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