Authorizes dental hygienists to provide such services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.
TITLE OF BILL: An act to amend the education law, in relation to registered dental hygienists working without supervision but within a collaborative practice agreement with a licensed dentist
PURPOSE: To create the category of registered dental hygienist, collaborative practice, which authorizes dental hygienists to practice without supervision but within a collaborative practice agreement with a licensed dentist.
SUMMARY OF PROVISIONS:
Section one adds a new section 6607-a to the education law which creates and defines the practice of collaborative practice dental hygiene. This section provides that the practice of dental hygiene may be performed in collaboration with a licensed dentist provided such services are performed in accordance with a written practice agreement and written practice protocols.
This section also establishes the required content and procedures pertaining to the written collaborative practice agreement and collaborative practice arrangements.
Section one of this bill also requires dental hygienists to provide a patient with a written statement advising the patient that dental hygiene services are not a substitute for a dental examination by a licensed dentist, and to make referrals for further dental procedures as necessary.
Section two provides for the immediate enactment of this bill.
JUSTIFICATION: According to the Department of Health's Oral Health Plan for New York State (2005), approximately 50% of children in New York experience tooth decay by the third grade and about 18% of New Yorkers 65 years and older have lost all their teeth. Because of current disparities that exist in oral health, these numbers are even higher among low-income and minority populations. Increasing access to dental hygiene services will help to ensure that all New Yorkers are able to receive quality oral healthcare.
Dental hygienists fulfill a critical role in the provision of dental care, both in private-practice and public health settings. In fact, a 2010 report issued by the Pew Center on the States found that adding dental hygienists to a practice enables most private-practice dentists to serve more patients while increasing profitability and productivity. With the enactment of the federal health care reform law in 2010, which will extend dental insurance to an estimated 5.3 million more children nationally by 2014, patient demand for dental care will continue to increase. Thus, it is imperative that dental hygienists' skills and training are fully utilized freeing up dentists to treat more patients.
Medicaid Redesign Team (MRT) supports this action as one of its top five priorities of their twelve final recommendations. According to the 2011 published recommendations from MRT, this bill will allow fox the maximum utilization of the dental hygienists in New York State, in keeping with their education, training, and expertise as oral health prevention specialists. Collaborative Practice will serve to improve the oral health status of New Yorkers and promote the prevention of disease and oral health.
Collaborative practice is another way to increase access to dental hygiene care and disease prevention. Collaborative practice dental hygienists would be able to practice, pursuant to the terms of the collaborative practice agreement, without the supervision of the dentist. This makes it much easier for dental hygienists to practice in under served communities, where there is a great need for prophylactic treatments and oral health counseling. Collaborative practice dental hygienists would also screen patients for disease and refer them to the collaborating dentist for dental examinations and other treatments. This creates more opportunities for New Yorkers to receive dental hygiene care, and decreases their risk of developing oral disease and tooth decay.
Moreover this bill requires registered dental hygienist to apply for a new certification with the New York State Education Department for Collaborative Practice (RDH-CP). As a prerequisite, three years experience and continuing education requirements are provided for.
LEGISLATIVE HISTORY: S7353 of 2012 - referred to education
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 1944 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________Introduced by Sen. RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education AN ACT to amend the education law, in relation to registered dental hygienists working without supervision but within a collaborative practice agreement with a licensed dentist THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The education law is amended by adding a new section 6607-a to read as follows: S 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 1. THE PRACTICE OF THE PROFESSION OF DENTAL HYGIENE, AS DEFINED UNDER THIS ARTICLE, MAY BE PERFORMED IN COLLABORATION WITH A LICENSED DENTIST PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRAC- TICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A COLLABO- RATIVE PRACTICE AGREEMENT. UNDER A COLLABORATIVE PRACTICE AGREEMENT, DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU- LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND MAY BE PERFORMED WITHOUT SUPERVISION IN A COLLABORATIVE PRACTICE SETTING. 2. (A) THE COLLABORATIVE PRACTICE AGREEMENT SHALL INCLUDE CONSIDER- ATION FOR MEDICALLY COMPROMISED PATIENTS, SPECIFIC MEDICAL CONDITIONS, AND AGE- AND PROCEDURE-SPECIFIC PRACTICE PROTOCOLS, INCLUDING, BUT NOT LIMITED TO RECOMMENDED INTERVALS FOR THE PERFORMANCE OF DENTAL HYGIENE SERVICES AND A PERIODICITY IN WHICH AN EXAMINATION BY A DENTIST SHOULD OCCUR. (B) THE COLLABORATIVE AGREEMENT SHALL BE: (I) SIGNED AND MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST, AND THE FACILITY, PROGRAM, OR ORGANIZATION;EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06537-01-3 S. 1944 2
(II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN- IST; AND (III) MADE AVAILABLE TO THE DEPARTMENT AND OTHER INTERESTED PARTIES UPON REQUEST. (C) ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE AT A TIME. 3. BEFORE PERFORMING ANY SERVICES AUTHORIZED UNDER THIS SECTION, A DENTAL HYGIENIST MUST PROVIDE THE PATIENT WITH A WRITTEN STATEMENT ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A SUBSTITUTE FOR A DENTAL EXAMINATION BY A LICENSED DENTIST. IF THE DENTAL HYGIENIST MAKES ANY REFERRALS TO THE PATIENT FOR FURTHER DENTAL PROCE- DURES, THE DENTAL HYGIENIST MUST FILL OUT A REFERRAL FORM AND PROVIDE A COPY OF THE FORM TO THE COLLABORATING DENTIST. 4. THE COLLABORATIVE PRACTICE DENTAL HYGIENIST MAY ENTER INTO A CONTRACTUAL ARRANGEMENT WITH ANY NEW YORK STATE LICENSED AND REGISTERED DENTIST, HEALTH CARE FACILITY, PROGRAM, AND/OR NON-PROFIT ORGANIZATION TO PERFORM DENTAL HYGIENE SERVICES IN THE FOLLOWING SETTINGS: DENTAL OFFICES; LONGTERM CARE FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR PRIVATE SCHOOLS; PUBLIC HEALTH AGENCIES/FEDERALLY QUALIFIED HEALTH CENTERS; CORRECTIONAL FACILITIES; PUBLIC INSTITUTIONS/MENTAL HEALTH FACILITIES; AND PRIVATE SETTINGS IN WHICH HOMEBOUND RESIDENTS ARE UNABLE TO BE RELOCATED FOR NECESSARY TREATMENT. 5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO MORE THAN SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS. THE DEPARTMENT MAY GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON A CASE-BY-CASE BASIS. 6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE NEW YORK STATE EDUCATION DEPARTMENT TO PRACTICE AS A REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) AND PAY A FEE SET BY THE DEPARTMENT. AS A CONDITION OF COLLABORATIVE PRACTICE, THE DENTAL HYGIENIST MUST HAVE BEEN ENGAGED IN PRACTICE FOR THREE YEARS WITH A MINIMUM OF FOUR THOUSAND FIVE HUNDRED PRACTICE HOURS AND MUST COMPLETE AN EIGHT HOUR CONTINUING EDUCATION PROGRAM THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCE- DURES, RISK MANAGEMENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL ETHICS. S 2. This act shall take effect immediately.