The CARE

ActHR-1011

Prepared by the Society of Nuclear Medicine Technologist Section

Government Relations Subcommittee

What is the CARE Act?

The CARE Act is proposed legislation which will mandate 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.

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').”

What does CARE stand for?

Consumer

Assurance of

Radiologic

Excellence

The CARE Act

The CARE Act (HR-5274) is a bill which was introduced in the US House of Representatives by Representative

Rick Lazio (R-NY) & five bipartisan

co-sponsors September 25, 2000. Seventeen bipartisan members of The

House had agreed to support this effort.

Who else supports this effort?

The SNM-TS and ASRT are founding members of the

Alliance for Quality Medical Imaging and Radiation

Therapy.

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

Presently, the Alliance is comprised of twelve organizations representing diagnostic imaging and radiation

therapy, dedicated to the provision of safe, high-quality radiologic care.

This Alliance is progressively growing.

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.

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.

Who are the 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

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

Additional Organizations endorsing the CARE Act

American College of Radiology American Cancer Society American Organization of Nurse Executives Cancer Research Foundation of America International Society of Radiographers and

Radiologic Technologists

Additional Organizations endorsing the CARE Act

National Coalition for Quality Diagnostic Imaging Services National Coalition for Cancer Survivorship Conference of Radiation Control Program

Directors Help Disabled War Veterans Help Hospitalized War Veterans Philips Medical Systems

...and the list is growing

Who is the bill’s primary sponsor?

Since Rick Lazio stepped down from his seat in the House, the Alliance has sought a new primary sponsor.

Representative Heather Wilson, (R-NM) has now become the champion supporter of this bill. She re-introduced the CARE Act, Bill HR1011.

There are presently 28 co-sponsors 7/09/01

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.

Isn’t there already a similar law?

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

Isn’t 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.

Non Compliant States

There are currently no regulations governing the education or competence of imaging/therapy personnel

15 states - no regulations for RTs29 states - no regulations for NMTs22 states – no regulations for RRTsSource: Congressional record of Rick Lazio’s Statements

States Without Licensure

Alabama Arkansas Colorado Connecticut

Georgia Idaho Indiana Kansas

Kentucky Michigan Minnesota Missouri

Montana Nevada New York North Carolina

North Dakota Oklahoma Oregon South Carolina

South Dakota Tennessee Virginia Wisconsin

Washington DC Puerto Rico

States Without Continuing Education Requirements

Alabama Arkansas Colorado ConnecticutDelaware Georgia Idaho IndianaKansas Kentucky Michigan MinnesotaMissouri Montana Nevada New JerseyNew York North Carolina North Dakota OklahomaOregon Pennsylvania South Carolina South DakotaTennessee Virginia Wisconsin WashingtonWashington DC Puerto Rico

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.

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.

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 Technologists

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

radiopharmaceuticals and operate imaging equipment.

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 professional standing.

The CARE Act:

FREQUENTLY ASKED

QUESTIONS

“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.

“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.

“When will the change take place?”

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

“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.

“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.

“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.

“What are those benefits?”

• Job quality • Professional standing• Support for Continuing Education

“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

“Where can I get additional information?”

www.asrt.orgwww.snm.org

– UPTAKE newsletter

– JNMT

“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 don’t forget to speak to your family & friends about writing letters - they have a right to high quality patient care

References NUCLEAR Guide to Continuing Education -

Nuclear Medicine Technologist Understanding Certification Licensure Education and Resource

Congressional Record - September 25, 2000 Central Chapter Newsletter - Oct/Nov 2000 UPTAKE - Winter 2001 ASNC Newsletter - Spring 2001 snm.org asrt.org

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Slides for Exchange: General Audience

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

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

Yes. Of course, radiation safety plays an important role within the responsibilities for anyone who performs procedures involving radiation.

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.

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

Individuals planning for or administering to patients radiation will be required to:– graduate from an accredited institution– pass a certifying exam, such as the

ARRT (N) or NMTCB.– participate in continuing education