TITLE 22.EXAMINING BOARDS

Part 9. TEXAS STATE BOARD OF MEDICAL EXAMINERS

Chapter 184. SURGICAL ASSISTANTS

22 TAC §184.4

The Texas State Board of Medical Examiners proposes new §184.4 concerning Surgical Assistants. The new section is proposed as a result of House Bill 1183 of the 77th Legislature requiring the board to license and regulate surgical assistants.

Elsewhere in this issue of the Texas Register the Texas State Board of Medical Examiners has withdrawn the previously proposed version of §184.4, which appeared in the April 19, 2002, issue of the Texas Register (27 TexReg 3300). The new section is simultaneously proposed on an emergency basis elsewhere in this issue of the Texas Register .

Michele Shackelford, General Counsel, Texas State Board of Medical Examiners, has determined that for the first five-year period the section is in effect there will be fiscal implications to state or local government as a result of enforcing the rule as proposed. The Fiscal impact to those individuals required to comply is as follows: $300 for processing licensure application and $200 for annual renewal. Revenue to state: FY02 estimated at 500 applications x $300 = $150,000; FY03 estimated at 500 renewals x $200 = $100,000 + new applications which we are unable to estimate at this time.

Ms. Shackelford also has determined that for each year of the first five years the section as proposed are in effect the public benefit anticipated as a result of enforcing the section will be the licensing and regulation of surgical assistants. There will be no effect on small businesses. There will be no effect to individuals required to comply with the section as proposed.

Comments on the proposal may be submitted to Pat Wood, P.O. Box 2018, MC-901, Austin, Texas 78768-2018. A public hearing will be held at a later date.

The new section is proposed under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

The following are affected by the proposed new rule: Title 3, Subtitle C, Texas Occupations Code Annotated Chapter 206.

§184.4.Qualifications for Licensure.

(a) Except as otherwise provided in this section, an individual applying for licensure must:

(1) submit an application on forms approved by the board;

(2) pay the appropriate application fee;

(3) certify that the applicant is mentally and physically able to function safely as a surgical assistant;

(4) not have a license, certification, or registration in this state or from any other licensing authority or certifying professional organization that is currently revoked, suspended, or subject to probation or other disciplinary action for cause;

(5) have no proceedings that have been instituted against the applicant for the restriction, cancellation, suspension, or revocation of certificate, license, or authority to practice surgical assisting in the state, Canadian province, or uniformed service of the United States in which it was issued;

(6) have no prosecution pending against the applicant in any state, federal, or Canadian court for any offense that under the laws of this state is a felony;

(7) be of good moral character;

(8) not have been convicted of a felony or a crime involving moral turpitude;

(9) not use drugs or alcohol to an extent that affects the applicant's professional competency;

(10) not have engaged in fraud or deceit in applying for a license;

(11) pass an independently evaluated surgical assistant examination approved by the board;

(12) have been awarded at least an associate's degree at a two or four year institution of higher education;

(13) have successfully completed an educational program in surgical assisting or a substantially equivalent educational program as outlined in subparagraphs (A) and (B) of this paragraph;

(A) A surgical assistant program or a substantially equivalent program is limited to the following:

(i) a surgical assistant program approved by the board. After September 1, 2003, applicants who wish the board to recognize their education and training at a surgical assistant program must demonstrate that the program is in compliance with the guidelines for program accreditation established by Commission on Accreditation of Allied Health Education Programs (CAAHEP);

(ii) a medical school whereby the applicant can verify completion of basic and clinical sciences coursework;

(iii) a registered nurse first assistant program acceptable to the board; and

(iv) an accredited surgical physician assistant program acceptable to the board.

(B) The curriculum of a surgical assisting educational program must include at a minimum, either as a part of that curriculum or as a required prerequisite, successful completion of college level instruction in the following courses, with the exception that clauses (iv) and (v) of this subparagraph are not required to be college level instruction:

(i) anatomy;

(ii) physiology;

(iii) basic pharmacology;

(iv) aseptic techniques;

(v) operative procedures;

(vi) chemistry;

(vii) microbiology;

(viii) pathophysiology;

(ix) clinical service rotations, that either:

(I) are each at least 80 hours in length, in the following areas:

(-a-) cardiovascular surgery;

(-b-) trauma surgery;

(-c-) general surgery;

(-d-) obstetrics and gynecology;

(-e-) orthopedics;

(-f-) pediatrics or an elective if the applicant affirms that he or she has no intent to work as a surgical assistant for pediatric surgery; or

(II) meet the CAAHEP's supervised clinical preceptorship guidelines.

(14) demonstrate to the satisfaction of the board the completion of full-time work experience performed in the United States under the direct supervision of a physician licensed in the United States consisting of at least 2,000 hours of performance as an assistant in surgical procedures for the three years preceding the date of the application;

(15) be currently certified by a national certifying board approved by the board; and

(16) submit to the board any other information the board considers necessary to evaluate the applicant's qualifications.

(b) An applicant who submits an application before September 1, 2002 must provide documentation that the applicant has passed an examination required for certification by one of the following certifying boards:

(1) American Board of Surgical Assistants;

(2) Liaison Council on Certification for the Surgical Technologist (LCC-ST); or

(3) National Surgical Assistant Association.

(c) An applicant who submits an application before September 1, 2002 and is unable to meet the educational requirements set out in subsection (a)(12) and (13) of this section must also provide documentation that the applicant:

(1) will complete before the third anniversary of the date the license is issued under this chapter the following academic courses approved by the board:

(A) anatomy;

(B) physiology;

(C) basic pharmacology;

(D) aseptic techniques;

(E) operative procedures;

(F) chemistry; and

(G) microbiology; or

(2) since September 30, 1995, has practiced full-time as a surgical assistant in the United States under the direct supervision of a physician licensed in the United States and has continuously been certified as a surgical assistant by one of the following national certifying boards:

(A) American Board of Surgical Assistants;

(B) Liaison Council on Certification for the Surgical Technologist (LCC-ST); or

(C) National Surgical Assistant Association.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 29, 2002.

TRD-200203336

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Earliest possible date of adoption: July 14, 2002

For further information, please call: (512) 305-7016


Part 10. TEXAS FUNERAL SERVICE COMMISSION

Chapter 201. LICENSING AND ENFORCEMENT--PRACTICE AND PROCEDURE

22 TAC §201.3

The Texas Funeral Service Commission (Commission) proposes new §201.3, concerning Expiration Dates for Licenses and Registrations.

The Commission proposes a new section to set expiration dates for licenses and registrations and to prescribe penalties.

O.C. Robbins, Executive Director, has determined that for the first five year period this section is in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the section. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the proposed section.

Mr. Robbins has also determined that for the first five year period this section is in effect, the public benefit will be clarification of license expiration and license renewal information for licensees.

Comments on the proposal may be submitted in writing for a 30 day period to O.C. Robbins, Executive Director, Texas Funeral Service Commission, P.O. Box 12217 Capitol Station, Austin, Texas 78711-1440, (512) 479-5064 (fax), or chet.robbins@tfsc.state.tx.us. The staff will be available on the third Thursday of the 30 day period after publication to hold a public hearing for anyone wishing to make comments on the proposed new section.

The new section is proposed under Section 651.152 of the Texas Occupations Code which authorizes the Commission to issue such rules and regulations as may be necessary to effect the provisions of this Section.

No other statutes, articles or codes are affected by the proposed new rule.

§201.3.Expiration Dates for Licenses and Registrations.

(a) Funeral Establishment and Commercial Embalming Establishment License: The term of this license is one year expiring on September 30.

(b) Cemetery and Crematory Registration: The term of this registration is one year expiring on March 31.

(c) Provisional license: The term of this license is one year expiring on January 2.

(d) Individual funeral director, embalmer, or dual license: The term of this license is expiring on May 31 or November 30. The Commission may issue an initial interim license for no more than six months covering the period from the date of cancellation of a provisional license to the following May 31 or November 30.

(e) Licensees and registrants are responsible for the timely renewal of their licenses and registrations.

(f) A license or registration that is not renewed on or before the renewal is subject to a late renewal penalty.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 30, 2002.

TRD-200203345

O.C. "Chet" Robbins

Executive Director

Texas Funeral Service Commission

Earliest possible date of adoption: July 14, 2002

For further information, please call: (512) 936-2466


Chapter 203. LICENSING AND ENFORCEMENT--SPECIFIC SUBSTANTIVE RULES

22 TAC §203.24

The Texas Funeral Service Commission (Commission) proposes an amendment to §203.24, concerning Unprofessional Conduct.

The Commission proposes this amendment to include additional definitions of unprofessional conduct, including interfering with a complainant or witness and exhibiting disrespect for the dead.

O.C. Robbins, Executive Director, has determined that for the first five year period this section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. There is no anticipated economic cost to persons who are required to comply with the proposed section, beyond what is already required under the existing rule.

Mr. Robbins has also determined that for the first five year period this section is in effect the public benefit will be the protection of complainants, witnesses, or both, from harassment, threat, or retaliation by licensees. There will be no effect on small businesses.

Comments on the proposal may be submitted in writing for a 30 day period to O.C. Robbins, Executive Director, Texas Funeral Service Commission, P.O. Box 12217 Capitol Station, Austin, Texas 78711-1440, (512) 479-5064 (fax), or chet.robbins@tfsc.state.tx.us. The staff will be available on the third Thursday of the 30 day period after publication to hold a public hearing for anyone wishing to make comments.

The amendment is proposed under Section 651.152 of the Texas Occupations Code which authorizes the Commission to issue such rules and regulations as may be necessary to effect the provision of this Section.

No other statutes, articles or codes are affected by the proposed amendment.

§203.24.Unprofessional Conduct.

(a) (No change.)

(b) For the purpose of this section, unprofessional conduct shall include but not be limited to:

(1)-(9) (No change.)

(10) attempting to influence the outcome of any investigation or adjudicatory proceeding of or against a licensee by directly communicating with a member of the Board of Commissioners prior to the final disposition of the complaint;

(11) attempting to influence a complainant or witness in any complaint case to change the nature of the complaint, or withdraw the complaint by means of coercion, harassment, bribery, or by force, or threat of force; et

(12) retaliating or threatening to retaliate against a complainant who has filed a complaint with the Commission in good faith;

(13) exhibiting disrespect for dead human bodies in violation of any Texas law governing the transportation, storage, refrigeration, interment, or disinterment of the dead.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 30, 2002.

TRD-200203346

O.C. "Chet" Robbins

Executive Director

Texas Funeral Service Commission

Earliest possible date of adoption: July 14, 2002

For further information, please call: (512) 936-2466


22 TAC §203.27

The Texas Funeral Service Commission (Commission) proposes an amendment to §203.27, concerning Sponsors of Provisional Licensees.

The Commission proposes an amendment to establish the requirement that a licensed embalmer or funeral director be physically present in the room with the provisional licensee and in view of the work performed during the course of the work performed by the provisional licensee and to clarify additional duties of sponsors of provisional licensees.

O.C. Robbins, Executive Director, Texas Funeral Service Commission, has determined that for the first five-year period this section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section.

Mr. Robbins has also determined that for the first five year period this section is in effect the public benefit will be clarification of new license requirements for those operating establishments. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the proposed section.

Comments on the proposal may be submitted in writing for a 30 day period to O.C. Robbins, Executive Director, Texas Funeral Service Commission, P.O. Box 12217, Capitol Station, Austin, Texas 78711-1440, (512) 479-5064 (fax), or chet.robbins@tfsc.state.tx.us. The staff will be available on the third Thursday of the 30 day period after publication to hold a public hearing for anyone wishing to make comments on the proposed amendment to this section.

The amendment is proposed under §651.152 of the Texas Occupations Code which authorizes the Commission to issue such rules and regulations as may be necessary to effect the provisions of this section.

No other statutes, articles or codes are affected by the proposed amendment.

§203.27.Sponsors of Provisional Licensees.

(a) - (b) (No change.)

(c) A sponsor shall ensure that direct personal supervision of a provisional licensee is provided in order to provide firsthand and factual documentation of work accomplished by the provisional licensee on each case report submitted. The term personal supervision as used in Texas Occupations Code §§651.251, 651.301, 651.303, and 651.306 requires a licensed embalmer or funeral director to be physically present in the room with the provisional licensee and in view of the work performed during the course of the work performed by the provisional licensee.

(d) - (f) (No change.)

(g) Any time that a Provisional Licensee leaves the establishment listed as the licensee's place of employment, it is the responsibility of the Sponsor to notify the Commission within 15 days in writing that the provisional licensee is no longer under sponsorship or receiving personal supervision from the establishment's licensed personnel.

(h) All documents pertaining to case reports and funeral purchase agreements either submitted for credit by the provisional licensee or in which the provisional participated in any procedure must be retained for 2 years by the establishment and must be produced upon request by the Commission.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 30, 2002.

TRD-200203347

O.C. "Chet" Robbins

Executive Director

Texas Funeral Service Commission

Earliest possible date of adoption: July 14, 2002

For further information, please call: (512) 936-2466


22 TAC §203.28

The Texas Funeral Service Commission (Commission) proposes an amendment to §203.28, concerning Establishment Licenses.

The Commission proposes this amendment to set forth application requirements for a new establishment license.

O.C. Robbins, Executive Director, has determined that for the first five year period this section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section.

Mr. Robbins has also determined that for the first five year period this section is in effect the public benefit will be clarification of new license requirements for those operating establishments. There will be no effect on small businesses. There is no anticipated economic cost to persons who are required to comply with the proposed section, beyond what is already required under the existing rule.

Comments on the proposal may be submitted in writing for a 30 day period to O.C. Robbins, Executive Director, Texas Funeral Service Commission, P.O. Box 12217 Capitol Station, Austin, Texas 78711-1440, (512) 479-5064 (fax), or chet.robbins@tfsc.state.tx.us. The staff will be available on the third Thursday of the 30 day period following publication to hold a public hearing for anyone wishing to make comments.

The amendment is proposed under §651.152 of the Texas Occupations Code which authorizes the Commission to issue such rules and regulations as may be necessary to effect the provision of this section.

No other statutes, articles or codes are affected by the proposed amendment.

§203.28.Establishment Licenses.

(a) - (c) (No change.)

(d) An application for an establishment license has three elements: name, owner, and location. If any element changes during the license period, a new application must be submitted. A new establishment license fee must be remitted before issuance of the new license.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on May 30, 2002.

TRD-200203348

O.C. "Chet" Robbins

Executive Director

Texas Funeral Service Commission

Earliest possible date of adoption: July 14, 2002

For further information, please call: (512) 936-2466