SB 616 Text

Senate Bill No. 616

(By Senators Stollings and Foster)

____________

[Introduced February 16, 2012; referred to the Committee on Government Organization.]

____________

A BILL to repeal §30-23-1 of the Code of West Virginia, 1931, as amended; to amend and reenact §30-23-2, §30-23-4, §30-23-5, §30-23-6, §30-23-7, §30-23-10, §30-23-11, §30-23-12, §30-23-14, §30-23-15, §30-23-16, §30-23-17, §30-23-18, §30-23-19, §30-23-22, §30-23-23, §30-23-24, §30-23-25, §30-23-26 and §30-23-27 of said code; and to amend said code by adding thereto two new sections, designated §30-23-18a and §30-23-18b, all relating to radiologic technologists; defining the practice of “medical imaging” and “radiation therapy”; defining additional terms; renaming the Medical Imaging and Radiation Therapy Technology Board of Examiners the West Virginia Medical Imaging and Radiation Therapy Technology Board; setting out the powers and duties of the board; establishing rulemaking; setting out requirements for radiologic technology license and exemptions; establishing the scope of practice for a radiologic technologist; establishing the scope of practice for a radiation therapist; setting out the requirements for temporary medical imaging and radiation therapy technology license; setting out requirements regarding license from another state and license to practice in this state; providing requirements for nuclear medicine technologist license and scope of practice; providing for requirements for magnetic resonance imaging technologist license and scope of practice; setting out requirements for sonographer license and scope of practice; setting out requirements for an apprentice license for nuclear medicine technologists, magnetic resonance imaging technologists and diagnostic medical sonographer; setting out requirements for podiatric medical assistant permit and scope of practice; establishing license and permit renewal requirements; setting out display of license requirements; clarifying complaint, investigation, due process procedure and grounds for disciplinary action; clarifying procedures for hearing, right of appeal and judicial review; setting forth injunction procedure; and clarifying criminal proceedings and misdemeanor penalties.

Be it enacted by the Legislature of West Virginia:

That §30-23-1 of the Code of West Virginia, 1931, as amended, be repealed; that §30-23-2, §30-23-4, §30-23-5, §30-23-6, §30-23-7, §30-23-10, §30-23-11, §30-23-12, §30-23-14, §30-23-15, §30-23-16, §30-23-17, §30-23-18, §30-23-19, §30-23-22, §30-23-23, §30-23-24, §30-23-25, §30-23-26 and §30-23-27 of said code be amended and reenacted; and that said code be amended by adding thereto two new section, designated §30-23-18A and §30-23-18b, all to read as follows:

ARTICLE 23. RADIOLOGIC TECHNOLOGISTS.

§30-23-2. Unlawful acts.

(a) It is unlawful for any person to practice or offer to practice medical imaging or radiation therapy technology in this state without a license, apprentice license, temporary license, or podiatry medical assistant permit issued under the provisions of this article, or advertise or use any title or description tending to convey the impression that the person is a licensed medical imaging technologist or radiation therapy technologist, unless such person has been duly licensed under the provisions of this article, and such license, apprentice license, temporary license, or podiatry medical assistant permit has not expired, been suspended or revoked.

(b) Without a licensee, it is unlawful for any business entity to render any service or engage in any activity which if rendered or engaged in by an individual, would constitute the practice of medical imaging or radiation therapy technology.

§30-23-4. Definitions.

As used in this article, the following words and terms have the following meanings, unless the context clearly indicates otherwise:

(a) “ASPMA” means the American Society of Podiatric Medical Assistants.

(1) “ARDMS” means the American Registry for Diagnostic Medical Sonography.

(b) (2) “ARMRIT” means the American Registry of Magnetic Resonance Imaging Technologists.

(4) “ASPMA” means the American Society of Podiatric Medical Assistants.

(5) "Accreditation" or "accredited" means recognition by a nationally recognized organization recognized by the board and the United States Department of Education that verifies a medical imaging or radiation therapy educational program's compliance with defined national standards for training and competence in the medical imaging or radiation therapy modality;

(6) "Advanced nurse practitioner" means a person licensed as an advanced nurse practitioner.

(7) "Apprentice license" means a license issued by the board to:

(A) Provide a grace period following enactment of provisions of this article for implementation of certification requirements for those persons who have been practicing a specific medical imaging modality but have not earned the certification required by the board for licensure;

(B) Permit cross-training of medical imaging modalities.

(8) "Approved school" means an educational program in a medical imaging modality or subspecialty that has been accredited by a nationally recognized accreditation organization that is recognized by the board and whose graduates are qualified to sit for a certification examination recognized by the board in the graduate's medical imaging modality or subspecialty.

(d) (9) “Board” means the West Virginia Medical Imaging and Radiation Therapy Technology Board of Examiners.

(e) (10) “Business entity” means any firm, partnership, association, company, corporation, limited partnership, limited liability company or other entity providing medical imaging or radiation therapy technology.

(11) "CAAHEP" means the Commission on Accreditation of Allied Health Education Programs.

(12) “CCI” means Cardiovascular Credentialing International.

(13) “CMA" means the Canadian Medical Association.

(14) "Certification organization" means a nationally recognized organization recognized by the board that issues credentials through testing or evaluations that determine that a person meets defined standards for training and competence in a medical imaging or radiation therapy modality.

(f) (15) “Dental X-rays” means X-rays taken of the oral cavity with x-ray units designed for this specific performance.

(16) "Diagnostic medical sonography" means the use of nonionizing high frequency soundwaves with specialized equipment to direct the sound waves into areas of the human body for the assessment and diagnosis of various medical conditions.

(17) "Graduate" means an individual who has completed the didactic and clinical education at an approved school, including documented clinical proficiency, but who has not met all requirements for certification by a certification organization.

(18) "JRC-CVT" means the Joint Review Committee on Cardiovascular Technology.

(19) "JRC-DMS" means the Joint Review Committee on Education in Diagnostic Medical Sonography.

(g) (20) “JRCERT” means the Joint Review Committee on Education in Radiologic Technology.

(h) (21) “JRCNMT” means the Joint Review Committee on Education Programs in Nuclear Medicine Technology.

(i) (22) “License” means a medical imaging and radiation therapy technology license issued under the provisions of this article.

(j) (23) “Licensed practitioner” means a person licensed in West Virginia to practice medicine, chiropractic, podiatry, osteopathy or dentistry.

(k) (24) “Licensee” means a person holding a license issued under the provisions of this article.

(l) (25) “Magnetic resonance imaging or MRI” means the performance of medical imaging using radio waves, magnetic fields and a computer to produce images of the body tissues.

(m) “Medical Imaging” means the use of ionizing radiation, electromagnetic radiation, or radioactivity for evaluation of body tissue in order to diagnose injury and disease by means of image production.

(26) “Medical imaging” means image production through the use of ionizing, nonionizing or electromagnetic radiation, high frequency sound waves or radioactivity for diagnostic evaluation of human anatomy, tissue, organs or other therapeutic purposes pursuant to an order or prescription by a licensed practitioner.

(27) “Medical Imaging/Radiation Therapy” modality means:

(A) Diagnostic medical sonography and all its subspecialties;

(B) Magnetic resonance imaging and all its subspecialties;

(D) Radiation therapy and all its subspecialties; or

(E) Radiography and all its subspecialities.

(n) (28) “NMTCB” means the Nuclear Medicine Technology Certification Board.

(o) (29) “Nuclear medicine technologist” means a person holding a nuclear medicine license issued under the provisions of this article.

(p) (30) “Nuclear medicine technology” means the compounding, calibrating, dispensing and administrating of radio-pharmaceuticals, pharmaceuticals and radio-nuclides under the direction of an individual listed as an authorized user by the U.S. Nuclear Regulatory Commission for the production of images for diagnosis and/or treatment of various disorders.

(31) “Nurse midwife” means a person licensed as a nurse midwife pursuant to the provisions of article fifteen of this chapter.

(32) “Permit” means a podiatric medical assistant permit issued under the provisions of this article.

(q) (33) “Permittee” means any person holding a podiatric medical assistant permit issued pursuant to the provisions of this article.

(r) (34) “PET/CT Technologist” means an individual recognized by the board as qualified to operate a PET/CT scanner.

(s) (35) “PET/CT Technology” means the operation of a Positron Emission Tomography/Computerized Tomography scanner to view internal images of the body.

(36) “Physician assistant” means a person licensed or certified as a physician assistant by the Board of Medicine pursuant to the provisions of article three, section sixteen of this chapter or the Board of Osteopathy pursuant to the provisions of article fourteen-a of this chapter.

(t) (37) “Podiatric medical assistant” means a person who has been issued a permit under the provisions of this article, to perform podiatric radiographs.

(u) (38) “Podiatric radiographs” means radiographs confined to the foot and ankle performed on dedicated podiatric X-ray equipment.

(39) “Point-of-care ultrasound” means the use of ultrasound in real-time fashion or make immediate assessments in patient care and where the qualifications and expertise of the operator of such equipment is limited to basic equipment operations.

(v) (40) “Practice of medical imaging and radiation therapy technology” means the practice of radiologic technology, radiation therapy, nuclear medicine technology and magnetic resonance imaging technology.

(w) (41) “Radiologic technologist” means a person, other than a licensed practitioner, who applies medical imaging or assists in the application of ionizing radiation to human beings for diagnostic or therapeutic purposes as prescribed by a licensed practitioner.

(x) (42) “Radiologic technology” means the application of ionizing radiation or assisting in the application of medical imaging ionizing radiation to human beings for diagnostic or therapeutic purposes as prescribed by a licensed practitioner.

(y) (43) "Radiologist" means a licensed practitioner who has successfully completed a residency in the field of radiology and specializes in the use of medical imaging for the diagnosis or treatment of disease.

(z) (44) “Radiologist assistant or RA” means an individual who is licensed under the rules of the West Virginia Board of Medicine and has completed specialized training from an accredited program in the profession and passed a written examination as recognized by the West Virginia Board of Medicine.

(aa) (45) “Radiology resident” means a licensed practitioner who is in training to become a radiologist and who uses medical imaging in the diagnosis or treatment of disease, under the supervision of a radiologist.

(46) “Sonographer” or “diagnostic medical sonographer” means a person who provides patient care services using ultrasound and includes a vascular sonographer, echocardiographer or other licensed practitioner.

(bb) (47) “Supervision” means responsibility for and control of quality, safety and technical aspects in the application of medical imaging technology on human beings for diagnostic or therapeutic purposes.

(cc) (48) “Technology” means medical imaging technology or radiation therapy technology.

(49) "Temporary license" means a license issued by the board to permit graduates of approved programs to work for a limited time in the applicable medical imaging modality while preparing for and completing a certification examination.

(50) "Ultrasound" means the use of nonionizing high frequency soundwaves above 20,000 cycles per second (Hz) with specialized equipment to direct the sound waves into areas of the human body to generate images for the assessment, diagnosis and treatment of various medical conditions.

§30-23-5. Medical Imaging and Radiation Therapy Board.

(a) The West Virginia Medical Imaging and Radiation Therapy Technology Board of Examiners is continued. Effective July 1, 2012, the board shall be renamed the West Virginia Medical Imaging and Radiation Therapy Board. The members of the board in office, unless sooner removed, continue to serve until their respective terms expire and until their successors have been appointed and qualified.

(b) The board shall consist of the following eleven thirteen members, appointed by the Governor by and with the advice and consent of the Senate:

(1) One Radiologic health specialist from the Radiation, Toxics and Indoor Air Division of the West Virginia Department of Health and Human Resources;

(2) Three licensed practitioners, two of whom one shall be Radiologists a radiologist;

(3) Three licensed Radiologic Technologists, one of whom shall be an active medical imaging educator;

(4) One licensed nuclear medicine technologist;

(5) One licensed magnetic resonance imaging technologist; and

(6) One licensed radiation therapist;

(7) One licensed sonographer; and

(6) (8) Two citizen members, who are not licensed under the provisions of this article and do not perform any services related to the practice licensed under the provisions of this article.

(c) Each member shall be appointed for a term of three five years and may not serve more than two consecutive full terms. A member having served two consecutive full terms may not be appointed for one year after completion of his or her second full term. A member continues to serve until a successor has been appointed and has qualified. The terms shall be staggered in accordance with the initial appointments under prior enactments of this article.

(d) Each member of the board shall be a resident of West Virginia during the appointment term.

(e) The Radiologic Technologists, Nuclear Medicine Technologists and the Magnetic Resonance Imaging Technologists serving on the board shall maintain an active license with the board. All members who are required to be licensed as a condition of board membership shall maintain an active license with the board.

(f) A vacancy on the board shall be filled by appointment by the Governor for the unexpired term of the member whose office is vacant.

(g) The Governor may remove any member from the board for neglect of duty, incompetency or official misconduct.

(h) A licensed member of the board immediately and automatically forfeits membership to the board if his or her license authorization to practice has been suspended or revoked in any jurisdiction. A member of the board immediately and automatically forfeits membership to the board if he or she is convicted of a felony under the laws of any state or the United States, or becomes a nonresident of this state.

(i) The board shall designate one of its members as chairperson and one member as secretary who shall serve at the will of the board.

(j) Each member of the board shall receive compensation and expense reimbursement in accordance with article one of this chapter.

(k) A majority of the members serving on the board shall constitute a quorum.

(l) The board shall hold at least two annual meetings annually. Other meetings shall be held at the call of the chairperson or upon the written request of two four members, at such time and place as designated in the call or request.

(m) Prior to commencing his or her duties as a member of the board, each member shall take and subscribe to the oath required by section five, article four of the Constitution of this state.

§30-23-6. Powers and duties of the board.

(a) The board has all the powers and duties set forth in this article, by rule, in article one of this chapter, and elsewhere in law.

(b) The board shall:

(1) Hold meetings, conduct hearings and administer examinations;

(2) Establish requirements for a license, apprentice license, temporary license and permit;

(3) Establish procedures for submitting, approving and rejecting applications for a license, apprentice license, temporary license and permit;

(4) Determine the qualifications of any applicant for a license, permit, certificate and registration;

(5) Provide standards for approved schools of medical imaging and radiation therapy technology and programs within schools, procedures for obtaining and maintaining approval, and procedures of revocation of approval where standards are not maintained: Provided, That the standards for approved schools meet at least the minimal requirements of the American Registry of Radiologic Technologist JRCERT, JRCNMT or standards determined programmatically equivalent by the board applicable minimum accreditation requirements for JRCERT, JRCNMT, CAAHEP (in accordance with standards established by the JRC-DMS or JRC-CVT) or CMA, or standards determiner programmatically equivalent by the board;

(6) Work with the West Virginia Board of Medicine to determine the scope of practice, the required education and training, and the type of regulations necessary for radiologist assistants;

(7) Prepare, conduct, administer and grade written, oral or written and oral examinations for a license, certificate and registration Prepare conduct, administer and grade written, oral or written and oral examinations for a license, certificate and registration. If medical imaging or radiation therapy examinations are not available from a certification organization recognized by the board;

(8) Determine the passing grade for the examinations;

(9) Maintain records of the examinations the board or a third party administers, including the number of persons taking the examination and the pass and fail rate;

(10) Maintain an office, and hire, discharge, establish the job requirements and fix the compensation of employees and contract with persons necessary to enforce the provisions of this article;

(11) Investigate alleged violations of the provisions of this article, legislative rules, orders and final decisions of the board;

(12) Conduct disciplinary hearings of persons regulated by the board;

(13) Determine disciplinary action and issue orders;

(14) Institute appropriate legal action for the enforcement of the provisions of this article;

(15) Maintain an accurate registry of names and addresses of all persons regulated by the board;

(16) Keep accurate and complete records of its proceedings, and certify the same as may be necessary and appropriate;

(17) Establish, by legislative rule, the continuing education requirements for licensees and permittees; certificate holders and registrants; and

(18) Propose rules in accordance with the provisions of article three, chapter twenty-nine-a of this code to implement the provisions of this article.

(1) Contract with third parties to administer the examinations required under the provisions of this article;

(2) Define, by legislative rule, the fees charged under the provisions of this article;

(3) Issue, renew, deny, suspend, revoke or reinstate a license, apprentice license, temporary license or permit, certificate and registration;

(4) Sue and be sued in its official name as an agency of this state;

(5) Confer with the Attorney General or his or her assistant in connection with legal matters and questions; and

(6) Take all other actions necessary and proper to effectuate the purposes of this article.

§30-23-7. Legislative rule-making authority.

(a) The board shall propose rules for legislative approval, in accordance with the provisions of article three, chapter twenty-nine-a of this code, to implement the provisions of this article, including:

(1) Standards and requirements for licensure, apprentice licensure temporary license and permits to practice medical imaging or radiation therapy technology;

(2) Procedures for examinations and reexaminations;

(3) Requirements for third parties to prepare and/or administer examinations and reexaminations;

(4) Educational and experience requirements, and the passing grade on the examination;

(5) Standards for approval of courses;

(6) Procedures for the issuance and renewal of a license, apprentice license, temporary license and permit;

(7) A fee schedule;

(8) Continuing education requirements for licensees and permittees;

(9) The procedures for denying, suspending, revoking, reinstating or limiting the practice of a licensee or permittee;

(10) Requirements for inactive or revoked licenses, apprentice licenses, temporary licensure and permits; and

(11) Any other rules necessary to effectuate the provisions of this article.

(b) All rules in effect on the effective date of this article shall remain in effect until they are amended or repealed, and references to provisions of former enactments of this act are interpreted to mean provisions of this article.

§30-23-10. Scope of practice for a radiologic technologist.

(a) The scope of practice of a radiologic technologist includes the following:

(1) Analysis and correlation of procedure requests and clinical information provided by a physician or patient, or both, for preprocedure determination of the appropriate exam, its extent, and its scope;

(2) Evaluation of the physical, mental and emotional status of the patient with respect to the ability to understand the risk versus benefit of the procedure and to undergo the procedure requested;

(3) Selection, preparation, and operation of medical imaging equipment and accessories to perform procedures;

(4) Positioning patient to best demonstrate anatomy of interest, while respecting patient's physical limitations and comfort;

(5) Determination of imaging exposure factors, setting of factors on control panel, and application of medical imaging exposures;

(6) Application of radiation protection principles to minimize radiation exposure to patient, self, and others;

(7) Evaluation of images for technical quality;

(8) Performance of noninterpretive fluoroscopic procedures according to institutional policy;

(9) Oversight of image processing standards and the appropriate labeling of images;

(10) Administering contrast media after consultation with, and under the supervision of, a physician who is immediately and physically available;

(10) Establishing or maintaining, or both, intravenous infusion, and preparing and administering medications incidental to medical imaging procedures, including, but not limited to, contrast agents, only when ordered by a qualified physician, advanced nurse practitioner or physician assistant who is immediately available: Provided, That the technologist is currently certified in cardiopulmonary resuscitation, and is educationally prepared and clinically competent to do so;

(11) Maintaining values congruent with the profession’s Code of Ethics and scope of practice as well as adhering to national, institutional and/or or departmental standards, or both, policies and procedures regarding delivery of services and patient care; and

(12) Use aseptic technique and observe universal standard precautions; and

(12) (13) Performing any other duties that the board authorizes for a radiologic technologist.

(b) An institution may limit the scope of practice for a technologist by institutional policy. However, nothing contained in this section may be construed to permit any entity the authority to expand the scope of practice outlined in this section.

§30-23-11. Scope of practice for a radiation therapist.

The scope of practice for a radiation therapist includes the following:

(1) Providing radiation therapy services by contributing as an essential member of the radiation oncology treatment team through provision of total quality care of each patient undergoing a prescribed course of treatment;

(2) Evaluating and assessing treatment delivery components;

(3) Providing radiation therapy treatment delivery services to cure or improve the quality of life of patients by accurately delivering a prescribed course of treatment;

(4) Evaluating and assessing daily, the physical and emotional status of each patient to treatment delivery;

(5) Maintaining values congruent with the profession’s Code of Ethics and scope of practice as well as adhering to national, institutional and/or or departmental standards, or both institutional and department standards, policies and procedures regarding treatment delivery and patient care; and

(6) Establishing or maintaining, or both establishing and maintaining, intravenous infusion and preparing and administering medications incidental to medical imaging procedures, including, but not limited to, contrast agents, only when ordered by a qualified physician, advanced nurse practitioner or physician assistant who is immediately available: Provided, That the technologist is currently certified in cardiopulmonary resuscitation and is educationally prepared and clinically competent to do so. An institution may limit the scope of practice for a technologist by institutional policy. However, nothing contained in this provision may be construed to permit any entity the authority to expand the scope of practice outlined in this section.

(7) Use aseptic technique and observe universal standard precautions; and

(6) (8) Preforming any other duties that the board authorizes for a radiation therapist.

§30-23-12. Exemptions from radiologic technology license.

The following persons are not required to obtain a radiologic technology license in accordance with the provisions of this article:

(1) A medical imaging technology student enrolled in and attending an approved school program of medical imaging technology who as part of his or her course of study applies performs medical imaging technology to a human being under the supervision of a licensed medical imaging technologist;

(2) A person acting as a dental assistant or dental hygienist who under the supervision of a licensed dentist operates only radiographic dental equipment for the sole purpose of dental radiography of the oral cavity or ultrasonic equipment for dental procedures;

(3) A person engaged in performing the duties of a medical imaging technologist in the person's employment by an agency, bureau or division of the Government of the United States;

(4) A licensed practitioner, Radiologist or Radiology resident;

(4) A licensed practitioner or a resident performing medical imaging authorized under their medical speciality’s scope of practice and authorized by the institution’s or facility’s policies;

(5) A person licensed as a radiologist assistant under the West Virginia Board of Medicine; and

(6) A registered nurse licensed by the West Virginia Board of Examiners for Registered Professional Nurses who performs point-of-care ultrasound for immediate patient care which shall include, but is not limited to, fetal positioning, bladder volume, ultrasound guided line inserts or other examinations, or both, approved by the board;

(7) A Therapist or physical or occupational assistant licensed by the appropriate state licensing board, who uses ultrasound for therapeutic purposes only; and

(6) (8) A person who demonstrated to the board, prior to July 1, 1999, that he or she:

(A) Had engaged in the practice of radiologic technology for the limited purpose of performing bone densitometry in this state for five or more years;

(B) Practiced under the supervision of a licensed practitioner; and

§30-23-14. Medical imaging and radiation therapy technology license from another state+; license to practice in this state.

The board may issue a license to practice medical imaging and radiation therapy technology in this state, without requiring an examination, to an applicant from another jurisdiction who:

(1) Is not a resident of this state;

(2) Is of good moral character:

(3) Holds a valid medical imaging and radiation therapy technology license, certificate or other authorization, including the American Registry of Radiologic Technologists, or Nuclear Medicine Technology Certification Board American Registry for Diagnostic Medical Sonography, Cardiovascular Credentialing International or equivalent to practice Medical Imaging and Radiation Therapy Technology the same medical imaging modality or modalities in another jurisdiction and meets requirements which are substantially equivalent to the medical imaging and radiation therapy technology licensure requirements set forth in this article;

(4) Is not currently being investigated by a disciplinary authority of this state or another jurisdiction, does not have charges pending against his or her license or other authorization to practice medical imaging and radiation therapy technology, and has never had a license or other authorization to practice medical imaging and radiation therapy technology revoked;

(5) Has not previously failed an examination for licensure in this state;

(6) Has paid all the applicable fees; and

(7) Has completed other action as required by the board.

§30-23-15. Requirements for nuclear medicine technologist license. (a) To be eligible for a license to practice nuclear medicine technology, the applicant must:

(1) Be of good moral character;

(2) Have a high school diploma or its equivalent;

(3) Not have been convicted of a felony under the laws of any state or the United States within five years preceding the date of application for licensure, which conviction remains unreversed;

(4) Not have been convicted of a misdemeanor or a felony under the laws of any state or the United States at any time if the offense for which the applicant was convicted related to the practice of medical imaging, which conviction remains unreversed.

(5) (A) Have a national certification as a certified nuclear medicine technologist or a national certification as a registered radiographer specializing in nuclear medicine; or

(5) (B) Meet one of the following qualifications:

(A) (i) Have a baccalaureate or associate degree in one of the physical or biological sciences pertaining to the medical imaging or radiation therapy profession;

(B) (ii) Have a baccalaureate or associate degree in other disciplines of medical imaging with successful completion of courses in the following areas: College algebra, physics or chemistry, human anatomy, physiology, and radiation safety;

(D) (iv) Have a national certification as a Registered Radiographer (ARRT (R));

(E) (v) Have a national certification as a Registered Radiographer specializing in Nuclear Medicine (ARRT (N)); or

(F) (vi) Have a national certification as a Radiation Therapist (ARRT(T)); and

(6) Qualify for and pass an examination which has been approved by the board, with a minimum passing score of seventy-five percent, which examination shall cover the basic subject matter of medical imaging, radiation safety, skills and techniques as it pertains to nuclear medicine technology.

(b) A person seeking a nuclear medicine technology license shall submit an application on a form prescribed by the board and pay the license fee, which fee shall be returned to the applicant if the license application is denied.

(c) A nuclear medicine technology license issued by the board prior to July 1, 2007, shall for all purposes be considered a license issued under this article: Provided, That a person holding a nuclear medicine technology license issued prior to July 1, 2007, must renew the license pursuant to the provisions of this article.

§30-23-16. Scope of practice for nuclear medicine technologist.

(a) The scope of practice for nuclear medicine technology includes the following:

(1) The practice of diagnostic in-vivo procedures and in-vitro procedures which include:

(A) Analysis and correlation of procedure request and clinical information provided by the referring physician or patient, or both, for determination of appropriate exam, extent, and scope;

(B) Evaluation of the physical and emotional status of the patient with respect to the ability to undergo the procedure requested;

(C) Immediate prates review of patient's identification, prescribed dose quantity and route of administration, and identification of the test agent designed to prevent dose mis-administration;

(D) Preparation of the appropriate radio pharmaceutical with measurement of dose activity;

(E) Administration of appropriate diagnostic dose levels of radio pharmaceuticals;

(F) Establishing or maintaining, or both establishing and maintaining, intravenous infusion and preparing and administering medications incidental to nuclear medicine procedures, including, but not limited to, contrast agents, only when ordered by a qualified physician, advanced nurse practitioner or physician assistant who is immediately available: Provided, That the technologist is currently certified in cardiopulmonary resuscitation and is educationally prepared and clinically competent to do so;

(G) Using aseptic technique and observe universal standard precautions;

(F) (H) Administration of nonradioactive pharmaceuticals utilized in conjunction with a nuclear medicine imaging or in-vivo procedure, for example, cholecystokinin, furosemide, vitamin B12, in accordance with hospital or facility procedures, excluding narcotic and sedating medication;

(G) (I) Selection of appropriate imaging or test parameters, or both;

(H) (J) Obtaining images according to established protocols and any special views to optimize information as appropriate;

(I) (K) Placement of patient in proper position using supportive materials and immobilizer as necessary;

(J) (L) Assuring appropriate image labeling as to patient;

(K) (M) Monitoring of patient and equipment during procedure for determination and application of any corrective actions necessary;

(L) (N) Monitoring of data collection and processing and performance of technical analysis of test results;

(M) (O) Preparation and performance of laboratory in-vivo nuclear medicine procedures, inclusive of the selection and operation of laboratory counting equipment, performance of calculations and data processing necessary for completion of lab procedures and the submission of results to the physician or licensee;

(N) (P) Oversight and application of image development; and

(O) (Q) Performance of in-vitro testing of serum, plasma, or other body fluids using radio immunoassay, or similar ligand assay methods.

(2) The practice for handling radio pharmaceuticals which includes:

(A) Preparation, by means of tagging, compounding, etc., in accordance with manufacturer's specifications;

(B) Measurement and calculation of activity of radionuclides with a dose calibrator;

(C) Application of radioactive decay calculations to determine required volume or unit form necessary to deliver the prescribed radioactive dose; and

(D) Recording of radio pharmaceutical information on a patient's permanent record.

(3) The practice for radionuclide therapy which includes:

(A) Assisting licensee in the preparation and applications of therapeutic radionuclides;

(B) Oversight of radiation safety practices related to the handling and administration of radio pharmaceuticals for therapy of patients;

(C) Maintenance of records of radioactive material receipt, use, storage, and disposal in accordance with regulatory requirements;

(D) Oversight and enforcement of radiation safety policies, practices, and regulations regarding the possession and use of radioactive materials;

(E) Performance of radiation safety procedures such as radiation survey and wipe testing of incoming radioactive shipments and facility fixtures;

(F) Maintaining values congruent with the profession’s code of ethics and scope of practice as well as adhering to national, institutional and/or or departmental standards, or both institutional and departmental standards, policies and procedures regarding delivery of services and patient care; and

(G) Performing any other duties that the board determines may be performed by a nuclear medicine technologist.

(4) The scope of practice for a nuclear medicine technologist or certified PET Technologist to operate a multimodality device, i.e. PET/CT, SPECT/CT etc, requires that:

(A) A Nuclear Medicine Technologist, (ARRT(N) or NMTCB) or certified PET Technologist may administer radio pharmaceuticals and/or or ionizing radiation or both radio pharmaceuticals and ionizing radiation, from an integrated multimodality device, if the ionizing radiation is produced for the sole purpose of attenuation correction and considered an essential component of the procedure, provided the licensee has obtained proper documented training that has been approved by the board in the radiation safety aspect of the operation of these units; and

(B) A licensed radiographer, (ARRT(R)), or nuclear medicine technologist with an additional certification by the ARRT or other nationally recognized certifying body in computed tomography, shall operate the computed tomography scanner if it is used for any other diagnostic radiographic procedures.

(b) An institution may limit the scope of practice for a technologist by institutional policy. However, nothing contained in this provision may be construed to permit any entity the authority to expand the scope of practice outlined in this section.

§30-23-17. Requirements for magnetic resonance imaging technologist license.

(a) To be eligible for a license to practice magnetic resonance imaging technology, the applicant must:

(1) Be of good moral character;

(2) Have a high school diploma or its equivalent;

(3) Not have been convicted of a felony under the laws of any state or the United States within five years preceding the date of application for licensure, which conviction remains unreversed;

(5) (A) Have a national certification as an MRI technologist (ARRT (MR) or ARMRIT); or

(5)(B) Meet one of the following qualifications:

(A) (i) Have a baccalaureate or associate degree in one of the physical or biological sciences pertaining to the medical imaging or radiation therapy profession;

(B) (ii) Have a baccalaureate or associate degree in other disciplines of medical imaging with successful completion of courses in the following areas: college algebra, physics or chemistry, human anatomy, physiology, and radiation safety;

(D) (iv) Have a national certification as a Registered Radiographer (ARRT (R));

(E) (v) Have a national certification as a Registered Radiographer specializing in Nuclear Medicine (ARRT (N));

(F) (vi) Have a national certification as a Radiation Therapist (ARRT(T); or and

(G) National certification as an MRI technologist (ARRT (MR) or ARMRIT); and

(6) Qualify for and pass an examination which has been approved by the board, with a minimum passing scaled score of seventy-five percent, which examination shall cover the basic subject matter of Medical Imaging, radiation safety, skills and techniques as it pertains to magnetic resonance imaging.

(b) A person seeking a magnetic resonance imaging technology license shall submit an application on a form prescribed by the board and pay the license fee, which fee shall be returned to the applicant if the license application is denied.

(c) A magnetic resonance imaging technology license issued by the board prior to July 1, 2007, shall for all purposes be considered a license issued under this article: Provided, That a person holding a magnetic resonance imaging technology license issued prior to July 1, 2007, must renew the license pursuant to the provisions of this article.

§30-23-18. Scope of practice for magnetic resonance imaging technologist.

(a) The scope of practice for magnetic resonance imaging technology includes the following:

(1) Make Making arrangements with other departments for ancillary patient services (e.g. transportation, anesthesia);

(2) Orient Orienting patient and family to requirements necessary for the exam and instruct patient regarding preparation prior to imaging procedures;

(3) Assist Assisting with scheduling patients and coordinating exams to assure smooth work flow and review patient’s chart to verify physician’s orders;

(4) Assist patient Assisting patients on and off the scanning table and maintain maintaining communication and provide providing reassurance to patient patients throughout scanning procedure procedures;

(5) Obtain Obtaining patient’s medical history prior to scan and observe patient’s vital signs, O2 saturation, patient’s level of consciousness during scanning procedure, and observe patient’s physical status prior to discharge from the scanning procedure;

(6) Maintain Maintaining controlled access to restricted area of strong magnetic field to ensure safety of patients, visitors, and hospital personnel and screen patient for ferrous and RF-sensitive material prior to entrance into magnetic field;

(7) Evacuate patient Evacuating patients in emergency situation situations (e.g., quench, code, metallic object);

(8) Provide Providing hearing protection to patient patients and others;

(9) Inspect Inspecting equipment to make sure it is operable and safe (e.g., coils, cables, door seals), perform document and interpret performing, documenting and interpreting the results of daily QC tests (center frequency, signal to noise, image quality and artifacts);

(10) Monitor Monitoring specific absorption rate (SAR) and cryogen levels;

(11) Position patient Positioning patients according to type of study indicated and enter entering patient’s data needed to initiate scan;

(12) Establishing or maintaining, or both, intravenous infusion and preparing and administering medications incidental to nuclear medicine procedures, including, but not limited to, contrast agents, only when ordered by a qualified physician, advanced nurse practitioner or physician assistant who is immediately available: Provided, That the technologist is currently certified in cardiopulmonary resuscitation and is educationally prepared and clinically competent to do so;

(12) Explain (13) Explaining the risks of contrast media injections, obtain obtaining signed consent form forms, determine determining appropriate dose required, program or activate the power injector and administer the contrast media;

(14) Using aseptic technique and observing universal standard precautions;

(13) Select (15) Selecting all parameters needed to obtain a highly diagnostic image;

(14) Archive (16) Archiving images to or retrieve images from data storage devices;

(15) Evaluate (17) Evaluating quality of filmed images and reformat images;

(16) Perform (18) Performing automatic or manual frequency tuning;

(17) Differentiate (19) Differentiating between normal and abnormal images to assess completion of procedure;

(18) Monitor (20) Monitoring image production and discriminate between technically acceptable and unacceptable images;

(19) (21) Maintaining values congruent with the profession’s code of ethics and scope of practice as well as adhering to national, institutional and/or or departmental standards, or both institutional and departmental standards, policies and procedures regarding delivery of services and patient care; and

(20) Perform (22) Performing any other duties that the board authorizes.

§30-23-18a. Requirements for a sonographer license.

This licensure is intended for operators of medical ultrasound equipment who perform ultrasound for the purpose of capturing images for submission to a physician for an interpretation.

(a) To be eligible for a license to practice as a sonographer, the applicant must:

(1) Be of good moral character;

(2) Have a high school diploma or its equivalent;

(3) Not have been convicted of a felony under the laws of any jurisdiction within five years preceding the date of application for licensure, which conviction remains unreversed;

(4) Not have been convicted of a misdemeanor or a felony under the laws of any jurisdiction at any time if the offense for which the applicant was convicted related to the practice of medical imaging, which conviction remains unreversed;

(5) Have a national certification as a diagnostic medical sonographer, registered cardiac sonographer or registered vascular sonographer; or

(6) Meet one of the following qualifications:

(A) Have a baccalaureate or associate degree in one of the physical or biological sciences pertaining to the medical imaging or radiation therapy profession;

(B) Have a baccalaureate or associate degree in other disciplines of medical imaging with successful completion of courses in the following areas: College algebra, physics or chemistry, human anatomy, physiology and radiation safety;

(D) Have a national certification as a Registered Radiographer (ARRT (R));

(E) Have a national certification as a Registered Radiographer

specializing in Nuclear Medicine (ARRT (N));

(F) Have a national certification as a Radiation Therapist (ARRT(T);

(G) Have a national certification as an MRI technologist (ARRT (MR) or ARMRIT); or

(H) Be a registered nurse.

(7) Qualify for and pass an examination which has been approved by the board, with a minimum passing scaled score of seventy-five, which examination shall cover the basic subject matter of medical imaging, safety skills and techniques as it pertains to diagnostic medical sonography.

(b) An individual may perform sonography only in the speciality category in which they are credentialed. To perform sonography in a specialized category, such as breast sonography, cardiac sonography, vascular sonography, the individual will need to document that they are educationally prepared and clinically competent in the specialized category.

(c) A person seeking a sonographer license shall submit an application on a form prescribed by the board and pay the license fee, which fee shall be returned to the applicant if the license application is denied.

§30-23-18b. Scope of practice for diagnostic medical sonography.

(a) The scope of practice for diagnostic medical sonography includes the following:

(1) Performing sonography and related procedures pursuant to an order or prescription of a licensed practitioner, advanced nurse practitioner, nurse-midwife or physician assistant. These procedures may be for diagnostic or therapeutic purposes;

(2) Preparing the patient for procedures, including providing instructions to obtain desired results, gain cooperation and minimize anxiety;

(3) Obtaining or verifying patient's clinical history and informed consent in accordance with institutional policy;

(4) Using aseptic technique and observe universal standard precautions;

(5) Selecting and operating medical ultrasound equipment and related devices to achieve desired results;

(6) Positioning patients and equipment to best achieve desired results, respecting patients ability and comfort while preventing patient and sonographer injury;

(7) Using independent judgment and systematic problem solving methods to produce high quality diagnostic information and optimize patient care;

(8) Establishing or maintaining, or both establishing and maintaining, intravenous infusion and preparing and administering medications incidental to sonography procedures, including, but not limited to, contrast agents, only when ordered by a qualified physician, advanced nurse practitioner or physician assistant who is immediately available: Provided, That the sonographer is currently certified in cardiopulmonary resuscitation, and is educationally prepared and clinically competent to do so;

(9) Documenting diagnostic and patient data and providing oral or written preliminary findings to the licensed practitioner to aid in patient diagnosis and management in accordance with institutional policy;

(10) Maintaining records and complying with confidentiality laws and policies;

(11) Participating in quality assessment and improvement activities in accordance with institutional policy;

(12) Providing basic life support as necessary;

(13) Providing patient education as necessary;

(14) Providing clinical instruction for students or other health care professionals, or both students and other health care professionals, as necessary in accordance with institutional policy;

(15) Adhering to the principle of "As Low As Reasonably Achievable" (ALARA) for patient exposure to nonionizing radiation;

(16) Maintaining values congruent with the profession's Code of Ethics and scope of practice as well as adhering to national, institutional or departmental standards, or both institutional and departmental standards, policies and procedures regarding delivery of services and patient care; and

(17) Performing any other duties that the board authorizes for a sonographer.

(b) An institution may limit the scope of practice for a sonographer by institutional policy. However, nothing contained in this provision may be construed to permit any entity the authority to expand the scope of practice outlined in this section.

§30-23-19. Requirements for an apprentice license for nuclear medicine technologists and magnetic resonance imaging technologists.

(a) The board may issue an apprentice license to an individual who is practicing as a nuclear medicine technologist or a magnetic resonance imaging technologist prior to July 1, 2007 but has not obtained certification in the discipline imaging modality. A notarized letter, signed by the individual’s supervising licensed physician, must be submitted with the individual’s application, stating that the individual has performed the duties of a nuclear medicine technologist or magnetic resonance imaging technologist prior to July 1, 2007.

(b) The An apprentice license for nuclear medicine and magnetic resonance imaging is valid for one year. An apprentice license may be renewed annually for an additional four years, giving the individual a total of five years to complete or meet the requirements and successfully pass the certification examination for a nuclear medicine technologist license or a magnetic resonance imaging technologist license. All individuals possessing an apprentice license must work under the supervision of a licensed practitioner for MRI, an authorized user for nuclear medicine or a technologist an individual who is licensed in that discipline.

(c) Any individual possessing a valid medical imaging license issued by the board and seeks to cross-train in the discipline of nuclear medicine technology or magnetic resonance imaging technology, may obtain an apprentice license in that discipline for the purpose of obtaining the necessary clinical experience requirements in order to qualify to sit for the required examination. This apprentice license will be valid for one year and renewable for four years, giving allowing a cross-trained individual five years to obtain certification in the discipline.

(d) The board may issue an apprentice license to an individual who is practicing as a diagnostic medical sonographer prior to July 1, 2012, but has not obtained certification in the imaging modality. A notarized letter, signed by the individual's supervising licensed physician, must be submitted with the individual's application, stating that the individual has performed the duties of a diagnostic medical sonographer prior to July 1, 2012. An apprentice licensed issued under this section will be good for one year and may be renewed for one additional year.

(e) Any individual possessing a valid medical imaging license issued by the board and seeking to cross-train in the discipline of diagnostic medical sonography may obtain an apprentice license in that discipline for the purpose of obtaining the necessary clinical experience requirements in order to qualify to sit for the required examination. This apprentice license will be valid for one year and renewable for one additional year, allowing a cross-trained individual two years to obtain certification in the discipline. After July 1, 2014, an individual will not be allowed to obtain an apprentice license to cross-train in sonography. The individuals will have to be graduates from a recognized school of sonography and pass a national examination in sonography.

§30-23-22. License and permit renewal requirements.

(a) A licensee and permittee shall annually renew his or her license or permit by completing a form prescribed by the board, paying a renewal fee, and submitting any other information required by the board.

(b) The board shall charge a fee for each renewal of a license or permit and a late fee for any renewal not paid in a timely manner.

(c) The board shall require as a condition for the renewal of a license and permit that each licensee or permittee complete continuing education requirements.

(d) The board may deny an application for renewal for any reason which would justify the denial of an original application for a license or permit.

(e) An application submitted electronically for a license renewal of a license or a temporary license shall be considered as signed by the applicant.

§30-23-23. Display of license.

(a) The board shall prescribe the form for a license and permit and may issue a duplicate license or permit, upon payment of a fee.

(b) A licensee shall conspicuously display his or her license at his or her principal place of practice. A photocopy of the original license shall be conspicuously displayed at his or her secondary place of employment.

(c) A permittee shall conspicuously display his or her permit at his or her principal place of practice. A photocopy of the original permit shall be conspicuously displayed at his or her secondary place of employment.

§30-23-24. Refusal to issue or renew, suspension or revocation;

disciplinary action.

(a) The board shall upon the written complaint of any person cause an investigation to be made to determine whether grounds exist for disciplinary action under this article or the legislative rules promulgated pursuant to this article. The board may also cause an investigation to be made upon its own motion based on credible information.

(b) Upon initiation or receipt of the complaint, the board shall provide a copy of the complaint to the licensee or permittee.

(c) After reviewing any information obtained through an investigation, the board shall determine if probable cause exists that the licensee or permittee has violated subsection (g) of this section or legislative rules promulgated pursuant to this article.

(d) Upon a finding that probable cause exists that the licensee or permittee has violated subsection (g) of this section or legislative rules promulgated pursuant to this article, the board may enter into a consent decree or hold a hearing for the suspension or revocation of the license or permit or the imposition of sanctions against the licensee or permittee. Any hearing shall be held in accordance with the provisions of this article.

(e) Any member of the board or the executive director of the board may issue subpoena and subpoena duces tecum for witnesses and documents to aid in the investigation of allegations against any person regulated by the article.

(f) Institute proceedings in the courts of this state to enforce a subpoena for the production of witnesses or documents.

(g) Any member of the board or its executive director may sign a consent decree or other legal document on behalf of the board.

(h) After notice and opportunity for hearing the board may deny or refuse to renew, suspend, restrict or revoke the license or permit of, or impose probationary conditions upon or take disciplinary action against, any licensee or permittee for any of the following reasons once a violation has been proven by a preponderance of the evidence:

(1) Obtaining a license or permit by fraud, misrepresentation or concealment of material facts;

(2) Being convicted of a felony or other crime involving moral turpitude;

(3) Being guilty of unprofessional conduct which placed the public at risk, as defined by legislative rule of the board;

(4) Intentional violation of a lawful order or legislative rule of the board;

(5) Having had a license or other authorization revoked or suspended, other disciplinary action taken or an application for licensure or other authorization revoked or suspended by the proper authorities of another jurisdiction;

(6) Aiding or abetting unlicensed practice; or

(7) Engaging in an act while acting in a professional capacity which has endangered or is likely to endanger the health, welfare or safety of the public.

(i) For the purposes of this section, effective July 1, 2012, disciplinary action may include:

(1) Reprimand;

(2) Probation;

(3) Restrictions;

(4) Administrative fine, not to exceed $1,000 per day per violation;

(5) Mandatory attendance at continuing education seminars or other training;

(6) Practicing under supervision or other restriction; or

(7) Requiring the licensee or permittee to report to the board for periodic interviews for a specified period of time.

(j) In addition to any other sanction imposed, the board may require a licensee or permittee to pay the costs of the proceeding.

§30-23-25. Procedures for hearing; right of appeal.

(a) Hearings are governed by the provisions of section eight, article one of this chapter.

(b) The board may conduct the hearing or elect to have an administrative law judge conduct the hearing.

(c) If the hearing is conducted by an administrative law judge the administrative law judge shall prepare a proposed written order containing findings of fact and conclusions of law at the conclusion of the hearing. The proposed order may contain proposed disciplinary actions if the board so directs. The board may accept, reject or modify the decision of the administrative law judge.

(d) Any member or the executive director of the board may administer oaths, examine any person under oath and issue a subpoena or a subpoena duces tecum for the appearance of witnesses or documents.

(e) If after a hearing the board determines the licensee or permittee has violated provisions of this article or the board’s rules, a formal written decision shall be prepared which contains findings of fact, conclusions of law and a specific description of the disciplinary actions imposed.

§30-23-26. Hearing and judicial review.

Following a hearing any licensee or permittee adversely affected by a formal written decision of the board may obtain judicial review of the decision in accordance with section four, article five, chapter twenty-nine-a of this code and may appeal any ruling resulting from judicial review in accordance with article six, chapter twenty-nine-a of this code.

§30-23-27. Injunctions.

(a) When, by reason of an investigation under this article or otherwise, the board or any other interested person believes that a person has violated or is about to violate any provision of this article, any rule promulgated hereunder, any order of the board or any final decision of the board, the board or any other interested person may apply to any court of competent jurisdiction for an injunction against such person enjoining such person from the violation. Upon a showing that the person has engaged in or is about to engage in any prohibited act or practice, an injunction, restraining order or other appropriate order may be granted by the court without bond.

(b) The board may fine and/or or issue cease and desist orders or both fine and issue cease and desist orders against individuals and/or or firms, or both individuals and firms, found to be in violation of the provisions of this article or any rule adopted thereunder.

(c) A cause of action by the board may be brought in the circuit court of Kanawha County or in the circuit court of the county where the cause of action took place.

NOTE: The purpose of this bill is to update and rewrite the article concerning the practice of medical imaging and radiation therapy technology. The bill updates definitions and licensing requirements. The governing board is renamed the West Virginia Medical Imaging and Radiation Therapy Board. Membership on the board was expanded to thirteen. The powers and duties of the board regarding the granting of temporary licenses, standards for approved schools of medical imaging and licensing examinations have been rewritten. The rule-making authority has been changed to provide for temporary licensing. Scope of practice for radiologic technologist, radiation therapist, nuclear medicine technologist and magnetic resonance imaging technologist have been revised. Licensing requirements for various disciplines have also been revised, including apprentice licenses. Sonographer licenses are now required and the scope of practice of a sonographer is detailed. The provisions regarding complaints, investigations and disciplinary actions have been rewritten as have the provisions for a hearing and the right of appeal.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.

§30-23-24, §30-23-25 and §30-23-26 have been completely rewritten; therefore, strike-throughs and underscoring have been omitted.

§30-23-18a and §30-23-18b are new; therefore, strike-throughs and underscoring have been omitted.

Print On Demand