SENATE BILL REPORT

                   SB 5323

                    As of February 19, 1997

Title:  An act relating to the certification of public health dental hygienists practicing among underserved populations.

Brief Description:  Certifying public health dental hygienists practicing among underserved populations.

Sponsors:  Senators Deccio, Thibaudeau, Wood, Strannigan and Kohl.

Brief History:

Committee Activity:  Health & Long‑Term Care:  2/11/97, 2/20/97.

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Staff:  Rhoda Jones (786-7198)

Background:  Dental hygienists may practice independent of dental supervision in institutional settings such as nursing homes, hospitals, state institutions and public health facilities, but their scope of practice in these situations is limited to prophylaxis, traditional dental hygiene services.  The application of sealants and fluoride is permitted only after a diagnosis of decay has been made by a licensed dentist. They may not do injections of anesthetics, administer nitrous oxide, or diagnose dental treatment.  They must otherwise refer patients for dental treatment.

In recent years, there have been various proposals to permit independent practice of dental hygienists under specified conditions. A sunrise review by the Department of Health approved unsupervised practice under certain conditions including: the applicant have continuous practice under dental supervision for at least two years, receive an endorsement from the Secretary of Health and receive an additional endorsement for the administration of topical preventive fluoride agents and for injection of anesthetics. 

Summary of Substitute Bill:  A licensed dental hygienist may apply for certification by the Department of Health as a public health dental hygienist. Certification requires the completion of a course of study and establishing practice protocols with a licensed dentist.

Certified public health dental hygienists may assess for and apply sealants and fluoride treatments in community clinics, migrant and community health centers, tribal clinics and in any public health dental programs.  Patients treated by certified public health dental hygienists must establish a dentist of record, if possible, within 12 months of the first appointment with the hygienist.

Any dental hygienist who is certified under the provisions of this act must establish a practice arrangement with a dentist, signed by both the practitioners and filed with the Secretary of Health and the Dental Quality Assurance Commission.

The Department of Health, in consultation with the University of Washington School of Dentistry and the Higher Education Coordinating Board, must develop a training course for the public health certification. General course topics are described.

The secretary reports to the Legislature by December 31, 1998 on the sufficiency of safeguards related to this act.    

Substitute Bill Compared to Original Bill:  The original bill was not considered.

Appropriation:  None.

Fiscal Note:  Requested on February 14, 1997.

Effective Date:  July 1, 1997.