Bill Text: CA AB3097 | 2023-2024 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Radiologist assistants.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2024-05-16 - In committee: Held under submission. [AB3097 Detail]

Download: California-2023-AB3097-Amended.html

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Amended  IN  Assembly  April 03, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 3097

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Introduced by Assembly Member Chen

February 16, 2024

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An act to add Chapter 8.5 (commencing with Section 3800) to Division 2 of the Business and Professions Code, relating to healing arts. Section 114876 to the Health and Safety Code, relating to radiologist assistants.

LEGISLATIVE COUNSEL'S DIGEST

AB 3097, as amended, Chen. Radiologist assistants.

Existing law, the Medical Practice Act, establishes the Medical Board of California for the licensure and regulation of physicians and surgeons. Existing law, the Radiologic Technology Act, prohibits a person from administering or using diagnostic or therapeutic x-rays X-rays on human beings in this state, unless that person either qualifies for a specified exemption or has been certified or granted a permit by the State Department of Public Health, as specified, is acting within the scope of that certification or permit, and is acting under the supervision of a healing arts licensee. 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 establish the Radiologist Assistant Practice Act, to be administered by the Radiologist Assistant Committee, which this bill would create within the Medical Board of California. The bill would establish the duties of the committee, including considering the qualifications of individuals who apply for registration under the act and granting registration, and would impose related duties on the Medical Board of California, including establishing reasonable fees for registration and registration renewal, to be deposited in the Radiologist Assistant Fund, which would be established by the bill. The bill would require money in the fund to be available upon appropriation by the Legislature to implement and administer the provisions of the act. The bill would establish requirements for registration as a radiologist assistant, including passing an examination, maintaining registration with specified national organizations, and possessing and maintaining a certification or permit under the Radiologic Technology Act, as specfied. The bill would prescribe requirements for supervision of a radiologist assistant by a radiologist, would prohibit a radiologist assistant from performing specified acts, and would make a violation of the act’s provisions a misdemeanor, and, under specified circumstances, subject to a specified civil penalty. By creating a new crime, the bill would impose a state-mandated local program.

This bill would prohibit a person from holding themselves out as a radiologist assistant unless the person meets certain requirements, including that they have passed the radiologist assistant examination, as specified, and that they maintain current registration with prescribed entities. The bill would require a radiologist assistant to work only under the supervision of a radiologist and would prohibit a radiologist assistant from functioning in that capacity independent of a supervising radiologist. The bill, among other things, would authorize a radiologist assistant to communicate and document initial clinical and imaging observations or procedures only to a radiologist for the radiologist’s use. The bill would authorize a supervising radiologist to delegate to a radiologist assistant, as the radiologist determines appropriate to the assistant’s competence, those tasks or services that a radiologist usually performs and is qualified to perform. By imposing additional prohibitions and requirements under the Radiologic Technology Act, the violation of which is a crime, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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Bill Text

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

SECTION 1.

 The Legislature finds and declares all of the following:

(a) The radiologist assistant is an advanced-level radiographer who has completed a nationally recognized radiologists assistant educational program and successfully completed a nationally recgonized recognized certification examination for radiologist assistants.

(b) Radiologist assistants are an extension of a radiologist and work under the supervision of a radiologist, as part of a radiologist-led team, performing medical imaging procedures within the scope of practice that the radiologist assistant is educationally prepared, clinically competent, and delegated by a radiologist to perform.

(c) Radiologist assistants do not hold the responsibility of diagnosing illnesses; however, radiologist assistants assist a radiologist by completing patient history, describing procedures, performing medical imaging procedures, and communicating initial clinical and imaging observations or procedure details only to the supervising radiologist for the radiologist’s use.

(d) Radiologist assistants work in hospitals, outpatient facilities, or diagnostic imaging centers. Radiologist assistants work only under the supervision and delegation of a radiologist.

SEC. 2.Chapter 8.5 (commencing with Section 3800) is added to Division 2 of the Business and Professions Code, to read:

8.5.Radiologist Assistant Practice Act

1.General Provisions

3800.

This chapter shall be known and cited as the Radiologist Assistant Practice Act.

3801.

This chapter does not apply to any of the following:

(a)A radiologist assistant trainee or a student enrolled in a radiologist assistant approved educational program.

(b)A radiologist assistant employed in the service of the federal government while performing duties incident to that employment.

(c)A health care professional, technician, or other assistant or employee of a physician and surgeon who performs delegated tasks in the office of a physician and surgeon, but who does not render services as a radiologist assistant or profess to be a radiologist assistant.

3802.

This chapter grants a supervising radiologist or radiologist designee the authority to delegate, as the radiologist determines is appropriate, those tasks or services the radiologist typically performs and is qualified to perform.

3803.

This chapter does not grant authority to a radiologist assistant to function independently of a radiologist’s supervision.

3804.

(a)“Approved educational program” means an educational program for radiologist assistants approved by the committee.

(b)“Board” means the Medical Board of California.

(c)“Committee” means the Radiologist Assistant Committee established by this chapter.

(d)“Interpret” means to identify and classify a medical image pattern that results in the creation of a final diagnosis and final report.

(e)“Radiologist assistant” means an individual who meets the qualifications of, and is registered under, this chapter.

(f)“Radiologist designee” means a physician and surgeon who works, or is trained, in the same practice area as the practice area of the supervising radiologist and to whom responsibility for the supervision of a radiologist assistant is temporarily designated when the supervising radiologist is unavailable.

(g)“Supervising radiologist” means a physician and surgeon licensed by the board and certified by the American Board of Radiology who supervises, and is responsible for, a radiologist assistant.

(h)“Supervision” means overseeing the activities of and accepting responsibility for, the medical services rendered or performed by a radiologist assistant. The term includes the use of protocols, guidelines, levels of supervision, and standing orders developed or approved by the supervising radiologist.

(i)“Trainee” means an individual who is currently enrolled in an approved radiologist assistant program.

2.Administration

3811.

There is established a Radiologist Assistant Committee within the Medical Board of California. The committee shall consist of five members appointed by the Governor for three-year terms as follows:

(a)Three radiologist assistants who are residents of the state, have at least two years of experience as radiologist assistants, and are registered or meet the requirements for registration under this chapter.

(b)One radiologist licensed in this state who supervises the practice of radiologist assistants.

(c)One public member who is not associated with radiologist assistants in any way other than as a consumer.

3812.

A radiologist assistant appointed to the committee is required to continue to practice as a radiologist assistant while serving as a member of the committee. A member of the committee may be removed by the Governor for misconduct, neglect of duty, or incompetence.

3813.

The initial terms of appointment of the members of the committee shall be as follows:

(a)One radiologist assistant for a one-year term.

(b)One radiologist assistant for a two-year term.

(c)One radiologist assistant for a three-year term.

(d)One radiologist for a two-year term.

(e)One public member for a three-year term.

3814.

(a)The committee shall have regular meetings, called upon the request of the president of the board or by a majority of the members appointed to the committee, and upon the advice and consent of the executive director of the board for the transaction of business that comes before the committee under this chapter.

(b)At the first committee meeting of each calendar year, the committee shall elect a chief and any other officer considered necessary by the committee by an affirmative vote of a majority of the members appointed to the committee.

3815.

Three members of the committee constitute a quorum. An affirmative vote of a majority of the members appointed to the committee is required for the committee to take action on any business.

3816.

It shall be the duty of the committee to do all of the following:

(a)Consider the qualifications of individuals who apply for an initial registration under this chapter.

(b)Approve or reject registration applications and registration renewal applications.

(c)Propose rules to the board concerning the competent practice of radiologist assistants and the administration of this chapter.

(d)Recommend to the board the amounts of fees required under this chapter.

3817.

After considering the committee’s proposed rules, the board shall adopt rules establishing standards for the following:

(a)The competent practice of radiologist assistants.

(b)The renewal of registrations issued under this chapter.

(c)Standards for the administration of this chapter.

3818.

After considering the committee’s recommendations for fees, the board shall establish reasonable fees to be imposed to administer the provisions of this chapter.

3819.

Each member of the committee shall receive a per diem and expenses as provided in Section 103.

3.Registration

3821.

An individual shall be registered by the committee before the individual engages in practice as a radiologist assistant. The committee shall grant registration as a radiologist assistant to an applicant who meets all of the following requirements:

(a)Submits an application on forms approved by the committee.

(b)Pays the fee established by the board.

(c)Passed the radiologist assistant examination administered by the American Registry of Radiologic Technologists, the radiology practitioner assistant examination administered by the Certification Board for Radiology Practitioner Assistants, or another examination, approved by the committee, by a successor or comparable entity. The committee shall ensure the examination evaluates the knowledge and skills necessary to ensure the protection of the public.

(d)Maintains current registration as a radiologist assistant with the American Registry of Radiologic Technologists, the Certification Board for Radiology Practitioner Assistants, or a successor or comparable entity.

(e)Possesses and maintains a certification or permit granted pursuant to subdivision (b) or (c) of Section 114870, Section 114871, or Section 114885 of the Health and Safety Code.

(f)Submits to the committee any other information the committee considers necessary to evaluate the applicant’s qualifications.

(g)Presents satisfactory evidence to the committee that the individual has not been engaged in an act that would constitute grounds for discipline or be the subject of a disciplinary action by a licensing or certification agency of another state or jurisdiction on the grounds that the individual was not able to practice as a radiologist assistant without endangering the public.

3822.

The committee may refuse to issue a registration to an individual if the individual has been disciplined by an administrative agency in another jurisdiction or has been convicted of a crime and the committee determines the act for which the individual was disciplined or convicted has a direct bearing on the individual’s ability to practice competently as a radiologist assistant.

3823.

(a)The committee may grant a temporary registration to an applicant who meets the qualifications for registration under this act, but is awaiting the next scheduled meeting of the committee for registration approval.

(b)A temporary registration is valid until the committee makes a final decision on the applicant’s request for registration.

3824.

(a)A registration issued by the committee expires two years following the date of issuance.

(b)An individual may renew a registration by paying a renewal fee on or before the expiration date of the registration.

(c)If an individual fails to pay a renewal fee on or before the expiration date of a registration, the registration becomes invalid and shall be returned to the committee.

3825.

The committee shall reinstate an invalid registration up to three years after the expiration date of the registration if the individual holding the invalid registration meets the requirements under this chapter.

3826.

(a)An individual who is registered under this chapter shall notify the committee in writing when the individual retires from practice.

(b)Upon receipt of the notice, the committee shall record the fact that the individual is retired and release the individual from further payment of renewal fees.

3827.

If an individual surrenders a registration to the committee, the committee may reinstate the registration upon written request by the individual. The committee may impose conditions on the license that the committee deems are appropriate to the reinstatement. An individual may not surrender a registration without written approval by the committee if a disciplinary proceeding under this chapter is pending against the individual.

3828.

(a)A radiologist assistant who notifies the committee in writing may elect to place the radiologist assistant’s registration on inactive status.

(b)The renewal fee for an inactive registration is one-half of the renewal fee to maintain an active registration.

(c)If a radiologist assistant with an inactive registration elects to activate the registration, the radiologist assistant shall pay the renewal fee less any of the amount paid for the inactive registration.

(d)An individual who holds a registration under this chapter and who practices as a radiologist assistant while the individual’s registration has lapsed or if the individual’s registration is on inactive status is considered to be practicing without a registration and is subject to discipline.

3829.

Supervision by the supervising radiologist or the radiologist designee shall be continuous and the supervising radiologist or the radiologist designee shall be physically present in the radiologist assistant’s practice site to render direction or assistance in the performance of a patient procedure. A supervising radiologist shall determine the level of supervision of a radiologist assistant performing a procedure based on a radiologist assistant’s technical ability, the procedure, the patient’s history and clinical presentation, and other relevant factors.

3830.

A radiologist shall not supervise more than two radiologist assistants at the same time.

3831.

It is the obligation of each supervising radiologist to ensure the following:

(a)That the radiologist assistant’s scope of practice is identified.

(b)That delegation of medical tasks is appropriate to the radiologist assistant’s level of competence and within the supervising radiologist’s scope of practice.

(c)That the relationship of, and access to, the supervising radiologist is defined.

(d)That a process for evaluating the radiologist assistant’s performance is established and maintained.

3832.

(a)A supervising radiologist shall meet all of the following requirements:

(1)Be licensed as a physician and surgeon to practice medicine in the state.

(2)Register with the committee the radiologist’s intent to supervise a radiologist assistant.

(3)Submit a statement to the committee that the radiologist shall exercise supervision over the radiologist assistant in accordance with rules adopted by the board and retain professional and legal responsibility for the care rendered by the radiologist assistant.

(4)Not have a disciplinary action restriction that limits the radiologist’s ability to supervise a radiologist assistant.

(5)(A)Maintain a written agreement with the radiologist assistant that states the radiologist shall do both of the following:

(i)Exercise supervision over the radiologist assistant in accordance with any rules adopted by the board.

(ii)Retain responsibility for the care rendered by the radiologist assistant.

(B)The agreement shall be signed by the supervising radiologist and radiologist assistant, updated annually, and made available to the committee upon request.

(b)Except as provided in this section, the provisions of this chapter shall not be construed to limit the employment arrangement with a supervising radiologist under this chapter.

3833.

(a)Before engaging in practice pursuant to this chapter, the supervising radiologist and the radiologist assistant shall submit, on forms approved by the board, the following information:

(1)The name, the business address, and the telephone number of the supervising radiologist.

(2)The name, the business address, and the telephone number of the radiologist assistant.

(3)A brief description of the setting in which the radiologist assistant will practice.

(4)Any other information required by the board.

(b)A radiologist assistant shall notify the committee of any changes or additions in practice sites or supervising radiologists not more than 30 days after the change or addition.

3834.

If a radiologist assistant is employed by a radiologist, a group of radiologists, or another legal entity, the radiologist assistant shall be supervised by, and be the legal responsibility of, the supervising radiologist. The legal responsibility for the radiologist assistant’s patient care activities are that of the supervising radiologist, including when the radiologist assistant provides care and treatment for patients in health care facilities. If a radiologist assistant is employed by a health care facility or other entity, the legal responsibility for the radiologist assistant’s actions is that of the supervising radiologist. A radiologist assistant employed by a health care facility or entity shall be supervised by a licensed radiologist.

3835.

(a)This section applies to a radiologist assistant registered in this state, registered or authorized to practice in any other state or territory of the United States, or credentialed as a radiologist assistant by a federal employer.

(b)As used in this section, “emergency” means an event or a condition that is an emergency, a disaster, or a public health emergency.

(c)A radiologist assistant who responds to a need for medical care created by an emergency may render care that the radiologist assistant is able to provide without the supervision required under this chapter, but with such supervision as is available.

(d)A radiologist who supervises a radiologist assistant providing medical care in response to an emergency is not required to meet the requirements under this chapter for a supervising radiologist.

4.Prohibitions and Offenses

3840.

An individual may not do any of the following unless the individual is registered as a radiologist assistant under this chapter.

(a)Profess to be a radiologist assistant.

(b)Use the title “radiologist assistant,” “certified radiologist assistant,” or “registered radiologist assistant.”

(c)Use the initials “R.A.,” “R.R.A.,” “R.P.A.,” or any other words, letters, abbreviations, or insignia indicating or implying that the individual is a radiologist assistant registered under this chapter.

3841.

A radiologist assistant shall not interpret images, make diagnoses, or prescribe medications or therapies. A radiologist assistant may administer prescribed drugs as directed by the supervising radiologist or radiologist designee. A radiologist assistant may communicate and document initial clinical and imaging observations or procedure details only to the radiologist for the radiologist’s use.

3842.

A violation of this chapter is a misdemeanor. An individual who intentionally, or through gross negligence, violates this chapter shall also be subject to a civil penalty not to exceed five thousand dollars ($5,000).

5.Revenue

3851.

The Radiologist Assistant Fund is hereby created in the State Treasury. All fees, penalties, and fines authorized by this chapter shall be deposited into the fund. All money in the fund shall, upon appropriation by the Legislature, be used by the board to carry out the purposes of this chapter.

3852.

Fees to be paid by radiologist assistants for registration and renewal of registration shall be set by the board in an amount sufficient to cover the reasonable and necessary costs of implementing and administering this chapter.

SEC. 2.

 Section 114876 is added to the Health and Safety Code, to read:

114876.

 (a) No person shall hold themselves out to be a radiologist assistant, or use the title of “radiologist assistant,” or any other term, to imply or to suggest that the person is a radiologist assistant, unless the person meets all of the following requirements:

(1) The person has passed the radiologist assistant examination administered by the American Registry of Radiologic Technologists, the radiology practitioner assistant examination administered by the Certification Board for Radiology Practitioner Assistants, or another examination offered by a successor or comparable entity that has been determined by the department to evaluate the knowledge and skills necessary to ensure the protection of the public and has been approved by the department.

(2) The person maintains current registration with the American Registry of Radiologic Technologists, the Certification Board for Radiology Practitioner Assistants, or a successor or comparable entity.

(3) The person is certified or permitted to conduct radiologic technology in this state or possesses a radiologist assistant license from another state that licenses radiologist assistants.

(b) A radiologist assistant shall work only under the supervision of a radiologist. A radiologist assistant shall not function in their capacity as a radiologist assistant independent of a supervising radiologist.

(c) A radiologist assistant shall not interpret images, make diagnoses, or prescribe medications or therapies.

(d) A radiologist assistant may administer prescribed drugs only as directed by a supervising radiologist or their designee.

(e) (1) A radiologist assistant may communicate and document initial clinical and imaging observations or procedures only to a radiologist for the radiologist’s use.

(2) A radiologist assistant may communicate a supervising radiologist’s report to an appropriate health care provider consistent with the American College of Radiology guideline for communicating diagnostic imaging findings.

(f) A supervising radiologist may delegate to a radiologist assistant, as the radiologist determines appropriate to the radiologist assistant’s competence, those tasks or services that a radiologist usually performs and is qualified to perform.

SEC. 3.

  No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.