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AAPM-GRAC is currently collecting comments on the NRC rule changes, which can be entered here. We are meeting tomorrow at noon PDT to create our response. I will invite commentors to this meeting. Matt Wait, MS, DABR, DABSNM, MRSE Senior Diagnostic</div>
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AAPM-GRAC is currently collecting comments on the NRC rule changes, which can be entered
<a href="https://urldefense.com/v3/__https://docs.google.com/spreadsheets/d/1Op_dwZyFvxTKM9wSa2hZHIKtskbCbjXqKOn18gS9lFk/edit?usp=sharing__;!!BZ50a36bapWJ!sMAsvAfdKrgzN8lC6OKfEQN_lQa-QllulQHjAYxnOq9fgUpFB_tYXx4sQllrlGBb7B-iGQb3kLc$" title="https://urldefense.com/v3/__https://docs.google.com/spreadsheets/d/1Op_dwZyFvxTKM9wSa2hZHIKtskbCbjXqKOn18gS9lFk/edit?usp=sharing__;!!BZ50a36bapWJ!sMAsvAfdKrgzN8lC6OKfEQN_lQa-QllulQHjAYxnOq9fgUpFB_tYXx4sQllrlGBb7B-iGQb3kLc$">
<b>here</b></a>.</div>
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<br>
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We are meeting <b>tomorrow at noon PDT </b>to create our response. I will invite commentors to this meeting.</div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: rgb(0, 120, 179);"><b>Matt Wait, MS, DABR, DABSNM, MRSE</b></span><span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: black;"><br>
Senior Diagnostic Physicist</span></p>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: black;">Associate Radiation Safety Officer</span></p>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: rgb(0, 132, 185);"><b>Kaiser Permanente</b></span></p>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: rgb(0, 132, 185);"><b>Southern Permanente Medical Group</b></span></p>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: black;">Medical Imaging Technology and Informatics<br>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: black;">Los Angeles, CA 90027</span></p>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 10pt; color: black;">x5347 (office)</span></p>
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<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" style="font-size:11pt" color="#000000"><b>From:</b> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+matt.wait=kp.org@lists.osu.edu> on behalf of Lemieux, Bryan P. via Intl_dxmedphys_wd_osu_list
<intl_dxmedphys_wd_osu_list@lists.osu.edu><br>
<b>Sent:</b> Thursday, July 30, 2026 9:15 AM<br>
<b>To:</b> Mary Ellen Jafari <MaryEllen.Jafari@kp.org>; Steiner, Joseph [BSD] <Joseph.Steiner@bsd.uchicago.edu>; Adam Springer <adam@klsphysics.com>; kenharper14 via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list@lists.osu.edu><br>
<b>Subject:</b> Re: [Intl_DxMedPhys] NRC rule changes</font>
<div> </div>
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<div style="display:none!important; display:none; visibility:hidden; font-size:1px; color:#ffffff; line-height:1px; max-height:0px; opacity:0; overflow:hidden">
Agree those are all big ones. For patient release we use NCRP 155. Our limiting factor is almost always the caregiver dose under the current model. I suspect for Lu-177 therapies like Pluvicto and Lutathera a treatment regimen dose of 500 mrem</div>
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<p class="x_MsoNormal"><span style="font-size:12.0pt">Agree those are all big ones.
</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt">For patient release we use NCRP 155. Our limiting factor is almost always the caregiver dose under the current model. I suspect for Lu-177 therapies like Pluvicto and Lutathera a treatment regimen dose
of 500 mrem to general public will work out ok in the end, but the devil is n the details with the models, edge cases, and such – like how do you treat patients who get treated at multiple locations? Is it the same regimen or a different one?
</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt">How consent in this context is expected to work also worries me too greatly. Its not currently a requirement from NRC – they only must agree to follow the instructions. Its not so much the caregiver needing
to consent to go over 500 mrem – it’s the patient “consent” for any / all of it and how that will work like Mary Ellen points out.</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt">Also I do want to point out that the public dose one, while maybe less obvious – is pretty important in all of the repercussions it can have. NCRP 147 for example tells us to design to 100 mrem / 1 mSv
per year public dose. TG 108 adapts NCRP 147 methods and limits. Now imagine a world where you need to shield to 25 mrem / 0.25 mSv /year or run a cost benefit analysis comparing cost of more shielding for the project vs $5200 / person-rem in 2014 dollars
adjusted for inflation if you don’t want to design to 25 mrem. Now imagine that for every project to install or upgrade equipment that is done across the US every year.</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt">Its one thing to add another 1/16 lead to x-ray room walls, quite another to adjust PET facility or new therapy facilities….</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
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<div>
<p class="x_MsoNormal"><span style="font-size:12.0pt; color:black">Bryan Lemieux MS CHP DABMP</span><span style="font-size:12.0pt; color:black"></span></p>
</div>
<div>
<p class="x_MsoNormal"><span style="font-size:12.0pt; color:black">Associate Chief for Radiation Safety</span><span style="font-size:12.0pt; color:black"></span></p>
</div>
<div>
<p class="x_MsoNormal"><span style="font-size:12.0pt; color:black">Radiation Safety Officer</span><span style="font-size:12.0pt; color:black"></span></p>
</div>
</div>
<p class="x_MsoNormal"><span style="font-size:12.0pt; color:black">UK HealthCare</span><span style="font-size:12.0pt"></span></p>
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<div style="border:none; border-top:solid #E1E1E1 1.0pt; padding:3.0pt 0in 0in 0in">
<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"> Mary Ellen Jafari <MaryEllen.Jafari@kp.org>
<br>
<b>Sent:</b> Thursday, July 30, 2026 11:31 AM<br>
<b>To:</b> Steiner, Joseph [BSD] <Joseph.Steiner@bsd.uchicago.edu>; Adam Springer <adam@klsphysics.com>; kenharper14 via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list@lists.osu.edu>; Lemieux, Bryan P. <bryan.lemieux@uky.edu><br>
<b>Subject:</b> RE: [Intl_DxMedPhys] NRC rule changes</span></p>
</div>
</div>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:#9C6500; border:solid #9C6500 1.0pt; padding:2.0pt; background:#FFEB9C">CAUTION:</span></b><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black; border:solid #9C6500 1.0pt; padding:2.0pt; background:#FFEB9C">
External Sender</span></b><span style="font-size:12.0pt"></span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt">I support many of the changes, but a few issues I noticed at first glance:</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<ul type="disc" style="margin-top:0in">
<li class="x_MsoListParagraph" style="margin-left:0in"><span style="font-size:12.0pt">The patient or caregiver consent requirement for patient release is going to be very problematic, at least as currently written it appears to require patient consent for release
for any radiopharmaceutical exam. This will be a massive increase in recordkeeping and brings up of potential issues such as are we required to then hospitalize any patient who refuses consent.</span></li></ul>
<p class="x_MsoListParagraph"><span style="font-size:12.0pt"> </span></p>
<ul type="disc" style="margin-top:0in">
<li class="x_MsoListParagraph" style="margin-left:0in"><span style="font-size:12.0pt">The 7-year recentness of training requirement is being replaced with continuing education and experience, again requiring a massive increase in recordkeeping requirements,
as well as a lack of clarity because acceptable education and experience is not defined in the regulation or guidance.</span></li></ul>
<p class="x_MsoListParagraph"><span style="font-size:12.0pt"> </span></p>
<ul type="disc" style="margin-top:0in">
<li class="x_MsoListParagraph" style="margin-left:0in"><span style="font-size:12.0pt">Changing the permissible exposure to the caregiver and public from per treatment to per regimen is a huge change. It will require longitudinal recordkeeping which is not
currently required. It is also problematic because a regimen in clinical practice is not always as clearly defined as indicated in the rule. In addition, although the permissible dose to the caregiver from a released patient is increased, it is not changed
for members of the public. With the change to per regimen, the limit is thus greatly decreased for members of the public such as non-caregiver household members.</span></li></ul>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">Mary Ellen Jafari, MS, DABR (D,N), MRSE, MRSO, FACR, FAAPM, CIIP</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">Chief Physicist and Regional Radiation Safety Officer</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">Kaiser Permanente Southern California
</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">Southern California Permanente Medical Group</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">Medical Imaging Technology and Informatics</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">199 S. Los Robles Ave.,Ste. 600B, Pasadena CA 91101</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">626-430-1231 (office mobile)</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"><a href="mailto:Maryellen.Jafari@kp.org"><span style="color:#467886">Maryellen.Jafari@kp.org</span></a></span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt"> </span></p>
<div style="border:none; border-top:solid #E1E1E1 1.0pt; padding:3.0pt 0in 0in 0in">
<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"> Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces+maryellen.jafari=kp.org@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces+maryellen.jafari=kp.org@lists.osu.edu</a>>
<b>On Behalf Of </b>Steiner, Joseph [BSD] via Intl_dxmedphys_wd_osu_list<br>
<b>Sent:</b> Thursday, July 30, 2026 8:10 AM<br>
<b>To:</b> Adam Springer <<a href="mailto:adam@klsphysics.com">adam@klsphysics.com</a>>; kenharper14 via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>>; Lemieux, Bryan P. <<a href="mailto:bryan.lemieux@uky.edu">bryan.lemieux@uky.edu</a>><br>
<b>Subject:</b> Re: [Intl_DxMedPhys] NRC rule changes</span></p>
</div>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">Adam is right, the summary is very positive (is there a catch??). Some things that caught my eye: 3. Eliminating the requirement for license amendments to add authorized users for diagnostic
uses, allowing licensees to approve and document these</span></p>
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</span></strong><span style="font-size:13.5pt; color:red">This email came from outside Kaiser Permanente. Do not open attachments or click on links if you do not recognize the sender.</span></p>
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<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black">Adam is right, the summary is very positive (is there a catch??). Some things that caught my eye:</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black">3. Eliminating the requirement for license amendments to add authorized users for diagnostic uses, allowing licensees to approve and document these users internally due to the lower risk of
these non-therapeutic uses. </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black">9. Removing the written directive requirement for diagnostic administrations of sodium iodide I-131, aligning regulatory oversight with current clinical practice and other diagnostic administrations
with comparable risk. </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black">12. Expanding decay-in-storage eligibility by increasing the allowable half-life from 120 to 275 days, enabling safe, cost-effective onsite disposal of longer-lived materials like lutetium-177
metastable (Lu-177m) and cobalt-57 (Co-57).</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black">Joe</span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt; font-family:"Calibri",sans-serif; color:black"> </span></p>
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<p class="x_MsoNormal"><b><span style="font-size:12.0pt; font-family:"Calibri",sans-serif; color:black">From:</span></b><span style="font-size:12.0pt; font-family:"Calibri",sans-serif; color:black"> Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu</a>>
on behalf of Lemieux, Bryan P. via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Sent:</b> Thursday, July 30, 2026 8:06 AM<br>
<b>To:</b> Adam Springer <<a href="mailto:adam@klsphysics.com">adam@klsphysics.com</a>>; kenharper14 via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Subject:</b> [EXTERNAL] Re: [Intl_DxMedPhys] NRC rule changes </span></p>
<p class="x_MsoNormal"><span style="font-size:12.0pt; font-family:"Calibri",sans-serif; color:black"> </span></p>
<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">For those who have not been following all this, one is a revision to Part 20 and one is a revision to Part 35. There is also a revision in a separate rule making about licensing to permit
General Licenses for simple diagnostic nuclear med. There</span></p>
<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">For those who have not been following all this, one is a revision to Part 20 and one is a revision to Part 35. There is also a revision in a separate rule making about licensing to permit
General Licenses for simple diagnostic nuclear med. There</span></p>
<p><span style="color:#212121">For those who have not been following all this, one is a revision to Part 20 and one is a revision to Part 35. There is also a revision in a separate rule making about licensing to permit General Licenses for simple diagnostic
nuclear med. There are also 3 new regulatory guides, and some older ones referenced…… around 450 pages of new stuff and coming.</span></p>
<p><span style="color:#212121"> </span></p>
<p><span style="color:#212121">Some highlights for you all…</span></p>
<p><span style="color:#212121"> </span></p>
<ul type="disc" style="margin-top:0in">
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">As Adam mentioned – traditional ALARA is dead – long live… Alara V 2.0? Now with built in cost benefit analysis and $$$ / Person-Rem avoided justification guidance once you hit some
of those stepwise trigger levels….</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Updated dose guidance to allow alternate schema than ICRP 26/30 for occupational dose and NRC compliance without having to ask for special permission – lots of new stuff will be pre-approved
for general use – and doses may be used interchangeably – which will cause great angst for some people.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Public dose remains at 100 mrem/yr; proposed to drop 2 mrem in an hour restriction on uncontrolled areas.</span></li><ul type="circle" style="margin-top:0in">
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Dose constraints apply here – cost benefit proposed if going over 25 mrem / yr according to narrative.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">See also new regulatory guide proposed for control of dose at medical institutions.</span></li></ul>
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Occupational dose limits remain “mostly” the same – we get a new special limit if we want to use it for Planned Occupational Dose Limit Extension which allows occupational workers
to exceed the annual limit but ties back to a “budget” of accrued dose/risk allowance over rolling 5 year preceding period.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Patient release limits change</span></li><ul type="circle" style="margin-top:0in">
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Now per treatment Course; still 500 mrem to general public</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">New Caregiver limit (if consenting) 5000 mrem – separate from any dose below.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">As written any patient release requires consent of the patient regardless of dose to others.</span></li></ul>
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">In-patient care limits change.</span></li><ul type="circle" style="margin-top:0in">
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Instead of needing a license amendment, caregivers can get 2 rem during a hospital admission built into the regs….</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Added rules for safety instructions on care of some other classes of patients.</span></li></ul>
<li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">AU training is revised.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">New record keeping requirements proposed to replace the 7 year Recentness of Training provisions.</span></li><li class="x_MsoNormal" style="color:#212121"><span style="font-size:12.0pt">Lots of cleanup on requirements for medical uses, bringing Y-90 into Part 35, updating gamma knife rules etc….; close loophole on computer based treatment planning and acceptance testing.</span></li></ul>
<p><span style="color:#212121"> </span></p>
<p><span style="color:#212121">This will of course all trickle out to the agreement states, most is pretty high compatibility class – and once it hits the AS especially it will probably affect all of your x-ray and other machine produced sources as well since
most states have unified rules. Keep all that in mind while reviewing these and how it will affect your practices and programs generally when looking to comment.</span></p>
<p><span style="color:#212121"> </span></p>
<p><span style="color:#212121">Regards,</span></p>
<div id="x_x_ms-outlook-mobile-body-separator-line">
<p> </p>
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<div id="x_x_ms-outlook-mobile-signature">
<p><span style="color:#212121">Bryan Lemieux, MS CHP DABMP</span></p>
<p><span style="color:#212121">Associate Chief - Radiation Safety</span></p>
<p><span style="color:#212121">Radiation Safety Officer </span></p>
<p><span style="color:#212121">UK HealthCare</span></p>
</div>
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<p><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">From:</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black"> Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces+bryan.lemieux=uky.edu@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces+bryan.lemieux=uky.edu@lists.osu.edu</a>>
on behalf of Adam Springer via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Sent:</b> Thursday, 30 July 2026 07:21:19<br>
<b>To:</b> kenharper14 via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Subject:</b> [Intl_DxMedPhys] NRC rule changes</span></p>
<p> </p>
</div>
<p><span class="x_spanwithbackgroundcolor"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:#9C6500; background:#FFEB9C">CAUTION:</span></b></span><span class="x_spanwithbackgroundcolor"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black; background:#FFEB9C">
External Sender</span></b></span></p>
<p> </p>
<p><span style="font-size:1.0pt; color:white">Forgive me if someone has posted on this already. The executive order for the NRC is resulting in regulatory changes for medical use of RAM. See the proposed rules and a way to give feedback at the link below. The
summary makes them sound good.</span><span style="font-size:1.0pt; font-family:"Arial",sans-serif; color:white"> </span></p>
<p><span style="font-family:"system-ui",serif">Forgive me if someone has posted on this already. </span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif">The executive order for the NRC is resulting in regulatory changes for medical use of RAM. See the proposed rules and a way to give feedback at the link below. The summary makes them sound good. </span></p>
<p style="min-height:16.7px"><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif; color:blue"><a href="https://urldefense.com/v3/__https:/www.regulations.gov/document/NRC-2025-1237-0001__;!!KGKeukY!wYrr9HpiPIDFbIQL6GdB0Y95nj01gFH4PzbfcLU8SbJ5_d4UvYc837ORULrHxriRDym71iUb4_OyLYLLaSy8lvUh4xYqswqYxc1aUA$">https://www.regulations.gov/document/NRC-2025-1237-0001</a></span><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif">Another version is below with details about replacing ALARA with “determinate” levels. It’s very long so I haven’t compared the two yet. </span></p>
<p><span style="font-family:"system-ui",serif; color:blue"><a href="https://urldefense.com/v3/__https:/www.govinfo.gov/content/pkg/FR-2026-07-15/pdf/2026-14208.pdf?utm_campaign=subscription*mailing*list&utm_medium=email&utm_source=federalregister.gov__;Kys!!KGKeukY!wYrr9HpiPIDFbIQL6GdB0Y95nj01gFH4PzbfcLU8SbJ5_d4UvYc837ORULrHxriRDym71iUb4_OyLYLLaSy8lvUh4xYqswo21poyxA$">https://www.govinfo.gov/content/pkg/FR-2026-07-15/pdf/2026-14208.pdf?utm_campaign=subscription+mailing+list&utm_medium=email&utm_source=federalregister.gov</a></span><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif">I assumed it would be awhile before agreement states followed suit, but one of my local regulators informed me that the states have been asked to expedite adoption of the NRC’s updates. </span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p><span style="font-family:"system-ui",serif">-Adam</span></p>
<p><span style="font-family:"system-ui",serif"> </span></p>
<p>================================<br>
Adam C. Springer, MS, <span style="color:blue"><a href="https://urldefense.com/v3/__https:/myabr.theabr.org/*/certificate-public-reporting/P5911__;Iw!!KGKeukY!wYrr9HpiPIDFbIQL6GdB0Y95nj01gFH4PzbfcLU8SbJ5_d4UvYc837ORULrHxriRDym71iUb4_OyLYLLaSy8lvUh4xYqswoPuc4bHA$">DABR®</a></span>,
<span style="color:blue"><a href="https://urldefense.com/v3/__https:/www.absnm.org/certification-verification.html*/certificate-public-reporting/ABSNM-2026-09__;Iw!!KGKeukY!wYrr9HpiPIDFbIQL6GdB0Y95nj01gFH4PzbfcLU8SbJ5_d4UvYc837ORULrHxriRDym71iUb4_OyLYLLaSy8lvUh4xYqswp3Ozs_xg$">DABSNM</a></span>,
<span style="color:blue"><a href="https://urldefense.com/v3/__https:/ibmrs.org/abmrs-credential-search-global/__;!!KGKeukY!wYrr9HpiPIDFbIQL6GdB0Y95nj01gFH4PzbfcLU8SbJ5_d4UvYc837ORULrHxriRDym71iUb4_OyLYLLaSy8lvUh4xYqswraWDXtkg$">MRSE</a></span> (MRSC™)<br>
Medical Physicist & CEO</p>
<p>KLS Physics Group, LLC<br>
PO Box 700<br>
Ruston, LA 71273<br>
Office: 318-255-5033<br>
Mobile: 318-272-8292</p>
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