CARE Act H.R. 1214 RadCARE Act S. 1197 Presentation Prepared by the Society of Nuclear Medicine Technologist Section Government Relations Subcommittee

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CARE ActH.R. 1214RadCARE ActS.
1197Presentation Prepared by the Society of
Nuclear Medicine Technologist SectionGovernment
Relations Subcommittee
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What is CARE RadCARE?

• The CARE Act and the RadCARE Act are proposed
  legislation in the House and Senate which will
  require that every state enact a program of
  minimum standards for the education and
  certification of Radiologic and Nuclear Medicine
  Technologists as well as
• Radiation Therapists.

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The Bill Specifically States

• it is unlawful for an individual in the State to
  intentionally administer or plan medical imaging
  procedures or radiation therapy procedures to or
  for another individual for medical or
  chiropractic purposes unless the individual has
  obtained from the State a license, certificate,
  or other document that authorizes the individual
  to administer or plan such procedures in the
  State (referred to in this section as a medical
  radiation license').

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What does CARE stand for?

• Consumer
• Assurance of
• Radiologic
• Excellence

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The CARE Act

• The CARE Act (H.R.1214) is a bill which was
  introduced in the US House of Representatives by
  Representative Heather Wilson (R-NM) on March 11,
  2003.

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The RadCARE Act

• The RadCARE Act (S.1197) is a virtually identical
  bill which was introduced in the US Senate by
  Senator Mike Enzi
• (R-WY) on June 3, 2003.

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What will the CARE Act do?

• The CARE Act would require that in order for
  nuclear medicine and other diagnostic imaging and
  radiation therapy procedures to be eligible for
  Medicaid payments, they must be performed by
  licensed individuals who have met the federal
  minimum standards for education
• and certification.

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Isnt there already a similar law?

• The CARE Act is designed to amend the
  Consumer-Patient Radiation Health and Safety Act
  of 1981 (Randolph Bill). This law established
  minimum education and certification standards of
  radiologic technologists. However, compliance
  was voluntary.

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Isnt there already a similar law?

• There was no mechanism attached to the Consumer
  Patient Radiation Health and Safety Act for
  enforcing this law.
• Several states did pursue licensure,
• but many did not.

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Non Compliant States

• There are currently no regulations governing the
  education and/or competence of imaging/therapy
  personnel
• 17 jurisdictions - no regulations for RTs
• 23 jurisdictions - no regulations for RTTs
• 30 jurisdictions (incl. D.C. Puerto Rico) - no
  regulations for NMTs
• (2 jurisdictions with pending regulations for
  NMTs)

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NMT licensure Pending NMT licensure No NMT
licensure
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States Without Licensure for NMTs

• Alaska Alabama Colorado Connecticut
• Georgia Idaho Iowa Indiana
• Kansas Kentucky Michigan Missouri
• Minnesota Montana Nevada New Hampshire
• New York North Carolina North Dakota Oklahoma
• Oregon Pennsylvania Puerto Rico South
  Carolina
• South Dakota Tennessee Virginia West Virginia
• Wisconsin District of Columbia
• Arizona South Carolina licensure effective
  2004
• New York and Kansas have licensure bills pending

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How is this bill different?

• The CARE Act links
• Medicaid reimbursement with
• licensure. This will give
• the CARE Act
• the necessary teeth
• which will require compliance
• at the state level.

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Who will be affected by the CARE Act?

• Patients will be provided with the best possible
  care administered by licensed imaging
  professionals.
• Imaging Technologists will need to maintain the
  set standards.
• Institutions will be required to hire only
  licensed imaging personnel.
• Not including ultrasound and echocardiography

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Who will be licensed by the CARE Act?

• Nuclear Medicine Technologists
• Radiologic Technologists
• CT Technologists
• Vascular and Interventional Radiographers
• MR Technologists
• Radiation Therapists
• Dental workers
• Chiropractic imaging personnel
• NOT Ultrasound or Echocardiography Technologists

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Why are we doing this?

• Health care quality depends upon adequately
  trained professional caregivers. In many states,
  nuclear medicine technologists are not
• required to maintain certification or possess a
  license to administer/dispense radiopharmaceutical
  s and operate imaging equipment.

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The proposed minimum Federal standards will

• Ensure that quality information is presented for
  diagnosis leading to accurate diagnosis and
  treatment.
• Reduce health care costs by decreasing the number
  of repeated studies due to improper positioning
  or poor technique.
• Improve the safety of diagnostic
  imaging/treatment procedures.
• Reflect the professional standing of imaging
  technologists.

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Who supports this effort?

• The SNMTS and ASRT are founding members of the
  Alliance for Quality Medical Imaging and
  Radiation Therapy.

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What is the Alliance for Quality Medical Imaging
and Radiation Therapy?

• Presently, the Alliance is comprised of 17
  organizations representing diagnostic imaging and
  radiation therapy, dedicated to the provision of
  safe, high-quality radiologic care.
• This Alliance is progressively growing.

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The Alliance for Quality Medical Imaging and
Radiation Therapy

• The Alliance members agree that
• the personnel who perform medical imaging
  procedures as well as plan and deliver radiation
  therapy treatments should be required to
  demonstrate competency in their area of practice.
  

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Who does the Alliance represent?

• This Coalition represents over 250,000 allied
  health professionals in thirteen disciplines in
  the field of Diagnostic Imaging and Radiation
  Therapy.

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Who are some other members of the Alliance?

• Nuclear Medicine Technology Certification Board
• Joint Review Committee on Education in Nuclear
  Medicine Technology
• American Registry of Radiologic Technologists
• Joint Review Committee on Education in
  Radiologic Technology

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Additional Alliance members

• Association of Vascular and Interventional
  Radiographers
• American Association of Physicists in Medicine
• Section for Magnetic Resonance Technologists
  of ISMRM
• Society for Radiation Oncology Administrators
• Association of Educators in Radiologic Sciences

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Additional Organizations endorsing the CARE and
RadCARE Acts

• American College of Radiology
• American Cancer Society
• American Heart Associations Council on
  Cardiovascular Radiology
• American Organization of Nurse Executives
• Cancer Research and Prevention Foundation of
  America
• International Society of Radiographers and
  Radiologic Technologists

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Additional Organizations endorsing CARE and
RadCARE Acts

• National Coalition for Quality Diagnostic
• Imaging Services
• National Coalition for Cancer Survivorship
• Conference of Radiation Control Program Directors
• Help Disabled War Veterans
• Help Hospitalized Veterans
• Philips Medical Systems
• ...and the list is growing

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Who supports the bill in the House of
Representatives?

• Representative Heather Wilson, (R-NM) has now
  become the champion supporter of this bill. She
  re-introduced the CARE Act, Bill HR1214, on March
  11, 2003.
• As of September 9, 2003, there are 52 co-sponsors
  from 24 states.

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Is my Representative a co-sponsor?

• AL (Bachus) NC (Price, Watt)
• AR (Berry, Ross) ND (Pomeroy)
• AZ (Grijalva, Hayworth) NE (Osborne, Terry)
• CA (Eshoo) NJ (Pallone, Payne)
• CT (Larson) NY (Engel, Israel, King, McCarthy,
• IL (Gutierrez, Lipinski Walsh)
• Rush, Shimkus) OR (Blumenauer, Hooley)
  
• IN (Burton, Visclosky) PA (Doyle)
• MA (Frank, Markey) TN (Cooper, Davis, Duncan,
  Gordon,
• MD (Van Hollen, Wynn) Tanner, Wamp)
• MI (Conyers, Kildee, VA (Cantor)
• Knollenburg) WA (Dicks, Inslee, Nethercutt,
  George)
• MO (Clay, Emerson) WI (Baldwin)
• MN (Peterson, Sabo)
• MS (Pickering)

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Who supports the bill in the Senate?

• Senator Mike Enzi (WY) introduced the
• RadCARE Act to the Senate on June 3, 2003.
• As of September 2003, there are five co-sponsors
• Sen. Ted Kennedy (D-MA)
• Sen. Tom Daschle (D-SD)
• Sen. Frank Lautenberg (D-NJ)
• Sen. Byron Dorgan (D-ND)
• Sen. James Jeffords (I-VT)

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Sen. Enzis comments

• When it comes right down to it, its a big
  enough battle to fight the cancers or the
  injuries to our bodies that require such invasive
  treatments or diagnosis. We shouldnt have to
  worry about the level of competence of those who
  are providing us with the services we so
  desperately require for the maintenance of our
  health.

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CARE and RadCAREFREQUENTLY ASKED QUESTIONS

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Why are we doing this?

• Health care quality depends upon adequately
  trained professional caregivers.
• In many states
• Personnel using radiation, magnetic devices
  and/or radiopharmaceuticals for diagnostic and
  therapeutic procedures are not required to
• maintain certification
• possess a license
• or document training
• to plan, administer, dispense or treat patients

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What are those benefits?

• Job quality
• Professional standing
• Support for Continuing Education

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So, this is more about adequate care than about
radiation safety?

• Yes. Of course, radiation safety plays an
  important role within the responsibilities of an
  NMT.
• But, we all know that a person can be well
  trained in radiation safety and still not be able
  to perform adequately as a technologist.
• The CARE Act addresses all aspects of
  technologist education and training.

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My state already has licensure. Will it change?

• It depends upon your state laws. State licensure
  laws that do
• not meet the minimum
• standards of the CARE Act
• will need to be revised.

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When will the change take place?

• It will take 2-4 years after passage of the CARE
  Act for states to implement licensure.

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There is no licensure requirement in my state.
What will I have to do?

• NMTs will be required to graduate from an
  accredited institution.
• NMTs will be required to pass a certifying exam,
  such as the ARRT (N) or NMTCB.
• NMTs will be required to participate in
  continuing education.

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I was grandfathered in and never took an exam.
Will I have to take one now?

• This licensure is not intended to legislate
  people out of jobs. State bills will be drafted
  to include appropriate grandfather clauses.
• You will, however, be required to participate in
  continuing education.

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What will this cost me?

• It is possible that state licensing boards will
  require an annual fee. The benefits of
  professional licensure, however, outweigh the
  nominal costs.

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There is a tech shortage and I have solid job
security right now. Why do I need licensure?

• Assurance of quality patient care in every state.
• Assurance that you will not be replaced by
  someone who does not have the proper education
  and credentials to perform diagnostic or
  therapeutic procedures

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Where can I get additional and timely
information?

• www.snm.org
• UPTAKE newsletter
• JNMT
• www.asrt.org

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What can I do to help?

• Participate in letter-writing campaigns.
• Write to your representatives in both the
• Congress and Senate
• Talk to fellow technologists and administrators
  about the importance of licensure and dont
  forget to speak to your family friends about
  writing letters - they have a right to high
  quality patient care

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• Questions?
• Thank you!