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TITLE 32: ENERGY CHAPTER II: DEPARTMENT OF NUCLEAR SAFETY SUBCHAPTER b: RADIATION PROTECTION

PART 401 ACCREDITING PERSONS IN THE PRACTICE OF MEDICAL RADIATION TECHNOLOGY

Section 401.10 Policy and Scope 401.20 Definitions 401.30 Exemptions 401.40 Application for Accreditation 401.50 Categories of Accreditation 401.60 Examination Requirements 401.70 Acceptable Examinations 401.80 Approved Program 401.90 Practice Requirement - Initial Licensure (Repealed) 401.100 Initial Issuance of Accreditation 401.110 Duration of Accreditation 401.120 Suspension and Revocation of Accreditation 401.130 Fees 401.140 Requirements for Renewal of Accreditation 401.150 Reciprocity 401.160 Minimum Course of Education (Repealed) 401.170 Civil Penalties 401.APPENDIX A Limited Diagnostic Radiography Procedures by Type of Limited Accreditation 401.APPENDIX B Example Topics Directly Related to Radiologic Sciences

AUTHORITY: Implementing and authorized by Sections 5, 6, 7 and 36 of the Radiation Protection Act of 1990 (P.A. 86-1341, effective September 7, 1990).

SOURCE: Adopted at 7 Ill. Reg. 17318, effective January 1, 1984; Emergency amendment at 8 Ill. Reg. 17584, effective September 12, 1984, for a maximum of 150 days; amended at 9 Ill. Reg. 2499, effective February 13, 1985; amended at 10 Ill. Reg. 13259, effective July 28, 1986; amended at 10 Ill. Reg. 21086 effective January 1, 1987; amended at 11 Ill. Reg. 15623, effective September 11, 1987; Emergency amendment at 11 Ill. Reg. 19797, effective November 24, 1987, for a maximum of 150 days; amended at 12 Ill. Reg. 7603, effective April 18, 1988; amended at 12 Ill. Reg. 18164, effective January 1, 1989; amended at 13 Ill. Reg. 15005, effective September 11, 1989; amended at 14 Ill. Reg. 15341, effective September 4, 1990; amended at 15 Ill. Reg. 7054, effective April 29, 1991.

Section 401.10 Policy and Scope

a) This Part establishes educational standards and an accreditation program for persons who apply ionizing radiation to human beings. Specifically, this Part provides:

1) Minimum standards of preparatory education and experience for persons who apply ionizing radiation to human beings in the disciplines of medical radiography, nuclear medicine technology, radiation therapy technology and chiropractic radiography.

2) Examination requirements for certain categories of accreditation.

3) Continuing education requirements for renewal of accreditation.

b) This Part shall apply to any person who applies ionizing radiation to human beings for diagnostic or therapeutic purposes in this State or who otherwise engages in the practice of medical radiation technology in this State unless specifically exempted by the Act or under Section 401.30. This Part shall also apply to persons who are not appropriately licensed under other statutes or requlations and who supervise students for purposes of instructing them while applying ionizing radiation to human beings.

c) The Board may propose to the Department of Nuclear Safety such regulations as it deems to be appropriate for purposes of fulfilling the policy and scope of the accreditation program.

(Source: Amended at 14 Ill. Reg. 15341, effective September 4, 1990)

Section 401.20 Definitions

As used in this Part, the following definitions shall apply:

"Accreditation" - The process by which the Department of Nuclear Safety grants permission to persons meeting the requirements of this Act and the Department's rules and regulations to engage in the practice of administering radiation to human beings. (Section 4 of the Act)

"Act" - The Radiation Protection Act of 1990 (P.A. 86-1341, effective September 7, 1990).

"Administers Ionizing Radiation" - see "Applies Ionizing Radiation"

"Applies Ionizing Radiation" - The act(s) of using ionizing radiation for diagnostic or therapeutic purposes. Specifically included are those tasks which have a direct impact on the radiation burden of the patient, e.g.: Positioning of the patient, film and beam; preparation, calibration, and injection of radiopharmaceuticals; imaging or laboratory techniques which if performed improperly would result in the re-administration of radiation; selection of technique or treatment parameters.

"Approved Program" - A program which the Department has determined is adequate to prepare students to meet the education requirements prescribed in 42 CFR 75.3 Appendix A, D, and E (1983), exclusive of subsequent amendments or editions. A copy of 42 CFR 75.3 is available for inspection at the Department's offices, 1035 Outer Park Drive, Springfield, IL.

"Board"- The Radiologic Technologist Accreditation Advisory Board (R.T.A.A.B.).

"Chiropractic Radiographic Assistant" - A person other than a licensed practitioner who performs medical radiation procedures and applies x-radiation to the human body for diagnostic evaluation of skeletal anatomy, while under the supervision of a licensed chiropractor.

"Chiropractic Radiography" - The science and art of applying x- radiation to human beings for diagnostic purposes in Chiropractic.

"Credentialing" - Means any process whereby a State government or non-governmental agency or association grants recognition to an individual who meets certain predetermined qualifications.

"Department" - Means the Illinois Department of Nuclear Safety.

"Direct Supervision" - An individual is in the physical presence of a licensed practitioner or medical radiation technologist who holds active status accreditation and assists, evaluates and approves of the individual's performance of the various tasks involved in the application of ionizing radiation.

"Director" - Means the Director of the Department of Nuclear Safety.

"Ionizing Radiation" - Means gamma rays, and x-rays, alpha and beta particles, high speed electrons, neutrons, protons, and other nuclear particles; but not sound or radio waves, or visible, infrared or ultraviolet light.

"In vitro" - Isolated from the living organism.

"In vivo" - Occurring within the living organism.

"Licensed Practitioner" - A person licensed or otherwise authorized by law to practice medicine, dentistry, osteopathy, chiropractic or podiatry.

"Limited Diagnostic Radiographer-Chest" - A person, other than a licensed practitioner, who, while under the supervision of a licensed practitioner, applies x-radiation to the human chest for diagnostic purposes.

"Limited Diagnostic Radiographer-Extremities" - A person, other than a licensed practitioner, who, while under the supervision of a licensed practitioner, applies x-radiation to the human extremities for diagnostic purposes.

"Limited Diagnostic Radiographer-Skull and Sinuses" - A person, other than a licensed practitioner, who, while under the supervision of a licensed practitioner, applies x-radiation to the human skull and sinuses for diagnostic purposes.

"Limited Diagnostic Radiographer-Spine" - A person, other than a licensed practitioner, who, while under the supervision of a licensed practitioner, applies x-radiation to the human spine for diagnostic purposes.

AGENCY NOTE: Specific radiographic examinations appropriate to each type of limited radiography accreditation may be found in Appendix A.

"Medical Radiation Technology" - The science and art of performing medical radiation procedures involving the application of ionizing radiation to human beings for diagnostic and therapeutic purposes. The five specialized disciplines of Medical Radiation Technology are Medical Radiography, Nuclear Medicine Technology, Radiation Therapy Technology, Chiropractic Radiography, and Podiatric Radiography.

"Medical Radiographer" - A person, other than a licensed practi- tioner, who, while under the supervision of a licensed practitioner, applies x-radiation to any part of the human body and who, in conjunction with radiation studies may, administer contrast agents and related drugs for diagnostic purposes.

"Medical Radiography" - The science and art of applying x- radiation to human beings for diagnostic purposes.

"Nuclear Medicine Technologist" - A person, other than a licensed practitioner, who, administers radiopharmaceuticals and related drugs to human beings for diagnostic purposes, performs in vivo and in vitro detection and measurement of radioactivity and administers radiopharmaceuticals to human beings for therapeutic purposes. A nuclear medicine technologist may perform such procedures only while under the supervision of a licensed practitioner who is licensed to possess and use radioactive materials.

"Nuclear Medicine Technology" - The science and art of in vivo and in vitro detection and measurement of radioactivity and the administration of radiopharmaceuticals to human beings for diagnostic and therapeutic purposes.

"Radiation Therapist" - A person, other than a licensed practitioner, who performs procedures and applies ionizing radiation emitted from x-ray machines, particle accelerators, or sealed radioactive sources to human beings for therapeutic purposes while under the supervision of a licensed practitioner who is licensed, as required, to possess and use radioactive materials.

"Radiation Therapy Technology" - The science and art of applying ionizing radiation emitted from x-ray machines, particle accelerators and sealed radioactive sources to human beings for therapeutic purposes.

"Supervision" - Responsibility for, and control of, quality, radiation safety and protection, and technical aspects of the application of ionizing radiation to human beings for diagnostic and/or therapeutic purposes.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.30 Exemptions

a) Nothing in the Act or this Part shall be construed to limit or affect in any respect, the practice of persons properly licensed under other statutes or regulations with respect to their professions.

b) The Department shall, upon application therefor or upon its own initiative, grant such exemptions or exceptions from the requirements of this Part as it determines are authorized by law and will not result in a hazard to public health and safety.

c) Exemptions shall include:

1) A student enrolled in an approved program applicable to his/her profession who, as a part of his/her course of study, applies ionizing radiation to human beings while under the supervision of a licensed practitioner.

2) A person registered with the Department as a student-in- training in limited diagnostic radiography pursuant to Section 401.80(c) who applies ionizing radiation to human beings while under the supervision of a licensed practitioner, provided that the procedures performed shall be limited to the procedures as listed in Appendix A, applicable to the particular status condition of limited diagnostic radiography for which the student is registered. This exemption shall only apply to individuals who are registered with the Department and shall only apply for 16 months.

3) A person licensed to practice a treatment of human ailments by virtue of the Medical Practice Act of 1987 (Ill. Rev. Stat. 1989, ch. 111, par. 4400-1 et seq.), the Illinois Dental Practice Act (Ill. Rev. Stat. 1989, ch. 111, par. 2301 et seq.), or the Podiatric Medical Practice Act of 1987 (Ill. Rev. Stat. 1989, ch. 111, par. 4801 et seq.) (Section 5 of the Act)

4) A person employed as a dental assistant who performs dental radiography for a licensed dentist.

5) A technician, nurse or other assistant who performs radiography under the supervision of a person licensed under the Podiatric Medical Practice Act of 1987.

6) A person who holds Conditional Accreditation Type II issued in accordance with Section 401.100(d) during such time as that person is under the direct supervision of a licensed practitioner or medical radiation technologist who holds active status accreditation for purposes of being instructed in the use of equipment and/or procedures other than those for which the person is currently accredited.

7) A nurse, technician, or other assistant who, under the supervision of a person licensed under the Medical Practice Act of 1987, administers radiation to human beings, but only when such administration is performed on employees of a business at a medical facility owned and operated by that business. (Section 6 of the Act)

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.40 Application for Accreditation

Any person applying for initial accreditation or renewal of accreditation must submit a complete and legible application form, must pay the appropriate application fee in accordance with Section 401.130, and must provide evidence that he/she has met the requirements for the given category and status of accreditation which is sought. Persons applying for Active Status Accreditation shall submit evidence of registration, Board certification, or other examination as appropriate pursuant to Section 401.70. Persons applying for accreditation in Limited Diagnostic Radiography (i.e., limited-chest, limited-extremities, limited-skull and sinuses and limited-spine) shall submit evidence that they have passed the required examinations as specified in Section 401.60 (d-g). Persons applying for Temporary Accreditation shall submit evidence of graduation from an approved program. Fees and charges collected by the Department shall be paid into the Radiation Protection Fund. Such fees and charges shall be used to defray costs incurred in the administration of this program. Accreditation shall be valid for a specified period of time and shall entitle the individual to privileges consistent with the category and status of accreditation indicated unless the accreditation is suspended or revoked in accordance with Section 401.120.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.50 Categories of Accreditation

a) The Department shall accredit persons in the practice of Medical Radiation Technology in one or more of these specific categories:

1) Medical Radiography;

2) Nuclear Medicine Technology;

3) Radiation Therapy Technology;

4) Chiropractic Radiography; and

5) Limited Diagnostic Radiography.

b) The Department shall recognize the following status conditions for the categories of accreditation:

1) Active - An applicant who meets the requirements as set forth in Section 401.100(a).

2) Temporary - An applicant who meets the requirements as set forth in Section 401.100(b).

3) Conditional - An applicant who meets the requirements as set forth in Section 401.100(c), or (d).

4) Limited-Chest - An applicant who meets the requirements as set forth in Section 401.100(e). This status condition is applicable to the category of Limited Diagnostic Radiography only.

5) Limited-Extremities - An applicant who meets the requirements as set forth in Section 401.100(e). This status condition is applicable to the category of Limited Diagnostic Radiography only.

6) Limited-Skull and Sinuses - An applicant who meets the requirements as set forth in Section 401.100(e). This status condition is applicable to the category of Limited Diagnostic Radiography only.

7) Limited-Spine - An applicant who meets the requirements as set forth in Section 401.100(e). This status condition is applicable to the category of Limited Diagnostic Radiography only.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.60 Examination Requirements

a) Active - Persons who seek active status accreditation in medical radiation technology must pass a written examination as appropriate to the category of accreditation sought in accordance with Section 401.70.

b) Temporary - Persons who seek active status accreditation and are awaiting the successful completion of an examination in accordance with Section 401.70 may apply for and be issued temporary accreditation. Temporary accreditation shall be valid until the person has passed the appropriate examination and has applied for and been issued active status accreditation. In no case shall temporary accreditation be valid for more than two years from the date of issuance.

c) Conditional - Examination shall not be required for conditional accreditation.

d) Limited Diagnostic Radiographer-Chest - Persons who seek accreditation to perform radiography of the chest, but not any other parts of the body, must pass a written examination on general radiography topics and a written or practical examination on chest anatomy and clinical skills required to perform radiography of the chest in accordance with Section 401.70(c).

e) Limited Diagnostic Radiographer-Extremities - Persons who seek accreditation to perform radiography of the extremities, but not any other parts of the body, must pass a written examination on general radiography topics and a written or practical examination on anatomy of the extremities and clinical skills required to perform radiography of the extremities in accordance with Section 401.70(c).

f) Limited Diagnostic Radiographer-Skull and Sinuses - Persons who seek accreditation to perform radiography of the skull and or sinuses, but not any other parts of the body, must pass a written examination on general radiography topics and a written or practical examination on anatomy of the skull and sinuses and clinical skills required to perform radiography of the skull and sinuses in accordance with Section 401.70(c).

g) Limited Diagnostic Radiographer-Spine - Persons who seek accreditation to perform radiography of the spine, but not any other parts of the body, must pass a written examination on general radiography topics and a written or practical examination on anatomy of the spine and clinical skills required to perform radiography of the spine in accordance with Section 401.70(c).

AGENCY NOTE: Persons may seek accreditation in more than one status condition of limited diagnostic radiography.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.70 Acceptable Examinations

a) The Department shall accept for, issuance of Active Status Accreditation, examinations as identified by this Section. Accreditation shall be specific to the category of examination as specified in subsection (b) of this Section.

b) Examinations as appropriate to category of accreditation are as follows:

1) Medical Radiography

- The American Registry of Radiologic Technologists (R) (A.R.R.T.).

2) Nuclear Medicine Technology

- The American Registry of Radiologic Technologists (N) (A.R.R.T.), the Nuclear Medicine Technology Certification Board (N.M.T.C.B.), the American Society of Clinical Pathologists (NM) (A.S.C.P.).

3) Radiation Therapy Technology

- The American Registry of Radiologic Technologists (T) (A.R.R.T.).

4) Chiropractic Radiography

- American Chiropractic Registry of Radiologic Technologists (ACRRT), provided that the examination was administered after June 30, 1984.

c) Examinations in Limited Diagnostic Radiography - Applicants for accreditation in one or more areas of limited diagnostic radiography shall have passed a written examination on general radiography topics and a written or practical examination specific to the type of limited accreditation sought. All written examinations shall be approved by and scheduled through the Department. The passing score for written examinations shall be a scaled score of 75 percent. All practical examinations shall cover items prescribed by the Department. Practical examinations may be administered by a technologist who holds active accreditation in radiography and is a full-time faculty member of an approved program as defined in Section 401.80 or by a licensed practitioner, certified as a radiologist by the American Board of Radiology, the American Osteopathic Board of Radiology, or the American Chiropractic Board of Radiology. Practical examinations shall be graded on a pass/fail basis on forms provided by the Department.

d) For Active Status Accreditation, examinations by other certifying organizations shall be accepted upon written request to the Department, provided that the Department finds that the certifying organization has met the National Commission for Health Certifying Agencies (NCHCA) requirements. (Publication Title: Perspectives on Health Occupational Credentialing) Contract #232-78-0187, dated September 30, 1979, DHHS Publication No. (HRA) 81-4, U.S. Government Printing Office, Washington, D. C. 20402.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.80 Approved Program

a) The Department shall base its approval of didactic and clinical education for Medical Radiography, Nuclear Medicine Technology, or Radiation Therapy Technology on the standards accepted by the Committee on Allied Health Education and Accreditation (CAHEA). (Specific information concerning these standards is available from the Committee on Allied Health Education and Accreditation of the American Medical Association and from the Department. These standards are entitled: Essentials and Guidelines of an Accredited Education Program for the Radiation Therapy Technologist (1983); Essentials and Guidelines of an Accredited Educational Program for the Radiographer (1983); Essentials of an Accredited Educational Program for the Nuclear Medicine Technologist (1984), and do not include subsequent amendments or editions).

b) The Department shall base its approval of didactic and clinical education in Chiropractic Radiography on the standards accepted by the Chiropractic Council on Education (CCE), published January 27, 1985, exclusive of subsequent amendments or editions. Specific information concerning these standards is available from the Department or from the Chiropractic Council on Education, 3209 Ingersoll Avenue, Des Moines, Iowa 50312. Student exemption for persons enrolled in an approved Chiropractic Radiography program shall not exceed 12 months.

c) The Department shall base its approval of didactic and clinical education in Limited Diagnostic Radiography on standards contained in the "Curriculum Guide for Limited Permittee Programs", June 1987, exclusive of subsequent amendments or editions. Copies of these standards are available from the American Society of Radiologic Technologists, 15000 Central Avenue South East, Albuquerque, New Mexico, 87123. Students-in-training in Limited Diagnostic Radiography shall be registered with the Department on forms provided by the Department. Registration with the Department shall include application and payment of applicable fees for examination. Students-in-training in Limited Diagnostic Radiography shall not begin application of ionizing radiation to humans prior to the Department's approval of the student's proposed training as identified through the student-in-training registration process. The Department shall refuse to register an individual as a student-in-training when the party(s) responsible for the training of said student has demonstrated poor training of students as evidenced by either a cumulative failure rate in excess of 50 percent of the trainer's students or two consecutive students who fail the examinations specified in Section 401.70(c). If the employer is not identified as the party responsible for training the student, the Department shall register an individual as a student-in-training in the employer's practice only if the student is concurrently enrolled in a program that meets the minimum requirements for a training program in limited radiography established by the Joint Review Committee on Education in Radiologic Technology, published 1990, by the Joint Review Committee on Education, 20 N. Wacker Drive, Suite 900, Chicago, Illinois 60606-2901. Students-in-training in Limited Diagnostic Radiography shall take the appropriate written or written and practical examinations not later than the eighth month of training. Students shall not perform radiographic procedures beyond the 16 months of training unless the required examinations have been passed.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.90 Practice Requirement - Initial Licensure (Repealed)

(Source: Repealed at 9 Ill. Reg. 2499, effective February 13, 1985)

Section 401.100 Initial Issuance of Accreditation

a) The Department shall issue Active Status Accreditation in a category of medical radiation technology to persons who have passed an examination as indicated in Section 401.70(b). Active Status Accreditation issued after January 1, 1988, shall be valid for two years from the date of issuance.

b) The Department shall issue Temporary Accreditation in a category of medical radiation technology and chiropractic radiography to persons who are awaiting an examination in accordance with Section 401.70(b) and have completed an approved program. Applicants for Temporary Accreditation must provide specific evidence of the intent to take such an examination, the category of examination to be taken, and the date on which the examination will be taken. Temporary Accreditation shall convey the same rights as the Active Status Accreditation for which the individual is awaiting examination. Temporary Accreditation shall be valid until such time as the individual successfully completes the appropriate examination and applies for and is issued Active Status Accreditation in accordance with subsection (a), but in no instance longer than twenty-four (24) months from the date of issuance for medical radiation technology and no longer than twelve (12) months from the date of issuance for chiropractic radiography.

c) The Department shall issue Conditional Accreditation Type I in a category of medical radiation technology upon determining that community hardship exists. When making a determination of the existence of community hardship, the Department will consult Health Systems Agencies or County or Local Health Departments, and will evaluate the availability of alternative radiology services and trained personnel. In addition, the Department shall require the applicant's employer or prospective employer to demonstrate that recruitment of qualified personnel, at competitive compensation, has been attempted and unsuccessful. Such demonstration can take the form of documented advertising in publications intended to reach radiologic technologists. If based on the information submitted, the Department determines that qualified personnel cannot be recruited, and that the people in the locality in which the conditional accreditation is sought would be denied adequate health care because of the unavailability of appropriately accredited persons, the Department shall issue Conditional Accreditation Type I which shall be valid for a period of twenty-four (24) months from the date of issuance.

d) The Department shall issue Conditional Accreditation Type II in a category of medical radiation technology to any person who, twenty-four (24) months prior to July 1, 1989, was employed in medical radiation technology and who otherwise does not meet the qualifications for accreditation. Conditional accreditation issued pursuant to this Section shall be valid for two years from date of issuance. Issuance shall be contingent upon submitting a written Statement of Assurance that the person is competent to apply ionizing radiation to human beings. A Statement of Assurance submitted to the Department in accordance with this Section shall specify the nature of the equipment and procedures which the individual is competent to utilize. The Statement of Assurance must be provided by a licensed practitioner under whose supervision the individual is employed or has been employed at some time within the last twelve months. Conditional accreditation which is issued pursuant to this Section shall be specific to the procedures and equipment indicated in the Statement of Assurance. An individual who is accredited in accordance with this Section may expand the accreditation to additional procedures and/or equipment by receiving training in accordance with Section 401.30(c)(3). After such training, the individual may submit an additional Statement of Assurance from a licensed practitioner under whose supervision the individual is employed as to the additional equipment and procedures which the individual is competent to utilize. However, an individual may not become accredited pursuant to the provisions of this Section for equipment or procedures outside of those in the category of initial accreditation. Nothing in this Section should be interpreted to limit an individual's right to make application for and be issued Active Status Accreditation in accordance with subsection (a). The Department shall not issue Conditional Accreditation Type II as provided by this Section after September 7, 1990. However, Conditional Accreditation Type II issued on or before September 7, 1990, is renewable in accordance with Section 401.140.

e) The Department shall issue accreditation in one or more areas of Limited Diagnostic Radiography Accreditation to persons who have passed examinations as indicated in Section 401.70(c). Such accreditation shall be valid for two years from the date of issuance.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.110 Duration of Accreditation

a) The duration of initial issuance of Active Status Accreditation, regardless of the category of medical radiation technology, shall be two (2) years. Active Status Accreditation shall be renewable for periods of two years in accordance with meeting the requirements in Section 401.140.

b) The duration of Temporary Accreditation shall not exceed two years for the categories of Radiography, Nuclear Medicine Technology, or Radiation Therapy Technology and shall not exceed one year for Chiropractic Radiography. Temporary Accreditation shall not be renewed.

c) The duration of initial issuance of Conditional Accreditation Type I shall be two years and shall be renewable thereafter for periods of two years. Such renewal shall be based on a re-evaluation by the Department of a condition of community hardship and meeting the requirements of Section 401.140.

d) The duration of initial issuance of Conditional Accreditation Type II shall be two years. This accreditation shall be renewable for periods of two years in accordance with meeting the requirements in Section 401.140. The renewed accreditation shall be specific to the procedures and equipment indicated in the most recent Statement of Assurance which has been presented to the Department in accordance with Section 401.100(d).

e) The duration of initial issuance of accreditation in Limited Diagnostic Radiography shall be two years. This accreditation shall be renewable for periods of two years in accordance with meeting the requirements in Section 401.140.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.120 Suspension and Revocation of Accreditation

a) The Department shall act to suspend or revoke an individual's accreditation for any one or a combination of the following causes:

1) Knowingly causing a material misstatement or misrepresentation to be made in the application for initial accreditation or renewal of accreditation if such misstatement or misrepresentation would impair the Department's ability to assess and evaluate the applicant's qualifications for accreditation under this Part;

2) Wilfully evading the statute or regulations pertaining to accreditation, or wilfully aiding another person in evading such statute or regulations pertaining to accreditation;

3) Having been convicted of a crime which is a felony under the laws of this State or conviction of a felony in a federal court, unless such individual demonstrates to the Department that he/she has been sufficiently rehabilitated, by restoration of all civil rights, to warrant the public trust;

4) Exhibiting significant or repeated incompetence in the performance of professional duties;

5) Having a physical or mental illness or disability which results in the individual's inability to perform professional duties with reasonable judgment, skill and safety;

6) Continuing to practice medical radiation technology when knowingly having a potentially serious disease, such as those listed in 77 Ill. Adm. Code 690.100, which could be transmittable to patients;

7) Repeatedly using alcohol, narcotics or stimulants to such an extent as to impair the performance of professional duties;

8) Having had a similar credential by another state or the District of Columbia suspended or revoked if the grounds for that suspension or revocation are the same or equivalent to one or more grounds for suspension or revocation as set forth herein.

b) If, based upon any of the above grounds, the Department determines that action to suspend or revoke accreditation is warranted, the Department shall notify the individual and shall provide an opportunity for a hearing in accordance with 32 Ill. Adm. Code 200.60. An opportunity for a hearing shall be provided before the Department takes action to suspend or revoke an individual's accreditation unless the Department finds that an immediate suspension of accreditation is required to protect against immediate danger to the public health or safety,(Ill. Rev. Stat. 1985, ch. 111 1/2, par. 222), in which case the Department shall suspend an individual's accreditation pending a hearing.

c) If the Department finds that removal of accreditation is warranted, the usual action shall be a suspension of accreditation for up to one year. The term of suspension may be reduced by the Director, upon the recommendation of the hearing officer, if the hearing officer finds, based upon evidence presented to him/her at a hearing, that the conditions leading to the Preliminary Order for Suspension can be cured in less than one year. However, if the Department finds that the causes are of a serious or continuous nature, such as past actions which posed an immediate threat to public health or safety or deficiencies that cannot be cured within one year, the Department shall revoke the individual's accreditation.

d) When an individual's accreditation is suspended or revoked, the individual shall surrender his/her credential to the Department until the termination of the suspension period or until reissuance of the accreditation.

e) An individual whose accreditation has been revoked may seek reinstatement of accreditation by filing a petition for reinstatement with the Department which complies with the requirements of 32 Ill. Adm. Code 200.40. Such petition may be filed one year or more after the beginning of the revocation period. The individual shall be afforded a hearing in accordance with 32 Ill. Adm. Code 200 and shall bear the burden of proof of establishing that the accreditation should be reinstated due to rehabilitation or other just cause.

(Source: Amended at 10 Ill. Reg. 21086, effective January 1, 1987)

Section 401.130 Fees

a) The fees for accreditation in all categories shall be non- refundable and shall be as follows:

1) For applications filed before January 1, 1991:

A) Initial Accreditation - Active, Conditional or Temporary Status: $30.00 per application

B) Renewal of Accreditation - Active and Conditional Status: $30.00 per application

2) For applications filed on or after January 1, 1991:

A) Initial Accreditation - Active, Conditional, Temporary or Limited Status: $40.00 per application

B) Renewal of Accreditation - Active, Conditional, or Limited Status: $40.00 per application

3) Examination fee for Limited Diagnostic Radiography Accreditation shall be $30.00.

b) The appropriate fees are to accompany the application when filing with the Department. An application is filed on the date that it is received by the Department or on the date that it is postmarked by the United States Postal Service, whichever is earlier.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.140 Requirements for Renewal of Accreditation

a) Prerequisites

1) An individual must make application for renewal of accreditation on or before the expiration date of the accreditation. Accreditation shall lapse if not renewed within this time period. An individual may not legally perform medical radiation technology without valid accreditation. Nothing in this Section shall be interpreted to preclude an individual from seeking the renewal of lapsed accreditation.

2) Each applicant shall submit a complete and legible application with the fee for renewal of accreditation in accordance with Section 401.130. Submission of an application for renewal shall hold the prior accreditation valid until such time as the Department acts to grant or deny renewal of accreditation. The Department will grant or deny renewal of accreditation within ninety (90) days of receipt of application for renewal.

b) Continuing Education Requirements

All applicants for renewal of accreditation, regardless of the category or status of accreditation sought to be renewed, must provide evidence of having participated in an approved program of continuing education as indicated below:

1) The required effort in continuing education per year for each category of medical radiation technology, applicable to each year elapsed since the most recent date of issuance of accreditation is as follows:

A) Radiography 12 units

B) Nuclear Medicine Technology 12 units

C) Radiation Therapy Technology 12 units

D) Chiropractic Radiography 12 units

E) Limited Diagnostic Radiography 6 units

2) The continuing education effort may be averaged during the period to which the requirement applies and shall be prorated by month. Individual courses may be applicable to more than one category of accreditation. The Department will base its approval on the relevance of the course work or training to the category or categories of current accreditation. In establishing relevancy, the Department will use standards such as are accepted by Verification of Involvement in Continuing Education (V.O.I.C.E.), Evidence of Continuing Education (E.C.E.), Continuing Medical Education (C.M.E.), and Continuing Education Units (C.E.U.). The Department will also accept relevant course work from accredited colleges and universities to satisfy this requirement.

3) Credit for continuing education other than as indicated above shall be granted by the Department if the individual or activity sponsor seeks approval of the course or activity and the Department finds that the course or activity will be consistent with courses approved in accordance with Section 401.140(b)(1).

4) The basis for a unit of continuing education credit shall be the contact hour (50 minutes) of lecture. Activity other than lecture shall be approved for credit by the Department based upon the standards of subsection (b)(2).

5) In each category of accreditation the applicant for renewal shall have completed a minimum of 6 units of continuing education for each year elapsed since the most recent date of issuance of accreditation in continuing education in subject matter directly related to radiologic sciences. The balance of the requirement may be accomplished either in subject matter directly related to radiologic sciences or in subject matter directly related to patient care in the radiologic environment.

AGENCY NOTE: Applicants may refer to Appendix B for examples of specifically related continuing education subjects.

c) Nonrenewal of Accreditation

1) The Department shall not renew an individual's accreditation if he/she fails to present satisfactory evidence that he/she possesses the necessary qualifications for accreditation, and that he/she has participated in an approved continuing education program in accordance with this Part.

2) If the Department does not find satisfactory evidence that the individual meets these requirements, the Department shall, within ninety (90) days of receipt of the application for renewal of accreditation, send the individual a Notice of Intent Not to Renew Accreditation. This notice shall include the area(s) of deficiency and the individual's rights as set forth in this Section.

3) The individual may, within fifteen (15) days of the date of receipt of the Notice of Intent Not to Renew Accreditation, resubmit an application for renewal of accreditation which provides additional information to the Department in order to establish that the identified area(s) of deficiency have been met or corrected. The Department shall act upon such resubmission within thirty (30) days of receipt. Submission of such an application shall hold the prior accreditation valid until the Department acts on the application.

4) After receipt of a Notice of Intent Not to Renew Accreditation in accordance with subsections (2) or (3), the individual may request a hearing. Such request must be made within thirty (30) days of the date of receipt of the Notice of Intent Not to Renew Accreditation. The hearing shall be held in accordance with 32 Ill. Adm. Code 200, except that the applicant shall have the burden of proof of establishing that he/she has met the necessary qualifications for renewal of accreditation. Submission of a request for a hearing shall hold the prior accreditation valid until the individual's receipt of a decision pursuant to the hearing.

5) If the applicant does not request a hearing within thirty (30) days of receipt of a Notice of Intent Not to Renew Accreditation in accordance with subsections (2) or (3), the Department shall issue a Notice of Nonrenewal.

6) An individual's current credential shall be invalid as of the date of his/her receipt of a Notice of Nonrenewal pursuant to subsection (5) or a decision issued after a hearing in accordance with subsection (4) of this Section.

7) If an individual's accreditation is not renewed, he/she shall have the right at any time to submit an application for renewal of accreditation. Such application shall be reviewed and processed in accordance with the requirements of this Section except that an individual may not legally apply ionizing radiation to human beings until and unless the Department has acted to grant such application for renewal of accreditation.

(Source: Amended at 15 Ill. Reg. 7054, effective April 29, 1991)

Section 401.150 Reciprocity

The Department shall accredit an out-of-state applicant provided that:

a) The applicant holds a current credential as a Medical Radiographer, Nuclear Medicine Technologist, Radiation Therapy Technologist, Chiropractic Radiographic Assistant or Podiatric Radiographic Assistant issued by another state or jurisdiction; and

b) The standards and procedures for credentialing in the state or jurisdiction which issued the credential afford the same or comparable credentialing standards as those afforded by the Illinois statute and regulations; and

c) The applicant presents the credential to the Department; and

d) The applicant submits the appropriate application fee in accordance with Section 401.130.

(Source: Amended at 14 Ill. Reg. 15341, effective September 4, 1990)

Section 401.160 Minimum Course of Education (Repealed)

(Source: Repealed at 9 Ill. Reg. 2499, effective February 13, 1985)

Section 401.170 Civil Penalties

a) The Department shall assess civil penalties, in accordance with subsections (c) and (d), against any person who performs, and against the operator of the radiation installation where a person performs, medical radiation procedures without valid accreditation, unless the person performing the medical radiation procedures is specifically exempt from the accreditation requirements as specified in Section 401.30.

b) Prior to assessing civil penalties, the Department shall confirm the violation of the accreditation requirements by:

1) Observation of the violation by a Departmental Inspector or nondepartmental inspector;

2) Obtaining records, documents, or other physical evidence;

3) Obtaining statements from either the employer, or the employee which confirm the existence of the violation; or

4) Obtaining statements from third parties, e.g., patients or co-workers, that corroborate the allegation that a violation has occurred.

c) Civil Penalties shall be assessed against persons who perform medical radiation procedures without accreditation (i.e., unaccredited technologists) as follows:

1) First violation by an unaccredited technologist - $250.

2) Second violation by an unaccredited technologist - $500.

3) Third and subsequent violations by an unaccredited technologist - $1,000.

d) Civil Penalties shall be assessed against the operators of a radiation installation where a person performs medical radiation procedures without valid accreditation as follows:

1) First violation by an operator - $500.

2) Second and subsequent violations by an operator, within a 12 month period - $1,000.

e) The Department shall impose civil penalties by issuing a Preliminary Order and Notice of Opportunity for Hearing as provided in 32 Ill. Adm. Code 200.60. Each day the violation continues shall constitute a separate offense.

f) Failure of an operator of a radiation installation to abate an accreditation violation or to pay a properly assessed civil penalty, shall cause the Department to issue an order prohibiting the use of any source of radiation at the installation until such time as the violation has been abated and all assessed civil penalties have been paid.

(Source: Amended at 13 Ill. Reg. 15005, effective September 11, 1989)

Section 401.APPENDIX A Limited Diagnostic Radiography Procedures by Type of Limited Accreditation

a) Limited Diagnostic Radiography - Chest

Chest: Routine P.A. and Lateral

Chest: Lateral Decubitus, Apical Lordotic, Obliques

b) Limited Diagnostic Radiography - Extremities

Fingers

Hand

Wrist

Forearm

Elbow

Humerus

Shoulder

Clavicle

Scapula

Toes

Foot

Ankle

Lower leg

Knee

Patella

Femur

Hip

c) Limited Diagnostic Radiography - Spine

Cervical Spine

Thoracic Spine

Lumbar Spine

Lumbosacral Spine

Sacroiliac Joints

Sacrum

Coccyx

d) Limited Diagnostic Radiography - Skull and Sinuses

Skull

Paranasal Sinuses

Mandible

Facial bones

(Source: Added at 15 Ill. Reg. 7054, effective april 29, 1991) Section 401.APPENDIX B Example Topics Directly Related to Radiologic Sciences

As referenced in Section 401.140(b)(5), applicants may refer to this Appendix for subjects relating directly to radiologic sciences in completing the minimum requirements for continuing education.

(Source: Added at 15 Ill. Reg. 7054, effective April 29, 1991)