HB 0819CS

CHAMBER ACTION



1The Health Care Regulation Committee recommends the following:
2
3     Council/Committee Substitute
4     Remove the entire bill and insert:
5
A bill to be entitled
6An act relating to radiologist assistants; amending s.
7468.3001, F.S.; redesignating part IV of ch. 468, F.S., as
8the "Radiological Personnel Certification Act"; amending
9s. 468.301, F.S.; providing definitions; amending s.
10468.302, F.S.; providing for identification and duties of
11a radiologist assistant; providing for rulemaking by the
12Department of Health; providing limitations on duties a
13radiologist assistant may perform; amending s. 468.304,
14F.S.; providing conditions for qualification for a
15radiologist assistant's certificate; amending s. 468.306,
16F.S.; specifying the applicants required to pass a
17certification examination; requiring the department to
18accept certain demonstrations by an applicant for a
19certification to practice as a radiologist assistant in
20lieu of any examination requirement; amending s. 468.3065,
21F.S.; authorizing the Department of Health to issue
22certificates by endorsement to certain radiologist
23assistants; providing for a fee; amending ss. 468.307,
24468.309, 468.3095, 468.3101, 468.311, and 468.3115, F.S.;
25including radiologist assistants in provisions applicable
26to radiologic technologists with respect to requirements
27for certificate display, certificate renewal, change of
28certificate status, grounds for disciplinary action,
29violations, penalties, and injunctive relief; amending s.
30468.314, F.S.; adding a certified radiologist assistant to
31the membership of the Advisory Council on Radiation
32Protection; providing an effective date.
33
34Be It Enacted by the Legislature of the State of Florida:
35
36     Section 1.  Section 468.3001, Florida Statutes, is amended
37to read:
38     468.3001  Short title.--This part shall be known and may be
39cited as the "Radiological Personnel Radiologic Technologist
40Certification Act."
41     Section 2.  Present subsections (4) through (14) of section
42468.301, Florida Statutes, are renumbered as subsections (5)
43through (15), respectively, present subsection (15) is
44renumbered as subsection (18), new subsections (4), (16), and
45(17) are added to that section, and present subsection (14) of
46that section is amended, to read:
47     468.301  Definitions.--As used in this part, the term:
48     (4)  "Certificateholder" means any person who holds a
49certificate under this part that authorizes that person to use
50radiation on human beings.
51     (15)(14)  "Radiologic technologist" means a person, other
52than a licensed practitioner, who is qualified by education,
53training, or experience, as more specifically defined in s.
54468.302(3)(d)-(g) s. 468.302, to use radiation on human beings
55under the specific direction and general supervision of a
56licensed practitioner in each particular case.
57     (16)  "Radiologist" means a physician specializing in
58radiology certified by or eligible for certification by the
59American Board of Radiology or the American Osteopathic Board of
60Radiology, the British Royal College of Radiology, or the
61Canadian College of Physicians and Surgeons.
62     (17)  "Radiologist assistant" means a person, other than a
63licensed practitioner, who is qualified by education and
64certification, as set forth in s. 468.304, as an advanced-level
65radiologic technologist who works under the supervision of a
66radiologist to enhance patient care by assisting the radiologist
67in the medical imaging environment.
68     Section 3.  Subsections (1), (5), and (6) of section
69468.302, Florida Statutes, are amended, paragraph (g) is added
70to subsection (2) of that section, and paragraph (h) is added to
71subsection (3) of that section, to read:
72     468.302  Use of radiation; identification of certified
73persons; limitations; exceptions.--
74     (1)  Except as provided in this section, a person may not
75use radiation or otherwise practice radiologic technology or any
76of the duties of a radiologist assistant on a human being unless
77he or she:
78     (a)  Is a licensed practitioner; or
79     (b)  Is the holder of a certificate, as provided in this
80part, and is operating under the direct supervision or general
81supervision of a licensed practitioner in each particular case;
82or.
83     (c)  Is the holder of a radiologist assistant certificate,
84as provided in this part, and is operating under the supervision
85of a radiologist, as specified in paragraph (3)(h).
86     (2)
87     (g)  A person holding a certificate as a radiologist
88assistant may use the title "Certified Radiologist Assistant" or
89the letters "CRA" after his or her name.
90
91No other person is entitled to so use a title or letters
92contained in this subsection or to hold himself or herself out
93in any way, whether orally or in writing, expressly or by
94implication, as being so certified.
95     (3)
96     (h)  A person holding a certificate as a radiologist
97assistant may:
98     1.  Perform specific duties allowed for a radiologist
99assistant as defined by the department by rule. The rule must be
100consistent with guidelines adopted by the American College of
101Radiology, the American Society of Radiologic Technologists, and
102the American Registry of Radiologic Technologists, with the
103level of supervision required by such guidelines.
104     2.  Not perform nuclear medicine or radiation therapy
105procedures unless currently certified and trained to perform
106those duties under the person's nuclear medicine technologist or
107radiation therapy technologist certificate, interpret images,
108make diagnoses, or prescribe medications or therapies.
109     (5)  Nothing contained in this part relating to radiologic
110technology or a radiologist assistant shall be construed to
111limit, enlarge, or affect in any respect the practice by duly
112licensed practitioners of their respective professions.
113     (6)  Requirement for certification does not apply to:
114     (a)  A hospital resident who is not a licensed practitioner
115in this state or a student enrolled in and attending a school or
116college of medicine, osteopathic medicine, chiropody, podiatric
117medicine, or chiropractic medicine or a radiologic technology
118educational program or radiologist assistant educational program
119and who applies radiation to a human being while under the
120direct supervision of a licensed practitioner.
121     (b)  A person who is engaged in performing the duties of a
122radiologic technologist or of a radiologist assistant in his or
123her employment by a governmental agency of the United States.
124     (c)  A person who is trained and skilled in cardiopulmonary
125technology and who provides cardiopulmonary technology services
126at the direction, and under the direct supervision, of a
127licensed practitioner.
128     Section 4.  Paragraph (e) of subsection (3) of section
129468.304, Florida Statutes, is amended to read:
130     468.304  Certification.--The department shall certify any
131applicant who meets the following criteria:
132     (3)  Submits satisfactory evidence, verified by oath or
133affirmation, that she or he:
134     (e)1.  Has successfully completed an educational program,
135which program may be established in a hospital licensed pursuant
136to chapter 395 or in an accredited postsecondary academic
137institution which is subject to approval by the department as
138maintaining a satisfactory standard; or
139     2.a.  With respect to an applicant for a basic X-ray
140machine operator's certificate, has completed a course of study
141approved by the department with appropriate study material
142provided the applicant by the department;
143     b.  With respect to an applicant for a basic X-ray machine
144operator-podiatric medicine certificate, has completed a course
145of study approved by the department, provided that such course
146of study shall be limited to that information necessary to
147perform radiographic procedures within the scope of practice of
148a podiatric physician licensed pursuant to chapter 461;
149     c.  With respect only to an applicant for a general
150radiographer's certificate who is a basic X-ray machine operator
151certificateholder, has completed an educational program or a 2-
152year training program that takes into account the types of
153procedures and level of supervision usually and customarily
154practiced in a hospital, which educational or training program
155complies with the rules of the department; or
156     d.  With respect only to an applicant for a nuclear
157medicine technologist's certificate who is a general
158radiographer certificateholder, has completed an educational
159program or a 2-year training program that takes into account the
160types of procedures and level of supervision usually and
161customarily practiced in a hospital, which educational or
162training program complies with the rules of the department; or.
163     e.  With respect to an applicant for a radiologist
164assistant's certificate who demonstrates to the department that
165he or she holds a current certificate or registration as a
166radiologist assistant granted by the American Registry of
167Radiologic Technologists.
168
169The department may not certify any applicant who has committed
170an offense that would constitute a violation of any of the
171provisions of s. 468.3101 or the rules adopted thereunder if the
172applicant had been certified by the department at the time of
173the offense. No application for a limited computed tomography
174certificate shall be accepted. All persons holding valid
175computed tomography certificates as of October 1, 1984, are
176subject to the provisions of s. 468.309.
177     Section 5.  Section 468.306, Florida Statutes, is amended
178to read:
179     468.306  Examinations.--All applicants for certification as
180a radiologic technologist, basic X-ray machine operator, or
181basic X-ray machine operator-podiatric medicine, except those
182certified pursuant to s. 468.3065, shall be required to pass an
183examination. In lieu of an examination for a radiologist
184assistant certificate, the department shall accept a
185demonstration by the applicant for such a certificate that he or
186she holds a current certificate or registration as a radiologist
187assistant granted by the American Registry of Radiologic
188Technologists. The department may is authorized to develop or
189use examinations for each type of certificate. The department
190may require an applicant who does not pass an examination after
191five attempts to complete additional remedial education, as
192specified by rule of the department, before admitting the
193applicant to subsequent examinations.
194     (1)  The department may shall have the authority to
195contract with organizations that develop such test examinations.
196Examinations may be administered by the department or the
197contracting organization.
198     (2)  Examinations shall be given for each type of
199certificate at least twice a year at such times and places as
200the department may determine to be advantageous for applicants.
201     (3)  All examinations shall be written and include
202positioning, technique, and radiation protection. The department
203shall either pass or fail each applicant on the basis of his or
204her final grade. The examination for a basic X-ray machine
205operator shall include basic positioning and basic techniques
206directly related to the skills necessary to safely operate
207radiographic equipment.
208     (4)  A nonrefundable fee not to exceed $75 plus the actual
209per-applicant cost for purchasing the examination from a
210national organization shall be charged for any subsequent
211examination.
212     Section 6.  Section 468.3065, Florida Statutes, is amended
213to read:
214     468.3065  Certification by endorsement.--
215     (1)  The department may issue a certificate by endorsement
216to practice as a radiologist assistant to an applicant who, upon
217applying to the department and remitting a nonrefundable fee not
218to exceed $50, demonstrates to the department that he or she
219holds a current certificate or registration as a radiologist
220assistant granted by the American Registry of Radiologic
221Technologists.
222     (2)  The department may issue a certificate by endorsement
223to practice radiologic technology to an applicant who, upon
224applying to the department and remitting a nonrefundable fee not
225to exceed $50, demonstrates to the department that he or she
226holds a current certificate, license, or registration to
227practice radiologic technology, provided that the requirements
228for such certificate, license, or registration are deemed by the
229department to be substantially equivalent to those established
230under this part and rules adopted under this part.
231     Section 7.  Subsection (3) of section 468.307, Florida
232Statutes, is amended to read:
233     468.307  Certificate; issuance; display.--
234     (3)  Every employer of certificateholders radiologic
235technologists shall display the certificates of all of such
236employees in a place accessible to view.
237     Section 8.  Paragraph (a) of subsection (1) and subsections
238(4), (5), (6), and (7) of section 468.309, Florida Statutes, are
239amended to read:
240     468.309  Certificate; duration; renewal; reversion to
241inactive status; members of Armed Forces and spouses.--
242     (1)(a)  A radiologic technologist's certificate issued in
243accordance with this part expires as specified in rules adopted
244by the department which establish a procedure for the biennial
245renewal of certificates. A certificate shall be renewed by the
246department for a period of 2 years upon payment of a renewal fee
247in an amount not to exceed $75 and upon submission of a renewal
248application containing such information as the department deems
249necessary to show that the applicant for renewal is a
250certificateholder radiologic technologist in good standing and
251has completed any continuing education requirements that the
252department establishes.
253     (4)  Any certificate that is not renewed by its expiration
254date shall automatically be placed in an expired status, and the
255certificateholder may not practice radiologic technology or
256perform the duties of a radiologist assistant until the
257certificate has been reactivated.
258     (5)  A certificateholder in good standing remains in good
259standing when he or she becomes a member of the Armed Forces of
260the United States on active duty without paying renewal fees or
261accruing continuing education credits as long as he or she is a
262member of the Armed Forces on active duty and for a period of 6
263months after discharge from active duty, if he or she is not
264engaged in practicing radiologic technology or performing the
265duties of a radiologist assistant in the private sector for
266profit. The certificateholder must pay a renewal fee and
267complete continuing education not to exceed 12 classroom hours
268to renew the certificate.
269     (6)  A certificateholder who is in good standing remains in
270good standing if he or she is absent from the state because of
271his or her spouse's active duty with the Armed Forces of the
272United States. The certificateholder remains in good standing
273without paying renewal fees or completing continuing education
274as long as his or her spouse is a member of the Armed Forces on
275active duty and for a period of 6 months after the spouse's
276discharge from active duty, if the certificateholder is not
277engaged in practicing radiologic technology or performing the
278duties of a radiologist assistant in the private sector for
279profit.  The certificateholder must pay a renewal fee and
280complete continuing education not to exceed 12 classroom hours
281to renew the certificate.
282     (7)  A certificateholder may resign his or her
283certification by submitting to the department a written,
284notarized resignation on a form specified by the department. The
285resignation automatically becomes effective upon the
286department's receipt of the resignation form, at which time the
287certificateholder's certification automatically becomes null and
288void and may not be reactivated or renewed or used to practice
289radiologic technology or to perform the duties of a radiologist
290assistant. A certificateholder who has resigned may become
291certified again only by reapplying to the department for
292certification as a new applicant and meeting the certification
293requirements pursuant to s. 468.304 or s. 468.3065. Any
294disciplinary action that had been imposed on the
295certificateholder prior to his or her resignation shall be
296tolled until he or she again becomes certified. Any disciplinary
297action proposed at the time of the certificateholder's
298resignation shall be tolled until he or she again becomes
299certified.
300     Section 9.  Paragraphs (a) and (c) of subsection (2) of
301section 468.3095, Florida Statutes, are amended to read:
302     468.3095  Inactive status; reactivation; automatic
303suspension; reinstatement.--
304     (2)(a)  A certificate that has been expired for less than
30510 years may be reactivated upon payment of the biennial renewal
306fee and a late renewal fee, not to exceed $100, and submission
307of a reactivation application containing any information that
308the department deems necessary to show that the applicant is a
309certificateholder radiologic technologist in good standing and
310has met the requirements for continuing education. The
311department shall prescribe, by rule, continuing education
312requirements as a condition of reactivating a certificate. The
313continuing education requirements for reactivating a certificate
314may not exceed 10 classroom hours for each year the certificate
315was expired and may not exceed 100 classroom hours for all years
316in which the certificate was expired.
317     (c)  A certificate that has been inactive or expired for 10
318years or more automatically becomes null and void and may not be
319reactivated, renewed, or used to practice radiologic technology
320or to perform the duties of a radiologist assistant. A
321certificateholder whose certificate has become null and void may
322become certified again only by reapplying to the department as a
323new applicant and meeting the requirements of s. 468.304 or s.
324468.3065.
325     Section 10.  Subsections (1), (2), (3), and (5) of section
326468.3101, Florida Statutes, are amended to read:
327     468.3101  Disciplinary grounds and actions.--
328     (1)  The department may make or require to be made any
329investigations, inspections, evaluations, and tests, and require
330the submission of any documents and statements, which it
331considers necessary to determine whether a violation of this
332part has occurred. The following acts shall be grounds for
333disciplinary action as set forth in this section:
334     (a)  Procuring, attempting to procure, or renewing a
335certificate to practice radiologic technology by bribery, by
336fraudulent misrepresentation, or through an error of the
337department.
338     (b)  Having a voluntary or mandatory certificate to
339practice radiologic technology or to perform the duties of a
340radiologist assistant revoked, suspended, or otherwise acted
341against, including being denied certification, by a national
342organization; by a specialty board recognized by the department;
343or by a certification authority of another state, territory, or
344country.
345     (c)  Being convicted or found guilty, regardless of
346adjudication, in any jurisdiction of a crime that directly
347relates to the practice of radiologic technology or to the
348performance of the duties of a radiologist assistant, or to the
349ability to practice radiologic technology or the ability to
350perform the duties of a radiologist assistant. Pleading nolo
351contendere shall be considered a conviction for the purpose of
352this provision.
353     (d)  Being convicted or found guilty, regardless of
354adjudication, in any jurisdiction of a crime against a person.
355Pleading nolo contendere shall be considered a conviction for
356the purposes of this provision.
357     (e)  Making or filing a false report or record that the
358certificateholder knows to be false, intentionally or
359negligently failing to file a report or record required by state
360or federal law, or willfully impeding or obstructing such filing
361or inducing another to do so. Such reports or records include
362only those reports or records which are signed in the capacity
363of the certificateholder as a radiologic technologist.
364     (f)  Engaging in unprofessional conduct, which includes,
365but is not limited to, any departure from, or the failure to
366conform to, the standards of practice of radiologic technology
367or the standards of practice for radiologist assistants as
368established by the department, in which case actual injury need
369not be established.
370     (g)  Being unable to practice radiologic technology or to
371perform the duties of a radiologist assistant with reasonable
372skill and safety to patients by reason of illness or use of
373alcohol, drugs, narcotics, chemicals, or other materials or as a
374result of any mental or physical condition. A certificateholder
375radiologic technologist affected under this paragraph shall, at
376reasonable intervals, be afforded an opportunity to demonstrate
377that he or she can resume the competent practice of his or her
378certified profession radiologic technology with reasonable skill
379and safety.
380     (h)  Failing to report to the department any person who the
381certificateholder knows is in violation of this part or of the
382rules of the department.
383     (i)  Violating any provision of this part, any rule of the
384department, or any lawful order of the department previously
385entered in a disciplinary proceeding or failing to comply with a
386lawfully issued subpoena of the department.
387     (j)  Employing, for the purpose of applying ionizing
388radiation or otherwise practicing radiologic technology or
389performing the duties of a radiologist assistant on a human
390being, any individual who is not certified under the provisions
391of this part.
392     (k)  Testing positive for any drug, as defined in s.
393112.0455, on any confirmed preemployment or employer-required
394drug screening when the certificateholder radiologic
395technologist does not have a lawful prescription and legitimate
396medical reason for using such drug.
397     (l)  Failing to report to the department in writing within
39830 days after the certificateholder has had a voluntary or
399mandatory certificate to practice radiologic technology or to
400perform the duties of a radiologist assistant revoked,
401suspended, or otherwise acted against, including being denied
402certification, by a national organization, by a specialty board
403recognized by the department, or by a certification authority of
404another state, territory, or country.
405     (m)  Having been found guilty of, regardless of
406adjudication, or pleading guilty or nolo contendere to, any
407offense prohibited under s. 435.03 or under any similar statute
408of another jurisdiction.
409     (n)  Failing to comply with the recommendations of the
410department's impaired practitioner program for treatment,
411evaluation, or monitoring. A letter from the director of the
412impaired practitioner program that the certificateholder is not
413in compliance shall be considered conclusive proof under this
414part.
415     (2)  If the department finds any person or firm guilty of
416any of the grounds set forth in subsection (1), it may enter an
417order imposing one or more of the following penalties:
418     (a)  Refusal to approve an application for certification.
419     (b)  Revocation or suspension of a certificate.
420     (c)  Imposition of an administrative fine not to exceed
421$1,000 for each count or separate offense.
422     (d)  Issuance of a reprimand.
423     (e)  Placement of the certificateholder radiologic
424technologist on probation for such period of time and subject to
425such conditions as the department may specify, including
426requiring the certificateholder radiologic technologist to
427submit to treatment, to undertake further relevant education or
428training, to take an examination, or to work under the
429supervision of a licensed practitioner.
430     (3)  The department shall not reinstate a person's the
431certificate of a radiologic technologist, or cause a certificate
432to be issued to a person it has deemed unqualified, until such
433time as the department is satisfied that such person has
434complied with all the terms and conditions set forth in the
435final order and is capable of safely engaging in the practice of
436his or her certified profession radiologic technology.
437     (5)  A final disciplinary action taken against a
438certificateholder radiologic technologist in another
439jurisdiction, whether voluntary or mandatory, shall be
440considered conclusive proof of grounds for a disciplinary
441proceeding under this part.
442     Section 11.  Section 468.311, Florida Statutes, is amended
443to read:
444     468.311  Violations; penalties.--Each of the following acts
445constitutes a misdemeanor of the second degree, punishable as
446provided in s. 775.082 or s. 775.083:
447     (1)  Practicing radiologic technology or performing the
448duties of a radiologist assistant without holding an active
449certificate to do so.
450     (2)  Using or attempting to use a certificate which has
451been suspended or revoked.
452     (3)  The willful practice of radiologic technology or the
453willful performance of the duties of a radiologist assistant by
454a student radiologic technologist without a direct supervisor
455being present.
456     (4)  Knowingly allowing a student radiologic technologist
457to practice radiologic technology or perform the duties of a
458radiologist assistant without a direct supervisor being present.
459     (5)  Obtaining or attempting to obtain a certificate under
460this part through bribery or fraudulent misrepresentation.
461     (6)  Using any the name or title specified in s. 468.302(2)
462"Certified Radiologic Technologist" or any other name or title
463which implies that a person is certified to practice radiologic
464technology or to perform the duties of a radiologist assistant,
465unless such person is duly certified as provided in this part.
466     (7)  Knowingly concealing information relating to the
467enforcement of this part or rules adopted pursuant to this part.
468     (8)  Employing, for the purpose of applying ionizing
469radiation to, or otherwise practicing radiologic technology or
470any of the duties of a radiologist assistant on, any human
471being, any individual who is not certified under the provisions
472of this part.
473     Section 12.  Section 468.3115, Florida Statutes, is amended
474to read:
475     468.3115  Injunctive relief.--The practice of radiologic
476technology or the performance of the duties of a radiologist
477assistant in violation of this part, or the performance of any
478act prohibited in this part, is declared a nuisance inimical to
479the public health, safety, and welfare of this state. In
480addition to other remedies provided in this part, the
481department, or any state attorney in the name of the people of
482this state, may bring an action for an injunction to restrain
483such violation until compliance with the provisions of this part
484and the rules adopted pursuant to this part has been
485demonstrated to the satisfaction of the department.
486     Section 13.  Subsections (1), (2), and (5) of section
487468.314, Florida Statutes, are amended to read:
488     468.314  Advisory Council on Radiation Protection;
489appointment; terms; powers; duties.--
490     (1)  The Advisory Council on Radiation Protection is
491created within the Department of Health and shall consist of 16
49215 persons to be appointed by the secretary for 3-year terms.
493     (2)  The council shall be comprised of:
494     (a)  A certified radiologic technologist-radiographer.
495     (b)  A certified radiologic technologist-nuclear medicine.
496     (c)  A certified radiologic technologist-therapy.
497     (d)  A basic X-ray machine operator or a licensed
498practitioner who employs such an operator.
499     (e)  A board-certified radiologist.
500     (f)  A board-certified nuclear medicine physician.
501     (g)  A certified health physicist.
502     (h)  A certified radiologist assistant.
503     (i)(h)  A representative from the administration of a
504hospital affiliated with a radiologic technology educational
505program.
506     (j)(i)  An expert in environmental radiation matters.
507     (k)(j)  A chiropractic radiologist.
508     (l)(k)  A board-certified podiatric physician.
509     (m)(l)  A board-certified radiological physicist.
510     (n)(m)  A board-certified therapeutic radiologist or board-
511certified radiation oncologist.
512     (o)(n)  Two persons, neither of whom has ever been
513certified pursuant to this part as a radiologic technologist or
514been a member of any closely related profession.
515     (5)(a)  The council may recommend to the department
516examination procedures for applicants and minimum requirements
517for qualification of applicants.
518     (b)  The council shall:
519     1.  Recommend to the department a code of ethics for the
520certificateholder's practice of his or her certified profession
521radiologic technology.
522     2.  Make recommendations for the improvement of continuing
523education courses.
524     3.  Make recommendations to the department on matters
525relating to the practice of radiologic technology, the
526performance of the duties of a radiologist assistant, and
527radiation protection.
528     4.  Study the utilization of medical imaging and
529nonionizing radiation, such as nuclear magnetic resonance or
530similarly related technology, and make recommendations to the
531department on the personnel appropriate to conduct such
532procedures and the minimum qualifications for such personnel.
533     Section 14.  This act shall take effect July 1, 2006.


CODING: Words stricken are deletions; words underlined are additions.