OCCUPATIONS CODE
CHAPTER 206. SURGICAL ASSISTANTS
SUBCHAPTER A. GENERAL PROVISIONS
§ 206.001. DEFINITIONS. In this chapter:
(1) "Advisory committee" means the advisory committee
created under this chapter.
(2) "Delegating physician" means a physician who is
licensed by the medical board either as a doctor of medicine or
doctor of osteopathic medicine and who delegates, to a licensed
surgical assistant, surgical assisting and oversees and accepts
responsibility for that surgical assisting.
(3) "Direct supervision" means supervision by a
delegating physician who is physically present and who personally
directs delegated acts and remains immediately available to
personally respond to any emergency until the patient is released
from the operating room or care and has been transferred, as
determined by medical board rule, to another physician.
(4) "Executive director" means the executive director
of the medical board.
(5) "Medical board" means the Texas State Board of
Medical Examiners.
(6) "Surgical assisting" means providing aid under
direct supervision in exposure, hemostasis, and other
intraoperative technical functions that assist a physician in
performing a safe operation with optimal results for the patient,
including the delegated authority to provide local infiltration or
the topical application of a local anesthetic at the operation
site. This term is synonymous with "first assisting."
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.002. APPLICABILITY. (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;
(5) a registered nurse; or
(6) a licensed physician assistant.
(b) This chapter does not affect the authority of a licensed
physician to delegate acts under Subtitle B.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER B. ADVISORY COMMITTEE
§ 206.051. ADVISORY COMMITTEE. (a) The advisory
committee is an informal advisory committee to the medical board
and is not subject to Chapter 2110, Government Code.
(b) The advisory committee has no independent rulemaking
authority.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.052. APPOINTMENT OF ADVISORY COMMITTEE. (a) The
advisory committee consists of six members appointed by the
president of the medical board. One member must be a registered
perioperative nurse with at least five years of clinical experience
as a registered perioperative nurse. Each of the remaining members
must be:
(1) a practicing surgical assistant who has at least
five years of clinical experience as a surgical assistant; or
(2) a physician licensed in this state who supervises
a surgical assistant.
(b) Appointments to the advisory committee shall be made
without regard to the race, color, disability, sex, religion, age,
or national origin of the appointees.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.053. MEMBERSHIP AND EMPLOYEE
RESTRICTIONS. (a) In this section, "Texas trade association"
means a cooperative and voluntarily joined association of business
or professional competitors in this state designed to assist its
members and its industry or profession in dealing with mutual
business or professional problems and in promoting their common
interest.
(b) A person may not be a member of the advisory committee
if:
(1) the person is an officer, employee, or paid
consultant of a Texas trade association in the field of surgical
assisting; or
(2) the person's spouse is an officer, manager, or paid
consultant of a Texas trade association in the field of surgical
assisting.
(c) A person may not be a member of the advisory committee if
the person is required to register as a lobbyist under Chapter 305,
Government Code, because of the person's activities for
compensation on behalf of a profession related to the field of
surgical assisting.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.054. TERMS; VACANCY. (a) Members of the
advisory committee are appointed for two-year terms. The terms of
the members expire on February 1 of each odd-numbered year.
(b) If a vacancy occurs during a member's term, the
president of the medical board shall appoint a new member to fill
the unexpired term.
(c) An advisory committee member may not serve more than two
consecutive full terms.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.055. GROUNDS FOR REMOVAL. (a) It is a ground for
removal from the advisory committee that a member:
(1) does not have at the time of appointment the
qualifications required by Section 206.052;
(2) does not maintain during service on the advisory
committee the qualifications required by Section 206.052;
(3) is ineligible for membership under Section
206.053; or
(4) cannot, because of illness or disability,
discharge the member's duties for a substantial part of the member's
term.
(b) The validity of an action of the committee is not
affected by the fact that it is taken when a ground for removal of a
committee member exists.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.056. OFFICERS. The president of the medical board
shall designate biennially a committee member as the presiding
officer of the advisory committee to serve in that capacity at the
will of the president.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.057. PER DIEM. An advisory committee member is
not entitled to reimbursement for travel expenses or compensation.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.058. MEETINGS. (a) The advisory committee shall
meet as requested by the medical board.
(b) A meeting may be held by telephone conference call.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER C. POWERS AND DUTIES OF MEDICAL BOARD
§ 206.101. GENERAL POWERS AND DUTIES. The medical board
shall:
(1) establish qualifications for a surgical assistant
to practice in this state;
(2) establish requirements for an examination for a
license to practice as a surgical assistant;
(3) establish minimum education and training
requirements necessary for a license to practice as a surgical
assistant;
(4) prescribe the application form for a license to
practice as a surgical assistant; and
(5) develop an approved program of mandatory
continuing education and the manner in which attendance at all
approved courses, clinics, forums, lectures, programs, or seminars
is monitored and recorded.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.102. ANNUAL REPORT. (a) The medical board shall
prepare annually a complete and detailed written report accounting
for all funds received and disbursed by the medical board under this
chapter during the preceding fiscal year.
(b) The annual report must meet the reporting requirements
applicable to financial reporting provided in the General
Appropriations Act.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.103. GIFTS, GRANTS, AND DONATIONS. In addition to
any fees paid to the medical board or money appropriated to the
medical board, the medical board may receive and accept under this
chapter a gift, grant, donation, or other item of value from any
source, including the United States or a private source.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND
INVESTIGATIVE INFORMATION
§ 206.151. PUBLIC PARTICIPATION. (a) The medical
board shall develop and implement policies that provide the public
with a reasonable opportunity to appear before the medical board
and speak on any issue relating to surgical assistants.
(b) The executive director of the medical board shall
prepare and maintain a written plan that describes how a person who
does not speak English may be provided reasonable access to the
medical board's programs and services under this chapter.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.152. PUBLIC INTEREST INFORMATION. (a) The
medical board shall prepare information of public interest
describing the functions of the medical board and the procedures by
which complaints are filed and resolved under this chapter.
(b) The medical board shall make the information available
to the public and appropriate state agencies.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.153. COMPLAINTS. (a) The medical board by rule
shall establish methods by which consumers and service recipients
are notified of the name, mailing address, and telephone number of
the medical board for the purpose of directing complaints about
licensed surgical assistants to the medical board.
(b) The medical board shall list with its regular telephone
number any toll-free telephone number established under other state
law that may be called to present a complaint about a licensed
surgical assistant.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.154. RECORDS OF COMPLAINTS. (a) The medical
board shall maintain a file on each written complaint filed with the
medical board under this chapter. The file must include:
(1) the name of the person who filed the complaint;
(2) the date the complaint is received by the medical
board;
(3) the subject matter of the complaint;
(4) the name of each person contacted in relation to
the complaint;
(5) a summary of the results of the review or
investigation of the complaint; and
(6) an explanation of the reason the file was closed,
if the medical board closed the file without taking action other
than to investigate the complaint.
(b) The medical board shall provide to the person filing the
complaint and to each person who is a subject of the complaint a
copy of the medical board's policies and procedures relating to
complaint investigation and resolution. A person who reports a
complaint by phone shall be given information on how to file a
written complaint.
(c) The medical board, at least quarterly and until final
disposition of the complaint, shall notify the person filing the
complaint and each person who is a subject of the complaint of the
status of the investigation unless the notice would jeopardize an
undercover investigation.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.155. LICENSE HOLDER ACCESS TO COMPLAINT
INFORMATION. (a) The medical board shall provide a license
holder who is the subject of a formal complaint filed under this
chapter with access to all information in its possession that the
medical board intends to offer into evidence in presenting its case
in chief at the contested hearing on the complaint, subject to any
other privilege or restriction established by rule, statute, or
legal precedent. The medical board shall provide the information
not later than the 30th day after receipt of a written request from
the license holder or the license holder's counsel, unless good
cause is shown for delay.
(b) Notwithstanding Subsection (a), the medical board is
not required to provide:
(1) medical board investigative reports;
(2) investigative memoranda;
(3) the identity of a nontestifying complainant;
(4) attorney-client communications;
(5) attorney work product; or
(6) other material covered by a privilege recognized
by the Texas Rules of Civil Procedure or the Texas Rules of
Evidence.
(c) The provision of information does not constitute a
waiver of privilege or confidentiality under this chapter or other
law.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.156. HEALTH CARE ENTITY REQUEST FOR
INFORMATION. On the written request of a health care entity, the
medical board shall provide to the entity:
(1) information about a complaint filed against a
license holder that was resolved after investigation by:
(A) a disciplinary order of the medical board;
or
(B) an agreed settlement; and
(2) the basis of and current status of any complaint
under active investigation that has been referred by the executive
director or the director's designee for legal action.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.157. CONFIDENTIALITY OF INVESTIGATIVE
INFORMATION. A complaint, adverse report, investigation file, or
other report, the identity of and reports made by a physician or
surgical assistant performing or supervising compliance monitoring
for the medical board, or other investigative information in the
possession of or received or gathered by the medical board, medical
board employee or agent relating to a license holder, a license
application, or a criminal investigation or proceeding is
privileged and confidential and is not subject to discovery,
subpoena, or other means of legal compulsion for release to any
person other than the medical board or medical board employee or
agent involved in license holder discipline.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE
INFORMATION. (a) Investigative information in the possession of
the medical board, medical board employee, or agent that relates to
the discipline of a license holder may be disclosed to:
(1) a licensing authority in another state or a
territory or country in which the license holder is licensed or has
applied for a license; or
(2) a peer review committee reviewing:
(A) an application for privileges; or
(B) the qualifications of the license holder with
respect to retaining privileges.
(b) If the investigative information in the possession of
the medical board or a medical board employee or agent indicates a
crime may have been committed, the medical board shall report the
information to the proper law enforcement agency. The medical
board shall cooperate with and assist all law enforcement agencies
conducting criminal investigations of a license holder by providing
information relevant to the investigation. Confidential
information disclosed by the medical board to a law enforcement
agency remains confidential and may not be disclosed by the law
enforcement agency except as necessary to further the
investigation.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.159. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
medical peer review committee in this state, a quality assurance
committee in this state, a surgical assistant, a surgical assistant
student, a physician practicing medicine in this state, or any
person usually present in an operating room, including a nurse or
surgical technologist, shall report relevant information to the
advisory committee related to the acts of a surgical assistant in
this state if, in that person's opinion, a surgical assistant poses
a continuing threat to the public welfare through the person's
practice as a surgical assistant. The duty to report under this
section may not be nullified through contract.
(b) A person who, without malice, furnishes records,
information, or assistance to the advisory committee under this
section is immune from any civil liability arising from that action
in a suit against the person brought by or on behalf of a surgical
assistant who is reported under this section.
(c) Sections 160.002, 160.003, 160.006, 160.007, 160.009,
160.013, and 160.014 apply to medical peer review regarding a
licensed surgical assistant.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER E. LICENSE REQUIREMENTS
§ 206.201. LICENSE REQUIRED. (a) Except as provided
by Section 206.002, a person may not practice as a surgical
assistant unless the person is licensed under this chapter.
(b) Unless the person holds a license under this chapter, a
person may not use, in connection with the person's name:
(1) the title "Licensed Surgical Assistant"; or
(2) any other designation that would imply that the
person is a licensed surgical assistant.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.202. LICENSE APPLICATION. An applicant for a
license must:
(1) file a written application with the medical board
on a form prescribed by the medical board; and
(2) pay the application fee set by the medical board.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.203. LICENSE ELIGIBILITY. (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;
(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 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.
(c) A degree program described by Subsection (b)(2) must
contain a clinical component and must include courses in anatomy,
physiology, basic pharmacology, aseptic techniques, operative
procedures, chemistry, microbiology, and pathophysiology.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.204. EXAMINATION. An applicant for a surgical
assistant license must pass a surgical assistant examination
approved by the medical board. Any written portion of the
examination must be validated by an independent testing
professional.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.205. SPECIAL ELIGIBILITY FOR LICENSE. (a) A
person who is otherwise eligible for a license under Section
206.203 is not required to take the examination required by Section
206.203(b)(1) if the person:
(1) passed a surgical assistant examination required
for certification under Section 206.203(b)(4) that the medical
board determines is substantially equivalent to the examination
required by the medical board under this chapter; and
(2) applies for a license under this section before
September 1, 2002.
(b) A person who is otherwise eligible for a license under
Section 206.203 is not required to meet the educational
requirements under Section 206.203(b)(2) if the person applies for
a license under this section before September 1, 2002, and:
(1) will complete before the third anniversary of the
date the license is issued under this subsection the following
academic courses approved by the medical board:
(A) anatomy;
(B) physiology;
(C) basic pharmacology;
(D) aseptic techniques;
(E) operative procedures;
(F) chemistry; and
(G) microbiology; or
(2) has been continuously certified since September
30, 1995, as a surgical assistant by a national certifying body
approved by the medical board and has practiced full-time as a
surgical assistant under the direct supervision of a physician
licensed in this country.
(c) A license issued under Subsection (b)(1) may not be
renewed after the third anniversary of the date of issuance unless
the license holder completes the academic courses described by
Subsection (b)(1).
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.206. TEMPORARY LICENSE. (a) The medical board
may, through the executive director, issue a temporary license to
an applicant who:
(1) submits an application on a form prescribed by the
medical board;
(2) has passed an examination required by the medical
board relating to the practice of surgical assisting;
(3) pays the appropriate fee set by the medical board;
(4) if licensed in another state, is licensed in good
standing; and
(5) meets all the qualifications for a license under
this chapter and is waiting for the next scheduled meeting of the
medical board for the license to be issued.
(b) A temporary license is valid until the 100th day after
the date issued and may be extended until the 130th day after the
date issued.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.207. ASSISTANCE BY MEDICAL BOARD. The medical
board shall provide administrative and clerical employees as
necessary to administer this subchapter.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.208. FEES. (a) The medical board shall set and
collect fees in amounts that are reasonable and necessary to cover
the costs of administering and enforcing this chapter without the
use of any other funds generated by the medical board.
(b) Fees collected by the medical board under this chapter
shall be deposited by the medical board in the state treasury to the
credit of an account in the general revenue fund and may be spent to
cover the costs of administering and enforcing this chapter. At the
end of each fiscal biennium, the comptroller shall transfer any
surplus money remaining in the account to the general revenue fund.
(c) All money paid to the medical board under this chapter
is subject to Subchapter F, Chapter 404, Government Code.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.209. ISSUANCE AND RENEWAL OF LICENSE. The medical
board shall issue a surgical assistant license in this state to a
person who meets the requirements of this chapter and the rules
adopted under this chapter.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.210. LICENSE RENEWAL. (a) A surgical assistant
license expires on the second anniversary of the date of issuance.
The medical board by rule shall provide for the renewal of a
surgical assistant license.
(b) The medical board by rule may adopt a system under which
licenses expire on various dates during the year. For the year in
which the license expiration date is changed, license fees shall be
prorated on a monthly basis so that each license holder pays only
that portion of the license fee that is allocable to the number of
months during which the license is valid. On renewal of the license
on the new expiration date, the total license renewal fee is
payable.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
Amended by Acts 2003, 78th Leg., ch. 886, § 1, eff. Sept. 1,
2003.
§ 206.211. NOTICE OF LICENSE RENEWAL. At least 30 days
before the expiration of a person's license, the medical board
shall send written notice of the impending license expiration to
the person at the license holder's last known address according to
the records of the medical board.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.212. PROCEDURE FOR RENEWAL. (a) A person who is
otherwise eligible to renew a license may renew an unexpired
license by paying the required renewal fee to the medical board
before the expiration date of the license. A person whose license
has expired may not engage in activities that require a license
until the license has been renewed under this section.
(b) If the person's license has been expired for 90 days or
less, the person may renew the license by paying to the medical
board one and one-half times the required renewal fee.
(c) If the person's license has been expired for longer than
90 days but less than one year, the person may renew the license by
paying to the medical board two times the required renewal fee.
(d) If the person's license has been expired for one year or
longer, the person may not renew the license. The person may obtain
a new license by complying with the requirements and procedures for
obtaining an original license.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.213. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
PRACTITIONER. (a) If the person was licensed as a surgical
assistant in this state, moved to another state, and is currently
licensed as a surgical assistant and has been in practice as a
surgical assistant in the other state for the two years preceding
application, the person may renew an expired surgical assistant
license without reexamination.
(b) The person must pay to the medical board a fee that is
equal to two times the required renewal fee for the license.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.214. LICENSE HOLDER INFORMATION. (a) Each
license holder shall file with the medical board:
(1) the license holder's mailing address;
(2) the address of the license holder's residence;
(3) the mailing address of each of the license holder's
offices; and
(4) the address for the location of each of the license
holder's offices if that address is different from the office's
mailing address.
(b) A license holder shall:
(1) notify the medical board of a change of the license
holder's residence or business address; and
(2) provide the medical board with the license
holder's new address not later than the 30th day after the date the
address change occurs.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER F. SCOPE OF PRACTICE
§ 206.251. SCOPE OF PRACTICE. (a) The practice of a
surgical assistant is limited to surgical assisting performed under
the direct supervision of a physician who delegated the acts.
(b) The practice of a surgical assistant may be performed in
any place authorized by a delegating licensed physician, including
a clinic, hospital, ambulatory surgical center, or other
institutional setting.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.252. SERVICE CONTRACTS. 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;
(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.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.2525. REIMBURSEMENT FOR SERVICES. (a) This
chapter does not limit the way in which a surgical assistant
licensed under this chapter may be reimbursed for services.
(b) A surgical assistant licensed under this chapter may
directly bill a patient or third-party payor for services provided
by the surgical assistant.
Added by Acts 2003, 78th Leg., ch. 886, § 2, eff. Sept. 1, 2003.
§ 206.253. CERTAIN PROHIBITED PRACTICES. (a) This
chapter does not authorize a person who holds a license issued under
this chapter to engage in the practice of:
(1) medicine, as defined by Subtitle B; or
(2) nursing, as defined by Chapter 301.
(b) A health maintenance organization, preferred provider
organization, or health benefit plan may not require a registered
nurse or physician assistant to be licensed as a surgical assistant
as a condition for reimbursement.
(c) A clinic, hospital, ambulatory surgical center, or
other facility may not require a registered nurse or physician
assistant to be licensed as a surgical assistant as a condition for
assisting at surgery at the facility.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
Amended by Acts 2003, 78th Leg., ch. 553, § 2.016, eff. Feb. 1,
2004.
§ 206.254. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
STANDARDS. A surgical assistant and the surgical assistant's
delegating physician shall ensure that:
(1) the surgical assistant's scope of function is
identified;
(2) the delegation of medical tasks is appropriate to
the surgical assistant's level of competence;
(3) the relationship between the surgical assistant
and the delegating physician and the access of the surgical
assistant to the delegating physician are defined; and
(4) a process is established for evaluating the
surgical assistant's performance.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
§ 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL
BOARD. (a) Except as provided by Section 206.305, on a
determination that an applicant or license holder committed an act
described by Section 206.302, 206.303, or 206.304, the medical
board by order shall take any of the following actions:
(1) deny the person's license application or revoke
the person's license;
(2) require the person to submit to the care,
counseling, or treatment of a health care practitioner designated
by the medical board;
(3) stay enforcement of an order and place the person
on probation;
(4) require the person to complete additional
training;
(5) suspend, limit, or restrict the person's license,
including:
(A) limiting the practice of the person to, or
excluding from the person's practice, one or more specified
activities of surgical assisting; or
(B) stipulating periodic medical board review;
(6) assess an administrative penalty against the
person as provided by Section 206.351;
(7) order the person to perform public service; or
(8) administer a public reprimand.
(b) If the medical board stays enforcement of an order and
places a person on probation, the medical board retains the right to
vacate the probationary stay and enforce the original order for
noncompliance with the terms of probation or impose any other
remedial measure or sanction authorized by this section.
(c) The medical board may restore or reissue a license or
remove any disciplinary or corrective measure that the medical
board has imposed.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.302. CONDUCT RELATED TO FRAUD OR
MISREPRESENTATION. The medical board may take action under
Section 206.301 against an applicant or license holder who:
(1) fraudulently or deceptively obtains or attempts to
obtain a license;
(2) fraudulently or deceptively uses a license;
(3) falsely represents that the person is a physician;
(4) acts in an unprofessional or dishonorable manner
that is likely to deceive, defraud, or injure the public;
(5) fraudulently alters any surgical assistant
license, certificate, or diploma;
(6) uses any surgical assistant license, certificate,
or diploma that has been fraudulently purchased, issued, or
counterfeited or that has been materially altered;
(7) directly or indirectly aids or abets the practice
as a surgical assistant by any person not licensed by the medical
board to practice as a surgical assistant; or
(8) unlawfully advertises in a false, misleading, or
deceptive manner as defined by Section 101.201.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.303. CONDUCT RELATED TO VIOLATION OF
LAW. (a) The medical board may take action under Section 206.301
against an applicant or license holder who:
(1) violates this chapter or a rule adopted under this
chapter;
(2) is convicted of a felony, placed on deferred
adjudication, or placed in a pretrial diversion program; or
(3) violates state law if the violation is connected
with practice as a surgical assistant.
(b) A complaint, indictment, or conviction of a law
violation is not necessary for the medical board to act under
Subsection (a)(3). Proof of the commission of the act while in
practice as a surgical assistant or under the guise of practice as a
surgical assistant is sufficient for action by the medical board.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.304. CONDUCT INDICATING LACK OF
FITNESS. (a) The medical board may take action under Section
206.301 against an applicant or license holder who:
(1) habitually uses drugs or intoxicating liquors to
the extent that, in the medical board's opinion, the person cannot
safely perform as a surgical assistant;
(2) has been adjudicated as mentally incompetent;
(3) has a mental or physical condition that renders
the person unable to safely perform as a surgical assistant;
(4) has committed an act of moral turpitude;
(5) has failed to practice as a surgical assistant in
an acceptable manner consistent with public health and welfare;
(6) has had the person's license or other
authorization to practice as a surgical assistant suspended,
revoked, or restricted;
(7) has had other disciplinary action taken by another
state or by the uniformed services of the United States regarding
practice as a surgical assistant;
(8) is removed or suspended or has disciplinary action
taken by the person's peers in any professional association or
society or is being disciplined by a licensed hospital or medical
staff of a hospital, including removal, suspension, limitation of
privileges, or other disciplinary action, if that action, in the
opinion of the medical board, was based on unprofessional conduct
or professional incompetence that was likely to harm the public;
(9) has repeated or recurring meritorious health care
liability claims that, in the medical board's opinion, are evidence
of professional incompetence likely to harm the public; or
(10) sexually abuses or exploits another person during
the license holder's practice as a surgical assistant.
(b) For the purpose of Subsection (a)(7), a certified copy
of the record of the state or uniformed services of the United
States taking the action constitutes conclusive evidence of that
action.
(c) An action described by Subsection (a)(8) does not
constitute state action on the part of the association, society, or
hospital medical staff.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.305. REHABILITATION ORDER. The medical board,
through an agreed order or after a contested case proceeding, may
impose a rehabilitation order on an applicant, as a prerequisite
for issuing a license, or on a license holder based on:
(1) the person's intemperate use of drugs or alcohol
directly resulting from habituation or addiction caused by medical
care or treatment provided by a physician;
(2) the person's intemperate use of drugs or alcohol
during the five years preceding the date of the report that could
adversely affect the person's ability to safely practice as a
surgical assistant, if the person:
(A) reported the use; and
(B) has not previously been the subject of a
substance abuse related order of the medical board;
(3) a judgment by a court that the person is of unsound
mind; or
(4) the results of a mental or physical examination,
or an admission by the person, indicating that the person suffers
from a potentially dangerous limitation or an inability to practice
as a surgical assistant with reasonable skill and safety because of
illness or any other physical or mental condition.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.306. EFFECT OF REHABILITATION ORDER. (a) A
rehabilitation order imposed under Section 206.305 is a
nondisciplinary private order. If entered into by agreement, the
order is an agreed disposition or settlement agreement for purposes
of civil litigation and is exempt from Chapter 552, Government
Code.
(b) The rehabilitation order must contain findings of fact
and conclusions of law. The order may impose a license revocation
or suspension, a period of probation or restriction, or any other
sanction authorized by this chapter or agreed to by the medical
board and the person subject to the order.
(c) A violation of a rehabilitation order may result in
disciplinary action under this chapter or under the terms of the
agreed order.
(d) A violation of a rehabilitation order is grounds for
disciplinary action based on:
(1) unprofessional or dishonorable conduct; or
(2) any provision of this chapter that applies to the
conduct that resulted in the violation.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.307. AUDIT OF REHABILITATION ORDER. (a) The
medical board shall maintain a rehabilitation order imposed under
Section 206.305 in a confidential file. The file is subject to an
independent audit by the state auditor or a private auditor with
whom the board contracts to perform the audit to ensure that only
qualified license holders are subject to rehabilitation orders.
(b) An audit may be performed at any time at the direction of
the medical board. The medical board shall ensure that an audit is
performed at least once in each three-year period.
(c) The audit results are a matter of public record and
shall be reported in a manner that maintains the confidentiality of
each license holder who is the subject of a rehabilitation order.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.308. SUBPOENA. (a) The executive director, the
director's designee, or the secretary-treasurer of the board may
issue a subpoena or subpoena duces tecum:
(1) to conduct an investigation or a contested case
proceeding related to:
(A) alleged misconduct by a surgical assistant;
(B) an alleged violation of this chapter or
another law related to the practice of a surgical assistant; or
(C) the provision of health care under this
chapter;
(2) for purposes of determining whether to issue,
suspend, restrict, or revoke a license under this chapter; or
(3) for purposes of determining whether to issue or
deny a license under this chapter.
(b) Failure to timely comply with a subpoena issued under
this section is a ground for:
(1) disciplinary action by the medical board or
another licensing or regulatory agency with jurisdiction over the
person subject to the subpoena; and
(2) denial of a license application.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.309. PROTECTION OF PATIENT IDENTITY. In a
disciplinary investigation or proceeding conducted under this
chapter, the medical board shall protect the identity of each
patient whose medical records are examined and used in a public
proceeding unless the patient:
(1) testifies in the public proceeding; or
(2) submits a written release in regard to the
patient's records or identity.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.310. RULES FOR DISCIPLINARY PROCEEDINGS. Rules
of practice adopted under this chapter by the medical board under
Section 2001.004, Government Code, applicable to the proceedings
for a disciplinary action may not conflict with rules adopted by the
State Office of Administrative Hearings.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.311. REQUIRED SUSPENSION OF INCARCERATED SURGICAL
ASSISTANT. Regardless of the offense, the medical board shall
suspend the license of a surgical assistant serving a prison term in
a state or federal penitentiary during the term of the
incarceration.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
§ 206.312. TEMPORARY SUSPENSION. (a) The president of
the medical board, with medical board approval, shall appoint a
three-member disciplinary panel consisting of medical board
members to determine whether a surgical assistant's license should
be temporarily suspended.
(b) If the disciplinary panel determines from the evidence
or information presented to the panel that a person licensed to
practice as a surgical assistant would, by the person's
continuation in practice, constitute a continuing threat to the
public welfare, the disciplinary panel shall temporarily suspend
the license of that person.
(c) A license may be suspended under this section without
notice or hearing on the complaint if:
(1) institution of proceedings for a hearing before
the medical board is initiated simultaneously with the temporary
suspension; and
(2) a hearing is held under Chapter 2001, Government
Code, and this chapter as soon as possible.
(d) Notwithstanding Chapter 551, Government Code, the
disciplinary panel may hold a meeting by telephone conference call
if immediate action is required and convening the disciplinary
panel at one location is inconvenient for any member of the panel.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
SUBCHAPTER H. ADMINISTRATIVE PENALTY
§ 206.351. ADMINISTRATIVE PENALTY. (a) The medical
board by order may impose an administrative penalty against a
person licensed under this chapter who violates this chapter or a
rule or order adopted under this chapter.
(b) The penalty may be in an amount not to exceed $5,000.
Each day a violation continues or occurs is a separate violation for
purposes of imposing a penalty.
(c) The medical board shall base the amount of the penalty
on:
(1) the severity of patient harm;
(2) the severity of economic harm to any person;
(3) the severity of any environmental harm;
(4) the increased potential for harm to the public;
(5) any attempted concealment of misconduct;
(6) any premeditated or intentional misconduct;
(7) the motive for the violation;
(8) any prior misconduct of a similar or related
nature;
(9) the license holder's disciplinary history;
(10) any prior written warnings or written
admonishments from any government agency or official regarding
statutes or rules relating to the misconduct;
(11) whether the violation is of a board order;
(12) the person's failure to implement remedial
measures to correct or mitigate harm from the misconduct;
(13) the person's lack of rehabilitative potential or
likelihood of future misconduct of a similar nature;
(14) any relevant circumstances increasing the
seriousness of the misconduct; and
(15) any other matter that justice may require.
(d) The medical board by rule shall prescribe the procedures
by which it may impose an administrative penalty. A proceeding
under this section is subject to Chapter 2001, Government Code.
(e) If the medical board by order determines that a
violation has occurred and imposes an administrative penalty, the
medical board shall give notice to the person of the order. The
notice must include a statement of the person's right to judicial
review of the order.
Added by Acts 2001, 77th Leg., ch. 1014, § 1, eff. Sept. 1, 2001.
