SB 173-DENTIST SPEC. LICENSE/RADIOLOGIC EQUIP  2:06:04 PM ACTING CHAIR STEVENS reconvened the meeting and announced the consideration of SENATE BILL NO. 173 "An Act relating to the practice of dentistry; relating to dental radiological equipment; and providing for an effective date." 2:06:32 PM SENATOR DAVID WILSON, Alaska State Legislature, Juneau, Alaska, sponsor of SB 173, stated that the bill does two things: 1) it transfers the inspection of dental radiology equipment from the Board of Dental Examiners to the Department of Health and Social Services; and 2) it establishes a specialty license. Members of the dental industry brought these suggestions forward and the matter has been considered in previous legislatures. These updates are needed and will enhance public safety. He deferred further introduction to Jasmin Martin. 2:07:24 PM JASMIN MARTIN, Staff, Senator David Wilson, Alaska State Legislature, Juneau, Alaska, introduced SB 173 on behalf of the sponsor. She stated that the components in the bill were contained in legislation in the 2020 session that was cut short [due to COVID-19]. She paraphrased the following sponsor statement. [Original punctuation provided.] Senate Bill 173 does two things. It transfers dental radiological equipment inspections from the Board of Dental Examiners to the Department of Health and Social Services and it establishes a specialty dental license in the State of Alaska. For the first part, the Board of Dental Examiners currently certifies inspectors of dental radiological equipment who in turn conduct inspections at dental offices. This bill would move the authority and responsibility for inspections to the Department of Health and Social Services, which already inspects medical radiological equipment and employs state inspectors. This bill also allows for the collection of fees to cover the costs associated with inspection. The second part of the legislation is a "truth in advertising" concept. It simply establishes that if a dentist advertises as a specialist in a field, they must meet certain minimum qualifications as a specialist as established by the Alaska State Board of Dental Examiners (board). There is currently no definition in statue for what a dental specialist is, and the board does not have the authority to define the term. A dentist in Alaska can legally promote themselves as specialist in fields such as orthodontics, oral surgery, endodontistry, etc., even if they have no specialty training in that fields. The board cannot stop this practice if it does not have the authority to set standards for what a specialist is. This lack of authority for the board makes it difficult to police misleading advertisements to the public. 2:08:37 PM MS. MARTIN presented the sectional analysis for SB 173. It read as follow: [Original punctuation provided.] Section 1: Conforming language in AS 08.01.065(c). Section 2: Adds a new section (k) to AS 08.01.065 (Title 8. Business and Professions, Chapter 1. Centralized Licensing, Section 065. Establishment of fees) Requires the Board of Dental Examiners to establish and collect fees on behalf of the Department of Health and Social Services for the inspection of dental radiological equipment. Section 3: Adds new sections to AS 08.36 (Title 8. Business and Professions, Chapter 36. Dentistry) AS 08.36.242. License to practice as a specialist  required. Establishes that a dentist may not advertise using the term "specialist," the name of a specialty, or other phrases that suggest they are a specialist unless they have a specialist license as established. AS 08.36.243. Qualification for specialist; scope of  practice. (a) Establishes that in order to qualify for a specialist licenses a person must (1) Hold a dental license issued by the board and (2) Meet the qualifications of a specialist as established by the board in regulation. (b) In creating the qualifications for a specialist license, the board shall consider the standards of a nationally recognized certifying entity approved by the board. (c) Establishes that a dental specialist can only claim to be a specialist in the specialty they hold a license in. Sec. 08.36.245. Suspension or revocation of specialist license. Establishes that a board may suspend or revoke a specialist license as set by AS 08.36.315. Section 4: Adds a new section (d) to AS 44.29.020 (Title 44. State Government, Chapter 29. Department of Health and Human Services, Section 020. Duties of the Department) Requires DHSS to establish standards of registration, use, record keeping, and inspection of dental radiological equipment in compliance with federal law. Section 5: Conforming language in AS 44.46.029 Section 6: Conforming language in AS 46.03.022 Section 7: Repeals: AS 08.36.075: Section of law requiring the Board of Dental Examiners to set standards for inspection of dental radiological equipment. Placed under DHSS by section 4. AS 18.05.065, AS 18.60.525(e), and AS 44.29.027: Sections of law prohibiting DHSS from regulating dental radiological equipment. Section 8: Allows the Board of Dental Examiners, the Department of Commerce, Community, and Economic Development, and the Department of Health and Social Services to adopt regulations in line with this act. Section 9: Allows the departments and board to immediately begin setting regulations. Section 10: Set a delayed effective date for the rest of the act to July 1, 2023. 2:10:33 PM ACTING CHAIR STEVENS asked for the source of the funds that pay for the inspections. MS. MARTIN replied that the Board of Dental Examiners collects fees to pay for the inspections and those funds are passed on to the Department of Health and Social Services. VICE CHAIR STEVENS asked if the fees are collected from the licensed dentists who have equipment that is inspected. MS. MARTIN answered yes. SENATOR MICCICHE observed that the Department of Commerce, Community and Economic Development (DCCED) fiscal note reflects the need for a new position. He asked if the entire cost of the bill is covered by the licensing fees. MS. MARTIN replied that is the intent, but she would defer to Ms. Chambers. ACTING CHAIR STEVENS turned to invited testimony. 2:12:02 PM DAVID LOGAN, DDS, Executive Director, Alaska Dental Society, Anchorage, Alaska, thanked the sponsor for introducing the bill and the committee for hearing it. He summarized that the bill has two parts: 1) it addresses expert inspections; and 2) it addresses specialty dental licenses. He deferred to Dr. Nielson to speak to why the issue of specialty licenses has been problematic for the board. Speaking to the matter of inspections, he explained that dentists are required to have their x-ray machines inspected by a certified inspector once every six years. This has been difficult. At this time there are no certified inspectors in the state, and by the end of this year some dentists will either be faced with not providing x-rays or operating out of compliance, neither of which is acceptable. 2:13:29 PM SENATOR GRAY-JACKSON thanked Dr. Logan for meeting with her yesterday to explain the bill. VICE CHAIR STEVENS asked how to prevent the potential compliance issue. DR. LOGAN offered his understanding that if the inspections were transferred, the Department of Health and Social Services (DHSS) could promulgate regulations, set the standards, and presumably do the inspections. He noted that dentists could look at the date sticker on their equipment to determine whether or not an inspection was needed. ACTING CHAIR STEVENS asked Ms. Chambers to address the question of funding the inspections. 2:15:15 PM SARA CHAMBERS, Director, Division of Corporations Business and Professional Licensing, Department of Commerce, Community and Economic Development (DCCED), Juneau, Alaska, confirmed that the intention is that the individual dentists will be charged for the inspections and payment will be through fee recovery receipt services. As a general rule, if a program grows the associated costs are borne by the licensees in that industry. She said the DCCED fiscal note looks large but that is primarily because the program has not been operating for several years. She described it as a public safety cost to cover the backlog of uncollected fees. ACTING CHAIR STEVENS asked if she was concerned about x-ray equipment potentially being out of compliance. MS. CHAMBERS replied that as a consumer of dental services and as the director of the division she would like assurance that dental radiological equipment that is in use is safe. She added that while the Board of Dental Examiners has employed different strategies to make this work, it is outside their scope. She posited that it is more appropriate for DHSS to address this missing piece. SENATOR GRAY-JACKSON asked her to speak to the effect the specialty services component will have on Medicaid. MS. CHAMBERS deferred the question to DHSS. 2:18:25 PM ACTING CHAIR STEVENS asked Dr. Nielson if he had any comment on the bill. 2:18:50 PM DAVID NIELSON, DDS, Chair, Alaska Board of Dental Examiners, Anchorage, Alaska, said he had prepared comments on Section 2 and was happy to answer any additional questions, but he thought Dr. Logan and Sara Chambers explained it very well. Moving to Section 3, he explained that the Dental Practice Act repealed specialty licenses in about 2012. The result was that the board stopped investigating false and misleading advertising complaints. To restart these investigations, it is necessary to have specialty license categories that can hold up under legal scrutiny. He highlighted that an accredited dental post-graduate program takes an extra two years of training beyond dental school. He also informed the committee that the board has had to deny a few licenses for specialists who want to come work in Alaska because there is no way to approve such an applications without having a license type that is limited to a specialty area of dentistry. ACTING CHAIR STEVENS asked if there were further questions. 2:21:18 PM SENATOR GRAY-JACKSON said she would like somebody from DHSS to provide information about what effect the specialty services component will have on Medicaid. ACTING CHAIR STEVENS passed the request to the committee aide for follow up. 2:21:48 PM ACTING CHAIR STEVENS opened public testimony on SB 173; finding none, he closed public testimony. Finding no further questions or comments from the committee, he solicited the will of the committee. 2:22:13 PM SENATOR MICCICHE moved to report SB 173, work order 32-LS0865\I, from committee with individual recommendations and attached fiscal note(s). ACTING CHAIR STEVENS found no objection and SB 173 was reported from the Senate Labor and Commerce Standing Committee.