641—42.2 (136C) General requirements.
	 42.2(1) Application process. Any individual seeking certification under 641—Chapter 42 shall:
	  a.   	 Meet minimum eligibility requirements:
	 (1) 	 Graduation from high school or its equivalent.
	 (2) 	 Attainment of 18 years of age.
	 (3) 	 Ability to adequately perform necessary duties without constituting a hazard to the health or safety of patients or operators.
	  b.   	 Satisfactorily complete an agency-approved training program.
	  c.   	 Satisfactorily complete an agency-approved examination.
	  d.   	 Upon completion of “b” and “c,” apply to the agency for a permit to practice, and pay the fees as specified in 641—subrule 38.8(6).
	  e.   	 Submit an annual renewal application which includes the fees specified in 641—subrule 38.8(6).
	  f.   	 Report continuing education as required in 42.2(3).
	  g.   	 Post the permit at the individual’s place of employment.
	  h.   	 As a diagnostic radiographer, work only under the supervision of a licensed practitioner as defined in 641—38.2(136C); as a nuclear medicine technologist, work only under the supervision of an authorized user as defined in 641—41.2(136C); or as a radiation therapist, work only under the supervision of a licensed physician or authorized user as defined in 641—41.2(136C).
	  i.   	 Submit a written report of any misdemeanor or felony, any disciplinary action brought against the individual in connection with a certificate or license issued from a certifying or licensing entity, or any disciplinary action brought against the individual by an employer or patient.
	  j.   	 For podiatric radiographers only, follow the application process in 42.7(4).
	 42.2(2) Disciplinary grounds and actions. The procedures for administrative enforcement actions are found in 641—38.9(136C) and 38.10(136C). The following shall be grounds for disciplinary action involving possible probation, suspension, revocation, or denial of certification, levying of fines or other sanctions:
	  a.   	 Operating as a diagnostic radiographer, podiatric radiographer, radiologist assistant, nuclear medicine technologist, or radiation therapist without meeting the requirements of this chapter.
	  b.   	 Allowing any individual excluding a licensed practitioner as defined in 641—38.2(136C) to operate as a diagnostic radiographer, podiatric radiographer, radiologist assistant, nuclear medicine technologist, or radiation therapist if that individual cannot provide proof of certification by the agency.
	  c.   	 Failing to report to the agency any individual whom the certificate holder knows is in violation of this rule.
	  d.   	 Submitting false information in order to obtain certification or renewal certification as a diagnostic radiographer, podiatric radiographer, radiologist assistant, nuclear medicine technologist, or radiation therapist.
	  e.   	 Any action that the department determines may jeopardize the public, other staff, or certificate holder’s health and safety. These actions shall include but not be limited to:
	 (1) 	 Any medical condition which may impair or limit the individual’s ability to perform diagnostic radiography, nuclear medicine procedures, or radiation therapy;
	 (2) 	 Activity related to illegal or improper use of drugs or other chemical substances;
	 (3) 	 A misdemeanor or felony which may impair or limit the individual’s ability to perform diagnostic radiography, nuclear medicine procedures, or radiation therapy;
	 (4) 	 Any disciplinary action brought against the individual in connection with a certificate or license issued from a certifying or licensing entity;
	 (5) 	 Being found guilty of incompetence or negligence during the certificate holder’s performance as a certificate holder;
	 (6) 	 Performing diagnostic radiography, radiation therapy, or nuclear medicine procedures without either supervision or a written order of a licensed practitioner;
	 (7) 	 Interpreting and rendering a diagnosis based on a diagnostic image for a physician, a patient, the patient’s family, or the public.
	  f.   	 Performing procedures not allowed under the individual’s current certification.
	  g.   	 Failing to pay fees or costs required to meet the requirements of this chapter. Penalties for working without a current permit will be considered on a case-by-case basis.
	  h.   	 Failure to respond to an audit request or failure to provide proper documentation.
	  i.   	 Submitting false information to a facility that might place the facility in noncompliance with 641—Chapters 38 to 41.
	  j.   	 Violating any of the rules of 641—Chapters 38 to 42.
	 42.2(3) Continuing education.
	  a.   	 Each individual who is certified under these rules shall, during a two-year period, obtain continuing education credit as follows:
	 (1) 	 General diagnostic radiographer: 24 clock hours, 1.0 hour must be in radiation protection. Subjects must be directly related to general diagnostic radiography as defined in 42.1(2) and approved by the agency.
	  1. 	 Individuals holding an additional category in CT, as specified in 42.2(9), must complete 6.0 of the 24.0 hours in CT-related courses.
	  2. 	 Individuals not holding the additional category in CT may not submit continuing education hours in CT.
	 (2) 	 Limited in-hospital diagnostic radiographer: 24 clock hours, 1.0 hour must be in radiation protection.
	 (3) 	 Limited diagnostic radiographer: 12 clock hours, 1.0 hour must be in radiation protection.
	 (4) 	 General nuclear medicine technologist: 24 hours total.
	  1. 	 One clock hour in principles of radiation protection and exposure each year, a total of two hours each two-year period.
	  2. 	 One clock hour in quality assurance each year, a total of two hours each two-year period.
	  3. 	 The remaining 20 clock hours of continuing education in each two-year period must be in subjects directly related to nuclear medicine procedures as defined in 42.1(2) and approved by the agency.
	  ● 	 Individuals holding an additional category in CT, as specified in 42.2(9), must complete 6.0 of the 24.0 hours in CT-related courses.
	  ● 	 Individuals not holding the additional category in CT may not submit continuing education hours in CT.
	 (5) 	 Limited nuclear medicine technologists: 12 hours total, 1.0 hour must be radiation protection and 1.0 hour must be in quality assurance.
	 (6) 	 Radiation therapist, dosimetrist, simulation therapist: 24.0 clock hours, 1.0 hour must be in radiation protection. Continuing education courses must be directly related to radiation therapy as defined in 42.1(2) and approved by the agency.
	  1. 	 Individuals holding an additional category in CT, as specified in 42.2(9), must complete 6.0 of the 24.0 hours in CT-related courses.
	  2. 	 Individuals not holding an additional category in CT may not submit continuing education hours in CT.
	 (7) 	 Rescinded IAB 8/1/07, effective 9/5/07.
	 (8) 	 Radiologist assistant: See 641—42.6(136C).
	 (9) 	 Podiatric radiographer: See 42.7(5).
	  b.   	 Continuing education course approval.
	 (1) 	 Information must be submitted in writing and must provide sufficient detail to show that the course meets the relevancy requirements of these rules and the agency guidelines.
	 (2) 	 Following its review, the agency will, in consultation with or under predetermined guidance of the technical advisory committee, approve, disapprove, or request additional information on the proposed course.
	 (3) 	 The agency may audit any continuing education course to verify the adequacy of program content and delivery.
	 (4) 	 Courses must be at least one clock hour in length and if lasting more than one hour, will be assigned credit in half-hour increments to the closest half-hour.
	 (5) 	 No continuing education credit is approved for passing an initial certification examination or for basic CPR, hands-on practice, mandatory abuse reporting, or ultrasound or MRI courses that are less than 50 percent directly related to radiography, nuclear medicine, or radiation therapy.
	 (6) 	 One-half hour of credit will be granted for each hour of formal demonstration of equipment by the application specialist. Content must be company-specific but not site-specific. Credit is limited to 50 percent of the total hours required.
	 (7) 	 Courses will be approved for a three-year period and may be given anytime within the three-year period.
	  c.   	 Continuing education credit will be awarded under provisions of 42.2(3) by the department to individuals:
	 (1) 	 Who have successfully completed a continuing education course which has been approved by the department.
	 (2) 	 Who present a department-approved continuing education course to individuals certified in the presenter’s field. Credit granted shall be at a rate of two times the amount of time it takes to present the course up to a maximum of 50 percent of the total hours required.
	 (3) 	 Only once during a two-year period for the same continuing education course.
	 (4) 	 Who complete 12.0 hours of tumor boards each two-year reporting period. Tumor board credit is limited to general radiographers, nuclear medicine technologists, and radiation therapists.
	 (5) 	 Who complete all credit hours in self-studies. A self-study may not be repeated in subsequent reporting periods.
	 (6) 	 Who pass an advanced ARRT certification examination in a permit-related area. Twenty-four hours will be granted.
	  d.   	 Continuing education must be directly related to the area of practice of the operator attending the program. Twenty-five percent of the total hours required may be in “special category.”
	  e.   	 Proof of continuing education must be maintained for at least three years. Proof of continuing education may be a sign-in sheet, certificate, or answer sheet. It must be signed and dated by the presenter, program representative, or the individual’s supervisor. Individuals authorized for mammography must meet the records requirements in 641—41.6(136C) and 641—41.7(136C).
	  f.   	 All continuing education requirements shall be completed during the two-year period prior to the certification continuing education due date.
	  g.   	 Late submission of continuing education requirements.
	 (1) 	 For any individual who completes the required continuing education before the continuing education due date but fails to submit the required proof within 30 days after the continuing education due date, the certification shall be terminated and the renewal fee will not be refunded.
	 (2) 	 Any individual who fails to complete the required continuing education before the continuing education due date but submits a written plan of correction to obtain the required hours and the fee required in 641—paragraph 38.8(6)“c” shall be allowed no more than 60 days after the original continuing education due date to complete the plan of correction and submit the documentation of completion of continuing education requirements. After 60 days, the certification shall be terminated and the individual shall not function as a diagnostic radiographer, radiation therapist, nuclear medicine technologist, radiologist assistant, or podiatric radiographer in Iowa.
	 (3) 	 Once certification has been terminated, any individual who requests permission to reestablish certification within six months of the initial continuing education due date must submit proof of continuing education hours and shall submit a late fee as set forth in 641—paragraph 38.8(6)“c” in addition to the annual fee set forth in 641—paragraph 38.8(6)“a” in order to obtain reinstatement of certification.
	 42.2(4) Recertification.
	  a.   	 If an individual allows the certification to expire for any reason or if any individual voluntarily terminates certification, the following will apply:
	 (1) 	 Any individual who wishes to regain certification and makes application within six months of the termination date will be allowed to do so with no additional training or testing required but must complete any delinquent continuing education.
	 (2) 	 Any individual who wishes to regain certification after the six-month period will need to meet the current educational and testing requirements for that particular certification. Proof of possession of a previous certification may satisfy the training portion of this requirement.
	 (3) 	 Any individual who has not renewed certification for at least two years and wants to regain certification, or who has not applied for certification within two years of the completion date of the original training course, will need to complete a recertification program approved by the department of not less than 24 contact hours for general certifications and 12 contact hours for limited certifications which specifically applies to the area of certification.
	 (4) 	 Podiatric radiographers must meet the requirements of 42.7(6).
	  b.   	 Recertification programs.
	 (1) 	 The recertification program must review those basic principles necessary to ensure minimum competency in the certification area and must also include the satisfactory completion of a written examination. Both the program and the examination must acquire prior approval from the department. Courses designed for use in the recertification program will not qualify for continuing education credit for those individuals required to attend in order to recertify.
	 (2) 	 If no approved programs are available, the department may require attendance for a minimum of 24 contact hours for general certifications and 12 hours for limited certifications at specific continuing education programs. The continuing education must be confined to subjects which apply to the area of certification limitation, if any, and would have to be completed within a specified time period.
	  c.   	 Exemptions. Any or all of the above-mentioned requirements may be waived for an individual who has been actively employed in the certification area in another state, country, or federal institution or who can prove circumstances above and beyond the norm. These cases will be reviewed on an individual basis and the decision of the department shall be final.
	  d.   	 Training programs. Rescinded IAB 4/3/02, effective 5/8/02.
	  e.   	 Upon the completion of the recertification training, the following must be submitted:
	 (1) 	 A statement of competency from the trainer.
	 (2) 	 A statement of permission to allow a representative of the department to comprehensively evaluate whether the individual meets the training standard.
	 42.2(5) Fees. Rescinded IAB 4/11/07, effective 5/16/07.
	 42.2(6) Training programs.
	  a.   	 Any individual wishing to train an individual as a diagnostic radiographer, nuclear medicine technologist, or radiation therapist must submit a training program to the agency for approval. This provision includes individuals providing clinical training for out-of-state students. For radiologist assistants, see 641—42.6(136C). For podiatric radiographers, see 641—42.7(136C). No training may be started until written approval from the agency is received. The training request must provide, at a minimum, the following:
	 (1) 	 An outline of the didactic and clinical studies to meet the requirements of 42.3(1), 42.4(2), or 42.5(2), as applicable.
	 (2) 	 Listed body parts to be taught if this is a limited radiography training program. Procedures are limited to chest, extremities, spinal, or sinus radiography.
	 (3) 	 Proof that:
	  1. 	 The instructor of a general training program meets the requirements of this chapter as a two-year educated diagnostic radiographer, nuclear medicine technologist, or radiation therapist holding a current Iowa general permit to practice and having at least two years of current experience or is a licensed physician trained in the specific area of the training program.
	  2. 	 The instructor of a limited training program meets the following:
	  ● 	 The principal instructor of a limited training program is a general radiographer holding a current Iowa permit to practice and having at least two years of current experience or is a licensed physician trained in the specific area of the training program.
	  ● 	 The on-site clinical instructor is a general radiographer holding a current Iowa permit to practice and having at least two years of current experience or is a limited radiographer holding a current Iowa permit to practice in the area of instruction and having at least two years of current experience. On-site clinical instructors shall be supervised by the principal instructor.
	 (4) 	 A time schedule of the training program. The projected completion date of the clinical portion of the program or course of study shall be within a time period equal to or less than twice that required for the original program or course of study.
	 (5) 	 A description of the testing to be used to determine proficiency of the didactic portion and the mechanism to be used to determine clinical competency. All clinical competency testing shall be conducted by the principal instructor.
	 (6) 	 A statement of permission to allow a representative of the agency to periodically evaluate the progress of the student. The agency will evaluate all non-school students.
	 (7) 	 A statement that the student will be directly supervised until the student’s competency is documented and indirectly supervised after the student’s competency is documented.
	  b.   	 Upon the completion of the training program, the following must be submitted to the agency:
	 (1) 	 A statement of competency from the trainer for each area completed.
	 (2) 	 A statement of permission to allow a representative of the agency to comprehensively evaluate whether the individual meets the training standard.
	  c.   	 Additional training for limited radiographers wishing to perform pediatric radiography. Training requires a general radiographer to submit to the agency a training program that includes the additional anatomy and physiology, positioning, radiation protection, technique, and film critique necessary for pediatrics. The training must include both chest and extremities but no spinal radiography. The program must include didactic instruction plus film critique time. Upon completion of training, the general radiographer must submit a letter of competency to the agency. No additional testing will be required.
	 42.2(7) Requirements for operators of dual imaging devices.
	  a.   	 When a unit is operated as a stand-alone nuclear medicine imaging device, the operator must have a permit to practice as a nuclear medicine technologist and meet the requirements of 641—42.4(136C).
	  b.   	 When the unit is operated as a stand-alone CT imaging device, the operator must have a permit to practice as a general diagnostic radiographer, nuclear medicine technologist, or radiation therapist and meet the requirements of 42.2(9).
	  c.   	 When a unit is operated in dual mode as a SPECT/CT or PET/CT device, the operator must have a permit to practice as a nuclear medicine technologist and meet the requirements of 42.2(9).
	 42.2(8) Examinations. All individuals seeking certification under 641—Chapter 42 must pass a written examination before the permit can be issued. The individual is allowed to practice under the direct supervision of a licensed practitioner, an authorized user listed on a radioactive materials license, or a permitted individual with the permit in the same or higher category until the permit is issued provided the test is pending. Individuals who fail the examination three times will be required to satisfactorily complete the training course again.
	 42.2(9) Specific requirements for CT certification.
	  a.   	 Operators of CT units must meet the following requirements:
	 (1) 	 Hold certification as a general diagnostic radiographer, radiation therapist, or nuclear medicine technologist;
	 (2) 	 Complete the manufacturer’s training or an agency-approved equivalent training course. Training must include equipment operation, contrast media, sectional anatomy, and CT radiation protection and be at least 15.0 hours in length. Initial training may be used as continuing education in the reporting period taken if approved by the agency. Passing the ARRT certification examination in CT will meet the training requirement; and
	 (3) 	 Complete 6.0 hours of continuing education in CT-related subjects each two-year reporting period. These hours may be a part of the 24.0 hours of continuing education required in 42.2(3)“a”(1), (4), and (6).
	  b.   	 Proof of initial training shall be forwarded to the agency for review.
	  c.   	 “CT” must be on the individual’s permit in order for the individual to perform CT scans.