Part 1.
TEXAS DEPARTMENT OF HEALTH
Chapter 34.
WAIVER PROGRAM FOR MEDICALLY DEPENDENT CHILDREN
25 TAC §34.3
On behalf of the State Medicaid director, the Texas Department
of Health (department) adopts an amendment to §34.3, concerning the deinstitutionalization
of children from nursing facilities into the Medically Dependent Children
Program (MDCP) with changes to the proposed text as published in the July
13, 2001 issue of the
Texas Register
(26 TexReg
5197). The purpose of the amendment will redefine the population who may access
existing MDCP services.
This section is amended in order to will allow the department to move eligible
children from institutions to home and community settings, if the parents
choose this option. The amendment to §34.3 refers to an agreement between
the Texas Department of Human Services and the department to support the placement
of current or prior resident children from Texas nursing facilities into permanent
placement in their homes or community settings. The children targeted under
this provision will have been in placement for continuous institutional long-term
care purposes. The provision excludes institutional placements that are for
respite purposes or the treatment of an acute condition.
The amendment to §34.3(c) resulted from the recognition that current
MDCP deinstitutionalization rules are constraining, due to the four-month
residency requirements. The amendments remove the four-month residency requirement.
No comments were received in regards to this proposal.
The department is making the following minor change due to staff comments
to clarify the intent and improve the accuracy of the section.
Change: A punctuation change was made to proposed §34.3(c)(3)(B)
The amendment is adopted under the Social Security Act, §1915(c)
relating to Medicaid Waiver programs for home or community based services;
Chapter 15, §1.07, Acts of the 72nd Legislature, First Called Session
(1991), as amended by Chapter 747, Actions of the 73rd Legislature (1993)
which authorizes the Texas Board of Health (board) to adopt rules necessary
to administer the MDCP; and the Health and Safety Code, §12.001, which
provides the board with authority to adopt rules to implement every duty imposed
by law on the board, the department, and the commissioner of health.
§34.3.Participant Eligibility Criteria.
(a)
Applicant eligibility. To be an applicant of the Medically
Dependent Children Program (MDCP), an individual must reside in Texas.
(b)
Participant eligibility. To be a participant of the MDCP,
an individual must:
(1)
live in Texas;
(2)
be under 21;
(3)
be Medicaid eligible;
(4)
participate in no other §1915(c) Medicaid waiver program;
(5)
meet the medical necessity criteria for nursing facility
care. Each applicant's/participant's medical necessity criteria must be assessed
on the client assessment review and evaluation form. Reevaluations are performed
at a minimum every 12 months using the same process;
(6)
have a physician's signed approval attesting that the authorized
and other specified services are necessary to avoid institutional placement
and are appropriate to meet the participant's needs in the home. The physician-approved
individual plan of care (IPC) must specify health-related care needs and must
document waiver services, non-waiver Medicaid services, and any other home
and community-based services, as well as services and supports provided by
the primary caregiver(s);
(7)
have an IPC which documents the Texas Department of Health's
(department's) plan to authorize and the participant's plan to utilize waiver
services without an interruption in service delivery of more than 60 days;
(8)
have an approved IPC for which the projected annual cost
for waiver services does not exceed the established annual waiver service
cost allowance. The allocation for direct care waiver services (respite services
and adjunct supports) for participants who are age 20 will be prorated for
the participant's remaining eligibility period. The department may grant exceptions
to the cost allowance for respite services or adjunct supports on a temporary
basis when extenuating circumstances preclude the development or implementation
of an IPC within the cost allowance. In such cases, approval will depend upon
the department's review of the circumstances of the request; upon the availability
of other resources, including family, volunteer, or community resources; and
upon the waiver program's financial status. The department may deny requests
for exceptions to the annual cost allowance if vacancies in the waiver are
frozen, if the program anticipates a budgetary shortfall, if the primary caregiver
does not participate in identifying and pursuing other possible resources
which must be used prior to waiver services, or if the request does not demonstrate
that extenuating circumstances exist. A reduction in the annual cost allowance
does not in itself constitute an extenuating circumstance. Following a review
of the circumstances, the department will determine which category of exceptional
funding is appropriate, as described in subparagraphs (A) and (B) of this
paragraph. The specific amount approved within a given category will be based
on a budget developed to address the extenuating circumstances. Once approved,
continuation of funding for each approved exception to the cost allowance
is subject to periodic review and renewal.
(A)
Category A. The department may grant an exception to a
participant's annual cost allowance not to exceed 10% of the participant's
annual cost allowance if the existing extenuating circumstances will likely
be resolved within six months.
(B)
Category B. The department may grant an exception to the
participant's annual cost allowance under one or more of the special circumstances
described in clauses (i)-(iv) of this subparagraph. The total amount allowable
for exceptions under Category B may not exceed $5,000. Special circumstances
include:
(i)
the caregiving ability of the participant's sole primary
caregiver is expected to be affected significantly for more than six months
due to a disability or illness of the caregiver;
(ii)
the caregiving ability of the participant's primary caregiver
is expected to be affected significantly for more than six months due to a
disability or illness of one of the participant's siblings, parents, grandparents,
or other member of the participant's household; or due to the recent loss
of another primary caregiver;
(iii)
the participant's primary caregiver needs additional
services to support provider training during a transition from one type of
provider to another. An exception under this circumstance may not exceed $1,000;
and
(iv)
the participant has a severe immunological disorder or
a similar medical condition which would make child care in a group setting
a life-threatening situation; and
(9)
meet the following requirements:
(A)
the applicant or participant must be eligible for supplemental
security income (SSI) benefits in the community; or
(B)
the applicant or participant must meet SSI disability criteria
and must:
(i)
meet the institutional income and resource criteria established
for the Texas Medicaid Program; or
(ii)
be an individual under 19 years of age for whom the Texas
Department of Protective and Regulatory Services (PRS) assumes financial responsibility,
in whole or in part (not to exceed Level II foster care payment), and who
is being cared for in:
(I)
a family foster home which is licensed or certified and
supervised by PRS; or
(II)
a family foster home which is licensed or certified and
supervised by a licensed public or private nonprofit child-placing agency;
or
(iii)
be a member of a family which receives full Medicaid
benefits as a result of qualifying for temporary assistance to needy families
(TANF); or
(iv)
qualify under other Medicaid Type Programs covered under
the waiver.
(c)
Deinstitutionalization.
(1)
For purposes of this section, "deinstitutionalization"
refers to an interagency agreement between the Texas Department of Human Services
and the Texas Department of Health to support the permanent placement of current
and previous resident children of Texas nursing facilities into their homes
and community settings. The children targeted under this provision will have
been in placement for continuous institutional long-term care purposes.
(2)
"Placement for continuous institutional long term care
purposes," refers to placement and subsequent residence in an institution
for the purpose of meeting a registrant's ongoing needs when the child's needs
cannot be met in the home on an ongoing basis. This excludes respite placements
and placements for treatment of acute episodes.
(3)
An MDCP interest/waiting list registrant may be considered
for deinstitutionalization into MDCP at any time since September 1, 1995 if
the registrant:
(A)
has resided in a Texas nursing facility for continuous
institutional long term care purposes; or
(B)
has resided in another Texas institution, (i.e., an ICF-MR,
hospital, long-term acute care setting), for continuous institutional long
term care purposes, followed by residence in a Texas nursing facility;
(C)
has been determined to be Medicaid eligible; and
(D)
has met all of the criteria in subsection (b) of this section.
(4)
The names of qualified individuals applying for nursing
facility deinstitutionalization shall be maintained on a waiting list separate
from that for other MDCP registrants.
(5)
An individual applying for nursing facility deinstitutionalization
under MDCP shall become eligible for waiver services under this subsection
if:
(A)
a vacancy designated for qualified individuals under this
subsection exists within the waiver; and
(B)
the individual's Texas Index for Level of Effort (TILE)
funding is available to be allocated for home and community-base services.
(d)
Applicant/participant choice. An eligible applicant or
participant and his parent or guardian or both must be provided the option
of:
(1)
participating in the waiver program as specified in the
IPC;
(2)
being placed in institutional care; or
(3)
refusing both options specified in paragraphs (1) and (2)
of this subsection.
(e)
Waiting lists. Participants in the waiver program are selected
from the MDCP waiting list, which is maintained on a first-come, first-served
basis. The names of Medicaid-eligible, qualified individuals who complete
the MDCP pre-application registration process and who are residents of a Texas
nursing facility as described in subsection (c) of this section are maintained
on a separate waiting list for nursing facility deinstitutionalization. Their
participation in the waiver will not delay the entry of individuals who are
not residents of a Texas nursing facility and whose names are maintained on
the regular MDCP waiting list. A registrant's waiting list status is assured
unless:
(1)
the pre-application registration materials clearly indicate
the individual does not qualify as a candidate for the waiver program; or
(2)
the family or the registrant requests that the registrant's
name be removed from the waiting list.
(f)
Medicaid eligibility date. A participant's Medicaid eligibility
under the waiver is contingent upon the actual delivery of waiver services.
For participants eligible for Medicaid only through this waiver, the effective
date of Medicaid coverage coincides with the date the participant actually
receives waiver services.
(g)
Application deadline. If a registrant fails to complete
and return all required application materials within 35 calendar days from
the date of the application transmittal letter, the registrant's potential
application shall be closed. In such a case, the registrant's name may be
re-entered at the end of the waiting list, upon request. Exceptions may be
made following a review of special circumstances.
(h)
Eligibility denial and exceptions. Unless an exception
is made following a review of special circumstances, waiver eligibility shall
be denied or terminated if:
(1)
waiver services are not utilized as described in the IPC,
unless:
(A)
the participant is hospitalized;
(B)
the planned waiver service provider is temporarily unable
to comply with the participant's IPC;
(C)
a replacement waiver service provider is being sought;
or
(D)
other non-waiver, non-Medicaid resources are being used
temporarily;
(2)
the applicant/participant's primary caregiver fails to
return a signed IPC within the specified time frame, not to exceed 30 days
from transmittal of the unsigned document;
(3)
the applicant/participant's primary caregiver does not
participate in the eligibility determination process, the care planning process,
or the implementation of the IPC;
(4)
the applicant/participant's primary caregiver does not
comply with the responsibilities enumerated in a departmental form which he/she
has signed; or
(5)
the IPC, inclusive of MDCP services, does not reflect a
routine direct care contribution by the primary caregiver(s).
(i)
Reduction in services. Waiver services may be reduced when:
(1)
the need for waiver services decreases as determined during
the care planning process;
(2)
non-waiver resources become available;
(3)
the primary caregiver does not participate fully in the
care planning process;
(4)
the participant's TILE score changes in such a way that
the participant's annual cost allowance decreases;
(5)
the rate(s) paid to MDCP providers increase and the participant's
IPC is already at the maximum annual cost allowance;
(6)
a time-limited exception to the annual cost allowance expires;
or
(7)
MDCP expenditures and budgetary considerations and constraints
indicate that cost reduction is necessary.
This agency hereby certifies that the adoption has been
reviewed by legal counsel and found to be a valid exercise of the agency's
legal authority.
Filed with the Office of
the Secretary of State on August 17, 2001.
TRD-200104840
Susan K. Steeg
General Counsel
Texas Department of Health
Effective date: September 6, 2001
Proposal publication date: July 13, 2001
For further information, please call: (512) 458-7236
25 TAC §§123.1 - 123.15
The Respiratory Care Practitioner Certification Program (advisory
committee) with the approval of the Texas Board of Health (board) adopts amendments
to §§123.1 - 123.14 and new §123.15 concerning the regulation
and certification of respiratory care practitioners. Sections 123.2, 123.6,
123.9,123.10, and 123.14 adopted with changes to the proposed text as published
in the March 16, 2001, issue of the
Texas Register
(26 TexReg 2102). Sections 123.1, 123.3 - 123.5, 123.7 - 123.8, 123.11
- 123.13, and 123.15 are adopted without changes and those sections will not
be republished.
Specifically the amendments cover the purpose and scope; definitions, advisory
committee, fees, exemptions, application requirements and procedures, types
of certificates and temporary permits and applicant eligibility, examination,
certificate renewal, continuing education requirements, changes of name or
address, and violations, complaints and subsequent actions. The adopted new
section covers informal disposition.
The Government Code, §2001.39 requires each state agency to review
and consider for readoption each rule adopted by that agency pursuant to the
Government Code, Chapter 2001 (Administrative Procedure Act). Title 25 Texas
Administrative Code (TAC), Chapter 123 which includes §§123.1-123.14,
has been revised in its entirety and the advisory committee and staff has
determined that reasons for adopting the sections continue to exist.
The Notice of Intention to Review the sections as required by Government
Code, §2001.039 was published in the
Texas Register
on December 17, 1999 (24 TexReg 11542). No comments were received
in response to the notice.
No comments were received during the comment period on the proposed amendments.
Due to staff comments, minor editorial changes to §§123.2, 123.6,
123.9, 123.10, and 123.14 were made to improve the accuracy of the sections.
The amendments and new section are adopted under Texas Occupations
Code, §604.052, which requires the Respiratory Care Practitioners Certification
Program to adopt rules, with the approval of the Texas Board of Health; and
the Health and Safety Code §12.001, that are reasonably necessary to
properly perform its duties under this Act.
§123.2.Definitions.
The following words and terms when used in these sections, shall have
the following meanings, unless the context clearly indicates otherwise:
(1)
AARC--The American Association for Respiratory Care and
its predecessor or successor organizations.
(2)
Act--Texas Occupations Code, Chapter 604; and Texas Revised
Civil Statutes portions of 4512l, as amended.
(3)
Administrator--The department employee designated as the
administrator of certification activities authorized by the Act.
(4)
Advisory committee--The Respiratory Care Practitioners
Advisory Committee.
(5)
Aides/orderlies--Health care workers who perform routine
tasks under the direct supervision of a practitioner such as transporting
patients, assembling treatment equipment, preparing work areas, and other
assigned duties. Aides/orderlies may not perform respiratory care procedures.
(6)
AMA--The American Medical Association.
(7)
Applicant--A person who applies to the Texas Department
of Health for a certificate or temporary permit.
(8)
Appropriate educational agency--The Texas Education Agency
or other governmental agency authorized by law or statute to approve educational
institutions and curriculum, or an educational accrediting body of a professional
organization, such as the Committee on Respiratory Care (COARC) and its predecessor
or successor organization.
(9)
Board--The Texas Board of Health.
(10)
BME--Texas State Board of Medical Examiners.
(11)
Certificate--A respiratory care practitioner certificate
issued by the Texas Department of Health.
(12)
Commissioner--The commissioner of the Texas Department
of Health.
(13)
Delegated authority--As defined in the Texas Medical Practice
Act, Texas Occupations Code, Chapter 157 and the rules pertaining thereto
adopted by the BME.
(14)
Department--The Texas Department of Health.
(15)
Diagnostic--Of or relating to or used in the art or act
of identifying a disease or disorder.
(16)
Educational accrediting body--The Committee on Allied
Health Education and Accreditation of the American Medical Association, or
its successor organization which approves respiratory care education programs.
(17)
Formally trained--Completion of an organized educational
activity which:
(A)
includes supervised and directed instruction specific to
the respiratory care procedures to be performed by the individual;
(B)
includes specific objectives, activities, and an evaluation
of competency; and
(C)
is supervised and directed by another individual qualified
to provide the training and supervision.
(18)
NBRC--The National Board for Respiratory Care, Inc., and
its predecessor or successor organizations.
(19)
Palliative--Serving to moderate the intensity of pain
or other disease process.
(20)
Practice--Engaging in respiratory care as a clinician,
educator, or consultant.
(21)
Qualified medical director--A physician licensed and in
good standing with the BME, and who has special interest and knowledge in
the diagnosis and treatment of respiratory care problems who is actively engaged
in the practice of medicine. This physician must be a member of the active
medical staff of a health care facility, agency or organization who supervises
the provision of respiratory care.
(22)
Respiratory care--The treatment, management, control,
diagnostic evaluation, and care of inpatients or outpatients who have deficiencies
and abnormalities associated with the cardiorespiratory system. Respiratory
care does not include the delivery, assembly, set up, testing, and demonstration
of respiratory care equipment upon the order of a licensed physician. Demonstration
is not to be interpreted here as the actual patient assessment and education,
administration, or performance of the respiratory care procedure(s).
(23)
Respiratory care education program--
(A)
a program in respiratory care approved by the educational
accrediting body;
(B)
a program approved by an appropriate education agency and
working toward becoming an approved program in respiratory care. A program
will qualify as a respiratory care education program under this subparagraph
only for a period of one year from the date of the first class offered by
the program; after that one year, the program must be an approved program
in respiratory care; or
(C)
a program accredited by the Canadian Medical Association
and whose graduates are eligible to take the national registry exam given
by the Canadian Board of Respiratory Care.
(24)
Respiratory care practitioner (RCP)--A person permitted
or certified under the Act to practice respiratory care.
(25)
Respiratory care procedure--Respiratory care provided
by the therapeutic and diagnostic use of medical gases, humidifiers, and aerosols,
the administration of drugs and medications to the cardiorespiratory system,
ventilatory assistance and ventilatory control, postural drainage, chest drainage,
chest percussion or vibration, breathing exercises, respiratory rehabilitation,
cardiopulmonary resuscitation, maintenance of natural airways, and the insertion
and maintenance of artificial airways. The term includes a technique employed
to assist in diagnosis, monitoring, treatment, and research, including the
measurement of ventilatory volumes, pressures and flows, the specimen collection
of blood and other materials, pulmonary function testing, and hemodynamic
and other related physiological forms of monitoring or treating, as ordered
by the patient's physician, the cardiorespiratory system. These procedures
include:
(A)
administration of medical gases - such as nitric oxide,
helium and carbon dioxide;
(B)
providing ventilatory assistance and ventilatory control
- including high frequency oscillatory ventilation and high frequency jet
ventilation;
(C)
providing artificial airways - including insertion, maintenance
and removal;
(D)
performing pulmonary function testing - including neonatal
and pediatric studies;
(E)
hyperbaric oxygen therapy;
(F)
monitoring - including pulse oximeter, end-tidal carbon
dioxide and apnea monitoring;
(G)
extracorporeal membrane oxygenation (ECMO);
(H)
patient assessment, respiratory patient care planning;
and
(I)
implementation of respiratory care protocols.
(26)
Respiratory therapist--A person permitted or certified
under the Act to practice respiratory care.
(27)
Temporary permit--A permit issued in accordance with §123.7(d)
of this title (relating to Types of Certificates, Temporary Permits, and Applicant
Eligibility) for a period of six months.
(28)
Therapeutic--Of or relating to the treatment of disorders
by remedial agents or methods.
(29)
Under the direction--Assuring that established policies
are carried out; monitoring and evaluating the quality, safety, and appropriateness
of respiratory care services and taking action based on findings; and providing
consultation whenever required, particularly on patients receiving continuous
ventilatory or oxygenation support.
§123.6.Application Requirements and Procedures.
(a)
General.
(1)
Unless otherwise indicated, an applicant must submit all
required information and documentation of credentials on official department
forms.
(2)
The department shall not consider an application as officially
submitted until the applicant pays the application fee and the fee clears
the appropriate financial institution. The fee must accompany the application
form.
(3)
The administrator shall send a notice listing the additional
materials required to an applicant who does not complete the application in
a timely manner. An application not completed within 30 days after the date
of the notice shall be invalid.
(b)
Required application materials.
(1)
Application form. The application form shall contain:
(A)
specific information regarding personal data, social security
number, birth month and day, place of employment, other state licenses and
certifications held, misdemeanor and felony convictions, educational and training
background, and work experience;
(B)
a statement that the applicant has read the Act and these
sections and agrees to abide by them;
(C)
the applicant's permission to the department to seek any
information or references it deems fit to determine the applicant's qualifications;
(D)
a statement that the applicant, if issued a certificate
or temporary permit, shall return the certificate or temporary permit and
identification card(s) to the department upon the revocation or suspension
of the certificate or temporary permit;
(E)
a statement that the applicant understands that fees submitted
are nonrefundable;
(F)
a statement that the applicant understands that materials
submitted become the property of the department and are nonreturnable (unless
prior arrangements have been made);
(G)
a statement that the information in the application is
truthful and that the applicant understands that providing false information
of any kind may result in the voiding of the application and failure to be
granted a certificate or permit, or the revocation of a certificate or permit
issued;
(H)
a statement that if issued a certificate or permit the
practitioner shall keep the department advised of his or her current mailing
address; and
(I)
the signature of the applicant which has been dated;
(J)
a full-face color photograph signed on the reverse side
with the applicant's signature as it appears on the application. The photograph
must have been taken within the two year period prior to application to the
department and the minimum size is one and one-half inches by one and one-half
inches.
(2)
Educational records. Applicants for a certificate, who
were not certified or registered in respiratory care by the NBRC on or before
September 1, 1985, or a temporary permit must submit:
(A)
a photocopy which has been notarized as a true and exact
copy of an unaltered:
(i)
an official diploma or official transcript indicating graduation
from high school;
(ii)
certificate of high school equivalency issued by the appropriate
educational agency; or
(iii)
official transcript from an accredited college or university
indicating that the applicant received a high school diploma or equivalency
or was awarded an associate, baccalaureate, or post-baccalaureate degree;
and
(B)
a photocopy which has been notarized as a true and exact
copy of an unaltered certificate of completion from a respiratory care education
program. The certificate must contain:
(i)
name and number of the program (exactly as listed with
the educational accrediting body);
(ii)
name of the graduate;
(iii)
exact day and month individual is recognized as a program
graduate;
(iv)
accreditation statement; and
(v)
signatures of the medical director, program director and
administrative official; or
(C)
an expected graduation statement signed by the program
director. Within 30 days of the completion date noted in the statement, the
department must receive either:
(i)
a notarized copy of the certificate of completion, as set
out in subparagraph (B) of this paragraph; or
(ii)
a notarized statement signed by the program director indicating
that the applicant officially completed the program but the certificate is
not available within 30 days of the completion date.
(3)
Examination results.
(A)
If the applicant is making application for a temporary
permit, an examination score release form shall be signed allowing the department
to obtain the applicant's examination results from the NBRC, or other agency
administering the examination prescribed by the board.
(B)
If an applicant for a regular certificate is:
(i)
recognized as certified respiratory therapist or registered
respiratory therapist by the NBRC at the time of application, a photocopy
of the certificate issued by NBRC shall be submitted in lieu of examination
results; or
(ii)
unable to show proof of successful completion or otherwise
provide documentation acceptable to the department of the applicant's examination
results, the application shall be disapproved.
(4)
Employment/experience documentation report form. Persons
applying for any certificate or permit who are not recognized as a certified
respiratory therapist or registered respiratory therapist by the NBRC and
who are licensed, registered, or otherwise regulated in another state, territory,
or country at the time of application must submit with their applications
a properly completed employment/experience documentation report form signed
by their medical director as defined in §123.2 of this title (relating
to Definitions), attesting that the applicant is currently practicing, or
has practiced respiratory care within the 12-month period immediately preceding
application to the department.
(5)
Medical direction requirement. If the applicant is practicing
respiratory care in Texas at the time of application to the department, the
applicant shall obtain on the application form the signature and the license
number of the qualified medical director as defined in §123.2 of this
title (relating to Definitions) or other Texas licensed physician directing
the provision of respiratory care services.
(c)
Information/Documentation form. Persons applying for any
certificate or permit who are licensed, registered, or otherwise regulated
in any profession at the time of application to the department must submit
with their applications a properly completed information/documentation form
signed by an agency official. The signature must be notarized if the agency
does not have or does not affix its official seal on the form.
(d)
Application processing.
(1)
Time periods. The department shall comply with the following
procedures in processing applications for a permit or certificate.
(A)
The following periods of time shall apply from the date
of receipt of an application until the date of issuance of a written notice
that the application is complete and accepted for filing or that the application
is deficient and additional specific information is required. A written notice
stating that the application has been approved may be sent in lieu of the
notice of acceptance of a complete application. The time periods are as follows:
(i)
letter of acceptance of application for permit or certification--14
working days. The notice of acceptance may include a statement that an application
for temporary permit received more than 45 days from the date of the applicant's
graduation will be held pending until the applicant is within 45 days of graduation;
and
(ii)
letter of application deficiency-14 working days.
(B)
The following periods of time shall apply from the receipt
of the last item necessary to complete the application until the date of issuance
of written notice approving or denying the application. The time periods for
denial include notification of the proposed decision and of the opportunity,
if required, to show compliance with the law, and of the opportunity for a
formal hearing. The time periods are as follows:
(i)
letter of approval-14 working days; and
(ii)
letter of denial of permit or certificate-180 working
days.
(2)
Reimbursement of fees.
(A)
In the event an application is not processed in the time
periods stated in paragraph (1) of this subsection, the applicant has the
right to request reimbursement of all fees paid in that particular application
process. Requests for reimbursement shall be made to the program administrator.
If the program administrator does not agree that the time period has been
violated or finds that good cause existed for exceeding the time period, the
request will be denied.
(B)
Good cause for exceeding the time period is considered
to exist if the number of applications for licensure and licensure renewal
exceeds by 15% or more the number of applications processed in the same calendar
quarter the preceding year, another public or private entity relied upon by
the department in the application process caused the delay, or any other condition
exists giving the department good cause for exceeding the time period.
(3)
Appeal. If a request reimbursement under paragraph (2)
of this subsection is denied by the program administrator, the applicant may
appeal to the commissioner of health for a timely, resolution of any dispute
arising from a violation of the time periods. The applicant shall give written
notice to the commissioner of health at the address of the department that
he or she requests full reimbursement of all fees paid because his or her
application was not processed within the applicable time period. The program
administrator shall submit a written report of the facts related to the processing
of the application and of any good cause for exceeding the applicable time
period. The commissioner of health shall provide written notice of the decision
to the applicant and the program administrator. An appeal shall be decided
in favor of the applicant if the applicable time period was exceeded and good
cause was not established. If the appeal is decided in favor of the applicant,
full reimbursement of all fees paid in that particular application process
shall be made.
(4)
Contested cases. The time periods for contested cases related
to the denial of licensure renewals are not included with the time periods
stated in paragraph (1) of this subsection. The time period for conducting
a contested case haring runs from the date the department receives a written
request for a hearing and ends when the decision of the department is final
and appealable. a hearing may be completed within one to four months, but
may extend for a longer period of time depending on the particular circumstances
of the hearing.
(e)
Application approval.
(1)
The administrator shall be responsible for reviewing all
applications.
(2)
The administrator shall approve all applications which
are in compliance with subsections (a)-(c) of this section and which properly
document applicant eligibility, unless the application is disapproved under
the provisions of subsection (f) of this section.
(f)
Disapproved applications.
(1)
The department shall disapprove the application if the
person:
(A)
has not completed the requirements in subsection (b) of
this section;
(B)
has failed to pass the examination prescribed by the board
as set out in §123.8 of this title (relating to Examination) during the
period for which the temporary certificate, or temporary permit or temporary
permit extension, was valid, if applicable;
(C)
has failed to remit any applicable fees required in §123.4
of this title (relating to Fees);
(D)
has failed or refused to properly complete or submit any
application form(s) or endorsement(s), or presented false information on the
application form, or any other form or document required by the department
to verify the applicant's qualifications;
(E)
has been in violation of the Act, §123.14 of this
title (relating to Violations, Complaints, and Subsequent Actions), the code
of ethics as set out in §123.12 of this title (relating to Professional
and Ethical Standards), or any other applicable provision of this chapter;
(F)
has been convicted of a felony or misdemeanor, if the crime
directly relates to the duties and responsibilities of a respiratory care
practitioner as set out in §123.13 of this title (relating to Certifying
or Permitting Persons with Criminal Backgrounds To Be Respiratory Care Practitioners);
(G)
holds a license, certification, or registration to practice
respiratory care in another state or jurisdiction and that license, certification,
or registration has been suspended, revoked, or otherwise restricted by the
licensing entity in that state or jurisdiction for reasons to the person's
professional competence or conduct which could adversely affect the health
and welfare of a patient;
(H)
is not currently practicing, or has not practiced within
the 12-month period preceding the date of application, respiratory care, as
set out in §123.7(d)(1)(B) of this title (relating to Types of Certificates
and Temporary Permits and Applicant Eligibility); or
(I)
has submitted a copy of a National Board for Respiratory
Care, Inc. (NBRC) certificate in lieu of examination results in accordance
with subsection (b)(3)(B)(i) of this section, but is not recognized by the
NBRC as a certified respiratory therapist or registered respiratory therapist.
(2)
If after review the administrator determines that the application
should not be approved, the administrator shall give the applicant written
notice of the reason for the proposed decision and of the opportunity for
a formal hearing. The formal hearing shall be conducted according to the Administrative
Procedure Act, Texas Government Code ?2001, et seq. Within 10 days after receipt
of the written notice, the applicant shall give written notice to the administrator
that the applicant either waives the hearing, or wants the hearing. Receipt
of the written notice is deemed to occur on the tenth day after the notice
is mailed unless another date of receipt is reflected on a United States Postal
Service return receipt. If the applicant fails to respond within 10 days after
receipt of the notice of opportunity, or if the applicant notifies the administrator
that the hearing be waived, the applicant is deemed to have waived the hearing.
If the hearing has been waived, the department shall disapprove the application.
(3)
An applicant whose application has been disapproved under
paragraph (1)(E) and (F) of this subsection shall be permitted to reapply
after a period of not less than one year from the date of the disapproval
and shall submit with the reapplication proof satisfactory to the department
of compliance with all rules of the board and the provisions of the Act in
effect at the time of reapplication. The date of disapproval is the effective
date of a disapproval order signed by the commissioner of health.
§123.9.Certificate Renewal.
(a)
General. Except as provided by subsection (b) of this section,
a practitioner shall renew the certificate annually. A practitioner shall
renew the certificate annually.
(1)
The renewal date of a certificate shall be the last day
of the practitioner's birth month.
(2)
Each practitioner shall be responsible for renewing the
certificate on or before the expiration date and shall not be excused from
paying reinstatement fees. Failure to receive notification from the department
prior to the expiration date will not excuse failure to file for renewal or
reinstatement.
(3)
The department may not renew the certificate or permit
of the practitioner who is in violation of the Act or board rules at the time
of application for renewal.
(4)
The department shall deny renewal of a certificate or permit
if renewal is prohibited by the Education Code, §57.491, concerning guaranteed
student loan defaults.
(b)
Staggered renewals. The department shall use a staggered
system for certificate renewals.
(c)
Certificate renewal.
(1)
At least 30 days prior to the expiration date of a person's
certificate, the department shall send notice to the practitioner of the expiration
date of the certificate, the amount of the renewal fee due, and a renewal
form which the practitioner must complete and return to the department with
the required renewal fee.
(2)
The renewal form for all practitioners shall require the
provision of the preferred mailing address, primary employment address and
telephone number, and category of employment, misdemeanor and felony convictions,
statement concerning status with The National Board for Respiratory Care,
Inc., and continuing education completed. If the applicant is practicing as
a respiratory care practitioner at the time of renewal the name, signature
and license number of the physician directing the provision of respiratory
care and the physician's institutional affiliation(s), if any, shall be provided
on the renewal form if requested by the department.
(3)
A practitioner has renewed the certificate when the department
has received the completed renewal form, continuing education as set out in §123.10
if this title (relating to Continuing Education Requirements), and the required
renewal fee on or prior to the expiration date of the certificate. The postmark
date shall be considered as the date of mailing.
(4)
The department shall issue identification cards for the
current renewal period to a practitioner who has met all requirements for
renewal.
(d)
Late renewal or reapplication.
(1)
A person whose certificate has expired may renew the certificate
by submitting to the department the renewal form, continuing education as
set out in §123.10 of this title (relating to Continuing Education Requirements)
completed since the last renewal, and if respiratory care procedures were
performed after the certificate expired, a notarized statement indicating
how the person complied with the Act, §604.003.
(A)
If renewal is requested from one day up to 90 days after
expiration, the applicant shall submit a fee that is equal to one and one
half times the renewal fee, as set out in §123.4 of this title (relating
to Fees).
(B)
If renewal is requested more than 90 days after expiration
but less than one year after expiration, the applicant shall submit a fee
that is equal to two times the renewal fee, as set out in §123.4 of this
title.
(C)
If the person received a 90-day extension of the person's
certificate pursuant to §123.10(f) of this title (relating to Continuing
Education Requirements), the expiration date under subparagraphs (A)-(B) of
this paragraph is the expiration date of the person's last annual certificate.
(D)
After the certificate is renewed, the next continuing education
reporting period starts on the date the certificate is renewed and continues
until the next expiration date.
(2)
The department shall inform a person who has not renewed
a certificate by the expiration date of the amount of the fee required for
renewal, the continuing education required for renewal, and the date the certificate
expired.
(3)
A person whose certificate has been expired for one year
or more may apply for a new certificate by complying with the then-current
requirements for obtaining a certificate.
(4)
After a certificate is expired and until a person has renewed
the certificate, a person may not practice respiratory care in violation of
the Act.
(5)
A person who fails to renew a certificate within one year
may obtain a new certificate without examination if the person:
(A)
pays a fee that is equal to two times the renewal fee;
(B)
is currently certified as a respiratory care practitioner
in another state;
(C)
has been practicing respiratory care in the state where
the certification is held for the two years preceding the date of application
for renewal; and
(D)
submits proof of completion of the continuing education
requirements as set out in §123.10 of this title within the 12 month
period preceding the date of application for a new certificate.
(e)
Renewal Processing.
(1)
The department shall issue a certificate renewal within
14 days after receipt of documentation of all renewal requirements.
(2)
The reimbursement of fees, appeals, and contested cases
relating to renewals shall be governed by the provisions of §123.6(d)(2)-(4)
of this title (relating to Application Requirements and Procedures).
(f)
Military duty. If a practitioner fails to timely renew
his or her permit or certificate because the practitioner is or was on active
duty with the armed forces of the United States of America, serving outside
the State of Texas, the practitioner may renew the permit or certificate pursuant
to this subsection.
(1)
Renewal of the permit or certificate may be requested by
the practitioner, the practitioner's spouse, or an individual having power
of attorney from the practitioner. The renewal form shall include a current
address and telephone number for the individual requesting the renewal.
(2)
Renewal may be requested before or after expiration of
the permit or certificate.
(3)
A copy of the official orders or other official military
documentation showing that the practitioner is or was on active duty, serving
outside the State of Texas, shall be filed with the department along with
the renewal form.
(4)
A copy of the power of attorney from the practitioner shall
be filed with the department along with the renewal form if the individual
having the power of attorney executes any of the documents required in this
subsection.
(5)
A practitoner renewing under this subsection shall pay
the renewal fee.
(6)
A practitioner renewing under this subsection shall submit
proof of having earned any clock hours of continuing education prior to being
called to active duty serving outside the State of Texas and no further continuing
education hours shall be required for renewal.
(g)
Inactive status. A respiratory care practitioner who holds
a certificate under the Act and who is not actively engaged in the practice
of respiratory care may make application to the department in writing on a
form prescribed by the department to be placed on an inactive status list
maintained by the department. The application for inactive status must be
postmarked prior to the expiration of the practitioner's annual certificate.
No refund will be made of any fees paid prior to application for inactive
status.
(1)
A person on inactive status is not required to pay the
annual renewal fee.
(2)
A person on inactive status may not perform any activities
regulated under this Act. Practice as a respiratory care practitioner in any
capacity for compensation or as a volunteer is prohibited, and the person
may not use the title respiratory care practitioner while on inactive status.
(3)
A person on inactive status is not required to complete
the requirements in accordance with §123.10 of this title (relating to
Continuing Education Requirements), except as provided in paragraph (4)(D)
of this subsection.
(4)
If a person on inactive status desires to reenter active
practice, the person shall:
(A)
notify the department in writing;
(B)
complete appropriate forms;
(C)
pay a renewal fee for the current renewal period plus a
reinstatement fee equal to one-half the renewal fee; and
(D)
submit to the department proof of successful completion,
within 12-month period prior to reentering active status, of the continuing
education hours as set out in §123.10 of this title.
(5)
A person in compliance with this subsection is not subject
to subsection (d) of this section.
(h)
Expiration of certificate. A person whose certificate has
expired may not use the title or represent or imply that he has the title
of certified respiratory care practitioner, respiratory care practitioner,
or respiratory therapist, or use the letters RCP, and may not use any facsimile
of those titles in any manner. Until a person has renewed the certificate,
a person may not practice respiratory care in violation of the Act.
§123.10.Continuing Education Requirements.
(a)
General. Continuing education requirements for renewal
shall be fulfilled each renewal year.
(1)
The initial period shall begin with the date the department
issues the certificate and end on the last day of the birth month at the time
of the second renewal.
(2)
At the time the certificate is mailed, each practitioner
shall be notified of the beginning and ending dates of the continuing education
period.
(3)
A practitioner must complete 12 hours of continuing education
acceptable to the department during each renewal year.
(4)
A clock hour shall be 50 minutes of attendance and participation
in an acceptable continuing education experience.
(b)
Types of acceptable continuing education. Continuing education
must be in skills relevant to the practice of respiratory care and must have
a direct benefit to patients and clients and shall be acceptable if the experience
falls in one or more of the following categories:
(1)
respiratory care course work seminars, workshops, review
sessions, or other organized educational programs completed at or though any
respiratory care education program;
(2)
participation in any program (e.g., in-service educational
training programs, institutes, seminars, workshops and conferences) which
is:
(A)
directly related to the profession of respiratory care;
(B)
instructor directed; and
(C)
approved, recognized, accepted, or assigned continuing
education credits by professional organizations or associations or offered
by a federal, state, or local government entity. A list approved by the advisory
committee is available from the department upon request;
(3)
instruction or teaching in programs set out in paragraphs
(1) and (2) of this subsection, provided that such instruction or teaching
is not a part of, or required as a part of, one's employment, or;
(4)
up to four credit hours during each renewal period of self-directed
Internet-based or computer-based studies, including a post-test, which meets
the requirements described in paragraphs (2)(A) and (2)(C) of this subsection.
(c)
Determination of clock hours. The department shall credit
continuing education experiences as follows.
(1)
Completion of course work at or through a respiratory care
educational program as set out in subsection (b)(1) of this section shall
be credited on the basis of 15 clock hours for each semester hour successfully
completed for credit or audit, evidenced by a certificate of successful completion
or official transcript.
(2)
Parts of programs, activities, workshops, seminars, sessions,
etc., which meet the criteria of subsections (b)(1) or (2) of this section
shall be credited on a one-for-one basis with one clock hour for each clock
hour spent in the continuing education activity.
(3)
Teaching in programs which meet the department's criteria
as set out in subsection (b)(3) of this section shall be credited on the basis
of two clock hours for each hour actually taught.
(4)
Passing the certified respiratory therapist recredentialing
examination shall be credited on the basis of ten clock hours.
(5)
Passing the written registry examination for advanced respiratory
therapy practitioners for credentialing or recredentialing shall be credited
on the basis of nine clock hours.
(6)
Passing the registered respiratory therapist clinical simulation
examination for credentialing or recredentialing shall be credited on the
basis of nine clock hours.
(7)
Passing the National Board for Respiratory Care, Inc. (NBRC)
pediatric specialty examination shall be credited on the basis of ten clock
hours.
(8)
Successful completion of the initial course in advanced
cardiac life-support, pediatric advanced life-support, the neonatal advanced
life-support course, basic trauma life-support, or pre-hospital trauma life-support
shall be credited on the basis of 12 clock hours. Recertification courses
shall be credited for the number of hours actually completed during the recertification
course, but shall not count for more than 12 hours.
(9)
Passing the certification examination for entry level pulmonary
function technologists or the registry examination for advanced pulmonary
function technologists for credentialing shall be credited on the basis of
ten clock hours.
(10)
Passing the registration examination offered by the Board
of Registered Polysomnographic Technologists shall be credited on the basis
of ten clock hours.
(d)
Reporting of continuing education. Each practitioner shall
be responsible for reporting to the department the continuing education activities
completed.
(1)
A practitioner shall report the number of hours of continuing
education completed during the renewal period. If requested by the department,
each practitioner shall submit proof of completion of the required continuing
education activity to the department at the time of certificate renewal, or
at other times as directed by the department. However, if an extension has
been granted in accordance with subsection (f) of this section, the practitioner
shall file the continuing education hours immediately following completion
of the activity.
(2)
If required by the department, each continuing education
activity filed by a practitioner must be accompanied by appropriate documentation
of the continuing education claimed as follows:
(A)
for a program attended, signed certification by a program
leader or instructor of the practitioner's participation in the program by
certificate, or letter on letterhead of the sponsoring agency, or official
continuing education validation form or official transcript of the sponsoring
agency accompanied by a brochure, agenda, program, or other applicable information,
indicating content of the program;
(B)
for teaching or instruction in approved programs, a letter
on sponsoring agency's letterhead giving name of program, location, dates,
and subjects taught, and giving total clock hours of teaching or instruction;
(C)
for completion of course work at or through respiratory
care education programs, a certificate of successful completion or an official
transcript.
(e)
Activities unacceptable as continuing education. The department
may not grant continuing education credit to any practitioner for:
(1)
education incidental to the regular professional activities
of a practitioner such as learning occurring from experience or research;
(2)
organization activity such as serving on committees or
councils or as an officer in a professional organization;
(3)
any program or activity which is not approved in accordance
with subsection (b)(2) of this section;
(4)
any experience which does not fit the types of acceptable
continuing education in subsection (b) of this section;
(5)
any continuing education activity completed before or after
the renewal year for which the continuing education credit is submitted except
as allowed under subsection (f)(1) of this section;
(6)
self-study continuing education programs or activities
except those set out in subsection (b)(4) of this section; or
(7)
activities which have been completed more than once during
the continuing education period.
(f)
Failure to complete required continuing education.
(1)
A practitioner who has failed to complete the requirements
for continuing education as specified in subsection (a) of this section may
be granted up to a 90-day extension to a reporting period if the renewal fee
and continuing education extension fee is paid on or prior to the expiration
date. The 90-day extension is the maximum that may be granted and there will
be no exceptions.
(A)
Following the receipt of the current renewal form, renewal
fee and continuing education extension fee, the department shall issue identification
cards valid for a 90-day period beginning with the day following the expiration
date of the practitioner's annual certificate and a written notice that the
continuing education period has been extended.
(B)
If the deficiency is made up prior to the end of the extension,
the department will notify the practitioner that the next reporting period
commences on the day following the completion of the credits to correct the
deficiency. The new reporting period shall end on the next renewal date. In
other words, whenever an extension is granted, the time is borrowed from the
next reporting period.
(C)
If an excess number of credits were earned during an extension,
the excess will be credited toward the new reporting period.
(D)
A practitioner may not receive another extension at the
end of the 90-day extension.
(2)
A practitioner who has failed to complete the requirements
for continuing education as specified in subsection (a) of this section and
who has not completed the continuing education requirement during the 90-day
extension shall return the certificate and identification cards to the department
and shall not advertise or represent himself or herself as a respiratory care
practitioner in any manner. The person may renew the certificate or reapply
for a new certificate in accordance with §123.9(d) of this title (relating
to Certificate Renewal).
(g)
Other miscellaneous provisions.
(1)
Audiovisual programs may be accepted by the department
if such a program represents one of the instructional methods or strategies
rather than constituting the entire program and provided the program meets
the criteria as set out in subsection (b) of this section.
(2)
A practitioner who also holds a current license, registration,
or certification in another health care profession or a current license, registration,
or certification as a respiratory care practitioner in another state, territory,
or country may satisfy the continuing education requirements for renewal in
Texas with hours counted toward renewal of another license, registration,
or certification as long as all of the hours meet all of the requirements
of this section.
(3)
Hardships will be considered and granted by the department
on a case by case basis.
(4)
The department may conduct random audits of continuing
education completed by practitioners to determine compliance with this section.
(5)
No continuing education hours may be carried over from
one renewal period to another renewal period unless the hours were earned
during a continuing education extension as set out in subsection (f) of this
section.
§123.14.Violations, Complaints, and Subsequent Actions.
(a)
General. This section establishes standards relating to:
(1)
offenses and prohibited actions under Texas Occupations
Code, §604.102 which result in the penalty of a Class B misdemeanor;
(2)
violations which result in disciplinary actions;
(3)
procedures for filing complaints alleging violations and
prohibited actions under the Act or rules; and
(4)
the department's investigation of complaints and the department's
and commissioner's actions, on behalf of the board, when offenses and prohibited
actions and violations have occurred.
(b)
Types of offenses and prohibited actions. A person is guilty
of a Class B misdemeanor if:
(1)
a person intentionally or knowingly represents oneself
as able to practice respiratory care or represents oneself as a respiratory
care practitioner unless the person holds a certificate or permit issued under
the Act;
(2)
a person who is not permitted or certified under the Act
as a respiratory care practitioner or whose temporary permit or certificate
has been suspended or revoked uses in connection with his or her practice
the words "respiratory care," "respiratory therapist," "respiratory care practitioner,"
"certified respiratory care practitioner," "respiratory therapy technician,"
or the letters "RCP" or any other words, letters, abbreviations, or insignia
indicating or implying that the person is a respiratory care practitioner.
Such a person may not in any way, either orally, in writing, in print, or
by sign, directly or by implication, represent himself or herself as a respiratory
care practitioner;
(3)
a person practices respiratory care other than under the
direction of a qualified medical director or other physician licensed by the
Board of Medical Examiners (BME);
(4)
a person sells, fraudulently obtains, or furnishes any
respiratory care diploma, certificate, permit, or record;
(5)
a person practices respiratory care under a respiratory
care diploma, certificate, permit, or record illegally or fraudulently obtained
or issued;
(6)
a person practices respiratory care during the time that
person's certificate or permit is suspended, revoked, or expired;
(7)
a person conducts a formal respiratory care education program
for the preparation of respiratory care personnel unless the program is approved
by the department;
(8)
a person employs another person who does not hold a certificate
or permit to practice respiratory care in the capacity of a respiratory care
practitioner;
(9)
a person who holds a certificate or permit to practice
respiratory care practices medicine, as defined by the Medical Practice Act,
Texas Occupations Code, Chapter 157 without holding an appropriate license
issued by the BME; or
(10)
a person otherwise violates Texas Occupations Code, §§604.002,
604.102, 604.351, or 604.352.
(c)
Filing of complaints.
(1)
Anyone may complain to the department alleging that a person
has committed an offense or action prohibited under the Act or that a certificate
or permit holder has violated the Act or a this chapter.
(2)
A person wishing to complain about an offense, prohibited
action, or alleged violation against a practitioner or other person shall
notify the administrator. The initial notification of a complaint may be in
writing, by telephone, or by personal visit to the administrator's office.
(Mailing address: 1100 West 49th Street, Austin, Texas 78756-3183, Phone:
512-834-6632.
(3)
Upon receipt of a complaint the administrator or the administrator's
designee shall send an acknowledgment letter to the complainant and the department's
complaint form which the complainant must complete and return to the administrator
or the administrator's designee before further action can be taken. If the
complaint is made by a visit to the administrator's office, the form may be
given to the complainant at that time; however, it must be completed and returned
to the administrator or the administrator's designee before further action
may be taken. Copies of the complaint form may be obtained from the Texas
Department of Health, 1100 West 49th Street, Austin, Texas 78756-3183.
(4)
Anonymous complaints shall be investigated by the administrator
or the administrator's designee, provided sufficient information is submitted.
(d)
Investigation of complaints.
(1)
The administrator and the department are responsible for
handling complaints.
(2)
The administrator, or his or her designee, shall make the
initial investigation and report the findings to the director of Professional
Licensing and Certification Division or his or her designee, or the director
or designee of its successor.
(e)
The department's action.
(1)
The department shall take one or more actions described
in this section.
(2)
The department may determine that an allegation is groundless
and dismiss the complaint.
(3)
The department may determine that a practitioner has violated
the Act or a board rule and may institute disciplinary action in accordance
with subsection (f) of this section.
(4)
Whenever the department dismisses a complaint or closes
a complaint file, the department shall give a summary report of the final
action to the advisory committee, the complainant, and the accused party.
(f)
Disciplinary actions.
(1)
The department may reprimand a practitioner or initiate
action to deny, suspend, suspend on an emergency basis, probate, not renew,
or revoke a certificate or a temporary permit.
(2)
The department may take disciplinary action if it determines
that a person who holds a certificate or temporary permit is in violation
of §123.12 of this title (relating to Professional and Ethical Standards).
(3)
The department may also take action under §123.13
of this title (relating to Certifying or Permitting Persons with Criminal
Backgrounds To Be Respiratory Care Practitioners).
(4)
The department shall take into consideration the following
factors in determining the appropriate action to be imposed in each case:
(A)
the severity of the offense;
(B)
the danger to the public;
(C)
the number of repetitions of offenses;
(D)
the length of time since the date of the violation;
(E)
the number and type of previous disciplinary cases filed
against the respiratory care practitioner (RCP);
(F)
the length of time the RCP has performed respiratory care
procedures;
(G)
the actual damage, physical or otherwise, to the patient,
if applicable;
(H)
the deterrent effect of the penalty imposed;
(I)
the effect of the penalty upon the livelihood of the RCP;
(J)
any efforts for rehabilitation; and
(K)
any other mitigating or aggravating circumstances.
(g)
Formal hearing.
(1)
The formal hearing shall be conducted according to the
Administrative Procedure Act (APA), Texas Government Code Chapter 2001.
(2)
Prior to institution of formal proceedings to revoke or
suspend a permit or certificate, the program administrator shall give written
notice to the permit or certificate holder by certified mail, return receipt
requested, of the facts or conduct alleged to warrant revocation or suspension,
and the person shall be given the opportunity, as described in the notice,
to show compliance with all requirements of the Act and this chapter.
(3)
To initiate formal hearing procedures, the administrator
shall give the practitioner written notice for the opportunity for hearing.
The notice shall state the basis for the proposed action. Within 10 days after
receipt of the notice, the practitioner must give written notice to the administrator
that he or she either waives the hearing or wants the hearing. Receipt of
the notice is deemed to occur on the 10th day after the notice is mailed unless
another date of receipt is reflected on a United States Postal Service return
receipt.
(A)
If the practitioner fails to request a hearing, the practitioner
is deemed to have waived the hearing. If the hearing has been waived, the
department shall recommend to the commissioner that the proposed action be
taken.
(B)
If the practitioner requests a hearing within 10 days after
receiving the notice of opportunity for hearing, APA, Texas Government Code §2001.
(h)
Final action.
(1)
If the department suspends a certificate or permit, the
suspension remains in effect until the administrator or the department determines
that the reasons for suspension no longer exist. The practitioner whose certificate
or permit has been suspended is responsible for securing and providing to
the department such evidence, as may be required by the department that the
reasons for the suspension no longer exist. The administrator or the department
shall investigate prior to making a determination.
(2)
During the time of suspension, the former certificate or
permit holder shall return the certificate or permit and identification card(s)
to the department.
(3)
If a suspension overlaps a certificate renewal period,
the former certificate holder shall comply with the normal renewal procedures
in these sections; however, the department may not renew the certificate until
the administrator or the department determines that the reasons for suspension
have been removed.
(4)
If the department suspends a temporary permit and the suspension
is in effect at the time of the expiration of the temporary permit, the former
temporary permit holder must reapply in order to obtain a new temporary permit.
The department may not issue a new temporary permit until the administrator
or the department determines that the reasons for suspension have been removed.
(5)
A person whose application is denied or whose temporary
permit or certificate is revoked or surrendered is ineligible for a temporary
permit or certificate under this Act for one year from the date of the denial
or revocation or surrender.
(6)
Upon revocation or nonrenewal, the former certificate or
permit holder shall return the certificate or permit and any identification
card(s) to the department.
This agency hereby certifies that the adoption has been
reviewed by legal counsel and found to be a valid exercise of the agency's
legal authority.
Filed with the Office of
the Secretary of State on August 20, 2001.
TRD-200104882
Susan Steeg
General Counsel
Texas Department of Health
Effective date: September 9, 2001
Proposal publication date: March 16, 2001
For further information, please call: (512) 458-7236
25 TAC §§143.1 - 143.20
The Texas Department of Health (department) adopts amendments
to §§143.1-143.14 and 143.16-143.20, the repeal of §143.15
and new §143.15 concerning the regulation and certification of persons
performing radiologic procedures. Sections 143.1-143.2, 143.4-143.12, 143.14
and 143.17 are adopted with changes to the proposed text as published in the
March 9, 2001, issue of the
Texas Register
(26 TexReg 1979). Sections 143.3, 143.13, 143.15-143.16, and 143.18-143.20
are adopted without changes, and therefore the sections will not be republished.
The repeal is adopted without changes, and therefore will not be republished.
Specifically the amendments cover purpose and scope; definitions; medical
radiologic technologist advisory committee; fees; applicability; application
requirements and procedures; types of certificates and applicant eligibility;
examinations; standards for the approval of curricula and instructors; certificate
issuance, renewals, and late renewals; continuing education requirements;
changes of name and address; certifying persons with criminal backgrounds;
disciplinary actions; dangerous or hazardous procedures; mandatory training
programs for non-certified technicians; registry of non-certified technicians;
hardship exemptions; and alternate training requirements. The repeal covers
alternate eligibility requirements. The new section proposed covers advertising
or competitive bidding.
The Government Code §2001.39 requires each state agency to review
and consider for readoption each rule adopted by that agency pursuant to the
Government Code, Chapter 2001 (Administrative Procedures Act). Title 25 Texas
Administrative Code (TAC), Chapter 143 which includes §§143.1-143.20
has been reviewed in its entirety and the department has determined that reasons
for adopting the sections continue to exist.
The Notice of Intention to Review the sections as required by Government
Code, §2001.039 was published in the
Texas Register
on September 8, 2000 (25 TexReg 9018). No comments were received in
response to the notice.
The amendments satisfy the requirements of Government Code, §2001.039
that requires each state agency to consider for readoption of each rule adopted
by that agency, amends the rules pursuant to the codification of the Medical
Radiologic Technologist Certification Act into the new Texas Occupations code,
Chapter 601, implement provisions of House Bill (HB) 2085 and HB 2636, 76th
Legislature, 1999; delete language that is no longer necessary; add a definition
for a provisional medical radiologic technologist; add fees for application
and renewal of non-certified technicians, hardship exemptions and returned
checks; add formal hearing requirements; and update and clarify existing language.
The repeal of §143.15 allows for adoption of new §143.15 implementing
provisions of HB 2085 concerning advertising or competitive bidding.
The following comments were received concerning the proposed amendments.
Following each comment is the department's response and any resulting change(s).
Comment: Concerning §143.7(b), a comment was received noting that
the title radiation therapy technologist has been changed to radiation therapist
and that the American Registry of Clinical Radiography Technologists is no
longer in existence.
Response: The department agrees and has changed radiation therapy technologist
to radiation therapist and has deleted the reference to American Registry
of Clinical Radiography Technologists. The change to radiation therapist is
also being made in §§143.7(d)(2), 143.7(f)(1) and 143.8(b).
Comment: Concerning §143.7(b), a comment was received recommending
current registration not just for radiographers registered with the American
Registry of Radiologic Technologists but for all persons who are and were
nationally certified.
Response: The department agrees and has made the suggested changes.
Comment: Concerning §143.7(f)(1), one commenter noted that the Committee
on Allied Health Education and Accreditation (CAHEA) had been replaced and
suggested wording using completion of a course of study that is accredited
by the United States Department of Education.
Response: The department agrees and has added language that includes courses
of study in radiography, radiation therapy, or nuclear medicine technology
that are accredited by the United State Department of Education including
but not limited to the Joint Committee on Education in Nuclear Medicine Technology
(JRCNMT) or the Joint Review Committee on Education in Radiologic Technology
(JRCERT).
Comment: Concerning §143.8(f), one commenter suggested adding language
to cover the pass or fail performance for the invasive cardiovascular and
basic science examination so for the Cardiovascular Credentialing International
examination since the passing score for that examination is 70 and not 75.
Response: The department agrees and has added language to address the scaled
score to determine the pass or fail performance of the Cardiovascular Credentialing
International examination as 70.
Comment: Concerning §143.9(h)(2)(C), one commenter requested changing
the language to clearly indicate that the applicable content of the limited
certification program be equal to the general certificate curriculum.
Response: The department agrees and appropriate language has been added
to the subparagraph.
Comment: Concerning §143.11, one commenter requested that all 24 hours
of continuing education be satisfied by online testing, directed reading or
self-study and not require 12 instructor directed hours of continuing education.
Response: The department disagrees. The department feels that instructor
directed hours of continuing education is needed. In the proposed amendments
the number of instructor directed hours had been reduced to three, but the
advisory committee recommended that classroom experience of instructor directed
hours not be reduced to three but to remain at 12. Language has been added
to require only 50% (12 hours) of the 24 hours be satisfied through verifiable
independent self study. Adding the language to only 12 hours of self study
requires the re-numbering of paragraphs in subsection (a) beginning with paragraph
(6) and in (g) beginning with paragraph (5).
Comment: Concerning proposed §143.11(a)(7), one commenter recommended
deleting submission of a current and active annual registration with the Nuclear
Medicine Technology Certification Board (NMTCB) to satisfy the continuing
education requirement since continuing education is not required to hold a
current and active annual registration with the NMTCB.
Response: The department agrees with the commenter and has deleted reference
to NMTCB in new §143.11(a)(8).
Comment: Concerning §143.11(d)(4) and (5) and §143.11(g)(9) and
(10), a commenter suggested that it would be more appropriate to allow six
hours of teaching and/or developing and publishing a manuscript for continuing
education. The recommendation would raise the total hours to 25% of the total
24 needed to renew.
Response: The department agrees and has made changes to subsection (d)
paragraphs (4) and (5) and to subsection (g) paragraphs (9) and (10) to reflect
six hours of continuing education which would be acceptable for teaching and/or
developing and publishing a manuscript during a continuing education period.
Comment: Concerning §143.14(c)(14), one commenter recommended the
addition of the Cardiovascular Credentialing International to the credentialing
agency or organizations recognized by the department for qualifying medical
radiologic technologists.
Response: The department agrees and has added Cardiovascular Credentialing
International to the list.
The following minor changes are being made due to staff comments to correct
the citation for the Texas Occupations Code. Other minor editorial changes
were made to §§143.2; 143.7(h)(1) - (2) and (i), 143.9(b)(2); 143.11(c)(2),
(g)(9) and (i)(6). Editorial changes to delete acronyms were made to §§143.2(8),
(10), (25), (27), (33); 143.5(b)(2), 143.5(c)(1)-(2) and (4); 143.9(g)(1)(C)
and 143.17(a)(1)(C).
Change: Concerning §§143.1(a) and 143.2(1), changes were made
to delete references to Texas Civil Statutes, Article 4512m.
Change: Concerning §143.4(b)(10) and (11), language was deleted requesting
a specific fee amount for an examination and added language that the fee amount
charged for an examination is set by contract with the examining board.
Change: Concerning §143.6, all reference of notarization was removed
to simply the application process.
Change: Concerning §143.6(a)(5), citation was changed from §143.10(f)
to §143.10(e) to reference the correct subsection.
Change: Concerning §143.7(c)(6), reference added to include provisional
license to the list of certificates that can be issued.
Change: Concerning §143.10(e), language has been added requiring submission
of supporting documentation to satisfy continuing education requirements when
persons request late renewal of their certificate. Without the additional
language a current and active registration with the American Registry of Radiologic
Technologist could be submitted.
Change: Concerning §143.11(d)(4), language was added to clarify that
if teaching is considered part of one's employment then continuing education
credit would not be acceptable for that teaching.
Change: Concerning §143.11(j)(2), language was added to include for
partial continuing education exemption all forms of non-ionizing advanced
level examinations offered by the American Registry of Radiologic Technologists
Change: Concerning §143.12(c), language on the necessity of having
documentation notarized when requesting a name change was deleted.
Change: Since §143.15, concerning Alternate Eligibility Requirements
is repealed, language has been added to §143.7(f)(5), to allow examination
for state certification purposes only.
Change: Concerning §142.17(c)(1)(C), make correction in reference
of a state agency.
The comments on the proposed rules received by the department during the
comment period were submitted by the American Registry of Radiologic Technologists.
In addition, numerous individuals commented. All commenters were not against
the rules in their entirety; however, they expressed concerns, and suggested
recommendations for change as discussed in the summary of comments.
The amendments and new section are adopted under the Medical
Radiologic Technologist Certification Act, §601.052, Texas Occupations
Code, which provides the Texas Board of Health (board) with the authority
to adopt rules necessary to implement the Act; and the Texas Health and Safety
code §12.001, which provides the board with the authority to adopt rules
for the performance of every duty imposed by law on the board, the department,
and commissioner for health.
§143.1.Purpose and Scope.
(a)
Purpose. These sections are intended to implement the provisions
of the Medical Radiologic Technologist Certification Act, Texas Occupations
Code, Chapter 601.
(b)
Scope. These sections cover definitions; the Medical Radiologic
Technologist Advisory Committee; fees; applicability (exceptions to certification);
application requirements and procedures; types of certificates; examinations;
standards for curricula and instructor approval; certificate renewal; continuing
education requirements; changes of name or address; certifying persons with
criminal backgrounds to be medical radiologic technologists; disciplinary
actions; alternate eligibility requirements; dangerous or hazardous procedures;
mandatory training programs for non-certified technicians; registry of non-certified
technicians; hardship exemptions; and alternate training requirements.
§143.2.Definitions.
The following words and terms, when used in this chapter, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)
Act--The Medical Radiologic Technologist Certification
Act Texas Occupations Code, Chapter 601.
(2)
Administrator--The department employee designated as the
administrator of regulatory activities authorized by the Act.
(3)
Applicant--A person who applies to the Texas Department
of Health for a certificate or temporary certificate, general or limited or
a provisional certificate.
(4)
ARRT--The American Registry of Radiologic Technologists
and its predecessor or successor organizations.
(5)
Board--The Texas Board of Health.
(6)
Cardiovascular (CV)--Limited to radiologic procedures involving
the use of contrast media and or ionizing radiation for the purposes of diagnosing
or treating a disease or condition of the cardiovascular system
(7)
Certificate--A medical radiologic technologist certificate,
general, limited or provisional, unless the wording specifically refers to
one or the other, issued by the Texas Department of Health.
(8)
Chiropractor--A person licensed by the Texas State Board
of Chiropractic Examiners to practice chiropractic.
(9)
Committee--The Medical Radiologic Technologist Advisory
Committee.
(10)
Dentist--A person licensed by the Texas State Board of
Dental Examiners to practice dentistry.
(11)
Department--The Texas Department of Health.
(12)
Federally qualified health center (FQHC)--A health center
as defined by 42 United States Code, §1396d(2)(B).
(13)
Fluoroscopy--The practice of examining tissues using a
fluorescent screen, including digital and conventional methods.
(14)
Fluorography--Hard copy of a fluoroscopic image; also
known as spot films.
(15)
General certification--An authorization to perform radiologic
procedures.
(16)
Instructor--An individual approved by the department to
provide instruction and training in the discipline of medical radiologic technology
in an educational setting.
(17)
Limited certification--An authorization to perform radiologic
procedures that are limited to specific parts of the human body.
(18)
Limited Medical Radiologic Technologist (LMRT)--A person
who holds a limited certificate issued under the Act, and who under the direction
of a practitioner, intentionally administers radiation to specific parts of
the bodies of other persons for medical reasons. The limited categories are
the skull, chest, spine, extremities, podiatric, chiropractic and cardiovascular.
(19)
Medical radiologic technologist (MRT)--A person who holds
a general certificate issued under the Act, and who, under the direction of
a practitioner, intentionally administers radiation to other persons for medical
reasons.
(20)
Mobile radiography--Includes mobile x-ray equipment and
portable x-ray equipment.
(21)
Mobile x-ray equipment--Equipment mounted on a permanent
base with wheels and/or casters for moving while completely assembled.
(22)
NMTCB--Nuclear Medicine Technology Certification Board
and its successor organizations.
(23)
Non-Certified Technician (NCT)--A person who has completed
a training program and who is listed in the registry. An NCT may not perform
a radiologic procedure which has been identified as dangerous or hazardous.
(24)
Pediatric--A person within the age range of fetus to age
18 or otherwise required by Texas law, when the growth and developmental processes
are generally complete. These rules do not prohibit a practitioner taking
into account the individual circumstances of each patient and determining
if the upper age limit requires variation by not more than two years.
(25)
Physician--A person licensed by the Texas State Board
of Medical Examiners to practice medicine.
(26)
Physician assistant--A person licensed as a physician
assistant by the Texas State Board of Physician Assistant Examiners.
(27)
Podiatrist--A person licensed by the Texas State Board
of Podiatric Medical Examiners to practice podiatry.
(28)
Portable x-ray equipment--Equipment designed to be hand-carried.
(29)
Practitioner--A doctor of medicine, osteopathy, podiatry,
dentistry, or chiropractic who is licensed under the laws of this state and
who prescribes radiologic procedures for other persons for medical reasons.
(30)
Provisional medical radiologic technologist (PMRT) --An
authorization to perform radiologic procedures not to exceed 180 days for
individuals currently licensed or certified in another jurisdiction.
(31)
Radiation--Ionizing radiation in amounts beyond normal
background levels from sources such as medical and dental radiologic procedures.
(32)
Radiologic procedure--Any procedure or article intended
for use in the diagnosis of disease or other medical or dental conditions
in humans (including diagnostic x-rays or nuclear medicine procedures) or
the cure, mitigation, treatment, or prevention of disease in humans that achieves
its intended purpose through the emission of ionizing radiation.
(33)
Registered nurse--A person licensed by the Board of Nurse
Examiners to practice professional nursing.
(34)
Registry--A list of names and other identifying information
of non-certified technicians.
(35)
Sponsoring institution--A hospital, educational, or other
facility, or a division thereof, that offers or intends to offer a course
of study in medical radiologic technology.
(36)
Supervision--Responsibility for and control of quality,
radiation safety and protection, and technical aspects of the application
of ionizing radiation to human beings for diagnostic and/or therapeutic purposes.
(37)
Temporary certification, general or limited--An authorization
to perform radiologic procedures for a limited period, not to exceed one year.
(38)
TRCR--Texas Regulations for the Control of Radiation,
25 Texas Administrative Code, Chapter 289 of this title. The regulations are
available from the Standards Branch, Bureau of Radiation Control, Texas Department
of Health, 1100 West 49th Street, Austin, Texas 78756-3189 (phone 1-512-834-6688).
§143.4.Fees.
(a)
Unless otherwise specified, the fees established in this
section must be paid to the department before a certificate is issued. All
fees shall be submitted in the form of a personal check, certified check or
a money order, if paid by mail. If submitted in person, cash may be accepted
by the department's cashier. All fees are nonrefundable.
(b)
The schedule of fees is as follows:
(1)
application and initial certification fee--$75;
(2)
biennial certificate renewal fee--$40;
(3)
one to 90-day late renewal fee-- one and one half of the
normally required renewal fee;
(4)
91-day to one year late renewal fee--two times the normally
required renewal fee;
(5)
certificate and/or identification card replacement or duplicate
fee--$20;
(6)
general certificate to limited certificate conversion fee--$20;
(7)
temporary certificate fee--$25;
(8)
temporary certificate and/or identification card replacement
or duplicate fee--$20;
(9)
general examination fee--the fee for the examination as
set by contract with the examining body;
(10)
chiropractic examination fee-the fee for the examination
as set by contract with the examining board;
(11)
skull, chest, spine, extremities or podiatric examination
fee--the fee for the examination as set by contract with the examining board;
(12)
upgrade of a temporary certificate to a renewable certificate,
limited or general--$25;
(13)
limited instructor approval fee--$50;
(14)
limited curriculum application fee--$450 per year per
course of study;
(15)
site visit fee--a fee equal to the round trip travel expenses
including meals and lodging of the inspection committee members, not to exceed
$1,000;
(16)
training program application fee--$350 (the application
fee for training programs accredited by the Texas Higher Education Coordinating
Board shall be waived);
(17)
training program amendment fee--$40 (the amendment fee
for training programs accredited by the Texas Higher Education Coordinating
Board shall be waived);
(18)
training program renewal fee--$150 (the renewal fee for
training programs accredited by the Texas Higher Education Coordinating Board
shall be waived);
(19)
limited curriculum amendment fee -- $40;
(20)
annual limited curriculum approval fee for general certificate
programs--$225;
(21)
non-certified technician application fee--$25;
(22)
non-certified technician renewal fee--$25;
(23)
non-certified technician late renewal fee--$50;
(24)
hardship exemption application fee--$25;
(25)
provisional certificate fee--$75;
(26)
return check fee--$25.
§143.5.Applicability of Chapter; Exemptions.
(a)
Except as specifically exempted by subsections (b) and
(c) of this section, the provisions of the Act and this chapter apply to any
person representing that he or she performs radiologic procedures.
(b)
This chapter does not prohibit the performance of a radiologic
procedure by the following:
(1)
A person who is a practitioner and performs the procedure
in the course and scope of the profession for which that person holds the
license; or
(2)
a person who performs a radiologic procedure involving
a dental x-ray machine, including panarex or other equipment designed and
manufactured only for use in dental radiography and under the instruction
or direction of a dentist, if the person and the dentist are in compliance
with rules adopted under the Act, §§601.251 and 601.252 by the Texas
State Board of Dental Examiners.
(c)
This chapter does not prohibit the performance of a radiologic
procedure which has not been identified as dangerous or hazardous under §143.16
of this title (relating to Dangerous or Hazardous Procedures) by the following:
(1)
a person who has successfully completed a training program
for non-certified technicians (NCT), in accordance with §143.17 of this
title (relating to Mandatory Training Programs for Non-Certified Technicians)
and who performs the procedure under the instruction or direction of a practitioner
if the person and the practitioner are in compliance with rules adopted under
the Act, §§601.251 - 601.253, by the Texas State Board of Chiropractic
Examiners, Texas State Board of Medical Examiners, Texas State Board of Nurse
Examiners, or Texas State Board of Podiatry Examiners;
(2)
a person who has successfully completed a training program
for NCTs, in accordance with §143.17 of this title and who performs the
procedure in a hospital that participates in the federal Medicare program
or is accredited by the Joint Commission on Accreditation of Healthcare Organizations;
(3)
students of medicine, osteopathic medicine, podiatry or
chiropractic when under instruction or direction of a practitioner and if
the student and the practitioner are in compliance with paragraph (1) of this
subsection;
(4)
a person who performs only in-vitro clinical or laboratory
testing procedures as described in the Texas Regulations for the Control of
Radiation;
(5)
a student enrolled in a radiologic technology program which
meets the requirements of §143.9 of this title (relating to Standards
for the Approval of Curricula and Instructors) or §143.17 of this title
who is performing radiologic procedures in an academic or clinical setting
as part of the program; or
(6)
a person who performs radiologic procedures for a period
of not more than ten days, while enrolled in and as a part of continuing education
activities which meet the minimum standards set out in §143.11 of this
title (relating to Continuing Education Requirements) and who is licensed
or otherwise registered as a medical radiologic technologist in or by another
state, District of Columbia, a territory of the United States, the American
Registry of Radiologic Technologists (ARRT), the Nuclear Medicine Technology
Certification Board (NMTCB), the Board of Registry of the American Society
of Clinical Pathologists, the Canadian Association of Medical Radiologic Technologists,
the British Society of Radiographers, the Australian Institute of Radiography,
or the Society of Radiographers of South Africa; or
(7)
a person who performs the procedure in a hospital, federally
qualified health center (FQHC), or for a practitioner, if a hardship exemption
was granted to the hospital, FQHC or practitioner by the department during
the previous 12-month period under §143.19 of this title (relating to
Hardship Exemptions).
§143.6.Application Requirements and Procedures For Examination and Certification.
(a)
General.
(1)
Unless otherwise indicated, an applicant must submit all
required information and documentation of credentials on official department
forms.
(2)
The department shall not consider an application as officially
submitted until the applicant pays the correct fee in accordance with §143.4
of this title. The correct fee must accompany the application form.
(3)
The department shall send a notice listing the additional
materials required to an applicant whose application is incomplete. An application
not completed within 30 days after the date of notice shall be invalid unless
the applicant has advised the department of a valid reason for the delay.
(4)
Applications will be accepted for a temporary certificate
from students not more than 28 calendar days prior to the date of graduation
from an approved medical radiologic technologist education program.
(5)
A certificate may be reinstated only in accordance with §143.10(e)
of this title.
(b)
Required application materials.
(1)
The application form shall contain the following items:
(A)
specific information regarding personal data, social security
number, birth date, current and previous places of employment, other state
licenses and certificates held, misdemeanor and felony convictions, and educational
and training background;
(B)
a statement that the applicant has read the Texas Medical
Radiologic Technologist Certification Act (the Act) and this chapter and agrees
to abide by them;
(C)
the applicant's permission to the department to seek any
information or references which are material in determining the applicant's
qualifications;
(D)
a statement that the applicant, if issued a certificate,
shall return the certificate and identification card(s) to the department
upon the expiration, revocation, surrender or suspension of the certificate;
(E)
a statement that the applicant understands that the fees
submitted are nonrefundable unless the processing time is exceeded without
good cause as set out in subsection (e)(1) of this section;
(F)
a statement that the applicant understands that the materials
submitted become the property of the department and are nonreturnable (unless
prior arrangements have been made);
(G)
a statement that the information in the application is
truthful and that the applicant understands that providing false or misleading
information which is material in determining the applicant's qualifications
may result in the voiding of the application and failure to be granted any
certificate or the revocation of any certificate issued;
(H)
a statement that the applicant shall advise the department
of his or her current mailing address within 30 days of any change of address;
(I)
the signature of the applicant which has been dated; and
(J)
a full-face color photo signed on the reverse side with
the applicant's signature as it appears on the application. The photograph
must have been taken within the two-year period prior to application to the
department and the minimum size is 1-1/2 inches by 1-1/2 inches.
(2)
Applicants for a certificate who do not qualify under the
provisions of §143.7(b) of this title (relating to Types of Certificates
and Applicant Eligibility) must submit the following additional documents:
(A)
if the applicant is not a graduate of or expected to graduate
within 28 calendar days from a general certificate program in accordance with §143.9(a)
of this title (relating to Standards for the Approval of Curricula and Instructors),
a photocopy which has been notarized as a true and exact copy of an unaltered
official diploma or official transcript indicating graduation from high school;
a certificate of high school equivalency issued by the appropriate educational
agency; or an official transcript from an accredited college or university
indicating that the applicant received a high school diploma or the equivalency
or was awarded an associate, baccalaureate, or post-baccalaureate degree;
and
(B)
at least one of the items set out as follows:
(i)
a photocopy of an unaltered certificate of completion from
an approved medical radiologic technologist educational program in accordance
with §143.9 of this title. The certificate must contain the following
items: name of the program; name of the graduate; the exact day and month
applicant is recognized as a program graduate; and the signature of the program
director or his designate;
(ii)
an original letter or other notification from either the
American Registry of Radiologic Technologists (ARRT) or the Nuclear Medicine
Technology Certification Board (NMTCB) that the applicant is considered examination
eligible; or
(iii)
if applying prior to graduation, from an approved medical
radiologic program in accordance with §143.9 of this title, an expected
graduation statement signed by the program director or registrar. Within 30
days of the completion date noted in the graduation statement, the department
must receive:
(I)
a photocopy of the certificate of completion or letter
on letterhead indicating graduation, containing the items set out in clause
(i) of this subparagraph; or
(II)
a statement signed by the program director or registrar
indicating that the applicant officially completed the program.
(3)
Persons applying under the provisions of §143.7(d)(5)
of this title must submit to the department a properly completed other license/registration
documentation report form which has been completed and signed by an authorized
representative of the governmental agency which issued the license or other
form of registration. A photocopy of the license or other form of registration
in medical radiologic technology issued by the government of another state,
District of Columbia, or territory of the United States shall be submitted
by the applicant.
(c)
Application approval.
(1)
The administrator shall be responsible for reviewing all
applications.
(2)
The administrator shall approve any application which is
in compliance with this chapter and which properly documents applicant eligibility,
unless the application is disapproved under the provisions of subsection (d)
of this section.
(d)
Disapproved applications.
(1)
The department may disapprove the application if the applicant:
(A)
has not met the eligibility and application requirements
set out in this section and §143.7 of this title;
(B)
has failed to pass the examination prescribed in §143.8
of this title (relating to Examinations);
(C)
has failed to remit any required fees;
(D)
has failed or refused to properly complete or submit any
application form(s) or endorsement(s) or has knowingly presented false or
misleading information on the application form, or any other form or documentation
required by the department to verify the applicant's qualifications for certification;
(E)
has obtained or attempted to obtain a certificate issued
under the Act by bribery or fraud;
(F)
has made or filed a false report or record made in the
person's capacity as a medical radiologic technologist;
(G)
has intentionally or negligently failed to file a report
or record required by law;
(H)
has intentionally obstructed or induced another to intentionally
obstruct the filing of a report or record required by law;
(I)
has engaged in unprofessional conduct, including the violation
of the standards of practice of radiologic technology established by the board
in §143.14 of this title (relating to Violations and Subsequent Actions);
(J)
has developed an incapacity that prevents the practice
of radiologic technology with reasonable skill, competence, and safety to
the public as the result of:
(i)
an illness;
(ii)
drug or alcohol dependency; or
(iii)
another physical or mental condition or illness;
(K)
has failed to report to the department the violation of
the Act by another person;
(L)
has employed, for the purpose of applying ionizing radiation
to a person, a person who is not certified under or in compliance with the
Act;
(M)
has violated a provision of the Act, a rule adopted under
the Act, an order of the department previously entered in a disciplinary proceeding,
or an order to comply with a subpoena issued by the department;
(N)
has had a certificate revoked, suspended, or otherwise
subjected to adverse action or been denied a certificate by another certification
authority in another state, territory, or country; or
(O)
has been convicted of, pled nolo contendere to, or received
deferred adjudication for a crime which directly relates to the practice of
radiologic technology.
(2)
If the administrator determines that the application should
not be approved, the administrator shall give the applicant written notice
of the reason for the disapproval and of the opportunity for a formal hearing
in accordance with the department's formal hearing procedures in Chapter 1
of this title (relating to Texas Board of Health). Within ten days after receipt
of the written notice, the applicant shall give written notice to the administrator
to waive or request the hearing. If the applicant fails to respond within
ten days after receipt of the notice of opportunity or if the applicant notifies
the administrator that the hearing be waived, the department shall disapprove
the application.
(3)
An applicant whose application has been disapproved under
paragraph (1)(D)-(O) of this subsection shall be permitted to reapply after
a period of not less than one year from the date of the disapproval and shall
submit a current application, the certification fee and proof, satisfactory
to the department, of compliance with the then current requirements of this
chapter and the provisions of the Act.
(e)
Application processing.
(1)
The department shall comply with the following procedures
in processing applications for a certificate.
(A)
The following periods of time shall apply from the date
of receipt of an application until the date of issuance of a written notice
that the application is complete and accepted for filing or that the application
is deficient and additional specific information is required. A written notice
stating that the application has been approved may be sent in lieu of the
notice of acceptance of a complete application. The time periods are as follows:
(i)
letter of acceptance of application for certification--21
days. The notice of acceptance may include a statement that an application
for temporary certificate received more than 28 calendar days from the date
of the applicant's graduation will be held pending until the applicant is
within 28 calendar days of graduation; and
(ii)
letter of application deficiency--21 days.
(B)
The following periods of time shall apply from the receipt
of the last item necessary to complete the application until the date of issuance
of written notice approving or denying the application. The time periods for
denial include notification of the proposed decision and of the opportunity,
if required, to show compliance with the law and of the opportunity for a
formal hearing. The time periods are as follows:
(i)
letter of approval--42 days; and
(ii)
letter of denial of certificate--90 days.
(2)
The department shall comply with the following procedures
in processing refunds of fees paid to the department.
(A)
In the event an application is not processed in the time
periods stated in paragraph (1) of this subsection, the applicant has the
right to request reimbursement of all fees paid in that particular application
process. Application for reimbursement shall be made to the administrator.
If the administrator does not agree that the time period has been violated
or finds that good cause existed for exceeding the time period, the request
will be denied.
(B)
Good cause for exceeding the time period is considered
to exist if the number of applications for certification or renewal exceeds
by 15% or more the number of applications processed in the same calendar quarter
the preceding year; another public or private entity relied upon by the department
in the application process caused the delay; or any other condition exists
that gives the department good cause for exceeding the time period.
(3)
If a request for reimbursement under paragraph (2) of this
subsection is denied by the administrator, the applicant may appeal to the
commissioner of health for a timely resolution of any dispute arising from
a violation of the time periods. The applicant shall give written notice to
the commissioner of health at the address of the department that he or she
requests full reimbursement of all fees paid because his or her application
was not processed within the applicable time period. The administrator shall
submit a written report of the facts related to the processing of the application
and of any good cause for exceeding the applicable time period. The commissioner
of health shall provide written notice of the decision to the applicant and
the program administrator. An appeal shall be decided in favor of the applicant,
if the applicable time period was exceeded and good cause was not established.
If the appeal is decided in favor of the applicant, full reimbursement of
all fees paid in that particular application process shall be made.
(4)
The time periods for contested cases related to the denial
of certification or renewal are not included with the time periods stated
in paragraph (1) of this subsection. The time period for conducting a contested
case hearing runs from the date the department receives a written request
for a hearing and ends when the decision of the department is final and appealable.
A hearing may be completed within three to six months, but may extend for
a longer period of time depending on the particular circumstances of the hearing.
§143.7.Types of Certificates and Applicant Eligibility.
(a)
General.
(1)
The department shall issue general certificates, limited
certificates, temporary certificates (general or limited) or provisional certificates.
(2)
Certificates and identification cards shall bear the signature
of the commissioner of the department.
(3)
Any certificate or identification card(s) issued by the
department remains the property of the department and shall be surrendered
to the department on demand.
(4)
A person certified as an MRT, LMRT or PMRT shall carry
or display the original certificate or current identification card at the
place of employment. Photocopies shall not be carried or displayed.
(5)
A person certified as an MRT, LMRT, or PMRT shall only
allow his or her certificate to be copied for the purpose of verification
by employers, licensing boards, professional organizations and third party
payors for credentialing and reimbursement purposes. Other persons and/or
agencies may contact the board's office in writing or by phone to verify certification.
(6)
No one shall display, present, or carry a certificate or
an identification card which has been altered, photocopied, or otherwise reproduced.
(7)
No one shall make any alteration on any certificate or
identification card issued by the department.
(b)
Special provisions for persons who are nationally certified.
Upon payment of the application fee, submission of the application forms and
approval by the department, the department shall issue a general certificate
to a person who is currently registered by the American Registry of Radiologic
Technologists (ARRT) as a radiographer, is currently registered by the ARRT
as a radiation therapist, or is currently registered by the ARRT or is currently
certified by the Nuclear Medicine Technologist Certification Board (NMTCB)
as a nuclear medicine technologist.
(c)
Minimum eligibility requirements for certification. The
following requirements apply to all individuals applying for certification
who do not meet the requirements of subsection (b) of this section:
(1)
graduation from high school or its equivalent as determined
by the Texas Education Agency;
(2)
attainment of 18 years of age;
(3)
freedom from physical or mental impairment which interferes
with the performance of duties or otherwise constitutes a hazard to the health
or safety of patients;
(4)
submission of a satisfactory completed application on a
form supplied by the department;
(5)
payment of the required fees; and
(6)
eligibility for the specific certificate requested as set
out in subsections (d), (e), (f), (g), (h) or (i), of this section.
(d)
Medical radiologic technologist. To qualify for a general
certificate an applicant shall meet at least one of the following requirements
:
(1)
possess current national certification as a registered
technologist by the ARRT;
(2)
have successfully completed the ARRT's examination in radiography,
radiation therapy, or nuclear medicine technology;
(3)
possess current national certification as a certified nuclear
medicine technologist by the NMTCB;
(4)
have successfully completed the NMTCB's examination in
nuclear medicine technology; or
(5)
be currently licensed or otherwise registered as a medical
radiologic technologist in another state, the District of Columbia, or a territory
of the United States whose requirements are more stringent than or are substantially
equivalent to the requirements for Texas certification.
(e)
Limited medical radiologic technologist. To qualify for
a limited certificate, an applicant shall meet the requirements in paragraph
(4) of this subsection and subsection (c) of this section.
(1)
The limited categories shall be as follows: skull; chest;
spine; extremities; chiropractic; podiatry; and cardiovascular.
(2)
Holding a limited certificate in all categories shall not
be construed to mean that the holder of the limited certificate has the rights,
duties, and privileges of a general certificate holder.
(3)
Persons holding a limited certificate in one or more categories
may not perform radiologic procedures involving the use of contrast media,
utilization of fluoroscopic equipment, mammography, tomography, mobile radiography,
nuclear medicine, and/or radiation therapy procedures. However, a person holding
a limited certificate in the cardiovascular category may perform radiologic
procedures involving the use of contrast media and/or ionizing radiation for
the purposes of diagnosing or treating a disease or condition of the cardiovascular
system.
(4)
To qualify for a certificate as an LMRT an applicant must
provide satisfactory documentary evidence to the department of the following:
(A)
the successful completion of a limited course of study
as set out in §143.9 of this title and the successful completion of the
appropriate limited examination in accordance with §143.8 of this title;
(B)
current licensure or registration as an LMRT in another
state, the District of Columbia, or a territory of the United States of America
whose requirements are more stringent than or substantially equivalent to
the requirements for the Texas limited certificate at the time of application
to the department; or
(C)
current general certification as an MRT issued by the department.
The MRT must surrender the general certificate and submit a written request
for a limited certificate indicating the limited categories requested. The
request shall be postmarked on or before the certificate expiration date and
shall be accompanied by the general certificate and the certificate and/or
identification card replacement fee.
(f)
Temporary medical radiologic technologist (general). To
qualify as a temporary medical radiologic technologist (general), an applicant
shall meet at least one of the following requirements. These are in addition
to those listed in subsection (c) of this section. For the general temporary
certificate, an applicant must:
(1)
have successfully completed or be within 28 calendar days
of successful completion of a course of study in radiography, radiation therapy,
or nuclear medicine technology which is accredited by the United States Department
of Education including but not limited to the Joint Committee on Education
in Nuclear Medicine Technology (JRCNMT) or the Joint Review Committee on Education
in Radiologic Technology (JRCERT);
(2)
be approved by the ARRT as examination eligible;
(3)
be approved by the NMTCB as examination eligible;
(4)
be currently licensed or otherwise registered as an MRT
in another state, the District of Columbia, or a territory of the United States
whose requirements are more stringent than or substantially equivalent to
the Texas requirements for certification at the time of application to the
department or;
(5)
have completed education, training and clinical experience
which is equivalent to that of a accredited educational program in radiography
as listed in paragraph (1) of this subsection. An applicant who meets this
requirement is eligible to be examined for state certification purposes only.
(g)
Temporary limited medical radiologic technologist. The
applicant shall meet at least one of the following requirements. These are
in addition to those listed in subsection (c) of this section. The applicant
must:
(1)
have successfully completed or be within 28 calendar days
of successful completion of a limited certificate program in the categories
of skull, chest, spine, abdomen or extremities, which is approved in accordance
with §143.9(b) of this title (relating to Standards for the Approval
of Curricula and Instructors);
(2)
be currently enrolled in a course of study in a general
certificate program approved in accordance with §143.9(a) of this title
and have been issued a certificate of completion by the program signifying
that the person has completed classroom instruction, clinical instruction,
evaluations and competency testing in all areas included in the limited curriculum,
as set out in §143.9(d) of this title; or
(3)
be currently licensed or otherwise registered as an LMRT
in another state, the District of Columbia, or a territory of the United States
whose requirements are more stringent than or substantially equivalent to
the Texas requirements for certification at the time of application to the
department.
(h)
Special provisions for technologists on active military
duty. An MRT or LMRT whose certificate has expired and was not renewed under §143.10(g)
of this title may file a complete application for another certificate of the
same type as that which expired.
(1)
The application shall be on official department forms and
be filed with the application and initial certification fee.
(2)
An applicant shall be entitled to a certificate of the
same type as that which expired based upon the applicant's previously accepted
qualification and no further qualifications or examination shall be required.
(3)
The application must include a copy of the official orders
or other official military documentation showing that the holder was on active
duty during any portion of the period for which the applicant was last certified.
(4)
An application is subject to disapproval in accordance
with §143.6(d) of this title.
(5)
An applicant for a different type of certificate than that
which expired must meet the requirements of this chapter generally applicable
to that type of certificate.
(i)
Provisional medical radiologic technologist. A provisional
certificate may be issued to an applicant who is currently licensed or certified
in another jurisdiction and who:
(1)
has been licensed or certified in good standing as a medical
radiologic technologist for at least two years in another jurisdiction, including
a foreign country, that has licensing or certification requirements substantially
equivalent to the requirements of the Act;
(2)
has passed a national or other examination recognized by
the department relating to the practice of radiologic technology; and
(3)
is sponsored by a medical radiologic technologist certified
by the department under this Act with whom the provisional certificate holder
will practice during the time the person holds a provisional certificate.
§143.8.Examinations.
(a)
Examination eligibility.
(1)
Holders of temporary certificates, limited or general may
take the appropriate examination provided the person complies with the requirements
of the Act and this chapter.
(2)
Persons who qualify under §143.7(b), (d), (e) or (i)
of this title are not required to be reexamined for state certification.
(b)
Approved examination for the general certificate. A general
certificate shall be issued upon successful completion of the Nuclear Medicine
Technology Certification Board (NMTCB) examination or the appropriate examination
of the American Registry of Radiologic Technologists (ARRT). The three disciplines
are radiography, nuclear medicine technology, and radiation therapy. Determination
of the appropriate examination shall be made on the basis of the type of educational
program completed by the general temporary certificate holder.
(c)
Approved examination for the limited certificate. An approval
letter requesting the limited certification fee shall be issued upon successful
completion of the appropriate examination, as follows:
(1)
skull--the ARRT examination for the limited scope of practice
in radiography (skull);
(2)
chest--the ARRT examination for the limited scope of practice
in radiography (chest);
(3)
spine--the ARRT examination for the limited scope of practice
in radiography (spine);
(4)
extremities--the ARRT examination for the limited scope
of practice in radiography (extremities);
(5)
chiropractic--the ARRT examinations for the limited scope
of practice in radiography (spine and extremities);
(6)
podiatric--the ARRT examination for the limited scope of
practice in radiography (podiatry); or
(7)
cardiovascular--the Cardiovascular Credentialing International
invasive registry examination.
(d)
Applicants approved for the limited certification examination
will be allowed three attempts to pass the examination. The three attempts
must be made within a three-year period of time. When either three unsuccessful
attempts have been made or three years have expired, the individual is no
longer considered eligible under this section. To be eligible for an additional
examination the applicant must submit documentation indicating completion
of remedial activities. The fourth attempt must occur within the one-year
period following the third unsuccessful attempt. Those failing the fourth
attempt, or waiting longer than one year following the third unsuccessful
attempt, shall only become eligible by re-entering and completing an approved
limited certification program. Upon the applicant's successful completion
of the examination, the department shall issue an approval letter for the
limited certificate.
(e)
Examination schedules. A schedule of examinations indicating
the date(s), location(s), fee(s) and application procedures shall be provided
by the agency or organization administering the examination(s) for the department
to each person issued any temporary certificate.
(f)
Standards of acceptable performance. The scaled score to
determine pass or fail performance shall be 75. For the cardiovascular limited
certificate, the Cardiovascular Credentialing International examinations (Cardiovascular
Science Examination and/or the Invasive Registry Examination as required to
obtain the Registered Cardiovascular Invasive Specialist RCIS credential)
the scaled score to determine pass or fail performance shall be 70.
(g)
Completion of examination application forms. Each applicant
shall be responsible for completing and transmitting appropriate examination
application forms and paying appropriate examination fees by the deadlines
set by the department or the agency or organization administering the examinations
prescribed by the department.
(h)
Examination Results.
(1)
Notification to examinees. Results of an examination prescribed
by the department but administered under the auspices of another agency will
be communicated to the applicant by the department, unless the contract between
the department and that agency provides otherwise.
(2)
Score release. The applicant is responsible for submitting
a signed score release to the examining agency or organization or otherwise
arranging to have examination scores forwarded to the department.
(3)
Deadlines. The department shall notify each examinee of
the examination results within 14 days of the date the department receives
the results.
(i)
Refunds. Examination fee refunds will be in accordance
with policies and procedures of the department or the agency or organization
prescribed by the department to administer an examination. No refunds will
be made to examination candidates who fail to appear for an examination.
§143.9.Standards for the Approval of Curricula and Instructors.
(a)
General certificate programs. All curricula and programs
to train individuals to perform radiologic procedures must be accredited by
the United States Department of Education including but not limited to the
Joint Review Committee on Education in Nuclear Medicine Technology (JRCNMT)
or the Joint Review Committee on Education in Radiologic Technology (JRCERT).
(b)
Limited certificate programs. All curricula and programs
to train individuals to perform limited radiologic procedures must:
(1)
be accredited by the JRCERT to offer a limited curriculum
in radiologic technology;
(2)
be accredited by the Joint Review Committee on Education
in Cardiovascular Technology (JRCCVT) to offer a curriculum in invasive cardiovascular
technology;
(3)
be accredited by JRCERT under subsection (b) of this section;
or
(4)
be approved by the department and be offered within the
geographic limits of the State of Texas. Subsections (c)-(g) of this section
apply only to department-approved programs.
(c)
Application procedures for limited certificate programs
which are not accredited by JRCERT or JRCCVT. An application shall be submitted
to the department at least ten weeks prior to the starting date of the program
to be offered by a sponsoring institution. Official application forms are
available from the department and must be completed and signed by the program
director of the sponsoring institutions program. Program directors shall be
responsible for the curriculum, the organization of classes, the maintenance
and availability of facilities and records, and all other policies and procedures
related to the program or course of study.
(1)
All official application forms must be notarized and shall
be accompanied by the application fee in accordance with §143.4 of this
title.
(2)
An original and four copies of the entire application and
supporting documentation must be submitted in three-ring binders with all
pages clearly legible and consecutively numbered. Each application binder
must contain a table of contents and must be divided with tabs identified
to correspond with the items listed in this section. If any item is inapplicable,
a page shall be included behind the tab for that item with a statement explaining
the inapplicability.
(3)
Narrative materials must be typed, double-spaced, and clearly
legible. All signatures on the official forms and supporting documentation
must be originals. Photocopied signatures will not be accepted.
(4)
Notices will be mailed to applicants informing the applicant
of the completeness or within 60 days of receipt of the application in the
department. Applications which are received incomplete may cause postponement
of the program starting date. The time of receipt of the last item necessary
to complete the application to the date of issuance of written notice approving
or denying the application is 120 days. In the event these time periods are
exceeded, the applicant has the right to request reimbursement of fees, as
set out in §143.6 (e)(2) and (3) of this title.
(5)
If the application is revised or supplemented during the
review process, the applicant shall submit an original and four copies of
a transmittal letter plus an original and three copies of the revision or
supplement. If a page is to be revised, the complete new page must be submitted
with the changed item/information clearly marked on five copies.
(6)
The application shall include:
(A)
the anticipated dates of the program or course of study;
(B)
the daily hours of the program or course of study;
(C)
the location, mailing address, phone and facsimile numbers
of the program;
(D)
a list of instructors approved by the department, in accordance
with subsection (f) of this section, and any other persons responsible for
the conduct of the program including management and administrative personnel.
The list must indicate what courses each will teach or instruct or the area(s)
of responsibility for the non-instructional staff;
(E)
a list of clinical facilities, written agreements on forms
prescribed by the department from clinical facilities signed by the program
director and the chief executive officer(s) of each facility, and clinical
schedules, including the following items identified for each clinical site
utilized. A clinical facility which is not listed on the application may not
be utilized for a student's clinical practicum until the department has accepted
the additional clinical facility in accordance with paragraph (10) of this
subsection. The items are:
(i)
the number and types (name brands and model numbers) of
radiologic equipment to be utilized in the limited curriculum;
(ii)
a copy of the current registration(s) for the radiologic
equipment from the department's Bureau of Radiation Control;
(iii)
the number and location(s) of examination rooms available;
(iv)
whether or not the clinical facility is accredited by
the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
or certified to participate in the federal Medicare program, and if required,
is licensed by the appropriate statutory authority. For example, if the facility
is an ambulatory surgical center, licensure by the department is required;
(v)
an acknowledgement that students may only perform radiologic
procedures under supervision of a practitioner, a limited medical radiologic
technologist (LMRT) employed at the clinical facility or medical radiologic
technologist (MRT) employed at the clinical facility;
(vi)
copies of the current identification cards issued by the
department to the LMRTs or MRTs who will supervise the students at all times
while performing radiologic procedures;
(vii)
an acknowledgment that the students in a limited curriculum
program in the categories of skull, chest, spine, abdomen, extremities, chiropractic
or podiatric shall not perform procedures utilizing contrast media, mammography,
fluoroscopy, tomography, nuclear medicine studies, radiation therapy or other
procedures beyond the scope of the limited curriculum; and
(viii)
an acknowledgment that the students in a limited curriculum
program in the cardiovascular category shall not perform mammography, tomography,
nuclear medicine studies, radiation therapy or other procedures beyond the
scope of the limited curriculum. Such students may only perform radiologic
procedures of the cardiovascular system which involve the use of contrast
media and fluoroscopic equipment.
(F)
clearly defined and written policies regarding admissions,
costs, refunds, attendance, disciplinary actions, dismissals, re-entrance,
and graduation which are provided to all prospective students prior to registration
and by which the program director shall administer the program. The admission
requirements shall include the minimum eligibility requirements for certification
in accordance with §143.7(c)(1)-(2) of this title.
(G)
the name of the program director who is an approved instructor
in accordance with subsection (f) of this section, and who has not less than
three years of education or teaching experience in the appropriate field or
practice;
(H)
a letter of acknowledgement and a photocopy of the current
Texas license from a practitioner in the appropriate field of practice who
is knowledgeable in radiation safety and protection and who shall be known
as the designated medical director. The practitioner shall work in consultation
with the program director in developing goals and objectives and in implementing
and assuring the quality of the program;
(I)
a letter or other documentation from the Texas Workforce
Commission, Proprietary Schools Section indicating that the proposed training
program has complied with or has been granted exempt status under the Texas
Proprietary School Act, Texas Education Code, Chapter 32, and 19 Texas Administrative
Code, Chapter 175, or verification of accreditation by the Texas Higher Education
Coordinating Board; and
(J)
the correct number of students to be enrolled in each cycle
of the program, and if more than one cycle will be conducted concurrently,
the maximum number of students to be enrolled at any one time.
(7)
All applications must identify the type of curriculum according
to the limited categories in accordance with §143.7(e) of this title.
Each application must be accompanied by an outline of the curriculum and course
content which clearly indicates that students must complete a structured curriculum
in proper sequence according to subsection (d) of this section. If the curriculum
differs from that set out in subsection (d) of this section, a typed comparison
in table format clearly indicating how the curriculum differs from the required
curriculum, including the number of hours for each topic or unit of instruction,
shall be included.
(8)
In making application to the department, the program director
shall agree in writing to:
(A)
provide a ratio of not more than three students to one
full-time certified medical radiologic technologist engaged in the supervision
of the students in the clinical environment;
(B)
provide on-site instruction and direction by a practitioner
for students when performing radiologic procedures on human beings;
(C)
prohibit students from being assigned to any situation
where they would be required to apply radiation to a human being while not
under the on-site instruction or direction of a practitioner;
(D)
prohibit intentional exposure to human beings from any
source of radiation except for medically prescribed diagnostic purposes;
(E)
provide appropriate facilities, sufficient volume of procedures,
and a variety of diagnostic radiologic procedures to properly conduct the
course. Facilities, agencies, or organizations utilized in the program shall
be accredited or certified and licensed by the appropriate agencies. Equipment
and radioactive materials utilized in the program shall be used only in facilities
registered or licensed by the department's Bureau of Radiation Control;
(F)
keep an accurate record of each student's attendance and
participation, evaluation instruments and grades, clinical experience including
radiation exposure history, and subjects completed for not less than five
years from the last date of the student's attendance. Such records shall be
made available to examining boards, regulatory agencies, and other appropriate
organizations, if requested;
(G)
issue to each student, upon successful completion of the
program, a written statement in the form of a diploma or certificate of completion,
which shall include the program's name, the student's name, the date of completion,
the categories of instruction, and the signatures of the program director
or independent sponsor and medical director/program advisor;
(H)
permit site inspections by departmental representatives
to determine compliance and conformity with the provision of this section.
In lieu of a site inspection, the department may accept the most recent site
visit report from a recognized accrediting body set out in subsection (b)(1)
of this section;
(I)
understand and recognize that the graduates' success rate
on the prescribed examination will be monitored by the department and utilized
as a criteria for rescinding approval. In addition to this criteria, the department
may rescind approval in accordance with §143.14 of this title; and
(J)
comply with the Texas Regulations for the Control of Radiation,
including but not limited to, personnel monitoring devices for each student
upon the commencement of the clinical instruction and clinical experience.
(9)
A site visit may be necessary to grant approval of the
program. If a site visit is required, a site visit fee must be paid in accordance
with §143.4 of this title.
(10)
Following program approval, a written request(s) for amendment(s)
shall be submitted to and approved by the department in advance of taking
the anticipated action. The request to add or drop an instructor, clinical
site, category of instruction, program director or other change, shall be
accompanied by the limited curriculum program amendment application and fee
in accordance with §143.4 of this title.
(d)
Curricula requirements. Each student must complete a curriculum
which meets or exceeds the following requirements:
(1)
at least 132 clock hours of basic theory or classroom instruction
in the categories of skull, chest, extremities, spine, and chiropractic, and
not less than 66 clock hours of basic theory instruction for podiatric is
required. The required clock hours of basic theory/classroom instruction need
not be repeated if two or more categories of curriculum are completed simultaneously
or to add a category to a temporary limited or limited certificate. Pediatric
instruction shall be included in the hours of training. The following subject
areas and minimum number of hours (in parentheses) must be included in all
programs and must be instructor directed. The recommended clock hours for
each shall be:
(A)
radiation protection for the patient, self, and others
(40);
(B)
radiographic equipment including safety standards, operation,
and maintenance (15);
(C)
image production and evaluation (35);
(D)
applied human anatomy and radiologic procedures (20);
(E)
patient care and management essential to radiologic procedures
and recognition of emergency patient conditions and initiation of first aid
(10);
(F)
medical terminology (6); and
(G)
medical ethics and law (6); and
(2)
a clinical practicum for each category of limited curriculum
including pediatrics is required. The practicum must include clinical instruction
and clinical experience under the instruction or direction of a practitioner
and an MRT or LMRT in accordance with the following chart.
Figure: 25 TAC §143.9(d)(2)
(A)
The clinical instruction must be concurrent with the classroom
instruction, as set out in paragraph (1) of this subsection.
(B)
The clinical experience must commence immediately following
the clinical instruction and be completed within 180 days of the starting
date of the clinical experience. Variances from this must be approved in advance
by the department and must demonstrate good cause. A request for a variance
must be submitted in writing to the administrator. For the purposes of this
section, a normal pregnancy or medical disability shall constitute good cause.
(C)
For the skull category, the 100 hours of clinical experience
must include a minimum of 4 independently performed procedures to include
the skull (posterior/anterior, anterior/posterior, lateral and occipital),
paranasal sinuses, facial bones, and the mandible. At least one procedure
must be the mandible. The mandible procedure may be completed by simulation
with 90% accuracy. Only one student shall receive credit for any one radiologic
procedure performed.
(D)
The program director shall be responsible for supervising
and directing the evaluation of the students' clinical experience and shall
certify in writing that the student has or has not successfully completed
the required clinical instruction and clinical experience. Such written documentation
must be provided to each student within 14 days of completion of the clinical
experience. Students who successfully complete the required clinical experience
may be required to submit such documentation to the department if applying
for a temporary limited certificate with an expected graduation statement,
as set out in §143.6(b)(2)(B)(iii) of this title. Persons who participate
in the evaluation of students' clinical experience must be an MRT or LMRT
and have a minimum of two years of practical work experience performing radiologic
procedures. For cardiovascular, persons who makes the final evaluation of
students' clinical experience must be an MRT or LMRT and have a minimum of
two years of practical work experience performing cardiovascular procedures.
(e)
Limited certificate educational program approval.
(1)
Provided the requirements are met, the sponsoring institution
shall receive a letter from the department indicating approval of the educational
program in accordance with §113.1 of this title (relating to Processing
Permits for Special Health Services Professionals).
(2)
A program shall be denied approval if the application is
incomplete or not submitted as set out in this section. The applicant shall
be notified in accordance with §113.1 of this title.
(3)
If approval is proposed to be denied, the applicant shall
be notified in writing of the proposed denial and shall be given an opportunity
to request a formal hearing within 10 days of the applicant's receipt of the
written notice from the department. The formal hearing shall be conducted
according to the department's formal hearing procedures in Chapter 1 of this
title. If no hearing is requested, the right to a hearing is waived and the
proposed action shall be taken.
(f)
Instructor approval for limited certificate programs.
(1)
All persons who plan to or who will provide instruction
and training in the limited certificate courses of study or programs shall:
(A)
submit a completed application form prescribed by the department;
(B)
submit the prescribed application fee in accordance with §143.4
of this title;
(C)
document the appropriate instructor qualifications in accordance
with subsection (g) of this section.
(2)
Guest lecturers who are not full or part-time employees
of the sponsoring institution are not required to apply for instructor approval.
(3)
Within 21 days of receipt of the application in the department,
a notice will be mailed informing the applicant of the completeness or deficiency
of the application. The time of receipt of the last item necessary to complete
the application to the date of issuance of a written notice approving or denying
the application is 42 days. In the event these time periods are exceeded,
the applicant has the right to request reimbursement of fees paid as set out
in §143.6(e)(2) and (3) of this title.
(4)
An applicant who is not approved by the department shall
be given an opportunity to request a formal hearing within ten days of the
applicant's receipt of the written notice from the department. The formal
hearing shall be conducted according to the department's formal hearing procedures
in Chapter 1 of this title. If no hearing is requested, the right to a hearing
is waived and the proposed action shall be taken.
(g)
Instructor qualifications for limited certificate programs.
(1)
An instructor(s) shall have education and not less than
six months classroom or clinical experience teaching the subjects assigned,
shall meet the standards required by a sponsoring institution, if any, and
shall meet at least one or more of the following qualifications:
(A)
be a currently certified MRT who is also currently credentialed
as a radiographer by the American Registry of Radiologic Technologists (ARRT);
(B)
be a currently certified LMRT (excluding a temporary certificate)
whose limited certificate category(ies) matches the category(ies) of instruction
and training; or
(C)
be a practitioner who is in good standing with all appropriate
regulatory agencies including, but not limited to, the department, the Texas
State Board of Chiropractic Examiners, Texas State Board of Medical Examiners,
or Texas State Board of Podiatry Examiners, the Texas Department of Human
Services, and the United States Department of Health and Human Services.
(2)
A limited medical radiologic technologist may not teach,
train, or provide clinical instruction in a program or course of study different
from the technologist's current level of certification. An LMRT who holds
a limited certificate in spine radiography may not teach, train, or provide
clinical instruction in a limited course of study for chest radiography.
(h)
Application procedures for limited certificate programs
accredited by JRCERT or JRCCVT.
(1)
Application shall be made by the program director on official
forms available from the department.
(2)
The application must be notarized and shall be accompanied
by the following items:
(A)
the limited curriculum application fee, in accordance with §143.4
of this title;
(B)
a copy of the current accreditation issued to the program
by the JRCERT or JRCCVT;
(C)
a description in narrative and/or table format clearly
indicating that the applicable content of the limited certificate program
curriculum be equal to the general certificate curriculum; and
(D)
an agreement to allow the department to conduct an administrative
audit of the program to determine compliance with this section.
§143.10.Certificate Issuance, Renewals, and Late Renewals.
(a)
Issuance of certificates.
(1)
The department shall send each applicant whose application
has been approved a general, limited or provisional certificate with an expiration
date and a certificate number. An identification card shall be included with
the general certificate.
(2)
The department shall replace a lost, damaged, or destroyed
certificate or identification card(s) upon a written request and payment of
the replacement fee. Requests shall include a statement detailing the loss
or destruction of the original certificate and/or identification card(s),
or be accompanied by the damaged certificate or card(s).
(b)
Temporary certificates.
(1)
The department shall send each applicant whose application
has been approved for the temporary certificate (general or limited) an appropriate
temporary certificate which shall expire one year from the date of issue.
(2)
The department shall send with the temporary certificate
information regarding examinations and examination application deadlines.
(3)
All temporary certificates are not subject to renewals
or extensions for any reason. A person whose temporary certificate has expired
is not eligible to reapply for another temporary certificate.
(c)
Certificates. The initial general or limited certificate
is valid through the medical radiologic technologist's (MRT's) or limited
medical radiologic technologist's (LMRT's) next birth month; however, when
the next birth month occurs within six months, the certificate shall be issued
for that period plus the next full year in order to establish a staggered
renewal system.
(d)
Certificate renewal. Each MRT or LMRT shall renew the certificate
biennially on or before the last day of the MRT's or LMRT's birth month.
(1)
Each MRT is responsible for renewing the certificate before
the expiration date and shall not be excused from paying late fees. Failure
to receive notification from the department prior to the expiration date will
not excuse failure to file for renewal or late renewal.
(2)
At least 60 days prior to the expiration of an MRT's or
LMRT's certificate, the department shall send notice to the MRT or LMRT at
the address in the department's records at the time the notice is sent, of
the expiration date of the certificate, the amount of renewal fee due, and
a renewal form which the MRT or LMRT must complete and return to the department
with the required renewal fee.
(3)
The renewal form shall require the provision of the MRT's
or LMRT's preferred mailing address, primary employment address and phone
number, information regarding misdemeanor and felony convictions (if any since
initial certification or last renewal), and continuing education completed
in accordance with §143.11 of this title. The renewal form must be signed
and dated by the renewal applicant.
(4)
The MRT or LMRT has renewed the certificate when the renewal
form and required renewal fee are mailed on or before the expiration date
of the certificate and received by the administrator. The postmarked date
shall be considered the date of mailing. The processing times and procedures
set out in §143.6(e) of this title shall apply to renewals.
(5)
The department is not responsible for lost, misdirected,
or undelivered renewal application forms, fees, renewal certificates, or renewal
identification cards.
(6)
The department shall issue renewal identification cards
for the current renewal period to an MRT or LMRT who has met all the requirements
for renewal. The cards shall be sent to the preferred mailing address provided
on the renewal application form. The renewal cards shall be issued for a two-year
period except when a certificate is renewed in accordance with paragraph (7)
of this subsection or subsection (e) of this section.
(7)
The department shall issue renewal identification cards
to an MRT or LMRT who complies with paragraph (4) of this subsection but who
fails to complete the continuing education requirements for recertification
as set out in §143.11 of this title. The renewal identification cards
shall expire 120 days after the last day of the MRT's or LMRT's birth month.
If the deficiency is corrected and proof of completion of the continuing education
requirements is sent to the department within the 120-day period, the department
shall issue a renewal identification card which expires on the last day of
the MRT's or LMRT's next birth month plus one year. An MRT or LMRT who does
not correct the deficiency within 120 days shall not be allowed to extend
or renew the certificate.
(8)
The department shall deny renewal of a certificate if required
by the Education Code, §57.491, concerning defaults on guaranteed student
loans.
(9)
The department may not renew the certificate of an MRT
or LMRT who is in violation of the Act or this chapter at the time of renewal.
(e)
Late renewals.
(1)
A person whose certificate has expired for not more than
one year may renew the certificate by submitting to the department the completed
renewal form, completed continuing education report forms including supporting
documentation (if required), and the late renewal fee. An active annual registration
or credential card issued by the American Registry of Radiologic Technologists
does not constitute supporting documentation. A certificate issued under this
subsection shall expire two years from the date the previous certificate expired,
not including a 120-day certificate issued in accordance with subsection (d)(7)
of this section.
(A)
If the certificate has been expired for 90 days or less,
a person may renew the certificate by paying the one to 90-day late renewal
fee.
(B)
If the certificate has been expired for over 90 days but
not more than one year, a person may renew the certificate by paying the 91-day
to one-year late renewal fee.
(C)
A person must comply with the continuing education requirements
for renewal as set out in §143.11 of this title before the late renewal
is effective. A person is not eligible for a 120-day certificate as described
in subsection (d)(7) of this section.
(2)
The late renewal is effective if it is mailed to the department
or personally delivered by the MRT or LMRT or his/her agent to the department
not more than one year after certificate expiration. If mailed, the postmark
date shall be considered the date of mailing. A postage metered date is not
considered as a postmark. A certificate not renewed within one year after
expiration cannot be renewed.
(3)
A person whose certificate has expired may not administer
a radiologic procedure during the one-year period in violation of the Act.
A person may not use a title that implies certification while the certificate
is expired.
(4)
A person whose certificate has been expired for more than
one year may apply for another certificate by meeting the then-current requirements
of the Act and this chapter which apply to all new applicants.
(f)
Expired certificates. The department, using the last address
known, shall attempt to inform each MRT or LMRT who has not timely renewed
a certificate, after a period of more than 10 days after the expiration of
the certificate that the certificate has automatically expired. A person whose
certificate automatically expires is required to surrender the certificate
and identification cards to the department.
(g)
Active duty. If an MRT or LMRT is called to or on active
duty with the armed forces of the United States and so long as the MRT or
LMRT does not administer a radiologic procedure in a setting outside of the
active duty responsibilities during the time the MRT or LMRT is on active
duty, the MRT or LMRT shall not be required to complete any continuing education
activities during the renewal period in which the MRT or LMRT was on active
duty.
(1)
Renewal of the certificate may be requested by the MRT
or LMRT, a spouse, or an individual having power of attorney from the MRT
or LMRT. The renewal form shall include a current address and telephone number
for the individual requesting the renewal.
(2)
A copy of the official orders or other official military
documentation showing that the MRT or LMRT was on active duty for any portion
of the renewal period shall be filed with the department along with the renewal
form.
(3)
An affidavit stating that the MRT or LMRT has not administered
a radiologic procedure in a setting outside of the MRT or LMRT's active duty
responsibilities during the time of active duty shall be filed with the department
along with the renewal form. The affidavit may be executed by the MRT or LMRT,
a spouse, or an individual having power of attorney from the MRT or LMRT.
(4)
A copy of the power of attorney from the MRT or LMRT shall
be filed with the department along with the renewal form if the individual
having power of attorney executes any of the documents required by this subsection.
(5)
A certificate covered by this subsection may be renewed
in accordance with subsection (e) of this section. The 60-day late fee shall
be waived for a renewal under this subsection.
(6)
An MRT or LMRT on active duty with the United States armed
forces serving outside the State of Texas may request renewal of the certificate
at any time before or after the expiration of the certificate. An MRT or LMRT
on active duty serving within the State of Texas may request renewal before
the expiration of the certificate or under subsection (e) of this section.
An MRT or LMRT on active duty serving within the State of Texas who does not
renew under subsection (e) of this section may file a complete application
for another certificate in accordance with §143.7(h) of this title.
§143.11.Continuing Education Requirements.
(a)
General. Continuing education requirements for recertification
shall be fulfilled during each biennial renewal period beginning on the first
day of the month following each MRT's or LMRT's birth month and ending on
the last day of each MRT's or LMRT's birth month two years thereafter.
(1)
The initial continuing education period shall begin on
the first day of the MRT's or LMRT's first biennial renewal period. Each subsequent
period shall begin on the first day of the next biennial renewal period.
(2)
An MRT must complete 24 contact hours of continuing education
acceptable to the department during each biennial renewal period.
(3)
An LMRT must complete 12 contact hours of continuing education
acceptable to the department during each biennial renewal period. The continuing
education activities must be general radiation health and safety topics or
related to the categories of limited certificate held.
(4)
Each MRT or LMRT shall be notified of the continuing education
requirements with the first biennial renewal certificate sent by the department.
(5)
At least 50% of the required number of hours shall be satisfied
by attendance and participation in instructor-directed activities.
(6)
No more than 50% of the required number of hours may be
satisfied through verifiable independent self-study. These activities include
reading materials, audio materials, audiovisual materials, or a combination
thereof which meet the requirements set out in subsection (d) of this section.
(7)
An MRT or LMRT who also holds a current Texas license/registration/certification
in another health profession may satisfy the continuing education requirement
for renewal of the MRT or LMRT with hours counted toward renewal of the other
license, registration, or certification provided the hours meet all the requirements
of this section.
(8)
An MRT or LMRT who holds a current and active annual registration
or credential card issued by the American Registry of Radiologic Technologists
(ARRT) indicating that the MRT is in good standing and not on probation satisfies
the continuing education requirement for renewal of the general or limited
certificate provided the hours accepted by the agency or organization which
issued the card were completed not more than one year prior to the expiration
of the MRT or LMRT certificate and meet or exceed the requirements set out
in paragraph (5) of this section and subsection (b) of this section. The department
shall be able to verify the status of the card presented by the MRT or LMRT
electronically or by other means acceptable to the department. The department
may review documentation of the continuing education activities in accordance
with subsection (e) of this section.
(9)
A contact hour shall be defined as 50 minutes of attendance
and participation. One-half contact hour shall be defined as 30 minutes of
attendance and participation during a 30-minute period.
(10)
Persons who hold temporary certificates, either general
or limited, are not subject to these continuing education requirements.
(b)
Content. All continuing education activities should provide
for the professional growth of the technologist.
(1)
At least 50% of the required number of hours must be activities
which are directly related to the use and application of ionizing forms of
radiation to produce diagnostic images and/or administer treatment to human
beings for medical purposes. For the purpose of this section, directly related
topics include, but are not limited to: radiation safety, radiation biology
and radiation physics; anatomical positioning; radiographic exposure technique;
radiological exposure technique; emerging imaging modality study; patient
care associated with a radiologic procedure; radiopharmaceutics, pharmaceutics,
and contrast media application; computer function and application in radiology;
mammography applications; nuclear medicine application; and radiation therapy
applications.
(2)
No more than 50% of the required number of hours may be
satisfied by completing or participating in learning activities which are
related to the use and application of non-ionizing forms of radiation for
medical purposes.
(3)
No more than 50% of the required number of hours may be
satisfied by completing or participating in learning activities which are
indirectly related to radiologic technology. For the purpose of the section,
indirectly related topics include, but are not limited to, patient care, computer
science, computer literacy, introduction to computers or computer software,
physics, human behavioral sciences, mathematics, communication skills, public
speaking, technical writing, management, administration, accounting, ethics,
adult education, medical sciences, and health sciences. Other courses may
be accepted for credit provided there is a demonstrated benefit to patient
care.
(c)
Types of acceptable continuing education. Continuing education
shall be acceptable if the experience or activity is at least 30 consecutive
minutes in length and:
(1)
is offered for semester hour or quarter hour credit by
an institution accredited by a regional accrediting organization such as the
Southern Association of Colleges and Schools and is directly or indirectly
related to the disciplines of radiologic technology as specified in subsection
(a) of this section; or
(2)
is offered for continuing education credit by an institution
accredited by the Joint Review Committee on Education in Radiologic Technology
(JRCERT), Joint Review Committee on Education in Nuclear Medicine Technology
(JRCNMT), Joint Review Committee on Education in Cardiovascular Technology
(JTCCVT), or the Council on Chiropractic Education (CCE) and is directly or
indirectly related to the disciplines of radiologic technology; or
(3)
is an educational activity which meets the following criteria:
(A)
the content meets the requirements set out in subsection
(b) of this section; and
(B)
is approved, recognized, accepted, or assigned continuing
education credits by professional organizations or associations, or offered
by a federal, state, or local governmental entity. A list is available from
the department upon request.
(d)
Additional acceptable activities. The additional activities
for which continuing education credit will be awarded are as follows:
(1)
successful completion of an entry-level or advanced-level
examination previously passed in the same discipline of radiologic technology
administered by or for the ARRT during the renewal period. The examinations
shall be topics dealing with ionizing forms of radiation administered to human
beings for medical purposes. Such successful completion shall be limited to
not more than one-half of the continuing education hours required;
(2)
successful completion or recertification in a cardiopulmonary
resuscitation course, basic cardiac life support course, or advanced cardiac
life support course during the continuing education period. Such successful
completion or recertification shall be limited to not more than:
(A)
three hours credit during a renewal period for a cardiopulmonary
resuscitation course or basic cardiac life support course; or
(B)
six hours credit during a renewal period for an advanced
cardiac life support course;
(3)
attendance and participation in tumor conferences (limited
to six hours), inservice education and training offered or sponsored by Joint
Commission on Accreditation of Healthcare Organizations (JCAHO)-accredited
or Medicare certified hospitals, provided the education/training is properly
documented and is related to the profession of radiologic technology;
(4)
teaching in a program described in subsection (c) of this
section with a limit of one contact hour of credit for each hour of instruction
per topic item once during the continuing education reporting period for up
to a total of six hours. No credit shall be given for teaching that is required
as part of one's employment. Credit may be granted in direct, indirect or
non-ionizing radiation based on the topic; or
(5)
developing and publishing a manuscript of at least 1,000
words in length related to radiologic technology with a limit of six contact
hours of credit during a continuing education period. Upon audit by the department
the MRT must submit a letter from the publisher indicating acceptance of the
manuscript for publication or a copy of the published work. The date of publication
will determine the continuing education period for which credit will be granted.
Credit may be granted in direct, indirect or non-ionizing radiation based
on the topic.
(e)
Reporting of continuing education. Each MRT or LMRT is
responsible for and shall complete and file with the department at the time
of renewal or to be considered for renewal when in an extension, a continuing
education report form approved by the department listing the title, date and
number of hours for each activity for which credit is claimed. In the alternative,
a technologist may request an exemption as set out in subsection (i) of this
section or may submit a copy of the technologist's current and active annual
registration or credential card indicating that the technologist is in good
standing and not on probation in accordance with subsection (a)(8) of this
section, with a signed statement that the technologist completed during the
renewal period at least 50% of the required number of hours of continuing
education directly related to the performance of a procedure utilizing ionizing
radiation for medical purposes and that no more than 50% of the required number
of hours shall be verifiable independent self-study activities.
(1)
At the time of renewal or at other times determined by
the department, the department will select a random sample of technologists
to verify compliance with the continuing education requirements. The technologists
selected in the random sample shall submit at the time of renewal or within
30 days following notification from the department:
(A)
documentation of participation in and completion of continuing
education acceptable to the department; and
(B)
any additional information or documentation deemed necessary
by the department to verify the technologist's compliance with the continuing
education requirements.
(2)
The department shall notify the technologist of the results
of the verification process.
(3)
If the department determines that the technologist failed
to successfully complete the continuing education requirements, the technologist
shall be granted a 120-day extension period in which to complete the continuing
education hours needed to fulfill the requirements.
(f)
Determination of contact hour credits. The department shall
credit continuing education experiences and activities as follows.
(1)
Semester hour or quarter hour credits as set in subsection
(c)(1) of this section shall be credited on the basis of 15 contact hour credits
for each semester hour and 10 contact hour credits for each quarter hour successfully
completed with a grade of "C" or better, evidenced by an official transcript.
(2)
Activities or experiences as set out in subsection (c)(2)
and (3) of this section shall be credited on a one-for-one basis with one
contact hour credit for each contact hour of attendance and participation.
Credit will be accepted only in whole hour or half-hour increments. Minutes
in excess of whole or half-hour increments shall not be aggregated for additional
credit.
(g)
Activities unacceptable as continuing education. The department
shall not grant credit for:
(1)
education incidental to the regular professional activities
of an MRT or LMRT such as learning from experience or research;
(2)
organizational activity such as serving on committees or
councils or as an officer in a professional association, society, or other
organization;
(3)
any activities completed before or after the two-year continuing
education period for which the credit is submitted;
(4)
verifiable independent study activities which have no post-test
or other measurement or evaluation instrument provided;
(5)
verifiable independent study activities as set out in subsection
(a)(6) of this section which exceed 50% of the clock hour requirements;
(6)
learning activities indirectly related to radiologic technology
as set out in subsection (b)(3) of this section which exceed 50% of the contact
hour requirements;
(7)
learning activities which are related to non-ionizing forms
of radiation as set out in subsection (b)(2) of this section which exceed
50% of the contact hour requirements;
(8)
any activities or experiences which do not meet the criteria
set out in subsection (a), (b), (c) or (d) of this section;
(9)
activities in accordance with subsection (d)(1) and (2)
of this section which are repeated during the renewal period;
(10)
activities in accordance with subsection (d)(4) of this
section in excess of the one-time credit per topic of instruction or in excess
of a total of six contact hours during a continuing education period;
(11)
activities in accordance with subsection (d)(5) of this
section in excess of six contact hours during a continuing education period;
or
(12)
activities that are an employment requirement or concerning
specific institutional policies and procedures.
(h)
Failure to complete the required continuing education.
(1)
An MRT or LMRT who has failed to complete the requirements
for continuing education may be granted a 120-day certificate as described
in §143.10(d)(7) of this title. The 120-day extension is the maximum
that shall be granted and there will be no exceptions, nor may an additional
extension period be granted.
(2)
The next continuing education reporting period shall commence
on the day following the completion of continuing education credits to correct
the deficiency and shall end two years from the date the previous renewal
period ended. The extension period is borrowed from the next reporting period.
(3)
An MRT or LMRT who has not corrected the deficiency by
the expiration date of the 120-day certificate shall be considered as noncompliant
with the renewal requirements and may no longer perform radiologic procedures
under the expired certificate.
(4)
A person may renew late under §143.10(e) of this title
after all the continuing education requirements have been met. A person who
renews late is not eligible for a 120-day extension.
(i)
Exemptions. The department will consider granting an exemption
from the continuing education requirement on a case-by-case basis if:
(1)
a technologist completes and forwards to the department
a sworn affidavit indicating retirement status for the entire renewal period
for which the exemption is requested. A technologist who has been granted
this exemption and who desires to resume performing radiologic procedures
shall be required to accrue continuing education hours. These hours shall
be accrued immediately following the technologist's return to performing radiologic
procedures to satisfy the continuing education requirements for renewal in
accordance with subsection (a) of this section;
(2)
a technologist completes and forwards to the department
a sworn affidavit indicating that the technologist is employed but does not
perform radiologic procedures for the entire renewal period. A technologist
who has been granted this exemption and who desires to resume performing radiologic
procedures shall be required to accrue continuing education hours. These hours
shall accrue immediately following the technologist's return to performing
radiologic procedures to satisfy the continuing education requirements for
renewal in accordance with subsection (a) of this section;
(3)
a technologist shows reasons of health, certified by a
licensed physician, that prevent compliance with the continuing education
requirement for the entire renewal period. A technologist must complete and
forward to the department a sworn affidavit and provide documentation that
clearly establishes the period of disability and resulting physical limitations;
(4)
a technologist submits a sworn statement and shows reason
which prevents compliance and the reason is acceptable to the department;
(5)
a technologist is called to or on active duty with the
armed forces of the United States for the entire renewal period and so long
as the technologist does not administer a radiologic procedure in a setting
outside of the active duty responsibilities during the time on active duty.
The technologist must file a copy of orders to active military duty with the
department; or
(6)
a technologist submits proof of successful completion of
an advanced level examination or an entry level examination in another discipline
of radiologic technology administered or approved by the ARRT during the renewal
period. All examinations shall be topics dealing with ionizing forms of radiation
administered to human beings for medical purposes.
(j)
Partial exemption. The department may consider granting
an exemption for one-half of the continuing education requirement if the technologist
submits proof of successful completion during the renewal period of an examination
accepted by the department in a topic dealing with non-ionizing radiation.
The balance of the hours must be directly related to the performance of a
radiologic procedure utilizing ionizing radiation in accordance with subsection
(b)(1) of this section. The following are examinations accepted by the department:
(1)
the registry examination offered by the American Registry
of Diagnostic Medical Sonographers; and
(2)
the advanced-level examination in non-ionizing imaging
offered by the ARRT.
(k)
Denial of request for exemption. A technologist whose request
for exemption is denied by the department may be granted a 120-day extension
to complete the continuing education requirements and may request a hearing
on the denial within 30 days after the date the department notified the technologist
of the exemption denial. If no hearing is requested in writing within 30 days,
the opportunity for hearing shall be waived.
(l)
Record keeping. An MRT or LMRT shall be responsible for
keeping, for a period of not less than two years, accurate and complete documentation
or other records of continuing education reported to the department. An MRT
or LMRT shall submit documentation of attendance and participation in continuing
education activities upon written request by the department.
§143.12.Changes of Name and Address.
(a)
The certificate holder shall notify the department of changes
in name, preferred mailing address, or place(s) of business or employment
within 30 days of such change(s).
(b)
Notification of address changes shall be made in writing
including the name, mailing address, zip codes, and be mailed to the administrator.
(c)
Before any certificate and identification cards will be
issued by the department, notification of name changes must be mailed to the
administrator and shall include a copy of a marriage certificate, court decree
evidencing such change, or a social security card reflecting the new name.
The certificate holder shall submit a certified check or money order for the
replacement fee, as set out in §143.4 of this title. Upon receipt of
the new certificate and identification cards, the MRT or LMRT shall return
the previously issued certificate and cards immediately to the department.
If those items have been lost, destroyed, or are not available to return,
a statement detailing the loss or destruction must be signed and submitted
to the department.
§143.14.Disciplinary Actions.
(a)
The department is authorized to take the following disciplinary
actions for the violation of any provisions of the Medical Radiologic Technologist
Certification Act (Act) or this chapter:
(1)
suspension, revocation, or nonrenewal of a certificate;
(2)
rescission of curriculum, training program, or instructor
approval;
(3)
denial of an application for certification or approval;
(4)
assessment of a civil penalty in an amount not to exceed
$1,000 for each separate violation of the Act;
(5)
issuance of a reprimand; or
(6)
placement of the offender's certificate on probation and
requiring compliance with a requirement of the department, including submitting
to medical or psychological treatment, meeting additional educational requirements,
passing an examination, or working under the supervision of an MRT or other
practitioner.
(b)
The department may take disciplinary action against a person
subject to the Act for:
(1)
obtaining or attempting to obtain a certificate issued
under the Act by bribery or fraud;
(2)
making or filing a false report or record made in the person's
capacity as an MRT;
(3)
intentionally or negligently failing to file a report or
record required by law;
(4)
intentionally obstructing or inducing another to intentionally
obstruct the filing of a report or record required by law;
(5)
engaging in unprofessional conduct, including the violation
of the standards of practice of radiologic technology established by the department;
(6)
developing an incapacity that prevents the practice of
radiologic technology with reasonable skill, competence, and safety to the
public as the result of:
(A)
an illness;
(B)
drug or alcohol dependency; or
(C)
another physical or mental condition or illness;
(7)
failing to report to the department the violation of the
Act by another person;
(8)
employing, for the purpose of applying ionizing radiation
to a person, a person who is not certified under or in compliance with the
Act;
(9)
violating a provision of the Act or this chapter, an order
of the department previously entered in a disciplinary proceeding, or an order
to comply with a subpoena issued by the department;
(10)
having a certificate revoked, suspended, or otherwise
subjected to adverse action or being denied a certificate by another certification
authority in another state, territory, or country; or
(11)
being convicted of or pleading nolo contendere to a crime
directly related to the practice of radiologic technology.
(c)
Engaging in unprofessional conduct means the following:
(1)
making any misleading, deceptive, or false representations
in connection with service rendered;
(2)
engaging in conduct that is prohibited by state, federal,
or local law, including those laws prohibiting the use, possession, or distribution
of drugs or alcohol;
(3)
performing a radiologic procedure on a patient or client
which has not been authorized by a practitioner;
(4)
aiding or abetting a person in violating the Act or rules
adopted under the Act;
(5)
any practice or omission that fails to conform to accepted
principles and standards of the medical radiologic technology profession;
(6)
performing a radiologic procedure which results in mental
or physical injury to a patient or which creates an unreasonable risk that
the patient may be mentally or physically harmed;
(7)
misappropriating medications, supplies, equipment, or personal
items of the patient, client or employer;
(8)
performing or attempting to perform radiologic procedures
in which the person is not trained by experience or education or in which
the procedure is performed without appropriate supervision;
(9)
performing or attempting to perform any medical procedure
which relates to or is necessary for the performance of a radiologic procedure
and for which the person is not trained by experience or education or when
the procedure is performed without appropriate supervision;
(10)
performing a radiologic procedure which is not within
the scope of an LMRT's certificate, as set out in §143.7(e) of this title;
(11)
disclosing confidential information concerning a patient
or client except where required or allowed by law;
(12)
failing to adequately supervise a person in the performance
of radiologic procedures;
(13)
providing false or misleading information on an application
for employment to perform radiologic procedures;
(14)
providing information which is false, misleading, or deceptive
regarding the status of certification; registration with the American Registry
of Radiologic Technologists, Cardiovascular Credentialing International, or
Nuclear Medicine Technology Certification Board; or licensure by another country,
state, territory, or the District of Columbia;
(15)
discriminating on the basis of race, creed, gender, sexual
orientation, religion, national origin, age, physical handicaps or economic
status in the performance of radiologic procedures;
(16)
impersonating or acting as a proxy for an examination
candidate for any examination required for certification;
(17)
acting as a proxy for an MRT or LMRT at any continuing
education required under §143.11 of this title;
(18)
obtaining, attempting to obtain, or assisting another
to obtain certification or placement on the registry by bribery or fraud;
(19)
making abusive, harassing or seductive remarks to a patient,
client or co-worker in the workplace or engaging in sexual contact with a
patient or client in the workplace;
(20)
misleadingly, deceptively or falsely offering to provide
education or training relating to radiologic technology;
(21)
failing to complete the continuing education requirements
for renewal as set out in §143.11 of this title;
(22)
failing to document the continuing education requirements
for renewal as required by the department;
(23)
failing to cooperate with the department by not furnishing
required documents or responding to a request for information or a subpoena
issued by the department or the department's authorized representative;
(24)
interfering with an investigation or disciplinary proceeding
by willful misrepresentation of facts to the department or its authorized
representative or by use of threats or harassment against any person;
(25)
failing to follow appropriate safety standards or the
Texas Regulations for the Control of Radiation in the operation of diagnostic
or therapeutic radiologic equipment or the use of radioactive materials;
(26)
failing to adhere to universal precautions or infection
control standards as required by the Health and Safety Code, Chapter 85, Subchapter
I;
(27)
defaulting on a guaranteed student loan, as provided in
the Education Code, §57.491;
(28)
assaulting any person in connection with the practice
of radiologic technology or in the workplace;
(29)
intentionally or knowingly offering to pay or agreeing
to accept any remuneration directly or indirectly, overtly or covertly, in
cash or in kind, to or from any person, firm, association of persons, partnership,
or corporation for securing or soliciting patients or patronage to or from
a person licensed, certified or registered by a state health care regulatory
agency. The provisions of the Health and Safety Code, §161.091, concerning
the prohibition of illegal remuneration apply to MRTs and LMRTs;
(30)
using or permitting or allowing the use of the person's
name, certificate, or professional credentials in a way that the person knows,
or with the exercise of reasonable diligence should know:
(A)
violates the Act, this chapter or department rule relating
to the performance of radiologic procedures; or
(B)
is fraudulent, deceitful or misleading;
(31)
knowingly allowing a student enrolled in an education
program to perform a radiologic procedure without direct supervision; or
(32)
knowingly concealing information relating to enforcement
of the Act or this chapter.
(33)
failing reasonably to protect the certificate from fraudulent
or unlawful use.
(d)
A person subject to disciplinary action under subsection
(b)(6) of this section shall, at reasonable intervals, be afforded an opportunity
to demonstrate that the person is able to resume the practice of radiologic
technology.
(e)
An instructor engages in unprofessional conduct if the
instructor violates any of the provisions of subsections (b) or (c) of this
section or if the instructor:
(1)
is an MRT or LMRT who fails to renew the certificate;
(2)
is a practitioner who fails to renew his or her license
or who has the license suspended, revoked, or otherwise restricted by the
appropriate regulatory agency;
(3)
discriminates in decisions regarding student recruitment,
selection of applicants, student training or instruction on the basis of race,
creed, gender, religion, national origin, age, physical handicaps, sexual
orientation, or economic status;
(4)
abandons an approved course of study or a training program
with currently enrolled students;
(5)
knowingly provides false or misleading information on the
application for instructor approval or on any student's application for certification;
or
(6)
fails to provide instruction on universal precautions as
required by the Health and Safety Code, §85.203.
(f)
An education program engages in unprofessional conduct
if the program, including its employees or agents, violates any of the provisions
of subsections (b) or (c) of this section or if the program:
(1)
makes any misleading, deceptive, or false representations
in connection with offering or obtaining approval of an education program;
(2)
fails to follow appropriate safety standards or the TRCR
in the operation of diagnostic or therapeutic radiologic equipment or the
use of radioactive materials;
(3)
discriminates in decisions regarding student recruitment,
selection of applicants, student training or instruction on the basis of race,
creed, gender, sexual orientation, age, physical handicaps, economic status,
religion or national origin;
(4)
aids or abets a person in violating the Act or rules adopted
under the Act;
(5)
abandons an approved education program with currently enrolled
students; or
(6)
fails to provide instruction on universal precautions as
required by the Health and Safety Code, Section 85, Subchapter I.
(g)
The department may take disciplinary action against a student
for intentionally practicing radiologic technology without direct supervision.
(h)
In determining the appropriate action to be imposed in
each case, the department shall take into consideration the following factors:
(1)
the severity of the offense;
(2)
the danger to the public;
(3)
the number of repetitions of offenses;
(4)
the length of time since the date of the violation;
(5)
the number and type of previous disciplinary cases filed
against the person or program;
(6)
the length of time the person has performed radiologic
procedures;
(7)
the length of time the instructor or education program
has been approved;
(8)
the actual damage, physical or otherwise, to the patient
or student, if applicable;
(9)
the deterrent effect of the penalty imposed;
(10)
the effect of the penalty upon the livelihood of the person
or program;
(11)
any efforts for rehabilitation; and
(12)
any other mitigating or aggravating circumstances.
(i)
Formal hearing requirements:
(1)
Notice requirements.
(A)
Notice of the hearing shall be given according to the notice
requirements of the Administrative Procedure Act (APA).
(B)
If a party fails to appear or be represented at a hearing
after receiving notice, the Administrative Law Judge examiner may proceed
with the hearing or take whatever action is fair and appropriate under the
circumstances.
(C)
All parties shall timely notify the Administrative Law
Judge of any changes in their mailing addresses.
(2)
Parties to the hearing.
(A)
The parties to the hearing shall be the applicant or licensee
and the complaints subcommittee or executive director, as appropriate.
(B)
A party may appear personally or be represented by counsel
or both.
(3)
Prehearing conferences.
(A)
In a contested case, the Administrative Law Judge, on his
own motion or the motion of a party, may direct the parties to appear at a
specified time and place for a conference prior to the hearing for the purpose
of:
(i)
the formulation and simplification of issues;
(ii)
the necessity or desirability of amending the pleading;
(iii)
the possibility of making admissions or stipulations;
(iv)
the procedure at the hearing.
(v)
specifying the number of witnesses;
(vi)
the mutual exchange of prepared testimony and exhibits;
(vii)
the designation of parties; and
(viii)
other matters which may be expedite the hearing.
(B)
The Administrative Law Judge shall have the minutes of
the conference recorded in an appropriate manner and shall issue whatever
orders are necessary covering said matters or issues.
(C)
Any action taken at the prehearing conference may be reduced
to writing, signed by the parties, are made a part of the record.
(4)
Assessing the cost of a court reporter and the record of
the hearing.
(A)
In the event a court reporter is utilized in the making
of the record of the proceedings, the department shall bear the cost of the
per diem or other appearance fee for such reporter.
(B)
The department may prepare, or order the preparation of,
a transcript (statement of facts) of the hearing upon the written request
of any party. The department may pay the cost of the transcript or assess
the cost to one or more parties.
(C)
In the event a final decision of the department is appealed
to the district court wherein the department is required to transmit to the
reviewing court a copy of the record of the hearing proceeding, or any part
thereof, the department may be require the appealing party to pay all or part
of the cost of preparations of the original or a certified copy of the record
of the department proceedings that is required to be transmitted to the reviewing
court.
(5)
Disposition of case. Unless precluded by law, informal
disposition may be made of any contested case by agreed settlement order or
default order.
(6)
Agreements in writing. No stipulation or agreement between
the parties with regard to any matter involved in any proceeding shall be
enforced unless it shall have been reduced to writing and signed by the parties
or their authorized representatives, dictated into the record during the course
of a hearing, or incorporated in an order bearing their written approval.
This rule does not limit a party's ability to waive, modify, or stipulate
away any right or privilege afforded by these sections.
(7)
Final orders or decisions.
(A)
The final order or decision will be rendered by the department.
The department is not required to adopt the recommendation of the Administrative
Law Judge and may take action as it deems appropriate and lawful.
(B)
All final orders or decisions shall be in writing and shall
set forth the findings of fact and conclusions required by law.
(C)
All final orders shall be signed by the commissioner; however,
interim orders maybe issued by the Administrative Law Judge.
(D)
A copy of all final orders and decisions shall be timely
provided to all parties as required by law.
(8)
Motion for rehearing. A motion for rehearing shall be governed
by APA, §2001.146, Texas Government Code, and shall be addressed to the
department and filed with the administrator.
(9)
Appeals. All appeals from final department orders or decisions
shall be governed by APA, Subchapter G, Texas Government Code and communications
regarding any appeal shall be to the administrator.
(j)
The following applies after disciplinary action has been
taken.
(1)
The department may not reinstate a certificate to a holder
or cause a certificate to be issued to an applicant previously denied a certificate
unless the department is satisfied that the holder or applicant has complied
with requirements set by the department and is capable of engaging in the
practice of radiologic technology. The person is responsible for securing
and providing to the department such evidence, as may be required by the department.
The administrator or the department shall investigate prior to making a determination.
(2)
During the time of suspension, the former certificate holder
shall return the certificate and identification card(s) to the department.
(3)
If a suspension overlaps a certificate renewal period,
the former certificate holder shall comply with the normal renewal procedures
in this chapter; however, the department may not renew the certificate until
the administrator or the department determines that the reasons for suspension
have been removed and that the person is capable of engaging in the practice
of radiologic technology.
(4)
If the commissioner of health revokes or does not renew
the certificate, the former certificate holder may reapply in order to obtain
a new certificate by complying with the requirements and procedures at the
time of reapplication. The department may not issue a new certificate until
the administrator or the department determines that the reasons for revocation
or nonrenewal have been removed and that the person is capable of engaging
in the practice of radiologic technology. An investigation may be required.
(5)
If the commissioner rescinds the approval of an instructor
or program, the formerly approved instructor or program may reapply for approval
by complying with the requirements and procedures at the time of reapplication.
Approval will not be issued until the administrator or the department determines
that the reasons for revocation have been removed. An investigation may be
required.
(k)
Pursuant to the Act, §601.351, the department is authorized
to assess an administrative penalty against a person who violates the Act
or this chapter.
§143.17.Mandatory Training Programs for Non-Certified Technicians.
(a)
General. This section sets out the minimum standards for
approval of mandatory training programs, as required by the Medical Radiologic
Technologist Certification Act (Act), §2.05(f), which are intended to
train individuals to perform radiologic procedures which have not been identified
as dangerous or hazardous. Individuals who complete an approved training program
may not use that training toward the educational requirements for a general
or limited certificate as set out in §143.7 of this title (relating to
Types of Certificates and Applicant Eligibility). Before a person performs
a radiologic procedure, the person must complete all the hours in subsection
(d)(1)(A)-(D) of this section, and at least one unit in subsection (d)(2)(A)-(G)
of this section.
(b)
Instructor direction required. All hours of the training
program completed for the purposes of this section must be live and interactive
and directed by an approved instructor. No credit will be given for training
completed by self-directed study or correspondence.
(c)
Instructor qualifications.
(1)
An instructor(s) shall have education and not less than
six months classroom or clinical experience teaching the subjects assigned,
shall meet the standards required by a sponsoring institution, if any, and
shall meet at least one or more of the following qualifications:
(A)
be a currently certified MRT who is also currently credentialed
as a radiographer by the American Registry of Radiologic Technologists;
(B)
be a currently certified LMRT (excluding a temporary certificate)
whose limited certificate category(ies) matches the category(ies) of instruction
and training; or
(C)
be a practitioner who is in good standing with all appropriate
regulatory agencies including, but not limited to, the department, the Texas
State Board of Chiropractic Examiners, Texas State Board of Medical Examiners,
or Texas State Board of Podiatry Examiners, the Texas Health and Human Services
Commission, the United States Department of Health and Human Services.
(2)
An LMRT may not teach, train, or provide clinical instruction
in a portion of a training program which is different from the LMRT's level
of certification. An LMRT holding a limited certificate in the chest and extremities
categories may not participate in the portion of a training program relating
to radiologic procedures of the spine. The LMRT may participate in the portions
of the training program which are of a general nature and those specific to
the specific categories on the limited certificate.
(d)
Training requirements. In order to successfully complete
a program, each student must complete the following minimum training:
(1)
prerequisites recommended for admission include high school
graduation or general equivalency diploma; certified medical assistant; graduation
from a medical assistant program; or six months full time patient care experience,
otherwise determined by the practitioner.
(2)
courses which are fundamental to diagnostic radiologic
procedures:
(A)
radiation safety and protection for the patient, self and
others-22 classroom hours;
(B)
image production and evaluation-24 classroom hours; and
(C)
radiographic equipment maintenance and operation-16 classroom
hours which includes at least six hours of quality control, darkroom, processing,
and Texas Control of Radiation Regulations; and
(3)
one or more of the following units of applied human anatomy
and radiologic procedures of the:
(A)
skull (five views: Caldwell, Townes, Waters, AP/PA, and
lateral)-10 classroom hours;
(B)
chest-eight classroom hours;
(C)
spine-eight classroom hours;
(D)
abdomen, not including any procedures utilizing contrast
media- four classroom hours;
(E)
upper extremities-14 classroom hours;
(F)
lower extremities-14 classroom hours; and/or
(G)
podiatric--five classroom hours.
(e)
Application procedures for training programs. An application
shall be submitted to the department at least 30 days prior to the starting
date of the training program. Official application forms are available from
the department and must be completed and signed by an approved instructor,
who shall be designated as the training program director. The training program
director shall be responsible for the curriculum, the instructors, and determining
whether students have successfully completed the training program.
(1)
Official application forms must be executed in the presence
of a notary public and shall be accompanied by the application fee in accordance
with §143.4 of this title. Photocopied signatures will not be accepted.
(2)
Application forms and fees shall be mailed to the address
indicated on the application materials. The department is not responsible
for lost, misdirected, or undeliverable application forms. An application
received without the application fee will be returned to the applicant.
(f)
Application materials. The application shall include, at
a minimum:
(1)
the beginning date and the anticipated length of the training
program;
(2)
the number of programs which will be conducted concurrently
and whether programs will be conducted consecutively;
(3)
the number of students anticipated in each program;
(4)
the daily hours of operation;
(5)
the location, mailing address, phone and facsimile numbers
of the program;
(6)
the name of the training program director;
(7)
a list of the names of the approved instructors and the
topics each will teach, and a list of management and administrative personnel
and any practitioners who will participate in conducting the program;
(8)
clearly defined and written policies regarding the criteria
for admission, discharge, readmission and completion of the program;
(9)
evidence of a structured pre-planned learning experience
with specific outcomes;
(10)
a letter or other documentation from the Texas Workforce
Commission, Proprietary Schools Section indicating that the proposed training
program has complied with or has been granted exempt status under the Texas
Proprietary School Act, Texas Education Code, Chapter 32 and 19 Texas Administrative
Code, Chapter 175. If approval has been granted by the Texas Higher Education
Coordinating Board, a letter or other documentation from the Texas Workforce
Commission, Proprietary Schools Section is not necessary; and
(11)
specific written agreements to:
(A)
provide the training as set out in subsection (d) of this
section and provide not more than 75 students per instructor in the classroom;
(B)
advise students that they are prohibited from performing
radiologic procedures which have been identified as dangerous or hazardous
in accordance with §143.16 of this title (relating to Dangerous or Hazardous
Procedures) unless they become an LMRT, MRT or a practitioner;
(C)
use written and oral examinations to periodically measure
student progress;
(D)
keep an accurate record of each student's attendance and
participation in the program, accurate evaluation instruments and grades for
not less than five years. Such records shall be made available upon request
by the department or any governmental agency having authority;
(E)
issue to each student who successfully completes the program
a certificate or written statement including the name of the student, name
of the program, dates of attendance and the types of radiologic procedures
covered in the program completed by the student;
(F)
retain an accurate copy for not less than five years and
submit an accurate copy of the document described in subparagraph (E) of this
paragraph to the department within 30 days of the issuance of the document
to the student; and
(G)
permit site inspections by employees or representatives
of the department to determine compliance with this section.
(g)
Application approval.
(1)
The administrator shall be responsible for reviewing all
applications for training program approval. The administrator shall approve
any application which is in compliance with this section. A letter of approval
shall be issued for a period of one year.
(2)
A program shall be denied approval if the application is
incomplete or not submitted as set out in this section. The training program
director shall be notified in accordance with §113.1 of this title (relating
to Processing Permits for Special Health Services Professionals).
(3)
If approval is proposed to be denied, the training program
director shall be notified in writing of the proposed denial and shall be
given an opportunity to request a formal hearing within ten days of the training
program director's receipt of the written notice from the department. The
formal hearing shall be conducted according to the department's formal hearing
procedures in Chapter 1 of this title (relating to Texas Board of Health).
If no hearing is requested, the right to a hearing is waived and the proposed
action shall be taken.
(h)
Application processing. The department shall use the same
process as described in §143.6(e) of this title, except the time periods
are as follows:
(1)
letter of acceptance--30 days;
(2)
letter of application deficiency--30 days;
(3)
letter of approval--42 days; and
(4)
letter of denial of approval--42 days.
(i)
Renewal.
(1)
The training program director shall be responsible for
renewing the approval of the training program on or before the anniversary
date of the initial application.
(2)
The department shall send a renewal notice to the training
program at least 60 days prior to the anniversary date. The department is
not responsible for lost, misdirected, undeliverable or misplaced mail.
(3)
The renewal is effective if the official renewal form and
fee in accordance with §143.4 of this title are postmarked or delivered
to the department on or before the anniversary date.
(4)
Failure to submit the renewal form and renewal fee in accordance
with §143.4 of this title by the deadline will result in the expiration
of the training program's approval.
(5)
A training program which does not renew the approval shall
cease representing the program as an approved training program. The program
director shall notify, or cause the notification of currently enrolled students
that the training program is no longer approved under this section. The notification
shall be in writing and must be issued within ten days of the expiration of
the approval.
(6)
The training program may reapply for approval and meet
the then current requirements for approval under this section.
This agency hereby certifies that the adoption has been
reviewed by legal counsel and found to be a valid exercise of the agency's
legal authority.
Filed with the Office of
the Secretary of State on August 20, 2001.
TRD-200104887
Susan K. Steeg
General Counsel
Texas Department of Health
Effective date: September 9, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 458-7236
25 TAC §143.15
The repeal is adopted under the Medical Radiologic Technologist
Certification Act, §601.052, Texas Occupations Code, which provides the
Texas Board of Health (board) with the authority to adopt rules necessary
to implement the Act; and the Texas Health and Safety code §12.001, which
provides the board with the authority to adopt rules for the performance of
every duty imposed by law on the board, the department, and commissioner for
health.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on August 20, 2001.
TRD-200104888
Susan K. Steeg
General Counsel
Texas Department of Health
Effective date: September 9, 2001
Proposal publication date: March 9, 2001
For further information, please call: (512) 458-7236
Subchapter E. DOG AND CAT STERILIZATION
Chapter 123.
RESPIRATORY CARE PRACTITIONER CERTIFICATION
Chapter 143.
MEDICAL RADIOLOGIC TECHNOLOGISTS
Chapter 169.
ZOONOSIS CONTROL