BP BHEAD INT S

AN ACT Relating to the certification of public health dental hygienists practicing among underserved populations; adding new sections to chapter 18.29 RCW; creating a new section; 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 access to preventive oral health care services by low-income families and eligible medicaid recipients is currently restricted by supervision requirements for dental hygienists practicing within their existing scope of practice.

It is the intent of the legislature to provide access to and reduce the cost of preventive oral health care services provided by licensed dental hygienists to eligible medicaid recipients, low-income families, children, elderly persons, and other dentally underserved populations. In the absence of an adequate supply and distribution of dentists treating underserved populations, the provision of sealants and fluoride treatments by dental hygienists under general dental supervision is necessary in rural and underserved areas of the state. The legislature intends to create a special public health certification for dental hygienists to provide access to these services to target populations.

NEW SECTION. Sec. 2. (1) A dental hygienist licensed under this chapter may apply for certification by the department as a public health dental hygienist upon:

(a) Completion of the approved course of study developed under section 4 of this act;

(b) Establishment and maintenance of an acceptable practice protocol with a licensed dentist; and

(c) Compliance with administrative procedures, administrative requirements, and fees determined as provided in RCW 43.70.250 and 43.70.280.

(2) Certification as a public health dental hygienist 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 certification as a public health dental hygienist does not affect the license to practice, unless there is a separate action taken with regard to the license.

NEW SECTION. Sec. 3. (1) Dental hygienists certified as public health dental hygienists under section 2 of this act may assess for and apply sealants and fluoride treatments under general dental supervision for clients in community clinics, migrant and community health centers, tribal clinics, and public health dental programs.

(2) A dental hygienist certified under section 2 of this act shall require that each patient for whom the dental hygienist performs dental hygiene service establish a dentist of record, if available, within twelve months of the first appointment with the dental hygienist.

(3) A dental hygienist certified under section 2 of this act shall establish a practice arrangement through a practice protocol with one or more dentists licensed in this state. The practice protocol entered into by the dental hygienist and a dentist must be signed by both practitioners and filed with the secretary and with the dental quality assurance commission.

(4) Practice protocols of a public health dental hygienist under general supervision by a licensed dentist include, but are not limited to, the following:

(a) Consultation;

(b) Referral to a dentist for dental care;

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

NEW SECTION. Sec. 4. The department of health, in consultation with the University of Washington school of dentistry and upon approval of the higher education coordinating board, shall develop an oral health assessment course of study to be required as additional training for licensed dental hygienists who apply for a dental hygienist public health certification. The course must include a training on the assessment of teeth and oral tissues among the underserved for the purpose of planning and administering appropriate preventive and disease control interventions within the scope of practice. The course must include dental caries assessment and management, current science about the importance of oral hygiene and the role of fluorides for maintaining proper oral health, oral cancer detection, and psychosocial conditions that impact a family's attitudes and behaviors about seeking dental services.

NEW SECTION. Sec. 5. The secretary of health shall review and make recommendations on the administration and operation of this act and report to the legislature by December 31, 1998, on the sufficiency of safeguards to protect the health and safety of patients and the effect on patient access to dental hygiene services and dental care.

NEW SECTION. Sec. 6. 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 takes effect July 1, 1997.

NEW SECTION. Sec. 7. Sections 1 through 4 of this act are each added to chapter 18.29 RCW.