HHES - 03/07/95 HB 182 - DELEGATION OF DUTIES TO DENTAL ASSISTANTS Number 647 CO-CHAIR TOOHEY said that following the subcommittee meeting on HB 182 which took place on Saturday, March 4, she would ask the HESS Committee to pass out this bill as amended. The subcommittee contends that the authority to license or otherwise regulate dental assistants already rests with the Board of Dental Examiners. Co- Chair Toohey hopes that after HB 182 becomes law, the board will work with the affected groups to come up with some guidelines or regulations that satisfy everyone. CO-CHAIR TOOHEY said that the subcommittee found that the Board of Dental Examiners does have regulating powers and it, not the legislature, should be regulating those under its control. On page 121 of the regulations, number 11 states that the dental board has the authority to issue permits or certificates to license dentists, dental hygienists and dental assistants who meet standards determined by the board for specific procedures that require specific education and training. CO-CHAIR TOOHEY said that is where the subcommittee made its determination. Number 755 CO-CHAIR TOOHEY said she would like the bill to pass as amended, and then the board should be directed to come up with its recommendations as to implementation. CO-CHAIR BUNDE asked to clarify what was occurring. First, Co- Chair Toohey would like to amend HB 182 for federal dentists. Then, if the bill passes, it would be the will of the HESS Committee members that the dental board promulgate regulations that would or would not allow the application of sealants, etc., by dental assistants, as they see fit. This is an enabling kind of bill, the bill is not a mandate. CO-CHAIR TOOHEY said it was discovered from conversations with dental clinics that there is a stack of Occupational Safety and Health Administration (OSHA) regulations in clinics that dental assistants are obliged to read, follow and sign off on. Indeed, they have an incredible amount of training. Number 844 CO-CHAIR BUNDE moved that HB 182 be adopted. REPRESENTATIVE ROKEBERG said that as Co-Chair Toohey mentioned, if the proper board has the power to make these regulatory changes, why is this statute being passed? CO-CHAIR TOOHEY answered that the bill allows federal dentists who practice under the Indian Health Service (IHS) to delegate authorities to dental assistants. REPRESENTATIVE ROKEBERG asked if the word "or" was being removed from Amendment 1. CO-CHAIR BUNDE said the amendment had not yet been adopted, and moved that Amendment 1 be adopted so that discussion may begin. CO-CHAIR TOOHEY asked for discussion. Number 910 REPRESENTATIVE ROKEBERG said Amendment 1 spoke of an assistant to a licensed dentist under that statute, or a federal dentist. CO-CHAIR BUNDE continued "...or a dentist licensed under the Alaska statute which regards the IHS." CO-CHAIR TOOHEY said that Amendment 1 had been adopted at last week's meeting. A Committee Substitute (CS) for HB 182 was now being used. REPRESENTATIVE ROKEBERG asked if the intention of the bill is to just exempt the federal dentists. Number 963 SAM KITO, Lobbyist, representing the Alaska Dental Society, said the language in the statute is neither permissive or restrictive in the sense that the language is not present. But rather than have the legislature, through statute, mandate that these dental assistants must be licensed to perform the duties in question, the language says, "This section does not prohibit a dental assistant from applying these agents." MR. KITO said that allows, with specificity, that the board can or cannot make that determination as they see fit under the law. It is not being said through statute that the board must do something. The board will make its determinations. But because what dental assistants can or cannot do is not specifically addressed under statute, the board can make a determination either way. REPRESENTATIVE ROKEBERG asked what would occur if the board did not want dental assistants to perform specific duties. CO-CHAIR TOOHEY answered that such decisions are up to the board. MR. KITO said that the statute does not say dental assistants or the board cannot do anything. It is up to the board to make those decisions. REPRESENTATIVE ROKEBERG said this does not give the dental assistants, without the proper regulatory framework, permission to proceed. MR. KITO said the board oversees whether dentists want or do not want to delegate these duties. Number 1035 CO-CHAIR TOOHEY said the opinion from the board concerning its authority to grant licenses and permits was given in 1988. This authority has been known by the dental community for quite awhile, and the repercussions have been tossed about for the last seven years. Therefore, Co-Chair Toohey feels that HB 182 and the contentions with dental assistant competency is being placed where it belongs. REPRESENTATIVE GARY DAVIS thought the amendment was adding to the bill, when in fact it is deleting exemptions. Number 1082 CO-CHAIR BUNDE said that both he and Representative Davis were at another committee meeting when the amendment was adopted. The only action now necessary is to vote on CSHB 182(HES). He moved that the bill, as amended, move from the HESS Committee with individual recommendations. There were no objections and the bill was passed from committee. CO-CHAIR TOOHEY passed the gavel to Co-Chair Bunde for the remainder of the meeting. Number 1123 CO-CHAIR BUNDE announced that Representative Davis joined the meeting at 3:15 p.m., and Representative Brice joined the meeting at 3:25 p.m. CO-CHAIR BUNDE said it was not his intention to move HB 215, HB 217 or HJR 17 out of the committee today. These hearings are for discussion only.