Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 1309

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Expands the circumstances under which a dental hygienist may practice without the supervision of a dentist.

Changes the definition of "senior center" for purposes of allowing the unsupervised practice of dental hygiene.

Removes reporting requirements relating to the unsupervised practice of dental hygiene in senior centers.

Removes the expiration date from provisions relating to the unsupervised practice of dental hygiene in senior centers.

Removes reporting requirements relating to the practice of dental hygiene in community-based sealant programs.

Removes the expiration date from provisions allowing dental hygienists to remove deposits and stains from the surfaces of teeth in community-based sealant programs.

Background:

Unsupervised Practice of Dental Hygiene

A licensed dental hygienist is authorized to remove deposits and stains from the surfaces of teeth, apply topical preventative or prophylactic agents, polish and smooth restorations, perform root planing and soft-tissue curettage, and other dental operations and services delegated by a dentist. Generally speaking, a dental hygienist must be supervised by a dentist when performing these services.

One exception to this general rule is that a dental hygienist with two years of practical clinical experience within the last five years may provide dental hygiene operations and services without the supervision of a dentist when employed or retained by a health care facility, including a hospital, a nursing home, and a home health agency. Such a hygienist may only remove deposits and stains from the surfaces of teeth, apply topical preventative or prophylactic agents, polish and smooth restorations, and perform root planing and soft-tissue curettage.

Senior Centers

In 2007, the definition of "health care facilities" for purposes of allowing the unsupervised practice of dental hygiene was temporarily expanded to include senior centers. For purposes of this expansion, "senior center" was defined as a multi-purpose community facility operated and maintained by a nonprofit organization or local government for the organization and provision of a broad spectrum of health, social, nutritional, and educational services and recreational activities for persons 60 years of age or older. When providing services in a senior center, the dental hygienist must:

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

The provisions authorizing a dental hygienist to provide dental hygiene without supervision in a senior center expire on July 1, 2009.

Community-Based Sealant Programs

A licensed dental hygienist is authorized 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 in schools. A dental hygienist participating in a community-based sealant program must either have been licensed prior to April 19, 2001, or be school-sealant endorsed under the DOH's School Sealant Endorsement Program. In 2007, the services a dental hygienist is authorized to carry out in these programs were expanded to include removing stains from the surfaces of teeth. This expansion expires on July 1, 2009.

A dental hygienist providing services in a community-based sealant program must collect data on the patients treated under the program and provide the data to the DOH quarter.

Summary of Bill:

Unsupervised Practice of Dental Hygiene

The circumstances under which a dental hygienist may practice without the supervision of a dentist are expanded to include:

when a dental hygienist with two years practical experience in the preceding five years is contracted by a health care facility to provide dental hygiene operations and services; and
when a dental hygienist with two years practical experience in the preceding five years provides dental hygiene operations and services under a lease agreement.

Senior Centers

The definition of "senior center" for purposes of allowing the unsupervised practice of dental hygiene is changed. Instead of a "broad spectrum" of health, social, nutritional, and educational services and recreational activities, the center must only provide one or more of these services. The minimum age persons using the facility is decreased from 60 to 50.

The requirement of reporting patient data to the Department of Health (DOH) is eliminated.

The provisions that allow the unsupervised practice of dental hygiene in senior centers is made permanent; i.e., the expiration date is eliminated.

Community-Based Sealant Programs

The requirement of reporting patient data to the DOH is eliminated.

The provisions that allow dental hygienists to remove deposits and stains from the surfaces of teeth in community-based sealant programs are made permanent; i.e., the expiration date is eliminated.