Plasma donation/physicians

AN ACT Relating to authorizing certain health professions to act 1
as physician substitutes for plasma source donation centers; amending 2
RCW 18.360.040; and reenacting and amending RCW 18.360.050.3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
Sec. 1. RCW 18.360.040 and 2024 c 217 s 4 are each amended to 5
read as follows: 6
(1)(a) The secretary shall issue a certification as a medical 7
assistant-certified to any person who has satisfactorily completed a 8
medical assistant training program approved by the secretary, passed 9
an examination approved by the secretary, and met any additional 10
qualifications established under RCW 18.360.030. 11
(b) The secretary shall issue an interim certification to any 12
person who has met all of the qualifications in (a) of this 13
subsection, except for the passage of the examination. A person 14
holding an interim permit possesses the full scope of practice of a 15
medical assistant-certified. The interim permit expires upon passage 16
of the examination and issuance of a certification, or after one 17
year, whichever occurs first, and may not be renewed.18
(2)(a) The secretary shall issue a certification as a medical 19
assistant-hemodialysis technician to any person who meets the 20
S-1151.1
SENATE BILL 5657
State of Washington 69th Legislature 2025 Regular Session
By Senators Harris and Dozier
Read first time 02/04/25. Referred to Committee on Health & Long-
Term Care.
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qualifications for a medical assistant-hemodialysis technician 1
established under RCW 18.360.030. 2
(b) In order to allow sufficient time for the processing of a 3
medical assistant-hemodialysis technician certification, applicants 4
for that credential who have completed their training program are 5
allowed to continue to work at dialysis facilities, under the level 6
of supervision required for the training program, for a period of up 7
to 180 days after filing their application, to facilitate patient 8
continuity of care. 9
(3)(a) The secretary shall issue a certification as a medical 10
assistant-phlebotomist to any person who meets the qualifications for 11
a medical assistant-phlebotomist established under RCW 18.360.030.12
(b) In order to allow sufficient time for the processing of a 13
medical assistant-phlebotomist certification, applicants for that 14
credential who have completed their training program are allowed to 15
work, under the level of supervision required for the training 16
program, for a period of up to 180 days after filing their 17
application, to facilitate access to services. 18
(4) The secretary shall issue a certification as a medical 19
assistant-EMT to any person who meets the qualifications for a 20
medical assistant-EMT established under RCW 18.360.030.21
(5) The secretary shall issue a certification as a forensic 22
phlebotomist to any person who meets the qualifications for a 23
forensic phlebotomist established under RCW 18.360.030.24
(6)(a) The secretary shall issue a registration as a medical 25
assistant-registered to any person who has a current endorsement from 26
a health care practitioner, clinic, or group practice.27
(b) In order to be endorsed under this subsection (6), a person 28
must: 29
(i) Be endorsed by a health care practitioner, clinic, or group 30
practice that meets the qualifications established under RCW 31
18.360.030; and 32
(ii) Have a current attestation of his or her endorsement to 33
perform specific medical tasks signed by a supervising health care 34
practitioner filed with the department. A medical assistant-35
registered may only perform the medical tasks listed in his or her 36
current attestation of endorsement. 37
(c) A registration based on an endorsement by a health care 38
practitioner, clinic, or group practice is not transferable to 39
another health care practitioner, clinic, or group practice.40
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(d) An applicant for registration as a medical assistant-1
registered who applies to the department within seven days of 2
employment by the endorsing health care practitioner, clinic, or 3
group practice may work as a medical assistant-registered for up to 4
sixty days while the application is processed. The applicant must 5
stop working on the sixtieth day of employment if the registration 6
has not been granted for any reason. 7
(7) A certification issued under subsections (1) through (3) of 8
this section is transferable between different practice settings. A 9
certification under subsection (4) of this section is transferable 10
only between hospitals licensed under chapter 70.41 RCW and source 11
plasma donation centers. A certification under subsection (5) of this 12
section is transferable between law enforcement agencies.13
Sec. 2. RCW 18.360.050 and 2024 c 248 s 3 and 2024 c 217 s 5 are 14
each reenacted and amended to read as follows: 15
(1) A medical assistant-certified may perform the following 16
duties delegated by, and under the supervision of, a health care 17
practitioner: 18
(a) Fundamental procedures: 19
(i) Wrapping items for autoclaving; 20
(ii) Procedures for sterilizing equipment and instruments;21
(iii) Disposing of biohazardous materials; and22
(iv) Practicing standard precautions. 23
(b) Clinical procedures: 24
(i) Performing aseptic procedures in a setting other than a 25
hospital licensed under chapter 70.41 RCW; 26
(ii) Preparing of and assisting in sterile procedures in a 27
setting other than a hospital under chapter 70.41 RCW;28
(iii) Taking vital signs; 29
(iv) Preparing patients for examination; 30
(v) Capillary blood withdrawal, venipuncture, and intradermal, 31
subcutaneous, and intramuscular injections; and 32
(vi) Observing and reporting patients' signs or symptoms.33
(c) Specimen collection: 34
(i) Capillary puncture and venipuncture; 35
(ii) Obtaining specimens for microbiological testing; and36
(iii) Instructing patients in proper technique to collect urine 37
and fecal specimens. 38
(d) Diagnostic testing: 39
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(i) Electrocardiography; 1
(ii) Respiratory testing; and 2
(iii)(A) Tests waived under the federal clinical laboratory 3
improvement amendments program on July 1, 2013. The department shall 4
periodically update the tests authorized under this subsection (1)(d) 5
based on changes made by the federal clinical laboratory improvement 6
amendments program; and 7
(B) Moderate complexity tests if the medical assistant-certified 8
meets standards for personnel qualifications and responsibilities in 9
compliance with federal regulation for nonwaived testing.10
(e) Patient care: 11
(i) Telephone and in-person screening limited to intake and 12
gathering of information without requiring the exercise of judgment 13
based on clinical knowledge; 14
(ii) Obtaining vital signs; 15
(iii) Obtaining and recording patient history;16
(iv) Preparing and maintaining examination and treatment areas;17
(v) Preparing patients for, and assisting with, routine and 18
specialty examinations, procedures, treatments, and minor office 19
surgeries; 20
(vi) Maintaining medication and immunization records; and21
(vii) Screening and following up on test results as directed by a 22
health care practitioner. 23
(f)(i) Administering medications. A medical assistant-certified 24
may only administer medications if the drugs are: 25
(A) Administered only by unit or single dosage, or by a dosage 26
calculated and verified by a health care practitioner. For purposes 27
of this section, a combination or multidose vaccine shall be 28
considered a unit dose; 29
(B) Limited to legend drugs, vaccines, and Schedule III-V 30
controlled substances as authorized by a health care practitioner 31
under the scope of his or her license and consistent with rules 32
adopted by the secretary under (f)(ii) of this subsection; and33
(C) Administered pursuant to a written order from a health care 34
practitioner. 35
(ii) A medical assistant-certified may not administer 36
experimental drugs or chemotherapy agents. The secretary may, by 37
rule, further limit the drugs that may be administered under this 38
subsection (1)(f). The rules adopted under this subsection must limit 39
the drugs based on risk, class, or route. 40
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(iii) A medical assistant-certified may administer intramuscular 1
injections for the purposes of treating known or suspected syphilis 2
infection without immediate supervision if a health care practitioner 3
is providing supervision through interactive audio or video 4
telemedicine technology in accordance with RCW 18.360.010(((11))) 5
(12)(c)(ii). 6
(g) Intravenous injections. A medical assistant-certified may 7
establish intravenous lines for diagnostic or therapeutic purposes, 8
without administering medications, under the supervision of a health 9
care practitioner, and administer intravenous injections for 10
diagnostic or therapeutic agents under the direct visual supervision 11
of a health care practitioner if the medical assistant-certified 12
meets minimum standards established by the secretary in rule. The 13
minimum standards must be substantially similar to the qualifications 14
for category D and F health care assistants as they exist on July 1, 15
2013. 16
(h) Urethral catheterization when appropriately trained.17
(2) A medical assistant-hemodialysis technician may perform 18
hemodialysis when delegated and supervised by a health care 19
practitioner. A medical assistant-hemodialysis technician may also 20
administer drugs and oxygen to a patient when delegated and 21
supervised by a health care practitioner and pursuant to rules 22
adopted by the secretary. 23
(3) A medical assistant-phlebotomist may perform:24
(a) Capillary, venous, or arterial invasive procedures for blood 25
withdrawal when delegated and supervised by a health care 26
practitioner and pursuant to rules adopted by the secretary;27
(b) Tests waived under the federal clinical laboratory 28
improvement amendments program on July 1, 2013. The department shall 29
periodically update the tests authorized under this section based on 30
changes made by the federal clinical laboratory improvement 31
amendments program; 32
(c) Moderate and high complexity tests if the medical assistant-33
phlebotomist meets standards for personnel qualifications and 34
responsibilities in compliance with federal regulation for nonwaived 35
testing; and 36
(d) Electrocardiograms. 37
(4) A medical assistant-registered may perform the following 38
duties delegated by, and under the supervision of, a health care 39
practitioner: 40
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(a) Fundamental procedures: 1
(i) Wrapping items for autoclaving; 2
(ii) Procedures for sterilizing equipment and instruments;3
(iii) Disposing of biohazardous materials; and 4
(iv) Practicing standard precautions. 5
(b) Clinical procedures: 6
(i) Preparing for sterile procedures; 7
(ii) Taking vital signs; 8
(iii) Preparing patients for examination; and 9
(iv) Observing and reporting patients' signs or symptoms.10
(c) Specimen collection: 11
(i) Obtaining specimens for microbiological testing; and12
(ii) Instructing patients in proper technique to collect urine 13
and fecal specimens. 14
(d) Patient care: 15
(i) Telephone and in-person screening limited to intake and 16
gathering of information without requiring the exercise of judgment 17
based on clinical knowledge; 18
(ii) Obtaining vital signs; 19
(iii) Obtaining and recording patient history;20
(iv) Preparing and maintaining examination and treatment areas;21
(v) Preparing patients for, and assisting with, routine and 22
specialty examinations, procedures, treatments, and minor office 23
surgeries, including those with minimal sedation. The department may, 24
by rule, prohibit duties authorized under this subsection (4)(d)(v) 25
if performance of those duties by a medical assistant-registered 26
would pose an unreasonable risk to patient safety;27
(vi) Maintaining medication and immunization records; and28
(vii) Screening and following up on test results as directed by a 29
health care practitioner. 30
(e) Diagnostic testing and electrocardiography.31
(f)(i) Tests waived under the federal clinical laboratory 32
improvement amendments program on July 1, 2013. The department shall 33
periodically update the tests authorized under subsection (1)(d) of 34
this section based on changes made by the federal clinical laboratory 35
improvement amendments program. 36
(ii) Moderate complexity tests if the medical assistant-37
registered meets standards for personnel qualifications and 38
responsibilities in compliance with federal regulation for nonwaived 39
testing. 40
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(g) Administering eye drops, topical ointments, and vaccines, 1
including combination or multidose vaccines. 2
(h) Urethral catheterization when appropriately trained.3
(i) Administering medications: 4
(i) A medical assistant-registered may only administer 5
medications if the drugs are: 6
(A) Administered only by unit or single dosage, or by a dosage 7
calculated and verified by a health care practitioner. For purposes 8
of this section, a combination or multidose vaccine shall be 9
considered a unit dose; 10
(B) Limited to legend drugs, vaccines, and Schedule III through V 11
controlled substances as authorized by a health care practitioner 12
under the scope of his or her license and consistent with rules 13
adopted by the secretary under (i)(ii) of this subsection; and14
(C) Administered pursuant to a written order from a health care 15
practitioner. 16
(ii) A medical assistant-registered may only administer 17
medication for intramuscular injections. A medical assistant-18
registered may not administer experimental drugs or chemotherapy 19
agents. The secretary may, by rule, further limit the drugs that may 20
be administered under this subsection (4)(i). The rules adopted under 21
this subsection must limit the drugs based on risk, class, or route.22
(j)(i) Intramuscular injections. A medical assistant-registered 23
may administer intramuscular injections for diagnostic or therapeutic 24
agents under the immediate supervision of a health care practitioner 25
if the medical assistant-registered meets minimum standards 26
established by the secretary in rule. 27
(ii) A medical assistant-registered may administer intramuscular 28
injections for the purposes of treating known or suspected syphilis 29
infection without immediate supervision if a health care practitioner 30
is providing supervision through interactive audio or video 31
telemedicine technology in accordance with RCW 18.360.010(((11))) 32
(12)(c)(ii). 33
(5)(a) A medical assistant-EMT may perform the following duties 34
delegated by, and under the supervision of, a health care 35
practitioner if the duties are within the scope, training, and 36
endorsements of the medical assistant-EMT's emergency medical 37
technician, advanced emergency medical technician, or paramedic 38
certification: 39
(i) Fundamental procedures: 40
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(A) Disposing of biohazardous materials; and 1
(B) Practicing standard precautions; 2
(ii) Clinical procedures: 3
(A) Taking vital signs; 4
(B) Preparing patients for examination; 5
(C) Observing and reporting patients' signs or symptoms;6
(D) Simple eye irrigation; 7
(E) Hemorrhage control with direct pressure or hemostatic gauze;8
(F) Spinal and extremity motion restriction and immobilization;9
(G) Oxygen administration; 10
(H) Airway maintenance, stabilization, and suctioning;11
(I) Cardiopulmonary resuscitation; and 12
(J) Use of automated external defibrillators and semiautomated 13
external defibrillators; 14
(iii) Specimen collection: 15
(A) Capillary puncture and venipuncture; and 16
(B) Instructing patients in proper technique to collect urine and 17
fecal specimens; 18
(iv) Diagnostic testing: 19
(A) Electrocardiography; and 20
(B) Respiratory testing, including nasopharyngeal swabbing for 21
COVID-19; 22
(v) Patient care: 23
(A) Telephone and in-person screening, limited to intake and 24
gathering of information without requiring the exercise of judgment 25
based on clinical knowledge; 26
(B) Obtaining vital signs; 27
(C) Obtaining and recording patient history; and28
(D) Preparing and maintaining examination and treatment areas;29
(vi) Administering medications: A medical assistant-EMT may only 30
administer medications if the drugs are: 31
(A) Administered only by unit or single dosage, or by a dosage 32
calculated and verified by a health care practitioner. For purposes 33
of this subsection, a combination or multidose vaccine shall be 34
considered a unit dose; 35
(B) Limited to vaccines, opioid antagonists, and oral glucose, as 36
authorized by a health care practitioner under the scope of his or 37
her license and consistent with rules adopted by the secretary under 38
(b) of this subsection; and 39
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(C) Administered pursuant to a written order from a health care 1
practitioner; ((and))2
(vii) Establishing intravenous lines: A medical assistant-EMT may 3
establish intravenous lines for diagnostic or therapeutic purposes, 4
without administering medications, and remove intravenous lines under 5
the supervision of a health care practitioner; and6
(viii) Performing the duties of a physician substitute in a 7
plasma source donation center as authorized in 21 C.F.R. Sec. 630.5.8
(b) The secretary may, by rule, further limit the drugs that may 9
be administered under this subsection. The rules adopted under this 10
subsection must limit the drugs based on risk, class, or route.11
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