SB0120

SENATE BILL 120

50th legislature - STATE OF NEW MEXICO - second session, 2012

INTRODUCED BY

Howie Morales

AN ACT

RELATING TO HEALTH CARE; AMENDING SECTIONS OF THE MEDICAL IMAGING AND RADIATION THERAPY HEALTH AND SAFETY ACT TO PERMIT CERTAIN LICENSED HEALTH CARE PROFESSIONALS AND STUDENTS TO PERFORM POINT-OF-CARE ULTRASOUND IMAGING PROCEDURES, TO EXEMPT CERTAIN LICENSED HEALTH CARE PROFESSIONALS FROM CERTAIN REQUIREMENTS OF THE MEDICAL IMAGING AND RADIATION THERAPY HEALTH AND SAFETY ACT, TO MAKE TECHNICAL CORRECTIONS AND CLARIFICATION TO MEDICAL IMAGING AND RADIATION THERAPY LICENSURE REQUIREMENTS AND TO CHANGE THE NAME OF THE RADIOLOGIC TECHNOLOGY FUND TO THE MEDICAL IMAGING AND RADIATION THERAPY FUND; AMENDING A SECTION OF THE NURSING PRACTICE ACT TO PROVIDE FOR RULEMAKING RELATING TO ULTRASOUND IMAGING EDUCATION AND STANDARDS; ENACTING A NEW SECTION OF THE PUBLIC HEALTH ACT TO PROVIDE FOR RULEMAKING RELATING TO ULTRASOUND IMAGING EDUCATION AND STANDARDS; RECONCILING MULTIPLE AMENDMENTS TO THE SAME SECTION OF LAW IN LAWS 2003.

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.] C. "credential" or "certification" means the recognition awarded to an individual who meets the requirements of a credentialing or certification organization in a medical imaging or radiation therapy modality and specialty area;

[F.] D. "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 or radiation therapy modality and specialty area;

[G.] E. "department" means the department of environment;

[H.] F. "diagnostic medical sonographer" means a person, including a vascular technologist or echocardiographer, other than a licensed practitioner, who [provides patient care services] performs medical imaging procedures using ultrasound;

[I. "division" means the environmental health division of the department of environment;]

G. "diagnostic medical sonography" means the use of specialized equipment to direct ultrasound into areas of the human body to generate images for the assessment, diagnosis and treatment of various medical conditions;

H. "direct patient care" means care of a patient provided personally by a health care provider;

I. "endorsement" means an additional authorization to a licensee's scope of practice;

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] an authorization to perform medical imaging and radiation therapy procedures that has been 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 practice license to perform specific medical imaging and radiation therapy [services] procedures pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act;

N. "limited practice license" means a license issued pursuant to Section 61-14E-7.1 NMSA 1978;

[N.] O. "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.] P. "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. "modality" means:

(1) diagnostic medical sonography and all specialty areas of diagnostic medical sonography;

(2) magnetic resonance imaging and all specialty areas of magnetic resonance imaging;

(3) nuclear medicine technology and all speciality areas of nuclear medicine technology;

(4) radiation therapy and all specialty areas of radiation therapy; and

(5) radiography and all specialty areas of radiography;

[R.] S. "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;

T. "non-physician practitioner" means a:

(1) nurse licensed pursuant to the Nursing Practice Act;

(2) certified nurse-midwife licensed pursuant to the Public Health Act;

(3) osteopathic physician's assistant licensed pursuant to the Osteopathic Physicians' Assistants Act; or

(4) physician assistant licensed pursuant to the Physician Assistant Act;

[S.] U. "nuclear medicine technologist" means a person other than a licensed practitioner who applies pharmaceutical or radiopharmaceutical agents to humans for diagnostic or therapeutic nuclear medicine 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;]

V. "point-of-care ultrasound imaging" means the limited use of ultrasound to create real-time images necessary for direct patient care, within a point-of-care ultrasound imaging provider's scope of practice, that are not transmitted or referred for interpretation by a licensed practitioner or a non-physician practitioner;

W. "point-of-care ultrasound imaging provider" means an individual who:

(1) 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 individual's scope of practice; and

(2) is certified or licensed in this state as:

(a) a paramedic pursuant to the Emergency Medical Services Act;

(b) a phlebotomist certified by a credentialing organization recognized by the board; or

(c) a physician assistant pursuant to the Physician Assistant Act or an osteopathic physician's assistant pursuant to the Osteopathic Physicians' Assistants Act;

[U.] X. "radiation therapy" means the application of ionizing radiation to humans for therapeutic purposes;

[V.] Y. "radiation [therapy technologist] therapist" means a person other than a licensed practitioner whose application of ionizing and non-ionizing radiation to humans is for therapeutic purposes;

[W.] Z. "radiographer" means a person other than a licensed practitioner whose application of radiation to humans is for diagnostic or interventional purposes;

[X.] AA. "radiography" means the application of radiation to humans for diagnostic or interventional 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.] BB. "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.] CC. "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;

DD. "restricted" means having a limitation on a licensee's license term or scope of practice;

EE. "specialty area" means an area of specialization within a medical imaging or radiation therapy modality as designated by the applicable certification or credentialing organization;

FF. "supervision" means the direction or oversight of a medical imaging or radiation therapy procedure and includes the following levels of supervision:

(1) "direct supervision" means supervision where the individual supervising a procedure is present in the facility and immediately available to furnish assistance and direction during the performance of the procedure;

(2) "general supervision" means supervision where the individual supervising a procedure provides overall direction and control but is not present in the facility or room during the performance of the procedure; and

(3) "personal supervision" means supervision where the individual supervising a procedure is present in the room during the performance of the procedure; and

GG. "ultrasound" means the use of non-ionizing high-frequency sound waves 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; for purposes of the Medical Imaging and Radiation Therapy Health and Safety Act, "ultrasound" does not include the use of high-frequency sound waves for non-imaging medical applications."

SECTION 2. Section 61-14E-5.1 NMSA 1978 (being Laws 2009, Chapter 106, Section 12) is amended to read:

"61-14E-5.1. MEDICAL IMAGING AND RADIATION THERAPY ADVISORY COUNCIL--CREATION AND ORGANIZATION.--

A. The "medical imaging and radiation therapy advisory council" is established, consisting of eleven members. The members shall be appointed by the governor, after consultation with the secretary of environment and professional organizations representing medical imaging and radiation therapy, for three-year staggered terms. The governor shall fill any vacancy occurring on the advisory council within sixty days of the vacancy. The replacement appointee shall serve the remainder of the original member's unexpired term.

B. The members of the advisory council shall be:

(1) six [medical imaging professionals licensed by the department] licensees, representing each medical imaging and radiation therapy modality defined under the Medical Imaging and Radiation Therapy Health and Safety Act, including [one licensed radiographer and] one licensed radiologist assistant;

(2) one individual who holds a [certificate of] limited practice license in radiography;

(3) three physicians licensed pursuant to Section 61-6-1 or 61-10-1 NMSA 1978, each of whom represents a different medical specialty, only one of whom shall be a radiologist and at least one of whom shall be from a rural area; and

(4) one member of the general public who is not [licensed by the department] a licensee nor a relative of anyone licensed by the department.

C. The advisory council may create ad hoc disciplinary review committees to consider medical matters and make recommendations to the advisory council. Ad hoc disciplinary review committees shall, at a minimum, include:

(1) one [individual licensed by the department] licensee in the specific modality in question and who holds similar credentials as the individual under disciplinary review;

(2) one physician, licensed pursuant to Section 61-6-1 or 61-10-1 NMSA 1978, who is experienced in the modality in question; and

(3) one member of the general public.

D. A member shall serve no more than two consecutive three-year terms.

E. A member of the advisory council or an ad hoc disciplinary review committee may receive per diem and mileage as provided for non-salaried public officers in the Per Diem and Mileage Act and shall receive no other compensation, perquisite or allowance in connection with the discharge of the duties as [a] an advisory council or committee member.

F. A member failing to attend three consecutive regular and properly noticed meetings of the advisory council without a reasonable excuse shall be automatically removed from the advisory council.

G. In the event of a vacancy, the department shall immediately notify the governor of the vacancy. Within ninety days of receiving notice of a vacancy, the governor shall appoint a qualified person to fill the remainder of the unexpired term.

H. A majority of the advisory council members currently serving constitutes a quorum of the council.

I. The advisory council shall meet at least once a year and at such other times as it deems necessary.

J. The advisory council shall annually elect officers as deemed necessary to administer its duties.

K. Notwithstanding the provisions of Subsections A through I of this section, members shall initially be appointed by the governor so that five members shall be appointed for terms of three years and six members shall be appointed for terms of five years. Thereafter, the additional members shall be appointed by the governor for staggered terms of three years each.

L. As used in this section:

(1) "relative" means a person's spouse, parent, grandparent, stepfather, stepmother, child, grandchild, brother, sister, half-brother, half-sister or spouse's parent; and

(2) "rural" means an area or location within a county having fifty thousand or fewer inhabitants as of the last federal decennial census."

SECTION 3. Section 61-14E-6 NMSA 1978 (being Laws 1983, Chapter 317, Section 6, as amended) is amended to read:

"61-14E-6. [DIVISION] DEPARTMENT--POWERS--DUTIES.--The [division] department, pursuant to the rules and regulations promulgated by the board, shall:

A. maintain and enforce licensure standards for magnetic resonance, radiography, radiation therapy [technology], nuclear medicine technology, diagnostic medical sonography [and radiology] and limited practice licensure standards for restricted diagnostic radiography and may:

(1) require students in medical imaging and radiation therapy educational programs to register with the department while enrolled in an approved education program; and

(2) adopt rules and regulations for the education and licensure of advanced medical imaging professionals;

B. refer to national educational accreditation standards for educational programs and, pursuant to those standards, establish criteria for education programs of magnetic resonance, radiography, radiation therapy [technology], nuclear medicine technology and diagnostic medical sonography;

C. provide for surveys of educational programs preparing persons for [certification] licensure under the Medical Imaging and Radiation Therapy Health and Safety Act;

D. grant, deny or withdraw approval from educational programs for failure to meet prescribed standards, provided that a majority of the board concurs in any decision;

E. establish procedures for examination, [certification] licensure and renewal of [certificates] licensure of applicants; and

F. establish scope of practice and ethics rules."

SECTION 4. 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 [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]:

(1) a licensed practitioner;

(2) a nurse licensed pursuant to the Nursing Practice Act performing ultrasound procedures;

(3) a certified nurse-midwife licensed pursuant to the Public Health Act performing ultrasound procedures; or

(4) 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 practices in a specialty area authorized under the scope of practice for the student's professional program;

(b) performs a 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; and

(c) is enrolled in and attending an accredited education program and who performs ultrasound authorized under the scope of practice for the student's professional program.

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 point-of-care ultrasound imaging provider; or

(2) a student who is enrolled in an accredited program in preparation for licensure as a point-of-care ultrasound imaging provider who performs point-of-care ultrasound imaging under the direct supervision of a licensed practitioner, point-of-care ultrasound imaging provider or licensed diagnostic medical sonographer.

[C.] 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. The department shall adopt rules and regulations for the education and licensure of advanced medical imaging professionals.

E. 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.]

E. Nothing in the Medical Imaging and Radiation Therapy Health and Safety Act shall affect the authority of a licensed health care professional licensed pursuant to Chapter 61 or Chapter 24 NMSA 1978 to use images resulting from medical imaging procedures in accordance with the licensed health care professional's scope of practice."

SECTION 5. Section 61-14E-7.1 NMSA 1978 (being Laws 1994, Chapter 82, Section 2) is amended to read:

"61-14E-7.1. EMERGENCY PROVISION.--

A. A person having a valid [certificate of] limited practice license may authorize diagnostic radiography procedures outside the normal scope of a limited radiographic practitioner if the person issued the [certificate of] limited practice license is employed in an area having a federal designation as a medically underserved area and the person issued the [certificate of] limited practice license is confronted with an emergency situation where, by order of a licensed practitioner [a certified nurse practitioner or a registered physician assistant] or a non-physician practitioner in accordance with the licensed practitioner's or non-physician practitioner's scope of practice, the additional diagnostic radiography procedure is medically necessary for the immediate safety or health of the patient.

B. A person who performs non-mobile restricted diagnostic radiography pursuant to the provisions of this section shall be limited to the following procedures:

(1) applying radiation to humans for diagnostic purposes in the practice of dentistry; or

(2) applying radiation to these specific areas of the human body:

(a) the viscera of the thorax;

(b) extremities;

(d) the foot, ankle or lower leg.

C. If the board determines that additional time is needed, the board may delay full implementation of licensure requirements for diagnostic medical sonography and magnetic resonance imaging under the Medical Imaging and Radiation Therapy Health and Safety Act until no later than July 1, 2016."

SECTION 6. Section 61-14E-8 NMSA 1978 (being Laws 1991, Chapter 14, Section 3, as amended) is amended to read:

"61-14E-8. TEMPORARY CERTIFICATION.--

A. The department may issue a temporary [certificate to practice as a radiologic technologist] license to a person who satisfactorily completes an approved program in [radiologic technology] medical imaging or radiation therapy; provided that the temporary [certificate] license:

[A.] (1) is applied for no more than sixty days before graduation or within one year of graduation;

[B.] (2) is valid only for a period not to exceed one year; and

[C.] (3) is only issued to a person once [and

D. is contingent upon successful completion of an examination required by the board and expires upon failure to pass the examination].

B. If an individual who has been issued a temporary license fails to graduate from an educational program in medical imaging or radiation therapy, a temporary license is no longer valid and the person shall notify the department within thirty days of leaving the educational program.

C. The department may issue temporary endorsements to allow a licensee to perform medical imaging or radiation therapy procedures in one or more additional specialty areas of the licensee's authorized modality; provided that the temporary endorsement:

(1) is valid for a period not to exceed two years;

(2) is only issued to a person once for a specific specialty area; and

(3) is valid only when the licensee performs under the supervision of a licensed practitioner or a person licensed in the medical imaging or radiation therapy modality and specialty area being performed."

SECTION 7. Section 61-14E-10 NMSA 1978 (being Laws 1983, Chapter 317, Section 10, as amended) is amended to read:

"61-14E-10. FUND ESTABLISHED--DISPOSITION--METHOD OF PAYMENT.--

A. There is created in the state treasury the ["radiologic technology] "medical imaging and radiation therapy fund".

B. All fees received by the department pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act shall be deposited with the state treasurer. The state treasurer shall place the money to the credit of the [radiologic technology] medical imaging and radiation therapy fund.

C. Payments out of the [radiologic technology] medical imaging and radiation therapy fund shall be on vouchers issued and signed by the [person] individual designated by the department of environment upon warrants drawn by the department of finance and administration and shall be used by the department of environment for the purpose of meeting necessary expenses incurred in the enforcement of the purposes of the Medical Imaging and Radiation Therapy Health and Safety Act, the duties imposed by that act and the promotion of education and standards for medical imaging technology and radiation therapy in this state. All money unexpended or unencumbered at the end of the fiscal year shall remain in the [radiologic technology] medical imaging and radiation therapy fund for use in accordance with the provisions of the Medical Imaging and Radiation Therapy Health and Safety Act."

SECTION 8. Section 61-14E-11 NMSA 1978 (being Laws 1983, Chapter 317, Section 11, as amended) is amended to read:

"61-14E-11. SUSPENSION--REVOCATION--APPLICATION OF UNIFORM LICENSING ACT.--The board, pursuant to the advice and recommendation of the advisory council, may deny, revoke or suspend any license held or applied for under the Medical Imaging and Radiation Therapy Health and Safety Act, pursuant to the procedures established in the Uniform Licensing Act, upon grounds that the medical imaging professional, radiation therapist or the applicant:

A. is guilty of fraud or deceit in procuring or attempting to procure a license or [certificate of] limited practice license;

B. is convicted of a felony subsequent to [certification] licensure;

C. is unfit or incompetent;

D. is habitually intemperate or is addicted to the use of habit-forming drugs;

E. is mentally incompetent;

F. has aided and abetted a person who does not possess a license pursuant to the Medical Imaging and Radiation Therapy Health and Safety Act or otherwise authorized by that act in engaging in the activities of a license holder;

G. has engaged in any practice beyond the scope of authorized activities of [an individual licensed or a certificate of limited practice holder pursuant to] a licensee under the Medical Imaging and Radiation Therapy Health and Safety Act;

H. is guilty of unprofessional conduct or unethical conduct as defined by rules promulgated by the board;

I. except in cases where a board rule has authorized preliminary findings from diagnostic medical sonography procedures, has interpreted a diagnostic imaging procedure for a patient, the patient's family or the public; or

J. has willfully or repeatedly violated any provisions of the Medical Imaging and Radiation Therapy Health and Safety Act."

SECTION 9. Section 61-14E-12 NMSA 1978 (being Laws 1983, Chapter 317, Section 12, as amended) is amended to read:

"61-14E-12. VIOLATIONS--PENALTIES.--

A. It is a misdemeanor for any person, firm, association or corporation to:

[A.] (1) knowingly or willfully employ as a medical imaging professional or radiation therapist any person who is required to but does not possess a valid license [or certificate of limited practice] to engage in the practice of medical imaging or radiation therapy;

[B.] (2) sell, fraudulently obtain or furnish any medical imaging [technology] or radiation therapy license [or certificate of limited practice] or to aid or abet therein;

[C.] (3) practice medical imaging or radiation therapy as defined by the Medical Imaging and Radiation Therapy Health and Safety Act unless exempted or licensed to do so under the provisions of that act; or

[D.] (4) otherwise violate any provisions of the Medical Imaging and Radiation Therapy Health and Safety Act.

B. The department shall assist the proper legal authorities in the prosecution of all persons violating the provisions of the Medical Imaging and Radiation Therapy Health and Safety Act. In prosecutions under that act, it shall not be necessary to prove a general course of conduct. Proof of a single act, a single holding out or a single attempt shall constitute a violation, and, upon conviction, such person shall be sentenced to be imprisoned in the county jail for a definite term not to exceed one year or to the payment of a fine of not more than one thousand dollars ($1,000) or both. The department shall notify within thirty days of a final disciplinary action any credentialing organization through which the person is credentialed or certified."

SECTION 10. Section 61-6-17 NMSA 1978 (being Laws 1973, Chapter 361, Section 8, as amended) is amended to read:

"61-6-17. EXCEPTIONS TO ACT.--The Medical Practice Act shall not apply to or affect:

A. gratuitous services rendered in cases of emergency;

B. the domestic administration of family remedies;

C. the practice of midwifery as regulated in this state;

D. commissioned medical officers of the armed forces of the United States and medical officers of the United States public health service or the veterans administration of the United States in the discharge of their official duties or within federally controlled facilities; provided that such persons who hold medical licenses in New Mexico shall be subject to the provisions of the Medical Practice Act and provided that all such persons shall be fully licensed to practice medicine in one or more jurisdictions of the United States;

E. the practice of medicine by a physician, unlicensed in New Mexico, who performs emergency medical procedures in air or ground transportation on a patient from inside of New Mexico to another state or back, provided the physician is duly licensed in that state;

F. the practice, as defined and limited under their respective licensing laws, of:

(1) osteopathy;

(2) dentistry;

(3) podiatry;

(4) nursing;

(5) optometry;

(6) psychology;

(7) chiropractic;

(8) pharmacy;

(9) acupuncture and oriental medicine; or

(10) physical therapy;

G. an act, task or function performed by a physician assistant at the direction of and under the supervision of a licensed physician, when:

(1) the physician assistant is currently licensed by the board;

(2) the act, task or function is performed at the direction of and under the supervision of a licensed physician in accordance with rules promulgated by the board; and

(3) the acts of the physician assistant are within the scope of duties assigned or delegated by the supervising licensed physician and the acts are within the scope of the assistant's training;

H. an act, task or function of laboratory technicians or technologists, [x-ray technicians, nurse practitioners] nurses, medical or surgical assistants or other technicians or qualified persons permitted by law or established by custom as part of the duties delegated to them by:

(1) a licensed physician or a hospital, clinic or institution licensed or approved by the public health division of the department of health or an agency of the federal government; or

(2) a health care program operated or financed by an agency of the state or federal government;

I. a properly trained medical or surgical assistant or technician or professional licensee performing under the physician's employment and direct supervision or a visiting physician or surgeon operating under the physician's direct supervision a medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician, the act can be properly and safely performed in its customary manner and if the person does not hold [himself] the person's own self out to the public as being authorized to practice medicine in New Mexico. The delegating physician shall remain responsible for the medical acts of the person performing the delegated medical acts;

J. the practice of the religious tenets of a church in the ministration to the sick or suffering by mental or spiritual means as provided by law; provided that the Medical Practice Act shall not be construed to exempt a person from the operation or enforcement of the sanitary and quarantine laws of the state;

K. the acts of a physician licensed under the laws of another state of the United States who is the treating physician of a patient and orders home health or hospice services for a resident of New Mexico to be delivered by a home and community support services agency licensed in this state; provided that a change in the condition of the patient shall be physically reevaluated by the treating physician in the treating physician's jurisdiction or by a licensed New Mexico physician;

L. a physician licensed to practice under the laws of another state who acts as a consultant to a New Mexico-licensed physician on an irregular or infrequent basis, as defined by rule of the board; and

M. a physician who engages in the informal practice of medicine across state lines without compensation or expectation of compensation; provided that the practice of medicine across state lines conducted within the parameters of a contractual relationship shall not be considered informal and is subject to licensure and rule by the board."

SECTION 11. Section 61-3-10 NMSA 1978 (being Laws 1968, Chapter 44, Section 7, as amended by Laws 2003, Chapter 276, Section 4 and by Laws 2003, Chapter 307, Section 7) is amended to read:

"61-3-10. POWERS--DUTIES.--The board:

A. shall adopt and revise such rules and regulations as may be necessary to enable it to carry into effect the provisions of the Nursing Practice Act and to maintain high standards of practice;

B. shall prescribe standards and approve curricula for educational programs preparing persons for licensure under the Nursing Practice Act;

C. shall provide for surveys of educational programs preparing persons for licensure under the Nursing Practice Act;

D. shall grant, deny or withdraw approval from educational programs for failure to meet prescribed standards, if a majority of the board concurs in the decision;

E. shall provide for the examination, licensing and renewal of licenses of applicants;

F. shall conduct hearings upon charges relating to discipline of a licensee or nurse not licensed to practice in New Mexico who is permitted to practice professional registered nursing or licensed practical nursing in New Mexico pursuant to a multistate licensure privilege as provided in the Nurse Licensure Compact or the denial, suspension or revocation of a license in accordance with the procedures of the Uniform Licensing Act;

G. shall cause the prosecution of all persons, including firms, associations, institutions and corporations, violating the Nursing Practice Act and have the power to incur such expense as is necessary therefor;

H. shall keep a record of all proceedings;

I. shall make an annual report to the governor;

J. shall appoint and employ a qualified registered nurse, who shall not be a member of the board, to serve as executive officer to the board, who shall define the duties and responsibilities of the executive officer, except that the power to grant, deny or withdraw approval for schools of nursing or to revoke, suspend or withhold any license authorized by the Nursing Practice Act shall not be delegated by the board;

K. shall provide for such qualified assistants as may be necessary to carry out the provisions of the Nursing Practice Act. Such employees shall be paid a salary commensurate with their duties;

L. shall, for the purpose of protecting the health and well-being of the citizens of New Mexico and promoting current nursing knowledge and practice, adopt rules and regulations establishing continuing education requirements as a condition of license renewal and shall study methods of monitoring continuing competence;

M. may appoint advisory committees consisting of at least one member who is a board member and at least two members expert in the pertinent field of health care to assist it in the performance of its duties. Committee members may be reimbursed as provided in the Per Diem and Mileage Act;

N. may adopt and revise rules and regulations designed to maintain an inactive status listing for registered nurses and licensed practical nurses;

O. may adopt rules and regulations to regulate the advanced practice of professional registered nursing and expanded practice of licensed practical nursing;

P. shall license qualified certified nurse practitioners, certified registered nurse anesthetists and clinical nurse specialists;

Q. shall register nurses not licensed to practice in New Mexico who are permitted to practice professional registered nursing or licensed practical nursing in

New Mexico pursuant to a multistate licensure privilege as provided in the Nurse Licensure Compact; [and]

R. shall adopt rules and regulations establishing standards for authorizing prescriptive authority to certified nurse practitioners, [and] clinical nurse specialists and certified registered nurse anesthetists; and

S. shall adopt rules for education and training that meet nationally recognized standards of practice for the provision of ultrasound procedures."

SECTION 12. A new section of the Public Health Act is enacted to read:

"[NEW MATERIAL] ULTRASOUND PROCEDURES--RULEMAKING.--

A. The department of health shall adopt rules for education and training for nurse-midwives in the provision of ultrasound procedures that meet nationally recognized ultrasound education and training standards.

B. For the purposes of this section, "nurse-midwife" means a registered nurse whom the department of health has licensed as a nurse-midwife."

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