Authorizes a licensed dental hygienist, collaborative practice to provide services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A488C
SPONSOR: Paulin TITLE OF BILL: An act to amend the education law, in relation to
registered dental hygienists working without supervision but within a
collaborative practice agreement with a licensed dentist
PURPOSE: :
To authorize registered dental hygienists, collaborative practice, to
provide certain dental services without supervision under a collabora-
tive practice agreement with a licensed dentist.
SUMMARY OF PROVISIONS:
Section one amends section 6606 of the education law to establish and
define the practice of collaborative practice dental hygiene. This
section provides that the practice of dental hygiene may be performed in
collaboration with a licensed dentist provided such services are
performed in accordance with a written practice agreement and written
practice protocols. This section also establishes the required content
and procedures pertaining to the written collaborative practice agree-
ment.
Section one of this bill also requires dental hygienists to provide a
patient with a written statement advising the patient that dental
hygiene services are not a substitute for a dental examination by a
licensed dentist, and to make referrals for further dental procedures as
necessary.
Section one further provides the Locations where dental services may be
provided by a registered dental hygienist, collaborative practice. Addi-
tionally, section one lays out the training, experience, and education
requirements for a registered dental hygienist to practice under a
collaborative agreement.
Section two provides the effective date .
JUSTIFICATION:
According to the Department of Health's Oral Health Plan for New York
State (2014) , approximately 44% of children in New York experience
tooth decay by the third grade and about of New Yorkers 65 years and
older have lost all their teeth. Because of current disparities that
exist in oral health, these numbers are even higher among low-income and
minority populations. Increasing access to dental hygiene services will
help to ensure that all New Yorkers are able to receive quality oral
healthcare.
Dental hygienists fulfill a critical role in the provision of dental
care, both in private practice and public health settings. In fact, a
2010 report issued by the Pew Center on the States found that adding
dental hygienists to a practice. enables most private-practice dentists
to serve more patients while increasing profitability and productivity.
The enactment of the federal Affordable Care Act, which mandates
insurance coverage for pediatric dental care, continues to increase
patient demand for dental care. Thus, it is imperative that dental
hygienists skills and training are fully utilized, freeing-'up dentists
to treat more patients.
The Medicaid Redesign Team (MRT) supported this action as one of its top
five priorities of their twelve final recommendations. According to the
2011 published recommendations from MRT, this bill will allow for the
maximum utilization of the dental hygienists in New York State, in keep-
ing with their education, training, and expertise as oral health
prevention specialists. Collaborative Practice will serve to improve the
oral health status of New Yorkers and promote the prevention of disease
and oral health.
Collaborative practice is another way to increase access to dental
hygiene care and disease prevention. Collaborative practice dental
hygienists would be able to practice, pursuant to the terms of the
collaborative practice agreement, without the supervision of the
dentist. This makes it much easier for dental hygienists to practice in
under-served communities, where there is a great need for prophylactic
treatments and oral health counseling. Collaborative practice dental
hygienists would also screen patients for disease and refer them to the
collaborating dentist for dental examinations and other treatments This
creates more opportunities for New Yorkers to receive dental hygiene
care, and decreases their risk of developing oral disease and tooth
decay.
Moreover, this bill requires registered dental hygienists to apply for a
new certification with the New York State Education Department for
Collaborative Practice (RDH-CP). Three years of experience and continu-
ing education requirements are required for the certification.
LEGISLATIVE HISTORY: :
A. 3934, 2021 and 2022, referred to higher education.
A. 335, 2019 and 2020, referred to higher education.
A. 2553, 2017 and 2018, referred to higher education.
Same as S. 743, 2017 and 2018, referred to higher education.
A. 1959, 2015 and 2016, referred to higher education.
Same as S. 3308, 2015 and 2016, referred to higher education.
A. 5096, 2013 and 2014, referred to higher education.
Same as 5.1944, 2013 and 2014, referred to higher education.
A. 111-A, 2011 and 2012, referred to higher education. Same as 5.7353,
2012, referred to higher education.
FISCAL IMPLICATIONS: :
None.
EFFECTIVE DATE:
This act shall take effect eighteen months after it shall have become
law.
STATE OF NEW YORK
________________________________________________________________________
488--C
2023-2024 Regular Sessions
IN ASSEMBLY
January 9, 2023
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Higher Education -- recommitted to the Committee on Higher Educa-
tion in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee -- recommitted to the Committee on Higher Education
in accordance with Assembly Rule 3, sec. 2 -- committee discharged,
bill amended, ordered reprinted as amended and recommitted to said
committee -- recommitted to the Committee on Higher Education in
accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the education law, in relation to registered dental
hygienists working without supervision but within a collaborative
practice agreement with a licensed dentist
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 6606 of the education law, as amended by chapter
2 244 of the laws of 1973, subdivision 1 as amended by chapter 239 of the
3 laws of 2013, is amended to read as follows:
4 § 6606. Definition of practice of dental hygiene. 1. The practice of
5 the profession of dental hygiene is defined as the performance of dental
6 services which shall include removing calcareous deposits, accretions
7 and stains from the exposed surfaces of the teeth which begin at the
8 epithelial attachment and applying topical agents indicated for a
9 complete dental prophylaxis, removing cement, placing or removing rubber
10 dam, removing sutures, placing matrix band, providing patient education,
11 applying topical medication, placing and exposing diagnostic dental
12 X-ray films, performing topical fluoride applications and topical anes-
13 thetic applications, polishing teeth, taking medical history, charting
14 caries, taking impressions for study casts, placing and removing tempo-
15 rary restorations, administering and monitoring nitrous oxide analgesia
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02162-11-4
A. 488--C 2
1 and administering and monitoring local infiltration anesthesia, subject
2 to certification in accordance with section sixty-six hundred five-b of
3 this article, and any other function in the definition of the practice
4 of dentistry as may be delegated by a licensed dentist in accordance
5 with regulations promulgated by the commissioner. The practice of dental
6 hygiene may be conducted in the office of any licensed dentist or in any
7 appropriately equipped school or public institution but [must] shall be
8 done either under the supervision of a licensed dentist or[, in the case
9 of a registered dental hygienist working for a hospital as defined in
10 article twenty-eight of the public health law, pursuant to a collabora-
11 tive arrangement with a licensed and registered dentist who has a formal
12 relationship with the same hospital in accordance with regulations
13 promulgated by the department in consultation with the department of
14 health] may be performed by a registered dental hygienist designated as
15 a registered dental hygienist, collaborative practice in collaboration
16 with a licensed dentist provided such services are performed in accord-
17 ance with a written practice agreement and written practice protocols to
18 be known as a collaborative practice agreement. Under a collaborative
19 practice agreement, dental hygienists may perform all services which are
20 designated in regulation under general supervision without prior evalu-
21 ation of a dentist or medical professional and may be performed without
22 supervision in an authorized setting as defined in subdivision four of
23 this section. Such collaborative [arrangement] agreements shall not
24 obviate or supersede any law or regulation which requires identified
25 services to be performed under the personal supervision of a dentist.
26 [When dental hygiene services are provided pursuant to a collaborative
27 agreement, such dental hygienist shall instruct individuals to visit a
28 licensed dentist for comprehensive examination or treatment.]
29 2. The collaborative practice agreement shall:
30 (a) be signed and maintained by the dentist, the dental hygienist and
31 authorized setting;
32 (b) be reviewed annually by the dentist and dental hygienist;
33 (c) include consideration for medically compromised patients, specific
34 medical conditions, and age- and procedure-specific practice protocols,
35 including, but not limited to recommended intervals for the performance
36 of dental hygiene services and a periodicity in which an examination
37 by a dentist should occur; and
38 (d) be made available to the department and other interested parties
39 upon request.
40 3. Before performing services pursuant to a collaborative practice
41 agreement, a dental hygienist, collaborative practice shall provide the
42 patient with a written statement advising the patient that the dental
43 hygiene services provided are not a substitute for a dental examination
44 by a licensed dentist. If the dental hygienist makes any referrals to
45 the patient for further procedures, the dental hygienist shall fill out
46 a referral form and provide a copy of the form to the collaborating
47 dentist.
48 4. The performance of services pursuant to a collaborative agreement
49 is authorized in the following settings: a hospital as defined in arti-
50 cle twenty-eight of the public health law, an appropriately equipped
51 school, a federally qualified health center, a long-term care facility,
52 a group home servicing people with intellectual and developmental disa-
53 bilities, a facility serving veterans, a temporary housing facility, a
54 prison, a drug treatment facility, a domestic violence shelter, and
55 appropriate settings in which homebound residents are unable to be relo-
56 cated for necessary treatment.
A. 488--C 3
1 5. A registered dental hygienist, collaborative practice shall have
2 no more than one collaborative agreement with a dentist at one time.
3 6. A dentist shall not have a collaborative agreement with more than
4 six registered dental hygienists, collaborative practice at one time.
5 The department may grant an exception to such limitation for public
6 health settings on a case-by-case basis.
7 7. A dental hygienist shall file an application with the department to
8 practice as a registered dental hygienist, collaborative practice and
9 pay a fee determined by the department. As a condition of collaborative
10 practice, the dental hygienist shall have been engaged in practice for
11 three years with a minimum of four thousand five hundred practice hours
12 and shall complete an eight-hour continuing education program that
13 includes instruction in medical emergency procedures, risk management,
14 dental hygiene jurisprudence and professional ethics.
15 8. The commissioner shall promulgate regulations defining the func-
16 tions a dental hygienist may perform that are consistent with the train-
17 ing and qualifications for a license as a dental hygienist.
18 § 2. This act shall take effect eighteen months after it shall have
19 become a law.
