wa-law.org > bill > 2025-26 > HB 1784 > Original Bill

HB 1784 - Certified medical assistants

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Section 1

(1) A medical assistant-certified may perform the following duties delegated by, and under the supervision of, a health care practitioner:

Section 2

  1. A medical assistant-certified may enter an order for health care services into an entry-order system and approve such order if:

    1. The supervising health care practitioner directs the medical assistant-certified to enter and approve the order as a delegated task, using explicit verbal or written instructions that enable the medical assistant-certified to enter and approve the order without exercising judgment based on clinical knowledge;

    2. The medical assistant-certified enters and approves the order in accordance with the instructions of the supervising health care practitioner, without exercising judgment based on clinical knowledge;

    3. The order is reviewed by the supervising health care practitioner during the same business day and countersigned by the supervising health care practitioner within 72 hours of approval by the medical assistant-certified;

    4. The medical assistant-certified has completed training regarding order-entry systems as specified in subsection (2) of this section;

    5. The delegated order is in compliance with RCW 18.360.060; and

    6. The order is not a prescription for a controlled substance, as defined in RCW 69.50.101. If the order is for a prescription for a controlled substance, the medical assistant-certified may enter, but not approve, the order.

  2. [Empty]

    1. A medical assistant-certified may only enter and approve orders in accordance with this section if the medical assistant-certified has received training from a supervising health care practitioner regarding order-entry systems. The training must take place annually and must cover the scope of permitted tasks, when to obtain clarification from a supervising health care practitioner, and compliance with regulatory requirements.

    2. The employer of a medical assistant-certified must maintain records regarding participation in annual order-entry training.

  3. Upon department request, including during any on-site facility surveys conducted by the department, an employer of a medical assistant-certified must provide documentation to the department demonstrating compliance with the training and countersignature requirements of this section.

  4. The department may adopt rules to implement this section.

Section 3

  1. Prior to delegation of any of the functions in RCW 18.360.050, a health care practitioner shall determine to the best of his or her ability each of the following:

    1. That the task is within that health care practitioner's scope of licensure or authority;

    2. That the task is indicated for the patient;

    3. The appropriate level of supervision;

    4. That no law prohibits the delegation;

    5. That the person to whom the task will be delegated is competent to perform that task; and

    6. That the task itself is one that should be appropriately delegated when considering the following factors:

      1. That the task can be performed without requiring the exercise of judgment based on clinical knowledge;

      2. That results of the task are reasonably predictable;

      3. That the task can be performed without a need for complex observations or critical decisions;

      4. That the task can be performed without repeated clinical assessments; and

    v.(A) For a medical assistant other than a medical assistant-hemodialysis technician, that the task, if performed improperly, would not present life-threatening consequences or the danger of immediate and serious harm to the patient; and

(B) For a medical assistant-hemodialysis technician, that the task, if performed improperly, is not likely to present life-threatening consequences or the danger of immediate and serious harm to the patient.

  1. Nothing in this section prohibits the use of protocols that do not involve clinical judgment and do not involve the administration of medications, other than vaccines.

  2. The entry and approval of orders by a medical assistant-certified in accordance with section 2 of this act is not considered a task that requires the exercise of judgment based on clinical experience.

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