§ 1366. Additional Technical Supportive Services

(a) A medical assistant may perform additional technical supportive services such as those specified herein provided that all of the following conditions are met:

1. (1) Each technical supportive service is not prohibited by another provision of law, including Section 2069(c) of the code, or these regulations, and is a usual and customary part of the medical or podiatric practice where the medical assistant is employed;
2. (2) The supervising physician or podiatrist authorizes the medical assistant to perform the service and shall be responsible for the patient's treatment and care;
3. (3) The medical assistant has completed the training specified in Sections 1366.2, 1366.3, and 1366.4 and has demonstrated competence in the performance of the service;
4. (4) A record shall be made in the patient chart or other record, including a computerized record, if any, of each technical supportive service performed by the medical assistant, indicating the name, initials or other identifier of the medical assistant, the date and time, a description of the service performed, and the name of the physician or podiatrist who gave the medical assistant patient-specific authorization to perform the task or who authorized such performance under a patient-specific standing order.
5. (5) The supervising physician or podiatrist may, at his or her discretion, provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. Such written instructions may provide that a physician assistant or registered nurse may assign a task authorized by a physician or podiatrist.

1. (1) Administer medication orally, sublingually, topically, vaginally or rectally, or by providing a single dose to a patient for immediate self-administration. Administer medication by inhalation if the medications are patient-specific and have been or will be routinely and repetitively administered to that patient. In every instance, prior to administration of medication by the medical assistant, a licensed physician or podiatrist, or another person authorized by law to do so shall verify the correct medication and dosage. Nothing in this section shall be construed as authorizing the administration of any anesthetic agent by a medical assistant.
2. (2) Perform electrocardiogram, electroencephalogram, or plethysmography tests, except full body plethysmography. Nothing in this section shall permit a medical assistant to perform tests involving the penetration of human tissues except for skin tests as provided in Section 2069 of the code, or to interpret test findings or results.
3. (3) Apply and remove bandages and dressings; apply orthopedic appliances such as knee immobilizers, envelope slings, orthotics, and similar devices; remove casts, splints and other external devices; obtain impressions for orthotics, padding and custom molded shoes; select and adjust crutches to patient; and instruct patient in proper use of crutches.
4. (4) Remove sutures or staples from superficial incisions or lacerations.
5. (5) Perform ear lavage to remove impacted cerumen.
6. (6) Collect by non-invasive techniques, and preserve specimens for testing, including urine, sputum, semen and stool.
7. (7) Assist patients in ambulation and transfers.
8. (8) Prepare patients for and assist the physician, podiatrist, physician assistant or registered nurse in examinations or procedures including positioning, draping, shaving and disinfecting treatment sites; prepare a patient for gait analysis testing.
9. (9) As authorized by the physician or podiatrist, provide patient information and instructions.
10. (10) Collect and record patient data including height, weight, temperature, pulse, respiration rate and blood pressure, and basic information about the presenting and previous conditions.
11. (11) Perform simple laboratory and screening tests customarily performed in a medical office.
12. (12) Cut the nails of otherwise healthy patients.
    1. (c) Nothing in this section prohibits the administration of first aid or cardiopulmonary resuscitation in an emergency.
    2. (d) Nothing in these regulations shall be construed to authorize a medical assistant to practice physical therapy.
    3. (e) Nothing in these regulations shall be construed to modify the requirement that a licensed physician or podiatrist be physically present in the treatment facility as required in Section 2069 of the code.
    4. (f) A medical assistant may also fit prescription lenses or use any optical device in connection with ocular exercises, visual training, vision training, or orthoptics pursuant to Sections 2544 and 3042 of the code, but nothing in these regulations shall require a technician performing only those functions permitted by Sections 2544 and 3042 of the code to be qualified as a medical assistant.

NOTE
Authority cited: Sections 2018 and 2071, Business and Professions code. Reference: Sections 2069 and 2070, Business and Professions Code.

HISTORY
1. Renumbering and amendment of former article 4 (sections 1376-1377.1) to article 2 (sections 1366 and 1366.1); effective thirtieth day thereafter (Register 83, No. 32). For prior history, see Registers 79, No. 49; 78, No. 12; and 77, No. 35.
2. Renumbering and amendment of former section 1366 to section 1366.1 and new section filed 3-20-92; operative 4-20-92 (Register 92, No. 13).
3. Change without regulatory effect repealing subsection (b)(4) and the introductory portion of subsection (d) filed 11-17-94 pursuant to section 100, title 1, California Code of Regulations in accordance with the Judgment of the Superior Court of California for the County of Sacramento entered on 5-25-94, Case Nos. 532588 and 531542 (Register 94, No. 46).
4. Amendment of subsection (a)(1), new subsection (b)(4), repealer of subsection (d) and subsection relettering filed 2-14-96; operative 3-15-96 (Register 96, No. 7).
5. Repealer of subsection (b)(4) and subsection renumbering pursuant to California Optometric Association v. The Division of Licensing of the Medical Board of California, Sacramento Superior Court Case 96 AS 01599, judgment entered June 12, 1997. Filed 12-12-97; operative 12-12-97 pursuant to Government Code Section 11343.4(d) (Register 97, No. 50).

§ 1366.2.Training to Perform Additional Technical Supportive Services.

Prior to performing any of the additional technical supportive services provided in Section 1366, a medical assistant shall receive such training as, in the judgement of the supervising physician, podiatrist or instructor, as referenced in Section 1366.3(a)(2), is necessary to assure the medical assistant's competence in performing that service at the appropriate standard of care. Such training shall be administered pursuant to either subsection (a)(1) or (a)(2) of Section 1366.3.

NOTE
Authority cited: Sections 2018 and 2071, Business and Professions Code.
Reference: Sections 2069, 2070 and 2071, Business and Professions Code.

HISTORY
1. New section filed 3-20-92; operative 4-20-92 (Register 92, No. 13).

§ 1366.3. Administration of Training.

NOTE
Authority cited: Sections 2018 and 2071, Business and Professions Code.
Reference: Sections 2069, 2070 and 2071, Business and Professions Code.

HISTORY
1. Renumbering and amendment of former section 1366.1 to section 1366.3 filed 3-20-92; operative 4-20-92 (Register 92, No. 13).
2. Amendment of subsections (a)(1)-(2) filed 10-26-94; operative 11-25-94 (Register 94, No. 43).
3. Amendment of subsections (a)(1) and (a)(2), new subsections (c)-(c)(3) and amendment of Note filed 3-23-99; operative 4-22-99 (Register 99, No. 13).

§ 1366.31.Approved Certifying Organizations.

NOTE
Authority cited: Sections 2018 and 2071, Business and Professions Code.
Reference: Sections 2069, 2070 and 2071, Business and Professions Code.

HISTORY
1. New section filed 3-23-99; operative 4-22-99 (Register 99, No. 13).