Senate Bill sb1366

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    Florida Senate - 2006                                  SB 1366

    By Senator Atwater





    25-752-06

  1                      A bill to be entitled

  2         An act relating to radiologist assistants;

  3         amending s. 468.301, F.S.; providing

  4         definitions; amending s. 468.302, F.S.;

  5         providing for identification and duties of a

  6         radiologist assistant; requiring that a

  7         radiologist assistant be under the supervision

  8         of a radiologist in certain circumstances;

  9         amending s. 468.304, F.S.; providing criteria

10         for certification as a radiologist assistant;

11         amending s. 468.305, F.S.; revising standards

12         of training for certification for categories of

13         radiological personnel; amending s. 468.306,

14         F.S.; exempting an applicant for certification

15         as a radiologist assistant from a requirement

16         to pass an examination; amending s. 468.3065,

17         F.S.; providing for the Department of Health to

18         issue a certification by endorsement as a

19         radiologist assistant to an applicant holding

20         certain credentials; amending s. 468.314, F.S.;

21         revising the membership of the Advisory Council

22         on Radiation Protection; providing an effective

23         date.

24  

25  Be It Enacted by the Legislature of the State of Florida:

26  

27         Section 1.  Present subsection (15) of section 468.301,

28  Florida Statutes, is redesignated as subsection (17), and new

29  subsection (15) and subsection (16) are added to that section,

30  to read:

31         468.301  Definitions.--As used in this part, the term:

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    Florida Senate - 2006                                  SB 1366
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 1         (15)  "Radiologist" means a physician specializing in

 2  radiology who is certified by or board-eligible for the

 3  American Board of Radiology or the American Osteopathic Board

 4  of Radiology, the British Royal College of Radiology, or the

 5  Canadian College of Physicians and Surgeons.

 6         (16)  "Radiologist assistant" means a person, other

 7  than a licensed practitioner, who is qualified by education

 8  and certification, as defined in s. 468.302, as an

 9  advanced-level radiologic technologist who works under the

10  supervision of a radiologist to enhance patient care by

11  assisting the radiologist in the medical-imaging environment.

12         Section 2.  Subsections (2) and (3) of section 468.302,

13  Florida Statutes, are amended to read:

14         468.302  Use of radiation; identification of certified

15  persons; limitations; exceptions.--

16         (2)(a)  A person holding a certificate as a basic X-ray

17  machine operator may use the title "Basic X-ray Machine

18  Operator."

19         (b)  A person holding a certificate as a basic X-ray

20  machine operator-podiatric medicine may use the title "Basic

21  X-ray Machine Operator-Podiatric Medicine."

22         (c)  A person holding a certificate as a general

23  radiographer may use the title "Certified Radiologic

24  Technologist-Radiographer" or the letters "CRT-R" after his or

25  her name.

26         (d)  A person holding a certificate as a limited

27  computed tomography technologist may use the title "Certified

28  Radiologic Technologist-Computed Tomography" or the letters

29  "CRT-C" after his or her name.

30         (e)  A person holding a certificate as a radiation

31  therapy technologist may use the title "Certified Radiologic

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    Florida Senate - 2006                                  SB 1366
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 1  Technologist-Therapy" or the letters "CRT-T" after his or her

 2  name.

 3         (f)  A person holding a certificate as a nuclear

 4  medicine technologist may use the title "Certified Radiologic

 5  Technologist-Nuclear Medicine" or the letters "CRT-N" after

 6  his or her name.

 7         (g)  A person holding a certificate as a radiologist

 8  assistant may use the title "Certified Radiologist Assistant"

 9  or the letters "CRA" after his or her name.

10  

11  No other person is entitled to so use a title or letters

12  contained in this subsection or to hold himself or herself out

13  in any way, whether orally or in writing, expressly or by

14  implication, as being so certified.

15         (3)(a)  A person holding a certificate as a basic X-ray

16  machine operator may perform general diagnostic radiographic

17  and general fluoroscopic procedures, specifically excluding

18  nuclear medicine and radiation therapy procedures, under the

19  direct supervision and control of a licensed practitioner in

20  that practitioner's office or in a hospital pursuant to

21  paragraph (b). A basic X-ray machine operator may participate

22  in additional approved programs as provided by rule of the

23  department.

24         (b)  A basic X-ray machine operator or basic X-ray

25  machine operator-podiatric medicine may not practice

26  radiologic technology in walk-in emergency centers,

27  freestanding breast clinics, freestanding cancer clinics,

28  state mental hospitals, state correctional institutions, or in

29  any facility regulated under chapter 390, chapter 392, chapter

30  393, chapter 394, or chapter 641.  For a facility licensed

31  under chapter 395, a basic X-ray machine operator may only

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    Florida Senate - 2006                                  SB 1366
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 1  perform the procedures specified in paragraph (a) in a

 2  hospital with a capacity of 150 beds or fewer less.  If such a

 3  hospital has or acquires radiographic or fluoroscopic

 4  equipment other than general diagnostic radiographic and

 5  general fluoroscopic equipment, that hospital shall keep a

 6  record documenting which personnel performed each radiographic

 7  or fluoroscopic procedure. For purposes of this paragraph, a

 8  walk-in emergency center does shall not include a

 9  physician-operated walk-in clinic that which operates with or

10  without appointments and with extended hours and that which

11  does not hold itself out to the public as an emergency center.

12         (c)  A person holding a certificate as a basic X-ray

13  machine operator-podiatric medicine may perform only podiatric

14  radiographic procedures under the direct supervision and

15  control of a licensed podiatric physician.

16         (d)  A person holding a certificate as a general

17  radiographer may not perform nuclear medicine and radiation

18  therapy procedures, except as provided in this paragraph. A

19  person who is a general radiographer certified pursuant to

20  this part who receives additional training and skills in

21  radiation therapy technology procedures as referenced in this

22  paragraph may assist with managing patients undergoing

23  radiation therapy treatments if that assistance is provided to

24  a person registered with the American Registry of Radiologic

25  Technologists in radiation therapy who is also certified

26  pursuant to this part as a radiation therapy technologist.

27  Both the general radiographer and the radiation therapy

28  technologist must perform these radiation therapy services

29  under the general supervision of a physician licensed under

30  chapter 458 or chapter 459 who is trained and skilled in

31  performing radiation therapy treatments. The radiation therapy

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 1  technologist identified under this paragraph may not delegate

 2  any function to the general radiographer which could

 3  reasonably be expected to create an unnecessary danger to a

 4  patient's life, health, or safety. The general radiographer

 5  identified under this section may not, however, perform the

 6  following services while assisting the radiation therapy

 7  technologist: radiation treatment planning, calculation of

 8  radiation therapy doses, or any of the duties of a medical

 9  physicist. The general radiographer identified under this

10  section must successfully complete a training program in the

11  following areas before assisting with radiation therapy

12  technology duties:

13         1.  Principles of radiation therapy treatment;

14         2.  Biological effects of radiation;

15         3.  Radiation exposure and monitoring;

16         4.  Radiation safety and protection;

17         5.  Evaluation and handling of radiographic treatment

18  equipment and accessories; and

19         6.  Patient positioning for radiation therapy

20  treatment.

21  

22  In addition, a general radiographer may participate in

23  additional approved programs as provided by rule of the

24  department.

25         (e)  A person holding a certificate as a limited

26  computed tomography technologist may perform only diagnostic

27  computed tomography examinations.

28         (f)  A person holding a certificate as a radiation

29  therapy technologist may administer only X radiation and

30  ionizing radiation emitted from particle accelerators and

31  external beam teletherapy from sealed sources of radioactive

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 1  material to human beings for therapeutic or simulation

 2  purposes.

 3         (g)1.  A person holding a certificate as a nuclear

 4  medicine technologist may only:

 5         a.  Conduct in vivo and in vitro measurements of

 6  radioactivity and administer radiopharmaceuticals to human

 7  beings for diagnostic and therapeutic purposes.

 8         b.  Administer X radiation from a combination nuclear

 9  medicine-computed tomography device if that radiation is

10  administered as an integral part of a nuclear medicine

11  procedure that uses an automated computed tomography protocol

12  for the purposes of attenuation correction and anatomical

13  localization and the person has received device-specific

14  training on the combination device.

15         2.  The authority of a nuclear medicine technologist

16  under this paragraph excludes:

17         a.  Radioimmunoassay and other clinical laboratory

18  testing regulated pursuant to chapter 483;

19         b.  Creating or modifying automated computed tomography

20  protocols; and

21         c.  Any other operation of a computed tomography

22  device, especially for the purposes of stand-alone diagnostic

23  imaging, which must be performed by a general radiographer

24  certified under this part.

25         (h)  A person holding a certificate as a radiologist

26  assistant may:

27         1.  Perform specific duties allowed for a radiologist

28  assistant as defined by the department by rule. The rule must

29  be consistent with guidelines adopted by the American College

30  of Radiology, the American Society of Radiologic

31  

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    Florida Senate - 2006                                  SB 1366
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 1  Technologists, and the American Registry of Radiologic

 2  Technologists.

 3         2.  Use radiation or radiation-producing equipment on

 4  human beings for diagnostic or therapeutic purposes while

 5  operating, in each particular case, under the supervision of a

 6  radiologist.

 7         3.  Not interpret images, make diagnoses, or prescribe

 8  medications or therapies.

 9  

10  For the purpose of this paragraph, the term "supervision"

11  means the radiologist must be present in the office suite and

12  immediately available to furnish assistance and direction

13  throughout the performance of the procedure. The term does not

14  mean that the radiologist must be present in the room when the

15  procedure is performed.

16         Section 3.  Subsection (3) of section 468.304, Florida

17  Statutes, is amended to read:

18         468.304  Certification.--The department shall certify

19  any applicant who meets the following criteria:

20         (3)  Submits satisfactory evidence, verified by oath or

21  affirmation, that she or he:

22         (a)  Is at least 18 years of age at the time of

23  application;

24         (b)  Is a high school, vocational school, technical

25  school, or college graduate or has successfully completed the

26  requirements for a graduate equivalency diploma (GED) or its

27  equivalent;

28         (c)  Is of good moral character;

29         (d)  Has passed an examination as specified in s.

30  468.306 or meets the requirements specified in s. 468.3065;

31  and

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    Florida Senate - 2006                                  SB 1366
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 1         (e)1.  Has successfully completed an educational

 2  program, which program may be established in a hospital

 3  licensed pursuant to chapter 395 or in an accredited

 4  postsecondary academic institution which is subject to

 5  approval by the department as maintaining a satisfactory

 6  standard; or

 7         2.a.  With respect to an applicant for a basic X-ray

 8  machine operator's certificate, has completed a course of

 9  study approved by the department with appropriate study

10  material provided the applicant by the department;

11         b.  With respect to an applicant for a basic X-ray

12  machine operator-podiatric medicine certificate, has completed

13  a course of study approved by the department, provided that

14  such course of study shall be limited to that information

15  necessary to perform radiographic procedures within the scope

16  of practice of a podiatric physician licensed pursuant to

17  chapter 461;

18         c.  With respect only to an applicant for a general

19  radiographer's certificate who is a basic X-ray machine

20  operator certificateholder, has completed an educational

21  program or a 2-year training program that takes into account

22  the types of procedures and level of supervision usually and

23  customarily practiced in a hospital, which educational or

24  training program complies with the rules of the department; or

25         d.  With respect only to an applicant for a nuclear

26  medicine technologist's certificate who is a general

27  radiographer certificateholder, has completed an educational

28  program or a 2-year training program that takes into account

29  the types of procedures and level of supervision usually and

30  customarily practiced in a hospital, which educational or

31  

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 1  training program complies with the rules of the department;

 2  or.

 3         e.  With respect to an applicant for a radiologist

 4  assistant's certificate who is a general radiographer

 5  certificateholder, has completed an advanced educational

 6  program encompassing a nationally recognized curriculum for

 7  training radiologist assistants, culminating in a

 8  baccalaureate degree, postbaccalaureate certificate, or

 9  graduate degree that incorporates a radiologist-directed

10  clinical preceptorship.

11         Section 4.  Section 468.305, Florida Statutes, is

12  amended to read:

13         468.305  Certification; standards.--The department

14  shall develop standards for certification for the categories

15  of radiological personnel or procedures specified in s.

16  468.302.  The certification standards shall be developed by

17  the department to provide for educational programs for persons

18  who are duly licensed or have a credential in a recognized

19  health care profession or who have other training that is

20  relevant to the program of study to be undertaken.  All such

21  categories shall include a demonstration of safety procedure

22  competency; however, an operator nothing in this part shall be

23  construed to require that all operators of radiation equipment

24  is not required to be a registered radiologic technologist,

25  with the exception of a radiologist assistant technologists.

26  An application fee of not more than $350 shall be assessed

27  those educational programs seeking approval from the

28  department.  Application for approval shall be made on forms

29  provided by the department.  Once approved by the department,

30  an educational program shall be assessed an annual fee not to

31  exceed $150.

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    Florida Senate - 2006                                  SB 1366
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 1         Section 5.  Section 468.306, Florida Statutes, is

 2  amended to read:

 3         468.306  Examinations.--All applicants, except those

 4  certified by endorsement pursuant to s. 468.3065, shall be

 5  required to pass an examination.  The department may is

 6  authorized to develop or use examinations for each type of

 7  certificate. The department may require an applicant who does

 8  not pass an examination after five attempts to complete

 9  additional remedial education, as specified by rule of the

10  department, before admitting the applicant to subsequent

11  examinations.

12         (1)  The department may shall have the authority to

13  contract with organizations that develop such test

14  examinations. Examinations may be administered by the

15  department or the contracting organization.

16         (2)  Examinations shall be given for each type of

17  certificate at least twice a year at such times and places as

18  the department may determine to be advantageous for

19  applicants.

20         (3)  All examinations shall be written and include

21  positioning, technique, and radiation protection.  The

22  department shall either pass or fail each applicant on the

23  basis of his or her final grade.  The examination for a basic

24  X-ray machine operator shall include basic positioning and

25  basic techniques directly related to the skills necessary to

26  safely operate radiographic equipment.

27         (4)  A nonrefundable fee not to exceed $75 plus the

28  actual per-applicant cost for purchasing the examination from

29  a national organization shall be charged for any subsequent

30  examination.

31  

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 1         Section 6.  Section 468.3065, Florida Statutes, is

 2  amended to read:

 3         468.3065  Certification by endorsement.--

 4         (1)  The department shall issue a certificate by

 5  endorsement to practice as a radiologist assistant to an

 6  applicant who, upon applying to the department and remitting a

 7  nonrefundable fee not to exceed $50, demonstrates to the

 8  department that he or she holds a current certificate or

 9  registration as a radiologist assistant granted by the

10  American Registry of Radiologic Technologists.

11         (2)  The department may issue a certificate by

12  endorsement to practice radiologic technology to an applicant

13  who, upon applying to the department and remitting a

14  nonrefundable fee not to exceed $50, demonstrates to the

15  department that he or she holds a current certificate,

16  license, or registration to practice radiologic technology, if

17  provided that the requirements for such certificate, license,

18  or registration are deemed by the department to be

19  substantially equivalent to those established under this part

20  and rules adopted under this part.

21         Section 7.  Paragraph (g) of subsection (2) of section

22  468.314, Florida Statutes, is amended to read:

23         468.314  Advisory Council on Radiation Protection;

24  appointment; terms; powers; duties.--

25         (2)  The council shall be comprised of:

26         (g)  A certified radiologist assistant health

27  physicist.

28         Section 8.  This act shall take effect July 1, 2006.

29  

30  

31  

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 1            *****************************************

 2                          SENATE SUMMARY

 3    Provides for identification and duties of a radiologist
      assistant. Revises criteria for certification as a
 4    radiologist assistant. Revises standards for
      certification for categories of radiological personnel.
 5    Provides an exception for use of an examination for
      certification as a radiologist assistant. Revises the
 6    requirements for certification by endorsement. Amends the
      membership of the Advisory Council on Radiation
 7    Protection.

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