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AB-407 Fluoroscopy and radiography permit or certification and continuing education: exceptions.(2019-2020)

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Date Published: 07/01/2019 02:00 PM
AB407:v95#DOCUMENT

Amended  IN  Senate  July 01, 2019
Amended  IN  Senate  June 17, 2019
Amended  IN  Assembly  April 11, 2019
Amended  IN  Assembly  March 28, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 407


Introduced by Assembly Member Santiago

February 07, 2019


An act to amend Sections 107110 and 114870 of the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 407, as amended, Santiago. Fluoroscopy and radiography permit or certification and continuing education: exceptions.
The Radiologic Technology Act makes it unlawful for any licentiate of the healing arts to administer or use diagnostic, mammographic, or therapeutic X-ray on human beings in this state, unless that person is certified by the State Department of Public Health and acting within the scope of that certification. The act requires the department to prescribe minimum qualifications for granting a fluoroscopy permit and continuing education requirements for the holders of that permit. A person who violates a provision of the Radiologic Technology Act or regulation of the department adopted pursuant to that act is guilty of a misdemeanor.
This bill would, notwithstanding the above-described requirement to be certified to administer or use diagnostic, mammographic, or therapeutic X-ray on human beings in this state, authorize a physician and surgeon or a doctor of podiatric medicine to provide fluoroscopy and radiography services and supervise radiologic technologists without prior to receiving a Fluoroscopy X-ray Supervisor and Operator’s permit or certification, if the physician and surgeon or the doctor of podiatric medicine submits to the department evidence of completing radiation safety training provided by a facility accredited by the Centers for Medicare and Medicaid Services, as specified. The bill would require the department to issue a Fluoroscopy X-ray Supervisor and Operator’s permit or certification, without requiring an examination, to a physician and surgeon or a doctor of podiatric medicine who applies under these provisions.
The bill would require the department to provide that working in a setting that is in compliance with conditions relating to radiation safety that are required by the Centers for Medicare and Medicaid Services satisfies a requirement for fluoroscopy and radiography continuing education as set forth in a specific regulation.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 107110 of the Health and Safety Code is amended to read:

107110.
 (a) It shall be unlawful for any licentiate of the healing arts to administer or use diagnostic, mammographic, or therapeutic X-ray on human beings in this state after January 1, 1972, unless that person is certified pursuant to subdivision (e) of Section 114870, Section 114872, or Section 114885, and is acting within the scope of that certification.
(b) Notwithstanding subdivision (a), a physician and surgeon or a doctor of podiatric medicine, who complies with subdivision (c), may provide fluoroscopy and radiography services and may supervise radiologic technologists without prior to receiving a Fluoroscopy X-ray Supervisor and Operator’s permit or certification.
(c) A physician and surgeon or a doctor of podiatric medicine, who has completed the radiation safety training provided by a facility accredited by the Centers for Medicare and Medicaid Services’ Conditions for Coverage relating to radiation safety, shall submit evidence that they have completed the facility’s radiation safety training to the State Department of Public Health within 60 days of completing the training. That training shall serve in lieu of passing the Fluoroscopy X-ray Supervisor and Operator’s permitting or certification test required by the State Department of Public Health. After
(d) After receiving evidence that the radiation safety training is complete, along with a copy of their valid license and any required and reasonable permit or certification fee, the State Department of Public Health shall issue the physician and surgeon or the doctor of podiatric medicine a Fluoroscopy X-ray Supervisor and Operator’s permit or certification without requiring a permitting or certification examination.

SEC. 2.

 Section 114870 of the Health and Safety Code is amended to read:

114870.
 The department shall do all of the following:
(a) Upon recommendation of the committee, adopt regulations as may be necessary to accomplish the purposes of this chapter.
(b) (1) Provide for certification of radiologic technologists, without limitation as to procedures or areas of application, except as provided in Section 106980. Separate certificates shall be provided for diagnostic radiologic technology, for mammographic radiologic technology, and for therapeutic radiologic technology. If a person has received accreditation to perform mammography from a private accreditation organization, the department shall consider this accreditation when deciding to issue a mammographic radiologic technology certificate.
(2) Provide, upon recommendation of the committee, that a radiologic technologist who operates digital radiography equipment devote a portion of their continuing education credit hours to continuing education in digital radiologic technology.
(c) (1) (A) Provide, as may be deemed appropriate, for granting limited permits to persons to conduct radiologic technology limited to the performance of certain procedures or the application of X-rays to specific areas of the human body, except for mammography, prescribe minimum standards of training and experience for these persons, and prescribe procedures for examining applicants for limited permits. The minimum standards shall include a requirement that persons granted limited permits under this subdivision shall meet those fundamental requirements in basic radiological health training and knowledge similar to those required for persons certified under subdivision (b) as the department determines are reasonably necessary for the protection of the health and safety of the public.
(B) Provide that an applicant for approval as a limited permit X-ray technician in the categories of chest radiography, extremities radiography, gastrointestinal radiography, genitourinary radiography, leg-podiatric radiography, skull radiography, and torso-skeletal radiography, as these categories are defined in Section 30443 of Title 17 of the California Code of Regulations, shall have at least 50 hours of education in radiological protection and safety. The department may allocate these hours as it deems appropriate.
(2) Provide that a limited permit X-ray technician in the categories of chest radiography, extremities radiography, gastrointestinal radiography, genitourinary radiography, leg-podiatric radiography, skull radiography, and torso-skeletal radiography, as these categories are defined in Section 30443 of Title 17 of the California Code of Regulations, may perform digital radiography within their respective scopes of practice after completion of 20 hours or more of instruction in digital radiologic technology approved by the department. This requirement does not preclude limited permit X-ray technicians in the categories of dental laboratory radiography and X-ray bone densitometry from performing digital radiography upon meeting the educational requirements determined by the department.
(3) Provide, upon recommendation of the committee, that a limited permit X-ray technician who has completed the initial instruction described in paragraph (2) devote a portion of their required continuing education credit hours to additional continuing instruction in digital radiologic technology.
(d) Provide for the approval of schools for radiologic technologists. Schools for radiologic technologists shall include 20 hours of approved instruction in digital radiography. The department may exempt a school from this requirement as it deems appropriate.
(e) Provide, upon recommendation of the committee, for certification of licentiates of the healing arts to supervise the operation of X-ray machines or to operate X-ray machines, or both, prescribe minimum standards of training and experience for these licentiates of the healing arts, and prescribe procedures for examining applicants for certification. This certification may limit the use of X-rays to certain X-ray procedures and the application of X-rays to specific areas of the human body.
(f) (1) Provide for certification of any physician and surgeon to operate, and supervise the operation of, a bone densitometer, if that physician and surgeon provides the department a certificate that evidences training in the use of a bone densitometer by a representative of a bone densitometer machine manufacturer, or through any radiologic technology school. The certification shall be valid for the particular bone densitometer the physician and surgeon was trained to use, and for any other bone densitometer that meets all of the criteria specified in subparagraphs (A) to (C), inclusive, if the physician and surgeon has completed training, as specified in subparagraph (A) of paragraph (2), for the use of that bone densitometer. The physician and surgeon shall, upon request of the department, provide evidence of training, pursuant to subparagraph (A) of paragraph (2), for the use of any bone densitometer used by the physician and surgeon. The activity covered by the certificate shall be limited to the use of an X-ray bone densitometer to which all of the following is applicable:
(A) The bone densitometer does not require user intervention for calibration.
(B) The bone densitometer does not provide an image for diagnosis.
(C) The bone densitometer is used only to estimate bone density of the heel, wrist, or finger of the patient.
(2) The certificate shall be accompanied by a copy of the curriculum covered by the manufacturer’s representative or radiologic technology school. The curriculum shall include, at a minimum, instruction in all of the following areas:
(A) Procedures for operation of the bone densitometer by the physician and surgeon, and for the supervision of the operation of the bone densitometer by other persons, including procedures for quality assurance of the bone densitometer.
(B) Proper radiation protection of the operator, the patient, and third parties in proximity to the bone densitometer.
(C) Provisions of Article 5 (commencing with Section 106955) of Chapter 4 of Part 1 of Division 104.
(D) Provisions of Chapter 6 (commencing with Section 114840) of Part 9 of Division 104.
(E) Provisions of Group 1 (commencing with Section 30100) of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(F) Provisions of Group 1.5 (commencing with Section 30108) of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(G) Provisions of Article 1 (commencing with Section 30252) of Group 3 of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(H) Provisions of Article 2 (commencing with Section 30254) of Group 3 of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(I) Provisions of Article 3 (commencing with Section 30275) of Group 3 of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(J) Provisions of Article 4 (commencing with Section 30305) of Group 3 of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(K) Provisions of Subchapter 4.5 (commencing with Section 30400) of Chapter 5 of Division 1 of Title 17 of the California Code of Regulations.
(3) (A) Notwithstanding any other law, this subdivision shall constitute all the requirements that must be met by a physician and surgeon in order to operate, and supervise the operation of, a bone densitometer. The department may adopt regulations consistent with this section in order to administer the certification requirements.
(B) No person may be supervised by a physician and surgeon in the use of a bone densitometer unless that person possesses the necessary license or permit required by the department.
(C) Nothing in this subdivision shall affect the requirements imposed by the committee or the department for the registration of a bone densitometer machine, or for the inspection of facilities in which any bone densitometer machine is operated.
(D) This subdivision shall not apply to a licentiate of the healing arts who is certified pursuant to subdivision (e) or pursuant to Section 107111.
(E) The department shall charge a fee for a certificate issued pursuant to this subdivision to the extent necessary to administer certification. The fee shall be in an amount sufficient to cover the department’s costs of implementing this subdivision and shall not exceed the fee for certification to operate or supervise the operation of an X-ray machine pursuant to subdivision (e). The fees collected pursuant to this subparagraph shall be deposited into the Radiation Control Fund established pursuant to Section 114980.
(g) Upon recommendation of the committee, exempt from certification requirements those licentiates of the healing arts who have successfully completed formal courses in schools certified by the department and who have successfully passed a roentgenology technology and radiation protection examination approved by the department and administered by the board that issued their license.
(h) (1) No later than July 1, 2019, the department shall require an applicant to provide either the individual taxpayer identification number or social security number for purposes of applying for or the renewal of a certificate, license, or permit issued under this section or regulations promulgated pursuant thereto.
(2) The individual taxpayer identification or the social security number shall serve to establish the identification of persons affected by state tax laws and for purposes of establishing compliance with subsection (a) of Section 666 of Title 42 of the United States Code, Section 60.15 of Title 45 of the Code of Federal Regulations, Section 17520 of the Family Code, and Section 11105 of the Penal Code, and to that end, the information furnished pursuant to this section shall be used exclusively for those purposes.
(3) The department shall not do either of the following:
(A) Require an applicant to disclose citizenship status or immigration status for purposes of the application or renewal of a certificate, license, or permit issued under this section or regulations promulgated pursuant thereto.
(B) Deny certification to an otherwise qualified and eligible applicant based solely on citizenship status or immigration status.
(4) If the department utilizes a national examination to issue a certificate, and if a reciprocity agreement or comity exists between the State of California and the state requesting release of the individual taxpayer identification number or social security number, any deputy, agent, clerk, officer, or employee of the department may release an individual’s taxpayer identification number or social security number to an examination or certifying entity, only for the purpose of verification of certification or examination status.
(i) A physician and surgeon or a doctor of podiatric medicine, who works in a setting that is in compliance with the Centers for Medicare and Medicaid Services’ Conditions for Coverage relating to radiation safety, satisfies the requirement for fluoroscopy and radiography continuing education as set forth in subdivision (b) of Section 30403 of Title 17 of the California Code of Regulations.