Volume 35 Number 6 | December 2021
Pamela Meadows, EdD, MT(ASCP), West Virginia Society for Clinical Laboratory Sciences President
Licensure of clinical laboratory professionals is a principal measure that signifies the profession’s focus on quality health care and patient safety. It is imperative that licensure be viewed not only as a means of ensuring adequate education for workers, but also as a mechanism to guarantee a high standard of patient care. Winning the battle to establish state licensure is only the beginning. In a profession plagued with workforce shortages amidst a pandemic, the need for review and as needed amendment of licensure regulations is even more crucial. However, the current political climate of deregulation is alarming and can be a deterrent to proposing such amendments.
A legislative rule, Clinical Laboratory Technician and Scientist Licensure and Certification 54 CSR 57, requiring the licensing of clinical laboratory professionals in West Virginia was first enacted in the 1990s. Although the individuals involved in the initial passage of the rule drafted well-developed and thoughtful guidelines, close examination of the legislative rule in recent years revealed licensure routes that focused primarily on education and training, while creating a loophole for those without certification. As a rural state, West Virginia is faced with unique challenges amidst the clinical laboratory workforce shortage, so close coordination between the West Virginia Office of Laboratory Services (WVOLS) and the West Virginia Society for Clinical Laboratory Sciences (WVSCLS) was imperative to ensure that any legislative changes to the rule would not cripple rural hospitals and clinics. The WVSCLS recognized that any amendments to the rule must address the needs of various types of facilities, while not hindering their ability to find employees eligible for licensure. In 2017, at the request of the WVSCLS, an amendment was passed to close licensure eligibility loopholes by requiring that all individuals graduating from a medical laboratory technician or medical laboratory science program obtain national certification as a requirement for state licensure.
“It is important to periodically review licensure regulations to ensure they adequately address current workforce issues and patient safety concerns.”
In 2019, shortcomings in the legislative rule were once again identified after an event involving falsification of test results by multiple laboratory professionals at one facility. Laboratory management was surprised that, under the current legislative rule, license revocation applies only if the event resulted in felony charges for the employee(s) involved. Luckily, in this situation no patients were injured in such a manner that would lead to felony charges. However, the thought that the individuals involved would keep their professional license and continue to work in the field was unnerving to those professionally and personally vested in advocating for efficient and quality care for patients.
As a result of the case involving test result falsification, the WVSCLS decided to move forward once again with a request for additional licensure amendments that would broaden the scope of license revocation guidelines. Under the current rule, a license is revoked under three circumstances: falsification of information supplied on a license application, failure to meet licensure requirements as outlined in the rule, or felony conviction involving laboratory practices. After multiple meetings, the WVSCLS board of directors drafted a set of circumstances under which we felt revocation of license would be justified. We then communicated our concerns with the current licensure rule, along with suggestions for amendment, to constituent societies of the American Medical Technologists (AMT) and the Clinical Laboratory Management Association (CLMA) in West Virginia, as we felt it was important that they also support any changes to the rule. After discussion with both WVAMT and WVCLMA, the board of the WVSCLS filed a formal request with the WVOLS for proposed amendments to the revocation guidelines in the current rule.
The amendment of legislative rules can be a daunting and lengthy process. First, clarification of the request for amendment is needed. In our situation, that required correspondence and meetings with both the WVOLS director and the licensure supervisor. Once the WVOLS fully understood the background situation and resulting request for amendment, additional meetings were held with other major stakeholders, including laboratory directors, educators, and members of state constituent societies for ASCLS, AMT, and CLMA. After further discussion with stakeholders, the WVSCLS board requested another meeting with the WVOLS and their legal counsel to ensure that the amendment would continue to move forward. It was during this meeting that legal counsel noted concern with legislative trends in deregulation. Professionals in both dietetics and radiology are currently facing the possibility of losing state licensure requirements in West Virginia. The WVSCLS board acknowledged that risk but agreed that our first duty is to the patient, and that the proposed amendments were needed to ensure quality of care for patients in West Virginia. The WVOLS and legal counsel then worked together to develop a proposed amendment that would address our request for tightening revocation guidelines, while not creating significant burden for health care facilities. The amendment was posted for public comment during the summer of 2021 and is scheduled for vote during the next legislative session, as the current legislation expires on June 1, 2022.
We must all continue to advocate for state licensure, as it plays a monumental role in recognition and elevation of our profession. For those states fortunate enough to have licensure for clinical laboratory professionals, the fight is not over. It is important to periodically review licensure regulations to ensure they adequately address current workforce issues and patient safety concerns. Engaging a variety of stakeholders and keeping an open mind is important to ensure that any proposed licensure amendments are fair and equitable. It is impossible to foresee every possible circumstance which may reveal licensure regulations to be inadequate, but proactive and periodic review and amendment of licensure rules can greatly benefit the profession by defining the importance of the clinical laboratory’s role in the delivery of quality care.
Clinical Laboratory Technician and Scientist Licensure and Certification 64 CSR 57. (2017). Available at http://apps.sos.wv.gov/adlaw/csr/readfile.aspx?DocId=49385&Format=PDF
Pamela Meadows is Associate Professor of Clinical Laboratory Sciences at Marshall University, in Huntington, West Virginia.