Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 1514

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 Description: Concerning advanced function dental auxiliaries.

Sponsors: Representatives Cody, Moeller, Green, Jinkins, Appleton and Pollet.

Brief Summary of Bill

  • Creates a new profession: advanced function dental auxiliaries.

Hearing Date: 2/5/13

Staff: Jim Morishima (786-7191).

Background:

Dental Personnel in Washington.

Washington currently has a variety of credentialed providers who provide assistance to licensed dentists. For example:

The Dental Quality Assurance Commission.

The DQAC is the disciplining authority for dentists, dental assistants, expanded function dental auxiliaries, and dental anesthesia assistants. The DQAC consists of 16 members: 12 dentists, two public members, and two expanded function dental auxiliaries.

Mid-Level Dental Providers In Other States.

Other states have established mid-level dental providers who are authorized to provide a wide range of services. For example:

Summary of Bill:

A new profession is created: advanced function dental auxiliary. An advanced function dental auxiliary must meet the following requirements to be licensed by the DQAC:

The DQAC must adopt rules relating to the scope of advanced function dental auxiliary services. An advanced function dental auxiliary may perform the following services under the general supervisionof a dentist:

An advanced function dental auxiliary may perform the following services under the close supervisionof a dentist:

Services provided by an advanced function dental auxiliary are subject to the direction and control of the supervising dentist, to applicable protocols established by the supervising dentist, and to rules established by the DQAC. The supervising dentist must examine the patient, make the diagnosis of the patient's dental condition, and determine the treatment to be provided. An advanced function dental auxiliary may not diagnose the dental condition of a patient or independently determine the treatment to be provided.

An advanced function dental auxiliary must work within the parameters of a written practice agreement with a dentist. If the supervisory relationship ends, the advanced function dental auxiliary must discontinue practice until a new agreement is established. Practice agreements must be submitted to the DQAC and made available upon request. The practice agreement must include the delegated functions the advanced function dental auxiliary may perform and practice protocols established by the supervising dentist. The protocols must, at a minimum, contain the following:

An advanced function dental auxiliary must wear a badge identifying his or her profession whenever he or she is treating patients. An advanced function dental auxiliary may not be presented in a manner that would tend to mislead patients or the public as to his or her title. Patient consent must include specific disclosure of the services that will be provided by the advanced function dental auxiliary.

An advanced function dental auxiliary may only practice in federally qualified health centers approved by the DQAC. A dentist may supervise no more than two advanced function dental auxiliaries. By November 15, 2022, the DQAC must submit recommendations to the Legislature on maintaining, modifying, or removing these restrictions.

The membership of the DQAC is expanded by one dental auxiliary member (currently, two members must be expanded function dental auxiliaries). Of the three dental auxiliary members, one must be an expanded function dental auxiliary, one must be an advanced function dental auxiliary, and one may be either type of dental auxiliary.

The scope of practice of expanded function dental auxiliaries is expanded to include:

Appropriation: None.

Fiscal Note: Requested on January 30, 2013.

Effective Date: This bill takes effect 90 days after adjournment of the session in which the bill is passed, except for section 14 adding members to the DQAC, which takes effect on July 1, 2018, and sections 16 and 18 adding dental practitioners and dental hygiene practitioners to the Uniform Disciplinary Act and the definition of "practitioner" for purposes of sunrise reviews, which take effect on July 1, 2016.