Legislature(2021 - 2022)DAVIS 106
04/12/2022 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB295 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 295 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 295-DENTIST SPEC. LICENSE/RADIOLOGIC EQUIP
3:11:18 PM
CO-CHAIR ZULKOSKY announced that the only order of business
would be HOUSE BILL NO. 295, "An Act relating to the practice of
dentistry; relating to dental radiological equipment; and
providing for an effective date."
3:11:24 PM
REPRESENTATIVE DAN ORTIZ, Alaska State Legislature, as prime
sponsor, presented HB 295. He paraphrased the sponsor statement
[included in committee packet], which read as follows [original
punctuation provided]:
House Bill 295 accomplishes two things: it transfers
dental radiological equipment inspections from the
Board of Dental Examiners to the Department of Health
and Social Services and it establishes specialty
dental licenses in the State of Alaska.
The Board of Dental Examiners currently certifies
inspectors of dental radiological equipment who in
turn conduct inspections at dental offices. This bill
would move the authority and responsibility for
inspections to the Department of Health and Social
Services, which already inspects medical radiological
equipment and employs state inspectors. This bill also
allows for the collection of fees to cover the costs
associated with inspection.
The second part of the legislation establishes "truth
in advertising" for dental specialists. In Alaska,
there is currently no legal definition for what a
dental specialist is, and the board does not have the
authority to define the term. HB295 ensures that if a
dentist advertises as a specialist in a field, they
must meet the qualifications for a specialist
established by the Alaska State Board of Dental
Examiners.
A dentist in Alaska can legally promote themselves as
specialist in fields such as orthodontics, oral
surgery, endodontistry, etc., even if they have no
specialty training in that fields. Without the
authority to define dental specialists, the board
cannot prevent misleading advertisements to protect
consumer interests. This bill ensures that a dentist
who advertises as a specialist has the training to
adequately provide the services a patient would seek a
specialist for.
3:13:34 PM
ABIGAIL SWEETMAN, Staff, Representative Dan Ortiz, Alaska State
Legislature, on behalf of Representative Ortiz, prime sponsor,
presented the sectional analysis for HB 295 [included in
committee packet], which read as follows [original punctuation
provided]:
Section 1: Conforming language in AS 08.01.065(c).
Section 2: Adds a new section (k) to AS 08.01.065
(Title 8. Business and Professions, Chapter 1.
Centralized Licensing, Section 065. Establishment of
fees) Requires the Board of Dental Examiners to
establish and collect fees on behalf of the Department
of Health and Social Services for the inspection of
dental radiological equipment.
Section 3: Adds new sections to AS 08.36 (Title 8.
Business and Professions, Chapter 36. Dentistry) AS
08.36.242. License to practice as a specialist
required. Establishes that a dentist may not advertise
using the term "specialist," the name of a specialty,
or other phrases that suggest they are a specialist
unless they have a specialist license as established.
AS 08.36.243. Qualification for specialist; scope of
practice. (a)Establishes that in order to qualify for
a specialist licenses a person must (1)Hold a dental
license issued by the board and (2)Meet the
qualifications of a specialist as established by the
board in regulation. (b) In creating the
qualifications for a specialist license, the board
shall consider the standards of a nationally
recognized certifying entity approved by the board.
(c) Establishes that a dental specialist can only
claim to be a specialist in the specialty they hold a
license in. Sec. 08.36.245. Suspension or revocation
of specialist license. Establishes that a board may
suspend or revoke a specialist license as set by AS
08.36.315.
Section 4: Adds a new section (d) to AS 44.29.020
(Title 44. State Government, Chapter 29. Department of
Health and Human Services, Section 020. Duties of the
Department) Requires DHSS to establish standards of
registration, use, record keeping, and inspection of
dental radiological equipment in compliance with
federal law.
Section 5: Conforming language in AS 44.46.029
Section 6: Conforming language in AS 46.03.022
Section 7: Repeals: AS 08.36.075: Section of law
requiring the Board of Dental Examiners to set
standards for inspection of dental radiological
equipment. Placed under DHSS by section 4. AS
18.05.065, AS 18.60.525(e), and AS 44.29.027: Sections
of law prohibiting DHSS from regulating dental
radiological equipment.
Section 8: Allows the Board of Dental Examiners, the
Department of Commerce, Community, and Economic
Development, and the Department of Health and Social
Services to adopt regulations in line with this act.
Section 9: Allows the departments and board to
immediately begin setting regulations.
Section 10: Set a delayed effective date for the rest
of the act to July 1, 2023.
CO-CHAIR ZULKOSKY sought questions from committee members.
3:16:03 PM
REPRESENTATIVE MCCARTY had several questions he hoped would be
answered through the invited testimony. He asked how many
specialists this legislation would affect, how much the
inspection of machinery would cost, and how quickly a specialty
license can be obtained from the state.
CO-CHAIR ZULKOSKY proceeded with invited testimony.
3:17:36 PM
DAVID LOGAN, DDS, Executive Director, Alaska Dental Society,
shared his expertise on the equipment inspection component of
the legislation. He gave a brief history of how the inspections
were implemented, stating that the Department of Health and
Social Services (DHSS) used to complete these inspections until
the Board of Dental Examiners took the process over in 2001. He
reported that the board initially saw success with inspections
completed in a timely manner and with better coverage around the
state. However, he emphasized that due to the arduous nature of
the requirements for becoming an x-ray inspector, it became
difficult for the board to find qualified individuals to
complete the inspections once the private contractors started to
retire. He stated that the board is ready to revert
responsibility for x-ray inspections back to the department,
which already has inspectors on staff. He acknowledged that an
extra x-ray inspector would be required to cover the addition of
dental practices to the department's caseload, adding that the
board is prepared to cover those costs for the benefit and
safety of the public.
3:20:06 PM
REPRESENTATIVE SPOHNHOLZ asked why it would be easier for DHSS
to hire an inspector than it was for the Board of Dental
Examiners to hire contractors.
DR. LOGAN explained that there were not enough dental x-ray
inspections in the state for it to be a full-time job and it was
hard to find inspectors on a part-time basis. He opined that
the state would be able to hire someone full-time because the
dental inspections would only be part of their purview.
3:21:59 PM
GREG JOHNSON, DDS, Member, Board of Dental Examiners, spoke on
the specialty license component of HB 295. He explained that
the state used to have a specialty license, but it was repealed
in 2012, leaving the Board of Dental Examiners in a compromised
position. He reported that there are many general dentists
throughout the state who may have expertise in a specialty area,
such as child dentistry, but advertise themselves as a "child
dentistry specialist" without having actually completed the two-
year specialty training. He explained that the public needs
better clarity around who is an accredited specialist. He
explained that an additional benefit of bringing back the
specialty license would be attracting more specialists to
practice in Alaska, since they would now be allowed to stick
with their preferred specialty without having to go through
general licensing. In response to Representative McCarty's
question regarding the number of impacted specialists, he stated
that the number would stay the same, as only dentists qualified
to give specialty care would be applying for and granted
specialty licenses.
REPRESENTATIVE MCCARTY, referring to the fiscal note, asked
where the additional funds attributed to the dentistry licenses
would come from.
CO-CHAIR ZULKOSKY directed the question to Sarah Chambers and
asked for an explanation of the fiscal note.
3:26:57 PM
SARA CHAMBERS, Director, Division of Corporations, Business, and
Professional Licensing, Department of Commerce, Community &
Economic Development (DCCED), explained the fiscal note,
beginning with the additional funds in the "services" line. She
stated that the $239,000 is the estimate of fees that would be
collected from dentists to buy into the x-ray inspector services
provided by DHSS. She reported that these funds would be
collected by DCCED through an expenditure agreement with DHSS.
She stated that the amount associated for "services" is an
estimate based on the current number of dental x-ray devices on
the register. She clarified that the number Representative
McCarty had referred to relates to those fees, not the special
licensure.
3:28:20 PM
REPRESENTATIVE MCCARTY referenced the fiscal note from DHSS,
which reflected a "services" cost of $224,000. He sought to
confirm that this reflects the same fee as the one listed in the
DCCED fiscal note, as opposed to an additional fee.
DIRECTOR CHAMBERS confirmed that the figure is accurate and
reflects the same cost.
REPRESENTATIVE PRAX noted a complaint from constituents about
the current issues in the timeline for processing licenses and
asked whether the department would be able to process the
additional applications expeditiously.
DIRECTOR CHAMBERS acknowledged the delays in licensure due to
staffing shortage. She voiced her excitement for the
legislation because it would lessen the workload of her
department by handing dental x-ray inspections to DHSS, which is
better equipped to implement those duties. She explained that
DCCED used to process the special licenses, adding that with the
addition of another occupational licensing examiner position, as
reflected in the fiscal note, they would be able to handle the
additional applications.
3:31:34 PM
REPRESENTATIVE PRAX sought to confirm that the additional
position would help "pick up slack" in other areas.
DIRECTOR CHAMBERS confirmed that the additional position would
assist with all dental licenses and potentially be cross-trained
to help with other forms of licensure that may be experiencing a
backlog.
CO-CHAIR SNYDER asked Ms. Sweetman whether the bill would need a
language change to reflect the bifurcation of DHSS.
MS. SWEETMAN asked which section of the bill was in question.
CO-CHAIR SNYDER cited page 3, lines 23 and 29, in addition to
page 2, line 14.
MS. SWEETMAN shared her belief that the language was taking the
inspection from the Board of Dental Examiners and transferring
it to DHSS.
3:34:07 PM
The committee took a brief at-ease.
3:34:35 PM
CO-CHAIR SNYDER indicated that the committee would work with the
sponsor's office to ensure that the responsibility would go to
the new Department of Health (DOH) and match the fiscal notes.
REPRESENTATIVE KURKA asked where the funds for the new DOH x-ray
inspector would come from and whether they would be hiring a
full-time position for part time work.
MS. SWEETMAN explained that currently, dentists are responsible
for finding and funding their own inspectors. She stated that
the bill would transfer the responsibility for finding the
inspectors to DHSS, which already employs x-ray inspectors. She
noted that the dentists would continue to pay for those
services.
REPRESENTATIVE KURKA sought to confirm that the dentists would
cover the fees themselves.
MS. SWEETMAN replied yes.
REPRESENTATIVE SPONHOLZ pointed to the operating budget increase
in the DHSS fiscal note for implementation of HB 295. She
referred to a statement in the analysis that attributed this in
part to the legislation's impact on Medicaid provider
enrollment. She shared her understanding that the bill would
create a special license but not increase the total number of
license holders, and questioned whether that was actually the
case. She requested an explanation of the rationale behind that
section of the fiscal note.
CO-CHAIR ZULKOSKY directed the question to Renee Gayheart.
RENEE GAYHART, Director, Division of Health Care Services,
Department of Health and Social Services, explained that even
though the special licenses may be going to licensed
practitioners, there is still work associated with attaching the
new license to that practitioner. She reported that the
additional workload is anticipated to require a new range 18
position to attach the licenses to Medicaid, allowing the
practitioner to be paid.
REPRESENTATIVE SPOHNHOLZ posed a follow-up question to [the
former Chair of the Board of Dental Examiners], Dr. Neilson.
3:39:22 PM
The committee took a brief at-ease.
3:39:36 PM
REPRESENTATIVE SPOHNHOLZ redirected her question to the current
Chair of the Board of Dental Examiners, Dr. Johnson, and asked
whether the board anticipates an increase in the number of
practicing dentists in Alaska, should the bill pass. She
questioned whether additional license holders are expected to
"show up" in Alaska or whether current practitioners would apply
for a new license type.
3:40:22 PM
DR. JOHNSON explained that the board expects it to be "a little
of both." He reiterated that in current statute, specialists
must also have a general dentistry license, which was a barrier
to attracting specialists into the state. He described the
lengthy training process for specialization and stated that many
specialists elsewhere in the country choose not to obtain a
general license in addition to the specialized one. He opined
that bringing back the special license would open the door for
new specialists to practice in Alaska and shared that even as
few as 10 within a specialty could make a big impact on access
to care.
CO-CHAIR SNYDER asked whether the correct amount for a half-time
range 18 position was $92,000 per year.
MR. GAYHART confirmed that it would be a half-time position.
REPRESENTATIVE PRAX questioned whether the special license would
allow current practitioners to offer a broader range of
services.
DR. JOHNSON clarified that the special license would ensure that
more of the care within specialty areas is provided by
specialists.
REPRESENTATIVE PRAX referred to the common example of pediatric
dentistry and asked whether a general care dentist is able to
practice on children.
DR. JOHNSON replied that general dentists receive training in
all areas of clinical dentistry, but that a specialist goes
through at least two additional years of training in their
specialty. He reported that most children are seen by a general
dentist rather than a pediatric specialist. However, he
explained that in Alaska, a general dentist who has experience
with and a preference for working with children may list
themselves as a specialist, while in the rest of the country,
these dentists would be advertised as having an "emphasis" in
pediatrics. He opined that it is important to clarify for the
public the distinction between a general dentist with an
emphasis in an area and a trained specialist and that putting it
into statute with the specialist license would give the board
purview to make sure general dentists were not over advertising
their training in a given area.
REPRESENTATIVE PRAX offered an analogy involving auto mechanics.
DR. JOHNSON said that would be a reasonable comparison. He
emphasized that while general dentists are knowledgeable in all
areas of dentistry, "you may not want to go to a general
practitioner for your [heart] bypass surgery." He opined that
reinstating the special licensure would remove any ambiguity for
the public in regard to choosing the right dentist for their
specialty care.
CO-CHAIR ZULKOSKY opened public testimony on HB 295. After
ascertaining that no one wished to testify, she closed public
testimony.
REPRESENTATIVE ZULKOSKY announced that HB 295 was held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 1. HB 295 version A.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 2. HB 295 Sponsor Statement.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 3. HB 295 Sectional Analysis.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 4. HB 295 Fiscal Note 1 - DCCED.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 5. HB 295 Fiscal Note 2 - Public Health Laboratorites 02.05.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 6. HB 295 Fiscal Note 3 - Health Care Services 02.05.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 7. HB 295 Follow-Up Information from CBPL 2.11.22.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 8. HB 295 Letter of Support - DEN 2.1.22.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |
| 9. HB 295 Letter of Support - ADS 2.9.22.pdf |
HHSS 4/12/2022 3:00:00 PM |
HB 295 |