By Capelo H.B. No. 1183
77R2814 GJH-F
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 board" means the Board of Surgical
1-11 Assistants.
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) "Medical board" means the Texas State Board of
1-17 Medical Examiners.
1-18 (4) "Surgical assistant" means a person who provides
1-19 aid to a delegating physician in exposure, hemostasis, and other
1-20 technical functions that assist the physician in performing a safe
1-21 operation with optimal results for the patient.
1-22 Sec. 206.002. APPLICABILITY. A person is not required to
1-23 hold a license under this chapter if the person is:
1-24 (1) a student enrolled in a surgical assistant
2-1 education program approved by the medical board who is assisting in
2-2 a surgical operation that is an integral part of the program of
2-3 study;
2-4 (2) a surgical assistant employed in the service of
2-5 the federal government while performing duties related to that
2-6 employment;
2-7 (3) a person acting under the delegated authority of a
2-8 licensed physician; or
2-9 (4) a licensed health care worker acting within the
2-10 scope of the person's license.
2-11 Sec. 206.003. APPLICATION OF SUNSET ACT. The Board of
2-12 Surgical Assistants is subject to Chapter 325, Government Code
2-13 (Texas Sunset Act). Unless continued in existence as provided by
2-14 that chapter, the advisory board is abolished and this chapter
2-15 expires September 1, 2011.
2-16 (Sections 206.004-206.050 reserved for expansion
2-17 SUBCHAPTER B. BOARD OF SURGICAL ASSISTANTS
2-18 Sec. 206.051. ADVISORY BOARD. The Board of Surgical
2-19 Assistants is created as an advisory board to the Texas State Board
2-20 of Medical Examiners and is not subject to Chapter 2110, Government
2-21 Code.
2-22 Sec. 206.052. APPOINTMENT OF ADVISORY BOARD. (a) The
2-23 advisory board consists of nine members appointed by the governor
2-24 as follows:
2-25 (1) three members must be practicing surgical
2-26 assistants who have at least five years of clinical experience as
2-27 surgical assistants;
3-1 (2) three members must be physicians licensed in this
3-2 state who supervise surgical assistants; and
3-3 (3) three members must be members of the public who
3-4 are not licensed as physicians or surgical assistants.
3-5 (b) Appointments to the advisory board shall be made without
3-6 regard to the race, color, disability, sex, religion, age, or
3-7 national origin of the appointees.
3-8 Sec. 206.053. PUBLIC MEMBER ELIGIBILITY. A person is not
3-9 eligible for appointment as a public member of the advisory board
3-10 if the person or the person's spouse:
3-11 (1) is licensed by an occupational regulatory agency
3-12 in the field of health care; or
3-13 (2) is employed by or participates in the management
3-14 of a business entity or other organization that provides health
3-15 care services or that sells, manufactures, or distributes health
3-16 care supplies or equipment.
3-17 Sec. 206.054. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
3-18 this section, "Texas trade association" means a cooperative and
3-19 voluntarily joined association of business or professional
3-20 competitors in this state designed to assist its members and its
3-21 industry or profession in dealing with mutual business or
3-22 professional problems and in promoting their common interest.
3-23 (b) A person may not be a member of the advisory board and
3-24 may not be an advisory board employee employed in a "bona fide
3-25 executive, administrative, or professional capacity," as that
3-26 phrase is used for purposes of establishing an exemption to the
3-27 overtime provisions of the federal Fair Labor Standards Act of 1938
4-1 (29 U.S.C. Section 201 et seq.), and its subsequent amendments, if:
4-2 (1) the person is an officer, employee, or paid
4-3 consultant of a Texas trade association in the field of surgical
4-4 assisting; or
4-5 (2) the person's spouse is an officer, manager, or
4-6 paid consultant of a Texas trade association in the field of
4-7 surgical assisting.
4-8 (c) A person may not be a member of the advisory board or
4-9 act as the general counsel to the advisory board if the person is
4-10 required to register as a lobbyist under Chapter 305, Government
4-11 Code, because of the person's activities for compensation on behalf
4-12 of a profession related to the operation of the advisory board.
4-13 Sec. 206.055. TERMS; VACANCY. (a) Members of the advisory
4-14 board are appointed for staggered six-year terms. The terms of
4-15 three members expire on February 1 of each odd-numbered year.
4-16 (b) If a vacancy occurs during a member's term, the governor
4-17 shall appoint a new member to fill the unexpired term.
4-18 (c) An advisory board member may not serve more than two
4-19 consecutive full terms.
4-20 Sec. 206.056. GROUNDS FOR REMOVAL. (a) It is a ground for
4-21 removal from the advisory board that a member:
4-22 (1) does not have at the time of appointment the
4-23 qualifications required by Sections 206.052 and 206.053;
4-24 (2) does not maintain during service on the board the
4-25 qualifications required by Sections 206.052 and 206.053;
4-26 (3) is ineligible for membership under Section
4-27 206.054;
5-1 (4) cannot, because of illness or disability,
5-2 discharge the member's duties for a substantial part of the
5-3 member's term; or
5-4 (5) is absent from more than half of the regularly
5-5 scheduled advisory board meetings that the member is eligible to
5-6 attend during a calendar year without an excuse approved by a
5-7 majority vote of the advisory board.
5-8 (b) The validity of an action of the advisory board is not
5-9 affected by the fact that it is taken when a ground for removal of
5-10 an advisory board member exists.
5-11 Sec. 206.057. OFFICERS. (a) The governor shall designate
5-12 biennially an advisory board member as the presiding officer of the
5-13 advisory board to serve in that capacity at the will of the
5-14 governor.
5-15 (b) The advisory board shall elect biennially from among its
5-16 members an assistant presiding officer and secretary-treasurer.
5-17 Sec. 206.058. PER DIEM. (a) An advisory board member may
5-18 not receive compensation for service on the advisory board.
5-19 (b) An advisory board member is entitled to:
5-20 (1) the per diem set by the General Appropriations Act
5-21 for each day that the member performs duties as an advisory board
5-22 member; and
5-23 (2) reimbursement for expenses as provided by the
5-24 General Appropriations Act.
5-25 Sec. 206.059. MEETINGS. (a) The advisory board shall meet
5-26 at least twice each year.
5-27 (b) The advisory board may meet at other times at the call
6-1 of the presiding officer or as provided by advisory board rule.
6-2 Sec. 206.060. TRAINING REQUIREMENTS. (a) A person who is
6-3 appointed to and qualifies for office as an advisory board member
6-4 may not vote, deliberate, or be counted as a member in attendance
6-5 at a meeting of the advisory board until the person completes a
6-6 training program that complies with this section.
6-7 (b) The training program must provide the person with
6-8 information regarding:
6-9 (1) the legislation that created the advisory board
6-10 and the medical board;
6-11 (2) the programs operated by the advisory board;
6-12 (3) the role and functions of the advisory board;
6-13 (4) the rules of the medical board, with an emphasis
6-14 on the rules that relate to disciplinary and investigatory
6-15 authority;
6-16 (5) the current budget for the advisory board;
6-17 (6) the results of the most recent formal audit of the
6-18 advisory board;
6-19 (7) the requirements of:
6-20 (A) the open meetings law, Chapter 551,
6-21 Government Code;
6-22 (B) the public information law, Chapter 552,
6-23 Government Code;
6-24 (C) the administrative procedure law, Chapter
6-25 2001, Government Code; and
6-26 (D) other laws relating to public officials,
6-27 including conflict of interest laws; and
7-1 (8) any applicable ethics policies adopted by the
7-2 medical board or the Texas Ethics Commission.
7-3 (c) A person appointed to the advisory board is entitled to
7-4 reimbursement, as provided by the General Appropriations Act, for
7-5 travel expenses incurred in attending the training program
7-6 regardless of whether the attendance at the program occurs before
7-7 or after the person qualifies for office.
7-8 (Sections 206.061-206.100 reserved for expansion
7-9 SUBCHAPTER C. POWERS AND DUTIES OF ADVISORY BOARD AND MEDICAL BOARD
7-10 Sec. 206.101. GENERAL POWERS AND DUTIES. (a) Subject to the
7-11 advice and approval of the medical board, the advisory board shall:
7-12 (1) establish qualifications for a surgical assistant
7-13 to practice in this state;
7-14 (2) establish minimum educational and training
7-15 requirements necessary for the advisory board to recommend that the
7-16 medical board issue a license to practice as a surgical assistant;
7-17 (3) administer an examination for a license to
7-18 practice as a surgical assistant;
7-19 (4) develop requirements for licensure by endorsement
7-20 of other states;
7-21 (5) prescribe the application form for a license to
7-22 practice as a surgical assistant;
7-23 (6) make recommendations on an application for a
7-24 license to practice as a surgical assistant;
7-25 (7) develop and implement policies that clearly
7-26 separate the policymaking responsibilities of the advisory board
7-27 and the management responsibilities of the executive director and
8-1 the staff of the medical board;
8-2 (8) develop an approved program of continuing
8-3 education and the manner in which attendance at all approved
8-4 courses, clinics, forums, lectures, programs, or seminars is
8-5 monitored, recorded, and submitted to the advisory board; and
8-6 (9) recommend additional rules as are necessary for
8-7 the administration and enforcement of this chapter.
8-8 (b) Notwithstanding Subsection (a), the advisory board has
8-9 no independent rulemaking authority.
8-10 Sec. 206.102. ANNUAL REPORT. (a) The advisory board shall
8-11 prepare annually a complete and detailed written report accounting
8-12 for all funds received and disbursed by the medical board under
8-13 this chapter during the preceding fiscal year.
8-14 (b) The annual report must meet the reporting requirements
8-15 applicable to financial reporting provided in the General
8-16 Appropriations Act.
8-17 Sec. 206.103. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
8-18 medical peer review committee in this state, a surgical assistant,
8-19 a surgical assistant student, or a physician practicing medicine in
8-20 this state shall report relevant information to the advisory board
8-21 related to the acts of a surgical assistant in this state if, in
8-22 that person's opinion, a surgical assistant poses a continuing
8-23 threat to the public welfare through the person's practice as a
8-24 surgical assistant. The duty to report under this section may not
8-25 be nullified through contract.
8-26 (b) A person who, without malice, furnishes records,
8-27 information, or assistance to the advisory board under this section
9-1 is immune from any civil liability arising from that action.
9-2 (Sections 206.104-206.150 reserved for expansion
9-3 SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND
9-4 INVESTIGATIVE INFORMATION
9-5 Sec. 206.151. PUBLIC PARTICIPATION. (a) Subject to the
9-6 advice and approval of the medical board, the advisory board shall
9-7 develop and implement policies that provide the public with a
9-8 reasonable opportunity to appear before the advisory board and
9-9 speak on any issue under the advisory board's jurisdiction.
9-10 (b) The executive director of the advisory board shall
9-11 prepare and maintain a written plan that describes how a person who
9-12 does not speak English may be provided reasonable access to the
9-13 advisory board's programs and services.
9-14 Sec. 206.152. PUBLIC INTEREST INFORMATION. (a) The advisory
9-15 board shall prepare information of public interest describing the
9-16 functions of the advisory board and the procedures by which
9-17 complaints are filed and resolved.
9-18 (b) The advisory board shall make the information available
9-19 to the public and appropriate state agencies.
9-20 Sec. 206.153. COMPLAINTS. (a) The advisory board by rule
9-21 shall establish methods by which consumers and service recipients
9-22 are notified of the name, mailing address, and telephone number of
9-23 the advisory board for the purpose of directing complaints to the
9-24 advisory board.
9-25 (b) The advisory board shall list with its regular telephone
9-26 number any toll-free telephone number established under other state
9-27 law that may be called to present a complaint about a health
10-1 professional.
10-2 Sec. 206.154. RECORDS OF COMPLAINTS. (a) The advisory board
10-3 shall maintain a file on each written complaint filed with the
10-4 advisory board. The file must include:
10-5 (1) the name of the person who filed the complaint;
10-6 (2) the date the complaint is received by the advisory
10-7 board;
10-8 (3) the subject matter of the complaint;
10-9 (4) the name of each person contacted in relation to
10-10 the complaint;
10-11 (5) a summary of the results of the review or
10-12 investigation of the complaint; and
10-13 (6) an explanation of the reason the file was closed,
10-14 if the agency closed the file without taking action other than to
10-15 investigate the complaint.
10-16 (b) The advisory board shall provide to the person filing
10-17 the complaint and to each person who is a subject of the complaint
10-18 a copy of the advisory board's policies and procedures relating to
10-19 complaint investigation and resolution.
10-20 (c) The advisory board, at least quarterly and until final
10-21 disposition of the complaint, shall notify the person filing the
10-22 complaint and each person who is a subject of the complaint of the
10-23 status of the investigation unless the notice would jeopardize an
10-24 undercover investigation.
10-25 Sec. 206.155. LICENSE HOLDER ACCESS TO COMPLAINT
10-26 INFORMATION. (a) The advisory board shall provide a license holder
10-27 who is the subject of a formal complaint filed under this chapter
11-1 with access to all information in its possession that the advisory
11-2 board intends to offer into evidence in presenting its case in
11-3 chief at the contested hearing on the complaint, subject to any
11-4 other privilege or restriction established by rule, statute, or
11-5 legal precedent. The advisory board shall provide the information
11-6 not later than the 30th day after receipt of a written request from
11-7 the license holder or the license holder's counsel, unless good
11-8 cause is shown for delay.
11-9 (b) Notwithstanding Subsection (a), the advisory board is
11-10 not required to provide:
11-11 (1) advisory board investigative reports;
11-12 (2) investigative memoranda;
11-13 (3) the identity of a nontestifying complainant;
11-14 (4) attorney-client communications;
11-15 (5) attorney work product; or
11-16 (6) other material covered by a privilege recognized
11-17 by the Texas Rules of Civil Procedure or the Texas Rules of
11-18 Evidence.
11-19 (c) The provision of information does not constitute a
11-20 waiver of privilege or confidentiality under this chapter or other
11-21 law.
11-22 Sec. 206.156. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On
11-23 the written request of a health care entity, the advisory board
11-24 shall provide to the entity:
11-25 (1) information about a complaint filed against a
11-26 license holder that was resolved after investigation by:
11-27 (A) a disciplinary order of the medical board;
12-1 or
12-2 (B) an agreed settlement; and
12-3 (2) the basis of and current status of any complaint
12-4 under active investigation.
12-5 Sec. 206.157. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION.
12-6 A complaint, adverse report, investigation file, other report, or
12-7 other investigative information in the possession of or received or
12-8 gathered by the advisory board, advisory board employee, or agent
12-9 relating to a license holder, a license application, or a criminal
12-10 investigation or proceeding is privileged and confidential and is
12-11 not subject to discovery, subpoena, or other means of legal
12-12 compulsion for release to any person other than the advisory board
12-13 or advisory board employee or agent involved in license holder
12-14 discipline.
12-15 Sec. 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE
12-16 INFORMATION. (a) Investigative information in the possession of
12-17 the advisory board, advisory board employee, or agent that relates
12-18 to the discipline of a license holder may be disclosed to:
12-19 (1) a licensing authority in another state or a
12-20 territory or country in which the license holder is licensed or
12-21 has applied for a license; or
12-22 (2) a peer review committee reviewing:
12-23 (A) an application for privileges; or
12-24 (B) the qualifications of the licensee with
12-25 respect to retaining privileges.
12-26 (b) If the investigative information in the possession of
12-27 the advisory board or an advisory board employee or agent indicates
13-1 a crime may have been committed, the advisory board shall report
13-2 the information to the proper law enforcement agency. The advisory
13-3 board shall cooperate with and assist all law enforcement agencies
13-4 conducting criminal investigations of a license holder by providing
13-5 information relevant to the investigation. Confidential
13-6 information disclosed by the advisory board to a law enforcement
13-7 agency remains confidential and may not be disclosed by the law
13-8 enforcement agency except as necessary to further the
13-9 investigation.
13-10 (Sections 206.159-206.200 reserved for expansion
13-11 SUBCHAPTER E. LICENSE REQUIREMENTS AND EXEMPTIONS
13-12 Sec. 206.201. LICENSE REQUIRED. (a) A person may not
13-13 practice as a surgical assistant unless the person is licensed
13-14 under this chapter.
13-15 (b) Unless the person holds a license under this chapter, a
13-16 person may not use, in connection with the person's name:
13-17 (1) the title "Licensed Surgical Assistant"; or
13-18 (2) any other designation that would imply that the
13-19 person is a licensed surgical assistant.
13-20 Sec. 206.202. LICENSE APPLICATION. An applicant for a
13-21 license must:
13-22 (1) file a written application with the advisory board
13-23 on a form prescribed by the medical board; and
13-24 (2) pay the application fee set by the medical board.
13-25 Sec. 206.203. LICENSE ELIGIBILITY. (a) Except as provided
13-26 by Section 206.206, to be eligible for a license, a person must:
13-27 (1) be of good moral character;
14-1 (2) have not been convicted of a felony or a crime
14-2 involving moral turpitude;
14-3 (3) not use drugs or alcohol to an extent that affects
14-4 the applicant's professional competency;
14-5 (4) not have had a license or certification revoked by
14-6 a licensing agency or by a certifying professional organization;
14-7 and
14-8 (5) not have engaged in fraud or deceit in applying
14-9 for a license under this chapter.
14-10 (b) In addition to meeting the requirements of Subsection
14-11 (a), a person must pass the examination required by this chapter
14-12 and:
14-13 (1) complete a surgical assistant educational program
14-14 approved by the medical board;
14-15 (2) complete a surgical technologist educational
14-16 program approved by the medical board and provide proof acceptable
14-17 to the medical board that the person has first assisted a total of
14-18 at least 1,500 hours during the 24 months preceding the date of
14-19 application; or
14-20 (3) provide proof acceptable to the medical board that
14-21 the person has:
14-22 (A) passed the following basic science courses
14-23 in a curriculum approved by the medical board:
14-24 (i) anatomy and physiology;
14-25 (ii) aseptic technique;
14-26 (iii) pharmacology;
14-27 (iv) surgical anatomy;
15-1 (v) operative procedures;
15-2 (vi) draping or prepping techniques;
15-3 (vii) positioning of the operative
15-4 patient; and
15-5 (viii) local regional and general
15-6 anesthesia techniques; and
15-7 (B) acted as a first assistant at surgical
15-8 procedures for at least 1,500 hours during the 24 months preceding
15-9 the date of application.
15-10 Sec. 206.204. EXAMINATION. To be eligible to take the
15-11 license examination, an applicant must:
15-12 (1) file an application on a form prescribed by the
15-13 medical board not later than the 90th day before the date of the
15-14 examination; and
15-15 (2) pay the examination fee set by the medical board
15-16 to cover the cost of administering the examination.
15-17 Sec. 206.205. EXAMINATION RESULTS. (a) Not later than the
15-18 30th day after the date a person takes a licensing examination, the
15-19 advisory board shall notify the person of the results of the
15-20 examination.
15-21 (b) If the examination is graded or reviewed by a testing
15-22 service:
15-23 (1) the advisory board shall notify the person of the
15-24 results of the examination not later than the 14th day after the
15-25 date the advisory board receives the results from the testing
15-26 service; and
15-27 (2) if notice of the examination results will be
16-1 delayed for longer than 90 days after the examination date, the
16-2 advisory board shall notify the person of the reason for the delay
16-3 before the 90th day.
16-4 (c) The advisory board may require a testing service to
16-5 notify a person of the results of the person's examination.
16-6 Sec. 206.206. SPECIAL ELIGIBILITY FOR LICENSE. A person may
16-7 be licensed as a surgical assistant under this chapter without
16-8 meeting the requirements of Section 206.203 if the person:
16-9 (1) is a resident of this state;
16-10 (2) is at least 21 years of age;
16-11 (3) provides proof acceptable to the medical board
16-12 that the person has acted as a first assistant at surgical
16-13 procedures for at least 1,500 hours during the 24 months preceding
16-14 the date of application under this section;
16-15 (4) provides proof acceptable to the medical board
16-16 that the person has successfully completed the basic science
16-17 courses listed under Section 206.203(b) in a curriculum approved by
16-18 the medical board;
16-19 (5) derives the majority of the person's income as a
16-20 surgical assistant; and
16-21 (6) applies for a license under this section before
16-22 September 1, 2002.
16-23 Sec. 206.207. TEMPORARY LICENSE. (a) The advisory board
16-24 may, through the executive director of the medical board, issue a
16-25 temporary license to an applicant who:
16-26 (1) submits an application on a form prescribed by the
16-27 medical board;
17-1 (2) has passed an examination recognized by the
17-2 advisory board relating to the practice of surgical assisting;
17-3 (3) pays the appropriate fee set by the medical board;
17-4 (4) if licensed in another state, is in good standing
17-5 as a surgical assistant; and
17-6 (5) meets all the qualifications for a license under
17-7 this chapter and is waiting for the next scheduled meeting of the
17-8 medical board for the license to be issued.
17-9 (b) A temporary license is valid until the 100th day after
17-10 the date issued and may be extended until the 130th day after the
17-11 date issued.
17-12 Sec. 206.208. ASSISTANCE BY MEDICAL BOARD. The medical
17-13 board shall provide administrative and clerical employees as
17-14 necessary to enable the advisory board to administer this
17-15 subchapter.
17-16 Sec. 206.209. FEES. (a) The medical board shall set and
17-17 collect fees in amounts that are reasonable and necessary to cover
17-18 the costs of administering and enforcing this chapter without the
17-19 use of any other funds generated by the medical board.
17-20 (b) Fees collected by the medical board under this chapter
17-21 shall be deposited by the medical board in the state treasury to
17-22 the credit of an account in the general revenue fund and may be
17-23 spent to cover the costs of administering and enforcing this
17-24 chapter. At the end of each fiscal biennium, the comptroller shall
17-25 transfer any surplus money remaining in the account to the general
17-26 revenue fund.
17-27 (c) All money paid to the medical board under this chapter
18-1 is subject to Subchapter F, Chapter 404, Government Code.
18-2 Sec. 206.210. ISSUANCE AND RENEWAL OF LICENSE. (a) After
18-3 consulting the advisory board, the medical board shall issue a
18-4 surgical assistant license in this state to a person who meets the
18-5 requirements of this chapter and the rules adopted under this
18-6 chapter.
18-7 (b) The medical board may waive any prerequisite to
18-8 obtaining a license for an applicant after reviewing the
18-9 applicant's credentials and determining that the applicant holds a
18-10 valid license from another state that has license requirements
18-11 substantially equivalent to those of this state.
18-12 Sec. 206.211. LICENSE RENEWAL. (a) The medical board by
18-13 rule shall provide for the annual renewal of a surgical assistant
18-14 license.
18-15 (b) The medical board by rule may adopt a system under which
18-16 licenses expire on various dates during the year. For the year in
18-17 which the license expiration date is changed, license fees shall be
18-18 prorated on a monthly basis so that each license holder pays only
18-19 that portion of the license fee that is allocable to the number of
18-20 months during which the license is valid. On renewal of the license
18-21 on the new expiration date, the total license renewal fee is
18-22 payable.
18-23 Sec. 206.212. NOTICE OF LICENSE RENEWAL. At least 30 days
18-24 before the expiration of a person's license, the advisory board
18-25 shall send written notice of the impending license expiration to
18-26 the person at the license holder's last known address according to
18-27 the records of the advisory board.
19-1 Sec. 206.213. PROCEDURE FOR RENEWAL. (a) A person who is
19-2 otherwise eligible to renew a license may renew an unexpired
19-3 license by paying the required renewal fee to the medical board
19-4 before the expiration date of the license. A person whose license
19-5 has expired may not engage in activities that require a license
19-6 until the license has been renewed under this section.
19-7 (b) If the person's license has been expired for 90 days or
19-8 less, the person may renew the license by paying to the medical
19-9 board one and one-half times the required renewal fee.
19-10 (c) If the person's license has been expired for longer than
19-11 90 days but less than one year, the person may renew the license by
19-12 paying to the medical board two times the required renewal fee.
19-13 (d) If the person's license has been expired for one year or
19-14 longer, the person may not renew the license. The person may
19-15 obtain a new license by complying with the requirements and
19-16 procedures for obtaining an original license.
19-17 Sec. 206.214. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
19-18 PRACTITIONER. (a) If the person was licensed in this state, moved
19-19 to another state, and is currently licensed and has been in
19-20 practice in the other state for the two years preceding
19-21 application, the person may renew an expired license without
19-22 reexamination.
19-23 (b) The person must pay to the medical board a fee that is
19-24 equal to two times the required renewal fee for the license.
19-25 Sec. 206.215. LICENSE HOLDER INFORMATION. (a) Each license
19-26 holder shall file with the advisory board:
19-27 (1) the license holder's mailing address;
20-1 (2) the address of the license holder's residence;
20-2 (3) the mailing address of each of the license
20-3 holder's offices; and
20-4 (4) the address for the location of each of the
20-5 license holder's offices if that address is different from the
20-6 office's mailing address.
20-7 (b) A license holder shall:
20-8 (1) notify the advisory board of a change of the
20-9 license holder's residence or business address; and
20-10 (2) provide the advisory board with the license
20-11 holder's new address not later than the 30th day after the date the
20-12 address change occurs.
20-13 (Sections 206.216-206.250 reserved for expansion
20-14 SUBCHAPTER F. SCOPE OF PRACTICE
20-15 Sec. 206.251. SCOPE OF PRACTICE. (a) The practice of a
20-16 surgical assistant includes medical services delegated by the
20-17 supervising physician that are within the education, training, and
20-18 experience of the surgical assistant.
20-19 (b) Medical services provided by a surgical assistant may
20-20 include:
20-21 (1) moving and positioning patients for surgery;
20-22 (2) retracting tissue and exposing the operative field
20-23 during operative procedures;
20-24 (3) clamping, dividing, and tying tissues to control
20-25 bleeding during surgical entry;
20-26 (4) keeping the operative site dry;
20-27 (5) affording the surgeon the best possible exposure
21-1 of the anatomy incident to the procedure;
21-2 (6) assisting in closure of the incision;
21-3 (7) applying sutures and wound dressings; and
21-4 (8) any other surgical duties authorized and
21-5 supervised by the delegating physician.
21-6 (c) The activities listed in Subsection (b) may be performed
21-7 in any place authorized by a delegating licensed physician,
21-8 including a clinic, hospital, ambulatory surgical center, or other
21-9 institutional setting.
21-10 Sec. 206.252. EXCLUSION OF LIMITATION ON EMPLOYMENT. This
21-11 chapter does not limit the employment arrangement of a surgical
21-12 assistant licensed under this chapter.
21-13 Sec. 206.253. PRACTICE OF MEDICINE PROHIBITED. This chapter
21-14 does not permit the practice of medicine, as defined by Subtitle B,
21-15 Title 3, Occupations Code, by a person issued a license under this
21-16 chapter.
21-17 (Sections 206.254-206.300 reserved for expansion
21-18 SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
21-19 Sec. 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL BOARD. (a)
21-20 The medical board may revoke, suspend, or refuse to issue or renew
21-21 a license or may limit the scope of practice of a license holder if
21-22 the license holder acts as a surgical assistant in violation of
21-23 this chapter or a rule of the medical board.
21-24 (b) The medical board may place on probation a person whose
21-25 license is suspended. If a license suspension is probated, the
21-26 medical board may require the person to:
21-27 (1) report regularly to the medical board on matters
22-1 that are the basis of the probation;
22-2 (2) limit practice to the areas prescribed by the
22-3 medical board; or
22-4 (3) continue or review professional education until
22-5 the person attains a degree of skill satisfactory to the medical
22-6 board in those areas that are the basis of the probation.
22-7 Sec. 206.302. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION.
22-8 The medical board may take action under Section 206.301 against an
22-9 applicant or license holder who:
22-10 (1) fraudulently or deceptively obtains or attempts to
22-11 obtain a license;
22-12 (2) fraudulently or deceptively uses a license;
22-13 (3) fraudulently alters any surgical assistant
22-14 license, certificate, or diploma;
22-15 (4) uses any surgical assistant license, certificate,
22-16 or diploma that has been fraudulently purchased, issued, or
22-17 counterfeited or that has been materially altered;
22-18 (5) directly or indirectly aids or abets the practice
22-19 as a surgical assistant by any person not duly licensed by the
22-20 medical board to practice as a surgical assistant; or
22-21 (6) unlawfully advertises in a false, misleading, or
22-22 deceptive manner as defined by Section 101.201.
22-23 Sec. 206.303. CONDUCT RELATED TO A VIOLATION OF LAW. (a)
22-24 The medical board may take action under Section 206.301 against an
22-25 applicant or license holder who:
22-26 (1) violates this chapter or a rule adopted under this
22-27 chapter;
23-1 (2) is convicted of a felony, placed on deferred
23-2 adjudication, or placed in a pretrial diversion program; or
23-3 (3) violates state law if the violation is connected
23-4 with practice as a surgical assistant.
23-5 (b) A complaint, indictment, or conviction of a law
23-6 violation is not necessary for the medical board to act under
23-7 Subsection (a)(3). Proof of the commission of the act while in
23-8 practice as a surgical assistant or under the guise of practice as
23-9 a surgical assistant is sufficient for action by the medical board.
23-10 Sec. 206.304. CONDUCT INDICATING LACK OF FITNESS. (a) The
23-11 medical board may take action under Section 206.301 against an
23-12 applicant or license holder who:
23-13 (1) habitually uses drugs or intoxicating liquors to
23-14 the extent that, in the medical board's opinion, the person cannot
23-15 safely perform as a surgical assistant;
23-16 (2) has been adjudicated as mentally incompetent;
23-17 (3) has a mental or physical condition that renders
23-18 the person unable to safely perform as a surgical assistant;
23-19 (4) has committed an act of moral turpitude;
23-20 (5) has failed to practice as a surgical assistant in
23-21 an acceptable manner consistent with public health and welfare;
23-22 (6) represents that the person is a physician;
23-23 (7) has acted in an unprofessional or dishonorable
23-24 manner that is likely to deceive, defraud, or injure any member of
23-25 the public;
23-26 (8) has had the person's license or other
23-27 authorization to practice as a surgical assistant suspended,
24-1 revoked, or restricted;
24-2 (9) has had other disciplinary action taken by another
24-3 state or by the uniformed services of the United States regarding
24-4 practice as a surgical assistant;
24-5 (10) is removed or suspended or has disciplinary
24-6 action taken by the person's peers in any professional association
24-7 or society or is being disciplined by a licensed hospital or
24-8 medical staff of a hospital, including removal, suspension,
24-9 limitation of privileges, or other disciplinary action, if that
24-10 action, in the opinion of the medical board, was based on
24-11 unprofessional conduct or professional incompetence that was likely
24-12 to harm the public;
24-13 (11) has repeated or recurring meritorious health care
24-14 liability claims that, in the medical board's opinion, are evidence
24-15 of professional incompetence likely to harm the public; or
24-16 (12) sexually abuses or exploits another person during
24-17 the license holder's practice as a surgical assistant.
24-18 (b) For the purpose of Subsection (a)(9), a certified copy
24-19 of the record of the state or uniformed services of the United
24-20 States taking the action constitutes conclusive evidence of that
24-21 action.
24-22 (c) An action described by Subsection (a)(10) does not
24-23 constitute state action on the part of the association, society, or
24-24 hospital medical staff.
24-25 Sec. 206.305. PROTECTION OF PATIENT IDENTITY. In a
24-26 disciplinary investigation or proceeding conducted under this
24-27 chapter, the advisory board shall protect the identity of each
25-1 patient whose medical records are examined and used in a public
25-2 proceeding unless the patient:
25-3 (1) testifies in the public proceeding; or
25-4 (2) submits a written release in regard to the
25-5 patient's records or identity.
25-6 Sec. 206.306. HEARING. A license holder is entitled to a
25-7 hearing before an administrative law judge of the State Office of
25-8 Administrative Hearings before a sanction is imposed under this
25-9 chapter.
25-10 Sec. 206.307. SCHEDULE OF SANCTIONS. (a) The medical board
25-11 by rule shall adopt a broad schedule of sanctions for violations
25-12 under this chapter.
25-13 (b) The State Office of Administrative Hearings shall use
25-14 the schedule for a sanction imposed as the result of a hearing
25-15 conducted by that office.
25-16 (Sections 206.308-206.350 reserved for expansion
25-17 SUBCHAPTER H. OTHER PENALTIES AND ENFORCEMENT PROVISIONS
25-18 Sec. 206.351. CIVIL PENALTY. (a) A person who violates
25-19 Section 206.201 or 206.253 or a rule or order adopted by the
25-20 medical board under this chapter is liable for a civil penalty not
25-21 to exceed $1,000 a day.
25-22 (b) At the request of the advisory board or medical board,
25-23 the attorney general shall bring an action to recover a civil
25-24 penalty authorized under this section.
25-25 Sec. 206.352. CRIMINAL PENALTY. (a) A person required to
25-26 hold a license under this chapter commits an offense if the person
25-27 knowingly acts as a surgical assistant without holding a license
26-1 issued under this chapter.
26-2 (b) An offense under this section is a felony of the third
26-3 degree.
26-4 Sec. 206.353. INJUNCTION. The board may seek an injunction
26-5 against a violation of this chapter or medical board rule.
26-6 SECTION 2. Subsection (B), Section 2, Chapter 397, Acts of
26-7 the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
26-8 Vernon's Texas Insurance Code), is amended to read as follows:
26-9 (B) No policy of accident and sickness insurance shall make
26-10 benefits contingent upon treatment or examination by a particular
26-11 practitioner or by particular practitioners of the healing arts
26-12 hereinafter designated unless such policy contains a provision
26-13 designating the practitioner or practitioners who will be
26-14 recognized by the insurer and those who will not be recognized by
26-15 the insurer. Such provision may be located in the "Exceptions" or
26-16 "Exceptions and Reductions" provisions, or elsewhere in the policy,
26-17 or by endorsement attached to the policy, at the insurer's option.
26-18 In designating the practitioners who will and will not be
26-19 recognized, such provision shall use the following terms: Doctor
26-20 of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
26-21 Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
26-22 Audiologist, Licensed Speech-language Pathologist, Doctor in
26-23 Psychology, Licensed Master Social Worker--Advanced Clinical
26-24 Practitioner, Licensed Dietitian, Licensed Professional Counselor,
26-25 Licensed Marriage and Family Therapist, Licensed Chemical
26-26 Dependency Counselor, Licensed Hearing Instrument Fitter and
26-27 Dispenser, Advanced Practice Nurse, Physician Assistant, Licensed
27-1 Occupational Therapist, Licensed Physical Therapist, Licensed
27-2 Acupuncturist, [and] Licensed Psychological Associate, and Licensed
27-3 Surgical Assistant.
27-4 For purposes of this Act, such designations shall have the
27-5 following meanings:
27-6 Doctor of Medicine: One licensed by the Texas State Board of
27-7 Medical Examiners on the basis of the degree "Doctor of Medicine";
27-8 Doctor of Osteopathy: One licensed by the Texas State Board
27-9 of Medical Examiners on the basis of the degree of "Doctor of
27-10 Osteopathy";
27-11 Doctor of Dentistry: One licensed by the State Board of
27-12 Dental Examiners;
27-13 Doctor of Chiropractic: One licensed by the Texas Board of
27-14 Chiropractic Examiners;
27-15 Doctor of Optometry: One licensed by the Texas Optometry
27-16 Board;
27-17 Doctor of Podiatry: One licensed by the Texas State Board of
27-18 Podiatric Medical Examiners;
27-19 Licensed Audiologist: One with a master's or doctorate
27-20 degree in audiology from an accredited college or university and
27-21 who is licensed as an audiologist by the State Board of Examiners
27-22 for Speech-Language Pathology and Audiology;
27-23 Licensed Speech-language Pathologist: One with a master's or
27-24 doctorate degree in speech pathology or speech-language pathology
27-25 from an accredited college or university and who is licensed as a
27-26 speech-language pathologist by the State Board of Examiners for
27-27 Speech-Language Pathology and Audiology;
28-1 Doctor in Psychology: One licensed by the Texas State Board
28-2 of Examiners of Psychologists and certified as a Health Service
28-3 Provider;
28-4 Licensed Master Social Worker--Advanced Clinical
28-5 Practitioner: One licensed by the Texas State Board of Social
28-6 Worker Examiners as a Licensed Master Social Worker with the order
28-7 of recognition of Advanced Clinical Practitioner;
28-8 Licensed Dietitian: One licensed by the Texas State Board of
28-9 Examiners of Dietitians;
28-10 Licensed Professional Counselor: One licensed by the Texas
28-11 State Board of Examiners of Professional Counselors;
28-12 Licensed Marriage and Family Therapist: One licensed by the
28-13 Texas State Board of Examiners of Marriage and Family Therapists;
28-14 Licensed Chemical Dependency Counselor: One licensed by the
28-15 Texas Commission on Alcohol and Drug Abuse;
28-16 Licensed Hearing Instrument Fitter and Dispenser: One
28-17 licensed by the State Committee of Examiners in the Fitting and
28-18 Dispensing of Hearing Instruments;
28-19 Advanced Practice Nurse: One licensed by the Board of Nurse
28-20 Examiners as a registered nurse and recognized by that board as an
28-21 advanced practice nurse;
28-22 Physician Assistant: One licensed by the Texas State Board
28-23 of Physician Assistant Examiners;
28-24 Licensed Occupational Therapist: One licensed by the Texas
28-25 Board of Occupational Therapy Examiners;
28-26 Licensed Physical Therapist: One licensed by the Texas Board
28-27 of Physical Therapy Examiners;
29-1 Licensed Acupuncturist: One licensed by the Texas State
29-2 Board of Medical Examiners as an acupuncturist; [and]
29-3 Licensed Psychological Associate: One licensed by the Texas
29-4 State Board of Examiners of Psychologists and practicing under the
29-5 supervision of a licensed psychologist; and
29-6 Licensed Surgical Assistant: One licensed by the Texas State
29-7 Board of Medical Examiners as a surgical assistant.
29-8 SECTION 3. Section 1, Article 21.52, Insurance Code, is
29-9 amended by adding Subsection (u) to read as follows:
29-10 (u) "Surgical assistant" means a person licensed by the
29-11 Texas State Board of Medical Examiners as a surgical assistant.
29-12 SECTION 4. Section 3(a), Article 21.52, Insurance Code, as
29-13 amended by Chapters 428 and 888, Acts of the 76th Legislature,
29-14 Regular Session, 1999, is amended to read as follows:
29-15 (a) Any person who is issued, who is a party to, or who is a
29-16 beneficiary under any health insurance policy delivered, renewed,
29-17 or issued for delivery in this state by any insurance company,
29-18 association, or organization to which this article applies may
29-19 select:
29-20 (1) a licensed doctor of podiatric medicine, a
29-21 licensed dentist, or a doctor of chiropractic to perform the
29-22 medical or surgical services or procedures scheduled in the policy
29-23 which fall within the scope of the license of that practitioner;
29-24 (2) a licensed doctor of optometry to perform the
29-25 services or procedures scheduled in the policy which fall within
29-26 the scope of the license of that doctor of optometry;
29-27 (3) an occupational therapist to provide the services
30-1 scheduled in the policy which fall within the scope of the license
30-2 of that occupational therapist;
30-3 (4) a physical therapist to provide the services
30-4 scheduled in the policy which fall within the scope of the license
30-5 of that physical therapist;
30-6 (5) a licensed audiologist to measure hearing for the
30-7 purpose of determining the presence or extent of a hearing loss and
30-8 to provide aural rehabilitation services to a person with a hearing
30-9 loss if those services or procedures are scheduled in the policy;
30-10 (6) a licensed speech-language pathologist to evaluate
30-11 speech and language and to provide habilitative and rehabilitative
30-12 services to restore speech or language loss or to correct a speech
30-13 or language impairment if those services or procedures are
30-14 scheduled in the policy;
30-15 (7) a licensed master social worker--advanced clinical
30-16 practitioner to provide the services that fall within the scope of
30-17 the license of such certified practitioner and which are specified
30-18 as services within the terms of the policy of insurance, including
30-19 the provision of direct, diagnostic, preventive, or clinical
30-20 services to individuals, families, and groups whose functioning is
30-21 threatened or affected by social or psychological stress or health
30-22 impairment, if those services or procedures are scheduled in the
30-23 policy;
30-24 (8) a licensed dietitian including a provisional
30-25 licensed dietitian under a licensed dietitian's supervision to
30-26 provide the services that fall within the scope of the license of
30-27 that dietitian if those services are scheduled in the policy;
31-1 (9) a licensed professional counselor to provide the
31-2 services that fall within the scope of the license of that
31-3 professional if those services are scheduled in the policy;
31-4 (10) a licensed marriage and family therapist to
31-5 provide the services that fall within the scope of the license of
31-6 that professional if those services are scheduled in the policy;
31-7 (11) a psychologist to perform the services or
31-8 procedures scheduled in the policy that fall within the scope of
31-9 the license of that psychologist;
31-10 (12) a licensed chemical dependency counselor to
31-11 perform the services or procedures scheduled in the policy that
31-12 fall within the scope of the license of that practitioner;
31-13 (13) [(12)] a licensed acupuncturist to perform the
31-14 services or procedures scheduled in the policy that fall within the
31-15 scope of the license of that practitioner;
31-16 (14) [(13)] an advanced practice nurse to provide the
31-17 services scheduled in the policy that fall within the scope of the
31-18 license of that practitioner;
31-19 (15) [(14)] a physician assistant to provide the
31-20 services scheduled in the policy that fall within the scope of the
31-21 license of that practitioner;
31-22 (16) [(15)] a licensed hearing instrument fitter and
31-23 dispenser to provide the services or procedures scheduled in the
31-24 policy that fall within the scope of the license of that
31-25 practitioner;
31-26 (17) a licensed surgical assistant to provide the
31-27 services or procedures scheduled in the policy that fall within the
32-1 scope of the license of that practitioner; or
32-2 (18) [(16)] a licensed psychological associate to
32-3 provide the services that fall within the scope of the license of
32-4 that professional if those services are scheduled in the policy.
32-5 SECTION 5. (a) Notwithstanding Section 206.201 and
32-6 Subchapter H, Chapter 206, Occupations Code, as added by this Act,
32-7 a person is not required to obtain a license under Chapter 206,
32-8 Occupations Code, as added by this Act, until September 1, 2002.
32-9 (b) The Texas State Board of Medical Examiners shall adopt
32-10 rules under Chapter 206, Occupations Code, as added by this Act,
32-11 not later than January 1, 2002.
32-12 (c) In making the initial appointments to the Board of
32-13 Surgical Assistants, the governor shall designate three members for
32-14 terms expiring February 1, 2003, three members for terms expiring
32-15 February 1, 2005, and three members for terms expiring February 1,
32-16 2007.
32-17 SECTION 6. Section 2, Chapter 397, Acts of the 54th
32-18 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
32-19 Insurance Code), and Article 21.52, Insurance Code, as amended by
32-20 this Act, apply only to an insurance policy, contract, or evidence
32-21 of coverage delivered, issued for delivery, or renewed on or after
32-22 January 1, 2003. A policy, contract, or evidence of coverage
32-23 delivered, issued for delivery, or renewed before January 1, 2003,
32-24 is governed by the law as it existed immediately before the
32-25 effective date of this Act, and that law is continued in effect for
32-26 that purpose.
32-27 SECTION 7. This Act takes effect September 1, 2001.