S-0205.2 _______________________________________________
SENATE BILL 5535
_______________________________________________
State of Washington 55th Legislature 1997 Regular Session
By Senators Thibaudeau and Prentice
Read first time 01/30/97. Referred to Committee on Health & Long‑Term Care.
AN ACT Relating to the provision of services by dental hygienists; amending RCW 18.29.021, 18.29.045, 18.29.060, 18.29.071, 18.29.100, 18.29.110, 18.29.120, 18.29.130, 18.29.140, 18.29.150, 18.29.160, 18.29.180, 18.29.190, and 18.29.210; adding new sections to chapter 18.29 RCW; repealing RCW 18.29.050 and 18.29.056; providing an effective date; and declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. A dental hygienist licensed under this chapter may obtain and administer topical fluoride and preventive agents and injectable and topical local anesthetics, which are legend drugs pursuant to chapter 69.41 RCW. The dental hygiene quality assurance commission, after consultation with the board of pharmacy, shall adopt rules that authorize a dental hygienist to purchase and administer legend drugs and devices consistent with the provisions of this section.
NEW SECTION. Sec. 2. (1) Any person licensed as a dental hygienist in this state may remove deposits and stains from the surfaces of the teeth, may apply topical and preventive prophylactic agents including sealants, may administer injectable anesthetic and apply topical anesthetic agents appropriate to dental hygiene services, may polish and smooth restorations, may perform root planing and soft tissue curettage, and other dental hygiene services not specifically excluded by law.
Dental hygienists shall not perform the following dental services or dental procedures:
(a) Any surgical removal of tissue of the oral cavity;
(b) Any prescription of drugs or medications requiring the written order or prescription of a licensed dentist or physician, but a licensed dental hygienist may dispense prescribed legend drugs for preventive dental hygiene services;
(c) Any diagnosis for dental treatment or dental treatment planning; or
(d) The taking of any impression 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.
(2) Such licensed dental hygienists may perform services under this chapter either under the supervision of a dentist or unsupervised after obtaining an unsupervised practice endorsement from the dental hygiene quality assurance commission.
(3) To obtain an unsupervised practice endorsement, a hygienist must provide to the dental hygiene quality assurance commission satisfactory evidence of: (a) Having attained local anesthetic administration education in an accredited dental hygiene program or its equivalent; (b) having established emergency, health care provider referral, and patient record protocols; and (c) having practiced, including local anesthetic administration, for at least five years, under supervision of a licensed dentist or a licensed dental hygienist practicing unsupervised under this chapter.
(4) A dental hygienist licensed under this chapter shall be responsible for completing a dental hygiene assessment and dental hygiene treatment plan for each patient.
NEW SECTION. Sec. 3. Dental hygienists practicing in unsupervised settings under RCW 18.29.056 before the effective date of this section shall be given an endorsement for unsupervised practice upon application to the dental hygiene quality assurance commission.
NEW SECTION. Sec. 4. The dental hygiene quality assurance commission shall provide forms for application under section 3 of this act before the effective date of section 3 of this act.
NEW SECTION. Sec. 5. An unlicensed person may not perform services authorized in section 2 of this act.
Sec. 6. RCW 18.29.021 and 1996 c 191 s 10 are each amended to read as follows:
(1)
The department shall issue a license to any applicant who, as determined by the
((secretary)) dental hygiene quality assurance commission:
(a)
Has successfully completed an educational program approved by the ((secretary))
dental hygiene quality assurance commission. This educational program
shall include course work encompassing the subject areas within the scope of
the license to practice dental hygiene in the state of Washington;
(b)
Has successfully completed an examination administered or approved by the
dental hygiene ((examining committee)) quality assurance commission;
and
(c) Has not engaged in unprofessional conduct or is not unable to practice with reasonable skill and safety as a result of a physical or mental impairment.
(2) Applications for licensure must comply with administrative procedures, administrative requirements, and fees established according to RCW 43.70.250 and 43.70.280.
Sec. 7. RCW 18.29.045 and 1991 c 3 s 47 are each amended to read as follows:
An
applicant holding a valid license and currently engaged in practice in another
state may be granted a license without examination required by this chapter, on
the payment of any required fees, if the ((secretary in consultation with
the advisory committee)) dental hygiene quality assurance commission
determines that the other state's licensing standards are substantively
equivalent to the standards in this state: PROVIDED, That the ((secretary
in consultation with the advisory committee)) dental hygiene quality
assurance commission may require the applicant to: (1) File with the ((secretary))
dental hygiene quality assurance commission documentation certifying the
applicant is licensed to practice in another state; and (2) provide information
as the ((secretary)) dental hygiene quality assurance commission
deems necessary pertaining to the conditions and criteria of the uniform
disciplinary act, chapter 18.130 RCW and to demonstrate to the ((secretary))
dental hygiene quality assurance commission a knowledge of Washington
law pertaining to the practice of dental hygiene.
Sec. 8. RCW 18.29.060 and 1991 c 3 s 48 are each amended to read as follows:
Upon
passing an examination and meeting the requirements as provided in RCW
18.29.021, the ((secretary of health)) dental hygiene quality
assurance commission shall issue to the successful applicant a license as
dental hygienist. The license shall be displayed in a conspicuous place in the
operation room where such licensee shall practice.
Sec. 9. RCW 18.29.071 and 1996 c 191 s 11 are each amended to read as follows:
The
((secretary)) dental hygiene quality assurance commission shall
establish the administrative procedures, administrative requirements, and fees
for renewal of licenses as provided in this chapter and in RCW 43.70.250 and
43.70.280.
Sec. 10. RCW 18.29.100 and 1991 c 3 s 50 are each amended to read as follows:
Any
person who shall violate any provision of this chapter shall be guilty of a
misdemeanor. It shall be the duty of the prosecuting attorney of each county
to prosecute all cases involving a violation of this chapter arising within his
or her county. The attorney general may assist in such prosecutions and shall
appear at all hearings when requested to do so by the ((secretary of health))
dental hygiene quality assurance commission.
Sec. 11. RCW 18.29.110 and 1991 c 3 s 51 are each amended to read as follows:
There
shall be a dental hygiene ((examining committee)) quality assurance
commission consisting of three practicing dental hygienists and one public
member appointed by the ((secretary)) governor, to be known as
the Washington dental hygiene ((examining committee)) quality
assurance commission. Each dental hygiene member shall be licensed and
have been actively practicing dental hygiene for a period of not less than five
years in Washington state immediately before appointment and shall not
be connected with any dental hygiene school. The public member shall not be
connected with any dental hygiene program or engaged in any practice or
business related to dental hygiene. Members of the ((committee)) commission
shall be appointed by the ((secretary)) governor to prepare and
conduct examinations for dental hygiene licensure and to conduct
disciplinary procedures in compliance with chapter 18.130 RCW. Members
shall be appointed to serve for terms of three years from October 1 of the year
in which they are appointed. Terms of the members shall be staggered. Each
member shall hold office for the term of his or her appointment and until his
or her successor is appointed and qualified. Any member of the ((committee))
dental hygiene quality assurance commission may be removed by the ((secretary))
governor for neglect of duty, misconduct, malfeasance, or misfeasance in
office, after being given a written statement of the charges against him or her
and sufficient opportunity to be heard thereon. Members of the ((committee))
commission shall be compensated in accordance with RCW 43.03.240 and
shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and
43.03.060.
Sec. 12. RCW 18.29.120 and 1995 c 198 s 5 are each amended to read as follows:
The
((secretary in consultation with the Washington dental hygiene examining
committee)) dental hygiene quality assurance commission shall:
(1) Adopt rules in accordance with chapter 34.05 RCW necessary to prepare and conduct examinations for dental hygiene licensure;
(2)
Require an applicant for licensure to pass an examination consisting of written
and practical tests upon such subjects and of such scope as the ((committee))
commission determines;
(3) Set the standards for passage of the examination;
(4)
Administer at least two examinations each calendar year. Additional
examinations may be given as necessary; ((and))
(5) Establish by rule the procedures for an appeal of an examination failure; and
(6) Conduct disciplinary hearings in compliance with chapter 18.130 RCW.
Sec. 13. RCW 18.29.130 and 1991 c 3 s 53 are each amended to read as follows:
In
addition to any other authority provided by law, the ((secretary)) dental
hygiene quality assurance commission may:
(1) Adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;
(2) Establish forms necessary to administer this chapter;
(3) Issue a license to any applicant who has met the education and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure. Proceedings concerning the denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;
(4) Employ clerical, administrative, and investigative staff as needed to implement and administer this chapter and hire individuals, including those licensed under this chapter, to serve as examiners or consultants as necessary to implement and administer this chapter;
(5) Maintain the official departmental record of all applicants and licensees;
(6) Establish, by rule, the minimum education requirements for licensure, including but not limited to approval of educational programs; and
(7) Establish and implement by rule a continuing education program.
Sec. 14. RCW 18.29.140 and 1991 c 3 s 54 are each amended to read as follows:
The
((secretary)) dental hygiene quality assurance commission shall
establish by rule the standards and procedures for approval of educational
programs and may contract with individuals or organizations having expertise in
the profession or in education to report to the ((secretary)) dental
hygiene quality assurance commission information necessary for the ((secretary))
dental hygiene quality assurance commission to evaluate the educational
programs. The ((secretary)) dental hygiene quality assurance
commission may establish a fee for educational program evaluation. The fee
shall be set to defray the administrative costs for evaluating the educational
program, including, but not limited to, costs for site evaluation.
Sec. 15. RCW 18.29.150 and 1991 c 3 s 55 are each amended to read as follows:
(1)
The ((secretary)) dental hygiene quality assurance commission
shall establish the date and location of the examination. Applicants who meet
the education requirements for licensure shall be scheduled for the next
examination following the filing of the application. The ((secretary)) dental
hygiene quality assurance commission shall establish by rule the
examination application deadline.
(2) The examination shall contain subjects appropriate to the scope of practice and on laws in the state of Washington regulating dental hygiene practice.
(3)
The ((committee)) commission shall establish by rule the
requirements for a reexamination if the applicant has failed the examination.
(4)
The ((committee)) commission may approve an examination prepared
or administered by a private testing agency or association of licensing
authorities.
Sec. 16. RCW 18.29.160 and 1991 c 3 s 56 are each amended to read as follows:
The
((secretary)) dental hygiene quality assurance commission,
members of the ((committee)) commission, and individuals acting
on their behalf are immune from suit in any action, civil or criminal, based on
any acts performed in the course of their duties.
Sec. 17. RCW 18.29.180 and 1991 c 3 s 57 are each amended to read as follows:
The following practices, acts, and operations are excepted from the operation of this chapter:
(1) The practice of dental hygiene in the discharge of official duties by dental hygienists in the United States armed services, coast guard, public health services, veterans' bureau, or bureau of Indian affairs;
(2)
Dental hygiene programs approved by the ((secretary)) dental hygiene
quality assurance commission and the practice of dental hygiene by students
in dental hygiene programs approved by the ((secretary)) dental
hygiene quality assurance commission, when acting under the direction and
supervision of persons licensed under chapter 18.29 or 18.32 RCW acting as
instructors.
Sec. 18. RCW 18.29.190 and 1993 c 323 s 2 are each amended to read as follows:
(1)
The department shall issue a temporary license without the examination required
by this chapter to any applicant who, as determined by the ((secretary))
dental hygiene quality assurance commission:
(a) Holds a valid license in another state that allows the scope of practice in subsection (3)(a) through (j) of this section;
(b) Is currently engaged in active practice in another state. For the purposes of this section, "active practice" means five hundred sixty hours of practice in the preceding twenty-four months;
(c)
Files with the ((secretary)) dental hygiene quality assurance
commission documentation certifying that the applicant:
(i)
Has graduated from an accredited dental hygiene school approved by the ((secretary))
dental hygiene quality assurance commission;
(ii) Has successfully completed the dental hygiene national board examination; and
(iii) Is licensed to practice in another state;
(d)
Provides information as the ((secretary)) dental hygiene quality
assurance commission deems necessary pertaining to the conditions and
criteria of the uniform disciplinary act, chapter 18.130 RCW;
(e)
Demonstrates to the ((secretary)) dental hygiene quality assurance
commission a knowledge of Washington state law pertaining to the practice
of dental hygiene, including the administration of legend drugs;
(f) Pays any required fees; and
(g) Meets requirements for AIDS education.
(2) The term of the temporary license issued under this section is eighteen months and it is nonrenewable.
(3) A person practicing with a temporary license granted under this section has the authority to perform hygiene procedures that are limited to:
(a) Oral inspection and measuring of periodontal pockets;
(b) Patient education in oral hygiene;
(c) Taking intra-oral and extra-oral radiographs;
(d) Applying topical preventive or prophylactic agents;
(e) Polishing and smoothing restorations;
(f) Oral prophylaxis and removal of deposits and stains from the surface of the teeth;
(g) Recording health histories;
(h) Taking and recording blood pressure and vital signs;
(i) Performing subgingival and supragingival scaling; and
(j) Performing root planing.
(4)(a) A person practicing with a temporary license granted under this section may not perform the following dental hygiene procedures unless authorized in (b) or (c) of this subsection:
(i) Give injections of local anesthetic;
(ii) Place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration;
(iii) Soft tissue curettage; or
(iv) Administer nitrous oxide/oxygen analgesia.
(b) A person licensed in another state who can demonstrate substantively equivalent licensing standards in the administration of local anesthetic may receive a temporary endorsement to administer local anesthesia.
(c) A person licensed in another state who can demonstrate substantively equivalent licensing standards in restorative procedures may receive a temporary endorsement for restorative procedures.
Sec. 19. RCW 18.29.210 and 1993 c 323 s 4 are each amended to read as follows:
The
((secretary in consultation with the dental hygiene examining committee))
dental hygiene quality assurance commission shall develop rules and
definitions to implement this chapter.
NEW SECTION. Sec. 20. The following acts or parts of acts are each repealed:
(1) RCW 18.29.050 and 1971 ex.s. c 235 s 1, 1969 c 47 s 4, & 1923 c 16 s 27; and
(2) RCW 18.29.056 and 1984 c 279 s 63.
NEW SECTION. Sec. 21. Sections 1 through 5 of this act are each added to chapter 18.29 RCW.
NEW SECTION. Sec. 22. Section 4 of 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.
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