Original Notice.

     Preproposal statement of inquiry was filed as WSR 02-20-074.

     Title of Rule: WAC 246-926-100 Alternative training radiologic technologists.

     Purpose: There is currently a critical shortage of certified technologists in Washington state. The proposed rule amendment will allow more individuals to successfully complete the alternative training program and gain their certification in Washington state.

     Statutory Authority for Adoption: RCW 18.84.040.

     Summary: WAC 246-926-100 is being amended to allow a radiologist or nuclear medicine physician specialist who is already providing indirect supervision to provide direct supervision when a certified radiologic technologist in the designated specialty area is unavailable to provide direct supervision as part of the clinical practice experience through the alternative training program.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Holly Rawnsley, 1300 Quince Street S.E., Olympia, WA 98504-7869, (360) 236-4941.

     Name of Proponent: Department of Health, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: The proposed rule amendment would allow the radiologist or nuclear medicine physician specialist, who is currently providing indirect supervision, to provide direct supervision as well, when a certified radiologic technologist in the specialty area being requested is not available. There is a critical shortage of certified technologists in all three areas (diagnostic, therapeutic and nuclear medicine) certified by Washington state. The proposed rule amendment will allow more individuals to successfully complete the alternative training program and gain their certification in Washington state.

     Proposal Changes the Following Existing Rules: The proposed amendment will allow a radiologist or nuclear medicine physician specialist who is already providing indirect supervision to provide direct supervision when a certified radiologic technologist in the designated specialty area is unavailable to provide direct supervision as part of the clinical practice experience through the alternative training program. Currently, the rule allows only a certified radiologic technologist in the designated specialty area to provide direct supervision.

     A small business economic impact statement has been prepared under chapter 19.85 RCW.

     II. What industries are affected? The proposed regulations affect general medical and surgical hospitals and specialty outpatient clinics that employ and provide training for radiologic technologists in the diagnostic, therapeutic and nuclear medicine specialty areas.

				Average employment
SIC	DESCRIPTION	TOTAL UNITS		TOTAL EMP		Smallest 90%		Largest 10%
8062	General medical & surgical hospital	146		78,593		6		2,028
8093	Specialty outpatient clinics	245		7,530		11		159

     III. What are the costs? The cost to use a physician supervisor may be higher than using the certified radiologic technologist supervisor because the physician supervisor would be paid at a higher rate. The radiologist or nuclear medicine specialist providing indirect supervision would typically spend forty-five minutes to review the work. By allowing them to directly supervise the procedure it would add an additional fifteen minutes of time. There would only be a net difference of fifteen minutes because they would essentially be directly and indirectly supervising at the same time. The cost for the certified radiologic technologist supervisor's time, $23.98 per hour, can be subtracted since the physician is now providing the direct supervision. The additional cost for each person certified through the alternative training program is approximately $25.

     In the past we received approximately five requests per year for approval through the alternative training program. We expect the number of requests to increase to approximately 10-15 per year. The average cost increase for the time used by a physician supervisor to supervise between 5-10 more alternative training candidates is between $126.10 and $252.20 based on the number of candidates.

     It is important to note that this is an added option to the alternative training program and is not mandatory. The stakeholders requested the revision. The rule does not require additional training, course work or equipment.

     IV. Is the cost disproportionate? The cost is not disproportionate because it does not exceed the minor cost threshold of $396.57.

     V. What cost minimizing features were included? By allowing radiologists and nuclear medicine physician specialists to provide direct as well as indirect supervision, facilities are able to utilize current staff to provide the necessary supervision. There is a shortage of qualified certified radiologic technologists and vacancies are remaining unfilled for extended lengths of time. Because certified radiologic technologists are currently the only individuals allowed to provide direct supervision, this prohibits qualified individuals from participating in the alternative training program.

     VI. How will you involve small business in the rule making? The Department of Health has maintained open communication with stakeholders, such as hospital administrators, medical doctors, educators, related associations, the general public, and individuals credentialed under chapter 18.84 RCW. These people are employed in various work settings and geographic areas.

     The Department of Health held a public rules workgroup to draft amendment language. Approximately twenty people took part in the workgroup held simultaneously in Spokane and Olympia via videoconference. The department also received written correspondence from stakeholders with comments/recommendations to the proposed draft rule amendment.

     A copy of the statement may be obtained by writing to Holly Rawnsley, Program Manager, Radiologic Technologist Program, P.O. Box 47869, Olympia, WA 98504-7869, phone (360) 236-4941, fax (360) 236-2406.

     RCW 34.05.328 applies to this rule adoption. This rule revision is significant because it changes the supervisory process to allow a broader range of staff to provide direct supervision.

     Hearing Location: Department of Health, 1101 Eastside Street, Olympia, WA 98504, on January 23, 2003, at 10:00 a.m.

     Assistance for Persons with Disabilities: Contact Holly Rawnsley by January 15, 2003, TDD (800) 833-6388 or (360) 236-4941.

     Submit Written Comments to: Holly Rawnsley, Program Manager, Radiologic Technologist Program, P.O. Box 47869, Olympia, WA 98504-7869, fax (360) 236-2406, by January 20, 2003.

     Date of Intended Adoption: January 23, 2003.

December 18, 2002

Mary C. Selecky

Secretary

OTS-6052.2

AMENDATORY SECTION(Amending Order 121, filed 12/27/90, effective 1/31/91)

WAC 246-926-100   Definitions -- Alternative training radiologic technologists.   (1) Definitions. For the purposes of certifying radiologic technologists by alternative training methods the following definitions shall apply:

     (a) "One quarter credit hour" equals eleven "contact hours";

     (b) "One semester credit hour" equals sixteen contact hours;

     (c) "One contact hour" is considered to be fifty minutes lecture time or one hundred minutes laboratory time;

     (d) "One clinical year" is considered to be 1900 contact hours.

     (e) "Immediate supervision" means the radiologist or nuclear medicine physician is in audible or visual range of the patient and the person treating the patient.

     (f) "Direct supervision" means the supervisory clinical evaluator is on the premises, is quickly and easily available.

     (g) "Indirect supervision" means the supervising radiologist or nuclear medicine physician is on site no less than half-time.

     (h) "Allied health care profession" means an occupation for which programs are accredited by the American Medical Association Committee on Allied Health Education and Accreditation, Sixteenth Edition of the Allied Health Education Directory, 1988 or a previous edition.

     (i) "Formal education" shall be obtained in postsecondary vocational/technical schools and institutions, community or junior colleges, and senior colleges and universities accredited by regional accrediting associations or by other recognized accrediting agencies or programs approved by the Committee on Allied Health Education and Accreditation of the American Medical Association.

     (2) Clinical practice experience shall be supervised and verified by the approved clinical evaluators who must be:

     (a) A certified radiologic technologist designated in the specialty area the individual is requesting certification who provides direct supervision; and

     (b) A radiologist for those individuals requesting certification in practice of diagnostic radiologic technology or therapeutic radiologic technology; or for those individuals requesting certification as a nuclear medicine technologist, a physician specialist in nuclear medicine who provides indirect supervision. The physician supervisor shall routinely critique the films and evaluate the quality of the trainees' work.

     (c) If a certified radiologic technologist designated in the specialty area is not available to provide direct supervision, the radiologist or physician specialist in nuclear medicine, who is providing indirect supervision, may also provide direct supervision. Radiologists may only supervise individuals in the diagnostic or therapeutic specialty areas. Physician specialists in nuclear medicine may only supervise individuals in the nuclear medicine specialty area.

[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-926-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.84.040. 89-01-015 (Order PM 802), § 308-183-090, filed 12/9/88.]

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