S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5848
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                               May 15, 2019
                                ___________
 
 Introduced  by Sen. HARCKHAM -- 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 local block anesthesia
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1.  Section  6605-b of the education law, as added by chapter
 437 of the laws of 2001, is amended to read as follows:
   § 6605-b. Dental  hygiene  restricted  local  infiltration  AND  BLOCK
 anesthesia/nitrous  oxide  analgesia  certificate. 1. A dental hygienist
 shall not administer or monitor nitrous oxide analgesia or local  infil-
 tration  OR BLOCK anesthesia in the practice of dental hygiene without a
 dental    hygiene    restricted    local    infiltration    AND    BLOCK
 anesthesia/nitrous  oxide  analgesia  certificate  and  except under the
 personal supervision of a dentist and in conjunction with  the  perform-
 ance  of  dental  hygiene procedures 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 OR BLOCK anesthesia or
 nitrous oxide analgesia services are being performed, personally author-
 izes and prescribes the use of local infiltration OR BLOCK 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 OR BLOCK 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] ARTICLE shall be subject to the
 penalties prescribed  in  section  sixty-five  hundred  eleven  of  this
 [title] ARTICLE.
   2.  The  commissioner shall promulgate regulations establishing stand-
 ards and procedures for the issuance of such certificate. Such standards
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD03787-01-9

 S. 5848                             2
 
 shall require completion of an  educational  program  and/or  course  of
 training  or  experience sufficient to ensure that a dental hygienist is
 specifically trained in the administration  and  monitoring  of  nitrous
 oxide analgesia and local infiltration OR BLOCK anesthesia, the possible
 effects  of such use, and in the recognition of and response to possible
 emergency situations.
   3. The fee for a dental  hygiene  restricted  local  infiltration  AND
 BLOCK  anesthesia/nitrous  oxide  analgesia certificate shall be twenty-
 five dollars and shall be paid on a triennial basis upon renewal of such
 certificate. A certificate may be  suspended  or  revoked  in  the  same
 manner as a license to practice dental hygiene.
   § 2. Subdivision 1 of section 6606 of the education law, as amended by
 chapter 239 of the laws of 2013, 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  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 AND BLOCK 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 deleg-
 ated 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 and
 registered dentist who has a formal relationship with the same  hospital
 in  accordance with regulations promulgated by the department in consul-
 tation with the department of  health.  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 colla-
 borative agreement, such dental hygienist shall instruct individuals  to
 visit a licensed dentist for comprehensive examination or treatment.
   § 3. This act shall take effect immediately.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5848--A
     Cal. No. 1042
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                               May 15, 2019
                                ___________
 
 Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Higher  Education  --
   reported  favorably  from  said  committee,  ordered  to first report,
   amended on first report,  ordered  to  a  second  report  and  ordered
   reprinted, retaining its place in the order of second report
 
 AN  ACT  to  amend  the  education law, in relation to local block anes-
   thesia, infiltration anesthesia, nitrous oxide, and  dental  assisting
   practice
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 6605-b of the education law, as  added  by  chapter
 437 of the laws of 2001, is amended to read as follows:
   § 6605-b.  Dental  hygiene  restricted  local  infiltration  AND BLOCK
 anesthesia/nitrous oxide analgesia certificate. 1.  A  dental  hygienist
 shall  not administer or monitor nitrous oxide analgesia or local infil-
 tration OR BLOCK 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
 procedures] authorized by law and in accordance with regulations promul-
 gated 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 OR BLOCK
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD03787-10-9

 S. 5848--A                          2
 
 shall be subject to  the  penalties  prescribed  in  section  sixty-five
 hundred eleven of this title.
   2.    A DENTAL HYGIENIST SHALL NOT ADMINISTER OR MONITOR NITROUS OXIDE
 ANALGESIA OR LOCAL INFILTRATION OR BLOCK ANESTHESIA IN THE  PRACTICE  OF
 DENTAL  HYGIENE  WITHOUT  A DENTAL HYGIENE RESTRICTED LOCAL INFILTRATION
 AND BLOCK ANESTHESIA/NITROUS  OXIDE  ANALGESIA  CERTIFICATE  AND  EXCEPT
 UNDER  THE  PERSONAL  SUPERVISION  OF A DENTIST 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  OR
 BLOCK   ANESTHESIA   OR  NITROUS  OXIDE  ANALGESIA  SERVICES  ARE  BEING
 PERFORMED, PERSONALLY AUTHORIZES AND PRESCRIBES THE USE OF LOCAL  INFIL-
 TRATION  OR  BLOCK 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 OR BLOCK 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.
   3.  The  commissioner shall promulgate regulations establishing stand-
 ards and procedures for the issuance of such [certificate] CERTIFICATES.
 Such standards shall require completion of an educational program and/or
 course of training or experience APPROPRIATE TO EACH CERTIFICATE  suffi-
 cient  to  ensure that a dental hygienist is specifically trained in the
 administration and monitoring  of  nitrous  oxide  analgesia  and  local
 infiltration anesthesia OR IS SPECIFICALLY TRAINED IN THE ADMINISTRATION
 AND  MONITORING  OF  NITROUS  OXIDE  ANALGESIA, LOCAL INFILTRATION ANES-
 THESIA, AND BLOCK ANESTHESIA, the possible effects of such use,  and  in
 the recognition of and response to possible emergency situations.
   [3.  The]  A  REASONABLE  fee  SHALL  BE  CHARGED for a dental hygiene
 restricted local infiltration anesthesia/nitrous oxide analgesia certif-
 icate [shall be twenty-five dollars]  AND  A  REASONABLE  FEE  SHALL  BE
 CHARGED    A    DENTAL    HYGIENE    RESTRICTED    LOCAL    INFILTRATION
 ANESTHESIA/NITROUS OXIDE ANALGESIA AND BLOCK ANESTHESIA CERTIFICATE  and
 shall  EACH  be  paid  on a triennial basis upon renewal of such certif-
 icate. A certificate may be suspended or revoked in the same manner as a
 license to practice dental hygiene.
   § 2. Subdivision 1 of section 6606 of the education law, as amended by
 chapter 239 of the laws of 2013, 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 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  AND  BLOCK  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 deleg-

 S. 5848--A                          3
 
 ated 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 and
 registered dentist who has a formal relationship with the same  hospital
 in  accordance with regulations promulgated by the department in consul-
 tation with the department of  health.  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 colla-
 borative agreement, such dental hygienist shall instruct individuals  to
 visit a licensed dentist for comprehensive examination or treatment.
   §  3. Section 6608 of the education law, as amended by 239 of the laws
 of 2013, is amended to read as follows:
   § 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] HIS OR 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, selecting and prefitting provisional crowns, selecting and prefit-
 ting orthodontic bands, removing orthodontic  arch  wires  and  ligature
 ties,  placing  and  removing matrix bands, taking impressions for study
 casts or diagnostic casts, removing periodontal dressings,  PLACING  AND
 REMOVING  TEMPORARY  RESTORATIONS,  and  such  other  dental  supportive
 services authorized by the dentist consistent with  regulations  promul-
 gated  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  procedures,  irreversible
 procedures or procedures that would alter the hard or soft tissue of the
 oral  and  maxillofacial  area or any other procedures 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 condition 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. Nothing herein authorizes  a
 dental  assistant to perform any of the services or functions defined as
 part of the practice of dental hygiene in 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 either under a dentist's super-
 vision, as defined in regulations of the commissioner, 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  collabora-
 tive  arrangement with a licensed dentist in accordance with subdivision

 S. 5848--A                          4
 
 one of section sixty-six hundred six of this article. Such collaborative
 arrangement shall not obviate or supersede any law or  regulation  which
 requires  identified  services to be performed under the personal super-
 vision of a dentist.
   §  4.  This  act shall take effect immediately; provided that sections
 one and two of this act shall take effect one year after it  shall  have
 become a law.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5848--C
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                               May 15, 2019
                                ___________
 
 Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Higher  Education  --
   reported  favorably  from  said  committee,  ordered  to first report,
   amended on first report,  ordered  to  a  second  report  and  ordered
   reprinted,  retaining  its  place  in  the  order  of second report --
   amended on second report, ordered  to  a  third  reading,  and  to  be
   reprinted  as amended, retaining its place in the order of third read-
   ing -- recommitted to the Committee on Higher Education in  accordance
   with  Senate  Rule  6,  sec.  8 -- committee discharged, bill amended,
   ordered reprinted as amended and recommitted to said committee
 
 AN ACT to amend the education law, in  relation  to  infiltration  anes-
   thesia, nitrous oxide, and dental assisting practice
 
   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  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 perform-
 ance of dental hygiene procedures] 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD03787-14-0

 S. 5848--C                          2
 
 required by this section, and any dentist found guilty of  such  miscon-
 duct  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.
   §  2.  Section 6608 of the education law, as amended by chapter 390 of
 the laws of 2019, is amended to read as follows:
   § 6608. Definition of practice of  registered  dental  assisting.  The
 practice of registered dental assisting is defined as providing support-
 ive  services  to a dentist in his or 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,  PLACING  AND  REMOVING
 TEMPORARY  RESTORATIONS,  and  such  other  dental  supportive  services
 authorized by the dentist consistent with regulations 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 diagnos-
 ing and/or performing surgical procedures,  irreversible  procedures  or
 procedures  that  would  alter  the  hard or soft tissue of the oral and
 maxillofacial area or any other procedures determined by the department.
 The practice of registered 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  super-
 vision  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 condition 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 registered dental assistant. Nothing herein
 authorizes a registered dental assistant to perform any of the  services
 or  functions  defined  as  part  of  the  practice of dental hygiene in
 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 either  under
 a  dentist's supervision, as defined in regulations of the commissioner,
 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 dentist in accordance with
 subdivision one of section sixty-six hundred six of this  article.  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.
   § 3. This act shall take effect immediately.