I guess my first reply was too confusing. It's a confusing subject when your 
dealing with multiple states to which some are goverened by a requirement for a 
state license and some are not.
 
Hopfully this will clear it up or muddy it even more, not sure. 
 
Labs that are accredited and get  reimbursment from CMS have to follow CLIA 88 
guidelines. 
 
The Federal Centers for Medicare and Medicaid Services (CMS) regulates all 
laboratory testing
(except research) performed on patients in the United States through CLIA.8 
CLIA provides a
number of important patient protections, such as laboratory personnel 
standards, proficiency testing
(PT), quality assessment and control requirements, and cytology testing 
standards.
The level of personnel skill and training required by the CLIA regulations 
depends on the complexity
level of the testing performed.9 Complexity levels include waived, moderate and 
high complexity. In
order to perform laboratory testing of waived, moderate or high complexity 
tests, laboratory
personnel must satisfy minimum standards for the level of testing they perform. 
The CLIA personnel
qualifications for the three categories of tests are:
• Waived Testing: Standards: None.
• Moderate Complexity Testing: Standards: Minimum requirement is a high school 
diploma or
equivalent and documented training for the testing performed.10
• High Complexity Testing: Standards: Minimum requirement is an Associate 
degree,
including 24 semester hours in science, and completion of either: (1) an 
accredited or
approved clinical laboratory training program, or (2) three months laboratory 
training in the
specialty(ies) in which the individual performs high complexity testing.11
The personnel
 
 
Link for this and more info: 
http://www.ascp.org/pdf/StateLicensureofLaboratoryPersonnel.aspx
 
Here's a good article that talks about the 3 levels of complexity: 
http://www.aad.org/member-tools-and-benefits/practice-management-resources/compliance/clia/clia-faqs 
 
Here's how states that do 
not license thier histotechs do it. Tissue embedding, sectioning, and staining 
in Pathology are considered part of specimen preparation, not a laboratory 
test, and do not fall under CLIA. Macroscopic (gross) examinations of specimens 
must be performed by an individual qualified under §493.1449(l)   Note here: 
IHC and grossing of specimens are HIGH COMPLEXITY TESTING no matter where you 
are.
 
https://www.cms.gov/CLIA/downloads/apcindex.pdf   ^^^^^
 
So since this question was about a CAP approved lab and the reason to do so is 
to be CLIA compliant to accept GOV payments, you follow CLIA guidelines, and if 
your state has further guidelines like Florida does, you follow them too.
 
Is your state a licensure state? Ask that question. If not, then the answer to 
your question changes. 
 
That's about my entire 40 cents lol 
 
 
 
Kim


________________________________
From: Mandy O'Connor <ama...@ypii.com>
To: "'histonet@lists.utsouthwestern.edu'" <histonet@lists.utsouthwestern.edu> 
Sent: Wednesday, December 7, 2011 12:26 PM
Subject: RE: [Histonet] Histo Aide Duties

Hi guys and gals, I have to comment on this subject.  This is where I wish 
there was a clear cut answer in deciphering what duties an aide vs. HT vs. HTL 
should and shouldn't do.  I work in a private pathology lab where we have a 
little of everything-an HTL with BS in science, an HT with a 2 yr, an HT with 
no education, and an aide with only a couple college credits.  Everyone is 
expected to know everything-embedding, cutting, staining, IHC, and also 
grossing.  I highly do not agree with the expectations.

Is there some documentation that actually says what the limits are for 
unqualified people?  Also we need to question if they "should" be doing these 
duties.

Mandy O'Connor, HTL(ASCP)
Yellowstone Pathology Institute
Billings, MT
ama...@ypii.com<mailto:ama...@ypii.com>

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