HOUSE BILL No. 5106

 

August 21, 2007, Introduced by Reps. Wojno, Accavitti, Gaffney, Valentine, Amos, Lemmons, Hammon, Polidori and Dean and referred to the Committee on Health Policy.

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

(MCL 333.1101 to 333.25211) by adding section 16351 and part

 

187A.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 16351. Fees for a person licensed or seeking licensure

 

 2  as a medical laboratory scientist, associate medical laboratory

 

 3  assistant, or medical laboratory assistant under part 187A are as

 

 4  follows:

 

 

     (a)    Application processing fee....................  $ 25.00

     (b)    License fee, per year:

     (i)    Medical laboratory assistant..................  $ 25.00

     (ii)    Associate medical laboratory scientist........  $ 75.00


     (iii)   Medical laboratory scientist..................  $ 75.00

     (c)    Temporary license.............................  $ 15.00

     (d)    Limited license, per year....................  $ 25.00

 

 

 4             PART 187A. LABORATORY TESTING PERSONNEL

 

 5        Sec. 18751. (1) As used in this part:

 

 6        (a) "Accredited educational program" means a program that

 

 7  provides instruction and experience in laboratory testing and

 

 8  that has been approved or accredited by an accrediting agency

 

 9  recognized by the council for higher education accreditation or

 

10  the United States department of education.

 

11        (b) "Associate medical laboratory scientist" means an

 

12  individual who is licensed under this article to engage in the

 

13  practice of laboratory testing at the associate medical

 

14  laboratory scientist level.

 

15        (c) "Client" means the individual upon whose body, body

 

16  fluid, or body part a laboratory test is performed.

 

17        (d) "Laboratory" means the site at which a laboratory test

 

18  is performed.

 

19        (e) "Laboratory director" means an individual who is

 

20  qualified under 42 CFR 493, subpart M, to manage and direct the

 

21  technical and scientific operation of a clinical laboratory,

 

22  including the supervision of laboratory personnel, procedures,

 

23  and reporting of findings. If the qualifications for a laboratory

 

24  director under 42 CFR 493, subpart M, are amended after the

 

25  effective date of the amendatory act that added this part, the

 

26  director of the department of community health, in cooperation

 

27  with the board, shall determine whether those changes are


 

 1  congruent with this part and should apply to this section and, if

 

 2  so, may adopt those changes by rule.

 

 3        (f) "Laboratory test" means a biological, microbiological,

 

 4  serological, chemical, immunohematological, hematological,

 

 5  radiometric, cytological, biophysical, immunological,

 

 6  histological, genetic, or other clinical or anatomic pathological

 

 7  examination or procedure that is performed on material derived

 

 8  from or existing in a human body that provides information for

 

 9  the diagnosis, prevention, monitoring, or treatment of a disease

 

10  or impairment or assessment of a medical condition or

 

11  predisposition. Laboratory test does not include a waived test,

 

12  in vivo diagnostic imaging, noninvasive vascular diagnostic

 

13  studies, or the collection, handling, and preparation of a body

 

14  fluid or microbiology culture specimen used for a laboratory

 

15  test, or a test the results of which are used solely for

 

16  evidentiary purposes in a civil or criminal proceeding.

 

17        (g) "Medical laboratory assistant" means an individual who

 

18  is licensed under this article to engage in the practice of

 

19  laboratory testing at the medical laboratory assistant level.

 

20        (h) "Medical laboratory scientist" means an individual who

 

21  is licensed under this article to engage in the practice of

 

22  laboratory testing at the medical laboratory scientist level.

 

23        (i) "Perfusionist" means an individual who operates

 

24  extracorporeal circulation equipment for a patient whose medical

 

25  condition requires the support or temporary replacement of the

 

26  patient's cardiopulmonary-circulatory function and who satisfies

 

27  1 of the following:


 

 1        (i) Has graduated from a perfusion training program approved

 

 2  by the department and accredited by the commission on

 

 3  accreditation of allied health education programs or its

 

 4  successor organization and has successfully completed the

 

 5  examination developed by the American board of cardiovascular

 

 6  perfusion or its successor and approved by the department.

 

 7        (ii) Has performed a minimum of 40 perfusion cases per year

 

 8  during the 2 years immediately preceding the effective date of

 

 9  this part.

 

10        (iii) Has graduated from a perfusion training program approved

 

11  by the department and accredited by the commission on

 

12  accreditation of allied health education programs or its

 

13  successor organization and, before successfully completing the

 

14  examination developed by the American board of cardiovascular

 

15  perfusion or its successor and approved by the department, is

 

16  supervised by a perfusionist who meets the requirements of either

 

17  subparagraph (i) or (ii).

 

18        (j) "Point-of-care testing" means a laboratory test

 

19  performed in a hospital or a freestanding surgical outpatient

 

20  facility licensed under article 17 that is performed on and near

 

21  the patient to reduce testing time or time to treatment, but does

 

22  not include a laboratory test performed in a laboratory described

 

23  in section 20507(a), (b), or (c).

 

24        (k) "Practice of laboratory testing at the medical

 

25  laboratory assistant level" means 1 or more of the following:

 

26        (i) Performing a laboratory test pursuant to established

 

27  protocols.


 

 1        (ii) Comparing patient data to reference ranges established

 

 2  or approved by the laboratory director or a medical laboratory

 

 3  scientist.

 

 4        (iii) Applying arithmetic or algebraic calculations according

 

 5  to protocols.

 

 6        (iv) Performing automated tests in a manner requiring

 

 7  complete reliance on laboratory instruments for calibrations,

 

 8  calculations, and analyses.

 

 9        (l) "Practice of laboratory testing at the associate medical

 

10  laboratory scientist level" means the practice of laboratory

 

11  testing at the medical laboratory assistant level and any of the

 

12  following:

 

13        (i) Performing a laboratory test pursuant to criteria

 

14  established or approved by the laboratory director or a medical

 

15  laboratory scientist.

 

16        (ii) Evaluating data pursuant to criteria established or

 

17  approved by the laboratory director or a medical laboratory

 

18  scientist.

 

19        (iii) Arithmetical, mathematical, or statistical manipulation

 

20  of numbers according to protocol.

 

21        (iv) Identifying a direct cause of improper test performance

 

22  and correcting that cause according to strategies established by

 

23  the laboratory director or a medical laboratory scientist.

 

24        (m) "Practice of laboratory testing at the medical

 

25  laboratory scientist level" means the practice of laboratory

 

26  testing at the medical laboratory assistant level, the practice

 

27  of laboratory testing at the associate medical laboratory


 

 1  scientist level, and any of the following:

 

 2        (i) Decision making that employs advanced knowledge of

 

 3  pathophysiology, cytopathology laboratory methods, or laboratory

 

 4  instrumentation, and that does not employ predetermined criteria.

 

 5        (ii) Establishing criteria for decision making in laboratory

 

 6  testing.

 

 7        (iii) Validating laboratory test data.

 

 8        (iv) Establishing procedures for reporting results.

 

 9        (v) Selecting appropriate calculation methods in the absence

 

10  of established guidelines.

 

11        (vi) Without preset strategies, identifying causes of

 

12  improper test performance and determining alternative means of

 

13  obtaining correct test performance or solutions to problems

 

14  created by incorrect test performance.

 

15        (n) "Protocol" means information prepared or approved by the

 

16  laboratory director or a medical laboratory scientist that

 

17  provides a step-by-step description of the manner in which a

 

18  laboratory test is to be performed.

 

19        (o) "Waived test" means a laboratory examination or

 

20  procedure that meets the criteria established under the

 

21  provisions of 42 CFR 493 and is approved by the board. If the

 

22  criteria and designation of waived tests under 42 CFR 493 are

 

23  amended after the effective date of the amendatory act that added

 

24  this part, the director of the department of community health, in

 

25  cooperation with the board, shall determine whether those changes

 

26  are congruent with this part and should apply to this section

 

27  and, if so, may adopt those changes by rule.


 

 1        (2) In addition to the definitions in this part, article 1

 

 2  contains general definitions and principles of construction

 

 3  applicable to all articles in this code and part 161 contains

 

 4  definitions applicable to this part.

 

 5        Sec. 18753. (1) Beginning 1 year after the effective date of

 

 6  this part, a person shall not engage in laboratory testing at the

 

 7  medical laboratory scientist, associate medical laboratory

 

 8  scientist, or medical laboratory assistant level or use the

 

 9  titles "medical laboratory scientist", "associate medical

 

10  laboratory scientist", "medical laboratory assistant", "M.L.S.",

 

11  "A.M.L.S.", and "M.L.A.", or similar words that indicate that the

 

12  individual is a laboratory scientist or assistant unless that

 

13  person is licensed or otherwise authorized by this article.

 

14        (2) A licensee shall not perform any acts, tasks, or

 

15  functions included within his or her respective level of practice

 

16  unless he or she is trained to perform such acts, tests, or

 

17  functions.

 

18        Sec. 18755. (1) The department may grant a limited license

 

19  to an individual to practice laboratory testing at the medical

 

20  laboratory scientist, associate medical laboratory scientist, or

 

21  medical laboratory assistant level. A limited license to practice

 

22  laboratory testing at any level under this part shall require

 

23  that the individual has successfully completed the educational

 

24  requirements required under section 18761 for that level. An

 

25  individual who holds a limited license under this section shall

 

26  provide a laboratory test service only under the supervision of

 

27  an individual licensed, at an equivalent level or higher, or an


 

 1  individual who is licensed as a physician under part 170 or 175.

 

 2        (2) A limited license to practice laboratory testing at the

 

 3  medical laboratory scientist or associate medical laboratory

 

 4  scientist level issued under this section is effective for not

 

 5  more than 4 years from the date of issuance. A limited license to

 

 6  practice laboratory testing at the medical laboratory assistant

 

 7  level issued under this section is effective for not more than 2

 

 8  years from the date of issuance.

 

 9        (3) In addition to the grounds for discipline and sanctions

 

10  prescribed under sections 16221 and 16226, the board shall review

 

11  the supervision of an individual licensed under this section at

 

12  least once annually and may recommend to the department the

 

13  revocation or suspension of a limited license if the board

 

14  determines that the individual to whom that limited license is

 

15  issued lacks adequate supervision.

 

16        Sec. 18757. This part does not apply to the following:

 

17        (a) An individual who is enrolled in an accredited

 

18  educational program, if the laboratory testing performed by that

 

19  individual is part of a course of study within the accredited

 

20  educational program.

 

21        (b) An individual engaged in teaching or research, if the

 

22  results of each laboratory test performed by that individual are

 

23  not used in diagnosis, prevention, monitoring, or treatment of a

 

24  disease or impairment or assessment of a medical condition or

 

25  predisposition.

 

26        (c) A licensed or statutorily recognized member of any other

 

27  profession who practices his or her profession as authorized by


 

 1  law, if that individual does not hold himself or herself out to

 

 2  the public as a medical laboratory scientist, associate medical

 

 3  laboratory scientist, or medical laboratory assistant licensed

 

 4  under this article.

 

 5        (d) An individual performing point-of-care testing if both

 

 6  of the following requirements are met:

 

 7        (i) The facility in which the point-of-care testing is

 

 8  performed is under the direction of a medical laboratory

 

 9  scientist who is responsible for all of the following:

 

10        (A) Designing and providing or supervising the training

 

11  programs for individuals who perform point-of-care testing in the

 

12  hospital or freestanding surgical outpatient facility.

 

13        (B) Supervising and monitoring the quality assurance and

 

14  quality control activities of the laboratory.

 

15        (C) Assisting in the selection of technology for the point-

 

16  of-care testing.

 

17        (D) Monitoring the continued competency of individuals

 

18  performing point-of-care testing.

 

19        (E) Reviewing the results of proficiency testing of

 

20  individuals performing point-of-care testing and recommending

 

21  corrective action, if necessary.

 

22        (ii) The facility in which the point-of-care testing is

 

23  performed has procedures that ensure and document the continued

 

24  competency of individuals who perform point-of-care testing and

 

25  that are approved by the board.

 

26        (e) A perfusionist performing laboratory testing for

 

27  extracorporeal functions including, but not limited to, those


 

 1  functions necessary for the support, treatment, measurement, or

 

 2  supplementation of the cardiopulmonary or circulatory system of a

 

 3  patient, as long as he or she is trained to perform that act,

 

 4  task, or function.

 

 5        (f) An individual who performs laboratory testing as

 

 6  described in subdivision (e) while engaged in the practice of

 

 7  perfusion as a student in a perfusion training program approved

 

 8  by the department and accredited by the commission on

 

 9  accreditation of allied health education programs or its

 

10  successor organization, if during the performance of laboratory

 

11  testing the individual is under the direct physical supervision

 

12  of a perfusionist who meets the requirements of section

 

13  18751(i)(i) or (ii).

 

14        (g) A respiratory care practitioner licensed under this

 

15  article who performs laboratory testing while engaged in the

 

16  practice of respiratory care.

 

17        (h) An individual who only performs waived tests.

 

18        Sec. 18759. (1) The Michigan board of laboratory testing is

 

19  created within the department. The board shall comply with part

 

20  161 and shall consist of the following 7 members:

 

21        (a) Five members who are licensed under this part.

 

22        (b) Two public members.

 

23        (2) The board members appointed under subsection (1)(a)

 

24  shall have among them anatomical and clinical pathological

 

25  testing experience and shall meet the requirements of section

 

26  16135(2).

 

27        (3) The terms of office of individual members of the board


 

 1  created under this part, except those appointed to fill

 

 2  vacancies, expire 4 years after appointment on December 31 of the

 

 3  year in which the term expires.

 

 4        (4) The board shall submit rules to implement this part for

 

 5  public hearing pursuant to the administrative procedures act of

 

 6  1969 within 180 days after the effective date of this part.

 

 7        Sec. 18761. (1) Except as otherwise provided under section

 

 8  18763, the department shall require an individual seeking

 

 9  licensure under this part to meet the respective requirements

 

10  before the department decides to issue a license under this part:

 

11        (a) To engage in the practice of laboratory testing at the

 

12  medical laboratory assistant level to an individual who the board

 

13  determines has sufficient knowledge essential to the safe and

 

14  competent practice of his or her profession and who has

 

15  successfully completed high school or its equivalent and either

 

16  of the following:

 

17        (i) An accredited educational program approved by the board

 

18  including, but not limited to, programs at the medical laboratory

 

19  assistant level or at an equivalent level that is approved by the

 

20  board.

 

21        (ii) One year of full-time laboratory experience within the

 

22  3-year period immediately preceding the date of application in a

 

23  laboratory activity approved by the board and under the

 

24  supervision of a medical laboratory scientist, an associate

 

25  medical laboratory scientist, a medical laboratory assistant, or

 

26  an individual who is licensed as a physician under part 170 or

 

27  175.


 

 1        (b) To engage in the practice of laboratory testing at the

 

 2  associate medical laboratory scientist level to an individual who

 

 3  the board determines has sufficient knowledge essential to the

 

 4  safe and competent practice of his or her profession and who has

 

 5  successfully completed or attained an associate's degree from an

 

 6  accredited college or university approved by the board, including

 

 7  course work approved by the board, and 1 or more of the

 

 8  following:

 

 9        (i) An accredited educational program approved by the board,

 

10  including, but not limited to, programs at the associate medical

 

11  laboratory scientist level.

 

12        (ii) Two years of full-time laboratory experience attained

 

13  within the 3 years immediately preceding the date of application

 

14  in a laboratory activity approved by the board and under the

 

15  supervision of a medical laboratory scientist, an associate

 

16  medical laboratory scientist, or an individual who is licensed as

 

17  a physician under part 170 or 175.

 

18        (c) To engage in the practice of laboratory testing at the

 

19  medical laboratory scientist level to an individual who the board

 

20  determines has sufficient knowledge essential to the safe and

 

21  competent practice of his or her profession and who has

 

22  successfully completed or attained a baccalaureate degree from an

 

23  accredited college or university approved by the board, including

 

24  course work approved by the board, and 1 or more of the

 

25  following:

 

26        (i) An accredited educational program approved by the board

 

27  including, but not limited to, programs at the medical laboratory


 

 1  scientist level.

 

 2        (ii) Two years of full-time laboratory experience attained

 

 3  within the 4-year period immediately preceding the date of

 

 4  application in a laboratory activity approved by the board and

 

 5  under the supervision of a medical laboratory scientist or an

 

 6  individual who is licensed as a physician under part 170 or 175.

 

 7        (2) The department may accept a person's certification by a

 

 8  national organization approved by the board as evidence that the

 

 9  person has sufficient knowledge essential to the safe and

 

10  competent practice of his or her profession. The board shall not

 

11  accept certification of a person as described in this subsection

 

12  unless the certifying national organization requires successful

 

13  passage of a competency based examination validated by that

 

14  organization.

 

15        Sec. 18763. (1) Notwithstanding section 18761, the

 

16  department shall issue a license at the appropriate level to a

 

17  person who applies for licensure at that level within 1 year

 

18  after the effective date of this part if that person satisfies

 

19  either of the following:

 

20        (a) Is trained in laboratory testing at the level for which

 

21  he or she is seeking licensure and is certified by a national

 

22  certifying agency approved by the board.

 

23        (b) Has engaged in the practice of laboratory testing in a

 

24  laboratory at the level for which he or she is seeking licensure

 

25  on a consistent basis during the 2 years immediately preceding

 

26  his or her application for licensure.

 

27        (2) The department shall require each individual who applies


 

 1  for renewal of a license granted under this section to meet

 

 2  applicable continuing education requirements of section 18765.

 

 3        Sec. 18765. (1) In addition to the requirements of part 161,

 

 4  the department shall require a medical laboratory scientist or

 

 5  associate medical laboratory scientist seeking renewal of a

 

 6  license to furnish evidence of either of the following:

 

 7        (a) The licensee's successful completion, during the 3 years

 

 8  immediately preceding application for renewal, of at least 30

 

 9  clock hours of continuing education courses, clinics, lectures,

 

10  training programs, seminars, or other programs related to

 

11  laboratory testing that are approved by the board.

 

12        (b) Proof of recertification by a national certification

 

13  agency approved by the board.

 

14        (2) The department shall require a medical laboratory

 

15  assistant seeking renewal of a license to furnish evidence of

 

16  either of the following:

 

17        (a) That person's successful completion, during the 3 years

 

18  immediately preceding application for renewal, of at least 10

 

19  clock hours of continuing education courses, clinics, lectures,

 

20  training programs, seminars, or other programs approved by the

 

21  board.

 

22        (b) Proof of recertification by a national certifying agency

 

23  approved by the board.

 

24        Sec. 18767. A license issued under this part is effective

 

25  for 3 years.

 

26        Sec. 18771. A communication between a licensee and a client

 

27  and a client's laboratory test results are confidential and shall


 

 1  not be disclosed to a third party by the licensee without the

 

 2  consent of the client or except as otherwise provided by law. For

 

 3  purposes of this section, "third party" does not include a health

 

 4  care professional licensed under this article who requested the

 

 5  laboratory test on behalf of the client, a health care carrier,

 

 6  or a third party payer.

 

 7        Sec. 18773. This part does not require new or additional

 

 8  third party reimbursement or mandated worker's compensation

 

 9  benefits for services rendered by an individual licensed under

 

10  this part.