BILL NUMBER: SB 1237	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 23, 2010
	AMENDED IN SENATE  APRIL 28, 2010

INTRODUCED BY   Senator Padilla
   (Coauthor: Senator Alquist)

                        FEBRUARY 19, 2010

   An act to add Section 115111 to the Health and Safety Code,
relating to public health.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1237, as amended, Padilla. Radiation control: health facilities
and clinics: records.
   Under existing law, the State Department of Public Health licenses
and regulates health facilities and clinics, as defined.
   Under existing law, the Radiation Control Law, the department
licenses and regulates persons that use devices or equipment
utilizing radioactive materials. Under existing law the department
may also require registration and inspection of sources of ionizing
radiation, as defined. Violation of these provisions is a crime.
   This bill would, commencing January 1, 2012, require 
health facilities   hospitals  and clinics, as
specified, that use computed tomography  (CT) X-ray systems 
for diagnostic purposes to record  , where currently possible,
 the dose of radiation  used   produced
 during the administration of  the radiation on the
radiology image, if technologically feasible, and to record the dose
of radiation   a CT X-ray examination  in the
patient's medical record  and on an image produced by the
examination, as specified  . This bill would not require small
and rural hospitals, as defined, or hospitals and clinics that are
located in an area that is designated as a medically underserved area
pursuant to federal law, to comply with these requirements until
January 1, 2013.
   This bill would, commencing January 1, 2012, require 
physicians or other practitioners,  facilities  , or
other entities,  that furnish  diagnostic magnetic
resonance imaging, computed tomography, and nuclear medicine
  CT X-ray  services to be accredited by an
organization that is approved by the federal Centers for Medicare and
Medicaid Services.  The bill   would also require the
facility to report, immediately and in writing, certain information
to the department, the affected patient, and the patient's treating
physician. 
   Because this bill expands the definition of a crime, it 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.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 115111 is added to the Health and Safety Code,
to read:
   115111.  (a) Except as provided in subdivisions (b) and (c),
commencing January 1, 2012, general acute care hospitals, acute
psychiatric hospitals, and special hospitals licensed pursuant to
Article 1 (commencing with Section 1250) of Chapter 2 of Division 2,
clinics licensed pursuant to Article 1 (commencing with Section 1200)
of Chapter 1 of Division 2, and clinics exempt from licensure
pursuant to Section 1206 that use computed tomography  (CT) X-ray
systems  for diagnostic purposes shall record the dose of
radiation  used   produced  during the
administration  of the radiation on the radiology image and
in the patient's medical record.   of a CT X-ray
examination. The dosage shall be recorded using bot   h dose
length product (DLP) and volume computed tomography index (CTDI
vol), as defined by the International Electrotechnical Commission
(IEC) and recognized by the federal Food and Drug Administration
(FDA). The facility shall ensure that the CTDI vol is recorded in the
patient's medical record and on any image produced from the
examination. 
   (b) The requirement specified in subdivision (a) shall be limited
 to computed tomography machines for which it is
technologically feasible to record the dose of radiation directly or
through the use of added software or features.   to CT
examinations performed on equipment where it is currently possible to
record the CTDI vol directly or through the addition of updates that
have been approved or cleared by the FDA. 
   (c) Small and rural hospitals, as defined in Section 124840, and
health facilities and clinics specified in subdivision (a) that are
located in an area that is designated as a medically underserved area
pursuant to federal law, shall not be required to comply with the
requirements of subdivision (a) until January 1, 2013.
   (d) Commencing January 1, 2012,  physicians or other
practitioners, facilities, or other entities that furnish diagnostic
magnetic resonance imaging, computed tomography, and nuclear medicine
services, including positron emission tomography, shall 
 facilities that furnish CT X-ray services shall  be
accredited by an organization that is approved by the federal Centers
for Medicare and Medicaid Services  or an accrediting agency
approved by the Medical Board of California  . 
   (e) A facility that uses CT X-ray systems shall notify the
department, the affected patient, and the patient's treating
physician immediately, in writing, of the occurrence of any of the
following events:  
   (1) Repetition of a CT X-ray exposure due to equipment defect or
malfunction.  
   (2) Irradiation of the wrong patient or irradiation of a body part
other than that intended by the ordering physician and surgeon.
 
   (3) A diagnostic dosage that exceeds by 50 percent or more the
protocols established in subdivision (a).  
   (f) Each facility that utilizes therapeutic X-ray systems
operating at energies below one million electron volts (MeV) shall
notify and report to the department, in accordance with department
regulations, and shall also notify the affected patient and his or
her treating physician within 10 days, in writing, of the occurrence
of any of the following events:  
   (1) Irradiation of the wrong individual or wrong treatment site.
 
   (2) Any treatment consisting of three or fewer fractions, with the
calculated total administered dose differing from the total
prescribed dose by more than 10 percent of the total prescribed dose.
 
   (3) Any exposure resulting in a calculated total administered dose
differing from the total prescribed dose by more than 10 percent of
the total prescribed dose.  
   (g) Each facility that utilizes therapeutic X-ray systems
operating with energies at or above one Mev shall notify and report
to the department, in accordance with department regulations, and
shall notify the affected patient and his or her treating physician
within 10 days, in writing, of the occurrence of any of the following
events:  
   (1)  Any event involving irradiation of the wrong individual,
administration of the wrong type of radiation or the wrong energy, or
irradiation of the wrong treatment site.  
   (2) Any treatment consisting of three or fewer fractions, with the
calculated total administered dose differing from the total
prescribed dose by more than 10 percent of the total prescribed dose.
 
   (3) Any exposure resulting in a calculated total administration
dose differing from the total prescribed dose by more than 20 percent
of the total prescribed dose. 
  SEC. 2.  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.