Legislature(1993 - 1994)
03/01/1994 03:00 PM House HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
March 1, 1994
3:00 p.m.
MEMBERS PRESENT
Rep. Cynthia Toohey, Co-Chair
Rep. Con Bunde, Co-Chair
Rep. Gary Davis, Vice Chair
Rep. Al Vezey
Rep. Pete Kott
Rep. Harley Olberg
Rep. Irene Nicholia
Rep. Tom Brice
MEMBERS ABSENT
Rep. B. Davis (excused)
COMMITTEE CALENDAR
HB 267: "An Act increasing elementary and secondary
instructional units for certain school districts
with 800 or fewer students in average daily
membership; and providing for an effective date."
PASSED OUT OF COMMITTEE
HB 361: "An Act making an appropriation to the Department
of Education for support of kindergarten, primary,
and secondary education and community schools
programs; and providing for an effective date."
PASSED OUT OF COMMITTEE
*HB 507: "An Act relating to licensure by the State Medical
Board and temporary permits for certain
optometrists."
PASSED OUT OF COMMITTEE
*HB 324: "An Act extending the termination date of the
Board of Dental Examiners; and providing for an
effective date."
PASSED OUT OF COMMITTEE
HB 320: "An Act relating to public school health personal
safety education."
PASSED OUT OF COMMITTEE
*HB 472: "An Act relating to referrals involving dental
services."
PASSED OUT OF COMMITTEE
(* First public hearing.)
WITNESS REGISTER
LARRY LABOLLE, Legislative Aid
Rep. Richard Foster
Alaska State Legislature
State Capitol
Juneau, Alaska 99801-1182
Phone: (907) 465-3789
Position Statement: Answered questions on HB 267
WANDA COOKSEY, Representative
Single School District Consortium
P.O. Box 240052
Douglas, Alaska 99824-0052
Phone: (907) 586-9073
Position Statement: Supplied fiscal information on HB 267
to the committee
DR. ROY BOX, Optometrist
16185 Lena Loank Rd.
Juneau, Alaska 99801
Phone: (907) 789-3175
Position Statement: Answered questions on HB 472
(spoke via teleconference)
DR. DAVID MCGUIRE, Chairman
Alaska State Medical Board
448 Laurel St., Ste. 202
Anchorage, Alaska 99508
Phone: (907) 562-4142
Position Statement: Answered questions on HB 472
(spoke via offnet)
DR. DON LEHMANN, President
Alaska State Medical Association
700 Katlian St. #E
Sitka, Alaska 99835
Phone: (907) 747-5861
Position Statement: Testified in support of HB 507
DR. DAN PITTS, Former President
Alaska Dental Society
155 Smith Way
Soldotna, Alaska 99669
Phone: (907) 262-4989
Position Statement: Testified in support of HB 472
(spoke via offnet)
PREVIOUS ACTION
BILL: HB 267
SHORT TITLE: REVISE FOUNDATION FORMULA, SMALL SCHOOLS
SPONSOR(S): REPRESENTATIVE(S) FOSTER,Mackie,Menard,Olberg,
Nicholia,B.Davis
JRN-DATE JRN-PG ACTION
03/31/93 875 (H) READ THE FIRST TIME/REFERRAL(S)
03/31/93 875 (H) HES, FINANCE
01/31/94 2204 (H) SPONSOR SUBSTITUTE
INTRODUCED-REFERRALS
01/31/94 2204 (H) HES, FINANCE
02/02/94 2230 (H) COSPONSOR(S):OLBERG,NICHOLIA,
B.DAVIS
02/16/94 (H) HES AT 03:00 PM CAPITOL 106
02/16/94 (H) MINUTE(HES)
BILL: HB 361
SHORT TITLE: APPROP: EDUCATION FUNDING FOR FY 95
SPONSOR(S): FINANCE
JRN-DATE JRN-PG ACTION
01/11/94 2032 (H) READ THE FIRST TIME/REFERRAL(S)
01/11/94 2033 (H) HES, FINANCE
02/02/94 (H) HES AT 03:00 PM CAPITOL 106
02/14/94 (H) HES AT 03:00 PM CAPITOL 106
02/14/94 (H) MINUTE(HES)
BILL: HB 507
SHORT TITLE: LICENSING OF OPTOMETRISTS AND PHYSICIANS
SPONSOR(S): HEALTH, EDUCATION AND SOCIAL SERVICES BY REQUEST
JRN-DATE JRN-PG ACTION
02/16/94 2416 (H) READ THE FIRST TIME/REFERRAL(S)
02/16/94 2416 (H) HES, LABOR & COMMERCE
03/01/94 (H) HES AT 03:00 PM CAPITOL 106
BILL: HB 324
SHORT TITLE: EXTEND BOARD OF DENTAL EXAMINERS
SPONSOR(S): REPRESENTATIVE(S) BUNDE
JRN-DATE JRN-PG ACTION
01/03/94 2012 (H) PREFILE RELEASED
01/10/94 2012 (H) READ THE FIRST TIME/REFERRAL(S)
01/10/94 2012 (H) HES, FINANCE
03/01/94 (H) HES AT 03:00 PM CAPITOL 106
BILL: HB 320
SHORT TITLE: PUBLIC SCHOOL HEALTH AND SAFETY EDUCATION
SPONSOR(S): REPRESENTATIVE(S) TOOHEY,Hudson,Brice,Bunde,
Finkelstein,Nordlund,Olberg,Porter,Sitton,B.Davis
JRN-DATE JRN-PG ACTION
01/03/94 2011 (H) PREFILE RELEASED
01/10/94 2011 (H) READ THE FIRST TIME/REFERRAL(S)
01/10/94 2011 (H) HES, FINANCE
01/21/94 2127 (H) COSPONSOR(S):BRICE,BUNDE,
FINKELSTEIN
01/21/94 2127 (H) COSPONSOR(S):NORDLUND,OLBERG,
PORTER
01/21/94 2127 (H) COSPONSOR(S): SITTON
02/09/94 2328 (H) COSPONSOR(S): B. DAVIS
02/24/94 (H) HES AT 03:00 PM CAPITOL 106
02/24/94 (H) MINUTE(HES)
BILL: HB 472
SHORT TITLE: REFERRALS INVOLVING DENTAL SERVICES
SPONSOR(S): REPRESENTATIVE(S) G.DAVIS BY REQUEST
JRN-DATE JRN-PG ACTION
02/14/94 2375 (H) READ THE FIRST TIME/REFERRAL(S)
02/14/94 2375 (H) HES, JUDICIARY
03/01/94 (H) HES AT 03:00 PM CAPITOL 106
ACTION NARRATIVE
TAPE 94-32, SIDE A
Number 000
CHAIR BUNDE called the meeting to order at 3:06 p.m., noted
members present and announced the calendar. He mentioned
that Tanana and Galena were observing the meeting via
teleconference. He brought HB 267 to the table.
HB 267 - REVISE FOUNDATION FORMULA, SMALL SCHOOLS
Number 005
CHAIR BUNDE said that the bill had been discussed previously
and that it provides for single site schools to be included
in the foundation formula. He asked for further discussion.
REP. VEZEY said, "I'd like to know a little more about the
basis of these numbers and what these numbers really
translate to, into dollars and adjustments."
CHAIR BUNDE stated for the record that Rep. Brice arrived at
3:08 p.m. He then asked for clarification of which numbers
Rep. Vezey was referring to.
REP. VEZEY said "the factors."
Number 076
REP. OLBERG offered the assistance of Larry LaBolle.
Number 080
LARRY LABOLLE, Legislative Aid to Rep. Richard Foster, Prime
Sponsor of HB 267, stated that he did not have a fiscal note
included in his bill packet to refer to.
REP. OLBERG interjected that the fiscal note exactly matches
the amount of last year's appropriation.
MR. LABOLLE said the fiscal note dated February 1, 1994, is
for $3,372,100 for fiscal year (FY) 1995.
Number 143
REP. VEZEY said, "my question was more specifically... the
factor 1.12 for schools with membership below 250 and 1.08
for schools with membership below 525 and 1.06 with schools
with membership below 800."
MR. LABOLLE said those are calculations that were derived by
Dr. Cole, who is the author of the foundation formula. He
indicated that Dr. Cole came back and did a study of the
foundation unit and offered these recommendations when the
study was completed.
REP. VEZEY asked when the study was done.
MR. LABOLLE replied that it was conducted two years ago.
Number 173
REP. VEZEY asked if there was anything in the bill packets
pertaining to Dr. Cole's study.
MR. LABOLLE said that he personally had a copy of the report
which showed how those figures were derived.
REP. VEZEY said he would appreciate receiving a copy.
CHAIR BUNDE asked if there was other information to support
those figures.
Number 200
WANDA COOKSEY, Representative, Single Site School
Consortium, offered fiscal information to Rep. Vezey.
REP. OLBERG asked Chair Bunde to identify Wanda Cooksey for
the record.
Number 229
CHAIR BUNDE said it was his intention to pass HB 267 out of
committee and on to the Finance Committee.
REP. VEZEY made a motion to pass HB 267 out of committee
with individual recommendations and accompanying fiscal
note.
CHAIR BUNDE, hearing no objections, declared HB 267 was so
moved. He then brought HB 361 to the table.
HB 361 - APPROPRIATION: EDUCATION FUNDING FOR FY 95
CHAIR BUNDE stated that the HB 361 and a committee
substitute (CS) were both addressed previously. He said HB
361 was before the committee. He asked the pleasure of the
committee.
REP. BRICE clarified that it was the original bill HB 361
that was before the committee.
REP. TOOHEY made a motion to pass HB 361 out of committee
with individual recommendations and accompanying fiscal
note.
Number 278
CHAIR BUNDE clarified and said there is no fiscal note
because it is an appropriation.
Hearing no objections, CHAIR BUNDE stated that HB 361 was so
moved.
CHAIR BUNDE then asked for a subcommittee report from Rep.
G. Davis and Rep. Vezey regarding HB 362.
REP. VEZEY said that Rep. G. Davis and he had not gotten
together for that subcommittee meeting and questioned the
date that Chair Bunde had asked for them to produce their
recommendations.
CHAIR BUNDE asked if the committee could have an update by
Friday.
CHAIR BUNDE then brought HB 507 before the committee.
HB 507 - LICENSING OF OPTOMETRISTS & PHYSICIANS
Number 340
REP. TOOHEY stated that Section 1 of the bill addresses the
concerns of the State Medical Board to interview an
applicant for licensure in person. She indicated that the
board would like the section to be expanded to include a
designated representative. She said because of the large
geographical area of the state and the expense involved in
traveling, the change would be prudent. She said the
provision would allow actively licensed physicians who have
been previously approved by the board to interview
applicants. She further stated that Section 2 deals with
granting temporary permits for locum tenens for the purpose
of providing temporary medical coverage for an unserved area
as approved by the board. She said the board wishes to
amend that section of statute to allow locum tenens
physicians to practice for limited periods of time. Locum
tenens licenses would serve as 60 day permits in remote
areas with the knowledge and scrutiny of the board. She
said under current status locum tenens permits may only be
issued to physicians who are substituting for an absent
physician. She said the legislation would allow for a
temporary permit to be issued to a physician who would be
practicing in an area that does not have a residing
physician. She said the same requirements for a full
license are expected for temporary licensure.
REP. TOOHEY indicated those requirements as being: proof of
education, residency or internship, Federation of State
Medical Board approval, and at least one verification from
another state where the physician is licensed. She further
stated that in Section 3 of the bill, the locum tenens
permit may be issued to a nonresident optometrist for the
purpose of assisting or substituting for an optometrist
licensed under AS 08.72.172. She said if a practitioner in
a remote area of Alaska becomes seriously ill or injured and
must leave temporarily, presently the physician must close
down the clinic. She said the proposal would allow a
specialist, perhaps in the area of subnormal vision and
visual therapy, to be scheduled to assist local doctors
where specialist care does not exist now.
REP. TOOHEY said Dr. David McGuire, Chairman of the Alaska
State Medical Board, was on line to answer any questions
pertaining to Sections 1 and 2 of the bill. She also said
that Dr. Roy Box was available via teleconference from
Wrangell to discuss Section 3. She said there were others
in the audience from the Alaska Medical Association who
could assist with questions.
CHAIR BUNDE explained that Dr. McGuire was in the process of
connecting with offnet. He asked Rep. Toohey if she had
further testimony.
CHAIR TOOHEY said she was finished.
CHAIR BUNDE asked for Dr. Roy Box to testify.
Number 468
DR. ROY BOX, Optometrist, stated that the problem is that
there is a limited number of doctors and all have
established offices, so if an optometrist needs to leave his
office, it's almost impossible to get someone to fill in.
He said if there was a broader selection of licensed doctors
from other parts of the country, it would be easier to
maintain uniform care for patients. He further stated that
his profession is emerging into specialty areas; i.e.,
subnormal vision; and those practitioners are often located
in the larger metropolitan areas in other states.
CHAIR BUNDE asked for questions. There were none. He then
went to Dr. McGuire in Anchorage.
Number 523
DR. DAVID MCGUIRE, Chairman, Alaska State Medical Board,
testified via offnet on HB 507. He stated that existing
statute requires the board to interview all applicants for
permanent and temporary licenses. He said the board
suggested having designated reviewers. He felt that having
designated examiners would ease the burden of travel for
physicians coming to Alaska to be licensed. He urged the
passage of HB 507 to allow for designated reviewers.
Number 603
CHAIR BUNDE encouraged Dr. McGuire in his endeavors.
REP. OLBERG read the definition of locum tenens from the
dictionary. Locum tenens: a person, especially a physician
or member of the clergy, who substitutes for another.
Number 630
CHAIR BUNDE asked if there were any further questions or
comments.
Number 633
DR. LEHMANN, President, Alaska State Medical Association,
testified in Juneau in support of HB 507. He stated that
the proposal was a good start and could be made even better.
He said the current system of licensure was unnecessarily
cumbersome because of the interview. He asserted that the
problem, especially in rural areas, of obtaining licensure
is that it is unduly expensive, cumbersome, and sometimes
precludes having adequate physician coverage in various
parts of the state. He offered that his interview for
licensure took no longer than two minutes and he felt that
the interview itself does not accomplish much. He explained
that he informally interviewed 30 physicians and only one
said that he had a meaningful interview.
DR. LEHMANN related an incidence where a doctor from the
Virginia Mason Clinic in Washington came to conduct a
specialty clinic in Sitka. The doctor had to fly from Sitka
to Anchorage, drive a rental car to Wasilla, and interview
with a layperson of the board, who did not have his
interview material with him. Dr. Lehmann lamented that the
interview consisted of, "Hi. How are you?" He said the
process seems ineffective.
DR. LEHMANN indicated that on line 5, under Section 1, if
the word "shall" could be changed to "may" it would allow
the board to interview everybody at their discretion,
including the option of eliminating the interview process
completely. The proposed amendment would allow the board to
interview anyone they so choose, and consequently the board
would be able to spend more time hunting down "nefarious
characters."
Number 734
REP. VEZEY suggested that the words "in person" be deleted
from Section 1, instead of adding the word "may," indicating
that in this age of technology, telecommunications and
audiovisual communication is becoming more acceptable.
DR. LEHMANN said he was unsure what a telephonic interview
would accomplish.
REP. VEZEY asked what an in person interview would
accomplish.
DR. LEHMANN maintained that if the interviewer has serious
concerns regarding the applicant, it is important to conduct
the interview in person.
REP. VEZEY disagreed due to the factors of the time, money,
and travel that are involved. He said because of the
geographical expanse of Alaska, the state is forced to look
to other means of communication. He reiterated that he had
no problem changing the word "may" to "shall," but he felt
that the words "in person" were too restrictive for the
board.
DR. LEHMANN said that he would have no problems adding the
words or telephonically to interview the person.
REP. VEZEY stated that it would be redundant. He also said
that interactive video is an option.
Number 791
DR. LEHMANN said, "I did not want to step on any toes from
the state medical board. And this way, they would still
have their option to interview anybody they chose."
CHAIR BUNDE asked Dr. McGuire's reaction to the issue being
addressed.
DR. MCGUIRE asserted that the medical board is held to a
high standard. He related a story of an interviewee who
appeared for his licensure review and was noticeably
psychotic. He said that another interviewee was granted
licensure and sometime later the interviewee showed obvious
signs of psychosis. He indicated that in those instances a
telephonic interview would not have sufficed. He felt that
there were legal implications as to the interviewees that
are asked to interview in person and those who are not. He
said the board's approach is to have everybody interviewed
so as to avoid legal problems.
Number 856
CHAIR BUNDE stated for the record that Reps. Brice,
Nicholia, Olberg, Kott, Vezey, Toohey and Bunde were
present. He then said that he values the interpersonal, in
person, visual, and nonverbal aspects of an interview. He
felt that substituting the word "may" with "shall" would
only invite litigation.
REP. VEZEY said there is no substitute for a credentials and
reference check. He said he found the interview process the
least useful tool in selecting qualified personnel. He
reiterated that in person interviews are very archaic.
Number 900
CHAIR TOOHEY maintained that the issue should be decided by
the medical community.
Number 905
CHAIR BUNDE took an informal poll as to those in favor of
the word remaining "shall" and those who would prefer the
word to be "may." The poll unanimously favored using the
word "may." He polled again, asking if the words "in
person" should be deleted or if the word "telephonically"
should be added.
CHAIR TOOHEY interjected and said she would accept a
friendly amendment that indicates in person or by telephone.
CHAIR BUNDE asked if Rep. Toohey was proposing an amendment.
CHAIR TOOHEY said she would make the proposal at the
pleasure of the committee.
CHAIR BUNDE told Rep. Toohey to address the proposal and the
committee would vote.
Number 942
REP. BRICE said it was his understanding that there was
still concerns regarding the word telephonically.
CHAIR BUNDE asked for the amendment so the committee could
further discuss the issue.
REP. OLBERG asked if it was Rep. Vezey who suggested
deleting the words "in person."
CHAIR BUNDE said yes.
Number 954
REP. VEZEY made a motion to amend HB 507, Section 1, line 5,
to change the word "shall" to "may."
CHAIR BUNDE asked for discussion. He then expressed his
opposition to the amendment. He reiterated his concerns
pertaining to legal problems that could be inherent by
changing the word to "may." He called for a vote. Reps.
Toohey, Vezey, Olberg, Nicholia, and Brice voted "yea" and
Reps. Kott and Bunde voted "nay."
CHAIR BUNDE stated that HB 507 as amended was before the
committee. He then asked for further discussion.
Number 012
REP. VEZEY made a motion to amend HB 507, Section 1, line 6,
by deleting the words "in person."
CHAIR BUNDE stated that the committee had heard the
amendment and asked for further discussion. There was none.
REP. OLBERG asked, "does the use of the word `may' mean
allow for `may not'?"
REP. BRICE said yes.
CHAIR BUNDE said that word "may" would allow for an
interviewee to be interviewed in person, not in person, or
not at all. He asked Rep. Vezey if that was his
interpretation.
REP. VEZEY said yes. He felt that in person is unduly
restrictive and felt that its deletion would not invite
litigation.
CHAIR BUNDE asked if Rep. Vezey still preferred to delete
the words "in person" as opposed to having the line read
"may be interviewed in person."
REP. VEZEY said once the words have been changed from
"shall" to "may," the sentence becomes permissive, and
leaving the words "in person" becomes redundant.
REP. OLBERG suggested going back to the use of the word
"shall" and then deleting the words "in person." He then
read the sentence, "All applicants for licensure shall be
interviewed by at least one member of the board or the
board's designated representative."
Number 069
CHAIR BUNDE declared that there was an amendment before the
committee. He asked for further discussion.
DR. MCGUIRE said that his prior comments were still germane
and indicated that it was up to the legislature to decide
what the rules were going to be.
CHAIR BUNDE reiterated the intent of the amendment. He
asked Dr. McGuire if under those guidelines would he
continue to interview applicants.
Number 100
DR. MCGUIRE said a common ground must be found and the
decision should be that of the legislature. He said the
board would comply.
CHAIR BUNDE said there was no intention within the bill as
amended to require an interview to be conducted
telephonically. He then asked for further discussions or
any objections. Chair Bunde stated his objection for the
record. He then called for a vote.
Number 126
CHAIR TOOHEY clarified by saying that the intent of the
amendment was to remove the words "in person."
Reps. Vezey, Olberg, and Toohey voted "yea" and Reps. Bunde,
Kott, Nicholia, and Brice voted "nay."
Number 135
CHAIR BUNDE stated that the amendment failed. He asked for
further discussion.
DR. MCGUIRE asked if the provision for the designated
representative had survived the process.
CHAIR BUNDE said yes, the issue was not discussed at all.
Number 152
CHAIR BUNDE closed public testimony and asked the pleasure
of the committee for HB 507 as amended.
REP. KOTT made a motion to pass HB 507 as amended out of
committee with individual recommendations.
CHAIR BUNDE, hearing no objections, declared HB 507 was so
moved. He then brought HB 324 to the table.
HB 324 - EXTEND BOARD OF DENTAL EXAMINERS
TAPE 94-32, SIDE B
Number 000
CHAIR BUNDE passed the gavel to Rep. Toohey to preside over
the remainder of the meeting.
Number 019
REP. CON BUNDE said that before the committee was HB 324,
which extends the termination date for the Board of Dental
Examiners and provides for an effective date. He said that
the Board of Dental Examiners did sunset on June 30, 1993.
He explained that the board was in the process of phasing
itself out. He further explained that the board's role is
to regulate and control licensing permits and revocation of
licenses in the dental profession. He then cited other
responsibilities of the board. Chair Bunde indicated that
Mr. Sam Kito, Representing the Alaska Dental Association,
was available for questions.
Number 092
CHAIR TOOHEY asked if there were any questions for Mr. Kito.
There were none.
REP. BUNDE made a motion to pass HB 324 out of committee
with individual recommendations.
CHAIR TOOHEY, hearing no objections, declared HB 324 so
moved.
CHAIR TOOHEY indicated for the record that Rep. G. Davis
arrived at 3:50 p.m. She then brought HB 320 to the table.
HB 320 - PUBLIC SCHOOL HEALTH AND SAFETY EDUCATION
CHAIR TOOHEY stated that there was a committee substitute
(CS) that had been previously adopted for HB 320 and then
asked for comment from Rep. G. Davis.
Number 142
REP. G. DAVIS said his concerns about mandates and the issue
of grade level/content appropriateness had been resolved.
He said content of education is at the discretion of the
school district and there is an opt-out inclusion within the
bill.
REP. BRICE asked if the opt-out clause was new.
CHAIR TOOHEY said no.
Number 191
REP. OLBERG asked if the fiscal note was still for $452,000.
CHAIR TOOHEY said the fiscal note had been revised to show
$39,400. She said the decrease was the result of removing
mandates on everything except the HIV/AIDS curriculum. She
said all other health educational programs would be strongly
urged.
REP. BUNDE made a motion to pass CSHB 320 out of committee
with accompanying fiscal note. He then indicated that Rep.
Vezey had pointed out that a voice vote was required in an
open hearing. Reps. Brice, Nicholia, Olberg, Toohey, Bunde,
and G. Davis verbally voted "yea." The CS for HB 320 was so
moved.
Number 282
CHAIR TOOHEY brought HB 472 to the table.
HB 472 - REFERRALS INVOLVING DENTAL SERVICES
CHAIR TOOHEY asked Rep. G. Davis to address the bill.
Number 303
REP. GARY DAVIS stated that HB 472 will prohibit the receipt
of compensation by a dentist for referring a person to
another dentist or dental practice. He further stated that
the receipt of compensation by a person or advertisement
that refers a dental service is prohibited, unless the
compensation for referral is disclosed at the time of
referral. He maintained that the proposal would ensure that
patients would be referred to a dentist or a dental practice
as a result of the quality of service. He said the bill was
before the committee as a result of the American Dental
Association, Principles of Ethics and Professional Code of
Conduct. He said that it is against their code to solicit
patients in any form through referrals. He stated that the
legislation would put some of the American Dental
Association's ethics in statute.
CHAIR TOOHEY asked for questions.
Number 348
REP. VEZEY asked why the committee was attempting to codify
the ethical standards of any professional organization.
REP. G. DAVIS replied that the initial attempt was made
through a resolution, but Legal Services felt there was room
in statute for the provisions. He also said Mr. Sam Kito
from the Alaskan Dental Association was present to answer
questions.
REP. BUNDE asked if the legislation was inspired by any
specific cases concerning unethical "kickbacks."
Number 338
REP. G. DAVIS said the request was based specifically on the
1-800 number agencies that advertise for referrals.
CHAIR TOOHEY stated that Dr. Dan Pitts from Soldotna was on
line to answer questions.
Number 407
DR. DAN PITTS, Former President, Alaska Dental Society,
testified via offnet from Soldotna in support of HB 472. He
stated that the emphasis of the bill is to protect the
public. He stated that the code of ethics indicates that it
is unethical for any dentist to make payment to another
person or entity for referral of a patient for professional
services. He said commercial referral agencies violate that
code. He said the advertising is false and misleading. He
explained that most commercial referral services have had no
contact with the Alaska Dental Society to check the
credentials of the dentists they are referring. He felt
that practice to be very misleading. He also noted that
only a few dentists are getting referrals from the service
and that the dentists are paying the commercial referral
services for the referrals. He reiterated that this
practice is unprofessional and unethical. He said the
legislation is in line with the Alaska Dental Association's
principles of ethics and professional conduct.
Number 497
REP. BUNDE related a situation whereby dentists who utilize
the commercial referral service could possibly pass a
patient around for various dental work to be done only for
the goal of padding their bills. He indicated that type of
situation to be the only problem he could see. He further
stated that the notion of the referral service is just a
commercial entity that is selling a product for dentists.
He felt if the dentists are not getting their money's worth,
the dentist should stop buying the product, hence the
services to go out of business. He saw the issue as two
separate problems.
DR. PITTS said the thrust of the bill is to have the
commercial referral service disclose to the patient that
they are paid by dentists for these referrals. He said
patients are misled because they believe the commercial
referral service is an official referral service that gives
an objective referral. He stated that the issue is a
nationwide problem and that other states have legislation
that prohibits this particular practice.
Number 552
REP. BUNDE clarified that the legislation would mandate that
a commercial referral service disclose within conversation
with a potential referral patient that the referral agency
is paid by dentists for their services.
DR. PITTS agreed.
REP. G. DAVIS said that the legislation would include
additional review by the dental boards and indicated the
provision on page 2, line 1.
Number 585
REP. BUNDE cited the zero fiscal note and asked if the
professional dental board would be the official policing
agency. He further questioned if a complaint could be
brought to the board if disclosure is not made.
REP. G. DAVIS said that the board already has the
responsibility of oversight.
REP. BUNDE said that it is also the board's responsibility
to decide on ethics. He said it would be a breach of dental
ethics to not disclose. He then said that the referral
services are not dentists, so the board cannot fine someone
who is not a dentist for violation of dental ethics.
REP. G. DAVIS deferred to Dr. Pitts.
DR. PITTS assumed that the legislation would make it clear
as to how the commercial referral services would have to
operate. He reiterated the thrust of the proposal to be
that of disclosure to the patient.
REP. BUNDE clarified that kickbacks between two dentists is
a violation of dental ethics that could be brought up before
the dental board.
DR. PITTS said yes.
REP. BUNDE asserted that the board has no way of addressing
the ethics issue of commercial referral services because
they are not dentists. He then asked if there were any
services that were run by dentists.
Number 646
DR. PITTS said no referral services are run by dentists. He
felt for a commercial referral service to refer a patient
would be "pretty close to practicing dentistry."
REP. BUNDE said the commercial referral agencies are
currently doing just that. He commented that the issue
could also be raised if he was to tell his friends that he
needs a route canal and his friends suggest a dentist.
DR. PITTS said that a commercial entity would be practicing
dentistry by referring the patient to a dentist.
REP. BUNDE stated that the difference may be his friends
would not get paid for the referral.
CHAIR TOOHEY asked for further questions.
Number 674
REP. VEZEY asked Dr. Pitts if the adherence to the
professional ethics standards is a condition of licensure.
DR. PITTS said yes. He said the proposal focuses on the
commercial referral services, not on dentists.
REP. VEZEY indicated that under Title 836.315 there is no
provision made for the adherence to the professional ethics
standards as being a requirement of licensure or grounds for
revocation.
DR. PITTS said the a definition of the board's purpose is to
pass judgement on the ethical standards of the profession.
Number 724
REP. VEZEY said he felt the added wording was really
unnecessary, and further stated that he thinks the board
does not have the authority to revoke a license for
unethical behavior. He said he knew the board to have the
authority to revoke licensure on the grounds of professional
incompetence, but not for unethical behavior.
REP. BUNDE interjected and said the sponsor statement
indicates that the Board of Dental Examiners is charged with
developing ethics policy.
REP. VEZEY said the sponsor statement is not codified in
law.
REP. BUNDE agreed that Rep. Vezey brought up an interesting
point.
REP. VEZEY suggested that Dr. Pitts look at the board's
statutory authority, because he did not believe the board
has any authority in enforcing ethics. He stated that the
board only had authority to enforce professional standards.
Number 759
DR. PITTS questioned if professional standards are the same
as ethics.
REP. VEZEY stated that professional competence implies
technical competence.
DR. PITTS reiterated that the bill specifically addresses
disclosure by the commercial referral services.
REP. VEZEY said Dr. Pitts was referring to Section 2 that
amends Title 45, which is a chapter on unfair trade
practices. He further stated that the section dealing with
the authority of the board of licensing is in Title 8. He
again stated that he did not believe the board has the
authority to revoke a license for unethical behavior. He
suggested Dr. Pitts look into the matter.
DR. PITTS said that he is not a board member and would have
to talk with a board member. He said he had always assumed
that the dental board has the authority to revoke a license
for unethical behavior.
CHAIR TOOHEY asked the pleasure of the committee.
REP. VEZEY said he answered his own question.
Number 829
CHAIR TOOHEY asked again the pleasure of the committee.
REP. VEZEY made a motion to pass HB 472 out of committee
with individual recommendations.
CHAIR TOOHEY, hearing no objections, declared HB 472 so
moved.
Seeing no further business before the committee CHAIR TOOHEY
ADJOURNED the meeting at 4:15 p.m.
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