State law requires that each Department of Health (DOH) program, such as the dental program, is fully self-funded, and this includes the cost of licensing and regulating the members of each respective health care profession. In order to address the annual operating shortfall of the Dental Quality Assurance Commission (DQAC), the DOH is proposing to increase dental licensure fees. The proposed fee increase would become effective June 1, 2023 and would increase the base dental license renewal fees from $350 to $365, increasing the total renewal fee to $415 when taking into consideration the additional $50 surcharge for the Washington Physician Health Program. Based on a recent DOH study which has shown that the majority of costs incurred by DQAC are to support returning practitioners, the proposal does not include any changes to the application fee or fee for licensure without examination. Additionally, under the proposal the late renewal penalty would decrease from $288 to $185 in order to come into alignment with DOH standard policy, which requires late renewal fees be set at 50% of the renewal fee when the renewal fee is greater than $100. The below chart from the DOH outlines the current and proposed fees for dental personnel.

The last fee changes for the dental program occurred in 2014, decreasing licensing fees. However, as DQAC has been operating on an annual shortfall, the DOH is recommending a fee increase to bring revenue into alignment with the cost of licensing and regulating dental professions and to stabilize the dental program fund balance near reserve level. The primary drivers of these increased costs are the growth in discipline-related costs as well as the implementation of the Healthcare Enforcement and Licensing Management System (HELMS), the cost of which is spread across DOH professions.

In 2016, DQAC had discipline-related expenses totaling $1,387,191. For comparison, this number grew to $1,838,439 in 2021. HELMS is the DOH electronic licensing system replacing the current system, with the purpose of transforming the licensing and enforcement processes for health care providers and facilities, improving data security, supporting electronic records management, and improving access to information. The cost of HELMS is shared by other DOH licensing programs, such as physical therapy, hearing and speech, etc., based on the number of licensees per program. At this time, the DOH is unable to determine what portion of the proposed dental licensure fee increase would be allocated to cover the cost of HELMS as opposed to other program costs.

As part of the project to adjust fees as needed for professions, the DOH will be setting a process in place to ensure that every profession has its fee and fund balance monitored on an annual basis to more accurately adjust program fund projections. As these fund projections are adjusted, the DOH will communicate balance trends with individual programs, and if actual expenditures are lower than projected or if incoming revenue significantly exceeds expenditures, a fee reduction will be considered.

Proposed Licensure Fee Change Public Rule Hearing

The DOH is holding a public rules hearing for this proposed fee increase, along with proposed fee increases for several other professions, on Jan. 24, 2023 at 9:00 AM. The hearing will be held in a virtual meeting format via zoom, and those interested can register for the public rules hearing webinar here. Written comments regarding the proposed fee increase must be submitted by Jan. 23, 2023 either through the DOH online rules comment webpage, or by email to HSQAFeeRules@doh.wa.gov.

Questions?

The DOH has posted the official draft of the proposed fee rule language, and more information regarding the fee increase and cost drivers of the increase can be found on the DOH Dental Commission Fee Cost Drivers resource. Specific questions can be directed to DQAC Program Manager, Amber Freeberg, at amber.freeberg@doh.wa.gov or 360-236-4893.