HB 819

1
A bill to be entitled
2An act relating to radiologist assistants; amending s.
3468.3001, F.S.; redesignating part IV of ch. 468, F.S., as
4the "Radiological Personnel Certification Act"; amending
5s. 468.301, F.S.; providing definitions; amending s.
6468.302, F.S.; providing for identification and duties of
7a radiologist assistant; providing for rulemaking by the
8Department of Health; providing limitations on duties a
9radiologist assistant may perform; amending s. 468.304,
10F.S.; providing conditions for qualification for a
11radiologist assistant's certificate; amending s. 468.306,
12F.S.; specifying the applicants required to pass a
13certification examination; requiring the department to
14accept certain demonstrations by an applicant for a
15certification to practice as a radiologist assistant in
16lieu of any examination requirement; amending s. 468.3065,
17F.S.; authorizing the Department of Health to issue
18certificates by endorsement to certain radiologist
19assistants; providing for a fee; amending ss. 468.307,
20468.309, 468.3095, 468.3101, 468.311, and 468.3115, F.S.;
21including radiologist assistants in provisions applicable
22to radiologic technologists with respect to requirements
23for certificate display, certificate renewal, change of
24certificate status, grounds for disciplinary action,
25violations, penalties, and injunctive relief; amending s.
26468.314, F.S.; adding a certified radiologist assistant to
27the membership of the Advisory Council on Radiation
28Protection; providing an effective date.
29
30Be It Enacted by the Legislature of the State of Florida:
31
32     Section 1.  Section 468.3001, Florida Statutes, is amended
33to read:
34     468.3001  Short title.--This part shall be known and may be
35cited as the "Radiological Personnel Radiologic Technologist
36Certification Act."
37     Section 2.  Present subsections (4) through (14) of section
38468.301, Florida Statutes, are renumbered as subsections (5)
39through (15), respectively, present subsection (15) is
40renumbered as subsection (18), new subsections (4), (16), and
41(17) are added to that section, and present subsection (14) of
42that section is amended, to read:
43     468.301  Definitions.--As used in this part, the term:
44     (4)  "Certificateholder" means any person who holds a
45certificate under this part that authorizes that person to use
46radiation on human beings.
47     (15)(14)  "Radiologic technologist" means a person, other
48than a licensed practitioner, who is qualified by education,
49training, or experience, as more specifically defined in s.
50468.302(3)(d)-(g) s. 468.302, to use radiation on human beings
51under the specific direction and general supervision of a
52licensed practitioner in each particular case.
53     (16)  "Radiologist" means a physician specializing in
54radiology certified by or eligible for certification by the
55American Board of Radiology or the American Osteopathic Board of
56Radiology, the British Royal College of Radiology, or the
57Canadian College of Physicians and Surgeons.
58     (17)  "Radiologist assistant" means a person, other than a
59licensed practitioner, who is qualified by education and
60certification, as set forth in s. 468.304, as an advanced-level
61radiologic technologist who works under the supervision of a
62radiologist to enhance patient care by assisting the radiologist
63in the medical imaging environment.
64     Section 3.  Subsections (1), (5), and (6) of section
65468.302, Florida Statutes, are amended, paragraph (g) is added
66to subsection (2) of that section, and paragraph (h) is added to
67subsection (3) of that section, to read:
68     468.302  Use of radiation; identification of certified
69persons; limitations; exceptions.--
70     (1)  Except as provided in this section, a person may not
71use radiation or otherwise practice radiologic technology or any
72of the duties of a radiologist assistant on a human being unless
73he or she:
74     (a)  Is a licensed practitioner; or
75     (b)  Is the holder of a certificate, as provided in this
76part, and is operating under the direct supervision or general
77supervision of a licensed practitioner in each particular case;
78or.
79     (c)  Is the holder of a radiologist assistant certificate,
80as provided in this part, and is operating under the supervision
81of a radiologist, as specified in paragraph (3)(h).
82     (2)
83     (g)  A person holding a certificate as a radiologist
84assistant may use the title "Certified Radiologist Assistant" or
85the letters "CRA" after his or her name.
86
87No other person is entitled to so use a title or letters
88contained in this subsection or to hold himself or herself out
89in any way, whether orally or in writing, expressly or by
90implication, as being so certified.
91     (3)
92     (h)  A person holding a certificate as a radiologist
93assistant may:
94     1.  Perform specific duties allowed for a radiologist
95assistant as defined by the department by rule. The rule must be
96consistent with guidelines adopted by the American College of
97Radiology, the American Society of Radiologic Technologists, and
98the American Registry of Radiologic Technologists, with the
99level of supervision required by such guidelines.
100     2.  Not perform nuclear medicine or radiation therapy
101procedures unless currently certified and trained to perform
102those duties under the person's nuclear medicine technologist or
103radiation therapy technologist certificate; not interpret
104images; not make diagnoses; and not prescribe medications or
105therapies.
106     (5)  Nothing contained in this part relating to radiologic
107technology or a radiologist assistant shall be construed to
108limit, enlarge, or affect in any respect the practice by duly
109licensed practitioners of their respective professions.
110     (6)  Requirement for certification does not apply to:
111     (a)  A hospital resident who is not a licensed practitioner
112in this state or a student enrolled in and attending a school or
113college of medicine, osteopathic medicine, chiropody, podiatric
114medicine, or chiropractic medicine or a radiologic technology
115educational program or radiologist assistant educational program
116and who applies radiation to a human being while under the
117direct supervision of a licensed practitioner.
118     (b)  A person who is engaged in performing the duties of a
119radiologic technologist or of a radiologist assistant in his or
120her employment by a governmental agency of the United States.
121     (c)  A person who is trained and skilled in cardiopulmonary
122technology and who provides cardiopulmonary technology services
123at the direction, and under the direct supervision, of a
124licensed practitioner.
125     Section 4.  Paragraph (e) of subsection (3) of section
126468.304, Florida Statutes, is amended to read:
127     468.304  Certification.--The department shall certify any
128applicant who meets the following criteria:
129     (3)  Submits satisfactory evidence, verified by oath or
130affirmation, that she or he:
131     (e)1.  Has successfully completed an educational program,
132which program may be established in a hospital licensed pursuant
133to chapter 395 or in an accredited postsecondary academic
134institution which is subject to approval by the department as
135maintaining a satisfactory standard; or
136     2.a.  With respect to an applicant for a basic X-ray
137machine operator's certificate, has completed a course of study
138approved by the department with appropriate study material
139provided the applicant by the department;
140     b.  With respect to an applicant for a basic X-ray machine
141operator-podiatric medicine certificate, has completed a course
142of study approved by the department, provided that such course
143of study shall be limited to that information necessary to
144perform radiographic procedures within the scope of practice of
145a podiatric physician licensed pursuant to chapter 461;
146     c.  With respect only to an applicant for a general
147radiographer's certificate who is a basic X-ray machine operator
148certificateholder, has completed an educational program or a 2-
149year training program that takes into account the types of
150procedures and level of supervision usually and customarily
151practiced in a hospital, which educational or training program
152complies with the rules of the department; or
153     d.  With respect only to an applicant for a nuclear
154medicine technologist's certificate who is a general
155radiographer certificateholder, has completed an educational
156program or a 2-year training program that takes into account the
157types of procedures and level of supervision usually and
158customarily practiced in a hospital, which educational or
159training program complies with the rules of the department; or.
160     e.  With respect to an applicant for a radiologist
161assistant's certificate who demonstrates to the department that
162he or she holds a current certificate or registration as a
163radiologist assistant granted by the American Registry of
164Radiologic Technologists.
165
166The department may not certify any applicant who has committed
167an offense that would constitute a violation of any of the
168provisions of s. 468.3101 or the rules adopted thereunder if the
169applicant had been certified by the department at the time of
170the offense. No application for a limited computed tomography
171certificate shall be accepted. All persons holding valid
172computed tomography certificates as of October 1, 1984, are
173subject to the provisions of s. 468.309.
174     Section 5.  Section 468.306, Florida Statutes, is amended
175to read:
176     468.306  Examinations.--All applicants for certification as
177a radiologic technologist, basic X-ray machine operator, or
178basic X-ray machine operator-podiatric medicine, except those
179certified pursuant to s. 468.3065, shall be required to pass an
180examination. In lieu of an examination for a radiologist
181assistant certificate, the department shall accept a
182demonstration by the applicant for such a certificate that he or
183she holds a current certificate or registration as a radiologist
184assistant granted by the American Registry of Radiologic
185Technologists. The department may is authorized to develop or
186use examinations for each type of certificate. The department
187may require an applicant who does not pass an examination after
188five attempts to complete additional remedial education, as
189specified by rule of the department, before admitting the
190applicant to subsequent examinations.
191     (1)  The department may shall have the authority to
192contract with organizations that develop such test examinations.
193Examinations may be administered by the department or the
194contracting organization.
195     (2)  Examinations shall be given for each type of
196certificate at least twice a year at such times and places as
197the department may determine to be advantageous for applicants.
198     (3)  All examinations shall be written and include
199positioning, technique, and radiation protection. The department
200shall either pass or fail each applicant on the basis of his or
201her final grade. The examination for a basic X-ray machine
202operator shall include basic positioning and basic techniques
203directly related to the skills necessary to safely operate
204radiographic equipment.
205     (4)  A nonrefundable fee not to exceed $75 plus the actual
206per-applicant cost for purchasing the examination from a
207national organization shall be charged for any subsequent
208examination.
209     Section 6.  Section 468.3065, Florida Statutes, is amended
210to read:
211     468.3065  Certification by endorsement.--
212     (1)  The department may issue a certificate by endorsement
213to practice as a radiologist assistant to an applicant who, upon
214applying to the department and remitting a nonrefundable fee not
215to exceed $50, demonstrates to the department that he or she
216holds a current certificate or registration as a radiologist
217assistant granted by the American Registry of Radiologic
218Technologists.
219     (2)  The department may issue a certificate by endorsement
220to practice radiologic technology to an applicant who, upon
221applying to the department and remitting a nonrefundable fee not
222to exceed $50, demonstrates to the department that he or she
223holds a current certificate, license, or registration to
224practice radiologic technology, provided that the requirements
225for such certificate, license, or registration are deemed by the
226department to be substantially equivalent to those established
227under this part and rules adopted under this part.
228     Section 7.  Subsection (3) of section 468.307, Florida
229Statutes, is amended to read:
230     468.307  Certificate; issuance; display.--
231     (3)  Every employer of certificateholders radiologic
232technologists shall display the certificates of all of such
233employees in a place accessible to view.
234     Section 8.  Paragraph (a) of subsection (1) and subsections
235(4), (5), (6), and (7) of section 468.309, Florida Statutes, are
236amended to read:
237     468.309  Certificate; duration; renewal; reversion to
238inactive status; members of Armed Forces and spouses.--
239     (1)(a)  A radiologic technologist's certificate issued in
240accordance with this part expires as specified in rules adopted
241by the department which establish a procedure for the biennial
242renewal of certificates. A certificate shall be renewed by the
243department for a period of 2 years upon payment of a renewal fee
244in an amount not to exceed $75 and upon submission of a renewal
245application containing such information as the department deems
246necessary to show that the applicant for renewal is a
247certificateholder radiologic technologist in good standing and
248has completed any continuing education requirements that the
249department establishes.
250     (4)  Any certificate that is not renewed by its expiration
251date shall automatically be placed in an expired status, and the
252certificateholder may not practice radiologic technology or
253perform the duties of a radiologist assistant until the
254certificate has been reactivated.
255     (5)  A certificateholder in good standing remains in good
256standing when he or she becomes a member of the Armed Forces of
257the United States on active duty without paying renewal fees or
258accruing continuing education credits as long as he or she is a
259member of the Armed Forces on active duty and for a period of 6
260months after discharge from active duty, if he or she is not
261engaged in practicing radiologic technology or performing the
262duties of a radiologist assistant in the private sector for
263profit. The certificateholder must pay a renewal fee and
264complete continuing education not to exceed 12 classroom hours
265to renew the certificate.
266     (6)  A certificateholder who is in good standing remains in
267good standing if he or she is absent from the state because of
268his or her spouse's active duty with the Armed Forces of the
269United States. The certificateholder remains in good standing
270without paying renewal fees or completing continuing education
271as long as his or her spouse is a member of the Armed Forces on
272active duty and for a period of 6 months after the spouse's
273discharge from active duty, if the certificateholder is not
274engaged in practicing radiologic technology or performing the
275duties of a radiologist assistant in the private sector for
276profit.  The certificateholder must pay a renewal fee and
277complete continuing education not to exceed 12 classroom hours
278to renew the certificate.
279     (7)  A certificateholder may resign his or her
280certification by submitting to the department a written,
281notarized resignation on a form specified by the department. The
282resignation automatically becomes effective upon the
283department's receipt of the resignation form, at which time the
284certificateholder's certification automatically becomes null and
285void and may not be reactivated or renewed or used to practice
286radiologic technology or to perform the duties of a radiologist
287assistant. A certificateholder who has resigned may become
288certified again only by reapplying to the department for
289certification as a new applicant and meeting the certification
290requirements pursuant to s. 468.304 or s. 468.3065. Any
291disciplinary action that had been imposed on the
292certificateholder prior to his or her resignation shall be
293tolled until he or she again becomes certified. Any disciplinary
294action proposed at the time of the certificateholder's
295resignation shall be tolled until he or she again becomes
296certified.
297     Section 9.  Paragraphs (a) and (c) of subsection (2) of
298section 468.3095, Florida Statutes, are amended to read:
299     468.3095  Inactive status; reactivation; automatic
300suspension; reinstatement.--
301     (2)(a)  A certificate that has been expired for less than
30210 years may be reactivated upon payment of the biennial renewal
303fee and a late renewal fee, not to exceed $100, and submission
304of a reactivation application containing any information that
305the department deems necessary to show that the applicant is a
306certificateholder radiologic technologist in good standing and
307has met the requirements for continuing education. The
308department shall prescribe, by rule, continuing education
309requirements as a condition of reactivating a certificate. The
310continuing education requirements for reactivating a certificate
311may not exceed 10 classroom hours for each year the certificate
312was expired and may not exceed 100 classroom hours for all years
313in which the certificate was expired.
314     (c)  A certificate that has been inactive or expired for 10
315years or more automatically becomes null and void and may not be
316reactivated, renewed, or used to practice radiologic technology
317or to perform the duties of a radiologist assistant. A
318certificateholder whose certificate has become null and void may
319become certified again only by reapplying to the department as a
320new applicant and meeting the requirements of s. 468.304 or s.
321468.3065.
322     Section 10.  Subsections (1), (2), (3), and (5) of section
323468.3101, Florida Statutes, are amended to read:
324     468.3101  Disciplinary grounds and actions.--
325     (1)  The department may make or require to be made any
326investigations, inspections, evaluations, and tests, and require
327the submission of any documents and statements, which it
328considers necessary to determine whether a violation of this
329part has occurred. The following acts shall be grounds for
330disciplinary action as set forth in this section:
331     (a)  Procuring, attempting to procure, or renewing a
332certificate to practice radiologic technology by bribery, by
333fraudulent misrepresentation, or through an error of the
334department.
335     (b)  Having a voluntary or mandatory certificate to
336practice radiologic technology or to perform the duties of a
337radiologist assistant revoked, suspended, or otherwise acted
338against, including being denied certification, by a national
339organization; by a specialty board recognized by the department;
340or by a certification authority of another state, territory, or
341country.
342     (c)  Being convicted or found guilty, regardless of
343adjudication, in any jurisdiction of a crime that directly
344relates to the practice of radiologic technology or to the
345performance of the duties of a radiologist assistant, or to the
346ability to practice radiologic technology or the ability to
347perform the duties of a radiologist assistant. Pleading nolo
348contendere shall be considered a conviction for the purpose of
349this provision.
350     (d)  Being convicted or found guilty, regardless of
351adjudication, in any jurisdiction of a crime against a person.
352Pleading nolo contendere shall be considered a conviction for
353the purposes of this provision.
354     (e)  Making or filing a false report or record that the
355certificateholder knows to be false, intentionally or
356negligently failing to file a report or record required by state
357or federal law, or willfully impeding or obstructing such filing
358or inducing another to do so. Such reports or records include
359only those reports or records which are signed in the capacity
360of the certificateholder as a radiologic technologist.
361     (f)  Engaging in unprofessional conduct, which includes,
362but is not limited to, any departure from, or the failure to
363conform to, the standards of practice of radiologic technology
364or the standards of practice for radiologist assistants as
365established by the department, in which case actual injury need
366not be established.
367     (g)  Being unable to practice radiologic technology or to
368perform the duties of a radiologist assistant with reasonable
369skill and safety to patients by reason of illness or use of
370alcohol, drugs, narcotics, chemicals, or other materials or as a
371result of any mental or physical condition. A certificateholder
372radiologic technologist affected under this paragraph shall, at
373reasonable intervals, be afforded an opportunity to demonstrate
374that he or she can resume the competent practice of his or her
375certified profession radiologic technology with reasonable skill
376and safety.
377     (h)  Failing to report to the department any person who the
378certificateholder knows is in violation of this part or of the
379rules of the department.
380     (i)  Violating any provision of this part, any rule of the
381department, or any lawful order of the department previously
382entered in a disciplinary proceeding or failing to comply with a
383lawfully issued subpoena of the department.
384     (j)  Employing, for the purpose of applying ionizing
385radiation or otherwise practicing radiologic technology or
386performing the duties of a radiologist assistant on a human
387being, any individual who is not certified under the provisions
388of this part.
389     (k)  Testing positive for any drug, as defined in s.
390112.0455, on any confirmed preemployment or employer-required
391drug screening when the certificateholder radiologic
392technologist does not have a lawful prescription and legitimate
393medical reason for using such drug.
394     (l)  Failing to report to the department in writing within
39530 days after the certificateholder has had a voluntary or
396mandatory certificate to practice radiologic technology or to
397perform the duties of a radiologist assistant revoked,
398suspended, or otherwise acted against, including being denied
399certification, by a national organization, by a specialty board
400recognized by the department, or by a certification authority of
401another state, territory, or country.
402     (m)  Having been found guilty of, regardless of
403adjudication, or pleading guilty or nolo contendere to, any
404offense prohibited under s. 435.03 or under any similar statute
405of another jurisdiction.
406     (n)  Failing to comply with the recommendations of the
407department's impaired practitioner program for treatment,
408evaluation, or monitoring. A letter from the director of the
409impaired practitioner program that the certificateholder is not
410in compliance shall be considered conclusive proof under this
411part.
412     (2)  If the department finds any person or firm guilty of
413any of the grounds set forth in subsection (1), it may enter an
414order imposing one or more of the following penalties:
415     (a)  Refusal to approve an application for certification.
416     (b)  Revocation or suspension of a certificate.
417     (c)  Imposition of an administrative fine not to exceed
418$1,000 for each count or separate offense.
419     (d)  Issuance of a reprimand.
420     (e)  Placement of the certificateholder radiologic
421technologist on probation for such period of time and subject to
422such conditions as the department may specify, including
423requiring the certificateholder radiologic technologist to
424submit to treatment, to undertake further relevant education or
425training, to take an examination, or to work under the
426supervision of a licensed practitioner.
427     (3)  The department shall not reinstate a person's the
428certificate of a radiologic technologist, or cause a certificate
429to be issued to a person it has deemed unqualified, until such
430time as the department is satisfied that such person has
431complied with all the terms and conditions set forth in the
432final order and is capable of safely engaging in the practice of
433his or her certified profession radiologic technology.
434     (5)  A final disciplinary action taken against a
435certificateholder radiologic technologist in another
436jurisdiction, whether voluntary or mandatory, shall be
437considered conclusive proof of grounds for a disciplinary
438proceeding under this part.
439     Section 11.  Section 468.311, Florida Statutes, is amended
440to read:
441     468.311  Violations; penalties.--Each of the following acts
442constitutes a misdemeanor of the second degree, punishable as
443provided in s. 775.082 or s. 775.083:
444     (1)  Practicing radiologic technology or performing the
445duties of a radiologist assistant without holding an active
446certificate to do so.
447     (2)  Using or attempting to use a certificate which has
448been suspended or revoked.
449     (3)  The willful practice of radiologic technology or the
450willful performance of the duties of a radiologist assistant by
451a student radiologic technologist without a direct supervisor
452being present.
453     (4)  Knowingly allowing a student radiologic technologist
454to practice radiologic technology or perform the duties of a
455radiologist assistant without a direct supervisor being present.
456     (5)  Obtaining or attempting to obtain a certificate under
457this part through bribery or fraudulent misrepresentation.
458     (6)  Using any the name or title specified in s. 468.302(2)
459"Certified Radiologic Technologist" or any other name or title
460which implies that a person is certified to practice radiologic
461technology or to perform the duties of a radiologist assistant,
462unless such person is duly certified as provided in this part.
463     (7)  Knowingly concealing information relating to the
464enforcement of this part or rules adopted pursuant to this part.
465     (8)  Employing, for the purpose of applying ionizing
466radiation to, or otherwise practicing radiologic technology or
467any of the duties of a radiologist assistant on, any human
468being, any individual who is not certified under the provisions
469of this part.
470     Section 12.  Section 468.3115, Florida Statutes, is amended
471to read:
472     468.3115  Injunctive relief.--The practice of radiologic
473technology or the performance of the duties of a radiologist
474assistant in violation of this part, or the performance of any
475act prohibited in this part, is declared a nuisance inimical to
476the public health, safety, and welfare of this state. In
477addition to other remedies provided in this part, the
478department, or any state attorney in the name of the people of
479this state, may bring an action for an injunction to restrain
480such violation until compliance with the provisions of this part
481and the rules adopted pursuant to this part has been
482demonstrated to the satisfaction of the department.
483     Section 13.  Subsections (1), (2), and (5) of section
484468.314, Florida Statutes, are amended to read:
485     468.314  Advisory Council on Radiation Protection;
486appointment; terms; powers; duties.--
487     (1)  The Advisory Council on Radiation Protection is
488created within the Department of Health and shall consist of 16
48915 persons to be appointed by the secretary for 3-year terms.
490     (2)  The council shall be comprised of:
491     (a)  A certified radiologic technologist-radiographer.
492     (b)  A certified radiologic technologist-nuclear medicine.
493     (c)  A certified radiologic technologist-therapy.
494     (d)  A basic X-ray machine operator or a licensed
495practitioner who employs such an operator.
496     (e)  A board-certified radiologist.
497     (f)  A board-certified nuclear medicine physician.
498     (g)  A certified health physicist.
499     (h)  A certified radiologist assistant.
500     (i)(h)  A representative from the administration of a
501hospital affiliated with a radiologic technology educational
502program.
503     (j)(i)  An expert in environmental radiation matters.
504     (k)(j)  A chiropractic radiologist.
505     (l)(k)  A board-certified podiatric physician.
506     (m)(l)  A board-certified radiological physicist.
507     (n)(m)  A board-certified therapeutic radiologist or board-
508certified radiation oncologist.
509     (o)(n)  Two persons, neither of whom has ever been
510certified pursuant to this part as a radiologic technologist or
511been a member of any closely related profession.
512     (5)(a)  The council may recommend to the department
513examination procedures for applicants and minimum requirements
514for qualification of applicants.
515     (b)  The council shall:
516     1.  Recommend to the department a code of ethics for the
517certificateholder's practice of his or her certified profession
518radiologic technology.
519     2.  Make recommendations for the improvement of continuing
520education courses.
521     3.  Make recommendations to the department on matters
522relating to the practice of radiologic technology, the
523performance of the duties of a radiologist assistant, and
524radiation protection.
525     4.  Study the utilization of medical imaging and
526nonionizing radiation, such as nuclear magnetic resonance or
527similarly related technology, and make recommendations to the
528department on the personnel appropriate to conduct such
529procedures and the minimum qualifications for such personnel.
530     Section 14.  This act shall take effect July 1, 2006.


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