BP BHEAD INT S [atlas:bill]

AN ACT Relating to dental assistants; amending RCW 18.32.010, 18.32.030, and 18.32.039; adding a new section to chapter 18.32 RCW; and creating a new section.

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

NEW SECTION. Sec. 1. Currently, dental assistants perform certain duties under the supervision of a dentist and are regulated through the dentist's license. The legislature finds that technology, infection control, and dental procedures used by dentists has evolved in recent years, and patients properly expect safe and cost-effective delegation of some of the dentist's duties. The public could be better served, and its access to dental care enhanced, by permitting dental assistants to have training in and perform certain advanced procedures.

Sec. 2. RCW 18.32.010 and 1994 sp.s. c 9 s 202 are each amended to read as follows:

Words used in the singular in this chapter may also be applied to the plural of the persons and things; words importing the plural may be applied to the singular; words importing the masculine gender may be extended to females also; the term "commission" used in this chapter shall mean the Washington state dental quality assurance commission; the term "dental assistant" means a person not licensed as a dentist or dental hygienist who performs certain duties under the supervision of a dentist; and the term "secretary" shall mean the secretary of health of the state of Washington.

Sec. 3. 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) 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, under the supervision of a dentist, when performed by a dental assistant certified for advanced practice;

(10) The performing of dental operations or services by ((~~persons not licensed under this chapter~~)) a dental assistant when performed under the supervision of a licensed dentist((~~: PROVIDED HOWEVER, That such nonlicensed person~~)). However, the 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. 4. A new section is added to chapter 18.32 RCW to read as follows:

(1) The commission may authorize dentists to delegate to dental assistants additional duties as authorized under chapter . . ., Laws of 1998 (this act). However, these duties may only be delegated by a dentist if the assistant has demonstrated to the commission successful completion of an accredited postsecondary education program specifically designed for those duties. The commission shall require that applicants to the postsecondary education programs must be certified by a national dental assisting credentialing organization approved by the commission prior to admission to the program.

(2) The commission shall issue a certificate to a dental assistant for advanced practice who demonstrates to the commission's satisfaction that the following requirements have been met:

(a) Graduation from an educational program approved by the commission; and

(b) Successful completion of any experience requirement established by the commission.

(3) The commission shall establish by rule what constitutes adequate proof of meeting the criteria.

(4) Applicants are subject to the grounds for denial of a certificate or issuance of a conditional certificate under chapter 18.130 RCW.

(5) Applications for certification for advanced practice shall be on forms provided by the secretary. The commission may require any information and documentation that reasonably relates with the need to determine whether the applicant meets the criteria for certification provided in this section and chapter 18.130 RCW. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250, and the fee shall accompany the application.

(6) The secretary shall establish by rule the procedural requirements and fees for renewal of a certificate. Failure to renew invalidates the certificate and all privileges granted by the certificate.

Sec. 5. RCW 18.32.039 and 1987 c 150 s 17 are each amended to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed or unauthorized practice, the issuance and denial of licenses and certificates, and the discipline of licensees and dental assistants certified for advanced practice under this chapter. The commission is the disciplining authority under this chapter.