Thank you for the opportunity to comment on 18VAC85-160.  We respectfully request that you amend the current language that may detract from the spirit of the regulation and the supporting statute, thereby impacting your constituents’ certification and educational pathways. This correspondence is accompanied with the highest regard for everything you do for the people of the Commonwealth of Virginia and with the belief that you honorably serve with the best of intentions. 

Please amend the current regulation and supporting statute to include either of the following suggested provisions or derivative language that is inclusive of NCCT’s credential:

1.    “Successful completion of a surgical technologist training program, and a current certification issued by a NCCA accredited certification program;” 

-OR-

2.       “Successful completion of a surgical technologist training program, and a current certification issued by the National Center for Competency Testing (NCCT), the National Board for Surgical Technology and Surgical Assisting (NBSTSA), or their successors,”

Concerns:

The current language in this regulation and supporting statute includes only one certification and certifying body and excludes the fully accredited equivalent surgical technologist credential from the National Center for Competency Testing (NCCT).

This de facto monopoly has a negative impact on surgical facilities and surgical technologists alike by creating a bottleneck which accentuates a workforce shortage in an already stressed medical system.  

It exacerbates existing staffing shortages by creating more roadblocks for employers to recruit and adequately staff their operating rooms, while limiting qualified practitioners’ ability to practice and be contributing members of the Commonwealth of Virginia’s workforce. This impact will be of particular concern with vulnerable rural patient populations, where an active shortage of qualified surgical technologists already poses an obstacle to providing care in those underserved communities.

It is likely not your intent to name a certifier and certification at the exclusion of all others because you may be unaware that there exists a legitimate alternative to the named certification in the statute and regulation.  Stakeholders would ask that you take that into consideration going forward.  The TS-C (NCCT) is the Tech in Surgery-Certified (NCCT) credential administered by the National Center for Competency Testing [www.ncctinc.com].  This NCCT certification program holds the same NCCA accreditation as does the CST(NBSTSA). 

You can follow this link to the listing:

https://ice.learningbuilder.com/Public/MemberSearch/ProgramVerification  

Explanation/Justification:

Both exams are psychometrically sound and valid measures of surgical technologist job tasks and responsibilities.  Limiting employability to just one of the two equivalent certifications is detrimental to recruitment and employment of fully qualified and competent surgical technologists.

If a nationally recognized accrediting body for certifying agencies has assessed compliance according to its published standards, the Commonwealth of Virginia would be best served by reviewing those standards to determine whether they are sufficient for regulatory purposes.  These standards address eligibility requirements, among many other aspects of a credentialing organization and subsequent certification programs.

The certification programs of both NCCT and NBSTSA are equally accredited by the same accrediting agency, the NCCA. The NCCA, which is the benchmark of the national credentialing industry, has determined that both certification programs meet the same standards.   However, the current regulation does not permit persons holding NCCT certification who do not qualify to be grandfathered in, to move from one surgical facility to another within Virginia, or who choose to move from another state to Virginia, to practice their profession in the Commonwealth. 

There is no justification for the current distinction.  The effect of the statute and regulation, again without justification, prevents qualified persons certified by the NCCT from practicing in Virginia. Under the current regulation a surgical technologist holding NBSTA certification can practice while a surgical technologist holding NCCT certification cannot practice.  Again, this distinction is made in spite of the fact that both the NCCT and the NBSTA certification programs are accredited by the same agency, the NCCA.

“The NCCA’s Standards for the Accreditation of Certification Programs were the first standards developed by the credentialing industry for professional certification programs. The NCCA Standards were developed to help ensure the health, welfare, and safety of the public. They highlight the essential elements of a high-quality program.”

Source:  https://www.credentialingexcellence.org/Accreditation/Earn-Accreditation/NCCA

I would invite you to look at other states that have sought to avoid the unintended consequence of passing sole sourcing legislation that would exacerbate existing staffing shortages by creating more problems for employers to recruit and adequately staff their operating rooms, while limiting qualified practitioners’ ability to practice. 

Note the State of Emergency that this monopoly led to in Oregon that took several years to correct: https://olis.oregonlegislature.gov/liz/2022R1/Downloads/MeasureDocument/HB4106/Introduced

See attached link to see how Pennsylvania avoided the emergency beginning with Section 501(1) (I)Page 7 and so on:

https://www.iahcsmm.org/images/Advocacy/Certification_Bills/PA_HB81.pdf

After thorough review of this regulation, we believe you will conclude that this language should be amended to include NCCT’s certification.

Thank you for your time and for considering this information before limiting your constituents’ access to qualified medical professionals (by default, limiting some of those qualified constituents’ right to practice in their field). 

Respectfully submitted,

Dana Van Laeys