Legislature(2007 - 2008)BUTROVICH 205
03/26/2007 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SJR3 | |
| SB98 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SJR 3 | TELECONFERENCED | |
| *+ | SB 98 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 26, 2007
1:34 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator John Cowdery
Senator Kim Elton
Senator Fred Dyson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE JOINT RESOLUTION NO. 3
Relating to the effect of Medicare rates on senior citizens'
access to healthcare; and urging the United States Congress to
increase Medicare rates for Alaska.
MOVED SJR 3 OUT OF COMMITTEE
SENATE BILL NO. 98
"An Act relating to dental hygienists."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SJR 3
SHORT TITLE: MEDICARE RATES IN ALASKA
SPONSOR(s): SENATOR(s) WIELECHOWSKI
03/07/07 (S) READ THE FIRST TIME - REFERRALS
03/07/07 (S) HES
03/26/07 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 98
SHORT TITLE: DENTAL HYGIENISTS
SPONSOR(s): SENATOR(s) DAVIS
02/28/07 (S) READ THE FIRST TIME - REFERRALS
02/28/07 (S) HES, L&C
03/26/07 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Senator Bill Wielechowski
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of SJR 3
Karleen Jackson, Commissioner
Department of Health and Social Services (DHSS)
Juneau, AK
POSITION STATEMENT: Available for questions on SJR 3
Tom Obermeyer, aide to Senator Davis
Juneau, AK
POSITION STATEMENT: Presented SB 98 for the sponsor
Gail Walton, member
Alaska State Dental Hygienist Association
Wasilla, AK
POSITION STATEMENT: In support of SB 98
Rena Bauer, Faculty Director
Dental Hygiene Program
University of Alaska Fairbanks
Fairbanks, AK
POSITION STATEMENT: In support of SB 98
Mike Booth, President
Alaska Dental Society
Anchorage, AK
POSITION STATEMENT: In support of SB 98
Jim Tulle, Executive Director
Alaska Dental Society
Anchorage, AK
POSITION STATEMENT: In support of SB 98
Royann Royer, representing herself
Chugiak, AK
POSITION STATEMENT: In support of SB 98
Glenn Martin, representing himself
Anchorage, AK
POSITION STATEMENT: In support of SB 98
Mary Cerney, representing herself
Fairbanks, AK
POSITION STATEMENT: In support of SB 98
David Logan, Legislative Chair
Alaska Dental Society
Juneau, AK
POSITION STATEMENT: In support of SB 98
Nathan Lukes, representing himself
Anchorage, AK
POSITION STATEMENT: In support of SB 98
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:34:34
PM. Present at the call to order were Senators Dyson, Thomas,
Elton, Cowdery, and Chair Davis.
SJR 3-MEDICARE RATES IN ALASKA
CHAIR DAVIS announced SJR 3 to be under consideration.
SENATOR WIELECHOWSKI, sponsor of SJR 3, explained that it
regards Medicare reimbursement rates; 55,000 Alaskans rely on
the federal program, which is the largest health-care program in
the country. The resolution addresses the many Alaskans with
inadequate coverage; Medicare is letting down many citizens in
paying less than 50 percent of the costs of their medical
treatment. Seniors must often call dozens of doctors before
finding one that will treat them under Medicare. The problem is
projected to only get worse; the number of Alaskans on Medicare
will double in future years. If reimbursement rates drop any
further, doctors will have to stop accepting Medicare patients.
Military beneficiaries are being adversely affected as well. The
Congressional Budget Office projects a loss of $240 million in
Medicare funding Alaska between 2008 and 2015; the problem in
Alaska is particularly bad because the state has higher costs of
providing medical care and fewer doctors, and the funding
formula doesn't take these factors into account. Alaska is the
only state in which Medicare reimbursement rates are even lower
than those of Medicaid. The joint resolution calls on Congress
and the United States Department of Health and Human Services to
address this crisis by rewriting the funding formulas for
Alaska; he urged the committee to join him in supporting SJR 3.
1:38:59 PM
SENATOR DYSON asked if the same funding situation applies to
Medicaid.
SENATOR WIELECHOWSKI said that there is a problem with Medicaid,
but it isn't quite as extensive. Medicare is particularly
troubled because the funding rate is 25 percent less than that
of Medicaid; also the number of seniors is growing quickly.
SENATOR DYSON asked why both issues couldn't be addressed in one
resolution.
SENATOR WIELECHOWSKI said that the committee could certainly
decide to do so.
SENATOR COWDERY said that the problem with Medicaid is mostly
the cost of drugs, and the average wholesale prices are too high
and need to be brought to a reasonable level.
1:42:38 PM
KARLEEN JACKSON, Commissioner for the Department of Health and
Social Services (DHSS), thanked Senator Wielechowski and said
that the only way to fix this problem is to work with the
congressional delegation and the federal government. She gave an
example to show the importance of improving the Medicare
program.
1:44:00 PM
SENATOR THOMAS said that he hopes to see insurance and
pharmaceutical companies participate in finding a solution.
SENATOR COWDERY moved to report SJR 3 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, the motion carried.
SB 98-DENTAL HYGIENISTS
CHAIR DAVIS announced SB 98 to be under consideration.
1:46:21 PM
TOM OBERMEYER, aide to Senator Davis, sponsor of SB 98, said
that the bill will improve the oral health care, overall health,
well-being, and individual appearance and comfort of Alaskans.
It allows better access to professionally trained dental
hygienists and expanded services, and will help stem the
epidemic of oral diseases affecting certain segments of the
population; similar bills have passed in other states.
He then explained the process for becoming a licensed dental
hygienist, and how the bill will allow additional services to be
performed by hygienists with prior board approval and a minimum
of experience. The committee substitute (CS) for the bill makes
a few small changes.
1:50:02 PM
CHAIR DAVIS said that the CS reflects the differences in the
companion house bill.
SENATOR COWDERY moved to adopt the proposed committee substitute
to SB 98, labeled 25-LS0670\C, Version C, as the working
document of the committee. There being no objection, the motion
carried.
MR. OBERMEYER explained that the CS takes into account the
differences in the house bill, regarding licensing, observation,
and the approval of collaborative agreements.
1:52:30 PM
SENATOR ELTON asked why a dental hygienist wouldn't need to be
licensed in Alaska like a dentist would.
MR. OBERMEYER said that the board has the final word on the
matter, and it generally oversees assistants and examinations in
the state. There are substantial training and examinations
involved in working in Alaska.
SENATOR ELTON said that the language of the bill mentions a
national examining board, and it seems that the bill will allow
someone licensed anywhere in the country to practice in Alaska.
MR. OBERMEYER replied that the preface provides for a required
endorsement by the Alaskan board for someone wishing to practice
in the state.
CHAIR DAVIS said that other testifiers should be able to comment
on the issue.
SENATOR COWDERY asked how many other states have adopted similar
bills.
MR. OBERMEYER replied that at least four others have done so,
and cited statistics on each.
SENATOR COWDERY asked how many dental hygienists graduate every
year from University of Alaska (UA) schools.
MR. OBERMEYER said that the he knows the UA program is
competitive and effectual, but he will have to research its
graduation numbers.
1:58:57 PM
GAIL WALTON, member of the Alaska State Dental Hygienist
Association (ASDHA), said that UA Anchorage has 12 graduates
each year, and there's a UA Fairbanks program under development
for 6 additional students. The program is two years long.
SENATOR COWDERY asked if the program is sufficiently rigorous.
MS. WALTON said that the number of hygienists is sufficient but
could be reviewed; regardless, currently Alaskan needs are not
being met. Hygienists aren't allowed to work in nontraditional
settings and aren't being used to their full potential. The
ASDHA supports SB 98, as well as the state Oral Health
Coalition. She clarified that hygienists would have to be
licensed in Alaska if moving from another state.
2:02:29 PM
SENATOR ELTON asked if there are reciprocal agreements between
Alaska and other states in terms of dental hygienist licensing.
MS. WALTON replied that a license for each state must be
obtained, but the board for another state would automatically
give a hygienist a license if they were already licensed in
Alaska. There are some states that don't allow credentials from
different licensing boards; a license would be issued based on
completion of an accredited program, passing of the regional
boards, or licensing in another state. The board would still be
able to refuse a license.
She explained that the restorative function of the bill would
create an efficient oral health care delivery system in a
limited amount of time. Local anesthesia has been in Alaska
statue since 1981, with history of required disciplinary action.
A dentist is still required to diagnose the patient's needs;
whether or not the hygienists will be able to administer
anesthesia remains at the discretion of the dentist. This bill
will be allow for great improvement in dental health services in
nursing homes, hospitals, and rural areas; it will reach many
individuals needing dental care. Similar programs in other
states have been proven safe and effective.
2:06:40 PM
RENA BAUER, Faculty Director of the Dental Hygiene Program at
the UA Fairbanks campus, said that all hygienists are licensed
by the state; each hygienist has to meet a state's particular
criteria. She strongly supports the bill which will enhance the
UA's ability to attract students. The class of January 2008 will
be the first dental hygienist class at the UA Fairbanks. The
general supervision of anesthesia will enhance the ability to
serve the rural population in the state. She added that the
amount of graduates from the UA system is based on the American
Dental Association's requirement for a one-to-six
student/instructor ratio.
2:10:48 PM
SENATOR COWDERY asked how many dentists and hygienists are in
rural Alaska, and how more can be attracted.
MS. BAUER replied that most hygienists in rural Alaska would be
employed by the Alaska Native Medical Center; there are some
Anchorage dentists who fly out to rural communities on a regular
basis. She added that several states currently allow the
restorative hygiene measures proposed by the bill.
2:12:17 PM
MR. OBERMEYER referenced an informational packet to show the
number of dental hygienists by region in Alaska, which reflects
difficulties in the rural areas in terms of population.
2:14:30 PM
MIKE BOOTH, president of the Alaska Dental Society (ADS), said
that educating rural Alaskans about proper hygiene is one of the
greatest challenges facing the state, and dental auxiliary use
should be broadened. SB 98 and HB 136 will broaden the scope of
duties, but the fast pace of the hearings has hampered necessary
discussion. He then suggested several improvements to the bill
which will lead to the full support of the ADS, including the
categorization of local anesthesia.
He added that the UA Anchorage dental hygiene program has the
facilities to accommodate many more students, and should receive
the funding to do so.
2:18:05 PM
JIM TULLE, Executive Director of the ADS, said he was available
for questions.
ROYANN ROYER, representing herself, explained her work
background and said that the expanded functions covered under
the bill will increase the number of dental patients served
daily. A typical village trip takes about a week, so sending a
hygienist ahead of time would allow much more work to be done in
a shorter period of time; hygienists possess the education and
qualifications for expanded functions, and students could be
mentored in these positions. SB 98 could be put into practice
immediately.
2:22:57 PM
GLENN MARTIN, representing himself, related his dental work
experience and said that he strongly supports the bill;
collaborative agreement would greatly increase efficiency by
identifying need in advance. The dental profession needs to
start utilizing its mid-level practitioners.
2:25:54 PM
MARY CERNEY, representing herself, related her work history as a
dental hygienist, explained the steps and education necessary to
practice dental hygiene in the United States, and said that
hygienists would have to have an Alaskan license acquired either
through examination or endorsement.
She added that the bill addresses a health care need in the
general population, and would have a profound effect not only on
rural but urban towns. SB 98 will improve overall health care in
the state, and she encouraged the committee to pass the bill out
of committee.
2:31:56 PM
DAVID LOGAN, Legislative Chair for the Alaska Dental Society,
said that a couple of changes may eventually be needed in the
bill but that it should be passed out of the committee.
CHAIR DAVIS said that she was unaware of any proposed amendments
to the bill.
MR. LOGAN explained the changes he wished to see in the bill,
including the provision for general anesthetic.
2:34:44 PM
NATHAN LUKES, representing himself, expressed his support for
the bill and related a personal story about dental hygienists.
CHAIR DAVIS said that there appeared to be some confusion
regarding changes to the bill, and her intention was to keep it
in committee.
There being no further business to come before the committee,
she adjourned the meeting at 2:36:53 PM.
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