BILL ANALYSIS C.S.S.B. 729 By: Galloway Health and Human Services 4-20-95 Committee Report (Substituted) BACKGROUND The Medical Radiologic Certification Act (Article 4512m, V.T.C.S.) authorizes the Texas State Board of Medical Examiners, Texas State Board of Podiatry Examiners, Texas State Board of Nurse Examiners, Texas State Board of Dental Examiners, and Texas State Board of Chiropractic Examiners to identify radiologic procedures that must be performed only by a medical radiologic technologist certified under that Act. Currently, only the Board of Dental Examiners has identified these procedures for dental radiologic technicians. Although current law requires radiologic technician licensing violations to be reported to the Texas Department of Health, the law grants the department no injunctive powers against a violator. PURPOSE As proposed, C.S.S.B. 729 requires the Texas Board of Health to identify procedures that must be performed only by a medical radiologic technologist, expands the list of licensing violations for radiologic technicians and students, expands the powers of the Texas Board of Health in regulating medical radiologic technologists, and provides civil and criminal penalties for violating the provisions and rules of this Act. RULEMAKING AUTHORITY It is the committee's opinion that rulemaking authority is granted to the Texas Board of Health and other state agencies assisting the Texas Board of Health under SECTION 2 (Section 2.05(g), Article 4512m, V.T.C.S.), SECTION 4 (Section 2.08, Article 4512m, V.T.C.S.), and SECTION 8(a) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 2.03, Article 4512m ,V.T.C.S. (Medical Radiologic Technologist Certification Act), by adding Subdivisions (13) and (14) to define "direct supervision," "education program," "authorized person," and "registrant." SECTION 2. Amends Section 2.05, Article 4512m, V.T.C.S., by amending Subsection (a) and adding Subsections (f)-(k), as follows: (a) Requires the Texas Board of Health (board) to adopt rules establishing minimum standards for the approval of curricula and education programs to train individuals, registered nurses, and physician assistants to perform radiologic procedures; minimum standards for the approval of instructors to teach approved curricula or education programs, to train individuals to perform radiologic procedures; and a registry of persons who are required to comply with Subsection (f) of this section. (f) Requires the minimum standards of the board for approval of curricula and education programs to include mandatory training guidelines for a person, other than a practitioner or a medical radiologic technologist, who intentionally administers radiation to another person for medical purposes, including a person who does not hold a certificate issued under this Act who is performing a radiologic procedure under the direction of a practitioner, other than a dentist, or at a hospital. Requires the training program to contain an appropriate number of hours of education that must be completed before the person performs a radiologic procedure. (g) Requires the board, by rule, to identify radiologic procedures that are dangerous or hazardous and that only a practitioner or a medical radiologic technologist are authorized to perform. (h) Declares that Subsection (g) of this section does not apply to a radiologic procedure involving a dental X-ray machine. (i) Requires the Texas Department of Health (department), on application by a hospital, federally qualified health center, or practitioner, to exempt the applicant from the requirements of Subsection (f) in employing a person certified under this Act or trained as required by Subsection (f), if the applicant shows a hardship in employing a person certified under this Act or trained as required by Subsection (f). (j) Sets forth a list of conditions considered to be hardships for the purposes of Subsection (i). (k) Authorizes the board, in adopting rules under Subsection (g), to consider whether the radiologic procedure will be performed by a registered nurse or a licensed physician assistant. SECTION 3. Amends Section 2.07, Article 4512m, V.T.C.S., by amending Subsection (d) and adding Subsection (g), as follows: (d) Authorizes a person who performs a radiologic procedure in a hospital that participates in the federal Medicare program or that is accredited by the Joint Commission on Accreditation of Hospitals and who has completed a training program approved by the board under Section 2.05(f) of this Act to perform radiologic procedures without a certificate issued under this Act. (g) Provides that a person is not required to hold a certificate issued under this Act to perform a radiologic procedure if the procedure is performed under the supervision of a dentist, and the person is registered with the State Board of Dental Examiners and is in compliance with rules adopted by that board under Section 2.08 of this Act. SECTION 4. Amends Sections 2.08(b) and (c), Article 4512m, V.T.C.S., as follows: (b) Requires each agency subject to this Act to adopt rules in accordance with Chapter 2001, Government Code, regulating the direction of another authorized person in the performance of radiologic procedures. Requires rules adopted under this section to allow a practitioner the right to delegate certain designated radiologic procedures to a person not certified under this Act if the delegation is allowed by the regulatory board that licenses the practitioner. Makes a nonsubstantive change. (c) Deletes identifying radiologic procedures and establishing safety standards and procedures from the requirements for rules adopted under this section. Requires rules adopted under this section to establish standards, in addition to those required by this Act, for the training and supervision of equipment operators. Makes conforming changes. SECTION 5. Amends Section 2.11, Article 4512m, V.T.C.S., as follows: (a) Adds certain disciplinary actions which the department is authorized to take for violation of rules or provisions under this Act. (b) Makes conforming changes. (c) Sets forth actions for which the department may take disciplinary action against a person subject to this Act. (d) Requires a person subject to disciplinary action to be afforded an opportunity to demonstrate that the person is able to resume the practice of radiologic technology. (e) Prohibits the board from reinstating a certificate holder or causing a certificate to be issued to an applicant previously denied a certificate, unless the board believes the holder or applicant has complied with board requirements and is capable of practicing radiologic technology. (f) Authorizes the department to take disciplinary action against a student who intentionally practices radiologic technology without direct supervision. SECTION 6. Amends Section 2.13(a), Article 4512m, V.T.C.S., by adding certain actions, which if committed by a person required to be certified, constitute an offense. SECTION 7. Amends Section 2.14, Article 4512m, V.T.C.S., as follows: Sec. 2.14. INJUNCTION; CIVIL PENALTY. (a) Authorizes the board or department, if it appears that a person has, is, or is threatening to violate this Act, to bring a civil action to obtain injunctive relief to restrain the continued or threatened violation. (b) Subjects a violator of this Act to a civil penalty of not more than $1,000 for each day of violation. (c) Requires the attorney general, at the request of the board or department, to bring an action for injunctive relief, to recover a civil penalty, or both. Deletes existing Section 2.14. SECTION 8. (a) Requires the board, not later than January 1, 1996, to adopt rules relating to the education of persons performing a radiologic procedure. (b) Requires a person, subject to the board requirement that a person receive the appropriate number of hours of education, to complete the education requirements by January 1, 1998. Authorizes the person, until that date, to continue to perform radiological procedures, and continues the former law in effect for that purpose. SECTION 9. Effective date: September 1, 1995. SECTION 10. Emergency clause.