State of Tennessee Department of Health Medical Laboratory ...

[Pages:29]State of Tennessee Department of Health

Medical Laboratory Board

Metro Center Complex

665 Mainstream Drive, 2nd Floor

Nashville, TN 37243 (615) 532-3202

Toll Free 1-800-778-4123 ext. 5325128 or local 615-532-5128 health/article/medlab-about

PH 1056 (Rev 02/17)

Medical Laboratory Board Application Guidelines

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TABLE OF CONTENTS

I. Application Procedures Fees Application Acknowledgement Converting Quarter Hours to Semester Hours Converting CEUs to Clock Hours Converting Semester Hours to Clock Hours

II. Trainee Permits Registration of the Laboratory Trainee

III. Licensure Information

Processing Time Temporary License Renewals Retirement/Reactivation of License Change of Name or Address Verification of License Criminal Background Checks Practitioner Profile Questionnaire

IV. Requirements

General Requirements Military Trained Applicants Special Analyst Applicants Internationally Trained Applicants

V. Checklists

Laboratory Director, Director Level Credentialing Agencies Accepted by the Tennessee Medical Laboratory Board Laboratory Supervisor Documentation Information Management C.E. Subject Areas for Supervisor Licensure Cytology General Supervisor Medical Laboratory Technologist Generalist and Categorical Special Analyst National Certification Agencies Medical Laboratory Technician Cytotechnologist

Application/Clearance Form/Attachments

Medical Laboratory Licensure Application Attachment 1 - Clearance Form from Other State Licensure Boards Attachment 2 ? Training Program Accreditation Attachment 3 ? Transcript Request National Certification Verification

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7-10 8-10 10 11 12 12 13-14 15-16 16 17 18

19-25 26 27 28 29

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I. APPLICATION PROCEDURES

Fees (1200-6-1-.06)

The following fees are required for licensure:

$ 50 (application fee) - nonrefundable $ 10 (regulatory fee) - nonrefundable $ 60 TOTAL

Checks or money orders need to be made out to the State of Tennessee.

Converting Quarter Hours to Semester Hours:

Total Quarter Hours x 2 = Total Semester Hours 3

Converting CEUs to Clock Hours:

Total CEUs x 10 = Total Clock Hours

Converting Semester Hours to Clock Hours:

Total Semester Hours x 15 = Total Clock Hours

II. TRAINEE PERMITS (1200-06-01-.14)

Registration of the Laboratory Trainee

A qualified laboratory trainee shall register at no cost. Registration is valid for a period of two (2) years or less. Each trainee must submit a trainee application before beginning his/her practical training in a medical laboratory. The trainee work permit is only valid in the facility (ies) approved for practice training. The facility(ies) must be approved prior to internship. A trainee may work in a department after completion of the classroom requirements and clinical rotation period in that department provided he/she is under direct supervision of licensed medical laboratory personnel at the technologist level or higher. Documentation that the trainee has demonstrated acceptable competence levels in all procedures routinely performed in that clinical area must become part of that trainee's file.

The trainee permit shall be on file in the training program location and on-site during each clinical training program rotation.

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III. LICENSURE INFORMATION

Processing Time: Each application is unique, however be prepared for a minimum of 8-10 weeks processing time. Some applications will require more or less time depending on complexity and circumstances.

Temporary License (1200-06-01-.13)

A temporary license may be issued by the Board for an applicant who has successfully completed the academic work, clinical training, and all Board designated requirements for the license sought, and is scheduled to take the next available Board approved national or international examination.

If the applicant fails the examination or does not sit for the scheduled examination, the temporary license shall immediately become null and void.

Renewals (1200-06-01-.09)

Licenses are renewed every other year based on the licensee's birthday. A penalty fee is due if your renewal is postmarked past the renewal deadline. The licensee is responsible for notifying the administrative office in writing when there is an address or name change. Licenses can be renewed online:

Continuing Education/Renewals - All Licensees (1200-06-01-.12)

All individuals holding a Tennessee license as a medical laboratory professional, are required to fulfill 24 hours of board-approved continuing education during the two (2) calendar years previous to the renewal of their license. For example: 2018 Renewal Date: Submits CE's obtained January 01, 2016-December 31, 2017 2019 Renewal Date: Submits CE's obtained January 01, 2017-December 31, 2018 Courses accepted sponsored by the Medical Laboratory Board may be found on the following web site: . Documents submitted must contain licensee's name, subject materials, date, contact hours and appropriate signature of agency or medical laboratory director.

Retirement of Current License (1200-06-01-.11) A licensee who holds a current license and does not intend to practice as a medical laboratory professional in Tennessee may retire his/her license. The licensee must complete the Affidavit of Retirement from Practice in Tennessee document and have it notarized. The licensee will be notified in writing about the change of status of his/her license to the retired status. Renewal fees will not be required until the license is reactivated. This reactivation form may be obtained from the Board's administrative office. After two years, the applicant will not be required to submit continuing education, upon reactivation of a retired license. Note: Retirement from your job does not retire your professional license; you must submit an Affidavit of Retirement to this office. Failure to do so means you are still subject to continuing education requirements until your license is retired

Reactivation of Expired License(1200-06-01-.11) The completion of the Reactivation Form will allow the licensee to return to work. This form may be obtained from the administrative office for the Medical Laboratory Board. Upon reactivation of an expired license, the applicant will be required to submit continuing education documentation. Please refer to the above continuing education information.

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Change of Name or Address (1200-06-01-.17)

A change in name or address requires prompt notification to the Administrative office. You may fax this information to the administrative office: 615-253-8724 or call 615-532-5128.

Verification of License Status

The status of an individual's license is a matter of public record. Anyone inquiring about an individual's license will be given following information: the licensure category, date of certification and if licensee is in good standing. This information may be obtained through the Tennessee Department of Health automated phone system, (615) 532-3202 (local) or 1-888-310-4650 (toll free), following each prompt. Licensure information is also available from the Tennessee Department of Health website,

Criminal Background Check: Tennessee Code Annotated 63-1-116

Effective June 01, 2006 applicants for initial licensure in Tennessee (not applicable to the renewal, reinstatement or upgrade) must obtain a criminal background check. For instructions to obtain a criminal background check, go to .

Practitioner Profile Questionnaire

All applicants must complete a Practitioner Profile Questionnaire which can be found on line: . You are required by law to update this profile within 30 days of any change if you have an active license. Failure to update the profile may subject the practitioner to disciplinary actions.

IV. GENERAL REQUIREMENTS: ALL APPLICANTS General Requirements: ALL APPLICANTS

___

____ ____ ____

Completed application Complete fees Photograph (signed, passport size) Official transcript which indicates that a degree was conferred. (sent directly from the University to this administrative office) Graduation from a formal laboratory training program (NAACLS, CAHEA, CAAHEP) See Attachment 2 Proof of national certification (sent directly from the agency/designee to this administrative office) Completed Criminal Background Check Completed Practitioner Profile Questionnaire Completed Declaration of Citizenship

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Military Trained Applicants (1200-06-01-.22)

Medical Laboratory Technician (Rule 1200-06-01-.22(1)(c)(2)(ii)

Applicant must have an associate degree in a laboratory science and successful completion of an official military medical laboratory procedures course of at least fifty (50) weeks duration in residence and have held the military enlisted occupational specialty of Medical Laboratory Specialist (Medical Laboratory Technician). This information will be referenced on form DD214, a copy of which must be included with the application. National certification by examination is required.

Medical Laboratory Technologist (Rule 1200-06-01-.22(1)(a)(2)(iii)

Applicant must have a baccalaureate degree, completion of the fifty (50) week military laboratory training program, three (3) years of full time clinical laboratory work experience as defined in (1)(j) of this rule; the individual must have completed science coursework equivalent to that required in a laboratory science education program as defined by (1)(g) of this rule. The military training program will be referenced on form DD214, a copy of which must be included with the application. National certification by examination is required.

Special Analyst Applicants (1200-06-01-.22(1)(e))

An applicant may be issued a special analyst license to perform limited medical laboratory tests or group of tests, in the following specialties: andrology, embryology, cytology, molecular diagnostics, cytogenetics, toxicology, flow cytometry, virology, or histocompatibility-immunogenetics, on human specimens, but who is not trained to perform the broader range of tests required by medical laboratory personnel. All applicants must submit documentation of training relating to the categorical specialty.

Internationally Trained Applicants (1200-06-01.05(2)) An evaluation of a foreign transcript is required to determine the applicant's eligibility in addition to the general requirements. The evaluation must be obtained from one of the following agencies.

Center For Applied Research, Evaluation & Education, Inc. P.O. Box 18358 Anaheim, CA 92817 Phone: 714 -237-9272

714- 237-9276 Fax: 714-237-9279 Email: eval_career@

Educational Evaluators International, Inc. 11 S. Angell Street #348 Providence, RI 02906 Phone: 401-521-5340 Fax: 401-437-6474 WEB:

International Consultants of Delaware, Inc. 625 Barksdale Professional Center Suite 109 Newark, DE 19711 Phone: 302-737-8715 Fax: 302-737-8756 Email: icd@

Josef Silny and Associates, Inc. International Education Con. P.O. Box 248233 Coral Gables, FL 33124 Phone: 305- 273-1616 Fax: 305- 273-1338 Email: info@

Education Credential Evaluators, Inc.

P.O. Box 514070

Milwaukee, WI 53203-3470

Phone: 414-289-3400

Fax: 414-289-3411

Email: eval@

WEB:

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World Education Services, Inc. P.O. Box 745 Old Chelsea Station New York, NY 10113-0745 Phone: 212-966-6311 Fax: 212-739-6100 Email: info@

RDA 10137

Education International, Inc. 29 Denton Road Wellesley, MA 02482 Phone: 781-235-7425 Fax: 781-235-6831 Email: edint@

Foreign Academic Credentials Services, Inc. P.O. Box 400 Glen Carbon, IL 62034 Phone: 618-656-5291 Fax: 618-656-5291 Email: fasc@

Foundation for International Services, Inc. 505 5th Avenue South Suite 101 Edmonds, WA 98020 Phone: 425-248-2255 Fax: 425-248-2262 Email: info@fis- Web: fis-

International Education Research Foundation, Inc. P. O. Box 3665 Culver City, CA 90231 Phone: 310-258-9451 Fax: 310-342-7086 Email: info@ Web:

The evaluation must be submitted by the evaluating agency. This document must be in the Board's administrative office to determine your eligibility for licensure. The evaluation needs to be a general statement of equivalency utilizing a course-by-course comparison. All internationally trained applicants must submit a notarized photocopy of their foreign college transcript to the Board's administrative office.

V CHECKLISTS

LABORATORY DIRECTOR CHECKLIST (1200-06-01-.20)

Attach a check or money order in the amount of sixty ($60) dollars, payable to the State of Tennessee to your application. All applications for director are presented for review and approval by Medical Laboratory Board members during their quarterly meetings. The director-applicant is required to attend the quarterly meeting to respond to board member questions.

A pathologist and any other person recognized by the Board as having special qualifications and who is duly licensed and registered to practice medicine in the State of Tennessee will not be required to obtain a medical laboratory license in addition to his/her medical license. Individuals possessing an earned doctoral degree (non-medical degree) are required to obtain a license as a laboratory director from the Board.

A medical laboratory director must meet one of the following requirements:

Be a physician licensed in Tennessee and certified in clinical pathology by the American Board of Pathology or the American Osteopathic Board of Pathology or possess qualifications which are equivalent to those required for such certification (Board eligible).

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Meet one of the following requirements to qualify as a director of a laboratory in one or more specialties:

Is a physician licensed in Tennessee and certified by the American Board of Medical Microbiology, the American Board of Clinical Chemistry, or other certifying boards acceptable to the Board in one or more of the laboratory specialties.

Hold an earned doctoral degree in a chemical, physical, biological or clinical laboratory science, and be certified by the American Board of Medical Microbiology, American Board of Clinical Chemistry, American Board of Bioanalysis, American Board of Medical Laboratory Immunology or other certifying boards acceptable to the Board in one or more laboratory specialties.

Is a physician licensed in Tennessee, who subsequent to graduation has four (4) years or more experience in pulmonary function. The directorship is limited to blood gas analysis (pH, pO2, pCO2).

Is a physician licensed in Tennessee, who is certified by a national board acceptable to the Board (not in traditional laboratory specialty) in the specialty for which approval for directorship is being sought.

Holds an earned doctoral degree and has, in the opinion of the Board, appropriate work experience in a subspecialty for which there is no national certification. These individuals must obtain national boarding in the subspecialty when it becomes available.

General Requirements-Director

Completed application Complete fees Photograph (signed, passport size) Official transcript which indicates that a degree was conferred. (sent directly from the university to this administrative office) Proof of National Boarding (sent directly from the agency to this administrative office). ___ Declaration of Citizenship Form ___ Completed Criminal Background Check (Initial Applicants Only) ___ Completed Practitioner Profile Questionnaire ___ Proof of Training (Fellowship, Post-doctoral training, etc.)

Director Level Credentialing Agencies Accepted by the Tennessee Medical Laboratory Board

Medical Doctors, who are duly licensed and registered to practice medicine in the State of Tennessee and must be boarded by an acceptable credentialing agency, will not be required to obtain a medical laboratory director's license. Those who hold an earned non-medical doctoral degree must obtain a director's license from the Medical Laboratory Board.

I. American Board of Pathology (ABP)

(813) 286-2444

A. Anatomical Pathology and Clinical Pathology

Qualifies as a Director General ? Clinical and Anatomical Laboratory

B. Anatomical Pathology only

Qualifies as a Director General ? Anatomical Laboratory

C. Clinical Pathology only

Qualifies as a Director General ? Clinical Laboratory

D. Anatomical Pathology or Oral Pathology

MD or Dentist Qualifies as a Director ? Oral Pathology Laboratory

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