HLT-36-08-00023-A Practice of Radiologic Technology
2/25/09 N.Y. St. Reg. HLT-36-08-00023-A
NEW YORK STATE REGISTER
VOLUME XXXI, ISSUE 8
February 25, 2009
RULE MAKING ACTIVITIES
DEPARTMENT OF HEALTH
NOTICE OF ADOPTION
I.D No. HLT-36-08-00023-A
Filing No. 130
Filing Date. Feb. 06, 2009
Effective Date. Feb. 25, 2009
Practice of Radiologic Technology
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Repeal of Part 89 and addition of new Part 89 to Title 10 NYCRR.
Statutory authority:
Public Health Law, section 3504
Subject:
Practice of Radiologic Technology.
Purpose:
Amendment updates the register to reflect the current practice of radiologic technology and the administration of the program by DOH.
Text or summary was published
in the September 3, 2008 issue of the Register, I.D. No. HLT-36-08-00023-P.
Final rule as compared with last published rule:
No changes.
Text of rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Regulatory Affairs Unit, Room 2438, ESP, Tower Building, Albany, NY 12237, (518) 473-7488, email: regsqna@health.state.ny.us
Assessment of Public Comment
The Department received comments from six organizations and two individuals regarding the proposed revision of Part 89 of Title 10 of NYCRR. The New York Radiological Society endorsed approving the proposed regulation as written. SUNY Upstate Medical University, the New York State Society of Radiological Sciences, New York State Society of Physician Assistants, the Association of Educators in Radiologic Technology of the State of New York and the American Society of Radiologic Technologists objected to sections of the proposed regulation or requested that additional provisions be included in the regulation. The specific issues raised and responses to those issues follow:
Two comments: Part 89 should exempt a physician assistant from being licensed as a radiologic technologist in order to operate x-ray equipment.
Response: Physician assistants are not exempted from radiologic technology licensure by Article 35 of the Public Health Law, the authorizing legislation for Part 89 regulations. Therefore, Part 89 cannot exempt them from the requirement that they be licensed as radiologic technologists in order to operate x-ray equipment.
Comment: Individuals currently practicing as nuclear medicine technologists should be exempted from the requirements to obtain additional training and certification before operating the computed tomography (CT) portion of a combined PET/CT or SPECT/CT procedure.
Response: Nuclear medicine technology training does not include the use of diagnostic x-ray equipment. The Department believes that it is in the interest of patient and operator safety that any nuclear medicine technologist operating the CT portion of these combined procedures be trained and certified to do so. This training must be obtained in a training program approved by DOH and certification must be obtained from an accrediting organization recognized by DOH.
Comment: Facilities employing nuclear medicine technologists to operate the CT portion of a PET/CT or SPECT/CT exam will be tempted to also use the nuclear medicine technologist to perform other CT procedures, restricting the career path for radiographers.
Response: Part 89 allows Nuclear Medicine Technologists (NMTs) with additional training to apply x-ray only as part of a diagnostic fusion imaging procedure. Part 89 prohibits NMTs from performing any other x-ray procedures. Any nuclear medicine technologist found to be practicing outside the scope of his/her license will be subject to enforcement by DOH which could result in sanctions against their license. Allowing qualified NMTs to operate fusion imaging units will not restrict the career path of radiographers. Fusion imaging is a highly specialized procedure, used in a limited number of facilities. Radiographers interested in this advancement may continue his/her education in nuclear medicine technology and be licensed in that area.
Comment: Language should be added to Part 89 which will provide additional protection to patients to ensure that radiologic technologists do not perform tasks that are questionable.
Response: Public Health Law Article 35 and Part 89 already include several provisions that ensure that radiologic technologists apply radiation to patients as safely as possible. Physicians forcing, aiding or abetting a radiologic technologist into performing tasks outside the individual's scope of practice can be sanctioned by DOH. An RT can only operate x-ray equipment on the order of physician and cannot make the decision as to which exam is medically necessary and which is questionable.
Comment: There are very few individuals who are currently qualified to operate fusion imaging equipment. Therefore, language should added to Part 89 to allow non-credentialed individuals to operate fusion imaging equipment until a sufficient number of qualified individuals is available.
Response: DOH disagrees. It is important for patient and operator safety that the individual operating a CT unit is properly trained and credentialed. Until such time that there is a sufficient number of dually licensed radiologic technologists, or, CT trained nuclear medicine technologists available, the current situation of having a licensed diagnostic radiographer or licensed physician operate the CT portion of a fusion imaging unit will remain in effect.
Comment: Licensed nuclear medicine technologist should be able to administer therapeutic doses of radioactive materials to patients under the direct supervision of an authorized user (AU) physician rather than the personal supervision of that physician. This would make better use of the physician's time.
Response: Public Health Law Section 3501 requires the personal supervision of a nuclear medicine technologist by an authorized physician for the administration of therapeutic doses of radioactive material. Any change in this level of supervision will require a revision of this statute.
Comment: There is no probationary period in the regulation for radiologic technologist who will not have sufficient continuing education (CE) credits to reregister when the requirement becomes effective.
Response: There are no probationary periods for complying with any of the requirements of Part 89. Radiologic Technologists not fulfilling all the applicable requirements are not allowed to practice. RT's have sufficient opportunity to obtain the required CE credits before the requirement becomes effective in 2010. The majority of RT's are registered or accredited by organizations that require CE to maintain their membership. These individuals will have sufficient CE credits to meet the requirements to reregister.
Comment: The accrediting organizations approved by DOH require 24 CE credits in a two-year period. Part 89 would require RTs registering in 2010 to have received 12 CE credits in the previous year. The two-year CE period for the accrediting organization may not coincide with DOH registration cycle. An RT who received 24 CE credits in the first year of their accrediting organization's CE cycle may not have any CE credits in the second year immediately preceding registering with DOH. That RT would be in noncompliance with Part 89 as proposed.
Response: The Department has made a provision for this in the proposed Part 89 by accepting a copy of a current certificate of registration from an accrediting organization approved by the department as acceptable evidence to meet the continuing education requirements. [Section 89.20(g)]
Comment: 10 NYCRR Section 89-3(a), which requires an educational institution undergo a site inspection in order to qualify as an approved education program in radiologic technology, is unnecessary. Instead the accrediting standards of educational programs in radiologic sciences of the Joint Review Committee on Education in Radiologic Technology should apply.
Response: The Department finds that on site inspections are necessary to ensure that radiologic technology educational program facilities enable students to learn to use radiation emitting technology safely and effectively.
