HB 45-EXTEND BOARD OF DENTAL EXAMINERS  3:19:43 PM CO-CHAIR LEDOUX announced that the first order of business would be HOUSE BILL NO. 45, "An Act extending the termination date of the Board of Dental Examiners; and providing for an effective date." 3:20:31 PM REPRESENTATIVE DAN ORTIZ, Alaska State Legislature, as prime sponsor of HB 45, introduced the bill and read the following sponsor statement [original punctuation provided]: House Bill 45 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, and the continuation of this board will ensure that high standards of dental care are offered throughout the state. 3:22:21 PM REPRESENTATIVE FIELDS recalled that when the Alaska Tribal Health System (ATHS) implemented and expanded the Dental Health Aide Therapist (DHAT) program there was some debate within the dental community about the right way to regulate the program. He asked if that was something the Board of Dental Examiners oversees. He sought to clarify the board's current take the DHAT program and the provision of dental care in tribal settings. 3:23:02 PM REPRESENTATIVE ORTIZ admitted that he was unable to answer that question and deferred to David Nielson. 3:24:03 PM DAVID NIELSON, Chair, Board of Dental Examiners, Department of Commerce, Community & Economic Development, noted that he can't speak for the entire board on the DHAT program; however, he opined that the model seems to be working well in its current form. He addressed an issue that had arisen about the DHAT members not being licensed by the state, explaining that although that's true, their education includes supervision by a licensed dentist. He said that because they are not licensed by the state it allows them to stay in the villages and clinics where they are serving their population the best, adding that the aforementioned tension in the dental community has dissipated. 3:26:27 PM CO-CHAIR WOOL commented that "it's nice to hear the programs working and it's also nice to hear him say that the lack of a state license is actually helped it work and maybe even added to its success." He asked if that is correct. MR. NIELSON clarified that it would be best to speak with the tribal entities to determine the true impact of their program. Nonetheless, he offered his understanding that if they were licensed, [the DHAT members] would probably move to a higher populated area where their work isn't needed as much. 3:27:51 PM REPRESENTATIVE HANNAN referred the committee to page 7 of the sunset review on the Board of Dental Examiners [included in the committee packet] performed by the Division of Legislative Audit (DLA). The page displayed an unaudited schedule of the board's revenue and expenditures from FY 14 through March 31, 2018. She noted that every other year they had a deficit and asked if that was because licensures are two years at a time. 3:28:40 PM KRIS CURTIS, Legislative Auditor, Division of Legislative Audit, Answered yes. She said that with biannual licensing cycles it's common to see revenues fluctuate every other year. 3:28:54 PM REPRESENTATIVE HANNAN said she presumed that at the end of the fiscal year any excess money that was accrued through licensures rolls into the general fund and the following year they run a deficit. She asked if that happens regularly with the state boards. 3:29:29 PM MS. CURTIS referenced a statute that states board fees must be set at a level that covers board costs. She explained it's reviewed every other year rather than on an annual basis. She alleged hearing testimony that claimed a statute exists which allows boards to carry balances forward; however, they do track their deficits and surpluses and either one can last years. She further noted that boards try to "tweak" those fees every other year to approximate the cost of the occupation. 3:30:12 PM REPRESENTATIVE HANNAN directed attention to the audit's second recommendation: to implement controls to ensure the appropriate entities are notified when a licensee's prescription authority is suspended or revoked. She asked if action had been taken to meet that recommendation. 3:31:11 PM MS. CURTIS explained that there are two recommendations in the audit. The first one is a recommendation to the board president to correct regulation error. The second one is that the DCBPL'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. She noted that, in response, the department stated that they have implemented a policy to ensure those entities are notified. She further noted that the board responded in agreement to both recommendations and to taking corrective action. MS. CURTIS turned attention to the schedule of licensing activity on page 6 of the audit. She noted that as of January 2018, the board had 2,399 active licensees. 3:33:26 PM CO-CHAIR WOOL asked if a hygienist can get additional licensing for local anesthetic. 3:33:50 PM MS. CURTIS said that is her understanding and deferred the question to Mr. Nielson. 3:34:04 PM MR. NIELSON said that is correct. He explained that a hygienist can have a local anesthetic permit or endorsement on their license. He added that it is a separate permitting process. 3:35:41 PM REPRESENTATIVE HANNAN, referencing the attached fiscal, asked if this was a 50 percent reduction in the travel for the board to conduct its work. 3:36:04 PM FRED PARADY, Legislative Liaison, Department of Commerce, Community & Economic Development, answered no, the 50 percent reduction has not been taken. He said that cut is given to them as a general cut across the department, which they can balance at their discretion. 3:36:47 PM CO-CHAIR LEDOUX opened public testimony. 3:37:09 PM MR. NIELSON stated that the dental board serves as a vital role in the regulation of dentistry while always keeping the health and welfare of the Alaskan citizens in mind. Licensing, permitting, certification, and disciplinary action when appropriate, is a cornerstone of what the public should expect from the state government if they are to have confidence in their healthcare providers. He shared that personally, he has enjoyed the challenge to serve and appreciated the opportunity to continue fulfilling the board's purpose, adding that he was in full support of moving HB 45. 3:38:15 PM REPRESENTATIVE HANNAN mentioned that the previous board president, Paul S, wrote a letter in response to the audit regarding the finding about dentists who lost their pharmacy rights, noting that it was to be discussed at the December 7, 2018 board meeting. She asked if Mr. Nielson was at that board meeting and whether that topic was addressed by the board. 3:38:52 PM MR. NIELSON replied that he was at the December meeting and could not recall whether it was discussed. 3:40:49 PM CO-CHAIR LEDOUX closed public testimony [HB 45 was held over.]