By Nelson                                        S.B. No. 943

      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.