Legislature(2003 - 2004)

04/27/2004 03:11 PM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
HB 186-LICENSING RADIOLOGIC TECHNICIANS                                                                                       
Number 1496                                                                                                                     
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE  BILL   NO.  186,  "An  Act   establishing  the  Radiologic                                                               
Technology   Board   of   Examiners;   requiring   licensure   of                                                               
occupations   relating   to  radiologic   technology,   radiation                                                               
therapy, and  nuclear medicine technology;  and providing  for an                                                               
effective date."                                                                                                                
Number 1492                                                                                                                     
JIM  SHINE, Staff  to Representative  Tom Anderson,  Alaska State                                                               
Legislature,  presented  HB   186  for  Representative  Anderson,                                                               
sponsor of  HB 186,  and answered  questions from  the committee.                                                               
He read the following statement into the record:                                                                                
     The  unregulated  practice  of  Radiologic  Technology,                                                                    
     Nuclear  Medicine Technology  and Radiation  Therapy by                                                                    
     unqualified  individuals  represents a  serious  health                                                                    
     risk to the citizens of  Alaska.  HB 186 will establish                                                                    
     educational  and  certification  standards  for  health                                                                    
     care personnel  in Alaska  who perform  medical imaging                                                                    
     and  radiation  procedures.     The  Radiologic  Health                                                                    
     Science Professionals  in Alaska  are dedicated  to the                                                                    
     preservation  of  life  and  health,  as  well  as  the                                                                    
     prevention and  treatment of  disease.   The use  of x-                                                                    
     rays and other medical  imaging disciplines is the most                                                                    
     acceptable  method for  discovering  and treating  many                                                                    
     conditions that  might not otherwise be  observed until                                                                    
     it is too late for  treatment.  Any radiology procedure                                                                    
     is only as  effective as the person performing  it.  An                                                                    
     underexposed chest  x-ray cannot reveal pneumonia  or a                                                                    
     malignant  lesion, just  as  an inadequate  mammography                                                                    
     technique cannot detect breast  cancer.  No matter what                                                                    
     the procedure, the  radiologic technologist's knowledge                                                                    
     of  anatomy,  careful   application  of  radiation  and                                                                    
     skillful operation  of sophisticated  medical equipment                                                                    
     are the keys  to its success.  To  be clinically useful                                                                    
     diagnostic-imaging exams must be accurate.                                                                                 
     The  Alaska  Society  of  Radiologic  Technologist  has                                                                    
     consistently   supported   the   enactment   of   state                                                                    
     standards  for  the   education  and  credentialing  of                                                                    
     radiologic  technologists,   radiation  therapists  and                                                                    
     nuclear   medicine   technologists   as  a   means   of                                                                    
     protecting  Alaskans   from  the  harmful   effects  of                                                                    
     excessive   and   unnecessary   exposure   to   medical                                                                    
     radiation.      Thirty-eight    states   have   adopted                                                                    
     recommendations  for   state  licensure   of  radiology                                                                    
     personnel,  while  Alaska  is  not  one  of  those  38.                                                                    
     Establishing these standards  will ensure that Alaskans                                                                    
     will have  access to safe  and high  quality radiologic                                                                    
     care.   Licensure  will establish  radiation protection                                                                    
     measures,  as  well   as  education  and  credentialing                                                                    
     standards that  will ensure  the competency  of persons                                                                    
     operating  medical equipment  emitting  radiation.   To                                                                    
     ensure  that the  citizens  of  Alaska receive  maximum                                                                    
     protection from  the harmful  effects of  excessive and                                                                    
       improper exposure to radiation, licensure must be                                                                        
     passed to establish standards.                                                                                             
Number 1429                                                                                                                     
MR. SHINE  commented that  there are a  number of  people on-line                                                               
that would like to testify on the bill.                                                                                         
Number 1329                                                                                                                     
REPRESENTATIVE  SEATON  moved  to adopt  CSHB  186,  23-LS0380\E,                                                               
Mischel,  4/20/04,  as the  working  document.   There  being  no                                                               
objection,  CSHB 186,  version  E, is  before  the House  Health,                                                               
Education and  Social Services Standing Committee  as the working                                                               
Number 1258                                                                                                                     
CHRISTINE LUNG, Director,  Government Relations, American Society                                                               
of Radiologic  Technologists (ASRT),  testified in support  of HB
186.   She  told the  members that  ASRT represents  over 112,000                                                               
radiology  technologists practicing  in all  states.   The Alaska                                                               
Society of  Radiologic Technologists is an  affiliated chapter of                                                               
the ASRT.   Ms. Lung said  that ASRT supports HB  186 which would                                                               
set down  education and  credential standards  for radiographers,                                                               
radiation   therapists,  nuclear   medicine  technologists,   and                                                               
limited  radiologic technologists.    Currently patients  believe                                                               
that everyone that  they see in a physician's  office or hospital                                                               
is  an  educated  and   credentialed  health  care  practitioner.                                                               
However,  in 11  states that  is not  necessarily the  case.   In                                                               
those states  anyone can  be hired by  a hospital  or physician's                                                               
office to perform critical medical  imaging and radiation therapy                                                               
procedures   on  patients   without  any   formal  education   or                                                               
certification of their capability to do so, she said.                                                                           
Number 1187                                                                                                                     
MS. LUNG pointed out that  currently there are 235,000 radiologic                                                               
technologists  who are  voluntarily  registered  by the  American                                                               
Registry  of  Radiological  Technologists.    It  is  hoped  that                                                               
technologists in Alaska  will have the opportunity  to present to                                                               
their  patients  credentials  that   would  show  that  they  are                                                               
educated  to  perform  these procedures.    The  educational  and                                                               
credentialing standards  that are in  HB 186 reflect  the current                                                               
professional   standards   of   graduation   from   an   approved                                                               
educational program.   These programs  are approved by  the Joint                                                               
Review Committee  on the Education  on Radiologic  Technology and                                                               
national certification  by the American Registry  of Radiological                                                               
Technologists.   Ms. Lung told  the members that  currently there                                                               
are  over  400 technologists  in  the  state that  possess  these                                                               
MS.  LUNG explained  that the  credentials are  important because                                                               
medical  imaging accounts  for 90  percent of  human exposure  to                                                               
manmade  radiation.   It  encompasses 40  percent  of acute  care                                                               
health care  costs, she  added.   In summary,  Ms. Lung  told the                                                               
committee that  HB 186  would ensure a  reduction in  exposure to                                                               
radiation, reduced  health care costs, and  improved radiological                                                               
health care to all patients.                                                                                                    
Number 1089                                                                                                                     
ANN DAILEY, President, Alaska  Academy of Physician's Assistants,                                                               
testified in  opposition to  HB 186.   She shared  that she  is a                                                               
physician's  assistant in  Iliamna and  previously worked  in the                                                               
rural community of St. Paul.   Ms. Daily explained that there are                                                               
no radiologic  technicians available  in the remote  villages and                                                               
for this reason  oppose HB 186.  In remote  villages only limited                                                               
radiography is  performed as it  is described  in the bill.   The                                                               
provision of  limited radiographic  services to patients  is well                                                               
within  physician's  assistant's  scope   of  practice  which  is                                                               
regulated  by  Alaska  statute and  supervised  by  collaborative                                                               
physicians.   Radiologists over  read our  images and  report any                                                               
suspicions  concerning  quality,  appropriateness, and  over  and                                                               
under radiation levels to our  supervisors.  The equipment itself                                                               
reads  the amount  of  radiation  a patient  is  exposed to,  she                                                               
explained.   Quality checks and  calibrations are done  every six                                                               
months by certified personnel, she added.                                                                                       
MS. DAILEY told the members that  HB 186 will impose an untenable                                                               
burden to  the provision  of health care  to our  most vulnerable                                                               
patients in Rural  Alaska.  It will also erect  a barrier to care                                                               
by   unreasonably   and   unnecessarily  adding   an   additional                                                               
bureaucratic  administration, licensing  requirements, fees,  and                                                               
examination to  those already imposed,  she stated.  In  areas of                                                               
Alaska  where tuberculosis,  emphysema,  asthma,  and trauma  are                                                               
commonplace  the   ability  to  differentiate   these  conditions                                                               
radiographically is key to  prompt diagnosis, targeted treatment,                                                               
and prevention of public health  emergencies and loss of life and                                                               
limb.    She urged  the  members  to hold  HB  186  as it  is  an                                                               
impediment to the underserved people in Rural Alaska.                                                                           
Number 0869                                                                                                                     
CLYDE   PEARCE,  Chief,   Radiological  Physicist,   Radiological                                                               
Health,  Division  of Public  Health,  Department  of Health  and                                                               
Social Services, testified on HB  186 and answered questions from                                                               
the members.   He told  the members that he  performs inspections                                                               
at  facilities throughout  the state  including 23  hospitals and                                                               
137  medical  facilities.    Mr.  Pearce  explained  that  he  is                                                               
supportive of the bill because  it addresses some of the concerns                                                               
he  has   with  the  supervision  of   professional  health  care                                                               
providers   because  these   professionals   do  not   understand                                                               
radiology.  He said his greatest  concern is that the exposure to                                                               
radiation in  general is increasing  with new technologies.   For                                                               
example,  the  exposure  to  radiation  through  mammography  has                                                               
increased  even though  the  exposure time  has  decreased.   The                                                               
increased  speed  of the  exposure  makes  the margin  for  error                                                               
narrower, he explained.                                                                                                         
MR.  PEARCE told  the members  that Alaska  has a  unique problem                                                               
where there  is new technology  and old equipment.   For example,                                                               
in Southeast  the blue light used  in x-rays are to  be used with                                                               
blue  sensitive  film;  however,  new green  film  was  used  and                                                               
unfortunately green  film cannot see  blue light.   The automatic                                                               
machines  cannot  detect  those kinds  of  incompatibilities,  he                                                               
said.   As a  result patients  have received  increased radiation                                                               
exposure, rather than correcting the problem.                                                                                   
Number 0788                                                                                                                     
CHAIR  WILSON asked  Mr.  Pearce  to clarify  the  point he  made                                                               
concerning the blue and green film.                                                                                             
MR. PEARCE  explained that  it takes  a lot of  x-rays to  get an                                                               
image if the film is exposed in  an open manner, so what has been                                                               
used for  100 years is  an intensifying screen which  converts x-                                                               
rays  into  (indisc.) light  and  the  film  is exposed  to  that                                                               
(indisc.) light.  An x-ray film  is designed to be most sensitive                                                               
to a  particular color of light,  rather than a full  spectrum of                                                               
light.   The old  screens use  a blue light,  and x-ray  film was                                                               
made to  be sensitive to  the blue light.   The new  screens emit                                                               
green light,  so the  new film is  especially sensitive  to green                                                               
light, which  is the standard now.   Mr. Pearce said  he has seen                                                               
two  facilities using  the old  obsolete screen  x-rays with  new                                                               
green sensitive film and as a  result the patients were getting 6                                                               
to 10 times the amount of  radiation exposure.  The staff did not                                                               
even know it, he added.                                                                                                         
CHAIR WILSON  surmised that higher amounts  of radiation exposure                                                               
was  due  to the  fact  that  the film  didn't  come  out so  the                                                               
technician would turn up the machine and do it again.                                                                           
MR. PEARCE replied that is exactly right.                                                                                       
Number 0646                                                                                                                     
REPRESENTATIVE  SEATON asked  Mr.  Pearce to  comment on  digital                                                               
equipment.  He  asked if this equipment requires  a lesser dosage                                                               
of radiation.                                                                                                                   
MR. PEARCE replied  that digital imaging is  designed for safety.                                                               
This process  gets away  from film processing.   An  advantage to                                                               
digital  imaging  is  that  the   image  can  be  manipulated  by                                                               
increasing  contrast or  brightness.   He commented  that digital                                                               
equipment  does not  guarantee lower  dosages because  it largely                                                               
depends on  who is operating  the machine.   In fact, he  said he                                                               
believes  technicians  can  get  a   little  lazy  and  add  more                                                               
radiation  exposure to  ensure  that  a good  amount  of data  is                                                               
obtain so  that it  can be manipulated,  he added.   Potentially,                                                               
digital equipment could  reduce exposures, but in  practice it is                                                               
often doubled or more depending on the operator.                                                                                
CHAIR WILSON commented  that whenever a facility  purchases a new                                                               
digital imaging machine training is provided to the staff.                                                                      
Number 0541                                                                                                                     
MR. PEARCE  agreed that  training is provided.   He  compared the                                                               
training of  staff to a  person who has  a car with  an automatic                                                               
transmission  and   then  buys   a  new   car  with   a  standard                                                               
transmission.   The trainer may  teach the individual to  use the                                                               
stick shift,  but will not teach  the rules of the  road and help                                                               
the driver get  a driving license.  The trainer  will be teaching                                                               
staff the  unique aspects  of that digital  imaging machine.   It                                                               
will not be a replacement for  learning how to do radiography, he                                                               
Number 0472                                                                                                                     
DONNA  RUFSHOLM, Chair,  Licensure Committee,  and Board  Member,                                                               
Alaska   Society  of   Radiology   Technologists  Board   Member,                                                               
testified in  support of HB  186.  She  told the members  that in                                                               
1991  the  U.S. Congress  recognized  the  need to  regulate  the                                                               
operators of  radiology equipment.  It  passed legislation saying                                                               
that all states would have  in place licensure programs for those                                                               
individuals   who  perform   radiology   procedures,  she   said.                                                               
Unfortunately, there  were no repercussions  for the  states that                                                               
did not comply  with the law.  She explained  that today there is                                                               
legislation that  would make licensure mandatory  for all states.                                                               
If states do  not comply the Medicare and  Medicaid funding could                                                               
be cut.   Of the 50 states  38 have licensure laws  in place, but                                                               
Alaska is not one of them,  she pointed out.  Deficiencies in the                                                               
use  of radiation  have  been  witnessed all  over  the state  of                                                               
Alaska  which  has  prompted  the  Alaska  Society  of  Radiology                                                               
Technologists to  write regulations  for those who  perform those                                                               
MS. RUFSHOLM told  the members that HB 186 was  written to ensure                                                               
quality patient care,  as well as protecting  those operating the                                                               
radiology devices.  She emphasized that  it was not the intent of                                                               
the  Alaska  Society of  Radiology  Technologists  to deny  rural                                                               
residents  of radiology  services,  but to  provide training  and                                                               
education to staff who operate the equipment.                                                                                   
Number 0276                                                                                                                     
ED HALL,  Physician's Assistant (PA),  Member, Alaska  Academy of                                                               
Physician  Assistants, testified  in opposition  to HB  186.   He                                                               
told the members  that he has been a practicing  PA for ten years                                                               
and a member  of the academy for nine years.   Mr. Hall explained                                                               
that in  his discussions with PAs  across the state he  has found                                                               
that there is great concern about  the ability to provide care to                                                               
patients, particularly in the rural  areas of the state, but also                                                               
in  the urban  areas of  Alaska as  well.   He acknowledged  that                                                               
there  are  providers  out   there  using  antiquated  equipment;                                                               
however, this bill is directed  toward those using the equipment,                                                               
not to  the highest technology  or inappropriate equipment.   Mr.                                                               
Hall said  he would hope  anyone using radiology  equipment would                                                               
stay  current.   All providers  that he  knows have  been through                                                               
extensive anatomy courses,  he stated.  Mr.  Hall reiterated that                                                               
this appears  to be another self-serving  bureaucratic attempt at                                                               
creating another office which will  reduce access to optimal care                                                               
to  Alaskans.   In summary,  he  emphasized that  this bill  will                                                               
increase the cost of health care.                                                                                               
TAPE 04-38, SIDE A                                                                                                            
Number 0033                                                                                                                     
ERIKA  WHITE, Program  Director, University  of Alaska  Anchorage                                                               
(UAA), testified  in support  of HB  186.   She told  the members                                                               
that  the  university  currently  has an  Associates  of  Applied                                                               
Science  Degree  in  Radiologic   Technology.    There  are  also                                                               
students enrolled in  Fairbanks, Juneau, and Ketchikan.   It is a                                                               
21-month  educational   program  that  includes   physiology  and                                                               
anatomy  courses,  safety  training,   and  proper  exposure  and                                                               
positioning training.   The course  curriculum has  been approved                                                               
by the national accrediting body.   This training course prepares                                                               
students to take the national exam.                                                                                             
MS.  WHITE  commented that  the  university  received $84,000  to                                                               
implement a  limited radiology program  which will be  offered in                                                               
the fall  to PAs  and nurses.   She emphasized  that this  is not                                                               
full training, but limited training.   There is a need throughout                                                               
the state  for trained  professionals who  are licensed  and this                                                               
program  should address  those needs.   Ms.  White said  that the                                                               
most successful  facilities are those that  provide students with                                                               
funding,  by contracting  or sponsoring  students  who then  come                                                               
back to  its facility to work.   She commented that  rural health                                                               
facilities  are not  doing that  and  it is  important for  those                                                               
facilities  to   recognize  that   there  are  ways   to  attract                                                               
registered technologists.                                                                                                       
Number 0292                                                                                                                     
JOHN  BRINGHURST, Administrator,  Petersburg Hospital,  testified                                                               
in  opposition  to HB  186.    Petersburg  Hospital is  a  27-bed                                                               
hospital and long-term  care facility that serves  a community of                                                               
3,500  people whose  only access  to urgent  care services  comes                                                               
from this  facility.  Mr.  Bringhurst pointed out that  like most                                                               
Southeast  communities Petersburg  does not  have road  access to                                                               
other medical  facilities, so  transportation is  required either                                                               
by the marine highway system or air transportation.                                                                             
MR.  BRINGHURST told  the members  that  he was  selected by  the                                                               
Alaska State  Hospital and Nursing Homes  Association (ASHNA) and                                                               
Providence  Hospital  to  represent  both  the  small  and  large                                                               
hospitals' interests in working with  proponents of HB 186 and to                                                               
influence revisions  in the  bill so that  ASHNA can  support it.                                                               
While there  have been efforts to  this end, he said  he does not                                                               
believe  that ASHNA  can support  HB 186  because it  has serious                                                               
flaws.   The bill  now has provisions  for limited  licensing for                                                               
personnel  which  might  help small  hospitals  comply  with  the                                                               
requirement.    However,  the  drafters  of  the  bill  used  the                                                               
definition  of  limited license  to  apply  to  the size  of  the                                                               
community the person is employed in  rather than the scope of the                                                               
work being done.  Many  health care professionals make provisions                                                               
for   limited  scope   workers;  such   as  CNA,   LPN,  pharmacy                                                               
technicians,  and  physical therapy  aides,  etc.   However,  the                                                               
limitations  lie in  the  role  he/she is  able  to  play in  the                                                               
delivery of  the service and  not on  the size of  the community.                                                               
He  summarized  by  saying  he   questions  the  timing  of  this                                                               
legislation.  Mr.  Bringhurst said he believes this  is the worst                                                               
time  to implement  this policy  since Alaska  is experiencing  a                                                               
shortage of  radiological technicians.  Recently  ASHNA conducted                                                               
a  poll which  showed  radiology technicians  as  the number  two                                                               
position  in  terms  of  scarcity, which  is  only  surpassed  by                                                               
registered nurses.  In Petersburg  there is a 100 percent vacancy                                                               
rate in radiology and one of  those positions has been vacant for                                                               
over  22 months.   Small  hospitals have  a hard  time attracting                                                               
radiology  technicians and  often find  the only  solution is  to                                                               
train  staff themselves.   He  said this  legislation would  have                                                               
some  short-term negative  impacts  that would  nullify the  good                                                               
that  is being  accomplished.   Mr. Bringhurst  said he  believes                                                               
there are  serious flaws  that need to  be addressed  before this                                                               
would be a good piece of legislation.                                                                                           
Number 0559                                                                                                                     
B.  J.   ANDERSON,  Laboratory   and  X-Ray   Manager,  Anchorage                                                               
Neighborhood Health Center,  testified on HB 186.   She explained                                                               
that  the Anchorage  Neighborhood  Health Center  is a  community                                                               
health  center.     Ms.  Anderson  commended   UAA  for  creating                                                               
excellent course work  for radiologic technicians.   She said she                                                               
believes that  the new on-line  program will be a  great benefit;                                                               
however,  she expressed  concern with  required licensing  at the                                                               
state  level.   Ms.  Anderson  told the  members  that this  will                                                               
create a barrier  for those interested in  radiologic careers and                                                               
job opportunity.   This kind  of career opportunity is  common in                                                               
rural areas,  small clinics,  physicians' offices,  and community                                                               
health centers,  she said.  It  is difficult for these  small and                                                               
rural  offices to  recruit  certified personnel.    She said  she                                                               
can't over state that fact.   For instance, at  Iliuliuk Family &                                                               
Health   Services,  Inc.   in  Dutch   Harbor  there   are  three                                                               
individuals  who have  been trained  in radiological  procedures;                                                               
one  was  trained in  the  Philippines  and  the other  two  were                                                               
trained  on the  job.   She  stated that  these individuals  have                                                               
excellent skills,  but none  of the three  are certified.   These                                                               
individuals are also cross-trained to  perform lab testing.  This                                                               
is an  important dynamic in rural  health.  She told  the members                                                               
that she  has an  employee that  is highly  skilled, trustworthy,                                                               
dependable, and of high integrity.   Things that cannot be gauged                                                               
by  licensing  alone.    While   he  does  not  have  a  national                                                               
certificate, he is the best employee  she has.  Ms. Anderson told                                                               
the members that state licensing  created barriers for her in two                                                               
other states that  she has worked.  Ms.  Anderson summarized that                                                               
she  believes  education  is  the key,  not  licensing.    People                                                               
entering the health care field  will seek further education.  For                                                               
these reasons she opposes HB 186, Ms. Anderson stated.                                                                          
Number 0746                                                                                                                     
VERA  JAMES,   Program  Manager,  Alaska  Native   Health  Board,                                                               
testified in opposition to HB 186.   She told the member that the                                                               
Alaska Native Health Board  is nonprofit organization established                                                               
in 1968  that advocates  for 229  federally recognized  tribes on                                                               
health care issues.   The board believes that the  adoption of HB
186  as  currently  written  will be  harmful  to  tribal  health                                                               
providers  ability  to  provide  x-ray services  in  the  smaller                                                               
communities  that are  unable to  support radiology  technicians.                                                               
This is  because community health  aides in many  remote villages                                                               
are the  only providers available  to take images as  there would                                                               
be no  licensed practitioner  on-site.  It  is for  these reasons                                                               
the Alaska Native Health Board opposes HB 186.                                                                                  
Number 0852                                                                                                                     
BARBARA  HUFFTUCKNESS,  Director,  Governmental  and  Legislative                                                               
Affairs, Teamsters  Local 959,  testified in  support of  HB 186.                                                               
She  explained  that  Teamsters  Local  959  represents  all  the                                                               
employees  at  South Peninsula  Hospital  in  Homer.   While  the                                                               
community is  connected by the  road system, the  residents there                                                               
consider  themselves somewhat  rural.   She added  that Teamsters                                                               
Local  959   also  represent  the  employees   at  Kodiak  Island                                                               
Hospital.   She  said that  she always  made the  assumption that                                                               
radiologic  technologists  performing  the tests  were  licensed.                                                               
Every  employee who  is hired  at South  Peninsula Hospital  must                                                               
meet high standards.  Ms.  Hufftuckness said that Teamsters Local                                                               
959  support  HB 186  because  it  is  believed  it is  a  career                                                               
opportunity  in  building growth.    Employees  that have  worked                                                               
within  the  system,  for example  certified  nurses  aides,  are                                                               
required  to go  through  the licensure  process.   Many  careers                                                               
require licensing  including nurses.   It does not make  sense to                                                               
say that because there is a  shortage of nurses that licensing on                                                               
nurses  should be  eliminated.   Ms. Hufftuckness  said that  she                                                               
sympathizes  with  rural  areas that  have  difficulties  finding                                                               
employees, but sees it as a  career opportunity both in rural and                                                               
urban areas of  the state.  She reiterated  Teamsters Local 959's                                                               
support for passage of HB 186.                                                                                                  
Number 1050                                                                                                                     
CHAIR WILSON asked Mr. Shine if there is a senate-matching bill.                                                                
Number 1079                                                                                                                     
MR. SHINE  replied there  is not.   He commented  that he  is not                                                               
sure that some of the testifiers  have the current version of the                                                               
bill.  The last  version of the bill on Basis  is one that passed                                                               
out  of  the  House  Labor and  Commerce  Standing  Committee  in                                                               
January.   He noted, however,  the bill before the  House Health,                                                               
Education and Social Services  Standing Committee is dramatically                                                               
different.  One of the  testifiers mentioned that this bill would                                                               
create  a new  level of  bureaucracy; however,  one of  the major                                                               
changes  is that  the bill's  language went  from having  a board                                                               
with  the Alaska  Society of  Radiologic Technologists  and other                                                               
members from the  industry taking care of the  licensing issue to                                                               
the Division of Occupational Licensing  handling it, he said.  He                                                               
emphasized that no new level of bureaucracy is being created.                                                                   
MR. SHINE commented  that if anyone has questions  about the bill                                                               
Donna Rufsholm  of the Alaska Society  of Radiology Technologists                                                               
is very  knowledgeable.   He emphasized  that there  are dramatic                                                               
changes  in version  E which  is  before the  committee.   Anyone                                                               
wishing to receive  a copy of the latest version  can contact him                                                               
at 1-800-465-4939.                                                                                                              
Number 1185                                                                                                                     
[HB 186 was held in committee.]                                                                                                 

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