By Uher H.B. No. 1644
75R5907 JMM-D
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.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 2.03, Medical Radiologic Technologist
1-6 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-7 is amended by adding Subdivision (17) to read as follows:
1-8 (17) "Physician assistant" means a person licensed by
1-9 the Texas State Board of Physician Assistant Examiners to practice
1-10 as a physician assistant.
1-11 SECTION 2. Subchapter B, the Medical Radiologic Technologist
1-12 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-13 is amended by adding Section 2.041 to read as follows:
1-14 Sec. 2.041. ADVISORY COMMITTEE. An advisory committee
1-15 established by the board under Section 11.016, Health and Safety
1-16 Code, to assist the board in performing its duties under this Act
1-17 shall consist of persons having the following qualifications:
1-18 (1) two must be consumers;
1-19 (2) two must be medical radiologic technologists who
1-20 meet the qualifications for certification under this Act;
1-21 (3) one must be a licensed registered nurse who
1-22 regularly performs radiologic procedures;
1-23 (4) one must be a licensed physician assistant who
1-24 regularly performs radiologic procedures;
2-1 (5) one must be a licensed podiatrist;
2-2 (6) one must be a licensed physician who is an
2-3 osteopath and who practices in a rural area;
2-4 (7) one must be a licensed physician who specializes
2-5 in family practice;
2-6 (8) one must be a licensed physician who is an
2-7 orthopedist;
2-8 (9) two must be licensed chiropractors;
2-9 (10) one must be a medical radiation physicist engaged
2-10 in the instruction of radiologic technology; and
2-11 (11) two must be hospital administrators.
2-12 SECTION 3. Section 2.05, Medical Radiologic Technologist
2-13 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
2-14 is amended to read as follows:
2-15 Sec. 2.05. DUTIES OF TEXAS BOARD OF HEALTH. (a) The Texas
2-16 Board of Health shall adopt rules establishing:
2-17 (1) minimum standards for issuing, renewing,
2-18 suspending, and revoking certificates issued under this Act;
2-19 (2) minimum standards for the approval of curricula
2-20 and education programs to train individuals, registered nurses, and
2-21 physician assistants to perform radiologic procedures and for
2-22 rescinding the approval;
2-23 (3) minimum standards for the approval of instructors
2-24 to teach approved curricula or education programs to train
2-25 individuals to perform radiologic procedures and for rescinding the
2-26 approval; and
2-27 (4) a registry of persons who are required to comply
3-1 with Subsection (f) of this section.
3-2 (b) The Texas Board of Health shall establish different
3-3 classes of certificates to include all radiologic procedures used
3-4 in the course and scope of the practice of practitioners licensed
3-5 in this state. The Texas Board of Health may issue general and
3-6 limited certificates and general and limited temporary
3-7 certificates.
3-8 (c) When adopting minimum standards for certifying medical
3-9 radiologic technologists, the Texas Board of Health may establish
3-10 criteria for issuing a certificate to a person licensed or
3-11 otherwise registered as a medical radiologic technologist by
3-12 another state, the American Registry of Radiologic Technologists,
3-13 the American Registry of Clinical Radiography Technologists, the
3-14 District of Columbia, or a territory of the United States whose
3-15 requirements for licensure or registration were at the date of
3-16 licensing or registration substantially equal to the requirements
3-17 set forth in this Act.
3-18 (d) The Texas Board of Health may establish guidelines,
3-19 which may include requirements for continuing education for medical
3-20 radiologic technologists, and the Texas Board of Health may prepare
3-21 and conduct an examination for applicants for a certificate.
3-22 (e) The Texas Board of Health may adopt rules necessary to
3-23 implement this Act.
3-24 (f) The minimum standards of the Texas Board of Health for
3-25 approval of curricula and education programs under Subsection (a)
3-26 of this section shall include mandatory training guidelines for a
3-27 person, other than a practitioner or a medical radiologic
4-1 technologist, who intentionally administers radiation to another
4-2 person for medical purposes, including a person who does not hold a
4-3 certificate issued under this Act who is performing a radiologic
4-4 procedure at a hospital or under the direction of a practitioner,
4-5 other than a dentist. The training program approved by the Texas
4-6 Board of Health must contain an appropriate number of hours of
4-7 education that must be completed before the person may perform a
4-8 radiologic procedure. This subsection does not apply to a person
4-9 who administers radiation to another person for medical purposes if
4-10 the person, before September 1, 1998, had at least one year of
4-11 experience in performing radiologic procedures under the direction,
4-12 supervision, and authority of a practitioner.
4-13 (g) [The Texas Board of Health with the assistance of other
4-14 appropriate state agencies shall by rule identify radiologic
4-15 procedures that are dangerous or hazardous and that may only be
4-16 performed by a practitioner or a medical radiologic technologist
4-17 certified under this Act.]
4-18 [(h) Subsection (g) of this section does not apply to a
4-19 radiologic procedure involving a dental X-ray machine, including a
4-20 panarex or other equipment designed and manufactured only for use
4-21 in dental radiography.]
4-22 [(i)] On the application to the department by a hospital,
4-23 federally qualified health center as defined by 42 U.S.C. Section
4-24 1396d, or practitioner, the department shall exempt the applicant
4-25 from the requirements of Subsection (f) of this section in
4-26 employing a person certified under this Act or trained as required
4-27 by Subsection (f) of this section if the applicant shows a hardship
5-1 in employing a person certified under this Act or trained as
5-2 required by Subsection (f) of this section.
5-3 (h) [(j)] The following conditions are considered to be
5-4 hardships for the purposes of Subsection (g) [(i)] of this section:
5-5 (1) that the hospital, federally qualified health
5-6 center, or practitioner reports an inability to attract and retain
5-7 medical radiologic technologists;
5-8 (2) that the hospital, federally qualified health
5-9 center, or practitioner is located at a great distance from a
5-10 school of medical radiologic technology;
5-11 (3) that there is a list of qualified applicants to a
5-12 school of medical radiologic technology whose admissions are
5-13 pending because of a lack of faculty or space;
5-14 (4) that the school of medical radiologic technology
5-15 produces an insufficient number of graduates in medical radiologic
5-16 technology to meet the needs of the hospital, federally qualified
5-17 health center, or practitioner; or
5-18 (5) any other criteria determined by department rule.
5-19 (i) A person who performs a radiologic procedure in
5-20 compliance with the procedures adopted under Section 5.04, Medical
5-21 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), does
5-22 not have to comply with the requirements adopted under Subsections
5-23 (a)(2)-(4) or Subsection (f) of this section.
5-24 [(k) In adopting rules under Subsection (g) of this section,
5-25 the Texas Board of Health may consider whether the radiologic
5-26 procedure will be performed by a registered nurse or a licensed
5-27 physician assistant.]
6-1 SECTION 4. Subchapter E, Medical Practice Act (Article
6-2 4495b, Vernon's Texas Civil Statutes), is amended by adding
6-3 Sections 5.04 and 5.045 to read as follows:
6-4 Sec. 5.04. DANGEROUS OR HAZARDOUS RADIOLOGIC PROCEDURES.
6-5 (a) In this section:
6-6 (1) "Practitioner" means a doctor of podiatry,
6-7 dentistry, or chiropractic who is licensed under the laws of this
6-8 state and who prescribes radiologic procedures for other persons.
6-9 (2) "Radiologic procedure" has the meaning assigned
6-10 that term by Section 2.03, Medical Radiologic Technologist
6-11 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
6-12 (b) The board, with the assistance of the Texas Department
6-13 of Health and other appropriate state agencies, by rule shall
6-14 identify radiologic procedures that are dangerous or hazardous and
6-15 that may only be performed by a physician, practitioner, or medical
6-16 radiologic technologist certified under the Medical Radiologic
6-17 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
6-18 Statutes).
6-19 (c) This section does not apply to a radiologic procedure
6-20 involving a dental X-ray machine, including a panarex or other
6-21 equipment designed and manufactured only for use in dental
6-22 radiography.
6-23 (d) In adopting rules under this section, the board shall
6-24 consider whether the radiologic procedure will be performed by a
6-25 registered nurse or a licensed physician assistant.
6-26 Sec. 5.045. TRAINING GUIDELINES FOR RADIOLOGIC PROCEDURES.
6-27 (a) In this section, "practitioner" and "radiologic procedure"
7-1 have the meanings assigned by Section 5.04 of this Act.
7-2 (b) The board shall adopt minimum standards for mandatory
7-3 training guidelines for a person, other than a physician, a
7-4 practitioner, or a medical radiologic technologist, who
7-5 intentionally administers radiation to another person for medical
7-6 purposes under the direction, supervision, and authority of a
7-7 physician.
7-8 (c) The guidelines adopted under this section must permit a
7-9 person to comply with the guidelines by completing a course of
7-10 instruction under a physician who employs or supervises the person
7-11 and by passing a written examination approved by the board.
7-12 (d) A person who performed radiologic procedures under the
7-13 direction, supervision, or authority of a physician on or before
7-14 September 1, 1996, is exempt from complying with the requirements
7-15 of this section and may apply to the board for a certificate of
7-16 exemption from the requirements.
7-17 (e) The board may establish and collect fees necessary to
7-18 recover the costs of administering this section. Fees collected
7-19 under this section may be used only to administer this section.
7-20 SECTION 5. Sections 2.03(1) and 2.04, Medical Radiologic
7-21 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
7-22 Statutes), are repealed.
7-23 SECTION 6. (a) This Act takes effect September 1, 1997.
7-24 (b) The term of a member of the Medical Radiologic
7-25 Technologist Advisory Board serving immediately before the
7-26 effective date of this Act expires on that date and that advisory
7-27 board is abolished. The Texas Board of Health shall appoint an
8-1 advisory board under Section 2.041, Medical Radiologic Technologist
8-2 Certification Act, as added by this Act, as follows:
8-3 (1) five members for terms expiring January 1, 1998;
8-4 (2) five members for terms expiring January 1, 2000;
8-5 and
8-6 (3) five members for terms expiring January 1, 2002.
8-7 (c) Rules adopted before the effective date of this Act by
8-8 the Texas Board of Health under Section 2.05(f), Medical Radiologic
8-9 Technologist Certification Act (Article 4512m, Vernon's Texas Civil
8-10 Statutes), that provide mandatory training guidelines for the
8-11 administration of radiation by certain persons are repealed. The
8-12 board shall adopt new rules under that section after the date the
8-13 new members of the advisory board appointed under Subsection (b)
8-14 of this section have begun to serve.
8-15 (d) The Texas State Board of Medical Examiners shall adopt
8-16 rules under Section 5.04, Medical Practice Act (Article 4495b,
8-17 Vernon's Texas Civil Statutes), as added by this Act, not later
8-18 than January 1, 1998.
8-19 (e) The Texas State Board of Medical Examiners shall adopt
8-20 mandatory training guidelines under Section 5.045, Medical Practice
8-21 Act (Article 4495b, Vernon's Texas Civil Statutes), as added by
8-22 this Act, not later than June 1, 1998. A person must complete the
8-23 training under the guidelines not later than the later of:
8-24 (1) January 1, 2000; or
8-25 (2) the 18th month after the date the Texas State
8-26 Board of Medical Examiners adopts the training guidelines.
8-27 SECTION 7. The importance of this legislation and the
9-1 crowded condition of the calendars in both houses create an
9-2 emergency and an imperative public necessity that the
9-3 constitutional rule requiring bills to be read on three several
9-4 days in each house be suspended, and this rule is hereby suspended.