SENATE JUDICIARY COMMITTEE SUBSTITUTE FOR
SENATE BILL 336
50th legislature - STATE OF NEW MEXICO - first session, 2011
AN ACT
RELATING TO HEALTH CARE; AMENDING SECTIONS OF THE MEDICAL IMAGING AND RADIATION THERAPY HEALTH AND SAFETY ACT TO EXEMPT LICENSED NURSES AND CERTIFIED NURSE-MIDWIVES AND SUPERVISED STUDENTS IN ACCREDITED NURSING AND MIDWIFERY PROGRAMS WHO PROVIDE POINT-OF-CARE ULTRASOUND IMAGING FROM ENVIRONMENTAL IMPROVEMENT BOARD LICENSURE REQUIREMENTS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 61-14E-4 NMSA 1978 (being Laws 1983, Chapter 317, Section 4, as amended) is amended to read:
"61-14E-4. DEFINITIONS.--As used in the Medical Imaging and Radiation Therapy Health and Safety Act:
A. "advisory council" means the medical imaging and radiation therapy advisory council;
B. "board" means the environmental improvement board;
C. "certificate of limited practice" means a certificate issued pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act to persons who perform restricted diagnostic radiography under direct supervision of a licensed practitioner limited to the following specific procedures:
(1) the viscera of the thorax;
(2) extremities;
(3) radiation to humans for diagnostic purposes in the practice of dentistry;
(4) axial/appendicular skeleton; or
(5) the foot, ankle or lower leg;
D. "certified nurse practitioner" means a person licensed pursuant to Section 61-3-23.2 NMSA 1978;
E. "credential" or "certification" means the recognition awarded to an individual who meets the requirements of a credentialing or certification organization;
F. "credentialing organization" or "certification organization" means a nationally recognized organization recognized by the board that issues credentials or certification through testing or evaluations that determine whether an individual meets defined standards for training and competence in a medical imaging modality;
G. "department" means the department of environment;
H. "diagnostic medical sonographer" means a person, including a vascular technologist or echocardiographer, other than a licensed practitioner, who provides patient care services using ultrasound;
I. "division" means the environmental health division of the department of environment;
J. "ionizing radiation" means alpha particles, beta particles, gamma rays, x-rays, neutrons, high-speed electrons, high-speed protons and other particles capable of producing ions; "ionizing radiation" does not include non-ionizing radiation, such as sound waves, radio waves or microwaves, or visible, infrared or ultraviolet light;
K. "license" means a document issued by the department pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act to an individual who has met the requirements of licensure;
L. "licensed practitioner" means a person licensed to practice medicine, dentistry, podiatry, chiropractic or osteopathy in this state;
M. "licensure" means a grant of authority through a license or limited license to perform specific medical imaging and radiation therapy services pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act;
N. "magnetic resonance technologist" means a person other than a licensed practitioner who performs magnetic resonance procedures under the supervision of a licensed practitioner using magnetic fields and radio frequency signals;
O. "medical imaging" means the use of substances or equipment emitting ionizing or non-ionizing radiation on humans for diagnostic or interventional purposes;
P. "medical imaging modality" means:
(1) diagnostic medical sonography and all of its subspecialties;
(2) magnetic resonance imaging and all of its subspecialties;
(3) nuclear medicine technology and all of its subspecialties;
(4) radiation therapy and all of its subspecialties; and
(5) radiography and all of its subspecialties;
Q. "medical imaging professional" means a person who is a magnetic resonance technologist, radiographer, nuclear medicine technologist or diagnostic medical sonographer and who is licensed pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act;
R. "non-ionizing radiation" means the [optical radiations, including ultraviolet, visible, infrared and lasers] static and time-varying electric and magnetic fields and radio frequency, including microwave radiation and ultrasound;
S. "nuclear medicine technologist" means a person other than a licensed practitioner who applies radiopharmaceutical agents to humans for diagnostic or therapeutic purposes under the direction of a licensed practitioner;
T. "physician assistant" means a person licensed pursuant to Section 61-6-7 or 61-10A-4 NMSA 1978;
U. "point-of-care ultrasound imaging" means the limited use of ultrasound to create real-time images necessary for direct patient care that are not transmitted or referred for interpretation by another licensed practitioner or other health care professional licensed pursuant to Chapter 61 NMSA 1978 to provide health care within that professional's scope of practice;
[U.] V. "radiation therapy" means the application of ionizing radiation to humans for therapeutic purposes;
[V.] W. "radiation therapy technologist" means a person other than a licensed practitioner whose application of radiation to humans is for therapeutic purposes;
[W.] X. "radiographer" means a person other than a licensed practitioner whose application of radiation to humans is for diagnostic purposes;
[X.] Y. "radiography" means the application of radiation to humans for diagnostic purposes, including adjustment or manipulation of x-ray systems and accessories, including image receptors, positioning of patients, processing of films and any other action that materially affects the radiation dose to patients;
[Y.] Z. "radiologist" means a licensed practitioner certified by the American board of radiology, the British royal college of [radiology] radiologists, the American osteopathic board of radiology or the American chiropractic board of radiology; [and
Z.] AA. "radiologist assistant" means an individual licensed as a radiographer as defined in the Medical Imaging and Radiation Therapy Health and Safety Act who holds additional certification as a registered radiologist assistant by the American registry of radiologic technologists and who works under the supervision of a radiologist; provided that a radiologist assistant shall not interpret images, render diagnoses or prescribe medications or therapies; and
BB. "ultrasound" means the use of non-ionizing high-frequency sound waves, above twenty thousand cycles per second, with specialized equipment to direct the sound waves into areas of the human body to generate images for the assessment, diagnosis and treatment of various medical conditions."
SECTION 2. Section 61-14E-7 NMSA 1978 (being Laws 1983, Chapter 317, Section 7, as amended) is amended to read:
"61-14E-7. LICENSURE--EXCEPTIONS.--
A. It is unlawful, unless licensed by the department as a medical imaging professional or radiation therapist, for any person to:
(1) use ionizing [or non-ionizing] radiation on humans;
(2) use any title, abbreviation, letters, figures, signs or other devices to indicate that the person is a licensed medical imaging professional or radiation therapist; or
(3) engage in any of the medical imaging modalities as defined by the Medical Imaging and Radiation Therapy Health and Safety Act.
B. Notwithstanding any other provision of the Medical Imaging and Radiation Therapy Health and Safety Act, the requirement of a medical imaging license shall not apply to:
(1) a licensed practitioner; [or auxiliary or health practitioner licensed or certified by an independent board; provided that any certification and examination program for auxiliaries or health practitioners established by an independent board shall be submitted to the advisory council and approved by the board. The requirement of a medical imaging license shall also not apply to a student who is enrolled in and attending a required individual education program of a school or college of medicine, osteopathy, chiropractic, podiatry, dentistry or dental hygiene to apply radiation to humans under the supervision of a licensed practitioner or under the direct supervision of a licensed medical imaging professional or radiation therapist]
(2) a health care professional licensed pursuant to Chapter 61 NMSA 1978 by an independent board; provided that any health professional certification or examination program that an independent board establishes relating to the performance of any of the procedures described in Paragraphs (1) and (3) of Subsection A of this section shall be submitted to the advisory council and approved by the board; or
(3) a student who:
(a) is enrolled in and attending an accredited educational program at a college of medicine, osteopathy, chiropractic, podiatry, dentistry or dental hygiene and who performs a medical imaging or radiation therapy modality and specialty area authorized under the scope of practice for the student's professional program; and
(b) performs medical imaging or radiation therapy procedure under the supervision of a licensed practitioner or under the direct supervision of an individual licensed in the medical imaging or radiation therapy modality and specialty area.
C. Notwithstanding any other provision of the Medical Imaging and Radiation Therapy Health and Safety Act, the requirement of licensure shall not apply to point-of-care ultrasound imaging performed in this state by:
(1) a certified registered nurse anesthetist, nurse practitioner, clinical nurse specialist or nurse licensed pursuant to the Nursing Practice Act or a certified nurse-midwife licensed pursuant to the Public Health Act who has acquired the necessary knowledge, skills and training in the specific procedure to be performed and who provides point-of-care ultrasound imaging pursuant to the certified registered nurse anesthetist, nurse practitioner, clinical nurse specialist or nurse or nurse-midwife's scope of practice; or
(2) a student who is enrolled in an accredited program in preparation for licensure as a certified registered nurse anesthetist, nurse practitioner, clinical nurse specialist or nurse licensed pursuant to the Nursing Practice Act or a certified nurse-midwife licensed pursuant to the Public Health Act who performs point-of-care ultrasound imaging under the direct supervision of one of the following health professionals who acquired the necessary knowledge, skill and training in the specific procedure to be performed and who provides point-of-care ultrasound imaging pursuant to that professional's scope of practice:
(a) a licensed practitioner;
(b) a sonographer licensed pursuant to the provisions of the Medical Imaging and Radiation Therapy Health and Safety Act;
(c) a certified registered nurse anesthetist, nurse practitioner, clinical nurse specialist or nurse licensed pursuant to the Nursing Practice Act; or
(d) a certified nurse-midwife licensed pursuant to the Public Health Act.
D. Notwithstanding any other provision of the Medical Imaging and Radiation Therapy Health and Safety Act, the requirement of a license shall not apply to a student completing clinical requirements of an approved education program working under the supervision of a licensed practitioner or under the direct supervision of a medical imaging professional or radiation therapist licensed in the practice for which the student is seeking licensure.
[D.] E. The department shall adopt rules and regulations for the education and licensure of advanced medical imaging professionals.
[E.] F. The department may require students in medical imaging and radiation therapy educational programs to register with the department while enrolled in an approved education program.
G. Nothing in the Medical Imaging and Radiation Therapy Health and Safety Act shall affect the following health care professionals' authority to use images resulting from medical imaging procedures:
(1) a licensed practitioner;
(2) a certified registered nurse anesthetist, nurse practitioner, clinical nurse specialist or nurse licensed as a nurse pursuant to the Nursing Practice Act;
(3) a certified nurse-midwife licensed as a certified nurse-midwife pursuant to the Public Health Act;
(4) a physician assistant licensed pursuant to the Physician Assistant Act or the Osteopathic Physicians' Assistants Act; or
(5) another health care professional licensed to provide health care pursuant to Chapter 61 NMSA 1978."
- 11 -