86R5044 KKR-D
 
  By: Sheffield H.B. No. 4412
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the licensing and regulation of surgical assistants.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 206.002(a), Occupations Code, is amended
  to read as follows:
         (a)  A person is not required to hold a license under this
  chapter if the person is:
               (1)  a student enrolled in a surgical assistant
  education program approved by the medical board who is assisting in
  a surgical operation that is an integral part of the program of
  study;
               (2)  a surgical assistant employed in the service of
  the federal government while performing duties related to that
  employment;
               (3)  [a person acting under the delegated authority of
  a licensed physician;
               [(4)]  a licensed health care worker acting within the
  scope of the person's license;
               (4) [(5)]  a registered nurse; or
               (5) [(6)]  a licensed physician assistant.
         SECTION 2.  Section 206.052(a), Occupations Code, is amended
  to read as follows:
         (a)  The advisory committee consists of five [six] members
  appointed by the president of the medical board as follows:
               (1)  one[. One member must be a] registered
  perioperative nurse with at least five years of clinical experience
  as a registered perioperative nurse;
               (2)  three licensed[. Each of the remaining members
  must be:
               [(1)  a] practicing surgical assistants [assistant]
  who have [has] at least five years of clinical experience as a
  surgical assistant; and
               (3)  one [or
               [(2)  a] physician licensed in this state who
  supervises a surgical assistant.
         SECTION 3.  Section 206.056, Occupations Code, is amended to
  read as follows:
         Sec. 206.056.  OFFICERS. The president of the medical board
  shall designate biennially a committee member who is a licensed
  surgical assistant as the presiding officer of the advisory
  committee to serve in that capacity at the will of the president.
         SECTION 4.  Section 206.058(a), Occupations Code, is amended
  to read as follows:
         (a)  The advisory committee shall meet at the call of the
  presiding officer [as requested by the medical board].
         SECTION 5.  Section 206.203, Occupations Code, is amended by
  amending Subsections (a) and (b) and adding Subsection (d) to read
  as follows:
         (a)  Except as provided by Section 206.206, to be eligible
  for a license, a person must:
               (1)  [be of good moral character;
               [(2)     have not been convicted of a felony or a crime
  involving moral turpitude;
               [(3)]  not use drugs or alcohol to an extent that
  affects the applicant's professional competency; and
               (2) [(4)]  not have had a license or certification
  revoked by a licensing agency or by a certifying professional
  organization[; and
               [(5)     not have engaged in fraud or deceit in applying
  for a license under this chapter].
         (b)  In addition to meeting the requirements of Subsection
  (a), a person must:
               (1)  pass the examination required by Section 206.204;
               (2)  hold at least an associate's degree based on
  completion of an educational program that is substantially
  equivalent to the education required for a registered nurse or
  physician assistant who specializes in surgical assisting;
               (3)  demonstrate to the satisfaction of the medical
  board the completion of full-time work experience performed in this
  country under the direct supervision of a physician licensed in
  this country and consisting of at least 1,000 [2,000] hours of
  performance as an assistant in surgical procedures [for the three
  years preceding the date of application]; and
               (4)  possess a current certification by a national
  certifying body approved by the medical board.
         (d)  Clinical hours completed by a person under an
  educational program described by Subsection (b)(2) apply toward the
  1,000 hours required under Subsection (b)(3) if the person
  successfully completed the program. The medical board shall adopt
  rules regarding the evaluation and verification of hours completed
  under this subsection.
         SECTION 6.  Subchapter E, Chapter 206, Occupations Code, is
  amended by adding Sections 206.2031, 206.2051, and 206.2131 to read
  as follows:
         Sec. 206.2031.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
  require that an applicant for a license under this chapter submit a
  complete and legible set of fingerprints, on a form prescribed by
  the medical board, to the medical board or to the Department of
  Public Safety for the purpose of obtaining criminal history record
  information from the Department of Public Safety and the Federal
  Bureau of Investigation.
         (b)  The medical board may not issue a license to a person who
  does not comply with the requirement of Subsection (a).
         (c)  The medical board shall conduct a criminal history
  record information check of each applicant for a license using
  information:
               (1)  provided by the individual under this section; and
               (2)  made available to the medical board by the
  Department of Public Safety, the Federal Bureau of Investigation,
  and any other criminal justice agency under Chapter 411, Government
  Code.
         (d)  The medical board may:
               (1)  enter into an agreement with the Department of
  Public Safety to administer a criminal history record information
  check required under this section; and
               (2)  authorize the Department of Public Safety to
  collect from each applicant the costs incurred by the Department of
  Public Safety in conducting the criminal history record information
  check.
         Sec. 206.2051.  ALTERNATIVE ELIGIBILITY FOR LICENSE. (a) A
  person who does not meet the requirements of Section 206.203(b) is
  eligible for a license if the person:
               (1)  applies for a license before December 1, 2022; and
               (2)  completes the full-time work experience described
  by Subsection (b). 
         (b)  A person satisfies the requirement of Subsection (a)(2)
  if the person demonstrates to the satisfaction of the medical board
  that the person has full-time work experience performed in this
  country under the direct supervision of a physician licensed in
  this country consisting of:
               (1)  at least 1,000 hours of performance as a first
  assistant in surgical procedures completed after August 31, 2015;
  or
               (2)  subject to Subsection (c), less than 1,000 hours
  of performance as a first assistant in surgical procedures
  completed after August 31, 2015.
         (c)  A person who qualifies for the issuance of a license
  based on experience described by Subsection (b)(2) may not renew
  the license unless the person demonstrates to the satisfaction of
  the medical board that at the time of renewal the person has
  full-time work experience performed in this country under the
  direct supervision of a physician licensed in this country
  consisting of at least 1,000 hours of performance as a first
  assistant in surgical procedures.
         Sec. 206.2131.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
  issued under this chapter shall submit a complete and legible set of
  fingerprints for purposes of performing a criminal history record
  information check of the applicant as provided by Section 206.2031.
         (b)  The medical board may administratively suspend or
  refuse to renew the license of a person who does not comply with the
  requirement of Subsection (a).
         (c)  A license holder is not required to submit fingerprints
  under this section for the renewal of the license if the holder has
  previously submitted fingerprints under:
               (1)  Section 206.2031 for the initial issuance of the
  license; or
               (2)  this section as part of a prior renewal of a
  license.
         SECTION 7.  Section 206.252, Occupations Code, is amended to
  read as follows:
         Sec. 206.252.  SERVICE CONTRACTS. (a) This chapter does
  not:
               (1)  limit the employment arrangement of a surgical
  assistant licensed under this chapter;
               (2)  require a surgeon or hospital to contract with a
  surgical assistant; or
               (3)  authorize a health maintenance organization,
  preferred provider organization, or health benefit plan to require
  a surgeon to contract with a surgical assistant[; or
               [(4)     require a hospital to use a licensed surgical
  assistant for surgical assisting].
         (b)  A hospital licensed under Chapter 241, Health and Safety
  Code, or an ambulatory surgical center licensed under Chapter 243,
  Health and Safety Code, shall use a licensed surgical assistant for
  surgical assisting.
         SECTION 8.  Sections 206.203(c) and 206.205, Occupations
  Code, are repealed.
         SECTION 9.  Section 206.052(a), Occupations Code, as amended
  by this Act, applies only to a member of the advisory committee
  appointed on or after the effective date of this Act. A member
  appointed before the effective date of this Act may continue to
  serve until the expiration of the member's term. As vacancies occur
  on the advisory committee on and after the effective date of this
  Act, the president of the Texas Medical Board shall appoint members
  having the qualifications required by the changes in law made by
  this Act.
         SECTION 10.  Section 206.203, Occupations Code, as amended
  by this Act, and Sections 206.2031, 206.2051, and 206.2131,
  Occupations Code, as added by this Act, apply only to an application
  for the issuance or renewal of a license submitted to the Texas
  Medical Board on or after the effective date of this Act.  An
  application submitted before the effective date of this Act is
  governed by the law in effect on the date the application was
  submitted, and the former law is continued in effect for that
  purpose.
         SECTION 11.  Notwithstanding Section 206.252, Occupations
  Code, as amended by this Act, a hospital or ambulatory surgical
  center is not required to use a surgical assistant licensed under
  Chapter 206, Occupations Code, before January 1, 2021.
         SECTION 12.  Not later than September 1, 2021, the Texas
  Medical Board shall obtain criminal history record information on
  each person who, on the effective date of this Act, holds a license
  issued under Chapter 206, Occupations Code, and did not undergo a
  criminal history record information check based on the license
  holder's fingerprints on the initial application for the license.  
  The Texas Medical Board may suspend the license of a license holder
  who does not provide the criminal history record information as
  required by the board and this section.
         SECTION 13.  Not later than December 1, 2020, the Texas
  Medical Board shall adopt rules necessary to implement the changes
  in law made by this Act to Chapter 206, Occupations Code.
         SECTION 14.  This Act takes effect July 1, 2019, if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.  
  If this Act does not receive the vote necessary for effect on that
  date, this Act takes effect September 1, 2019.