02/07/2019 01:30 PM Senate LABOR & COMMERCE

             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.