GENERAL GOVERNMENT CABINET

Board of Medical Imaging and Radiation Therapy

(Amendment)

 

††††† 201 KAR 46:081. Limited X-Ray machine operator.

 

††††† RELATES TO: KRS 311B.020, 311B.150, 311B.100(2), 311B.110, 311B.120, 311B.180, 311B.190

††††† STATUTORY AUTHORITY: KRS 311B.050, 311B.100(2), 311B.110

††††† 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 a limited x-ray machine operator (LXMO). This administrative regulation establishes the requirements for the licensure of a limited x-ray machine operator.

 

††††† Section 1. Applicability. (1) This administrative regulation shall apply to individuals who perform limited diagnostic radiography while under the direct supervision or[while training and] indirect supervision[thereafter] of a licensed practitioner of the healing arts[, a licensed limited x-ray machine operator, or a licensed radiographer].

††††† (2) Limited diagnostic radiography shall include routine chest and thorax, cranium, extremity, podiatric, vertebral column radiography, and bone densitometry procedures.

 

††††† Section 2. Limited Licensee Employment Prohibition. An individual who holds a limited license shall not be employed as an operator of a source of radiation at a facility where contrast studies, fluoroscopy, mammography, computed tomography, magnetic resonance imaging, bedside radiography, nuclear medicine, positron emission tomography, or radiation therapy procedures are performed.

 

††††† Section 3. Pathway[Pathways] to the Limited X-ray Machine Operator License. An applicant shall complete an approved postsecondary educational program that meets the American Society of Radiologic Technologists (ASRT) Limited X-Ray Machine Operator Curriculum requirements. An individual[Individuals] shall complete[this requirement by either:

††††† (1)] a formal education program for limited x-ray machine operators approved by the board[; or

††††† (2) An independent study program for limited x-ray machine operators approved by the board].

 

††††† Section 4. Application for Temporary Limited X-ray Machine Operator License.[Issuance of a temporary limited license shall be dependent upon the educational pathway selected by the applicant.] (1) An applicant who has completed a formal educational program shall submit:

††††† (a) A completed and signed application Form KBMIRT Form 5;

††††† (b) A nonrefundable, nontransferrable temporary limited x-ray machine operator application and license fee as mandated in 201 KAR 46:020, Section 5;

††††† (c) The satisfactory 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

††††† (d) A copy of a government-issued photo ID.

††††† (2)[An applicant selecting the independent study program pathway shall receive a temporary license upon completion of the required coursework. As part of the application process for the independent study pathway, an applicant shall submit:

††††† (a) A completed and signed application KBMIRT Form 5;

††††† (b) A completed and signed application KBMIRT Form 5A;

††††† (c) A non-refundable, non-transferrable temporary limited x-ray machine operator application and license fee as mandated in 201 KAR 46:020, Section 5;

††††† (d) The satisfactory 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;

††††† (e) A copy of a government-issued photo ID;

††††† (f) A copy of the Cabinet for Health and Family Services radiation producing-machine registration card of their employer;

††††† (g) A copy of his or her high school diploma or equivalent; and

††††† (h) A home study course fee for an independent study course as mandated by 201 KAR 46:020, Section 10.

††††† (3)] The temporary limited x-ray machine operator license shall expire[:

††††† (a) Two (2) years from the date of enrollment in the independent study program;

††††† (b)] one (1) year from date of issuance for graduates of formal educational programs.

††††† (3)[(4)] Upon completion of the limited x-ray machine operator training program, individuals shall:

††††† (a) Apply for the limited scope radiography exam; and

††††† (b) Submit the nonrefundable, nontransferrable limited x-ray machine operator examination fee as mandated in 201 KAR 46:020, Section 9.

††††† (4)[(5)] If a temporary licensee has not successfully passed the American Registry of Radiologic Technologists (ARRT) administered limited scope radiography exam prior to the expiration date of the temporary license, the licensee shall cease to perform radiographic procedures. The licensee remains eligible to sit for the exam, however, the individual shall not perform radiographic procedures. Upon successful completion of the exam, the individual shall submit:

††††† (a) A limited x-ray machine operator license application using KBMIRT Form 4; and

††††† (b) An initial application and license fee as mandated in 201 KAR 46:020, Section 1.

††††† (6) If a temporary licensee has successfully passed the ARRT administered limited scope radiography exam prior to the expiration date of the temporary license[for the selected educational pathway], the licensee shall be issued a limited x-ray machine operator license which shall expire on the last day of the licenseeís birth month.

 

††††† Section 5. The issued license shall identify the licensee as a limited x-ray machine operator. The license shall also identify the category as general, bone densitometry, or podiatry.

 

††††† Section 6.[Employer Responsibility for Students Enrolled in the Independent Study Program for Limited X-Ray Machine Operators. Pursuant to Section 8 of this administrative regulation, clinical education shall be obtained at the studentís place of employment, an alternate facility, or a combination. The employer shall be responsible for providing or arranging for the required clinical education and for providing the direct or indirect supervision of the student by a licensed practitioner of the healing arts, a licensed limited x-ray machine operator, or a licensed radiographer as required by the student's level of competency. Clinical education shall begin only after the student has successfully completed the required coursework of the textbook and has received a temporary license issued by the board.

 

††††† Section 7.] Curricular Standards for Formal Educational Program. This administrative regulation applies to institutions offering a postsecondary program for limited x-ray machine operators. Programs shall:

††††† (1) Meet the curricular standards established by the American Society of Radiologic Technologists (ASRT);

††††† (2) Include a minimum of 240 classroom hours of didactic instruction and 360 clinical hours of education which shall include supervised practice and demonstration of clinical competency;

††††† (3) Supply data requested for a complete evaluation of its administration, organization, faculty, physical facilities, student policies, and curriculum;

††††† (4) Provide a structured curriculum with clearly written course descriptions, lesson plans, and objectives;

††††† (5) Provide an adequate faculty, which shall be qualified through academic preparation or experience to teach the subjects assigned;

††††† (6) Have a program director who is a licensed radiographer with a minimum of three (3) years of clinical or teaching experience or a combination of clinical and teaching experience;

††††† (7) Provide a licensee-to-student ratio consistent with professional educational guidelines in the appropriate field of practice;

††††† (8) Provide appropriate facilities, sufficient volume, and a variety of diagnostic exams to properly conduct the educational program;

††††† (9) Prohibit students from applying radiation to human beings for diagnostic purposes until they have obtained practical experience and have had their performance evaluated as satisfactory by the program faculty;

††††† (10) Provide direct or indirect supervision by a licensed practitioner of the healing arts or a licensee as required by the student's level of competency;

††††† (11) Prohibit students from administering radiation to a human being unless under direct or indirect supervision as required by the student's level of competency;

††††† (12) Maintain records of each student's attendance, grades, clinical competency, and subjects completed;

††††† (13) Designate a radiation safety officer; and

††††† (14) Permit site inspections by the boardís representative.

 

††††† Section 7.[8.][Curricular Standards for Independent Study Program. (1) The general limited x-ray machine operator independent study program shall:

††††† (a) Be completed within twenty-four (24) months;

††††† (b) Include the following subjects:

††††† 1. Human structure and function;

††††† 2. Medical terminology;

††††† 3. Radiation protection;

††††† 4. Radiation biology;

††††† 5. Medical ethics and law;

††††† 6. Equipment operation and maintenance;

††††† 7. Image production and evaluation;

††††† 8. Image processing;

††††† 9. Radiographic procedures;

††††† 10. Patient positioning; and

††††† 11. Patient care; and

††††† (c) Include clinical education consisting of a minimum of fifty (50) radiographic procedures in each of the following areas:

††††† 1. Chest;

††††† †2. Extremities; and

††††† 3. Musculoskeletal.

††††† (2) The limited podiatry x-ray machine operator independent study program shall:

††††† (a) Be completed within twenty-four (24) months;

††††† (b) Include the following subjects:

††††† 1. Human structure and function;

††††† 2. Medical terminology;

††††† 3. Radiation protection;

††††† 4. Radiation biology;

††††† 5. Medical ethics and law;

††††† 6. Equipment operation and maintenance;

††††† 7. Image production and evaluation;

†††††††††††† 8. Image processing;

††††† 9. Radiographic procedures;

††††† 10. Patient positioning; and

††††† 11. Patient care; and

††††† (c) Include clinical education consisting of a minimum of fifty (50) radiographic procedures of the feet and ankles.

††††† (3) The limited bone densitometry x-ray machine operator independent course of study shall:

††††† (a) Be completed within twenty-four (24) months;

††††† (b) Include the following subjects;

††††† 1. Human structure and function;

††††† 2. Medical terminology;

††††† 3. Radiation protection;

††††† 4. Radiation biology;

††††† 5. Medical ethics and law;

††††† 6. Equipment operation and maintenance;

††††† 7. Image production and evaluation;

††††† 8. Image processing;

††††† 9. Radiographic procedures;

††††† 10. Patient positioning;

††††† 11. Patient care; and

††††† 12. Equipment Specific training; and

††††† (c) Include clinical education consisting of a minimum of fifty (50) bone densitometry procedures.

 

††††† Section 9.] Approved Radiographic Procedures for the Limited X-ray Machine Operator. An individual who holds a limited license is limited to performing the procedures authorized for his or her license as described in subsections (1), (2), and (3) of this section. (1) An individual holding a general limited x-ray machine operator license shall perform only the following:

††††† (a) Radiography of the thorax, lungs and ribs;

††††† (b) Radiography of the skull and facial structures;

††††† (c) Radiography of the upper and lower extremities, including the pectoral girdle and the hips and pelvis; and

††††† (d) Radiography of the cervical, thoracic, and lumbar spines.

††††† (2) An individual holding a limited podiatry x-ray machine operator license shall perform radiographic procedures on the foot and ankle only.

††††† (3) An individual holding a limited bone densitometry x-ray machine operator license shall perform bone densitometry radiographic procedures only.

††††† (4) A limited x-ray machine operator shall comply with the Limited X-ray Machine Operator Practice Standards as incorporated by reference in 201 KAR 46:040, Section 15.

 

††††† Section 8.[10.] Continuing Education Requirements. Licensees shall complete and document twelve (12) hours of continuing education biennually as required by 201 KAR 46:060. A minimum of six (6) hours shall be related to radiation safety or medical imaging.

 

††††† Section 9.[11.] Continuing Education Audit Process. (1) The board shall select a sample of licensees to audit for continuing education compliance.

††††† (2) The board shall send each licensee selected for audit a notification of audit.

††††† (3) Each licensee shall maintain his or her 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 complete KBMIRT Form 8, as incorporated by reference in 201 KAR 46:060, and provide the board with a copy of his or her certificates or records of completion.

††††† (5) Failure to comply with an audit may result in nonrenewal, suspension or revocation of license.

 

††††† Section 10.[12.] Renewal of License. A licensee shall renew annually prior to the expiration of his or her current license, which is the last day of the licensee's birth month, by:

††††† (1) Completing KBMIRT Form 6; and

††††† (2) Submitting the Renewal License Fee in accordance with 201 KAR 46:020, Section 2.

 

††††† Section 11.[13.] Reinstatement of Lapsed License. A licensee who has allowed the license to lapse for more than one (1) month but less than twelve (12) months is eligible to be reinstated upon submission of KBMIRT Form 6, documentation of twelve (12) hours of continuing education, and the payment of reinstatement and renewal fees pursuant to 201 KAR 46:020, Sections 2 and 7. A licensee whose license has lapsed for more than twelve (12) months shall:

††††† (1) Successfully pass the ARRT limited scope radiography examination;

††††† (2) Submit a completed and signed application KBMIRT Form 4;

††††† (3) Submit a nonrefundable initial application and license fee as mandated in 201 KAR 46:020, Section 1;

††††† (4) Submit satisfactory 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

††††† (5) Submit a copy of a government-issued photo ID.

 

††††† Section 12.[14.] Incorporation by Reference. (1) The following material is incorporated by reference:

††††† (a) KBMIRT Form 4, "Limited X-ray Machine Operator License Application", November 2017[April 2015];

††††† (b) KBMIRT Form 5, "Limited X-ray Machine Operator Temporary License Application", November 2017[April 2015];

††††† (c)[KBMIRT Form 5A, "Limited X-ray Machine Operator Independent Study Course Application", April 2015; and

††††† (d)] KBMIRT Form 6, "Limited X-ray Machine Operator Renewal Application", November 2017[March 2015].

††††† (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Board of Medical Imaging and Radiation Therapy, 125 Holmes Street, Suite 320[42 Fountain Place], Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m.

 

AMY ADKINS, Chair

††††† APPROVED BY AGENCY: November 15, 2017

††††† FILED WITH LRC: November 15, 2017 at 11 a.m.

††††† PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall be held on December 22, 2017, at 10:00 a.m., in the office of the Board of Medical Imaging and Radiation Therapy, 42 Fountain Place, Frankfort, Kentucky 40601, (502) 782-5687. Individuals interested in attending this hearing shall notify the agency in writing by five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to attend the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until the end of the day on December 31, 2017. Send written notification of intent to attend the public hearing or submit written comments on the proposed administrative regulation to:

††††† CONTACT PERSON: Elizabeth Morgan, Executive Director, Board of Medical Imaging and Radiation Therapy, 42 Fountain Place, Frankfort, Kentucky 40601, phone (502) 782-5687, fax (502) 782-6495, email elizabeth.morgan@ky.gov.

 

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

 

Contact Person:††† Elizabeth Morgan

††††† (1) Provide a brief summary of:

††††† (a) What this administrative regulation does: This administrative regulation establishes the process and requirements for licensure of a limited x-ray machine operator or radiographer.

††††† (b) The necessity of this administrative regulation: This administrative regulation is necessary to allow establish the standards and qualifications for licensure of a limited x-ray machine operator.

††††† (c) How this administrative regulation conforms to the content of the authorizing statutes: KRS Chapter 311B authorizes the board to determine and establish the standards and qualifications for licensure of a limited x-ray machine operator or radiographer.

††††† (d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: This regulation standards and qualifications for licensure of a limited x-ray machine operator or radiographer.

††††† (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

††††† (a) How the amendment will change this existing administrative regulation: The amendment revises 201 KAR 46:081 will eliminate the independent study program for limited x-ray machine operators and update the forms.

††††† (b) The necessity of the amendment to this administrative regulation: The necessity of the amendment is because the board has found the overwhelming majority or applicants never complete the program and the examination pass rate is extremely low.

††††† (c) How the amendment conforms to the content of the authorizing statutes: KRS Chapter 311B authorizes the board to determine and establish the standards and qualifications for licensure of a limited x-ray machine operator or radiographer.

††††† (d) How the amendment will assist in the effective administration of the statutes: This amendment will ensure that only properly educated and trained individuals will operate radiation producing equipment.

††††† (3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation: Approximately 300 state health care organizations and approximately 8,100 licensees.

††††† (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:

††††† (a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: The amendment to the regulation abolishes the independent study program.

††††† (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): There is no impact on a licensee.

††††† (c) As a result of compliance, what benefits will accrue to the entities identified in question (3): Applicants for a limited x-ray license will know the requirements for licensure.

††††† (5) Provide an estimate of how much it will cost to implement this administrative regulation: No additional cost will be incurred as a result of amending this administrative regulation.

††††† (a) Initially: No new costs will be incurred by the changes.

††††† (b) On a continuing basis: No new costs will be incurred by the changes.

††††† (6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: The boardís operations are funded by fees paid by licensees and applicants.

††††† (7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment: No.

††††† (8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees: No.

††††† (9) TIERING: Is tiering applied? Tiering is not applied to this regulation. This regulation does not distinguish between similarly situated individuals on the basis of any factor.

 

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

 

††††† (1) What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? Board of Medical Imaging and Radiation Therapy.

††††† (2) Identify each state or federal statute or federal regulation that authorizes the action taken by the administrative regulation: 311B.050(2) and (7), KRS 311B.160, and KRS 311B.170.

††††† (3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation in to be in effect.

††††† (a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? N/A.

††††† (b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? N/A.

††††† (c) How much will it cost to administer this program for the first year? N/A

††††† (d) How much will it cost to administer this program for subsequent years? N/A

††††† Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.

††††† Revenues (+/-):

††††† Expenditures (+/-):

††††† Other Explanation: