Scope of Practice

Permissible Supervision Duties for North Carolina Medical Assistants

I recently received the following question:

[In North Carolina,] can a CMA (AAMA) be a supervisor over LPNs [licensed practical nurses] and RNs [registered nurses], as well as CMAs (AAMA)?

 To answer this question, note the following information from the “Frequently Asked Questions” webpage on the North Carolina Board of Nursing website:

Can a nurse be supervised by an unlicensed person or another discipline?

A non-nurse (other than a licensed physician) may not supervise nursing practice but could supervise basic employment issues (i.e., administrative supervision, human resource issues [such as] time, attendance, [and] dress code).

On the Job, Scope of Practice

Permissible Tuberculin Skin Test Tasks for Pennsylvania Medical Assistants 

I recently received the following question: 

I am a CMA (AAMA) working in Pennsylvania. What does Pennsylvania law allow medical assistants to do in regard to tuberculin skin tests? 

To answer this question, note the following from the Pennsylvania Department of Human Services Bureau of Human Services Licensing

Question: Are medical assistants permitted to read an individual’s TB [tuberculosis] skin test? 

Answer: According to the Centers for Disease Control and Prevention (CDC), a TB skin test should be read by a “health-care worker trained to read tuberculin skin testing (TST) results.” Therefore, a medical assistant who has been trained to read TST results is considered qualified and is permitted to do so under the regulations. 

The laws of other states vary greatly concerning what medical assistants are permitted to do in regard to tuberculin skin tests. Please email me at DBalasa@aama-ntl.org with questions about specific states. 

Scope of Practice

Key Scope of Practice Legislation Is Enacted in Connecticut and South Carolina

In May 2022, Connecticut and South Carolina legislatures passed two significant bills that empower medical assistants in these states to perform tasks for which they are educated, credentialed, and competent.

In Connecticut, “An Act Concerning the Department of Public Health’s Recommendations Regarding Various Revisions to the Public Health Statutes” will allow medical assistants to administer vaccinations (effective October 1, 2022).

In South Carolina, new legislation permits medical assistants to be delegated injections by not only physicians but also advanced practice registered nurses (including nurse practitioners) and physician assistants (effective July 14, 2022).   

Learn more about these legislative victories by reading the July/August 2022 Public Affairs article, “Key Scope of Practice Legislation Is Enacted in Connecticut and South Carolina,” on the “Public Affairs Articles” webpage.

delegation, Scope of Practice

Delegation to Medical Assistants under Florida Law

The Florida Medical Practice Act defines medical assistant as “a professional multiskilled person dedicated to assisting in all aspects of medical practice under the direct supervision and responsibility of a physician.” While some medical practice consultants argue that the act’s definition means medical assistants are permitted to work under only physicians, such an argument is flawed.

In the May/June 2022 Public Affairs article, “Delegation to Medical Assistants under Florida Law,” I provide evidence—from the Florida Board of Nursing—that demonstrates that Florida law permits medical assistants to work under advanced registered nurse practitioners as well as physicians. Then, I offer insight into medical assistants’ scope of service under Florida law.

Read the article on the “Public Affairs Articles” webpage.

delegation, medication administration, Scope of Practice

Proposed Delaware Regulation Expands APRN Delegation to Medical Assistants

On June 9, 2022, I sent a letter to the executive director of the Delaware Board of Nursing regarding proposed regulations that would allow advanced practice registered nurses (APRNs), including nurse practitioners, to delegate to educated and credentialed medical assistants the administration of medication.

Read the full letter here:

I am writing on behalf of the American Association of Medical Assistants® (AAMA), the national professional society for medical assistants, in regard to the following proposed addition to the regulations of the Delaware Board of Nursing (BON):

8.7.15.1 APRNs are authorized to assign and supervise medication administration to a medical assistant if the medical assistant has successfully completed a medical assistant training program and possesses current national medical assistant certification.

8.7.15.1.1 If a practice is solely operated by APRNs, the APRN must be present in the building when the medical assistant is administering medications and assumes liability for the actions of the medical assistant.

8.7.15.2 When a physician delegates to a medical assistant, and an organizational policy exists to allow the APRN to assign and supervise the medical assistant, the physician retains responsibility and accountability for the actions of the medical assistant and will be notified of unsafe or improper practices.

It is the position of the AAMA that medical assistants who have completed a medical assistant training program that includes medication administration theory and technique, and who have a current national medical assistant certification such as the CMA (AAMA)® that tests knowledge needed to safely administer medication, should be permitted to administer medication under the authority of APRNs—including nurse practitioners—and other licensed independent practitioners such as physicians.

The AAMA commends the Delaware BON for increasing the availability of safe and accessible health care for the residents of Delaware by proposing this revision to the BON regulations.