A BILL TO BE ENTITLED
AN ACT establishing standards for surgical technology care in hospitals and ambulatory surgical facilities.
The General Assembly of North Carolina enacts:
SECTION 1. Part 2 of Article 5 of Chapter 131E of the General Statutes is amended by adding a new section to read: 
"§ 131E‑79.3.  Hospital standards for surgical technology care.
(a)	Definitions. – The following definitions apply in this section:
(1)	Surgical technologist. – An individual who is employed or contracted by a hospital to perform surgical technology tasks and functions.
(2)	Surgical technology. – Surgical patient care that includes the following tasks or functions:
a.	Preparing the operating room and the sterile field for surgical procedures by ensuring that surgical equipment is functioning properly and safely and preparing sterile supplies, instruments, and equipment using sterile technique.
b.	As directed, performing tasks at the sterile field, including the following:
(1)	Maintaining asepsis and correcting breaks in the sterile field.
(2)	Passing supplies, equipment, or instruments according to the needs of the surgical team.
(3)	Sponging or suctioning an operative site.
(4)	Preparing and cutting suture material.
(5)	Transferring and irrigating with fluids.
(6)	Transferring but not administering drugs within the sterile field.
(7)	Handling specimens.
(8)	Holding retractors and other instruments.
(9)	Applying electrocautery to clamps on bleeders.
(10)	Connecting drains to suction apparatus.
(11)	Applying dressings to closed wounds.
(12)	Performing sponge, needle, supply, and instrument counts with the registered nurse circulator.
(b)	Except as provided in subsection (f) of this section, a hospital shall not employ or otherwise contract for the services of a surgical technologist in that hospital unless the individual meets at least one of the following qualifications:
(1)	Has successfully completed a program accredited by the Commission on Accreditation of Allied Health Education Programs or other nationally accredited educational program for surgical technologists and holds and maintains the Certified Surgical Technologist credential administered by the National Board of Surgical Technology and Surgical Assisting or its successor.
(2)	Has successfully completed an appropriate training program for surgical technology in the United States Army, Navy, Air Force, Marine Corps, or Coast Guard or in the United States Public Health Service.
(3)	Provides evidence that the individual meets either of the following requirements:
a.	Was employed to practice surgical technology in a hospital licensed under this Part or an ambulatory surgical facility licensed under Part 4 of Article 6 of this Chapter on December 31, 2017.
b.	Was employed to practice surgical technology during the two years immediately preceding December 31, 2017.
(4)	Is in the service of the federal government, to the extent the individual is performing duties related to that service.
(c)	A hospital may employ or contract with an individual to practice surgical technology during the 12‑month period immediately following successful completion of a surgical technology program described in subdivision (1) of subsection (b) of this section but may not continue to employ or contract with that individual beyond this initial 12‑month period without documentation that the employee or contractor holds and maintains the certified surgical technologist credential described in subdivision (1) of subsection (b) of this section.
(d)	A hospital may employ or contract with an individual who qualifies to practice surgical technology pursuant to subdivision (2) or (3) of subsection (b) of this section as long as that individual annually completes 15 hours of continuing education approved by the National Board of Surgical Technology and Surgical Assisting or its successor.
(e)	A hospital that employs or contracts with an individual to practice surgical technology shall verify that the individual meets the continuing education requirements of subsection (d) of this section or, if applicable, that the individual holds and maintains the Certified Surgical Technologist credential described in subdivision (1) of subsection (b) of this section.
(f)	A hospital may employ or otherwise contract with an individual who does not meet any of the qualifications specified in subsection (b) of this section if both of the following requirements are met:
(1)	The hospital makes a diligent and thorough effort, but was unable to employ or contract with a sufficient number of qualified surgical technologists who meet the requirements of this section.
(2)	The hospital makes and retains, at the hospital, a written record of its effort under subdivision (1) of this subsection.
(g)	Nothing in this section shall be construed to prohibit a licensed practitioner from performing surgical technology tasks or functions if the practitioner is acting within the scope of his or her license.
(h)	The Department of Health and Human Services may take adverse action against a hospital under G.S. 131E‑78 for a violation of this section."
SECTION 2.  Part 4 of Article 6 of Chapter 131E of the General Statutes is amended by adding a new section to read:
"§ 131E‑147.10.  Ambulatory surgical facility standards for surgical technology care.
(a)	Definitions. – The following definitions apply in this section:
(1)	Surgical technologist. – An individual who is employed or contracted by an ambulatory surgical facility to perform surgical technology tasks and functions.
(2)	Surgical technology. – Surgical patient care that includes the following tasks or functions:
a.	Preparing the operating room and the sterile field for surgical procedures by ensuring that surgical equipment is functioning properly and safely and preparing sterile supplies, instruments, and equipment using sterile technique.
b.	As directed, performing tasks at the sterile field, including the following:
(1)	Maintaining asepsis and correcting breaks in the sterile field.
(2)	Passing supplies, equipment, or instruments according to the needs of the surgical team.
(3)	Sponging or suctioning an operative site.
(4)	Preparing and cutting suture material.
(5)	Transferring and irrigating with fluids. 
(6)	Transferring but not administering drugs within the sterile field.
(7)	Handling specimens.
(8)	Holding retractors and other instruments.
(9)	Applying electrocautery to clamps on bleeders.
(10)	Connecting drains to suction apparatus.
(11)	Applying dressings to closed wounds.
(12)	Performing sponge, needle, supply, and instrument counts with the registered nurse circulator.
(b)	Except as provided in subsection (f) of this section, an ambulatory surgical facility shall not employ or otherwise contract for the services of a surgical technologist in that facility unless the individual meets at least one of the following qualifications:
(1)	Has successfully completed a program accredited by the Commission on Accreditation of Allied Health Education Programs or other nationally accredited educational program for surgical technologists and holds and maintains the Certified Surgical Technologist credential administered by the National Board of Surgical Technology and Surgical Assisting or its successor.
(2)	Has successfully completed an appropriate training program for surgical technology in the United States Army, Navy, Air Force, Marine Corps, or Coast Guard or in the United States Public Health Service.
(3)	Provides evidence that the individual meets either of the following requirements:
a.	Was employed to practice surgical technology in a hospital licensed under Part 2 of Article 5 of this Chapter or an ambulatory surgical facility licensed under this Part on December 31, 2017.
b.	Was employed to practice surgical technology during the two years immediately preceding December 31, 2017.
(4)	Is in the service of the federal government, to the extent the individual is performing duties related to that service.
(c)	An ambulatory surgical facility may employ or contract with an individual to practice surgical technology during the 12‑month period immediately following successful completion of a surgical technology program described in subdivision (1) of subsection (b) of this section but may not continue to employ or contract with that individual beyond this initial 12‑month period without documentation that the employee or contractor holds and maintains the certified surgical technologist credential described in subdivision (1) of subsection (b) of this section.
(d)	An ambulatory surgical facility may employ or contract with an individual who qualifies to practice surgical technology pursuant to subdivision (2) or (3) of subsection (b) of this section as long as that individual annually completes 15 hours of continuing education approved by the National Board of Surgical Technology and Surgical Assisting or its successor.
(e)	An ambulatory surgical facility that employs or contracts with an individual to practice surgical technology shall verify that the individual meets the continuing education requirements of subsection (d) of this section or, if applicable, that the individual holds and maintains the Certified Surgical Technologist credential described in subdivision (1) of subsection (b) of this section.
(f)	An ambulatory surgical facility may employ or otherwise contract with an individual who does not meet any of the qualifications specified in subsection (b) of this section if both of the following requirements are met:
(1)	The facility makes a diligent and thorough effort but was unable to employ or contract with a sufficient number of qualified surgical technologists who meet the requirements of this section.
(2)	The facility makes and retains, at the facility, a written record of its effort under subdivision (1) of this subsection.
(g)	Nothing in this section shall be construed to prohibit a licensed practitioner from performing surgical technology tasks or functions if the practitioner is acting within the scope of his or her license. 
(h)	The Department of Health and Human Services may take adverse action against an ambulatory surgical facility under G.S. 131E‑148 for a violation of this section."
SECTION 3.  This act becomes effective January 1, 2018.