By Josephine Colacci, JD
The International Association of Healthcare Central Service Materiel Management (IAHCSMM) has long been an outspoken advocate of state certification of central service (CS) professionals. Certification and continuing education credits keep technicians up-to-date on standards-based instrument processing practices, so these professionals can be skilled, competent and confident in their ability to keep patient safety and quality at the forefront.
Last year was an exciting year for IAHCSMM in regard to its legislative efforts. We successfully passed the CS technicians certification bill in the New York legislature unanimously. We had the support of the New York State Nurses Association, SEIU/1199, the New York chapter of the American College of Surgeons, the Association for Professionals in Infection Control and Epidemiology (APIC), the Association of periOperative Registered Nurses (AORN), the Association of Surgical Technologists (AST), and the Certification Board for Sterile Processing and Distribution (CBSPD). Additionally, the New York Hospital Association was neutral. Unfortunately, even with this support, the New York Governor vetoed the bill. The bills (A.878 and S.697) were reintroduced in New York in January 2013. Additionally, on March 6, we had a meeting with the Governors staff to discuss the reasons why the bill was vetoed. The next step is the Governors staff will meet with the Department of Health and Department of Education to discuss enforcement of the bill. The legislative session in New York ends at the end of June.
In Connecticut, we introduced a certification bill, SB 894. This legislation is similar in language to the New York bill. We will be requesting that changes be made to the legislation because it was introduced incorrectly. These changes include:
Adding the certification credentials, Certified Registered Central Service Technician or the Certified Sterile Processing and Distribution Technician;
Clarifying the grandfathering language to grandfather everyone currently working as a CS technician
Deleting the waiver language for CE credits
Clarifying the definition of CS technician
Adding language for collaboration with the nursing department
The Public Health Committee took testimony on this bill on March 15. I testified in support of the legislation. The hospital association, Department of Public Health, and ambulatory surgery center association testified in opposition to the bill. Some of the reasons for their opposition pertain to the language changes we are seeking (outlined above). The organizations also stated that we should have to undergo a scope of practice review in the summer and that the bill has to be enforced. We will attempt to work out compromises with these organizations before the April 5 committee deadline. If the bill is not passed out of committee by April 5, then the bill is dead.
In Pennsylvania, we are waiting for our certification bill to be reintroduced this year. Last year, the bill had a committee hearing to take witness testimony only and the bill did not undergo a vote. Pennsylvania runs on a two-year legislative cycle, which means we have until Dec. 31, 2014, to get the bill through the legislative process.
States Educating Legislators
Several additional states are educating legislators a critical first step toward introducing legislation and attaining state certification. We are reaching out to state elected officials to introduce them to IAHCSMM and the CS profession. Educating them on the critical duties of CS professionals and the impact on patient safety is essential for laying the foundation for legislation, and securing sponsors and support.
What follows is a brief summary of the educational initiatives currently underway:
In Maryland, we almost introduced legislation in 2013. We met with the majority of the House and Senate Health Committee members and identified legislative sponsors in both Houses. We were successful in doing this without the help of a lobbyist. We had a bill drafted, but the language was very different than our bills in other states. We are taking a step back to work on the bill language before we introduce it in 2014.
In Oregon, we were ready to introduce legislation in 2013. A lobbyist advised me to wait to introduce this legislation because there is a significant amount of healthcare legislation this year. We will be regrouping for 2014.
In Washington, we almost introduced legislation in this state in 2012. We waited because the surgical technologists initiated their process and we decided it would be wise to see how their efforts fare before introducing our own legislation. Washington has a regulatory process in the summer and then introduces legislation the following January.
In Massachusetts, we havent yet begun the legislative process; however, this state is on our list because the surgical technologists had a bill signed into law in December 2012. We will begin this process this summer.
In South Carolina, we havent yet begun the process, but we will begin this summer.
Bill Passage Statistics Underscore Challenges
What follows are states statistics from 2012 on the percentage of bills passed and vetoed by governors:
o Assembly passed 6 percent of bills introduced
o Senate passed 8 percent of bills introduced
o Governor vetoed 11.4 percent of bills passed
o House passed 23 percent of bills introduced
o Senate passed 20 percent of bills introduced
o Governor vetoed 3.8 percent of bills passed
o House passed 8 percent of bills introduced
o Senate passed 10 percent of bills introduced
o Governor vetoed 0.53 percent of bills passed
These statistics illustrate how difficult it is to get a bill through a state legislature and signed it into law. Still, dedication, hard work and perseverance pay and IAHCSMM is optimistic that its legislative efforts will be rewarded.
Josephine Colacci, JD, is government affairs director for the International Association of Healthcare Central Service Materiel Management (IAHCSMM).