HOUSE BILL NO.

IN THE LEGISLATURE OF THE STATE OF ALASKA

THIRTY-THIRD LEGISLATURE – FIRST SESSION

A BILL FOR AN ACT ENTITLED

“An Act requiring licensure of occupations relating to radiography, radiation therapy, and nuclear medicine technology; and providing for an effective date.”

 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
* Section 1. AS 08.01.010 is amended by adding a new paragraph to read: 
(42) regulation of radiographers, radiation therapists, nuclear medicine
technologists and radiologist assistants under AS 08.89.
* Sec. 2. AS 08 is amended by adding a new chapter to read:
Chapter 89. Radiography, Radiation Therapy, and Nuclear Medicine Technology and Radiologist Assistant.

Article 1. Licensing Requirements.
Sec. 08.89.100. Unlicensed practice prohibited. 

(a) Except as provided in

(b) of this section, a person may not knowingly

          (1) use radioactive materials or equipment emitting radiation on a human for diagnostic, interventional, or therapeutic purposes without a license issued under this chapter that authorizes the person to do so; or 

          (2) employ another to use radioactive materials or equipment emitting 
radiation on a human for diagnostic, interventional, or therapeutic purposes unless the employee has an appropriate license issued under   this chapter. 

     (b) The licensing requirement in (a) of this section does not apply to a person who is 

          (1) a licensed practitioner, if the practitioner certifies to the department
on a form prepared by the department that the practitioner has obtained education or training to ensure the examination or test is performed safely; 

          (2) a physician assistant licensed under AS 08.64, if the physician
assistant certifies to the department on a form prepared by the department that the physician assistant has obtained education or training to ensure the examination or test is performed safely; 

          (3) a nurse practitioner certified under AS 08.68, if the nurse
practitioner certifies to the department on a form prepared by the department that the nurse practitioner has obtained education or training to ensure the examination or test is performed safely;  

          (4) a dental assistant certified under AS 08.32, if the dental assistant certifies to the department that the dental assistant has obtained education or training to ensure the examination or test is performed safely.

 
          (5) a chiropractic clinical assistant certified under AS 08.20, if the chiropractic assistant certifies to the department that the chiropractic assistant has obtained education or training to ensure the examination or test is performed safely.

   
          (6) licensed under another provision of state law if the license 
authorizes the person to use radioactive materials or equipment emitting radiation on a human for diagnostic or therapeutic purposes and they certify to the department they have obtained education or training to ensure the examination or test is performed safely;

 
          (7) a student enrolled in and attending a school or college of medicine, 
osteopathy, dentistry, dental hygiene, chiropractic, podiatry, radiography, radiation therapy, or nuclear medicine technology, while, as part of course work in the school or college, the student uses radioactive materials or equipment emitting radiation on humans under the direct supervision of a

 
               (A) licensed practitioner; or
               (B) person licensed under this chapter as a radiographer, radiation therapist, or nuclear medicine technologist, as appropriate to the course;

   
          (8) in the regular medical service of the armed services of the United States or the United States Public Health Service while in the discharge of the person’s official duties; or

 
          (9) in the regular medical service of the armed services of the United 
States or the United States Public Health Service volunteering services without pay or other remuneration to a hospital, clinic, medical office, or other medical facility in the state.

 
     (c) Violation of this section is a class A misdemeanor. 

Sec. 08.89.110. Use of title prohibited. (a) Unless a person holds the 
corresponding license or limited license issued under this chapter or proof of
certification by the American Registry of Radiologic Technologists or the Nuclear Medicine Technology Certification Board, a person may not use 
          (1) the title “radiographer,” “radiation therapist,” “nuclear medicine
technologist,” “radiologist assistant,” “limited radiographic imager,” “temporary licensed radiographer,” “temporary licensed radiation therapist,” “temporary licensed nuclear medicine technologist,” or “temporary licensed limited radiographic imager”;
          (2) an abbreviation that corresponds to a title listed in (1) of this 
subsection; or
          (3) another title, abbreviation, letters, figures, signs, or other devices
that would lead a reasonable person to believe that the person is licensed under this chapter. 
     (b) Violation of this section is a class B misdemeanor. 

Sec. 08.89.120. Qualifications for licensure; radiographer, radiation 
therapist, nuclear medicine technologist. 

(a) To qualify for a license as a radiographer, radiation therapist, nuclear medicine technologist or radiologist assistant under this chapter, a person must
          (1) apply to the department in writing and indicate whether the person
is applying to practice as a radiographer, radiation therapist, or nuclear medicine technologist;

 
          (2) be at least 18 years of age; 

          (3) have graduated from secondary school or have passed an approved equivalency test;

  

          (4) have graduated from a program approved by the department under AS 08.89.130 in the area of practice for which the person seeks licensure; 

          (5) have met the examination requirement under AS 08.89.140 for the area of practice for which the person seeks licensure; and
          (6) pay the required fees.

 
     (b) A license must specify the area of practice authorized under the license.

 
     (c) A person with a license may practice in the authorized area of practice only under the supervision of a licensed practitioner.

 

Sec. 08.89.130. Program approval; radiography, radiation therapy,
nuclear medicine technology. 

(a) The department shall recognize an educational program that trains persons seeking licensure under AS 08.89.120 if

          (1) the program is affiliated with at least one hospital that provides a clinical component for the program that the department considers adequate;

 
          (2) the program’s curriculum for each course of study in the areas of 
practice licensed under AS 08.89.120 meets the standards approved by the Joint Review Committee on Education in Radiologic Technology, the Joint Review Committee on Educational Programs in Nuclear Medicine Technology, the United States Department of Education, or another appropriate accreditation agency whose standards the department considers equivalent;

 
          (3) a recognized national voluntary accreditation organization listed in AS 08.89.130 (2) has reviewed the program and submitted review comments.

Sec. 08.89.140. Examination; radiographer, radiation therapist, nuclear
medicine technologist. 

The examination requirement under AS 08.89.120 may be fulfilled by meeting one of the following criteria:

          (1) successfully passing an examination approved by the department in the area of practice for which the license is sought; 

          (2) proof of current certification by the American Registry of Radiologic Technologists or the Nuclear Medicine Technology Certification Board; or  

          (3) proof of current licensure in another jurisdiction in the area of practice for which a license is sought if the department determines the standards for licensure in the other jurisdiction are equivalent to the standards of this state. 

Sec. 08.89.150. Qualifications for licensure; radiologist assistant. 

(a) To qualify for a license as a radiologist assistant under this section, a person must

          (1) apply to the department in writing;
          (2) possess a current license as a radiographer or temporary radiographer;

 
          (3) provide proof of current certification as a radiologist assistant by the American Registry of Radiologic Technologists or as a radiology practitioner assistant by the Certification Board for Radiology Practitioner Assistants; and

 
          (4) pay the required fee. 

     (b) A radiologist assistant may not interpret images, render diagnoses, or prescribe medications or therapies. A radiologist assistant may practice only under the supervision of a radiologist. In this subsection, “radiologist” means a person who is board certified or eligible for board certification by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Radiologists, or a College of Physicians and Surgeons in Canada. 

Sec. 08.89.160. Qualifications for licensure; limited radiographic imager.

 
To qualify for a license as a limited radiographic imager, a person must

 
          (1) apply to the department in writing; 

          (2) be at least 18 years of age; 

          (3) have graduated from secondary school or have passed an approved equivalency test; 

          (4) have satisfactorily completed a course of study in limited radiographic imaging or its equivalent as determined by the department; 

          (5) pass an examination approved by the department; and 

          (6) pay the required fee.

Sec. 08.89.170. Reciprocity; limited radiographic imager. 

The department may recognize a license to practice limited radiographic imaging issued by another state if 

          (1) a person submits an application to the department in writing and provides proof satisfactory to the department of current licensure in another jurisdiction as a limited radiographic imager; and 

          (2) the department determines the standards for licensure in the other jurisdiction are equivalent to the standards of this state. 

 

Sec. 08.89.180. Scope of practice; limited radiographic imager.

 

(a) Subject to (b) of this section, a limited radiographic image

  
          (1) may perform limited diagnostic radiographic imaging using radiographic equipment only under the supervision of a radiographer licensed under AS 08.89.120 or a licensed practitioner, Physician Assistant or Nurse Practitioner.

                    (2) may not perform radiographic procedures involving the use of contrast media, fluoroscopic equipment, mammography, magnetic resonance imaging, nuclear medicine, radiation therapy, or computed tomography.

 
     (b) The department shall issue endorsements that allow a limited radiographic imager to perform diagnostic radiographic imaging on specific anatomical areas of the human body as follows:

 
          (1) chest radiography endorsement, authorizing radiography of the thorax, heart, and lungs;

 
          (2) extremity radiography endorsement, authorizing radiography of the upper and lower extremities and the pectoral girdle; 

          (3) spine radiography endorsement, authorizing radiography of the vertebral column; 

          (4) skull and sinus radiography endorsement, authorizing radiography of the skull and facial structures;

 
          (5) podiatric radiography endorsement, authorizing radiography of the foot, ankle, and lower leg below the knee;

 
          (6) bone densitometry endorsement, authorizing performance of bone densitometry testing; to qualify for an endorsement under this paragraph, a person must be certified in bone densitometry by the International Society for Clinical Densitometry or the American Registry of Radiologic Technologists 

Sec. 08.89.190. Program approval; limited radiographic imager.

 

(a) The department shall recognize an educational program that trains persons seeking licensure as limited radiographic imagers under AS 08.89.160 if 

     (b) the program includes didactic instruction and clinical instruction considered adequate by the department, as determined under the department’s regulations. In this subsection, “clinical instruction” means hands-on experience in a health facility setting, such as in a hospital or clinic, under the supervision of a radiographer licensed under AS 08.89.120 or licensed practitioner. 

 

Sec. 08.89.200. Examination; limited radiographic imager. 

(a) The department shall provide for an examination for qualification for licensure as a limited radiographic imager under AS 08.89.160. The department shall offer the examination at regular intervals to provide maximum access and sufficient opportunity for interested applicants.

 
     (b) The examination provided under this section must be based, in whole or in part, on the Limited Scope of Practice in Radiography examination designed by the American Registry of Radiologic Technologists, and the department shall design the examination in consultation with the Department of Health and Social Services, the State Medical Board, the Alaska Society of Radiologic Technologists, and at least one member of the American College of Radiology who resides in the state.

 
     (c) The department may enter into an agreement with the American Registry of Radiologic Technologists or other entity to use an established Limited Scope of Practice in Radiography examination and administer the examination to applicants.

 
     (d) An applicant must achieve a score of 75 percent to successfully pass an examination taken under this section.

 

Sec. 08.89.210. Temporary license; limited radiographic imager.

 

(a) The department may issue to a person a nonrenewable temporary license to practice limited radiographic imaging for an anatomical area of the human body corresponding to the person’s training if the person submits an application to the department in writing, pays the required fee, and  

          (1) is enrolled in an educational program for limited radiographic imaging approved under AS 08.89.190; or 

          (2) has completed within the preceding year an educational program for limited radiographic imaging approved under AS 08.89.190 and has taken but is still awaiting the results of the examination described in AS 08.89.200.

 
     (b) A temporary license issued under this section must indicate which anatomical area of the human body the license authorizes. A temporary license issued under this section expires two years after the date of issuance.

 
     (c) A person who holds a license under this section may use the title “temporary limited radiographic imager.”

 

Sec. 08.89.220. Temporary license; radiographer, radiation therapist, 
nuclear medicine technologist. 

(a) The department may issue to a person a nonrenewable temporary license to practice radiography, radiation therapy, or nuclear medicine technology if the person submits an application to the department in writing, pays the required fee, and

 
          (1) is enrolled in an educational program for radiography, radiation therapy, or nuclear medicine technology approved under AS 08.89.130; or

 
          (2) has completed within the preceding year an educational program for radiography, radiation therapy, or nuclear medicine technology approved under AS 08.89.130 and has taken but is still awaiting the results of the examination described in AS 08.89.140(1).

 
     (b) A temporary license issued under this section must indicate the area of practice authorized and expires two years after the date of issuance.

Sec. 08.89.230. Non conforming application

1. An individual who has been engaged in the practice of radiography, radiation therapy, nuclear medicine technology or limited radiographic imager, other than a radiologist assistant, who does not hold a current certification and registration by a certification organization recognized by the department, based on technical advice and recommendations from the Advisory Committee, may continue to practice in the area of radiography, radiation therapy, nuclear medicine technology or limited radiographic imaging in which the individual is currently employed, provided the individual:  

          (1) Register with the department in the form prescribed by the Department on or before….. 

          (2) Submit to the Department proof that he or she has completed training in radiation safety and proper positioning for x-ray images provided by the holder of a radiography license;  

          (3) Does not change employment or the scope of their current practice. 

          (4) Completes all continuing education requirements biennially as prescribed by the department.  

          (5)  Meets all licensure requirements of this chapter and the regulations adopted by the department and obtain a license from the department on or before…..

Sec. 08.89.240. Licensure exemption for underserved areas. 

The department may exempt a person from the licensure requirements of this chapter if

 
          (1) the person submits an application to the department in writing and pays the required fee; 

          (2) the department determines that the people in the geographical area in which the applicant would work would otherwise be denied adequate medical care because of the unavailability of a medical imaging professional;    

          (3) an Alaska tribal health organization or other health care organization has provided justification for the exemption; 

          (4) the applicant has completed a radiation control training acceptable to the department; and

 
          (5) the organization where the applicant intends to work

 
               (A) maintains a current list of personnel qualified to perform radiography procedures;

 
               (B) has implemented a competency program to protect the health and safety of personnel and persons undergoing radiography procedures; and

 
               (C) provides evidence that images taken are subject to a quality review process by a radiographer registered with the American Registry of Radiologic Technologists. 

Sec. 08.89.250. License renewal; continuing education. 

(a) The department may not renew a license issued under this chapter unless the licensee pays the required fee and submits evidence satisfactory to the department that the person has met the applicable continuing education requirements as determined by the department based on the technical advice and recommendations from the Advisory Committee.

     (b) The department may not require a person who is licensed to practice in more than one area of practice to complete more continuing education than a person who is licensed in only one area of practice. 

     (c) The department may not renew a limited radiographic imager license issued under this chapter unless the licensee pays the required fee and submits evidence satisfactory to the department that the person has met the applicable continuing competency requirements as determined by the department based on the technical advice and recommendations from the Advisory Committee.

Sec. 08.89.260. License to be kept on file. 

A person licensed under this chapter shall keep on file at each place of the person’s employment the license document issued under this chapter or a verified copy of the license document. 

Sec. 08.89.270. Notification of address changes. 

A licensee under this  chapter shall notify the department in writing within 30 days after a name or address change. 

 
Sec. 08.89.280. Reapplication after revocation. 

A person whose license is revoked by the department for a reason other than nonpayment of fees may not apply to be licensed under this chapter until one year has elapsed from the date of revocation. The department may require an examination for reinstatement. 

Sec. 08.89.300. Fees. 

The department shall set fees under AS 08.01.065 for each of the following:
          (1) application;  

          (2) examination; 
          (3) initial license; 
          (4) initial limited license;
          (5) temporary license;
          (6) temporary limited license; 
          (7) license renewal;
          (8) limited license renewal; 
          (9) adding an area of practice to an existing license;
          (10) program approval under AS 08.89.130. 

Article 2. Prohibitions; Penalties; Disciplinary Sanctions. 

Sec. 08.89.310. Prescription required.  

(a) A person holding a license issued under this chapter may not knowingly use a radioactive substance or equipment for radiologic procedures on a human for diagnostic or therapeutic purposes except as prescribed by a licensed practitioner.

 
     (b) Violation of this section is a class A misdemeanor.

 

Sec. 08.89.320. Civil penalty for unlicensed practice. 

A person required to be licensed under this chapter who engages or offers to engage in a type of radiography, radiation therapy, nuclear medicine technology, limited radiographic imaging, or the work of a radiologist assistant for which the person is not licensed may be fined up to $5,000 under the citation procedures of AS 08.01.102 – 08.01.104.

 

Sec. 08.89.330. Application requirement for licenses; criminal penalty for certain fraudulent practices. 

     (a) The department shall require that applications for a license issued under this chapter be submitted under oath or affirmation or with notice that false statements made are punishable as unsworn falsification in the second degree under AS 11.56.210.

 
     (b) A person who obtains or attempts to obtain a license issued under this chapter by false, fraudulent, or dishonest means is subject to prosecution for perjury or unsworn falsification.

 
     (c) A person who knowingly forges, counterfeits, or alters a license issued under this chapter is subject to prosecution for forgery under AS 11.46.505. 

Sec. 08.89.340. Grounds for disciplinary sanctions or denial of license.

 

The department may impose a disciplinary sanction authorized under AS 08.89.350 on a person licensed under this chapter or refuse to issue or renew a license if the department finds that the person

 
          (1) used fraud or deceit in the procurement or holding of the license or in the application process for the license; 
          (2) has been convicted of a felony in a court of competent jurisdiction, either within or outside of the state, unless the

 
               (A) conviction has been reversed and the person has been discharged or acquitted; or 

               (B) person has been pardoned with full restoration of civil rights;

 
          (3) has a medical problem, disability, or addiction that the department believes may impair professional competence;

 
          (4) has aided a person who is not licensed under this chapter, or otherwise authorized to perform the duties of a licensee, to perform radiography, radiation therapy, nuclear medicine technology, limited radiographic imaging, or the work of a radiologist assistant; 

          (5) has undertaken or engaged in practice beyond the scope of practice authorized by the license;

 
          (6) has, under an assumed name, impersonated a person licensed or formerly licensed under this chapter or is performing duties of a licensee or limited license

(7) is a licensee under this chapter and has violated the code of ethics of the American Registry of Radiologic Technologists or code of ethics of the professional organization a person is titled or credentialed under; 

          (8) has interpreted a diagnostic image for a clinician, a patient, a patient’s family, or the public;

 
          (9) is a licensee under this chapter and is or has been incompetent or negligent in the performance of the licensee’s duties; 

           (10) is on the sanctioned list of their professional credentialing organization; or

           (11) is on the Registry of Convicted Sex Offenders List.

Sec. 08.89.350. Disciplinary sanctions. 

1. When the department finds that a person licensed under this chapter has committed an act listed in AS 08.89.340, the department may impose the following sanctions singly or in combination:

(1) permanently revoke a license to practice;
  
(2) suspend a license for a determinate period;
  
(3) censure a licensee;

(4) issue a letter of reprimand;

(5) place a licensee on probationary status and require the licensee to

     (A) report regularly to the department on matters involving the basis of probation;

     (B) limit practice to areas as prescribed by the department;

     (C) continue professional education until a satisfactory degree of skill has been attained in those areas determined by the department to need improvement;

(6) impose limitations or conditions on the practice of a licensee.  The department may withdraw a limitation, condition, or probationary status if the department finds that the deficiency that required the sanction has been remedied.