CSSB 173(FIN) am H: "An Act relating to the practice of dentistry; relating to dental radiological equipment; relating to the practice of dental hygiene; relating to advanced practice permits for dental hygienists; relating to dental assistants; 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 CS FOR SENATE BILL NO. 173(FIN) am H 01 "An Act relating to the practice of dentistry; relating to dental radiological equipment; 02 relating to the practice of dental hygiene; relating to advanced practice permits for 03 dental hygienists; relating to dental assistants; prohibiting unfair discrimination under 04 group health insurance against a dental hygienist who holds an advanced practice 05 permit; relating to medical assistance for dental hygiene services; and providing for an 06 effective date." 07 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 08 * Section 1. AS 08.01.065(c) is amended to read: 09 (c) Except as provided in (f) - (k) [(f) - (j)] of this section, the department shall 10 establish fee levels under (a) of this section so that the total amount of fees collected 11 for an occupation approximately equals the actual regulatory costs for the occupation. 12 The department shall annually review each fee level to determine whether the 13 regulatory costs of each occupation are approximately equal to fee collections related
01 to that occupation. If the review indicates that an occupation's fee collections and 02 regulatory costs are not approximately equal, the department shall calculate fee 03 adjustments and adopt regulations under (a) of this section to implement the 04 adjustments. In January of each year, the department shall report on all fee levels and 05 revisions for the previous year under this subsection to the office of management and 06 budget. If a board regulates an occupation covered by this chapter, the department 07 shall consider the board's recommendations concerning the occupation's fee levels and 08 regulatory costs before revising fee schedules to comply with this subsection. In this 09 subsection, "regulatory costs" means costs of the department that are attributable to 10 regulation of an occupation plus 11 (1) all expenses of the board that regulates the occupation if the board 12 regulates only one occupation; 13 (2) the expenses of a board that are attributable to the occupation if the 14 board regulates more than one occupation. 15 * Sec. 2. AS 08.01.065 is amended by adding a new subsection to read: 16 (k) Notwithstanding (c) of this section, the department shall establish fee 17 levels under (a) of this section so that the total amount of fees collected by the Board 18 of Dental Examiners approximately equals the total regulatory costs of the department, 19 the board, and the Department of Health for all occupations regulated by the board. 20 For purposes of this subsection, the regulatory costs of the Department of Health for 21 the occupations regulated by the board include the cost of inspecting dental 22 radiological equipment under AS 44.29.020(d). 23 * Sec. 3. AS 08.32.110(e) is amended to read: 24 (e) This section does not prohibit a licensed dental hygienist 25 (1) with an endorsement issued under AS 08.32.085 from performing 26 the activities authorized under AS 08.32.085; 27 (2) who holds an advanced practice permit issued by the board 28 under AS 08.32.125 or has entered into a collaborative agreement approved by the 29 board under AS 08.32.115 from performing the activities authorized under the permit 30 or collaborative agreement; or 31 (3) from performing a dental operation, procedure, or service a dentist
01 may delegate to a dental assistant under AS 08.36.346 or that a licensed dental 02 hygienist who holds an advanced practice permit issued by the board under 03 AS 08.32.125 may delegate to a dental assistant under AS 08.36.346(c). 04 * Sec. 4. AS 08.32 is amended by adding a new section to read: 05 Sec. 08.32.125. Advanced practice permits. (a) The board may issue an 06 advanced practice permit to a licensed dental hygienist with a minimum of 4,000 07 documented hours of clinical experience. A licensed dental hygienist holding an 08 advanced practice permit may 09 (1) promote oral health and provide disease prevention education and 10 oral systemic health education; 11 (2) remove calcareous deposits, accretions, and stains from the 12 surfaces of the teeth beginning at the epithelial attachment by scaling and polishing 13 techniques; 14 (3) apply topical preventive or prophylactic agents, including silver 15 diamine fluoride, fluoride varnishes, and pit and fissure sealants; 16 (4) remove marginal overhangs; 17 (5) perform preliminary charting and triage to formulate a dental 18 hygiene assessment and dental hygiene treatment plan; 19 (6) expose and develop radiographs; 20 (7) use local periodontal therapeutic agents; 21 (8) perform nonsurgical periodontal therapy; 22 (9) screen for oral cancer; 23 (10) if certified by the board, administer local anesthetic agents; 24 (11) prescribe 25 (A) fluoride that is applied or provided to a patient; and 26 (B) chlorhexidine or a similar antibacterial rinse; and 27 (12) delegate dental operations and services to a dental assistant as 28 provided in AS 08.36.346. 29 (b) A licensed dental hygienist holding an advanced practice permit may 30 provide the services described in (a) of this section to a patient who is unable to access 31 dental treatment because of age, infirmity, or disability and is
01 (1) a resident in a senior center, including a hospital, long-term care 02 facility, adult foster home, residential care facility, or adult congregate living facility; 03 (2) a resident in a health care facility, including a mental health 04 residential program or facility for individuals with developmental or other disabilities; 05 (3) held in a local correctional facility for juveniles or adults; 06 (4) enrolled in a nursery school, day care program, vocational training 07 facility, primary school, secondary school, private school, or public charter school; 08 (5) entitled to benefits under 42 U.S.C. 1786 (Special Supplemental 09 Nutrition Program for Women, Infants, and Children); 10 (6) homebound; or 11 (7) a resident of a dental health professional shortage area designated 12 under 42 U.S.C. 254e. 13 (c) A licensed dental hygienist holding an advanced practice permit may 14 provide the services described in (a) of this section to a patient described in (b) of this 15 section without 16 (1) the physical presence, authorization, or supervision of a licensed 17 dentist; 18 (2) a licensed dentist's examination of the patient. 19 (d) A licensed dental hygienist who provides services under an advanced 20 practice permit shall maintain professional liability insurance and provide the patient, 21 or the parent or legal guardian of the patient, with 22 (1) a written notice that the treatment provided will be limited to 23 services permitted under (a) of this section; 24 (2) a written recommendation that the patient be examined by a 25 licensed dentist for comprehensive oral health care services; and 26 (3) assistance in obtaining a referral to a licensed dentist for further 27 dental planning and treatment, including a written description of methods for 28 obtaining a referral and a list of licensed dentists in the patient's community or other 29 resources for finding a licensed dentist. 30 (e) An advanced practice permit is valid until the expiration of the dental 31 hygienist's license to practice. A licensed dental hygienist may renew an advanced
01 practice permit at the time of license renewal under AS 08.32.071. 02 * Sec. 5. AS 08.32.160 is amended to read: 03 Sec. 08.32.160. Grounds for discipline, suspension, or revocation of license. 04 The board may revoke or suspend the license of a dental hygienist, or may reprimand, 05 censure, or discipline a licensee, if, after a hearing, the board finds that the licensee 06 (1) used or knowingly cooperated in deceit, fraud, or intentional 07 misrepresentation to obtain a license, certificate, or endorsement; 08 (2) engaged in deceit, fraud, or intentional misrepresentation in the 09 course of providing or billing for professional services or engaging in professional 10 activities; 11 (3) advertised professional services in a false or misleading manner; 12 (4) has been convicted of a felony or other crime that affects the 13 licensee's ability to continue to practice competently and safely; 14 (5) failed to comply with this chapter, with a regulation adopted under 15 this chapter or under AS 08.36, or with an order of the board; 16 (6) continued to practice after becoming unfit due to 17 (A) professional incompetence; 18 (B) addiction or dependence on alcohol or other drugs that 19 impairs the licensee's ability to practice safely; 20 (C) physical or mental disability; 21 (7) engaged in lewd or immoral conduct in connection with the 22 delivery of professional service to patients; 23 (8) except as permitted under an advanced practice permit under 24 AS 08.32.125, performed clinical procedures without being under the supervision of a 25 licensed dentist; 26 (9) did not conform to professional standards in delivering dental 27 hygiene services to patients regardless of whether actual injury to the patient occurred; 28 (10) permitted a dental assistant employed by an advanced 29 practice dental hygienist or working under the supervision of a dental hygienist 30 to perform a dental procedure in violation of AS 08.32.110 or AS 08.36.346; 31 (11) falsified or destroyed a patient or facility record, or failed to
01 maintain a patient or facility record for at least seven years after the date the 02 record was created. 03 * Sec. 6. AS 08.36 is amended by adding new sections to read: 04 Sec. 08.36.242. License to practice as specialist required. A licensed dentist 05 may not represent to the public to be qualified in a specialized branch of dentistry 06 through any means of public advertising using the term "specialist," the name of a 07 specialty, or a phrase that would suggest to the public that the dentist is a qualified 08 specialist in a branch of dentistry unless the dentist has a specialist license in that 09 branch as provided in this chapter. 10 Sec. 08.36.243. Qualification for specialist license; scope of practice. (a) An 11 applicant for a specialist license must 12 (1) hold a license issued by the board in accordance with AS 08.36.110 13 or 08.36.234; and 14 (2) meet additional qualifications for a specialist license in a specified 15 branch of dentistry as established by the board by regulation. 16 (b) In determining the qualifications for a specialist license in a specified 17 branch of dentistry under (a) of this section, the board shall consider the qualifications 18 necessary to obtain specialty certification by a nationally recognized certifying entity 19 approved by the board. 20 (c) The practice of a dentist who obtains a specialist license under (a) of this 21 section is limited to the branch of dentistry in which the dentist holds a specialist 22 license. 23 Sec. 08.36.245. Suspension or revocation of specialist license. The board 24 may suspend or revoke a specialist license on grounds and according to the procedures 25 set out in AS 08.36.315. 26 * Sec. 7. AS 08.36.346 is amended by adding a new subsection to read: 27 (c) A dental hygienist holding an advanced practice permit issued under 28 AS 08.32.125 may delegate to a dental assistant under a level of supervision specified 29 by the board in regulations 30 (1) the exposure and development of radiographs; 31 (2) application of topical preventive agents or pit and fissure sealants;
01 (3) other tasks specified by the board in regulations. 02 * Sec. 8. AS 21.36.090(d) is amended to read: 03 (d) Except to the extent necessary to comply with AS 21.42.365 and AS 21.56, a person may 04 not practice or permit unfair discrimination against a person who provides a service covered 05 under a group health insurance policy that extends coverage on an expense incurred basis, or 06 under a group service or indemnity type contract issued by a health maintenance organization 07 or a nonprofit corporation, if the service is within the scope of the provider's occupational 08 license. In this subsection, "provider" means a state licensed physician, physician assistant, 09 dentist, osteopath, optometrist, chiropractor, advanced practice registered nurse, naturopath, 10 physical therapist, occupational therapist, marital and family therapist, psychologist, 11 psychological associate, licensed clinical social worker, licensed professional counselor, [OR] 12 certified direct-entry midwife, or dental hygienist holding an advanced practice permit. 13 * Sec. 9. AS 44.29.020 is amended by adding a new subsection to read: 14 (d) The Department of Health shall establish standards that comply with 15 federal law for the registration, use, and inspection of dental radiological equipment, 16 including standards for record keeping relating to the control panels and the use of the 17 equipment. In this subsection, "dental radiological equipment" means equipment for 18 use in the practice of dentistry, consisting of a control panel and associated tube heads, 19 if the equipment emits electronic product radiation, as defined in AS 18.60.545, or 20 uses radionuclides, as defined in AS 18.60.545. 21 * Sec. 10. AS 44.46.029 is amended to read: 22 Sec. 44.46.029. Dental radiological equipment. This chapter does not 23 authorize the department to register, inspect, test, or otherwise regulate dental 24 radiological equipment or records relating to dental radiological equipment regulated 25 by the Department of Health [BOARD OF DENTAL EXAMINERS] under 26 AS 44.29.020(d) [AS 08.36.075]. 27 * Sec. 11. AS 46.03.022 is amended to read: 28 Sec. 46.03.022. Dental radiological equipment. This title does not authorize 29 the department to register, inspect, test, or otherwise regulate dental radiological 30 equipment or records relating to dental radiological equipment regulated by the 31 Department of Health [BOARD OF DENTAL EXAMINERS] under
01 AS 44.29.020(d) [AS 08.36.075]. 02 * Sec. 12. AS 47.07.030(b) is amended to read: 03 (b) In addition to the mandatory services specified in (a) of this section and the 04 services provided under (d) of this section, the department may offer only the 05 following optional services: case management services for traumatic or acquired brain 06 injury; case management and nutrition services for pregnant women; personal care 07 services in a recipient's home; emergency hospital services; long-term care 08 noninstitutional services; medical supplies and equipment; advanced practice 09 registered nurse services; clinic services; rehabilitative services for children eligible 10 for services under AS 47.07.063, substance abusers, and emotionally disturbed or 11 chronically mentally ill adults; targeted case management services; inpatient 12 psychiatric facility services for individuals 65 years of age or older and individuals 13 under 21 years of age; psychologists' services; clinical social workers' services; marital 14 and family therapy services; professional counseling services; midwife services; 15 prescribed drugs; physical therapy; occupational therapy; chiropractic services; low- 16 dose mammography screening, as defined in AS 21.42.375(e); hospice care; treatment 17 of speech, hearing, and language disorders; adult dental and dental hygiene services; 18 prosthetic devices and eyeglasses; optometrists' services; intermediate care facility 19 services, including intermediate care facility services for persons with intellectual and 20 developmental disabilities; skilled nursing facility services for individuals under 21 21 years of age; and reasonable transportation to and from the point of medical care. 22 * Sec. 13. AS 08.36.075; AS 18.05.065; AS 18.60.525(e); and AS 44.29.027 are repealed. 23 * Sec. 14. The uncodified law of the State of Alaska is amended by adding a new section to 24 read: 25 TRANSITION: REGULATIONS. The Board of Dental Examiners, the Department of 26 Commerce, Community, and Economic Development, and the Department of Health may 27 adopt regulations necessary to implement the changes made by this Act. The regulations take 28 effect under AS 44.62 (Administrative Procedure Act), but not before the effective date of the 29 law implemented by the regulation. 30 * Sec. 15. Section 14 of this Act takes effect July 1, 2022. 31 * Sec. 16. Sections 3 - 5, 7, 8, and 12 of this Act take effect January 1, 2023.
01 * Sec. 17. Except as provided in secs. 15 and 16 of this Act, this Act takes effect July 1, 02 2023.