Legislature(2007 - 2008)
02/15/2008 02:33 PM Senate HES
| Audio | Topic |
|---|---|
| Start | |
| SB239 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 239-DENTISTS & DENTAL ASSISTANTS
CHAIR DAVIS announced SB 239 for consideration.
2:34:27 PM
SENATOR THOMAS presented his sponsor statement and a brief
overview. SB 239 would improve the efficiency of dental care and
reduce treatment costs by expanding the functions dental
assistants are permitted to perform. It would allow a certified
dental assistant to place fillings into a cavity prepared by a
licensed dentist and to polish teeth that are already clean of
tartar. He noted that dental assistants are not currently
regulated by the state. They work very closely with dentists,
who are responsible for monitoring the quality of their work.
2:38:11 PM
DR. DAVID LOGAN, Doctor of Dental Surgery (DDS), Juneau AK
requested the committee adopt the changes in the CS for SB
239.He said this is a bill about access to care in rural areas
and for the underserved. He explained that it is difficult
children to be seen by a dentist or hygienist for a cleaning
because, in Alaska the Medicaid reimbursement for a child
cleaning is $48.00 and the average hourly salary for a hygienist
is $54.00. They are looking for avenues to resolve the problem
using the available labor pool and dental assistants are a
logical choice. They would be trained and certified to perform
the task, so it would be safe and cost-effective. He noted that
it is already done in many other states.
The restorative function would primarily serve the rural areas
for itinerant teams moving in. The dentists would numb the
patients, work with the assistants to prepare the teeth, and the
assistants would do the fillings. The dentists would return to
check their work afterward to make sure everything has been done
properly. This would provide a tremendous increase in service,
from 70 to 100 percent.
2:41:04 PM
SENATOR COWDERY joined meeting the meeting via teleconference
and asked how this addressed the concerns that cropped up from
prior proposals.
DR. LOGAN said he did not understand the question and asked what
concerns the senator was referring to.
SENATOR COWDERY responded that there were concerns that cropped
up from prior proposals regarding expanded duties of dental
assistants and he wondered whether all of them had been
addressed.
CHAIR DAVIS explained that this is the first hearing of the bill
and suggested that Senator Cowdery might be referring to a bill
on dental hygienists that had already passed the committee.
DR. PETE HIGGINS, DDS, said the bill would help in rural areas
and with elderly care. Alaska Dental Outreach Corporation (ADOC)
is a nonprofit organization put together by the Alaska Dental
Society to get dentists out in field with assistants, and this
would allow them to see more patients in the villages, where
they have limited capacity. He noted that the federal government
has certified assistants for expanded duties for years and one
of his assistants had been certified in California. The
Anchorage and Fairbanks Hygienist Associations were working with
them on training, and he was confident that the board could put
together a good certification program. He felt the bill was long
overdue and strongly supported passage.
2:45:41 PM
SENATOR ELTON asked about the training his assistant received
for certification in California.
DR HIGGENS said she trained for 16 months because she started
from scratch and had to take the core courses as well. In
California one can pick and choose what areas one wants to
expand into, but they would prefer to limit it cleaning and
fillings here in Alaska. He was not sure how long that training
would be.
2:47:11 PM
DAVID L. EICHLER, DMD, President, Alaska Board of Dental
Examiners supported the bill.
SENATOR ELTON asked whether a dental assistant is more highly
trained than a dental hygienist or vice versa.
DR EICHLER answered no, hygienists typically study for 3 to 5
years; assistants receive on-the-job training, although there
are some continuing education courses available at University of
Alaska Fairbanks.
2:50:11 PM
DR. MIKE BOOTH, Dentist, thought the bill would be a great
advantage to the children of state because dentists tend to be
old, male and grouchy; hygienists tend to be highly educated, a
little older and very expensive; dental assistants are usually
young women who look a lot like mom, which may be a lot less
stressful for them.
DR DAN PITTS, Dentist, Soldotna AK, spoke in favor of SB 239. He
had been practicing for 30 yr practice, the first 6 of which
were in the villages of Toke, Tetlin and Northway. This isn't a
new idea. He was trained to work with expanded-duty dental
assistants 30 yrs ago and it has continued to be common practice
in many states.
DR. MARK PRATER, Dentist, said he had practiced in the state for
31 years in Anchorage, Kotzebue, Amblin and Wasilla, so he was
familiar with the problems of access to care in the villages.
2:54:15 PM
He could see that passing this bill would be of great benefit to
people in the rural areas, to bring them adequate care. He added
his support for passage of SB 239.
PHYLLIS PENDERGRAST, Dentist, Fairbanks AK, said she had been
practicing in Alaska for 30 years, acted as president of the
dental board, president of the Alaska Dental Society, and
president of the Western Regional Examining Board. For the first
seven years she worked in villages, including four years in
Galena. She felt privileged to work with several extended-duty
dental assistants who would place amalgam and composite, chair
side reversible filling materials, in teeth after she had
prepared them. They were skilled, very professional, and good
with the patients. One of her assistants graduated from school
in Idaho and was certified to place amalgams and composites.
Another of her staff helped start the dental assisting program
in Fairbanks and actually practices placing amalgams in
dentiform teeth. That program could be expanded. The use of
expanded function dental assistants could help to solve the bush
problem and possibly a statewide shortage of dentists and dental
personnel.
2:58:12 PM
SENATOR THOMAS moved CSSB 239, referred to as Version e, be
adopted as the working document. There being no objection, the
motion carried.
CATHERINE REARDON, Staff to Senator Thomas, provided a brief
analysis of the bill. Page 1, paragraph B, line 9 authorizes an
assistant to perform coronal polishing only on teeth without
calculus and under direct supervision. She emphasized that this
should not be confused with full cleaning, it is just the last
step. It would also give the board the authority to establish
fees and renewal and continuing education requirements.
The second part, at the bottom line [page] one, covers
certification for packing a cavity with filling after the
dentist has drilled it out. Specific training requirements are
detailed at the top of line [page] two, including successful
completion of a program accredited by the Commission on Dental
Accreditation of the American Dental Association or other course
approved by the board; and passage of the Western Regional
Examining Board's restorative examination or other equivalent
examination approved by the board within the five years
preceding the dental assistant's certification application.
The next section lists what a dentist may delegate to a dental
assistant and is broken into two sections: what may be delegated
under indirect supervision what may be delegated under direct
supervision. Those terms are defined at the end of the bill.
Because dental assistants were not in statute previously, the
bill sets out things that they are already permitted to do under
indirect supervision. That list begins on page 2, line 18 and
includes such tasks as: x-rays, application of topical
preventative agents (fluoride) or pit and fissure sealants.
3:04:27 PM
Although other duties may be approved by the board under direct
supervision, they cannot include certain items under the
hygienist statute 08.32.110, such as anesthesia, even if the
board decided to allow it.
MS. REARDON finished by saying that additional terms are defined
at the end of the bill. She pointed out that the only reference
to "dental assistant" in statute was in 08.32.110 (d) and would
no longer be needed if this bill were to pass, so it is repealed
in this bill.
3:07:57 PM
SENATOR ELTON returned to the programs accredited by the
commission on the top of page two, paragraph (2) where it says
"...or the dental assistant has legal authorization from another
state or jurisdiction...." He warranted that another state may
have standards or requirements that are less stringent than the
state of Alaska's, and it seemed odd to him that we would be
willing to accept that. He asked if he was misreading that
paragraph.
MS REARDON answered that he was not misreading it.
SENATOR THOMAS said he believed it would have to be an
equivalent exam approved by the board, so the board would have
to approve it.
3:11:28 PM
SENATOR THOMAS moved to report CSSB 239(HES) version E from
committee with individual recommendations and attached fiscal
note(s). There being no objection, the motion carried.
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