Legislature(2007 - 2008)CAPITOL 17
03/19/2007 03:00 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s)|| Commissioner, Department of Labor & Workforce Development|| Commissioner, Department of Commerce, Community, & Economic Development | |
| HB182 | |
| HB136 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 136 | TELECONFERENCED | |
| *+ | HB 182 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
March 19, 2007
3:05 p.m.
MEMBERS PRESENT
Representative Kurt Olson, Chair
Representative Mark Neuman, Vice Chair
Representative Carl Gatto
Representative Gabrielle LeDoux
Representative Jay Ramras
Representative Robert L. "Bob" Buch
Representative Berta Gardner
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S)
Commissioner, Department of Labor & Workforce Development
Clark "Click" Bishop - Fairbanks
- CONFIRMATION(S) ADVANCED
Commissioner, Department of Commerce, Community, & Economic
Development
Emil Notti - Anchorage
- CONFIRMATION(S) ADVANCED
HOUSE BILL NO. 182
"An Act making the offering of certain promotional checks an
unfair or deceptive act or practice."
- MOVED HB 182 OUT OF COMMITTEE
HOUSE BILL NO. 136
"An Act relating to dental hygienists."
- MOVED HB 136 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 182
SHORT TITLE: OFFERING PROMOTIONAL CHECKS
SPONSOR(s): REPRESENTATIVE(s) LYNN
03/07/07 (H) READ THE FIRST TIME - REFERRALS
03/07/07 (H) L&C, JUD
03/19/07 (H) L&C AT 3:00 PM CAPITOL 17
BILL: HB 136
SHORT TITLE: DENTAL HYGIENISTS
SPONSOR(s): REPRESENTATIVE(s) STOLTZE
02/14/07 (H) READ THE FIRST TIME - REFERRALS
02/14/07 (H) HES, L&C
03/06/07 (H) HES AT 3:00 PM CAPITOL 106
03/06/07 (H) Moved Out of Committee
03/06/07 (H) MINUTE(HES)
03/07/07 (H) HES RPT 5DP
03/07/07 (H) DP: CISSNA, FAIRCLOUGH, GARDNER, ROSES,
WILSON
03/07/07 (H) FIN REFERRAL ADDED AFTER L&C
03/19/07 (H) L&C AT 3:00 PM CAPITOL 17
WITNESS REGISTER
REPRESENTATIVE BOB LYNN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 182.
CLYDE (ED) SNIFFEN, J.R., Assistant Attorney General
Commercial/Fair Business Section
Civil Division (Anchorage)
Department of Law
Anchorage, Alaska
POSITION STATEMENT: Answered questions and provided comments
during hearing on HB 182.
MARIE DARLIN, Coordinator
Capital City Task Force
Alaska AARP
POSITION STATEMENT: Testified in support of HB 182 and HB 136.
REPRESENTATIVE BILL STOLTZE
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 136.
BEN MULLIGAN, Staff
to Representative Bill Stoltze
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during hearing on HB
136.
GAIL WALDEN, Dental Hygienist;
Member
Alaska State Dental Hygienists' Association (ASHDA)
Wasilla, Alaska
POSITION STATEMENT: Testified in support of HB 136.
IVONNE MILLEA, President
Alaska State Dental Hygienists' Association (ASHDA)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 136.
JENNIFER MCELROY, Dental Hygienist;
President
Kenai Peninsula Dental Hygiene Association
Soldotna, Alaska
POSITION STATEMENT: Testified in support of HB 136.
GLENN MARTIN, DDS
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 136
ROYANN ROYER, Dental Hygienist
Chugiak, Alaska
POSITION STATEMENT: Testified in support of HB 136
DAVID LOGAN, DDS;
Member
Alaska Dental Society (ADS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 136 and offered
comments.
MARY CERNEY, Dental Hygienist
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 136 and offered
comments.
ACTION NARRATIVE
CHAIR KURT OLSON called the House Labor and Commerce Standing
Committee meeting to order at 3:05:01 PM. Representatives Buch,
Neuman, Gardner, Gatto, and Olson were present at the call to
order. Representatives Ramras and LeDoux arrived as the meeting
was in progress.
^CONFIRMATION HEARING(S)
^Commissioner, Department of Labor & Workforce Development
^Commissioner, Department of Commerce, Community, & Economic
Development
3:05:14 PM
CHAIR OLSON announced that the first order of business would be
the consideration of appointees to various boards and
commissions.
3:05:35 PM
CHAIR OLSON made a motion to advance the confirmations of Clark
"Click" Bishop as Commissioner of the Department of Labor &
Workforce Development, and Emil Notti as Commissioner of the
Department of Commerce, Community, & Economic Development, to
the joint floor session for consideration. There being no
objection, the confirmations were advanced.
The committee took an at-ease from 3:05 PM to 3:07 PM.
HB 182-OFFERING PROMOTIONAL CHECKS
CHAIR OLSON announced that the next order of business would be
HOUSE BILL NO. 182, "An Act making the offering of certain
promotional checks an unfair or deceptive act or practice."
3:07:54 PM
REPRESENTATIVE BOB LYNN, Alaska State Legislature, Sponsor,
stated that HB 182 deals with promotional checks. He explained
that these checks are often for as little as $3 or $4, and are
sent to thousands of businesses and individuals across the
state. Hundreds of these checks are cashed. These checks are
legitimate, which he opined is both good and bad. Unsuspecting
individuals endorse these checks, and are then obligated for
unwanted products and services. Last year, the Department of
Law (DOL) announced a settlement with a California based
company, Yellow Pages, Inc. He explained that Yellow Pages,
Inc. sent what appeared to be a rebate check for $3.49, but was
actually a contract for advertising services totaling $179.
Consumers did not see the financial disclosure in fine print on
the reverse of the check. Alaska, along with 27 other states,
eventually settled with the aforementioned company, which was
forced to give refunds to consumers, in addition to covering
attorney costs and consumer protection enforcement costs. These
checks are sent out to individuals and businesses. When cashed,
consumers are billed, and may be "hounded" by collection
agencies. The [Commercial/Fair Business Section] of the DOL
considers these checks to be a classic example of an unfair or
deceptive act of practice, as defined in state law. AS
45.50.471 defines an "unfair or deceptive trade practice" as
"Conduct that creates a likelihood of confusion or
misunderstanding, which misleads, deceives, or damages a buyer
or competitor with a sale or advertisement of goods or
services." He stated that these checks fit this definition, and
opined that HB 182 "is a fitting answer to this ... poor
business practice." The DOL believes that prohibiting the use
of these checks is the only effective way to prevent these
accidental agreements from occurring. He stated that HB 182
makes these "promotional checks" an unfair or deceptive act or
practice in violation of the Unfair Trade Practices and Consumer
Protection Act (Consumer Protection Act). This would enable the
Attorney General to enforce the remedies afforded in the
Consumer Protection Act. Companies that violate this law would
be subject to a civil penalty of a minimum of $1,000 per
violation, and a maximum of $25,000 per violation.
3:12:19 PM
REPRESENTATIVE NEUMAN stated that he has been affected by the
aforementioned promotional checks issued by Yellow Pages, Inc.
He inquired as to whether HB 182 applies to blank checks stating
that an individual has been approved for $30,000 or $50,000,
which can be signed and taken to the bank.
REPRESENTATIVE LYNN replied that the aforementioned checks are
not affected by this legislation.
REPRESENTATIVE NEUMAN asked if the sponsor has considered adding
this.
REPRESENTATIVE LYNN shared his wish that this be considered as a
separate piece of legislation, as he would prefer not to extend
the scope of this bill.
The committee took an at-ease from 3:13 PM to 3:14 PM.
REPRESENTATIVE LYNN explained that there is an amendment
addressing the aforementioned checks, which will be offered in
the next committee of referral.
3:14:26 PM
REPRESENTATIVE LEDOUX expressed appreciation for this
legislation. She then shared an experience with receiving this
type of check, and how she dealt with it.
REPRESENTATIVE LYNN stated that he introduced the bill after the
issue was brought to his attention by the DOL. He expressed his
appreciation for this being brought forward by the department.
3:15:11 PM
REPRESENTATIVE GARDNER stated that she has also seen these
checks. She opined that this is a clear attempt to "trick
people." She expressed appreciation for the comprehensive scope
of the information contained in the committee packet.
REPRESENTATIVE LYNN said that the question and answer sheet was
developed by his staff.
REPRESENTATIVE GARDNER commented that the aforementioned
question and answer sheet addressed all of her questions. She
stated that there may be legitimate practices, as well, such as
credit card companies that are attempting to get a consumer to
switch companies. She opined that while this may not be in the
consumer's best interest, it is not "as deceptive." There may
be a way to make this type of offer to a consumer that is not
deceptive, she said, and inquired as to whether Representative
Lynn would agree.
REPRESENTATIVE LYNN replied that he has seen these types of
offers from credit card companies.
REPRESENTATIVE GARDNER reiterated that there is a legitimate way
to do this, and there is a way that is an attempt to defraud, by
having consumers sign a contract without being aware of it. She
expressed hope that HB 182 does not attack those businesses that
are trying to get new customers to sign on by using legitimate
practices.
REPRESENTATIVE LYNN assured the committee that this is not the
intent of the bill. He opined there are honest and dishonest
ways to do business, and that the promotional checks in question
are dishonest.
3:17:51 PM
REPRESENTATIVE GATTO questioned whether simply cashing a check
is a contract.
3:18:48 PM
REPRESENTATIVE BUCH shared his understanding that the contract
agreement is on the back of the check, and is considered a legal
binding contract.
REPRESENTATIVE GATTO surmised, then, that this contract is
enforceable, and the signature on the check is considered the
signature on the contract.
CHAIR OLSON noted that the DOL is online to answer questions.
REPRESENTATIVE LYNN commented that this could be considered and
"illusory contract."
3:20:02 PM
CLYDE (ED) SNIFFEN, J.R., Assistant Attorney General,
Commercial/Fair Business Section, Civil Division (Anchorage),
Department of Law, explained that his duties include enforcement
of Alaska's consumer protection statutes. He thanked
Representative Lynn for introducing this legislation. The DOL
is concerned about this issue, which occurs often in Alaska. He
stated that these checks have generated many complaints. He
stated that while those who are sending the checks out could
argue that the terms were clear, the question is whether or not
the terms of the agreement were adequately disclosed.
Promotional checks may look like a refund or a rebate, and once
signed, bills may appear on a credit card statement, phone bill,
or may be deducted from the individual's bank account. The DOL
feels that this is a deceptive practice. Consumers do not
understand nor have the intent to enter into a contract;
therefore, these contracts are not enforceable. These checks
are a "headache" for the DOL, and having a specific provision in
the Consumer Protection Act will make it very clear that this is
a misleading and deceptive practice.
3:23:00 PM
MR. SNIFFEN, in response to a question from Representative
Neuman, said that he is unsure where Yellow Pages, Inc.
initially gets address and phone information. He surmised that
this may simply be from looking through the yellow pages in the
phone book. He explained that Yellow Pages, Inc. is an online
yellow page service, which has no affiliation with the local
yellow pages. However, when people see "Yellow Pages, Inc." on
the letterhead, they often assume this is connected with a
business ad they have placed in the local yellow pages. He
opined that not many people use the online service offered by
Yellow Pages, Inc.
REPRESENTATIVE GARDNER restated her earlier question regarding
legitimate offers versus attempts to defraud.
MR. SNIFFEN stated that this legislation is not intended to
apply to legitimate offers. He explained that there is a legal
distinction between the two. An example of a legitimate offer
would be a blank check from a credit card company, which are an
extension of an existing line of credit. These are a form of
convenience, and are not obligating the consumer to anything
that he or she is not aware of. An additional example would be
checks received from a mortgage lender that are intended to open
up a line of credit against home equity. This bill would not
apply to these offers. Whether the language of this bill would
encompass the mortgage lending checks is "a tricky question."
He opined that the language could be read as including the
mortgage lending checks, but would not apply to credit card
company checks. He stated that an amendment may be introduced
to address this.
3:27:33 PM
MR. SNIFFEN, in response to a question from Representative
Gatto, explained that consumers have called the DOL after
receiving calls from collection agencies. He relayed a story
involving a business in Kodiak that had experienced this. The
DOL wrote to the company and the money is being refunded. He
explained that it can be difficult to clear up the credit, once
this occurs. The perpetrating business must write a letter to
the credit agency and explain that this was an inadvertent
reporting. In response to an additional question, he stated
that the Fair Credit Reporting Act requires that the business
have a "good faith reason" for reporting an individual to the
bureau. If this is abused, the ability to report is taken away.
This is in federal statute.
3:30:37 PM
MARIE DARLIN, Coordinator, Capital City Task Force, Alaska AARP,
stated that AARP is in support of the bill.
3:32:19 PM
REPRESENTATIVE GARDNER moved to report HB 182 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 182 was reported from the
House Labor and Commerce Standing Committee.
The committee took an at-ease from 3:32 PM to 3:35 PM.
HB 136-DENTAL HYGIENISTS
CHAIR OLSON announced that the final order of business would be
HOUSE BILL NO. 136, "An Act relating to dental hygienists."
3:35:24 PM
REPRESENTATIVE STOLTZE explained that HB 136 is intended to
bring additional healthcare access to under-served communities.
The House Health, Education and Social Services Standing
Committee considered this bill and addressed several health
related concerns. He opined that this is an important issue,
noting that many healthcare professionals have been willing to
testify.
3:38:18 PM
REPRESENTATIVE GARDNER opined that this is a good bill. The
state has experienced a shortage of healthcare practitioners in
a range of fields, and needs to explore alternative ways of
providing healthcare, particularly in rural areas. She
questioned whether the implementation would be different in
rural areas versus urban areas.
REPRESENTATIVE STOLTZE speculated that the implementation would
have a broader application in rural areas of the state.
REPRESENTATIVE NEUMAN inquired as to the definition of "direct
supervision."
3:40:03 PM
BEN MULLIGAN, Staff to Representative Bill Stoltze, Alaska State
Legislature, sponsor, explained that "direct supervision" means
the dentist is in the same room, "indirect supervision" means
the dentist is in the same facility, and "general supervision"
means the dentist has authorized the procedure and may not be on
the premises.
REPRESENTATIVE STOLTZE, in response to a question from
Representative Neuman, explained that the dental hygienist
performs basic preventative oral care.
3:42:35 PM
REPRESENTATIVE RAMRAS relayed a request to include dental
assistants in HB 136, and inquired as to the difference between
a "dental hygienist" and a "dental assistant."
REPRESENTATIVE STOLTZE explained that a "dental hygienist" is
licensed, while "dental assistants" do not have a defined status
in statute.
REPRESENTATIVE RAMRAS expressed further confusion between the
difference between "dental hygienist" and "dental assistant."
He noted that the bill requires 4,000 hours of practice prior to
a dental hygienist being authorized for general supervision. He
surmised, then, that a dental assistant is "well below" a dental
hygienist in regard to education. He opined that empowering a
dental assistant to perform certain activities currently
performed by dental hygienists [is not wise].
REPRESENTATIVE STOLTZE replied that while he does not wish to
compare the two, there are defined qualification requirements
for dental hygienists, which he does not believe exist for
dental assistants.
MR. MULLIGAN explained that dental assistants are not required
to be licensed. Classes are offered, but are not required.
Dental assistants are not covered in statute.
REPRESENTATIVE RAMRAS commented that dental hygienists have a
defined licensing requirement.
REPRESENTATIVE GATTO shared his understanding that the dental
hygienist can offer certain services while the dentist is away,
while the dental assistant simply assists the dentist during the
procedure.
3:47:42 PM
GAIL WALDEN, Dental Hygienist, Member, Alaska State Dental
Hygienists' Association (ASDHA), stated that she is in support
of HB 136. She said that the needs of Alaskans are not being
met by the current oral healthcare delivery system. Current
statute prevents dental hygienists from providing oral
healthcare in non-traditional settings. She explained that
dental hygienists receive a comprehensive education, are
licensed and regulated by the state, and must meet continuing
education and cardiopulmonary resuscitation (CPR) requirements.
She opined that dental hygienists are not being utilized to full
potential. The Alaska State Board of Dental Examiners ("the
Board") is in support of HB 136, and has concluded that the
proposed changes are consistent with its vision of ensuring that
all Alaskans receive the best possible care. She pointed out
that HB 136 has received support from numerous members of the
Oral Health Coalition, including the Alaska Primary Care
Association, and AARP.
MS. WALDEN, referring to Section 1 of HB 136, stated that the
restorative function license endorsement creates an efficient
healthcare delivery system that increases the number of patients
seen. If the dentist is able to bring a dental hygienist and a
dental assistant when traveling to rural areas, this would allow
more procedures to be completed in the time available. The
procedures would be performed under the direct supervision of a
licensed dentist, and the dental hygienist would be trained in
these procedures. This endorsement would require separate
licensing. She pointed out that the curriculum, examining, and
licensing for restorative functions for dental hygienists has
been established in other states, including Washington State.
MS. WALDEN then referred to Section 2 of HB 136, explaining that
this allows dental hygienists to administer local anesthesia
under general supervision of a licensed dentist. She stated
that dental hygienists have been administering local anesthesia
under direct or in-direct supervision since 1981. Local
anesthesia is used to reduce stress and provide pain control in
the treatment of moderate to advanced gum disease. She
explained that under general supervision, the dentist must still
diagnose and provide a plan for treatment, but would not need to
be present in the facility during the treatment. Idaho and
Oregon currently allow dental hygienists to deliver local
anesthesia under general supervision. No disciplinary action
has been taken against these hygienists.
MS. WALDEN then moved on to Section 4, stating that this section
has the potential to provide the greatest impact to Alaskan
communities. Experienced dental hygienists may enter into a
written agreement with a dentist. This agreement would allow
the dental hygienist to provide services listed under the
agreement without supervision, and would allow access to nursing
homes, schools, and Headstart programs, among others. This
agreement must be approved by the Board. This is intended to
reach individuals that are not receiving care and to provide
preventative services to increase oral health, in addition to
increasing general health and well-being. She stated that the
changes made by HB 136 have been implemented in other states,
and have proven to be safe and effective. She opined that the
statutes show dental hygienists' continued professional
commitment to working with dentists to provide service to the
public.
3:52:02 PM
IVONNE MILLEA, President, Alaska State Dental Hygienists'
Association (ASHDA), gave a brief history of her experience as a
licensed dental hygienist in Alaska, and stated that she is in
support of HB 136.
3:53:02 PM
JENNIFER MCELROY, Dental Hygienist, President, Kenai Peninsula
Dental Hygiene Association, stated that she strongly supports HB
136. She has seen a need for increased access to oral
healthcare. In regard to senior dental care, she has seen a
complete lack of access. She explained that dentists do not
visit nursing or group homes, and residents of these facilities
may be unable to travel to an office for preventative care or
necessary healthcare screenings. She opined that licensed
dental hygienists are the key oral health professionals to
deliver care in this type of setting. Screenings performed by
licensed dental hygienists can identify oral health care issues
that may affect overall health. Many villages have a need for
oral healthcare, and residents travel once per year to see a
dentist.
3:54:35 PM
GLENN MARTIN, DDS, stated that he is a practicing public health
dentist, a member of the American Dental Association (ADA) and a
fellow of the Academy of General Dentistry. He gave a brief
history of his work experience in Alaska, which includes time
spent traveling to villages and providing dental care. During
the past 15 years, he has traveled to 62 villages, and has 128
weeks of experience practicing dentistry in rural Alaska. He is
currently working in Anchorage, where he is the director of
village travel for Southcentral Foundation Village Clinic. He
stated that he strongly supports HB 136, which would enable him
to provide healthcare to more patients. The collaborative
agreement portion of the bill would greatly increase sufficiency
by allowing dental hygienists to travel to villages prior to the
arrival of the dentist, in order to evaluate school-age children
and perform x-rays and oral screenings to identify needs. He
explained that initial screenings and preventative treatments
take 1-6 days, depending on village size. Allowing the dental
hygienists to perform these procedures would allow the dentist
to perform restorative and emergent needs. This would decrease
the time needed to complete children's dental needs and increase
the time available to address adult dental needs. He stated
that HB 136 would make a measurable impact on access to care,
and urged the passage of this bill.
REPRESENTATIVE NEUMAN asked if dental hygienists are included in
the Washington, Wyoming, Alaska, Montana, Idaho Medical
Education Program (WWAMI).
DR. MARTIN replied no.
REPRESENTATIVE GATTO thanked Dr. Martin for his service. He
shared his belief that Dr. Martin's presence in the villages was
beneficial to individuals that would not have enjoyed the
"pleasure of good health" without these efforts.
3:57:57 PM
ROYANN ROYER, Dental Hygienist, began by giving a brief history
of her experience as a dental hygienist, and stated that she is
a member of the Oral Health Coalition, which is in support of HB
136. She informed the members that she worked as a restorative
dental hygienist for two years in Washington State, and
therefore has first-hand knowledge of the effectiveness this
expanded function can provide. She explained that if passed, HB
136 would significantly increase the number of patients that can
be seen during a typical village visit. She agreed with earlier
testimony that these visits currently take one week. Allowing
the dental hygienists to do the initial screenings and
preventative procedures, the dentist would have more time to
perform restorative procedures. As an educator, she opined that
the collaborative agreement function could be incorporated into
the curriculum, and emphasis placed on utilizing this function
for servicing patients in nursing homes, and disabled, home-
bound patients. She stated that externships would most likely
be developed with practitioners working in these facilities, and
students would be mentored into these positions. She opined
that while some hygienists do not want to work full-time, there
are many who would utilize this expanded function to visit
limited-access areas for a few hours during the day to provide
services. She pointed out that HB 136 can be put into practice
immediately. The restorative aspect would require additional
training; however, the University of Alaska Anchorage (UAA) is
ready to develop and implement restorative courses as soon as
the legislation is passed. The initial courses would be
presented in a condensed format, to allow currently licensed
hygienists to receive this training in a short amount of time.
4:01:49 PM
DAVID LOGAN, DDS, Member, Alaska Dental Society (ADS). The ADS
would like to see the scope of HB 136 broadened to help increase
access to dental care in under-served areas. The ADS is
concerned that if this is limited only to dental hygienists,
this would restrict the use of other dental auxiliaries in the
aforementioned areas. He explained that the ADS formed a non-
profit in order to provide volunteer treatment in rural areas.
There is limited equipment available, and the plan involves
bringing dental assistants rather than hygienists. Allowing
assistants to perform expanded functions would provide a
valuable asset. He pointed out that 17 other states allow
auxiliaries to perform additional functions, adding that
Washington State is the only one to limit this to hygienists.
Additionally, the ADS would like to see additional training
allowed. The American Dental Association (ADA) is bringing
pilot programs into different states, and the ADS would like to
be involved in this. Legislation is needed to authorize this.
CHAIR OLSON asked whether the ADS considered an additional piece
of legislation for this. He opined that because dental
assistants are not regulated, this might slow the passage of the
bill.
DR. LOGAN replied that this has been considered; however, the
ADS believes that assistants and hygienists need to be held to
the same standards, therefore it is appropriate to address this
within the same legislation.
CHAIR OLSON reiterated that this might have a negative affect on
the passage of HB 136.
REPRESENTATIVE RAMRAS restated his earlier question regarding
the difference between a dental assistant and dental hygienist.
DR. LOGAN explained that dental assistants are not regulated,
and are "loosely defined" as a person who works with a dentist.
Dental assistants provide the following auxiliary functions:
placement of rubber dams, handing tools to the dentist, and
performing some impressions.
REPRESENTATIVE RAMRAS commented that a dental assistant is not
very well defined. He stated that he does not want to slow down
the aid to villages in need of dental healthcare while
attempting to incorporate a "loosely defined" group.
DR. LOGAN replied that dental assistants are loosely defined as
a result of limited access to training. While some states have
decided to certify dental assistants, others have not. Alaska
has elected to not require this certification. If all dental
assistants were required to receive certification, it would be
difficult for smaller communities to meet these requirements.
REPRESENTATIVE RAMRAS opined that these issues need to be
addressed prior to allowing dental assistants to perform these
expanded functions. While he is in favor of increasing the
number of dental professionals working in rural communities, he
is not comfortable with expanding the role of dental assistants
at this time.
4:09:13 PM
REPRESENTATIVE NEUMAN inquired as to whether Dr. Logan had
previously stated that dental hygienists should be independently
licensed.
DR. LOGAN replied no.
REPRESENTATIVE NEUMAN asked whether states currently allow the
independent licensing of dental hygienists, thus allowing them
to work independently from a dentist's office.
DR. LOGAN shared his understanding that this is allowed in
Colorado.
REPRESENTATIVE NEUMAN asked whether Dr. Logan would support this
in Alaska, considering the previous testimony.
DR. LOGAN replied that conceptually, parts of this "make sense."
However, he is unable to give an endorsement to something that
he is unable to see or examine.
REPRESENTATIVE LEDOUX asked whether Dr. Logan sees a downside to
allowing dental hygienists to perform the additional functions
included in the bill.
DR. LOGAN replied that he has no problems with the restorative
functions. In regard to the collaborative agreement, he said
that there is some concern with certain procedures allowed, in
addition to allowing dental hygienists to render a diagnosis.
Allowing general supervision for administering local anesthesia
"has its merits."
REPRESENTATIVE LEDOUX asked whether there are any specific
concerns.
DR. LOGAN replied that the largest concern is with collaborative
agreement, which allows the dental hygienist to render a
diagnosis.
REPRESENTATIVE LEDOUX asked whether dental assistants should be
allowed to do this.
DR. LOGAN replied no, adding that this would "certainly not be
appropriate."
CHAIR OLSON asked whether the House Health, Education and Social
Services Standing Committee was asked to incorporate dental
assistants into the bill.
DR. LOGAN replied yes. In response to an additional question,
he stated that the request was denied, although he does not
remember hearing a specific reason for this.
4:14:38 PM
MARY CERNEY, Dental Hygienist, gave a brief history of her work
experience. She stated that she previously served as president
of the Alaska State Dental Hygienists' Association (ASDHA), and
served eight years on the Board of Dental Examiners. She stated
strong support of HB 136. She agreed that dental assistants are
not regulated. Dental hygienists receive a formal education in
programs that are accredited by the American Dental
Association's (ADA) Council on Dental Accreditation. Dental
hygienists must pass a national board exam, and must prove
competency on an independently administered clinical exam, in
order to practice in all 50 states. She explained that she is
an examining hygienist with the Western Regional Examining
Board. The education received by dental hygienists is usually
two years of college prerequisites, and two academic years
integrated with clinical instruction. Faculty is also subject
to standards and qualifications.
MS. CERNEY went on to say that dental hygienists must maintain
good standing, and complete continuing education requirements.
This sets a baseline of education and qualifications for all
hygienists. The Western Regional Examining Board gives a
specific exam for the restorative clinical skills. Any
hygienist performing these functions would be required to take
this exam. She stated that the idea of expanding the setting in
which the local anesthetic is administered was proposed by Dr.
Logan when he was president of the Board of Dental Examiners.
She explained the situations in which this might occur, pointing
out that the dentist is not required to allow this. In
summation, she commented that the proposed changes improve the
healthcare delivery to residents of Alaska, help maintain
education standards currently in place, assure the competency by
requiring clinic exams, and mandate accountability. In regard
to administering anesthetic, she stated that the dentist has
recommended this treatment. The collaborative care agreement
gives the authorization by the dentist with whom the agreement
is initiated, and must be approved by the Board. She explained
that this does not allow the hygienist to diagnose or offer
treatment plans. The hygienist would simply be allowed to
perform the hygiene portion of what is normally done, without
the dentist providing a prior diagnosis. This is "just ...
flipping the order of things a little bit."
MS. CERNEY offered her understanding that proposed regulations
would require the hygienist to have additional training in
emergency medical procedures. She supports the requirement that
hygienists have at least 4,000 hours of documented clinical
experience prior to being allowed to enter into a collaborative
agreement. Referring to a program to open in Fairbanks, she
stated that the intent is to graduate hygienists with a strong
emphasis in a variety of health settings, and to encourage
treatment in communities that do not receive a broad scope of
dental treatment. She shared her experience volunteering at the
Salvation Army Clinic in Fairbanks, and expressed frustration
that she has been unable to administer local anesthetic to make
patients comfortable. She opined that many of these patient
have experienced neglect and need more thorough treatment than
the patients seen at a highly established practice. If dental
hygienists were able to administer local anesthetic under
general supervision, the patients could be seen regardless of
whether a dentist was willing to volunteer on a particular day.
4:23:23 PM
MARIE DARLIN, Coordinator, Capital City Task Force, Alaska AARP,
expressed support for HB 136. The AARP believes that all
Alaskans should have access to high quality, affordable
healthcare, including oral health. The AARP also believes that
HB 136 would help reduce dental costs, as well as improve
accessibility.
CHAIR OLSON stated that he had planned to hold the bill over
until the next committee hearing; however, he has not heard any
significant concerns.
4:25:13 PM
REPRESENTATIVE BUCH stated that if the dental community is in
support of the legislation, he is in support, and does not see
any reason to hold it over.
CHAIR OLSON stated that while he would be willing to help draft
legislation to address specific concerns, he is not supportive
of any additions to HB 136. He opined that this would be
"counter productive."
REPRESENTATIVE RAMRAS stated that he would like to see more
people capable of providing dental healthcare to rural
communities, adding that he would look forward to assisting the
dental community in broadening this at a later date.
4:27:12 PM
REPRESENTATIVE NEUMAN suggested that independent licensing of
dental hygienists be considered. He surmised that this would
promote competition and better rates for preventative care.
4:28:41 PM
REPRESENTATIVE LEDOUX moved to report HB 136 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 136 was reported from the
House Labor and Commerce Standing Committee.
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
4:29:11 PM.
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