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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- CERTIFIED SURGICAL FIRST

ASSISTANTS

     

     Introduced By: Representatives Bennett, McGaw, McEntee, Cardillo, Costantino, Serpa,
Hull, Fogarty, Cortvriend, and Edwards

     Date Introduced: January 06, 2023

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS"

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is hereby amended by adding thereto the following chapter:

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CHAPTER 54.1

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CERTIFIED SURGICAL FIRST ASSISTANTS

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     5-54.1-1. Short title.

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     This chapter shall be known and may be cited as "Certified Surgical First Assistants".

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     5-54.1-2. Definitions.

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     For purposes of this chapter, the following terms shall have the following meanings:

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     (1) "Board" means the board of licensure of certified surgical first assistants established

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pursuant to § 5-54.1-5.

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     (2) "Certified surgical first assistant" means an individual who has met the requirements of

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the board of licensure as a certified surgical first assistant and who works under the direct

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supervision of a licensed doctor of medicine, osteopathy, or podiatry.

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     (3) "Department" means the department of health.

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     (4) "Director" means the director of the department of health.

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     (5) "Surgical assisting" means surgical patient care, including, but not limited to, any of

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the following:

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     (i) Manipulation of organs;

 

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     (ii) Suturing of tissue;

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     (iii) Placement of hemostatic agents;

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     (iv) Injection of local anesthetic;

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     (v) Harvesting of veins;

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     (vi) Implementation of devices; and

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     (vii) Other duties as directed by a licensed doctor of medicine, osteopathy, or podiatry.

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     (6) "Surgical facility" means an entity that provides surgical health care services, whether

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inpatient or outpatient and whether overnight or ambulatory, including, but not limited to, a

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hospital, clinic or private office of a health care practitioner, whether conducted for charity or for

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profit.

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     5-54.1-3. Certified surgical first assistants.

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     (a) A surgical facility shall not employ or otherwise retain the services of a surgical

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assistant unless an individual is licensed by the board as a certified surgical first assistant.

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     (b) Notwithstanding subsection (a) of this section, a registered nurse, licensed or registered

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health care provider or other health care practitioner may perform surgical assistant tasks or

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functions if that individual is acting within the scope of licensure.

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     (c) Notwithstanding subsection (a) of this section, a surgical facility may employ as a

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surgical assistant an individual who does not meet the requirements of this section if that individual

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receives a waiver from the department certifying that the individual has met special circumstances

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as determined by the department.

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     5-54.1-4. Board of licensure -- Creation.

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     Within the division of professional regulation established in the department of health

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pursuant to chapter 26 of this title there is a board of licensure for certified surgical first assistant

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as provided by §§ 5-54.1-5 to 5-54.1-6.

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     5-54.1-5. Establishment of the board of licensure.

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     (a) The governor, after consultation with the director of the department of health and with

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the advice and consent of the senate, shall appoint a board to consist of seven (7) members, residents

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of the state, to constitute a board of licensure for certified surgical first assistants with the duties,

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powers, and authority as set forth in § 5-54.1-6, and that board shall be composed of the following:

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     (1) Two (2) members shall be licensed physicians under the provisions of chapter 37 of

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this title who have actively engaged in the practice of surgery;

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     (2) Two (2) members who are representatives of the general public not employed in any

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health-related field; and

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     (3) Three (3) members shall be certified surgical first assistants or health care practitioners

 

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with at least three (3) years of practice in the state involving delivery of medical surgical services.

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     (b) Members shall be appointed for terms of three (3) years each with no member serving

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more than two (2) consecutive terms.

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     (c) In the director's initial appointment, the director shall designate the members of the

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board of licensure for certified surgical first assistants as follows: two (2) members to serve for a

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term of three (3) years; two (2) members to serve for a term of two (2) years; and three (3) members

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to serve for a term of one year. Any additional appointments shall serve for one year.

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     (d) The director may remove any member of the board for cause.

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     (e) Vacancies shall be filled for the unexpired portion of any term in the same manner as

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the original appointment.

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     (f) Members shall serve without compensation, but shall be reimbursed for actual and

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reasonable expenses incurred in the performance of their duties.

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     (g) The board shall elect its own chairperson annually and shall meet at the call of the

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administrator, the chairperson, or upon the request for two (2) or more members of the board.

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     (h) A quorum shall consist of at least four (4) members present.

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     5-54.1-6. Board of licensure -- powers and duties.

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     (a) The board shall administer, coordinate, and enforce the provisions of this chapter;

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evaluate the qualifications of applicants; supervise any examination of applicants deemed

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necessary; recommend to the director the commencement of disciplinary hearings in accordance

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with chapter 35 of title 42 and the provisions of this chapter; and investigate persons engaging in

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practices that violate the provisions of this chapter. This authority shall specifically encompass

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practicing certified surgical first assistants, surgical facilities and those health care agencies

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employing certified surgical first assistants. The board shall investigate all persons and agencies

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engaging in practices that violate the provisions in this chapter.

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     (b) The board shall conduct hearings of a nondisciplinary nature and shall keep the records

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and minutes that are necessary to an orderly dispatch of business.

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     (c) The board, with the approval of the director, shall adopt rules and regulations necessary

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to carry into effect the provisions of this chapter and may amend or repeal them.

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     (d) Regular meetings of the board shall be held at any time and place that the board

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prescribes and special meetings shall be held upon the call of the chairperson; provided that, at least

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one regular meeting is held each year.

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     (e) The conferral or enumeration of specific powers in this chapter shall not be construed

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as a limitation of the general powers conferred by this section.

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     (f) The board shall recommend to the director for registration those persons meeting the

 

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criteria stated by this chapter.

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     (g) The board shall recommend to the director the revocation or suspension of the license

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of any certified surgical first assistant who does not conform to the requirements of this chapter or

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regulations adopted under this chapter.

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     (h) In accordance with its authority under subsection (a) of this section, the board shall

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make recommendations to the director for discipline of supervising surgeons, surgical facilities and

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employing healthcare agencies found wanting in their use of certified surgical first assistants.

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     (i) The board shall approve programs for continuing medical education.

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     5-54.1-7. Criteria for licensure as a certified surgical first assistant.

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     The board shall recommend to the director for licensure as a certified surgical first assistant

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an applicant who:

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     (1) Has completed at least one of the following:

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     (i) A current credential as a surgical assistant or surgical first assistant issued by the

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National Board of Surgical Technology and Surgical Assisting, the National Surgical Assistant

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Association, or the National Commission for Certification of Surgical Assistants or their

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successors;

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     (ii) Successful completion of a surgical assistant training program during the individual’s

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service as a member of any branch of the armed forces of the United States; or

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     (iii) At least one year of experience as a surgical assistant in the state.

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     (2) An application for original license, a license renewal or for the licensing examination

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shall be made on forms approved by the department and accompanied by the appropriate fee as set

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by the department. An application for original license shall be sworn and shall furnish satisfactory

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proof that an applicant is at least eighteen (18) years of age, of good moral character and has met

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the educational and professional experience requirements as set forth in subsection (b) of this

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section.

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     (3) For renewal of license as a certified surgical first assistant, a licensee shall attest to

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having successfully completed thirty-eight (38) hours of continuing education in courses directly

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related to the practice of surgical assisting as approved and documented by a provider recognized

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by one of the following:

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     (i) The National Board of Surgical Technology and Surgical Assisting;

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     (ii) The National Commission for the Certification of Surgical Assistants; or

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     (iii) The National Surgical Assistant Association.

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     (4) A licensee shall retain a completed form with all supporting documentation in the

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licensees' records for a period of four (4) years following the renewal of an active license.

 

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     (5) The board shall periodically conduct a random audit of its active licensees to determine

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compliance and the licensees selected for the audit shall provide all supporting documentation

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within thirty (30) days of receiving notification of the audit.

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     (6) Failure of a licensee to comply with the requirements of this section may subject the

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licensee to disciplinary action by the board.

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     (7) The board, at its discretion, may grant an extension of the deadline for continuing

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education requirements, for up to one year, for good cause shown upon a written request from the

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licensee, prior to the renewal date.

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     (8) The board, at its discretion, may grant an exemption for all or part of the requirements

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for circumstances beyond the control of the licensee, such as temporary disability, mandatory

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military service, or officially declared disasters.

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     5-54.1-8. Grounds for refusal to renew, suspension or revocation of certificates.

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     The director may, after notice and a hearing, refuse to grant, renew, suspend, or revoke any

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certificate of licensure or discipline any registrant upon proof that the person is guilty of

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unprofessional conduct as defined in § 5-54-2.

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     5-54.1-9. Requirements relating to professional conduct.

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     The board shall receive and maintain a confidential file which shall be available to the

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board to precipitate or aid in their investigations. The information shall also be available to licensed

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surgical facilities in connection with the granting of staff privileges and to the individual certified

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surgical first assistants themselves. The file shall contain the following information:

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     (1) Cases of malpractice suits against certified surgical first assistants as reported to the

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board by insurers and self-insurers;

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     (2) Cases of malpractice suits that result in allegations being dropped, a dismissal, a

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settlement, or court judgment or arbitration award adverse to the certified surgical first assistant;

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     (3) Reports by any hospital or state or local professional medical association/society of

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disciplinary action taken against any certified surgical first assistant. These reports should also

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include any resignation of a certified surgical first assistant if related to unprofessional conduct as

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defined in law or any withdrawal of an application for hospital privileges relating to unprofessional

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conduct;

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     (4) Reports by state and federal courts of certified surgical first assistants found guilty of a

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felony;

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     (5) Reports by professional review organizations and third-party health insurers of

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sanctions imposed on a certified surgical first assistant; and

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     (6) Contain any other data that the board by reasonable rule or regulation deems

 

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appropriate.

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     5-54.1-10. Severability.

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     The provisions of this chapter are severable and if any of the provisions of this chapter are

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held unconstitutional by any court of competent jurisdiction, the decision of that court does not

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affect or impair any of the remaining provisions.

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     SECTION 2. This act shall take effect on July 1, 2024.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- CERTIFIED SURGICAL FIRST

ASSISTANTS

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     This act would allow for the licensing of certified surgical first assistants through the

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department of health to assist in surgeries.

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     This act would take effect on July 1, 2024.

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