Amends TCA Title 4; Title 63 and Title 68.

This bill creates a registration system for certified medical assistants, which this bill defines to mean personnel with training to function in an assistive role to a licensed physician or nurse in the provision of patient care activities in a facility used as an ambulatory clinic or hospital outpatient department as delegated by the physician or nurse. A licensed physician assistant or certified medication aide will not be subject to this bill's registration requirements or practice restrictions. This bill authorizes licensed hospitals to employ certified medical assistants to administer approved medications to its patients in a facility used as an ambulatory clinic or hospital outpatient department. An individual employed as a certified medical assistant within a facility used as an ambulatory clinic or hospital outpatient department will be required to register with the department of health and pay a registration fee established by the department. To be eligible to register as a certified medical assistant, an applicant must: (1) Be at least 18 years of age; (2) Have completed the twelfth grade or its equivalent, or have successfully passed the test for and received a general equivalency diploma; and (3) Hold a certification from one of several certifying groups identified in the full text of this bill or any certifying body approved by the department. A certified medical assistant registration is valid for two years and may be renewed. The full text of this bill specifies numerous types of unprofessional and criminal conduct for which the department of health will be authorized to deny, revoke, or suspend the registration of a certified medical assistant. This bill prohibits certified medical assistants from administering medications to hospital inpatients or patients in an emergency department. This bill authorizes certified medical assistants to administer approved, standardized dosage vaccines to the patients of an ambulatory clinic or hospital outpatient department that use certified medical assistants. A certified medical assistant will only be authorized to administer other medications pursuant to delegation by a licensed nurse. This bill requires the board of nursing and the board of medical examiners to promulgate rules related to the administration of vaccines by certified medical assistants. A certified medical assistant will only be authorized to administer vaccines to individuals who have been assessed by a physician or licensed nurse and determined to be appropriate recipients of the immunization. A delegation of medication administration or other nursing tasks to a certified medical assistant from a professional nurse or physician must be carried out in accordance with rules for nursing delegation adopted by the board of nursing or board of medical examiners. The full text of this bill specifies medication categories and patient care activities that may be delegated to a certified medical assistant, as well as medication categories that may not be delegated to a certified medical assistant. This bill requires the department of health to promulgate rules to effectuate its purposes. This bill takes effect upon becoming a law for purposes of rule promulgation, establishing a registration process, and effectuating the intent of this bill. All other provisions of this bill take effect January 1, 2022. ON APRIL 1, 2021, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 559, AS AMENDED. AMENDMENT #1 removes the requirement for registration with the department of health, but retains the other requirements that a certified medical assistant must meet (as described above in the bill summary). This amendment also changes references from "ambulatory clinic or hospital outpatient department" to "ambulatory outpatient hospital clinic" throughout the bill, and defines "ambulatory outpatient hospital clinic" as a clinic or physician office that is owned and operated by a hospital and that provides treatment to patients who are not admitted as inpatients to the hospital. This amendment requires an ambulatory outpatient hospital clinic to verify compliance with this bill by a medical assistant and specifies that the clinic is responsible for training and verifying the competence of a certified medical assistant. This amendment makes the promulgation of rules by the board of nursing and board of medical examiners discretionary instead of mandatory in regard to the administration of vaccines. This amendment specifies that this bill will not apply to personnel employed by a physician performing duties in settings other than in an ambulatory outpatient hospital clinic.