Brief Description: Regarding dental hygienist employment by health care facilities and sealant programs in schools.

Sponsors: By House Committee on Health Care & Wellness (originally sponsored by Representatives Green, Campbell, Cody, Morrell, Moeller and Conway).

House Committee on Health Care & Wellness
Senate Committee on Health & Long-Term Care

Background:

Dental hygienists must be licensed by the Department of Health (DOH) to perform specified services under a licensed dentist's supervision. These basic services include removing deposits and stains from the surfaces of the teeth, applying topical preventive agents, polishing and smoothing restorations, and performing root planing and soft-tissue curettage. A licensed dentist may also delegate other services to dental hygienists, but certain services may not be delegated, such as surgical removal of oral cavity tissue and prescribing prescription drugs.

Under a statutory exception, experienced dental hygienists may perform the basic services without dental supervision. These dental hygienists may be employed to perform these services for patients, students, and residents of health care facilities, including hospitals, nursing homes, and certain public facilities and institutions. To participate, the dental hygienist must have had, within the last five years, two years of practical clinical experience with a licensed dentist.

Licensed dental hygienists are also permitted to assess for and apply sealants and fluoride varnishes for low-income, rural, and other at-risk populations in community-based sealant programs carried out at schools. Dental hygienists who participate in these programs must complete a school sealant endorsement program created by the DOH or be licensed before April 19, 2001.

Summary:

Until July 1, 2009, the list of health care facilities that may employ experienced licensed dental hygienists to perform basic services without on-site dental supervision is expanded to include senior centers. When providing these services, however, the dental hygienist must:

• enter into a written practice arrangement plan, approved by the DOH, with a dentist who will provide off-site supervision;
• collect data on the patients treated and provide the data to the DOH each quarter; and
• obtain relevant information about the patient's health from the patient's primary care provider.

A "senior center" is a multipurpose community facility operated by a nonprofit or local government to provide health, social, nutritional, and educational services and recreational activities for persons age 60 or above.

The services that licenced dental hygienists may perform for low-income, rural, and at-risk populations are expanded to allow, until July 1, 2009, the removal of deposits and stains from the surfaces of teeth. The dental hygienist must collect data on the patients treated and provide data to DOH each quarter.

When providing services under these programs, the dental hygienist must provide the patient or patient's parent with a notice that the treatment is a preventive service only, and must assist the patient to obtain a dental referral, including providing a list of dentists in the community. Written information should be provided to the parent on potential needs of the patient.

The DOH must report to the Legislature by December 1, 2008, a summary of information about the patients served in these programs, including the dental health outcomes, and any recommendations about services that could appropriately be provided by dental hygienists in senior centers and school sealant programs.

Votes on Final Passage:

House   62   36
Senate   49   0   (Senate amended)
House   69   25   (House concurred)

Effective: July 22, 2007