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X-Ray and Tanning Bed Inspections in Jeopardy Without Support for Fee Increase

The Oregon Health Authority’s Public Health Division said the state would not be able to meet the responsibilities of the Radiation Protection Services without a significant fee increase for X-rays and tanning beds, but the division’s proposal has run into resistance from Sen. Chip Shields who would like the state to seek more input from businesses hit with the fee hike.
February 11, 2015

A public health official warned the Senate Health Committee on Monday that the state would have to cut back on inspections of X-ray machines and would have to disband enforcement of tanning beds altogether, unless the Legislature increases fees that have not been raised in almost a decade.

“If fees are not increased, the Radiation Protection Services Section will have to reduce services which will increase the potential for harmful radiation exposure and injury to patients, workers, and the public,” said Steven Wagner, the administrator of the Center for Health Protection at the state Public Health Division. “The bill will generate revenue to cover the costs of the program.”

Despite Wagner’s concerns, the legislation, Senate Bill 228, ran into skepticism from lawmakers and could be endangered after Sen. Chip Shields, D-Portland, sided with Republicans who said they wanted to hear from the tanning salons and X-ray operators who would be required to pay higher fees.

Sen. Tim Knopp, R-Bend, went as far to say that he couldn’t on principle support any fee increase unless the people absorbing the higher fees in his Deschutes County district came to him and said they needed to be raised.

The Public Health Division’s proposal, Senate Bill 228, would increase some fees on devices that emit radiation -- upping the ante on tanning beds from $100 to $150; X-ray machines for hospitals, imaging centers and doctor’s offices from $228 to $285 and fees for dental offices from $112 to $140. Tanning beds must re-registered every year while X-ray devices are registered every other year.

While the fee increases are high as a percent change -- rising 50 percent for tanning beds and 25 percent for X-ray machines -- Wagner said that the state has not raised its fees on these machines since 2007. He added that a cap on fees for radioactive material licensing hadn’t been raised since as far back as 2000; the division has suggested raising the cap from $3,000 to $5,000. The new fee schedule would bring in roughly $600,000.

Even after the increase, Wagner said Oregon’s fee schedule will still be 50 percent lower than neighboring states California, Washington and Nevada.

“The work they do on radiation technology is really important,” Sen. Alan Bates, D-Ashland, an osteopathic physician, told The Lund Report.

Sen. Elizabeth Steiner Hayward, D-Portland, an allopathic family physician, supports SB 228 and said she was puzzled by Shields’ reservations.

If the bill does clear the Senate Health Committee, it will still have to go through the Committee on Ways & Means for a further vetting, including the Human Services subcommittee, which Bates chairs. “If [some of the fees] have not been changed in 15 years, that needs to be looked at.”

Shields told The Lund Report that while hospitals can easily absorb the cost of higher X-ray fees, he was concerned about the added costs to independent radiology outfits like Epic Imaging.

“We’re big enough to absorb that kind of increase,” said Dr. Christopher Altenhofen, a radiologist at Epic. “The state should be inspecting and certifying these machines. I think it’s a necessary measure.”

He explained that those most likely to feel the impacted of the increase would be the individual doctor’s and dentist’s offices and small primary clinics that operate their own X-ray machines.

Altenhofen said that the state inspections ensure a certain standard for X-ray safety, but the imaging quality from some of these independent practitioners’ machines still did not tend to be as good as what Epic could provide. Shields’ wife, a nurse practitioner, operates the Hands on Medicine Clinic in north Portland, but Shields did not say whether the clinic has its own X-ray machine.

Either way, it may be Shields' perspective gained helping his wife run her small business that causes him to stick his neck out for other small businesses, from dental offices to tanning parlors, to guard against government overreach, even to the point that he bucks his own party. 

Public Health Division spokeswoman Susan Wickstrom wouldn’t answer questions from The Lund Report about the Radiology Inspections program or describe how thorough the inspections are, beyond directing a reporter to read the lengthy administrative rules posted on the division’s website.

Shields opposed the law that prohibited tanning salons from offering their service to people under 18 without a medical prescription, an otherwise popular bipartisan measure pushed by Oregon Health & Science University’s Knight Cancer Institute. Oregon has the highest melanoma death rate among women in the country, and studies show that the use of tanning beds increases the risk of developing skin cancer by 70 percent.

Without the funding enclosed in SB 228, Wagner said that Public Health would not be able to enforce the underage teen tanning ban. The state would also have to suspend inspections of the machines to ensure that adult patrons do not suffer unnecessary burns from faulty equipment.

Despite her belief in the importance of the program, Senate Health Committee Chairwoman Sen. Laurie Monnes Anderson, D-Gresham, told The Lund Report that Shields and Knopp had a good point, and she, too, would like to hear from more than just the Oregon Health Authority on the impact of the fee increases.