Legislature(2019 - 2020)ADAMS ROOM 519

04/12/2019 01:30 PM House FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 25 EXTEND BOARD OF DENTAL EXAMINERS TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 22 EXTEND SUICIDE PREVENTION COUNCIL TELECONFERENCED
Heard & Held
-- Public Testimony --
SENATE BILL NO. 25                                                                                                            
                                                                                                                                
     "An Act extending the termination  date of the Board of                                                                    
     Dental  Examiners;  and   providing  for  an  effective                                                                    
     date."                                                                                                                     
                                                                                                                                
1:31:52 PM                                                                                                                    
                                                                                                                                
SENATOR DAVID  WILSON, BILL  SPONSOR, thanked  the committee                                                                    
and apologized for being held  up with other state business.                                                                    
He reviewed the bill sponsor statement:                                                                                         
                                                                                                                                
     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.                                                                                     
                                                                                                                                
Senator Wilson reported that Legislative Audit made 2                                                                           
recommendations to the board. He read the recommendations                                                                       
from the sunset review:                                                                                                         
                                                                                                                                
Recommendation 1:                                                                                                               
                                                                                                                                
     The Board of Dental  Examiners (board) president should                                                                    
     take steps to correct a regulation error.                                                                                  
                                                                                                                                
     A  2016  change  to  a  dental  radiological  equipment                                                                    
     regulation  resulted  in  regulations  referring  to  a                                                                    
     repealed section of regulations.                                                                                           
     Specifically, 12 AAC 28.965 states:                                                                                        
                                                                                                                                
          (b) The inspection of dental radiological                                                                             
          equipment must                                                                                                        
          (1) be performed by an inspector who is on the                                                                        
          list                                                                                                                  
          maintained under (d) of this section;                                                                                 
                                                                                                                                
     However, section  12 AAC  28.965(d) was  repealed March                                                                    
     2016.                                                                                                                      
                                                                                                                                
Senator Wilson reported that the board had corrected the                                                                        
error.                                                                                                                          
                                                                                                                                
Recommendation 2:                                                                                                               
                                                                                                                                
     Division  of  Corporations, Business  and  Professional                                                                    
     Licensing'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.                                                                            
                                                                                                                                
Senator  Wilson explained  that although  the investigations                                                                    
were done in  a timely manner, Legislative  Audit found that                                                                    
there were no procedures and  notified the Board of Pharmacy                                                                    
or  the  Federal  Drug  Enforcement  Administration  when  a                                                                    
licensees  prescription  authority  had  been  suspended  or                                                                    
revoked. The  Division had  immediately addressed  the issue                                                                    
by implementing  controls to ensure  that the  entities were                                                                    
appropriately notified.                                                                                                         
                                                                                                                                
Senator Wilson  drew members' attention to  the fiscal note.                                                                    
The  note  reflected  a  spend of  $35,100  which  paid  for                                                                    
expenses for board  travel, attending meetings, advertising,                                                                    
and  board  and   conference  fees.  Professional  licensing                                                                    
programs within  the Division of Corporations,  Business and                                                                    
Professional  Licensing  were  funded by  Receipt  Supported                                                                    
Services with designated general  funds. Licensing fees were                                                                    
covered by the costs of the board.                                                                                              
                                                                                                                                
Senator Wilson reviewed the sectional analysis:                                                                                 
                                                                                                                                
     Section 1. AS 08.03.010(c)(7) is amended to read:                                                                          
          (7) Board of Dental Examiners (AS 08.36.010) -                                                                        
          June 30, 2027 [2019];                                                                                                 
                                                                                                                                
     Sec.  2. This  Act  takes effect  immediately under  AS                                                                    
     01.10.070(c).                                                                                                              
                                                                                                                                
Senator Wilson  reviewed the available testifiers  and urged                                                                    
members support.                                                                                                                
                                                                                                                                
Co-Chair Wilson invited Kris Curtis to the table.                                                                               
                                                                                                                                
1:35:59 PM                                                                                                                    
                                                                                                                                
KRIS  CURTIS,   LEGISLATIVE  AUDITOR,  ALASKA   DIVISION  OF                                                                    
LEGISLATIVE  AUDIT,  indicated  the purpose  of  the  sunset                                                                    
audit, dated  April 2018  (copy on  file), was  to determine                                                                    
whether  a  board or  commission  was  serving the  public's                                                                    
interest and  whether it should  be extended. She  read from                                                                    
the audit report:                                                                                                               
                                                                                                                                
     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.                                                                                         
                                                                                                                                
Ms.  Curtis directed  members to  turn to  page 6  regarding                                                                    
licensing  activity. She  relayed  that as  of January  2018                                                                    
there  were 2,399  active licenses.  On page  7 there  was a                                                                    
schedule of board revenues and  expenditures. It showed that                                                                    
as of  March 2018 the  board had  a deficit of  $36,000. She                                                                    
reported that  there was  a fee  analysis planned  for 2018.                                                                    
The schedule of fees was on page 8.                                                                                             
                                                                                                                                
Ms. Curtis continued that the  audit had two recommendations                                                                    
administrative  in nature.  The first  recommendation was  a                                                                    
regulation error  which should  be easy  to address.  A 2016                                                                    
regulation change  resulted in one regulation  referencing a                                                                    
repealed  recommendation. The  second recommendation  was an                                                                    
issue the auditor also found  with the Board of Nursing. She                                                                    
explained that when a  licensee's prescription authority was                                                                    
suspended  or revoked,  there were  no procedures  to notify                                                                    
the  Board  of  Pharmacy  or the  Federal  Drug  Enforcement                                                                    
Administration  (DEA). In  the  audit period  she found  two                                                                    
licensed  dentists  that  had their  prescription  authority                                                                    
revoked  and the  information was  not  communicated to  the                                                                    
proper entities.                                                                                                                
                                                                                                                                
Ms. Curtis  reported that the  response to the audit  was on                                                                    
page  21. The  board  agreed with  both recommendations  and                                                                    
planned to take corrective action.                                                                                              
                                                                                                                                
Representative  LeBon mentioned  there  had been  discussion                                                                    
about  a  level  of  dental  practice  that  would  allow  a                                                                    
practitioner to  serve the public  in rural  areas providing                                                                    
basic dental services. He asked  if a discussion had ensued.                                                                    
Ms.  Curtis responded  that the  audit did  not look  at the                                                                    
issue.  However, she  thought Dr.  Neilson, the  chairman of                                                                    
the board, could field the question.                                                                                            
                                                                                                                                
1:39:21 PM                                                                                                                    
                                                                                                                                
DR. DAVID NEILSON, MEMBER, ALASKA  BOARD OF DENTAL EXAMINERS                                                                    
(via  teleconference),  thought   Representative  LeBon  was                                                                    
referencing the  Dental Health  Aide Therapist.  He wondered                                                                    
if  he  was right.  Representative  LeBon  responded in  the                                                                    
affirmative.                                                                                                                    
                                                                                                                                
Dr.  Neilson relayed  that the  particular provider  was not                                                                    
regulated by the state or  the board. They were regulated by                                                                    
Indian Health  Service and supervised by  dentists that work                                                                    
in the villages. It was  difficult for him to comment except                                                                    
to say that it seemed to be working.                                                                                            
                                                                                                                                
Representative  LeBon  asked  how  common  the  program  was                                                                    
throughout the state. He wonder  how many practitioners were                                                                    
in the state. Dr. Neilson  did not have the information. The                                                                    
best way to  obtain the information would  be through Alaska                                                                    
Native  Tribal  Health  Consortium (ANTHC)  or  the  tribes.                                                                    
Since the  board did not license  them, he did not  know the                                                                    
numbers or where they were practicing.                                                                                          
                                                                                                                                
Co-Chair  Wilson   asked  if  Mr.  Neilson   had  additional                                                                    
testimony.  Dr.  Neilson  was available  for  questions.  He                                                                    
supported the extension.                                                                                                        
                                                                                                                                
Co-Chair Wilson  asked if any  regulations had  been brought                                                                    
forward  to  make it  easier  for  out-of-state dentists  to                                                                    
provide   service   in   Alaska.   Dr.   Neilson   responded                                                                    
affirmatively. The board's goal  was to accept all generally                                                                    
equivalent  regional  licensing  exams.   The  board  had  a                                                                    
current  regulation project  that  addressed  the issue.  He                                                                    
reported  that   it  was  just  signed   by  the  Lieutenant                                                                    
Governor's Office  and should be in  effect approximately by                                                                    
May 1,  2019. It should be  in effect for the  upcoming exam                                                                    
season.  Co-Chair  Wilson  appreciated  the  information  he                                                                    
provide over the interim.                                                                                                       
                                                                                                                                
1:42:31 PM                                                                                                                    
                                                                                                                                
DAVID   LOGAN,  ALASKA   DENTAL   SOCIETY,  ANCHORAGE   (via                                                                    
teleconference),  reported that  the  Alaska Dental  Society                                                                    
had  worked with  the board  for  several years  to bring  a                                                                    
change in place where  dentists graduating from U.S. schools                                                                    
could  take  any regional  board  and  apply for  an  Alaska                                                                    
dental  license.  The  society  was very  glad  to  see  the                                                                    
project come to  an end. He conveyed that  the Alaska Dental                                                                    
Society supported the board extension.                                                                                          
                                                                                                                                
1:43:36 PM                                                                                                                    
                                                                                                                                
Co-Chair Wilson OPENED Public Testimony.                                                                                        
                                                                                                                                
1:43:50 PM                                                                                                                    
                                                                                                                                
Co-Chair  Wilson CLOSED  Public  Testimony. Co-Chair  Wilson                                                                    
asked  Ms. Chambers  to review  the  fiscal note  associated                                                                    
with the bill.                                                                                                                  
                                                                                                                                
SARA CHAMBERS, DIRECTOR,  DIVISION OF CORPORATIONS, BUSINESS                                                                    
AND   PROFESSIONAL   LICENSING,  DEPARTMENT   OF   COMMERCE,                                                                    
COMMUNITY  AND  ECONOMIC DEVELOPMENT  (via  teleconference),                                                                    
reported  that   the  fiscal  note  reflected   all  receipt                                                                    
supported  services to  continue the  work of  the board  if                                                                    
extended  through  the  recommended   amount  of  time.  All                                                                    
expenses  were  paid through  license  fees.  There were  no                                                                    
undesignated general  funds. If  the board was  sunset there                                                                    
would not  be expenses for  maintaining the activity  of the                                                                    
board.  If   the  board  was  extended   expenses  would  be                                                                    
incurred.  She  estimated about  $35,000  per  year for  the                                                                    
activities of the board. If  the bill was not successful and                                                                    
the board  were not to  continue, the division  would assume                                                                    
all the  responsibilities for the licensing  program without                                                                    
the benefit of the wisdom of the board.                                                                                         
                                                                                                                                
Co-Chair Wilson  understood the  fiscal note  reflected what                                                                    
the department  would incur if  the board was not  in place.                                                                    
She  wondered  if  the  fees would  drop  down  without  the                                                                    
infrastructure  of   the  board   in  place.   Ms.  Chambers                                                                    
responded that it  was unlikely that the  division would see                                                                    
a  significant savings  by simply  discontinuing the  board.                                                                    
The  board  was  a  group  of  experienced  volunteers  that                                                                    
provided  service at  no salary  cost to  the division.  The                                                                    
division would likely  have to obtain expert  witnesses at a                                                                    
much  higher cost  to provide  the expertise  in regulations                                                                    
and  advising  regarding  investigations. The  real  benefit                                                                    
went  far  beyond  $35,000  per year  to  gather  the  board                                                                    
together to meet.                                                                                                               
                                                                                                                                
Co-Chair  Wilson did  not  object to  the  extension of  the                                                                    
board. Rather,  she was  trying to  be transparent  with the                                                                    
fiscal  note. She  referred to  page  7 of  the audit  which                                                                    
showed  the state's  direct expenditures  for the  board and                                                                    
the  money collected.  She thought  the  fiscal note  should                                                                    
include the  amount if board  was extended. She  thought the                                                                    
fiscal note currently reflected the  amount if the board was                                                                    
not extended. Ms. Chambers replied  that if the bill passed,                                                                    
the  division   would  require   $35,000  to   continue  the                                                                    
activities  of the  board. If  the  bill did  not pass,  the                                                                    
expense  would not  be part  of the  division's expenditures                                                                    
for the fiscal year.                                                                                                            
                                                                                                                                
Co-Chair  Wilson  asked  why   the  board  was  being  given                                                                    
$145,216 in program receipts to  do its business, but it was                                                                    
not  reflected in  the fiscal  note. Ms.  Chambers responded                                                                    
that  the only  thing that  changed  with the  bill was  the                                                                    
existence  of the  board. The  rest of  the program  did not                                                                    
change.  The   division  would   continue  to   perform  all                                                                    
licensing and  investigative functions for the  program. The                                                                    
fiscal note,  per the legislature,  reflected what  the bill                                                                    
accomplished, not  all of the  expenses associated  with the                                                                    
entire licensing program.                                                                                                       
                                                                                                                                
Co-Chair  Wilson  suggested  that  if the  board  no  longer                                                                    
existed there would  still be fees incurred  to regulate the                                                                    
profession.  She  asked if  she  was  correct. Ms.  Chambers                                                                    
responded  positively. Co-Chair  Wilson  suggested that  the                                                                    
fiscal note needed work.                                                                                                        
                                                                                                                                
Representative  Knopp  tried  to clarify  Co-Chair  Wilson's                                                                    
comment.  He  wondered  if   he  understood  correctly.  Ms.                                                                    
Chambers responded in the affirmative.                                                                                          
                                                                                                                                
Co-Chair  Wilson  wanted  to  make  sure  when  people  were                                                                    
looking at  the fiscal  note they did  not think  the amount                                                                    
listed was all that the program was spending.                                                                                   
                                                                                                                                
SB  25  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 25 Board of Dental Examiners Sunset Review.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 HFIN Hearing Request 4.3.2019.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 Letters of Support.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
SB 25 Sponsor Statement.pdf HFIN 4/12/2019 1:30:00 PM
SB 25
HB 22 Supporting Documents-Suicide Facts.pdf HFIN 4/12/2019 1:30:00 PM
HB 22