Ask the Expert: Lab Temperature, CLIA Waiver Requirements, Proficiency Testing for Waived Kits, Lab Salaries

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Ask the Expert

Barry Craig


Happy “Back to School” for all you moms and dads out there. The rush is over, the school supply lists completed, haircuts obtained, and school lunches prepared. Now the mind numbing routine of school, athletic practices, and school functions begin.

I honestly do not know how working parents manage to cram all that stuff into one 24 hour day! But child abandonment is still frowned upon, so buckle down and call it an adventure.

Here are some of the questions received lately.

It is too stuffy and hot in the lab. I keep telling my doctor that it is too hot for the instruments we run to function properly, but it is falling on deaf ears. Any suggestions?

Yes, I have a few suggestions for your hot and bothered state of being.

First, if you have windows in your lab with blinds, rotate the blinds so that the bottom of each slat is angled closest to the window.

If you angle the slats downward, sunlight still comes in through the window.  A simple way to do it is to look at the reflection on the floor and rotate the slats until the sunlight disappears. You can actually lower the temperature in your lab up to 15 degrees by changing the angle of your slats.

Second, make sure the vents that blow air into the lab are open all the way. Central air vents are sometimes left at their default position, which is not fully open.

Third, make it clear to your physician that on an inspection, you can be cited for improper environmental conditions for the lab. This citation means the environment would have to be corrected to the manufacturer’s specifications.

Can we perform Waived kit tests without a CLIA license if we are not billing for them?

NO. I cannot stress this enough. NO, NO, NO.

You must have a CLIA Certificate of Waiver to perform Waived testing whether you are billing for the testing or not. Billing has nothing to do with compliance. The Waiver cost $150.00 biannually, and your onsite physician can act as lab director. You must follow the manufacturer’s recommendations for quality control and you should document training and competency for performing the tests.

Whether you bill for the testing or not, your physician is still making decisions on diagnosis and treatment of the patient based on the results obtained. So the results should be accurate, right? You don’t want to tell Ms. Jones, “We checked your glucose level today but we have no idea if the results are right, but hey, don’t worry, we didn’t charge you for the test!”

I have heard that changes are coming for Waived testing and we might have to start doing proficiency testing in the future. What is the latest word?

It is true that CLIA is looking at Waived testing more carefully. One of the ideas under consideration is requiring that proficiency testing be performed for Waived testing. This would involve having one of the PT companies sending you blind specimens to run, have you fill in your results on the answer sheet then submit the report back to the PT company for grading. Once graded, they would send you a report of how you scored for the specimens you tested. This is only under consideration for now, but other accrediting bodies are already starting to require PT testing for Waived tests.

I do not feel I am being paid enough as a lab tech. What can I do to check this? and have online calculators for calculating what your position should pay based on factors such a geographic locations and experience.

The good news is that both MLTs and MTs are becoming more scarce as the programs that turn out these lab superheroes are shutting down. As lab professionals become more scarce, salaries will go up.