25 TAC §§143.1-143.20
The amendments and new section are proposed under Texas Occupations
Code, §601.052, which provides the Texas Board of Health (board) with
the authority to adopt rules concerning the regulation and certification of
persons performing radiologic procedures; and the Health and Safety Code, §12.001
which provides the board with authority to adopt rules for the performance
of every duty imposed by law on the board, the department, and the commissioner
of health.
The amendments and new section affect the Occupations Code, Title 3. Health
Professions, Subtitle K, Chapter 601; Texas Civil Statutes, Article 4512m;
and Government Code, §2001.039.
§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, and portions of
Texas Civil Statutes, Article 4512m[
, and Acts 1987, 70th Legislature, Chapter 1096, §3.01
].
(b)
(No change.)
§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, and portions of
Texas
Civil Statutes, Article 4512m[
,Acts 1987, 70th Legislature, Chapter 1096, §3.01
].
(2)
(No change.)
[(3)
AMA--The American Medical Association.]
[(4)
AP--Anterior/posterior.]
(3)
[
(5)
] Applicant--A person who applies
to the Texas Department of Health for a certificate or temporary certificate,
general or limited
or a provisional certificate
.
[(6)
ARCRT--American Registry of Clinical
Radiography Technologists and its successor organizations.]
(4)
[
(7)
] ARRT--The American Registry
of Radiologic Technologists and its predecessor or successor organizations.
[(8)
BCE--The Texas State Board of Chiropractic
Examiners.]
[(9)
BDE--The Texas State Board of Dental
Examiners.]
[(10)
Biennial--Occurring every two years.]
[(11)
BME--The Texas State Board of Medical
Examiners.]
[(12)
BNE--The Texas State Board of Nurse
Examiners.]
(5)
[
(13)
] Board--The Texas Board of
Health.
[(14)
BPE--The Texas State Board of Podiatry
Examiners.]
(6)
[
(15)
] Cardiovascular (CV)--Limited
to
radiologic procedures involving the use of contract medical and or
ionizing radiation for the purposes of diagnosing or treating a disease or
condition of the cardiovascular system
[
the coronary vessels, atria,
ventricula, ascending aorta and aortic arch
].
(7)
[
(16)
] Certificate--A medical radiologic
technologist certificate, general
,
[
or
] limited
or provisional
, unless the wording specifically refers to one or the
other, issued by the Texas Department of Health.
(8)
[
(17)
] Chiropractor--A person licensed
by the
Texas State
Board of Chiropractic Examiners (BCE) to practice
chiropractic.
(9)
[
(18)
] Committee--The Medical Radiologic
Technologist Advisory Committee.
(10)
[
(19)
] Dentist--A person licensed
by the
Texas State
Board of Dental Examiners (BDE) to practice
dentistry.
(11)
[
(20)
] Department--The Texas Department
of Health.
(12)
[
(21)
] Federally qualified health
center (FQHC)--A health center as defined by 42 United States Code, §1396d(2)(B).
(13)
[
(22)
] Fluoroscopy--The practice
of examining tissues using a fluorescent screen, including digital and conventional
methods.
(14)
[
(23)
] Fluorography--Hard copy
of a fluoroscopic image; also known as spot films.
(15)
[
(24)
] General certification--An
authorization to perform radiologic procedures.
(16)
[
(25)
] Instructor--An individual
approved by the department to provide instruction and training in the discipline
of medical radiologic technology in an educational setting.
[(26)
JCAHO--The Joint Commission on Accreditation
of Healthcare Organizations.]
[(27)
JRCENMT--The Joint Review Committee
on Education in Nuclear Medicine Technology and its successor organizations.]
[(28)
JRCERT--The Joint Review Committee on
Education in Radiologic Technology and its successor organizations.]
[(29)
JRCCVT- The Joint Review Committee in
Cardiovascular Technology.]
(17)
[
(30)
] Limited certification--An
authorization to perform radiologic procedures that are limited to specific
parts of the human body.
(18)
[
(31)
] 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)
[
(32)
] 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)
[
(33)
] Mobile radiography - Includes
mobile x-ray equipment and portable x-ray equipment.
(21)
[
(34)
] Mobile x-ray equipment -
Equipment mounted on a permanent base with wheels and/or casters for moving
while completely assembled.
(22)
[
(35)
] NMTCB--Nuclear Medicine
Technology Certification Board and its successor organizations.
(23)
[
(36)
] Non-Certified Technician
(NCT)--A person who has completed a training program and who is listed
in
[
on
] the registry. An NCT may not perform a radiologic
procedure which has been identified as dangerous or hazardous.
[(37)
PA--Posterior/anterior.]
(24)
[
(38)
] Pediatric - A person within
the age range of fetus to age 18 or otherwise required by Texas
law
[
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)
[
(39)
] Physician--A person licensed
by the
Texas State
Board of Medical Examiners (BME) to practice
medicine.
(26)
[
(40)
] Physician assistant - A
person licensed as a physician assistant by the Texas State Board of Physician
Assistant Examiners.
(27)
[
(41)
] Podiatrist--A person licensed
by the
Texas State
Board of
Podiatric
[
Podiatry
]
Medical
Examiners (BPE) to practice podiatry.
(28)
[
(42)
] Portable x-ray equipment
- Equipment designed to be hand- carried.
(29)
[
(43)
] 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)
[
(44)
] Radiation--Ionizing radiation
in amounts beyond normal background levels from sources such as medical and
dental radiologic procedures.
(32)
[
(45)
] 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)
[
(46)
] Registered nurse--A person
licensed by the Board of Nurse Examiners (BNE) to practice professional nursing.
(34)
[
(47)
] Registry--A list of names
and other identifying information of non-certified technicians.
(35)
[
(48)
] 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)
[
(49)
] 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)
[
(50)
] Temporary certification,
general or limited--An authorization to perform radiologic procedures for
a limited period, not to exceed one year.
(38)
[
(51)
] TRCR--Texas Regulations
for the Control of Radiation, 25 Texas Administrative Code, Chapter 289 of
this title [
(relating to Texas Regulations for the Control of Radiation)
]. 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).
§143.3.Medical Radiologic Technologist Advisory Committee.
(a)-(e)
(No change.)
(f)
Composition. The committee shall be composed of eleven
members appointed by the board. The composition of the committee shall include:
(1)-(6)
(No change.)
(7)
one licensed physician who has experience in radiologic
procedures and who practices in a rural community or at a site serving a medically
underserved population in Texas as defined in the Medical Practice Act,
Texas Occupations Code, Chapter 152
[
Texas Civil Statutes, Article
4495b, §3.06(d)(5)(E)(iv)
]; and
(8)
one registered nurse or certified physician assistant who
has experience in radiologic procedures and who practices in a rural community
or at a site serving a medically underserved population in Texas as defined
in the Medical Practice Act,
Texas Occupations Code, Chapter 152
[
Texas Civil Statutes, Article 4495b, §3.06(d)(5)(E)(iv)
].
(g)-(h)
(No change.)
(i)
Meetings. The committee shall meet only as necessary to
conduct committee business.
(1)
A meeting may be called by agreement of
department
[
Texas Department of Health (department)
] staff and either
the presiding officer or at least three members of the committee.
(2)
Meeting arrangements shall be made by department staff.
Department staff shall contact committee members to determine availability
of
[
for
] a meeting date and place.
(3)-(7)
(No change.)
(j)-(l)
(No change.)
(m)
Subcommittees. The committee may establish subcommittees
as necessary to assist the committee in carrying out its duties.
(1)
(No change.)
(2)
Subcommittees shall meet when called by the subcommittee
chairperson or when so directed by the
committee's
[
committee
]
presiding officer
.
(3)
(No change.)
(n)
Statements
[
Statement
] by members.
(1)
(No change.)
(2)
The committee and its members may not participate in legislative
activity in the name of the board, the department or the committee except
with approval
by
[
through
] the
department
[
department's legislative process
]. Committee members are not prohibited
from representing themselves or other entities in the legislative process.
(o)-(p)
(No change.)
§143.4.Fees.
(a)
Unless otherwise specified, the fees established in this
section must be paid to the department before
a
[
any
]
certificate is issued. All fees shall be submitted in the form of a
personal check,
certified check [
for guaranteed funds
] 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)
(No change.)
(3)
one to 90-day late renewal fee--
one and one half
of the normally required renewal fee
[
$25 (plus all unpaid renewal
fees when the certificate is renewed within 90 days of expiration)
];
(4)
91-day to one year late renewal fee--
two times the
normally required renewal fee
[
$50 (plus all unpaid renewal fees
when the certificate is renewed more than 90 days after expiration but not
more than one year after expiration)
];
(5)-(8)
(No change.)
(9)
general examination fee--
the fee for the examination
as set by contract with the examining body
[
$25
];
[(10)
alternate eligibility fee--$150;]
(10)
[
(11)
] chiropractic examination
fee--$50;
(11)
[
(12)
] skull, chest, spine, extremities
or podiatric examination fee--$25 for the first examination and $20 for each
additional examination taken on the same day;
(12)
[
(13)
] upgrade of a temporary certificate
to a renewable certificate, limited or general--
$25
[
$42 (prorated
at $3.50 per month)
];
(13)
[
(14)
] limited instructor approval
fee--$50;
(14)
[
(15)
] limited curriculum application
fee--$450 per year per course of study;
(15)
[
(16)
] 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)
[
(17)
] training program application
fee--$350 (the application fee for training programs accredited by the Texas
Higher Education Coordinating Board shall be waived);
(17)
[
(18)
] training program amendment
fee--$40 (the amendment fee for training programs accredited by the Texas
Higher Education Coordinating Board shall be waived);
(18)
[
(19)
] training program renewal
fee--$150 (the renewal fee for training programs accredited by the Texas Higher
Education Coordinating Board shall be waived);
(19)
[
(20)
] limited curriculum amendment
fee -- $40; [
and
]
(20)
[
(21)
] 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)
The purpose of this section is to describe
who is exempt from certification under the Medical Radiologic Technologist
Certification Act (Act) and who must be certified under the Act.]
(a)
[
(b)
] Except as specifically exempted
by subsections
(b)
[
(c)
] and
(c)
[
(d)
] of this section, the provisions of the Act and this chapter apply
to any person representing that he or she performs radiologic procedures.
(b)
[
(c)
] 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
[
§2.08
] by the Texas State Board of Dental Examiners (BDE).
(c)
[
(d)
] 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
[
§2.08
],
by the Texas State Board of Chiropractic Examiners (BCE), Texas State Board
of Medical Examiners (BME), Texas State Board of Nurse Examiners (BNE), or
Texas State Board of Podiatry Examiners (BPE);
(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
(JCAHO);
(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 (TRCR);
(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)
Purpose. The purpose of this section
is to set out the application procedures for examination and certification.]
(a)
[
(b)
] 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 [
(relating to Fees)
]. 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
(f)
[
(i)
] of this title [
(relating to Certificate Issuance,
Renewals, and Late Renewals)
].
(b)
[
(c)
] 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
[
licences
] 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)
[
(f)(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
notarized; 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
(a)
[
(b)
] or
(b)
[
(c)
] of this title (relating to Types of Certificates and Applicant
Eligibility) must submit the following additional documents [
or qualify
under the provisions of §143.15 of this title (relating to Alternate
Eligibility Requirements)
]:
(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)
[
(b)
] 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 which has been notarized as a true and exact
copy 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 notarized 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 notarized 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)
[
(e)(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)
[
(d)
] 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)
[
(e)
] of this section.
(d)
[
(e)
] 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
,
[
or
] pled
nolo contendere to
, or received deferred adjudication for
a crime
which
directly
relates
[
related
] 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)
[
(f)
] 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. [
The purpose of this section is to set out
the types of certificates issued and the qualifications of applicants for
certification as a medical radiologic technologist (MRT) or limited medical
radiologic technologist (LMRT).
]
(1)
The
department
[
Texas Department of Health
(department)
] shall issue general certificates, limited certificates,
[
or
] temporary certificates (general or limited)
or provisional
certificates
.
(2)
Certificates
and identification cards
shall
bear the signature of
[
be signed by
] the commissioner of
the department [
and the chairperson of the advisory board. Identification
cards shall bear the signature of the commissioner
].
(3)
(No change.)
(4)
A person certified as an MRT
,
[
or
]
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
,
[
or
]
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)-(7)
(No change.)
(b)
Special provisions for persons who were nationally certified
on September 1, 1987. 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 was
and is currently
registered
by the American Registry of Radiologic Technologists (ARRT) or American Registry
of Clinical Radiography Technologists (ARCRT) as a radiographer, was registered
by the ARRT as a radiation therapy technologist, or was registered by the
ARRT or certified by the Nuclear Medicine Technologist Certification Board
(NMTCB) as a nuclear medicine technologist.
[(c)
Special provisions for persons who have
performed radiologic procedures during the five-year period, September 1,
1982, through August 31, 1987. Upon payment of the certification fee, submission
of the application forms and approval by the department, the department shall
issue:]
[(1)
a general certificate to a person who has performed radiologic
procedures for not less than two years, as documented on form(s) prescribed
by the department; or]
[(2)
a limited certificate to a person who has performed radiologic
procedures for not less than one year, as documented on forms prescribed by
the department. The category or categories of the limited certificate shall
be based upon the type of documented radiologic procedures performed by the
applicant. However, a limited certificate in the chiropractic or podiatric
categories may be issued provided the applicant submits written evidence satisfactory
to the department of at least one of the following items:]
[(A)
for the chiropractic limited certificate, that the applicant
was certified by the American Chiropractic Registry of Radiologic Technologists
(ACRRT) on September 1, 1987; and]
[(B)
for the podiatry limited certificate, that the applicant
was certified by the American Society of Podiatry Assistants (ASPA) on September
1, 1987.]
(c)
[
(d)
] Minimum eligibility requirements
for certification. The following requirements apply to all individuals applying
for certification who do not meet the requirements of
subsection
[
subsections
] (b) [
or (c)
] 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
[
appropriate
]
fees; and
(6)
eligibility for the specific certificate requested as set
out in subsections
(d)
, (e), (f), (g),
or
(h), [
or (i)
] of this section.
(d)
[
(e)
] Medical radiologic technologist.
To qualify for a general certificate an applicant shall meet at least one
of the following requirements [
in addition to those listed in subsection
(d) of this section
]:
(1)
possess current national certification as a registered
technologist by the ARRT;
(2)
have successfully completed the ARRT's examination in radiography,
radiation therapy technology, 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
[
by
] another state,
the
District of Columbia, or
a
territory of the United States
whose requirements are more stringent than or are substantially
equivalent
[
equal
] to the requirements for Texas certification.
(e)
[
(f)
] 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)
[
(d)
] 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
[
and
]
ionizing radiation
[
fluoroscopic equipment
]
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 [
documentary evidence
] 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 [
(relating to Standards for the
Approval of Curricula and Instructors)
] and the successful completion
of the appropriate limited examination in accordance with §143.8 of this
title [
(relating to Examinations)
];
(B)
current licensure or registration as an LMRT
in
[
by
] another state,
the
District of Columbia, or
a
territory of the United States of America whose requirements are more
stringent than or substantially
equivalent
[
equal
] 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)
[
(g)
] 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)
[
(d)
] 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
technology, or nuclear medicine technology which is accredited by the Committee
on Allied Health Education and Accreditation (CAHEA);
(2)
be approved by the ARRT as examination eligible;
(3)
be approved by the NMTCB as examination eligible; or
(4)
be currently licensed or otherwise registered as an MRT
in
[
by
] another state,
the
District of Columbia,
or
a
territory of the United States whose requirements are
more stringent than or
[
not
] substantially
equivalent
[
equal
] to the Texas requirements for certification at the
time of application to the department.
(g)
[
(h)
] 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)
[
(d)
] 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)
[
(c)
] 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)
[
(b)
] 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)
[
(e)
] of this title; or
(3)
be
currently
licensed or
otherwise
registered as an LMRT
in
[
by
] another state,
the
District of Columbia, or
a
territory of the United States
whose requirements are
more stringent than or
[
not
]
substantially
equivalent
[
equal
] to the Texas requirements
for certification at the time of application to the department.
(h)
[
(i)
] Special provisions for technologists
on active military duty. An MRT or LMRT whose certificate has expired and
was not renewed under §143.10
(g)
(h) of this title [
(relating to Certificate Issuance, Renewals, and Late Renewals)
] 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 processing 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
except payment of the certification fee.
(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)
[
(e)
] of this title [
(relating
to Application Requirements and Procedures)
].
(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.
[(j)
Alternate eligibility. An individual
who does not qualify under subsections (a)-(i) of this section may qualify
under §143.15 of this title (relating to Alternate Eligibility Requirements).]
(i)
Provisional medical radiologic technologist.
A provisional certificate may be issued to an applicant who is currently licensed
or certified in another jurisidiation 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)
Purpose. This section sets out the rules
governing the administration, content, grading, and other examination procedures
for certification.]
(a)
[
(b)
] Examination eligibility.
(1)
Holders of temporary certificates, limited or general[
, and persons approved by the department under the provisions of §143.15
of this title (relating to Alternate Eligibility Requirements)
] may
take the appropriate examination provided the person complies with the requirements
of the [
Medical Radiologic Technologist Certification
] Act and
this chapter.
(2)
Persons who qualify under §143.7(b), [
(c),
]
(d),
(e) or
(i)
[
(f)
] of this title [
(relating
to Types of Certificates and Applicant Eligibility)
] are not required
to be reexamined for state certification.
(b)
[
(c)
] 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 technology. 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)
[
(d)
] 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
[
Cardiac
] Credentialing International invasive registry examination.
(d)
[
(e)
] 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
[
may
] 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)
[
(f)
] 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
[
or approved under the provisions of §143.15 of this title
].
(f)
[
(g)
] Standards of acceptable performance.
The scaled score to determine pass or fail performance shall be 75.
(g)
[
(h)
] 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)
[
(i)
]
Examination
Results.
(1)
Notification
to
[
of
] 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)
[
(j)
] 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)
Purpose. The purpose of this section
is to establish the minimum standards for approval of curricula, programs,
and instructors to train individuals to perform radiologic procedures and
to qualify for the general or limited certificates, or both. All programs
shall primarily provide educational and training opportunities for the student(s)
rather than primarily provide service to the sponsor or its patients or clients.]
(a)
[
(b)
] 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 (JRCENMT) or the Joint Review Committee on Education in
Radiologic Technology (JRCERT).
(b)
[
(c)
] 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 for 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)
[
(d)-(h)
] of this section apply only to department-approved programs.
(c)
[
(d)
] 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 institution's 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 [
(relating to Fees)
].
(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)
[
(f)(2) and (3)
]
of this title [
(relating to Application Requirements and Procedures)
].
(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)
[
(g)
] 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
[
Texas Department of Health,
] 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 [
(relating to
Types of Certificates and Applicant Eligibility)
].
(G)
the name of the program director who is an approved instructor
in accordance with subsection
(f)
[
(g)
] 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)
[
(f)
] 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)
[
(e)
] of this section. If the curriculum differs from
that set out in subsection
(d)
[
(e)
] 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
[
Texas Department
of Health,
] 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
[
conformance
]
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)
[
(c)(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 [
(relating to Violations and Subsequent Actions)
]; and
(J)
comply with the Texas Regulations for the Control of Radiation
(TRCR), 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)
[
(e)
] 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)
Figure: 25 TAC §143.9(e)(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
[
be
] 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)
[
(c)(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)
[
(f)
] 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 [
(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.
(f)
[
(g)
] 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)
[
(h)
] 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)
[
(f)
](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
[
proposal
] action shall be
taken.
(g)
[
(h)
] 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 (BCE), Texas State Board of Medical
Examiners (BME), or Texas State Board of Podiatry Examiners (BPE), 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
[
For example, an
] LMRT who holds a limited certificate in
spine
[
dental
] radiography may not teach, train, or provide clinical
instruction in a limited course of study for chest radiography.
[(i)
Transition. Limited certificate programs
approved as of June 28, 1996, shall have one year to comply with the requirements
adopted on June 28, 1996. Limited certificate programs approved after June
28, 1996, shall comply with the requirements in effect at the time of application
to the department.]
(h)
[
(j)
] 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 curriculum of the
limited
[
general
]
certificate program and the sequencing of the curriculum are equal to the
general
[
limited
] 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)
Purpose. The purpose of this section
is to set out the rules for issuing certificates (limited or general) and
temporary certificates (limited or general) and certificate renewal.]
(a)
[
(b)
] Issuance of certificates.
(1)
The
department
[
Texas Department of Health
(department)
] shall send each applicant whose application has been approved
[
for
] a general
,
[
or
] limited
or provisional
certificate [
a form to complete and return with the prorated certification
fee. Failure to pay the fee requested within 60 days of the date of the original
approval letter shall result in the application being invalidated.
]
[
(2)
]
[
Upon receiving the applicant's form
and fee, the department shall issue the person a general certificate or limited
certificate
] with an expiration date and a certificate number. An identification
card shall be included with the general certificate.
(2)
[
(3)
] 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 [
of
] the loss or destruction of
the original certificate and/or identification card(s), or be accompanied
by the damaged certificate or card(s).
(b)
[
(c)
] 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)
[
(d)
] 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. [
Fees shall be prorated and must be paid
before a certificate will be issued by the department.
]
(d)
[
(e)
] 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, [
category of employment,
] 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 [
(relating to Continuing Education Requirements)
]. 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
[
postmark
] date shall be considered the date of mailing.
The processing times and procedures set out in §143.6
(e)
[
(f)
] of this title [
(relating to Application Requirements and Procedures)
] 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)
[
(f)
] 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 [
(relating to Continuing Education
Requirements)
]. 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)
[
(f)
] 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 (if required), the
renewal fee, and the late renewal fee. 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)
[
(e)(7)
] of this section.
(A)
If the certificate has been expired for 90 days or less,
a
[
the
] 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
[
the
] person may renew the
certificate by paying the 91-day to one-year late renewal fee.
(C)
A
[
the
] person must comply with the
continuing education requirements for renewal as set out in §143.11 of
this title [
(relating to Continuing Education Requirements)
] before
the late renewal is effective.
A
[
the
] person is not
eligible for a 120-day certificate as described in subsection
(d)(7)
[
(e)(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)
[
(g)
] Expired certificates. The department,
[
by certified mail
] 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)
[
(h)
] 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
[
the
] 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)
[
(f)
] 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)
[
(f)
] of this section. An MRT or LMRT on active duty serving within the
State of Texas who does not renew under subsection
(e)
[
(f)
] of this section may file a complete application for another certificate
in accordance with §143.7
(h)
[
(i)
] of this title
[
(relating to Types of Certificates and Applicant Eligibility)
].
§143.11.Continuing Education Requirements.
[(a)
Purpose. The purpose of this section
is to establish the continuing education requirements which a medical radiologic
technologist (MRT) or limited medical radiologic technologist (LMRT) must
complete periodically to maintain certification. The requirements are intended
to maintain and improve the quality of professional services provided to the
public and to keep the MRT or LMRT knowledgeable of current research, techniques,
and practice, and provide other resources which will improve skill and competency
in performing radiologic procedures.]
(a)
[
(b)
] 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
[
hence
].
(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
three hours
[
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.]
(6)
[
(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.
(7)
[
(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), or Nuclear Medicine Technology
Certification Board (NMTCB) 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 meet or exceed the requirements set
out in
paragraph (5) of this subsection and
subsection
(b)
[
(c)
] 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)
[
(f)(1)
] of this section. [
This procedure shall be
effective for renewals beginning in 1997.
]
(8)
[
(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.
(9)
[
(10)
] Persons who hold temporary
certificates, either general or limited, are not subject to these continuing
education requirements.
(b)
[
(c)
] 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)
[
(d)
] 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)
[
(b)
] 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
(JRCENMT), 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)
[
(c)
] 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)
[
(e)
] 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)
[
(1)
] 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)
[
(2)
] 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)
[
(3)
] teaching in a program described
in subsection
(c)
[
(d)
] 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 five hours. Credit may be granted in direct, indirect or non-ionizing
radiation based on the topic; or
(5)
[
(4)
] developing and publishing a
manuscript of at least 1,000 words in length related to radiologic technology
with a limit of five 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)
[
(f)
] 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)
[
(j)
] 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)
[
(b)(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)
[
(g)
] 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)
[
(d)(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)
[
(d)(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)
[
(h)
] 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 (b)(6) of this section which exceed 50% of the clock
hour requirements;]
(5)
[
(6)
] learning activities indirectly
related to radiologic technology as set out in subsection
(b)(3)
[
(c)(3)
] of this section which exceed 50% of the contact hour requirements;
(6)
[
(7)
] learning activities which are
related to non-ionizing forms of radiation as set out in subsection
(b)(2)
[
(c)(2)
] of this section which exceed 50% of the contact
hour requirements;
(7)
[
(8)
] any activities or experiences
which do not meet the criteria set out in subsection
(a), (b), (c) or
(d)
[
(b), (c), (d) or (e)
] of this section;
(8)
[
(9)
] activities in accordance with
subsection
(d)(1) and (2)
[
(e)(1)
] of this section which
are repeated during the renewal period or hours in excess of three hours per
renewal period;
(9)
[
(10)
] activities in accordance with
subsection
(d)(4)
[
(e)(3)
] of this section in excess
of the one-time credit per topic of instruction or in excess of a total of
five contact hours during a continuing education period;
(10)
[
(11)
] activities in accordance
with subsection
(d)(5)
[
(e)(4)
] of this section in excess
of five contact hours during a continuing education period; or
(11)
[
(12)
] activities that are an employment
requirement or concerning specific institutional policies and procedures.
(h)
[
(i)
] 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)
[
(e)(7)
] of this title [
(relating to Certificates, Renewals, and Late Renewals)
]. 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
[
In other words, 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
[
the
] person may renew late under §143.10
(e)
[
(f)
] of this title [
(relating to Certificates, Renewals,
and Late Renewals)
] after all the continuing education requirements
have been met. A person who renews late is not eligible for a 120-day extension.
(i)
[
(j)
] 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 [
missed as a result
of the exemption, subject to a maximum of 24 hours
]. These hours shall
be accrued [
during the six-month period
] 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 [
missed
as a result of the exemption, subject to a maximum of 24 hours
]. These
hours shall [
be
]
accrue
[
accrued during the six-month
period
] 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
[
the
] 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 by or for 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)
[
(k)
] 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)
[
(c)(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 magnetic resonance imaging
offered by the ARRT.
(k)
[
(l)
] 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
[
denied exemption
]. If no hearing is requested in writing within 30 days,
the opportunity for hearing shall be waived.
(l)
[
(m)
] 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 purpose of this section is to set
out the responsibilities and procedures for name and address changes.]
(a)
[
(b)
] 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)
[
(c)
] Notification of address changes
shall be made in writing including the name, mailing address, [
and
]
zip codes, and be mailed to the administrator.
(c)
[
(d)
] 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 notarized
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 [
(relating to Fees)
]. Upon receipt
of the new certificate and identification cards, the
MRT
[
medical radiologic technologist (MRT)
] or
LMRT
[
limited
medical radiologic technologist (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.
§143.13.Certifying Persons with Criminal Backgrounds [ To Be Medical Radiologic Technologists ].
[(a)
Purpose. This section is designed to
establish guidelines and criteria on the eligibility of persons with criminal
backgrounds to obtain certificates or temporary certificates as medical radiologic
technologists.]
(a)
[
(b)
] [
Pleadings of nolo contendere
or
]
Criminal
[
criminal
] convictions which directly
relate to the profession of radiology.
(1)
The department may suspend or revoke any existing certificate,
disqualify a person from receiving any certificate, or deny to a person the
opportunity to be examined for a certificate
if the
[
because
of a
] person
is convicted of,
[
pleading
]
enters a plea of
nolo contendere
or guilty to
[
or being
convicted of
] a felony or misdemeanor if the crime directly relates
to the duties and responsibilities of a [
medical radiologic technologist
]
MRT
[
(MRT)
] or [
limited medical radiologic
technologist
]
LMRT
[
(LMRT)
].
(2)
In considering whether a pleading of nolo contendere or
a criminal conviction directly relates to the occupation of an MRT or LMRT,
the department shall consider:
(A)
the nature and seriousness of the crime;
(B)
the relationship of the crime to the purposes for certification.
The following felonies and misdemeanors relate to any certificate because
these criminal offenses indicate an inability or a tendency to be unable to
perform as an MRT or LMRT:
(i)
the misdemeanor of knowingly or intentionally acting as
an MRT or LMRT without a certificate under the Medical Radiologic Technologist
Certification Act (the Act);
(ii)
any misdemeanor and/or felony offense defined as a crime
of moral turpitude by statute or common law;
(iii)
a misdemeanor or felony offense under various titles
of the Texas Penal Code:
(I)
offenses against the person (Title 5);
(II)
offenses against property (Title 7);
(III)
offenses against the public order and decency (Title
9);
(IV)
offenses against public health, safety, and morals (Title
10); and
(V)
offenses of attempting or conspiring to commit any of the
offenses in this subsection;
(C)
the extent to which any certificate might offer an opportunity
to engage in further criminal activity of the same type as that in which the
person previously had been involved; and
(D)
the relationship of the crime to the ability, capacity,
or fitness required to perform the duties and discharge the responsibility
of an MRT or LMRT. In making this determination, the department will apply
the criteria outlined in
Texas Occupations Code, Chapter 53
[
Texas Civil Statutes, Article 6252-13c, §4(c)(1)-(7)
], the legal
authority for the provisions of this section.
(3)
The misdemeanors and felonies listed in paragraph (2)(B)(i)-(iii)
of this subsection are not inclusive in that the department may consider other
particular crimes in special cases in order to promote the intent of the Act
and these sections.
(b)
[
(c)
] Procedures for revoking, suspending,
or denying a certificate or temporary certificate to persons with criminal
backgrounds.
(1)
The administrator shall give written notice to the person
that the department intends to deny, suspend, or revoke the certificate or
temporary certificate after hearing in accordance with the provisions of the
Administrative Procedure Act, the Government Code, Chapter 2001, and the formal
hearing procedures in §§1.21-1.34 of this title [
(relating
to Formal Hearing Procedures)
].
(2)
If the department denies, suspends, or revokes a certificate
or temporary certificate under these sections after hearing, the administrator
shall give the person written notice:
(A)
of the reasons for the
decision
[
decisions
];
(B)
that the person, after exhausting administrative appeals,
may file an action in a District Court of Travis County for review of the
evidence presented to the department and its decision; and
(C)
that the person must begin the judicial review by filing
a petition with the court within 30 days after the department's action is
final and appealable.
§143.14.Disciplinary Actions.
(a)
The
department
[
Texas Department of Health
(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)-(5)
(No change.)
(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
[
education
] requirements, passing an examination, or working
under the supervision of
an
[
a medical radiologic technologist
]
MRT
[
(MRT)
] or other practitioner.
(b)
(No change.)
(c)
Engaging in unprofessional conduct means the following:
(1)-(9)
(No change.)
(10)
performing a radiologic procedure which is not within
the scope of
an
[
a limited medical radiologic technologist's
]
LMRT's
[
(LMRT)
] certificate, as set out in §143.7
(e)
[
(f)
] of this title [
(relating to Types of Certificates
and Applicant Eligibility)
];
(11)-(13)
(No change.)
(14)
providing information which is false, misleading, or deceptive
regarding the status of certification; registration with the American Registry
of Radiologic Technologists [
(ARRT)
] or Nuclear Medicine Technology
Certification Board [
(NMTCB)
]; or licensure by another country,
state, territory, or
the
District of Columbia;
(15)-(16)
(No change.)
(17)
acting as a proxy for an MRT or LMRT at any continuing
education required under §143.11 of this title [
(relating to Continuing
Education Requirements)
];
(18)-(24)
(No change.)
(25)
failing to follow appropriate safety standards or the
Texas Regulations for the Control of Radiation [
(TRCR)
] in the
operation of diagnostic or therapeutic radiologic equipment or the use of
radioactive materials;
(26)-(33)
(No change.)
(d)-(h)
(No change.)
(i)
Formal hearing requirements [
are as follows
]:
(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 rules 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.
[(1)
The administrator may only initiate or
propose disciplinary action. Final action may be taken by the department only
after the person has had an opportunity for a formal hearing to contest the
proposed action.]
[(2)
The formal hearing shall be conducted
in accordance with the department's formal hearing procedures in Chapter 1
of this title (relating to the Texas Board of Health).]
[(3)
Prior to institution of formal proceedings,
the administrator shall give written notice to the person or program of the
facts or conduct alleged to warrant disciplinary action and the person or
program shall be given the opportunity, as described in the notice, to show
compliance with all requirements of the Act and this chapter.]
[(4)
To initiate formal hearing procedures,
the administrator shall give the person or program written notice of the opportunity
for hearing. The notice shall state the basis for the proposed action. Within
ten days after receipt of the notice, the person or program shall give written
notice to the administrator that the hearing is requested. Receipt of the
written notice is presumed to occur on the tenth day after the notice is sent
to the last address known to the department unless another date is reflected
on the return receipt.]
[(A)
If no request for a hearing is given within ten days after
receipt of the notice, the person or program is deemed to have waived the
hearing and be in agreement with the allegations and proposed action. If the
hearing has been waived, the department shall recommend disciplinary action
to the commissioner.]
[(B)
If the person or program requests a hearing within ten
days after receiving the notice of opportunity for hearing, the department
shall initiate the department's formal hearing procedures in accordance with
Chapter 1 of this title.]
[(C)
If the person or program fails to appear or be represented
at the scheduled hearing, the person or program is deemed to be in agreement
with the allegations and proposed action and to have waived the right to a
hearing. An appropriate order may be entered without further notice except
as required by law.]
(j)
(No change.)
(k)
Pursuant to the Act,
§601.351
[
§2.15
], the department is authorized to assess an administrative penalty
against a person who violates the Act or this chapter.
§143.15.Advertising or Competitive Bidding.
(a)
The department may not adopt rules restricting advertising
or competitive bidding by a medical radiologic technologist except to prohibit
false, misleading, or deceptive practices.
(b)
A person, including a medical radiologic technologist,
that is not certified under the Act shall not use the word "medical radiologic
technologist", on any sign, display, or other form of advertising unless the
person is expressly exempt from the certification requirement.
(c)
A certificate holder shall not use advertising that is
false, misleading, or deceptive or that is not readily subject to verification.
False, misleading, or deceptive advertising or advertising that is not really
subject to verification includes advertising that:
(1)
makes a material misrepresentation of fact or omits a fact
necessary to make the statement as a whole not materially misleading;
(2)
makes a representation likely to create an unjustified
expectation about the results of a health care service or procedure;
(3)
compares a health care professional's services with another
health care professional's services unless the comparison can be factually
substantiated;
(4)
contains a testimonial;
(5)
causes confusion or misunderstanding as to the credentials,
education, or registration of a health care professional;
(6)
advertises or represents that health care insurance deductibles
or copayments may be waived or are not applicable to health care services
to be provided if the deductibles or copayments are required;
(7)
advertises or represents that the benefits of a health
benefit plan will be accepted as full payment when deductibles or copayments
are required;
(8)
makes a representation that is designed to take advantage
of the fears or emotions of a particularly susceptible type of patient; or
(9)
advertises or represents in the use of a professional name,
title or professional identification that is expressly or commonly reserved
to or used by another profession or professional.
(d)
When an assumed name is used in a person's practice as
a medical radiologic technologist, the legal name or certificate number of
the medical radiologic technologist must be listed in conjunction with the
assumed name. An assumed name used by a medical radiologic technologist must
not be false, misleading, or deceptive.
(e)
A limited medical radiologic technology educational program
or a training program for non-certified technicians shall not make false,
misleading, or deceptive statements concerning the activities or programs
of another limited medical radiologic technology education program or a training
program for non-certified technicians.
(f)
A limited medical radiologic technology educational program
or a training program for non-certified technicians shall not maintain, advertise,
solicit for or conduct any course of instruction intended to qualify a person
for certification or placement on the registry without first obtaining approval
from the department.
(g)
Advertisement by an educational or training program seeking
prospective students must clearly indicate that training is being offered,
and shall not, either by actual statement, omission, or intimation, imply
that prospective employees are being sought.
(h)
Advertisements seeking prospective students must include
the full and correct name of the educational or training program.
(i)
No statement or representation shall be made to prospective
or enrolled students that employment will be guaranteed upon completion of
any program or that falsely represents opportunities for employment.
(j)
No statement shall be made by an educational or training
program that it has been accredited unless the accreditation is that of an
appropriate nationally recognized accrediting agency listed by the United
States Office of Education.
(k)
No educational or training program shall advertise an employment
agency under the same name or a confusingly similar name or at the same location
as the educational or training program. No representative shall solicit students
for a program through an employment agency.
§143.16.Dangerous or Hazardous Procedures.
(a)
General
[
Purpose
]. [
The purpose
of
]
This
[
this
] section [
is to
]
identifies
[
identify
] the radiologic procedures which are
dangerous or hazardous and may only be performed by a practitioner, medical
radiologic technologist (MRT) or limited medical radiologic technologist (LMRT).
There are specific procedures identified in subsections (b) and (c) of this
section which may be performed by a registered nurse (RN) or a physician assistant
trained under §143.17 of this title (relating to Mandatory Training Programs
for Non-Certified Technicians) or §143.20 of this title (relating to
Alternative Training Programs). A person trained under §143.17 or §143.20
of this title and placed on a registry under §143.18 of this title (relating
to Registry of Non-Certified Technicians) is not an MRT, LMRT or otherwise
certified under the Medical Radiologic Technologist Certification Act (Act)
and shall not perform a dangerous or hazardous procedure identified in this
section unless expressly permitted under this section.
(b)
Dangerous procedures [
identified
]. Unless otherwise
noted, the list of dangerous procedures which may only be performed by a practitioner
or MRT are:
(1) -(2)
(No change.)
(3)
radiation therapy, including simulation
,
[
and
] brachytherapy
and all external radiation therapy beams including
Grenz rays
;
(4)-(7)
(No change.)
(c)
Hazardous procedures [
identified
]. Unless otherwise
noted, the list of hazardous procedures which may only be performed by a practitioner
or MRT are:
(1)-(9)
(No change.)
(10)
pediatric radiography, excluding extremities, unless performed
by an RN or physician assistant who is appropriately trained, as set out in §143.17
or §143.20 of this title or an LMRT with the
appropriate category
[
cardiovascular specialty
]. If an emergency condition exists
which threatens serious bodily injury, protracted loss of use of a bodily
function or death of a pediatric patient unless the procedure is performed
without delay, or if other extenuating circumstances deemed by the practitioner
exist, a pediatric radiographic procedure is also excluded. The emergency
condition or extenuating circumstance must be documented by the ordering practitioner
in the patient's clinical record and the record must document that a regularly
scheduled MRT, LMRT, RN or physician assistant is not reasonably available
to perform the procedure.
(d)-(f)
(No change.)
(g)
Mammography. In accordance with the Health and Safety Code, §401.421
et seq, mammography is a radiologic procedure which may only be performed
by an MRT [
(not an LMRT)
] who meets the qualifications set out
in §289.230
(f)(2)
[
(d)(2)
] of this title (relating
to Mammography). Mammography shall not be performed by a practitioner, an
LMRT, an NCT, or any other person.
(h)
(No change.)
(i)
[
Effective date.
]
[(1)
This section shall become effective on
June 1, 1997.]
[
(2)
]
[
On or after January 1, 1998,
]
An
[
an
] RN or physician assistant must be trained under §143.17
of this title or §143.20 of this title, or have been approved to perform
radiologic procedures under a hardship exemption granted under §143.19
of this title (relating to Hardship Exemptions), in addition to performing
the listed procedure under the direction and supervision of a practitioner.
Subsections (b)(6) and (c)(8) shall not be construed to authorize an RN or
physician assistant to independently perform fluoroscopy, fluorography or
procedures utilizing contrast media.
(j)
(No change.)
§143.17.Mandatory Training Programs for Non-Certified Technicians.
(a)
General
[
Purpose
]. [
The purpose
of
]
This
[
this
] section [
is to
]
sets
[
set
] 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). [
Effective January 1, 1998,
]
Before
[
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)
(No change.)
(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 [
(ARRT)
];
(B)
(No change.)
(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 [
(BCE)
], Texas State Board
of Medical Examiners (BME), or Texas State Board of Podiatry Examiners (BPE),
the Texas Department of Human Services, the United States Department of Health
and Human Services.
(2)
An
[
A
]
LMRT
[
limited
medical radiologic technologist (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. [
For example,
]
An
[
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. [
As of July 1, 2000,
]
In
[
in
] order to successfully complete a program, each student
must complete the following minimum training:
(1)-(3)
(No change.)
(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 [
(relating to Fees)
]. Photocopied
signatures will not be accepted.
(2)
(No change.)
(f)
Application materials. The application shall include, at
a minimum:
(1)-(10)
(No change.)
(11)
specific written agreements to:
(A)
(No change.)
(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
[
medical radiologic
technologist (MRT)
] or a practitioner;
(C)-(G)
(No change.)
(g)
(No change.)
(h)
Application processing. The department shall use the same
process as described in §143.6
(e)
[
(f)
] of this
title [
(relating to Application Requirements and Procedures)
],
except the time periods are as follows:
(1)-(4)
(No change.)
(i)
(No change.)
§143.18.Registry of Non-Certified Technicians.
(a)
General
[
Purpose
]. [
The purpose
of
]
This
[
this
] section [
is to
]
sets forth
[
set out
] the rules for administering the registry
of non-certified technicians performing radiologic procedures, established
in accordance with the
Act
[
Medical Radiologic Technologist
Certification Act (Act)
],
§601.202
[
§2.05(a)(4)
]. [
The purpose of
]
The
[
the
] department's
registry is to provide a mechanism for consumers or employers to ascertain
or verify that a person performing radiologic procedures has complied with
the Act,
§601.201
[
§2.05(f)
] by successfully
completing a training program in accordance with §143.17 of this title
[
(relating to Mandatory Training Programs for Non-Certified Technicians)
] or §143.20 of this title (relating to Alternate Training Requirements).
(b)
(No change.)
(c)
Initial placement on the registry. In order to be listed
on the registry for the first time, the information described in subsection
(b) of this section shall be reported to the
department
[
Texas Department of Health (department)
] by the training program approved
under §143.17 or §143.20 of this title after the person's successful
completion of the training. A person who has completed all the training program
through previously completed courses in accordance with §143.17
(d)
[
(j)
] of this title may apply directly to the department
to be placed on the registry
upon receipt of an application and required
fee.
(d)-(f)
(No change.)
(g)
Employer responsibility. If a person performing radiologic
procedures is not an medical radiologic technologist, limited medical radiologic
technologist or is not registered under this section, the employer shall be
responsible for determining whether the person performing radiologic procedures
is in compliance with §143.17 of this title. This subsection does not
apply to a hospital, federally qualified health center [
(FQHC)
],
or practitioner granted a hardship exemption by the department within the
previous 12-month period.
(h)
(No change.)
§143.19.Hardship Exemptions.
[(a)
Purpose. The purpose of this section
is to set out the procedure for applying for a hardship exemption under the
Medical Radiologic Technologist Certification Act (Act), §2.05(i) and
(j) for a hospital, federally qualified health center (FQHC), or practitioner.]
(a)
[
(b)
] General.
(1)
A hospital,
federally qualified health center (FQHC)
[
FQHC
] or practitioner may apply to the
department
[
Texas Department of Health (department)
] for an exemption
from employing
an
[
a
]
MRT
[
medical radiologic
technologist (MRT)
],
LMRT
[
limited medical radiologic
technologist (LMRT)
], or
NCT
[
non-certified technician
(NCT)
].
(2)
The applicant must demonstrate a hardship as described
in subsection
(b)(5)
[
(c)(5)
] of this section in employing
an MRT, LMRT, or NCT.
(3)
The applicant shall not allow a person who is not an MRT,
LMRT, or NCT to perform a radiologic procedure until the department grants
a hardship exemption.
(4)
A hardship exemption granted by the department does not
constitute licensure, certification, registration, or authorization to perform
a dangerous or hazardous radiologic procedure or mammography.
(b)
[
(c)
] Required application materials.
(1)
The applicant must apply for a hardship on the forms prescribed
by the department. The date of application shall be the date the application
and application fee
is postmarked. If there is no visible postmark,
or if the application is hand-delivered, the application date shall be the
date the administrator received the application.
(2)
The application must be accompanied by documentation clearly
indicating that the applicant is a licensed hospital, FQHC or licensed practitioner.
A copy of the current hospital license, certificate of qualification issued
to the FQHC, or current license of the practitioner shall be acceptable documentation.
(3)
If the application is from a hospital or FQHC, the administrator
or chief executive officer of the hospital or FQHC must sign the application
form. If the applicant is a practitioner, the practitioner must sign the application
form.
(4)
The application must include a list of the person(s) performing
radiologic procedures who is not
an
[
a
] MRT, LMRT, or
NCT.
(5)
The application shall be accompanied by one or more of
the following:
(A)
if the applicant is unable to attract or retain an MRT
or LMRT, a sworn affidavit describing in narrative form the applicant's attempts
to attract and retain an MRT or LMRT at a comparable salary for the area;
(B)
if the applicant is located more than 50 highway miles
from the nearest school of medical radiologic technology approved in accordance
with §143.9 of this title [
(relating to Standards for the Approval
of Curricula and Instructors)
], a sworn affidavit describing in narrative
form the physical address of the nearest school of medical radiologic technology;
the physical address of the applicant hospital, FQHC, or primary practice
location of the practitioner; and the actual distance in highway miles between
the school and the applicant hospital, FQHC, or practitioner's primary practice.
The applicant shall include a map of the area clearly indicating the locations
of each entity;
(C)
if the nearest school of medical radiologic technology
approved in accordance with §143.9 of this title has a waiting list of
school applicants due to a lack of faculty or space, a sworn affidavit from
the applicant indicating that admissions to the school are pending because
of a lack of faculty or space;
(D)
if the need for graduates in medical radiologic technology
of the applicant exceeds the number of graduates from the nearest school of
medical radiologic technology approved in accordance with §143.9 of this
title, a sworn affidavit from the applicant indicating that the number of
graduates from the nearest school does not meet the applicant's needs for
radiologic technologists;
(E)
if emergency conditions have occurred during the 90 days
prior to making application for the hardship exemption, a sworn affidavit
from the applicant describing the emergency conditions, the hardship(s) the
emergency conditions have created and how long the hardship(s) is anticipated
to continue. For the purposes of this subparagraph, emergency conditions may
include a disaster, epidemic, or other catastrophic event;
(F)
documentation that the United States government has declared
a state of war;
(G)
if the equipment operated is a bone densitometry unit(s)
which utilizes x-radiation, a sworn affidavit from the applicant indicating
the name of the person operating the equipment and proof that the person is
a certified densitometry technologist in good standing with the International
Society for Clinical Densitometry (ISCD) or has completed at least 20 hours
of training as follows:
(i)
specific bone densitometry equipment utilizing x-radiation
to be used by the operator--16 hours presented by a medical radiologic technologist
(MRT) or an equipment applications specialist knowledgeable of the specific
equipment to be utilized; and
(ii)
radiation safety and protection for the patient, self
and others--four hours presented by an MRT or a licensed medical physicist
within the 24-month period prior to application or reapplication for a hardship
exemption;
(H)
if the applicant uses only a hand-held fluoroscope with
a maximum operating capability of 65 kilovolts and 1 milliampere, or a similar
type of x-ray unit for imaging upper extremities only, at the location indicated
on the application form and the applicant believes that the radiation produced
by the radiographic equipment represents a minimal threat to the patient and
the operator of the equipment, the following is required to be submitted:
(i)
a copy of the current certificate of registration issued
by the Bureau of Radiation Control; and
(ii)
a sworn affidavit describing the equipment used; the types
of radiographs performed; the training completed by the operator of the equipment
within the 24-month period prior to application or reapplication for a hardship
exemption; the date(s) the training was completed by the operator; the radiation
safety measures taken for the patient, operator and others; the level or amount
of supervision provided by an MRT or a practitioner(s) to the operator while
performing the radiographic procedure; and the equipment manufacturer's specifications
for the diagnostic radiographic equipment utilized at the location indicated
on the application form, including the maximum operating capability;
[
(I)
if the applicant employs,
for the purpose of performing radiologic procedures, a person registered in
accordance with rules adopted under §2.08 of the Act on or before January
1, 1998, a sworn affidavit indicating the name(s) of the person(s) and proof
that the person(s) was registered on or before January 1, 1998. Such affidavit
shall be on a form attesting that the training under §143.17 of this
title (relating to Mandatory Training Programs for Non-Certified Technicians)
or §143.20 of this title (relating to Alternate Training Requirements)
causes a fiscal hardship for the applicant. The affidavit shall include a
statement that the person(s) performing radiologic procedures is adequately
supervised and trained for the procedures being performed. If the applicant
is a practitioner or FQHC, the person who will perform radiologic procedures
must be registered in accordance with rules adopted under §2.08 of the
Act at the time of application for the hardship exemption. If the person who
will perform radiologic procedures is not an RN, the name of the practitioner
for whom the radiologic procedures are performed, as named on the current
registration permit, shall match the name or location of the applicant for
whom the hardship is granted;
]
[(J)
if the applicant is a hospital accredited
by the Joint Commission on the Accreditation of Health Care Organizations
or which participates in the federal Medicare cost reimbursement program,
an original letter on hospital letterhead stating the name(s) of the person(s)
performing radiologic procedures in compliance with §2.07(d) of the Act
on or before January 1, 1998. The letter shall be accompanied by a sworn affidavit
from the applicant attesting that the training under §143.17 or §143.20
of this title causes a fiscal hardship for the applicant. The affidavit shall
include a statement that the person(s) performing radiologic procedures is
adequately supervised and trained for the procedures being performed;]
(I)
[
(K)
] if the applicant employs for
the purpose of performing radiologic procedures, a person who is registered
to take the Texas Medical Association's/Texas Osteopathic Medical Association's
Physician's Training program for X-ray Operators approved by the department
under §143.20 of this title, a sworn affidavit including justification
for application under one of the requirements described in paragraph
(5)(A)-(I)
[
(5)(A)-(J)]
of this subsection. The following
items must be submitted:
(i)
the name(s), date of birth and social security number of
the person(s) who will perform radiologic procedures pursuant to this hardship
exemption;
(ii)
the name of the facility where the training program will
be taken, the date the program will begin and the anticipated date of completion;
(iii)
the name(s) of the certified medical radiologic technologist
instructor meeting the requirements set out in §143.17(c) of this title;
(iv)
the name(s) of the company and the name of the person(s)
who will be the designated equipment applications specialist knowledgeable
of the specific equipment to be utilized; and
(v)
a list of the anatomical categories to be included in the
training.
(6)
All application materials and information are subject to
verification by the department.
(7)
The department shall send a written notice listing the
additional materials required to an applicant whose application is incomplete.
An application not completed within 30 days after the date of the written
notice shall be invalid unless the applicant has advised the department of
a valid reason for the delay.
(c)
[
(d)
] Application approval.
(1)
The administrator shall be responsible for reviewing all
applications. The administrator shall approve any application which is in
compliance with this section and which properly documents applicant eligibility.
(2)
If granted by the department, a letter of exemption shall
be issued for a period of one year.
(d)
[
(e)
] Disapproved applications.
(1)
The department shall disapprove the application if the
applicant has not met the application requirements set out in this section
or has failed or refused to complete or submit any form or documentation required
by the department to verify the eligibility for the exemption.
(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. The applicant may appeal the decision to
the associate commissioner over the administrator by submitting a written
request within ten days after receipt of the written notice of the reason(s)
for the disapproval.
(3)
Based upon the application and any additional information
submitted by the applicant or the administrator, the associate commissioner
shall approve or disapprove the application.
(4)
An applicant whose application has been disapproved under
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 new application
and supporting information. The applicant may reapply for an exemption any
time the basis for the exemption application changes.
(e)
[
(f)
] Application processing. The
department shall use the same process as described in §143.6
(e)
[
(f)
] of this title [
(relating to Application Requirements
and Procedures)
], 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 exemption--42 days.
(f)
[
(g)
]Reapplication for hardship exemption.
(1)
The hospital, FQHC, or a practitioner must reapply annually
for the exemption and meet the then current requirements for a hardship exemption.
(2)
A hospital, FQHC, or a practitioner who does not reapply
for an exemption shall not allow a person to perform a radiologic procedure
unless the person is a practitioner, MRT, LMRT, or NCT.
§143.20.Alternate Training Requirements.
(a)
General
[
Purpose
]. [
The purpose
of
]
This
[
this
] section [
is to
]
sets
[
set
] out the minimum standards for registered nurses
(RNs), physician assistants, podiatric medical assistants (PMAs) and x-ray
equipment operators in a physician's office.
(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
instructor
approved [
instructor
]
by the department
. Distance learning activities and audiovisual teleconferencing
may be utilized, provided these include two-way, interactive communications
which are broadcast or transmitted at the actual time of occurrence. Appropriate
on-site supervision of persons participating in the distance learning activities
or teleconferencing shall be provided by the approved training program. No
credit will be given for training completed by self-directed study or correspondence.
The provisions of this subsection shall not apply to the out of classroom
training requirements for podiatric medical assistants and x-ray equipment
operators in a physician's offices.
(1)
[
Effective January 1, 1998,
]
Before
[
before
] an RN or physician assistant performs a radiologic procedure,
the RN or physician assistant must complete the hours stated in subsection
(d) of this section, or the hours stated in §143.17 of this title [
(relating to Mandatory Training Programs for Non-Certified Technicians)
].
(2)
[
Effective January 1, 1998,
]
Before
[
before
] a PMA performs a radiologic procedure, the PMA must complete
the hours stated in subsection (e) of this section, or the hours stated in §143.17(d)
of this title concerning podiatric radiologic procedures.
(3)
Individuals who complete training approved under this section
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 Eligibility)
].
(c)
Approved instructors.
(1)
For purposes of this section, an individual is approved
by the
department
[
Texas Department of Health (department)
] to teach in a training program if the individual meets the requirements
of §143.9
(g)(1)-(2)
[
(h)(1)-(2)
] of this title [
(relating to Standards for the Approval of Curricula and Instructors)
].
The application for the training program must demonstrate that the instructors
meet the qualifications. No application for individual instructor approval
is required.
(2)
An
[
A
]
LMRT
[
limited
medical radiologic technologist (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. [
For example,
]
An
[
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)-(k)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on February 23, 2001.
TRD-200101134
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: April 8, 2001
For further information, please call: (512) 458-7236
25 TAC §143.15
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Department of Health or in the Texas Register office, Room 245,
James Earl Rudder Building, 1019 Brazos Street, Austin.)
The repeal is proposed under Texas Occupations Code, §601.052,
which provides the Texas Board of Health (board) with the authority to adopt
rules concerning the regulation and certification of persons performing radiologic
procedures; and the Health and Safety Code, §12.001 which provides the
board with authority to adopt rules for the performance of every duty imposed
by law on the board, the department, and the commissioner of health.
The repeal affects the Occupations Code, Title 3. Health Professions, Subtitle
K, Chapter 601; Texas Civil Statutes, Article 4512m; and Government Code, §2001.039.
§143.15. Alternate Eligibility Requirements.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed
with the Office of the Secretary of State, on February 23, 2001.
TRD-200101133
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: April 8, 2001
For further information, please call: (512) 458-7236