2015 -- S 0683 SUBSTITUTE A | |
======== | |
LC001791/SUB A/2 | |
======== | |
STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2015 | |
____________ | |
A N A C T | |
RELATING TO BUSINESSES AND PROFESSIONS -- DENTISTS AND DENTAL | |
HYGIENISTS | |
| |
Introduced By: Senators Nesselbush, Crowley, Pichardo, Miller, and P Fogarty | |
Date Introduced: March 12, 2015 | |
Referred To: Senate Health & Human Services | |
(Department of Health) | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 5-31.1 of the General Laws entitled "Dentists and Dental |
2 | Hygienists" is hereby amended by adding thereto the following section: |
3 | 5-31.1-39. Public health hygienists. – (a) Any public health dental hygienist which for |
4 | purposes of this chapter means any practicing registered dental hygienist who may perform dental |
5 | hygiene procedures in a public health setting subject to conditions adopted by the Rhode Island |
6 | board of examiners in dentistry, may perform in a public health setting, without the immediate or |
7 | direct supervision or direction of a dentist, any procedure or provide any service that is within the |
8 | dental hygiene scope of practice that has been authorized and adopted by the Rhode Island board |
9 | of examiners in dentistry as a delegable procedure for a dental hygienist under general |
10 | supervision in a private practice setting. |
11 | (b) Public health settings shall for purposes of this section, include, but are not limited to, |
12 | residences of the homebound, schools, nursing home and long-term care facilities, clinics, |
13 | hospitals, medical facilities, community health centers licensed or certified by the department of |
14 | health, mobile and portable dental health programs licensed or certified by the department of |
15 | health and operated by a local or state agency, head start programs and any other facilities or |
16 | programs deemed appropriate by the department of health. |
17 | (c) Any public health hygienist shall enter into a written collaborative agreement with a |
18 | local or state government agency or institution or with a licensed dentist who states that he or she |
| |
1 | shall be able to provide the appropriate level of communication and consultation with the dental |
2 | hygienist to ensure patient health and safety prior to performing any procedure or providing any |
3 | service under this section. The written collaborative agreement will follow the appropriate |
4 | guidelines as determined and established by the Rhode Island board of examiners in dentistry. |
5 | (d) Any public health dental hygienist shall provide to the patient or to the patient's legal |
6 | guardian a consent form to be signed by the patient or legal guardian. The consent form shall be |
7 | consistent with current department of health policies that describes services to be rendered and |
8 | explains that services rendered are not a substitute for a dental examination by a dentist. The |
9 | consent form shall also inform the patient or legal guardian that the patient should obtain a dental |
10 | examination by a dentist within ninety (90) days after undergoing a procedure authorized |
11 | pursuant to this section. The patient or legal guardian shall also obtain written referral to a dentist |
12 | and an assessment of further dental needs. |
13 | (e) The public health dental hygienist shall be directly reimbursed for services |
14 | administered in a public health setting by Medicaid or the state health care insurance program |
15 | except as required by federal Medicaid law, but shall not seek reimbursement from any other |
16 | insurance or third-party payor. A public health dental hygienist shall not operate independently of |
17 | a dentist, except for a dental hygienist working for a local or state government agency or |
18 | institution or practicing in a mobile or portable prevention program licensed or certified by the |
19 | department of health. In such cases the local or state government agency or institution or mobile |
20 | or portable prevention program licensed or certified by the department of health may seek |
21 | reimbursement from any other third-party payor. |
22 | SECTION 2. Section 16-21-9 of the General Laws in Chapter 16-21 entitled "Health and |
23 | Safety of Pupils" is hereby amended to read as follows: |
24 | 16-21-9. Health examinations and dental screenings -- Reports -- Records. -- (a) Each |
25 | community as defined in § 16-7-16 shall provide for the appointment of a physician to make |
26 | examinations of the health of the school children, who shall report any deviation from the normal, |
27 | and for the preservation of records of the examinations of the children. Each community shall |
28 | further provide for dental screenings by a licensed dentist or licensed dental hygienist or a |
29 | licensed public health dental hygienist, with at least three (3) years of clinical experience, who |
30 | shall report any suspected deviation from the normal and for the preservation of records of the |
31 | screenings of the children. Each community shall notify the parents or custodians of children of |
32 | conditions requiring professional or skilled treatment. The state commissioner of elementary and |
33 | secondary education shall provide blank forms and record books that he or she may deem |
34 | necessary for the purposes of this section. |
| LC001791/SUB A/2 - Page 2 of 3 |
1 | (b) Each community as defined in § 16-7-16 shall only contract with a licensed dentist, |
2 | and/or a licensed public health dental hygienist, for the provision of the dental screenings services |
3 | required by this section. Dental hygienists performing the dental screenings pursuant to the |
4 | provisions of this section shall do so under the general supervision of the dentist liable and |
5 | responsible under the contract with the community or within the collaborative agreement |
6 | guidelines between a licensed public health hygienist and licensed dentist. |
7 | (c) Except in emergency circumstances, referral by a dentist, or dental hygienist, and/or |
8 | public health dental hygienist of children screened pursuant to the provisions of this section to a |
9 | dental practice by which the dentist or dental hygienist is employed and/or which the dentist owns |
10 | shall be strictly prohibited. In the event that a referral has been made in violation of this |
11 | provision, the community shall terminate its contract with the dentist. In the case of an egregious |
12 | violation of the referral prohibition contained in this section, that conduct shall be reported to the |
13 | board of dental examiners. |
14 | (d) Each community shall provide to parents or custodians of children who require |
15 | professional or skilled treatment a list of both dental practices in the community which accept |
16 | patients insured by Medical Assistance and/or RIte Care and dental practices which provide |
17 | services on a sliding scale basis to uninsured individuals. The department of human services shall |
18 | provide each community with a list containing the addresses and telephone numbers of both |
19 | dental practices which accept patients insured by Medical Assistance and/or RIte Care and dental |
20 | practices which provide services on a sliding scale basis to uninsured individuals. |
21 | (e) Dental screenings for children in kindergarten, third, and ninth grade shall only be |
22 | performed by a licensed dentist. |
23 | (f) All dentists, or dental hygienists and/or public health dental hygienists, performing |
24 | dental screenings pursuant to the provisions of this section shall meet with the oral health director |
25 | of the department of health on a regular basis, as determined by the chief. |
26 | SECTION 3. This act shall take effect upon passage. |
======== | |
LC001791/SUB A/2 | |
======== | |
| LC001791/SUB A/2 - Page 3 of 3 |
EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO BUSINESSES AND PROFESSIONS -- DENTISTS AND DENTAL | |
HYGIENISTS | |
*** | |
1 | This act would allow public health dental hygienists to perform certain dental hygiene |
2 | procedures in a public setting without the immediate supervision of a dentist. This act would also |
3 | allow licensed dental health hygienists in certain circumstances to provide dental screenings to |
4 | school children. |
5 | This act would take effect upon passage. |
======== | |
LC001791/SUB A/2 | |
======== | |
| LC001791/SUB A/2 - Page 4 of 3 |