What is CARE & Rad CARE ?

CARE ActH.R. 1214

RadCARE ActS. 1197

Presentation Prepared by the Society of Nuclear Medicine Technologist SectionGovernment Relations Subcommittee

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.

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 (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.

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.

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 (“Randolph Bill”). 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 and/or competence of

imaging/therapy personnel

17 jurisdictions - no regulations for RTs23 jurisdictions - no regulations for RTTs30 jurisdictions (incl. D.C. & Puerto Rico) -

no regulations for NMTs(2 jurisdictions with pending regulations for

NMTs)

NMT licensure

Pending NMT licensure

No NMT licensure

States Without Licensure for NMTs

Alaska Alabama Colorado ConnecticutGeorgia Idaho Iowa Indiana

Kansas* Kentucky Michigan MissouriMinnesota Montana Nevada New HampshireNew York* North Carolina North Dakota OklahomaOregon Pennsylvania Puerto Rico South

CarolinaSouth Dakota Tennessee Virginia West Virginia Wisconsin District of Columbia

**Arizona & South Carolina licensure effective 2004*New York and Kansas have licensure bills pending

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.

*Not including ultrasound and echocardiography

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

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 the professional standing of imaging technologists.

Who supports this effort?

The SNMTS 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 17 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 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

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 and RadCARE Acts

American College of Radiology American Cancer Society American Heart Association’s Council on

Cardiovascular Radiology American Organization of Nurse Executives Cancer Research and Prevention Foundation of America International Society of Radiographers and Radiologic

Technologists

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

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.

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)

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)

Sen. Enzi’s comments

“When it comes right down to it, it’s a big enough battle to fight the cancers or the injuries to our bodies that require such invasive treatments or diagnosis. We shouldn’t 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.”

CARE and RadCARE:FREQUENTLY ASKED

QUESTIONS

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

“What are those benefits?”

• Job quality • Professional standing• Support for Continuing Education

“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.

“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 and timely information?”

www.snm.orgUPTAKE newsletter

JNMT

www.asrt.org

“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

Questions?

Thank you!