BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2062
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          Date of Hearing:  April 22, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
               AB 2062 (Roger Hernández) - As Amended:  April 10, 2014
           
          SUBJECT  :  Health facilities: surgical technologists.

           SUMMARY  :  Prohibits a health facility from employing a surgical  
          technologist unless they meet specific training requirements.   
          Specifically,  this bill  :  

          1)Prohibits a health facility from employing a surgical  
            technologist or contracting with an individual to practice  
            surgical technology at the facility unless the individual  
            meets either of the following requirements:

             a)   Meets both of the following requirements:  

               i)     Has successfully completed a nationally accredited  
                 educational program for surgical technologists or a  
                 training program for surgical technology provided by the  
                 U.S. Army, Navy, Air Force, Marine Corps, Coast Guard, or  
                 Public Health Service; and,

               ii)    Holds and maintains certification as a surgical  
                 technologist by the National Board of Surgical Technology  
                 and Surgical Assisting (NBSTSA) or its successor, or from  
                 the National Center for Competency Testing (NCCT) or its  
                 successor.

             b)   Provides evidence that the individual was employed to  
               practice surgical technology in a health facility prior to  
               January 1, 2015.

          2)Requires a health facility, upon the request of another health  
            facility or a surgical technologist who is currently or was  
            formerly employed or contracted with the health facility, to  
            verify the dates of employment of, or contract with, the  
            surgical technologist.

          3)Allows a health facility to employ a surgical technologist or  
            contract with an individual to practice surgical technology  
            during the 12-month period immediately following the  
            individual's completion of an educational or training program,  








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            but that the employment or contract will cease at the end of  
            the 12 months unless the individual becomes certified by the  
            NBSTSA or the NCCT.

          4)Allows a health facility to employ or contract with a surgical  
            technologist who does not meet the requirements in 1) above  
            if, after a diligent and thorough effort has been made to  
            employ or contract with qualified surgical technologists and  
            not enough can be found.  Requires the health facility to make  
            a written record of the efforts and maintain that record at  
            the facility.

          5)Clarifies that the provisions of this bill do not prohibit a  
            licensed health care practitioner from performing tasks that  
            fall within the practice of surgical technology if the  
            individual is acting within the scope of practice of his or  
            her license.

          6)Provides that a violation of these provisions is not subject  
            to health facility licensing provision penalties.

          7)Defines a surgical technologist as an individual who practices  
            surgical technology which is defined as intraoperative  
            surgical patient care at the direction of, or subject to the  
            supervision by, a physician and surgeon, or registered nurse,  
            and includes, among other things, preparing the operating room  
            for surgical procedures by ensuring that surgical equipment is  
            functioning properly and safely, and preparing the operating  
            room and the sterile field for surgical procedures by  
            preparing sterile supplies, instruments, and equipment using  
            sterile techniques.

           EXISTING LAW  :  Provides for the licensure and regulation of  
          healing arts licensees by boards within the Department of  
          Consumer Affairs, including the licensure and regulation of  
          physicians and surgeons by the Medical Board of California, and  
          registered nurses by the Board of Registered Nursing.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal  
          committee.

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  According to the author, surgical  
            technologists are the only member of the surgical team with no  








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            required, mandated minimum level of education, training, or  
            certification.  The author states that surgical technologists  
            are a key member of the surgical team in any operating room  
            responsible for the environmental disinfection, safety, and  
            efficiency and that this is important because surgical site  
            infections (SSIs) significantly drive up health care costs.   
            The author asserts that nationwide, hospital costs are  
            estimated at $20,785 per surgical site infection, accounting  
            for $3.3 billion in total annual U.S. healthcare costs and  
            that this bill will improve patient care safety while lowering  
            health care costs by raising the education and training  
            standards for surgical technologists in California. 

           2)BACKGROUND  .  According to the Centers for Disease Control and  
            Prevention, a SSI is an infection that occurs after surgery in  
            the part of the body where the surgery took place.  SSIs can  
            sometimes be superficial infections involving the skin only.   
            Other SSIs are more serious and can involve tissues under the  
            skin, organs, or implanted material.  Nationwide, about  
            157,500 SSIs occur as a result of inpatient surgery each year.

            Currently eight states have minimum education and  
            certification requirements for surgical technologists:  Idaho,  
            Indiana, Massachusetts, New Jersey, New York, South Carolina,  
            Tennessee, and Texas.  Data from Virginia indicate that  
            facilities utilizing certified surgical technologists reduced  
            the costs associated with extended stays due to SSIs by 11%.

           3)SUPPORT  .  The California State Council of the Service  
            Employees International Union (SEIU California) is the sponsor  
            of this bill and states, currently there are no training or  
            educational standards for surgical technologists in  
            California, and this bill requires a newly hired surgical  
            technologist to attend an accredited training program and  
            obtain a certification from a nationally accredited  
            organization.  SEIU California asserts that an accredited  
            training program gives surgical technologists an unparalleled  
            understanding of how to maintain a sterile field and allows  
            them to anticipate the needs of the surgical team.  SEIU  
            California further argues that accredited training programs  
            and certification along with the experience of the current  
            workforce will contribute to lower the rates of surgical site  
            infections and adverse surgical events, improving patient  
            safety.









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            The Association of Surgical Technologists supports this bill  
            and writes that the surgical technologist is the professional  
            in the operating room charged with the responsibility of  
            maintaining the integrity of the sterile field and preventing  
            surgical site infections and if a surgical technologist holds  
            certification, it means the individual has had extensive  
            didactic education and training in sterile technique.

            The California Labor Federation (CLF) supports this bill,  
            writing that hospitals can help prevent SSIs and other  
            operating room hazards by employing the most skilled and  
            highly-trained surgical technologists available.  CLF furthers  
            argue that the eight states that have minimum standards for  
            surgical technologists have seen a reduction in health care  
            costs due to fewer SSIs and the costs associated with longer  
            hospital stays after surgical infection.

           4)PREVIOUS LEGISLATION  .  AB 2561 (Roger Hernández) of 2012 would  
            have established the Certified Surgical Technologist Act and  
            made it unlawful for a person to use the title "certified  
            surgical technologist" unless the person met certain  
            requirements.  AB 2561 was vetoed by Governor Brown.  He  
            stated in his veto message, "I respect the time and effort  
            that surgical technologists have put into developing their  
            skills and obtaining voluntary certification. Such actions  
            speak well of their professional commitment and desire to  
            advance their careers.  I don't agree, however, that we need  
            to establish 'title protection' for certified surgical  
            technologists in law.  For those who have taken the time to  
            become certified, let the marketplace reward their higher  
            skills and education.  Recognition by the state is not  
            needed."

           REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          California State Council of the Service Employees International  
          Union (sponsor)
          Association of Surgical Technologists
          California Dietetic Association
          California Health Collaborative
          California Labor Federation
          National Board of Surgical Technology and Surgical Assisting
          One individual surgeon








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           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Lara Flynn / HEALTH / (916) 319-2097