BP BHEAD INT H

AN ACT Relating to dental assistants; amending RCW 18.32.030, 18.32.0351, 18.32.0355, and 18.32.0357; and adding new sections to chapter 18.32 RCW.

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

NEW SECTION. Sec. 1. A new section is added to chapter 18.32 RCW to read as follows:

Unless a different meaning is indicated by the context, the following definitions apply throughout this chapter:

(1) "Dental assistant" means an unlicensed person who assists a licensed dentist in providing dental care to patients pursuant to this chapter.

(2) "Credentialed dental assistant" means a licensed dental assistant who is authorized to perform the duties specified in section 3 of this act.

Sec. 2. RCW 18.32.030 and 1994 sp.s. c 9 s 203 are each amended to read as follows:

The following practices, acts, and operations are excepted from the operation of the provisions of this chapter:

(1) The rendering of dental relief in emergency cases in the practice of his or her profession by a physician or surgeon, licensed as such and registered under the laws of this state, unless the physician or surgeon undertakes to or does reproduce lost parts of the human teeth in the mouth or to restore or to replace in the human mouth lost or missing teeth;

(2) The practice of dentistry in the discharge of official duties by dentists in the United States federal services on federal reservations, including but not limited to the armed services, coast guard, public health service, veterans' bureau, or bureau of Indian affairs;

(3) Dental schools or colleges approved under RCW 18.32.040, and the practice of dentistry by students in Washington state dental schools or colleges approved by the commission, when acting under the direction and supervision of Washington state-licensed dental school faculty;

(4) The practice of dentistry by licensed dentists of other states or countries while appearing as clinicians at meetings of the Washington state dental association, or component parts thereof, or at meetings sanctioned by them, or other groups approved by the commission;

(5) The use of roentgen and other rays for making radiographs or similar records of dental or oral tissues, under the supervision of a licensed dentist or physician;

(6) The making, repairing, altering, or supplying of artificial restorations, substitutions, appliances, or materials for the correction of disease, loss, deformity, malposition, dislocation, fracture, injury to the jaws, teeth, lips, gums, cheeks, palate, or associated tissues or parts; providing the same are made, repaired, altered, or supplied pursuant to the written instructions and order of a licensed dentist which may be accompanied by casts, models, or impressions furnished by the dentist, and the prescriptions shall be retained and filed for a period of not less than three years and shall be available to and subject to the examination of the secretary or the secretary's authorized representatives;

(7) The removal of deposits and stains from the surfaces of the teeth, the application of topical preventative or prophylactic agents, and the polishing and smoothing of restorations, when performed or prescribed by a dental hygienist licensed under the laws of this state;

(8) A qualified and licensed physician and surgeon or osteopathic physician and surgeon extracting teeth or performing oral surgery pursuant to the scope of practice under chapter 18.71 or 18.57 RCW;

(9) The performing of dental operations or services by ((~~persons not licensed under this chapter~~)) dental assistants and/or credentialed dental assistants when performed under the supervision of a licensed dentist: PROVIDED HOWEVER, That ((~~such nonlicensed person~~)) a dental assistant shall in no event perform the following dental operations or services unless permitted to be performed by the person under this chapter or chapters 18.29, 18.57, 18.71, and 18.79 RCW as it applies to registered nurses and advanced registered nurse practitioners:

(a) Any removal of or addition to the hard or soft tissue of the oral cavity;

(b) Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, or physical condition of the human teeth or jaws, or adjacent structure;

(c) Any administration of general or injected local anaesthetic of any nature in connection with a dental operation, including intravenous sedation;

(d) Any oral prophylaxis;

(e) The taking of any impressions of the teeth or jaw or the relationships of the teeth or jaws, for the purpose of fabricating any intra-oral restoration, appliance, or prosthesis.

NEW SECTION. Sec. 3. A new section is added to chapter 18.32 RCW to read as follows:

(1) Credentialed dental assistants may perform all duties performed by dental assistants and one or all of the following expanded duties, after meeting the requirements set forth in subsection (2) of this section:

(a) Under the close supervision of a dentist, place restorative material into a cavity prepared by the dentist and thereafter carve, contour, and adjust contacts and occlusions of the restoration, and cement or recement stainless steel crowns. This expanded function requires coursework and ability in such subjects as dental anatomy, restorative materials, and restorative techniques;

(b) Under the close supervision of a dentist, give oral injections of local anesthetic. This expanded function requires coursework and ability in such subjects as head and neck anatomy, pharmacology, and local anesthesia; and

(c) Under the close supervision of a dentist, perform supragingival tooth scaling and polishing on patients with either periodontally healthy mouths or localized plaque-induced gingivitis and exhibiting no significant complicating systemic medical disease or disorder. This expanded function requires coursework and ability in subjects such as periodontal orientation, oral pathology, and clinical techniques.

(2) To perform expanded duties, credentialed dental assistants must successfully complete an educational program approved by the commission that: (a) Was designed to provide adequate didactic and clinical training for expanded duties; and (b) has been approved by the commission. The credentialed dental assistant carrying out expanded duties must meet standards of proficiency in infection control and radiology, as determined by the commission. The commission may set other requirements by rule.

Sec. 4. RCW 18.32.0351 and 1994 sp.s. c 9 s 204 are each amended to read as follows:

The Washington state dental quality assurance commission is established, consisting of ((~~fourteen~~)) fifteen members, each appointed by the governor to a four-year term. No member may serve more than two consecutive full terms. In appointing the initial members of the commission, it is the intent of the legislature that, to the extent possible, members of the previous boards and committees regulating these professions be appointed to the commission. Members of the commission hold office until their successors are appointed. The governor may appoint members of the initial commission to staggered terms of from one to four years. Thereafter, all members shall be appointed to full four-year terms. Twelve members of the commission must be dentists ((~~and~~)), two members must be public members, and one member must be a dental assistant.

Sec. 5. RCW 18.32.0355 and 1994 sp.s. c 9 s 206 are each amended to read as follows:

Members must be citizens of the United States and residents of this state. Dentist members must be licensed dentists in the active practice of dentistry for a period of five years before appointment. Of the twelve dentists appointed to the commission, at least four must reside and engage in the active practice of dentistry east of the summit of the Cascade mountain range. Public members of the commission may not be a member of any other health care licensing board or commission, or have a fiduciary obligation to a facility rendering health services regulated by the commission, or have a material or financial interest in the rendering of health services regulated by the commission. The dental assistant member must be a dental assistant actively engaged in the practice of dental assisting for a period of five years before appointment.

Sec. 6. RCW 18.32.0357 and 1994 sp.s. c 9 s 207 are each amended to read as follows:

(1) The commission shall elect officers each year. Meetings of the commission are open to the public, except the commission may hold executive sessions to the extent permitted by chapter 42.30 RCW. The secretary of health shall furnish such secretarial, clerical, and other assistance as the commission may require.

(2) A majority of the commission members appointed and serving constitutes a quorum for the transaction of commission business. The affirmative vote of a majority of a quorum of the commission is required to carry a motion or resolution, to adopt a rule, or to pass a measure.

(3) The commission may appoint members of panels consisting of not less than three members. A quorum for transaction of any business shall be a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the commission.

(4) The members of the commission are immune from suit in an action, civil or criminal, based upon its disciplinary proceedings or other official acts performed in good faith as members of the commission.

(5) The commission may, whenever the workload of the commission requires, request that the secretary appoint pro tempore members. While serving as members pro tempore persons have all the powers, duties, and immunities, and are entitled to the emoluments, including travel expenses, of the commission.

(6) The commission shall prepare or determine the nature of the examinations for applicants to practice dentistry and applicants to practice credentialed dental assisting.

(7) The attorney general shall advise the commission and represent it in all legal proceedings.

NEW SECTION. Sec. 7. A new section is added to chapter 18.32 RCW to read as follows:

Applications for credentialed dental assistant's license shall be submitted on forms provided by the commission. The commission may require any information and documentation that reasonably relates to the need to determine whether the applicant meets the criteria provided for in this chapter. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250.