Legislature(2019 - 2020)BELTZ 105 (TSBldg)
03/10/2020 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s) | |
| SB182 | |
| SB195 | |
| SB68 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 182 | TELECONFERENCED | |
| *+ | SB 68 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 195 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
March 10, 2020
1:31 p.m.
MEMBERS PRESENT
Senator Click Bishop, Chair
Senator Gary Stevens, Vice Chair
Senator Joshua Revak
Senator Elvi Gray-Jackson
MEMBERS ABSENT
Senator Mia Costello
COMMITTEE CALENDAR
CONFIRMATION HEARING(S)
Board of Nursing
Lena M. Lafferty - Anchorage
- CONFIRMATION ADVANCED
Board of Direct-Entry Midwives
Amanda Penwell - Fairbanks
- CONFIRMATION ADVANCED
Board of Registration of Architects, Engineers, & Land Surveyors
Fred W. Wallis - Healy
- CONFIRMATION ADVANCED
Board of Psychologist and Psychological Associate Examiners
Bradley McConnell - Anchorage
Bernard Gatewood - Fairbanks
Christina Durham - Anchorage
- CONFIRMATIONS ADVANCED
SENATE BILL NO. 182
"An Act raising the minimum age to purchase, sell, exchange, or
possess tobacco, a product containing nicotine, or an electronic
smoking product; relating to the taxation of electronic smoking
products; and providing for an effective date."
- MOVED CSSB 182(L&C) OUT OF COMMITTEE
SENATE BILL NO. 195
"An Act relating to election of a domestic insurer's board of
directors."
- MOVED SB 195 OUT OF COMMITTEE
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 68
"An Act relating to the practice of dental hygiene; establishing
an advanced practice permit; prohibiting unfair discrimination
under group health insurance against a dental hygienist who
holds an advanced practice permit; and relating to medical
assistance for dental hygiene services."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 182
SHORT TITLE: AGE FOR NICOTINE/E-CIG; TAX E-CIG.
SPONSOR(s): SENATOR(s) STEVENS
02/10/20 (S) READ THE FIRST TIME - REFERRALS
02/10/20 (S) L&C, FIN
02/27/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
02/27/20 (S) Heard & Held
02/27/20 (S) MINUTE(L&C)
03/03/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/03/20 (S) Heard & Held
03/03/20 (S) MINUTE(L&C)
03/10/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SB 195
SHORT TITLE: BD OF DIRECTORS: DOMESTIC INSURERS
SPONSOR(s): LABOR & COMMERCE BY REQUEST
02/17/20 (S) READ THE FIRST TIME - REFERRALS
02/17/20 (S) L&C
03/05/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/05/20 (S) Heard & Held
03/05/20 (S) MINUTE(L&C)
03/10/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SB 68
SHORT TITLE: DENTAL HYGIENIST ADVANCED PRAC PERMIT
SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST
02/21/19 (S) READ THE FIRST TIME - REFERRALS
02/21/19 (S) L&C, FIN
04/03/19 (S) SPONSOR SUBSTITUTE INTRODUCED -
REFERRALS
04/03/19 (S) L&C, FIN
03/10/20 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
LENA LAFFERTY, RN, Appointee
Board of Nursing
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Anchorage, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Nursing.
AMANDA PENWELL, Appointee
Board of Direct-Entry Midwives
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Fairbanks, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Direct-Entry Midwives.
FRED WALLIS, PE, Appointee
Board of Registration for Architects, Engineers & Land Surveyors
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Healy, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Registration for Architects, Engineers, & Land Surveyors.
BRADLEY MCCONNELL, PsyD, Appointee
Board of Psychologists and Psychological Examiners
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Anchorage, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Psychologists and Psychological Examiners.
BERNARD GATEWOOD, LPC, Appointee
Board of Psychologists and Psychological Examiners
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Fairbanks, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Psychologists and Psychological Examiners.
CHRISTINA DURHAM, PhD, Appointee
Board of Psychologists and Psychological Examiners
Division of Corporations, Business and Professional Licensing
Department of Commerce, Community and Economic Development
Anchorage, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Psychologists and Psychological Examiners.
TIM LAMKIN, Staff
Senator Gary Stevens
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Explained the changes in the committee
substitute for SB 182, Version S.
SENATOR CATHY GIESSEL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as the sponsor of SB 68.
JANE CONWAY, Staff
Senator Cathy Giessel
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis on behalf
of the sponsor of SB 68.
KATRINA VIRGIN, President
Alaska Dental Hygienist Association
Kodiak, Alaska
POSITION STATEMENT: Stated support for SB 68.
DOMINIC WENZELL, Member
Dentist Dental Board
Girdwood, Alaska
POSITION STATEMENT: Testified in support of SB 68.
ANN LYNCH, Director of Advocacy and Education
American Dental Hygienists Association
Chicago, Illinois
POSITION STATEMENT: Testified in support of SB 68.
VIVIAN STIVER, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 68.
ACTION NARRATIVE
1:31:49 PM
CHAIR CLICK BISHOP called the Senate Labor and Commerce Standing
Committee meeting to order at 1:31 p.m. Present at call to order
were Senators Stevens, Revak, Gray-Jackson, and Chair Bishop.
^CONFIRMATION HEARING(S)
CONFIRMATION HEARING(S)
Board of Nursing
Board of Direct-Entry Midwives
Board of Registration of Architects, Engineers, & Land Surveyors
Board of Psychologist and Psychological Associate Examiners
1:32:45 PM
CHAIR BISHOP announced the first order of business would be
consideration of governor appointees to boards and commissions.
He asked each appointee to place their name and affiliation on
the record, give a brief introduction, and discuss the reason
for wanting to serve on the board or commission. He advised that
public testimony would be taken after all appointees have
testified and the names would be forwarded to the full body for
consideration. This hearing was not a recommendation on any
subsequent vote.
1:33:32 PM
LENA LAFFERTY, RN, Appointee, Board of Nursing, Division of
Corporations, Business and Professional Licensing, Department of
Commerce, Community and Economic Development, Anchorage, Alaska,
stated that she was appointed to fill the registered nurse (RN)
position on the board in July 2019. She offered her view that
the current board has made great strides in streamlining nursing
regulation while ensuring safe practice in Alaska. She related
that she served in the U.S. Navy as a hospital corpsman, that
she has been a licensed RN for five years, and that she
currently works at Providence Hospital. She would like to serve
on the board to be an advocate for the people of Alaska and to
promote and protect the health of Alaskans through the safe and
effective practice of nursing as defined by law. She thanked
members for their consideration.
CHAIR BISHOP found no questions.
1:35:09 PM
AMANDA PENWELL, Appointee, Board of Direct-Entry Midwives,
Division of Corporations, Business and Professional Licensing,
Department of Commerce, Community and Economic Development,
Fairbanks, Alaska, stated that she is a licensed direct-entry
midwife in Alaska, and has practiced midwifery for 22 years,
including her work overseas and in two other states. She
currently works as a staff midwife at a busy Fairbanks birth
center. She has the advantage of having experienced giving birth
using a midwife. She stated her interest in serving on the board
stems from her strong commitment to see the profession grow and
to ensure public safety.
CHAIR BISHOP found no questions.
1:36:51 PM
FRED WALLIS, PE, Appointee, Board of Registration for
Architects, Engineers, & Land Surveyors, Division of
Corporations, Business and Professional Licensing, Department of
Commerce, Community and Economic Development, Healy, Alaska,
stated that he serves as the Vice President of Usibelli Coal
mine, where he has worked for 23 years. He graduated from the
University of Alaska Fairbanks and holds a professional mining
engineering license in Alaska and Canada. He said he was
interested in serving on the board because as the construction
and development industries grow, the need for design
professionals will also grow. The most important issue for the
board is to ensure public safety. He thanked members for their
consideration.
CHAIR BISHOP noted that Mr. Wallis is a reappointment to the
AELS board. He found no questions.
1:37:59 PM
At ease
1:38:22 PM
CHAIR BISHOP reconvened the meeting.
1:38:34 PM
BRADLEY MCCONNELL, PsyD, Psychologist, Appointee, Board of
Psychologists and Psychological Examiners, Division of
Corporations, Business and Professional Licensing, Department of
Commerce, Community and Economic Development, Anchorage, Alaska,
said he was raised in rural California in an area with a
population about the size of Alaska's current population, with a
similar number of mental health professionals serving the area.
He offered his view that serving the needs of that population
translates well to Alaska because of access to care issues. He
predicted the need for mental health professionals will continue
to increase in coming years. He said professional psychology is
integral to him as an individual. After completing his training
as a psychologist seven years ago, he has worked in a variety of
settings, including university counseling centers, federally
qualified health centers, correctional facilities, and in-
patient hospitals. He is a board-certified psychologist through
the American Board of Professional Psychology and currently
serves as the director of Psychological Services at the Alaska
Psychiatric Institute. The biggest hurdle the board faces is
providing Alaskans with access to mental health care in a timely
and routine manner, he said. He said he does not have all the
answers, but he hopes to help the board explore what is being
accomplished through interstate compacts for psychological
services and via telehealth. He was humbled to be asked to serve
on the board.
CHAIR BISHOP found no questions.
1:40:44 PM
BERNARD GATEWOOD, LPC, Appointee, Board of Psychologists and
Psychological Examiners, Division of Corporations, Business and
Professional Licensing, Department of Commerce, Community and
Economic Development, Fairbanks, Alaska, stated that he has
lived in Alaska for about 35 years, and he holds a Master of
Science degree in counseling and a Bachelor of Arts degree in
sociology. He has over 30 years of public service with
experience primarily in juvenile corrections. He has spent
almost 16 years as the superintendent of the Fairbanks Youth
Facility, which includes oversight for the Nome and Bethel youth
correctional facilities. He has worked in mental health services
in Alaska and Alabama. He said he has served on numerous boards
and commissions, including the Fairbanks North Star Borough
Health and Social Services Commission and the Fairbanks City
Council. In 2015, he retired and since then he has been serving
his community in a variety of ways, including as a trustee for a
foundation and as a sports announcer for high school football
and basketball games. He expressed an interest in trying to do
more to address some of the behavioral health issues in the
state. He offered his view that this board plays a role in
licensure and it is important to get mental health professionals
to work as soon as possible in Alaska after proper vetting. He
expressed appreciation for the opportunity to serve on the
board.
CHAIR BISHOP thanked him for his service to the youth in the
state.
1:44:00 PM
CHRISTINA DURHAM, PsyD, Ph.D., Appointee, Board of Psychologists
and Psychological Examiners, Division of Corporations, Business
and Professional Licensing, Department of Commerce, Community
and Economic Development, Anchorage, Alaska, stated that she has
been a licensed psychologist since 2009, but she was a non-
traditional student. She earned an associate degree from the
University of Alaska Anchorage and then took almost 10 years to
complete her undergraduate degree and Ph.D. in clinical
psychology from Brigham Young University. She said she has
always felt that persistence is an important trait. She later
earned a post-doctoral Master of Science degree in clinical
psychopharmacology from Alliant International University. She
has been licensed in Alaska since 2009 and in Utah since 1999.
She has always attempted to give back to her community and now
she has time to do this since she is mostly retired. She stated
her interest in serving on the board is because she sees a
strong need to improve and further the practice of psychology.
She believes that her interest and her perspective as a forensic
practitioner may help the board. She said that she looks forward
to serving, if confirmed.
CHAIR BISHOP found no questions.
1:46:59 PM
CHAIR BISHOP stated that in accordance with AS 39.05.080, the
Senate Labor and Commerce Standing Committee reviewed the
following and recommends the appointments be forwarded to a
joint session for consideration:
Board of Direct-Entry Midwives
Amanda Penwell - Fairbanks
Board of Nursing
Lena M. Lafferty - Anchorage
Board of Registration of Architects, Engineers, and Land
Surveyors
Fred W. Wallis - Healy
Board of Psychologist and Psychological Associate Examiners
Bradley McConnell - Anchorage
Bernard Gatewood - Fairbanks
Christina Durham - Anchorage
Signing the reports regarding appointments to boards and
commissions in no way reflects individual members' approval or
disapproval of the appointees; the nominations are merely
forwarded to the full legislature for confirmation or rejection.
1:47:48 PM
At ease
SB 182-AGE FOR NICOTINE/E-CIG; TAX E-CIG.
1:48:54 PM
CHAIR BISHOP announced the consideration of SENATE BILL NO. 182,
"An Act raising the minimum age to purchase, sell, exchange, or
possess tobacco, a product containing nicotine, or an electronic
smoking product; relating to the taxation of electronic smoking
products; and providing for an effective date."
1:48:58 PM
SENATOR STEVENS moved to adopt the proposed committee substitute
(CS) for SB 182, work order 31-LS1478\S, as the working
document.
CHAIR BISHOP objected for an explanation of the changes.
1:49:15 PM
TIM LAMKIN, Staff, Senator Gary Stevens, Alaska State
Legislature, Juneau, Alaska, explained the changes in the
committee substitute for SB 182, Version S. He said the bill
will conform Alaska statutes to federal law. Last December,
Congress passed the law requiring anyone who buys, sells, or
possesses tobacco products to be at least 21 years of age. He
explained that the products affected by the federal law are
categorized as: cigarettes, other tobacco products, products
containing nicotine, and electronic smoking products (CONE)
products. Many states have a robust system to monitor and
enforce compliance with standard brick and mortar storefronts,
but there is not a system to enforce internet-based vendors
selling CONE products. Version S will reflect restrictions for
online sales. He said substantial evidence shows that minors
currently acquire these products from vendors who skirt Alaska's
existing laws for storefront retailers. Under the federal
Tobacco Control Act, the federal Food and Drug Administration
(FDA) has the authority to take these actions. However, no
actions have been taken against online sales. In that absence,
states are beginning to change their laws. Version S
incorporates what several other states have done to address
online sales. First, it will repeal existing exemptions for
individuals who are incarcerated. Second, the online CONE
venders must be licensed with the state. Third, an age
verification must be made at the point of purchase. Fourth,
packages must be clearly labeled as containing CONE products,
and finally, an age verification must be made at the point of
delivery. He related his understanding that the bill will be
silent on taxes and allow the Senate Finance Committee to
address that aspect.
1:52:30 PM
MR. LAMKIN reviewed the sectional analysis of SB 182, Version S:
Title: Adds relating to transportation of tobacco,
products containing nicotine and electronic smoking
products.
Sec. 3: (Page 2 lines 26-27) AS 11.76.105(a,) relating
to minor possession of tobacco or E-Cig products,
repeals an exemption for those in jail.
Sec. 9: (Page 5, lines 24-26) AS 43.50.105(b),
Relating to transporting cigarettes into the state a
wholesaler or distributor must use an age verification
service to confirm the age of an online purchaser.
Sec. 10: (Page 6, Lines 6-7) AS 43.50.105(c), relating
to common carriers (FedEx, UPS, USPS etc) shipping
cigarettes into the state, requires the carrier to
verify the age of the recipient before completing
delivery.
Sec. 15: (Page 7, Lines 14-31, continued through Page
8-9) AS 43.30.325, is a new section, relating to
transportation of tobacco products, products
containing nicotine, and E-Cig products into Alaska,
establishes identical shipping restrictions as those
placed on cigarettes; licensing and age verification.
Sec. 27: (page 15, Line 14) AS.76.100(e), relating to
selling or gifting cigarettes or tobacco to a minor,
repeals an exemption for those in jail.
CHAIR BISHOP noted that the fiscal aspects will be taken up in
the Senate Finance Committee.
1:55:36 PM
SENATOR STEVENS commented that he appreciated the clarification
on taxation. He acknowledged that it is important to be fair to
the shops in Alaska.
CHAIR BISHOP removed his objection.
1:56:07 PM
SENATOR STEVENS moved to report the CS for SB 182, work order
31-LS1478\S from committee with individual recommendations and
attached fiscal note(s).
CHAIR BISHOP found no objection and CSSB 182(L&C) was reported
from the Senate Labor and Commerce Standing Committee.
1:56:21 PM
At ease
SB 195-BD OF DIRECTORS: DOMESTIC INSURERS
2:00:43 PM
CHAIR BISHOP reconvened the meeting and announced the
consideration of SENATE BILL NO. 195, "An Act relating to
election of a domestic insurer's board of directors."
He opened public testimony on SB 195, and after determining no
one wished to comment, closed public testimony on SB 195.
2:01:33 PM
SENATOR STEVENS moved to report SB 195 from committee with
individual recommendations and attached fiscal note(s).
2:01:47 PM
CHAIR BISHOP found no objection and SB 195 was reported from the
Senate Labor and Commerce Standing Committee.
2:01:54 PM
At ease
SB 68-DENTAL HYGIENIST ADVANCED PRAC PERMIT
2:03:32 PM
CHAIR BISHOP reconvened the meeting and announced the
consideration of SPONSOR SUBSTITUTE FOR SENATE BILL NO. 68, "An
Act relating to the practice of dental hygiene; establishing an
advanced practice permit; prohibiting unfair discrimination
under group health insurance against a dental hygienist who
holds an advanced practice permit; and relating to medical
assistance for dental hygiene services."
He said this is the first hearing, but the companion has made
significant progress in the other body. He noted there was a
proposed committee substitute that would be addressed after the
sponsor makes opening remarks.
2:03:57 PM
SENATOR CATHY GIESSEL, Alaska State Legislature, Juneau, Alaska,
sponsor of SB 68, stated that this bill will create a dental
hygienist advanced practice permit. She explained that some
dental conditions can predispose a person to heart disease and
if they are missing teeth, their nutritional status falls
significantly, which affects their health. In Alaska, the most
vulnerable populations are children, seniors and those with
disabilities. She said the state has an enormous unmet need for
dental care in Alaska and dental costs are high. Many states
allow dental hygienists to hold advanced practice permits that
allow them to provide dental services to underserved populations
who are at risk. These patients may not have access to a dental
office, there may not be a dental office in their community, or
the patients may have transportation issues getting to a
dentist.
She explained that SB 68 would establish an advanced practice
permit for Alaska-licensed dental hygienists to expand access to
dental care. She highlighted that in 2019 there were 703
licensed dental hygienists in Alaska. These are skilled dental
health professionals whose focus is preventing and treating oral
diseases.
SENATOR GIESSEL said the lack of access to dental care in Alaska
has created enormous need in populations and communities that
are underserved by the traditional system of care and the cost
of obtaining treatment is high. Many states have addressed
similar challenges by allowing non-dentist oral healthcare
practitioners the freedom and flexibility to reach out to
patients in new and creative ways to help improve access to
basic oral care. Alaska would benefit from replicating such
innovative oral health care delivery models.
SENATOR GIESSEL related that dental hygienists have graduated
from nationally accredited dental hygiene education programs and
have successfully passed a national written and state clinical
examination. Given their comprehensive education and clinical
preparation, dental hygienists are well prepared to deliver
preventative oral health care and other services to the public,
safely and effectively, she said.
She listed the identified underserved areas in Alaska, which
includes nursing homes, K-12 schools, senior centers,
residential treatment centers, assisted living centers, nursing
homes, nursery schools, and day care centers.
SENATOR GIESSEL stated that licensed dental hygienists holding
advanced practice permits could provide early preventive
treatment thus reducing the number of acute dental care visits,
which can be very costly. Additionally, these advanced practice
dental hygienists could identify more acute dental issues early
on and refer patients needing definitive restorative treatment
to dentists. She pointed out that 62 percent of Alaska's
children have higher than normal tooth decay rates, so having
access to care at a day care center, nursery school, or K-12
school could help to reduce dental issues. SB 68 would create
new consumer choices for preventive oral health, and help to
educate individuals, families, caregivers, and health providers
on the basics of oral health and dental hygiene. It has support
from the Alaska Board of Dental Examiners, the Alaska Dental
Hygienists Association, the American Dental Hygienists
Association, the Alaska Dental Society, and dental hygienists.
2:07:37 PM
SENATOR STEVENS asked for an estimate of the cost savings if the
underserved dental care is met.
SENATOR GIESSEL replied it is difficult to estimate preventative
dental care savings, but the dental health aides that Alaska now
has have had a significant positive impact.
She added that the advanced practice dental hygienists could
help seniors with dementia some of the disruptive and
disorienting experiences of going to a dentist. An advanced
practice dental hygienist could go into the Pioneer Home, for
example, and meet the needs of many of those seniors.
CHAIR BISHOP noted that he and the sponsor recently heard an
overview on the Medicaid costs for dental care. He suggested
that this bill could help drive down those costs.
2:10:01 PM
SENATOR STEVENS moved to adopt the proposed committee substitute
(CS) for SSSB 68, work order 31-LS0224\R, as the working
document.
CHAIR BISHOP found no objection and Version R was adopted.
2:10:23 PM
JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State
Legislature, Juneau, Alaska, provided the following sectional
analysis for the CS for SSSB 68, Version R:
Section 1 AS 08.32.110. Scope of practice of dental
hygienists Amends section (e) of dental hygienists'
scope of practice to allow a licensed dental hygienist
who holds an advanced practice permit issued by the
board to perform the duties allowed by the permit.
Section 2
Adds a new section to AS 08.32:
AS 08.32.125. Advanced practice permits.
Outlines the advanced practice permit requirements and
privileges.
(a) The Board of Dental Examiners may issue an
advanced practice permit to a licensed dental
hygienist with a minimum of 4,000 documented hours of
clinical experience. A licensed dental hygienist with
an advanced practice permit may perform the specific
services listed in this section (1) (12)
(b) Describes patients a licensed dental hygienist who
holds an advanced practice permit may provide services
to, including:
• A patient not able to receive dental treatment
due to age, infirmity, or disability, and is
• A resident of a senior center, hospital, long-
term care, residential care facility, adult
foster home, adult congregate living facility, an
inmate in a local correctional facility a
healthcare facility, residential treatment center
or facility for those with disabilities, nursery
school, day care, vocational training program,
secondary school, private school, or charter
school
• A patient receiving benefits under the Special
Supplemental Food Program (WIC), homebound, or a
resident where there's a shortage of dental
health professionals. (1) (7) (c) A licensed
dental hygienist holding an advanced practice
permit can provide services listed in subsection
(a) to a patient described in subsection (b)
without the presence, authorization, or
supervision of a licensed dentist and without an
examination from a licensed dentist. (d) A
licensed dental hygienist with an advanced
practice permit who provides services must do the
following:
~ maintain professional liability insurance.
~ give the patient, parent, or legal
guardian written notice that the treatment
provided will be limited to services listed
under subsection (a)
~ provide a written recommendation that the
patient be examined by a licensed dentist
for comprehensive oral care
~ provide assistance for a referral to a
licensed dentist for further oral treatment.
(e) A licensed dental hygienist with an advanced
practice permit may practice as an independent
contractor.
(f) An advanced practice permit is valid until the
license of the dental hygienist expires. A licensed
dental hygienist can renew their advanced practice
permit at the same time they renew their license.
2:14:24 PM
CHAIR BISHOP noted that a dental hygienist with an advanced
practice permit who provides services must maintain professional
liability insurance. He asked if she agreed that these
individuals could work in a practice or set up their own shop.
MS. CONWAY answered that is correct but the expectation is that
most of these dental hygienists will work for a dentist and also
go out to underserved areas to provide services.
CHAIR BISHOP asked if the dental office as the primary employer
would maintain the professional liability insurance for these
dental hygienists who also go out on their own to provide
services in other settings.
2:15:29 PM
SENATOR GIESSEL answered that in her experience with advanced
practice nurses, employers will offer liability insurance as a
benefit, but it is typically up to the clinician to maintain
that liability insurance and pay the premiums.
2:16:01 PM
MS. CONWAY continued the sectional analysis for CSSSSB 68:
Section 3 Amends 08.32.160 Grounds for discipline,
suspension or revocation of license. Outlines and
amends grounds for discipline; allows the Board of
Dental Examiners to discipline, suspend, or revoke the
license of an advanced practice permit-holder who:
o Knowingly commits fraud or misrepresentation
to obtain a license
o Knowingly commits fraud/misrepresentation in
providing services or billing procedures o False
advertises or misleads
o Been convicted of a felony or other crime
that would affect ability to practice competently
o Failed to comply to statute or regulations
or board order
o Practices if unfit due to incompetence,
addiction or dependence on drugs or alcohol, is
physically or mentally disabled, engaged in
immoral conduct while in practice
o performs procedures outside scope of
practice or without supervision of a dentist
o allows a dental assistant to perform duties
outside their scope
o Falsifies or destroys a patient or facility
record or fails to maintain a patient or facility
record for at least seven years after the date
the record was created.
MS. CONWAY emphasized that when a dental hygienist with an
advanced practice permit is supervising a dental assistant, it
is mandatory that they make sure that the dental assistant only
operates within the advanced practice permit holder's scope of
practice. The provision related to falsifying or maintaining a
patient or facility record is the same requirement as for
dentists, she said.
SENATOR STEVENS asked what types of procedures would fall
outside the scope of practice.
MS. CONWAY answered that a dental hygienist would not do
invasive procedures such as pulling teeth. Those patients would
be referred to a dentist.
2:18:06 PM
MS. CONWAY continued the sectional analysis for CSSSSB 68:
Section 4 Adds a new subsection to AS 08.36.346.
(Delegation to dental assistant.) Allows delegation of
the following tasks to a dental assistant:
a. The exposure and development of radiographs,
b. Application of topical preventative agents or pit
and fissure sealants, and
c. Other tasks specified by the board in regulations.
The dental assistant must be supervised at a level
specified by Board of Dental Examiners in regulation.
Section 5 AS 21.36.090. Unfair discrimination. Adds
"dental hygienist holding an advanced practice permit"
to the list of providers who may not be discriminated
against in subsection (d).
Section 6 AS 47.07.030. Medical services to be
provided. (Medicaid) Adds dental hygiene services to
the list of services which may be provided by the
Department of Health & Social Services.
Section 7 This new section allows the Department of
Commerce, Community, and Economic Development (DCCED),
the Department of Health and Social Services, and the
Board of Dental Examiners to adopt regulations
necessary to implement the changes made in this bill.
The regulations may not take effect before the
effective date of this bill.
Section 8 Section 7 takes effect immediately.
Section 9 The effective date of this bill (not
including Section 7) is July 1, 2021.
2:19:38 PM
CHAIR BISHOP noted who was available to answer questions.
2:20:45 PM
KATRINA VIRGIN, President, Alaska Dental Hygienist Association,
Kodiak, Alaska, stated support for SB 68 and offered to answer
questions.
2:21:31 PM
DOMINIC WENZELL, DMD, Member, Alaska Board of Dental Examiners,
Girdwood, Alaska, stated support for Version R of SB 68 and
offered to answer questions.
2:22:02 PM
SENATOR REVAK asked Dr. Wenzell if he was back practicing
dentistry.
DR. WENZELL answered that the orthopedic surgeon just released
him to work one-half day per week.
2:22:35 PM
ANN LYNCH, Director of Advocacy and Education, American Dental
Hygienists Association (ADHA), Chicago, Illinois, spoke in
support of SB 68. She stated that she has been with ADHA for
eight years. Before that she served as a state senator in
Minnesota. She said ADHA is the largest national organization
representing dental hygienists in the nation. She related that
in 1995, only five states allowed dental hygienists to practice
without the presence and authorization of a dentist. Now there
are 42 states, including Alaska, that permit dental hygienists
to work in communities to provide preventive oral health
services without the presence or direct supervision of a
dentist. This will further utilize the dental hygienist
workforce in Alaska. She said there are national standards for
dental hygienist education programs that are accredited
throughout the country, including Alaska and this advanced
practice permit will allow dental hygienists to meet clients
where they live and receive service. As a former lawmaker, she
said SB 68 provides an opportunity to provide leadership and
support a change that will make a difference in the lives of
many people across Alaska for years to come. She thanked members
for their service and the leadership members provide.
2:26:27 PM
CHAIR BISHOP asked if there was any data on the number of
hygienists who go on to become dentists.
MS. LYNCH answered that it is far more common for dental
hygienists to seek the ability to practice at the top of their
scope of practice based on their education.
SENATOR REVAK asked about the scope of the practice and whether
advance practice dental hygienists can administer local
anesthesia.
MS. LYNCH directed attention to page 2, lines [9-29] of SB 68,
Version R, which lays out the scope of practice for an advanced
practice dental hygienist. The question about administering
local anesthesia is addressed on page 2, lines 24-27.
SENATOR REVAK asked for a description of nonsurgical periodontal
therapy, with or without local anesthesia.
MS. LYNCH answered that she is not a dental hygienist. She
suggested the question be posed to the dental hygienist online.
CHAIR BISHOP said he'd hold the question.
2:29:56 PM
SENATOR STEVENS referenced her earlier statement that in some
settings dental hygienists can work without a dentist being
present. He asked what that setting would be.
MS. LYNCH responded that 42 states have direct access, such that
in at least in one setting in each of those states, dental
hygienists can provide those services to patients without the
presence or authorization of a dentist. She said most commonly
that occurs in schools and that is the case in Alaska. Since
2008, dental hygienists in Alaska have been able to provide
services under a collaborative practice agreement. SB 68 creates
the advanced practice permit system, which will allow increased
access for dental hygienists to work in more settings.
2:32:18 PM
At ease
2:32:37 PM
CHAIR BISHOP reconvened the meeting and asked Senator Revak to
pose his earlier question to Dr. Wenzell.
SENATOR REVAK asked for help understanding the scope of practice
that includes nonsurgical periodontal surgery, with or without
anesthesia.
DR. WENZELL referred to page 2, lines 21-22 of SB 68, Version R.
He explained that if a patient has [gumline] probings that are
deeper than four millimeters and tenacious sublingual calculus,
the dental hygienist is not able to scale the root plane without
numbing the area so the patient is comfortable. Dental
hygienists currently are able to administer local anesthetic
under the general supervision of a dentist and the dental board
supports allowing dental hygienists to administer local
anesthetic in settings like a nursing home.
2:34:22 PM
CHAIR BISHOP opened public testimony on SB 68.
2:34:34 PM
VIVIAN STIVER, representing self, Fairbanks, Alaska, spoke in
support of SB 68. She said she has worked with the senior
population for nine years and has witnessed the oral health
problems low-income seniors experience due to cost and
transportation barriers. She said having bad teeth can be
painful, cause eating difficulty, and affect a person's overall
health. Sometimes seniors will opt for tooth extractions because
they cannot afford the other types of services. She said SB 68
will help with this situation by allowing dental hygienists to
screen, clean, and encourage seniors to address problems as they
crop up. This has the potential to improve the quality of life
for seniors. She summarized that she was pleased to see the
advanced practice permit system since it can help provide
services to those communities that are currently underserved.
2:36:46 PM
CHAIR BISHOP closed public testimony on SB 68 and held the bill
for future consideration.
2:37:21 PM
There being no further business to come before the committee,
Chair Bishop adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:37 p.m.