SB 25-EXTEND BOARD OF DENTAL EXAMINERS  2:14:23 PM CHAIR REINBOLD announced that the final order of business would be SENATE BILL NO. 25, "An Act extending the termination date of the Board of Dental Examiners; and providing for an effective date." 2:14:34 PM SENATOR COSTELLO clarified that the committee would be considering the original version of the bill. SENATOR BISHOP objected for the purpose of discussion. 2:15:03 PM SENATOR DAVID WILSON, Alaska State Legislature, paraphrased from his sponsor statement, which read as follows: Senate Bill 25 extends the termination date for the Board of Dental Examiners until June 30th, 2027. The Board of Dental Examiners is composed of nine members: six dentists, two dental hygienists, and one public member. Legislative Audit conducted their review of this board and determined that "The audit concludes that the board operated in the public's interest by effectively licensing and regulating dentists, dental hygienists, and dental assistants. The board monitored licensees and worked to ensure only qualified individuals practiced in Alaska. Furthermore, the board was active in amending regulations to improve the industry. In accordance with AS 08.03.010(c)(7), the board is scheduled to terminate on June 30, 2019. We recommend that the legislature extend the board's termination date eight years to June 30, 2027." The Board of Dental Examiners serves an important role in adopting regulations to carry out the laws governing the practice of dentistry and dental hygiene in Alaska. The continuation of this board plays an important role in ensuring high standards of dental care are offered throughout the state. Thank you for your consideration of this legislation. SENATOR WILSON remarked that Ms. Curtis could speak to the two recommendations the audit made. 2:16:38 PM KRIS CURTIS, Legislative Auditor, Legislative Audit Division, Legislative Agencies and Offices, presented audit findings on the Board of Dental Examiners, [Audit Control Number 08-20111- 18] dated April 26, 2018 in members' packets. This audit concluded that the board served the public's interest by effectively licensing and regulating dentists, dental hygienists, and dental assistants. The board monitored licensees and worked to ensure only qualified individuals practiced in Alaska. Furthermore, the board was active in amending regulations to improve the industry. The audit recommends the legislature extend the board for eight years. She referred to page 6 and related that the auditors reviewed licensing activity. She reported the number of licensees at the end of January 2018 was 2,399 active licensees. On page 7, the schedule of the board's revenues and expenditures shows that the board had a deficit of approximately $36,000 as of March 31, 2018. She referred members to page 8 for the 2018 fee analysis. MS. CURTIS referred to the two audit recommendations on pages 9- 10. She turned to audit recommendation 1, which read, "The Board of Dental Examiners (board) president should take steps to correct a regulation error." She said the auditors found that a 2016 regulation change referenced a repealed section of regulations. She characterized this as an easy administrative fix. She turned to audit recommendation 2, which read, "DCBPL's chief investigator, in consultation with the board, should implement controls to ensure the appropriate entities are notified when a licensee's prescription authority is suspended or revoked." She explained that the auditors found that during the audit period two licensed dentists had their prescription authority revoked or suspended. In both cases, the board did not notify the Board of Pharmacy or the federal Drug Enforcement Administration, mainly because there were no procedures that required notification. Failure to notify the DEA that a dentist's prescription authority has been suspended or revoked may result in improper or unauthorized prescriptions. She referred to the department's response to the audit on page 19. The department reported that it has implemented a policy to notify both entities. She turned to the board's response on page 21. The board agreed with both recommendations and agreed to take corrective action, she said. 2:19:22 PM CHAIR REINBOLD opened public testimony on SB 25. 2:20:04 PM DAVID NIELSON, Dentist (DDS); Member, Board of Dental Examiners, Division of Corporations, Business & Professional Licensing, Department of Commerce, Community and Economic Development, stated he was just reappointed to the Board of Dental Examiners. He said that the board serves a vital role in the regulation of dentistry by always keeping the health and welfare of Alaska's citizens in mind. He offered his belief that licensing, permitting, certification and disciplinary action, when appropriate, is a cornerstone of what the public should expect from the state government to have confidence in their health care providers. He said that he enjoys the challenges and appreciates the opportunity to continue to fulfill the board's purpose. He stated his support for SB 25. 2:21:05 PM SENATOR COSTELLO asked him to address the need for more dentists in Alaska. She further asked if he would discuss the future of telemedicine in dentistry. DR. NEILSON related that the board has been working to accept more national licensing exams and that will increase the pool of applicants and will improve the pathway to licensure. Further, the board has been considering allowing some military training in lieu of certain things done by examination. The board already reviews applicants' credentials. The distribution of dentists is an issue, but the overall number of dentists is probably fine. DR. NEILSON answered that the tribal system uses teledentistry with its dental health aide therapists and to some extent dentists in Alaska use teledentistry with their collaborative agreements with hygienists. While the mechanisms are in place and some forms of teledentistry can be performed, dentists in Alaska do not typically use it. 2:23:01 PM SENATOR GRAY-JACKSON asked what steps the board has taken to address the audit recommendations and findings. DR. NEILSON said he thought the board has already addressed the regulation issue related to the radiologic inspection. He said the board agreed this needed to be fixed, that he noticed it quite a while ago. Secondly, he deferred to the licensing examiner in terms of reporting prescriptions. He stated that turnover with examiners has caused some issues with continuity, and the board has had three licensing examiners during his tenure. He said the board agrees with both audit recommendations. 2:24:23 PM SARA CHAMBERS, Director, Division of Corporations, Business & Professional Licensing, Department of Commerce, Community and Economic Development, in response to Representative Gray- Jackson, replied that this finding is a "sister finding" to the audit recommendation for Board of Nursing mentioned earlier. She explained that when the reporting issues were brought to the division's attention the chief investigator had initiated actions to improve procedures and better coordinate with the various prescriber boards, the Board of Pharmacy, and the DEA. She said the investigator wanted to assure that communications happen "on a two-way basis," and that the board was not just waiting for the DEA to perform the check. 2:24:59 PM SENATOR COSTELLO recalled the legislature passed legislation a few years ago that asked the state to consider reciprocity for military experience. She asked her to clarify how that is working or if the legislature needed to do something more. MS. CHAMBERS agreed the legislature passed several bills to address some of the employment concerns of military and military dependents. This board has been given an opportunity to use a comparison of military experience to more traditional educational experience. She pointed out that the board does not get a lot of military applicants. She said the public is protected since the dentist has experience and capability and the applicant with the experience can get to work. That law has been in place, but some boards do not use it due to the small number of military applicants. However, it is exciting when the [experience and education] can be pieced together to get to the same outcome 2:27:29 PM DAVID LOGAN, Dentist (DDS); Executive Director, Alaska Dental Society, stated that Dr. Neilson covered the board pretty well. He said it was fairly self-evident why the state needs a dental board. 2:27:51 PM CHAIR REINBOLD, after first determining no one wished to testify, closed public testimony on SB 25. 2:28:17 PM SENATOR BISHOP reviewed the fiscal note from the Department of Commerce, Community and Economic Development. He identified the appropriation and allocation as the Division of Corporations, Business, and Professional Licensing (DCBPL) in the amount $35,000, as follows: travel $3,360 for nine board members and one examiner to attend four board meetings, $400 for advertising public notices of board meetings, $1,000 for training and conference fees, and $100 for board member stipends. Professional licensing programs within the division are funded by receipt-supported services. Licensing fees for each occupation are set per AS 08.01.065 so the total amount of revenue collected approximately equals the occupation's actual regulatory costs, he said. 2:29:54 PM SENATOR BISHOP removed his objection. 2:30:12 PM SENATOR COSTELLO moved to report SB 25, 31-LS0125\A, from committee with individual recommendations and attached fiscal note. There being no objection, SB 25 was reported from the Senate Labor and Commerce Standing Committee.