Legislature(2007 - 2008)HOUSE FINANCE 519
03/27/2007 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB19 | |
| HB136 | |
| HB137 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 136 | TELECONFERENCED | |
| + | HB 137 | TELECONFERENCED | |
| + | HB 168 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 19 | TELECONFERENCED | |
HOUSE BILL NO. 136
"An Act relating to dental hygienists."
Vice Chair Stoltze MOVED to ADOPT the work draft to HB 136,
labeled 25-LS0364\K, Bullard, 3/26/07. There being NO
OBJECTION, it was so ordered.
Vice Chair Stoltze noted that this is the third reading of
the bill. It is a continuing effort for access for health
services for Alaska, especially underserved areas. He spoke
of the need for allowing dental hygienists to perform more
services. He referred to letters of support included in
members' packets.
2:05:09 PM
BEN MULLIGAN, STAFF, REPRESENTATIVE STOLTZE, explained the
three provisions of the bill. It would allow hygienists to
obtain a restorative function license endorsement. This
would allow a dental hygienist to place "fillings" into a
cavity prepared by a dentist. It would allow a dental
hygienist to administer local anesthetic agents under
general supervision of a dentist. The bill would also allow
hygienists and dentists to enter into a collaborative
agreement, which would allow the hygienists to perform
certain duties unsupervised.
Mr. Mulligan related the changes from the original version
of the bill. On page 1, line 14, the jurisdiction was
clarified. Page 3, line 2, references the statute where a
dentist is licensed. Line 13 on page 3 is a clarification
of terminology. Line 26 on page 3 adds a new subsection (d)
in order to clarify the number of agreements between
dentists and hygienists.
2:08:25 PM
Representative Crawford inquired about the training
necessary for hygienists to administer radiographs. He also
wondered about follow-up procedures by a dentist after the
hygienists have done their work. His concern was about
having less-qualified health care for rural areas due to
this bill.
2:10:53 PM
Vice Chair Stoltze recalled a past issue with a dental
therapist, not a dental hygienist. He explained that a
dental assistant does not have a licensing board or training
requirements. Representative Crawford thought that past
opposition was to a dental therapist. He questioned the
amount of training for each level. Vice Chair Stoltze
thought there were two separate issues.
Mr. Mulligan related the amount of training needed to become
a dental hygienist. Representative Crawford asked if they
can take x-rays. Mr. Mulligan deferred to others to answer.
Representative Foster said Indian Health Service dentists
used to serve the rural areas and were not licensed by the
state.
2:15:38 PM
Representative Nelson explained what federal dental health
aids are. They are studying in New Zealand now and will
return to serve rural communities in areas such as education
and diet. She emphasized the void in dental providers in
rural areas. She noted broad support for dental providers.
Representative Gara asked for clarification of the various
categories of aids and providers. He questioned the amount
of x-ray training a hygienist has.
Vice Chair Stoltze voiced a concern about public health
issues. In his experience a dentist has not been present
when x-rays were taken.
2:20:38 PM
ROYANN ROYER, DENTAL HYGIENIST, CHUGIAK, shared her
educational experience as a dental hygienist. She addressed
the restorative functions performed by a dental hygienist,
including training and personal experience. She described
how a hygienist would work together with a dentist. She
spoke about the collaborative agreement, which would have a
great impact on rural dental services, as well as in nursing
homes and other facilities.
2:25:30 PM
Ms. Royer maintained that currently dental hygienists would
take advantage of providing services on a limited basis.
She addressed the local anesthesia provision. Forty states
have incorporated this provision without any disciplinary
action. She reported that the Alaska Board of Dental
Examiners support the bill. The goal is to provide access
to quality dental care. She spoke in favor of HB 136.
2:29:06 PM
Representative Gara asked how many states have a
collaborative agreement. Ms. Royer thought about 10 do.
Representative Gara asked what training a hygienist gets for
radiology and local anesthesia. Ms. Royer replied that
there is a one semester course on radiology followed by four
clinical training semesters. Local anesthesia is a
separate licensing requirement with written and clinical
exams. In response to a question from Representative Gara,
Ms. Royer clarified how the instruction and testing is done.
2:31:49 PM
DR. HIGGINS, FAIRBANKS, addressed the "access of care"
issue. He noted that under the CHAP program, hygienists can
already perform cleanings in rural areas. In Oregon the
program has been a success. He questioned if the bill would
change the access problem. He related that hygienists
already spend their time cleaning teeth. He suggested
expanding the number of dental auxiliaries. He thought the
bill would be helpful, but does not address the real problem
of lack of hygienists.
Representative Crawford asked if the collaborative agreement
would make health care cheaper. Dr. Higgins thought it
would cost more because hygienists' duties would be
expanded. In order to see more patients, the duties of the
auxiliaries would have to be expanded.
2:40:40 PM
Representative Crawford asked if the collaborative agreement
would allow hygienists to travel to the villages without a
dentist. Dr. Higgins replied that the CHAPS program should
be doing that already. He questioned how many hygienists
would be willing to go out alone.
Vice Chair Stoltze asked for the definition of dental
auxiliary. Dr. Higgins replied that they are uncertified
assistants, trained in occlusions. They would need to be
certified and pass the boards.
Representative Gara asked if Dr. Higgins' concern is that
the bill would not expand treatment, but not with the safety
of service delivery. Dr. Higgins repeated that this bill
trains the wrong workforce and should be training assistants
rather than hygienists.
2:45:24 PM
DR. GLENN MARTIN, PUBLIC HEALTH DENTIST, read a prepared
statement. He described his job experience in traveling to
62 villages. He spoke in strong support for HB 136. He
spoke in favor of collaborative agreements and described how
that would result in better dental care in villages.
2:48:13 PM
DR. DAVID LOGAN, ALASKA DENTAL SOCIETY, JUNEAU, noted that
the Alaska Dental Society is in favor of CSHB 136 (FIN)
except for in the collaborative agreement section. He
referred to page 3, line 22, which currently reads "without
the dentist's diagnosis and treatment plan unless otherwise
specified in the collaborative agreement or in (a) of this
section". He preferred it to say "prior to the dentist's
diagnosis and with a treatment plan completed within a year"
to insure continuation of care and a full range of
treatment.
Representative Gara asked if a hygienist can do a cleaning
now without a dentist's diagnosis. Dr. Logan said they
cannot. All treatment requires a dentist's diagnosis and a
treatment plan. Representative Gara thought that was
excessive. Dr. Logan agreed. He thought the hygienist
should be able to work prior to a dentist's diagnosis and/or
treatment plan. He emphasized the importance of the
completion of the treatment plan.
2:52:12 PM
MARY CERNEY, DENTAL HYGIENIST, testified in support of the
legislation and provided information regarding the
legislation. She observed that a restorative endorsement
would be a separate endorsement. She detailed restorative
care that would be given. The collaborative practice would
provide care that would occur prior to the dentist's
treatment plan, not in lieu of a plan. Every dental
hygienist receives a Registered Dental Hygienist
certificate, which compares to a RN degree. She maintained
that the legislation would result in additional care and
noted the backlog in some areas. She reported that
hygienists had to have a dentist do an exam on each person
before a cleaning could be given. The legislation would
improve health care for the whole state, while providing
safeguards.
In response to a question by Representative Kelly, Ms.
Cerney noted that she supports the committee substitute.
She maintained that there is excellent training for both
radiology and radiography.
3:00:27 PM
DR. MIKE BOOTH, CHUGIAK, testified in support of the
legislation. He spoke in support of promoting hygienists
into rural areas. He maintained that local anesthesia is a
drug, which can cause side effects. He wanted to know that
hygienist were capable of dealing with conditions which
could occur with the use of anesthesia.
3:03:32 PM
JIM TOWLE, ALASKA DENTAL SOCIETY, informed the committee of
his group's efforts to work on the bill. He noted that he
had provided the committee with a list of amendments that
they would like to see in the bill (copy on file.) He
requested that safeguards be included with collaborative
agreements.
3:05:20 PM
RENA BOWER, ALASKA DENTAL HYGIENIST ASSOCIATION, testified
in support of the legislation and maintained that dental
hygienists are highly trained in radiology. Radiology
equipment is maintained and monitored by the state. She
hoped that the legislation would encourage students in rural
areas to go into the field. She spoke in favor of the
collaborative agreement and the ability for hygienists to
administer anesthesia.
3:10:14 PM
LINDA GOHL, AARP, CAPITAL CITY TASK FORCE, JUNEAU, testified
in support of the legislation. She stressed that the
legislation would increase access and pointed out that
Alaska's dental care is the most expensive in the United
States.
Vice Chair Stoltze acknowledged the issue of anesthesia and
stated that he would look into it.
Representative Hawker referred to a letter from James R.
Towle with a concern about how the local anesthesia would be
administered. He requested more information about this.
Co-Chair Meyer noted that that concern would be dealt with
before the bill goes to the House Floor. He mentioned the
new indeterminate fiscal note that accompanies the bill.
3:16:22 PM
Representative Foster MOVED to REPORT CSHB 136 (FIN) out of
committee with individual recommendations and the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
CSHB 136 (FIN) was REPORTED out of Committee with "no
recommendation" and with a new indeterminate fiscal note by
the Department of Commerce, Community and Economic
Development.
3:16:59 PM
| Document Name | Date/Time | Subjects |
|---|