Phlebotomy certification legislation: update on three of our 50

Oct. 1, 2009

Last year, MLO
published a summary of existing and pending state legislation on minimum
training standards, licensure, and mandatory certification of
blood-specimen collection personnel (“States fail to follow California’s
lead in certifying phlebotomists,” July 2008, pp. 40-42). At the time,
reports indicated that bills languished in the legislative bodies of
Massachusetts and Missouri. No other bills in any state were pending.
Because laboratory licensure is a topic of perennial interest to MLO
readers, an update at this time seems to be in order.

The Bay State’s “Dracula Bill”

The Massachusetts bill was to create a board of
registration of phlebotomists that would set forth licensure
requirements, standards, fees, continuing education, and professional
and ethical conduct for all healthcare professionals who draw blood

In Massachusetts, HR312 — known informally as the
“Dracula Bill” — provides a Board of Registry for phlebotomists that:

  • establishes licensure requirements;
  • determines the qualifications of applicants to be licensed, and
  • grants licenses to those deemed qualified.

If passed, those who perform phlebotomy in
Massachusetts must apply for licensure. Exempt are physicians, certified
clinical laboratory scientists, medical technologists, and medical
laboratory technicians.

Last year, the bill was reported out of
committee, requiring it to be refiled in December 2008. A hearing about
the bill took place in May 2009. Currently, the bill has been referred
to the Joint Committee on Consumer Protection and Professional

The “Show Me State” was a “no show”

In Missouri, the laboratory licensure bill earned a
Senate hearing in the 2008 legislative session but did not come up for a
vote. A hearing never occurred in the House chamber. According to Tim R.
Randolph, PhD, MT(ASCP), CLS(NCA) — associate professor in the Department of
Clinical Laboratory Science at St. Louis University and member of the Board
of Directors of the American Society for Clinical Laboratory Science, or
ASCLS — the bill would license phlebotomists along with clinical laboratory
scientists (CLS/MT, CLT/MLT, and BS credentials). It would also “grandfather
in” all currently practicing professionals in all four categories at the
level they are currently working. All future professionals, however, would
need to be certified by a nationally recognized certifying body. The
Missouri laboratory licensure bill will be resubmitted in December of this
year when the legislative body reconvenes.

New legislation in California recently relaxed the certification
requirements that took effect six years ago.

A little tarnish on the “Golden State”

New legislation in California recently
relaxed the certification requirements that took effect six years
ago. In September 2009, the legislature passed AB 211, a bill that
exempts certain healthcare professionals from the state’s highly
publicized certification requirement for performing blood-collection
procedures. Under the bill, HIV counselors who perform finger sticks
for rapid HIV testing will no longer need to become certified as
limited-phlebotomy technicians (LPTs).

According to the AIDS Healthcare Foundation (,
which operates the largest non-government HIV testing program in
California and which co-sponsored the bill, the training standards for
California’s HIV counselors, which has been required since 2003, is
“outdated, unnecessary, and expensive.” The foundation claims the
estimated $2,500 cost to train individuals (20 hours of training and 25
practical supervised finger sticks) to perform finger sticks properly
and safely “discouraged many test sites and organizations from
increasing the number of HIV counselors who are LPTs.” Should Governor
Schwarzenegger sign the bill, which is expected, AB 211 could become
effective immediately.

“Kudos to MLO for 40 years of producing the best magazine in the industry. You’ve enlightened and inspired generations of laboratory professionals to keep current with the technology, advanced the status of their professions, and have been unwavering advocates of accurate test results. You win the Triple Crown of laboratory publishing. Here’s hoping you go another 40 furlongs!”—Dennis J. Ernst, MT(ASCP),
director, Center for Phlebotomy Education (,
Corydon, IN, and member of MLO editorial advisory board.