Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 2430

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background:

Cardiac or Vascular Catheterization

Cardiac or vascular catheterization is the process of inserting a small tube, or catheter, into a person's heart or blood vessel using a fluoroscope (an X-ray device that provides real-time images). This type of catheterization is utilized for a variety of medical purposes, including angioplasty, electrophysiology studies, and pacemaker placement. Cardiac or vascular catheterization is usually carried out in a hospital’s catheterization lab or "cath lab."

Radiologic Technologists

Radiologic Technologists are professionals certified by the Department of Health and authorized to operate radiologic technology. There are four subcategories of radiologic technologists:

Diagnostic Radiologic Technologists, who are persons authorized to actually handle X-ray equipment in the process of applying radiation on a human being for diagnostic purposes at the direction of a licensed practitioner;
Therapeutic Radiologic Technologists, who are persons authorized to use radiation-generating equipment for therapeutic purposes on human subjects at the direction of a licensed practitioner;
Nuclear Medicine Technologists, who are persons authorized to prepare radiopharmaceuticals and administer them to human beings for diagnostic and therapeutic purposes and to perform in vivo and in vitro detection and measurement of radioactivity for medical purposes at the direction of a licensed practitioner; and
Radiologic Assistants, who are persons authorized to assist radiologists by performing advanced diagnostic imaging procedures.

Radiologic Technologists are authorized to administer diagnostic and therapeutic agents through intravenous, intramuscular, or subcutaneous injection, but not through arterial injections. These injections may only be performed if:

the technologist has necessary training and knowledge of the procedure;
appropriate facilities are available for coping with complications related to the procedure or reactions to the agent;
competent personnel and emergency facilities are available for at least 30 minutes in case of delayed reaction; and
the technologist is under the direct supervision of a physician.

Radiologic Technologists must complete minimum education requirements, pass an examination, and have good moral character prior to certification.

Summary of Bill:

A new type of Radiologic Technologist is created: Cardiovascular Invasive Specialists. Cardiovascular Invasive Specialists are persons who assist in cardiac or vascular catheterization procedures under the personal supervision of a physician. "Cardiac or vascular catheterization procedures" is defined as all anatomic or physiological studies of intervention, both diagnostic and therapeutic, in which the heart, coronary arteries, or vascular system are entered via a systemic vein or artery using a catheter that is manipulated under fluoroscopic visualization.

Cardiovascular Invasive Specialists are authorized to perform arterial injections in addition to the other types of injections all other Radiologic Technologists are authorized to perform.

In order to be certified, a Cardiovascular Invasive Specialist must:

complete a Cardiovascular Invasive Specialist program approved by the Secretary of Health. A program may be approved only if it includes training in cardiovascular anatomy and physiology, pharmacology, radiation physics and safety, radiation imaging and positioning, medical recordkeeping, and multi-cultural health;
completes a Cardiovascular Invasive Specialist examination approved by the Secretary of Health. The Secretary of Health may approve an examination for these purposes that is administered by a national credentialing organization for Cardiovascular Invasive Specialists; and
have good moral character.

Until July 1, 2012, the Secretary of Health must also issue a credential to any other type of Radiologic Technologist who has at least five years of experience in cardiac or vascular catheterization. A person certified in this manner is not subject to the education and examination requirements for certification as a Cardiovascular Invasive Specialists unless he or she lets his or her certification expire for more than one year without renewal.

Creation of the new Cardiovascular Invasive Specialist credential does not alter the scope of practice of any other credentialed health profession or limit the ability of any other credentialed health professional to assist in cardiac or vascular catheterization if such assistance is within the professional's scope of practice.