BILL REQ. #:  H-0573.1 

Read first time 01/17/2005.   Referred to Committee on Health Care.

     AN ACT Relating to providers of dental services; amending RCW 18.29.021, 18.29.045, 18.29.050, 18.29.120, 18.29.140, 18.29.150, 18.29.160, and 18.29.210; adding new sections to chapter 18.29 RCW; adding a new chapter to Title 18 RCW; and repealing RCW 18.29.110, 18.29.130, and 18.29.170.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 18.29 RCW to read as follows:
     Dental hygienists licensed under this chapter with two years' practical clinical experience with a licensed dentist within the preceding five years may perform all dental operations and services authorized under RCW 18.29.050 without dental supervision. However, the administration of local anesthetic and nitrous oxide may only be performed under the close supervision of a licensed dentist or physician.

NEW SECTION.  Sec. 2   A new section is added to chapter 18.29 RCW to read as follows:
     (1) The board of dental hygiene is created. The board consists of six members who must be appointed by the governor. Of the initial appointments, two members must be appointed for a term of two years, three members for a term of three years, and one member for a term of four years. Thereafter, all appointments shall be for terms of four years.
     (2) Five members of the board must: (a) Be dental hygienists licensed under this chapter and residing in this state; (b) have at least five years' experience in the practice of dental hygiene; (c) be actively engaged in the practice of dental hygiene within two years of appointment; and (d) not be connected with any dental hygiene school. The sixth member must be appointed from the public at large, have an interest in the rights of consumers of dental services, and not be or have been a member of any other licensing board, a licensee of any dental-related board, an employee of any dental services facility, not be connected with any dental hygiene program, or engaged in any practice or business related to dental hygiene or derive his or her primary livelihood from the provision of dental services at any level of responsibility.
     (3) In the event that a member of the board of dental hygiene cannot complete his or her term of office, the governor must appoint another member in accordance with the procedures stated in this section to fill the remainder of the term. No member may serve for more than two consecutive four-year terms.

NEW SECTION.  Sec. 3   A new section is added to chapter 18.29 RCW to read as follows:
     In addition to other duties specified in this chapter, the board of dental hygiene has the following powers and duties:
     (1) To develop and administer, or approve, or both, examinations to applicants for licensure under this chapter;
     (2) To establish the qualifications of persons applying for licensure as a dental hygienist under this chapter and to certify to the secretary duly qualified applicants;
     (3) To adopt rules not inconsistent with the laws of this state as may be deemed necessary or proper to carry out the purposes of this chapter;
     (4) To establish and administer requirements for continuing competency, which shall be a prerequisite to renewing a license under this chapter;
     (5) To keep an official record of all board of dental hygiene proceedings. The record is evidence of all proceedings of the board of dental hygiene that are set forth in the official record;
     (6) When appropriate, to adopt rules not inconsistent with the laws of this state in response to questions put to it by professional dental-related associations, dental hygienists, and consumers in this state concerning the authority of dental hygienists to perform certain acts; and
     (7) When appropriate, to consult with the dental quality assurance commission.

NEW SECTION.  Sec. 4   A new section is added to chapter 18.29 RCW to read as follows:
     The board of dental hygiene shall elect from its members a chair and vice-chair who must serve for one year or until their successors are elected. The board of dental hygiene must meet at least once a year and upon the call of the chair at such times and places as the chair designates. Four members constitute a quorum of any business. Meetings of the board of dental hygiene are open and public, except the board may hold executive sessions to the extent permitted by chapter 42.30 RCW. Members of the board of dental hygiene must be compensated in accordance with RCW 43.03.240 and be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060. The secretary shall furnish secretarial, clerical, and other assistance as the board may require.

Sec. 5   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:
     (a) Has successfully completed an educational program approved by the ((secretary)) board of dental hygiene. 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 board of dental hygiene ((examining committee)); 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. 6   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)) board of dental hygiene 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)) board of dental hygiene may require the applicant to: (1) File with the secretary documentation certifying the applicant is licensed to practice in another state; and (2) provide information as the secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW and to demonstrate to the secretary a knowledge of Washington law pertaining to the practice of dental hygiene.

Sec. 7   RCW 18.29.050 and 2003 c 257 s 1 are each amended to read as follows:
     (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 preventive or prophylactic agents, may polish and smooth restorations, may perform root planing and soft-tissue curettage, and may perform other dental operations and services delegated to them by a licensed dentist: PROVIDED HOWEVER, That licensed dental hygienists shall in no event perform the following dental operations or services:
     (((1))) (a) Any surgical removal of tissue of the oral cavity;
     (((2))) (b) Any prescription of drugs or medications requiring the written order or prescription of a licensed dentist or physician, except that a hygienist may place antimicrobials pursuant to the order of a licensed dentist and under the dentist's required supervision;
     (((3))) (c) Any diagnosis for treatment or treatment planning; or
     (((4))) (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 dental operations and services only under the supervision of a licensed dentist, and under such supervision may be employed by hospitals, boards of education of public or private schools, county boards, boards of health, or public or charitable institutions, or in dental offices.
     (3) For the purpose of this section, a licensed dental hygienist may delegate certain functions to a dental assistant as established by the board of dental hygiene by rule. The dental assistant may only perform the delegated function under the close supervision of a licensed dental hygienist.

Sec. 8   RCW 18.29.120 and 1995 c 198 s 5 are each amended to read as follows:
     The ((secretary in consultation with the Washington)) board of dental hygiene ((examining committee)) 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)) board of dental hygiene 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.

Sec. 9   RCW 18.29.140 and 1991 c 3 s 54 are each amended to read as follows:
     The ((secretary)) board of dental hygiene 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)) board of dental hygiene information necessary for the secretary to evaluate the educational programs. The ((secretary)) board of dental hygiene 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. 10   RCW 18.29.150 and 1991 c 3 s 55 are each amended to read as follows:
     (1) The ((secretary)) board of dental hygiene 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)) board of dental hygiene 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)) board of dental hygiene shall establish by rule the requirements for a reexamination if the applicant has failed the examination.
     (4) The ((committee)) board of dental hygiene may approve an examination prepared or administered by a private testing agency or association of licensing authorities.

Sec. 11   RCW 18.29.160 and 1991 c 3 s 56 are each amended to read as follows:
     The secretary, members of the ((committee)) board of dental hygiene, 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. 12   RCW 18.29.210 and 1993 c 323 s 4 are each amended to read as follows:
     The ((secretary in consultation with the)) board of dental hygiene ((examining committee)) shall develop rules and definitions to implement this chapter.

NEW SECTION.  Sec. 13   The legislature finds that the health and well-being of the people of this state are of paramount importance.
     The legislature also finds that dental care has become more complex, while at the same time scientific knowledge has evolved, allowing for a better understanding of the relationship between oral health and overall physical health.
     The legislature declares that the registration of dental assistants is in the interest of the public health, safety, and welfare.

NEW SECTION.  Sec. 14   The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Commission" means the dental quality assurance commission.
     (2) "Dental assistant" means a person who is registered by the secretary to provide supportive services to a licensed dentist or licensed dental hygienist to the extent provided in this chapter under the close supervision of the dentist or dental hygienist.
     (3) "Secretary" means the secretary of health.

NEW SECTION.  Sec. 15   (1) The commission shall adopt rules relating to dental services that may be performed by registered dental assistants. All dental services performed by registered dental assistants must be performed under the close supervision of a licensed dentist or dental hygienist.
     (2) In addition to any other limitations established by the commission, registered dental assistants may not perform the following procedures:
     (a) Any scaling procedure;
     (b) Any oral prophylaxis, except coronal polishing;
     (c) Administration of any general or local anesthetic;
     (d) Any removal of or addition to the hard or soft tissue of the oral cavity;
     (e) Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, physical condition of the human teeth, jaw, or adjacent structures; and
     (f) The taking of 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. 16   The secretary shall issue a dental assistant registration to an applicant who pays the applicable fees and submits, on forms provided by the secretary, the applicant's name, address, and other information as determined by the commission, provided that there are no grounds for denial of registration or issuance of a conditional registration under this chapter or chapter 18.130 RCW.

NEW SECTION.  Sec. 17   Sections 13 through 16 of this act constitute a new chapter in Title 18 RCW.

NEW SECTION.  Sec. 18   The following acts or parts of acts are each repealed:
     (1) RCW 18.29.110 (Dental hygiene examining committee -- Generally) and 1991 c 3 s 51 & 1989 c 202 s 3;
     (2) RCW 18.29.130 (Secretary's authority -- Generally -- Continuing education) and 1991 c 3 s 53 & 1989 c 202 s 5; and
     (3) RCW 18.29.170 (Committee meetings -- Quorum -- Effect of vacancy) and 1989 c 202 s 9.