The Commonwealth of Massachusetts
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PETITION OF:
Richard T. Moore
Stephen R. Canessa
Michael J. Rodrigues
Lida E. Harkins
Robert M. Koczera
Joyce A. Spiliotis
Theodore C. Speliotis
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In the Year Two Thousand and Seven.
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An Act providing for the licensure and regulation of clinical laboratory science practioners and for related purposes . |
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION
1. Short Title.
Chapter 13 of the General Laws, as appearing in the 2002 Official Edition, is
hereby amended by inserting at the end thereof the following sections, which
shall be known and may be cited as the Clinical Laboratory Science Practice
Act.
SECTION
2. Declaration of Policy and Statement of Purpose.
It is hereby declared to be a policy of the Commonwealth that the practice of
clinical laboratory science by health care professionals affects the public
health, safety and welfare and is subject to control and regulation in the
public interest. It is further declared that clinical laboratories and clinical
laboratory science practitioners provide essential services to practitioners of
the healing arts by furnishing vital information which may be used in the
diagnosis, prevention and treatment of disease or impairment, and the
assessment of the health of humans. The purpose of this Act is to provide for
the better protection of public health by providing minimum qualifications for
clinical laboratory science practitioners, and by ensuring that clinical
laboratory tests are performed with the highest degree of professional
competency by those engaged in providing such services in the Commonwealth.
SECTION
3. Definitions.
The following words and terms when used in this Act shall have the following
meanings unless otherwise indicated within the context:—
(1) “Accredited clinical laboratory program” means a program planned to provide
a predetermined amount of instruction and experience in clinical laboratory
science that has been accredited by one of the accrediting agencies recognized
by the U.S. Department of Education.
(2) “Board” means the Board of Registration of Clinical Laboratory Science
Practitioners within the Division of Professional Licensure.
(3) “Clinical laboratory test” or “laboratory test” means a microbiological,
serological, chemical, hematological, radiobioassay, cytological, biophysical,
immunological or other pathological examination which is performed on material
derived from the human body, or any other test or procedure conducted by a
laboratory or facility which provides information for the diagnosis, prevention
or treatment of a disease or assessment of a human medical condition.
(4) “Clinical laboratory” or “laboratory” means any facility or office in which
clinical laboratory tests are performed.
(5) “Clinical laboratory science practitioner” or “one who engages in the
practice of clinical laboratory science” means a health care professional who
performs clinical laboratory tests or who is engaged in management, education,
consulting or research in clinical laboratory science, and includes laboratory
directors, supervisors, clinical laboratory scientists (technologists),
specialists, and technicians working in a laboratory, but does not include
persons employed by a clinical laboratory to perform supportive functions not
related to direct performance of laboratory tests and does not include clinical
laboratory trainees.
(6) “Clinical laboratory scientist” (technologist) means a person who performs
tests pursuant to established and approved protocols requiring the exercise of
independent judgment and responsibility, maintains equipment and records,
performs quality assurance activities related to test performance, and may
supervise and teach within a clinical laboratory setting.
(7) “Clinical laboratory technician” means a person who performs laboratory tests
pursuant to established and approved protocols which require limited exercise
of independent judgment and which are performed under the personal and direct
supervision of a clinical laboratory scientist (technologist), laboratory
supervisor, or laboratory director.
(8) “Division” means the Division of Professional Licensure.
(9) “Limited function test” means a test conducted using procedures which, as
determined by the board, have an insignificant risk of an erroneous result,
including those which:—
(a) have been approved by the United States Food and Drug Administration for
home use; or
(b) employ methodologies that are so simple and accurate as to render the
likelihood of erroneous results negligible; or
(c) the board has determined pose no reasonable risk of harm to the patient if
performed incorrectly.
SECTION
4. Exemptions.
This Act does not apply to:
(1) Any person licensed in the Commonwealth under any other Act from engaging
in the practice for which he is licensed.
(2) Clinical laboratory science practitioners employed by the United States
government or any bureau, division or agency thereof while in the discharge of
the employee’s official duties.
(3) Clinical laboratory science practitioners engaged in teaching or research,
provided that the results of any examination performed are not used in health
maintenance, diagnosis or treatment of disease.
(4) Students or trainees enrolled in a clinical laboratory science education
program provided that these activities constitute a part of a planned course in
the program, that the persons are designated by title such as intern, trainee,
or student, and the persons work directly under an individual licensed by this
state to practice clinical laboratory science.
(5) Individual performing only limited function tests.
(6) Persons incidentally in this state to provide service as part of an
emergency response team working in conjunction with disaster relief officials.
SECTION
5. License Required.
(1) No person shall practice clinical laboratory science or hold himself out as
a clinical laboratory science practitioner in this State unless he is licensed
under this Act.
(2) All persons engaged in the practice of clinical laboratory science on the
date of enactment of this Act (existing practitioners), are certified by or
eligible for certification by an Agency acceptable to the board, and who have
applied to the board on or before the effective date and have complied with all
necessary requirements for such application may continue to perform clinical
laboratory tests until (1) the expiration of 12 months after the filing of such
application, or (2) the denial of the application by the board, or (3) the
withdrawal of the application, whichever occurs first.
(3) Persons not meeting the education, training, and experience qualifications
for any license described in this Act may, prior to twenty-four (24) months after
the effective date of the board’s regulation, be considered to have met
qualifications providing they have three (3) years acceptable experience
immediately prior to the effective date of the board’s regulation and submit to
the board the job description of the position which the applicant has most
recently performed, attested to by his/her employer and notarized.
(4) Effective 24 months after the effective date of the board’s regulation, no
initial license shall be issued until an applicant meets all of the
requirements under this Act and successfully completes a nationally recognized
certification examination, or an appropriate categorical or specialty exam
recognized by the board.
SECTION
6. Administration.
There shall be a Board of Registration of Clinical Laboratory Science
Practitioners, herein called the board, within the Division of Professional
Licensure, which shall consist of seven (7) members, appointed by the governor,
who have been residents of the Commonwealth for at least two years prior to
their appointments and who are actively engaged in their areas of practice.
Appointments to the board will be made after consulting lists submitted by
organizations of clinical laboratory science practitioners and organizations of
physician pathologists.
The board shall be composed of:—
(1) One physician certified by the American Board of Pathology or
American Board of Osteopathic Pathology;
(2) Four clinical laboratory science practitioners, at least one of whom is a
non-physician laboratory director, one of whom is a clinical
laboratory scientist (technologist), and one of whom is a clinical laboratory
technician, and who, except for the initial appointments, hold active and valid
licenses as clinical laboratory science practitioners in this state; and
(3) Two public members who are not associated with or financially interested in
the practice of clinical laboratory science.
Board members shall serve for a term of three years and until their successors
are appointed and qualified, except that the initial appointments, which shall
be made within 90 days after the effective date of this Act, shall be as
follows:—
(1) A pathologist, a non-physician laboratory director, and a clinical laboratory
scientist shall be appointed to serve for three years;
(2) A public representative shall be appointed to serve for two years; and
(3) The remaining members shall be appointed to serve for one year.
Whenever a vacancy shall occur on the board by reason other than the expiration
of a term of office, a successor of like qualifications shall be appointed for
the remainder of the unexpired term. No person shall be appointed to serve more
than two successive 3-year terms.
The members of the board shall be public employees for the purposes of chapter
258 for all acts or omissions within the scope of their duties as board
members.
SECTION
7. Duties and Powers of the board.
In addition to powers conferred elsewhere in this Act, board shall:—
(1) prescribe, publish, adopt and amend rules and regulations for the
implementation of this Act including but not limited to regulations that
delineate qualifications for licensure of clinical laboratory science
practitioners; specify requirements for the renewal of licensure; establish
standards of professional conduct; and have power to amend or repeal the same.
Following their adoption, the rules and regulations shall govern and control
the professional conduct of every person who holds a license to perform
clinical laboratory tests or otherwise engages in the profession of clinical
laboratory science;
(2) authorize or administer standard written oral or practical examinations for
purposes of licensure of clinical laboratory science practitioners as provided
for in Section 5 of this Act;
(3) promulgate rules and regulations governing qualifications for licensure of
specialists in such clinical laboratory science specialties as the board may
determine in accordance with Section 8(3) herein;
(4) promulgate rules and regulations governing personnel performing tests in
limited function laboratories;
(5) establish criteria for the continuing education of clinical laboratory
science practitioners as required for license renewal.
SECTION
8. Standards for Licensure.
(1) Clinical Laboratory Scientist (Technologist).
The board shall issue a clinical laboratory scientist’s license to an
individual who meets such qualifications as promulgated by the board, including
at least one of the following qualifications:—
(a) A baccalaureate degree in clinical laboratory science (medical technology)
from an accredited college or university whose curriculum included appropriate
clinical education;
(b) A baccalaureate degree in biological, chemical or physical science from an
accredited college or university, and subsequent to graduation has at least 12
months of appropriate clinical education in an accredited clinical laboratory
science program;
(c) A baccalaureate degree which includes a minimum of thirty-six (36) semester
(or equivalent) hours in the biological, chemical and physical sciences from an
accredited college or university plus two years of full-time work experience
including a minimum of four months in each of the four major disciplines of
laboratory practice (clinical chemistry, clinical microbiology, hematology,
immunology/immunohematology); or
(d) A baccalaureate degree consisting of 90 semester (or equivalent) hours,
thirty-six of which must be in the biological, chemical or physical sciences,
from an accredited university, and appropriate clinical education in an
accredited clinical laboratory science program.
(e) A clinical laboratory scientist (technologist) who previously qualified
under federal regulatory requirements such as 493.1433 of the March 14, 1990
Federal Register or other regulations or criteria which may be established by
the board.
(f) A doctoral degree in a chemical, physical, biological or clinical
laboratory science from an accredited institution and is certified by the
American Board of Microbiology, the American Board of Clinical Chemistry, the
American Board of Bioanalysis, the American Board of Medical Laboratory
Immunology, the American Board of Medical Genetics, or other agencies deemed
comparable by the board and has at least one year of pertinent full time
laboratory training or experience.
(2) Clinical Laboratory Technician.
The board shall issue a clinical laboratory technician’s license
to an individual who meets such qualifications as promulgated by the board,
including at least one of the following qualifications:—
(a) An associate degree or completion of sixty (60) semester (or equivalent)
hours from a clinical laboratory technician program (CLT or equivalent) accredited by an agency
recognized by the U.S. Department of Education that included a structured
curriculum in clinical laboratory techniques;
(b) A high school diploma (or equivalent) and (a) completion of 12 months in a
technician training program in an accredited school approved by the board; or (b)
successful completion of an official military medical laboratory procedure
course of at least 50 weeks duration and has held the military enlisted
occupational specialty of medical laboratory specialist (laboratory technician); or
(c) A clinical laboratory technician who previously qualified under federal regulatory
requirements such as 493.1441 of the March 14, 1990 Federal Register which meet
or exceed the requirements for licensure set forth by the Board.
(3) Clinical Histotechnologist.
The board shall issue a Clinical Histotechnologist license to an individual who
meets such qualifications as promulgated by the board, including at least one
(1) of the following:—
(a) a baccalaureate degree which includes a combination of 30 semester hours of
biological and chemical science coursework and successful completion of an
accredited program in histotechnology.
(b) a baccalaureate degree which includes a combination of 30 semester hours of
biological and chemical science coursework and completion of one full year
post-baccalaureate experience in an histopathology laboratory under the
supervision of a histotechnologist or certified histotechnology supervisor with
at least three (3) years experience.
(4) Clinical Histologic Technician.
The board shall issue a Clinical Histologic Technician license to
an individual who meets such qualifications as promulgated by the board, including
at least one (1) of the following:—
(a) an associate degree or at least sixty (60) semester hours (or equivalent)
from an accredited college/university to include a combination of mathematics
and at least twelve (12) semester hours of biology and chemistry, and
successfully completes an accredited program in histologic technique or one
full year of training in histologic technique under the supervision of a
certified hytotechnologist or an appropriately certified histopathology
supervisor with at least three (3) years experience.
(b) high school graduation (or equivalent) and completion of an accredited
program or two years full time acceptable experience at a licensed clinical
laboratory in histologic technique.
(5) Cytotechnologist.
The board shall issue a Cytotechnologist license to an individual who meets
such qualifications as promulgated by the board including at least one (1) of
the following:—
(a) a baccalaureate degree from an accredited college or university with twenty
(20) semester hours (30 quarter hours) of biological science, eight (8)
semester hours (12 quarter hours) or chemistry and three (3) semester hours (4
quarter hours) of mathematics and successful completion of a twelve (12) month
cytotechnology program.
(b) a baccalaureate degree from an accredited college or university with twenty
(20) semester hours (30 quarter hours) of biological science, eight (8)
semester hours (12 quarter hours) of chemistry and three (3) semester hours (4
quarter hours) of mathematics and five (5) years full time acceptable clinical
laboratory experience including cytopreparatory techniques, microscopic
analysis and evaluation of the body systems within the last ten (10) years. At
least two of these years must be subsequent to the completion of the academic component
and at least two (2) years must be under the supervision of a licensed physician who is a
pathologist, certified, or eligible for certification, by the American Board of
Pathology in Anatomic Pathology or has other suitable qualification acceptable
to the board.
(c) a cytotechnologist who previously qualified under federal regulatory
requirements such as 493.1437 of the March 14, 1990
Federal Register.
(6) The board shall issue a Clinical Laboratory Science/Cytogenetic license to
an individual who meets such qualifications as promulgated by the board
including at least one (1) of the following:—
(a) a baccalaureate degree from an accredited college or university majoring in
either biology, chemistry or clinical laboratory science and two years experience
in clinical cytogenetics in the performance of diagnostic tests; or
(b) successful completion of a nationally recognized certification examination
such as the National Certification Agency (NCA), Department of Health and Human
Service (DHHS), American Board of Medical Genetics (ABMG), or others as may be
recognized by the board.
(7) The board may establish standards for such other clinical laboratory
science practitioners specializing in areas such as biophysics, chemistry,
cytology, hematology, histologic technique, immunohematology, microbiology,
serology, nuclear medical technology, or similar recognized academic and
scientific disciplines.
SECTION
9. Waiver of Requirements.
The board shall promulgate regulations providing procedures for waiver of the
requirements under Section 8 for all applicants who hold a valid license or its
equivalent issued by another jurisdiction; provided that the requirements under
which that license or its equivalent was issued to or exceed the standards
required by this Act.
SECTION
10. Licensure Application Procedures.
(1) Licensure applicants shall submit their application for licensure to the
board in the manner prescribed by the board, and shall pay the designated
application fee as determined by the secretary of administration and finance.
(2) Upon approval of an application and payment of a license fee, as determined
by the secretary of administration and finance, the board shall issue a license
for a Clinical Laboratory Scientist (technologist), a Clinical Laboratory
Technician, Histologic Technologist, Histologic Technician,
Cytotechnologist or an appropriate specialty license to any person who meets
the qualifications specified in this Act and the regulations promulgated
hereunder.
(3) The board may establish by regulation a procedure for issuance of
provisional licenses to individuals who otherwise qualify under this Act but
are awaiting the results of certification examinations. A provisional license
so issued shall be converted to a license under the provision of Section 10 or
expire not more than twelve (12) months after issuance. At the discretion of
the board, the provisional license may be reissued at least one time.
(4) The board, subject to a vote of the majority of its members, is authorized
to deny a license on the following grounds:
(a) conviction by a court of competent jurisdiction of a crime which the board
determines to be of such a nature as to render such person unfit to practice as
a laboratory scientist.
(b) violation of ethical standards of such a nature as to render such
individual unfit to practice as laboratory scientist.
(c) fraud or misrepresentation in obtaining a license; or
(d) other just and sufficient cause which renders a person unfit to practice as
a laboratory scientist.
(5) All fees collected pursuant to this section shall be deposited in the
division of professional licensure trust fund established under chapter 10,
section 35V.
SECTION
11. Licensure Renewal.
(1) Licenses issued under this Act shall expire every two years on the birthday
of the licensee, with the exception that the term of initial licenses shall
vary so as to fall on a subsequent birthday.
(2) Every person licensed under this Act shall be issued a renewal license
upon:
(a) Submission of an application for renewal in the manner prescribed by the
board and payment of an appropriate fee determined by the secretary of
administration and finance; and
(b) Proof of completion, in the period since the license was first issued or
last renewed, of at least twenty hours of continuing education courses,
clinics, lectures, training programs, seminars, or other programs related to
clinical laboratory practice which are approved or accepted by the board; or
proof of recertification by a board-approved, national certification organization
that mandates an annual minimum of twenty hours of continuing education.
(3) The board may require other such evidence of competency as it shall deem
reasonably appropriate as a prerequisite to the renewal of any license provided
for in this Act, so long as such requirements are uniform as to application,
are reasonably related to the measurement of qualification, performance, or
competence, and are desirable and necessary for the protection of the public
health.
(4) All fees collected pursuant to this section shall be deposited in the
division of professional licensure trust fund established under chapter 10,
section 35V.
SECTION
12. Effective Date.
This Act shall take effect on January 1, 2005.
SECTION
13. Disciplinary Requirements.
Complaints alleging any violation of this chapter or board regulation may be
initiated by any person or by the board. The board shall investigate all
complaints relating to the proper practice of laboratory science and alleging
any violation of this chapter or any rule or regulation of said board.
The board may discipline the licensee if such a licensee has:
(1) engaged in conduct which places into question the holder’s competence to
practice the profession including, but not limited to, gross misconduct or
misconduct in the practice of the profession;
(2) committed fraud or misrepresentation in obtaining a license;
(3) practiced the profession while the ability to practice impaired by alcohol,
drugs, physical disability or mental instability;
(4) violated any law, rule or regulation of the board;
(5) been convicted of a criminal offense which reasonably calls into question
the holder’s ability to practice the profession;
(6) engaged in dishonesty, fraud or deceit which is reasonably related to the
practice of the profession;
(7) knowingly permitted, aided, or abetted an unlicensed person to perform
activities requiring a license, registration, or authority;
(8) had a license, certificate, registration, or authority issued by another
state or territory of the United States, the District of Columbia, or foreign
state or nation with authority to issue such a license, certificate,
registration, or authority revoked, canceled, or suspended, not renewed or
otherwise acted against, or the license has been disciplined, if the basis for
the action would constitute a basis for disciplinary action in the
commonwealth;
(9) violated any ethical standard which the board determines to be of such a
nature as to render such person unfit to practice as a laboratory scientist,
such as:
(i) inappropriate conduct or touching in the practice of laboratory science;
(ii) negligence in the course of professional practice.
The board may, by a majority vote, after a hearing held subject to chapter 30A,
impose sanctions on an individual practicing laboratory science. The board may
undertake the following actions:
(1) suspend, revoke, cancel or place on probation such license, certificate,
registration or authority;
(2) reprimand or censure a licensee;
(3) assess upon such licensee an administrative penalty not to exceed $1,000
for the first violation and an administrative penalty not to exceed $2,500 for
a second and any subsequent violation;
(4) require such licensee to complete additional education and training as a
condition of retention or future consideration or reinstatement of said
license;
(5) require such licensee to practice under appropriate supervision for a
period of time as determined by the board as a condition of retention or future
consideration of reinstatement of such license;
(6) require such licensee to participate in medical treatment, mental health
treatment, a substance abuse program, or a combination thereof, as a condition
of retention or future consideration of reinstatement of said license, and
(7) require restitution where appropriate.
The board may, by emergency action summarily suspend or refuse to renew the
license of any licensee, whose continued practice poses an immediate threat to
the public health, safety or welfare, pending a hearing on the merits of the
allegation against the licensee, provided that the board shall hold a hearing
pursuant to chapter 30A on the necessity for the emergency action within 10
days of the action. The board shall issue to the licensee a written summary
suspension or refusal to renew which specifies the findings of the board and
the reasons for its action and which includes notice of the date, time and
place of the aforementioned 10-day hearing. At the request of the licensee, the
board may reschedule this hearing to a date and time mutually agreeable to the
board and licensee. Any such rescheduling of the hearing granted at the
licensee’s request shall not operate to lift or stay the summary suspension
order. If such hearing is not held within 10 days of the board’s emergency
action or at such time as mutually agreed by the board and licensee, the
license, against whom summary action was taken shall be deemed reinstated. At
the hearing on the necessity for summary suspension or refusal to renew, the
board shall receive evidence limited to determining whether the summary
suspension order shall continue in effect pending the final disposition of the
complaint. Following such hearing, any continuing suspension imposed by a board
shall remain in effect until the conclusion of any formal proceeding on the merits
of the allegations against the holder, including judicial review thereof or
withdrawn by such board. The board shall develop rules and regulations
governing the emergency summary suspension procedure authorized by this
section.
Nothing in this section shall be deemed a limitation on the board’s authority
to impose such sanctions by consent agreement as are deemed reasonable and
appropriate by the board. Any person aggrieved by any disciplinary action taken
by the board may, pursuant to section 14 of chapter 30A, file a petition for
judicial review of such disciplinary action with the superior court. The
superior court shall have exclusive jurisdiction over all such petitions, and
any such petition shall be limited to a review of the administrative record
before the board. All administrative penalties assessed pursuant to this
section shall be deposited in the General Fund.
SECTION
14. Unlicensed Practice.
The board may assess and collect an administrative penalty not to exceed $1,000
for the first violation and an administrative penalty not to exceed $2,500 for
a second and any subsequent violation, per occurrence, upon any person who
practices laboratory science at a time when his or her license to practice is
not valid because it has been suspended, revoked or canceled under authority of
this chapter, and upon any person who knowingly practices laboratory science at
a time when his or her license authorizing him or her to do so has expired. The
board may make application to the appropriate court for an order enjoining
unlicensed practice and obtaining a restraining order or other order as may be
appropriate. All administrative penalties assessed pursuant to this section
shall be deposited in the General Fund.
Except as otherwise permitted by law, the board, after a hearing held pursuant
to chapter 30A, may assess and collect an administrative penalty not to exceed
$1,000 for the first violation and an administrative penalty not to exceed
$2,500 for a second and any subsequent violation, per occurrence, upon any
person who, without holding the required license engages in the practice of
laboratory science. The provisions of this section shall not affect, but shall
be in addition to, any other penalty or remedy provided by law. The board may
make application to the appropriate court for an order enjoining unlicensed
practice, or ordering payment of any assessed administrative penalty, or both.
All administrative penalties assessed pursuant to this section shall be
deposited in the General Fund.
SECTION 15. Roster of Licenses. The board shall maintain a roster of the names and addresses of persons licensed and registered under the provision of this Act, and of all persons whose licenses have been suspended or revoked.
SECTION 16. Severability. The provisions of this Act are severable. If any part of this shall be declared invalid or unconstitutional, such declaration shall not affect the parts which remain.