77R10555 GJH-F
By Capelo H.B. No. 1183
Substitute the following for H.B. No. 1183:
By Capelo C.S.H.B. No. 1183
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of surgical assistants; granting
1-3 rulemaking authority; providing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle C, Title 3, Occupations Code, is amended
1-6 by adding Chapter 206 to read as follows:
1-7 CHAPTER 206. SURGICAL ASSISTANTS
1-8 SUBCHAPTER A. GENERAL PROVISIONS
1-9 Sec. 206.001. DEFINITIONS. In this chapter:
1-10 (1) "Advisory committee" means the advisory committee
1-11 created under this chapter.
1-12 (2) "Delegating physician" means a physician who is
1-13 licensed by the medical board either as a doctor of medicine or
1-14 doctor of osteopathic medicine and who assumes responsibility and
1-15 legal liability for the services rendered by a surgical assistant.
1-16 (3) "Direct supervision" means supervision by a
1-17 delegating physician who is present where the surgical assisting is
1-18 provided and is immediately available.
1-19 (4) "Executive director" means the executive director
1-20 of the medical board.
1-21 (5) "Medical board" means the Texas State Board of
1-22 Medical Examiners.
1-23 (6) "Surgical assisting" means providing aid under
1-24 direct supervision in exposure, hemostasis, and other
2-1 intraoperative technical functions that assist a physician in
2-2 performing a safe operation with optimal results for the patient,
2-3 including the delegated authority to provide local infiltration or
2-4 the topical application of a local anesthetic at the operation
2-5 site. This term is synonymous with "first assisting."
2-6 Sec. 206.002. APPLICABILITY. A person is not required to
2-7 hold a license under this chapter if the person is:
2-8 (1) a student enrolled in a surgical assistant
2-9 education program approved by the medical board who is assisting in
2-10 a surgical operation that is an integral part of the program of
2-11 study;
2-12 (2) a surgical assistant employed in the service of
2-13 the federal government while performing duties related to that
2-14 employment;
2-15 (3) a person acting under the delegated authority of a
2-16 licensed physician;
2-17 (4) a licensed health care worker acting within the
2-18 scope of the person's license;
2-19 (5) a registered nurse; or
2-20 (6) a licensed physician assistant.
2-21 (Sections 206.003-206.050 reserved for expansion
2-22 SUBCHAPTER B. ADVISORY COMMITTEE
2-23 Sec. 206.051. ADVISORY COMMITTEE. The advisory committee is
2-24 an informal advisory committee to the medical board and is not
2-25 subject to Chapter 2110, Government Code.
2-26 Sec. 206.052. APPOINTMENT OF ADVISORY COMMITTEE. (a) The
2-27 advisory committee consists of five members appointed by the
3-1 president of the medical board. Each member of the advisory
3-2 committee must be:
3-3 (1) a practicing surgical assistant who has at least
3-4 five years of clinical experience as a surgical assistant; or
3-5 (2) a physician licensed in this state who supervises
3-6 a surgical assistant.
3-7 (b) Appointments to the advisory committee shall be made
3-8 without regard to the race, color, disability, sex, religion, age,
3-9 or national origin of the appointees.
3-10 Sec. 206.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
3-11 this section, "Texas trade association" means a cooperative and
3-12 voluntarily joined association of business or professional
3-13 competitors in this state designed to assist its members and its
3-14 industry or profession in dealing with mutual business or
3-15 professional problems and in promoting their common interest.
3-16 (b) A person may not be a member of the advisory committee
3-17 if:
3-18 (1) the person is an officer, employee, or paid
3-19 consultant of a Texas trade association in the field of surgical
3-20 assisting; or
3-21 (2) the person's spouse is an officer, manager, or
3-22 paid consultant of a Texas trade association in the field of
3-23 surgical assisting.
3-24 (c) A person may not be a member of the advisory committee
3-25 if the person is required to register as a lobbyist under Chapter
3-26 305, Government Code, because of the person's activities for
3-27 compensation on behalf of a profession related to the field of
4-1 surgical assisting.
4-2 Sec. 206.054. TERMS; VACANCY. (a) Members of the advisory
4-3 committee are appointed for two-year terms. The terms of the
4-4 members expire on February 1 of each odd-numbered year.
4-5 (b) If a vacancy occurs during a member's term, the
4-6 president of the medical board shall appoint a new member to fill
4-7 the unexpired term.
4-8 (c) An advisory committee member may not serve more than two
4-9 consecutive full terms.
4-10 Sec. 206.055. GROUNDS FOR REMOVAL. (a) It is a ground for
4-11 removal from the advisory committee that a member:
4-12 (1) does not have at the time of appointment the
4-13 qualifications required by Section 206.052;
4-14 (2) does not maintain during service on the advisory
4-15 committee the qualifications required by Section 206.052;
4-16 (3) is ineligible for membership under Section
4-17 206.053; or
4-18 (4) cannot, because of illness or disability,
4-19 discharge the member's duties for a substantial part of the
4-20 member's term.
4-21 (b) The validity of an action of the committee is not
4-22 affected by the fact that it is taken when a ground for removal of
4-23 a committee member exists.
4-24 Sec. 206.056. OFFICERS. The president of the medical board
4-25 shall designate biennially a committee member as the presiding
4-26 officer of the advisory committee to serve in that capacity at the
4-27 will of the president.
5-1 Sec. 206.057. PER DIEM. An advisory committee member is not
5-2 entitled to reimbursement for travel expenses or compensation.
5-3 Sec. 206.058. MEETINGS. (a) The advisory committee shall
5-4 meet as requested by the medical board.
5-5 (b) A meeting may be held by telephone conference call.
5-6 (Sections 206.059-206.100 reserved for expansion
5-7 SUBCHAPTER C. POWERS AND DUTIES OF ADVISORY COMMITTEE
5-8 AND MEDICAL BOARD
5-9 Sec. 206.101. GENERAL POWERS AND DUTIES. (a) The medical
5-10 board shall:
5-11 (1) establish qualifications for a surgical assistant
5-12 to practice in this state;
5-13 (2) establish requirements for an examination for a
5-14 license to practice as a surgical assistant;
5-15 (3) establish minimum education and training
5-16 requirements necessary for a license to practice as a surgical
5-17 assistant;
5-18 (4) prescribe the application form for a license to
5-19 practice as a surgical assistant;
5-20 (5) make recommendations on an application for a
5-21 license to practice as a surgical assistant;
5-22 (6) develop an approved program of continuing
5-23 education and the manner in which attendance at all approved
5-24 courses, clinics, forums, lectures, programs, or seminars is
5-25 monitored, recorded, and submitted to the advisory committee; and
5-26 (7) recommend additional rules as are necessary for
5-27 the administration and enforcement of this chapter.
6-1 (b) The advisory committee has no independent rulemaking
6-2 authority.
6-3 Sec. 206.102. ANNUAL REPORT. (a) The medical board shall
6-4 prepare annually a complete and detailed written report accounting
6-5 for all funds received and disbursed by the medical board under
6-6 this chapter during the preceding fiscal year.
6-7 (b) The annual report must meet the reporting requirements
6-8 applicable to financial reporting provided in the General
6-9 Appropriations Act.
6-10 Sec. 206.103. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
6-11 medical peer review committee in this state, a quality assurance
6-12 committee in this state, a surgical assistant, a surgical assistant
6-13 student, a physician practicing medicine in this state, or any
6-14 person usually present in an operating room, including a nurse or
6-15 surgical technologist, shall report relevant information to the
6-16 advisory committee related to the acts of a surgical assistant in
6-17 this state if, in that person's opinion, a surgical assistant poses
6-18 a continuing threat to the public welfare through the person's
6-19 practice as a surgical assistant. The duty to report under this
6-20 section may not be nullified through contract.
6-21 (b) A person who, without malice, furnishes records,
6-22 information, or assistance to the advisory committee under this
6-23 section is immune from any civil liability arising from that action
6-24 in a suit against the person brought by or on behalf of a surgical
6-25 assistant who is reported under this section.
6-26 (c) Sections 160.002, 160.003, 160.006, 160.007(d), 160.009,
6-27 160.013, and 160.014 apply to medical peer review regarding a
7-1 licensed surgical assistant.
7-2 Sec. 206.104. GIFTS, GRANTS, AND DONATIONS. In addition to
7-3 any fees paid to the medical board or money appropriated to the
7-4 medical board, the medical board may receive and accept under this
7-5 chapter a gift, grant, donation, or other item of value from any
7-6 source, including the United States or a private source.
7-7 (Sections 206.105-206.150 reserved for expansion
7-8 SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND
7-9 INVESTIGATIVE INFORMATION
7-10 Sec. 206.151. PUBLIC PARTICIPATION. (a) The medical board
7-11 shall develop and implement policies that provide the public with a
7-12 reasonable opportunity to appear before the medical board and speak
7-13 on any issue relating to surgical assistants.
7-14 (b) The executive director of the medical board shall
7-15 prepare and maintain a written plan that describes how a person who
7-16 does not speak English may be provided reasonable access to the
7-17 medical board's programs and services under this chapter.
7-18 Sec. 206.152. PUBLIC INTEREST INFORMATION. (a) The medical
7-19 board shall prepare information of public interest describing the
7-20 functions of the medical board and the procedures by which
7-21 complaints are filed and resolved under this chapter.
7-22 (b) The medical board shall make the information available
7-23 to the public and appropriate state agencies.
7-24 Sec. 206.153. COMPLAINTS. (a) The medical board by rule
7-25 shall establish methods by which consumers and service recipients
7-26 are notified of the name, mailing address, and telephone number of
7-27 the medical board for the purpose of directing complaints about
8-1 licensed surgical assistants to the medical board.
8-2 (b) The medical board shall list with its regular telephone
8-3 number any toll-free telephone number established under other state
8-4 law that may be called to present a complaint about a licensed
8-5 surgical assistant.
8-6 Sec. 206.154. RECORDS OF COMPLAINTS. (a) The medical board
8-7 shall maintain a file on each written complaint filed with the
8-8 medical board under this chapter. The file must include:
8-9 (1) the name of the person who filed the complaint;
8-10 (2) the date the complaint is received by the medical
8-11 board;
8-12 (3) the subject matter of the complaint;
8-13 (4) the name of each person contacted in relation to
8-14 the complaint;
8-15 (5) a summary of the results of the review or
8-16 investigation of the complaint; and
8-17 (6) an explanation of the reason the file was closed,
8-18 if the medical board closed the file without taking action other
8-19 than to investigate the complaint.
8-20 (b) The medical board shall provide to the person filing the
8-21 complaint and to each person who is a subject of the complaint a
8-22 copy of the medical board's policies and procedures relating to
8-23 complaint investigation and resolution. A person who reports a
8-24 complaint by phone shall be given information on how to file a
8-25 written complaint.
8-26 (c) The medical board, at least quarterly and until final
8-27 disposition of the complaint, shall notify the person filing the
9-1 complaint and each person who is a subject of the complaint of the
9-2 status of the investigation unless the notice would jeopardize an
9-3 undercover investigation.
9-4 Sec. 206.155. LICENSE HOLDER ACCESS TO COMPLAINT
9-5 INFORMATION. (a) The medical board shall provide a license holder
9-6 who is the subject of a formal complaint filed under this chapter
9-7 with access to all information in its possession that the medical
9-8 board intends to offer into evidence in presenting its case in
9-9 chief at the contested hearing on the complaint, subject to any
9-10 other privilege or restriction established by rule, statute, or
9-11 legal precedent. The medical board shall provide the information
9-12 not later than the 30th day after receipt of a written request from
9-13 the license holder or the license holder's counsel, unless good
9-14 cause is shown for delay.
9-15 (b) Notwithstanding Subsection (a), the medical board is not
9-16 required to provide:
9-17 (1) medical board investigative reports;
9-18 (2) investigative memoranda;
9-19 (3) the identity of a nontestifying complainant;
9-20 (4) attorney-client communications;
9-21 (5) attorney work product; or
9-22 (6) other material covered by a privilege recognized
9-23 by the Texas Rules of Civil Procedure or the Texas Rules of
9-24 Evidence.
9-25 (c) The provision of information does not constitute a
9-26 waiver of privilege or confidentiality under this chapter or other
9-27 law.
10-1 Sec. 206.156. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On
10-2 the written request of a health care entity, the medical board
10-3 shall provide to the entity:
10-4 (1) information about a complaint filed against a
10-5 license holder that was resolved after investigation by:
10-6 (A) a disciplinary order of the medical board;
10-7 or
10-8 (B) an agreed settlement; and
10-9 (2) the basis of and current status of any complaint
10-10 under active investigation that has been referred by the executive
10-11 director or the director's designee for legal action.
10-12 Sec. 206.157. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION.
10-13 A complaint, adverse report, investigation file, compliance file,
10-14 other report, or other investigative information in the possession
10-15 of or received or gathered by the medical board, medical board
10-16 employee, or agent relating to a license holder, a license
10-17 application, or a criminal investigation or proceeding is
10-18 privileged and confidential and is not subject to discovery,
10-19 subpoena, or other means of legal compulsion for release to any
10-20 person other than the medical board or medical board employee or
10-21 agent involved in license holder discipline.
10-22 Sec. 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE
10-23 INFORMATION. (a) Investigative information in the possession of
10-24 the medical board, medical board employee, or agent that relates to
10-25 the discipline of a license holder may be disclosed to:
10-26 (1) a licensing authority in another state or a
10-27 territory or country in which the license holder is licensed or
11-1 has applied for a license; or
11-2 (2) a peer review committee reviewing:
11-3 (A) an application for privileges; or
11-4 (B) the qualifications of the license holder
11-5 with respect to retaining privileges.
11-6 (b) If the investigative information in the possession of
11-7 the medical board or a medical board employee or agent indicates a
11-8 crime may have been committed, the medical board shall report the
11-9 information to the proper law enforcement agency. The medical
11-10 board shall cooperate with and assist all law enforcement agencies
11-11 conducting criminal investigations of a license holder by providing
11-12 information relevant to the investigation. Confidential
11-13 information disclosed by the medical board to a law enforcement
11-14 agency remains confidential and may not be disclosed by the law
11-15 enforcement agency except as necessary to further the
11-16 investigation.
11-17 (Sections 206.159-206.200 reserved for expansion
11-18 SUBCHAPTER E. LICENSE REQUIREMENTS
11-19 Sec. 206.201. LICENSE REQUIRED. (a) Except as provided by
11-20 Section 206.002, a person may not practice as a surgical assistant
11-21 unless the person is licensed under this chapter.
11-22 (b) Unless the person holds a license under this chapter, a
11-23 person may not use, in connection with the person's name:
11-24 (1) the title "Licensed Surgical Assistant"; or
11-25 (2) any other designation that would imply that the
11-26 person is a licensed surgical assistant.
11-27 Sec. 206.202. LICENSE APPLICATION. An applicant for a
12-1 license must:
12-2 (1) file a written application with the medical board
12-3 on a form prescribed by the medical board; and
12-4 (2) pay the application fee set by the medical board.
12-5 Sec. 206.203. LICENSE ELIGIBILITY. (a) Except as provided
12-6 by Section 206.206, to be eligible for a license, a person must:
12-7 (1) be of good moral character;
12-8 (2) have not been convicted of a felony or a crime
12-9 involving moral turpitude;
12-10 (3) not use drugs or alcohol to an extent that affects
12-11 the applicant's professional competency;
12-12 (4) not have had a license or certification revoked by
12-13 a licensing agency or by a certifying professional organization;
12-14 and
12-15 (5) not have engaged in fraud or deceit in applying
12-16 for a license under this chapter.
12-17 (b) In addition to meeting the requirements of Subsection
12-18 (a), a person must:
12-19 (1) pass the examination required by Section 206.204;
12-20 (2) hold at least an associate's degree based on
12-21 completion of an educational program that is substantially
12-22 equivalent to the education required for a registered nurse or
12-23 physician assistant who specializes in surgical assisting;
12-24 (3) demonstrate to the satisfaction of the medical
12-25 board the completion of full-time work experience performed in this
12-26 country under the direct supervision of a physician licensed in
12-27 this country and consisting of at least 2,000 hours of performance
13-1 as an assistant in surgical procedures for the three years
13-2 preceding the date of application; and
13-3 (4) possess a current certification by a national
13-4 certifying body approved by the medical board.
13-5 (c) A degree program described by Subsection (b)(2) must
13-6 contain a clinical component and must include courses in anatomy,
13-7 physiology, basic pharmacology, aseptic techniques, operative
13-8 procedures, chemistry, microbiology, and pathophysiology.
13-9 Sec. 206.204. EXAMINATION. An applicant for a surgical
13-10 assistant license must pass a psychometrically validated surgical
13-11 assistant examination approved by the medical board.
13-12 Sec. 206.205. SPECIAL ELIGIBILITY FOR LICENSE. (a) A person
13-13 who is otherwise eligible for a license under Section 206.203 is
13-14 not required to take the examination required by Section
13-15 206.203(b)(1) if the person:
13-16 (1) passed a surgical assistant examination required
13-17 for certification under Section 206.203(b)(4) that the medical
13-18 board determines is substantially equivalent to the examination
13-19 required by the medical board under this chapter; and
13-20 (2) applies for a license under this section before
13-21 September 1, 2002.
13-22 (b) A person who is otherwise eligible for a license under
13-23 Section 206.203 is not required to meet the educational
13-24 requirements under Section 206.203(b)(2) if the person:
13-25 (1) completed an academic course approved by the
13-26 medical board in anatomy, physiology, basic pharmacology, aseptic
13-27 techniques, operative procedures, chemistry, and microbiology, or
14-1 has been certified after September 30, 1995, as a surgical
14-2 assistant by a national certifying body approved by the medical
14-3 board and has practiced full-time as a surgical assistant under the
14-4 direct supervision of a physician licensed in this country; or
14-5 (2) applies for a license under this section before
14-6 September 1, 2002.
14-7 (c) A license issued under Subsection (b) expires on the
14-8 third anniversary of issuance unless the license holder fulfills
14-9 both requirements of Subsection (b)(1).
14-10 Sec. 206.206. TEMPORARY LICENSE. (a) The medical board
14-11 may, through the executive director, issue a temporary license to
14-12 an applicant who:
14-13 (1) submits an application on a form prescribed by the
14-14 medical board;
14-15 (2) has passed an examination required by the medical
14-16 board relating to the practice of surgical assisting;
14-17 (3) pays the appropriate fee set by the medical board;
14-18 (4) if licensed in another state, is licensed in good
14-19 standing; and
14-20 (5) meets all the qualifications for a license under
14-21 this chapter and is waiting for the next scheduled meeting of the
14-22 medical board for the license to be issued.
14-23 (b) A temporary license is valid until the 100th day after
14-24 the date issued and may be extended until the 130th day after the
14-25 date issued.
14-26 Sec. 206.207. ASSISTANCE BY MEDICAL BOARD. The medical
14-27 board shall provide administrative and clerical employees as
15-1 necessary to administer this subchapter.
15-2 Sec. 206.208. FEES. (a) The medical board shall set and
15-3 collect fees in amounts that are reasonable and necessary to cover
15-4 the costs of administering and enforcing this chapter without the
15-5 use of any other funds generated by the medical board.
15-6 (b) Fees collected by the medical board under this chapter
15-7 shall be deposited by the medical board in the state treasury to
15-8 the credit of an account in the general revenue fund and may be
15-9 spent to cover the costs of administering and enforcing this
15-10 chapter. At the end of each fiscal biennium, the comptroller shall
15-11 transfer any surplus money remaining in the account to the general
15-12 revenue fund.
15-13 (c) All money paid to the medical board under this chapter
15-14 is subject to Subchapter F, Chapter 404, Government Code.
15-15 Sec. 206.209. ISSUANCE AND RENEWAL OF LICENSE. The medical
15-16 board shall issue a surgical assistant license in this state to a
15-17 person who meets the requirements of this chapter and the rules
15-18 adopted under this chapter.
15-19 Sec. 206.210. LICENSE RENEWAL. (a) The medical board by
15-20 rule shall provide for the annual renewal of a surgical assistant
15-21 license.
15-22 (b) The medical board by rule may adopt a system under which
15-23 licenses expire on various dates during the year. For the year in
15-24 which the license expiration date is changed, license fees shall be
15-25 prorated on a monthly basis so that each license holder pays only
15-26 that portion of the license fee that is allocable to the number of
15-27 months during which the license is valid. On renewal of the license
16-1 on the new expiration date, the total license renewal fee is
16-2 payable.
16-3 Sec. 206.211. NOTICE OF LICENSE RENEWAL. At least 30 days
16-4 before the expiration of a person's license, the medical board
16-5 shall send written notice of the impending license expiration to
16-6 the person at the license holder's last known address according to
16-7 the records of the medical board.
16-8 Sec. 206.212. PROCEDURE FOR RENEWAL. (a) A person who is
16-9 otherwise eligible to renew a license may renew an unexpired
16-10 license by paying the required renewal fee to the medical board
16-11 before the expiration date of the license. A person whose license
16-12 has expired may not engage in activities that require a license
16-13 until the license has been renewed under this section.
16-14 (b) If the person's license has been expired for 90 days or
16-15 less, the person may renew the license by paying to the medical
16-16 board one and one-half times the required renewal fee.
16-17 (c) If the person's license has been expired for longer than
16-18 90 days but less than one year, the person may renew the license by
16-19 paying to the medical board two times the required renewal fee.
16-20 (d) If the person's license has been expired for one year or
16-21 longer, the person may not renew the license. The person may
16-22 obtain a new license by complying with the requirements and
16-23 procedures for obtaining an original license.
16-24 Sec. 206.213. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
16-25 PRACTITIONER. (a) If the person was licensed as a surgical
16-26 assistant in this state, moved to another state, and is currently
16-27 licensed as a surgical assistant and has been in practice as a
17-1 surgical assistant in the other state for the two years preceding
17-2 application, the person may renew an expired surgical assistant
17-3 license without reexamination.
17-4 (b) The person must pay to the medical board a fee that is
17-5 equal to two times the required renewal fee for the license.
17-6 Sec. 206.214. LICENSE HOLDER INFORMATION. (a) Each license
17-7 holder shall file with the medical board:
17-8 (1) the license holder's mailing address;
17-9 (2) the address of the license holder's residence;
17-10 (3) the mailing address of each of the license
17-11 holder's offices; and
17-12 (4) the address for the location of each of the
17-13 license holder's offices if that address is different from the
17-14 office's mailing address.
17-15 (b) A license holder shall:
17-16 (1) notify the medical board of a change of the
17-17 license holder's residence or business address; and
17-18 (2) provide the medical board with the license
17-19 holder's new address not later than the 30th day after the date the
17-20 address change occurs.
17-21 (Sections 206.215-206.250 reserved for expansion
17-22 SUBCHAPTER F. SCOPE OF PRACTICE
17-23 Sec. 206.251. SCOPE OF PRACTICE. (a) The practice of a
17-24 surgical assistant is limited to surgical assisting performed under
17-25 the direct supervision of a physician who delegated the acts.
17-26 (b) The practice of a surgical assistant may be performed in
17-27 any place authorized by a delegating licensed physician, including
18-1 a clinic, hospital, ambulatory surgical center, or other
18-2 institutional setting.
18-3 Sec. 206.252. SERVICE CONTRACTS. This chapter does not:
18-4 (1) limit the employment arrangement of a surgical
18-5 assistant licensed under this chapter;
18-6 (2) require a surgeon or hospital to contract with a
18-7 surgical assistant;
18-8 (3) authorize a health maintenance organization,
18-9 preferred provider organization, or health benefit plan to require
18-10 a surgeon to contract with a surgical assistant;
18-11 (4) authorize a health maintenance organization,
18-12 preferred provider organization, or health benefit plan to require
18-13 a registered nurse or physician assistant to be licensed as a
18-14 surgical assistant as a condition of reimbursement;
18-15 (5) authorize a clinic, hospital, ambulatory surgical
18-16 center, or other facility to require a registered nurse or
18-17 physician assistant to be licensed as a surgical assistant as a
18-18 condition of assisting at surgery at the facility; or
18-19 (6) require a hospital to use a licensed surgical
18-20 assistant for surgical assisting.
18-21 Sec. 206.253. CERTAIN PROHIBITED PRACTICES. This chapter
18-22 does not authorize a person who holds a license issued under this
18-23 chapter to engage in the practice of:
18-24 (1) medicine, as defined by Subtitle B, Title 3,
18-25 Occupations Code;
18-26 (2) professional nursing, as defined by Chapter 301,
18-27 Occupations Code; or
19-1 (3) nursing, as defined by Chapter 302, Occupations
19-2 Code.
19-3 Sec. 206.254. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
19-4 STANDARDS. A surgical assistant and the surgical assistant's
19-5 delegating physician shall ensure that:
19-6 (1) the surgical assistant's scope of function is
19-7 identified;
19-8 (2) the delegation of medical tasks is appropriate to
19-9 the surgical assistant's level of competence;
19-10 (3) the relationship between the surgical assistant
19-11 and the delegating physician and the access of the surgical
19-12 assistant to the delegating physician are defined; and
19-13 (4) a process is established for evaluating the
19-14 surgical assistant's performance.
19-15 (Sections 206.255-206.300 reserved for expansion
19-16 SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
19-17 Sec. 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL BOARD. (a)
19-18 Except as provided by Section 206.305, on a determination that an
19-19 applicant or license holder committed an act described by Section
19-20 206.302, 206.303, or 206.304, the medical board by order shall take
19-21 any of the following actions:
19-22 (1) deny the person's license application or revoke
19-23 the person's license;
19-24 (2) require the person to submit to the care,
19-25 counseling, or treatment of a health care practitioner designated
19-26 by the medical board;
19-27 (3) stay enforcement of an order and place the person
20-1 on probation;
20-2 (4) require the person to complete additional
20-3 training;
20-4 (5) suspend, limit, or restrict the person's license,
20-5 including:
20-6 (A) limiting the practice of the person to, or
20-7 excluding from the person's practice, one or more specified
20-8 activities of surgical assisting; or
20-9 (B) stipulating periodic medical board review;
20-10 (6) assess an administrative penalty against the
20-11 person as provided by Section 206.351;
20-12 (7) order the person to perform public service; or
20-13 (8) administer a public reprimand.
20-14 (b) If the medical board stays enforcement of an order and
20-15 places a person on probation, the medical board retains the right
20-16 to vacate the probationary stay and enforce the original order for
20-17 noncompliance with the terms of probation or impose any other
20-18 remedial measure or sanction authorized by this section.
20-19 (c) The medical board may restore or reissue a license or
20-20 remove any disciplinary or corrective measure that the medical
20-21 board has imposed.
20-22 Sec. 206.302. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION.
20-23 The medical board may take action under Section 206.301 against an
20-24 applicant or license holder who:
20-25 (1) fraudulently or deceptively obtains or attempts to
20-26 obtain a license;
20-27 (2) fraudulently or deceptively uses a license;
21-1 (3) falsely represents that the person is a physician;
21-2 (4) acts in an unprofessional or dishonorable manner
21-3 that is likely to deceive, defraud, or injure the public;
21-4 (5) fraudulently alters any surgical assistant
21-5 license, certificate, or diploma;
21-6 (6) uses any surgical assistant license, certificate,
21-7 or diploma that has been fraudulently purchased, issued, or
21-8 counterfeited or that has been materially altered;
21-9 (7) directly or indirectly aids or abets the practice
21-10 as a surgical assistant by any person not licensed by the medical
21-11 board to practice as a surgical assistant; or
21-12 (8) unlawfully advertises in a false, misleading, or
21-13 deceptive manner as defined by Section 101.201.
21-14 Sec. 206.303. CONDUCT RELATED TO VIOLATION OF LAW. (a) The
21-15 medical board may take action under Section 206.301 against an
21-16 applicant or license holder who:
21-17 (1) violates this chapter or a rule adopted under this
21-18 chapter;
21-19 (2) is convicted of a felony, placed on deferred
21-20 adjudication, or placed in a pretrial diversion program; or
21-21 (3) violates state law if the violation is connected
21-22 with practice as a surgical assistant.
21-23 (b) A complaint, indictment, or conviction of a law
21-24 violation is not necessary for the medical board to act under
21-25 Subsection (a)(3). Proof of the commission of the act while in
21-26 practice as a surgical assistant or under the guise of practice as
21-27 a surgical assistant is sufficient for action by the medical board.
22-1 Sec. 206.304. CONDUCT INDICATING LACK OF FITNESS. (a) The
22-2 medical board may take action under Section 206.301 against an
22-3 applicant or license holder who:
22-4 (1) habitually uses drugs or intoxicating liquors to
22-5 the extent that, in the medical board's opinion, the person cannot
22-6 safely perform as a surgical assistant;
22-7 (2) has been adjudicated as mentally incompetent;
22-8 (3) has a mental or physical condition that renders
22-9 the person unable to safely perform as a surgical assistant;
22-10 (4) has committed an act of moral turpitude;
22-11 (5) has failed to practice as a surgical assistant in
22-12 an acceptable manner consistent with public health and welfare;
22-13 (6) has had the person's license or other
22-14 authorization to practice as a surgical assistant suspended,
22-15 revoked, or restricted;
22-16 (7) has had other disciplinary action taken by another
22-17 state or by the uniformed services of the United States regarding
22-18 practice as a surgical assistant;
22-19 (8) is removed or suspended or has disciplinary action
22-20 taken by the person's peers in any professional association or
22-21 society or is being disciplined by a licensed hospital or medical
22-22 staff of a hospital, including removal, suspension, limitation of
22-23 privileges, or other disciplinary action, if that action, in the
22-24 opinion of the medical board, was based on unprofessional conduct
22-25 or professional incompetence that was likely to harm the public;
22-26 (9) has repeated or recurring meritorious health care
22-27 liability claims that, in the medical board's opinion, are evidence
23-1 of professional incompetence likely to harm the public; or
23-2 (10) sexually abuses or exploits another person during
23-3 the license holder's practice as a surgical assistant.
23-4 (b) For the purpose of Subsection (a)(7), a certified copy
23-5 of the record of the state or uniformed services of the United
23-6 States taking the action constitutes conclusive evidence of that
23-7 action.
23-8 (c) An action described by Subsection (a)(8) does not
23-9 constitute state action on the part of the association, society, or
23-10 hospital medical staff.
23-11 Sec. 206.305. REHABILITATION ORDER. The medical board,
23-12 through an agreed order or after a contested case proceeding, may
23-13 impose a rehabilitation order on an applicant, as a prerequisite
23-14 for issuing a license, or on a license holder based on:
23-15 (1) the person's intemperate use of drugs or alcohol
23-16 directly resulting from habituation or addiction caused by medical
23-17 care or treatment provided by a physician;
23-18 (2) the person's intemperate use of drugs or alcohol
23-19 during the five years preceding the date of the report that could
23-20 adversely affect the person's ability to safely practice as a
23-21 surgical assistant, if the person:
23-22 (A) reported the use; and
23-23 (B) has not previously been the subject of a
23-24 substance abuse related order of the medical board;
23-25 (3) a judgment by a court that the person is of
23-26 unsound mind; or
23-27 (4) the results of a mental or physical examination,
24-1 or an admission by the person, indicating that the person suffers
24-2 from a potentially dangerous limitation or an inability to practice
24-3 as a surgical assistant with reasonable skill and safety because of
24-4 illness or any other physical or mental condition.
24-5 Sec. 206.306. EFFECT OF REHABILITATION ORDER. (a) A
24-6 rehabilitation order imposed under Section 206.305 is a
24-7 nondisciplinary private order. If entered into by agreement, the
24-8 order is an agreed disposition or settlement agreement for purposes
24-9 of civil litigation and is exempt from Chapter 552, Government
24-10 Code.
24-11 (b) The rehabilitation order must contain findings of fact
24-12 and conclusions of law. The order may impose a license revocation
24-13 or suspension, a period of probation or restriction, or any other
24-14 sanction authorized by this chapter or agreed to by the medical
24-15 board and the person subject to the order.
24-16 (c) A violation of a rehabilitation order may result in
24-17 disciplinary action under this chapter or under the terms of the
24-18 agreed order.
24-19 (d) A violation of a rehabilitation order is grounds for
24-20 disciplinary action based on:
24-21 (1) unprofessional or dishonorable conduct; or
24-22 (2) any provision of this chapter that applies to the
24-23 conduct that resulted in the violation.
24-24 Sec. 206.307. AUDIT OF REHABILITATION ORDER. (a) The
24-25 medical board shall maintain a rehabilitation order imposed under
24-26 Section 206.305 in a confidential file. The file is subject to an
24-27 independent audit by the state auditor or a private auditor with
25-1 whom the board contracts to perform the audit to ensure that only
25-2 qualified license holders are subject to rehabilitation orders.
25-3 (b) An audit may be performed at any time at the direction
25-4 of the medical board. The medical board shall ensure that an audit
25-5 is performed at least once in each three-year period.
25-6 (c) The audit results are a matter of public record and
25-7 shall be reported in a manner that maintains the confidentiality of
25-8 each license holder who is the subject of a rehabilitation order.
25-9 Sec. 206.308. SUBPOENA. (a) The executive director, the
25-10 director's designee, or the secretary-treasurer of the board may
25-11 issue a subpoena or subpoena duces tecum:
25-12 (1) to conduct an investigation or a contested case
25-13 proceeding related to:
25-14 (A) alleged misconduct by a surgical assistant;
25-15 (B) an alleged violation of this chapter or
25-16 another law related to the practice of a surgical assistant; or
25-17 (C) the provision of health care under this
25-18 chapter;
25-19 (2) for purposes of determining whether to issue,
25-20 suspend, restrict, or revoke a license under this chapter; or
25-21 (3) for purposes of determining whether to issue or
25-22 deny a license under this chapter.
25-23 (b) Failure to timely comply with a subpoena issued under
25-24 this section is a ground for:
25-25 (1) disciplinary action by the medical board or
25-26 another licensing or regulatory agency with jurisdiction over the
25-27 person subject to the subpoena; and
26-1 (2) denial of a license application.
26-2 Sec. 206.309. PROTECTION OF PATIENT IDENTITY. In a
26-3 disciplinary investigation or proceeding conducted under this
26-4 chapter, the medical board shall protect the identity of each
26-5 patient whose medical records are examined and used in a public
26-6 proceeding unless the patient:
26-7 (1) testifies in the public proceeding; or
26-8 (2) submits a written release in regard to the
26-9 patient's records or identity.
26-10 Sec. 206.310. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of
26-11 practice adopted under this chapter by the medical board under
26-12 Section 2001.004, Government Code, applicable to the proceedings
26-13 for a disciplinary action may not conflict with rules adopted by
26-14 the State Office of Administrative Hearings.
26-15 Sec. 206.311. REQUIRED SUSPENSION OF INCARCERATED SURGICAL
26-16 ASSISTANT. Regardless of the offense, the medical board shall
26-17 suspend the license of a surgical assistant serving a prison term
26-18 in a state or federal penitentiary during the term of the
26-19 incarceration.
26-20 Sec. 206.312. TEMPORARY SUSPENSION. (a) The president of
26-21 the medical board, with medical board approval, shall appoint a
26-22 three-member disciplinary panel consisting of medical board members
26-23 to determine whether a surgical assistant's license should be
26-24 temporarily suspended.
26-25 (b) If the disciplinary panel determines from the evidence
26-26 or information presented to the panel that a person licensed to
26-27 practice as a surgical assistant would, by the person's
27-1 continuation in practice, constitute a continuing threat to the
27-2 public welfare, the disciplinary panel shall temporarily suspend
27-3 the license of that person.
27-4 (c) A license may be suspended under this section without
27-5 notice or hearing on the complaint if:
27-6 (1) institution of proceedings for a hearing before
27-7 the medical board is initiated simultaneously with the temporary
27-8 suspension; and
27-9 (2) a hearing is held under Chapter 2001, Government
27-10 Code, and this chapter as soon as possible.
27-11 (d) Notwithstanding Chapter 551, Government Code, the
27-12 disciplinary panel may hold a meeting by telephone conference call
27-13 if immediate action is required and convening the disciplinary
27-14 panel at one location is inconvenient for any member of the panel.
27-15 (Sections 206.313-206.350 reserved for expansion
27-16 SUBCHAPTER H. OTHER PENALTIES AND ENFORCEMENT PROVISIONS
27-17 Sec. 206.351. ADMINISTRATIVE PENALTY. (a) The medical board
27-18 by order may impose an administrative penalty against a person
27-19 licensed under this chapter who violates this chapter or a rule or
27-20 order adopted under this chapter.
27-21 (b) The penalty may be in an amount not to exceed $5,000.
27-22 Each day a violation continues or occurs is a separate violation
27-23 for purposes of imposing a penalty.
27-24 (c) The medical board shall base the amount of the penalty
27-25 on:
27-26 (1) the severity of patient harm;
27-27 (2) the severity of economic harm to any person;
28-1 (3) the severity of any environmental harm;
28-2 (4) the increased potential for harm to the public;
28-3 (5) any attempted concealment of misconduct;
28-4 (6) any premeditated or intentional misconduct;
28-5 (7) the motive for the violation;
28-6 (8) any prior misconduct of a similar or related
28-7 nature;
28-8 (9) the license holder's disciplinary history;
28-9 (10) any prior written warnings or written
28-10 admonishments from any government agency or official regarding
28-11 statutes or rules relating to the misconduct;
28-12 (11) whether the violation is of a board order;
28-13 (12) the person's failure to implement remedial
28-14 measures to correct or mitigate harm from the misconduct;
28-15 (13) the person's lack of rehabilitative potential or
28-16 likelihood of future misconduct of a similar nature;
28-17 (14) any relevant circumstances increasing the
28-18 seriousness of the misconduct; and
28-19 (15) any other matter that justice may require.
28-20 (d) The medical board by rule shall prescribe the procedures
28-21 by which it may impose an administrative penalty. A proceeding
28-22 under this section is subject to Chapter 2001, Government Code.
28-23 (e) If the medical board by order determines that a
28-24 violation has occurred and imposes an administrative penalty, the
28-25 medical board shall give notice to the person of the order. The
28-26 notice must include a statement of the person's right to judicial
28-27 review of the order.
29-1 Sec. 206.352. CRIMINAL PENALTY. (a) A person commits an
29-2 offense if, without holding a license issued under this chapter,
29-3 the person:
29-4 (1) represents that the person is a surgical
29-5 assistant;
29-6 (2) uses any combination or abbreviation of the term
29-7 "surgical assistant" to indicate or imply that the person is a
29-8 surgical assistant; or
29-9 (3) acts as a surgical assistant.
29-10 (b) An offense under this section is a felony of the third
29-11 degree.
29-12 SECTION 2. Subsection (B), Section 2, Chapter 397, Acts of
29-13 the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
29-14 Vernon's Texas Insurance Code), is amended to read as follows:
29-15 (B) No policy of accident and sickness insurance shall make
29-16 benefits contingent upon treatment or examination by a particular
29-17 practitioner or by particular practitioners of the healing arts
29-18 hereinafter designated unless such policy contains a provision
29-19 designating the practitioner or practitioners who will be
29-20 recognized by the insurer and those who will not be recognized by
29-21 the insurer. Such provision may be located in the "Exceptions" or
29-22 "Exceptions and Reductions" provisions, or elsewhere in the policy,
29-23 or by endorsement attached to the policy, at the insurer's option.
29-24 In designating the practitioners who will and will not be
29-25 recognized, such provision shall use the following terms: Doctor
29-26 of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
29-27 Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
30-1 Audiologist, Licensed Speech-language Pathologist, Doctor in
30-2 Psychology, Licensed Master Social Worker--Advanced Clinical
30-3 Practitioner, Licensed Dietitian, Licensed Professional Counselor,
30-4 Licensed Marriage and Family Therapist, Licensed Chemical
30-5 Dependency Counselor, Licensed Hearing Instrument Fitter and
30-6 Dispenser, Advanced Practice Nurse, Physician Assistant, Licensed
30-7 Occupational Therapist, Licensed Physical Therapist, Licensed
30-8 Acupuncturist, [and] Licensed Psychological Associate, and Licensed
30-9 Surgical Assistant.
30-10 For purposes of this Act, such designations shall have the
30-11 following meanings:
30-12 Doctor of Medicine: One licensed by the Texas State Board of
30-13 Medical Examiners on the basis of the degree "Doctor of Medicine";
30-14 Doctor of Osteopathy: One licensed by the Texas State Board
30-15 of Medical Examiners on the basis of the degree of "Doctor of
30-16 Osteopathy";
30-17 Doctor of Dentistry: One licensed by the State Board of
30-18 Dental Examiners;
30-19 Doctor of Chiropractic: One licensed by the Texas Board of
30-20 Chiropractic Examiners;
30-21 Doctor of Optometry: One licensed by the Texas Optometry
30-22 Board;
30-23 Doctor of Podiatry: One licensed by the Texas State Board of
30-24 Podiatric Medical Examiners;
30-25 Licensed Audiologist: One with a master's or doctorate
30-26 degree in audiology from an accredited college or university and
30-27 who is licensed as an audiologist by the State Board of Examiners
31-1 for Speech-Language Pathology and Audiology;
31-2 Licensed Speech-language Pathologist: One with a master's or
31-3 doctorate degree in speech pathology or speech-language pathology
31-4 from an accredited college or university and who is licensed as a
31-5 speech-language pathologist by the State Board of Examiners for
31-6 Speech-Language Pathology and Audiology;
31-7 Doctor in Psychology: One licensed by the Texas State Board
31-8 of Examiners of Psychologists and certified as a Health Service
31-9 Provider;
31-10 Licensed Master Social Worker--Advanced Clinical
31-11 Practitioner: One licensed by the Texas State Board of Social
31-12 Worker Examiners as a Licensed Master Social Worker with the order
31-13 of recognition of Advanced Clinical Practitioner;
31-14 Licensed Dietitian: One licensed by the Texas State Board of
31-15 Examiners of Dietitians;
31-16 Licensed Professional Counselor: One licensed by the Texas
31-17 State Board of Examiners of Professional Counselors;
31-18 Licensed Marriage and Family Therapist: One licensed by the
31-19 Texas State Board of Examiners of Marriage and Family Therapists;
31-20 Licensed Chemical Dependency Counselor: One licensed by the
31-21 Texas Commission on Alcohol and Drug Abuse;
31-22 Licensed Hearing Instrument Fitter and Dispenser: One
31-23 licensed by the State Committee of Examiners in the Fitting and
31-24 Dispensing of Hearing Instruments;
31-25 Advanced Practice Nurse: One licensed by the Board of Nurse
31-26 Examiners as a registered nurse and recognized by that board as an
31-27 advanced practice nurse;
32-1 Physician Assistant: One licensed by the Texas State Board
32-2 of Physician Assistant Examiners;
32-3 Licensed Occupational Therapist: One licensed by the Texas
32-4 Board of Occupational Therapy Examiners;
32-5 Licensed Physical Therapist: One licensed by the Texas Board
32-6 of Physical Therapy Examiners;
32-7 Licensed Acupuncturist: One licensed by the Texas State
32-8 Board of Medical Examiners as an acupuncturist; [and]
32-9 Licensed Psychological Associate: One licensed by the Texas
32-10 State Board of Examiners of Psychologists and practicing under the
32-11 supervision of a licensed psychologist; and
32-12 Licensed Surgical Assistant: One licensed by the Texas State
32-13 Board of Medical Examiners as a surgical assistant.
32-14 SECTION 3. Section 1, Article 21.52, Insurance Code, is
32-15 amended by adding Subsection (u) to read as follows:
32-16 (u) "Surgical assistant" means a person licensed by the
32-17 Texas State Board of Medical Examiners as a surgical assistant.
32-18 SECTION 4. Section 3(a), Article 21.52, Insurance Code, as
32-19 amended by Chapters 428 and 888, Acts of the 76th Legislature,
32-20 Regular Session, 1999, is amended to read as follows:
32-21 (a) Any person who is issued, who is a party to, or who is a
32-22 beneficiary under any health insurance policy delivered, renewed,
32-23 or issued for delivery in this state by any insurance company,
32-24 association, or organization to which this article applies may
32-25 select:
32-26 (1) a licensed doctor of podiatric medicine, a
32-27 licensed dentist, or a doctor of chiropractic to perform the
33-1 medical or surgical services or procedures scheduled in the policy
33-2 which fall within the scope of the license of that practitioner;
33-3 (2) a licensed doctor of optometry to perform the
33-4 services or procedures scheduled in the policy which fall within
33-5 the scope of the license of that doctor of optometry;
33-6 (3) an occupational therapist to provide the services
33-7 scheduled in the policy which fall within the scope of the license
33-8 of that occupational therapist;
33-9 (4) a physical therapist to provide the services
33-10 scheduled in the policy which fall within the scope of the license
33-11 of that physical therapist;
33-12 (5) a licensed audiologist to measure hearing for the
33-13 purpose of determining the presence or extent of a hearing loss and
33-14 to provide aural rehabilitation services to a person with a hearing
33-15 loss if those services or procedures are scheduled in the policy;
33-16 (6) a licensed speech-language pathologist to evaluate
33-17 speech and language and to provide habilitative and rehabilitative
33-18 services to restore speech or language loss or to correct a speech
33-19 or language impairment if those services or procedures are
33-20 scheduled in the policy;
33-21 (7) a licensed master social worker--advanced clinical
33-22 practitioner to provide the services that fall within the scope of
33-23 the license of such certified practitioner and which are specified
33-24 as services within the terms of the policy of insurance, including
33-25 the provision of direct, diagnostic, preventive, or clinical
33-26 services to individuals, families, and groups whose functioning is
33-27 threatened or affected by social or psychological stress or health
34-1 impairment, if those services or procedures are scheduled in the
34-2 policy;
34-3 (8) a licensed dietitian including a provisional
34-4 licensed dietitian under a licensed dietitian's supervision to
34-5 provide the services that fall within the scope of the license of
34-6 that dietitian if those services are scheduled in the policy;
34-7 (9) a licensed professional counselor to provide the
34-8 services that fall within the scope of the license of that
34-9 professional if those services are scheduled in the policy;
34-10 (10) a licensed marriage and family therapist to
34-11 provide the services that fall within the scope of the license of
34-12 that professional if those services are scheduled in the policy;
34-13 (11) a psychologist to perform the services or
34-14 procedures scheduled in the policy that fall within the scope of
34-15 the license of that psychologist;
34-16 (12) a licensed chemical dependency counselor to
34-17 perform the services or procedures scheduled in the policy that
34-18 fall within the scope of the license of that practitioner;
34-19 (13) [(12)] a licensed acupuncturist to perform the
34-20 services or procedures scheduled in the policy that fall within the
34-21 scope of the license of that practitioner;
34-22 (14) [(13)] an advanced practice nurse to provide the
34-23 services scheduled in the policy that fall within the scope of the
34-24 license of that practitioner;
34-25 (15) [(14)] a physician assistant to provide the
34-26 services scheduled in the policy that fall within the scope of the
34-27 license of that practitioner;
35-1 (16) [(15)] a licensed hearing instrument fitter and
35-2 dispenser to provide the services or procedures scheduled in the
35-3 policy that fall within the scope of the license of that
35-4 practitioner;
35-5 (17) a licensed surgical assistant to provide the
35-6 services or procedures scheduled in the policy that fall within the
35-7 scope of the license of that practitioner; or
35-8 (18) [(16)] a licensed psychological associate to
35-9 provide the services that fall within the scope of the license of
35-10 that professional if those services are scheduled in the policy.
35-11 SECTION 5. (a) Notwithstanding Section 206.201 and
35-12 Subchapter H, Chapter 206, Occupations Code, as added by this Act,
35-13 a person is not required to obtain a license under Chapter 206,
35-14 Occupations Code, as added by this Act, until September 1, 2002.
35-15 (b) The Texas State Board of Medical Examiners shall adopt
35-16 rules under Chapter 206, Occupations Code, as added by this Act,
35-17 not later than January 1, 2002.
35-18 SECTION 6. Section 2, Chapter 397, Acts of the 54th
35-19 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
35-20 Insurance Code), and Article 21.52, Insurance Code, as amended by
35-21 this Act, apply only to an insurance policy, contract, or evidence
35-22 of coverage delivered, issued for delivery, or renewed on or after
35-23 January 1, 2003. A policy, contract, or evidence of coverage
35-24 delivered, issued for delivery, or renewed before January 1, 2003,
35-25 is governed by the law as it existed immediately before the
35-26 effective date of this Act, and that law is continued in effect for
35-27 that purpose.
36-1 SECTION 7. This Act takes effect September 1, 2001.