February 16, 2006, Introduced by Reps. Mortimer, Gaffney and Vander Veen and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16131 and 16263 (MCL 333.16131 and 333.16263),
as amended by 2004 PA 97, and by adding section 16351 and part
187A.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 16131. The terms of office of individual members of the
boards and task forces, except those appointed to fill vacancies,
expire 4 years after appointment as follows:
Audiologists June 30
Nursing June 30
Nursing home administrator June 30
Optometry June 30
Pharmacy June 30
Podiatric medicine and surgery June 30
Dentistry June 30
Chiropractic December 31
Counseling June 30
Laboratory testing December 31
Marriage and family therapy June 30
Medicine December 31
Occupational therapists December 31
Osteopathic medicine and surgery December 31
Physical therapy December 31
Psychology December 31
Respiratory care December 31
Social work December 31
Veterinary medicine December 31
Sec. 16263. (1) Except as provided in subsection (2), the
following words, titles, or letters or a combination thereof, with
or without qualifying words or phrases, are restricted in use only
to those persons authorized under this article to use the terms and
in a way prescribed in this article:
(a) "Chiropractic", "doctor of chiropractic", "chiropractor",
"d.c.", and "chiropractic physician".
(b) "Dentist", "doctor of dental surgery", "oral and
maxillofacial surgeon", "orthodontist", "prosthodontist",
"periodontist", "endodontist", "oral pathologist", "pediatric
dentist", "dental hygienist", "registered dental hygienist",
"dental assistant", "registered dental assistant", "r.d.a.",
"d.d.s.", "d.m.d.", and "r.d.h.".
(c) "Doctor of medicine" and "m.d.".
(d) "Physician's assistant" and "p.a.".
(e) "Registered professional nurse", "registered nurse",
"r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",
"nurse anesthetist", "nurse practitioner", "trained attendant", and
"t.a.".
(f) "Doctor of optometry", "optometrist", and "o.d.".
(g) "Osteopath", "osteopathy", "osteopathic practitioner",
"doctor of osteopathy", "diplomate in osteopathy", and "d.o.".
(h) "Pharmacy", "pharmacist", "apothecary", "drugstore",
"druggist", "medicine store", "prescriptions", and "r.ph.".
(i) "Physical therapy", "physical therapist",
"physiotherapist", "registered physical therapist", "licensed
physical therapist", "physical therapy technician", "p.t.",
"r.p.t.", "l.p.t.", and "p.t.t.".
(j) "Chiropodist", "chiropody", "chiropodical", "podiatry",
"podiatrist", "podiatric", "doctor of podiatric medicine", "foot
specialist", "podiatric physician and surgeon", and "d.p.m.".
(k) "Consulting psychologist", "psychologist", "psychological
assistant", "psychological examiner", "licensed psychologist", and
"limited licensed psychologist".
(l) "Licensed professional counselor", "licensed counselor",
"professional counselor", and "l.p.c.".
(m) "Sanitarian", "registered sanitarian", and "r.s.".
(n) Until July 1, 2005, "social worker", "certified social
worker", "social work technician", "s.w.", "c.s.w.", and "s.w.t.".
Beginning July 1, 2005, "social worker", "licensed master's social
worker", "licensed bachelor's social worker", "registered social
service technician", "social service technician", "l.m.s.w.",
"l.b.s.w.", and "r.s.s.t.".
(o) "Veterinary", "veterinarian", "veterinary doctor",
"veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",
"d.v.m.", "animal technician", or "animal technologist".
(p) "Occupational therapist", "occupational therapist
registered", "certified occupational therapist", "o.t.", "o.t.r.",
"c.o.t.", "certified occupational therapy assistant", "occupational
therapy assistant", or "c.o.t.a.".
(q) "Marriage advisor" or "marriage consultant"; "family
counselor", "family advisor", "family therapist", or "family
consultant"; "family guidance counselor", "family guidance
advisor", or "family guidance consultant"; "marriage guidance
counselor", "marriage guidance advisor", or "marriage guidance
consultant"; "family relations counselor"; "marriage relations
counselor", "marriage relations advisor", or "marriage relations
consultant"; "marital counselor" or "marital therapist"; "limited
licensed marriage and family therapist" or "limited licensed
marriage counselor"; "licensed marriage and family therapist" or
"licensed marriage counselor"; and "l.m.f.t.".
(r) "Nursing home administrator".
(s) "Respiratory therapist", "respiratory care practitioner",
"licensed respiratory therapist", "licensed respiratory care
practitioner", "r.t.", "r.c.p.", "l.r.t.", and "l.r.c.p.".
(t) "Audiometrist", "audiologist", "hearing therapist",
"hearing aid audiologist", "educational audiologist", "industrial
audiologist", and "clinical audiologist".
(u) "Licensed clinical laboratory scientist/medical
technologist", "licensed clinical laboratory scientist", "licensed
medical technologist", "licensed clinical laboratory
technician/medical laboratory technician", "licensed clinical
laboratory technician", "licensed medical laboratory technician",
"licensed clinical laboratory assistant", "licensed medical
laboratory assistant", "C.L.S./M.T.", "C.L.T./M.L.T.", and
"C.L.A./M.L.A.".
(2) Notwithstanding section 16261, a person who was specially
trained at an institution of higher education in this state to
assist a physician in the field of orthopedics and upon completion
of training, received a 2-year associate of science degree as an
orthopedic physician's assistant before January 1, 1977, may use
the title "orthopedic physician's assistant" whether or not the
person is licensed under this article.
Sec. 16351. Fees for a person licensed or seeking licensure to
engage in the practice of laboratory testing at the clinical
laboratory assistant/medical laboratory assistant level, the
practice of laboratory testing at the clinical laboratory
technician/medical laboratory technician level, or the practice of
laboratory testing at the clinical laboratory scientist/medical
technologist level under part 187A are as follows:
(a) Application processing fee................. $ 25.00
(b) License fee, per year:
(i) Clinical laboratory assistant/medical laboratory
assistant........................................... $ 25.00
(ii) Clinical laboratory technician/medical laboratory
technician.......................................... $ 75.00
(iii) Clinical laboratory scientist/medical
technologist........................................ $ 75.00
(c) Temporary license.......................... $ 15.00
(d) Limited license, per year.................. $ 25.00
PART 187A. LABORATORY TESTING PERSONNEL
Sec. 18751. (1) As used in this part:
(a) "Accredited educational program" means a program that
provides instruction and experience in laboratory testing and that
has been approved or accredited by an accrediting agency recognized
by the council for higher education accreditation or the United
States department of education.
(b) "Client" means the individual upon whose body, body fluid,
or body part a laboratory test is performed.
(c) "Laboratory" means the site at which a laboratory test is
performed.
(d) "Laboratory director" means an individual who is qualified
under 42 CFR part 493, subpart M, to manage and direct the
technical and scientific operation of a clinical laboratory,
including the supervision of laboratory personnel, procedures, and
reporting of findings. If the qualifications for a laboratory
director under 42 CFR part 493, subpart M, are amended after the
effective date of the amendatory act that added this section, the
director of the department of community health, in cooperation with
the board, shall determine whether those changes shall apply to
this section and may adopt those changes by rule.
(e) "Clinical laboratory assistant/medical laboratory
assistant" means an individual who is licensed under this article
to engage in the practice of laboratory testing at the clinical
laboratory assistant/medical laboratory assistant level, subject to
section 18767(2).
(f) "Clinical laboratory technician/medical laboratory
technician" means an individual who is licensed under this article
to engage in the practice of laboratory testing at the clinical
laboratory technician/medical laboratory technician level, subject
to section 18767(2).
(g) "Clinical laboratory scientist/medical technologist" means
an individual who is licensed under this article to engage in the
practice of laboratory testing at the clinical laboratory
scientist/medical technologist level, subject to section 18767(2).
(h) "Laboratory test" means a biological, microbiological,
serological, chemical, immunohematological, hematological,
radiometric, cytological, biophysical, immunological, histological,
genetic, or other clinical or anatomic pathological examination or
procedure that is performed on material derived from or existing in
a human body that provides information for the diagnosis,
prevention, monitoring, or treatment of a disease or impairment or
assessment of a medical condition or predisposition. Laboratory
test does not include a waived test, in vivo diagnostic imaging,
noninvasive vascular diagnostic studies, or the collection,
handling, and preparation of a body fluid or microbiology culture
specimen used for a laboratory test, or a test the results of which
are used solely for evidentiary purposes in a civil or criminal
proceeding.
(i) "Perfusionist" means an individual who operates
extracorporeal circulation equipment for a patient whose medical
condition requires the support or temporary replacement of the
patient's cardiopulmonary-circulatory function.
(j) "Point-of-care testing" means a laboratory test performed
in a hospital or a freestanding outpatient surgical facility
licensed under article 17 that is performed on and near the patient
to reduce testing time or time to treatment, but does not include a
laboratory test performed in a laboratory described in section
20507(a), (b), or (c).
(k) "Practice of laboratory testing at the clinical laboratory
assistant/medical laboratory assistant level" means 1 or more of
the following:
(i) Performing a laboratory test pursuant to established
protocols.
(ii) Comparing patient data to reference ranges established or
approved by the laboratory director or a clinical laboratory
scientist/medical technologist.
(iii) Applying arithmetic or algebraic calculations according to
protocols.
(iv) Performing automated tests in a manner requiring complete
reliance on laboratory instruments for calibrations, calculations,
and analyses.
(l) "Practice of laboratory testing at the clinical laboratory
technician/medical laboratory technician level" means the practice
of laboratory testing at the clinical laboratory assistant/medical
laboratory assistant level and 1 or more of the following:
(i) Performing a laboratory test pursuant to criteria
established or approved by the laboratory director or a clinical
laboratory scientist/medical technologist.
(ii) Evaluating data pursuant to criteria established or
approved by the laboratory director or a clinical laboratory
scientist/medical technologist.
(iii) Arithmetical, mathematical, or statistical manipulation of
numbers according to protocol.
(iv) Identifying a direct cause of improper test performance
and correcting that cause according to strategies established by
the laboratory director or a clinical laboratory scientist/medical
technologist.
(m) "Practice of laboratory testing at the clinical laboratory
scientist/medical technologist level" means the practice of
laboratory testing at the clinical laboratory assistant/medical
laboratory assistant level, the practice of laboratory testing at
the clinical laboratory technician/medical laboratory technician
level, and 1 or more of the following:
(i) Decision making that employs advanced knowledge of
pathophysiology, cytopathology laboratory methods, or laboratory
instrumentation, and that does not employ predetermined criteria.
(ii) Establishing criteria for decision making in laboratory
testing.
(iii) Validating laboratory test data.
(iv) Establishing procedures for reporting results.
(v) Selecting appropriate calculation methods in the absence
of established guidelines.
(vi) Without preset strategies, identifying causes of improper
test performance and determining alternative means of obtaining
correct test performance or solutions to problems created by
incorrect test performance.
(n) "Protocol" means information prepared or approved by the
laboratory director or a clinical laboratory scientist/medical
technologist that provides a step-by-step description of the manner
in which a laboratory test is to be performed.
(o) "Waived test" means a laboratory examination or procedure
that meets the criteria established under the provisions of part
493 of title 42 of the code of federal regulations, 42 CFR part
493, and is approved by the board. If the criteria and designation
of waived tests under part 493 of title 42 of the code of federal
regulations, 42 CFR part 493, are amended after the effective date
of the amendatory act that added this section, the director of the
department of community health, in cooperation with the board,
shall determine whether those changes shall apply to this section
and may adopt those changes by rule.
(2) In addition to the definitions in this part, article 1
contains general definitions and principles of construction
applicable to all articles in this code and part 161 contains
definitions applicable to this part.
Sec. 18753. Beginning 1 year after the effective date of this
part, a person shall not engage in laboratory testing as described
in section 18751(1)(k), (l), or (m) or use the titles described in
section 16263(1)(u) unless that person is licensed or otherwise
authorized by this article.
Sec. 18755. (1) The department may grant a limited license to
an individual to practice laboratory testing at the clinical
laboratory scientist/medical technologist, clinical laboratory
technician/medical laboratory technician, or clinical laboratory
assistant/medical laboratory assistant level. A limited license to
practice laboratory testing at the clinical laboratory
scientist/medical technologist, clinical laboratory
technician/medical laboratory technician, or clinical laboratory
assistant/medical laboratory assistant level under this part shall
require that the individual has successfully completed the
educational requirements required under section 18761 for that
level. An individual who holds a limited license under this section
shall provide a laboratory test service only under the supervision
of an individual licensed, at an equivalent level or higher, or
otherwise authorized under this part to perform the laboratory
test.
(2) A limited license to practice laboratory testing at the
clinical laboratory scientist/medical technologist or clinical
laboratory technician/medical laboratory technician level issued
under this section is effective for not more than 4 years from the
date of issuance. A limited license to practice laboratory testing
at the clinical laboratory assistant/medical laboratory assistant
level issued under this section is effective for not more than 2
years from the date of issuance.
(3) In addition to the grounds for discipline and sanctions
prescribed under sections 16221 and 16226, the board shall review
the supervision of an individual licensed under this section at
least once annually and may recommend to the department the
revocation or suspension of a limited license if the board
determines that the individual to whom that limited license is
issued lacks adequate supervision.
Sec. 18757. This part does not apply to the following:
(a) An individual who is enrolled in an accredited educational
program, if the laboratory testing performed by that individual is
part of a course of study within the accredited educational
program.
(b) An individual engaged in teaching or research, if the
results of each laboratory test performed by that individual are
not used in diagnosis, prevention, monitoring, or treatment of a
disease or impairment or assessment of a medical condition or
predisposition.
(c) A licensed or statutorily recognized member of any other
profession who practices his or her profession as authorized by
law, if that individual does not hold himself or herself out to the
public as a clinical laboratory scientist/medical technologist,
clinical laboratory technician/medical laboratory technician, or
clinical laboratory assistant/medical laboratory assistant licensed
under this article.
(d) An individual performing point-of-care testing if both of
the following requirements are met:
(i) The facility in which the point-of-care testing is
performed is under the direction of a clinical laboratory
scientist/medical technologist who is responsible for all of the
following:
(A) Designing and providing or supervising the training
programs for individuals who perform point-of-care testing in the
hospital or freestanding outpatient surgical facility.
(B) Supervising and monitoring the quality assurance and
quality control activities of the laboratory.
(C) Assisting in the selection of technology for the point-of-
care testing.
(D) Monitoring the continued competency of individuals
performing point-of-care testing.
(E) Reviewing the results of proficiency testing of
individuals performing point-of-care testing and recommending
corrective action, if necessary.
(ii) The facility in which the point-of-care testing is
performed has procedures that ensure and document the continued
competency of individuals who perform point-of-care testing and
that are approved by the board.
(e) A perfusionist performing laboratory testing for
extracorporeal functions including, but not limited to, those
functions necessary for the support, treatment, measurement, or
supplementation of the cardiopulmonary or circulatory system of a
patient, if the perfusionist does not perform an act, task, or
function for which he or she is not trained and meets 1 of the
following:
(i) Has graduated from a perfusion training program approved by
the department and accredited by the commission on accreditation of
allied health education programs or its successor organization and
has successfully completed the examination developed by the
American board of cardiovascular perfusion or its successor and
approved by the department.
(ii) Has performed a minimum of 40 perfusion cases per year
during the 2 years immediately preceding the effective date of this
part.
(iii) Has graduated from a perfusion training program approved
by the department and accredited by the commission on accreditation
of allied health education programs or its successor organization
and, before successfully completing the examination developed by
the American board of cardiovascular perfusion or its successor and
approved by the department, is supervised by a perfusionist who
meets the requirements of either subparagraph (i) or (ii).
(f) An individual who performs laboratory testing as described
in subdivision (e) while engaged in the practice of perfusion as a
student in a perfusion training program approved by the department
and accredited by the commission on accreditation of allied health
education programs or its successor organization, if during the
performance of laboratory testing the individual is under the
direct physical supervision of a perfusionist who meets the
requirements of subdivision (e)(i) or (ii).
(g) A respiratory care practitioner licensed under this
article who performs laboratory testing while engaged in the
practice of respiratory care.
Sec. 18759. (1) The Michigan board of laboratory testing is
created within the department. The board shall comply with part 161
and shall consist of the following 7 members:
(a) Five members who are licensed under this part.
(b) Two public members.
(2) The board members appointed under subsection (1)(a) shall
have among them anatomical and clinical pathological testing
experience and shall meet the requirements of section 16135(2).
(3) The board shall submit rules to implement this part for
public hearing pursuant to the administrative procedures act of
1969 within 180 days after the effective date of this part.
Sec. 18761. (1) The department may issue a license under this
part as follows:
(a) To engage in the practice of laboratory testing at the
clinical laboratory assistant/medical laboratory assistant level to
an individual who the board determines has sufficient knowledge
essential to the safe and competent practice of his or her
profession and who has successfully completed high school or its
equivalent and either of the following:
(i) An accredited educational program approved by the board
including, but not limited to, programs at the clinical laboratory
assistant/medical laboratory assistant level or at an equivalent
level that is approved by the board.
(ii) One year of full-time laboratory experience within the 3-
year period immediately preceding the date of application in a
laboratory activity approved by the board and under the supervision
of a clinical laboratory scientist/medical technologist, a clinical
laboratory technician/medical laboratory technician, clinical
laboratory assistant/medical laboratory assistant, or an individual
described in section 18769.
(b) To engage in the practice of laboratory testing at the
clinical laboratory technician/medical laboratory technician level
to an individual who the board determines has sufficient knowledge
essential to the safe and competent practice of his or her
profession and who has successfully completed or attained an
associate's degree from an accredited college or university
approved by the board, including course work approved by the board,
and 1 or more of the following:
(i) An accredited educational program approved by the board,
including, but not limited to, programs at the clinical laboratory
technician/medical laboratory technician or histotechnician level.
(ii) Two years of full-time laboratory experience attained
within the 3 years immediately preceding the date of application in
a laboratory activity approved by the board and under the
supervision of a clinical laboratory scientist/medical
technologist, clinical laboratory scientist/medical laboratory
technologist, or an individual described in section 18769.
(c) To engage in the practice of laboratory testing at the
clinical laboratory scientist/medical technologist level to an
individual who the board determines has sufficient knowledge
essential to the safe and competent practice of his or her
profession and who has successfully completed or attained a
baccalaureate degree from an accredited college or university
approved by the board, including course work approved by the board,
and 1 or more of the following:
(i) An accredited educational program approved by the board
including, but not limited to, programs at the cytotechnologist,
clinical laboratory scientist/medical technologist,
histotechnologist, cytogenetic technologist, or diagnostic
molecular scientist level.
(ii) Two years of full-time laboratory experience attained
within the 4-year period immediately preceding the date of
application in a laboratory activity approved by the board and
under the supervision of a clinical laboratory scientist/medical
technologist or an individual described in section 18769.
(2) The department may accept a person's certification by a
national organization approved by the board as evidence that the
person has sufficient knowledge essential to the safe and competent
practice of his or her profession. The board shall not accept
certification of a person as described in this subsection unless
the certifying national organization requires successful passage of
a competency based examination validated by that organization.
Sec. 18763. (1) If a person applies for licensure at a level
described in section 18751(1)(k), (l), or (m) within 1 year after
the effective date of this part and that person is trained in
laboratory testing at that level and certified by a national
certifying agency approved by the board, or has engaged in the
practice of laboratory testing at that level in a laboratory for a
period of at least 1 year or not less than 1,500 clock hours in the
immediately preceding year, the department shall issue to that
person a license for that level.
(2) The department shall require each individual who applies
for renewal of a license granted under this section to meet
applicable continuing education requirements of section 18765.
Sec. 18765. (1) In addition to the requirements of part 161,
the department shall require a clinical laboratory
scientist/medical technologist or clinical laboratory
technician/medical laboratory technician seeking renewal of a
license to furnish evidence of either of the following:
(a) The licensee's successful completion, during the 3 years
immediately preceding application for renewal, of at least 30 clock
hours of continuing education courses, clinics, lectures, training
programs, seminars, or other programs related to laboratory testing
that are approved by the board.
(b) Proof of recertification by a national certification
agency approved by the board.
(2) The department shall require a clinical laboratory
assistant/medical laboratory assistant seeking renewal of a license
to furnish evidence of either of the following:
(a) That person's successful completion, during the 3 years
immediately preceding application for renewal, of at least 10 clock
hours of continuing education courses, clinics, lectures, training
programs, seminars, or other programs approved by the board.
(b) Proof of recertification by a national certifying agency
approved by the board.
Sec. 18767. (1) A license issued under this part is effective
for 3 years.
(2) A licensee shall not perform an act, task, or function
within the practice of laboratory testing for which he or she is
not trained.
Sec. 18769. The supervision described in section 18755 may be
provided by an allopathic or osteopathic physician licensed under
this article.
Sec. 18771. A communication between a licensee and a client
and a client's laboratory test results are confidential and shall
not be disclosed to a third party by the licensee without the
consent of the client or except as otherwise provided by law. For
purposes of this section, "third party" does not include a health
care professional licensed under this article who requested the
laboratory test on behalf of the client.