1-1 By: Rodriguez, et al. (Senate Sponsor - Galloway) H.B. No. 1200
1-2 (In the Senate - Received from the House April 21, 1995;
1-3 April 24, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 10, 1995, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 8, Nays
1-6 0; May 10, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1200 By: Galloway
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of medical radiologic technologists and
1-11 other persons who perform radiologic procedures; providing civil
1-12 and criminal penalties.
1-13 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-14 SECTION 1. Section 2.03, Medical Radiologic Technologist
1-15 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-16 is amended by adding Subdivisions (13), (14), (15), and (16) to
1-17 read as follows:
1-18 (13) "Direct supervision" means supervision and
1-19 control by a medical radiologic technologist or a practitioner who
1-20 assumes legal liability for a student employed to perform a
1-21 radiologic procedure and enrolled in a program that meets the
1-22 requirements adopted by rule under Section 2.05 of this Act, and
1-23 who is physically present during the conduct of a radiologic
1-24 procedure to provide consultation or direct the action of the
1-25 student.
1-26 (14) "Education program" means clinical training or
1-27 any other program offered by an organization approved by the Texas
1-28 Board of Health that:
1-29 (A) has a specified objective;
1-30 (B) includes planned activities for the
1-31 participants; and
1-32 (C) uses an approved method for measuring the
1-33 progress of the participants.
1-34 (15) "Authorized person" means a person who meets or
1-35 exceeds the minimum educational standards of the Texas Board of
1-36 Health under Section 2.05(f) of this Act.
1-37 (16) "Registrant" means an individual, other than a
1-38 practitioner or medical radiologic technologist, who meets the
1-39 requirements of Section 2.05(f) of this Act.
1-40 SECTION 2. Section 2.05, Medical Radiologic Technologist
1-41 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-42 is amended by amending Subsection (a) and adding Subsections
1-43 (f)-(k) to read as follows:
1-44 (a) The Texas Board of Health shall adopt rules
1-45 establishing:
1-46 (1) minimum standards for issuing, renewing,
1-47 suspending, and revoking certificates issued under this Act;
1-48 (2) minimum standards for the approval of curricula
1-49 and education programs to train individuals, registered nurses, and
1-50 physician assistants to perform radiologic procedures and for
1-51 rescinding the approval; <and>
1-52 (3) minimum standards for the approval of instructors
1-53 to teach approved curricula or education programs to train
1-54 individuals to perform radiologic procedures and for rescinding the
1-55 approval; and
1-56 (4) a registry of persons who are required to comply
1-57 with Subsection (f) of this section.
1-58 (f) The minimum standards of the Texas Board of Health for
1-59 approval of curricula and education programs under Subsection (a)
1-60 of this section shall include mandatory training guidelines for a
1-61 person, other than a practitioner or a medical radiologic
1-62 technologist, who intentionally administers radiation to another
1-63 person for medical purposes, including a person who does not hold a
1-64 certificate issued under this Act who is performing a radiologic
1-65 procedure under the direction of a practitioner, other than a
1-66 dentist, or at a hospital. The training program approved by the
1-67 Texas Board of Health must contain an appropriate number of hours
1-68 of education that must be completed before the person may perform a
2-1 radiologic procedure.
2-2 (g) The Texas Board of Health with the assistance of other
2-3 appropriate state agencies shall by rule identify radiologic
2-4 procedures that are dangerous or hazardous and that may only be
2-5 performed by a practitioner or a medical radiologic technologist
2-6 certified under this Act.
2-7 (h) Subsection (g) of this section does not apply to a
2-8 radiologic procedure involving a dental X-ray machine, including a
2-9 panarex or other equipment designed and manufactured only for use
2-10 in dental radiography.
2-11 (i) On the application to the department by a hospital,
2-12 federally qualified health center as defined by 42 U.S.C. Section
2-13 1396d, or practitioner, the department shall exempt the applicant
2-14 from the requirements of Subsection (f) of this section in
2-15 employing a person certified under this Act or trained as required
2-16 by Subsection (f) of this section if the applicant shows a hardship
2-17 in employing a person certified under this Act or trained as
2-18 required by Subsection (f) of this section.
2-19 (j) The following conditions are considered to be hardships
2-20 for the purposes of Subsection (i) of this section:
2-21 (1) that the hospital, federally qualified health
2-22 center, or practitioner reports an inability to attract and retain
2-23 medical radiologic technologists;
2-24 (2) that the hospital, federally qualified health
2-25 center, or practitioner is located at a great distance from a
2-26 school of medical radiologic technology;
2-27 (3) that there is a list of qualified applicants to a
2-28 school of medical radiologic technology whose admissions are
2-29 pending because of a lack of faculty or space;
2-30 (4) that the school of medical radiologic technology
2-31 produces an insufficient number of graduates in medical radiologic
2-32 technology to meet the needs of the hospital, federally qualified
2-33 health center, or practitioner; or
2-34 (5) any other criteria determined by department rule.
2-35 (k) In adopting rules under Subsection (g) of this section,
2-36 the Texas Board of Health may consider whether the radiologic
2-37 procedure will be performed by a registered nurse or a licensed
2-38 physician assistant.
2-39 SECTION 3. Section 2.07, Medical Radiologic Technologist
2-40 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
2-41 is amended by amending Subsection (d) and adding Subsection (g) to
2-42 read as follows:
2-43 (d) A person who performs a radiologic procedure in a
2-44 hospital that participates in the federal Medicare program or that
2-45 is accredited by the Joint Commission on Accreditation of Hospitals
2-46 and who has completed a training program approved by the Texas
2-47 Board of Health under Section 2.05(f) of this Act <received
2-48 appropriate instruction and training in the use and operation of
2-49 diagnostic radiologic equipment consistent with either the federal
2-50 Medicare standards for certification of hospitals or the
2-51 accreditation standards of the Joint Commission on Accreditation of
2-52 Hospitals> may perform radiologic procedures without a certificate
2-53 issued under this Act. <A hospital that instructs and trains a
2-54 person in the performance of radiologic procedures shall develop a
2-55 protocol for the instruction and training.>
2-56 (g) A person is not required to hold a certificate issued
2-57 under this Act to perform a radiologic procedure if:
2-58 (1) the procedure is performed under the supervision
2-59 of a dentist; and
2-60 (2) the person is:
2-61 (A) registered with the State Board of Dental
2-62 Examiners; and
2-63 (B) in compliance with rules adopted by that
2-64 board under Section 2.08 of this Act.
2-65 SECTION 4. Sections 2.08(b) and (c), Medical Radiologic
2-66 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
2-67 Statutes), are amended to read as follows:
2-68 (b) Each agency, other than the Board of Nurse Examiners,
2-69 subject to this Act <section> shall adopt rules in accordance with
2-70 Chapter 2001, Government Code, <the Administrative Procedure and
3-1 Texas Register Act (Article 6252-13a, Vernon's Texas Civil
3-2 Statutes)> to regulate the manner in which a licensee of the agency
3-3 may order, instruct, or direct another authorized person in the
3-4 performance of radiologic procedures. Rules adopted under this
3-5 subsection shall allow a practitioner the right to delegate certain
3-6 designated radiologic procedures to a person not certified under
3-7 this Act if the delegation is allowed by the regulatory board that
3-8 licenses the practitioner.
3-9 (c) Rules adopted under this section must:
3-10 (1) require an authorized <a> person, other than a
3-11 registered nurse, <who is not certified under this Act> to register
3-12 with the agency that licenses the practitioner under whom the
3-13 person performs radiologic procedures;
3-14 (2) establish reasonable and necessary fees to cover
3-15 the administrative costs incurred by the agency in administering a
3-16 registration program created under this subsection;
3-17 (3) establish grounds for the suspension, revocation,
3-18 or nonrenewal of a registration issued under this subsection; and
3-19 (4) <identify radiologic procedures that are more
3-20 dangerous or hazardous and may only be performed by a practitioner
3-21 or by a medical radiologic technologist certified under this Act;>
3-22 <(5) establish safety standards and procedures for the
3-23 operation of equipment used to perform radiologic procedures; and>
3-24 <(6)> establish standards, in addition to those
3-25 required by this Act, for the training and supervision of the
3-26 operators of the equipment.
3-27 SECTION 5. Section 2.11, Medical Radiologic Technologist
3-28 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
3-29 is amended to read as follows:
3-30 Sec. 2.11. Disciplinary Actions. (a) The department is
3-31 authorized to take the following disciplinary actions for the
3-32 violation of any provisions of this Act or rules adopted under this
3-33 Act:
3-34 (1) suspension, revocation, or nonrenewal of a
3-35 certificate; <and>
3-36 (2) rescission of curriculum, training program, or
3-37 instructor approval;
3-38 (3) denial of an application for certification or
3-39 approval;
3-40 (4) assessment of a civil penalty in an amount not to
3-41 exceed $1,000 for each separate violation of this Act;
3-42 (5) issuance of a reprimand; or
3-43 (6) placement of the offender's certificate on
3-44 probation and requiring compliance with a requirement of the
3-45 department, including submitting to medical or psychological
3-46 treatment, meeting additional education requirements, passing an
3-47 examination, or working under the supervision of a medical
3-48 radiologic technologist or other practitioner.
3-49 (b) The procedure by which the department takes a
3-50 disciplinary action and the procedure by which a disciplinary
3-51 action is appealed are governed by department rules for a contested
3-52 case hearing and by Chapter 2001, Government Code <the
3-53 Administrative Procedure and Texas Register Act (Article 6252-13a,
3-54 Vernon's Texas Civil Statutes)>.
3-55 (c) The department may take disciplinary action against a
3-56 person subject to this Act for:
3-57 (1) obtaining or attempting to obtain a certificate
3-58 issued under this Act by bribery or fraud;
3-59 (2) making or filing a false report or record made in
3-60 the person's capacity as a medical radiologic technologist;
3-61 (3) intentionally or negligently failing to file a
3-62 report or record required by law;
3-63 (4) intentionally obstructing or inducing another to
3-64 intentionally obstruct the filing of a report or record required by
3-65 law;
3-66 (5) engaging in unprofessional conduct, including the
3-67 violation of the standards of practice of radiologic technology
3-68 established by the Texas Board of Health;
3-69 (6) developing an incapacity that prevents the
3-70 practice of radiologic technology with reasonable skill,
4-1 competence, and safety to the public as the result of:
4-2 (A) an illness;
4-3 (B) drug or alcohol dependency; or
4-4 (C) another physical or mental condition or
4-5 illness;
4-6 (7) failing to report to the department the violation
4-7 of this Act by another person;
4-8 (8) employing, for the purpose of applying ionizing
4-9 radiation to a person, a person who is not certified under or in
4-10 compliance with this Act;
4-11 (9) violating a provision of this Act, a rule adopted
4-12 under this Act, an order of the department previously entered in a
4-13 disciplinary proceeding, or an order to comply with a subpoena
4-14 issued by the department;
4-15 (10) having a certificate revoked, suspended, or
4-16 otherwise subjected to adverse action or being denied a certificate
4-17 by another certification authority in another state, territory, or
4-18 country; or
4-19 (11) being convicted of or pleading nolo contendere to
4-20 a crime directly related to the practice of radiologic technology.
4-21 (d) A person subject to disciplinary action under Subsection
4-22 (c)(6) of this section shall, at reasonable intervals, be afforded
4-23 an opportunity to demonstrate that the person is able to resume the
4-24 practice of radiologic technology.
4-25 (e) The Texas Board of Health may not reinstate a
4-26 certificate to a holder or cause a certificate to be issued to an
4-27 applicant previously denied a certificate unless the board is
4-28 satisfied that the holder or applicant has complied with
4-29 requirements set by the board and is capable of engaging in the
4-30 practice of radiologic technology.
4-31 (f) The department may take disciplinary action against a
4-32 student for intentionally practicing radiologic technology without
4-33 direct supervision.
4-34 SECTION 6. Section 2.13(a), Medical Radiologic Technologist
4-35 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
4-36 is amended to read as follows:
4-37 (a) A person who is required to be certified under this Act
4-38 commits an offense if the person:
4-39 (1) knowingly administers a radiologic procedure to
4-40 another person without holding a valid certificate issued by the
4-41 department;
4-42 (2) practices radiologic technology without holding a
4-43 certificate under this Act;
4-44 (3) uses or attempts to use a suspended or revoked
4-45 certificate;
4-46 (4) knowingly allows a student enrolled in an
4-47 education program to perform a radiologic procedure without direct
4-48 supervision;
4-49 (5) obtains or attempts to obtain a certificate
4-50 through bribery or fraudulent misrepresentation;
4-51 (6) uses the title or name "certified medical
4-52 radiologic technologist" or any other name or title that implies
4-53 the person is certified to practice radiologic technology, unless
4-54 the person is certified under this Act;
4-55 (7) knowingly conceals information relating to
4-56 enforcement of this Act or rules adopted under this Act; or
4-57 (8) employs a person not certified by or in compliance
4-58 with this Act for the purpose of applying ionizing radiation to a
4-59 person.
4-60 SECTION 7. Section 2.14, Medical Radiologic Technologist
4-61 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
4-62 is amended to read as follows:
4-63 Sec. 2.14. INJUNCTION; CIVIL PENALTY. (a) If it appears
4-64 that a person has violated, is violating, or is threatening to
4-65 violate this Act or a rule adopted under this Act, the Texas Board
4-66 of Health or the department may bring a civil action to obtain
4-67 injunctive relief to restrain the continued or threatened
4-68 violation.
4-69 (b) A person who violates this Act or a rule adopted under
4-70 this Act is subject to a civil penalty in an amount that may not
5-1 exceed $1,000 for each day of violation.
5-2 (c) At the request of the Texas Board of Health or the
5-3 department, the attorney general shall bring an action in the name
5-4 of the state for injunctive relief, to recover a civil penalty, or
5-5 both, as authorized by this section. <TERMS OF INITIAL MEMBERS;
5-6 INITIAL MEETING. (a) Four initial members appointed to the
5-7 Medical Radiologic Technologist Advisory Board serve for terms
5-8 expiring January 1, 1990, four initial members serve for terms
5-9 expiring January 1, 1992, and four initial members serve for terms
5-10 expiring January 1, 1994. The 12 initial members shall draw lots
5-11 to determine the lengths of their terms. The Texas Board of Health
5-12 shall make the initial appointments not later than January 1, 1988.>
5-13 <(b) The advisory board shall hold its initial meeting by
5-14 January, 1988, to organize, begin work, and set future meeting
5-15 dates.>
5-16 SECTION 8. (a) The Texas Board of Health shall adopt rules
5-17 relating to the education of persons performing a radiologic
5-18 procedure not later than January 1, 1996.
5-19 (b) A person subject to the requirement of the Texas Board
5-20 of Health that the person receive the appropriate number of hours
5-21 of education requirements before performing a radiologic procedure
5-22 must complete the education requirements approved by the Texas
5-23 Board of Health on or before January 1, 1998, but may until that
5-24 date continue to perform radiologic procedures authorized by the
5-25 Medical Radiologic Technologist Certification Act (Article 4512m,
5-26 Vernon's Texas Civil Statutes), and the former law is continued in
5-27 effect for that purpose.
5-28 SECTION 9. This Act takes effect September 1, 1995.
5-29 SECTION 10. The importance of this legislation and the
5-30 crowded condition of the calendars in both houses create an
5-31 emergency and an imperative public necessity that the
5-32 constitutional rule requiring bills to be read on three several
5-33 days in each house be suspended, and this rule is hereby suspended.
5-34 * * * * *