Legislature(2005 - 2006)CAPITOL 17
01/18/2006 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HB338 | |
| HB93 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 93 | TELECONFERENCED | |
| = | HB 295 | ||
| *+ | HB 338 | TELECONFERENCED | |
HB 93-DENTISTS AND DENTAL HYGIENISTS 4:13:01 PM CHAIR ANDERSON announced that the last 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 the proposed committee substitute (CS) for HB 93, Version 24-LS0384\G, Mischel, 1/31/05, which was adopted as a work draft on 2/2/05.] 4:13:11 PM REPRESENTATIVE KOTT moved to adopt the proposed CS for HB 93, Version 24-LS0384\I, Mischel, 1/12/06, as the working document. There being no objection, Version I was before the committee. 4:13:49 PM HEATH HILYARD, Staff to Representative Anderson, Alaska State Legislature, sponsor, informed the committee on behalf of Representative Anderson that many of the concerns expressed by the Alaska Dental Society, Inc. (ADS) and the Division of Occupational Licensing have been addressed via Version I. He explained that one of the concerns of the division was that in the original version, the Board of Dental Examiners was given far broader power than the division comfortable with. He added that Jim Towle from the ADS would be able to explain the changes in greater detail. 4:15:41 PM JIM TOWLE, Executive Director, Alaska Dental Society, Inc., (ADS), stated that the ADS has worked extensively with the division to address their concerns, adding that they are ready to address any new concerns that the division may have. He explained that the language in Version I has been modified to ensure that the department staff involved in the investigatory process work with the Board of Dental Examiners ("the board"), and the board would not be empowered to act independently. CHAIR ANDERSON commented that the CS was faxed to several dentists, and his office did not receive any objections. He asked if any members of the committee had received any calls with concerns or objections. 4:17:49 PM REPRESENTATIVE GUTTENBERG asked how the public feels about the proposed "peer review" and how it has worked in the past. CHAIR ANDERSON asked Mr. Towle to address the issue of having "peer review" instead of review by a neutral entity. MR. TOWLE replied that the public makes a complaint based on the performance of dentistry, and a licensed professional would have the background and working knowledge to protect the public. He added that an untrained "professional investigator" would not be aware of what goes on in a technical healthcare field. CHAIR ANDERSON asked if this is comparable to a doctor having oversight on the Alaska State Medical Board, or a real estate agent on the Real Estate Commission & Board of Certified Real Estate Appraisers. MR. TOWLE answered that this is correct. He added that someone who has the training and background in the field would be qualified to look at things like x-rays and tell if the care given was appropriate, and that someone who doesn't have the training and background would not be able to do this. CHAIR ANDERSON asked if by "background", he meant someone like an occupational licensing administrator. REPRESENTATIVE GUTTENBERG stated his concern is that the dentists who are reviewing complaints may know the party in question, and asked if there would be a "blind system" set up, so that the person performing the review would not know the person he/she is reviewing. MR. TOWLE responded that there is not a "blind system" in statute, and the board would have to set this up. CHAIR ANDERSON opined that the board should be able to deal with these situations, adding that he would rather have a group of dentists who have the knowledge than an administrator who is unable to understand the situation. 4:26:03 PM GEORGE SHAFFER, D.M.D, Alaska Dental Society, Inc., informed the committee that he has served as chairman on the [Board of Dental Examiners] and is currently on the executive council for the Alaska Dental Society, Inc., (ADS). He stated that the premise for the legislation was to maintain the professional standards of dentistry. He explained that during his term on the board, when a complaint was being made against a dentist, the board would be required to make a decision based on a report from department investigators, but would not be able to see any evidence. He stated that the board would ask to see evidence, such as an x-ray, and was told that it could not until an initial decision was made and appealed; however, the Administrative Procedure Act (APA) clearly specifies that an appeal regarding board action goes to the Alaska Superior Court, and not back to the board. DR. SHAFFER stated that the legislation engendered by a desire to make the process fairer and ensure that problems did not slip through the cracks. [The bill] would give the board stronger power by allowing it to impose heavier discipline than is currently in the law, and also gives broader powers for minor infractions such as fee disputes. The board is currently overworked, and this would allow the board to appoint other committees to investigate minor complaints, though the board would be the final arbitrator to take action. CHAIR ANDERSON asked if this is similar to the Alaska Bar Association (ABA). DR. SHAFFER replied that all other professions in the state are different than the ABA, adding that the bill provides for a better way to define "checks and balances," allows the board to deal with serious matters, and puts the board in charge of the direction and consequences of investigations. 4:31:50 PM REPRESENTATIVE CRAWFORD, referring to page 4, line 4, of the proposed CS, asked the significance of adding "clinical" before "practice". Referring to page 4, [lines 12-15], he asked if "20 hours" was weekly, monthly, or yearly. DR. SHAFFER replied that "clinical" was added to create fairness in the investigations. He stated that it is easy to get a license and then not work on a patient for many years, which can then cause the license holder to fall behind with current practice. He explained that adding "clinical" guarantees that the license holder is currently working with patients. In regard to the "20 hours", he stated that this is fairly arbitrary and that it was meant to be 20 hours per week, which would mean the license holder was working half time and staying fairly current. 4:35:07 PM CHAIR ANDERSON moved Amendment 1, to page 4, line 13, adding "per week" after 20 hours. There being no objection, amendment 1 was adopted. 4:35:26 PM DR. SHAFFER, in response to a question from Representative Guttenberg, explained that the term, "private clinical practice" was added as a way to guarantee independence for the people making the decisions, and to ensure that the licensees were not making certain choices out of fear that they might lose their job. REPRESENTATIVE LEDOUX, referring to page 3, line 11, subparagraph B, asked how "threatens or compromises patient care, has the potential to compromise patient care", differs from "impairs a licensee's ability to practice safely". DR. SHAFFER replied that this wording further clarifies the definition. In response to further questions and comments, he explained that "impairing" would require proof that harm has been done, whereas "potential to compromise" means that there is a drug problem or addiction that has serious potential to harm a patient. He added that this gives the board the opportunity to act sooner, instead of waiting until harm has been done. In response to another question from Representative LeDoux, who referred to proposed AS08.32.160(6)(c) and proposed AS08.36.315(8)(d), he explained that having a difference in physical and mental disability standards for dentists and hygienists was an oversight and they should instead be the same. He expressed a preference for wording that is more inclusive and allows the board to monitor both professions. CHAIR ANDERSON recommended that they use the wording on page 3, lines [14-16], subparagraph (c), as the standard for both professions. DR. SHAFFER replied that the ADS has no problem with this wording. Referring to the provisions pertaining to addiction, he said that if a dentist or dental hygienist had a drug or alcohol problem and was in rehabilitation, he/she should be able to work something out with the board so that he/she is able to continue working while in rehabilitation. REPRESENTATIVE CRAWFORD commented that he would prefer the wording on page 8 [lines 25-26], which read: (D) physical or mental disability that cannot be overcome through an accommodation for purposes of complying with this chapter; REPRESENTATIVE LEDOUX commented that they could try and combine the language in proposed AS08.32.160(6)(c) with the language in proposed AS08.36.315(8)(d). The resulting language might then read something along the lines of: physical or mental disability that threatens [or] compromises [patient care, has the potential to compromise patient care, or impairs the licensee's ability to practice safely] unless such physical or mental disability [can] be overcome through an accommodation for purposes of complying with this chapter. CHAIR ANDERSON asked whether such language in both provisions would work. DR. SHAFFER said yes. CHAIR ANDERSON referred to the aforementioned language as Conceptual Amendment 2, and [although no formal motion was made], announced that Conceptual Amendment 2 was adopted. 4:46:36 PM REPRESENTATIVE KOTT, referring to page 10, line 4, stated that he would like to have the language changed such that it would read in part, "SHALL, By certified mail, send a copy", because there is a 30-day requirement. DR. SHAFFER said he did not object to such a change. 4:48:31 PM CHAIR ANDERSON referred to the aforementioned suggested change as Conceptual Amendment 3. [Although no formal motion was made, Conceptual Amendment 3 was treated as adopted.] 4:48:44 PM RICK URION, Director, Central Office, Division of Occupational Licensing, Department of Commerce, Community, & Economic Development (DCCED) informed the committee that he had shown the bill to the Department of Law (DOL) and to his investigative staff, both of which came back with unfavorable opinions of the legislation. He explained that the premise of the bill was based on misconceptions of past history. He went on to say that last session, the legislature passed a bill that formed a new office of administrative hearing officers, which solved many of the problems that the department had. Mr. Urion explained that the legislation that was passed set time limits on how long a hearing officer has to act. He stated that the bill currently before the committee takes dentistry cases out of this new administrative hearing system, and so there would be no hearing officer on dentist cases if this legislation passes. He explained that the board would become the hearing officer and from the board it would go to the Alaska Superior Court, and suggested that the committee get a fiscal note from the superior court. MR. URION explained that there are 654 licensed dentists in the state and for the last 10 years there have been 195 complaints. He stated that this is less than 20 complaints per year, and went on to say that 6 of these complaints resulted in licensing action, 40 percent are closed with no action, and 30 percent have "some" action. He stated that [HB 93] changes a system that deals with six potential cases per year, and said he does not think there will be good results. He added that 30 days is not enough time to develop a case, stating that this is " ... certainly not [going to] protect the public, that's protecting the guilty party." He opined that to require the complaint information be made available to the [licensee] would discourage some people from making complaints, especially if they are employed by the licensee. He commented that to suspend a board member if a complaint is filed against them is unfair, adding that it may be an unjust complaint. Mr. Urion opined that the restriction on telephonic meetings for disciplinary actions will result in more plane fares and will cost the board members more money. He added that this will result in a higher licensing cost. MR. URION explained the system that the Alaska State Medical Board uses, adding that this would be a better system for the dental board to consider. In response to Dr. Shaffer's comments, Mr. Urion stated that there have been two summary suspensions in 10 years. He said that the department feels that the current system is working fine, and remarked that he would be willing to work with the dental community to find a system that works for them. 4:57:49 PM CHAIR ANDERSON stated that many of the concerns that the Division of Occupational Licensing had previously were addressed with the current CS, and remarked that the issues presently being raised would be more appropriately addressed in the House Judiciary Standing Committee. 5:00:35 PM DR. SHAFFER, in response to comments made by Representative Guttenberg, explained that when an accusation against a licensee goes to court, the judge or jury would get to see all the evidence involved prior to making a decision. Currently, the board is required to make decisions without seeing any evidence. He opined that the current situation lacks "fairness of law", adding that this is the reason for making the evidence available to the licensee. He stated that the "peer review" would offer more protection to the public, as it allows patients to ask other dentists whether or not certain behaviors are questionable. DR. SHAFFER, in response to questions from Chair Anderson, agreed that this would be comparable to court cases where the information must be made public. He explained that a few other states have similar systems, adding that the majority of states have dentists and [dental] hygienists on the state licensing board, overseeing the entire investigatory process. 5:06:32 PM MR. URION clarified that under the current system, when cases go to a hearing officer, the hearing officer makes a decision which is then sent on to the board. The board can then concur or reject the decision. He added that the board is then able to see all of the evidence, which is extensive and therefore may discourage some people from serving as board members. REPRESENTATIVE LEDOUX asked if, in regard to physicians, a hearing officer is used for disciplinary proceedings or if the case is heard by a panel of doctors. MR. URION answered that the case goes to a hearing officer. 5:07:51 PM REPRESENTATIVE KOTT moved to report the proposed CS for HB 93, Version 24-LS0384\I, Mischel, 1/12/06, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 93(L&C) was reported from the House Labor and Commerce Standing Committee.
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