Legislature(2011 - 2012)HOUSE FINANCE 519
04/09/2012 09:00 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB286 | |
| SB92 | |
| SB130 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 286 | TELECONFERENCED | |
| + | SB 92 | TELECONFERENCED | |
| + | SB 130 | TELECONFERENCED | |
| + | TELECONFERENCED |
CS FOR SENATE BILL NO. 92(FIN)
"An Act relating to dental hygienists, dentists,
dental assistants, dental hygiene, and dentistry."
9:31:35 AM
DANA OWEN, STAFF, SENATOR DENNIS EGAN, discussed that the
proposal for the legislation had been brought to the
sponsor by a committee of dentists and dental hygienists.
He explained that the related statutes had not been
reviewed or revised in over 20 years; during that time
there had been significant changes in dentist practices and
regulation. He relayed that Dr. David Logan, former
president of the dental board was present to provide
detail. He furthered that due to the bill's high level of
detail it had been amended in each committee of referral.
Co-Chair Stoltze asked for a general overview of the
legislation.
Mr. Owen observed that it was unusual to have two groups
such as dentists and hygienists come together on a single
bill; groups that overlapped in their practice were
frequently at odds over their scope of practice.
Co-Chair Stoltze had detected some tension between the
dentists and hygienists on prior iterations of the
legislation; both groups would have a chance to testify
during the meeting.
DAVID LOGAN, LEGISLATIVE CHAIR, ALASKA DENTAL SOCIETY,
thanked the sponsor's office for all of its work on the
legislation. He shared that the society had reached out to
the Alaska State Dental Hygienists' Association (ASDHA) in
recognition that the bill affected both groups of
professions. He relayed that a substantial amount of time
had gone into the development of the legislation, given the
numerous necessary changes. He explained that under the
legislation the dental board investigator position would be
increased from part-time to full-time, which would result
in an increase of licensure fees for license holders. The
legislation accomplished multiple items including, the
determination of who was eligible to own a dental practice,
the ability for a practice to transition out following the
death of a practitioner, and significant language cleanup.
9:36:31 AM
Representative Wilson asked what the increase in licensure
fees would be. Mr. Logan responded that the fee increase
would be determined by the Division of Corporations,
Businesses and Professional Licensing (CBPL). He had heard
estimates of a potential $100 increase.
Representative Guttenberg referred to a former constituent
who had been licensed and practiced dentistry in New
Zealand for 10 years; the individual had not been able to
obtain a license to practice in Alaska. He wondered whether
the legislation would address the issue. Mr. Logan
responded that the bill revised the section on
qualifications for licensure and the ability to obtain a
license through a credentialing process based on a
dentist's previous practice and history. He observed that
there were dentists credentialing in frequently from other
countries. He deferred the question to the director of CPBL
for additional detail.
Representative Guttenberg replied that the individual had
been told that he would need to go back to school in order
to obtain a license in the state. He would discuss the
matter with the CBPL director.
Vice-chair Fairclough asked whether the bill altered past
legislation that allowed dental hygienists to travel and
work in rural areas without the supervision of a dentist.
Mr. Logan replied that there was one section clarifying
allowed procedures, but that no substantial change had been
made.
Vice-chair Fairclough asked for the specific section in the
legislation. Mr. Logan pointed to Section 13, page 8. He
expounded that the bill would insert the word "licensed" in
front of the words "dental hygienist."
9:39:27 AM
Representative Doogan surmised that the bill would allow
other entities to own dental practices including
municipalities and higher education facilities. Mr. Logan
responded in the affirmative; Section 37.08.367 defined who
could own a dental practice.
Representative Doogan wondered why the ability to own a
dental practice would be expanded to other entities. Mr.
Logan replied that an entity may want to own a facility to
provide care for poor people.
Co-Chair Stoltze surmised that examples would include
neighborhood health clinics or the Department of
Corrections. Mr. Logan replied in the affirmative.
Representative Doogan believed the provision opened the
door for multiple dentists to take a share in a larger
facility and to expand the number of people licensed in a
particular place.
9:41:23 AM
Mr. Logan replied that there was currently no size
restriction on the number of dentists or hygienists allowed
to work in one practice.
Representative Doogan asked whether the bill would set up a
situation in which a number of dentists could create a
"Crowns R Us" practice. Mr. Logan replied that the bill
would not limit the ability for dentists to open a "Crowns
R Us" practice.
Representative Neuman asked whether the bill strengthened
or weakened hygiene requirements. Mr. Logan responded that
the bill would only clean up any antiquated language
related to dental hygienist requirements. He furthered that
current statute referred to a state exam; however, the exam
had not been conducted for approximately 20 years.
Qualifications remained the same and included graduation
from hygiene school, passing a national written test, and a
regional practical board.
9:43:40 AM
GAIL WALDEN, MEMBER, ALASKA STATE DENTAL HYGIENISTS
ASSOCIATION, WASILLA (via teleconference), supported the
bill. She was on the committee that had worked to review,
update, and condense the Dental Practice Act that was
addressed in the legislation before the committee. She
stated that the bill maintained the current high dental
hygiene standards, licensure, and practice. She added that
the bill updated a significant amount of outdated
information in statute.
Co-Chair Stoltze believed that the process that had gone
into developing the legislation was notably better than in
prior attempts because dentists and hygienists had worked
together.
Representative Neuman pointed to Section 3 related to
dental hygienist qualifications. He asked for verification
that the bill only provided cleanup language and did not
hinder the ability of existing hygienists to practice in
Alaska. Ms. Walden responded that ASDHA felt strongly that
the language would not make changes that would affect
dental hygienists or impact care. She emphasized the
association's support for the wording included in the bill.
Representative Guttenberg asked about the goal of proposed
language in Section 21: "the board may delegate the board's
power to act here and decide matters." Mr. Logan replied
that the mechanism allowed the board to delegate some of
the administrative capacities to the division. The day-to-
day paperwork would be virtually impossible for the
practicing professionals on the board.
9:46:42 AM
Representative Guttenberg asked for verification that the
bill would give some of the board's responsibility to the
department. Mr. Logan replied that the board was assigned
certain powers under the central statutes and it was
necessary to have the ability to delegate items to the
division from a practical standpoint; decisions would still
be made by the board.
Ms. Walden thanked the committee for hearing the bill.
Co-Chair Stoltze CLOSED public testimony.
Representative Wilson asked about current licensure fees
and how much they would increase under the proposed
legislation.
DON HABEGER, DIRECTOR, CORPORATIONS, BUSINESS AND
PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, COMMUNITY
AND ECONOMIC DEVELOPMENT, replied that currently a dental
license fee renewal cost approximately $290 to $300;
renewal for a dental hygienist license was $120. There were
a number of factors included in the determination of a new
fee; a new position would be created to meet the mandate of
the legislation. There was currently a part-time dental
investigator; the work would be shifted and other
professions would pick up the 30 percent to 50 percent
cost. Professionals would not pick up the entire cost; on
the high-end the increase would be approximately $80 on top
of the current price. He did not believe the analysis would
show the high-end increase because the board had a $100,000
roll-forward that may be used. A discussion and decision on
the fees would take place with the board and once
determined the detail would be set in regulation.
Vice-chair Fairclough asked whether the increase would be
proportionately raised between the dentist and dental
hygienist licensees. Mr. Habeger answered that CBPL was
required to have the discussion with the board prior to
setting the fees; therefore, he did not know whether the
increase would be directly proportional or equal.
Vice-chair Fairclough wondered who was sitting on the board
in order to determine how the fees would be allocated
between the two groups.
9:51:17 AM
Ms. Walden replied that ASDHA understood that the fees
would be up for discussion. She believed the board would
factor in that there were more investigations related to
dentistry than dental hygiene.
Representative Doogan noted that the initial fiscal note of
$113,000 was reduced to $107,000 [in subsequent fiscal
years]. He wondered whether the remainder represented the
leftover cost after the fee increase. He asked whether the
fiscal note would be zeroed out. Mr. Habeger responded that
the initial $113,000 recognized necessary startup costs for
items such as office equipment; because those items would
not be needed in subsequent years the cost had been reduced
[after FY 13].
Representative Doogan asked whether the note should be zero
[after FY 13]. Mr. Habeger replied that the startup costs
would be reduced to zero in subsequent years.
Representative Doogan pointed to the annual $107,000 cost
that extended out beyond the first year. Mr. Habeger
replied that certain costs would continue and were factored
into the $107,000 including, the investigator salary,
transportation costs of approximately $2,000 per year,
contractual costs such as the involvement of the Department
of Law if an investigation went to a hearing, and other.
Representative Doogan surmised that the additional cost was
related to law enforcement and not salary. Mr. Habeger
replied in the affirmative. He specified that costs
included in the $107,000 subsequent to FY 13 would be for
the investigator, and support services (including telephone
and internet).
Representative Doogan thought that the fiscal increase
resulting from the legislation would be covered by dentists
and dental hygienists; he no longer believed that was the
case.
Co-Chair Stoltze noted that Representative Doogan's initial
understanding was correct.
9:55:29 AM
Vice-chair Fairclough pointed to the Department of
Commerce, Community and Economic Development Fiscal Note 3.
She explained that for personnel services, costs would be
funded by receipts received by professionals. The fiscal
note included funds for travel, services, and commodities.
Commodities began at $6,000 in FY 13 and were reduced to
$1,000 from FY 14 to FY 18. The department was requesting
$112,900 in FY 13 from receipts collected from dental and
dental hygiene licensing; the figure was reduced to
$107,000 annually from FY 14 through FY 18. There was one
full-time position that would be hired in perpetuity to be
supported by licensing fees.
Co-Chair Stoltze MOVED to ADOPT Amendment 1 (by request of
the sponsor):
Page 15, following line 27:
Insert a new bill section to read:
"* Sec. 30. AS 08.36.234 is amended by adding a new
subsection to read:
(d) A dentist applying for licensure without
examination shall be interviewed in person by the
board or by a member of the board before a license is
issued. The interview must be recorded. If the
application is denied on the basis of the interview,
the denial shall be stated in writing, with the
reasons for it, and the record shall be preserved."
Renumber the following bill sections accordingly.
Co-Chair Thomas OBJECTED for discussion.
Mr. Owen explained that the amendment addressed an item
that had been overlooked earlier in the bill process. He
asked Dr. Logan to explain the intent of the amendment.
Mr. Logan communicated that dentists and hygienists could
obtain a license by taking an exam at one of the regional
boards or hygienists could use their past five years of
practice history as a basis. He furthered that the board
felt that there were not really any meaningful questions to
ask during the hygienist licensure process; similarly there
was not much to ask dentists coming out of school because
they had no practice experience or track record. He
detailed that the amendment would make it mandatory for
dentists who were credentialing into the state to interview
with the board because they did have a past track history.
Representative Costello asked about the decision to include
the language "or by a member of the board." She believed
that the responsibility for the people applying for
licensure in the state should be taken on by the entire
board. Mr. Logan replied that the decision had been made by
Legislative Legal Services with the goal of giving the
board flexibility. He was agreeable to the change that
would include the board in its entirety.
Representative Costello MOVED to AMEND Amendment 1 on line
5 to delete "or by a member of the board."
Representative Guttenberg OBJECTED for discussion. He asked
whether a decision by one member of the board would have to
be ratified by the entire board. Mr. Logan replied that
each application for credentialing was ratified by the
majority of the board.
Representative Guttenberg asked for verification that
Amendment 1 would allow the examination of a dentist
credentialing into the state to be conducted by a single
board member and the change under the amendment to
Amendment 1 would require the examination to be conducted
by the entire board. Mr. Logan responded in the
affirmative.
Representative Gara agreed that all of the board members
should have the opportunity to ask questions during an
examination of a dentist credentialing into the state. He
asked for verification that his understanding was the
intention of the amendment to Amendment 1.
Representative Costello replied in the affirmative.
Co-Chair Stoltze observed that there may be occasions when
the board was not able to get together for a couple of
months, which could delay an interview. He did not want to
cripple the board's ability to conduct interviews.
Vice-chair Fairclough wondered how the change would impact
a dentist who moved to an isolated location for service;
the person may be required to travel to a board meeting.
She asked how often the board met. Mr. Logan replied that
the board met quarterly. He relayed that jurisprudence
examinations occurred at board meetings; therefore,
interviewees would be required to attend a meeting for
their interview.
10:02:52 AM
Representative Joule wondered whether the amendment to
Amendment 1 would require all members of the board to be
present at the board meeting to conduct an interview. Mr.
Owen replied that the quorum to do business would be
sufficient.
10:04:55 AM
RECESSED
2:21:11 PM
RECONVENED
Co-Chair Stoltze indicated that an amendment to Amendment 1
had been discussed earlier in the morning. He asked if
there were any amendments to Amendment 1.
Representative Edgmon asked whether the earlier
contemplated amendment was no longer part of Amendment 1.
Co-Chair Stoltze indicated there were no amendments to
Amendment 1.
Co-Chair Thomas WITHDREW objection. There being NO further
OBJECTION Amendment 1 was adopted.
Co-Chair Thomas MOVED to report HCS CSSB 92(FIN) out of
committee with individual recommendations and the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
HCS CSSB 92(FIN) was REPORTED out of committee with a "do
pass" recommendation and with previously published fiscal
impact note: FN3 (CED).
2:23:45 PM
AT EASE
2:26:40 PM
RECONVENED