Relates to registered dental hygienists.
TITLE OF BILL: An act to amend the education law, in relation to registered dental hygienists
PURPOSE: To authorize dental hygienists to practice without supervision but within a collaborative practice agreement with a licensed dentist.
SUMMARY OF PROVISIONS:
Section one mandates that a dental hygienist shall not administer or monitor nitrous oxide analgesia or local infiltration anesthesia in the practice of dental hygiene without a proper certificate and except under the personal supervision of a dentist.
Section two defines the practice of dental hygiene. This section also provides that a registered dental hygienist working for a hospital may practice pursuant to a collaborative practice agreement with a licensed dentist.
Section three defines the practice of certified dental assisting as the provision of supportive services to a dentist in his/her performance of dental services. This section provides that these supportive services may be performed by a registered dental hygienist who practices in collaboration with a licensed dentist.
Section four extends the requirement to be certified in cardiopulmonary resuscitation (CPR) and maintain current certification to registered dental hygienists who practice in collaboration with a licensed dentist.
Section five provides that this act shall take effect April 1, 2014.
JUSTIFICATION: According to the Department of Health's Oral Health Plan for New York State (2005), approximately 50 percent of children in New York State experience tooth decay by the third grade and about 18 percent of adult 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. A 2010 report by the Pew Center on the States found that adding dental hygienists to a practice enables most dentists to serve more patients while increasing profitability and productivity. With the enactment of the federal health care reform law in 2010, which extended 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, thereby freeing up dentists to treat more patients.
The Medicaid Redesign Team (MRT) supports collaborative practice for dental hygienists as a way to reduce the cost of dental care.
Collaborative practice will improve the oral health status of New Yorkers by promoting oral healthcare and the prevention of disease.
Dental hygienists working in a collaborative practice would be able to practice in a hospital or health clinic, pursuant to the terms of the collaborative practice agreement, without the supervision of the dentist. Collaborative practice dental hygienists would 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.
LEGISLATIVE HISTORY: This is a new bill.
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect April 1, 2014.
STATE OF NEW YORK ________________________________________________________________________ 4604 2013-2014 Regular Sessions IN SENATE April 15, 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 THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 1 of section 6605-b of the education law, as added by chapter 437 of the laws of 2001, is amended to read as follows: 1.
[A]NOTWITHSTANDING ANY PROVISION HEREIN TO THE CONTRARY, A dental hygienist shall not administer or monitor nitrous oxide analgesia or local infiltration anesthesia in the practice of dental hygiene without a dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate and except under the personal supervision of a dentist and in conjunction with the performance of dental hygiene proce- dures authorized by law and in accordance with regulations promulgated by the commissioner. Personal supervision, for purposes of this section, means that the supervising dentist remains in the dental office where the local infiltration anesthesia or nitrous oxide analgesia services are being performed, personally authorizes and prescribes the use of local infiltration anesthesia or nitrous oxide analgesia for the patient and, before dismissal of the patient, personally examines the condition of the patient after the use of local infiltration anesthesia or nitrous oxide analgesia is completed. It is professional misconduct for a dentist to fail to provide the supervision required by this section, and any dentist found guilty of such misconduct under the procedures prescribed in section sixty-five hundred ten of this title shall be subject to the penalties prescribed in section sixty-five hundred eleven of this title. S 2. Subdivision 1 of section 6606 of the education law, as amended by chapter 437 of the laws of 2001, is amended to read as follows:EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09751-03-3 S. 4604 2
1. The practice of the profession of dental hygiene is defined as the performance of dental services which shall include removing calcareous deposits, accretions and stains from the exposed surfaces of the teeth which begin at the epithelial attachment and applying topical agents indicated for a complete dental prophylaxis, removing cement, placing or removing rubber dam, removing sutures, placing matrix band, providing patient education, applying topical medication, placing and exposing DIAGNOSTIC DENTAL X-ray films, performing topical fluoride applications and topical anesthetic applications, polishing teeth, taking medical history, charting caries, taking impressions for study casts, placing and removing temporary restorations, administering and monitoring nitrous oxide analgesia and administering and monitoring local infil- tration anesthesia, subject to certification in accordance with section sixty-six hundred five-b of this article, and any other function in the definition of the practice of dentistry as may be delegated by a licensed dentist in accordance with regulations promulgated by the commissioner. The practice of dental hygiene may be conducted in the office of any licensed dentist or in any appropriately equipped school or public institution but must be done EITHER under the supervision of a licensed dentist OR, IN THE CASE OF A REGISTERED DENTAL HYGIENIST WORK- ING FOR A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, PURSUANT TO A COLLABORATIVE ARRANGEMENT WITH A LICENSED DENTIST PURSUANT TO REGULATIONS PROMULGATED PURSUANT TO ARTICLE TWENTY- EIGHT OF THE PUBLIC HEALTH LAW. S 3. Section 6608 of the education law, as amended by chapter 300 of the laws of 2006, is amended to read as follows: S 6608. Definition of practice of certified dental assisting. The practice of certified dental assisting is defined as providing support- ive services to a dentist in his/her performance of dental services authorized under this article. Such support shall include providing patient education, taking preliminary medical histories and vital signs to be reviewed by the dentist, placing and removing rubber dams, select- ing and prefitting provisional crowns, selecting and prefitting ortho- dontic bands, removing orthodontic arch wires and ligature ties, placing and removing matrix bands, taking impressions for study casts or diag- nostic casts, removing periodontal dressings, and such other dental supportive services authorized by the dentist consistent with regu- lations promulgated by the commissioner, provided that such functions are performed under the direct personal supervision of a licensed dentist in the course of the performance of dental services. Such services shall not include diagnosing and/or performing surgical proce- dures, irreversible procedures or procedures that would alter the hard or soft tissue of the oral and maxillofacial area or any other proce- dures determined by the department. The practice of certified dental assisting may be conducted in the office of any licensed dentist or in any appropriately equipped school or public institution but must be done under the direct personal supervision of a licensed dentist. Direct personal supervision, for purposes of this section, means supervision of dental procedures based on instructions given by a licensed dentist in the course of a procedure who remains in the dental office where the supportive services are being performed, personally diagnoses the condi- tion to be treated, personally authorizes the procedures, and before dismissal of the patient, who remains the responsibility of the licensed dentist, evaluates the services performed by the dental assistant. Noth- ing herein authorizes a dental assistant to perform any of the services or functions defined as part of the practice of dental hygiene inS. 4604 3
accordance with the provisions of subdivision one of section sixty-six hundred six of this article, except those functions authorized pursuant to this section. All dental supportive services provided in this section may be performed by currently registered dental hygienists under a dentist's supervision OR BY A REGISTERED DENTAL HYGIENIST WORKING FOR A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHO PRACTICES IN COLLABORATION WITH A LICENSED DENTIST IN ACCORDANCE WITH SUBDIVISION ONE OF SECTION SIXTY-SIX HUNDRED SIX OF THIS ARTICLE, as defined in regulations of the commissioner. S 4. Subdivision 10 of section 6611 of the education law, as amended by chapter 65 of the laws of 2011, is amended to read as follows: 10.
[Beginning January first, two thousand nine, each]EACH dentist AND REGISTERED DENTAL HYGIENIST WORKING FOR A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHO PRACTICES IN COLLAB- ORATION WITH A LICENSED DENTIST shall become certified in cardiopulmo- nary resuscitation (CPR) from an approved provider and thereafter main- tain current certification, which shall be included in the mandatory hours of continuing education acceptable for dentists to the extent provided in the commissioner's regulations. In the event the dentist OR REGISTERED DENTAL HYGIENIST cannot physically perform CPR, the commis- sioner's regulations shall allow the dentist OR REGISTERED DENTAL HYGIENIST to make arrangements for another individual in the office to administer CPR. All dental facilities shall have an automatic external defibrillator or other defibrillator at the facility. S 5. This act shall take effect April 1, 2014, provided that effective immediately, the addition, amendment and/or repeal of any rule or regu- lation necessary for the implementation of such sections on the effec- tive date of this act are authorized and directed to be made and completed on or before such effective date.