New Mexico Sonographer Licensure Law Signed
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to Read our Frequently Asked Questions about the New Mexico Licensure Law ***
On April 6, 2009, New Mexico Governor Bill Richardson signed the historic bill
that, for the first time in the United States, requires licensure of
sonographers.
The bill adds sonographers (and MRI technologists) to the list of medical
imaging professionals licensed by the State of New Mexico. Until now, anyone
could perform sonograms in New Mexico. Prior to the passage of the New Mexico
licensure law, virtually all other health care providers and professionals had
to be licensed. As a result, the public is often surprised to learn that the
person performing a medical sonogram does not have any state licensure or
national certification requirements.
The original New Mexico bill stemmed from concerns expressed about the lack of minimum requirements by a SDMS member, Darla Matthew (Las Cruces, NM) to her State Representative, Jeff Steinborn. Although the SDMS opposed the original bill as written, Rep. Steinborn did a tremendous job of helping to facilitate significant revisions in the New Mexico Senate to construct a better bill. Within a few days, more than 60 amendments had been incorporated into the bill resulting in the bill’s unanimous passage in the Senate. When the Senate debated the bill, two Senators mentioned the large number of calls they received from sonographers regarding the bill, a testament to the grass roots efforts.
In the past, SDMS has opposed specific efforts to create state-by-state licensure and has instead worked for federal requirements. In part, this strategy has been based on the enormous amount of work required to ensure passage of a licensure bill in each state. But ultimately, even federal requirements would not stop what is now commonly occurring...people with a weekend course (or less) in ultrasound and enough money to buy a machine, are setting up shop ‘taking baby pictures’ or providing ‘medical’ sonograms without the proper education or certification. In Oregon, a state also considering a sonographer licensure bill (HR 2245), the idea for sonographer licensure came because a sonographer whose credentials were revoked but continues to provide sonograms in Oregon.
SDMS remains concerned about a state-by-state approach resulting in significant differences in licensure between the states. The legislative process is imperfect and the best of intentions can have negative impact on sonographers. However, SDMS also recognizes that it must work toward addressing the concerns raised by the states about unlicensed health care providers. Some of the key elements of a sonographer licensure bill identified during the development of the New Mexico and Oregon sonographer bills include:
- Reasonable licensure fees
State recognition of national certification examinations and continuing education to reduce bureaucratic burden on sonographers
- Representation of sonographers on the regulatory board. The regulatory board should also include:
- Physicians that use a wide variety of imaging modalities not just radiologists
- Members of the general public (the ultimate consumers of the medical imaging)
- Representation of knowledgeable, experienced sonographers on any disciplinary panel considering action against a sonographer
- Reduction of barriers to sonographers who wish to move from state to state or work in more than one state
The responsibility for administering the NM sonographer licensure program would rest with the New Mexico Environment Department. Although this was not the first choice in most sonographers’ minds, the Environment Department currently manages the radiologic technology licensure program so the administrative infrastructure is already in place. By ensuring the creation of an advisory council that includes representation by each medical imaging and radiation therapy modality regulated, the bill helps ensure that the Department’s other areas of emphasis do not detract from sonographer licensure.
Several members have also asked why the New Mexico and Oregon licensure bills link sonography with ionizing radiation and radiologic technology, when in reality, sonography is often done outside of the radiology department. Many would advocate establishing a separate “sonographer” licensing board. However, today’s practical realities in state government where severely limited resources and tough economic times dictate policy decisions, a separate licensure board is simply not viable. Radiologic technology licensure programs are in place in most states and adding another imaging modality is much more feasible than creating a new licensure board and licensing system. Another downside is that each state’s radiologic technology licensure act is different and will require careful consideration of how sonography can be incorporated.
Because sonographers have never had to be licensed before, they frequently do not see or understand the distinction between state licensure and national certification. National certifications or credentials issued by voluntary organizations such as ARDMS, CCI, ARRT have little legal weight. The certification process and resulting credential are valuable tools in ensuring sonographers have met minimum education and knowledge requirements but do not really regulate anyone’s ability to perform sonography. In an ideal world, no additional regulation of sonography would be required. However, as everyone knows, more and more people are taking weekend courses and buying ultrasound equipment without understanding the ramifications of using ultrasound technology (e.g., ALARA).
The NM bill will help ensure that physicians receive quality sonograms, that their treatment decisions are based on the best available information, and that those paying for sonograms will not have to pay to have the study repeated because the first person who performed it did not how to perform the study properly.
Under the bill passed by the New Mexico legislature, national credentials/certifications should provide evidence of meeting the state’s standards. All sonographers who are performing these critical medical imaging services in New Mexico will be required to meet national certification standards. As a result, there would be no additional exams in New Mexico beyond the national certification exams. The bill also requires the state to recognize the continuing medical education completed for national certification renewal.
The most visible impact on New Mexico sonographers will be a license fee. However, the legislation caps the license fee at $100 per two-year license. In addition, only the New Mexico Legislature can change this cap. We expect that many employers will pay or provide reimbursement for the license fee (as they often do for other licensed health care professionals). The license fees go toward administering the licensure program including paying for investigations or disciplinary actions when necessary. With approximately 350 certified sonographers in New Mexico, it will barely cover the cost of the program...but the public safety benefits far outweigh the cost! When needed, the state agency can conduct investigations of those who fail to meet the standards or who cause harm to their patients. Ad hoc disciplinary committees will be created to review and consider disciplinary actions against sonographers. The legislation ensures that when needed these ad hoc disciplinary committees include sonographers (with similar knowledge and experience), a physician, and a neutral, public member.
Another benefit related to the New Mexico bill is that despite years of discussion about the creation of 1) ultrasound practitioner, 2) advanced practice sonographer or 3) clinical sonographer specialist, there has been little movement toward establishing an advanced level sonographer. However, the New Mexico bill includes a specific provision that requires adoption of rules and regulations related to creation of advanced levels. This is an important first step toward establishment of an advanced level sonographer.
What is next for New Mexico licensure? The process of developing administrative rules to implement the legislation will
now begin. New Mexico sonographers will certainly have an opportunity to review and comment on any administrative rules under consideration by the New Mexico Environment Department. The Medical Imaging and Radiation Therapy Advisory Council will need to be formed as well. Once the administrative rules have been implemented, sonographers in New Mexico will need to apply for licensure and pay the license fee (student sonographers will have to register but are not required to pay a license fee).
At this time, it is not known how long the implementation process will take.
SDMS will be working closely with state officials and sonographers as the
licensure bill is implemented and will provide updates to SDMS members as
information becomes available.
What is next for sonographer licensure? Sonographer licensure can be very complex. Add to this, the complexities of other imaging modalities and you have a formula for potential problems! A thorough understanding of the ramifications of the existing state statute and any proposed licensure language is critical to ensure that the intended effects are achieved without undue burden on sonographers. SDMS expects other states will consider adoption of sonography licensure in the next few years and will be working to ensure the adoption of appropriate legislation.
SDMS plans to host a webinar later this year to discuss why sonographer
licensure is needed and how it could affect you. If you hear of a sonographer licensure bill in your state, please contact the SDMS as soon as possible!
*** [Click Here]
to Read our Frequently Asked Questions about the New Mexico Licensure Law ***
SDMS would like to acknowledge and thank all the SDMS members who actively worked toward the passage of the NM licensure bill, but in particular, we would like to thank Darla Matthew, Rebecca Hall, and Kathleen Brogdon for their tireless efforts.
Thinking about licensure in your state? The FIRST step is to contact the SDMS to discuss strategies for licensure! Contact Don Kerns.
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