This bill amends existing Washington law. It changes RCW 18.50.160 to allow a licensed midwife to delegate selected midwifery acts, tasks, or procedures to a registered nurse, licensed practical nurse, or medical assistant when those acts do not exceed the delegate’s education and scope of practice, and it adds an explicit statement that nothing in that section prohibits a licensed midwife from coordinating with an international board certified lactation consultant. It reenacts and amends RCW 18.360.010 to define terms used in that chapter, including delegation, several categories of medical assistants, forensic phlebotomist, health care practitioner (listing specific practitioner types), department, secretary, and supervision. The bill changes procedural rules about supervision. It generally requires the supervising health care practitioner to be physically present and immediately available in the facility, but it creates exceptions: the practitioner need not be physically present (but must be immediately available) for withdrawing blood, administering vaccines, or obtaining specimens or performing diagnostic testing; supervision may be provided through interactive audio and video telemedicine technology during a telemedicine visit; and a medical assistant-certified or medical assistant-registered may be supervised by interactive audio/video telemedicine when administering intramuscular injections to treat known or suspected syphilis in accordance with RCW 18.360.050. Section 2 of the act is temporary and expires June 30, 2027, and Section 3 takes effect June 30, 2027. These are amendments and reenactments that make procedural and definitional changes governing delegation and supervision; the text does not create a new criminal offense or change penalties. It affects the Department of Health, licensed midwives, nurses, various types of medical assistants, forensic phlebotomists, and the listed health care practitioners. The document excerpt omits full text of RCW 18.360.050 and RCW 18.360.040 (the specific functions and certification/registration details), does not explain an asterisked term or the reason for two slightly different nursing titles across the temporary and later versions, and does not show any overall effective date for the act beyond the dates given for Sections 2 and 3.

If enacted, licensed midwives will be able to hand off certain midwifery tasks to registered nurses, licensed practical nurses, or certified/registered medical assistants so long as those tasks match the delegate’s education and scope. That will allow midwives to shift routine procedures and coordination work (including explicit coordination with international board certified lactation consultants) to other staff, likely changing clinic staffing needs, daily workflows, and who is directly responsible for hands-on care. Supervising practitioners will mostly need to be physically present and immediately available in the facility, but the bill allows immediate availability instead of presence for blood draws, vaccines, and specimen collection/testing, permits supervision by live audio/video during telemedicine visits, and allows remote supervision for certain intramuscular injections to treat suspected syphilis, which creates some practical flexibility for remote or hybrid care models. The groups most affected are midwives, the various categories of medical assistants, registered and practical nurses, the Department of Health, affected clinics and facilities, and forensic phlebotomists in law enforcement or corrections. Clinics may incur costs to hire or certify additional delegates, to ensure supervising practitioners are available onsite or immediately reachable, and to train staff for delegated duties; supervising clinicians may take on more oversight and potential liability. Important details about the exact delegated functions and certification steps are referenced but not included here, and the bill phases a temporary definition of supervision that expires June 30, 2027 and a new version taking effect that day, so there is some transitional uncertainty until those timelines play out.