ADHA Access March 2012 : Page 27

T he 2012 legislative session is off to a busy start. To date, legislation affecting dental hygiene is pending in over 30 states. Below is a brief legislative rundown. Arizona Senate Bill 1004, which would allow dental hy-gienists to administer local anesthesia under general, rather than direct, supervision passed the senate on January 19 and moved on to the house. General supervision will require that patients are at least 18 and have been examined within the past 12 months. Also, the hygienist must consult with the dentist regarding any medical history changes since the exam, and the dentist must document approval in the patient’s record. Meanwhile in Florida , House Bill 1313 and its compan-ion Senate Bill 1040, which authorize dental hygienists who complete 60 hours of education to be certi ¿ ed to administer local anesthesia, have been moving through committees in their respective houses. Hawaii House Bill 1876, which would require that dental hy-gienists prominently display their license in the of ¿ ces in which they practice, passed the ¿ rst of two house committees by a vote of 9 to 0 on January 27. The bill is supported by the Hawaii Dental Hygienists’ Association and the Hawaii Board of Dental Examiners. Maryland Senate Bill 344 would allow dental hygienists who have met educational and examination requirements to administer block anesthesia for the provision of dental hygiene procedures under the direct supervision of a dentist. The legisla-tion directs the Maryland State Board of Dental Examiners to develop education and examination requirements. New Hampshire House Bill 1529 would prohibit the intro-duction of À uoride into the public water supply and prohibits the use of any herbicide within 10 miles upgradient of a water intake of a domestic water supply of a city, town or village. New Jersey Assembly Bill 728 and its Senate companion, Senate Bill 1148, would require public schools to include an educational program instructing students on the importance of oral health as part of the core curriculum. New Jersey Assembly Bill 1759 would allow dental hygienists to work under the general supervision of a dentist in a dental of ¿ ce, dental clinic or institution. The bill stipulates that a dental hygienist practicing under general supervision in a dental of ¿ ce or dental clinic may treat only patients who are existing patients of record. Additionally, a dental hygienist is limited to provid-ing À uoride application, pit and ¿ ssure sealants and topical agents for the prevention of oral disease or detection of caries in a school setting, upon any person whom the dental hygien-ist reasonably believes has not received an examination by a duly licensed dentist within the immediately preceding 365-day period. The bill also limits the number of dental hygienists a dentist may supervise under general supervision to three dental hygienists at one time. New Jersey Senate Bill 670 would allow graduates of foreign dental schools who pass an examination to qualify for dental hygiene licensure. The New Jersey Public Water Supply Fluoridation Act, Assem-bly Bill 1811, requires the À uoridation of all public community water systems in New Jersey. New York Assembly Bill 111 would authorize dental hygien-ists to provide dental hygiene services without supervision in collaboration with a dentist under a collaborative practice agree-ment. The dental hygienist must provide the patient a written statement indicating the dental hygiene services provided are not a substitute for a dental examination by a dentist. If the dental hygienist makes a referral to the patient for further care by a dentist, the hygienist must ¿ ll out a referral form and pro-vide a copy to the collaborating dentist. Assembly Bill 7750 would allow out-of-state licensed dental hygienists to practice in New York on a voluntary basis. In order to do so, the dental hygienist must be sponsored by an organi-zation registered with the Department of Health. The volunteer licensee shall not receive any compensation for their services. Under New York Assembly Bill 8073, any dentist or dental hygienist using X-rays on the mouth of a patient under 18 would be required to use only digital radiography. Legislation has been introduced in Oklahoma (House Bill 2263/Senate Bill 1405) to increase the number of dental hygienist members of the board from one to three. The number of dentist members (eight) and public members (two) would not be changed. Rhode Island House Bill 7078 would add one certi ¿ ed dental assistant member to the Rhode Island Board of Examin-ers in Dentistry. The board is currently composed of six licensed dentists, four public members, two dental hygienists, and the chief of the Of ¿ ce of Dental Public Health. Tennessee House Bill 2775 would authorize collaborative practice between dentists and dental hygienists outside the private dental of ¿ ce. Virginia Senate Bill 146 seeks to expand remote supervi-sion program that allows licensed dental hygienists employed by the Department of Health to provide educational and preventive dental care pursuant to a standing protocol under the remote supervision of a dentist. If passed, dental hygienists working with this protocol will be able to provide care throughout the Commonwealth of Virginia.  Identical bills have been introduced in Washington State to license dental practitioners and dental hygiene practitioners, both of whom would provide a number of basic restorative services according to a “practice plan” made with a dentist. } Vermont House Bill 615 would task the commissioner of health to design a community dental health coordinator (CDHC) pilot project in which the CDHC may provide educational ser-vices, preventive and limited palliative care services, and dental assessment services in a variety of settings under the supervi-sion of a dentist, meaning the dentist has authorized the proce-dures. The commissioner shall submit design recommendations for the pilot project to the house committee on health care and senate committee on health and welfare no later than January 15, 2013. While the commissioner is charged with designing the pilot, the scope of practice for this provider is laid out in the legislation. It includes placing temporary and sedative restor-ative material in unexcavated carious lesions and unprepared tooth fractures; collecting and transmitting diagnostic data and images via a telemetric connection; dispensing and applying medications on the speci ¿ c order of a dentist; and providing limited services for dental emergencies, in consultation with a supervising dentist. A CDHC is de ¿ ned as a dental assistant, dental hygienist or other trained dental professional certi ¿ ed by the commissioner of health. Following the 2011 regular session of the West Virginia Legislature, the Joint Committee on Health was established to study a number of resolutions during the course of the 2011-2012 interim period. The committee was very interested in improving oral health in West Virginia and recommended that legislation be introduced to create a loan forgiveness program and expand the role of the dental hygienist in public health. As such, West Virginia House Bill 2052 and House Bill 4077 were introduced. HB 2052 would create a student loan forgiveness program that allows dentists and dental hygienists who received a stu-dent loan and practiced in a dental health professional area es-tablished by the Division of Health to cancel $5,000 for every 12 months of service. House Bill 4077/Senate Bill 187 would allow access MAR 2012 27

Stateline

The 2012 legislative session is off to a busy start. To date, legislation affecting dental hygiene is pending in over 30 states. Below is a brief legislative rundown. Arizona Senate Bill 1004, which would allow dental hygienists to administer local anesthesia under general, rather than direct, supervision passed the senate on January 19 and moved on to the house. General supervision will require that patients are at least 18 and have been examined within the past 12 months. Also, the hygienist must consult with the dentist regarding any medical history changes since the exam, and the dentist must document approval in the patient’s record. Meanwhile in Florida, House Bill 1313 and its companion Senate Bill 1040, which authorize dental hygienists who complete 60 hours of education to be certi..ed to administer local anesthesia, have been moving through committees in their respective houses. Hawaii House Bill 1876, which would require that dental hygienists prominently display their license in the of..ces in which they practice, passed the ..rst of two house committees by a vote of 9 to 0 on January 27. The bill is supported by the Hawaii Dental Hygienists’ Association and the Hawaii Board of Dental Examiners. Maryland Senate Bill 344 would allow dental hygienists who have met educational and examination requirements to administer block anesthesia for the provision of dental hygiene procedures under the direct supervision of a dentist. The legislation directs the Maryland State Board of Dental Examiners to develop education and examination requirements. New Hampshire House Bill 1529 would prohibit the introduction of fluoride into the public water supply and prohibits the use of any herbicide within 10 miles upgradient of a water intake of a domestic water supply of a city, town or village. New Jersey Assembly Bill 728 and its Senate companion, Senate Bill 1148, would require public schools to include an educational program instructing students on the importance of oral health as part of the core curriculum. New Jersey Assembly Bill 1759 would allow dental hygienists to work under the general supervision of a dentist in a dental office, dental clinic or institution. The bill stipulates that a dental hygienist practicing under general supervision in a dental office or dental clinic may treat only patients who are existing patients of record. Additionally, a dental hygienist is limited to providing fluoride application, pit and plssure sealants and topical agents for the prevention of oral disease or detection of caries in a school setting, upon any person whom the dental hygienist reasonably believes has not received an examination by a duly licensed dentist within the immediately preceding 365-day period. The bill also limits the number of dental hygienists a dentist may supervise under general supervision to three dental hygienists at one time. New Jersey Senate Bill 670 would allow graduates of foreign dental schools who pass an examination to qualify for dental hygiene licensure. The New Jersey Public Water Supply Fluoridation Act, Assembly Bill 1811, requires the fluoridation of all public community water systems in New Jersey. New York Assembly Bill 111 would authorize dental hygienists to provide dental hygiene services without supervision in collaboration with a dentist under a collaborative practice agreement.The dental hygienist must provide the patient a written statement indicating the dental hygiene services provided are not a substitute for a dental examination by a dentist. If the dental hygienist makes a referral to the patient for further care by a dentist, the hygienist must fill out a referral form and provide a copy to the collaborating dentist. Assembly Bill 7750 would allow out-of-state licensed dental hygienists to practice in New York on a voluntary basis. In order to do so, the dental hygienist must be sponsored by an organization registered with the Department of Health. The volunteer licensee shall not receive any compensation for their services. Under New York Assembly Bill 8073, any dentist or dental hygienist using X-rays on the mouth of a patient under 18 would be required to use only digital radiography. Legislation has been introduced in Oklahoma (House Bill 2263/Senate Bill 1405) to increase the number of dental hygienist members of the board from one to three. The number of dentist members (eight) and public members (two) would not be changed. Rhode Island House Bill 7078 would add one certified dental assistant member to the Rhode Island Board of Examiners in Dentistry. The board is currently composed of six licensed dentists, four public members, two dental hygienists, and the chief of the Office of Dental Public Health. Tennessee House Bill 2775 would authorize collaborative practice between dentists and dental hygienists outside the private dental office. Virginia Senate Bill 146 seeks to expand remote supervision program that allows licensed dental hygienists employed by the Department of Health to provide educational and preventive dental care pursuant to a standing protocol under the remote supervision of a dentist. If passed, dental hygienists working with this protocol will be able to provide care throughout the Commonwealth of Virginia. Vermont House Bill 615 would task the commissioner of health to design a community dental health coordinator (CDHC) pilot project in which the CDHC may provide educational services, preventive and limited palliative care services, and dental assessment services in a variety of settings under the supervision of a dentist, meaning the dentist has authorized the procedures.The commissioner shall submit design recommendations for the pilot project to the house committee on health care and senate committee on health and welfare no later than January 15, 2013. While the commissioner is charged with designing the pilot, the scope of practice for this provider is laid out in the legislation. It includes placing temporary and sedative restorative material in unexcavated carious lesions and unprepared tooth fractures; collecting and transmitting diagnostic data and images via a telemetric connection; dispensing and applying medications on the specific order of a dentist; and providing limited services for dental emergencies, in consultation with a supervising dentist. A CDHC is defined as a dental assistant, dental hygienist or other trained dental professional certified by the commissioner of health. Following the 2011 regular session of the West Virginia Legislature, the Joint Committee on Health was established to study a number of resolutions during the course of the 2011- 2012 interim period. The committee was very interested in improving oral health in West Virginia and recommended that legislation be introduced to create a loan forgiveness program and expand the role of the dental hygienist in public health. As such, West Virginia House Bill 2052 and House Bill 4077 were introduced. HB 2052 would create a student loan forgiveness program that allows dentists and dental hygienists who received a student loan and practiced in a dental health professional area established by the Division of Health to cancel $5,000 for every 12 months of service. House Bill 4077/Senate Bill 187 would allow A dental hygienist to place sealants on the teeth of a patient without prior examination of a licensed dentist. Identical bills have been introduced in Washington State (House Bill 2226 and Senate Bill 6126) to license dental practitioners (DPs) and dental hygiene practitioners (DHPs), both of whom would provide a number of basic restorative services according to a “practice plan” made with a dentist. The legislation has the support of the Washington State Dental Hygienists’ Association and the Washington Children’s Alliance (which has partnered with the Kellogg Foundation). The DP would complete an approximately two-year didactic and clinical program based on the Alaska Dental Health Aide Therapist (DHAT) education. (DHATs practice exclusively in Native American facilities in Alaska, but the DHAT educational program was developed in and is currently headquartered in Washington State). Upon completion, the DP would begin a 400-hour preceptorship program with a dentist. The DHP requires licensure as a dental hygienist and a one-year post-baccalaureate program (which Eastern Washington State University is prepared to offer) as well as 250 hours of clinical practice under the supervision of a dentist. The DHP program would be approved by the dental hygiene committee, which writes the rules concerning dental hygiene education. Both the DP and the DPH will have the same dental therapist model restorative scope, but only DHPs will also be allowed to provide dental hygiene services. Both would practice according to a practice plan with a dentist, although the DP would also need the “off-site supervision” of a dentist. The practice plan would describe settings, limitations on services, practice protocols, procedures concerning records, a medical emergency plan, a quality assurance plan, a plan for administering and dispensing medication, criteria for patients with specific medical conditions and a protocol for patients requiring services beyond the practitioner’s scope. The Department of Health and the Dental Quality Assurance Commission will have rulemaking authority over DP and DHP practice. One DP and one DHP would be added to the current dental board of 12 dentists, two Expanded Functions Dental Assistants and two public members. To follow the progress of these bills as well as bills currently pending in your state and across the country, visit ADHA’s online legislative tracker. This dynamic web resource allows users to view and follow the progress of legislation by state or by subject matter. Bills are added to the legislative tracker daily. Stateline is prepared by the ADHA Division of Governmental Affairs.

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