GENERAL GOVERNMENT
CABINET
Board of Medical Imaging and Radiation Therapy
(As Amended at ARRS, October 13, 2015)
201 KAR 46:040. Medical imaging
technologist, advanced imaging professional, radiographer, nuclear medicine
technologist, and radiation therapist licenses[General radiation
operator requirements].
RELATES
TO: KRS 311B.020, 311B.050, 311B.080, 311B.100(2),
311B.110, 311B.120, 311B.180, 311B.190[211.890, 211.993]
STATUTORY
AUTHORITY: KRS[311B.010,] 311B.050, 311B.080,
311B.100(2), 311B.110[311B.120, 311B.180,
311B.190][194.050, 211.090, 211.870]
NECESSITY,
FUNCTION, AND CONFORMITY: KRS 311B.050 requires the Board of Medical
Imaging and Radiation Therapy to promulgate administrative regulations to
establish the procedures for the issuance and renewal of a license. KRS
311B.100(2) and KRS 311B.110(6) require the board to promulgate administrative
regulations to establish the qualifications for an advanced imaging
professional, a medical imaging technologist, a radiographer, a radiation
therapist, and a nuclear medicine technologist. KRS 311B.080 requires the board
to recognize and enforce national practice standards and scopes of practice[The
Board of Medical Imaging and Radiation Therapy is authorized by KRS 311B][211.870
and 211.890][to regulate individuals][an
operator of a source of radiation][other than a licensed practitioner
of the healing arts, including but not limited to: the][classification
and][licensure of medical imaging technologists, advanced
imaging professionals and radiation therapists; approval of accredited
educational programs of medical imaging or radiation therapy and the monitoring
of compliance with the educational standards established by the individual
disciplines, as recognized by the board][operators;
examinations; standards of training and experience; curricula standards for
institutions teaching persons to operate sources of radiation][;
issuance, renewal, suspension, and revocation of licenses; the fixing of
a reasonable schedule of fees and charges to be paid by applicants for][examinations,][licenses][,][and
renewal licenses; and to set other standards as may be appropriate for the
protection of health and safety]. This administrative regulation
establishes uniform standards for the licensure of individuals who perform
medical imaging and radiation therapy[operate sources of radiation] for[human]
diagnostic and therapeutic purposes while under the supervision of a[medical,
osteopathic, or chiropractic] licensed practitioner of the healing arts.
Section
1. Applicability. This administrative regulation shall apply to individuals who
perform medical imaging or radiation therapy[operate sources of
radiation] for[human] diagnostic medical imaging[radiologic]
or therapeutic purposes while under the direct or indirect
supervision of a[medical, osteopathic, or chiropractic] licensed
practitioner of the healing arts as specified by practice
standards, by scope of practice, and in the ACR-AAPM Technical Standard
For The Management Of The Use Of Radiation In Fluoroscopic Procedures as
listed in Section 11 of this administrative regulation[, revised 2013
(Resolution 44) and incorporated by reference].
Section
2.[General License Required to Perform Contrast Procedures. Only individuals
holding a general license shall operate sources of radiation at facilities
where contrast studies, fluoroscopic, nuclear medicine or radiation therapy
procedures are performed.
Section
3.] Eligibility for an Advanced Imaging Professional, a Medical
Imaging Technologist, a Radiographer, a Radiation Therapist, and a Nuclear
Medicine Technologist[a Medical Imaging Technologist, Radiation
Therapist or Advanced Imaging Professional][General] License.
No person shall be eligible for a[general] license pursuant to this
administrative regulation[as an operator of a source of radiation] for[human]
diagnostic imaging[radiologic] or therapeutic purposes unless the
person has:
(1)
Satisfactorily passed the national examination administered by the American
Registry of Radiologic Technologists or[and/or]
the Nuclear Medicine Technology[Technologist]
Certification Board examination[completed a course of study in radiography,
nuclear medicine technology, radiation therapy, or radiologist assistant
approved by the board as described in 201 KAR 46:030]; and
(2)
Satisfactorily completed a program in radiography, nuclear medicine
technology, radiation therapy, or advanced imaging practice that has achieved
and maintained programmatic accreditation recognized by the board as described
in 201 KAR 46:030[Satisfactorily passed an examination approved by the
cabinet as prescribed in 201 KAR 46:020, Section 3].
Section
3. Application for Initial License. (1) An
applicant shall submit:
(a)
A[(1)] completed and signed application
KBMIRT Form 1;
(b)
A[(2)] non-refundable initial application and
license fee as established by 201 KAR 46:020, Section 1;
(c)
The[(3)] results of a criminal
background check completed within the past six (6) months in state of residence
and employment and any other state of residence and employment within the past
five (5) years;
(d)
A[(4)] copy of a government-issued
photo ID;
(e)[(5)]
Documentation of active registration or certification with the ARRT or NMTCB;
and
(f)[(6)]
Verification of graduation from a program accredited by the Joint Review
Committee on Education in Radiologic Technology or the Joint Review Committee
on Educational Programs in Nuclear Medicine Technology.
(2) Notwithstanding subsection (1)(f) of this
section, if a student enters a program not under probation, and the majority of
the education program is completed under the accreditation required under 201
KAR 46:030, then the board may waive the accreditation standard as long as the
graduate passes the American Registry of Radiologic Technologists (ARRT)
examination on the first attempt.
Section
4. The issued license shall identify the licensee as an advanced
imaging professional, a medical imaging technologist, a
radiographer, a radiation therapist, or a nuclear medicine
technologist[advanced imaging professional].
The medical imaging technologist license shall also identify any ARRT or NMTCB
disciplines awarded to the licensee.
Section
5. The license shall expire annually on the last day of the licensee’s birth
month.
Section
6. Renewal of License. To renew a license, the licensee shall submit:
(1)
KBMIRT Form 2;
(2)
Verification of current active status with the[of]
ARRT or NMTCB; and
(3)
The renewal license fee as established by
201 KAR 46:020, Section 2.
Section
7. Reinstatement of Lapsed License. (1) A licensee who has allowed the license
to lapse for more[greater] than one
(1) month but less than twelve (12) months is eligible to be reinstated upon submission
of KBMIRT Form 2[the renewal application],
documentation of twenty-four (24) hours of approved continuing education
biennially, and the payment of reinstatement and
renewal fees as established by 201 KAR 46:020, Sections 2 and 7.
(2)
A licensee whose license has lapsed for more than twelve (12) months shall submit:
(a)
Verification of current active status with the[of]
ARRT or NMTCB;
(b)
KBMIRT Form 1;
(c)
Continuing education KBMIRT Form 8, as incorporated by reference in 201
KAR 46:060, that documents twenty-four (24) hours of approved
continuing education;
(d)
The non-refundable initial application and license fee
as established by 201 KAR 46:020, Section 1;
(e)
The results of a criminal
background check completed within the past six (6) months in state of residence
and employment and any other state of residence and employment within the past
five (5) years; and
(f)
A copy of a government-issued photo ID.
Section
8.[4.] Temporary License. The board may, upon completion
of Form KBMIRT 3, as incorporated by reference in 201 KAR 46:045,[proper
application] and payment of the[appropriate]
fee established in 201 KAR 46:020, Section 3, issue a temporary
license to an applicant who has successfully completed an approved course of
study in radiography, nuclear medicine technology,[or] radiation therapy,
or an advanced imaging profession and meets the other requirements of 201
KAR 46:045[these administrative regulations] other than
having taken the required examination. Temporary licenses shall be effective
for one (1) year only and are not renewable.
Section
9. Continuing Education Audit Process. (1) The board shall select a sample of
licensees[licenses] to audit for continuing
education[CE] compliance.
(2)
The board shall send each licensee selected for audit a notification of audit.
(3)
Each licensee shall maintain his or her[their]
personal files such as certificates or records of credit from approved
continuing education programs from the current biennium and immediate prior biennium.
(4)
A licensee selected for audit shall provide the board with a copy of his
or her[their] certificate or records of completion.
(5)
Failure to comply with an audit may result in non-renewal, suspension, or
revocation of license.
Section
10. Contrast Procedures. Only individuals holding a license pursuant to this
administrative regulation shall perform diagnostic imaging or radiation therapy
procedures regulated by KRS Chapter 311B at
facilities where contrast studies are performed.
Section
11.[5.] Practice Standards[for General Licensee]. Individuals
licensed pursuant to this administrative regulation[General licensees]
shall perform according to practice standards of the discipline for which
they hold credentials, as established by the American Society of Radiologic
Technologists (ASRT), the American College of Radiology (ACR), the
American Association of Physicists in Medicine (AAPM), and the Society of Nuclear
Medicine and Molecular Imaging (SNMMI) and incorporated by reference. These
standards include the:
(1) Radiography Practice Standards;
(2) Nuclear Medicine Technologist Scope of
Practice and Performance Standards;
(3) Positron Emission Tomography (PET)
Technologist Scope of Practice and Performance Standards;
(4) Scope of Practice for the Nuclear Medicine
Advanced Associate;
(5) Radiation Therapy Practice Standards;
(6) Bone Densitometry Practice Standards;
(7) Cardiovascular Interventional Technology
Practice Standards;
(8) Computed Tomography Practice Standards;
(9) Limited X-ray Machine Operator Practice
Standards;
(10) Mammography Practice Standards;
(11) Radiologist Assistant Practice Standards;
(12) ACR ASRT Joint-Policy
Statement-Radiologist Assistant: Roles and Responsibilities; and
(13) ACR-AAPM Technical Standard For Management Of
The Use Of Radiation In Fluoroscopic Procedures.
Section
12. CT Training for Nuclear Medicine Technologists and Radiation Therapists.
Individuals who are licensed in the primary discipline of nuclear medicine or
radiation therapy, are certified by the ARRT or NMTCB, and are seeking
post-primary certification in computed tomography (CT) may work under the
direct supervision of a licensed and certified CT technologist to gain clinical
competency. An individual who wishes to complete clinical training in CT shall
submit a Provisional License Application, as incorporated by
reference in 201 KAR 46:050,[an application for a provisional license]
which shall expire twenty-four (24) months from the date of issuance.
Section
13. PET Training for Radiographers and Radiation Therapists. Individuals who
are licensed in the primary discipline of radiography or radiation therapy, are
certified by the ARRT, and are seeking post-primary certification in positron
emission tomography (PET) may work under the direct supervision of a licensed
and certified PET technologist with the permission of an authorized user to
gain clinical competency. An individual who wishes to complete clinical
training in PET shall submit a Provisional License Application, as
incorporated by reference in 201 KAR 46:050,[an application for a
provisional license] which shall expire twenty-four (24)
months from the date of issuance.
Section
14. Applications for licensure shall be filed with the Board of
Medical Imaging and Radiation Therapy, 42 Fountain Place, Frankfort, Kentucky
40601.
Section 15. Incorporation by
Reference. (1) The following material is incorporated by reference:
(a)
"Radiography Practice Standards", revised
June 16, 2013;
(b)
"Nuclear Medicine Technologist Scope of Practice and Performance Standards",
revised June 7, 2013;
(c)
"Positron Emission Tomography (PET) Technologist Scope of Practice and
Performance Standards", revised January 26, 2013;
(d)
"Scope of Practice for the Nuclear Medicine Advanced Associate",
created 2009;[and]
(e)
"Radiation Therapy Practice Standards ",
revised June 19, 2011;[and]
(f) "Bone
Densitometry Practice Standards", revised June 19, 2011;
(g) "Cardiovascular Interventional Technology
Practice Standards", revised June 16, 2013;
(h) "Computed Tomography Practice Standards",
revised June 16, 2013;
(i) "Limited X-ray Machine Operator Practice
Standards", revised June 16, 2013;
(j) "Mammography Practice Standards",
revised July 1, 2012;
(k) "Radiologist
Assistant Practice Standards", revised July 29, 2014;
(l) "ACR ASRT Joint Policy
Statement-Radiologist Assistant: Roles and Responsibilities", May 2003;
(m) "ACR-AAPM Technical
Standard For Management Of The Use Of Radiation In Fluoroscopic Procedures", revised 2013 (Resolution
44);
(n) KBMIRT Form 1, "License
Application-Medical Imaging or Radiation Therapy", March 2015; and
(o) KBMIRT Form 2, "License Renewal
Application-Medical Imaging or Radiation Therapy", March 2015.
(2)
This material may be inspected, copied, or obtained, subject to applicable
copyright law, at:
(a)
American Society of Radiologic Technologists, 15000 Central Ave. SE Albuquerque,
NM 87123-3909, http://www.asrt.org/main/standards-regulations/practice-standards; [or]
(b)
Society for Nuclear Medicine and Molecular Imaging, 1850 Samuel Morse Drive
Reston, Virginia 20190, http://www.snmmi.org; or
(c) The Board of Medical Imaging and Radiation
Therapy, 42 Fountain Place, Frankfort, Kentucky 40601, Monday through Friday,
8:00 a.m. to 4:30 p.m.[including the following:
(1)
Radiography standards. The radiographer shall:
(a)
Apply knowledge of the principles of radiation protection for the patient,
self, and others;
(b)
Apply knowledge of anatomy, positioning, and radiographic techniques to
accurately demonstrate anatomical structures in medical imaging;
(c)
Determine exposure factors to achieve optimum radiographic technique with a
minimum of radiation exposures to the patient;
(d)
Examine radiographs for the purpose of evaluating technique, positioning, and
other pertinent technical qualities;
(e)
Exercises discretion and judgment in the performance of medical imaging
procedures;
(f)
Provide patient care essential to radiologic procedures; and
(g)
Recognize emergency patient conditions and initiate lifesaving first aid.
(2)
Nuclear medicine technology standards. The nuclear medicine technologist shall:
(a)
Apply knowledge of the principles of radiation protection for the patient,
self, and others;
(b)
Apply knowledge of radio pharmacy, instrumentation, patient examination
protocols to produce accurate metabolic and image data;
(c)
Provide patient care essential to nuclear medicine procedures;
(d)
Maintain patient records;
(e)
Participate in the quality assurance program;
(f)
Prepare, calculate, identify, administer, and dispose of radiopharmaceuticals;
(g)
Exercise discretion and judgment in the performance of medical imaging and
therapeutic procedures; and
(h)
Recognize emergency patient conditions and initiate lifesaving first aid.
(3)
Radiation therapist standards. The
radiation therapist shall:
(a)
Apply knowledge of the principles of radiation protection for the patient,
self, and others;
(b)
Demonstrate knowledge of human structure, function, and pathology;
(c)
Maintain the records of treatment administration;
(d)
Deliver a planned course of radiation therapy;
(e)
Produce and utilize immobilization and beam directional devices;
(f)
Prepare commonly used brach therapy sources;
(g)
Demonstrate knowledge of methods of calibration of equipment, and quality
assurance;
(h)
Prepare isodose summations;
(i)
Detect malfunctioning equipment;
(j)
Apply wedge and compensating filters;
(k)
Exercise discretion and judgment in the performance of therapy procedures; and
(l)
Recognize emergency patient conditions and initiate lifesaving first aid.
(4)
Radiologist assistant standards. The radiologist assistant, if ordered to do so
by the supervising radiologist, shall:
(a)
Perform selected procedures including static and dynamic fluoroscopic
procedures;
(b)
Assess and evaluate the physiologic and psychological responsiveness of
patients undergoing radiologic procedures;
(c)
Participate in patient management including acquisition of additional imaging
for completion of the examination and record documentation in medical records;
(d)
Evaluate image quality, make initial image observations, and communicate
observations to the supervising radiologist;
(e)
Administer intravenous contrast media or other prescribed medications; and
(f)
Follow the established standards listed in subsections (1)(a) through (g) of
this section.
Section
6. Requirements for the Nuclear Medicine Technologist. (1) An individual
holding a license as a nuclear medicine technologist may:
(a)
Conduct in-vivo and in-vitro measurements of radioactivity and administer
radiopharmaceuticals to human beings for diagnostic and therapeutic purposes;
and
(b)
Administer x-radiation from a combination nuclear medicine-computed tomography
device if:
1.
The radiation is administered as an integral part of a nuclear medicine
procedure that uses an automated computed tomography protocol for the purposes
of attenuation correction and anatomical localization; and
2.
The technologist has received device-specific training on the combination
device.
Section
7. Requirements for the Radiologist Assistant. In addition to the requirements
of Section 5(1)(a) through (g) and through (e) of this administrative
regulation, an individual holding a license as a radiologist assistant shall
comply with the following requirements:
(1)
The individual is a general licensed radiographer in this state;
(2)
The individual has satisfactorily completed an advanced academic program
encompassing a nationally recognized radiologist assistant curriculum
culminating in a baccalaureate degree, post baccalaureate certificate, or
master’s degree that incorporates a radiologist-directed clinical preceptorship
and meets the eligibility requirements for certification by the American
Registry of Radiologic Technologists;
(3)
The individual is certified in advanced cardiac life support (ACLS);
(4)
The radiologist assistant shall not interpret images, make diagnoses, or
prescribe medications or therapies; and
(5)
The radiologist assistant shall comply with the Standards of Ethics of the American
Registry of Radiologic Technologists as well as the standards, policies, and
procedures regarding the standard of care of patients, established by the
American Society of Radiologic Technologists (ASRT), and the institution
employing the radiologist assistant.
Section
8. Licensure in Nuclear Medicine Technology or Radiation Therapy. The board may
issue a license pursuant to the following conditions:
(1)
The applicant shall be currently employed full-time as a nuclear medicine
technologist or radiation therapist and have held the position for twenty-four
(24) months prior to May 31, 2006; and
(2)
The applicant shall satisfactorily demonstrate through employer documentation
that he or she has clinical experience in nuclear medicine technology or radiation
therapy. The employer and the licensed practitioner shall be responsible for
documentation of the required clinical experience and supervision].
[Section
15.][9.][Applications for licensure][in
nuclear medicine technology and radiation therapy][shall be filed
with the Board of Medical Imaging and Radiation Therapy, 42 Fountain Place,
Frankfort, Kentucky 40601][275 East Main Street, Mailstop HS
1C-A, Frankfort, Kentucky 40621][.]
SHERYL
L. ABERCROMBIE, Chair
APPROVED
BY AGENCY: July 13, 2015
FILED
WITH LRC: July 15, 2015 at 9 a.m.
CONTACT PERSON: Vanessa
Breeding, Executive Director, Board of Medical Imaging and Radiation Therapy,
42 Fountain Place, Frankfort, Kentucky 40601, phone (859) 782-5687, fax (859)
782-6495.
