delegation, On the Job, Scope of Practice

Permissible Delegation of Influenza Vaccination Administration in Michigan

Medical assistants are well-positioned to assist with vaccinations, but legal considerations may vary depending on state law. For example, I recently received the following question regarding when a medical assistant in Michigan can be delegated the administration of influenza vaccinations:

I have two medical assistants in our occupational health/employee health clinic who operate under a provider and can give injections. We are part of a hospital that is across the street from our clinic. Can the two medical assistants give influenza shots in the hospital setting without our provider actually on-site?

To answer this question, note the following from the Michigan Public Health Code, which is posted in the Michigan subsection of the State Scope of Practice Laws webpage on the AAMA website:

333.16215 Delegation of acts, tasks, or functions to licensed or unlicensed individual; supervision; rules; immunity; third party reimbursement or worker’s compensation benefits.

Sec. 16215.

(1) Subject to subsections (2) to (6), a licensee who holds a license other than a health profession subfield license may delegate to a licensed or unlicensed individual who is otherwise qualified by education, training, or experience the performance of selected acts, tasks, or functions where the acts, tasks, or functions fall within the scope of practice of the licensee’s profession and will be performed under the licensee’s supervision. A licensee shall not delegate an act, task, or function under this section if the act, task, or function, under standards of acceptable and prevailing practice, requires the level of education, skill, and judgment required of the licensee under this article. [Italics added.]

In this excerpt, the definition of “licensee” includes a licensed physician. Medical assistants are considered unlicensed individuals under Michigan law.

Furthermore, the definition of “supervision” in this part of the Michigan law is as follows:

(2) “Supervision”, except as otherwise provided in this article, means the overseeing of or participation in the work of another individual by a health professional licensed under this article in circumstances where at least all of the following conditions exist:

(a) The continuous availability of direct communication in person or by radio, telephone, or telecommunication between the supervised individual and a licensed health professional.

(b) The availability of a licensed health professional on a regularly scheduled basis to review the practice of the supervised individual, to provide consultation to the supervised individual, to review records, and to further educate the supervised individual in the performance of the individual’s functions.

Therefore, my legal opinion is that Michigan law permits physicians to delegate the administration of influenza vaccinations to knowledgeable and competent unlicensed individuals such as medical assistants as long as the delegating physician is accessible to the medical assistants by radio, telephone, or telecommunication.

4 thoughts on “Permissible Delegation of Influenza Vaccination Administration in Michigan”

  1. Would the same rules pertain to a nurse practitioner, ordering a medical assistant to go to a patient’s house and administer an injection such as dexamethasone?

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