1-1 By: Nelson S.B. No. 943
1-2 (In the Senate - Filed March 5, 1997; March 6, 1997, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 28, 1997, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 8, Nays 0; April 28, 1997,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 943 By: Nelson
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.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Section 2.03, Medical Radiologic Technologist
1-14 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-15 is amended by adding Subdivision (17) to read as follows:
1-16 (17) "Physician assistant" means a person licensed by
1-17 the Texas State Board of Physician Assistant Examiners to practice
1-18 as a physician assistant.
1-19 SECTION 2. Section 2.05, Medical Radiologic Technologist
1-20 Certification Act (Article 4512m, Vernon's Texas Civil Statutes),
1-21 is amended to read as follows:
1-22 Sec. 2.05. DUTIES OF TEXAS BOARD OF HEALTH. (a) The Texas
1-23 Board of Health shall adopt rules establishing:
1-24 (1) minimum standards for issuing, renewing,
1-25 suspending, and revoking certificates issued under this Act;
1-26 (2) minimum standards for the approval of curricula
1-27 and education programs to train individuals, registered nurses, and
1-28 physician assistants to perform radiologic procedures and for
1-29 rescinding the approval;
1-30 (3) minimum standards for the approval of instructors
1-31 to teach approved curricula or education programs to train
1-32 individuals to perform radiologic procedures and for rescinding the
1-33 approval; and
1-34 (4) a registry of persons who are required to comply
1-35 with Subsection (f) of this section.
1-36 (b) The Texas Board of Health shall establish different
1-37 classes of certificates to include all radiologic procedures used
1-38 in the course and scope of the practice of practitioners licensed
1-39 in this state. The Texas Board of Health may issue general and
1-40 limited certificates and general and limited temporary
1-41 certificates.
1-42 (c) When adopting minimum standards for certifying medical
1-43 radiologic technologists, the Texas Board of Health may establish
1-44 criteria for issuing a certificate to a person licensed or
1-45 otherwise registered as a medical radiologic technologist by
1-46 another state, the American Registry of Radiologic Technologists,
1-47 the Nuclear Medicine Technology Certification Board [American
1-48 Registry of Clinical Radiography Technologists], the District of
1-49 Columbia, or a territory of the United States whose requirements
1-50 for licensure or registration were at the date of licensing or
1-51 registration substantially equal to the requirements set forth in
1-52 this Act.
1-53 (d) The Texas Board of Health may establish guidelines,
1-54 which may include requirements for continuing education for medical
1-55 radiologic technologists, and the Texas Board of Health may prepare
1-56 and conduct an examination for applicants for a certificate.
1-57 (e) The Texas Board of Health may adopt rules necessary to
1-58 implement this Act.
1-59 (f) The minimum standards of the Texas Board of Health for
1-60 approval of curricula and education programs under Subsection (a)
1-61 of this section shall include mandatory training guidelines for a
1-62 person, other than a practitioner or a medical radiologic
1-63 technologist, who intentionally administers radiation to another
1-64 person for medical purposes, including a person who does not hold a
2-1 certificate issued under this Act who is performing a radiologic
2-2 procedure at a hospital or under the direction of a practitioner,
2-3 other than a dentist. The training program approved by the Texas
2-4 Board of Health must contain an appropriate number of hours of
2-5 education that must be completed before the person may perform a
2-6 radiologic procedure. This subsection does not apply to a person
2-7 who administers radiation to another person for medical purposes if
2-8 the person, before September 1, 1998, had at least one year of
2-9 experience in performing radiologic procedures under the direction,
2-10 supervision, and authority of a practitioner.
2-11 (g) This [The Texas Board of Health with the assistance of
2-12 other appropriate state agencies shall by rule identify radiologic
2-13 procedures that are dangerous or hazardous and that may only be
2-14 performed by a practitioner or a medical radiologic technologist
2-15 certified under this Act.]
2-16 [(h) Subsection (g) of this] section does not apply to a
2-17 radiologic procedure involving a dental X-ray machine, including a
2-18 panarex or other equipment designed and manufactured only for use
2-19 in dental radiography.
2-20 (h) [(i)] On the application to the department by a
2-21 hospital, federally qualified health center as defined by 42 U.S.C.
2-22 Section 1396d, rural health clinic, or practitioner, the department
2-23 shall exempt the applicant from the requirements of Subsection (f)
2-24 of this section in employing a person certified under this Act or
2-25 trained as required by Subsection (f) of this section if the
2-26 applicant shows a hardship in employing a person certified under
2-27 this Act or trained as required by Subsection (f) of this section.
2-28 (i) [(j)] The following conditions are considered to be
2-29 hardships for the purposes of Subsection (h) [(i)] of this section:
2-30 (1) that the hospital, federally qualified health
2-31 center, or practitioner reports an inability to attract and retain
2-32 medical radiologic technologists;
2-33 (2) that the hospital, federally qualified health
2-34 center, or practitioner is located at a great distance from a
2-35 school of medical radiologic technology;
2-36 (3) that there is a list of qualified applicants to a
2-37 school of medical radiologic technology whose admissions are
2-38 pending because of a lack of faculty or space;
2-39 (4) that the school of medical radiologic technology
2-40 produces an insufficient number of graduates in medical radiologic
2-41 technology to meet the needs of the hospital, federally qualified
2-42 health center, or practitioner; or
2-43 (5) any other criteria determined by department rule.
2-44 (j) A person who performs a radiologic procedure in
2-45 compliance with the procedures adopted under Section 5.04, Medical
2-46 Practice Act (Article 4495b, Vernon's Texas Civil Statutes),
2-47 Section 13c, Chapter 94, Acts of the 51st Legislature, Regular
2-48 Session, 1949 (Article 4512b, Vernon's Texas Civil Statutes), or
2-49 Article 4577, Revised Statutes, does not have to comply with the
2-50 requirements adopted under Subsections (a)(2)-(4) or Subsection (f)
2-51 of this section.
2-52 (k)(1) A person who performs a radiologic procedure in
2-53 compliance with the guidelines adopted under any one of the
2-54 following provisions is not required to comply with the
2-55 requirements adopted under Subsections (a)(2)-(4) or Subsection (f)
2-56 of this section:
2-57 (A) Section 5.045, Medical Practice Act (Article
2-58 4495b, Vernon's Texas Civil Statutes);
2-59 (B) Section 13d, Chapter 94, Acts of the 51st
2-60 Legislature, Regular Session, 1949 (Article 4512b, Vernon's Texas
2-61 Civil Statutes); or
2-62 (C) Article 4578, Revised Statutes.
2-63 (2) A person who meets the requirements of Subsection
2-64 (f) of this section or who is employed in a facility that obtains a
2-65 hardship exemption under Subsection (h) of this section is not
2-66 required to comply with the guidelines adopted under any one of the
2-67 provisions listed in Subdivisions (1)(A)-(C) of this subsection.
2-68 [(k) In adopting rules under Subsection (g) of this section,
2-69 the Texas Board of Health may consider whether the radiologic
3-1 procedure will be performed by a registered nurse or a licensed
3-2 physician assistant.]
3-3 SECTION 3. Subchapter E, Medical Practice Act (Article
3-4 4495b, Vernon's Texas Civil Statutes), is amended by adding
3-5 Sections 5.04 and 5.045 to read as follows:
3-6 Sec. 5.04. DANGEROUS OR HAZARDOUS RADIOLOGIC PROCEDURES.
3-7 (a) In this section, "radiologic procedure" has the meaning
3-8 assigned that term by Section 2.03, Medical Radiologic Technologist
3-9 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
3-10 (b) The board, with the advice of the Texas Department of
3-11 Health and other appropriate state agencies, by rule shall identify
3-12 radiologic procedures that are dangerous or hazardous and that may
3-13 only be performed by a physician or medical radiologic technologist
3-14 certified under the Medical Radiologic Technologist Certification
3-15 Act (Article 4512m, Vernon's Texas Civil Statutes).
3-16 (c) This section does not apply to a radiologic procedure
3-17 involving a dental X-ray machine, including a panarex or other
3-18 equipment designed and manufactured only for use in dental
3-19 radiography.
3-20 (d) In adopting rules under this section, the board shall
3-21 consider whether the radiologic procedure will be performed by a
3-22 registered nurse or a licensed physician assistant.
3-23 Sec. 5.045. TRAINING GUIDELINES FOR RADIOLOGIC PROCEDURES.
3-24 (a) In this section, "radiologic procedure" has the meaning
3-25 assigned by Section 5.04 of this Act.
3-26 (b) The board shall adopt minimum standards for mandatory
3-27 training guidelines for a person, other than a physician or a
3-28 medical radiologic technologist, who intentionally administers
3-29 radiation to another person for medical purposes under the
3-30 direction, supervision, and authority of a physician.
3-31 (c) The guidelines adopted under this section must permit a
3-32 person to comply with the guidelines by completing a course of
3-33 instruction under a physician who employs or supervises the person
3-34 and by passing a written examination approved by the board.
3-35 (d) A person who performed radiologic procedures under the
3-36 direction, supervision, or authority of a physician on or before
3-37 September 1, 1998, is exempt from complying with the requirements
3-38 of this section and may apply to the board for a certificate of
3-39 exemption from the requirements.
3-40 (e) The board may establish and collect fees necessary to
3-41 recover the costs of administering this section. Fees collected
3-42 under this section may be used only to administer this section.
3-43 SECTION 4. Subsection (a), Section 13a, Chapter 94, Acts of
3-44 the 51st Legislature, Regular Session, 1949 (Article 4512b,
3-45 Vernon's Texas Civil Statutes), is amended to read as follows:
3-46 (a) The practice of chiropractic shall not be construed to
3-47 include:
3-48 (1) incisive or surgical procedures;
3-49 (2) the prescribing of controlled substances or
3-50 dangerous drugs or any drug that requires a prescription; or
3-51 (3) except as provided by Section 13c of this Act, the
3-52 use of x-ray therapy or therapy that exposes the body to
3-53 radioactive materials.
3-54 SECTION 5. Chapter 94, Acts of the 51st Legislature, Regular
3-55 Session, 1949 (Article 4512b, Vernon's Texas Civil Statutes), is
3-56 amended by adding Sections 13c and 13d to read as follows:
3-57 Sec. 13c. DANGEROUS OR HAZARDOUS RADIOLOGIC PROCEDURES.
3-58 (a) In this section, "radiologic procedure" has the meaning
3-59 assigned that term by Section 2.03, Medical Radiologic Technologist
3-60 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
3-61 (b) The board, with the advice of the Texas Department of
3-62 Health and other appropriate state agencies, by rule shall identify
3-63 radiologic procedures that are dangerous or hazardous and that may
3-64 only be performed by a chiropractor or medical radiologic
3-65 technologist certified under the Medical Radiologic Technologist
3-66 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
3-67 (c) The provisions of Section 5.04, Medical Practice Act
3-68 (Article 4495b, Vernon's Texas Civil Statutes), shall apply in lieu
3-69 of this section when the procedure is performed in a hospital.
4-1 Sec. 13d. TRAINING GUIDELINES FOR RADIOLOGIC PROCEDURES.
4-2 (a) In this section, "radiologic procedure" has the meaning
4-3 assigned by Section 13c of this Act.
4-4 (b) The board shall adopt minimum standards for mandatory
4-5 training guidelines for a person, other than a chiropractor or a
4-6 medical radiologic technologist, who intentionally administers
4-7 radiation to another person for medical purposes under the
4-8 direction, supervision, and authority of a chiropractor.
4-9 (c) The guidelines adopted under this section must permit a
4-10 person to comply with the guidelines by completing a course of
4-11 instruction under a chiropractor who employs or supervises the
4-12 person and by passing a written examination approved by the board.
4-13 (d) A person who performed radiologic procedures under the
4-14 direction, supervision, or authority of a chiropractor on or before
4-15 September 1, 1998, is exempt from complying with the requirements
4-16 of this section and may apply to the board for a certificate of
4-17 exemption from the requirements.
4-18 (e) The board may establish and collect fees necessary to
4-19 recover the costs of administering this section. Fees collected
4-20 under this section may be used only to administer this section.
4-21 SECTION 6. Chapter 11, Title 71, Revised Statutes, is
4-22 amended by adding Articles 4577 and 4578 to read as follows:
4-23 Art. 4577. DANGEROUS OR HAZARDOUS RADIOLOGIC PROCEDURES.
4-24 (a) In this article, "radiologic procedure" has the meaning
4-25 assigned that term by Section 2.03, Medical Radiologic Technologist
4-26 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
4-27 (b) The board, with the advice of the Texas Department of
4-28 Health and other appropriate state agencies, by rule shall identify
4-29 radiologic procedures that are dangerous or hazardous and that may
4-30 only be performed by a podiatrist or a medical radiologic
4-31 technologist certified under the Medical Radiologic Technologist
4-32 Certification Act (Article 4512m, Vernon's Texas Civil Statutes).
4-33 (c) The provisions of Section 5.04, Medical Practice Act
4-34 (Article 4495b, Vernon's Texas Civil Statutes), shall apply in lieu
4-35 of this article when the procedure is performed in a hospital.
4-36 Art. 4578. TRAINING GUIDELINES FOR RADIOLOGIC PROCEDURES.
4-37 (a) In this article, "radiologic procedure" has the meaning
4-38 assigned by Article 4577, Revised Statutes.
4-39 (b) The board shall adopt minimum standards for mandatory
4-40 training guidelines for a person, other than a podiatrist or a
4-41 medical radiologic technologist, who intentionally administers
4-42 radiation to another person for medical purposes under the
4-43 direction, supervision, and authority of a podiatrist.
4-44 (c) The guidelines adopted under this article must permit a
4-45 person to comply with the guidelines by completing a course of
4-46 instruction under a podiatrist who employs or supervises the person
4-47 and by passing a written examination approved by the board.
4-48 (d) A person who performed radiologic procedures under the
4-49 direction, supervision, or authority of a podiatrist on or before
4-50 September 1, 1998, is exempt from complying with the requirements
4-51 of this article and may apply to the board for a certificate of
4-52 exemption from the requirements.
4-53 (e) The board may establish and collect fees necessary to
4-54 recover the costs of administering this article. Fees collected
4-55 under this article may be used only to administer this article.
4-56 SECTION 7. (a) This Act takes effect September 1, 1997.
4-57 (b) Rules adopted before the effective date of this Act by
4-58 the Texas Board of Health under Subsection (f), Section 2.05,
4-59 Medical Radiologic Technologist Certification Act (Article 4512m,
4-60 Vernon's Texas Civil Statutes), that provide mandatory training
4-61 guidelines for the administration of radiation by certain persons
4-62 remain in effect after the effective date of this Act except to the
4-63 extent the rules conflict with a provision of this Act.
4-64 (c) The Texas State Board of Medical Examiners shall adopt
4-65 rules under Section 5.04, Medical Practice Act (Article 4495b,
4-66 Vernon's Texas Civil Statutes), as added by this Act, not later
4-67 than January 1, 1998. The Texas Board of Chiropractic Examiners
4-68 shall adopt rules under Section 13c, Chapter 94, Acts of the 51st
4-69 Legislature, Regular Session, 1949 (Article 4512b, Vernon's Texas
5-1 Civil Statutes), as added by this Act, not later than January 1,
5-2 1998. The Texas State Board of Podiatric Medical Examiners shall
5-3 adopt rules under Article 4577, Revised Statutes, as added by this
5-4 Act, not later than January 1, 1998.
5-5 (d) The Texas State Board of Medical Examiners shall adopt
5-6 mandatory training guidelines under Section 5.045, Medical Practice
5-7 Act (Article 4495b, Vernon's Texas Civil Statutes), as added by
5-8 this Act, not later than June 1, 1998. A person must complete the
5-9 training under the guidelines not later than the later of:
5-10 (1) January 1, 2000; or
5-11 (2) the 18th month after the date the Texas State
5-12 Board of Medical Examiners adopts the training guidelines.
5-13 (e) The Texas Board of Chiropractic Examiners shall adopt
5-14 mandatory training guidelines under Section 13d, Chapter 94, Acts
5-15 of the 51st Legislature, Regular Session, 1949 (Article 4512b,
5-16 Vernon's Texas Civil Statutes), as added by this Act, not later
5-17 than June 1, 1998. A person must complete the training under the
5-18 guidelines not later than the later of:
5-19 (1) January 1, 2000; or
5-20 (2) the 18th month after the date the Texas Board of
5-21 Chiropractic Examiners adopts the training guidelines.
5-22 (f) The Texas State Board of Podiatric Medical Examiners
5-23 shall adopt mandatory training guidelines under Article 4578,
5-24 Revised Statutes, as added by this Act, not later than June 1,
5-25 1998. A person must complete the training under the guidelines not
5-26 later than the later of:
5-27 (1) January 1, 2000; or
5-28 (2) the 18th month after the date the Texas State
5-29 Board of Podiatric Medical Examiners adopts the training
5-30 guidelines.
5-31 SECTION 8. The importance of this legislation and the
5-32 crowded condition of the calendars in both houses create an
5-33 emergency and an imperative public necessity that the
5-34 constitutional rule requiring bills to be read on three several
5-35 days in each house be suspended, and this rule is hereby suspended.
5-36 * * * * *