BILL ANALYSIS ---------------------------------------------------------- |Hearing Date:June 26, 2006 |Bill No:AB | | |2720 | ---------------------------------------------------------- SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Liz Figueroa, Chair Bill No: AB 2720Author:Spitzer As Amended: May 8, 2006 Fiscal: Yes SUBJECT: Radiologic technology. SUMMARY: Authorizes nuclear medicine technologists and diagnostic radiologic technologists to operate dual mode equipment used to perform computerized tomography (CT) scans and positron emission tomography (PET) scans when the equipment is performing both types of scans in the dual mode. Existing law: 1) Establishes the Radiologic Health Branch within the Department of Health Services (DHS) which is responsible for licensing of radioactive materials, registration of X-ray producing machines, certification of X-ray and radioactive material users, inspection of facilities using radiation, investigation of radiation incidents, and surveillance of radioactive contamination in the environment. 2) Requires certification or licensure for any person who administers or uses diagnostic or therapeutic X-ray equipment and specifies examination requirements for obtaining a radiologic technology certificate. 3) Requires certification for individuals performing nuclear medicine technology and the passage of a DHS administered examination or submission of documentary evidence of passing an equivalent examination offered by the Nuclear Medicine Technology Certification Board, American Registry of Radiologic Technologists, or AB 2720 Page 2 American Society of Clinical Pathologists. 4) Defines nuclear medicine technology as technology applied under the supervision of a physician and surgeon or licensed clinical bioanalyst, when performing in vitro procedures that pertain to the utilization of radiopharmaceuticals for the diagnosis and treatment of disease in humans. This bill: 1) Allows a person who has obtained certification in nuclear medicine technology to perform a CT scan only on a dual mode machine on which both a nuclear medicine procedure, to include a PET scan, and a CT scan if both of the following conditions are met: a) The person holds a current, valid certificate in CT issued by the American Registry of Radiologic Technologists, a similarly recognized organization, or is a student, as specified. b) The person is under the supervision of a person who is an authorized user identified on a specific license authorizing medical use of radioactive materials, as specified. 2) Allows a person who holds a current, valid certificate in diagnostic radiologic technology to perform a PET scan only on a dual mode machine on which both a PET scan and a CT scan may be performed if both of the following conditions are met: a) The person holds a current, valid certificate in PET issued by the Nuclear Medicine Technology Certification Board, or a similarly recognized organization, or complies with the regulations issued by DHS governing students of nuclear medicine technology in order to obtain a current, valid certificate in PET issued by the Nuclear Technology Certification Board. b) The person is under the supervision of a person who is an authorized user identified on a specific license authorizing medical use of AB 2720 Page 3 radioactive materials, as specified. 3) Makes a violation of these provisions a misdemeanor and makes a violator subject to disciplinary actions, as specified. FISCAL EFFECT: According to the Assembly Appropriations Committee there would be no state fiscal impact as a result of the passage of this measure. COMMENTS: 1.Purpose. According to the Author, this bill creates a mechanism to allow diagnostic radiologic technologists and nuclear medicine technologists to perform CT scans and PET scans on dual mode equipment subject to specific training, certification, and supervision standards. The Author points out that for several years machines have been available that combine both PET and CT scan capability into a hybrid unit. However, current law limits a diagnostic radiologic technologist to performing only procedures involving ionizing radiation or CT scans, but not one involving nuclear medicine, or PET scans. Similarly the law restricts a nuclear medicine technologist to performing only procedures involving nuclear medicine, or PET scans. To eliminate the need to have both types of technologists present when using one of these hybrid units in the dual mode, the consensus among all parties including physicians and the technologists was to cross train the respective technologist for this limited purpose. 2.Background. Current DHS regulations include guidelines in the operation of dual imaging devices, including PET scanners. The regulation describes the following circumstances under which these devices can be used and who can operate them: a) When a unit is operated as a nuclear medicine imaging device, the individual operating the machine must be certified as a nuclear medicine technologist operating under the supervision of a physician user named on the appropriate radioactive materials license. b) When a unit is operated as a dual imaging device, it constitutes a nuclear medicine technology procedure, rather than a radiologic technology AB 2720 Page 4 procedure, and a nuclear medicine technologist is adequately certified to perform the study and operate the device. c) When a unit is operated as a radiologic technology imaging device, the individual operating the machine must be a certified radiologic technologist working under the supervision of a certified supervisor and operator. A computerized axial tomography scan is more commonly known by its abbreviated name, CAT scan or CT scan. It is an X-ray procedure which combines many X-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. A CAT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments. A large donut-shaped X-ray machine takes X-ray images at many different angles around the body. A positron emission tomography or PET scan is a diagnostic examination that involves the acquisition of physiologic images based on the detection of radiation from the emission of positrons. According to the Mayo Clinic Website, a PET scan is a specific type of imaging test that can help a doctor see how the tissues and organs inside the body are functioning. Unlike other scanning techniques, a PET scan does not produce clear structural images of organs. Instead, it shows images containing areas of more or less intense color to provide information about chemical activity within certain organs and tissues. This chemical activity may indicate areas of disease not detected by other scanning methods. 3.Arguments in Support. This measure is sponsored by the Society for Nuclear Medicine, Pacific Southwest Technologist Chapter. Proponents state that technicians who operate "hybrid" diagnostic imaging machines that can perform both PETs and CTs should not have to be licensed as both a nuclear medicine technologist and a radiologic technologist and there are a limited number of individuals who have both licenses. However, individuals who perform both PETs and CTs must be adequately trained to provide both services. In response to this situation, the industry put forth a proposal to cross train nuclear medicine technologists and radiologic technologists to AB 2720 Page 5 perform both types of scans. In addition, the American Registry of Radiologic Technology and the Nuclear Medicine Technology Certification Board, which certify radiologic technologists and nuclear medicine technologists, respectively, have recognized the need for dually-trained imaging technologists and have developed curriculums to ensure that both technologists are sufficiently trained when operating hybrid imaging units. AB 2720 implements this consensus proposal. SUPPORT AND OPPOSITION: Support: Society of Nuclear Medicine, Pacific Southwest Technologist Chapter (Sponsor) California Medical Association California Radiological Society California Society of Radiologic Technologists Society of Nuclear Medicine Opposition: None Received. Consultant: George Cate