SB 68: "An Act relating to the practice of dental hygiene; establishing an advanced practice permit and eliminating collaborative agreements for dental hygienists; prohibiting unfair discrimination under group health insurance against a dental hygienist who holds an advanced practice permit; relating to medical assistance for dental hygiene services; and providing for an effective date."
00 SENATE BILL NO. 68 01 "An Act relating to the practice of dental hygiene; establishing an advanced practice 02 permit and eliminating collaborative agreements for dental hygienists; prohibiting 03 unfair discrimination under group health insurance against a dental hygienist who holds 04 an advanced practice permit; relating to medical assistance for dental hygiene services; 05 and providing for an effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 08.32.110(e) is amended to read: 08 (e) This section does not prohibit a licensed dental hygienist 09 (1) with an endorsement issued under AS 08.32.085 from performing 10 the activities authorized under AS 08.32.085; 11 (2) who holds an advanced practice permit issued [HAS ENTERED 12 INTO A COLLABORATIVE AGREEMENT APPROVED] by the board under 13 AS 08.32.115 from performing the activities authorized under the permit
01 [COLLABORATIVE AGREEMENT]; or 02 (3) from performing a dental operation, procedure, or service a dentist 03 may delegate to a dental assistant under AS 08.36.346. 04 * Sec. 2. AS 08.32.115(a) is amended to read: 05 (a) The board may issue an advanced practice permit to [IF THE 06 COLLABORATIVE AGREEMENT IS APPROVED BY THE BOARD UNDER (d) 07 OF THIS SECTION,] a licensed dental hygienist with a minimum of 4,000 08 documented hours of clinical experience. A licensed dental hygienist holding an 09 advanced practice permit may [WITHIN THE FIVE YEARS PRECEDING 10 APPLICATION FOR THE BOARD'S APPROVAL MAY ENTER INTO A 11 COLLABORATIVE AGREEMENT WITH A LICENSED DENTIST IN WHICH 12 THE LICENSED DENTIST AUTHORIZES THE LICENSED DENTAL 13 HYGIENIST TO] perform one or more of the following: 14 (1) oral health promotion, [AND] disease prevention education, and 15 oral systemic health education; 16 (2) removal of calcareous deposits, accretions, and stains from the 17 surfaces of teeth; 18 (3) application of topical preventive or prophylactic agents, including 19 silver diamine fluoride, fluoride varnishes, and pit and fissure sealants; 20 (4) polishing and smoothing restorations; 21 (5) removal of marginal overhangs; 22 (6) preliminary charting and triage to formulate a dental hygiene 23 assessment and dental hygiene treatment plan; 24 (7) the exposure and development of radiographs; 25 (8) use of local periodontal therapeutic agents; [AND] 26 (9) [PERFORMANCE OF] nonsurgical periodontal therapy, with or 27 without the administration of local anesthesia; 28 (10) screening for oral cancer; 29 (11) atraumatic restorative technique; and 30 (12) writing prescriptions for 31 (A) fluoride that is applied or provided to a patient; and
01 (B) chlorhexidine or a similar antibacterial rinse [, 02 SUBSEQUENT TO A LICENSED DENTIST'S AUTHORIZATION OR 03 DIAGNOSIS AS SPECIFIED IN THE LICENSED HYGIENIST'S 04 COLLABORATIVE AGREEMENT]. 05 * Sec. 3. AS 08.32.115(b) is repealed and reenacted to read: 06 (b) A licensed dental hygienist holding an advanced practice permit may 07 provide the services described in (a) of this section to a patient who is unable to 08 receive dental treatment because of age, infirmity, or disability and is 09 (1) a resident in a senior center, including a hospital, long-term care 10 facility, adult foster home, residential care facility, or adult congregate living facility; 11 (2) a resident in a health care facility, including a mental health 12 residential program or facility for individuals with developmental or other disabilities; 13 (3) held in a local correctional facility for juveniles or adults; 14 (4) enrolled in a nursery school, day care program, vocational training 15 facility, primary school, secondary school, private school, or public charter school; 16 (5) entitled to benefits under 42 U.S.C. 1786 (Special Supplemental 17 Food Program for Women, Infants, and Children); 18 (6) homebound; or 19 (7) a member of a population that the board determines is underserved 20 by the dental health profession. 21 * Sec. 4. AS 08.32.115(c) is repealed and reenacted to read: 22 (c) A licensed dental hygienist holding an advanced practice permit may 23 provide the services described in (a) of this section to a patient described in (b) of this 24 section without 25 (1) the physical presence, authorization, or supervision of a licensed 26 dentist; 27 (2) a licensed dentist's examination of the patient. 28 * Sec. 5. AS 08.32.115(d) is repealed and reenacted to read: 29 (d) A licensed dental hygienist who provides services under an advanced 30 practice permit shall maintain professional liability insurance and provide the patient, 31 or the parent or legal guardian of the patient, with
01 (1) a written notice that the treatment provided will be limited to 02 preventive services and will not include comprehensive oral health care services; 03 (2) a written recommendation that the patient be examined by a 04 licensed dentist for comprehensive oral health care services; and 05 (3) assistance in obtaining a referral to a licensed dentist for further 06 dental planning and treatment, including a written description of methods for 07 obtaining a referral and a list of licensed dentists in the patient's community or other 08 resources for finding a licensed dentist. 09 * Sec. 6. AS 08.32.115 is amended by adding new subsections to read: 10 (e) A licensed dental hygienist holding an advanced practice permit may 11 practice as an independent contractor. 12 (f) An advanced practice permit is valid until the expiration of the dental 13 hygienist's license to practice. A licensed dental hygienist may renew an advanced 14 practice permit at the time of license renewal under AS 08.32.071. 15 * Sec. 7. AS 21.36.090(d) is amended to read: 16 (d) Except to the extent necessary to comply with AS 21.42.365 and 17 AS 21.56, a person may not practice or permit unfair discrimination against a person 18 who provides a service covered under a group health insurance policy that extends 19 coverage on an expense incurred basis, or under a group service or indemnity type 20 contract issued by a health maintenance organization or a nonprofit corporation, if the 21 service is within the scope of the provider's occupational license. In this subsection, 22 "provider" means a state licensed physician, physician assistant, dentist, osteopath, 23 optometrist, chiropractor, advanced practice registered nurse, naturopath, physical 24 therapist, occupational therapist, marital and family therapist, psychologist, 25 psychological associate, licensed clinical social worker, licensed professional 26 counselor, [OR] certified direct-entry midwife, or dental hygienist holding an 27 advanced practice permit. 28 * Sec. 8. AS 47.07.030(b) is amended to read: 29 (b) In addition to the mandatory services specified in (a) of this section and the 30 services provided under (d) of this section, the department may offer only the 31 following optional services: case management services for traumatic or acquired brain
01 injury; case management and nutrition services for pregnant women; personal care 02 services in a recipient's home; emergency hospital services; long-term care 03 noninstitutional services; medical supplies and equipment; advanced practice 04 registered nurse services; clinic services; rehabilitative services for children eligible 05 for services under AS 47.07.063, substance abusers, and emotionally disturbed or 06 chronically mentally ill adults; targeted case management services; inpatient 07 psychiatric facility services for individuals 65 years of age or older and individuals 08 under 21 years of age; psychologists' services; clinical social workers' services; marital 09 and family therapy services; midwife services; prescribed drugs; physical therapy; 10 occupational therapy; chiropractic services; low-dose mammography screening, as 11 defined in AS 21.42.375(e); hospice care; treatment of speech, hearing, and language 12 disorders; adult dental and dental hygiene services; prosthetic devices and 13 eyeglasses; optometrists' services; intermediate care facility services, including 14 intermediate care facility services for persons with intellectual and developmental 15 disabilities; skilled nursing facility services for individuals under 21 years of age; and 16 reasonable transportation to and from the point of medical care. 17 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 18 read: 19 TRANSITION: COLLABORATIVE AGREEMENTS. Notwithstanding the 20 amendment to AS 08.32.110(e)(2) by sec. 1 of this Act, the repeal and reenactment of 21 AS 08.32.115(b) - (d) by secs. 3 - 5 of this Act, and the enactment of AS 08.32.115(e) and (f) 22 by sec. 6 of this Act, a collaborative agreement approved by the board under AS 08.32.115 23 before the effective date of secs. 1 - 6 of this Act is valid until the agreement expires under 24 AS 08.32.115 as that section read before the effective date of secs. 1 - 6 of this Act. 25 * Sec. 10. The uncodified law of the State of Alaska is amended by adding a new section to 26 read: 27 REGULATIONS. The Department of Commerce, Community, and Economic 28 Development and the Board of Dental Examiners may adopt regulations necessary to 29 implement the changes made by this Act. The regulations take effect under AS 44.62 30 (Administrative Procedure Act), but not before the effective date of the law implemented by 31 the regulation.
01 * Sec. 11. The uncodified law of the State of Alaska is amended by adding a new section to 02 read: 03 REVISOR'S INSTRUCTION. The revisor of statutes is requested to change the catch 04 line for AS 08.32.115 from "Collaborative agreements" to "Advanced practice permits." 05 * Sec. 12. Section 10 of this Act takes effect immediately under AS 01.10.070(c).