SENATE BILL NO. 92 "An Act relating to dental hygienists, dentists, dental assistants, dental hygiene, and dentistry." 9:08:41 AM Senator Egan explained that CSSB 92 (L&C) clarified statutes for dental hygienists, dentists and the board of dental examiners. DANA OWEN, STAFF, SENATOR EGAN, stated that the bill was introduced to the office by a group of dentists and dental hygienists. He stated that the dentistry and dental hygiene statutes had not been comprehensively reviewed in over 20 years. The bill makes many changes to the statutes, most of which are reflections of changes in dental practices. Some changes are due to differences in regulatory framework and others accommodate modern communications technology. The committee proposing the changes was composed of three dentists and three dental hygienists. One of the dentists and one of the dental hygienists on the committee sit on the board of dentistry. The committee originally proposed a sunset provision, but the provision is currently separated from the larger bill to facilitate reauthorization of the board. 9:11:47 AM Mr. Owen provided a sectional analysis.   Section 1. Removes a requirement that a person practicing dental hygiene, or who is offering to practice dental hygiene, must have a current certificate of registration. Section 2. Establishes the qualifications necessary for licensure as a dental hygienist. Section 3. Amends the qualifications necessary for a dental hygienist to be licensed by credentials. Section 4. Edits the dental hygiene licensing provision to provide that successful applicants for licensure will no longer be registered by the Board of Dental Examiners (board) (see sec. 25 for a parallel provision applicable to dentists). Sections 5 - 6. Conform the "renewal of license" and "lapse and reinstatement of license" provisions to the bill's removal of the registration requirement for dental hygienists. Section 7. Allows a dental hygienist who has completed a course offered by or under the auspices of a program accredited by the Commission on Dental Accreditation of the American Dental Association or other equivalent course or program to receive a restorative function endorsement from the board. Section 8. Changes the levels of supervision required for a dental hygiene student performing dental hygiene procedures. Makes the section applicable to all students enrolled in dental hygiene programs. Sections 9 - 11. Change the permitted scope of practice for a dental hygienist and clarify what practices and procedures may not be delegated to a dental hygienist by a dentist. Section 12. Clarifies what practices and procedures a dental hygienist, who has entered into a collaborative agreement with a dentist, may be authorized by the dentist to perform. Section 13. Makes stylistic changes. Section 14. Permits the board to sanction a dental hygienist who used or knowingly cooperated in deceit, fraud, or intentional misrepresentation to obtain a certificate or endorsement and amends the other grounds for discipline, suspension, or revocation of a dental hygienist's license. Section 15. Gives the board the authority to impose a civil fine of up to $25,000 for a violation of AS 08.32 or a regulation adopted under the chapter. Section 16. Amends the list of dental hygienists to whom the provisions of AS 08.32 do not apply. Section 17. Provides new definitions applicable to AS 08.32 for "licensed dental hygienist" and "licensed dentist." Section 18. Adds a qualification for the public member of the board. Section 19. Requires the members of the board to take an oath. Requires the board to adopt a seal. Section 20. Requires the president of the board to be a dentist or dental hygienist. Section 21. Amends the powers of the board. Section 22. Requires the Department of Commerce, Community, and Economic Development to employ an investigator for the board. Section 23. Requires the board to establish standards for dental radiological equipment that comply with applicable federal law. Permits the board to charge a fee for equipment registered under the section. Removes a requirement that inspections of radiologic equipment be performed by a person with certain qualifications. Section 24. Requires the board to maintain a registry of persons licensed as dentists or dental hygienists and persons certified as dental assistants, and a registry of licenses, certificates, and endorsements revoked by the board. Section 25. Edits the dentist licensing provision to provide that successful applicants for a license will no longer be registered by the board (see sec. 4 for a parallel provision applicable to dental hygienists). Section 26. Amends the qualifications for a license to practice dentistry in the state. Section 27. Requires that an applicant for licensure as a dentist must be interviewed in person by the board. Sections 28 - 29. Amend what is necessary for a dental hygienist to be licensed by credentials. Section 30. Permits all persons enrolled as students in an accredited school of dentistry to perform dental procedures without a license if certain conditions are met. Section 31. Conforms the "renewal of registration" provision to the bill's removal of the registration requirement for dentists. Section 32. Provides that a dentist who does not pay the license renewal fee forfeits the dentist's license. Permits the board to reinstate a license upon certain conditions. Section 33. Amends the grounds for discipline, suspension, or revocation of a license to practice dentistry. Section 34. Permits a dental assistant who has completed a course offered by or under the auspices of a program accredited by the Commission on Dental Accreditation of the American Dental Association or other equivalent course or program to receive a restorative function endorsement from the board. Section 35. Adds a new provision allowing persons enrolled in a program or course of study to perform dental assisting procedures as part of that course of study or program without a certificate if certain conditions are met. Section 36. Adds a new section that provides who may own, operate, or maintain a dental practice, office, or clinic. Section 37. Provides new definitions applicable to AS 08.36 for "certified dental assistant," "licensed dental hygienist," and "licensed dentist." Section 38. Repeals AS 08.32.020, 08.32.035, 08.32.040, 08.32.060, 08.32.097, 08.32.100, 08.32.120, 08.32.130, 08.32.140, 08.32.190(2); AS 08.36.075(b), 08.36.075(c), 08.36.075(d), 08.36.075(e), 08.36.114, 08.36.230, 08.36.244, 08.36.246, 08.36.247, 08.36.248, 08.36.260, 08.36.271, 08.36.290, 08.36.350(a)(3), and 08.36.350(a)(4). Section 39. Instructs the revisor of statutes to change the catch line for AS 08.36.250. 9:19:13 AM Co-Chair Stedman addressed Page 18, Line 28 regarding the ownership of the dental office and facility. He asked the reason for the new section. DAVID LOGAN, ALASKA DENTAL SOCIETY answered that the statute currently lacks a provision permitting a surviving spouse to have ownership of a practice during a transition period. The section allows a transitional period during which a spouse has ownership of a practice with a licensed dentist in control. During the transition period, the spouse may sell the practice to another individual. The section also clarifies additional mechanisms for ownership of a dental practice. Co-Chair Stedman mentioned the fiscal note from the Department of Commerce, Community and Economic Development (DCCED) for $114,200 in receipt support services to employ one full time investigator. 9:21:28 AM Senator Thomas asked about the first item in Section 1, the removal of the need for a current certification of registration. He asked if the language was redundant. Mr. Logan responded yes. Senator Thomas asked about the certification or inspection of equipment. He expressed interest in the hazards of x-ray and was curious about the condition of the equipment used. Mr. Logan answered yes. He expected that much of the content of the statutes will be transferred into regulations with some minor modifications. He mentioned the overarching federal law that ensures the minimum standard. He noted requirements for qualifications of the equipment inspectors along with a time allotment for inspection. Co-Chair Hoffman asked why the Labor and Commerce (L&C) committee felt the need for an investigator. Mr. Owen responded that an investigator would provide a more effective way of policing dental practices. Co-Chair Stedman asked about the committee. Mr. Owen responded that the committee was composed of three dentists and three dental hygienists. Mr. Logan added that board members expressed concern about the length of time required to adjudicate cases. He pointed out the limited number of investigators. The department has many investigations with different boards. The board opined that with its own investigator, the investigations would be performed in a timely manner. The board acknowledged that the change would result in additional licensing fees. 9:24:46 AM Senator Olson asked about Page 18. He understood that only a person who holds a valid license can own and operate a dental practice clinic. He asked if the owner of a dental practice must have a valid dental license. Mr. Logan responded that a laundry list of exceptions exists in the legislation. Senator Olson asked if a community owned dental clinic was trying to attract a dentist would they be exempted from the restriction. Mr. Logan agreed. He stated that the community could own the dental clinic but the management of the clinic must be done by a licensed dentist. Senator Olson asked about prescriptive authority and the midlevel practitioners. Mr. Logan answered that the bill has no effect on midlevel practitioners. They are exempt from the state licensure. Senator Olson asked about the health corporation's dental practitioners who have studied abroad and then returned. He wondered the effect the legislation has on those practitioners working for the native corporations. Mr. Owen responded that current practice in rural areas of Alaska will remain unchanged. He explained that the original drafted language was insufficient. He worked with attorneys and a drafter to incorporate the appropriate language into the amendment. Senator Olson wondered about letters of support from specific health corporations. Mr. Owen did not have the requested letters. 9:28:02 AM Senator Olson asked about Section 14 and the disciplinary action by the dental board. He recalled that medical boards are always seeking investigators. He wondered why the dental board was different. Mr. Logan suspected that additional boards would visit the legislature with the same request. Senator Olson asked about Section 23 and the radiological procedures. He asked how the legislation restricts the practice of current radiology technicians. Mr. Logan stated that a board member could answer the question. Senator Olson asked how many disciplinary actions occured in the last five years. Mr. Logan deferred the question to the director. 9:30:19 AM DEBORAH STAUFFER, ALASKA STATE BOARD OF DENTAL EXAMINERS (via teleconference), testified in support of the legislation. She stated that the board of dental examiners unanimously supported the passage of SB 92. She pointed out that the legislation updates current statutes. She stated that as of February, there were six open complaints filed and awaiting review. She mentioned nine open investigations with some consent agreements pending and noted nine other cases awaiting records or release documents since the last meeting in December. The results are similar to those noted in the November meeting regarding the number of complaints and investigations. She stated that one case closed in May after eight years of investigation. She opined that an additional investigator would help protect the public. Co-Chair Stedman requested the data in letter format. 9:34:28 AM Senator Olson asked how the number of open complaints compares with those of the medical board. Ms. Stauffer did not know. Senator Olson requested a comparison. He believed that the medical board did not possess their own investigator. Co- Chair Stedman stated that the data will be compiled for the committee. 9:35:06 AM GAIL WALDEN, MATSU, ALASKA STATE DENTAL HYGIENIST ASSOCIATION (via teleconference), testified in support of the legislation. She agreed that the dental practice act had not been thoroughly reviewed and updated in approximately 20 years. She noted that SB 92 amends and repeals dental hygiene statute language where appropriate, making the practice act more concise. She opined that SB 92 maintains high standards for dental hygienists. 9:36:33 AM DON HABEGER, DIRECTOR, DIVISION OF CORPORATE, BUSINESS, AND PROFESSIONAL LICENSING, stated that he did not have the requested information to answer Senator Olson's question. He offered to provide the information to the committee. Senator Egan offered to provide additional information and announced that an amendment would be offered during the bill's next hearing. SB 92 was HEARD and HELD in Committee for further consideration.