House Bill 1828 (H-1120.1), introduced in the 69th Legislature, 2025 Regular Session, amends RCW 18.360.040 and reenacts and amends RCW 18.360.050 to change certification, registration, scope-of-practice, and supervision rules for several categories of medical assistants. The bill directs the secretary to issue multiple specified credentials (medical assistant-certified; medical assistant-hemodialysis technician; medical assistant-phlebotomist; medical assistant-EMT; forensic phlebotomist; medical assistant-registered) when applicants meet qualifications under RCW 18.360.030 or listed endorsement requirements, and it authorizes the secretary to adopt implementing rules. The bill makes procedural and scope-of-practice changes: it creates interim certification for medical assistant-certified that allows full practice until the exam is passed or for one year (not renewable); allows trainees for hemodialysis technician or phlebotomist credentials to work under training supervision up to 180 days after application; requires a current endorsement and filed attestation for medical assistant-registered status and permits employment while an application is processed for up to 60 days if applied within seven days of hire. It specifies which certifications are transferable between practice settings, enumerates delegated duties that various medical assistant categories may perform under supervision (including fundamental procedures, specimen collection, diagnostic testing, IV line establishment/removal standards, and other clinical tasks), and sets detailed limits on medication administration (unit or verified dosages, specified drug classes, limits on routes such as intramuscular only for certain assistants, prohibition on experimental drugs and chemotherapy, and rulemaking authority for further limits). The bill also expressly allows certain procedures when appropriately trained (for example urethral catheterization), permits medical assistant-EMTs to perform specified EMT-scope duties and to act as physician substitutes in plasma source donation centers as authorized by 21 C.F.R. §630.5, and ties authorized diagnostic tests to CLIA-waived tests as of July 1, 2013 with periodic updates by the department. Important context is missing from the provided text: the excerpt is incomplete in places, the identity of "the secretary" is not specified, full qualification details from RCW 18.360.030 are not included, and part of subsection text is cut off, so some cross-references and specific limits cannot be confirmed from the facts given.

If enacted, the bill would broaden the kinds of medical assistant credentials the state issues and let more assistants perform defined clinical tasks under supervision, including catheterization, certain medication administration under a written order, intramuscular injections (with supervision limits), IV line establishment and removal (with limits), expanded specimen and diagnostic tasks, and specific EMT-related duties — including acting as a physician substitute in plasma donation centers under federal rules. It also creates interim and short-term work allowances (an interim permit for one year or until passing an exam, 180 days of supervised work for some trainees, and a 60‑day processing window for newly employed registered assistants), sets transferability limits for different credential types, and lets the responsible state secretary and department update or limit which drugs and tests are authorized. The people most affected are medical assistants, the clinicians and clinics that must endorse and supervise them, dialysis facilities, hospitals, plasma donation centers, and law enforcement agencies for forensic phlebotomy. Employers may gain staffing flexibility and possibly reduce use of higher‑level clinicians, but they will also need to provide or pay for training, supervision, endorsements, and adapt policies to new scope rules, which could raise administrative and liability risks. Important details about exact qualification standards, which agency is the “secretary,” and some procedural limits are missing from the provided text, so the precise operational and cost impacts remain partly uncertain.