Title: An act relating to pilot projects for dental hygienists.

Brief Description: Creating pilot projects for dental hygienists.

Sponsors: Senators Thibaudeau, Deccio, Kastama, Benson, Keiser and McAuliffe.

Brief History:

Committee Activity: Health & Long-Term Care: 1/26/06, 2/1/06 [DPS, DNP].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report: That Substitute Senate Bill No. 6419 be substituted therefor, and the substitute bill do pass.Signed by Senators Keiser, Chair; Thibaudeau, Vice Chair; Deccio, Ranking Minority Member; Brandland, Franklin, Kastama and Kline.

Minority Report: Do not pass.Signed by Senator Benson.

Staff: Edith Rice (786-7444)

Background: According to the Dental Care Scope of Practice Sunrise Review issued January 2004 by the Department of Health, Washington State is facing a shortage of dental hygienists and dentists. Currently, 35 of 39 counties have some area or population designated as a "Dental Health Professional Shortage Area." The progressive nature of dental diseases coupled with a lack of access to preventive care can significantly diminish the general health and quality of life for those affected. Dental hygienists play an integral role in providing preventive dental care. They typically educate dental patients about appropriate dental care, remove deposits and stains from the surfaces of the teeth, apply topical preventive agents, polish and smooth restorations, take x-rays, record health histories and perform other functions delegated to them by a licensed dentist. Several states already allow for some degree of unsupervised dental hygiene practice. Studies conducted in Colorado and California concluded that unsupervised practice did not exhibit any undue or increased risk to the public. Dental hygienists in Washington already practice unsupervised in limited settings such as nursing homes.

Summary of Substitute Bill: The Secretary of the Department of Health can create five pilot projects in underserved areas of the state where dental hygienists can practice without dentist supervision. The goal is to increase access to effective preventive dental health care while controlling costs. These pilot projects are for a period of three years, during which time they will be used to collect data of those treated, evaluate independently managed dental hygiene practices and examine access to preventive oral health care. The Secretary of Health and the Washington State Dental Hygienists Association will submit a report regarding the outcome of these pilot projects to the Legislature by December 1, 2009. The Department of Health will establish a task force to recommend improvements to oral health services to dentally underserved children and adults in Washington. A report is due to the legislature December 1, 2009.

Substitute Bill Compared to Original Bill: The Secretary of the Department of Health will designate dentally underserved areas of the state, patients seen in this pilot program will be referred to a dentist as needed, the pilot programs will measure changes in access to dental care and the Department of Health will establish a task force to make recommendations regarding improvements to oral health services to dentally underserved children and adults in Washington.

Appropriation: None.

Fiscal Note: Available.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Testimony For: We already practice safely in nursing homes and adult family homes without direct supervision of a dentist. There are many underserved children who have no other access to care. This would expand their ability to be seen. We regularly refer those who need additional care to dentists for follow up. Guidelines would be helpful.

Testimony Against: These pilots would not protect the public or improve quality of care. People who are especially vulnerable would be harmed. It is not economically feasible to do. We should define the problem. This bill creates a conflict of interest, doesn't meet clinic trials standards and would create liability for the Department of Health.

Who Testified: PRO: Senator Thibaudeau, prime sponsor; Robin Houg, Washington Dental Hygienists Association (WSDHA); Robert Howard, (WSDHA); Patricia Funk, (WSDHA); Melissa Johnson, WSDHA.

CON: Mary Jennings, DD, Washington State Dental Assn.; Mark Walker, DD, WSDA; Linda Hull, WSDA.