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A00488 Summary:

BILL NOA00488A
 
SAME ASNo Same As
 
SPONSORPaulin
 
COSPNSR
 
MLTSPNSR
 
Amd §6606, Ed L
 
Authorizes a licensed dental hygienist, collaborative practice (RDH-CP) to provide services without supervision in collaboration with a licensed dentist under a collaborative practice agreement.
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A00488 Actions:

BILL NOA00488A
 
01/09/2023referred to higher education
01/03/2024referred to higher education
02/06/2024amend and recommit to higher education
02/06/2024print number 488a
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A00488 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A488A       Revised 2/7/24
 
SPONSOR: Paulin
  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 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 immediately.
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A00488 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         488--A
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                     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:
 
     1    Section 1.  Section 6606 of the education law, as amended  by  chapter
     2  244  of the laws of 1973, subdivision 1 as amended by chapter 239 of the
     3  laws of 2013, is amended to read as follows:
     4    § 6606. Definition of practice of dental hygiene.  1. The practice  of
     5  the profession of dental hygiene is defined as the performance of dental
     6  services  which  shall  include removing calcareous deposits, accretions
     7  and stains from the exposed surfaces of the teeth  which  begin  at  the
     8  epithelial  attachment  and  applying  topical  agents  indicated  for a
     9  complete dental prophylaxis, removing cement, placing or removing rubber
    10  dam, removing sutures, placing matrix band, providing patient education,
    11  applying topical medication,  placing  and  exposing  diagnostic  dental
    12  X-ray  films, performing topical fluoride applications and topical anes-
    13  thetic applications, polishing teeth, taking medical  history,  charting
    14  caries,  taking impressions for study casts, placing and removing tempo-
    15  rary restorations, administering and monitoring nitrous oxide  analgesia
    16  and  administering and monitoring local infiltration anesthesia, subject
    17  to certification in accordance with section sixty-six hundred five-b  of
    18  this  article,  and any other function in the definition of the practice
    19  of dentistry as may be delegated by a  licensed  dentist  in  accordance
    20  with regulations promulgated by the commissioner. The practice of dental
    21  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
 
     1  appropriately  equipped  school  or  public institution but must be done
     2  either under the supervision of a licensed dentist or[, in the case of a
     3  registered dental hygienist working for a hospital as defined in article
     4  twenty-eight  of  the  public  health  law,  pursuant to a collaborative
     5  arrangement with a licensed and registered  dentist  who  has  a  formal
     6  relationship  with  the  same  hospital  in  accordance with regulations
     7  promulgated by the department in consultation  with  the  department  of
     8  health]  may be performed by a registered dental hygienist designated as
     9  a  registered  dental  hygienist,  collaborative  practice  (RDH-CP)  in
    10  collaboration  with  a  licensed  dentist  provided  such  services  are
    11  performed in accordance with a written practice  agreement  and  written
    12  practice  protocols  to  be known as a collaborative practice agreement.
    13  Under a collaborative practice agreement, dental hygienists may  perform
    14  all  services  which  are  designated in regulation under general super-
    15  vision without prior evaluation of a dentist or medical professional and
    16  may  be  performed  without  supervision  in  a  collaborative  practice
    17  setting.   Such collaborative arrangement shall not obviate or supersede
    18  any law or regulation which requires identified services to be performed
    19  under the personal  supervision  of  a  dentist.  [When  dental  hygiene
    20  services are provided pursuant to a collaborative agreement, such dental
    21  hygienist  shall  instruct  individuals  to visit a licensed dentist for
    22  comprehensive examination or treatment.]
    23    2. (a) The collaborative practice agreement  shall  include  consider-
    24  ation  for  medically compromised patients, specific medical conditions,
    25  and age- and procedure-specific practice protocols, including,  but  not
    26  limited  to  recommended intervals for the performance of dental hygiene
    27  services and a periodicity in which an examination by a  dentist  should
    28  occur.
    29    (b) The collaborative practice agreement shall be:
    30    (i) signed and maintained by the dentist, the dental hygienist and the
    31  facility, program or organization; and
    32    (ii) reviewed annually by the collaborating dentist and dental hygien-
    33  ist; and
    34    (iii)  made  available  to the department and other interested parties
    35  upon    request.
    36    (c) A registered dental  hygienist,  collaborative  practice  (RDH-CP)
    37  shall  have  no  more  than  one collaborative practice agreement with a
    38  collaborative dentist at one time.
    39    3. Before performing services authorized under this section, a  dental
    40  hygienist must provide the patient with a written statement advising the
    41  patient  that  the dental hygiene services provided are not a substitute
    42  for a dental examination by a licensed dentist. If the dental  hygienist
    43  makes  any  referrals  to the patient for further procedures, the dental
    44  hygienist must fill out a referral form and provide a copy of  the  form
    45  to the collaborating dentist.
    46    4.  A contractual arrangement under this section may be made by either
    47  a New York state licensed and registered dentist or a registered  dental
    48  hygienist,  collaborative practice (RDH-CP) in the following settings: a
    49  hospital as defined in article twenty-eight of the public health    law,
    50  any appropriately  equipped  school, federally qualified health centers,
    51  long-term care facilities,  group homes servicing the intellectually and
    52  developmentally   disabled   population,  facilities  serving  veterans,
    53  facilities servicing the homeless, prisons, drug  treatment  facilities,
    54  domestic  violence shelters, and appropriate settings in which homebound
    55  residents are unable to be relocated for necessary treatment.

        A. 488--A                           3
 
     1    5. A collaborating dentist shall have collaborative agreements with no
     2  more than six RDH-CPs. The department  may  grant  exceptions  to  these
     3  limitations for public health settings on a case-by-case basis.
     4    6. A dental hygienist must make application to the department to prac-
     5  tice as an RDH-CP and pay a fee set by the department. As a condition of
     6  collaborative  practice,  the dental hygienist must have been engaged in
     7  practice for three years with a minimum of four  thousand  five  hundred
     8  practice  hours  and  shall  complete an eight-hour continuing education
     9  program that includes instruction in medical emergency procedures,  risk
    10  management, dental hygiene jurisprudence and professional ethics.
    11    7.  The  commissioner  shall promulgate regulations defining the func-
    12  tions a dental hygienist may perform that are consistent with the train-
    13  ing and qualifications for a license as a dental hygienist.
    14    § 2. This act shall take effect immediately.
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