Medical Assistant Eligibility for Transitioning to Other Positions

I recently received the following question: 

I would like to know why a CCMA [certified clinical medical assistant] in Texas can’t test out of the CCMA program and test to be a certified medication aide without having to become a certified nursing assistant first? 

Answers to this question can be found in my July/August 2012 Public Affairs article, “Legal Difference Between Working in Inpatient and Outpatient Settings.” 

Concisely, in Texas and most other states, medical assistants are governed by the medical practice act and the regulations and policies of the state medical board. Medication aides are governed by different laws, such as the public health act or nurse practice act. Medication aides also function under a board of health or board of nursing.

Also, medical assisting education is different from the education of nursing assistants and medication aides.

For these reasons, credentialed medical assistants are not automatically eligible to become certified nursing assistants or certified medication aides. 

CMAs (AAMA), CNAs, and Medication Aides

I recently received the following question:

Does the law permit a CMA (AAMA) to work as a certified nursing assistant (CNA) in a nursing home without meeting the state requirements for registering as a CNA?

The answer is no. A medical assistant—even a CMA (AAMA) who has graduated from a programmatically accredited medical assisting program—must meet the state requirements for CNAs and register with the state as a CNA in order to perform clinical tasks in a skilled nursing facility or other inpatient settings.

Some states have a category of “medication aides (or assistants).” Medication aides are permitted to distribute medications to patients in an inpatient setting, usually under registered nurse authority and supervision. CMAs (AAMA) must also meet state requirements in order to work as a medication aide.

For more discussion on this topic, read my previous blog post “Medical Assistants and Medication Aides/Assistants/Technicians: Differences and Clarifications.”

Medical Assistants and Medication Aides/Assistants/Technicians: Differences and Clarifications

Although I have written about the difference between medical assistants and medication aides/assistants/technicians in Public Affairs articles in CMA Today, I continue to receive questions about the topic. Here are the basics:

Medical assistants work in outpatient settings under direct provider supervision, and may be delegated clinical and administrative tasks. Medication aides/assistants/technicians work in inpatient settings, usually under registered nurse supervision. A primary task of medication aides is to pass medications as directed by the RN supervisor.

Medication aides do not exist under the laws of some states. The laws of other states refer to these health workers by a designation other than medication aide. In some states an individual must first meet the requirements and register with the state as a certified nursing assistant (CNA) in order to be eligible to receive additional training and become a medication aide.

Medical assistants do not work in a clinical capacity in inpatient settings as medical assistants per se. Medical assistants must meet the requirements and register with the state as a CNA and/or a medication aide in order to work in a clinical capacity in inpatient settings.

Some state laws refer to medication aides as “certified medication aides.” The initialism associated with this phrase can cause confusion between medical assistants and medication aides. To help minimize such confusion, the National Council of State Boards of Nursing refers to medication aides as “MA-Cs” and encourages states to use this initialism. This change was made at the request of the American Association of Medical Assistants.

Scope of Practice in Correctional Facilities

The versatility of CMAs (AAMA) is being reflected in the questions I am starting to receive about the scope of practice for medical assistants working in correctional facilities.

If the CMAs (AAMA) are working under direct provider supervision in a clinic within a correctional facility, the standard laws for medical assisting scope of practice apply.  However, if a CMA (AAMA) is functioning as a medication aide and distributing medications under registered nurse supervision (similar to what occurs in a skilled nursing facility or an assisted living facility), the medical assistant would have to meet the state requirements and register with the appropriate state agency as a medication aide.

Presentation to the NCSBN

I recently presented a webinar for the National Council of State Boards of Nursing entitled “Medical Assistants: Scope of Practice, Education, and Credentialing.”  This webinar was presented to the boards of nursing of the states and territories of the United States.  The content of this webinar will be published in the Public Affairs department in future issues of CMA Today, but I would like to offer the file for download on Legal Eye.

The substance of this presentation is especially helpful for nurses who have limited knowledge about CMAs (AAMA). The information within touches on some of the following subjects:

• Defining medical assistants vs. nursing assistants and medication aides
• Legal principles surrounding medical assisting
• Education of medical assistants—coursework and accreditation
• State laws governing medical assisting in South Dakota and New Jersey
• Medical assisting credentials—trends
• NCCA accreditation
• Value of the CMA (AAMA) credential
• Medical assisting scope of practice

Please view and share this presentation. And, as always, contact me with any questions regarding the legal aspects of the profession.