covid-19, delegation, On the Job, Scope of Practice

Delegation of COVID-19 Vaccinations in Tennessee

On December 4, 2020, Tennessee governor Bill Lee issued Executive Order No. 68: An Order to Facilitate the Continued Response to COVID-19 By Increasing Health Care Resources and Capacity. In part, this order authorizes “medical assistants certified by the American Association of Medical Assistants [to be delegated] tasks that would normally be within the practical nurse scope of practice, including, but not limited to, administration of COVID-19 vaccinations.” Tasks delegable to certified medical assistants “are required to have been ordered and authorized by a Tennessee licensed practitioner with prescriptive authority” and “performed under the supervision of the delegating registered nurse.”

According to the March 20, 2018, Policy Statement: Delegation of Medical Services by the Tennessee Board of Medical Examiners, physicians are permitted to delegate to supervisees (including educated and/or trained and currently competent medical assistants) in their medical practices “tasks … of the type that a reasonably prudent physician would find within the scope of sound medical judgment to delegate.” Such delegated tasks “may only be performed while the physician is either on-site or immediately available (i.e., telephone, video conferencing) for communication and consultation, as appropriate.”

Executive Order No. 68 provides evidence that the administration of COVID-19 vaccinations is a task “that a reasonably prudent physician would find within the scope of sound medical judgment to delegate” in the medical practice or clinic to an educated and/or trained and currently competent medical assistant.

2 thoughts on “Delegation of COVID-19 Vaccinations in Tennessee”

  1. Donald, I’m trying to find a legal opinion of MA’s in the state of Tennessee being delegated prescription refills via an EMR. I can’t find anything definitive on this. My question is can MA’s be allowed to refill medications via the EMR if a refill protocol is in place?

    1. Thank you for your question. The following legal principle applies, in my opinion, under all American jurisdictions:
      It is my legal opinion that common law principles applicable in all American jurisdictions permit physicians, nurse practitioners, and physician assistants to assign to knowledgeable and competent unlicensed professionals such as medical assistants working under their authority in outpatient settings the verbatim entering and pending of prescription/medication and diagnostic imaging orders into the computerized provider order entry (CPOE) system based on the provider’s standing order or verbal order. However, it is also my legal opinion that the delegating provider must review and approve and electronically sign the order before it may be transmitted.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      CEO and Legal Counsel, AAMA

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