ASCLS-Idaho Legislative Symposium 2013
St. Luke's Magic Valley Regional Medical Center
Twin Falls, Idaho
March 16, 2013 1:00-4:00PM

ASCLS-Idaho is proud to present the 2013 State Legislative Symposium. This Symposium provides great education on legislative and regulatory issues important to Idaho laboratory professionals. Debbie Shell, ASCLS Government Affairs Committee Member, will update attendees on national issues impacting laboratories, including issues to be discussed on the Hill during the 2013 ASCLS Legislative Symposium in Washington, DC:

• Clinical Laboratory Fee Schedule, Sequestration and Other Possible Cuts to Reimbursement
• Co-Pay and Competitive Bidding for Clinical Laboratory Tests
• FDA Oversight of Laboratory Developed Tests
• Patient Rights to Access Clinical Laboratory Test Results

State licensure for laboratory professionals and other issues of local interest will also be discussed, along with an update on the Idaho Legislature's 2013 session.

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Licensure Discussion

ASCLS-Idaho will be hosting a roundtable discussion about state licensure for Idaho laboratory professionals on Saturday, April 21, 10:50AM at the spring convention. The session will be an informal discussion of licensure options, advantages/disadvantages, and what steps would need to be taken to pursue this legislation. Following is a primer on licensure for laboratory professionals that you may want to review prior to our discussion.

State licensure for laboratory professionals is often discussed as a way to insure the quality of laboratory testing and ultimately patient safety. Efforts to pass a licensure law in Idaho in the mid-1990's were unsuccessful, primarily due to the beliefs of legislators that federal CLIA regulations were sufficient to protect the public, and that there were no laboratory quality problems in Idaho.

ASCLS and its constituent societies have long been proponents of licensure, dedicating a fair amount of time and effort to drafting a model licensure bill (available at ascls.org), collecting supporting documents for the pursuit of licensure, and supporting state efforts to gain licensure when they have occurred. Currently 12 states and Puerto Rico require persons performing laboratory tests to be licensed. Another 5-6 states are in the process of trying to become licensed.

Accurate laboratory test results are a key factor in the diagnosis and treatment of disease. In order for lab tests to be performed correctly, a combination of 3 mutually dependent factors must be in place: personnel standards, quality assurance (including quality control), and proficiency testing. A lack of, or deficiency in, any 1 of these factors, just as a broken leg on a 3-legged stool, results in substandard quality and jeopardizes patient care. State licensure guarantees adequate education, training, and experience of all persons performing lab tests, and ensures that they remain current with a requirement for annual continuing education. Inaccuracies in testing have led to misdiagnosis, incorrect or inappropriate treatment, additional unnecessary testing, unneeded hospital admissions, severe illness, and even death. State licensure could play a significant role in preventing these problems.

There are many questions that frequently come up during licensure discussions, and many myths that need to be dispelled.

1. Will I have to take another exam?

Most licensure bills set eligibility criteria that allow recognition of certification by quality national exams that meet the standards desired, and most states with licensure do not administer individual state exams.

1. What's the problem - hospitals in Idaho have to hire certified personnel anyway?

This is a common misunderstanding. Idaho hospitals are free to hire personnel to do lab work that have only a high school diploma and meet CLIA requirements. They are not required to have any formal education or training beyond high school. In addition, hundreds of laboratory tests are performed every day in settings other than hospitals.

1. I don't have certification - will I lose my job?

Nearly all licensure bills have what's called a "grandfather" clause. This allows current practitioners a limited time frame to obtain a license and remain in their jobs. They would have to participate in continuing education in order to renew their licenses, just as certified licensees would. It is not the intent of licensure bills to put people out of work.

1. Will this precipitate a shortage, or make a current shortage worse?

Studies have shown that states with licensure do not have any worse shortages than states without licensure.

1. Will wages go up?

Again, studies have shown that wages are not significantly different in states with licensure vs. those without it.

1. I took a national certification exam - now I'm licensed. Right?

A national certification exam is a voluntary action that confirms that the certificant has had the education, training and experience to perform the activity. Licensure is a state-granted right to perform the activity for which you are licensed, while others that are not licensed are not allowed to perform that activity. Examples range from acting as a physician or serving as a hairdresser to driving a car or going fishing.

Please come and share with us your thoughts and concerns about licensure, as well as your questions. If we want to consider tackling a licensure effort, we'll need everyone's input on this significant expenditure of time, effort and money.