Legislature(2021 - 2022)
2022-05-17 House Journal
Full Journal pdf2022-05-17 House Journal Page 2993 SB 173 The following was read the second time: CS FOR SENATE BILL NO. 173(FIN) "An Act relating to the practice of dentistry; relating to dental radiological equipment; and providing for an effective date." with the: Journal Page FIN RPT 7DP 4NR 2900 FN1: (DHS) 2900 FN2: (DHS) 2900 FN3: (CED) 2900 Amendment No. 1 was offered by Representatives Spohnholz, LeBon, Kaufman, Thompson, Nelson, Rauscher, and Cronk: Page 1, line 1, following "equipment;" (title amendment): 2022-05-17 House Journal Page 2994 Insert "relating to the practice of dental hygiene; relating to advanced practice permits for dental hygienists; relating to dental assistants; prohibiting unfair discrimination under group health insurance against a dental hygienist who holds an advanced practice permit; relating to medical assistance for dental hygiene services;" Page 2, following line 17: Insert new bill sections to read: "* Sec. 3. AS 08.32.110(e) is amended to read: (e) This section does not prohibit a licensed dental hygienist (1) with an endorsement issued under AS 08.32.085 from performing the activities authorized under AS 08.32.085; (2) who holds an advanced practice permit issued by the board under AS 08.32.125 or has entered into a collaborative agreement approved by the board under AS 08.32.115 from performing the activities authorized under the permit or collaborative agreement; or (3) from performing a dental operation, procedure, or service a dentist may delegate to a dental assistant under AS 08.36.346 or that a licensed dental hygienist who holds an advanced practice permit issued by the board under AS 08.32.125 may delegate to a dental assistant under AS 08.36.346(c). * Sec. 4. AS 08.32 is amended by adding a new section to read: Sec. 08.32.125. Advanced practice permits. (a) The board 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 holding an advanced practice permit may (1) promote oral health and provide disease prevention education and oral systemic health education; (2) remove calcareous deposits, accretions, and stains from the surfaces of the teeth beginning at the epithelial attachment by scaling and polishing techniques; (3) apply topical preventive or prophylactic agents, including silver diamine fluoride, fluoride varnishes, and pit and fissure sealants; (4) remove marginal overhangs; (5) perform preliminary charting and triage to formulate 2022-05-17 House Journal Page 2995 a dental hygiene assessment and dental hygiene treatment plan; (6) expose and develop radiographs; (7) use local periodontal therapeutic agents; (8) perform nonsurgical periodontal therapy; (9) screen for oral cancer; (10) if certified by the board, administer local anesthetic agents; (11) prescribe (A) fluoride that is applied or provided to a patient; and (B) chlorhexidine or a similar antibacterial rinse; and (12) delegate dental operations and services to a dental assistant as provided in AS 08.36.346. (b) A licensed dental hygienist holding an advanced practice permit may provide the services described in (a) of this section to a patient who is unable to access dental treatment because of age, infirmity, or disability and is (1) a resident in a senior center, including a hospital, long-term care facility, adult foster home, residential care facility, or adult congregate living facility; (2) a resident in a health care facility, including a mental health residential program or facility for individuals with developmental or other disabilities; (3) held in a local correctional facility for juveniles or adults; (4) enrolled in a nursery school, day care program, vocational training facility, primary school, secondary school, private school, or public charter school; (5) entitled to benefits under 42 U.S.C. 1786 (Special Supplemental Nutrition Program for Women, Infants, and Children); (6) homebound; or (7) a resident of a dental health professional shortage area designated under 42 U.S.C. 254e. (c) A licensed dental hygienist holding an advanced practice permit may provide the services described in (a) of this section to a patient described in (b) of this section without (1) the physical presence, authorization, or supervision of a licensed dentist; (2) a licensed dentist's examination of the patient. 2022-05-17 House Journal Page 2996 (d) A licensed dental hygienist who provides services under an advanced practice permit shall maintain professional liability insurance and provide the patient, or the parent or legal guardian of the patient, with (1) a written notice that the treatment provided will be limited to services permitted under (a) of this section; (2) a written recommendation that the patient be examined by a licensed dentist for comprehensive oral health care services; and (3) assistance in obtaining a referral to a licensed dentist for further dental planning and treatment, including a written description of methods for obtaining a referral and a list of licensed dentists in the patient's community or other resources for finding a licensed dentist. (e) An advanced practice permit is valid until the expiration of the dental hygienist's license to practice. A licensed dental hygienist may renew an advanced practice permit at the time of license renewal under AS 08.32.071. * Sec. 5. AS 08.32.160 is amended to read: Sec. 08.32.160. Grounds for discipline, suspension, or revocation of license. The board may revoke or suspend the license of a dental hygienist, or may reprimand, censure, or discipline a licensee, if, after a hearing, the board finds that the licensee (1) used or knowingly cooperated in deceit, fraud, or intentional misrepresentation to obtain a license, certificate, or endorsement; (2) engaged in deceit, fraud, or intentional misrepresentation in the course of providing or billing for professional services or engaging in professional activities; (3) advertised professional services in a false or misleading manner; (4) has been convicted of a felony or other crime that affects the licensee's ability to continue to practice competently and safely; (5) failed to comply with this chapter, with a regulation adopted under this chapter or under AS 08.36, or with an order of the board; (6) continued to practice after becoming unfit due to (A) professional incompetence; 2022-05-17 House Journal Page 2997 (B) addiction or dependence on alcohol or other drugs that impairs the licensee's ability to practice safely; (C) physical or mental disability; (7) engaged in lewd or immoral conduct in connection with the delivery of professional service to patients; (8) except as permitted under an advanced practice permit under AS 08.32.125, performed clinical procedures without being under the supervision of a licensed dentist; (9) did not conform to professional standards in delivering dental hygiene services to patients regardless of whether actual injury to the patient occurred; (10) permitted a dental assistant employed by an advanced practice dental hygienist or working under the supervision of a dental hygienist to perform a dental procedure in violation of AS 08.32.110 or AS 08.36.346; (11) falsified or destroyed a patient or facility record, or failed to maintain a patient or facility record for at least seven years after the date the record was created." Renumber the following bill sections accordingly. Page 3, following line 9: Insert new bill sections to read: "* Sec. 7. AS 08.36.346 is amended by adding a new subsection to read: (c) A dental hygienist holding an advanced practice permit issued under AS 08.32.125 may delegate to a dental assistant under a level of supervision specified by the board in regulations (1) the exposure and development of radiographs; (2) application of topical preventive agents or pit and fissure sealants; (3) other tasks specified by the board in regulations. * Sec. 8. AS 21.36.090(d) is amended to read: (d) Except to the extent necessary to comply with AS 21.42.365 and AS 21.56, a person may not practice or permit unfair discrimination against a person who provides a service covered under a group health insurance policy that extends coverage on an expense incurred basis, or under a group service or indemnity type contract issued by a health maintenance organization or a nonprofit corporation, if the service is within the 2022-05-17 House Journal Page 2998 scope of the provider's occupational license. In this subsection, "provider" means a state licensed physician, physician assistant, dentist, osteopath, optometrist, chiropractor, advanced practice registered nurse, naturopath, physical therapist, occupational therapist, marital and family therapist, psychologist, psychological associate, licensed clinical social worker, licensed professional counselor, [OR] certified direct-entry midwife, or dental hygienist holding an advanced practice permit." Renumber the following bill sections accordingly. Page 3, following line 29: Insert a new bill section to read: "* Sec. 12. AS 47.07.030(b) is amended to read: (b) In addition to the mandatory services specified in (a) of this section and the services provided under (d) of this section, the department may offer only the following optional services: case management services for traumatic or acquired brain injury; case management and nutrition services for pregnant women; personal care services in a recipient's home; emergency hospital services; long-term care noninstitutional services; medical supplies and equipment; advanced practice registered nurse services; clinic services; rehabilitative services for children eligible for services under AS 47.07.063, substance abusers, and emotionally disturbed or chronically mentally ill adults; targeted case management services; inpatient psychiatric facility services for individuals 65 years of age or older and individuals under 21 years of age; psychologists' services; clinical social workers' services; marital and family therapy services; professional counseling services; midwife services; prescribed drugs; physical therapy; occupational therapy; chiropractic services; low-dose mammography screening, as defined in AS 21.42.375(e); hospice care; treatment of speech, hearing, and language disorders; adult dental and dental hygiene services; prosthetic devices and eyeglasses; optometrists' services; intermediate care facility services, including intermediate care facility services for persons with intellectual and developmental disabilities; skilled nursing facility services for individuals under 21 years of age; and reasonable transportation to and from the point of medical care." 2022-05-17 House Journal Page 2999 Renumber the following bill sections accordingly. Page 4, line 7: Delete "Section 8" Insert "Section 14" Page 4, following line 7: Insert a new bill section to read: "* Sec. 16. Sections 3 - 5, 7, 8, and 12 of this Act take effect January 1, 2023." Renumber the following bill section accordingly. Page 4, line 8: Delete "sec. 9" Insert "secs. 15 and 16" Representative Spohnholz moved and asked unanimous consent that Amendment No. 1 be adopted. There was objection. The question being: "Shall Amendment No. 1 be adopted?" The roll was taken with the following result: CSSB 173(FIN) Second Reading Amendment No. 1 YEAS: 36 NAYS: 1 EXCUSED: 1 ABSENT: 2 Yeas: Carpenter, Cronk, Drummond, Edgmon, Fields, Foster, Gillham, Hannan, Hopkins, Johnson, Josephson, Kaufman, Kreiss-Tomkins, Kurka, LeBon, McCabe, McCarty, McKay, Nelson, Ortiz, Patkotak, Prax, Rauscher, Schrage, Shaw, Snyder, Spohnholz, Story, Stutes, Tarr, Thompson, Tilton, Tuck, Vance, Wool, Zulkosky Nays: Eastman Excused: Merrick Absent: Claman, Rasmussen And so, Amendment No. 1 was adopted and the new title follows: 2022-05-17 House Journal Page 3000 CS FOR SENATE BILL NO. 173(FIN) am H "An Act relating to the practice of dentistry; relating to dental radiological equipment; relating to the practice of dental hygiene; relating to advanced practice permits for dental hygienists; relating to dental assistants; prohibiting unfair discrimination under group health insurance against a dental hygienist who holds an advanced practice permit; relating to medical assistance for dental hygiene services; and providing for an effective date." Representative Tuck moved and asked unanimous consent that CSSB 173(FIN) am H be considered engrossed, advanced to third reading, and placed on final passage. There being no objection, it was so ordered. CSSB 173(FIN) am H was read the third time. The question being: "Shall CSSB 173(FIN) am H pass the House?" The roll was taken with the following result: CSSB 173(FIN) am H Third Reading Final Passage YEAS: 36 NAYS: 2 EXCUSED: 1 ABSENT: 1 Yeas: Carpenter, Claman, Cronk, Drummond, Edgmon, Fields, Foster, Gillham, Hannan, Hopkins, Johnson, Josephson, Kaufman, Kreiss-Tomkins, LeBon, McCabe, McCarty, McKay, Nelson, Ortiz, Patkotak, Prax, Rasmussen, Rauscher, Schrage, Shaw, Snyder, Spohnholz, Story, Stutes, Tarr, Thompson, Tilton, Vance, Wool, Zulkosky Nays: Eastman, Kurka Excused: Merrick Absent: Tuck And so, CSSB 173(FIN) am H passed the House. Representative Tuck moved and asked unanimous consent that the roll call on the passage of the bill be considered the roll call on the effective date clause. There being no objection, it was so ordered. 2022-05-17 House Journal Page 3001 CSSB 173(FIN) am H was referred to the Chief Clerk for engrossment.