HF 3794

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 03/09/2020 05:29pm

A bill for an act
relating to health; changing x-ray provisions; amending Minnesota Statutes 2018,
section 144.121, subdivisions 1, 2, 5, by adding subdivisions; Minnesota Statutes
2019 Supplement, section 144.121, subdivisions 1a, 5a; repealing Minnesota
Statutes 2018, section 144.121, subdivisions 3, 5b.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 144.121, subdivision 1, is amended to read:

Subdivision 1.

Registration; fees.

The fee for the registration for x-ray deleted text begin machines deleted text end new text begin
equipment new text end and other sources of ionizing radiation required to be registered under rules
adopted by the state commissioner of health pursuant to section 144.12, shall be in an amount
as described in subdivision 1a pursuant to section 144.122. The registration shall expire and
be renewed as prescribed by the commissioner pursuant to section 144.122.

Sec. 2.

Minnesota Statutes 2019 Supplement, section 144.121, subdivision 1a, is amended
to read:

Subd. 1a.

Fees for ionizing radiation-producing equipment.

(a) A facility with ionizing
radiation-producing equipment new text begin and other sources of ionizing radiation new text end must pay an deleted text begin annual deleted text end
initial or annual renewal registration fee consisting of a base facility fee of $100 and an
additional fee for each deleted text begin radiation source deleted text end new text begin x-ray tube new text end , as follows:

(1)	medical or veterinary equipment	$	100
(2)	dental x-ray equipment	$	40
(3)	x-ray equipment not used on humans or animals	$	100
(4)	devices with sources of ionizing radiation not used on humans or animals	$	100
(5)	security screening system	$	100

(b) A facility with radiation therapy and accelerator equipment must pay an new text begin initial or
new text end annual registration fee of $500. A facility with an industrial accelerator must pay an new text begin initial
or new text end annual registration fee of $150.

(c) Electron microscopy equipment is exempt from the registration fee requirements of
this section.

(d) For purposes of this section, a security screening system means new text begin ionizing
new text end radiation-producing equipment designed and used for security screening of humans who
are in the custody of a correctional or detention facility, and used by the facility to image
and identify contraband items concealed within or on all sides of a human body. For purposes
of this section, a correctional or detention facility is a facility licensed under section 241.021
and operated by a state agency or political subdivision charged with detection, enforcement,
or incarceration in respect to state criminal and traffic laws.

Sec. 3.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:

new text begin Subd. 1d. new text end

new text begin Handheld dental x-ray equipment. new text end

new text begin A facility that uses handheld dental x-ray
equipment according to section 144.1215 must comply with this section.
new text end

Sec. 4.

Minnesota Statutes 2018, section 144.121, subdivision 2, is amended to read:

Subd. 2.

Inspections.

Periodic radiation safety inspections of the new text begin x-ray equipment and
other new text end sources of ionizing radiation shall be made by the deleted text begin state deleted text end commissioner of health. The
frequency of safety inspections shall be prescribed by the commissioner on the basis of the
frequency of use of the new text begin x-ray equipment and other new text end source of ionizing radiation deleted text begin ; deleted text end new text begin , new text end provided
that each source shall be inspected at least once every four years.

Sec. 5.

Minnesota Statutes 2018, section 144.121, subdivision 5, is amended to read:

Subd. 5.

Examination for individual operating x-ray deleted text begin equipment deleted text end new text begin systems new text end .

(a) deleted text begin After
January 1, 2008, deleted text end An individual in a facility with x-ray deleted text begin equipment deleted text end new text begin systems new text end for use on new text begin living
new text end humans that is registered under subdivision 1 may not operate, nor may the facility allow
the individual to operate, x-ray deleted text begin equipment deleted text end new text begin systems new text end unless the individual has passed a national
new text begin or state new text end examination deleted text begin for limited x-ray machine operators that meets the requirements of
paragraphs (b) and (c) and is approved by the commissioner of health deleted text end .

deleted text begin (b) The commissioner shall establish criteria for the approval of examinations based on
national standards, such as the examination in radiography from the American Registry of
Radiologic Technologists, the examination for limited scope of practice in radiography from
the American Registry of Radiologic Technologists for limited x-ray machine operators,
and the American Registry of Chiropractic Radiography Technologists for limited
radiography in spines and extremities; or equivalent examinations approved by other states.
Equivalent examinations may be approved by the commissioner, if the examination is
consistent with the standards for educational and psychological testing as recommended by
the American Education Research Association, the American Psychological Association,
the National Council on Measurement in Education, or the National Commission for
Certifying Agencies. The organization proposing the use of an equivalent examination shall
submit a fee to the commissioner of $1,000 per examination to cover the cost of determining
the extent to which the examination meets the examining standards. The collected fee shall
be deposited in the state treasury and credited to the state government special revenue fund.
deleted text end

new text begin (b) Individuals who may operate x-ray systems include:
new text end

new text begin (1) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiography examination;
new text end

new text begin (2) an individual who has passed the American Chiropractic Registry of Radiologic
Technologists (ACRRT) registry examination and is limited to radiography of spines and
extremities;
new text end

new text begin (3) a registered limited scope x-ray operator and a registered bone densitometry equipment
operator who passed the examination requirements in paragraphs (d) and (e) and practices
according to subdivision 5a;
new text end

new text begin (4) an x-ray operator who has the original certificate or the original letter of passing the
examination that was required before January 1, 2008, under Minnesota Statutes 2008,
section 144.121, subdivision 5a, paragraph (b), clause (1);
new text end

new text begin (5) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiation therapy examination according to subdivision 5e;
new text end

new text begin (6) a cardiovascular technologist according to subdivision 5c;
new text end

new text begin (7) a nuclear medicine technologist according to subdivision 5d;
new text end

new text begin (8) an individual who has passed the examination for a dental hygienist under section
150A.06 and only operates dental x-ray systems;
new text end

new text begin (9) an individual who has passed the examination for a dental therapist under section
150A.06 and only operates dental x-ray systems;
new text end

new text begin (10) an individual who has passed the examination under Minnesota Rules, part
3100.8500, subpart 3, and only operates dental x-ray systems;
new text end

new text begin (11) an individual who has passed the examination for a limited dental permit assistant
under section 150A.06 and only operates dental x-ray systems; and
new text end

new text begin (12) a qualified practitioner who is licensed by a health-related licensing board with
active practice authority and is working within the practitioner's scope of practice.
new text end

new text begin (c) Except for individuals under clauses (3) and (4), an individual who is participating
in a training or educational program in any of the occupations listed in paragraph (b) is
exempt from the examination requirement within the scope and for the duration of the
training or educational program.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end The new text begin Minnesota new text end examination for limited new text begin scope new text end x-ray deleted text begin machine deleted text end operators must
include:

(1) radiation protection, new text begin radiation physics and radiobiology, new text end equipment deleted text begin maintenance and deleted text end
operation new text begin and quality assurance new text end , image deleted text begin production deleted text end new text begin acquisition new text end and new text begin technical new text end evaluation, and
patient deleted text begin care deleted text end new text begin interactions new text end and management; and

(2) at least one of the following regions of the human anatomy: chest, extremities, skull
and sinus, spine, or deleted text begin ankle and foot deleted text end new text begin podiatry new text end . The examinations must include the anatomy
of, and deleted text begin positioning deleted text end new text begin radiographic positions and projections new text end for, the specific regions.

new text begin (e) The examination for bone densitometry equipment operators must include:
new text end

new text begin (1) osteoporosis, bone physiology, bone health and patient education, patient preparation,
fundamental principals, biological effects of radiation, units of measurements, radiation
protection in bone densitometry, fundamentals of x-ray production, quality control, measuring
bone mineral testing, determining quality in bone mineral testing, file and database
management; and
new text end

new text begin (2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm.
The examination must include the anatomy, scan acquisition, and scan analysis for these
three procedures.
new text end

deleted text begin (d) deleted text end new text begin (f) new text end A limited new text begin scope new text end x-ray operator new text begin , and a bone densitometry equipment operator, new text end
who deleted text begin is deleted text end new text begin are new text end required to take an examination under this subdivision must submit to the
commissioner deleted text begin an deleted text end new text begin a registration new text end application for the examination deleted text begin , deleted text end new text begin and new text end a $25 processing fee deleted text begin ,
and the required examination fee set by the national organization offering the examination deleted text end .
The processing fee deleted text begin and the examination fee deleted text end shall be deposited in the state treasury and
credited to the state government special revenue fund. deleted text begin The commissioner shall submit the
fee to the national organization providing the examination.
deleted text end

Sec. 6.

Minnesota Statutes 2019 Supplement, section 144.121, subdivision 5a, is amended
to read:

Subd. 5a.

Limited new text begin scope new text end x-ray deleted text begin machine deleted text end new text begin and bone densitometry equipment new text end operator
practice.

deleted text begin (a) deleted text end A new text begin registered new text end limited new text begin scope new text end x-ray operator new text begin and a registered bone densitometry
equipment operator new text end may only practice medical radiography on limited regions of the human
anatomy for which the operator has successfully passed an examination identified in
subdivision 5, deleted text begin unless the operator meets one of the exemptions described in paragraph (b).
The operator may practice using only routine radiographic procedures, for the interpretation
by and under the direction of a qualified practitioner, excluding deleted text end new text begin paragraphs (d) and (e) and
may not operate new text end computed tomography, new text begin cone beam computed tomography, new text end the use of contrast
media, and the use of fluoroscopic or mammographic deleted text begin equipment deleted text end new text begin x-ray systems new text end .

deleted text begin (b) This subdivision does not apply to:
deleted text end

deleted text begin (1) limited x-ray machine operators who passed the examination that was required before
January 1, 2008;
deleted text end

deleted text begin (2) certified radiologic technologists, licensed dental hygienists, registered dental
assistants, certified registered nurse anesthetists, and registered physician assistants;
deleted text end

deleted text begin (3) individuals who are licensed in Minnesota to practice medicine, osteopathic medicine,
chiropractic, podiatry, or dentistry;
deleted text end

deleted text begin (4) individuals who are participating in a training course in any of the occupations listed
in clause (2), (3), or (5) for the duration and within the scope of the training course; and
deleted text end

deleted text begin (5) cardiovascular technologists who assist with the operation of fluoroscopy equipment
if they:
deleted text end

deleted text begin (i) are credentialed by Cardiovascular Credentialing International as a registered
cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist,
are a graduate of an education program accredited by the Commission on Accreditation of
Allied Health Education Programs, which uses the standards and criteria established by the
Joint Review Committee on Education in Cardiovascular Technology, or are designated on
a variance granted by the commissioner, effective July 31, 2019; and
deleted text end

deleted text begin (ii) are under the personal supervision and in the physical presence of a qualified
practitioner for diagnosing or treating a disease or condition of the cardiovascular system
in fluoroscopically guided interventional procedures. Cardiovascular technologists may not
activate the fluoroscopic system or evaluate quality control tests.
deleted text end

Sec. 7.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:

new text begin Subd. 5c. new text end

new text begin Cardiovascular technologist practice. new text end

new text begin (a) Cardiovascular technologists may
assist with the operation of fluoroscopy equipment if they:
new text end

new text begin (1) are credentialed by Cardiovascular Credentialing International as a registered
cardiovascular invasive specialist or as a registered cardiac electrophysiology specialist,
are a graduate of an educational program accredited by the Commission on Accreditation
of Allied Health Education Programs, which uses the standards and criteria established by
the Joint Review Committee on Education in Cardiovascular Technology, or are designated
on a variance granted by the commissioner effective July 31, 2019; and
new text end

new text begin (2) are under the personal supervision and in the physical presence of a qualified
practitioner for diagnosing or treating a disease or condition of the cardiovascular system
in fluoroscopically guided interventional procedures. Cardiovascular technologists may not
activate the fluoroscopic system or evaluate quality control tests.
new text end

new text begin (b) A cardiovascular technologist who is participating in a training or educational program
in any of the occupations listed in this subdivision is exempt from the examination
requirement within the scope and for the duration of the training or educational program.
new text end

Sec. 8.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:

new text begin Subd. 5d. new text end

new text begin Nuclear medicine technologist practice. new text end

new text begin (a) Nuclear medicine technologists
who have passed the primary pathway credential in Nuclear Medicine Technology
Certification Board (NMTCB) for nuclear medicine or the American Registry of Radiologic
Technologists (ARRT) for nuclear medicine technology or the American Society of Clinical
Pathologists (NM) (ASCP) may operate a fusion imaging device or a dual imaging device
that uses radioactive material as a point source in transmission scanning and attenuation
correction.
new text end

new text begin (b) A nuclear medicine technologist in paragraph (a) may only operate a stand-alone
computed tomography x-ray system if the technologist has passed the Nuclear Medicine
Technology Certification Board for computed tomography (CT) or are credentialed in
computed tomography (CT) from the American Registry of Radiologic Technologists
(ARRT).
new text end

new text begin (c) A nuclear medicine technologist who meets the requirements under paragraph (a)
and who is participating in a training or educational program to obtain a credential under
paragraph (b) is exempt from the examination requirement within the scope and for the
duration of the training or educational program.
new text end

Sec. 9.

Minnesota Statutes 2018, section 144.121, is amended by adding a subdivision to
read:

new text begin Subd. 5e. new text end

new text begin Radiation therapy technologist practice. new text end

new text begin (a) A radiation therapy technologist
who has passed the primary pathway credential in radiation therapy may operate radiation
therapy accelerator and simulator x-ray systems.
new text end

new text begin (b) A radiation therapy technologist in paragraph (a) may only operate a stand-alone
computed tomography x-ray system if the technologist has passed and is credentialed in
computed tomography (CT) from the American Registry of Radiologic Technologists
(ARRT).
new text end

new text begin (c) A radiation therapy technologist who meets the requirements under paragraph (a)
and who is participating in a training or educational program to obtain a credential under
paragraph (b) is exempt from the examination requirement within the scope and for the
duration of the training or educational program.
new text end

Sec. 10. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 144.121, subdivisions 3 and 5b, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: H3794-1

144.121 X-RAY MACHINES; OTHER SOURCES OF IONIZING RADIATION.

Subd. 3.

Exemption.

Notwithstanding rules adopted by the commissioner under section 144.12, subdivision 1, clause (15), practitioners of veterinary medicine are not required to conduct densitometry and sensitometry tests as part of any ionizing radiation quality assurance program.

Subd. 5b.

Variance of scope of practice.

The commissioner may grant a variance according to Minnesota Rules, parts 4717.7000 to 4717.7050, to a facility for the scope of practice of an x-ray operator in cases where the delivery of health care would otherwise be compromised if a variance were not granted. The request for a variance must be in writing, state the circumstances that constitute hardship, state the period of time the facility wishes to have the variance for the scope of practice in place, and state the alternative measures that will be taken if the variance is granted. The commissioner shall set forth in writing the reasons for granting or denying the variance. Variances granted by the commissioner must specify in writing the time limitation and required alternative measures to be taken by the facility. A request for the variance shall be denied if the commissioner finds the circumstances stated by the facility do not support a claim of hardship, the requested time period for the variance is unreasonable, the alternative measures proposed by the facility are not equivalent to the scope of practice, or the request for the variance is not submitted to the commissioner in a timely manner.