Bill Sponsors
Bennett, Shallcross Smith, Corvese, Fogarty, Carson, Potter, Cortvriend, Donovan, Fellela, and Read
Committee
House Health & Human Services
Summary
Select
This legislation establishes the "Certified Surgical First Assistants Act," creating a new licensing requirement for individuals who assist physicians during surgical procedures in Rhode Island. It creates a seven-member Board of Licensure within the Department of Health to oversee the profession. The bill defines the scope of practice for surgical assistants, such as suturing and harvesting veins, and mandates that surgical facilities generally employ licensed individuals. It sets forth criteria for licensure, including national certification or military training, establishes continuing education requirements, and outlines disciplinary procedures for unprofessional conduct.
Sponsor
Analysis
Pros for Progressives
- Enhances public safety and patient welfare by ensuring that only qualified, trained, and licensed professionals perform invasive surgical assistance tasks.
- Establishes a formal oversight board and a system for tracking malpractice and disciplinary actions, increasing accountability within the healthcare system.
- Formalizes the profession of surgical assisting, potentially leading to better workplace standards and recognition for these healthcare workers.
Cons for Progressives
- Creates financial and educational barriers to entry that may disproportionately affect low-income individuals trying to enter the medical field.
- Establishes a new bureaucratic structure that grants significant power to a small board, potentially leading to gatekeeping rather than genuine public service.
- Could potentially increase healthcare costs if the licensing fees and restricted labor supply lead to higher expenses for medical facilities.
Pros for Conservatives
- Explicitly recognizes military training as a valid qualification for licensure, supporting veterans transitioning into the civilian workforce.
- Establishes clear professional standards that may help reduce liability risks for surgical facilities and surgeons by ensuring staff competency.
- Includes provisions for waivers and allows existing medical professionals (like nurses) to perform tasks, offering some flexibility to private businesses.
Cons for Conservatives
- Expands the size and scope of state government by creating a new regulatory board and increasing administrative bureaucracy within the Department of Health.
- Imposes government mandates on private surgical facilities regarding who they can hire, interfering with free-market employment practices.
- Creates a "permission slip to work" system that forces individuals to pay fees to the government to practice their chosen trade.
Constitutional Concerns
None Likely
Impact Overview
Groups Affected
- Surgical First Assistants
- Surgeons (MDs/DOs/Podiatrists)
- Hospitals and Surgical Facilities
- Patients
- Department of Health
Towns Affected
All
Cost to Taxpayers
Amount unknown
Revenue Generated
Amount unknown
BillBuddy Impact Ratings
Importance
Measures population affected and overall level of impact.
Freedom Impact
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Public Services
How much the bill is likely to impact one or more public services.
Regulatory
Estimated regulatory burden imposed on the subject(s) of the bill.
Clarity of Bill Language
How clear the language of the bill is. Higher ambiguity equals a lower score.
Enforcement Provisions
Measures enforcement provisions and penalties for non-compliance (if applicable).
Environmental Impact
Impact the bill will have on the environment, positive or negative.
Privacy Impact
Impact the bill is likely to have on the privacy of individuals.
Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 01/14/2026 Introduced, referred to House Health & Human Services
Bill Text
SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS" is hereby amended by adding thereto the following chapter: CHAPTER 54.1 CERTIFIED SURGICAL FIRST ASSISTANTS
5-54.1-1. Short title.
This chapter shall be known and may be cited as "The Certified Surgical First Assistants Act".
5-54.1-2. Definitions.
For purposes of this chapter, the following terms shall have the following meanings:
(1) "Board" means the board of licensure of certified surgical first assistants established pursuant to § 5-54.1-5.
(2) "Certified surgical first assistant" means an individual who has met the requirements of the board of licensure as a certified surgical first assistant and who works under the direct supervision of a licensed doctor of medicine, osteopathy, or podiatry.
(3) "Department" means the department of health.
(4) "Director" means the director of the department of health.
(5) "Surgical assisting" means surgical patient care, including, but not limited to, any of the following:
(i) Manipulation of organs;
(ii) Suturing of tissue;
(iii) Placement of hemostatic agents;
(iv) Injection of local anesthetic;
(v) Harvesting of veins;
(vi) Implementation of devices; and
(vii) Other duties as directed by a licensed doctor of medicine, osteopathy, or podiatry.
(6) "Surgical facility" means an entity that provides surgical health care services, whether inpatient or outpatient and whether overnight or ambulatory, including, but not limited to, a hospital, clinic or private office of a health care practitioner, whether conducted for charity or for profit.
5-54.1-3. Certified surgical first assistants.
(a) A surgical facility shall not employ or otherwise retain the services of a surgical assistant unless an individual is licensed by the board as a certified surgical first assistant.
(b) Notwithstanding subsection (a) of this section, a registered nurse, licensed or registered health care provider or other health care practitioner may perform surgical assistant tasks or functions if that individual is acting within the scope of licensure.
(c) Notwithstanding subsection (a) of this section, a surgical facility may employ as a surgical assistant an individual who does not meet the requirements of this section if that individual receives a waiver from the department certifying that the individual has met special circumstances as determined by the department.
5-54.1-4. Board of licensure -- Creation.
Within the division of professional regulation established in the department of health pursuant to chapter 26 of this title, there is created a board of licensure for certified surgical first assistant as provided by §§ 5-54.1-5 and 5-54.1-6.
5-54.1-5. Establishment of the board of licensure.
(a) The governor, after consultation with the director of the department of health and with the advice and consent of the senate, shall appoint to the board seven (7) members, who are residents of the state, to constitute a board of licensure for certified surgical first assistants with the duties, powers, and authority as set forth in § 5-54.1-6, and that board shall be composed of the following:
(1) Two (2) members who shall be licensed physicians under the provisions of chapter 37 of this title who have actively engaged in the practice of surgery;
(2) Two (2) members who are representatives of the general public not employed in any LC003178 - Page 2 of 7 health-related field; and
(3) Three (3) members who shall be certified surgical first assistants or health care practitioners with at least three (3) years of practice in the state involving delivery of medical surgical services.
(b) Members shall be appointed for terms of three (3) years each with no member serving more than two (2) consecutive terms.
(c) Upon the governor's initial appointments, the director shall designate the members of the board of licensure for certified surgical first assistants as follows: two (2) members to serve for a term of three (3) years; two (2) members to serve for a term of two (2) years; and three (3) members to serve for a term of one year. Any additional appointments shall serve for one year.
(d) The director may remove any member of the board for cause.
(e) Vacancies shall be filled for the unexpired portion of any term in the same manner as the original appointment.
(f) Members shall serve without compensation; provided, however, members shall be reimbursed for actual and reasonable expenses incurred in the performance of their duties.
(g) The board shall elect its own chairperson annually and shall meet at the call of the chairperson, or upon the request of two (2) or more members of the board.
(h) A quorum shall consist of at least four (4) members present.
5-54.1-6. Board of licensure -- Powers and duties.
(a) The board shall administer, coordinate, and enforce the provisions of this chapter; evaluate the qualifications of applicants; supervise any examination of applicants deemed necessary; recommend to the director the commencement of disciplinary hearings in accordance with chapter 35 of title 42 and the provisions of this chapter; and investigate persons engaging in practices that violate the provisions of this chapter. This authority shall specifically encompass practicing certified surgical first assistants, surgical facilities and those health care agencies employing certified surgical first assistants. The board shall investigate all persons and agencies engaging in practices that violate the provisions in this chapter.
(b) The board shall conduct hearings of a nondisciplinary nature and shall keep the records and minutes that are necessary to an orderly dispatch of business.
(c) The board, with the approval of the director, shall adopt rules and regulations necessary to implement the provisions of this chapter and may amend or repeal them.
(d) Regular meetings of the board shall be held at any time and place that the board prescribes and special meetings shall be held upon the call of the chairperson; provided that, at least one regular meeting is held each year. LC003178 - Page 3 of 7
(e) The conferral or enumeration of specific powers in this chapter shall not be construed as a limitation of the general powers conferred by this section.
(f) The board shall recommend to the director for registration those persons meeting the criteria set forth in this chapter.
(g) The board shall recommend to the director the revocation or suspension of the license of any certified surgical first assistant who does not conform to the requirements of this chapter or regulations adopted under this chapter.
(h) In accordance with its authority under subsection (a) of this section, the board shall make recommendations to the director for discipline of supervising surgeons, surgical facilities and employing healthcare agencies found wanting in their use of certified surgical first assistants.
(i) The board shall approve programs for continuing medical education.
5-54.1-7. Criteria for licensure as a certified surgical first assistant.
(a) The board shall recommend to the director for licensure as a certified surgical first assistant an applicant who:
(1) Has completed at least one of the following:
(i) A current credential as a surgical assistant or surgical first assistant issued by the National Board of Surgical Technology and Surgical Assisting, the National Surgical Assistant Association, or the National Commission for Certification of Surgical Assistants or their successors;
(ii) Successful completion of a surgical assistant training program during the individual’s service as a member of any branch of the armed forces of the United States; or
(iii) At least one year of experience as a surgical assistant in the state.
(b) An application for original license, a license renewal or for the licensing examination shall be made on forms approved by the department and accompanied by the appropriate fee as set by the department. An application for original license shall be sworn and shall furnish satisfactory proof that an applicant is at least eighteen (18) years of age, of good moral character and has met the educational and professional experience requirements as set forth in this section.
(c) For renewal of license as a certified surgical first assistant, a licensee shall attest to having successfully completed thirty-eight (38) hours of continuing education in courses directly related to the practice of surgical assisting as approved and documented by a provider recognized by one of the following:
(1) The National Board of Surgical Technology and Surgical Assisting;
(2) The National Commission for the Certification of Surgical Assistants; or
(3) The National Surgical Assistant Association. LC003178 - Page 4 of 7
(d) A licensee shall retain a completed form with all supporting documentation in the licensee's records for a period of four (4) years following the renewal of an active license.
(e) The board shall periodically conduct a random audit of its active licensees to determine compliance and the licensees selected for the audit shall provide all supporting documentation within thirty (30) days of receiving notification of the audit.
(f) Failure of a licensee to comply with the requirements of this section may subject the licensee to disciplinary action by the board.
(g) The board, at its discretion, may grant an extension of the deadline for continuing education requirements, for up to one year, for good cause shown upon a written request from the licensee, prior to the renewal date.
(h) The board, at its discretion, may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.
5-54.1-8. Grounds for refusal to renew, suspension or revocation of certificates.
The director may, after notice and a hearing, refuse to grant, renew, suspend, or revoke any certificate of licensure or discipline any registrant upon proof that the person is guilty of unprofessional conduct as defined in § 5-54-2.
5-54.1-9. Requirements relating to professional conduct.
The board shall receive and maintain a confidential file which shall be available to the board to precipitate or aid in their investigations. The information shall also be available to licensed surgical facilities in connection with the granting of staff privileges and to the individual certified surgical first assistants themselves. The file shall contain the following information:
(1) Cases of malpractice suits against certified surgical first assistants as reported to the board by insurers and self-insurers;
(2) Cases of malpractice suits that result in allegations being dropped, a dismissal, a settlement, or court judgment or arbitration award adverse to the certified surgical first assistant;
(3) Reports by any hospital or state or local professional medical association/society of disciplinary action taken against any certified surgical first assistant. These reports should also include any resignation of a certified surgical first assistant if related to unprofessional conduct as defined in § 5-54-2 or any withdrawal of an application for hospital privileges relating to unprofessional conduct;
(4) Reports by state and federal courts of certified surgical first assistants found guilty of a felony;
(5) Reports by professional review organizations and third-party health insurers of LC003178 - Page 5 of 7 sanctions imposed on a certified surgical first assistant; and
(6) Contain any other data that the board by reasonable rule or regulation deems appropriate.
5-54.1-10. Severability.
The provisions of this chapter are severable and if any of the provisions of this chapter are held unconstitutional by any court of competent jurisdiction, the decision of that court shall not affect or impair any of the remaining provisions.
SECTION 2. This act shall take effect on July 1, 2027.
5-54.1-1. Short title.
This chapter shall be known and may be cited as "The Certified Surgical First Assistants Act".
5-54.1-2. Definitions.
For purposes of this chapter, the following terms shall have the following meanings:
(1) "Board" means the board of licensure of certified surgical first assistants established pursuant to § 5-54.1-5.
(2) "Certified surgical first assistant" means an individual who has met the requirements of the board of licensure as a certified surgical first assistant and who works under the direct supervision of a licensed doctor of medicine, osteopathy, or podiatry.
(3) "Department" means the department of health.
(4) "Director" means the director of the department of health.
(5) "Surgical assisting" means surgical patient care, including, but not limited to, any of the following:
(i) Manipulation of organs;
(ii) Suturing of tissue;
(iii) Placement of hemostatic agents;
(iv) Injection of local anesthetic;
(v) Harvesting of veins;
(vi) Implementation of devices; and
(vii) Other duties as directed by a licensed doctor of medicine, osteopathy, or podiatry.
(6) "Surgical facility" means an entity that provides surgical health care services, whether inpatient or outpatient and whether overnight or ambulatory, including, but not limited to, a hospital, clinic or private office of a health care practitioner, whether conducted for charity or for profit.
5-54.1-3. Certified surgical first assistants.
(a) A surgical facility shall not employ or otherwise retain the services of a surgical assistant unless an individual is licensed by the board as a certified surgical first assistant.
(b) Notwithstanding subsection (a) of this section, a registered nurse, licensed or registered health care provider or other health care practitioner may perform surgical assistant tasks or functions if that individual is acting within the scope of licensure.
(c) Notwithstanding subsection (a) of this section, a surgical facility may employ as a surgical assistant an individual who does not meet the requirements of this section if that individual receives a waiver from the department certifying that the individual has met special circumstances as determined by the department.
5-54.1-4. Board of licensure -- Creation.
Within the division of professional regulation established in the department of health pursuant to chapter 26 of this title, there is created a board of licensure for certified surgical first assistant as provided by §§ 5-54.1-5 and 5-54.1-6.
5-54.1-5. Establishment of the board of licensure.
(a) The governor, after consultation with the director of the department of health and with the advice and consent of the senate, shall appoint to the board seven (7) members, who are residents of the state, to constitute a board of licensure for certified surgical first assistants with the duties, powers, and authority as set forth in § 5-54.1-6, and that board shall be composed of the following:
(1) Two (2) members who shall be licensed physicians under the provisions of chapter 37 of this title who have actively engaged in the practice of surgery;
(2) Two (2) members who are representatives of the general public not employed in any LC003178 - Page 2 of 7 health-related field; and
(3) Three (3) members who shall be certified surgical first assistants or health care practitioners with at least three (3) years of practice in the state involving delivery of medical surgical services.
(b) Members shall be appointed for terms of three (3) years each with no member serving more than two (2) consecutive terms.
(c) Upon the governor's initial appointments, the director shall designate the members of the board of licensure for certified surgical first assistants as follows: two (2) members to serve for a term of three (3) years; two (2) members to serve for a term of two (2) years; and three (3) members to serve for a term of one year. Any additional appointments shall serve for one year.
(d) The director may remove any member of the board for cause.
(e) Vacancies shall be filled for the unexpired portion of any term in the same manner as the original appointment.
(f) Members shall serve without compensation; provided, however, members shall be reimbursed for actual and reasonable expenses incurred in the performance of their duties.
(g) The board shall elect its own chairperson annually and shall meet at the call of the chairperson, or upon the request of two (2) or more members of the board.
(h) A quorum shall consist of at least four (4) members present.
5-54.1-6. Board of licensure -- Powers and duties.
(a) The board shall administer, coordinate, and enforce the provisions of this chapter; evaluate the qualifications of applicants; supervise any examination of applicants deemed necessary; recommend to the director the commencement of disciplinary hearings in accordance with chapter 35 of title 42 and the provisions of this chapter; and investigate persons engaging in practices that violate the provisions of this chapter. This authority shall specifically encompass practicing certified surgical first assistants, surgical facilities and those health care agencies employing certified surgical first assistants. The board shall investigate all persons and agencies engaging in practices that violate the provisions in this chapter.
(b) The board shall conduct hearings of a nondisciplinary nature and shall keep the records and minutes that are necessary to an orderly dispatch of business.
(c) The board, with the approval of the director, shall adopt rules and regulations necessary to implement the provisions of this chapter and may amend or repeal them.
(d) Regular meetings of the board shall be held at any time and place that the board prescribes and special meetings shall be held upon the call of the chairperson; provided that, at least one regular meeting is held each year. LC003178 - Page 3 of 7
(e) The conferral or enumeration of specific powers in this chapter shall not be construed as a limitation of the general powers conferred by this section.
(f) The board shall recommend to the director for registration those persons meeting the criteria set forth in this chapter.
(g) The board shall recommend to the director the revocation or suspension of the license of any certified surgical first assistant who does not conform to the requirements of this chapter or regulations adopted under this chapter.
(h) In accordance with its authority under subsection (a) of this section, the board shall make recommendations to the director for discipline of supervising surgeons, surgical facilities and employing healthcare agencies found wanting in their use of certified surgical first assistants.
(i) The board shall approve programs for continuing medical education.
5-54.1-7. Criteria for licensure as a certified surgical first assistant.
(a) The board shall recommend to the director for licensure as a certified surgical first assistant an applicant who:
(1) Has completed at least one of the following:
(i) A current credential as a surgical assistant or surgical first assistant issued by the National Board of Surgical Technology and Surgical Assisting, the National Surgical Assistant Association, or the National Commission for Certification of Surgical Assistants or their successors;
(ii) Successful completion of a surgical assistant training program during the individual’s service as a member of any branch of the armed forces of the United States; or
(iii) At least one year of experience as a surgical assistant in the state.
(b) An application for original license, a license renewal or for the licensing examination shall be made on forms approved by the department and accompanied by the appropriate fee as set by the department. An application for original license shall be sworn and shall furnish satisfactory proof that an applicant is at least eighteen (18) years of age, of good moral character and has met the educational and professional experience requirements as set forth in this section.
(c) For renewal of license as a certified surgical first assistant, a licensee shall attest to having successfully completed thirty-eight (38) hours of continuing education in courses directly related to the practice of surgical assisting as approved and documented by a provider recognized by one of the following:
(1) The National Board of Surgical Technology and Surgical Assisting;
(2) The National Commission for the Certification of Surgical Assistants; or
(3) The National Surgical Assistant Association. LC003178 - Page 4 of 7
(d) A licensee shall retain a completed form with all supporting documentation in the licensee's records for a period of four (4) years following the renewal of an active license.
(e) The board shall periodically conduct a random audit of its active licensees to determine compliance and the licensees selected for the audit shall provide all supporting documentation within thirty (30) days of receiving notification of the audit.
(f) Failure of a licensee to comply with the requirements of this section may subject the licensee to disciplinary action by the board.
(g) The board, at its discretion, may grant an extension of the deadline for continuing education requirements, for up to one year, for good cause shown upon a written request from the licensee, prior to the renewal date.
(h) The board, at its discretion, may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.
5-54.1-8. Grounds for refusal to renew, suspension or revocation of certificates.
The director may, after notice and a hearing, refuse to grant, renew, suspend, or revoke any certificate of licensure or discipline any registrant upon proof that the person is guilty of unprofessional conduct as defined in § 5-54-2.
5-54.1-9. Requirements relating to professional conduct.
The board shall receive and maintain a confidential file which shall be available to the board to precipitate or aid in their investigations. The information shall also be available to licensed surgical facilities in connection with the granting of staff privileges and to the individual certified surgical first assistants themselves. The file shall contain the following information:
(1) Cases of malpractice suits against certified surgical first assistants as reported to the board by insurers and self-insurers;
(2) Cases of malpractice suits that result in allegations being dropped, a dismissal, a settlement, or court judgment or arbitration award adverse to the certified surgical first assistant;
(3) Reports by any hospital or state or local professional medical association/society of disciplinary action taken against any certified surgical first assistant. These reports should also include any resignation of a certified surgical first assistant if related to unprofessional conduct as defined in § 5-54-2 or any withdrawal of an application for hospital privileges relating to unprofessional conduct;
(4) Reports by state and federal courts of certified surgical first assistants found guilty of a felony;
(5) Reports by professional review organizations and third-party health insurers of LC003178 - Page 5 of 7 sanctions imposed on a certified surgical first assistant; and
(6) Contain any other data that the board by reasonable rule or regulation deems appropriate.
5-54.1-10. Severability.
The provisions of this chapter are severable and if any of the provisions of this chapter are held unconstitutional by any court of competent jurisdiction, the decision of that court shall not affect or impair any of the remaining provisions.
SECTION 2. This act shall take effect on July 1, 2027.