BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 1199|
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UNFINISHED BUSINESS
Bill No: SB 1199
Author: Dutton (R)
Amended: 8/24/12
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/11/12
AYES: Hernandez, Harman, Alquist, Anderson, Blakeslee, De
Le�n, DeSaulnier, Rubio, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SENATE FLOOR : 38-0, 5/7/12
AYES: Alquist, Anderson, Berryhill, Blakeslee, Calderon,
Cannella, Corbett, Correa, De Le�n, DeSaulnier, Dutton,
Emmerson, Evans, Fuller, Gaines, Hancock, Harman,
Hernandez, Huff, Kehoe, La Malfa, Leno, Lieu, Liu,
Lowenthal, Negrete McLeod, Padilla, Pavley, Price, Rubio,
Simitian, Steinberg, Vargas, Walters, Wolk, Wright,
Wyland, Yee
NO VOTE RECORDED: Runner, Strickland
ASSEMBLY FLOOR : Not available
SUBJECT : Radiologic technologists
SOURCE : California Radiological Society
DIGEST : This bill authorizes a radiologic technologist
(RT) who is permitted to perform venipuncture in an upper
extremity in administering contrast materials, to use a
CONTINUED
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saline-based solution if certain requirements are met.
Assembly Amendments address issues regarding persons who
are currently certified as meeting the standards of
competence in nuclear medicine, and make clarifying
changes.
ANALYSIS :
Existing law:
1. Defines "radiologic technologist" as any person, other
than a licentiate of the healing arts, making
application of X-rays to human beings for diagnostic or
therapeutic purposes, as specified.
2. Permits certified RTs with sufficient education and
training to perform venipuncture in an upper extremity
and to administer contrast materials under the general
supervision of a licensed physician.
3. Deems training and education to sufficient if the RT
has, among other things, performed 10 venipunctures
under supervision.
This bill:
1. Requires a saline-based solution used in administering
contrast materials to conform with a facility's protocol
that has been approved by a licensed physician and
surgeon. Requires the protocol to specify that only
contrast materials or pharmaceuticals approved by the
U.S. Food and Drug Administration may be used, and
require the use to be in accordance with the labeling.
2. Requires an RT, prior to performing venipuncture in in
upper extremity to administer contrast materials, to
have performed at least 10 venipunctures on live humans,
under the personal supervision of a licensed physician
and surgeon, a registered nurse, or a person the
physician or nurse has previously deemed qualified to
provide personal supervision to the RT for purposes of
performing venipuncture, as specified. Indicates that
only after completion of a minimum of 10 venipunctures
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may the supervising individual evaluate whether the RT
is competent to perform venipuncture under direct
supervision. States that the number of venipunctures
required is in addition to those performed as part of
certification, as specified.
3. Indicates that a certificate issued to an RT for purpose
of certification documents completion of the required
education and training and may not by itself, be
construed to authorize a person to perform venipuncture
or to administer contrast materials.
4. Replaces the terms general supervision with direct
supervision.
5. Defines personal supervision as the oversight of the
procedures by a supervising individual identified, as
specified, who is physically present to observe and
correct, as needed, the performance of the individual
who is performing the procedure.
6. Authorizes an RT as part of completion of the training
and education in venipuncture to perform 10
venipunctures on a human or training mannequin upper
extremity under personal supervision, as specified.
States that if the performance of the venipuncture is on
a human, only an upper extremity may be used.
7. Requires RT schools to issue to RT students upon
satisfactory completion of training and education
required of venipuncture, to issue to the student a
completion document. Indicates that this document may
not be construed to authorize a person to perform
venipuncture or to administer contrast materials.
8. Provides that provisions of this bill shall not be
construed to authorize an RT to perform any central
venous access procedures, as specified.
9. States that RTs who met existing training and education
requirements, as specified, prior to January 1, 2013,
need not repeat those requirements, or perform
additional venipunctures specified in #3 above, provided
the facility documents that the RT is competent to
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perform venipuncture in the upper extremity, as
specified.
10.Authorizes a certified nuclear medicine technologist who
is authorized a perform a computerized tomography
scanner only on a dual-mode machine, as specified to use
saline-based solution in performing venipuncture in an
upper extremity to administer contrast materials, as
specified.
Background
According to the website of Ca�ada College in Redwood City
(which has a DPH-approved RT school), a RT is a health care
professional who performs diagnostic imaging examinations
with the use of X-rays, working directly with patients and
physicians. RTs are educated in patient care, radiation
safety, radiation protection, image and film processing,
anatomy, physiology, patient positioning and examination
techniques. RTs often specialize in a particular
diagnostic imaging area, such as computed tomography
magnetic resonance, mammography, bone densitometry,
cardiovascular-interventional and general radiography. As
of October 4, 2010-the date of the most recent list of
schools that provide RT training that DPH has, there are 35
diagnostic RT schools, six therapeutic RT schools, 34 RT
fluoroscopy permit schools, and 13 limited permit schools
in California.
Injecting contrast materials . The ACR Practice Guideline
for the Use of Intravascular Contrast Media states that the
health care professional performing the injection may be a
certified and/or licensed RT, nurse, physician assistant,
physician, or other appropriately credentialed health care
professional under the direct supervision of a radiologist
or his/her physician designee, if the practice is in
compliance with institutional and state regulations.
Training and proficiency in cardiopulmonary resuscitation
are recommended for those who attend to patients undergoing
contrast-enhanced examinations.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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According to the Assembly Appropriations Committee, this
bill would have negligible state fiscal effect.
SUPPORT : (Verified 8/29/12)
California Radiological Society (source)
California Medical Association
Merced College Diagnostic Radiologic Technology Program
ARGUMENTS IN SUPPORT : According to the author, this bill
is necessary to clarify that an RT is able to administer
saline-based solutions in accordance with hospital or
imaging facility protocol specific to ensuring the
integrity of the IV cannula. In some patients, it is
necessary to inject a saline-based solution related to the
contrast injection or the patency of the port of injection.
The bill's sponsor points out that although it is not the
standard of practice in all radiology settings to use
saline-based solution, in situations where necessary, the
radiology community would like to clarify statute and allow
for this possibility.
The sponsor of this bill, the California Radiological
Society (CRS), states that the ability of students to
perform venipunctures on human volunteers has been
increasingly difficult due to concerns over liability and
availability of volunteers. CRS states that unless the
current law is modified to allow the use of simulator
phantoms, many schools have indicated that their ability to
train RTs will be impaired. In addition, CRS writes that
it is necessary for RTs to be allowed to inject materials
that are approved by the ACR, other than the actual
contrast materials. An example of this would be the use of
saline, which in some cases can support the patency of the
cannula or port for injection. The Merced College
Diagnostic Radiologic Technology Program (Program) writes
that it is especially disconcerting that RT schools have
until the end of this year to be in compliance with
existing law as there is no way they can abide by how it
reads. The Program further states that, while it is not
the standard of practice in all radiology settings, the
radiology community would like the statute to allow RTs to
inject other substances related to a contrast injection.
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CTW:dm 8/29/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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