WSR 19-13-093

PROPOSED RULES

DEPARTMENT OF HEALTH

(Dental Quality Assurance Commission)

[Filed June 18, 2019, 3:53 p.m.]

Supplemental Notice to WSR 19-03-072.

Preproposal statement of inquiry was filed as WSR 18-04-078.

Title of Rule and Other Identifying Information: WAC 246-817-550 Acts that may be performed by licensed dental hygienists under general supervision, supplemental notice to WSR 19-03-072. The dental quality assurance commission (commission) is proposing rule amendments add identified tasks from WAC 246-817-520, acts that may be performed by dental assistants under close supervision, to the list of allowable tasks that a dentist can delegate to dental hygienists under general supervision. This supplemental proposal removes orthodontic tasks.

Hearing Location(s): On July 26, 2019, at 9:35 a.m., at the Department of Health, Point Plaza East, Room 152/153, 310 Israel Road S.E., Tumwater, WA 98501.

Date of Intended Adoption: July 26, 2019.

Submit Written Comments to: Jennifer Santiago, P.O. Box 47852, Olympia, WA 98504, email https://fortress.wa.gov/doh/policyreview, fax 360-236-2901, by July 22, 2019.

Assistance for Persons with Disabilities: Contact Jennifer Santiago, phone 360-236-4893, fax 360-236-2901, TTY 360-833-6388 or 711, email jennifer.santiago@doh.wa.gov, by July 22, 2019.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule amendments update the listing of allowable duties a dentist may delegate to a licensed dental hygienist under general supervision with the exception of orthodontic tasks that were previously proposed. A licensed dental hygienist has appropriate education and training to competently perform the tasks in the proposed rule amendments after a dentist has examined and diagnosed the patient and provided subsequent instructions to be performed without the dentist physically present in the office. Additionally, several tasks in the proposed rule amendments may provide more opportunities for teledentistry when a dentist is not required to be on site. This would allow a dentist and dental hygienist to provide dental care to patients unable to be physically in the dental office.

Reasons Supporting Proposal: The commission considered a rule request in July 2017 to allow dental hygienists to perform certain tasks under general supervision that are typically completed by dental assistants under close supervision. Close supervision requires the dentist to be physically present in the treatment facility during the performance of a delegated task while general supervision does not. Identifying a list of acceptable tasks that may be delegated by a licensed dentist to a licensed dental hygienist in rule establishes enforceable practice standards while ensuring patient safety. Because a general supervision list of tasks already exists in current rule, rule making is necessary to amend the rule to include proposed tasks which are currently allowed under close supervision. Stakeholder comments received during the March 1, 2019, hearing expressed concerns that several of the orthodontic tasks were inappropriate to delegate under general supervision. The commission determined four of the six orthodontic tasks require[d] examination, diagnosis, and treatment planning each time the task was performed.

The commission changed the original proposal to delete the following: Prepare teeth for the bonding of orthodontic appliances; bond attachments for clear removable orthodontic aligners; remove and replace archwires and orthodontic wires; and remove fixed orthodontic appliances, orthodontic cement, and orthodontic bonded resin material.

Statutory Authority for Adoption: RCW 18.32.0365 and 18.29.050.

Statute Being Implemented: RCW 18.32.0365 and 18.29.050.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Dental quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Jennifer Santiago, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4893.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Jennifer Santiago, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4893, fax 360-236-2901, TTY 360-833-6388 or 711, email jennifer.santiago@doh.wa.gov.

The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The proposed rule does not impose costs on businesses.

June 18, 2019

Julia Richman, DDS, Chairperson

Dental Quality Assurance Commission