S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  10721

                          I N  A S S E M B L Y

                             April 16, 2010
                               ___________

Introduced  by  M. of A. PAULIN, CAHILL, CASTRO -- Multi-Sponsored by --
  M. of A. GABRYSZAK, HYER-SPENCER, ORTIZ, REILLY, TITONE --  read  once
  and referred to the Committee on Higher Education

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:

  Section 1. Subdivision 1 of section 6606  of  the  education  law,  as
amended  by  chapter  437  of  the  laws  of 2001, is amended to read as
follows:
  1. The practice of the profession of dental hygiene is defined as  the
performance  of [dental] services [which shall include removing calcare-
ous deposits, accretions and stains from the  exposed  surfaces  of  the
teeth  which  begin  at  the  epithelial attachment and applying topical
agents indicated for a complete  dental  prophylaxis,  removing  cement,
placing  or  removing rubber dam, removing sutures, placing matrix band,
providing patient education, applying topical  medication,  placing  and
exposing  X-ray  films,  performing  topical  fluoride  applications and
topical anesthetic applications, polishing teeth, taking medical  histo-
ry,  charting  caries,  taking  impressions for study casts, placing and
removing temporary restorations, administering  and  monitoring  nitrous
oxide  analgesia  and  administering  and  monitoring local infiltration
anesthesia, subject to certification in accordance with  section  sixty-
six  hundred five-b of this article, and any other function in the defi-
nition of the practice of dentistry as may be delegated  by  a  licensed
dentist  in accordance with regulations promulgated by the commissioner.
The practice of dental hygiene may be conducted in  the  office  of  any
licensed  dentist  or  in  any  appropriately  equipped school or public
institution but must  be  done  under  the  supervision  of  a  licensed
dentist]  FOR  THE  CONTROL  OF  ORAL  DISEASE AND THE PROMOTION OF ORAL
HEALTH THROUGH EDUCATION AND THE DELIVERY OF PREVENTATIVE AND  THERAPEU-
TIC TREATMENTS TO MINIMIZE ORAL DISEASE. SUCH SERVICES SHALL INCLUDE BUT
NOT  BE  LIMITED TO ASSESSMENT, DENTAL HYGIENE DIAGNOSIS, DENTAL HYGIENE
CARE  PLANNING,  ORAL  HEALTH  TEACHING,  ORAL  HEALTH  COUNSELING,  AND
PROVISION  OF TREATMENT SUPPORTIVE TO THE DENTAL HYGIENE CARE PRESCRIBED
BY A LICENSED DENTIST CONSISTENT  WITH  REGULATIONS  SET  FORTH  BY  THE
              

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD16818-01-0

A. 10721                            2

COMMISSIONER.  UNDER THE SUPERVISION OF A LICENSED DENTIST, THE PRACTICE
OF DENTAL HYGIENE SHALL NOT  BE  IMPEDED  BY  THE  SETTING  IN  WHICH  A
LICENSED  DENTAL HYGIENIST MAY PROVIDE DENTAL HYGIENE SERVICES. A REGIS-
TERED  DENTAL  HYGIENIST, COLLABORATIVE PRACTICE, AUTHORIZED PURSUANT TO
SECTION SIX THOUSAND SIX HUNDRED SEVEN-A OF THIS ARTICLE SHALL  PRACTICE
WITHOUT  SUPERVISION  BUT  WITHIN  THE  COLLABORATIVE PRACTICE AGREEMENT
BETWEEN A LICENSED DENTIST AND SUCH DENTAL HYGIENIST.
  S 2. The education law is amended by adding a new  section  6607-a  to
read as follows:
  S 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
TITLE  "REGISTERED  DENTAL  HYGIENIST, COLLABORATIVE PRACTICE". 1.   THE
PRACTICE OF THE PROFESSION OF DENTAL  HYGIENE,  AS  DEFINED  UNDER  THIS
ARTICLE,  MAY  BE  PERFORMED  IN  COLLABORATION  WITH A LICENSED DENTIST
PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN  PRAC-
TICE  AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A COLLABO-
RATIVE PRACTICE  AGREEMENT.  UNDER  COLLABORATIVE  PRACTICE  AGREEMENTS,
DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU-
LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
MAY  BE  PERFORMED  WITHOUT  SUPERVISION  IN  A  COLLABORATIVE  PRACTICE
SETTING.
  2. (A) THE COLLABORATIVE PRACTICE AGREEMENT  SHALL  INCLUDE  CONSIDER-
ATION  FOR  MEDICALLY COMPROMISED PATIENTS, SPECIFIC MEDICAL CONDITIONS,
AND AGE- AND PROCEDURE-SPECIFIC PRACTICE PROTOCOLS, INCLUDING,  BUT  NOT
LIMITED  TO  RECOMMENDED INTERVALS FOR THE PERFORMANCE OF DENTAL HYGIENE
SERVICES AND A PERIODICITY IN WHICH AN EXAMINATION BY A  DENTIST  SHOULD
OCCUR.
  (B) THE COLLABORATIVE AGREEMENT SHALL BE:
  (I)  SIGNED  AND  MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST, AND
THE FACILITY, PROGRAM, OR ORGANIZATION;
  (II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
IST; AND
  (III) MADE AVAILABLE TO THE DEPARTMENT AND  OTHER  INTERESTED  PARTIES
UPON REQUEST.
  3.  BEFORE  PERFORMING  ANY  SERVICES AUTHORIZED UNDER THIS SECTION, A
DENTAL HYGIENIST MUST PROVIDE  THE  PATIENT  WITH  A  WRITTEN  STATEMENT
ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A
SUBSTITUTE FOR A DENTAL EXAMINATION BY A LICENSED DENTIST. IF THE DENTAL
HYGIENIST  MAKES  ANY REFERRALS TO THE PATIENT FOR FURTHER DENTAL PROCE-
DURES, THE DENTAL HYGIENIST MUST FILL OUT A REFERRAL FORM AND PROVIDE  A
COPY OF THE FORM TO THE COLLABORATING DENTIST.
  4.  THE  COLLABORATIVE  PRACTICE  DENTAL  HYGIENIST  MAY  ENTER INTO A
CONTRACTUAL ARRANGEMENT WITH ANY QUALIFIED DENTIST, HEALTH CARE  FACILI-
TY,  PROGRAM,  AND/OR  NON-PROFIT ORGANIZATION TO PERFORM DENTAL HYGIENE
SERVICES IN  THE  FOLLOWING  SETTINGS:  DENTAL  OFFICES;  LONGTERM  CARE
FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR PRIVATE SCHOOLS; PUBLIC
HEALTH AGENCIES/FEDERALLY QUALIFIED HEALTH CENTERS; CORRECTIONAL FACILI-
TIES; PUBLIC INSTITUTIONS/MENTAL HEALTH FACILITIES; AND PRIVATE SETTINGS
IN  WHICH  HOMEBOUND  RESIDENTS ARE UNABLE TO BE RELOCATED FOR NECESSARY
TREATMENT.
  5. A COLLABORATIVE PRACTICE DENTAL HYGIENIST MAY HAVE  MORE  THAN  ONE
COLLABORATING  DENTIST  OR  ORGANIZATION.  A COLLABORATING DENTIST SHALL
HAVE COLLABORATIVE AGREEMENTS WITH NO MORE THAN SIX COLLABORATIVE  PRAC-
TICE  DENTAL  HYGIENISTS.  THE  DEPARTMENT MAY GRANT EXCEPTIONS TO THESE
LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON A CASE-BY-CASE BASIS.
  S 3. This act shall take effect immediately.