S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    488
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              January 9, 2023
                                ___________
 
 Introduced by M. of A. PAULIN -- 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. The education law is amended by adding a new section 6607-a
 to read as follows:
   § 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
 TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 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  A  COLLABORATIVE  PRACTICE  AGREEMENT,
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02162-01-3
              

 A. 488                              2
 
   (III) MADE AVAILABLE TO THE DEPARTMENT AND  OTHER  INTERESTED  PARTIES
 UPON REQUEST.
   (C)  ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND REGISTERED
 DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE  AT  A
 TIME.
   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 NEW YORK STATE LICENSED AND  REGISTERED
 DENTIST,  HEALTH  CARE FACILITY, 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  FACILITIES;  PUBLIC  INSTITUTIONS/MENTAL  HEALTH
 FACILITIES; AND PRIVATE SETTINGS IN WHICH HOMEBOUND RESIDENTS ARE UNABLE
 TO BE RELOCATED FOR NECESSARY TREATMENT.
   5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
 MORE THAN SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS.  THE  DEPARTMENT
 MAY  GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON
 A CASE-BY-CASE BASIS.
   6. A DENTAL HYGIENIST MUST MAKE APPLICATION  TO  THE  NEW  YORK  STATE
 EDUCATION  DEPARTMENT  TO  PRACTICE  AS  A  REGISTERED DENTAL HYGIENIST,
 COLLABORATIVE PRACTICE (RDH-CP) AND PAY A FEE SET BY THE DEPARTMENT.  AS
 A  CONDITION  OF  COLLABORATIVE PRACTICE, THE DENTAL HYGIENIST MUST HAVE
 BEEN ENGAGED IN PRACTICE FOR THREE YEARS WITH A MINIMUM OF FOUR THOUSAND
 FIVE HUNDRED PRACTICE HOURS AND MUST COMPLETE AN EIGHT  HOUR  CONTINUING
 EDUCATION  PROGRAM THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCE-
 DURES, RISK MANAGEMENT, DENTAL HYGIENE  JURISPRUDENCE  AND  PROFESSIONAL
 ETHICS.
   § 2. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  488--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              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

 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.  Section 6606 of the education law, as amended  by  chapter
 244  of the laws of 1973, subdivision 1 as amended by chapter 239 of the
 laws of 2013, is amended to read as follows:
   § 6606. Definition of practice of dental hygiene.  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 anes-
 thetic applications, polishing teeth, taking medical  history,  charting
 caries,  taking impressions for study casts, placing and removing tempo-
 rary 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 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02162-03-4
              

 A. 488--A                           2
 
 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 working for a hospital as defined in article
 twenty-eight  of  the  public  health  law,  pursuant to a collaborative
 arrangement with a licensed and registered  dentist  who  has  a  formal
 relationship  with  the  same  hospital  in  accordance with regulations
 promulgated by the department in consultation  with  the  department  of
 health]  MAY BE PERFORMED BY A REGISTERED DENTAL HYGIENIST DESIGNATED AS
 A  REGISTERED  DENTAL  HYGIENIST,  COLLABORATIVE  PRACTICE  (RDH-CP)  IN
 COLLABORATION  WITH  A  LICENSED  DENTIST  PROVIDED  SUCH  SERVICES  ARE
 PERFORMED IN ACCORDANCE WITH A WRITTEN PRACTICE  AGREEMENT  AND  WRITTEN
 PRACTICE  PROTOCOLS  TO  BE KNOWN AS A COLLABORATIVE PRACTICE AGREEMENT.
 UNDER A COLLABORATIVE PRACTICE AGREEMENT, DENTAL HYGIENISTS MAY  PERFORM
 ALL  SERVICES  WHICH  ARE  DESIGNATED IN REGULATION UNDER GENERAL SUPER-
 VISION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
 MAY  BE  PERFORMED  WITHOUT  SUPERVISION  IN  A  COLLABORATIVE  PRACTICE
 SETTING.   Such collaborative arrangement shall not obviate or supersede
 any law or regulation which requires identified services to be performed
 under the personal  supervision  of  a  dentist.  [When  dental  hygiene
 services are provided pursuant to a collaborative agreement, such dental
 hygienist  shall  instruct  individuals  to visit a licensed dentist for
 comprehensive examination or treatment.]
   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 PRACTICE AGREEMENT SHALL BE:
   (I) SIGNED AND MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST AND THE
 FACILITY, PROGRAM OR ORGANIZATION; AND
   (II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
 IST; AND
   (III)  MADE  AVAILABLE  TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
 UPON    REQUEST.
   (C) A REGISTERED DENTAL  HYGIENIST,  COLLABORATIVE  PRACTICE  (RDH-CP)
 SHALL  HAVE  NO  MORE  THAN  ONE COLLABORATIVE PRACTICE AGREEMENT WITH A
 COLLABORATIVE DENTIST AT ONE TIME.
   3. BEFORE PERFORMING 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 PROCEDURES, THE DENTAL
 HYGIENIST MUST FILL OUT A REFERRAL FORM AND PROVIDE A COPY OF  THE  FORM
 TO THE COLLABORATING DENTIST.
   4.  A CONTRACTUAL ARRANGEMENT UNDER THIS SECTION MAY BE MADE BY EITHER
 A NEW YORK STATE LICENSED AND REGISTERED DENTIST OR A REGISTERED  DENTAL
 HYGIENIST,  COLLABORATIVE PRACTICE (RDH-CP) IN THE FOLLOWING SETTINGS: A
 HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH    LAW,
 ANY APPROPRIATELY  EQUIPPED  SCHOOL, FEDERALLY QUALIFIED HEALTH CENTERS,
 LONG-TERM CARE FACILITIES,  GROUP HOMES SERVICING THE INTELLECTUALLY AND
 DEVELOPMENTALLY   DISABLED   POPULATION,  FACILITIES  SERVING  VETERANS,
 FACILITIES SERVICING THE HOMELESS, PRISONS, DRUG  TREATMENT  FACILITIES,
 DOMESTIC  VIOLENCE SHELTERS, AND APPROPRIATE SETTINGS IN WHICH HOMEBOUND
 RESIDENTS ARE UNABLE TO BE RELOCATED FOR NECESSARY TREATMENT.
 A. 488--A                           3
 
   5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
 MORE THAN SIX RDH-CPS. THE DEPARTMENT  MAY  GRANT  EXCEPTIONS  TO  THESE
 LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON A CASE-BY-CASE BASIS.
   6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE DEPARTMENT TO PRAC-
 TICE AS AN RDH-CP AND PAY A FEE SET BY THE DEPARTMENT. AS A CONDITION OF
 COLLABORATIVE  PRACTICE,  THE DENTAL HYGIENIST MUST HAVE BEEN ENGAGED IN
 PRACTICE FOR THREE YEARS WITH A MINIMUM OF FOUR  THOUSAND  FIVE  HUNDRED
 PRACTICE  HOURS  AND  SHALL  COMPLETE AN EIGHT-HOUR CONTINUING EDUCATION
 PROGRAM THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCEDURES,  RISK
 MANAGEMENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL ETHICS.
   7.  The  commissioner  shall promulgate regulations defining the func-
 tions a dental hygienist may perform that are consistent with the train-
 ing and qualifications for a license as a dental hygienist.
   § 2. This act shall take effect immediately.