Legislature(2017 - 2018)BELTZ 105 (TSBldg)
02/22/2018 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB165 | |
| SB161 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 165 | TELECONFERENCED | |
| *+ | SB 161 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 161-DENTISTRY: TEMPORARY PERMIT
1:50:48 PM
CHAIR COSTELLO reconvened the meeting and announced the
consideration of SB 161.
1:51:18 PM
SENATOR DAVID WILSON, Alaska State Legislature, Juneau, Alaska,
introduced SB 161 on behalf of the Senate Health and Social
Services Committee. He and Senator von Imhof both worked on this
committee bill. It is "An Act relating to the licensure of
dentists. It would allow the Board of Dental Examiners to grant
a temporary license when a dentist is suddenly incapacitated and
needs an immediate replacement. When an Alaska dentist is unable
to work, it creates an immediate gap in care for Alaskans. Many
other health care professionals have a mechanism in place to
issue temporary licenses and SB 161 would allow one for the
dental profession.
1:52:24 PM
JASMIN MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, stated that Senate Bill 161, "An
Act relating to the licensure of dentists," would allow the
Board of Dental Examiners to issue a temporary license when an
incapacitated dentist needs a replacement for an extended
period. She said there are so few dental specialists in Alaska
that just one incapacitation can leave a large gap in care. She
referenced a document that lists the various dental specialties
and noted that Anchorage is the only community where all the
specialties are represented. Several specialties are represented
in Fairbanks, Juneau, and the MatSu area but the remaining
communities in the state are either not served or served by a
traveling dental specialist. Small communities have historically
had difficulty recruiting health care practitioners. SB 161
provides a quick solution through a temporary permit.
1:53:49 PM
She provided the following sectional analysis for SB 161:
Section 1 amends Sec. 08.36.100, which is the section
addressing examination and licensing for dentistry.
Section 2 adds a new section to article 2, Sec.
08.36.254. Temporary permit to substitute for an
incapacitated dentist. It details the requirements and
process for obtaining this new dental permit.
MS. MARTIN reviewed the fiscal note for SB 161 from the
Department of Commerce, Community and Economic Development.
Should the bill pass, the Division of Corporations, Business and
Professional Licensing will need $2,600 in FY19 to cover legal
costs to amend regulations, printing, and postage. The total
revenue collected from the licensing fee will approximately
equal the costs.
She noted the letters of support in the bill packets from the
Alaska Dental Society and the Alaska State Board of Dental
Examiners.
1:54:58 PM
At ease
1:57:42 PM
CHAIR COSTELLO reconvened the meeting and advised that members
had received the document that shows the breakdown of dental
specialists in Alaska.
1:58:09 PM
SENATOR GARDNER asked if the proposed temporary license holders
would have met all the requirements to be a licensed dentist.
SENATOR WILSON deferred the question to dental experts who were
available online to answer questions.
1:58:56 PM
SENATOR MEYER asked if dentists who hold a temporary license
would become part of a pool that can be called upon to replace
an incapacitated dentist.
SENATOR WILSON directed attention to paragraph (f) on page 2.
That language specifies that a temporary permit is initially
valid for 90 consecutive calendar days. Permit extensions are
allowed but for not more than 240 calendar days during any
consecutive 24 months. The idea was not to have a locum tenens
dentist who travels to and from Alaska. It is for a temporary
substitution in an emergent situation.
SENATOR MEYER asked if there is a pool of temporary licensees to
choose from.
SENATOR WILSON said not necessarily.
SENATOR GARDNER directed attention to subsection (c) starting on
page 1, line 15. She noted that language is contrary to previous
testimony that suggested that there are dentists who treat
patients in a cluster of villages. Subsection (c) specifies that
the temporary permit is only valid to treat patients "at the
address listed on the business license of the incapacitated
dentist."
2:02:00 PM
MS. MARTIN deferred to the experts online.
SENATOR GARDNER directed attention to subsection (g) starting on
page 2, line 17. It says the permit can only be extended if the
board determines it is necessary to provide essential dental
services and has received clearance reports from the National
Practitioner Data Bank and the U.S. Drug Enforcement
Administration. She asked why those two clearance reports
wouldn't be advisable for the original permit if they are
required for the extension.
SENATOR WILSON said the idea is to have more due diligence for a
more permanent situation.
2:03:50 PM
SENATOR STEVENS questioned why someone would apply for a
temporary license when they could get a permanent license.
MS. MARTIN replied a temporary permit is appropriate for someone
who doesn't plan to practice dentistry in Alaska permanently or
is recently retired and willing to temporarily fill the gap.
SENATOR STEVENS asked if the process of getting a permanent
license is much more onerous and lengthy.
MS. MARTIN deferred the question to the dentistry board.
SENATOR MICCICHE offered his understanding that someone who
applies for a temporary permit could have previously been
licensed under AS 08.36.110 but has chosen not to keep up with
the requirements under AS 08.36.234. The individual would be a
qualified dentist who is not continuing their competency
requirements.
MS. MARTIN agreed.
SENATOR MICCICHE pointed out that the initial 90-day temporary
permit and three 60-day extensions do not add up to the 240-day
maximum. He requested an explanation.
CHAIR COSTELLO suggested the sponsor follow up with the answer
since the bill wasn't moving today.
She observed that the members' questions are focused on where
the pool of people is coming from. She asked if these could be
people licensed in other states or Alaskan dentists who aren't
practicing.
SENATOR WILSON said it could be either or both scenarios.
CHAIR COSTELLO asked him to talk about the public safety aspect;
she assumed that the clearance reports referenced on page 2 in
subsection (g), paragraphs (1) and (2) would include a
background check.
SENATOR WILSON explained that the Board of Dentistry will
thoroughly vet and select the qualified applicants. This
includes an extensive background check and fingerprinting that
goes through the FBI system.
CHAIR COSTELLO asked if the bill covers liability and the
client's right to file suit. She also asked if other states have
successfully implemented temporary dental licenses.
SENATOR WILSON said his office has not looked at other state
laws regarding dentistry. He offered to do some research and
follow up with the information.
SENATOR STEVENS offered his understanding that a temporary
permit only relates someone who has been licensed in the past.
He asked if that excludes a recent dental school graduate who
has never applied for and held a permanent license.
SENATOR WILSON replied it would not exclude a recent graduate if
they have the qualifications.
SENATOR STEVENS observed that previous testimony that it would
need to be someone who was licensed in the past isn't quite
accurate.
SENATOR WILSON said he would follow up with clarification.
CHAIR COSTELLO said the committee will wait for an answer to
that question too.
She asked if the board meets often enough or has a provision to
meet to accommodate these emergency situations. She also asked
if the temporary license must be displayed and if the licensee
is obligated to inform the patient that he/she has a temporary
license.
SENATOR WILSON replied that could be added to the bill if that
is the will of the committee.
2:13:52 PM
CHAIR COSTELLO opened public testimony on SB 161.
2:14:20 PM
DAVID NIELSON, Member, Board of Dental Examiners, Anchorage,
Alaska, stated that the dental board recently noticed that the
governing statutes lacked a permitting option that is available
to other professional licensing boards in Alaska. The board
approached the dental society to help with the issue that arises
in the rare instance that a dentist becomes incapacitated and
their patient base can't be absorbed by licensed dentists who
are practicing in the state. Creating a temporary permit would
allow the board to address this issue without waiting the four
to six months it generally takes to collect the information
required for an applicant to become credentialed and issued a
license.
He mentioned the requirements under AS 08.36.234 and stated that
the board is willing to develop regulations that would apply to
the new permit. He recalled an earlier question about liability
and opined that there would be a requirement that the applicant
have a license in good standing in some other U.S. state or
territory. He surmised that they would also be in good standing
with the National Practitioner Data Bank.
CHAIR COSTELLO asked him to comment on Senator Gardner's
question about the temporary permit only being valid "to treat
patients of the incapacitated dentist at the address listed on
the business license of the incapacitated dentist." Senator
Gardner asked if this would make it more challenging for the
temporary licensee to treat people in a region.
DR. NIELSON said that was generally meant to mean that practices
could occur in satellite offices
CHAIR COSTELLO asked if he had the document that shows the
different dental specialties represented in Alaska.
DR. NIELSON said no but he is aware that specialists are
concentrated in larger communities.
2:19:37 PM
SENATOR GARDNER asked for clarification that the people getting
a temporary permit would all be licensed practitioners of
dentistry.
DR. NIELSON said yes. He added that the board would develop
regulations, but he didn't imagine that a recent graduate who
had not been licensed in any U.S. state or territory would
qualify for this permit.
SENATOR GARDNER asked if the applicants would need to hold an
active license to practice dentistry.
DR. NIELSON declined to speak to that and noted that a committee
substitute was anticipated. He pointed out that the current
draft says it must be a position that is not reasonably filled
by current licensees.
SENATOR GARDNER suggested the forthcoming committee substitute
should include language about an active license and liability
insurance. She also expressed interest in knowing how Alaska's
license requirements for dentists compare to other states and if
there is a national standard.
2:22:44 PM
SENATOR MICCICHE pointed out that the bill only waives the
continued competency requirements under AS 08.36.234. The
temporary permit holder would still need to meet the
requirements under AS 08.36.110, which is the qualifications for
license. He described some areas of the legislation as a little
foggy
MR. NIELSON said there is a committee substitute in the other
body and he assumes one is forthcoming in the Senate. He wanted
it clear that the dental board supports a permit category of
this type.
2:24:05 PM
SENATOR STEVENS asked how long a license remains in effect when
a dentist retires.
MR. NIELSON replied the license is valid as long as the dentist
pays the annual renewal fees and keeps up with continuing
education.
SENATOR STEVENS said he suspects that retiring dentists would
maintain their licenses in good standing much the same way that
teachers do.
MR. NIELSON agreed that most people keep their license active as
long as they feel they can contribute.
CHAIR COSTELLO directed attention to the language in paragraph
(e) on page 2. She observed that it will be a burden to reach
out to find out if somebody "may reasonably substitute for the
incapacitated dentist. She asked the meaning of the phrase may
reasonably substitute.
MR. NIELSON replied it probably means that if a general dentist
in Anchorage becomes incapacitated, it is reasonable to expect
another Anchorage dentist could help.
2:28:32 PM
DR. JULIE ROBINSON, Delegate, Alaska Dental Society, Anchorage,
Alaska, stated that the dental society recently became aware of
rare situations where an Alaska dentist becomes incapacitated
and their patient base is uncovered for geographic reasons or
because the dentist is a specialist and no licensed dentist is
willing or able to cover. The Alaska Dental Society supports SB
161 which gives the Board of Dental Examiners an expedited
process to grant a temporary permit in such cases.
SENATOR STEVENS asked if the bill would allow the board to
decide to substitute a dentist who practices outside the
specialty field of the incapacitated dentist.
DR. ROBINSON offered her understanding that nobody outside the
specialty field would be approved to substitute for a
specialist. Finding a substitute for a specialist is the primary
concern, she said. If a specialist who travels to rural areas
becomes incapacitated, the specialists in those larger cities
may not be able to leave their practices, whereas a specialist
from out of state may be able to do that for a limited period.
SENATOR MICCICHE asked for clarification that the bill does not
affect a dentist who is licensed in Alaska. They can step in and
substitute for another dentist.
DR. ROBINSON said that is correct. It's not uncommon for a
general dentist in a larger city to fill in on a short-term
basis. It's a different matter if the incapacitated dentist is a
specialist who travels to rural communities
SENATOR MICCICHE offered his understanding that currently
unlicensed dentists that have previously been licensed may be
temporarily permitted to practice through the waiver of
continued competency requirements.
DR. ROBINSON said no; the person must have an active license in
[Alaska or] another state and thus have continued competency.
The bill just waives the fact that the person does not have an
Alaska license.
2:32:42 PM
CHAIR COSTELLO found no one else who wished to testify and
closed public testimony on SB 161.
She held SB 161 in committee awaiting answers to several
questions.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 165.PDF |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB165 Sponsor Statement.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB165 Sectional Analysis.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB 165 CMS Letter Approving Alaska's State Innovation Waiver.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB165-DOA-DOF-02-15-18.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB165-DCCED-DOI-02-16-18.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 165 |
| SB 161.PDF |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB 161 - Sponsor Statment.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB 161 Legal Memo Exemptions 01-22-18.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB 161 Legal Memo Temporary Permits, Exemptions 01-26-18.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB 161 - Letter of Support - Alaska Dental Society.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB 161 - Letter of Support - Alaska State Board of Dental Examiners President.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |
| SB161-DCCED-CBPL-02-16-18.pdf |
SL&C 2/22/2018 1:30:00 PM |
SB 161 |