CLINICAL LAB SCIENEC

CHAPTER 2: LABORATORY PERSONNEL CREDENTIALING AND FACILITY ACCREDITATION 45
for a variety of health care professions, while others accept certification or
registry as an official means of ensuring competency of a number of practitioners.
There are basically two types of state licenses:
a. Personal Licensure for Individuals
b. Facility Licensure (may be for a department or for an entire institution
and does not cover individual practitioners, but may require employment
of only registered personnel)
3. Registration is the process by which an association of professionals places an
individual on a list (registry) of persons who are in possession of minimum
competencies necessary to perform a group of related tasks. In cases where
state licensure is not required, this process includes the medical laboratory
worker. To qualify for the registry examination, there are both educational
and training requirements, and in some cases supervised experiential aspects
of preparation for entering the medical laboratory profession.
4. Equivalency testing is a relative newcomer to the medical laboratory field. A
number of states began to accept College Level Entrance Proficiency (CLEP)
examinations in lieu of registry examinations in the 1970s. Some states have
now dropped the acceptance of the CLEP tests as a substitute for registry
examinations in qualifying personnel for medical laboratory work. In this
way, a candidate for a position in the laboratory could at one time take a
categorical examination in one of the specialties such as hematology, clinical
chemistry, microbiology, or blood banking and work in this area as a technologist,
or could take the entire set of specialty examinations offered and
then work as a generalist technologist.
The most dramatic example of equivalency testing occurred in the
1970s and 1980s when HEW (now HHS) offered an equivalency examination,
which was given four times in the 1970s and once time in the 1980s.
This test was given to aid hospitals in fulfilling the Medicare regulations,
which stipulated that laboratory workers must have certification, registry, or
a license for the health care facility to receive reimbursement from Medicare
and Medicaid. Only a few laboratory workers of this category of technicians
and technologists currently remain in the workplace as medical laboratory
workers; most workers of these categories have retired.
Federal Regulation of Medical Laboratories
After many committee hearings in both the U.S. House of Representatives and
the U.S. Senate during the 1960s, the federal government entered into the arena
concerning the competence of workers in the medical laboratory field. Some of
the concerns voiced were aimed at ensuring that quality results were obtained on
federally funded testing through Medicare, but some were prompted by citizens
who had been damaged through erroneous laboratory results. Erroneous Pap
smear evaluations were the most visible of the problem areas that caught the
attention of federal lawmakers. HHS still recognizes those who completed the
equivalency examinations given in the 1970s but, as alluded to previously,
the numbers are so small as to be insignificant.
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