Legislature(2019 - 2020)BARNES 124
05/03/2019 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB91 | |
| HB24 | |
| HB127 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 91 | TELECONFERENCED | |
| += | HB 24 | TELECONFERENCED | |
| *+ | HB 127 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 127-DENTAL HYGIENIST ADVANCED PRAC PERMIT
5:15:35 PM
CO-CHAIR WOOL announced that the final order of business would
be HOUSE BILL NO. 127, "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; relating to medical assistance for dental hygiene
services; and providing for an effective date."
5:15:45 PM
REPRESENTATIVE IVY SPOHNHOLZ, Alaska State Legislature, as prime
sponsor, introduced HB 127. She paraphrased parts of the
sponsor statement [included in the committee packet], which read
in its entirety as follows [original punctuation provided]:
Oral health plays a crucial role in the overall health
and well-being of Alaskans. The lack of access to
dental care in Alaska has created enormous need in
communities that are underserved by the traditional
system of care. Dental diseases disproportionately
affect our state's most vulnerable populations and
rural areas where the access to treatment is limited.
We need all dental health care providers practicing to
the full scope of their training to address this
issue. Alaska would benefit from implementing an
innovative oral health care delivery model.
House Bill 127 would establish an Advanced Practice
Permit for Alaska-licensed dental hygienists while
continuing the collaborative agreement between
licensed dentists and dental hygienists. Dental
hygienists are skilled, licensed oral healthcare
professionals who focus on preventing and treating
oral diseases. HB 127 would allow dental hygienists
who meet the necessary advanced education, experience
and licensure requirements of the Advanced Practice
Permit to work independently within their scope of
practice across a variety of institutional and
organizational settings, including nursing homes,
schools, hospitals and clinics.
The creation of Advanced Practice Permits would allow
access to individuals who need oral care but cat get
to a dental office because of illness or disability,
create new consumer choices for preventive treatments
and services, educate individuals, families, and
caregivers on the basics of dental hygiene, and oral
health's connection to overall health and well-being.
Additionally, licensed dental hygienists would
identify more acute dental issues early on before they
become serious and provide referrals for patients
needing restorative treatment.
HB 127 removes barriers by allowing qualified,
licensed dental hygienists to practice to the full
extent of their professional training, experience and
scope of practice to help promote and restore oral
health to Alaska's underserved communities.
5:18:36 PM
CO-CHAIR WOOL suggested foregoing the sectional because of time
constraints.
5:18:51 PM
KATRINA VIRGIN, Alaska Dental Hygienists Association, stated
that dental hygienists would like the ability to use their scope
of practice to visit areas in Alaska that are underserved. The
4,000 clinical hours that they complete under a dentist's
supervision makes them more than competent to provide this care
she said.
5:20:22 PM
REPRESENTATIVE FIELDS requested additional information on the
areas that Ms. Virgin anticipates providing service to currently
underserved populations.
5:20:54 PM
MS. Virgin said would like to provide services in nursing care
facilities, where the oral systemic link has been greatly
associated with pneumonia. Another target population, she said,
would be schools, especially providing sealants to those with
underserved children. Correctional facilities and Homebound as
well, as both have individuals that cannot get into a dental
facility. She said their goal is to help asses oral health and
do as many preventative measures as possible, keep the bacteria
in the oral environment down to help decrease inflammation in
the overall body.
5:22:03 PM
REPRESENTATIVE SPOHNHOLZ referenced a list of dental health
professional shortage areas [provided in the bill packet], which
includes a list of geographic areas - healthcare communities
that are served by FQHCs as well as the Alaska Native Tribal
Healthcare Continuum. She noted that there is also a list in
the bill of the centers and facilities in which dental
hygienists would like the opportunity to have an advanced
practice in.
5:22:38 PM
REPRESENTATIVE HANNAN questioned whether dental hygienists are
allowed prescriptive authority in Alaska and what additional
training it takes.
5:23:19 PM
MS. VIRGIN explained that currently. there is no prescriptive
authority for dental hygienists in this state; however, eight
other states provide limited prescriptive authority. She added
that they are limited to fluoride prescriptions and anti-
microbial mouthwash, which would be the extent of the
prescriptive authority being asked for in this bill.
5:24:03 PM
REPRESENTATIVE SPOHNHOLZ noted that on page 2, lines 24-25, it
clearly defines the prescriptive authority that is being
outlined in the bill.
REPRESENTATIVE HANNAN sought clarification on whether limited
prescriptive authority is being granted in HB 127.
REPRESENTATIVE SPONHOLZ acknowledged that the bill grants dental
hygienists the authority to prescribe fluoride and anti-
microbial mouthwash.
REPRESENTATIVE SPOHNHOLZ, responding to a follow-up question
from Representative Hannan, said that a business license and
billing structure would be needed to practice independently,
adding that this bill creates the opportunity for independent
self-employment of advanced practice dental hygienists to set up
their own practice with their own Medicaid billing, which is
currently impossible without a collaborative agreement.
5:25:47 PM
REPRESENTATIVE REVAK asked what the fiscal note is for.
MS. VIRGIN said that was a base estimate due to the time it took
to collaborate with the ADS and the state Board of Dental
Examiners. She noted that it would be for the Medicaid system
portal that would be built for providing reimbursements.
REPRESENTATIVE REVAK asked if this would allow for billing
Medicaid for reimbursement.
5:27:14 PM
REPRESENTATIVE SPOHNHOLZ explained that HB 127 would allow
dental hygienists to bill Medicaid. She noted that currently
they are already paid for through Medicaid, so the bill is not
adding a new population of providers, just a new class within
the preexisting population. She said the fiscal note is to
update the MMIS system that processes and tracks the payments.
5:29:01 PM
REPRESENTATIVE STUTES pointed out that this will be helpful for
communities, like her own, with many rural villages. She sought
clarification if this bill would allow someone to set up own
their own business.
5:29:35 PM
MS. VIRGIN said she answered the question incorrectly yesterday,
adding that she should have said it would be very difficult to
set up shop in a rural area. She said the intention of the bill
is to provide underserved communities that do not have oral
healthcare, not to open individual practices. She continued by
saying that they are providing dental hygiene services because
the scope of practice is very limited.
5:31:44 PM
REPRESENTATIVE FIELDS commented that this bill has potential for
cost-savings if it's allows to identify dental problems earlier
instead of manifesting later at the ER, adding that it will be
interesting to see how the cost-savings materialize.
5:32:20 PM
REPRESENTATIVE REVAK sought clarification on what HB 127 solves,
regarding helping underserved communities.
REPRESENTATIVE SPOHNHOLZ said it's much like a physician's
assistant collaborative agreement that defines the scope of
practice; this would allow for them to provide work without a
collaborative agreement set up and increases access to dental
care.
5:34:35 PM
CO-CHAIR WOOL announced that HB 127 was held over.
5:36:38 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
5:36 p.m.