HOUSE BILL NO. 93 "An Act relating to dentists and dental hygienists and the Board of Dental Examiners; establishing certain committees for the discipline and peer review of dentists; excluding the adjudicatory proceedings of the Board of Dental Examiners and its committees from the Administrative Procedure Act and from the jurisdiction of the office of administrative hearings; and providing for an effective date." HEATH HILYARD, STAFF, REPRESENTATIVE TOM ANDERSON, noted that he went over the adopted work draft, Version C, at the previous meeting. Co-Chair Meyer opened public testimony. 1:44:41 PM DR. ROBERT ROBERTSON, DMD, ALASKA DENTAL SOCIETY, offered to answer questions. DR. GEORGE SHAFFER, DMD, ALASKA DENTAL SOCIETY, KETCHIKAN, spoke to the purpose of the bill. The bill strengthens the action of the Board of Dental Examiners allowing them to deal with discipline in a more-timely manner, ensuring that all of the testimony and records that are included in a complaint are viewed. The bill would also allow the board to enter the process at an earlier stage when complaints from patients are more benign. He offered to answer questions. 1:47:16 PM JIM TOWLE, EXECUTIVE DIRECTOR, ALASKA DENTAL SOCIETY, ANCHORAGE, offered to answer questions. 1:48:53 PM DAVID LOGAN, DMD, ALASKA DENTAL SOCIETY, echoed Dr. Shaffer's comments. He related that the bill would establish peer review, a feature currently not available. It will allow the board to collectively use its expertise on dental matters. Currently, the board is limited in that only one board member is allowed to review a case. HB 93 would allow the public to bring more cases to the board. It would allow for earlier intervention for impaired practitioners. 1:50:31 PM RICK URION, DIRECTOR, OCCUPATIONAL LICENSING, DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT, testified that the Board of Dental Examiners met last month and 7 out of 8 opposed the bill. He read an email from a board member, which implied that attorneys want dentists to think that the bill will rid them of occupational licensing. He related that in the past ten years there have been 195 cases, 40 of which were brought against two dentists, and 95 that were dismissed without action. He discussed how the current peer review operates, referring to a Dental Complaint Flow Chart (copy on file.) He stated that the purpose of licensure is for public safety. He strongly opposed the bill. Representative Kelly asked Mr. Urion if he wrote the fiscal note. Mr. Urion replied that he did not. Co-Chair Meyer noted that it has changed considerably. Mr. Urion pointed out that the bill has changed considerably. Representative Kelly asked how the bill differs from how physicians self regulate. Mr. Urion said that doctors do exactly what the dentists are doing now. 1:56:58 PM Co-Chair Chenault referred to the new fiscal note and the expense for travel, which is the same as in the old fiscal note. He wondered where the funds would come from to pay for those costs. Mr. Urion said that the law requires those costs to be paid by dentists. Co-Chair Meyer asked if they are receipt paid. Mr. Urion said yes. All costs are paid by the dentists. 1:58:24 PM Mr. Hilyard addressed Mr. Urion's concerns. He mentioned the sponsor's work with the Division throughout the process of re-writing the bill. He noted that it is a difference of philosophy. Co-Chair Meyer asked why the bill's approach is better than the status quo. Mr. Hilyard stated that the bill provides for a better public process. 2:00:39 PM Representative Kelly asked for more information about the various models. Mr. Hilyard said he is not familiar enough to speak about them. Representative Kelly asked why the board is so opposed to this bill. Mr. Hilyard referred to an email from a dental board member from North Pole, which says the board takes no official position on the bill. Representative Kelly asked if there is a split in the dental society. Mr. Hilyard deferred to Mr. Towle to address that issue. 2:03:08 PM Mr. Towle reported that there is no division within the Alaska Dental Society regarding this bill. He referred to an email, which states that the board takes no position on the bill. Co-Chair Meyer asked Dr. Logan to comment. Dr. Logan opined that all board members he talked to spoke in support of the legislature. He noted that dentists do not feel that the board is out to get them. Speaking as a board member, he stated that the board takes a balanced view. He cited problems with the board not getting information regarding investigations. He addressed the peer review for organized dentistry, a panel of board members that hears a case itself, usually regarding minor matters. 2:07:39 PM Representative Kelly asked for comments on why dentists are moving in a different direction than doctors. Dr. Logan could only speak from the dentists' perspective. The largest change is that peer review would be opened up. The board would now hear cases earlier in the process and direct them to a peer review or disciplinary committee or full investigative process. The investigators now are well trained, but not qualified to assess dental matters. 2:09:47 PM Co-Chair Chenault asked if the current ruling is that the finding has to come back to the board after 120 days. Dr. Logan said that is correct. Co-Chair Chenault asked if the concern is that board members don't know what has been going on. Dr. Logan explained the current system. Investigators present the findings and recommendations and the board votes, having never heard about the case previously. The new program is that the board would be aware of the case from the beginning and direct it to the best place to be dealt with, then the case would come back to the board for approval of the decision. Co-Chair Chenault summarized that currently the board is not given much information and the bill would allow for access to more information. 2:12:48 PM Representative Kerttula asked if a due process problem is created because some on the board may investigate and then vote. Dr. Logan deferred to Dr. Shaffer. Dr. Shaffer related that under the present system the board operates under the Administrator Procedures Act (APA). This gives the board the ability to look at evidence early on in the process or to refer it to an investigator. In the present system, there is a problem with reserving the board's independence. Currently, the board cannot see any evidence. The board does not sit as an appeals body. The appeals body goes to the Superior Court. That was the driving force behind the bill. The present system does not allow the board to participate earlier in order to protect the public. The bill would allow for the process to be defined outside of the Administrative Procedures Act. 2:17:30 PM Representative Kerttula asked if currently the board makes decisions that can be appealed. Dr. Shaffer said according to the APA, the appeal is to the Superior Court. The Department says the appeal is back to the Department. This is a difference of opinion. Representative Kerttula asked if the board is the original decision maker regarding suspended licenses. Dr. Shaffer said that is correct, but for many years the board has not been allowed to see evidence. Representative Kerttula recalled that the AG's office would bring the evidence to the board after an investigation was complete, and a decision would be made. She asked if the new system would create due process problems. Dr. Shaffer replied that under the bill, there would be a single person, the board president, who would do a triage, and who could be recused from the process. The rest of the board members would have the evidence and then make the decision. The Department maintains that the board cannot see the evidence. Dr. Shaffer explained that in the bill there are two committees, the peer review committee and a disciplinary committee, both of which can be made up of members of the board. The board can also call on other dentists to help them with the process. Then the board would make the final decision. Representative Kerttula summarized Dr. Shaffer's concern about lack of information to the board. Dr. Shaffer concurred. Representative Kelly asked how other states deal with this issue. Dr. Logan reported that there is a huge variation. Most states have a peer review process. 2:22:49 PM Co-Chair Chenault thought that the board might have a variety of opinions on the bill. Mr. Logan said the board is not allowed to take a position on legislation. Representative Weyhrauch asked if the committee could request the board to take an opinion. Co-Chair Chenault thought it would be a personal opinion. 2:24:33 PM Representative Foster MOVED to REPORT CSHB 93 (FIN) out of committee with individual recommendations and the accompanying fiscal note. Representative Hawker OBJECTED. He spoke to reservations related to the Division of Occupational Licensing. He opined that something in Alaska about licensing is not working. He wondered what the root of the problem is. Representative Stoltze also spoke of a concern about licensing and the bill. Co-Chair Meyer said there is no reason to hold the bill over. Representative Weyhrauch said he does not know what the bill does, either. Representative Kerttula related that her experience with occupation licensing is that they do have all of the information at their hearings. She also voiced concerned about the bill. 2:28:02 PM Representative Hawker WITHDREW his objection to moving CSHB 93 from committee. CSHB 93 (FIN) was REPORTED out of Committee with a "no recommendation" and with fiscal note #1 by the Department of Commerce, Community and Economic Development. 2:28:42 PM At-ease. 2:30:35 PM