STATE BOARD OF DENTISTRY [49 PA. CODE CH. 33] Application Fees [31 Pa.B. 5714] The State Board of Dentistry (Board) proposes to amend § 33.3 (relating to fees) by revising certain application fees to read as set forth in Annex A.
A. Effective Date
The amendment will be effective upon publication of the final-form regulation in the Pennsylvania Bulletin.
B. Statutory Authority
The proposed amendment is authorized under section 4(b) of the Dental Law (law) (63 P. S. § 123(b)).
C. Background and Purpose
The law requires the Board to set fees by regulation so that revenues meet or exceed expenditures over a biennial period. General operating expenses of the Board for services that are provided directly to individual licensees or applicants are excluded from general operating revenues and are funded through fees in which the cost of providing the service forms the basis for the fee.
In a recent systems audit of the operations of the Board within the Bureau of Professional and Occupational Affairs (Bureau), the fees for services to licensees and applicants were analyzed to determine if the fees reflected the actual cost of providing the services. Actual cost calculations are based upon the following formula:
Number of minutes to perform the function
×
Pay rate for the classification of personnel performing the function
+
A proportionate share of administrative overhead
The analysis, with regard to the Board, determined that there are currently no fees for two services, which do not support the actual cost of providing those services: application for dental radiology authorization and notification application--postgraduate training or faculty member.
Section 11.4 of the law (63 P. S. § 130e) provides that no auxiliary personnel may perform radiologic procedures unless under the direct supervision of the dentist who is on the premises at the time that the X-ray is taken, and unless the person has passed the radiologic examination. Section 33.302 (relating to auxiliary personnel performing radiologic procedures) implements these provisions. Persons who have passed the Board approval dental radiologic procedure examination file an application requesting authorization to perform those radiologic procedures under the direct supervision of a dentist. A letter of authorization is issued by the Board.
Section 2(d) of the law (63 P. S. § 121(d)) allows dentists who are licensed in another state or country to practice without Pennsylvania licensure in this Commonwealth for the limited purpose of teaching, including clinical teaching, in a dental school or advanced dental education program in this Commonwealth approved by the Board after notification to the Board and in accordance with Board regulations. Section 2(f) of the law also allows the practice of dentistry without a license by persons in a dental clinic operated not for profit during the duration of an internship, residency or other approved graduate training program, by persons with the required education for admission into the program, and after notification to the Board.
In this proposal, fees for the services identified previously would be adjusted to allocate costs to those who use the service or make application. The Board would continue to apportion enforcement and operating costs to the general licensing population by means of its license renewal fee through the biennial reconciliation of revenue and expenditures.
Administrative Overhead
During reviews of similar proposed application fee regulations for other boards, the Independant Regulatory Review Commission (IRRC) requested that the Bureau and the boards: (1) itemize the overhead cost to be recouped by the fees; and (2) reexamine the method that is used to determine the administrative overhead factor for each fee.
IRRC commented that although the Bureau's method was reasonable, there was no assurance that the fees would recover the actual overhead cost because the charge was not related to the service, and because the charge was based on the actual rather than the projected expenditures. IRRC also commented that there was no certainty that the projected revenues would meet or exceed projected expenditures over a 2-year period, as required under enabling statutes.
In computing overhead charges, the boards and the Bureau include expenses resulting from service of support staff operations, equipment, technology initiatives or upgrades, leased office space and other sources not directly attributable to a specific board. Once determined, the Bureau's total administrative charge is apportioned to each board based upon the board's share of the total active licensee population. In turn, the board's administrative charge is divided by the number of active licensees to calculate a ''per application'' charge which is added to direct personnel cost to establish the cost of processing. The administrative charge is consistently applied to every application regardless of how much time the staff spends processing the application.
This method of calculating administrative overhead to be apportioned to fees for services was first included in the biennial reconciliation of fees and expenses conducted in 1988-89. In accordance with the regulatory review, the method was approved by the Senate and House Standing Committees and IRRC as reasonable and consistent with the legislative intent of statutory provisions which require the Board to establish fees which meet or exceed expenses.
IRRC suggested that within each board, the administrative charge should be determined by the amount of time required to process each application. For example, an application requiring ½ hour of processing time would pay one-half as much overhead charge as an application requiring 1 hour of processing time. The Bureau concurs with IRRC that by adopting this methodology the Bureau and the boards would more nearly and accurately accomplish their objective of setting fees that cover the cost of the service. Therefore, in accordance with IRRC's suggestions, the Bureau conducted a test to compare the resulting overhead charges obtained by applying the IRRC suggested time factor versus the current method.
This review of board operations showed that approximately 25% of staff time was devoted to providing services described in the regulations. The current method recouped 22% to 28% of the administrative overhead charges versus 25% recouped using a ratio-based time factor. However, when the time factor is combined with the licensing population for each board, the resulting fees vary widely even though different licensees may receive the same services, for example, using the time-factor method to issue a verification of licensure would cost $34.58 for a landscape architect as compared with a cost of $10.18 for a cosmetologist. Conversely, under the Bureau method the administrative overhead charge of $9.76 represents the cost of processing a verification application for all licensees in the Bureau. Also, the Bureau found that employing a time factor in the computation of administrative overhead would result in a different amount of overhead charge being made for each fee proposed.
With regard to IRRC's suggestions concerning projected versus actual expenses, the boards note that the computation of projected expenditures based on amount actually expended has been the basis for biennial reconciliations for the past 12 years. During these 6 biennial cycles, the experience of both the boards and the Bureau has established that verifiable data can be substantiated by collective bargaining agreements, pay scales and cost benefit factors. This method has provided a reliable basis for fees. Also, the fees are kept at a minimum for licensees, but appear adequate to sustain the operations of the boards over an extended period. Similarly, accounting, recordkeeping and swift processing of applications, renewals and other fees were the primary basis for ''rounding up'' the actual costs to establish a fee. This rounding up process has in effect resulted in the necessary but minimal cushion or surplus to accommodate unexpected needs and expenditures.
For these reasons, the boards have not made changes in the method by which administrative expenditures are allocated and the resulting fees will remain as proposed.
D. Description of Services
Professional licensing boards other than the Board have also been proposing revisions to nonrenewal fees. Review of the proposed new fee regulations by the House Professional Licensure Committee and Senate Consumer Protection and Professional License Committee indicated that certain explanations of the services for which fees are charged would be helpful for an understanding of the need to set appropriate fees.
Application Fee for Dental Radiology Authorization
This fee is necessary to offset costs incurred by the Board to process a request for authorization to perform radiologic procedures under the direct supervision of a dentist.
Applicants apply to and are examined by a professional testing contractor. Candidates who pass the examination are reported to the Bureau by the contractor. This information is entered into the Bureau's database and an authorization letter is issued to the applicant. The information must be maintained in the database perpetually, for informational purposes and also for providing duplication authorization letters upon request. This fee is the only contribution applicants make to the operational expenses of the Board since the authorization is not subject to renewal. The administrative overhead charge has been averaged for the boards offering the radiology examination.
Notification Application--Postgraduate Training or Faculty Member
This fee is necessary to offset costs incurred by the Board to process a notification application for postgraduate training or faculty member.
The Board receives the application and supporting documents, reviews for completeness, contacts the applicant to request any missing information or documents, or both, confirms the status of the applicant's license in another state or foreign education, if applicable, and issues a letter of authorization, or discrepancy notice, as appropriate.
G. Description of Proposed Amendments
A $20 fee would be established for Board authorization to perform radiologic procedures under the direct supervision of a dentist. A $25 fee is proposed to issue an approval of training.
H. Compliance with Executive Order 1996-1
In accordance with Executive Order 1996-1 (February 6, 1996), in drafting and promulgating the proposed amendment, the Board considered the least restrictive alternative to regulate costs for services requested by licensees and applicants. The Board solicited predraft comments from 133 dental organizations, schools and individuals on July 18, 2001.
I. Fiscal Impact and Paperwork Requirements
The proposed rulemaking will have no adverse fiscal impact on the Commonwealth or its political subdivisions. The fees will have a modest fiscal impact on those members of the private sector who apply for services from the Board. The amendments will impose no additional paperwork requirements upon the Commonwealth, political subdivisions or the private sector.
J. Sunset Date
The Board continuously monitors the cost effectiveness of its regulations. Therefore, no sunset date has been assigned.
K. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on September 27, 2001, the Board submitted a copy of this proposed rulemaking to the House Professional Licensure Committee, the Senate Consumer Protection and Professional Licensure Committee and IRRC. In addition to submitting the proposed rulemaking, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
If IRRC has objections to any portion of the proposed rulemaking, it will notify the Board within 10 days after the expiration of the Committees' review period. The notification shall specify detailed procedures for review, prior to final publication of the regulation, by the Board, the General Assembly and the Governor, of objections raised.
L. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed amendment to Lisa Burns, Administrator, State Board of Dentistry, P. O. Box 2649, Harrisburg, PA 17105-2649, within 30 days of publication of this proposed rulemaking. Please reference No. 16A-4611 (Application Fees), when submitting comments.
NORBERT O. GANNON, D.D.S.,
ChairpersonFiscal Note: 16A-4611. No fiscal impact; (8) recommends adoption.
Annex A TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS PART I. DEPARTMENT OF STATE Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS CHAPTER 33. STATE BOARD OF DENTISTRY Subchapter A. GENERAL PROVISIONS § 33.3. Fees.
Following is the schedule of fees charged by the Board:
* * * * * Application fee--dental radiology authorization $20
Notification application--postgraduate training or faculty member $25
[Pa.B. Doc. No. 01-1838. Filed for public inspection October 12, 2001, 9:00 a.m.]
