AN ACT Relating to currently credentialed dental auxiliaries; amending RCW 18.29.190, 18.260.010, 18.260.040, and 18.260.090; adding new sections to chapter 18.29 RCW; adding new sections to chapter 18.260 RCW; and creating a new section.

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:

Beginning January 1, 2024, the department shall issue an expanded function endorsement to any applicant who, as determined by the secretary:

(1) Holds a current license as a dental hygienist in this state;

(2) Completes clinical training approved by the secretary, including coursework encompassing the subject areas within the scope of the expanded function endorsement;

(3) Performs satisfactorily on an examination, if required by the committee; and

(4) Completes an application form and pays all application fees required by the dental hygiene examining committee.

NEW SECTION.  Sec. 2. A new section is added to chapter 18.29 RCW to read as follows:

(1) The department shall adopt requirements that qualify a licensed dental hygienist to be issued the following endorsements:

(a) A restorative expanded function endorsement; and

(b) An anesthesia expanded function endorsement.

(2) A person licensed as a dental hygienist in this state can apply for, and the department may issue to such applicant, an expanded function endorsement under subsection (1)(a) or (b) of this section, or both.

Sec. 4. RCW 18.29.190 and 2019 c 111 s 3 are each amended to read as follows:

(1) The department shall issue an initial limited license without the examination required by this chapter to any applicant who, as determined by the secretary:

(a) Holds a valid license in another state or Canadian province that allows a substantively equivalent scope of practice in subsection (3)(a) through (((j)))(k) of this section;

(b) Is currently engaged in active practice in another state or Canadian province. For the purposes of this section, "active practice" means ((five hundred sixty))560 hours of practice in the preceding ((twenty-four))24 months;

(c) Files with the secretary documentation certifying that the applicant:

(i) Has graduated from an accredited dental hygiene school approved by the secretary;

(ii) Has successfully completed the dental hygiene national board examination; and

(iii) Is licensed to practice in another state or Canadian province;

(d) Provides information as the secretary deems necessary pertaining to the conditions and criteria of the uniform disciplinary act, chapter 18.130 RCW;

(e) Demonstrates to the secretary a knowledge of Washington state law pertaining to the practice of dental hygiene, including the administration of legend drugs;

(f) Pays any required fees; and

(g) Meets requirements for AIDS education.

(2) The term of the initial limited license issued under this section is ((eighteen))18 months and it is renewable upon:

(a) Demonstration of successful passage of a substantively equivalent dental hygiene patient evaluation/prophylaxis examination; and

(b) Demonstration of successful passage of a substantively equivalent local anesthesia examination((;

(d) Demonstration of successful passage of an educational program on the administration of local anesthesia and nitrous oxide analgesia)).

(3) A person practicing with an initial limited license granted under this section has the authority to perform hygiene procedures that are limited to:

(a) Oral inspection and measuring of periodontal pockets;

(b) Patient education in oral hygiene;

(c) Taking intra-oral and extra-oral radiographs;

(d) Applying topical preventive or prophylactic agents;

(e) Polishing and smoothing restorations;

(f) Oral prophylaxis and removal of deposits and stains from the surface of the teeth;

(g) Recording health histories;

(h) Taking and recording blood pressure and vital signs;

(i) Performing subgingival and supragingival scaling; ((and))

(j) Performing root planing; and

(k) Soft tissue curettage.

(((4)(a) A person practicing with an initial limited license granted under this section may not perform the following dental hygiene procedures unless authorized in (b) or (c) of this subsection:

(b) A person practicing with a renewed limited license granted under this section may not place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration.))

Sec. 5. RCW 18.260.010 and 2007 c 269 s 1 are each amended to read as follows:

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

(1) "Close supervision" means that a supervising dentist whose patient is being treated has personally diagnosed the condition to be treated and has personally authorized the procedures to be performed. The supervising dentist is continuously on-site and physically present in the treatment facility while the procedures are performed by the assistive personnel and capable of responding immediately in the event of an emergency. The term does not require a supervising dentist to be physically present in the operatory.

(2) "Commission" means the Washington state dental quality assurance commission created in chapter 18.32 RCW.

(3) "Dental assistant" means a person who is registered by the commission to provide supportive services to a licensed dentist to the extent provided in this chapter and under the ((close))specified level of supervision of a dentist.

(4) "Dentist" means an individual who holds a license to practice dentistry under chapter 18.32 RCW.

(5) "Department" means the department of health.

(6) "Expanded function dental auxiliary" means a person who is licensed by the commission to provide supportive services to a licensed dentist to the extent provided in this chapter and under the specified level of supervision of a dentist.

(7) "General supervision" means that a supervising dentist has examined and diagnosed the patient and provided subsequent instructions to be performed by the assistive personnel, but does not require that the dentist be physically present in the treatment facility.

(8) "Secretary" means the secretary of health.

(9) "Supervising dentist" means a dentist licensed under chapter 18.32 RCW that is responsible for providing the appropriate level of supervision for dental assistants and expanded function dental auxiliaries.

Sec. 6. RCW 18.260.040 and 2015 c 120 s 3 are each amended to read as follows:

(1)(a) The commission shall adopt rules relating to the scope of dental assisting services related to patient care and laboratory duties that may be performed by dental assistants.

(b) In addition to the services and duties authorized by the rules adopted under (a) of this subsection, a dental assistant may apply topical anesthetic agents.

(c) All dental services performed by dental assistants under (a) or (b) of this subsection must be performed under the close or general supervision of a supervising dentist as the dentist may allow.

(2) In addition to any other limitations established by the commission, 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, including intravenous sedation;

(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, or physical condition of the human teeth, jaw, or adjacent structures; and

(f) The taking of any 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, other than impressions allowed as a delegated duty for dental assistants pursuant to rules adopted by the commission.

(3) A dentist may not assign a dental assistant to perform duties until the dental assistant has demonstrated skills necessary to perform competently all assigned duties and responsibilities.

NEW SECTION.  Sec. 7. A new section is added to chapter 18.260 RCW to read as follows:

The commission shall issue a license to practice as a preventive dental assistant to any applicant who:

(1) Pays any applicable fees as established by the secretary in accordance with RCW 43.70.110 and 43.70.250;

(2) Submits, on forms provided by the secretary, the applicant's name, address, and other applicable information as determined by the secretary; and

(3) Demonstrates competency as a preventive dental assistant as determined by the commission.

NEW SECTION.  Sec. 8. A new section is added to chapter 18.260 RCW to read as follows:

(1) The commission shall adopt rules relating to the scope of preventive dental assistant services that may be performed by preventive dental assistants under the supervision of a licensed dentist.

(2) The rules adopted by the commission in subsection (1) of this section shall be limited to:

(a) Services that a dental assistant may perform under the close or general supervision of a supervising dentist;

(b) Dental prophylaxis for patients in a healthy oral state with periodontitis of no greater than stage II as defined by the American academy of periodontology;

(c) Periodontal probing; and

(d) Gross debridement of visible calculus with a noninvasive ultrasonic device.

(3) A dentist may not assign a preventive dental assistant to perform services until the preventive dental assistant has demonstrated skills necessary to perform competently all assigned duties and responsibilities.

Sec. 9. RCW 18.260.090 and 2007 c 269 s 8 are each amended to read as follows:

(1) The commission shall issue an initial credential or renewal credential to an applicant who has met the requirements for a credential or deny an initial credential or renewal credential based upon failure to meet the requirements for a credential or unprofessional conduct or impairment governed by chapter 18.130 RCW.

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