PUBLIC HEARING SCRIPT – AUGUST 16, 2023  
Good morning. I would like to call the Hearing to Order. My name is Daniela Pelachyk,  
Rules Analyst with the MIOSHA Standards and FOIA Section, I will be facilitating the  
hearing today. This meeting is being recorded. At this time, please make sure your cell  
phones are silenced. Thank you.  
This hearing is being called to order at 10:01 a.m., on August 16, 2023, at the Michigan  
Library & Historical Center, 1st Floor Forum, 702 West Kalamazoo, Lansing MI 48915.  
This is a public hearing for proposed administrative rules for MIOSHA Part 5. Operator  
Qualifications.  
This hearing is being conducted pursuant to provisions of the  
• Administrative Procedures Act 306 of 1969, MCL 24.242;  
• Public Health Code, Public Act 368 of 1978, MCL 408.1014r, MCL 333.13515, MCL  
333.13521, MCL 333.13522, and MCL 333.13527;  
• Executive Reorganization Order Nos. 1996-1, 1996-2, 2003-1, 2011-4, and 2019-3,  
MCL 330.3101, 445.2001, 445.2011, 445.2030, and 125.1998.  
• and on behalf of the Michigan Department of Labor and Economic Opportunity.  
The public hearing notice was published in three newspapers of general circulation, as well  
as the August 1, 2023, edition of the Michigan Register.  
We are here today to receive your comments only on the proposed rules. If you wish to  
speak, please make sure you have signed in and indicated your willingness to speak. We  
will call on speakers in the order in which names are listed on the sign in sheets. When you  
come forward, please identify yourself by giving your name, as well as who you represent  
so that this information can be included in the hearing report. If you have additional  
comments to submit in writing, you may leave them at the registration desk or submit them  
to our department no later than 5 p.m. today, August 16, 2023.  
Rex Miller:  
Good morning, Mr. Ray and Ms. Kugler. My name is Rex Miller. I am a two time  
Past President and Board Chairman of the Michigan Society of Radiographic  
Technologists. I have worked in the radiologic sciences for nearly 40 years and  
have recently retired as the radiology service manager for the College of  
Veterinary Medicine in the Veterinary Teaching Hospital at Michigan State  
University. Prior to that I worked for the Department of Radiology at the  
Michigan State University Clinical Center where I spent 24 years in the Magnetic  
Resonance Imaging department. I have also taught Magnetic Resonance  
Imaging at Michigan States MRI Program as well as at Lansing Community  
College. As Ms. Richmond testified, she was one of my students, and I am  
pleased she has risen to leadership in my professional organization.  
The Department, MiOSHA, and the Radiation Safety Unit are to be commended  
for taking this significant step forward toward enhancing public safety by  
establishing education and training standards for those who operate  
sophisticated imaging machinery. By taking this step, the Department will put  
Michigan in line with over 40 other states, placing minimum education and  
training standards for operators.  
I do recommend, however, the Department reconsider its position regarding its  
authority to regulate nuclear medicine, or in the alternative, explicitly exclude  
nuclear medicine and nuclear medicine technologists from the ambit of the  
regulations so as so avoid confusion.  
I also recommend that consideration be given to the following amendments  
involving replacement of the word "therapeutic" with "research" as the term  
"therapeutic" is covered by the term "radiation therapy."  
On page 3, Rule 5206(1), delete the word "therapeutic" and insert the word  
"research," so that the last clause reads:  
"... involving the application ofx-radiation to human beings for diagnostic and  
research purposes."  
Moreover, I recommend that changing "therapeutic" to "research" be used for  
Rule 5206(2) so that the operative language would read:  
"... application ofx-radiation to human beings for diagnostic and research  
purposes."  
And, to be consistent, I recommend replacement of the word "therapeutic" with  
the word "research" for Rule 5206(4), so the operative language would read:  
"... applying x-radiation to human beings for diagnostic and research purposes."  
I also suggest favorable consideration be given to amendments to Rule  
5210(2)(d) by removing the long list of body parts allowed for imaging for limited  
scope procedures. In its stead, I recommend a list of areas of the body -  
namely, chest, extremities, spine, skull/sinuses and  
podiatric. By so doing, the Department avoids any misunderstandings and lessens  
the chance for any errors by omission.  
Finally, I recommend amending Rule 5212(1), again dealing with limited scope, by  
requiring a minimum of 40 hours of clinical and didactic training to the radiologic  
science within the limited scope of practice.  
Thank you once again for hearing my testimony and thank you for your efforts toward  
enhancing public safety.  
If you have any questions, I will do my best to answer them or, if l cannot answer  
them today, find those answers for you.  
Ralph Lieto:  
My name is Ralph Lieto and I am a board-certified medical physicist and radiation safety  
officer, retired, with over 35 years of experience in large health care systems in  
Michigan. I am speaking on behalf of the Michigan Radiological Society (MRS), and I  
am a past-president of the MRS.  
The MRS is a professional and educational organization of board-certified diagnostic  
radiologists, radiation oncologists, nuclear medicine physicians, medical physicists, and  
interventional radiologists. MRS members work with and supervise technologists who  
perform diagnostic and therapeutic procedures with ionizing radiation. Many of our  
members are involved in the education of student technologists both for their classroom  
and clinical training.  
The MRS strongly supports the Michigan Department of Labor and Economic  
Opportunity (OLEO) proposing rules to establish credentialing regulations for  
technologists who use ionizing radiation for diagnostic and therapeutic medical  
purposes. MRS is disappointed that efforts for nearly 30 years have been unsuccessful.  
The patient in the state of Michigan deserves government's commitment that those  
directly administering ionizing radiation have demonstrated adequate training. Michigan  
is one of the minority of states that has not done this. Establishing proper credentials for  
technologists will be a tremendously positive step to assure the use of medical ionizing  
radiation is done in a manner that optimizes the patient dose and clinical objectives of  
the study.  
MRS supports the proposed rules with following clarifications and changes:  
General - Use the term "ionizing radiation" to replace "x-radiation". It is the proper term  
and is inclusive of electron and gamma radiation used in medical applications,  
especially therapy.  
Purpose and Scope, Rule 5210- This needs to clearly indicate that medical research  
subjects, and not just patients, are included. The proposed rules may be interpreted to  
exempt them by their exclusion. Such exemption would be improper and inconsistent  
with federal rules.  
Definitions, Rules 5206-5208 - There are outdated and missing definitions which need to  
be addressed. The MRS is suggesting language but strongly recommend OLEO obtain  
definitive language from the American Society of Radiologic Technologists (ASRT) and  
the American Registry of Radiologic Technologists (ARRT).  
"Medical x-radiation technologist" is obsolete and should be deleted.  
Revise: "Medical radiographer means an individual, other than licensed practioners, who  
is a registered technologist under that general supervision of licensed practioner and  
performs procedures using machine produced medical ionizing radiation for diagnostic  
and interventional purposes."  
Add: "Medical radiation therapist means an individual, other than licensed practioners,  
who is a registered technologist under that direct supervision of radiation oncologist and  
performs procedures using machine produced medical ionizing radiation for therapeutic  
purposes."  
Add: "Nuclear medicine technologist means an individual, other than licensed  
practioners, who is a registered technologist under that general supervision of an  
authorized user of the U.S. Nuclear Regulatory Commission and performs procedures  
using medical ionizing radiation for diagnostic and therapeutic purposes."  
Delete: "technology" from "Radiation therapy technology" and revise definition to be  
consistent with language for "Radiology", such as "branch of medicine that uses ionizing  
radiation machines for therapeutic purposes."  
Categories and Qualifications, Rule 5210 - Subpart Rule 5210 (c) needs clarification in  
the description of the three categories of conditional status after the three years  
following effective date of the final rules. As written, it appears that an individual who  
has not met active status can obtain conditional status every 3 years with a simple  
"statement of assurance". This should be clarified to assure it is NOT a means to  
circumvent requiring completion of active status criteria.  
Credentials Requirements, Rule 5211 -Add the category of "nuclear medicine  
technology" with the appropriate credentials from the (i) ARRT and the (ii) NMTCB  
(Nuclear Medicine Technology Certification Board).  
Limited Scope, Rule 5212 - This addresses limited scope operator requirements. MRS is  
pleased that minimum training requirements are being established for this category.  
However, 40 hours, or one week, of unspecified training is inadequate to work  
independently. As proposed, the training also does not require actual patients be  
imaged. The MRS supports the limited scope training recommendations of the ASRT  
which specifies classroom hours plus a minimum number of patient studies. This will  
provide prudent assurance of adequate clinical training for this category.  
The MRS strongly support the inclusion of nuclear medicine technologists (NMT) in the  
credentialing requirements of these proposed rules. No current Nuclear Regulatory  
Commission (NRC) regulations or guidance specifies the credentials of persons  
performing duties under an Authorized User (i.e., physician named on an NRC licensee  
with authorized uses). This absence of specifications for supervised personnel is a well-  
known void, very analogous to the current situation in Michigan which can allow a  
clerical person or nurse to perform radiography under the supervision of a licensed  
practioner. A misinformed assertion is that Michigan cannot establish NMT credentials  
because it is not an Agreement State. This is false! Indiana, an NRC regulated state,  
has had NMT licensure since 2008! It is MRS's understanding from the NRC that an  
NRC regulated state can establish credentials for personnel under an Authorized User  
as long as it does not impose on NRC's supervision rule (10 CFR 35.27).  
Accordingly, inclusion of NMT in these proposed rules is permissible, justified, and  
assures that all areas using ionizing radiation for medical use are employing properly  
credentialed technologists. This change also necessitates replacing "x-radiation" with  
"ionizing radiation".  
MRS applauds the MLEO initiative to establish technologist credentials for performing  
medical procedures which is decades overdue. Because of the type and significance of  
the recommendations and comments being made today, we request that a proposed  
final rule be published with a 30-45 day comment period. This request is a reasonable  
considering these rules are an initial proposal to the regulated medical users, and it is  
unclear what if any medical radiation resources provided input into these proposed  
rules. The MRS is willing to assist the MLEO in achieving a needed final draft  
satisfactory to both the state and the regulated medical community.  
The MRS appreciates the opportunity to comment on these proposed credentialing  
rules.  
Melissa Snody:  
Director Pickelman  
I am here to testify today on behalf on the SNMMI regarding the Administrative  
Rules for Ionizing Radiation Governing the Use of Radiation Machines.  
SNMMI is a non-profit, scientific, and professional organization representing the  
interests of more than 15,000 nuclear medicine and molecular imaging  
professionals globally, including physicians, scientists, pharmacists, and  
technologists. The SNMMI-Technologists Section (SNMMI-TS) advocates for best  
practices in evidence-based science that promotes the highest quality in patient  
care and safety. In addition, SNMMI is committed to the advancement of policy,  
regulation, and legislation that promotes the science, technology, and practical  
application of nuclear medicine and molecular imaging and strives to be a leader in  
the unifying, advancing, and optimizing molecular imaging. Our mission is to  
empower nuclear medicine and molecular imaging professionals to transform the  
science and practice of precision nuclear medicine for diagnosis and therapy to  
advance patient care.  
Earlier this year, the SNMMI recommended language to be included in this rule that  
would define the requirements and standards of technologists administering nuclear  
materials for diagnostic and therapeutic procedures specifically, recommending  
registration and certification standards to be included as set forth under the  
American Registry of Radiologic Technologists (ARRT), Nuclear Medicine  
Technology Certification Board (NMTCB) and/or equivalent standards.  
Unfortunately, despite this request, the proposed rule makes no mention of  
nuclear medicine and fails to include certification and/or licensing standards for  
nuclear medicine technologists.  
Therefore, SNMMI would recommend strict exemption language be included in this  
rule to make it abundantly clear that the proposed rule does, in fact, exclude nuclear  
medicine.  
Rule 333.5209 Exemptions  
We recommend inserting the following language:  
A nuclear medicine technologist who, under the supervision of an authorized user,  
utilizes sealed and unsealed radioactive materials for diagnostic, treatment, and  
research purposes.  
We believe that explicitly excluding nuclear medicine technologists from the Ionizing  
Radiation Rules Governing the Use of Radiation Machines will allow for the  
continued use of radioactive materials by nuclear medicine technologists for  
diagnostic, treatment and research purposes.  
In Michigan, no department or agency regulates the profession of nuclear medicine  
technology--nor does the practice of nuclear medicine technology fall under the  
purview of any federal agency. This explicit exemption will avoid any  
misinterpretation of the rule and ensure that nuclear medicine technologists are  
able to continue to practice within their scope.  
On behalf of the SNMMI, I thank you for your time and careful consideration on this  
matter.  
If there are no further comments at this time, I will close the hearing, at 10:24 a.m. The  
record will remain open until 5 p.m. today, August 16, 2023, for any additional comments  
you may wish to share regarding the proposed rules.  
Thank you all for coming today.  
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