BP BHEAD INT H

AN ACT Relating to licensed dental hygienists; adding new sections to chapter 18.29 RCW; creating new sections; providing an effective date; and declaring an emergency.

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

NEW SECTION. Sec. 1. The legislature finds that present law results in restricting the public's access to services provided by licensed dental hygienists as defined in chapter 18.29 RCW. The legislature finds it necessary to eliminate restrictions in current law to promote public access to services provided by licensed dental hygienists.

NEW SECTION. Sec. 2. A new section is added to chapter 18.29 RCW to read as follows:

A dental hygienist licensed under this chapter, who has two years' practical clinical experience with a licensed dentist within the preceding five years, may perform dental hygiene services without the supervision of a dentist. These services shall be limited to removal of deposits and stains from the surfaces of the teeth, application of topical preventive or prophylactic agents, polishing and smoothing of restorations, assessment and treatment planning for dental hygiene services, and root planing and soft tissue curettage. For dental planning and dental treatment, dental hygienists shall refer patients to licensed dentists.

Dental hygienists authorized for unsupervised practice pursuant to this chapter may perform injections of local anaesthetic agents for dental hygiene treatment upon the prior approval of the primary dentist sponsor, or dentist of record if practicing in a health facility.

A dental hygienist performing dental hygiene services without supervision as authorized in this section shall notify the patient on forms adopted by the secretary in conjunction with the dental hygiene examining committee that the services being provided are not dental services.

A dental hygienist authorized to perform dental hygiene services under this section shall require that each patient for whom the dental hygienist performs dental hygiene service establish a dentist of record within twelve months of the first appointment with the dental hygienist.

NEW SECTION. Sec. 3. A new section is added to chapter 18.29 RCW to read as follows:

Dental hygienists qualifying for practice without dental supervision pursuant to section 2 of this act may apply for a license endorsement by the department of health for unsupervised practice. The department shall issue an endorsement subject to a verification of the qualifications specified in section 2 of this act, and submission of an acceptable practice protocol required pursuant to section 4 of this act, and payment of a fee determined by the secretary pursuant to law.

An endorsement for unsupervised practice is subject to the provisions of the uniform disciplinary act, chapter 18.130 RCW, on the same grounds as a license for practice. However, any action taken by the secretary with regard to an endorsement for unsupervised practice shall not affect the license to practice, unless there is a separate action taken with regard to the license.

NEW SECTION. Sec. 4. A new section is added to chapter 18.29 RCW to read as follows:

(1) A dental hygienist receiving an endorsement for unsupervised practice shall establish a practice protocol with one or more dentists licensed in this state, one of which shall be designated as the primary dentist sponsor, and which establishes the parameters of unsupervised practice. The practice parameters shall include mechanisms involving the following:

(a) Consultation;

(b) Deferral to a dentist for dental care;

(d) Emergency procedures;

(e) Identification of dental disease;

(f) Premedication; and

(g) Other matters adopted by rule by the secretary.

(2) The practice protocol entered into by the dental hygienist and a dentist shall be signed by both practitioners, and filed with the secretary and with the dental disciplinary board or its successor.

(3) A dental hygienist who performs any service in violation of the practice parameters of the protocol is deemed to commit unprofessional conduct and is subject to the sanctions and procedures of the uniform disciplinary act, chapter 18.130 RCW, notwithstanding the fact that such service may be within the scope of practice of dental hygiene.

NEW SECTION. Sec. 5. A new section is added to chapter 18.29 RCW to read as follows:

The secretary shall adopt such rules as are necessary for the implementation of sections 1 through 4 of this act. The secretary is authorized to appoint a joint advisory subcommittee to meet on the call of the secretary and to advise and assist the secretary in the implementation and administration of chapter . . ., Laws of 1995 (this act). If convened, the secretary shall serve ex officio as chair and designate members of the subcommittee from the membership of the dental hygiene examining committee and dental disciplinary board composed of an equal number of dental hygienists and dentists respectively; the secretary shall also include a member representing the public who is not a member of any health board or committee and who presents no conflicts of interest. Members of the joint subcommittee may be removed by the secretary for cause. In the conduct of subcommittee business, members shall receive reimbursement as if engaged as members of their respective board or committee, and the public member shall receive reimbursement equal to a public member of the dental disciplinary board.

NEW SECTION. Sec. 6. The secretary of health shall review and make recommendations on the administration and operation of the provisions of this act and report to the legislature by December 31, 1995, on the sufficiency of safeguards to protect the health and safety of patients, and its effect on patient access to dental hygiene services and dental care.

NEW SECTION. Sec. 7. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect July 1, 1995.