Legislature(2005 - 2006)CAPITOL 120
02/24/2006 02:00 PM House JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HB329 | |
| HB446 | |
| HB441 | |
| HB414 | |
| HB93 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 441 | TELECONFERENCED | |
| + | HB 93 | TELECONFERENCED | |
| *+ | HB 446 | TELECONFERENCED | |
| += | TELECONFERENCED | ||
| = | HB 329 | ||
| = | HB 414 | ||
HB 93 - DENTISTS AND DENTAL HYGIENISTS 3:07:32 PM CHAIR McGUIRE announced that the final order of business would be HOUSE BILL NO. 93, "An Act relating to dentists and dental hygienists and the Board of Dental Examiners; establishing certain committees for the discipline and peer review of dentists; excluding the adjudicatory proceedings of the Board of Dental Examiners and its committees from the Administrative Procedure Act and from the jurisdiction of the office of administrative hearings; and providing for an effective date." [Before the committee was CSHB 93(L&C); in committee packets was a proposed committee substitute (CS) for HB 93, Version 24- LS0384\S, Mischel, 2/1/06.] 3:07:37 PM HEATH HILYARD, Staff to Representative Tom Anderson, Alaska State Legislature, sponsor, noted on behalf of Representative Anderson that committee packets contain a proposed committee substitute (CS) for HB 93. 3:08:07 PM REPRESENTATIVE COGHILL moved to adopt the proposed CS for HB 93, Version 24-LS0384\S, Mischel, 2/1/06, as the work draft. There being no objection, Version S was before the committee. MR. HILYARD explained that [Version S] creates a "peer review committee" for the Board of Dental Examiners, which oversees dentists and dental hygienists operating in the state. This will provide members of these professions greater involvement in the adjudicatory proceedings that come before the Board of Dental Examiners. He mentioned that representatives from the Alaska Dental Society were available and could stress the value and importance that the proposed changes represent for them. He mentioned that members' packets contain a summary of the changes encompassed in Version S. MR. HILYARD reviewed those changes. A change on page 2, line 30, reinserts the words, "or knowingly cooperated in"; this language mirrors language [on page 8], and [counsel] for the Alaska Dental Society believed that keeping the language consistent throughout the bill was of value. A change on page 4, line 3, inserts the word, "physically" between "who" and "reside"; this addresses the concern that those who serve on the Board of Dental Examiners actually reside in the state. A change to page 4, line 3, inserts the word, "clinical" between "the" and "practice"; this addresses the concern that those who serve on the Board of Dental Examiners are currently clinically practicing. A change to page 7, line 2, substitutes the word, "reasonable" for "substantial"; this pertains to the type of evidence that would be required. A change to page 9, lines 8-9, deletes the words, "or an approved provider of continuing education for dentists"; [the Alaska Dental Society felt] that using the term, "dental schools" would be sufficient. A change to page 13, line 28, provides for a $50,000 civil fine. REPRESENTATIVE GRUENBERG [although Version S had already been adopted as the work draft] said he was objecting to the adoption of Version S for the purpose of asking a question. He referred to page 4, line 3, and noted that there are types of dentistry practice other than clinical, such as forensic dentistry and academic dentistry. He asked what other types of non-clinical dentistry practices exist. 3:11:46 PM DAVID G. LOGAN, D.D.S., Chairman, Legislative Affairs Committee, Alaska Dental Society, acknowledged Representative Gruenberg's point, and said that a dentist performing insurance reviews would also be considered to be practicing dentistry. GEORGE SHAFFER, D.D.S., Member, Legislative Affairs Committee, Alaska Dental Society, added that "public health dentistry" would also be considered a dentistry practice; a dentist with such a practice analyzes epidemiological data. He indicated that dentists who don't have a clinical practice won't necessarily be staying current with clinical dentistry practices. REPRESENTATIVE GRUENBERG said he understands why there would be a desire for members of the Board of Dental Examiners to be dentists who actually perform dental procedures on patients. [Although Version S had already been adopted as a work draft] he removed his objection to the adoption of Version S. REPRESENTATIVE COGHILL noted that proposed AS 08.36.010 - located on page 4, lines 13-16 - specifies what would constitute a "practice of dentistry" and a "practice of dental hygiene" for purposes of that section. 3:15:21 PM REPRESENTATIVE WILSON offered her understanding that there is a shortage of dentists willing to practice in rural areas of the state, so much so that some Native corporations are sending people down to New Zealand to get training in this field. She asked whether HB 93 would alleviate this problem. DR. LOGAN said HB 93 would have no affect on that issue; rather, it simply pertains to the make up and function of the Board of Dental Examiners with regard to disciplinary actions, with the intent being to give the Board of Dental Examiners more insight into the cases that come before it. DR. SHAFFER, in response to a question, said that HB 93 was triggered by the fact that for many years the Board of Dental Examiners was making disciplinary decisions without ever seeing any evidence, and it was felt that this was unfair, particularly given that these decisions could affect a person's career. DR. SHAFFER emphasized that the Alaska Dental Society would like the state to be more involved [in the Board of Dental Examiners's disciplinary process]. Presently peer review is only done by [and for] Alaska Dental Society members, and if one is not a member, then peer review is not available; passage of HB 93 will allow the peer review process to fall under the purview of the state, which will oversee all parts of that process. Additionally, Version S contains a clause that provides the Board of Dental Examiners with the ability to address situations in which a dentist has issues of drug or alcohol dependence. REPRESENTATIVE GRUENBERG indicated that he is expecting the Alaska Dental Society to continue developing language that will address some of the concerns expressed by Catherine Reardon, former director the Division of Occupational licensing, and said that he is willing to assist in that effort. In response to a question, he explained that those concerns pertained to: timelines regarding the disciplinary process - possibly eliminating from proposed AS 08.01.087 both the word, "discipline" and subsection (e); the language in proposed AS 08.36.030 regarding what should happen if the president of the Board of Dental Examiners is not a licensed dentist and how the requirements listed on page 10 would then be met; possibly eliminating the word, "only" from page 6, line 2, so that other identifiers could be transmitted; possibly altering language on page 7 such that examinations could be conducted by someone outside the state who is otherwise qualified; language in proposed AS 08.36.080 regarding how the Alaska Superior Court would review a matter; and a possible conforming amendment on page 10. He predicted that with a little bit of work, these issues could be resolved by the time the bill is heard in the House Finance Committee. CHAIR McGUIRE, after ascertaining that no one else wished to testify, closed public testimony on HB 93. 3:25:33 PM REPRESENTATIVE COGHILL moved to report the proposed CS for HB 93, Version 24-LS0384\S, Mischel, 2/1/06, out of committee with individual recommendations and the accompanying fiscal note. REPRESENTATIVE GARA objected for the purpose of discussion. He referred to page 11, lines 9, and page 12, line 19. He asked whether a patient has the right to appeal a decision. REPRESENTATIVE GRUENBERG noted that other language on page 11 specifies that "a party to the peer review" may appeal. [Chair McGuire turned the gavel over to Representative Anderson.] REPRESENTATIVE GARA asked whether a patient gets to appeal a decision that doesn't include a recommendation for disciplinary action. DR. SHAFFER said that he reads the language such that it means either party could appeal a decision. REPRESENTATIVE GARA noted, though, that the language appears to only pertain to decisions that include a recommendation for disciplinary action. DR. SHAFFER said that the Alaska Dental Society would have no objection to adding language which specifies that either a patient or a complainant may appeal a decision that does not include a recommendation for disciplinary action. In response to comments, he said the Alaska Dental Society wants [the peer review process] to be an open process, and so would be amenable to any changes to that effect. REPRESENTATIVE GARA said it seems like language on page 12 only allows a licensee to appeal a decision for disciplinary action. DR. SHAFFER said the Alaska Dental Society's response is the same regarding that point. REPRESENTATIVE GARA referred to language on page 2, lines 9-10, and asked whether a finding against a dentist or dental hygienist would remain confidential. He opined that such ought to be made public - the public should know whether a dentist or dental hygienist is performing poorly. DR. SHAFFER pointed out that the bill contains a provision specifying that the public is notified after the Board of Dental Examiners takes action. He relayed that the Alaska Dental Society is working on a conceptual change to "open that up even more," so that more details can be added when the Board of Dental Examiners notifies the public. He assured the committee that the language on page 2, lines 9-10, is not making an action of the Board of Dental Examiners confidential. 3:31:21 PM REPRESENTATIVE GARA said he is considering offering a conceptual amendment which would say that if the board finds that there is a violation, the information relating to the violation shall be made public. The committee took an at-ease from 3:31 p.m. to 3:33 p.m. [Representative Anderson returned the gavel to Chair McGuire.] DR. SHAFFER referred to language on page 6, line 2, and indicated that deleting the word, "only" ought to alleviate Representative Gara's concern. REPRESENTATIVE GARA pointed out, though, that the language on page 6 pertains to providing notice in a newspaper that the Board of Dental Examiners took some action. He opined that the records relating to the violation should also be made public. DR. SHAFFER said that the Alaska Dental Society has no intention of purging records or attempting to hide something; if the Board of Dental Examiners takes an action against a [licensee], that "goes on the record" and is reported to the National Practitioner Data Bank (NPDB). REPRESENTATIVE GARA offered an example wherein a patient dies because of the actions taken by a dentist; future consumers should be informed that such has occurred. REPRESENTATIVE COGHILL posited that the public will find out about criminal action, and offered his understanding that using newspapers is simply the typical way [that certain organizations] inform the public of their decisions. Perhaps the statutes should be updated to reflect that notification should occur via other methods of communication as well, he remarked. CHAIR McGUIRE noted that there is a motion to report the bill from committee. 3:36:30 PM REPRESENTATIVE COGHILL withdrew the motion to report the bill from committee. [Following was a brief discussion regarding how the committee wished to proceed.] 3:38:41 PM REPRESENTATIVE GARA made a motion to adopt Conceptual Amendment 1, to alter the language on page 2 [lines 9-10] such that when the Board of Dental Examiners finds that there has been a violation by a licensee, the information relating to the violation, including the board's decision, shall be made public except that personal medical records of the licensee shall not be made public. There being no objection, Conceptual Amendment 1 was adopted. REPRESENTATIVE GARA referred to the language on page 7, lines 30-31, and asked what is meant by the phrase, "impose another form of discipline that the board determines is warranted and necessary". DR. SHAFFER said this language would allow the Board of Dental Examiners the flexibility to impose lesser forms of discipline than it would for more serious accusations. REPRESENTATIVE GRUENBERG suggested that Representative Gara work with him and the Alaska Dental Society representatives to address this issue before the bill is heard in the House Finance Committee. CHAIR McGUIRE noted that the committee could either leave that language as is or strike out all references to it and allow the issue to be addressed before the bill is heard in the House Finance Committee. She opined that the language should be more specific. DR. SHAFFER referred to language on page 14, lines 28-30, which says in part, "The board shall establish standards in regulation for the imposition of consistent discipline linked to each action giving rise to the discipline". This wording would require the Board of Dental Examiners to specify, via regulations, what type discipline would be administered for each type of [violation]; the promulgation of such regulations would require the Board of Dental Examiners to go through the regulation process and the public notice and comment periods that such a process entails. This will ensure that all future boards apply discipline equally using the same guidelines. CHAIR McGUIRE acknowledged Dr. Shaffer's points, but opined that the statutory language should be clarified. REPRESENTATIVE ANDERSON suggested simply replacing the words, "another form" with the words, "a lesser form". 3:44:01 PM REPRESENTATIVE WILSON made a motion to adopt Amendment 2, to delete from page 7, line 30, the word "another" and insert the words, "a lesser". There being no objection, Amendment 2 was adopted. REPRESENTATIVE GARA made a motion to adopt Conceptual Amendment 3, to alter the language on page 9, line 16, such that the Board of Dental Examiners shall comply with federal and state laws governing discrimination. Noting that the current language pertains to decisions based on the existence of a physical disability, he remarked, "I don't want to relax the laws on discrimination." REPRESENTATIVE ANDERSON suggested instead simply adding the phrase, "with all applicable laws relating to discrimination" this would address situations in which there are municipal laws relating to discrimination. REPRESENTATIVE GARA said, "Sure; federal, state, and municipal, I guess ...." CHAIR McGUIRE opined that "all applicable" would be too [broad]. REPRESENTATIVE COGHILL concurred, noting that a physical disability could actually impair the person's ability [to perform the services correctly]. He surmised that the bill is attempting to address situations in which a licensee has become unable to perform the duties required of a dentist. REPRESENTATIVE GARA offered his understanding that state and federal laws allow for the termination of someone's license if such a person would be a danger to the public. CHAIR McGUIRE noted that the language [in proposed AS 08.36.315(C)] starts out by saying, "The board may not discriminate against a licensee solely on the basis of a mental of physical impairment or disability". She asked Representative Gara whether he would like the language to say, "shall comply with both federal and state law". REPRESENTATIVE GARA remarked, "Federal and state law governing discrimination - yeah." 3:47:20 PM REPRESENTATIVE GARA restated his motion to adopt Conceptual Amendment 3, to alter the language on page 9, line 16, such that it says in part, "shall comply with federal and state laws governing discrimination". REPRESENTATIVE GRUENBERG asked whether the language on lines 10- 11 of page 9 would be retained. REPRESENTATIVE GARA and CHAIR McGUIRE said yes. REPRESENTATIVE COGHILL characterized the language being proposed by Conceptual Amendment 3 as redundant. CHAIR McGUIRE, after ascertaining that were no objections, announced that Conceptual Amendment 3 was adopted. 3:47:57 PM REPRESENTATIVE GARA made a motion to adopt Conceptual Amendment 4, "wherever the licensee has a right to appeal, the complainant or ... the department shall also have the same rights to appeal." In response to questions, he said that Conceptual Amendment 4 would apply to pages 11 and 12 and perhaps elsewhere as well, and would ensure that all parties have the right to appeal equally. There being no objection, Conceptual Amendment 4 was adopted. REPRESENTATIVE GRUENBERG in response to comments, relayed that he is willing to vote to report the bill from committee as long as he has an opportunity, before the bill is heard in the House Finance Committee, to work with the Alaska Dental Society representatives [and the sponsor's staff] to address his concerns, perhaps via a new proposed CS. MR. HILYARD agreed to assist Representative Gruenberg. 3:51:01 PM REPRESENTATIVE COGHILL moved to report the proposed CS for HB 93, Version 24-LS0384\S, Mischel, 2/1/06, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 93(JUD) was reported from the House Judiciary Standing Committee.
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