BILL REQ. #:  S-4254.1 

Read first time 01/16/08.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to radiologist assistants; amending RCW 18.84.010, 18.84.020, 18.84.030, 18.84.040, and 18.84.080; and adding new sections to chapter 18.84 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 18.84.010 and 1991 c 222 s 1 are each amended to read as follows:
     It is the intent and purpose of this chapter to protect the public by the certification and registration of practitioners of radiological technology. By promoting high standards of professional performance, by requiring professional accountability, and by credentialing those persons who seek to provide radiological technology under the title of ((radiological)) radiologic technologists, and by regulating all persons utilizing ionizing radiation on human beings this chapter identifies those practitioners who have achieved a particular level of competency. Nothing in this chapter shall be construed to require that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person certified under this chapter.
     The legislature finds and declares that this chapter conforms to the guidelines, terms, and definitions for the credentialing of health or health-related professions specified under chapter 18.120 RCW.

Sec. 2   RCW 18.84.020 and 2000 c 93 s 42 are each amended to read as follows:
     ((Unless the context clearly requires otherwise,)) The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Department" means the department of health.
     (2) "Secretary" means the secretary of health.
     (3) "Licensed practitioner" means any licensed health care practitioner performing services within the person's authorized scope of practice.
     (4) "Radiologic technologist" means an individual certified under this chapter, other than a licensed practitioner, who practices radiologic technology as a:
     (a) Diagnostic radiologic technologist, who is a person who actually handles X-ray equipment in the process of applying radiation on a human being for diagnostic purposes at the direction of a licensed practitioner, this includes parenteral procedures related to radiologic technology when performed under the direct supervision of a physician licensed under chapter 18.71 or 18.57 RCW; ((or))
     (b) Therapeutic radiologic technologist, who is a person who uses radiation-generating equipment for therapeutic purposes on human subjects at the direction of a licensed practitioner, this includes parenteral procedures related to radiologic technology when performed under the direct supervision of a physician licensed under chapter 18.71 or 18.57 RCW; ((or))
     (c) Nuclear medicine technologist, who is a person who prepares radiopharmaceuticals and administers them to human beings for diagnostic and therapeutic purposes and who performs in vivo and in vitro detection and measurement of radioactivity for medical purposes at the direction of a licensed practitioner; or
     (d) Radiologist assistant, who is an advanced-level certified diagnostic radiologic technologist who practices under levels of supervision defined by the secretary, and:
     (i) Enhances patient care by assisting the radiologist in the diagnostic imaging environment;
     (ii) Performs advanced diagnostic procedures including injecting agents that facilitate or enable diagnostic imaging, performs selected diagnostic aspirations and needle localizations for biopsy under radiologist direction and supervision, performs fluoroscopy, and placing nasoenteric and oroenteric feeding tubes in uncomplicated patients;
     (iii) Monitors and tailors selected examinations;
     (iv) Communicates preliminary observations to a radiologist and communicates final radiologist reports to referring health care providers when directed;
     (v) Performs selected peripheral venous diagnostic procedures; and
     (vi) Assists radiologists with invasive procedures and performs additional procedures under radiologist direction and supervision.
     (5) "Approved school of radiologic technology" means a school of radiologic technology or radiologist assistant program approved by the council on medical education of the American medical association or the American registry of radiologic technologists or a school found to maintain the equivalent of such a course of study as determined by the department. Such school may be operated by a medical or educational institution, and for the purpose of providing the requisite clinical experience, shall be affiliated with one or more general hospitals.
     (6) "Radiologic technology" means the use of ionizing radiation upon a human being for diagnostic or therapeutic purposes.
     (7) "Radiologist" means a physician certified by the American board of radiology or the American osteopathic board of radiology.
     (8) "Registered X-ray technician" means a person who is registered with the department, and who applies ionizing radiation at the direction of a licensed practitioner and who does not perform parenteral procedures.

Sec. 3   RCW 18.84.030 and 1991 c 222 s 3 are each amended to read as follows:
     No person may practice radiologic technology without being registered or certified under this chapter, unless that person is a licensed practitioner as defined in RCW 18.84.020(3). A person represents himself or herself to the public as a certified ((radiological)) radiologic technologist when that person adopts or uses a title or description of services that incorporates one or more of the following items or designations:
     (1) Certified radiologic technologist or CRT, for persons so certified under this chapter;
     (2) Certified radiologic therapy technologist, CRTT, or CRT, for persons certified in the therapeutic field;
     (3) Certified radiologic diagnostic technologist, CRDT, or CRT, for persons certified in the diagnostic field; ((or))
     (4) Certified nuclear medicine technologist, CNMT, or CRT, for persons certified as nuclear medicine technologists; or
     (5) Certified radiologist assistant or CRA for persons certified as radiologist assistants.

Sec. 4   RCW 18.84.040 and 1994 sp.s. c 9 s 506 are each amended to read as follows:
     (1) In addition to any other authority provided by law, the secretary may:
     (a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;
     (b) Set all registration, certification, and renewal fees in accordance with RCW 43.70.250;
     (c) Establish forms and procedures necessary to administer this chapter;
     (d) Evaluate and designate those schools from which graduation will be accepted as proof of an applicant's eligibility to receive a certificate;
     (e) Determine whether alternative methods of training are equivalent to formal education, and to establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to receive a certificate;
     (f) Prepare, grade, and administer, or determine the nature of, and supervise the grading and administration of examinations for obtaining a certificate;
     (g) Issue a certificate to any applicant who has met the education, training, examination, preceptorship, and conduct requirements for certification; and
     (((g))) (h) Issue a registration to an applicant who meets the requirement for a registration.
     (2) The secretary may hire clerical, administrative, and investigative staff as needed to implement this chapter.
     (3) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of registrations and certifications, unregistered and uncertified practice, and the discipline of registrants and certificants under this chapter. The secretary is the disciplining authority under this chapter.
     (4) The secretary may appoint ad hoc members of the profession to serve in an ad hoc advisory capacity to the secretary in carrying out this chapter. The members will serve for designated times and provide advice on matters specifically identified and requested by the secretary. The members shall be compensated in accordance with RCW 43.03.220 and reimbursed for travel expenses under RCW 43.03.040 and 43.03.060.

Sec. 5   RCW 18.84.080 and 1991 c 3 s 209 are each amended to read as follows:
     (1) The secretary shall issue a certificate to any applicant who demonstrates to the secretary's satisfaction, that the following requirements have been met to practice as:
     (a) A diagnostic radiologic technologist, therapeutic radiologic technologist, or nuclear medicine technologist:
     (i) Graduation from an approved school or successful completion of alternate training that meets the criteria established by the secretary; and
     (((b))) (ii) Good moral character; or
     (b) A radiologist assistant:
     (i) Satisfactory completion of a baccalaureate degree, postbaccalaureate certificate, or master's degree encompassing a radiologist assistant curriculum from an approved school of radiologic technology;
     (ii) Satisfactory completion of a radiologist-directed clinical preceptorship; and
     (iii) Satisfactory completion of a radiologist assistant examination approved by the secretary.
     (2) Applicants shall be subject to the grounds for denial or issuance of a conditional license under chapter 18.130 RCW.
     (3) The secretary shall establish by rule what constitutes adequate proof of meeting the requirements for certification and for designation of certification in a particular field of radiologic technology.

NEW SECTION.  Sec. 6   A new section is added to chapter 18.84 RCW to read as follows:
     (1) The date and location of radiologist assistant examinations must be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for obtaining a certificate must be scheduled for the next examination following the filing of the application. The secretary shall establish by rule the examination application deadline.
     (2) The secretary or the secretary's designee shall examine each applicant, by means determined most effective, on subjects appropriate to the scope of practice, as applicable. The examinations must be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.
     (3) The examination papers, all grading of the papers, and the grading of any practical work must be preserved for a period of not less than one year after the secretary has made and published the decisions. All examinations must be conducted under fair and wholly impartial methods.
     (4) Any applicant failing to make the required grade in the first examination may take up to two subsequent examinations as the applicant desires upon prepaying a fee determined by the secretary under RCW 43.70.250 for each subsequent examination. Upon failing four examinations, the secretary may invalidate the original application and require remedial education before the person may take future examinations.
     (5) The secretary may approve an examination prepared or administered by a private testing agency or association of credentialing agencies for use by an applicant in meeting the credentialing requirements, including examinations prepared and administered by the American registry of radiologic technologists.

NEW SECTION.  Sec. 7   A new section is added to chapter 18.84 RCW to read as follows:
     It is unprofessional conduct under chapter 18.130 RCW for any person registered or certified under this chapter to interpret images, make diagnoses, prescribe medications or therapies, or perform other procedures that may be prohibited by rule.