txt

SSSB 68: "An Act relating to the practice of dental hygiene; establishing an advanced practice permit; prohibiting unfair discrimination under group health insurance against a dental hygienist who holds an advanced practice permit; and relating to medical assistance for dental hygiene services."

00                  SPONSOR SUBSTITUTE FOR SENATE BILL NO. 68                                                              
01 "An Act relating to the practice of dental hygiene; establishing an advanced practice                                   
02 permit; prohibiting unfair discrimination under group health insurance against a dental                                 
03 hygienist who holds an advanced practice permit; and relating to medical assistance for                                 
04 dental hygiene services."                                                                                               
05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
06    * Section 1. AS 08.32.110(e) is amended to read:                                                                   
07            (e)  This section does not prohibit a licensed dental hygienist                                              
08                 (1)  with an endorsement issued under AS 08.32.085 from performing                                      
09       the activities authorized under AS 08.32.085;                                                                     
10 (2)  who holds an advanced practice permit issued by the board                                                      
11 under AS 08.32.125 or has entered into a collaborative agreement approved by the                                    
12 board under AS 08.32.115 from performing the activities authorized under the permit                                 
13       or collaborative agreement; or                                                                                
14                 (3)  from performing a dental operation, procedure, or service a dentist                                
01       may delegate to a dental assistant under AS 08.36.346.                                                            
02    * Sec. 2. AS 08.32 is amended by adding a new section to read:                                                     
03 Sec. 08.32.125. Advanced practice permits. (a) The board may issue an                                                 
04 advanced practice permit to a licensed dental hygienist with a minimum of 4,000                                         
05 documented hours of clinical experience. A licensed dental hygienist holding an                                         
06       advanced practice permit may perform one or more of the following:                                                
07                 (1)  oral health promotion, disease prevention education, and oral                                      
08       systemic health education;                                                                                        
09                 (2)  removal of calcareous deposits, accretions, and stains from the                                    
10       surfaces of teeth;                                                                                                
11 (3)  application of topical preventive or prophylactic agents, including                                                
12       silver diamine fluoride, fluoride varnishes, and pit and fissure sealants;                                        
13                 (4)  polishing and smoothing restorations;                                                              
14                 (5)  removal of marginal overhangs;                                                                     
15 (6)  preliminary charting and triage to formulate a dental hygiene                                                      
16       assessment and dental hygiene treatment plan;                                                                     
17                 (7)  the exposure and development of radiographs;                                                       
18                 (8)  use of local periodontal therapeutic agents;                                                       
19 (9)  nonsurgical periodontal therapy, with or without the administration                                                
20       of local anesthesia;                                                                                              
21                 (10)  screening for oral cancer;                                                                        
22                 (11)  administration of local anesthesia; and                                                           
23                 (12)  writing prescriptions for                                                                         
24                      (A)  fluoride that is applied or provided to a patient; and                                        
25                      (B)  chlorhexidine or a similar antibacterial rinse.                                               
26 (b)  A licensed dental hygienist holding an advanced practice permit may                                                
27 provide the services described in (a) of this section to a patient who is unable to                                     
28       receive dental treatment because of age, infirmity, or disability and is                                          
29 (1)  a resident in a senior center, including a hospital, long-term care                                                
30       facility, adult foster home, residential care facility, or adult congregate living facility;                      
31 (2)  a resident in a health care facility, including a mental health                                                    
01       residential program or facility for individuals with developmental or other disabilities;                         
02                 (3)  held in a local correctional facility for juveniles or adults;                                     
03                 (4)  enrolled in a nursery school, day care program, vocational training                                
04       facility, primary school, secondary school, private school, or public charter school;                             
05                 (5)  entitled to benefits under 42 U.S.C. 1786 (Special Supplemental                                    
06       Food Program for Women, Infants, and Children);                                                                   
07                 (6)  homebound; or                                                                                      
08                 (7)  a resident of a dental health professional shortage area designated                                
09       under 42 U.S.C. 254e.                                                                                             
10 (c)  A licensed dental hygienist holding an advanced practice permit may                                                
11 provide the services described in (a) of this section to a patient described in (b) of this                             
12       section without                                                                                                   
13 (1)  the physical presence, authorization, or supervision of a licensed                                                 
14       dentist;                                                                                                          
15                 (2)  a licensed dentist's examination of the patient.                                                   
16 (d)  A licensed dental hygienist who provides services under an advanced                                              
17 practice permit shall maintain professional liability insurance and provide the patient,                                
18       or the parent or legal guardian of the patient, with                                                              
19 (1)  a written notice that the treatment provided will be limited to                                                    
20       services permitted under (a) of this section;                                                                     
21 (2)  a written recommendation that the patient be examined by a                                                         
22       licensed dentist for comprehensive oral health care services; and                                                 
23 (3)  assistance in obtaining a referral to a licensed dentist for further                                               
24 dental planning and treatment, including a written description of methods for                                           
25 obtaining a referral and a list of licensed dentists in the patient's community or other                                
26       resources for finding a licensed dentist.                                                                         
27 (e)  A licensed dental hygienist holding an advanced practice permit may                                                
28       practice as an independent contractor.                                                                            
29 (f)  An advanced practice permit is valid until the expiration of the dental                                            
30 hygienist's license to practice. A licensed dental hygienist may renew an advanced                                      
31       practice permit at the time of license renewal under AS 08.32.071.                                              
01    * Sec. 3. AS 21.36.090(d) is amended to read:                                                                      
02 (d)  Except to the extent necessary to comply with AS 21.42.365 and                                                     
03 AS 21.56, a person may not practice or permit unfair discrimination against a person                                    
04 who provides a service covered under a group health insurance policy that extends                                       
05 coverage on an expense incurred basis, or under a group service or indemnity type                                       
06 contract issued by a health maintenance organization or a nonprofit corporation, if the                                 
07 service is within the scope of the provider's occupational license. In this subsection,                                 
08 "provider" means a state licensed physician, physician assistant, dentist, osteopath,                                   
09 optometrist, chiropractor, advanced practice registered nurse, naturopath, physical                                     
10 therapist, occupational therapist, marital and family therapist, psychologist,                                          
11 psychological associate, licensed clinical social worker, licensed professional                                         
12 counselor, [OR] certified direct-entry midwife, or dental hygienist holding an                                      
13       advanced practice permit.                                                                                     
14    * Sec. 4. AS 47.07.030(b) is amended to read:                                                                      
15 (b)  In addition to the mandatory services specified in (a) of this section and the                                     
16 services provided under (d) of this section, the department may offer only the                                          
17 following optional services: case management services for traumatic or acquired brain                                   
18 injury; case management and nutrition services for pregnant women; personal care                                        
19 services in a recipient's home; emergency hospital services; long-term care                                             
20 noninstitutional services; medical supplies and equipment; advanced practice                                            
21 registered nurse services; clinic services; rehabilitative services for children eligible                               
22 for services under AS 47.07.063, substance abusers, and emotionally disturbed or                                        
23 chronically mentally ill adults; targeted case management services; inpatient                                           
24 psychiatric facility services for individuals 65 years of age or older and individuals                                  
25 under 21 years of age; psychologists' services; clinical social workers' services; marital                              
26 and family therapy services; midwife services; prescribed drugs; physical therapy;                                      
27 occupational therapy; chiropractic services; low-dose mammography screening, as                                         
28 defined in AS 21.42.375(e); hospice care; treatment of speech, hearing, and language                                    
29 disorders; adult dental and dental hygiene services; prosthetic devices and                                         
30 eyeglasses; optometrists' services; intermediate care facility services, including                                      
31 intermediate care facility services for persons with intellectual and developmental                                     
01       disabilities; skilled nursing facility services for individuals under 21 years of age; and                        
02       reasonable transportation to and from the point of medical care.