Medical assistants want to step up
Group seeks ability to give vaccines
Certified medical assistants are hoping the COVID-19 pandemic and the effort to vaccinate the population finally will enable them to be able to give the injections, freeing up doctors and nurses.
Connecticut and New York are the only states that bar the assistants from giving vaccinations for the flu, COVID-19 and other diseases.
After years of effort trying to get a bill passed in the General Assembly, they are hoping it finally will pass this year. It recently passed the Public Health Committee 23-10. The bill addresses training and certification; advocates say the measure would help
Senate President Pro Tem Martin Looney, D-New Haven, said “it’s too early to tell what its prospects are or whether it will get compromised in some way.” But he said “it does have a certain amount of momentum” because it passed the Public Health Committee in a bipartisan vote.
The bill requires the medical assistant to be certified by one of four bodies, including the American Association of Medical Assistants, and to have been accredited by an organization recognized by the U.S. Department of Education or by a branch of the armed forces.
Rebecca Rivera, president of the Connecticut Society of Medical Assistants, said enabling her profession to give shots would expand access to underserved populations. “There are people that can’t afford to pay a doctor, so therefore they’re on Medicaid,” which not all doctors will accept, she said.
But clinics serving the poor can’t always afford to have a nurse on staff, Rivera said. A medical assistant giving vaccinations frees the doctor to give more time to patients, she said.
Holly Martin, chairwoman of the Connecticut Society of Medical Assistants’ Public Policy Committee, said the bill assures that medical assistants are trained and overseen by a doctor or nurse practitioner when they give vaccines. “We’ve been working on this for the last 20 years,” she said.
“You have to have enough clinical time. You have to do work out in the field … and we have to do 60 hours of education every five years,” she said. Medical assistants must pass a threehour exam in order to be certified.
“You cannot call yourself a certified medical assistant if you have not gone through the certification program and certified through the AAMA,” Martin said.
Workloads and training
While “there’s all kinds of programs that have popped up,” the society is only interested in giving trained, certified professionals the ability to give COVID-19 and other vaccines, she said. There are 355 members of the Connecticut society and about 900 medical assistants in the state, according to the Department of Public Health.
The AAMA certification exam includes administrative, clinical and general questions, including medical ethics, communication, business practices, medical finances, anatomy and physiology, infection control and pharmacology. The clinical section makes up 47 percent of the exam.
Enabling medical assistants to
give vaccinations “takes the workload off of the doctors and the nurses,” Martin said. “We’re not working to our scope of practice because of the state of Connecticut.”
As for any opponents’ objections, “They keep saying we’re not trained to see if anyone has an allergic reaction or side effect to the drugs, but we are trained for that,” she said. “It’s very frustrating because it’s not the reality. Go look at what we have in our education, what we’re trained to do.”
The bill would allow medical assistants to give vaccinations only “under the supervision, control and responsibility” of a physician or advanced practice registered nurse. “It’s their responsibility” to be aware of drug interactions, allergic reactions and side effects, Martin said. “If they don’t feel we’re capable, then they don’t have to give us that duty.”
Rivera said it would be no problem for the people in her profession to take on the additional task.
“Medical assistants are very versatile, so we do many different jobs,” she said.
Dr. Craig Olin, president of the Fairfield County Medical Association,
wrote to Gov. Ned Lamont in December, asking for an executive order to allow medical assistants to give vaccinations, anticipating that medical practices would be “deluged with requests” for the COVID vaccine and pointing out that many doctors’ offices do not have nurses on staff.
“It’s really a lack of knowledge. To be a certified medical assistant you get trained to give vaccinations for many hours. The physician or APRN has to be on site,” he said. “It’s basically an administrative task to draw it up in a syringe and give it.” He pointed out that “people who are on insulin, they’re lay people and they inject themselves.”
Olin said moving the vaccine rollout from hospital-run clinics into doctors’ offices also would help get more people immunized against COVID. “A lot of primary care doctors feel they have relationships with their patients. They would be more likely to get this done,” he said.
Max Reiss, spokesman for Lamont, said Friday “it was considered to allow medical assistants, but [the Department of Public Health] decided that it wasn’t necessary.” He said acting Public Health Commissioner
Deidre Gifford decided that, with the state’s Medical Reserve Corps and people being trained at the local level, “they feel there’s enough people out there to get the job done.”
Reiss said the governor’s office had not reviewed the bill so he could not say whether Lamont would sign it if it passed.
Anne Hulick, Government Relations Committee liaison with the Connecticut Nurses Association, said the group had opposed the measure in the past, but “our position this year is essentially that we understand that the health care workforce is changing and physicians’ practices often want medical assistants to provide vaccinations. … Our position has kind of evolved over the years, recognizing that this is a growing trend.”
However, she said, “the education for medical assistants is quite variable and we wanted to make sure that they were all trained, not only with enough anatomy, physiology, pharmacology, but also the practical component of safe injection.”
She said patients’ safety was the highest priority. “We really are trying to be part of the solution, not just the opposition,” Hulick said.
Mary Jane Williams, a senior policy adviser for the Connecticut Nurses Association’s Government Relations Committee, testified against the bill as written, saying it should require a minimum of an associate’s degree.
During the Public Health Committee’s debate on the bill, state Sen. Tony Hwang, R-Fairfield, ranking Republican, said, “I think the overwhelming response is the workload will be eased. You’re always going to have the oversight of a medical professional. This is about increasing access and efficiency.” State Rep. Nicole Klarides-Ditria, R-Seymour, who voted for the bill, said, “The medical community has wanted this for years.”
However, state Rep. Peter Tercyak, D-Meriden, who is a nurse, opposed the bill. “There is no reason to do it. I want us to hold on to this work. We don’t need to do this,” he said. State Sen. Julie Kushner, DDanbury, also voted against the bill. “I have not been convinced that we need to do this at this time,” she said.