Senate Bill S8759B

2023-2024 Legislative Session

Authorizes dental hygienists to provide such services in collaboration with a licensed dentist

download bill text pdf

Archive: Last Bill Status - In Senate Committee Higher Education Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 20, 2024	print number 8759b
May 20, 2024	amend and recommit to higher education
Mar 21, 2024	print number 8759a
Mar 21, 2024	amend and recommit to higher education
Mar 07, 2024	referred to higher education

Bill Amendments

Original

B (Active)

2023-S8759 - Details

See Assembly Version of this Bill:: A488
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6606, Ed L
Versions Introduced in Other Legislative Sessions:: 2011-2012: A111
2013-2014: A5096
2015-2016: A1959
2017-2018: A2553
2019-2020: A335
2021-2022: A3934
2025-2026: S3157, A2341

2023-S8759 - Summary

Authorizes a licensed dental hygienist, collaborative practice to provide services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.

2023-S8759 - Sponsor Memo

                                 
BILL NUMBER: S8759

SPONSOR: MAY
 
TITLE OF BILL:

An act to amend the education law, in relation to registered dental
hygienists working without supervision but within a collaborative prac-
tice agreement with a licensed dentist

 
PURPOSE:

To create the category of registered dental hygienist, collaborative
practice, which authorizes dental hygienists to practice without super-
vision but within a collaborative practice agreement with a licensed
dentist.

 
SUMMARY OF PROVISIONS:

Section one amends section 6606 of the education law to create 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 and collaborative practice arrangements.

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 two provides for the immediate enactment of this bill.

 
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 17% 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 insur-
ance 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 5.3308, 2015 and 2016, referred to higher education.

A.5096, 2013 and 2014, referred to higher education.

Same as S.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 immediately.

2023-S8759 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8759
 
                             I N  S E N A T E
 
                               March 7, 2024
                                ___________
 
 Introduced  by  Sen.  MAY  --  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  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
 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

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

                                                            LBD02162-04-4
 S. 8759                             2

 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.
   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
 S. 8759                             3

 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.

2023-S8759A - Details

See Assembly Version of this Bill:: A488
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6606, Ed L
Versions Introduced in Other Legislative Sessions:: 2011-2012: A111
2013-2014: A5096
2015-2016: A1959
2017-2018: A2553
2019-2020: A335
2021-2022: A3934
2025-2026: S3157, A2341

2023-S8759A - Summary

Authorizes a licensed dental hygienist, collaborative practice to provide services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.

2023-S8759A - Sponsor Memo

                                 
BILL NUMBER: S8759A

SPONSOR: MAY
 
TITLE OF BILL:

An act to amend the education law, in relation to registered dental
hygienists working without supervision but within a collaborative prac-
tice agreement with a licensed dentist

 
PURPOSE:

To create the category of registered dental hygienist, collaborative
practice, which authorizes dental hygienists to practice without super-
vision but within a collaborative practice agreement with a licensed
dentist.

 
SUMMARY OF PROVISIONS:

Section one amends section 6606 of the education law to create 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 and collaborative practice arrangements.

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 two sets the effective date.

The A-print of this bill amends the effective date to 9 months after
becoming law.

 
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 17% 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 insur-
ance 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 9 months after becoming law.

2023-S8759A - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8759--A
 
                             I N  S E N A T E
 
                               March 7, 2024
                                ___________
 
 Introduced  by  Sen.  MAY  --  read  twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Higher  Education  --
   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
 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

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

                                                            LBD02162-06-4
 S. 8759--A                          2

 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.
   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
 S. 8759--A                          3
 
 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 nine months after it shall have become
 a law.

2023-S8759B (ACTIVE) - Details

See Assembly Version of this Bill:: A488
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §6606, Ed L
Versions Introduced in Other Legislative Sessions:: 2011-2012: A111
2013-2014: A5096
2015-2016: A1959
2017-2018: A2553
2019-2020: A335
2021-2022: A3934
2025-2026: S3157, A2341

2023-S8759B (ACTIVE) - Summary

Authorizes a licensed dental hygienist, collaborative practice to provide services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.

2023-S8759B (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8759B

SPONSOR: MAY
 
TITLE OF BILL:

An act to amend the education law, in relation to registered dental
hygienists working without supervision but within a collaborative prac-
tice 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.
Additionally, section one lays out the training, experience, and educa-
tion 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 17% 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 insur-
ance 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.

2023-S8759B (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8759--B
 
                             I N  S E N A T E
 
                               March 7, 2024
                                ___________
 
 Introduced  by  Sen.  MAY  --  read  twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Higher  Education  --
   committee  discharged,  bill amended, ordered reprinted as amended and
   recommitted to said committee -- 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
 appropriately  equipped school or public institution but [must] SHALL 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

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

                                                            LBD02162-12-4
 S. 8759--B                          2

 article  twenty-eight of the public health law, pursuant to a collabora-
 tive 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 IN COLLABORATION
 WITH A LICENSED DENTIST PROVIDED SUCH SERVICES ARE PERFORMED IN  ACCORD-
 ANCE 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 SUPERVISION WITHOUT PRIOR  EVALU-
 ATION  OF A DENTIST OR MEDICAL PROFESSIONAL AND MAY BE PERFORMED WITHOUT
 SUPERVISION IN AN AUTHORIZED SETTING AS DEFINED IN SUBDIVISION  FOUR  OF
 THIS  SECTION.  Such  collaborative  [arrangement]  AGREEMENTS 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. THE COLLABORATIVE PRACTICE AGREEMENT SHALL:
   (A) BE SIGNED AND MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST  AND
 AUTHORIZED SETTING;
   (B) BE REVIEWED ANNUALLY BY THE DENTIST AND DENTAL HYGIENIST;
   (C) INCLUDE CONSIDERATION 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; AND
   (D)  BE  MADE AVAILABLE TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
 UPON REQUEST.
   3. BEFORE PERFORMING SERVICES PURSUANT  TO  A  COLLABORATIVE  PRACTICE
 AGREEMENT,  A DENTAL HYGIENIST, COLLABORATIVE PRACTICE SHALL 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 SHALL FILL OUT
 A REFERRAL FORM AND PROVIDE A COPY OF  THE  FORM  TO  THE  COLLABORATING
 DENTIST.
   4.  THE  PERFORMANCE OF SERVICES PURSUANT TO A COLLABORATIVE AGREEMENT
 IS AUTHORIZED IN THE FOLLOWING SETTINGS: A HOSPITAL AS DEFINED IN  ARTI-
 CLE  TWENTY-EIGHT  OF  THE  PUBLIC HEALTH LAW, AN APPROPRIATELY EQUIPPED
 SCHOOL, A FEDERALLY QUALIFIED HEALTH CENTER, A LONG-TERM CARE  FACILITY,
 A  GROUP HOME SERVICING PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISA-
 BILITIES, A FACILITY SERVING VETERANS, A TEMPORARY HOUSING  FACILITY,  A
 PRISON,  A  DRUG  TREATMENT  FACILITY,  A DOMESTIC VIOLENCE SHELTER, AND
 APPROPRIATE SETTINGS IN WHICH HOMEBOUND RESIDENTS ARE UNABLE TO BE RELO-
 CATED FOR NECESSARY TREATMENT.
   5. A REGISTERED  DENTAL  HYGIENIST, COLLABORATIVE PRACTICE SHALL  HAVE
 NO MORE THAN ONE COLLABORATIVE AGREEMENT  WITH  A DENTIST AT ONE TIME.
   6.  A  DENTIST SHALL NOT HAVE A COLLABORATIVE AGREEMENT WITH MORE THAN
 SIX REGISTERED DENTAL HYGIENISTS, COLLABORATIVE PRACTICE  AT  ONE  TIME.
 THE  DEPARTMENT  MAY  GRANT  AN  EXCEPTION TO SUCH LIMITATION FOR PUBLIC
 HEALTH SETTINGS ON A CASE-BY-CASE BASIS.
   7. A DENTAL HYGIENIST SHALL FILE AN APPLICATION WITH THE DEPARTMENT TO
 PRACTICE AS A REGISTERED DENTAL HYGIENIST,  COLLABORATIVE  PRACTICE  AND
 PAY  A FEE DETERMINED BY THE DEPARTMENT. AS A CONDITION OF COLLABORATIVE
 S. 8759--B                          3
 
 PRACTICE, THE DENTAL HYGIENIST SHALL 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.
   8. 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 eighteen months after it shall have
 become a law.

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