter 18.71 RCW;15
(b) An osteopathic physician and surgeon licensed under chapter 16
18.57 RCW; or 17
(c) Acting within the scope of their respective licensure, a 18
podiatric physician and surgeon licensed under chapter 18.22 RCW, a 19
registered nurse or *advanced registered nurse practitioner licensed 20
under chapter 18.79 RCW, a naturopath licensed under chapter 18.36A 21
RCW, a physician assistant licensed under chapter 18.71A RCW, a 22
midwife licensed under chapter 18.50 RCW, or an optometrist licensed 23
under chapter 18.53 RCW. 24
(6) "Medical assistant-certified" means a person certified under 25
RCW 18.360.040 who assists a health care practitioner with patient 26
care, executes administrative and clinical procedures, and performs 27
functions as provided in RCW 18.360.050 under the supervision of the 28
health care practitioner. 29
(7) "Medical assistant-EMT" means a person certified under RCW 30
18.360.040 who performs functions as provided in RCW 18.360.050 under 31
the supervision of a health care practitioner and holds: An emergency 32
medical technician certification under RCW 18.73.081; an advanced 33
emergency medical technician certification under RCW 18.71.205; or a 34
paramedic certification under RCW 18.71.205. 35
(8) "Medical assistant-hemodialysis technician" means a person 36
certified under RCW 18.360.040 who performs hemodialysis and other 37
functions pursuant to RCW 18.360.050 under the supervision of a 38
health care practitioner. 39
p. 2 HB 2329
(9) "Medical assistant-phlebotomist" means a person certified 1
under RCW 18.360.040 who performs capillary, venous, and arterial 2
invasive procedures for blood withdrawal and other functions pursuant 3
to RCW 18.360.050 under the supervision of a health care 4
practitioner. 5
(10) "Medical assistant-registered" means a person registered 6
under RCW 18.360.040 who, pursuant to an endorsement by a health care 7
practitioner, clinic, or group practice, assists a health care 8
practitioner with patient care, executes administrative and clinical 9
procedures, and performs functions as provided in RCW 18.360.050 10
under the supervision of the health care practitioner.11
(11) "Secretary" means the secretary of the department of health.12
(12)(a) "Supervision" means supervision of procedures permitted 13
pursuant to this chapter by a health care practitioner who is 14
physically present and is immediately available in the facility, 15
except as provided in (b) and (c) of this subsection.16
(b) The health care practitioner does not need to be present 17
during procedures to withdraw blood, administer vaccines, or obtain 18
specimens for or perform diagnostic testing, but must be immediately 19
available. 20
(c)(i) During a telemedicine visit, supervision over a medical 21
assistant assisting a health care practitioner with the telemedicine 22
visit may be provided through interactive audio and video 23
telemedicine technology. 24
(ii) When administering intramuscular injections for the purposes 25
of treating a known or suspected syphilis infection in accordance 26
with RCW 18.360.050, a medical assistant-certified or medical 27
assistant-registered may be supervised through interactive audio or 28
video telemedicine technology. 29
Sec. 3. RCW 18.360.010 and 2025 c 58 s 5084 are each amended to 30
read as follows: 31
The definitions in this section apply throughout this chapter 32
unless the context clearly requires otherwise. 33
(1) "Administer" means the retrieval of medication, and its 34
application to a patient, as authorized in RCW 18.360.050.35
(2) "Delegation" means direct authorization granted by a licensed 36
health care practitioner to a medical assistant to perform the 37
functions authorized in this chapter which fall within the scope of 38
p. 3 HB 2329
practice of the health care provider and the training and experience 1
of the medical assistant. 2
(3) "Department" means the department of health.3
(4) "Forensic phlebotomist" means a police officer, law 4
enforcement officer, or employee of a correctional facility or 5
detention facility, who is certified under this chapter and meets any 6
additional training and proficiency standards of his or her employer 7
to collect a venous blood sample for forensic testing pursuant to a 8
search warrant, a waiver of the warrant requirement, or exigent 9
circumstances. 10
(5) "Health care practitioner" means: 11
(a) A physician licensed under chapter 18.71 RCW;12
(b) An osteopathic physician and surgeon licensed under chapter 13
18.57 RCW; or 14
(c) Acting within the scope of their respective licensure, a 15
podiatric physician and surgeon licensed under chapter 18.22 RCW, a 16
registered nurse or advanced practice registered nurse licensed under 17
chapter 18.79 RCW, a naturopath licensed under chapter 18.36A RCW, a 18
physician assistant licensed under chapter 18.71A RCW, a midwife 19
licensed under chapter 18.50 RCW, or an optometrist licensed under 20
chapter 18.53 RCW. 21
(6) "Medical assistant-certified" means a person certified under 22
RCW 18.360.040 who assists a health care practitioner with patient 23
care, executes administrative and clinical procedures, and performs 24
functions as provided in RCW 18.360.050 under the supervision of the 25
health care practitioner. 26
(7) "Medical assistant-EMT" means a person certified under RCW 27
18.360.040 who performs functions as provided in RCW 18.360.050 under 28
the supervision of a health care practitioner and holds: An emergency 29
medical technician certification under RCW 18.73.081; an advanced 30
emergency medical technician certification under RCW 18.71.205; or a 31
paramedic certification under RCW 18.71.205. 32
(8) "Medical assistant-hemodialysis technician" means a person 33
certified under RCW 18.360.040 who performs hemodialysis and other 34
functions pursuant to RCW 18.360.050 under the supervision of a 35
health care practitioner. 36
(9) "Medical assistant-phlebotomist" means a person certified 37
under RCW 18.360.040 who performs capillary, venous, and arterial 38
invasive procedures for blood withdrawal and other functions pursuant 39
p. 4 HB 2329
to RCW 18.360.050 under the supervision of a health care 1
practitioner. 2
(10) "Medical assistant-registered" means a person registered 3
under RCW 18.360.040 who, pursuant to an endorsement by a health care 4
practitioner, clinic, or group practice, assists a health care 5
practitioner with patient care, executes administrative and clinical 6
procedures, and performs functions as provided in RCW 18.360.050 7
under the supervision of the health care practitioner.8
(11) "Secretary" means the secretary of the department of health.9
(12)(a) "Supervision" means supervision of procedures permitted 10
pursuant to this chapter by a health care practitioner who is 11
physically present and is immediately available in the facility, 12
except as provided in (b) and (c) of this subsection.13
(b) The health care practitioner does not need to be present 14
during procedures to withdraw blood, administer vaccines, or obtain 15
specimens for or perform diagnostic testing, but must be immediately 16
available. 17
(c)(i) During a telemedicine visit, supervision over a medical 18
assistant assisting a health care practitioner with the telemedicine 19
visit may be provided through interactive audio and video 20
telemedicine technology. 21
(ii) When administering intramuscular injections for the purposes 22
of treating a known or suspected syphilis infection in accordance 23
with RCW 18.360.050, a medical assistant-certified or medical 24
assistant-registered may be supervised through interactive audio or 25
video telemedicine technology. 26
NEW SECTION. Sec. 4. Section 2 of this act expires June 30, 27
2027.28
NEW SECTION. Sec. 5. Section 3 of this act takes effect June 29
30, 2027.30
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p. 5 HB 2329