WSR 17-15-075 PERMANENT RULES DEPARTMENT OF HEALTH [Filed July 14, 2017, 1:55 p.m., effective August 14, 2017] Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-827-0010 Definitions and 246-827-0430 Forensic blood draws—Standards of practice (new), the department of health (department) has adopted rules to add a definition of "forensic blood draw" and establish a new section under the medical assistant (MA) chapter of rules related to standards of practice for forensic blood draws to provide clarification regarding blood draws taken to collect evidence as they relate to MAs.
Citation of Existing Rules Affected by this Order: Amending WAC 246-827-0010.
Adopted under notice filed as WSR 17-09-022 on April 11, 2017.
Changes Other than Editing from Proposed to Adopted Version: Two minor changes were made in response to the passage of E2SHB 1614 during the 2017 legislative session. The department is preparing paperwork to consider rule making to implement this bill. The bill amends several impaired driving laws and creates a department-issued "forensic phlebotomist" credential. Based on this, a reference to "forensic phlebotomist" was added to the new definition of "forensic blood draw" in amended WAC 246-827-0010.
Additionally, under WAC 246-827-0430 Forensic blood draws—Standards of practice (new), the department added "by medical assistant-certified and medical assistant-phlebotomist" to the second sentence of subsection (1) to clarify that the language in the subsection applies to MA-certified and MA-phlebotomist, and not to forensic phlebotomist.
A final cost-benefit analysis is available by contacting Brett Cain, P.O. Box 47852, Olympia, WA 98504-7852, phone (360) 236-4766, fax (360) 236-2901, email brett.cain@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Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 1, Amended 1, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 1, Repealed 0.
Date Adopted: July 13, 2017.
John Wiesman, DrPH, MPH
Secretary
AMENDATORY SECTION (Amending WSR 13-12-045, filed 5/31/13, effective 7/1/13)
WAC 246-827-0010 Definitions.
The following definitions apply throughout this chapter unless the context clearly indicates otherwise:
(1) "Direct visual supervision" means the supervising health care practitioner is physically present and within visual range of the medical assistant.
(2) "Forensic blood draw" means a blood sample drawn at the direction of a law enforcement officer for the purpose of determining its alcoholic or drug content by a person holding one of the credentials listed in RCW 46.61.506, including a medical assistant-certified, medical assistant-phlebotomist, or forensic phlebotomist.
(3) "Health care practitioner" means a physician licensed under chapter 18.71 RCW; an osteopathic physician and surgeon licensed under chapter 18.57 RCW; or acting within the scope of their respective licensure, a podiatric physician and surgeon licensed under chapter 18.22 RCW, a registered nurse or advanced registered nurse practitioner licensed under chapter 18.79 RCW, a naturopath licensed under chapter 18.36A RCW, a physician assistant licensed under chapter 18.71A RCW, an osteopathic physician assistant licensed under chapter 18.57A RCW, or an optometrist licensed under chapter 18.53 RCW.
(((3))) (4) "Hemodialysis" is a procedure for removing metabolic waste products or toxic substances from the human body by dialysis.
(((4))) (5) "Immediate supervision" means the supervising health care practitioner is on the premises and available for immediate response as needed.
(((5))) (6) "Legend drug" means any drug which is required by any applicable federal or state law or regulation to be dispensed on prescription only or is restricted to use by practitioners only.
(((6))) (7) "Medical assistant" without further qualification means a person credentialed under chapter 18.360 RCW as a:
(a) Medical assistant-certified;
(b) Medical assistant-registered;
(c) Medical assistant-hemodialysis technician; and
(d) Medical assistant-phlebotomist.
(((7))) (8) "Medical assistant-hemodialysis technician" means a patient care dialysis technician trained in compliance with federal requirements for end stage renal dialysis facilities.
(((8))) (9) "Secretary" means the secretary of the department of health or the secretary's designee.
NEW SECTION
WAC 246-827-0430 Forensic blood draws—Standards of practice.
(1) Any medical assistant-certified or medical assistant-phlebotomist certified under this chapter who performs a forensic blood draw must do so in accordance with the rules governing delegation and supervision in WAC 246-827-0110 and 246-827-0420, as well as the standards of practice for a medical assistant in Washington state. Forensic blood draws by medical assistant-certified or medical assistant-phlebotomist are not limited to specific settings and must comply with the standards of practice described in this section.
(2) A medical assistant-phlebotomist or medical assistant-certified meets the supervision requirements to perform a blood draw at the direction of a law enforcement officer if either:
(a) The medical assistant's supervising health care practitioner delegates the blood draw; or
(b) The blood draw is performed under the supervising health care practitioner's protocol for blood draws as provided in RCW 18.360.060.
(3) As provided in RCW 18.130.410, it is not professional misconduct for a medical assistant-certified or medical assistant-phlebotomist to collect a blood sample without consent under direction of law enforcement pursuant to a search warrant or under exigent circumstances; however, nothing relieves a medical provider from professional discipline arising from the use of improper procedures or from failing to exercise the required standard of care.
(4) RCW 46.61.508 sets forth the circumstances under which medical assistants-certified and medical assistants-phlebotomist are immune from civil and criminal liability when conducting a lawful forensic blood draw at the direction of a law enforcement officer. This protection does not extend to civil liability arising from the use of improper procedures or failing to exercise the required standard of care.
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