(a) General. This section sets forth the requirements related to §601.203 of the Act.
  (1) A hospital, federally qualified health center (FQHC) as defined by 42 U.S.C. §1396d, or practitioner may apply to the board for a hardship exemption from employing an MRT, LMRT, or NCT.
  (2) The following conditions are considered to be a hardship for the purposes of paragraph (1) of this subsection:
    (A) the applicant reports an inability to attract and retain medical radiologic technologists and the location for which the hardship exemption is sought is in a county with a population of less than 50,000;
    (B) the applicant is located more than 200 miles from a school of medical radiologic technology or non-certified technician education program approved in accordance with §194.12 of this chapter (relating to Standards for the Approval of Certificate Program Curricula and Instructors) or §194.13 of this chapter (relating to Mandatory Training Programs for Non-Certified Technicians);
    (C) the nearest school of medical radiologic technology approved in accordance with §194.12 or §194.13 of this chapter has a waiting list of applicants due to a lack of faculty or space;
    (D) the applicant's need for graduates in medical radiologic technology exceeds the number of graduates from the nearest school of medical radiologic technology approved in accordance with §194.12 or §194.13 of this chapter; or
    (E) emergency conditions have occurred during the 90 days prior to making application for the hardship exemption.
  (3) The applicant must demonstrate a hardship in employing an MRT, LMRT, or NCT, and must provide information indicating that the individuals who will perform radiologic procedures meet the minimum requirements as described in subsection (b)(5) of this section.
  (4) The applicant shall not allow the individual(s) named in the application to perform a radiologic procedure until the board grants a hardship exemption.
  (5) A hardship exemption granted by the board does not constitute licensure, certification, registration, or authorization to perform a dangerous or hazardous radiologic procedure or mammography.
  (6) No more than seven individuals will be allowed to perform radiologic procedures under the hardship exemption, if granted.
(b) Required application materials.
  (1) The applicant must apply for a hardship on the forms prescribed by the board and must be accompanied by the appropriate fee, as provided under chapter 175 of this title (relating to Fees and Penalties). The date of application shall be the date the application and application fee is postmarked. If there is no visible postmark, or if the application is hand-delivered, the application date shall be the date the board receives the application.
  (2) The application must be accompanied by documentation clearly indicating that the applicant is a licensed hospital, FQHC, or practitioner. A copy of the current hospital license, certificate of qualification issued to the FQHC, or current license of the practitioner shall be acceptable documentation.
  (3) If the application is from a hospital or FQHC, the administrator or chief executive officer of the hospital or FQHC must sign the application form. If the applicant is a practitioner, the practitioner must sign the application form.
  (4) The applicant must meet the following requirements:
    (A) Each individuals named in the application as hired or employed to perform radiologic procedures under the hardship exemption must:
      (i) graduate from high school or its equivalent as determined by the Texas Education Agency;
      (ii) attain at least 18 years of age;
      (iii) provide a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation;
      (iv) be mentally and physically able to perform radiologic procedures; and
      (v) be of good professional character as defined under §194.2 of this chapter (relating to Definitions).
    (B) The applicant must meet one or more of the following requirements:
      (i) if the applicant is unable to attract or retain an MRT or LMRT, a sworn affidavit providing the physical address of the applicant hospital, FQHC, or practice location of the practitioner, and describing the reasons the applicant is unable to attract and retain an MRT or LMRT at a comparable salary for the area, the applicant's attempts to attract and retain an MRT or LMRT, evidence of recruiting efforts during the 30-day period prior to application for the hardship exemption. The applicant must also provide copies of advertisements to hire an MRT or LMRT;
      (ii) if the applicant is located more than 200 highway miles from the nearest school of medical radiologic technology approved in accordance with §194.12 or §194.13 of this chapter, a sworn affidavit describing in narrative form the physical address of the nearest school of medical radiologic technology; the physical address of the applicant hospital, FQHC, or primary practice location of the practitioner; and the actual distance in highway miles between the school and the applicant hospital, FQHC, or practitioner's primary practice. The applicant shall include a map of the area clearly indicating the locations of each entity;
      (iii) if the nearest school of medical radiologic technology approved in accordance with §194.12 and §194.13 of this chapter has a waiting list of school applicants due to a lack of faculty or space, a sworn affidavit from the applicant indicating that admissions to the school are pending because of a lack of faculty or space;
      (iv) if the applicant's need for graduates in medical radiologic technology exceeds the number of graduates from the nearest school of medical radiologic technology approved in accordance with §194.12 of this chapter, a sworn affidavit from the applicant indicating that the number of graduates from the nearest school does not meet the applicant's needs for radiologic technologists; or
      (v) if emergency conditions have occurred during the 90 days prior to making application for the hardship exemption, a sworn affidavit from the applicant describing the emergency conditions, the hardship(s) the emergency conditions have created and how long the hardship(s) is anticipated to continue. For the purposes of this subparagraph, emergency conditions may include a disaster, epidemic, or other catastrophic event.
  (5) All application materials and information are subject to verification by the board.
  (6) The board shall send a written notice listing the additional materials required to an applicant whose application is incomplete. An application not completed within 30 days after the date of the written notice shall be invalid unless the applicant has advised the board of a valid reason for the delay.
(c) Application approval. If granted by the board, a letter of exemption shall be issued for a period of one year.
(d) The process for approval or denial of applications for program approval are subject to the procedures outlined in §194.6(g) of this chapter (relating to Procedural Rules and Minimum Eligibility Requirements for Applicants for a Certificate or Placement on the Board's Non-Certified Technician General Registry). An applicant whose application has been disapproved §194.6(g) of this chapter shall be permitted to reapply after a period of not less than one year from the date of the disapproval and shall submit a new application and supporting information. The applicant may reapply for an exemption any time the basis for the exemption application changes.
(e) Reapplication for hardship exemption.
  (1) The hospital, FQHC, or a practitioner must reapply annually for the exemption and meet the then current requirements for a hardship exemption.
  (2) A hospital, FQHC, or a practitioner who does not reapply for an exemption shall not allow a person to perform a radiologic procedure unless the person is a practitioner, MRT, LMRT, or NCT.

Source Note: The provisions of this §194.16 adopted to be effective April 3, 2017, 42 TexReg 1763; amended to be effective March 27, 2018, 43 TexReg 1867