Health Care Assistant Frequently Asked Questions (FAQs) - Washington State Department of Health

A new state law has expanded the type of work that health care assistants can do. This change began July 26, 2009. The law is formally known as Substitute House Bill (SHB) 1414.

Health care assistants (HCAs) can now administer certain drugs. These medicines can be administered by topical, rectal, otic, ophthalmic or inhaled routes. Health care assistants in categories C and E may administer certain oral drugs.

The new section 3 specifies the types of drugs that may be administered. This section expires on July 1, 2013.

Health care assistants working under this expanded scope of practice must have sufficient training, experience and supervision to administer medicines with reasonable skill and safety.

Q.	What are the different classifications or levels of health care assistants, and what is each level permitted to do as far as patient care?
A.	There are seven categories of health care assistants. All may administer vaccines with appropriate delegation and supervision. This can be done by injection, orally, topically, or by nasal administration. The procedures approved for each category are: (1) Category A -- venous and capillary invasive procedures for blood withdrawal. (2) Category B -- arterial invasive procedures for blood withdrawal. (3) Category C -- intradermal, subcutaneous and intramuscular injections for diagnostic agents and skin tests. (4) Category D -- intravenous injections for diagnostic agents. (5) Category E -- intradermal, subcutaneous and intramuscular injections for therapeutic agents and skin tests. (6) Category F -- intravenous injections for therapeutic agents. (7) Category G ? hemodialysis.	Back to Top
Q.	Can a health care assistant start an IV? If not, what are their duties relating to IV?s?
A.	No. A health care assistant may not start an IV. Health care assistants in categories D and F may interrupt an IV, administer an injection, and restart at the same rate. Line draws may only be performed by a category B assistant if the IV is stopped and restarted by a licensed practitioner. The rule does not say a health care assistant can discontinue the IV, so it is not in their scope of practice to do so. (WAC 246-826-210 (1))
Q.	Can a facility set up dosing guidelines for a health care assistant to use without consulting the provider?
A.	No.
Q.	Can a health care assistant assist in colonoscopies, use the biopsy forceps and snares to cut and obtain tissue samples at the direction of the MD?
A.	No.	Back to Top
Q.	Can a health care assistant access, flush, and withdraw blood for an Implanted Venous Access device (port-a-cath)?
A.	No.
Q.	Can a health care assistant insert urinary catheters?
A.	No.
Q.	Who can supervise a health care assistant?
A.	A health care assistant can only be supervised by licensed medical doctors, osteopathic doctors, physician assistants, podiatric doctors, advanced registered nurse practitioners, registered nurses, and naturopathic doctors.
Q.	Can a health care assistant be a part of the controlled substance count at the beginning and end of the day and sign for the count?
A.	No.	Back to Top
Q.	Can a health care assistant sign out and administer a controlled substance that has been ordered by a supervising practitioner? This includes obtaining the narcotic cabinet keys, opening the cabinet, removing the narcotic ordered and then administering it intramuscularly.
A.	No. A health care assistant cannot sign out a controlled substance, have the narcotic cabinet keys or open the cabinet. A health care assistant certified in Category C or Category E can give an intramuscular injection. He or she can only do this if the supervising practitioner is physically present and immediately available in the facility during the administration of the injection.
Q.	Can a health care assistant work at the facility before he/she receives the health care certification in the mail?
A.	The health care assistant can work and perform the duties of his or her category while waiting for the actual certification document. This is considered a training period. The assistant can work during the application process.	Back to Top
Q.	What types of drugs can a health care assistant administer by injection?
A.	Class C, D, E, or F health care assistants working in a hospital or nursing home may administer by injection the drugs listed below. They may do so only as authorized and directed by a delegator. They are also limited by what is allowed by their category of certification. Antihistamines, Anti-infective agents, Antineoplastic agents, Autonomic drugs, Blood derivatives, Blood formation and coagulation, Cardiovascular drugs, CNS agents, Diagnostic agents, Electrolytic, caloric and water balance, Gastrointestinal drugs, Gold compounds, Heavy metal antagonists, Hormones/synthetic substitutes, Local anesthetics, Oxytocics, Radioactive agents, Serums toxoids, vaccines, Skin and mucous membrane agents, Smooth muscle relaxants, Vitamins, Unclassified therapeutic agents.	Back to Top
Q.	How many health care assistants can a delegator supervise?
A.	There are no limitations on how many health care assistants a delegator can supervise.
Q.	What type of recognition is given, if any, for people who have obtained education and training through the military, and would like to pursue health care assistant certification?
A.	An individual who served in the Air Force as a Medical Service Specialist meets the requirements for categories A, B, C, and E. An individual who has served in the Army (Bravo's of Whiskey's) and have completed the technical training, meets the requirement of categories A, B, C, and E. An individual who served in the Navy and has completed the Hospital Corps School meets the requirement for categories A,B,C, and E.	Back to Top
Q.	Is telephone triage and advice using a Barton Schmitt, MD protocol book within the scope of practice for a credentialed health care assistant?
A.	No.
Q.	Is a health care assistant credential transferable to other hospitals?
A.	No. Certification at one health care faculty or health care practitioner is not transferable to another health care facility or health care practitioner.	Back to Top