delegation, On the Job, Scope of Practice

Medical Assistants and Vaccination Administration under Pharmacists

Improving vaccination rates and lessening vaccination hesitancy is a top priority for all health care professionals. Medical assistants are in a prime position to help, but the exact nature of their role requires some legal considerations.

Consider the following situation:

I own a pharmacy in which pharmacists administer influenza vaccinations. Could I hire a medical assistant to help us administer these influenza shots, or is it required that medical assistants work only under the supervision of a physician?

Most often, medical assistants work under the authority and supervision of licensed providers such as physicians (doctors of medicine or osteopathic medicine), nurse practitioners, and physician assistants in outpatient settings. However, state laws generally do not prohibit other licensed health care professionals (such as podiatrists, dentists, optometrists, and pharmacists) from employing medical assistants and delegating legally permitted tasks to them.

In response to your specific question, it is necessary to check the pharmacy practice act of your state—and the regulations and policies of the state board of pharmacy—to ascertain which allied health professionals (if any) may be delegated the administration of influenza vaccinations by a pharmacist. It is also necessary to determine the degree of supervision pharmacists must exercise over allied health professionals who are administering influenza vaccinations. I suspect the pharmacy law of your state requires delegating pharmacists to exercise on-site supervision over professionals who are administering influenza vaccinations.

If you’d like to know more about your specific state laws, visit the State Scope of Practice Laws webpage on the AAMA website.

delegation, medication administration, On the Job, Scope of Practice

Massachusetts Law Outlines Delegation of Immunizations

In 2016 the Massachusetts legislature passed legislation that permits primary care providers to delegate the administration of immunizations to a medical assistant who is the following:

… is a graduate of a post-secondary medical assisting education program accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, or its successor, the Accrediting Bureau of Health Education Schools, or its successor or such other certificate program as the commissioner of public health shall approve; (ii) is employed in the medical practice of a licensed primary care provider; and (iii) who performs basic administrative, clerical, and clinical duties upon the specific authorization and under the direct supervision of a licensed primary care provider.

Note the following definitions from the legislation:

Direct supervision: “Oversight of a certified medical assistant exercised by a primary care provider who is present in the facility and immediately available to furnish assistance and direction throughout the course of the performance of a delegated procedure but is not required to be present in the room when the procedure is being performed.”

Primary care provider: “A health care professional qualified to provide general medical care for common health care problems who: (i) supervises, coordinates, prescribes, or otherwise provides or proposes health care services; (ii) initiates referrals for specialist care; and (iii) maintains continuity of care within the scope of practice.”

The legislation directs the Massachusetts Department of Public Health to promulgate regulations regarding the specifics of the delegation of immunizations. The full text of the legislation can be found on the AAMA website, under State Scope of Practice Laws.