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.