A.R.S. tit. 32 ch. 28 — Arizona Revised Statutes Title 32 Chapter 28 — Radiologic Technologists

32-2801. Definitions In this chapter, unless the context otherwise requires: 1. "Certificate" means a certificate that is granted and issued by the department. 2. "Certified technologist" means a person holding a certificate that is granted and issued by the department. 3. "Computed tomography technologist" means a person who applies ionizing radiation to a human using a computed tomography machine for diagnostic purposes. 4. "Department" means the department of health services. 5. "Direction" means responsibility for and control of the application of ionizing radiation to human beings for diagnostic or therapeutic purposes. 6. "Director" means the director of the department of health services. 7. "Ionizing radiation" means gamma rays and x-rays, alpha and beta particles, high speed electrons, neutrons, protons and other nuclear particles or rays. 8. "Leg" means that part of the lower limb between the knee and the foot. 9. "Licensed practitioner" means a person who is licensed or otherwise authorized by law to practice medicine, dentistry, osteopathic medicine, podiatry, chiropractic or naturopathic medicine in this state. 10. "Mammographic technologist" means a person who applies ionizing radiation to the breasts of a human being for diagnostic purposes. 11. "Nuclear medicine technologist" means a person who uses radiopharmaceutical agents on humans for diagnostic or therapeutic purposes as set forth in rules adopted pursuant to section 32-2815. 12. "Practical technologist in bone densitometry" means a technologist who holds a certificate to apply ionizing radiation to a person's hips, spine and extremities through the use of a bone density machine. 13. "Practical technologist in podiatry" means a person holding a practical technologist in podiatry certificate that is granted and issued by the department. 14. "Practical technologist in podiatry certificate" means a certificate that is issued to a person, other than a licensed practitioner, who applies ionizing radiation to the foot and leg for diagnostic purposes while under the specific direction of a licensed practitioner. 15. "Practical technologist in radiology" means a person holding a practical technologist in radiology certificate that is granted and issued by the department. 16. "Practical technologist in radiology certificate" means a certificate that is issued to a person, other than a licensed practitioner, who applies ionizing radiation to specific parts of the human body for diagnostic purposes while under the specific direction of a licensed practitioner. 17. "Radiation therapy technologist" means a person who uses radiation on humans for therapeutic purposes. 18. "Radiologic technologist" means a person who holds a certificate that is issued by the department and that allows that person to apply ionizing radiation to individuals at the direction of a licensed practitioner for general diagnostic or therapeutic purposes. 19. "Radiologic technology" means the science and art of applying ionizing radiation to human beings for general diagnostic or therapeutic purposes. 20. "Radiologic technology certificate" means a certificate that is issued in radiologic technology to a person with at least twenty-four months of full-time study or its equivalent through an approved program and who has successfully completed an examination by a national certifying body. 21. "Radiologist" means a licensed practitioner of medicine or osteopathic medicine who has undertaken a course of training that meets the requirements for admission to the examination of the American board of radiology or the American osteopathic board of radiology. 22. "Radiologist assistant" means a person who holds a certificate pursuant to section 32-2819 and who performs independent advanced procedures in medical imaging and interventional radiology under the guidance, directions, supervision and discretion of a licensed practitioner of medicine or osteopathic medicine specializing in radiology as set forth in section 32-2819 and the rules adopted pursuant to that section. 23. "Unethical professional conduct" means the following acts, whether occurring in this state or elsewhere: (a) Intentionally betraying a professional confidence or intentional violation of a privileged communication except as required by law. This subdivision does not prevent the department from exchanging information with the radiologic licensing and disciplinary boards of other states, territories or districts of the United States or foreign countries. (b) Using controlled substances as defined in section 36-2501, narcotic drugs, dangerous drugs or marijuana as defined in section 13-3401 or hypnotic drugs, derivatives or any compounds, mixtures or preparations that may be used for producing hypnotic effects or the use of alcohol to the extent that it affects the ability of the certificate or permit holder to practice his profession. (c) Using drugs for other than accepted therapeutic purposes. (d) Committing gross malpractice. (e) Procuring or attempting to procure a certificate or license by fraud or misrepresentation. (f) Having professional connection with or lending one's name to an illegal practitioner of radiologic technology or any other health profession. (g) Offering, undertaking or agreeing to correct, cure or treat a condition, disease, injury, ailment or infirmity by a secret means, method, device or instrumentality. (h) Refusing to divulge to the department, on reasonable notice and demand, the means, method, device or instrumentality used in the treatment of a condition, disease, injury, ailment or infirmity. This subdivision does not apply to communication between a technologist or permit holder and a patient with reference to a disease, injury, ailment or infirmity, or as to any knowledge obtained by personal examination of the patient. (i) Giving or receiving, or aiding or abetting the giving or receiving, of rebates, either directly or indirectly. (j) Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of radiologic technology. (k) Having a certificate or license refused, revoked or suspended by any other state, territory, district or country for reasons that relate to the person's ability to safely and skillfully practice radiologic technology or to any act of unprofessional conduct. (l) Engaging in any conduct or practice that does or would constitute a danger to the health of the patient or the public. (m) Obtaining a fee by fraud or misrepresentation or wilfully or intentionally filing a fraudulent claim with a third party for services rendered or to be rendered to a patient. (n) Employing uncertified persons to perform or aiding and abetting uncertified persons in the performance of work that can be done legally only by certified persons. (o) Violating or attempting to violate, directly or indirectly, or assisting or abetting the violation of or conspiring to violate this chapter or a rule adopted by the department. 24. "Unlimited practical technologist in radiology" means a person holding an unlimited practical technologist in radiology certificate that is granted and issued by the department. 25. "Unlimited practical technologist in radiology certificate" means a certificate that was issued to a person in 1977 or 1978, other than a licensed practitioner, who applies ionizing radiation to the human body for diagnostic purposes while under the specific direction of a licensed practitioner. 32-2802. Advisory committee; members; appointment; terms; compensation; meetings; removal; employees; immunity A. The director shall appoint an advisory committee to collaborate with and assist the director in performing the duties prescribed in this chapter. The director shall inform the advisory committee regarding all disciplinary actions. In addition to the director who serves as chairperson, the advisory committee shall include: 1. Four members who are practicing radiologic technologists, who have at least five years' experience and who hold radiologic technology certificates issued pursuant to this chapter. 2. Two public members. Only a person who has never been a member, or the spouse of a member, of a health care delivery profession and who has never had a material financial interest in providing health care or in a directly related activity is eligible to be a public member of the advisory committee. 3. Two members who are licensed practitioners, one of whom is a radiologist. 4. One member who is a practical technologist in radiology, who has at least five years' experience and who is a current license holder. 5. One member who is a practicing nuclear medicine technologist, who has at least five years' experience in that field and who holds an active certificate issued pursuant to this chapter. B. All advisory committee members serve a term of three years to begin and end on the third Monday of January in the appropriate year. The director shall fill a vacancy that occurs before the expiration of a term for the unexpired term. C. Each advisory committee member is eligible to receive compensation as determined pursuant to section 38-611. D. The advisory committee shall meet at least once every six months at times and places determined by the advisory committee. Special meetings also may be held at such times as the advisory committee may decide or on the call of the chairperson. A written notice of the time, place and purpose of any special meeting shall be mailed to all members of the advisory committee. E. The department may provide additional professional, technical, secretarial and clerical assistance as the advisory committee may require to carry out its functions. F. The advisory committee shall hold examinations for applicants for certificates pursuant to this chapter at least once every six months, at times and places as the advisory committee may determine. G. The director may terminate the term of an advisory committee member and declare the position vacant if the member fails to attend three consecutive advisory committee meetings. H. The advisory committee may hire practicing radiologic technologists and other medical specialists to assist it in preparing and administering examinations. These specialists shall receive the same compensation as advisory committee members. I. The advisory committee may employ temporary and permanent personnel necessary to carry out the purposes of this chapter. J. Advisory committee members, advisory committee staff and advisory committee examiners are personally immune from suit for all actions taken in good faith in furtherance of the purposes of this chapter. 32-2803. Rules The director may adopt rules as may be needed to carry out the purposes of this chapter. The rules shall include: 1. Minimum standards of training and experience for persons to be certified pursuant to this chapter and procedures for examining applicants for certification. 2. Provisions identifying the types of applications of ionizing radiation for a practical technologist in podiatry, practical technologist in radiology, practical technologist in bone densitometry, radiologic technologist, radiation therapy technologist, mammographic technologist, nuclear medicine technologist, computed tomography technologist and radiologist assistant and any new radiologic modality technologist and those minimum standards of education and training to be met by each type of applicant. 32-2804. School approval; standards; considerations A. The department may approve a school of radiologic technology as maintaining a satisfactory standard if the school's course of study: 1. Is accredited by the commission on accreditation of allied health education programs or the joint review committee on education in radiologic technology or accredited as recognized by the United States department of education, or meets or exceeds the standards of this chapter. 2. Includes at least four hundred hours of classroom work, including radiation protection, x-ray physics, radiographic techniques, radiographic imaging and patient care procedures, anatomy and physiology, radiographic positioning, an introduction to other imaging modalities and professional ethics. 3. Includes at least one thousand six hundred fifty hours devoted to clinical experience. 4. Includes demonstrations, discussions, seminars and supervised practice. 5. Includes at least eighty hours of regularly scheduled supervised image critiques. B. An approved school of radiologic technology may be operated by a medical or educational institution or other public or private agency or institution and, for the purpose of providing the requisite clinical experience, shall be affiliated with one or more hospitals that the department determines are likely to provide this experience. C. In approving a school of radiologic technology, the department shall consider the standards adopted by appropriate professional organizations, including the joint review committee on education in radiologic technology, and may accept the certification of a school of radiologic technology or the accreditation of a hospital to provide requisite clinical experience if the department finds that certification or accreditation was granted on the basis of standards that will afford the same protection to the public as the standards provided by this chapter. 32-2805. Fees; deposit The department shall deposit all fees collected pursuant to this chapter as prescribed by section 30-654, subsection C. 32-2811. Ionizing radiation; prohibitions; limitations; exceptions A. Except as provided in subsection D of this section, a person may not use ionizing radiation on a human being unless the person is a licensed practitioner or the holder of a certificate as provided in this chapter. B. A person holding a certificate may use ionizing radiation on human beings only for diagnostic or therapeutic purposes while operating in each particular case at the direction of a licensed practitioner, except that a person holding a certificate may use ionizing radiation on human beings for diagnostic purposes only while operating in each particular case at the direction of a licensed practitioner who is licensed in any other state, territory or district of the United States. The application of ionizing radiation and the direction to apply ionizing radiation are limited to those persons or parts of the human body specified in the law under which the licensed practitioner is licensed. The provisions of the technologist's certificate govern the extent of application of ionizing radiation. C. The provisions of this chapter relating to technologists do not limit, enlarge or affect in any respect the practice of their respective professions by duly licensed practitioners. D. The requirement of a certificate does not apply to: 1. A hospital resident specializing in radiology who is not a licensed practitioner in this state or a student enrolled in and attending a school or college of medicine, osteopathic medicine, podiatry, dentistry, naturopathic medicine, chiropractic or radiologic technology and who applies ionizing radiation to a human being while under the specific direction of a licensed practitioner. 2. A person engaged in performing the duties of a technologist in that person's employment by an agency, bureau or division of the government of the United States. 3. Dental hygienists licensed in this state and dental assistants holding a valid certificate in dental radiology from a course approved by the state board of dental examiners. 4. Persons providing assistance during an ionizing radiation procedure, apart from such procedures conducted in a health care institution, under the direction of a person licensed to use an ionizing radiation machine. 5. A person who is employed by or acting on behalf of the state department of corrections or a county jail and who uses a low-dose ionizing radiation body scanning device to detect contraband, as defined in section 13-2501, in or on an inmate. 6. A podiatric medical assistant who holds a valid certificate in podiatric radiology from a course approved by the state board of podiatry examiners. E. Subsection B of this section does not apply to ionizing radiation ordered by a licensed practitioner for other than diagnostic or therapeutic purposes pursuant to section 13-2505, subsection E. 32-2812. Applications for certificate; qualifications; fees; examination; denial A. An applicant for a certificate shall submit an application for certification or an application for examination for certification, accompanied by a nonrefundable fee established by the director. An applicant who has practiced radiography without certification shall pay a prorated fee retroactively to the earliest date of uncertified practice. The fee for a replacement certificate is $10. The application for examination fee is $70 and shall not be prorated. An application shall contain information that the applicant: 1. Is at least eighteen years of age. 2. Meets one of the following requirements: (a) In the case of an application for radiologic technologist, radiation therapy technologist or nuclear medicine technologist certification, has successfully completed a course of study at a school of radiologic technology that is approved by the department or an out-of-state school of radiologic technology that is approved by the joint review committee on education in radiologic technology, the American registry of radiologic technologists or the nuclear medicine technology certification board. (b) In the case of an application for practical technologist in podiatry certification, practical technologist in bone densitometry certification and practical technologist in radiology certification, satisfactorily meets the basic requisites determined by the department pursuant to section 32-2803. (c) In the case of an application for radiologist assistant certification, has obtained a baccalaureate degree or postbaccalaureate certificate from an advanced academic program that encompasses a nationally recognized radiologist assistant curriculum that includes a radiologist-directed clinical preceptorship. An applicant for certification before April 1, 2009 is not required to have a baccalaureate degree or postbaccalaureate certificate, but must have completed an advanced academic program that encompasses a nationally recognized radiologist assistant curriculum that includes a radiologist-directed clinical preceptorship. B. If the application is in proper form and it appears that the applicant meets the eligibility requirements, the applicant shall be notified of the time and place of the next examination. C. The department may accept, in lieu of its own examination, a certificate issued on the basis of an examination by a certificate-granting body recognized by the department or a certificate, registration or license issued by another state if that state's standards for certification, registration or licensure are satisfactory to the department. D. The department may deny a certificate to an applicant who has committed an act or engaged in conduct in any jurisdiction that resulted in a disciplinary action against the applicant or that would constitute grounds for disciplinary action under this chapter. 32-2813. Examination; contents; subsequent examinations A. Examinations for certification shall include the subjects of radiation protection, x-ray physics, radiographic techniques, radiographic imaging and patient care procedures, anatomy terminology, radiological mathematics, professional ethics and such other subjects as the department may deem appropriate, including the content specifications outlined by the American registry of radiologic technologists. B. The department shall prepare lists of examination questions or problems and administer the examinations. C. Examinations shall include written questions but may also include practical and oral portions. Following each examination, the papers and the practical and oral examinations shall be graded and the standing of each applicant shall be recorded. The department shall either pass or reject each applicant. D. An applicant who fails to pass an examination may reapply for examination in the manner prescribed by section 32-2812. The department shall require a candidate who fails the examination three times to successfully complete additional training prescribed by the department before accepting the candidate for reexamination. 32-2814. Initial certificates; special permits; temporary certificates A. The department shall issue an initial certificate that is valid for two years to each candidate who has paid the prescribed fee and who either has successfully passed the examination or has been accepted pursuant to section 32-2812. B. The department, on application, may issue a special permit to exempt a person from this chapter if the department finds to its satisfaction that there is substantial evidence that the people in the locality of the state in which such an exemption is sought would be denied adequate medical care because of the unavailability of certified licensed practitioners or persons holding certificates pursuant to this chapter. The department shall issue a special permit for a limited period of time, not to exceed one year, to be prescribed by the department in accordance with the purposes of this chapter. The department may renew a special permit if the permittee's circumstances have not changed. C. The department may issue a temporary certificate to any person whose certification or recertification is pending and in whose case the issuance of a temporary certificate may be justified by reason of special circumstances. D. A temporary certificate shall be issued only if the department finds that its issuance will not violate the purposes of this chapter or tend to endanger the public health and safety. A temporary certificate expires thirty days after the date of the next examination if the applicant is required to take the examination or, if the applicant does not take the examination, on the date of the examination. In all other cases, a temporary certificate expires when the determination is made either to issue or to deny the issuance of a certificate. A temporary certificate shall not be valid for more than one year and may not be renewed. E. A person shall submit an application for certification in a form prescribed by the department. 32-2815. Rules; bone densitometry certification; nuclear medicine certification; continuing education A. The department shall adopt rules regarding the certification of practical technologists in bone densitometry to allow the certificate holder to apply ionizing radiation to a person's hips, spine and extremities through the use of a bone densitometry machine. The rules shall prescribe: 1. The minimum education and training qualifications for certification. The qualifications prescribed by the department shall allow a person who does not meet the education and training requirements of a radiologic technologist or a practical technologist in radiology to obtain a certificate as a practical technologist in bone densitometry. 2. The application and renewal fees. B. Subsection A of this section does not prohibit a radiologic technologist or a practical technologist in radiology from operating a bone densitometry machine. C. A person who wishes to practice as a nuclear medicine technologist must apply to the department for certification as prescribed by rule. The department shall adopt rules to establish minimum educational and training requirements for nuclear medicine technologists. D. The department shall adopt rules to prescribe the following minimum continuing education requirements for the renewal of the following certificates: 1. Practical technologist in podiatry, two hours every two years. 2. Practical technologist in radiology, six hours every two years. 3. Practical technologist in bone densitometry, two hours every two years. 4. Unlimited practical technologist in radiology, twenty-four hours every two years. 5. Nuclear medicine technologist, twenty-four hours every two years. 6. Radiologist assistant, fifty hours every two years. 7. Radiologic technologist, twenty-four hours every two years. 8. Radiation therapy technologist, twenty-four hours every two years. E. The department may require an applicant for renewal to document compliance with the appropriate continuing education requirements of subsection D of this section. 32-2816. Certificates; fee; terms; registration; renewal; cancellation; waiver A. Except as provided in section 32-4301, a certificate issued under this section is valid for two years. B. The department may renew a certificate for two years on payment of a renewal fee established by the director and submission of a renewal application containing information the department requires to show that the applicant for renewal is a technologist in good standing. The applicant for renewal shall also present evidence satisfactory to the department of having completed the required continuing education in radiologic technology within the preceding two years. If a radiologic technologist is certified by the American registry of radiologic technologists or nuclear medicine technology certification board, that person must satisfy the continuing education requirements of this subsection by providing the department with evidence of the technologist's good standing and current certification with that registry. C. A certificate holder who fails to renew the certificate on or before the certificate's expiration as prescribed in subsection B of this section shall pay a penalty fee of fifty dollars for late renewal. D. A certificate holder who does not renew a certificate within thirty days after the certificate expires and who continues the active practice of radiologic technology without adequate cause satisfactory to the department is subject to censure, reprimand or denial of right to renew the certificate pursuant to section 32-2821. E. On the request of a certificate holder in good standing, the department shall cancel a certificate. F. The department shall waive the renewal fee if a certificate holder submits an affidavit to the department stating that the certificate holder is retired from the practice of radiologic technology or wishes to be placed on inactive status. A retired or inactive technologist who practices is subject to the same penalties imposed pursuant to this chapter on a person who practices radiologic technology without a certificate. G. The department may reinstate a technologist on retired or inactive status on payment of the renewal fee pursuant to subsection B of this section. 32-2817. Use of title; display of certificate or permit A. A person holding a certificate may use the title "certified radiologic technologist", "certified nuclear medicine technologist", "certified radiation therapy technologist", "certified computed tomography technologist", "certified mammographic technologist", "certified radiologist assistant", "certified practical technologist in podiatry", "certified practical technologist in bone densitometry" or "certified practical technologist in radiology", as applicable. No other person shall be entitled to use such titles or title or letters after such person's name that indicates or implies that such person is a certified technologist or to represent the person in any way, whether orally or in writing, expressly or by implication, as being so certified. B. Every technologist or special permit holder shall display a certificate or permit at the technologist's or permit holder's place of employment. 32-2818. Lapsed certification; inactive status; reinstatement A person who was an unlimited practical technologist in radiology under this chapter from and after December 31, 1992 and whose certificate was not suspended or revoked but who failed to renew the certificate, on application to the department, may be placed on inactive status or reinstated pursuant to section 32-2816. 32-2819. Radiologist assistants; certification; rules; scope of practice A. A person who wishes to practice as a radiologist assistant must apply to the department for a certificate on a form and in the manner prescribed by the department pursuant to the requirements of section 32-2812. B. The department shall adopt rules to implement this section. The rules shall include the following: 1. Continuing education requirements. 2. Any other requirements the department considers appropriate to implement this section. C. Pursuant to rules adopted by the department and except as provided in section 32-2819.01, a radiologist assistant may do the following under the direct supervision of a radiologist: 1. Perform fluoroscopic procedures. 2. Assess and evaluate the physiologic and psychological responsiveness of patients who are undergoing radiologic procedures. 3. Evaluate image quality, make initial image observations and communicate observations to the supervising radiologist. 4. Administer contrast media or other medications prescribed by the supervising radiologist. 5. Perform any other procedures consistent with rules adopted by the department. D. In adopting rules pursuant to subsection C of this section, the department shall consider guidelines established by the American society of radiologic technologists and the American registry of radiologic technologists. E. A radiologist assistant shall not interpret images, make diagnoses or prescribe medications or therapies. F. A radiologist who supervises a radiologist assistant may authorize the radiologist assistant to perform only those radiologic procedures described in this section. G. A person shall not do any of the following without a certificate issued pursuant to this section: 1. Perform the radiologic procedures described in subsection C of this section. 2. Claim to be a radiologist assistant, including using any sign, advertisement, card, letterhead, circular or other writing, document or design to induce others to believe the person is authorized to practice as a radiologist assistant. H. Subsection G of this section does not apply to either of the following: 1. A person who is engaging in the scope of practice for which the person holds a valid license or certificate. 2. A person who is performing a task as part of an advanced academic program. 32-2819.01. Radiologist assistants; general supervision; rural counties; critical access hospitals; definition A. In a county with a population of less than five hundred thousand persons or a health care institution that is licensed as a critical access hospital, the department shall allow for general supervision of radiologist assistants if the health care facility ensures all of the following: 1. The health care facility or radiologist: (a) Has established a written protocol for the application of radiation to a patient for each procedure that may be conducted by a radiologist assistant under the general supervision of a radiologist, including follow-up instructions for the patient. (b) Reviews and, as necessary, revises the written protocol at least annually. (c) Documents the review required by subdivision (b) of this paragraph with a signature and date of signature. 2. Each radiologist assistant follows the applicable written protocol when delivering radiation to a patient. 3. At least every six months, the radiologist: (a) Observes each radiologist assistant while the radiologist assistant is performing a procedure to ensure the radiologist assistant's adherence to the applicable written protocol. (b) Documents the radiologist's observation and assessment of the radiologist assistant. 4. A radiologist is on-site and available for consultation about patient care at least once every five working days, as verified in documentation maintained by the registrant. 5. The health and safety of patients are maintained. B. A radiologist that uses general supervision to comply with the requirements of this section shall develop, maintain and implement policies and procedures to monitor both: 1. The performance of each procedure by a radiologist assistant under general supervision. 2. The quality of patient care. C. For the purposes of this section, "general supervision" means supervision by a radiologist who is licensed in this state and who is readily accessible by telecommunication. 32-2821. Revocation or suspension of certificate or permit; civil penalties; enforcement; appeals; hearings A. The director may revoke or suspend a certificate or permit issued under this chapter if the holder of the certificate or permit: 1. Is guilty of any fraud or deceit in activities as a technologist or radiologist assistant or has been guilty of any fraud or deceit in procuring or maintaining a certificate. 2. Has been convicted in a court of competent jurisdiction of a crime involving moral turpitude. If the conviction has been reversed and the holder of the certificate or permit has been discharged or acquitted or if the holder of the certificate or permit has been pardoned or the holder's civil rights have been restored, the certificate may be restored. 3. Is an habitual drunkard or is addicted to the use of morphine, cocaine or other drugs having similar effect, is insane or uses hallucinogens. 4. Has knowingly aided or abetted a person, not otherwise authorized, who is not a certified technologist or radiologist assistant or has not been issued a special permit in engaging in the activities of a technologist or radiologist assistant. 5. Has undertaken or engaged in any practice beyond the scope of the authorized activities of a certified technologist, radiologist assistant or permit holder pursuant to this chapter. 6. Has impersonated a duly certified technologist, radiologist assistant or permit holder or former duly certified technologist, radiologist assistant or permit holder or is engaging in the activities of a technologist, radiologist assistant or permit holder under an assumed name. 7. Has been guilty of unethical professional conduct. 8. Has continued to practice without obtaining a certificate renewal or a special permit renewal. 9. Has applied ionizing radiation to a human being when not operating in each particular case under the direction of a duly licensed practitioner or to any person or part of the human body other than specified in the law under which the practitioner is licensed. 10. Has acted or is acting as an owner, co-owner or employer in any enterprise engaged in the application of ionizing radiation to human beings for the purpose of diagnostic interpretation or the treatment of disease, without being under the direction of a licensed practitioner. 11. Has used or is using the prefix "Dr.", the word "doctor" or any prefix or suffix to indicate or imply that the person is a duly licensed practitioner if this is not true. 12. Is or has been guilty of incompetence or negligence in activities as a technologist. 13. Is or has been afflicted with any medical problem, disability or addiction that the department determines impairs the certificate or permit holder's professional competence. 14. Has interpreted a diagnostic image for a physician, a patient, the patient's family or the public. 15. Has violated any provision of this chapter or rule adopted pursuant to this chapter. B. A person may appeal the revocation or suspension under subsection A of this section by requesting a hearing pursuant to title 41, chapter 6, article 10. If the revocation or suspension is appealed, the director may not take further action to enforce the revocation or suspension until after the hearing. C. If the certificate of any person has been revoked or suspended, the department, after the expiration of two years, may consider an application for restoration of the certificate. D. The director may assess a civil penalty against a person in an amount not to exceed two hundred fifty dollars for each violation of this chapter or a rule adopted pursuant to this chapter. Each day a violation occurs constitutes a separate violation. E. The director shall issue a notice of assessment that includes the proposed amount of the assessment. In determining the amount of a civil penalty assessed against a person under this subsection, the department shall consider all of the following: 1. Repeated violations of statutes and rules. 2. Patterns of noncompliance. 3. Types of violations. 4. The severity of violations. 5. The potential for and occurrences of actual harm. 6. Threats to health and safety. 7. The number of persons affected by the violations. 8. The number of violations. 9. The length of time the violations have been occurring. F. A person may appeal the civil penalty assessment by requesting a hearing pursuant to title 41, chapter 6, article 10. If an assessment is appealed, the director may not take further action to enforce and collect the assessment until after the hearing. G. Actions to enforce the collection of civil penalties assessed pursuant to this section shall be brought by the attorney general or the county attorney in the name of the state in the justice court or the superior court in the county in which the violation occurred. H. The department shall deposit, pursuant to sections 35-146 and 35-147, civil penalties collected pursuant to this section in the state general fund. I. The department shall conduct any hearing to revoke or suspend a certificate or permit or impose a civil penalty under this section pursuant to title 41, chapter 6, article 10. J. The department may issue a nondisciplinary order requiring the certificate holder or permit holder to complete a prescribed number of hours of continuing education in an area or areas prescribed by the department to provide the certificate holder or permit holder with the necessary understanding of current developments, skills, procedures or treatment. The department may also file a letter of concern, issue a decree of censure, prescribe a period of probation or restrict or limit the practice of a certificate or permit holder. 32-2822. Unlawful acts; classification A. It is unlawful for any person to: 1. Sell or fraudulently obtain or furnish a radiologic technologist diploma, certificate or record. 2. Engage in the activities of a technologist under cover of a diploma or certificate illegally obtained or obtained by fraudulent misrepresentation of a material fact. 3. Engage in the activities of a technologist under a false or assumed name. 4. Engage in or hold himself or herself out as entitled to engage in the activities of a technologist without a valid certificate. 5. Otherwise violate any of the provisions of this chapter or any rule promulgated pursuant to this chapter. B. Any person who violates any provisions of this section shall be guilty of a class 2 misdemeanor. 32-2824. Inspections A. The department or its duly authorized representatives may enter during scheduled work hours on private or public property for the purpose of: 1. Ensuring that only certified individuals or individuals who are exempt from certification are operating ionizing radiation machines. 2. Determining whether a certified individual is practicing beyond the scope of the person's certificate. 3. Determining whether a certified individual has violated the provisions of this chapter. 4. Auditing ionizing radiation logbooks. 5. Determining compliance with this chapter and the rules adopted pursuant to this chapter. B. The department may enter areas under the jurisdiction of the federal government only with its permission. 32-2825. Injunctive relief The department may file a petition for injunctive relief against a person who violates a provision of this chapter. The person may be served in any county of this state. The action shall be brought on behalf of the director by the attorney general or the county attorney of the county in which the violation is occurring. 32-2841. Mammographic technologists; computed tomography technologists; certification; renewal A. A person who wishes to perform diagnostic mammography or screening mammography as defined in section 30-651 shall obtain a mammographic technologist certificate from the department. A person who wishes to perform computed tomography shall obtain a computed tomography technologist certificate from the department. The department shall issue a certificate to an applicant who: 1. Pays the application fee that is prescribed in rule by the department. 2. Holds a current radiologic technology certificate issued by the department. 3. For a mammographic technologist certification, completes the training and education requirements of subsection B of this section and passes an examination as prescribed in subsection D of this section. 4. For a computed tomography technologist certification, provides documentation of two years of experience in computed tomography and completion of twelve hours of computed tomography specific education or passes an examination as prescribed in subsection D of this section. B. To satisfy the education requirements of subsection A of this section, an applicant shall meet the initial training and education requirements of the mammography quality standards act regulations for quality standards of mammographic technologists (21 Code of Federal Regulations section 900.12). C. The department shall issue a student mammography permit, preceptorship or temporary certificate to a person who is in training and who meets the requirement of subsection A, paragraph 2 of this section if the applicant also provides the department with verification of employment and the name of the radiologist who agrees to be responsible for the applicant's supervision and training. A student mammography permit, preceptorship or temporary certificate is valid for one year after the date it is issued and may not be renewed. If the holder completes all of the requirements of subsection A of this section within the permitted period, the department shall issue a mammographic technologist or computed tomography technologist certificate. The mammographic technologist or computed tomography technologist certificate shall be renewed as prescribed by subsection E of this section. D. To satisfy the examination requirements of this section, an applicant shall pass an examination in mammography or computed tomography administered by the department or, in lieu of its own examination, the department may accept a certificate issued on the basis of an examination by a certificate-granting body recognized by the department. E. Except as provided in section 32-4301, a certificate that is issued under this section is valid for two years. The department shall notify a certificate holder thirty days before the expiration date of the certificate. An applicant for renewal of a mammographic technologist certificate shall meet the continuing education requirements of the mammography quality standards act regulations for quality standards of mammographic technologists (21 Code of Federal Regulations section 900.12). If a radiologic technologist is certified by the American registry of radiologic technologists, that person must satisfy the continuing education requirements of this subsection by providing the department with evidence of the radiologic technologist's good standing and current certification with that registry. The applicant shall also pay a renewal fee as prescribed in rule by the department. F. A person or facility that employs a person who is certified under this section shall report any suspected violations of section 32-2821 to the department. The department shall investigate the complaint. If in the course of its investigation the department determines that a person regulated by another regulatory agency of this state may have violated that agency's laws, the department shall report the violation to the other agency for disciplinary action. 32-2842. Mammographic images; physicians; requirements A physician licensed under chapter 13 or 17 of this title who reads or interprets mammographic images shall meet the following requirements: 1. Have completed forty hours of medical education credits in mammography. 2. Be certified by either the American board of radiology in diagnostic radiology or the American osteopathic board of radiology in diagnostic radiology, as applicable, or meet the requirements of the mammography quality standards act regulations for quality standards of interpreting physicians, 21 Code of Federal Regulations section 900.12. 32-2843. Facilities; requirements A. A facility that wishes to conduct patient self-referral mammographic screening examinations after January 1, 1994 shall submit the following to the department: 1. The physician-approved guide for accepting self-referrals by patients. 2. A copy of the facility's quality assurance program. 3. The medical physicist's evaluation report of the facility. B. A facility that does not have a darkroom on-site or that does not develop the films within one hour of exposure shall submit the following to the department: 1. A description of how the facility plans to ensure that the equipment is operating properly at the start of each day. 2. Information regarding the darkroom that develops the film that demonstrates to the department's satisfaction that transportation conditions will not adversely affect a person's ability to interpret the films. C. The director shall prescribe requirements for the documents required to be submitted to the department under subsections A and B of this section.