SB 5657
In CommitteeSenate
Plasma donation/physicians
Authorizing certain health professions to act as physician substitutes for plasma source donation centers.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill allows medical assistants with EMT credentials to serve as physician substitutes in plasma donation centers, performing donor screening and evaluation tasks. It also expands and clarifies the scope of practice for various medical assistant certifications—including certified, registered, phlebotomist, hemodialysis technician, and EMT—under supervision, and establishes temporary work authorizations during certification processing.
- Authorizes medical assistants-EMT to act as physician substitutes in plasma source donation centers, specifically to conduct donor screening and evaluation as permitted under federal regulations.
- Expands the scope of practice for medical assistant certifications to include more detailed duties—such as administering certain medications, performing intravenous procedures, and conducting moderate-complexity tests—under defined supervision levels.
- Creates or clarifies interim and endorsement-based pathways for certification (e.g., interim medical assistant-certified, medical assistant-registered), allowing individuals to work temporarily while awaiting full certification.
- Permits medical assistant-phlebotomists and medical assistant-hemodialysis technicians to work for up to 180 days after applying for certification, to ensure uninterrupted patient care.
- Clarifies transferability of certifications: medical assistant-EMT certifications are only transferable between hospitals and plasma donation centers; forensic phlebotomist certifications are transferable only among law enforcement agencies.
Who is affected
- Plasma source donation centers — Plasma donation centers will be able to use certified medical assistants-EMT to perform duties of a physician substitute during donor screening and evaluation, improving staffing flexibility and continuity of care.
- Medical assistants-EMT — Medical assistants with EMT credentials can now legally perform physician substitute roles in plasma centers, expanding their scope of practice in this specific setting.
- Plasma donors and patients — Patients at plasma donation centers may benefit from increased availability of qualified staff to conduct donor screenings, potentially reducing wait times and improving access to donation services.
- Health care practitioners and clinics — Health care practitioners and clinics employing medical assistants may benefit from clearer and expanded delegation authority for certified and registered medical assistants, especially in phlebotomy and medication administration.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
The 180-day interim work authorization for hemodialysis and phlebotomy technicians—and 60-day interim for registered assistants—helps retain continuity of care in underserved areas (e.g., rural dialysis clinics, community health centers) where staffing shortages are acute, directly benefiting patients who rely on timely access to life-sustaining treatments.
HealthcarePeopleRef: Sec. 1(2), (3), (6)(d); Sec. 2(2), (3), (4)Authorizing medical assistants-EMT to serve as physician substitutes in plasma donation centers (per 21 C.F.R. §630.5) expands access to plasma donation services, especially in communities where plasma centers are primary sources of income or therapeutic apheresis. This supports public health infrastructure and increases donor throughput, benefiting donors and patients receiving plasma-derived therapies.
HealthcarePeopleRef: Sec. 1(4), Sec. 2(5)(a)(viii)Expanding medication administration authority (including IM injections and IV therapy) for certified and registered medical assistants allows clinics—especially safety-net providers—to delegate more tasks to mid-level staff, reducing physician/nurse burden and enabling faster patient throughput, which improves access and affordability of routine care in high-demand settings.
HealthcarePeopleRef: Sec. 2(1)(f), (g), (i); Sec. 2(4)(i), (j)Interim certification pathways (e.g., interim medical assistant-certified for up to 1 year, 60-day work while registered application processes) reduce barriers to entry for low- and middle-income job seekers pursuing medical assisting careers, supporting workforce development and upward mobility—particularly for those who cannot afford extended unpaid training periods.
HealthcarePeopleRef: Sec. 1(1)(b), (6)(d)Clarifying authority to perform moderate-complexity tests and IV procedures under supervision helps standardize scope of practice across settings, reducing ambiguity that previously led to inconsistent delegation and potential underutilization of trained staff—benefiting clinics seeking to optimize staffing and service delivery.
HealthcareLean peopleRef: Sec. 2(1)(d)(ii), (1)(g), (3)(c), (4)(d)(v)
Potential Concerns (5)
The bill permits medical assistants-registered to administer certain medications (e.g., intramuscular injections for syphilis) without *immediate* physical supervision if telemedicine supervision is used, raising concerns about delayed response to adverse events in settings without on-site clinical oversight. While the law requires supervision, the use of telemedicine in non-emergency outpatient settings may reduce real-time oversight capacity, potentially increasing risk if complications arise.
Public SafetyRef: Sec. 1(4), (6)(a)-(d), (7); Sec. 2(4)(i)-(j)The bill authorizes medical assistants-certified and -registered to administer controlled substances (Schedule III–V) and perform intravenous procedures, including IV line establishment and medication administration—tasks that carry inherent risk if performed incorrectly. Although supervision is required, the delegation of such tasks to non-physician staff without requiring direct visual supervision in some cases (e.g., telemedicine for IM syphilis treatment) introduces potential for error or misuse, especially in under-resourced clinics with high staff turnover or limited training.
Public SafetyRef: Sec. 2(1)(f)(ii), (g), (i); Sec. 2(4)(i)-(ii)The bill allows medical assistants to perform *moderate-complexity* diagnostic tests and IV procedures under supervision, but federal CLIA regulations require specific personnel qualifications for nonwaived testing; the bill defers to the secretary to establish standards “substantially similar” to 2013 levels, which may not reflect current best practices or adequately address competency gaps in rapidly evolving lab medicine.
Public SafetyRef: Sec. 2(1)(d)(ii), (1)(g), (2), (3)(c), (4)(d)(v), (4)(i)The bill allows individuals to work for up to 180 days (for hemodialysis/phlebotomy) or 60 days (for registered) while awaiting certification, potentially enabling unlicensed personnel to perform increasingly complex clinical tasks before full credentialing is complete. While intended to prevent service disruption, this interim work period could expose patients to avoidable risk if training or supervision is insufficient during the transition window.
Public SafetyRef: Sec. 1(2), (3), (6)(d)Forensic phlebotomist certifications are restricted to law enforcement agencies only, and EMT certifications are restricted to hospitals and plasma centers—limiting mobility and potentially creating siloed practice, which could delay cross-system emergency response coordination in regional crises (e.g., mass casualty incidents requiring multi-agency blood collection or testing).
Public SafetyRef: Sec. 1(5), (7)
Who Is Most Affected
Plasma donation centers benefit from increased staffing flexibility and regulatory clarity, enabling them to staff donor screening roles with EMT-credentialed medical assistants—potentially reducing reliance on higher-cost licensed clinicians and improving service continuity.
Medical assistants-EMT gain formal recognition of their existing EMT training in a new clinical setting, expanding career pathways and earning potential without requiring additional degrees or certifications.
Patients in underserved areas benefit from improved access to plasma donation and dialysis services, as interim work authorizations help maintain staffing levels during certification delays—though risk of suboptimal supervision remains if oversight is not robust.
Clinics and community health centers gain operational flexibility by allowing certified and registered assistants to perform more complex tasks (e.g., moderate-complexity testing, IV therapy), but must invest in training and supervision infrastructure to comply with new standards.
Patients receiving plasma-derived therapies benefit indirectly from increased donor capacity and streamlined screening, but may face longer waits if centers over-rely on mid-level staff without adequate backup for complex donor reactions.