senate Bill S4604

Relates to registered dental hygienists

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 15 / Apr / 2013
    • REFERRED TO HIGHER EDUCATION
  • 08 / Jan / 2014
    • REFERRED TO HIGHER EDUCATION

Summary

Relates to registered dental hygienists.

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Bill Details

See Assembly Version of this Bill:
A6232A
Versions:
S4604
Legislative Cycle:
2013-2014
Current Committee:
Senate Higher Education
Law Section:
Education Law
Laws Affected:
Amd ยงยง6605-b, 6606, 6608 & 6611, Ed L

Sponsor Memo

BILL NUMBER:S4604

TITLE OF BILL: An act to amend the education law, in relation to
registered dental hygienists

PURPOSE: To authorize dental hygienists to practice without
supervision but within a collaborative practice agreement with a
licensed dentist.

SUMMARY OF PROVISIONS:

Section one mandates that a dental hygienist shall not administer or
monitor nitrous oxide analgesia or local infiltration anesthesia in
the practice of dental hygiene without a proper certificate and except
under the personal supervision of a dentist.

Section two defines the practice of dental hygiene. This section also
provides that a registered dental hygienist working for a hospital may
practice pursuant to a collaborative practice agreement with a
licensed dentist.

Section three defines the practice of certified dental assisting as
the provision of supportive services to a dentist in his/her
performance of dental services. This section provides that these
supportive services may be performed by a registered dental hygienist
who practices in collaboration with a licensed dentist.

Section four extends the requirement to be certified in
cardiopulmonary resuscitation (CPR) and maintain current certification
to registered dental hygienists who practice in collaboration with a
licensed dentist.

Section five provides that this act shall take effect April 1, 2014.

JUSTIFICATION: According to the Department of Health's Oral Health
Plan for New York State (2005), approximately 50 percent of children
in New York State experience tooth decay by the third grade and about
18 percent of adult 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. A 2010 report by the Pew Center on the States found that adding
dental hygienists to a practice enables most dentists to serve more
patients while increasing profitability and productivity. With the
enactment of the federal health care reform law in 2010, which
extended dental insurance to an estimated 5.3 million more children
nationally by 2014, patient demand for dental care will continue to
increase. Thus, it is imperative that dental hygienists' skills and
training are fully utilized, thereby freeing up dentists to treat more
patients.

The Medicaid Redesign Team (MRT) supports collaborative practice for
dental hygienists as a way to reduce the cost of dental care.


Collaborative practice will improve the oral health status of New
Yorkers by promoting oral healthcare and the prevention of disease.

Dental hygienists working in a collaborative practice would be able to
practice in a hospital or health clinic, pursuant to the terms of the
collaborative practice agreement, without the supervision of the
dentist. Collaborative practice dental hygienists would 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.

LEGISLATIVE HISTORY: This is a new bill.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: This act shall take effect April 1, 2014.

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

                                  4604

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             April 15, 2013
                               ___________

Introduced  by  Sen. RITCHIE -- read twice and ordered printed, and when
  printed to be committed to the Committee on Higher Education

AN ACT to amend the education law,  in  relation  to  registered  dental
  hygienists

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 1 of section 6605-b of the  education  law,  as
added by chapter 437 of the laws of 2001, is amended to read as follows:
  1.  [A] NOTWITHSTANDING ANY PROVISION HEREIN TO THE CONTRARY, A dental
hygienist shall not administer or monitor  nitrous  oxide  analgesia  or
local  infiltration anesthesia in the practice of dental hygiene without
a dental hygiene restricted local infiltration anesthesia/nitrous  oxide
analgesia  certificate  and  except  under the personal supervision of a
dentist and in conjunction with the performance of dental hygiene proce-
dures authorized by law and in accordance with  regulations  promulgated
by the commissioner. Personal supervision, for purposes of this section,
means  that  the  supervising dentist remains in the dental office where
the local infiltration anesthesia or nitrous  oxide  analgesia  services
are  being  performed,  personally  authorizes and prescribes the use of
local infiltration anesthesia or nitrous oxide analgesia for the patient
and, before dismissal of the patient, personally examines the  condition
of the patient after the use of local infiltration anesthesia or nitrous
oxide  analgesia  is  completed.  It  is  professional  misconduct for a
dentist to fail to provide the supervision required by this section, and
any dentist  found  guilty  of  such  misconduct  under  the  procedures
prescribed  in  section  sixty-five  hundred  ten of this title shall be
subject to the penalties prescribed in section sixty-five hundred eleven
of this title.
  S 2. 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:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09751-03-3

S. 4604                             2

  1. The practice of the profession of dental hygiene is defined as  the
performance  of  dental services which shall include removing calcareous
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
DIAGNOSTIC  DENTAL X-ray films, performing topical fluoride applications
and topical anesthetic applications,  polishing  teeth,  taking  medical
history,  charting  caries,  taking impressions for study casts, placing
and  removing  temporary  restorations,  administering  and   monitoring
nitrous  oxide  analgesia  and administering and monitoring local infil-
tration anesthesia, subject to certification in accordance with  section
sixty-six  hundred five-b of this article, and any other function in the
definition 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 EITHER under the supervision of a
licensed dentist OR, IN THE CASE OF A REGISTERED DENTAL HYGIENIST  WORK-
ING  FOR  A  HOSPITAL  AS  DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC
HEALTH LAW, PURSUANT TO A  COLLABORATIVE  ARRANGEMENT  WITH  A  LICENSED
DENTIST  PURSUANT TO REGULATIONS PROMULGATED PURSUANT TO ARTICLE TWENTY-
EIGHT OF THE PUBLIC HEALTH LAW.
  S 3. Section 6608 of the education law, as amended by chapter  300  of
the laws of 2006, is amended to read as follows:
  S 6608. Definition  of  practice  of  certified  dental assisting. The
practice of certified dental assisting is defined as providing  support-
ive  services  to  a  dentist  in his/her performance of dental services
authorized under this article.  Such  support  shall  include  providing
patient  education, taking preliminary medical histories and vital signs
to be reviewed by the dentist, placing and removing rubber dams, select-
ing and prefitting provisional crowns, selecting and  prefitting  ortho-
dontic bands, removing orthodontic arch wires and ligature ties, placing
and  removing  matrix bands, taking impressions for study casts or diag-
nostic casts, removing periodontal  dressings,  and  such  other  dental
supportive  services  authorized  by  the  dentist consistent with regu-
lations promulgated by the commissioner, provided  that  such  functions
are  performed  under  the  direct  personal  supervision  of a licensed
dentist in the course  of  the  performance  of  dental  services.  Such
services  shall not include diagnosing and/or performing surgical proce-
dures, irreversible procedures or procedures that would alter  the  hard
or  soft  tissue  of the oral and maxillofacial area or any other proce-
dures determined by the department. The  practice  of  certified  dental
assisting  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 direct personal supervision of a  licensed  dentist.    Direct
personal supervision, for purposes of this section, means supervision of
dental  procedures  based on instructions given by a licensed dentist in
the course of a procedure who remains in the  dental  office  where  the
supportive services are being performed, personally diagnoses the condi-
tion  to  be  treated,  personally authorizes the procedures, and before
dismissal of the patient, who remains the responsibility of the licensed
dentist, evaluates the services performed by the dental assistant. Noth-
ing herein authorizes a dental assistant to perform any of the  services
or  functions  defined  as  part  of  the  practice of dental hygiene in

S. 4604                             3

accordance with the provisions of subdivision one of  section  sixty-six
hundred  six of this article, except those functions authorized pursuant
to this section. All dental supportive services provided in this section
may  be  performed  by  currently  registered  dental hygienists under a
dentist's supervision OR BY A REGISTERED DENTAL HYGIENIST WORKING FOR  A
HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHO
PRACTICES  IN  COLLABORATION  WITH A LICENSED DENTIST IN ACCORDANCE WITH
SUBDIVISION ONE OF SECTION SIXTY-SIX HUNDRED SIX  OF  THIS  ARTICLE,  as
defined in regulations of the commissioner.
  S  4.  Subdivision 10 of section 6611 of the education law, as amended
by chapter 65 of the laws of 2011, is amended to read as follows:
  10. [Beginning January first, two thousand nine,  each]  EACH  dentist
AND  REGISTERED  DENTAL  HYGIENIST  WORKING FOR A HOSPITAL AS DEFINED IN
ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHO PRACTICES  IN  COLLAB-
ORATION  WITH  A LICENSED DENTIST shall become certified in cardiopulmo-
nary resuscitation (CPR) from an approved provider and thereafter  main-
tain  current  certification,  which  shall be included in the mandatory
hours of continuing education acceptable  for  dentists  to  the  extent
provided  in the commissioner's regulations. In the event the dentist OR
REGISTERED DENTAL HYGIENIST cannot physically perform CPR,  the  commis-
sioner's  regulations  shall  allow  the  dentist  OR  REGISTERED DENTAL
HYGIENIST to make arrangements for another individual in the  office  to
administer  CPR.  All dental facilities shall have an automatic external
defibrillator or other defibrillator at the facility.
  S 5. This act shall take effect April 1, 2014, provided that effective
immediately, the addition, amendment and/or repeal of any rule or  regu-
lation  necessary  for the implementation of such sections on the effec-
tive date of this act  are  authorized  and  directed  to  be  made  and
completed on or before such effective date.

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