By Rodriguez, et al. H.B. No. 1200
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of medical radiologic technologists and
1-3 other persons who perform radiologic procedures; providing civil
1-4 and criminal penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 2.03, Medical Radiologic Technologist
1-7 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-8 is amended by adding Subdivisions (13), (14), (15), and (16) to
1-9 read as follows:
1-10 (13) "Direct supervision" means supervision and
1-11 control by a medical radiologic technologist or a practitioner who
1-12 assumes legal liability for a student employed to perform a
1-13 radiologic procedure and enrolled in a program that meets the
1-14 requirements adopted by rule under Section 2.05 of this Act, and
1-15 who is physically present during the conduct of a radiologic
1-16 procedure to provide consultation or direct the action of the
1-17 student.
1-18 (14) "Education program" means clinical training or
1-19 any other program offered by an organization approved by the Texas
1-20 Board of Health that:
1-21 (A) has a specified objective;
1-22 (B) includes planned activities for the
1-23 participants; and
1-24 (C) uses an approved method for measuring the
2-1 progress of the participants.
2-2 (15) "Authorized person" means a person who meets or
2-3 exceeds the minimum educational standards of the Texas Board of
2-4 Health under Section 2.05(f) of this Act.
2-5 (16) "Registrant" means an individual who meets the
2-6 requirements of Section 2.05(f) of this Act, other than a
2-7 practitioner or medical radiologic technologist.
2-8 SECTION 2. Section 2.05, Medical Radiologic Technologist
2-9 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
2-10 is amended by amending Subsection (a) and adding Subsections (f),
2-11 (g), (h), (i), and (j) to read as follows:
2-12 (a) The Texas Board of Health shall adopt rules
2-13 establishing:
2-14 (1) minimum standards for issuing, renewing,
2-15 suspending, and revoking certificates issued under this Act;
2-16 (2) minimum standards for the approval of curricula
2-17 and education programs to train individuals, registered nurses, and
2-18 physician assistants to perform radiologic procedures and for
2-19 rescinding the approval; <and>
2-20 (3) minimum standards for the approval of instructors
2-21 to teach approved curricula or education programs to train
2-22 individuals to perform radiologic procedures and for rescinding the
2-23 approval; and
2-24 (4) a registry of persons required to comply with
2-25 Section 2.05(f) of this Act.
2-26 (f) The minimum standards of the Texas Board of Health for
2-27 approval of curricula and education programs under Subsection (a)
3-1 of this section shall include mandatory training guidelines for a
3-2 person, other than a practitioner, or a medical radiologic
3-3 technologist, who intentionally administers radiation to another
3-4 person for medical purposes, including a person who does not hold a
3-5 certificate issued under this Act who is performing a radiologic
3-6 procedure under the direction of a practitioner, other than a
3-7 dentist, or at a hospital. The training program approved by the
3-8 Texas Board of Health must contain the appropriate number of hours
3-9 of education that must be completed before the person may perform a
3-10 radiologic procedure.
3-11 (g) The Texas Board of Health with the assistance of other
3-12 appropriate state agencies shall identify radiologic procedures
3-13 that are dangerous or hazardous and that may only be performed by a
3-14 practitioner or a medical radiologic technologist certified under
3-15 this Act.
3-16 (h) Subsection (g) of this section does not apply to a
3-17 radiologic procedure involving a dental X-ray machine, including a
3-18 panarex or other equipment designed and manufactured only for use
3-19 in dental radiography.
3-20 (i) The Texas Department of Health shall have the authority
3-21 to grant an exemption from the requirements of Subsection (f) of
3-22 this section to a hospital, federally qualified health center as
3-23 defined by 42 U.S.C. Section 1396(d), or practitioner based upon
3-24 hardship. A hospital, federally qualified health center, or
3-25 practitioner may apply to the Texas Department of Health for an
3-26 exemption from the requirements of Subsection (f) of this section,
3-27 which shall be granted if the hospital, federally qualified health
4-1 center, or practitioner can show a hardship in employing a person
4-2 certified under this Act or trained under Subsection (f) of this
4-3 section. Any one of the following shall be deemed to be a
4-4 hardship:
4-5 (1) the hospital, federally qualified health center,
4-6 or practitioner reports an inability to attract or retain medical
4-7 radiologic technologists;
4-8 (2) the hospital, federally qualified health center,
4-9 or practitioner is located at a geographic distance from a school
4-10 of medical radiologic technology;
4-11 (3) there is a list of qualified applicants to a
4-12 school of medical radiologic technology whose admission is pending
4-13 because of lack of faculty or space;
4-14 (4) the school produces an insufficient number of
4-15 graduates in medical radiologic technology to meet the needs of the
4-16 hospital, federally qualified health center, or practitioner; or
4-17 (5) any other criteria as established by the
4-18 department by rule.
4-19 (j) In adopting rules under Subsection (g) of this section,
4-20 the department may take into account whether the radiologic
4-21 procedure will be performed by a registered nurse or a physician
4-22 assistant licensed under the Physician Assistant Licensing Act
4-23 (Article 4495b-1, Vernon's Texas Civil Statutes).
4-24 SECTION 3. Section 2.07, Medical Radiologic Technologist
4-25 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
4-26 is amended by amending Subsection (d) and adding Subsection (g) to
4-27 read as follows:
5-1 (d) A person who performs a radiologic procedure in a
5-2 hospital that participates in the federal Medicare program or that
5-3 is accredited by the Joint Commission on Accreditation of Hospitals
5-4 and who has completed a training program approved by the Texas
5-5 Board of Health under Section 2.05(f) of this Act <received
5-6 appropriate instruction and training in the use and operation of
5-7 diagnostic radiologic equipment consistent with either the federal
5-8 Medicare standards for certification of hospitals or the
5-9 accreditation standards of the Joint Commission on Accreditation of
5-10 Hospitals> may perform radiologic procedures without a certificate
5-11 issued under this Act.
5-12 (g) A person is not required to hold a certificate issued
5-13 under this Act to perform a radiologic procedure if:
5-14 (1) the procedure is performed under the supervision
5-15 of a dentist; and
5-16 (2) the person is:
5-17 (A) registered with the State Board of Dental
5-18 Examiners; and
5-19 (B) in compliance with rules adopted by that
5-20 board under Section 2.08 of this Act. <A hospital that instructs
5-21 and trains a person in the performance of radiologic procedures
5-22 shall develop a protocol for the instruction and training.>
5-23 SECTION 4. Sections 2.08(b) and (c), Medical Radiologic
5-24 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
5-25 Statutes), are amended to read as follows:
5-26 (b) Each agency, other than the Board of Nurse Examiners,
5-27 subject to this Act <section> shall adopt rules in accordance with
6-1 Chapter 2001, Government Code, <the Administrative Procedure and
6-2 Texas Register Act (Article 6252-13a, Vernon's Texas Civil
6-3 Statutes)> to regulate the manner in which a licensee of the agency
6-4 may order, instruct, or direct another authorized person in the
6-5 performance of radiologic procedures. Rules adopted under this
6-6 subsection shall allow a practitioner the right to delegate certain
6-7 designated radiologic procedures to a person not certified under
6-8 this Act if the delegation is allowed by the regulatory board that
6-9 licenses the practitioner.
6-10 (c) Rules adopted under this section must:
6-11 (1) require a person, other than a registered nurse,
6-12 who is not certified under this Act to register with the agency
6-13 that licenses the practitioner under whom the person performs
6-14 radiologic procedures;
6-15 (2) establish reasonable and necessary fees to cover
6-16 the administrative costs incurred by the agency in administering a
6-17 registration program created under this subsection;
6-18 (3) establish grounds for the suspension, revocation,
6-19 or nonrenewal of a registration issued under this subsection; and
6-20 (4) <identify radiologic procedures that are more
6-21 dangerous or hazardous and may only be performed by a practitioner
6-22 or by a medical radiologic technologist certified under this Act;>
6-23 <(5) establish safety standards and procedures for the
6-24 operation of equipment used to perform radiologic procedures; and>
6-25 <(6)> establish standards, in addition to those
6-26 required by this Act, for the training and supervision of the
6-27 operators of the equipment.
7-1 SECTION 5. Section 2.11, Medical Radiologic Technologist
7-2 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
7-3 is amended to read as follows:
7-4 Sec. 2.11. DISCIPLINARY ACTIONS. (a) The department is
7-5 authorized to take the following disciplinary actions for the
7-6 violation of any provisions of this Act or rules adopted under this
7-7 Act:
7-8 (1) suspension, revocation, or nonrenewal of a
7-9 certificate; <and>
7-10 (2) rescission of curriculum, training program, or
7-11 instructor approval;
7-12 (3) denial of an application for certification or
7-13 approval;
7-14 (4) assessment of a civil penalty in an amount not to
7-15 exceed $1,000 for each separate violation of this Act;
7-16 (5) issuance of a reprimand; or
7-17 (6) placement of the offender's certificate on
7-18 probation and requiring compliance with a requirement of the
7-19 department, including submitting to medical or psychological
7-20 treatment, meeting additional education requirements, passing an
7-21 examination, or working under the supervision of a medical
7-22 radiologic technologist or other practitioner.
7-23 (b) The procedure by which the department takes a
7-24 disciplinary action and the procedure by which a disciplinary
7-25 action is appealed are governed by department rules for a contested
7-26 case hearing and by Chapter 2001, Government Code <the
7-27 Administrative Procedure and Texas Register Act (Article 6252-13a,
8-1 Vernon's Texas Civil Statutes)>.
8-2 (c) The department may take disciplinary action against a
8-3 person subject to this Act for:
8-4 (1) obtaining or attempting to obtain a certificate
8-5 issued under this Act by bribery or fraud;
8-6 (2) making or filing a false report or record made in
8-7 the person's capacity as a medical radiologic technologist;
8-8 (3) intentionally or negligently failing to file a
8-9 report or record required by law;
8-10 (4) intentionally obstructing or inducing another to
8-11 intentionally obstruct the filing of a report or record required by
8-12 law;
8-13 (5) engaging in unprofessional conduct, including the
8-14 violation of the standards of practice of radiologic technology
8-15 established by the Texas Board of Health;
8-16 (6) developing an incapacity that prevents the
8-17 practice of radiologic technology with reasonable skill,
8-18 competence, and safety to the public as the result of:
8-19 (A) an illness;
8-20 (B) drug or alcohol dependency; or
8-21 (C) another physical or mental condition or
8-22 illness;
8-23 (7) failing to report to the department the violation
8-24 of this Act by any other person;
8-25 (8) employing, for the purpose of applying ionizing
8-26 radiation to a person, a person who is not certified under or in
8-27 compliance with this Act;
9-1 (9) violating a provision of this Act, a rule adopted
9-2 under this Act, an order of the department previously entered in a
9-3 disciplinary proceeding, or an order to comply with a subpoena
9-4 issued by the department;
9-5 (10) having a certificate revoked, suspended, or
9-6 otherwise subjected to adverse action or being denied a certificate
9-7 by another certification authority in another state, territory, or
9-8 country; or
9-9 (11) being convicted of or pleading nolo contendere to
9-10 a crime directly related to the practice of radiologic technology.
9-11 (d) A person subject to disciplinary action under Subsection
9-12 (c)(6) of this section shall, at reasonable intervals, be afforded
9-13 an opportunity to demonstrate that the person is able to resume the
9-14 practice of radiologic technology.
9-15 (e) The Texas Board of Health may not reinstate a
9-16 certificate to a holder or cause a certificate to be issued to an
9-17 applicant previously denied a certificate unless the board is
9-18 satisfied that the holder or applicant has complied with
9-19 requirements set by the board and is capable of engaging in the
9-20 practice of radiologic technology.
9-21 (f) The department may take disciplinary action against a
9-22 student for intentionally practicing radiologic technology without
9-23 direct supervision.
9-24 SECTION 6. Section 2.13(a), Medical Radiologic Technologist
9-25 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
9-26 is amended to read as follows:
9-27 (a) A person who is required to be certified under this Act
10-1 commits an offense if the person:
10-2 (1) knowingly administers a radiologic procedure to
10-3 another person without holding a valid certificate issued by the
10-4 department;
10-5 (2) practices radiologic technology without holding a
10-6 certificate under this Act;
10-7 (3) uses or attempts to use a suspended or revoked
10-8 certificate;
10-9 (4) knowingly allows a student enrolled in an
10-10 education program to perform a radiologic procedure without direct
10-11 supervision;
10-12 (5) obtains or attempts to obtain a certificate
10-13 through bribery or fraudulent misrepresentation;
10-14 (6) uses the title or name "certified medical
10-15 radiologic technologist" or any other name or title that implies
10-16 the person is certified to practice radiologic technology, unless
10-17 the person is certified under this Act;
10-18 (7) knowingly conceals information relating to
10-19 enforcement of this Act or rules adopted under this Act; or
10-20 (8) employs a person not certified by or in compliance
10-21 with this Act for the purpose of applying ionizing radiation to a
10-22 person.
10-23 SECTION 7. Section 2.14, Medical Radiologic Technologist
10-24 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
10-25 is amended to read as follows:
10-26 Sec. 2.14. INJUNCTION; CIVIL PENALTY. (a) If it appears
10-27 that a person has violated, is violating, or is threatening to
11-1 violate this Act or a rule adopted under this Act, the Texas Board
11-2 of Health or the department may bring a civil action to obtain
11-3 injunctive relief to restrain the continued or threatened
11-4 violation.
11-5 (b) A person who violates this Act or a rule adopted under
11-6 this Act is subject to a civil penalty in an amount that may not
11-7 exceed $1,000 for each day of violation.
11-8 (c) At the request of the Texas Board of Health or the
11-9 department, the attorney general shall bring an action in the name
11-10 of the state for injunctive relief, to recover a civil penalty, or
11-11 both, as authorized by this section. <TERMS OF INITIAL MEMBERS;
11-12 INITIAL MEETING. (a) Four initial members appointed to the
11-13 Medical Radiologic Technologist Advisory Board serve for terms
11-14 expiring January 1, 1990, four initial members serve for terms
11-15 expiring January 1, 1992, and four initial members serve for terms
11-16 expiring January 1, 1994. The 12 initial members shall draw lots
11-17 to determine the lengths of their terms. The Texas Board of Health
11-18 shall make the initial appointments not later than January 1, 1988.>
11-19 <(b) The advisory board shall hold its initial meeting by
11-20 January, 1988, to organize, begin work, and set future meeting
11-21 dates.>
11-22 SECTION 8. (a) The Texas Board of Health shall adopt rules
11-23 relating to the education of persons performing a radiologic
11-24 procedure not later than January 1, 1996.
11-25 (b) A person subject to the requirement of the Texas Board
11-26 of Health that the person receive the appropriate number of hours
11-27 of education requirements before performing a radiologic procedure
12-1 must complete the education requirements approved by the Texas
12-2 Board of Health on or before January 1, 1998, but may until that
12-3 date continue to perform radiologic procedures authorized by the
12-4 Medical Radiologic Technologist Certification Act (Article 4512m,
12-5 Vernon's Texas Civil Statutes), and the former law is continued in
12-6 effect for that purpose.
12-7 SECTION 9. This Act takes effect September 1, 1995.
12-8 SECTION 10. The importance of this legislation and the
12-9 crowded condition of the calendars in both houses create an
12-10 emergency and an imperative public necessity that the
12-11 constitutional rule requiring bills to be read on three several
12-12 days in each house be suspended, and this rule is hereby suspended.