By Rodriguez, et al. H.B. No. 1200
Substitute the following for H.B. No. 1200:
By McDonald C.S.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 Subdivision (13), (14), (15), and (16) to read
1-9 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 4521m, 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 physicians' 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) to a
3-22 hospital, federally qualified health center as defined by 42 USC
3-23 1396 (d), or practitioner based upon hardship. A hospital,
3-24 federally qualified health center, or practitioner may apply to the
3-25 Texas Department of Health for an exemption from the requirements
3-26 of Subsection (f) of this Section, which shall be granted if the
3-27 hospital, federally qualified health center, or practitioner can
4-1 show a hardship in employing a person certified under this Act or
4-2 trained under Subsection (f) of this Section. Any one of the
4-3 following shall be deemed to be a hardship:
4-4 (A) The hospital, federally qualified health
4-5 center, or practitioner reports an inability to attract or retain
4-6 medical radiologic technologists;
4-7 (B) the hospital, federally qualified health
4-8 center, or practitioner is located at a geographic distance from a
4-9 school of medical radiologic technology;
4-10 (C) there is a list of qualified applicants to a
4-11 school of medical radiologic technology whose admission is pending
4-12 because of lack of faculty or space;
4-13 (D) the school produces an insufficient number
4-14 of graduates in medical radiologic technology to meet the needs of
4-15 the hospital, federally qualified health center, or practitioner;
4-16 or
4-17 (E) any other criteria as established by the
4-18 department by rule.
4-19 (j) In adopting rules under Subsection (g), the department
4-20 may take into account whether the radiologic procedure will be
4-21 performed by a registered nurse or a physician assistant licensed
4-22 under Article 4495b-1, Vernon's Texas Civil Statutes.
4-23 SECTION 3. Section 2.07, Medical Radiologic Technologist
4-24 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
4-25 is amended by amending Subsection (d) and adding Subsection (g) to
4-26 read as follows:
4-27 (d) A person who performs a radiologic procedure in a
5-1 hospital that participates in the federal Medicare program or that
5-2 is accredited by the Joint Commission on Accreditation of Hospitals
5-3 and who has completed a training program approved by the Texas
5-4 Board of Health under Section 2.05 (f) of this Act <received
5-5 appropriate instruction and training in the use and operation of
5-6 diagnostic radiologic equipment consistent with either the federal
5-7 Medicare standards for certification of hospitals or the
5-8 accreditation standards of the Joint Commission on Accreditation of
5-9 Hospitals> may perform radiologic procedures without a certificate
5-10 issued under this Act. <A hospital that instructs and trains a
5-11 person in the performance of radiologic procedures shall develop a
5-12 protocol for the instruction and training.>
5-13 (g) A person is not required to hold a certificate issued
5-14 under this Act to perform a radiologic procedure if:
5-15 (1) the procedure is performed under the supervision
5-16 of a dentist; and
5-17 (2) the person is:
5-18 (A) registered with the State Board of Dental
5-19 Examiners; and
5-20 (B) in compliance with rules adopted by that
5-21 board under Section 2.08 of this Act.
5-22 SECTION 4. Section 2.08 (b), (c), and (e), Medical
5-23 Radiologic Technologist Certification Act (Article 4512m, Vernon's
5-24 Texas Civil Statutes), are amended to read as follows:
5-25 (b) Each agency, other than the Board of Nurse Examiners,
5-26 subject to this Act <section> shall adopt rules in accordance with
5-27 Chapter 2001, Government Code, <the Administrative Procedure and
6-1 Texas Register Act (Article 6252 13a, Vernon's Texas Civil
6-2 Statutes)> to regulate the manner in which a licensee of the agency
6-3 may order, instruct, or direct another authorized person in the
6-4 performance of radiologic procedures. Rules adopted under this
6-5 subsection shall allow a practitioner the right to delegate certain
6-6 designated radiologic procedures to a person not certified under
6-7 this Act if the delegation is allowed by the regulatory board that
6-8 licenses the practitioner.
6-9 (c) Rules adopted under this section must:
6-10 (1) require a person, other than a registered nurse,
6-11 who is not certified under this Act to register with the agency
6-12 that licenses the practitioner under whom the person performs
6-13 radiologic procedures;
6-14 (2) establish reasonable and necessary fees to cover
6-15 the administrative costs incurred by the agency in administering a
6-16 registration program created under this subsection;
6-17 (3) establish grounds for the suspension, revocation,
6-18 or nonrenewal of a registration issued under this subsection; and
6-19 (4) <identify radiologic procedures that are more
6-20 dangerous or hazardous and may only be performed by a practitioner
6-21 or by a medical radiologic technologist certified under this Act,>
6-22 <(5) establish safety standards and procedures for the
6-23 operation of equipment used to perform radiologic procedures, and>
6-24 <(6)> establish standards, in addition to those
6-25 required by this Act, for the training and supervision of the
6-26 operators of the equipment.
6-27 SECTION 5. Section 2.11, Medical Radiologic Technologist
7-1 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
7-2 is amended to read as follows:
7-3 Section 2.11. DISCIPLINARY ACTIONS. (a) The department is
7-4 authorized to take the following disciplinary actions for the
7-5 violation of any provisions of this Act or rules adopted under this
7-6 Act:
7-7 (1) suspension, revocation, or nonrenewal of a
7-8 certificate; <and>
7-9 (2) rescission of curriculum, training program, or
7-10 instructor approval;
7-11 (3) denial of an application for certification or
7-12 approval;
7-13 (4) assessment of a civil penalty in an amount not to
7-14 exceed $1,000 for each separate violation of this Act;
7-15 (5) issuance of a reprimand; or
7-16 (6) placement of the offender's certificate on
7-17 probation and requiring compliance with an requirement of the
7-18 department, including submitting to medical or psychological
7-19 treatment, meeting additional education requirements, passing an
7-20 examination, or working under the supervision of a medical
7-21 radiologic technologist or other practitioner.
7-22 (b) The procedure by which the department takes a
7-23 disciplinary action and the procedure by which a disciplinary
7-24 action is appealed are governed by department rules for a contested
7-25 case hearing and by Chapter 2001, Government Code <the
7-26 Administrative Procedure and Texas Register Act (Article 6252-13a,
7-27 Vernon's Texas Civil Statutes)>.
8-1 (c) The department may take disciplinary action against a
8-2 person subject to this Act, other than a registrant, for:
8-3 (1) obtaining or attempting to obtain a certificate
8-4 issued under this Act by bribery or fraud;
8-5 (2) making or filing a false report or record made in
8-6 the person's capacity as a medical radiologic technologist;
8-7 (3) intentionally or negligently failing to file a
8-8 report or record required by law;
8-9 (4) intentionally obstructing or inducing another to
8-10 intentionally obstruct the filing of a report or record required by
8-11 law;
8-12 (5) engaging in unprofessional conduct, including the
8-13 violation of the standards of practice of radiologic technology
8-14 established by the Texas Board of Health;
8-15 (6) developing an incapacity that prevents the
8-16 practice of radiologic technology with reasonable skill,
8-17 competence, and safety to the public as the result of:
8-18 (A) an illness;
8-19 (B) drug or alcohol dependency; or
8-20 (C) another physical or mental condition or
8-21 illness;
8-22 (7) failing to report to the department the violation
8-23 of this Act by any other person;
8-24 (8) employing, for the purpose of applying ionizing
8-25 radiation to a person, a person who is not certified under or in
8-26 compliance with this Act;
8-27 (9) violating a provision of this Act, a rule adopted
9-1 under this Act, an order of the department previously entered in a
9-2 disciplinary proceeding, or an order to comply with a subpoena
9-3 issued by the department;
9-4 (10) having a certificate revoked, suspended, or
9-5 otherwise subjected to adverse action or being denied a certificate
9-6 by another certification authority in another state, territory, or
9-7 country; or
9-8 (11) being convicted of or pleading nolo contendere to
9-9 a crime directly related to the practice of radiologic technology.
9-10 (d) A person subject to disciplinary action under Subsection
9-11 (c)(6) of this section shall, at reasonable intervals, be afforded
9-12 an opportunity to demonstrate that the person is able to resume the
9-13 practice of radiologic technology.
9-14 (e) The Texas Board of Health may not reinstate a
9-15 certificate to a holder or cause a certificate to be issued to an
9-16 applicant previously denied a certificate unless the board is
9-17 satisfied that the holder or applicant has complied with
9-18 requirements set by the board and is capable of engaging in the
9-19 practice of radiologic technology.
9-20 (f) The department may take disciplinary action against a
9-21 student for intentionally practicing radiologic technology without
9-22 direct supervision.
9-23 SECTION 6. Section 2.13(a), Medical Radiologic Technologist
9-24 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
9-25 is amended to read as follows:
9-26 (a) A person who is required to be certified under this Act
9-27 commits an offense if the person:
10-1 (1) knowingly administers a radiologic procedure to
10-2 another person without holding a valid certificate issued by the
10-3 department;
10-4 (2) practices radiologic technology without holding a
10-5 certificate under this Act;
10-6 (3) uses or attempts to use a suspended or revoked
10-7 certificate;
10-8 (4) knowingly allows a student enrolled in an
10-9 education program to perform a radiologic procedure without direct
10-10 supervision;
10-11 (5) obtains or attempts to obtain a certificate
10-12 through bribery or fraudulent misrepresentation;
10-13 (6) uses the title or name "certified medical
10-14 radiologic technologist" or any other name or title that implies
10-15 the person is certified to practice radiologic technology, unless
10-16 the person is certified under this Act;
10-17 (7) knowingly conceals information relating to
10-18 enforcement of this Act or rules adopted under this Act; or
10-19 (8) employs a person not certified by or in compliance
10-20 with this Act for the purpose of applying ionizing radiation to a
10-21 person.
10-22 SECTION 7. Section 2.14, Medical Radiologic Technologist
10-23 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
10-24 is amended to read as follows:
10-25 Sec. 2.14. INJUNCTION; CIVIL PENALTY. (a) If it appears
10-26 that a person has violated, is violating, or is threatening to
10-27 violate this Act or a rule adopted under this Act, the Texas Board
11-1 of Health or the department may bring a civil action to obtain
11-2 injunctive relief to restrain the continued or threatened
11-3 violation.
11-4 (b) A person who violates this Act or a rule adopted under
11-5 this Act is subject to a civil penalty in an amount that may not
11-6 exceed $1,000 for each day of violation.
11-7 (c) At the request of the Texas Board of Health or the
11-8 department, the attorney general shall bring an action in the name
11-9 of the state for injunctive relief, to recover a civil penalty, or
11-10 both, as authorized by this section. <TERMS OF INITIAL MEMBERS;
11-11 INITIAL MEETING. (a) Four initial members appointed to the
11-12 Medical Radiologic Technologist Advisory Board serve for terms
11-13 expiring January 1, 1990, four initial members serve for terms
11-14 expiring January 1, 1992, and four initial members serve for terms
11-15 expiring January 1, 1994. The 12 initial members shall draw lots
11-16 to determine the lengths of their terms. The Texas Board of Health
11-17 shall make the initial appointments not later than January 1, 1988.>
11-18 <(b) The advisory board shall hold its initial meeting by
11-19 January, 1988, to organize, begin work, and set future meeting
11-20 dates.>
11-21 SECTION 8. (a) The Texas Board of Health shall adopt rules
11-22 relating to the education of persons performing a radiologic
11-23 procedure not later than January 1, 1996.
11-24 (b) A person subject to the requirement of the Texas Board
11-25 of Health that the person receive the appropriate number of hours
11-26 of education requirements before performing a radiologic procedure
11-27 must complete the education requirements approved by the Texas
12-1 Board of Health on or before January 1, 1998, but may until that
12-2 date continue to perform radiologic procedures authorized by the
12-3 Medical Radiologic Technologists Certification Act (Article 4512m,
12-4 Vernon's Texas Civil Statutes), and the former law is continued in
12-5 effect for that purpose.
12-6 SECTION 9. This Act takes effect September 1, 1995.
12-7 SECTION 10. The importance of this legislation and the
12-8 crowded condition of the calendars in both houses create an
12-9 emergency and an imperative public necessity that the
12-10 constitutional rule requiring bills to be read on three several
12-11 days in each house be suspended, and this rule is hereby suspended.