S-1659

AN ACT Relating to denturitry; amending RCW 18.130.040; adding a new chapter to Title 18 RCW; creating a new section; prescribing penalties; making an appropriation; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds it necessary to regulate the practice of denturitry at the level of certification in order to protect the public health and safety and to establish an alternate means of denture delivery. It is the intent of the legislature that only individuals who meet and maintain minimum standards of competence and conduct provide service to the public.

NEW SECTION. Sec. 2. (1) Certification under this chapter is required in the practice of denturitry to perform the following acts:

(a) Engaging in or offering to engage in the practice of denturitry; or

(b) Using the word "denturist," "certified denturist," "CD," or other words, letters, abbreviations, or insignia in connection with a name, implying that the person is engaged in the practice of denturitry.

(2) Violation of this section shall constitute a gross misdemeanor.

NEW SECTION. Sec. 3. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Board" means the board of denturitry.

(2) "Complete denture" means a removable prosthetic dental appliance worn on the human edentulous arch.

(3) "Denturitry" means the practice of a denturist and is the making, fitting, altering, or repairing of a denture for a patient directly, and includes the taking of impressions, bite registrations, or inner arch relations, trying of dentures set in wax, and final seating and adjustment of dentures.

(4) "Department" means the department of health.

(5) "Immediate denture" means a denture that is fabricated prior to and inserted in the human oral cavity immediately after the extraction of natural teeth.

(6) "Partial denture" means a removable dental appliance that is attached to natural teeth for the purpose of replacing missing teeth on a partial edentulous arch.

(7) "Public member" means an individual who is not, and never has been a member or spouse of a member of a health profession currently regulated, or an individual who does not have and has never had a material financial interest in the rendering of denturitry or an activity directly related to denturitry.

NEW SECTION. Sec. 4. (1) Immediate dentures may be fabricated for a patient by a denturist on the written prescription and under the general supervision of a dentist. The dentist is responsible for the extraction of the natural teeth, inserting the immediate dentures, and the aftercare of the patient; however, the treating dentist may delegate portions of patient treatment, to a denturist, that fall under a denturist's scope of practice.

(2) Replacement dentures may be fabricated for the patient, by a denturist without the supervision of a dentist, six months from the date of the extractions.

(3) Partial dentures may be fabricated for a patient directly only on the written prescription of a dentist.

NEW SECTION. Sec. 5. A denturist certified under this chapter shall not:

(1) Extract or attempt to extract natural teeth;

(2) Surgically modify or attempt to surgically modify natural teeth or tissue;

(3) Recommend prescription drugs for oral or medical diseases;

(4) Fit orthodontic appliances; or

(5) Fabricate a partial denture or immediate complete denture, for a patient directly, without a prescription from a dentist.

NEW SECTION. Sec. 6. Nothing in this chapter shall be construed to prohibit or restrict persons authorized by the state of Washington to practice medicine or dentistry, persons authorized in writing by a dentist to perform nonclinical dental laboratory procedures, or a person from practicing the profession the person is authorized to practice.

NEW SECTION. Sec. 7. (1) In addition to authority provided by law, the department shall have the following authority to:

(a) Adopt rules necessary to implement this chapter;

(b) Set certification and renewal fees;

(d) Issue a certificate to an applicant that has met the education, training, examination, and conduct requirements; and

(e) Hire clerical, administrative, and investigative staff as needed to implement this chapter.

(2) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of certification and the discipline of certificate holders under this chapter. The department is the disciplining authority under this chapter.

NEW SECTION. Sec. 8. The department shall keep an official record of all proceedings. A part of the record shall consist of a register of all applicants for certification under this chapter.

NEW SECTION. Sec. 9. (1) The board of denturitry is hereby created consisting of five members appointed by the governor.

(a) Two members shall be public members, not associated with a health profession;

(b) Two members shall be denturists. Prior to the certification of a denturist under this chapter, two denturist applicants shall be conditional members. If a conditional member should fail to pass a portion of the written or practical examination he or she shall be dismissed; and

(2) A member's term of office is three years at the pleasure of the governor. The governor, before expiration of the term of a member, shall appoint a successor whose term begins on July 1. The terms of the first members shall be staggered to ensure an orderly succession of new members. A member is eligible for reappointment, but no member shall serve more than two consecutive terms, unless the governor determines good cause. If a vacancy arises, the governor shall make an appointment, effective immediately, for the unexpired term.

(3) Members shall be reimbursed for expenses in accordance with state statutes.

NEW SECTION. Sec. 10. Members of the board or individuals acting on their behalf are immune from civil suit in an action based on certification or disciplinary proceedings or other official acts performed in the course of duty.

NEW SECTION. Sec. 11. (1) Examinations shall determine the qualifications, fitness, and ability of the applicants to practice denturitry under this chapter. The form of the examination shall include a written and a practical demonstration of skills.

(2) The board shall conduct examinations at least annually if there are applicants. The written and practical examinations shall carry equal weight and the passing score is determined by agreement of the board members.

(3) Applicants who fail to score a passing grade on the written or practical examination, or both, may upon payment of the appropriate fee, have another opportunity to take the entire exam, or the written or practical portion only. The board may approve successive examinations upon application and payment of the prescribed fee.

NEW SECTION. Sec. 12. It is recognized that the scope of practice of denturists overlaps in some areas with the scope of practice of dentists, licensed under chapter 18.32 RCW. Denturists certified and practicing under this chapter are exempted from chapter 18.32 RCW when acting within their scope of practice.

NEW SECTION. Sec. 13. Upon application, payment of the appropriate fee, and successful completion of the board examination, the department shall issue a certificate to practice denturitry, that is valid for two years. Prior to taking the board examination applicants shall complete the following criteria:

(1) Graduation from two years of formal study at an approved college of denturitry that is recognized by the board; or

(2) Evidence of seven years of experience in the vocation of dental technology, that shall include four thousand hours in the fabrication of complete dentures, or complete and partial dentures. Two of the required seven years may be in a school of dental laboratory technology; and

(3) Completion of the following educational requirements which shall include but are not limited to:

(a) Embryology ten hours;

(b) Oral pathology one hundred forty hours;

(d) Physiology thirty hours;

(e) Histology ten hours;

(f) Clinical denturitry sixty hours;

(g) Periodontology twenty hours;

(h) Oral radiographic diagnosis thirty hours;

(i) Interpretation of medical five hours;

laboratory values

(j) Dental materials five hours;

(k) HIV/AIDS, and asepsis ten hours; and

(l) Microbiology five hours.

NEW SECTION. Sec. 14. Notwithstanding a provision of an insurance policy covering dental health, or a state agency that pays dental services, if an insurance policy provides for a service that is within the lawful scope of practice of this chapter, the insured patient under the policy is entitled to reimbursement for the service, or payment directly to the denturist or dentist provider.

NEW SECTION. Sec. 15. Consumer protection laws that apply to dentists shall apply to denturists.

NEW SECTION. Sec. 16. A denturist may enter into a lawful agreement with a dentist regarding fees, compensation, business associations, and professional corporations.

NEW SECTION. Sec. 17. Applications for certification shall be submitted on forms provided by the department. The department may require information and documentation that reasonably relates to making a determination that the applicant meets the criteria. Each applicant shall pay a fee determined by the department, that shall accompany the application.

NEW SECTION. Sec. 18. The department shall establish by rule the procedural requirements for the renewal of certificates. Failure to renew shall invalidate the certificate and all privileges granted by the certificate.

NEW SECTION. Sec. 19. This chapter may be known and cited as the denturist certification act.

Sec. 20. RCW 18.130.040 and 1990 c 3 s 810 are each amended to read as follows:

(1) This chapter applies only to the secretary and the boards having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.

(2) (a) The secretary has authority under this chapter in relation to the following professions:

(i) Dispensing opticians licensed under chapter 18.34 RCW;

(ii) Naturopaths licensed under chapter 18.36A RCW;

(iii) Midwives licensed under chapter 18.50 RCW;

(iv) Ocularists licensed under chapter 18.55 RCW;

(v) Massage operators and businesses licensed under chapter 18.108 RCW;

(vi) Dental hygienists licensed under chapter 18.29 RCW;

(vii) Acupuncturists certified under chapter 18.06 RCW;

(viii) Radiologic technologists certified under chapter 18.84 RCW;

(ix) Respiratory care practitioners certified under chapter 18.89 RCW;

(x) Persons registered or certified under chapter 18.19 RCW;

(xi) Persons registered as nursing pool operators;

(xii) Nursing assistants registered or certified under chapter 18.52B RCW;

(xiii) Dietitians and nutritionists certified under chapter 18.138 RCW; ((~~and~~))

(xiv) Sex offender treatment providers certified under chapter 18.155 RCW; and

(xv) Denturists certified under chapter 18.-- RCW (sections 1 through 18 of this act).

(b) The boards having authority under this chapter are as follows:

(i) The ((~~podiatry~~)) podiatric medical board as established in chapter 18.22 RCW;

(ii) The chiropractic disciplinary board as established in chapter 18.26 RCW governing licenses issued under chapter 18.25 RCW;

(iii) The dental disciplinary board as established in chapter 18.32 RCW;

(iv) The council on hearing aids as established in chapter 18.35 RCW;

(v) The board of funeral directors and embalmers as established in chapter 18.39 RCW;

(vi) The board of examiners for nursing home administrators as established in chapter 18.52 RCW;

(vii) The optometry board as established in chapter 18.54 RCW governing licenses issued under chapter 18.53 RCW;

(viii) The board of osteopathic medicine and surgery as established in chapter 18.57 RCW governing licenses issued under chapters 18.57 and 18.57A RCW;

(ix) The medical disciplinary board as established in chapter 18.72 RCW governing licenses and registrations issued under chapters 18.71 and 18.71A RCW;

(x) The board of physical therapy as established in chapter 18.74 RCW;

(xi) The board of occupational therapy practice as established in chapter 18.59 RCW;

(xii) The board of practical nursing as established in chapter 18.78 RCW;

(xiii) The examining board of psychology and its disciplinary committee as established in chapter 18.83 RCW;

(xiv) The board of nursing as established in chapter 18.88 RCW; and

(xv) The veterinary board of governors as established in chapter 18.92 RCW.

(3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses based on the conditions and criteria established in this chapter and the chapters specified in subsection (2) of this section. However, the board of chiropractic examiners has authority over issuance and denial of licenses provided for in chapter 18.25 RCW, the board of dental examiners has authority over issuance and denial of licenses provided for in RCW 18.32.040, and the board of medical examiners has authority over issuance and denial of licenses and registrations provided for in chapters 18.71 and 18.71A RCW. This chapter also governs any investigation, hearing, or proceeding relating to denial of licensure or issuance of a license conditioned on the applicant's compliance with an order entered pursuant to RCW 18.130.160 by the disciplining authority.

NEW SECTION. Sec. 21. Sections 1 through 18 of this act shall constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 22. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 23. This act shall take effect January 1, 1992.

NEW SECTION. Sec. 24. The sum of .............. dollars, or as much thereof as may be necessary, is appropriated for the biennium ending June 30, 1993, from the health professions account to the department of health for the purposes of this act.