Title: An act relating to dental hygiene.

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

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

Brief History: Passed House: 3/08/07, 62-36.

Committee Activity: Health & Long-Term Care: 3/15/07, 3/29/07 [DPA, DNP, w/oRec].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report: Do pass as amended.Signed by Senators Keiser, Chair; Franklin, Vice Chair; Pflug, Ranking Minority Member; Fairley, Kastama, Kohl-Welles and Parlette.

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

Minority Report: That it be referred without recommendation.Signed by Senator Carrell.

Staff: Edith Rice (786-7444)

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 of Substitute Bill: 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 DOH, with a dentist who will provide off-site supervision;
• collect data on the patients treated and provide the data to DOH on request; 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 DOH must report to the Legislature by December 1, 2008, a summary of information about the patients served in the senior center program, including the dental health outcomes, and any recommendations about services that could appropriately be provided in senior centers by dental hygienists.

The services that licenced dental hygienists may perform for low-income, rural, and at-risk populations are expanded to allow the removal of deposits and stains from the surfaces of teeth.

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.

EFFECT OF CHANGES MADE BY RECOMMENDED AMENDMENT(S) AS PASSED COMMITTEE (Health & Long-Term Care): Hygienists will capture data on patients treated in the sealant program and submit the data quarterly to the DOH. A sunset date of July 2009 is established for removing deposits and stains. Dentists will be involved in the DOH stakeholder consultation and information is provided to parents on potential needs of the patient which might need to be addressed by a dentist. DOH will review these services, including the dental sealant program, and the effect on the dental health of patients.

Appropriation: None.

Fiscal Note: Available.

Committee/Commission/Task Force Created: No.

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

Staff Summary of Public Testimony: PRO: This bill allows us to increase access to dental care and is very much consistent with establishing a dental home. These are individuals who wouldn't have access to dental care otherwise. Having a medical/dental home is important. There are protections built into the bill so that referrals are made to dentists.

CON: We oppose this care involving children because their parents need to be involved.

Persons Testifying: PRO: Representative Green, prime sponsor; Melissa Johnson, Kate Mills, Washington State Dental Hygienist Association; Anita Rodriquez, Alliance of Dental Hygiene Practitioners.

CON: David Michener, David Hemion, Dr. Mary Jennings, Washington State Dental Association.