HB 89-LICENSE RADIOLOGIC/NUC. MED TECHNOLOGISTS  3:10:04 PM CHAIR KITO announced that the next order of business would be HOUSE BILL NO. 89, "An Act requiring licensure of occupations relating to radiologic technology, radiation therapy, and nuclear medicine technology; and providing for an effective date." REPRESENTATIVE CHRIS TUCK, Alaska State Legislature, presented HB 89 as prime sponsor. 3:10:52 PM KENDRA KLOSTER, Staff, Representative Tuck, Alaska State Legislature, presented HB 89 on behalf of Representative Tuck, prime sponsor. She paraphrased from the sponsor statement [included in committee packet] which reads as follows [original punctuation provided]: House Bill 89 would establish licensing requirements for radiology technicians to increase safety for patients and healthcare professionals. Approximately two-thirds of the states have laws regulating the practice of radiologic technology. However, Alaska is not among the majority who require licensing of this profession. Radiology technicians have an important role in the healthcare field to provide services including x-rays used for checking broken bones; Magnetic Resonance Imaging (MRI) used to find tumors, bleeding, diseases, and infections; and Computed Tomography (CT) scans used to diagnose many types of cancer. While a number of Alaskans use these services, many may not be aware of the potential risk of over- exposure to radiation, which can lead to serious health problems, and even death. To increase safety for the patients and healthcare professionals, we need to ensure technicians are being trained properly and the equipment is checked regularly. We have been working closely with the radiologic technicians, the Alaska Departments of Health and Social Services and Commerce, Community and Economic Development to ensure we are crafting legislation that will improve public safety standards for Alaskan through these new licensing requirements. The Department of Health and Social Services have been working with radiology technicians across the state to develop regulations that will partner with this legislation to increase safety measures, update our out-of-date regulations, and ensure changes will not adversely affect technicians in rural Alaska. Radiation protection is about safety and the prevention of undue risk from radiation exposure. House Bill 89 will improve the safety of medical imaging procedures by establishing education and standards to ensure competency of all operators and patients. I respectfully ask for your support in the passage of House Bill 89. 3:13:37 PM REPRESENTATIVE BIRCH asked how many radiologists the legislation would embrace. MS. KLOSTER deferred to Ms. Rufsholm. 3:14:35 PM DONNA RUFSHOLM, Chair, Legislative Affairs Committee, Alaska Society of Radiologic Technologists, testified in the hearing on HB 89. She informed there are about 650 registered radio technologists in Alaska. She specified those individuals have gone through a formal program with a minimum of two to four years and passed a national exam. She indicated there are estimated to be one to two other individuals who are not registered and who have not gone through any formal education. REPRESENTATIVE BIRCH asked whether dental x-ray technicians are included. MS. RUFSHOLM answered dentists are exempted from this program because they have their own board and licensure. 3:17:00 PM REPRESENTATIVE BIRCH asked whether there are incidents of people being over-radiated in Alaska. MS. RUFSHOLM answered that many incidents are not heard about because they become locked files through litigation. She mentioned rural areas send images into urban centers to be read and medical assistants in those rural areas have very minimal training. She stated the biggest concern in Alaska is the assistance in rural areas involving the individuals taking x- rays who don't have the appropriate training. She said she sees x-rays that are over-exposed or under-exposed. She informed that radiation is cumulative, and it could be ten years before cancer from over-exposure appears. She said the proposed bill would ensure the people who take x-rays have the appropriate education and training. She added it is important that the training is affordable and accessible. 3:21:17 PM REPRESENTATIVE BIRCH shared his concern that the state was "painting itself into a corner" with certifications, particularly in rural areas. MS. RUFSHOLM said the clinics in rural areas "are okay with" a licensure program as long as it's affordable and accessible. She added the online program allows for accessible training for certification. She remarked the people she had spoken with want to have additional training as long as it is affordable. 3:24:26 PM CHAIR KITO mentioned there are lots of places in rural communities that might not have access to individuals who could become radio technologists. He asked whether a community with the equipment but no one who can be trained would have to wait for a licensed individual to obtain the x-ray image of a broken arm. MS. RUFSHOLM answered, "Absolutely not." She said the society had made provisions and had attempted to address these issues regarding the very rural areas in Alaska. She explained all the current health aides have to do is show competency to be grandfathered into the system. She said anyone new coming into a rural community can get temporary licensure while they are preparing for certification. 3:27:38 PM CHAIR KITO asked how the program would be funded without current licensees. SARA CHAMBERS, Director, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community, & Economic Development (DCCED), provided comments and responded to questions on HB 89. She explained the law requires the state to recover those costs. She said there is a complex method for allocating funds. She said there is authority to expend funds within the division. Those costs would be paid back with licensing fees. 3:29:21 PM REPRESENTATIVE BIRCH noted the proposed bill calls for a passing score of 75 percent average. He asked whether that is typical. MS. CHAMBERS answered that programs differ. She added a statutory change would be required if the percentage was deemed too high or too low. 3:30:45 PM CHAIR KITO opened public testimony on HB 89. 3:30:54 PM ROBERT MCCLUNG, Chair, Alaska Society of Radiologic Technologists, testified in support of HB 89. He explained currently only eight states including Alaska have no licensing for radiography. He said there are 697 certified radiology technicians in Alaska. He added the radiology profession is the third largest group of certified professionals, behind doctors and nurses. He said there are a number of reasons for the legislation. He said the first is safety. An untrained individual may not be aware of techniques to protect themselves and patient safety is also affected. He said the second reason is quality. The purpose of producing x-ray images is to provide the best quality image for a healthcare provider to provide a diagnosis. He added the certified x-ray technician understands the reason for the exam, how pathology can affect the image, and how to adjust the amount of radiation to produce the desired image. He said over- or under-exposure can affect the interpretation of the image. He added the certified technicians in the state have passed an exam and must follow continuing education. 3:34:49 PM RHONDA MERRIHEW, Member, Alaska Society of Radiologic Technologists, testified in support of HB 89. She shared her experience in a rural community. She explained the difference between adult and baby x-ray technique. She said she witnessed a technique which resulted in a baby getting more radiation than necessary. She said the proposed bill would help provide the training and ensure safety for the people of our state. 3:37:31 PM REPRESENTATIVE BIRCH asked about costs of licensing and registration. He noted the fiscal note (FN) is around $365 thousand which works out to around $520 per licensee. He asked whether the cost is a concern. MS. MERRIHEW deferred to Ms. Rufsholm. MS. RUFSHOLM stated the society had not been presented the most recent FN. She said the FN they have is from 2007 and it did not show such a high figure. She added there had not been discussion on the impact on the members. She said she assumed the licensure fees would be paid every two years and asked for confirmation. REPRESENTATIVE BIRCH said he think it comes out to a little over $500 per person per year. MS. RUFSHOLM said the figure was new to her and it has not yet been discussed. She emphasized the members knew licensure would have a cost and were prepared for it, but the new FN would have to be presented to the society. 3:42:15 PM CLAUDIA TESSIER, Member, Alaska Society of Radiologic Technologists, testified in support of HB 89. She shared her personal experience as a victim of untrained radiologists. She said it made her become a radiology technician. 3:44:12 PM REPRESENTATIVE BIRCH asked where the incident occurred. MS. TESSIER answered it had occurred in South Dakota. She added that technicians are now registered in that state. 3:44:36 PM CHAIR KITO said he would leave public testimony open on HB 89. 3:44:43 PM REPRESENTATIVE STUTES stated her support for HB 89. She shared her experience in Kodiak, Alaska. She said CT scans in Kodiak, Alaska, cost about 25 percent higher than in Anchorage, Alaska. 3:46:30 PM REPRESENTATIVE WOOL shared his personal background working in hospitals. He remarked the people he worked with had to be certified. 3:48:00 PM CHAIR KITO held over HB 89.