1-1 By: Galloway S.B. No. 729
1-2 (In the Senate - Filed February 23, 1995; February 23, 1995,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 18, 1995, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 9, Nays 0;
1-6 April 18, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 729 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 who
1-23 is physically present during the conduct of a radiologic procedure
1-24 to provide consultation or direct the action of the student.
1-25 (14) "Education program" means clinical training or
1-26 any other program offered by an organization approved by the Texas
1-27 Board of Health that:
1-28 (A) has a specified objective;
1-29 (B) includes planned activities for the
1-30 participants; and
1-31 (C) uses an approved method for measuring the
1-32 progress of the participants.
1-33 (15) "Authorized person" means a person who meets or
1-34 exceeds the minimum educational standards of the Texas Board of
1-35 Health under Section 2.05(f) of this Act.
1-36 (16) "Registrant" means an individual, other than a
1-37 practitioner or medical radiologic technologist, who meets the
1-38 requirements of Section 2.05(f) of this Act.
1-39 SECTION 2. Section 2.05, Medical Radiologic Technologist
1-40 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-41 is amended by amending Subsection (a) and by adding Subsections
1-42 (f), (g), (h), (i), (j), and (k) to read as follows:
1-43 (a) The Texas Board of Health shall adopt rules
1-44 establishing:
1-45 (1) minimum standards for issuing, renewing,
1-46 suspending, and revoking certificates issued under this Act;
1-47 (2) minimum standards for the approval of curricula
1-48 and education programs to train individuals, registered nurses, and
1-49 physician assistants to perform radiologic procedures and for
1-50 rescinding the approval; <and>
1-51 (3) minimum standards for the approval of instructors
1-52 to teach approved curricula or education programs to train
1-53 individuals to perform radiologic procedures and for rescinding the
1-54 approval; and
1-55 (4) a registry of persons who are required to comply
1-56 with Subsection (f) of this section.
1-57 (f) The minimum standards of the Texas Board of Health for
1-58 approval of curricula and education programs under Subsection (a)
1-59 of this section shall include mandatory training guidelines for a
1-60 person, other than a practitioner or a medical radiologic
1-61 technologist, who intentionally administers radiation to another
1-62 person for medical purposes, including a person who does not hold a
1-63 certificate issued under this Act who is performing a radiologic
1-64 procedure under the direction of a practitioner, other than a
1-65 dentist, or at a hospital. The training program approved by the
1-66 Texas Board of Health must contain an appropriate number of hours
1-67 of education that must be completed before the person may perform a
1-68 radiologic procedure.
2-1 (g) The Texas Board of Health with the assistance of other
2-2 appropriate state agencies shall by rule identify radiologic
2-3 procedures that are dangerous or hazardous and that may only be
2-4 performed by a practitioner or a medical radiologic technologist
2-5 certified under this Act.
2-6 (h) Subsection (g) of this section does not apply to a
2-7 radiologic procedure involving a dental X-ray machine, including a
2-8 panarex or other equipment designed and manufactured only for use
2-9 in dental radiography.
2-10 (i) On the application to the department by a hospital,
2-11 federally qualified health center as defined by 42 U.S.C. Section
2-12 1396d, or practitioner, the department shall exempt the applicant
2-13 from the requirements of Subsection (f) of this section in
2-14 employing a person certified under this Act or trained as required
2-15 by Subsection (f) of this section if the applicant shows a hardship
2-16 in employing a person certified under this Act or trained as
2-17 required by Subsection (f) of this section.
2-18 (j) The following conditions are considered to be hardships
2-19 for the purposes of Subsection (i) of this section:
2-20 (1) that the hospital, federally qualified health
2-21 center, or practitioner reports an inability to attract and retain
2-22 medical radiologic technologists;
2-23 (2) that the hospital, federally qualified health
2-24 center, or practitioner is located at a great distance from a
2-25 school of medical radiologic technology;
2-26 (3) that there is a list of qualified applicants to a
2-27 school of medical radiologic technology whose admissions are
2-28 pending because of a lack of faculty or space;
2-29 (4) that the school of medical radiologic technology
2-30 produces an insufficient number of graduates in medical radiologic
2-31 technology to meet the needs of the hospital, federally qualified
2-32 health center, or practitioner; or
2-33 (5) any other criteria determined by department rule.
2-34 (k) In adopting rules under Subsection (g) of this section,
2-35 the Texas Board of Health may consider whether the radiologic
2-36 procedure will be performed by a registered nurse or a licensed
2-37 physician assistant.
2-38 SECTION 3. Section 2.07, Medical Radiologic Technologist
2-39 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
2-40 is amended by amending Subsection (d) and by adding Subsection (g)
2-41 to read as follows:
2-42 (d) A person who performs a radiologic procedure in a
2-43 hospital that participates in the federal Medicare program or that
2-44 is accredited by the Joint Commission on Accreditation of Hospitals
2-45 and who has completed a training program approved by the Texas
2-46 Board of Health under Section 2.05(f) of this Act <received
2-47 appropriate instruction and training in the use and operation of
2-48 diagnostic radiologic equipment consistent with either the federal
2-49 Medicare standards for certification of hospitals or the
2-50 accreditation standards of the Joint Commission on Accreditation of
2-51 Hospitals> may perform radiologic procedures without a certificate
2-52 issued under this Act. <A hospital that instructs and trains a
2-53 person in the performance of radiologic procedures shall develop a
2-54 protocol for the instruction and training.>
2-55 (g) A person is not required to hold a certificate issued
2-56 under this Act to perform a radiologic procedure if:
2-57 (1) the procedure is performed under the supervision
2-58 of a dentist; and
2-59 (2) the person is:
2-60 (A) registered with the State Board of Dental
2-61 Examiners; and
2-62 (B) in compliance with rules adopted by that
2-63 board under Section 2.08 of this Act.
2-64 SECTION 4. Subsections (b) and (c), Section 2.08, Medical
2-65 Radiologic Technologist Certification Act (Article 4512m, Vernon's
2-66 Texas Civil Statutes), are amended to read as follows:
2-67 (b) Each agency, other than the Board of Nurse Examiners,
2-68 subject to this Act <section> shall adopt rules in accordance with
2-69 Chapter 2001, Government Code ( <the> Administrative Procedure <and
2-70 Texas Register> Act <(Article 6252-13a, Vernon's Texas Civil
3-1 Statutes>), to regulate the manner in which a licensee of the
3-2 agency may order, instruct, or direct another authorized person in
3-3 the performance of radiologic procedures. Rules adopted under this
3-4 subsection shall allow a practitioner the right to delegate certain
3-5 designated radiologic procedures to a person not certified under
3-6 this Act if the delegation is allowed by the regulatory board that
3-7 licenses the practitioner.
3-8 (c) Rules adopted under this section must:
3-9 (1) require an authorized <a> person, other than a
3-10 registered nurse, <who is not certified under this Act> to register
3-11 with the agency that licenses the practitioner under whom the
3-12 person performs radiologic procedures;
3-13 (2) establish reasonable and necessary fees to cover
3-14 the administrative costs incurred by the agency in administering a
3-15 registration program created under this subsection;
3-16 (3) establish grounds for the suspension, revocation,
3-17 or nonrenewal of a registration issued under this subsection; and
3-18 (4) <identify radiologic procedures that are more
3-19 dangerous or hazardous and may only be performed by a practitioner
3-20 or by a medical radiologic technologist certified under this Act;>
3-21 <(5) establish safety standards and procedures for the
3-22 operation of equipment used to perform radiologic procedures; and>
3-23 <(6)> establish standards, in addition to those
3-24 required by this Act, for the training and supervision of the
3-25 operators of the equipment.
3-26 SECTION 5. Section 2.11, Medical Radiologic Technologist
3-27 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
3-28 is amended to read as follows:
3-29 Sec. 2.11. Disciplinary Actions. (a) The department is
3-30 authorized to take the following disciplinary actions for the
3-31 violation of any provisions of this Act or rules adopted under this
3-32 Act:
3-33 (1) suspension, revocation, or nonrenewal of a
3-34 certificate; <and>
3-35 (2) rescission of curriculum, training program, or
3-36 instructor approval;
3-37 (3) denial of an application for certification or
3-38 approval;
3-39 (4) assessment of a civil penalty in an amount not to
3-40 exceed $1,000 for each separate violation of this Act;
3-41 (5) issuance of a reprimand; or
3-42 (6) placement of the offender's certificate on
3-43 probation and requiring compliance with a requirement of the
3-44 department, including submitting to medical or psychological
3-45 treatment, meeting additional education requirements, passing an
3-46 examination, or working under the supervision of a medical
3-47 radiologic technologist or other practitioner.
3-48 (b) The procedure by which the department takes a
3-49 disciplinary action and the procedure by which a disciplinary
3-50 action is appealed are governed by department rules for a contested
3-51 case hearing and by Chapter 2001, Government Code ( <the>
3-52 Administrative Procedure <and Texas Register> Act <(Article
3-53 6252-13a, Vernon's Texas Civil Statutes>).
3-54 (c) The department may take disciplinary action against a
3-55 person subject to this Act for:
3-56 (1) obtaining or attempting to obtain a certificate
3-57 issued under this Act by bribery or fraud;
3-58 (2) making or filing a false report or record made in
3-59 the person's capacity as a medical radiologic technologist;
3-60 (3) intentionally or negligently failing to file a
3-61 report or record required by law;
3-62 (4) intentionally obstructing or inducing another to
3-63 intentionally obstruct the filing of a report or record required by
3-64 law;
3-65 (5) engaging in unprofessional conduct, including the
3-66 violation of the standards of practice of radiologic technology
3-67 established by the Texas Board of Health;
3-68 (6) developing an incapacity that prevents the
3-69 practice of radiologic technology with reasonable skill,
3-70 competence, and safety to the public as the result of:
4-1 (A) an illness;
4-2 (B) drug or alcohol dependency; or
4-3 (C) another physical or mental condition or
4-4 illness;
4-5 (7) failing to report to the department the violation
4-6 of this Act by another person;
4-7 (8) employing, for the purpose of applying ionizing
4-8 radiation to a person, a person who is not certified under or in
4-9 compliance with this Act;
4-10 (9) violating a provision of this Act, a rule adopted
4-11 under this Act, an order of the department previously entered in a
4-12 disciplinary proceeding, or an order to comply with a subpoena
4-13 issued by the department;
4-14 (10) having a certificate revoked, suspended, or
4-15 otherwise subjected to adverse action or being denied a certificate
4-16 by another certification authority in another state, territory, or
4-17 country; or
4-18 (11) being convicted of or pleading nolo contendere to
4-19 a crime directly related to the practice of radiologic technology.
4-20 (d) A person subject to disciplinary action under Subsection
4-21 (c)(6) of this section shall, at reasonable intervals, be afforded
4-22 an opportunity to demonstrate that the person is able to resume the
4-23 practice of radiologic technology.
4-24 (e) The Texas Board of Health may not reinstate a
4-25 certificate to a holder or cause a certificate to be issued to an
4-26 applicant previously denied a certificate unless the board is
4-27 satisfied that the holder or applicant has complied with
4-28 requirements set by the board and is capable of engaging in the
4-29 practice of radiologic technology.
4-30 (f) The department may take disciplinary action against a
4-31 student for intentionally practicing radiologic technology without
4-32 direct supervision.
4-33 SECTION 6. Subsection (a), Section 2.13, Medical Radiologic
4-34 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
4-35 Statutes), is amended to read as follows:
4-36 (a) A person who is required to be certified under this Act
4-37 commits an offense if the person:
4-38 (1) knowingly administers a radiologic procedure to
4-39 another person without holding a valid certificate issued by the
4-40 department;
4-41 (2) practices radiologic technology without holding a
4-42 certificate under this Act;
4-43 (3) uses or attempts to use a suspended or revoked
4-44 certificate;
4-45 (4) knowingly allows a student enrolled in an
4-46 education program to perform a radiologic procedure without direct
4-47 supervision;
4-48 (5) obtains or attempts to obtain a certificate
4-49 through bribery or fraudulent misrepresentation;
4-50 (6) uses the title or name "certified medical
4-51 radiologic technologist" or any other name or title that implies
4-52 the person is certified to practice radiologic technology, unless
4-53 the person is certified under this Act;
4-54 (7) knowingly conceals information relating to
4-55 enforcement of this Act or rules adopted under this Act; or
4-56 (8) employs a person not certified by or in compliance
4-57 with this Act for the purpose of applying ionizing radiation to a
4-58 person.
4-59 SECTION 7. Section 2.14, Medical Radiologic Technologist
4-60 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
4-61 is amended to read as follows:
4-62 Sec. 2.14. INJUNCTION; CIVIL PENALTY. (a) If it appears
4-63 that a person has violated, is violating, or is threatening to
4-64 violate this Act or a rule adopted under this Act, the Texas Board
4-65 of Health or the department may bring a civil action to obtain
4-66 injunctive relief to restrain the continued or threatened
4-67 violation.
4-68 (b) A person who violates this Act or a rule adopted under
4-69 this Act is subject to a civil penalty in an amount that may not
4-70 exceed $1,000 for each day of violation.
5-1 (c) At the request of the Texas Board of Health or the
5-2 department, the attorney general shall bring an action in the name
5-3 of the state for injunctive relief, to recover a civil penalty, or
5-4 both, as authorized by this section. <TERMS OF INITIAL MEMBERS;
5-5 INITIAL MEETING. (a) Four initial members appointed to the
5-6 Medical Radiologic Technologist Advisory Board serve for terms
5-7 expiring January 1, 1990, four initial members serve for terms
5-8 expiring January 1, 1992, and four initial members serve for terms
5-9 expiring January 1, 1994. The 12 initial members shall draw lots
5-10 to determine the lengths of their terms. The Texas Board of Health
5-11 shall make the initial appointments not later than January 1, 1988.>
5-12 <(b) The advisory board shall hold its initial meeting by
5-13 January, 1988, to organize, begin work, and set future meeting
5-14 dates.>
5-15 SECTION 8. (a) The Texas Board of Health shall adopt rules
5-16 relating to the education of persons performing a radiologic
5-17 procedure not later than January 1, 1996.
5-18 (b) A person subject to the requirement of the Texas Board
5-19 of Health that the person receive the appropriate number of hours
5-20 of education requirements before performing a radiologic procedure
5-21 must complete the education requirements approved by the Texas
5-22 Board of Health on or before January 1, 1998, but may until that
5-23 date continue to perform radiologic procedures authorized by the
5-24 Medical Radiologic Technologist Certification Act (Article 4512m,
5-25 Vernon's Texas Civil Statutes), and the former law is continued in
5-26 effect for that purpose.
5-27 SECTION 9. This Act takes effect September 1, 1995.
5-28 SECTION 10. The importance of this legislation and the
5-29 crowded condition of the calendars in both houses create an
5-30 emergency and an imperative public necessity that the
5-31 constitutional rule requiring bills to be read on three several
5-32 days in each house be suspended, and this rule is hereby suspended.
5-33 * * * * *