Legislature(2017 - 2018)BELTZ 105 (TSBldg)

04/17/2018 01:30 PM Senate LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved CSHB 346(L&C) Out of Committee
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved SB 160 Out of Committee
                HB 346-DENTIST: TEMPORARY PERMIT                                                                            
1:33:26 PM                                                                                                                    
CHAIR COSTELLO  announced the consideration  of HB 346  and noted                                                               
that  the  committee previously  heard  the  companion bill.  She                                                               
stated  her  intention  to  move the  bill  after  taking  public                                                               
1:33:44 PM                                                                                                                    
REPRESENTATIVE SAM  KITO III,  Alaska State  Legislature, Juneau,                                                               
Alaska,   sponsor   of   HB  346   introduced   the   legislation                                                               
paraphrasing the following sponsor statement:                                                                                   
     House Bill 346  would allow the Alaska  Board of Dental                                                                    
     Examiners  to grant  temporary licenses  when a  dental                                                                    
     specialist is  suddenly incapacitated  or when  a small                                                                    
     community does not have access to specialized care.                                                                        
     Alaska  has a  limited  number  of dental  specialists,                                                                    
     many of  whom serve  multiple small  communities. There                                                                    
     are nine dental specialties  as defined by the American                                                                    
     Dental   Association:   oral   surgery,   orthodontics,                                                                    
     periodontics   (gums),   endodontics   (root   canals),                                                                    
     pedodontics  (kids), prosthodontics  (replacing teeth),                                                                    
     public health,  , oral  pathology (oral  diseases), and                                                                    
     oral radiology (x-rays); however,  Alaska does not have                                                                    
     a  single  specialist in  oral  radiology.  Of the  647                                                                    
     licensed   dentists  in   Alaska,   136  dentists   are                                                                    
     Dental specialists in Alaska  are limited in number and                                                                    
     have  full  schedules.  If  a  specialist  is  suddenly                                                                    
     incapacitated, there  is no reserve  to draw  from, and                                                                    
     multiple small communities  could be without specialist                                                                    
     care for an extended  period of time. Small communities                                                                    
     have   historically   had   a  hard   time   recruiting                                                                    
     healthcare  practioners  and  the  trend  seems  to  be                                                                    
     Temporary dental licenses would  allow the Alaska Board                                                                    
     of Dental  Examiners to maintain  dental care  in these                                                                    
     communities  until a  full-time dentist  can be  found.                                                                    
     The board is ideally qualified  to evaluate the need to                                                                    
     circumvent   transitional   licensing  procedures   for                                                                    
     dentists in exceptional circumstances.                                                                                     
     HB 346 will  allow temporary licenses to  be granted in                                                                    
     times of need at the  discretion of the Alaska Board of                                                                    
     Dental Examiners.                                                                                                          
REPRESENTATIVE KITO III advised that  the bill was changed in the                                                               
other body  to give the board  the authority to bring  a licensed                                                               
dentist  from another  jurisdiction to  Alaska to  fill in  for a                                                               
short period of time. One  extension is allowed but the temporary                                                               
dentist would  need to get an  Alaska license if they  spend more                                                               
time working in Alaska.                                                                                                         
1:36:29 PM                                                                                                                    
SENATOR GARDNER  asked if he  anticipates that a lot  of dentists                                                               
will be interested in taking advantage of this opportunity.                                                                     
REPRESENTATIVE   KITO   III   deferred  the   question   to   the                                                               
representative from the dental society.  He shared his experience                                                               
when  the  Southeast Alaska  Regional  Health  Center was  having                                                               
difficulty recruiting  a dentist  to come  to Juneau,  and opined                                                               
that this provision  might have allowed SEARHC  to bring somebody                                                               
in temporarily to fill the gap.                                                                                                 
SENATOR GARDNER asked if he  envisions the pool of dentists would                                                               
be those who are already licensed  - but perhaps not practicing -                                                               
and interested in coming to Alaska for a limited period.                                                                        
REPRESENTATIVE KITO replied the target  pool was dentists who are                                                               
not licensed in Alaska.                                                                                                         
SENATOR GARDNER  directed attention to  the provision on  page 2,                                                               
lines 3-5.  It says the temporary  permit is valid only  to treat                                                               
patients of  the incapacitated dentist  at the address  listed on                                                               
the business  license of the  incapacitated dentist.  Noting that                                                               
the companion bill  had the same problematic  language, she asked                                                               
what would  happen if the  incapacitated dentist did  business in                                                               
more than one location.                                                                                                         
REPRESENTATIVE  KITO   III  said  he  suspects   the  bill  would                                                               
accommodate  the  emergency  replacement  of a  dentist  who  had                                                               
offices  in  more than  one  location.  However, if  each  office                                                               
offered  different specialty  services,  the replacement  dentist                                                               
may not  have both  specialties. He  deferred further  comment to                                                               
the board.                                                                                                                      
CHAIR  COSTELLO said  she assumes  each location  has a  business                                                               
license,  and  her reading  is  that  the bill  does  contemplate                                                               
multiple locations.                                                                                                             
SENATOR GARDNER  observed that the  license is for  the facility,                                                               
not the individual.                                                                                                             
CHAIR COSTELLO  added that the  bill is written to  accommodate a                                                               
dentist who has multiple licenses.                                                                                              
SENATOR  MEYER  asked  if other  states  grant  temporary  dental                                                               
REPRESENTATIVE KITO III said he didn't know.                                                                                    
CHAIR COSTELLO asked  Sarah Chambers to respond  to any questions                                                               
she'd heard.                                                                                                                    
1:41:34 PM                                                                                                                    
SARAH  CHAMBERS,  Deputy   Director,  Division  of  Corporations,                                                               
Business  and  Professional  Licensing, Department  of  Commerce,                                                               
Community  and  Economic  Development  (DCCED),  Juneau,  Alaska,                                                               
confirmed that  businesses must maintain  a business  license for                                                               
each location. Thus, someone with  a temporary permit could cover                                                               
the dental office of the incapacitated dentist.                                                                                 
CHAIR COSTELLO asked if the  administration had a position on the                                                               
MS. CHAMBERS replied the administration  has not taken a position                                                               
on the bill but the dental board supports it.                                                                                   
SENATOR MEYER asked what it costs for a temporary permit.                                                                       
MS.  CHAMBERS explained  that a  typical temporary  permit for  a                                                               
health care profession  ranges from $50 to $100. It  would not be                                                               
cost prohibitive.                                                                                                               
SENATOR  MEYER noted  that  the fiscal  note  reflects $2,600  in                                                               
receipt services.                                                                                                               
MS.  CHAMBERS explained  that those  services would  generally be                                                               
covered by the licensing fees.                                                                                                  
CHAIR  COSTELLO  asked  if  the board  could  call  an  emergency                                                               
meeting to approve an emergency license.                                                                                        
MS.  CHAMBERS replied  the Administrative  Procedures Act  allows                                                               
all boards to call a teleconference meeting within five days.                                                                   
1:44:32 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on HB 346.                                                                               
1:44:57 PM                                                                                                                    
DR.  PAUL SILVEIRA,  Board of  Dental Examiners,  Valdez, Alaska,                                                               
stated that  the board  supports HB 346  to expedite  a temporary                                                               
permit to help an incapacitated dentist.                                                                                        
1:45:23 PM                                                                                                                    
DR.  DAVID  LOGAN,  Executive Director,  Alaska  Dental  Society,                                                               
Juneau  Alaska,  stated that  the  Alaska  Dental Society  is  in                                                               
strong  support of  HB 346.  He cited  examples of  the need  for                                                               
temporary  permits to  fill in  for dental  specialists who  were                                                               
unexpectedly incapacitated.  One had a  stroke and another  had a                                                               
major traffic accident. This isn't  a common occurrence, he said,                                                               
but  a temporary  permit is  a necessary  tool for  the board  to                                                               
maintain continuous  dental health  care in Alaska.  Unlike other                                                               
states,  Alaskans  can't easily  move  to  another community  for                                                               
treatment.  It  is more  effective  to  bring  one dentist  to  a                                                               
community than flying members of  a community to another location                                                               
for treatment. He  reiterated that this would be  a valuable tool                                                               
for the board.                                                                                                                  
1:47:08 PM                                                                                                                    
SENATOR MEYER asked how this would work.                                                                                        
DR.  LOGAN  said  the  expectation   is  that  the  incapacitated                                                               
specialist or  their designee would put  somebody's name forward.                                                               
He  posited   that  they  would  pull   from  former  classmates,                                                               
colleagues, and friends in the field.                                                                                           
SENATOR MEYER asked  if someone would need to  obtain a temporary                                                               
permit before they could be considered as a replacement.                                                                        
DR LOGAN said  the expectation is the name would  be submitted to                                                               
the board for  temporary license approval. If  the board approved                                                               
the   name,  the   individual  would   take  over   the  practice                                                               
SENATOR MEYER asked if it would be a fairly quick process.                                                                      
DR LOGAN  said it  could be  fairly quick. The  board is  able to                                                               
meet  on  an  emergency  basis  and  it  can  also  circulate  an                                                               
application  amongst the  members for  approval. This  might take                                                               
just a week, which isn't an unrealistic gap.                                                                                    
1:49:55 PM                                                                                                                    
CHAIR COSTELLO closed public testimony on HB 346.                                                                               
1:50:07 PM                                                                                                                    
SENATOR MEYER moved to report the  CS for HB 346, version D, from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
CHAIR COSTELLO  found no objection  and CSHB 346(L&C)  moved from                                                               
the Senate Labor and Commerce Standing Committee.                                                                               

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