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2009 Annual Conference in San Jose
See the SEMINARS page for more information of the conference and all 2009 CSRT CE Seminars
California Legislation Update
So far we have had a busy first half of the year with regards to California. The most controversial bills so far have been AB 356 (A-04/23/2009 html pdf) and AB 445 (I-02/24/2009 html pdf) , which were introduced in late February. These two bills would allow additional healthcare providers the access to use and supervise ionizing radiation equipment. AB 445 is specific to mini c-arms that would be used in the Emergency Department by PAs, Ortho NPs and Ortho residents in fracture evaluation. This would be performed under the direct or indirect supervision of a CRT. AB 356 would add PAs to the licentiate category and allow them to hold the Supervisor and Operator permit. It would also allow for them to qualify for the fluoroscopy permit. The CSRT mounted an email campaign to enlist the help of the RT community to voice opposition to what would be an unsafe situation given the lack of education and training required to operate such equipment. It could also be detrimental to other states, potentially, as the country often follows California lead.
Currently, AB 445, after being heard in the Assembly Health committee on April 21st, has been cancelled from further hearings and will be withdrawn for this year. It is pending clarification from the RHB whether or not a CRT would be able to perform the functions intended for the PAs and NPs in this bill. Ideally, this would be the better option given the education and training we receive in positioning and radiation safety. AB 356 was heard in the Assembly Health Committee on April 14th and amended after discussions between the PA community, the California Radiologist Society and the CSRT. Representatives from these groups were present at this hearing to voice their opinions. The CSRT was concerned and opposed the bill as written. AB 356 was written with blanket exemptions that would have allowed PAs the access to do any radiation procedure or exam on any equipment. There was also no training or education required and could be delegated by any physician. In discussions, we were able to limit the access to fluoroscopy only and with 40 hours of fluoroscopy education prior to sitting for the fluoroscopy permit. The supervising MD must also hold the fluoroscopy permit and the PA will do at least 10 hours of CE for renewal every two years. While not ideal to what we feel is appropriate, we are still unable to have RAs practice in California. Therefore, we are confident we have limited the bill to the safest practice at this time. The bill was then passed out of committee and on to the Assembly Business and Professions committee, where it was heard in its amended form on April 28th. It has passed through that committee and is now in front of the Assembly Appropriations committee. The hearing is set for May 13th.
For those who do not know, there is an Appropriations committee in each house. Most bills must pass through their respective house appropriations committee if the bill will "appropriate money, impose new responsibilities or duties on the state, liberalize any state function, program or responsibility, or result in substantial loss of revenue or reduction of state expenditures". Given the condition of the economy in this state, it will remain to be seen whether the funding required for this bill will be approved this year.