CERTIFICATION OF ENROLLMENT
SUBSTITUTE SENATE BILL 5940
Chapter 217, Laws of 2024
68th Legislature
2024 Regular Session
MEDICAL ASSISTANT-EMT CERTIFICATION
EFFECTIVE DATE: June 6, 2024
Passed by the Senate February 7, 2024 CERTIFICATE
Yeas 49 Nays 0
I, Sarah Bannister, Secretary of
the Senate of the State of
DENNY HECK Washington, do hereby certify that
President of the Senate the attached is SUBSTITUTE SENATE
BILL 5940 as passed by the Senate
and the House of Representatives on
the dates hereon set forth.
Passed by the House February 29, 2024
Yeas 96 Nays 0
SARAH BANNISTER
LAURIE JINKINS Secretary
Speaker of the House of
Representatives
Approved March 19, 2024 3:18 PM FILED
March 21, 2024
Secretary of State
JAY INSLEE State of Washington
Governor of the State of Washington
 SUBSTITUTE SENATE BILL 5940
Passed Legislature - 2024 Regular Session
State of Washington 68th Legislature 2024 Regular Session
By Senate Health & Long Term Care (originally sponsored by Senators
Van De Wege, Hasegawa, Keiser, Lovick, Muzzall, and Wagoner)
READ FIRST TIME 01/22/24.
1 AN ACT Relating to creating a medical assistant-EMT
2 certification; amending RCW 18.360.010, 18.360.020, 18.360.030,
3 18.360.040, and 18.360.050; and reenacting and amending RCW
4 18.120.020 and 18.130.040.
5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
6 Sec. 1. RCW 18.360.010 and 2023 c 134 s 1 are each amended to
7 read as follows:
8 The definitions in this section apply throughout this chapter
9 unless the context clearly requires otherwise.
10 (1) "Administer" means the retrieval of medication, and its
11 application to a patient, as authorized in RCW 18.360.050.
12 (2) "Delegation" means direct authorization granted by a licensed
13 health care practitioner to a medical assistant to perform the
14 functions authorized in this chapter which fall within the scope of
15 practice of the health care provider and the training and experience
16 of the medical assistant.
17 (3) "Department" means the department of health.
18 (4) "Forensic phlebotomist" means a police officer, law
19 enforcement officer, or employee of a correctional facility or
20 detention facility, who is certified under this chapter and meets any
21 additional training and proficiency standards of his or her employer
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 1 to collect a venous blood sample for forensic testing pursuant to a
2 search warrant, a waiver of the warrant requirement, or exigent
3 circumstances.
4 (5) "Health care practitioner" means:
5 (a) A physician licensed under chapter 18.71 RCW;
6 (b) An osteopathic physician and surgeon licensed under chapter
7 18.57 RCW; or
8 (c) Acting within the scope of their respective licensure, a
9 podiatric physician and surgeon licensed under chapter 18.22 RCW, a
10 registered nurse or advanced registered nurse practitioner licensed
11 under chapter 18.79 RCW, a naturopath licensed under chapter 18.36A
12 RCW, a physician assistant licensed under chapter 18.71A RCW, or an
13 optometrist licensed under chapter 18.53 RCW.
14 (6) "Medical assistant-certified" means a person certified under
15 RCW 18.360.040 who assists a health care practitioner with patient
16 care, executes administrative and clinical procedures, and performs
17 functions as provided in RCW 18.360.050 under the supervision of the
18 health care practitioner.
19 (7) "Medical assistant-EMT" means a person certified under RCW
20 18.360.040 who performs functions as provided in RCW 18.360.050 under
21 the supervision of a health care practitioner and holds: An emergency
22 medical technician certification under RCW 18.73.081; an advanced
23 emergency medical technician certification under RCW 18.71.205; or a
24 paramedic certification under RCW 18.71.205.
25 (8) "Medical assistant-hemodialysis technician" means a person
26 certified under RCW 18.360.040 who performs hemodialysis and other
27 functions pursuant to RCW 18.360.050 under the supervision of a
28 health care practitioner.
29 (((8))) (9) "Medical assistant-phlebotomist" means a person
30 certified under RCW 18.360.040 who performs capillary, venous, and
31 arterial invasive procedures for blood withdrawal and other functions
32 pursuant to RCW 18.360.050 under the supervision of a health care
33 practitioner.
34 (((9))) (10) "Medical assistant-registered" means a person
35 registered under RCW 18.360.040 who, pursuant to an endorsement by a
36 health care practitioner, clinic, or group practice, assists a health
37 care practitioner with patient care, executes administrative and
38 clinical procedures, and performs functions as provided in RCW
39 18.360.050 under the supervision of the health care practitioner.
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 1 (((10))) (11) "Secretary" means the secretary of the department
2 of health.
3 (((11))) (12)(a) "Supervision" means supervision of procedures
4 permitted pursuant to this chapter by a health care practitioner who
5 is physically present and is immediately available in the facility,
6 except as provided in (b) and (c) of this subsection.
7 (b) The health care practitioner does not need to be present
8 during procedures to withdraw blood, administer vaccines, or obtain
9 specimens for or perform diagnostic testing, but must be immediately
10 available.
11 (c) During a telemedicine visit, supervision over a medical
12 assistant assisting a health care practitioner with the telemedicine
13 visit may be provided through interactive audio and video
14 telemedicine technology.
15 Sec. 2. RCW 18.360.020 and 2017 c 336 s 15 are each amended to
16 read as follows:
17 (1) No person may practice as a medical assistant-certified,
18 medical assistant-hemodialysis technician, medical assistant-
19 phlebotomist, medical assistant-EMT, or forensic phlebotomist unless
20 he or she is certified under RCW 18.360.040.
21 (2) No person may practice as a medical assistant-registered
22 unless he or she is registered under RCW 18.360.040.
23 Sec. 3. RCW 18.360.030 and 2019 c 55 s 8 are each amended to
24 read as follows:
25 (1) The secretary shall adopt rules specifying the minimum
26 qualifications for a medical assistant-certified, medical assistant-
27 hemodialysis technician, medical assistant-phlebotomist, medical
28 assistant-EMT, and forensic phlebotomist.
29 (a) The qualifications for a medical assistant-hemodialysis
30 technician must be equivalent to the qualifications for hemodialysis
31 technicians regulated pursuant to chapter 18.135 RCW as of January 1,
32 2012.
33 (b) The qualifications for a forensic phlebotomist must include
34 training consistent with the occupational safety and health
35 administration guidelines and must include between twenty and thirty
36 hours of work in a clinical setting with the completion of more than
37 one hundred successful venipunctures. The secretary may not require
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 1 more than ((forty)) 40 hours of classroom training for initial
2 training, which may include online preclass homework.
3 (c) The qualifications for a medical assistant-EMT must be
4 consistent with the qualifications for the emergency medical
5 technician certification pursuant to RCW 18.73.081; the advanced
6 emergency medical technician certification pursuant to RCW 18.71.205;
7 or the paramedic certification pursuant to RCW 18.71.205. The
8 secretary must ensure that any person with an emergency medical
9 technician, advanced emergency medical technician, or paramedic
10 certification is eligible for a medical assistant-EMT certification
11 with no additional training or examination requirements if the
12 certification for the emergency medical technician, advanced
13 emergency medical technician, or a paramedic is in good standing.
14 (2) The secretary shall adopt rules that establish the minimum
15 requirements necessary for a health care practitioner, clinic, or
16 group practice to endorse a medical assistant as qualified to perform
17 the duties authorized by this chapter and be able to file an
18 attestation of that endorsement with the department.
19 (((3) The Washington medical commission, the board of osteopathic
20 medicine and surgery, the podiatric medical board, the nursing care
21 quality assurance commission, the board of naturopathy, and the
22 optometry board shall each review and identify other specialty
23 assistive personnel not included in this chapter and the tasks they
24 perform. The department of health shall compile the information from
25 each disciplining authority listed in this subsection and submit the
26 compiled information to the legislature no later than December 15,
27 2012.))
28 Sec. 4. RCW 18.360.040 and 2023 c 134 s 2 are each amended to
29 read as follows:
30 (1)(a) The secretary shall issue a certification as a medical
31 assistant-certified to any person who has satisfactorily completed a
32 medical assistant training program approved by the secretary, passed
33 an examination approved by the secretary, and met any additional
34 qualifications established under RCW 18.360.030.
35 (b) The secretary shall issue an interim certification to any
36 person who has met all of the qualifications in (a) of this
37 subsection, except for the passage of the examination. A person
38 holding an interim permit possesses the full scope of practice of a
39 medical assistant-certified. The interim permit expires upon passage
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 1 of the examination and issuance of a certification, or after one
2 year, whichever occurs first, and may not be renewed.
3 (2)(a) The secretary shall issue a certification as a medical
4 assistant-hemodialysis technician to any person who meets the
5 qualifications for a medical assistant-hemodialysis technician
6 established under RCW 18.360.030.
7 (b) In order to allow sufficient time for the processing of a
8 medical assistant-hemodialysis technician certification, applicants
9 for that credential who have completed their training program are
10 allowed to continue to work at dialysis facilities, under the level
11 of supervision required for the training program, for a period of up
12 to 180 days after filing their application, to facilitate patient
13 continuity of care.
14 (3)(a) The secretary shall issue a certification as a medical
15 assistant-phlebotomist to any person who meets the qualifications for
16 a medical assistant-phlebotomist established under RCW 18.360.030.
17 (b) In order to allow sufficient time for the processing of a
18 medical assistant-phlebotomist certification, applicants for that
19 credential who have completed their training program are allowed to
20 work, under the level of supervision required for the training
21 program, for a period of up to 180 days after filing their
22 application, to facilitate access to services.
23 (4) The secretary shall issue a certification as a medical
24 assistant-EMT to any person who meets the qualifications for a
25 medical assistant-EMT established under RCW 18.360.030.
26 (5) The secretary shall issue a certification as a forensic
27 phlebotomist to any person who meets the qualifications for a
28 forensic phlebotomist established under RCW 18.360.030.
29 (((5))) (6)(a) The secretary shall issue a registration as a
30 medical assistant-registered to any person who has a current
31 endorsement from a health care practitioner, clinic, or group
32 practice.
33 (b) In order to be endorsed under this subsection (((5))) (6), a
34 person must:
35 (i) Be endorsed by a health care practitioner, clinic, or group
36 practice that meets the qualifications established under RCW
37 18.360.030; and
38 (ii) Have a current attestation of his or her endorsement to
39 perform specific medical tasks signed by a supervising health care
40 practitioner filed with the department. A medical assistant-
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 1 registered may only perform the medical tasks listed in his or her
2 current attestation of endorsement.
3 (c) A registration based on an endorsement by a health care
4 practitioner, clinic, or group practice is not transferable to
5 another health care practitioner, clinic, or group practice.
6 (d) An applicant for registration as a medical assistant-
7 registered who applies to the department within seven days of
8 employment by the endorsing health care practitioner, clinic, or
9 group practice may work as a medical assistant-registered for up to
10 sixty days while the application is processed. The applicant must
11 stop working on the sixtieth day of employment if the registration
12 has not been granted for any reason.
13 (((6))) (7) A certification issued under subsections (1) through
14 (3) of this section is transferable between different practice
15 settings. A certification under subsection (4) of this section is
16 transferable only between hospitals licensed under chapter 70.41 RCW.
17 A certification under subsection (((4))) (5) of this section is
18 transferable between law enforcement agencies.
19 Sec. 5. RCW 18.360.050 and 2023 c 134 s 3 are each amended to
20 read as follows:
21 (1) A medical assistant-certified may perform the following
22 duties delegated by, and under the supervision of, a health care
23 practitioner:
24 (a) Fundamental procedures:
25 (i) Wrapping items for autoclaving;
26 (ii) Procedures for sterilizing equipment and instruments;
27 (iii) Disposing of biohazardous materials; and
28 (iv) Practicing standard precautions.
29 (b) Clinical procedures:
30 (i) Performing aseptic procedures in a setting other than a
31 hospital licensed under chapter 70.41 RCW;
32 (ii) Preparing of and assisting in sterile procedures in a
33 setting other than a hospital under chapter 70.41 RCW;
34 (iii) Taking vital signs;
35 (iv) Preparing patients for examination;
36 (v) Capillary blood withdrawal, venipuncture, and intradermal,
37 subcutaneous, and intramuscular injections; and
38 (vi) Observing and reporting patients' signs or symptoms.
39 (c) Specimen collection:
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 1 (i) Capillary puncture and venipuncture;
2 (ii) Obtaining specimens for microbiological testing; and
3 (iii) Instructing patients in proper technique to collect urine
4 and fecal specimens.
5 (d) Diagnostic testing:
6 (i) Electrocardiography;
7 (ii) Respiratory testing; and
8 (iii)(A) Tests waived under the federal clinical laboratory
9 improvement amendments program on July 1, 2013. The department shall
10 periodically update the tests authorized under this subsection (1)(d)
11 based on changes made by the federal clinical laboratory improvement
12 amendments program; and
13 (B) Moderate complexity tests if the medical assistant-certified
14 meets standards for personnel qualifications and responsibilities in
15 compliance with federal regulation for nonwaived testing.
16 (e) Patient care:
17 (i) Telephone and in-person screening limited to intake and
18 gathering of information without requiring the exercise of judgment
19 based on clinical knowledge;
20 (ii) Obtaining vital signs;
21 (iii) Obtaining and recording patient history;
22 (iv) Preparing and maintaining examination and treatment areas;
23 (v) Preparing patients for, and assisting with, routine and
24 specialty examinations, procedures, treatments, and minor office
25 surgeries;
26 (vi) Maintaining medication and immunization records; and
27 (vii) Screening and following up on test results as directed by a
28 health care practitioner.
29 (f)(i) Administering medications. A medical assistant-certified
30 may only 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 section, a combination or multidose vaccine shall be
34 considered a unit dose;
35 (B) Limited to legend drugs, vaccines, and Schedule III-V
36 controlled substances as authorized by a health care practitioner
37 under the scope of his or her license and consistent with rules
38 adopted by the secretary under (f)(ii) of this subsection; and
39 (C) Administered pursuant to a written order from a health care
40 practitioner.
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