BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 510
                                                                  Page  1

          (  Without Reference to File  )

          CONCURRENCE IN SENATE AMENDMENTS
          AB 510 (Bonnie Lowenthal)
          As Amended July 2, 2012
          2/3 vote.  Urgency
           
           ----------------------------------------------------------------- 
          |ASSEMBLY:  |75-0 |(January 26,    |SENATE: |36-0 |(July 5, 2012) |
          |           |     |2012)           |        |     |               |
           ----------------------------------------------------------------- 
                                                  
           
           Original Committee Reference:    HEALTH  

           SUMMARY  :  Makes technical and clarifying changes to existing 
          requirements that are to become effective July 1, 2012, relating 
          to computed tomography (CT) X-ray.

           The Senate amendments  :

          1)Provide that CT X-ray system studies used for delivery or for 
            calculating attenuation coefficients for nuclear medication 
            studies, or for therapeutic radiation treatment planning are 
            exempt from the dose recording requirement.

          2)Allow, instead of require, facilities to send each CT study 
            and protocol page to the electronic picture archiving and 
            communications system.

          3)Provide that the requirement that the displayed dose be 
            verified annually to ensure the displayed doses are within 20% 
            of the true measured dose to the facility's standard adult 
            brain, adult abdomen, and pediatric brain protocols is 
            effective until July 1, 2013.

          4)Clarify the existing exemption from annual verification 
            requirements for accredited facilities to specify that a 
            facility that has a CT X-ray system that is accredited by an 
            organization that is approved by the federal Centers for 
            Medicare and Medicaid Services, an accrediting agency approved 
            by the Medical Board of California, or the State Department of 
            Public Health (DPH) may elect not to perform the verification.

          5)Allow a facility that is subject to accreditation to elect to 








                                                                  AB 510
                                                                  Page  2

            have the CT X-ray system accredited pursuant to a single 
            accreditation survey that includes the CT service by the 
            accrediting organization.

          6)Specify that a CT X-ray system is not subject to the 
            accreditation requirements if the system is used for 
            therapeutic radiation treatment planning or delivery, 
            calculating attenuation coefficients for nuclear medicine 
            studies, or dedicated for image guidance for interventional 
            radiologic procedures.

          7)Clarify the reporting requirements for a CT X-ray examination 
            that exceeds certain dose values.

          8)Revise the extension of the reporting deadline from five 
            business days to no later than 10 business days for a facility 
            to report to DPH after the discovery of CT X-ray examination 
            that exceeds certain dose values or results in unanticipated 
            damage. 

          9)Add an urgency clause.

          10)Make relating technical changes.

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar 
          to the bill as passed by the Senate.

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  According to the author, this bill clarifies 
          requirements that health facilities and imaging centers must 
          meet regarding excess radiation exposure that were enacted in SB 
          1237 (Padilla), Chapter 521, Statutes of 2010, and SB 38 
          (Padilla), Chapter 139, Statutes of 2011.  The clarification is 
          needed for the facilities and DPH to meet the implementation 
          dates of July 1, 2012.  The author states that limiting record 
          keeping of a CT scan to those used only for diagnosis is 
          necessary because the American College of Radiology (ACR) has 
          not developed standards for therapeutic functions.  Therefore, 
          according to the author, there is no set standard for how these 
          machines will report the dose.  The author further states that 
          the requirement relating to verification of displayed doses must 
          be limited to the facility's standard adult brain, adult 
          abdomen, and pediatric brain procedures because these are the 








                                                                  AB 510
                                                                  Page  3

          three most common with established standards used by the ACR.  
          According to the author, there could otherwise be 200 or more 
          that could be requested which is inefficient and costly.  The 
          author points out that the intent of SB 1237 was to require the 
          hospital to report procedures that were done incorrectly and on 
          the wrong body part.  The author states that there are instances 
          where a neighboring body part may be affected by the treatment 
          in the normal course of the procedure.  According to the author, 
          this bill is intended to clarify this intent.


           Analysis Prepared by  :  Marjorie Swartz / HEALTH / (916) 319-2097 



          FN: 
          0004408