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A00284 Summary:

BILL NOA00284B
 
SAME ASSAME AS S06752-B
 
SPONSORPaulin
 
COSPNSRThiele, Sayegh
 
MLTSPNSRCook
 
Amd §§6605-b & 6606, Ed L
 
Provides that a dental hygienist shall not administer local block anesthesia without a 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 promulgated by the commissioner.
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A00284 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A284B           Revised: 3/26/24
 
SPONSOR: Paulin
  TITLE OF BILL: An act to amend the education law, in relation to local block anesthesia   PURPOSE: This bill allows hygienists to administer block anesthesia in addition to the currently allowed local anesthesia and infiltration, in conform- ance with regulations of the commissioner.   SUMMARY OF PROVISIONS: This bill amends article 133, sections 6606 and 6605-b, of the education law. Section 1 subdivision 2 of the bill adds a new, higher level of certif- ication, the dental hygiene block anesthesia certificate, which will allow certified dental hygienists to administer or monitor block anes- thesia under the supervision of a licensed dentist. Subdivision 3 specifies that the commissioner shall establish the stand- ards and procedures for the issuance of each certificate. Subdivision 4 provides that the department shall charge $25 triennially for the issuance of each certificate. Section 2 of the bill adds block anesthesia to the definition. of prac- tice of dental hygiene. Section 3 provides that the bill shall take effect one year after it shall have become law.   JUSTIFICATION: Dental hygienists are currently allowed to provide nitrous oxide analge- sia and to administer and monitor local infiltration anesthesia, but are not authorized to provide block anesthesia. Block anesthesia is a form of anesthesia that intra-orally anesthetizes an entire nerve group. Many dental services require the use of block anesthesia and there are no public safety issues inherent to allowing a qualified, trained dental hygienist to administer it under the supervision of a dentist. This bill provides for two separate certificates, the first of which reflects the current status of the law requiring a dental hygienist to obtain a certificate in order to administer or monitor nitrous oxide analgesia or local infiltration anesthesia. This bill further creates a second, higher level of certification building on the first, which would authorize certified dental hygienists to administer or monitor block anesthesia as well as nitrous oxide analgesia or local infiltration. Hygienists interested in receiving certification in block anesthesia will be required to complete additional training on top - but not dupli- cative of - the training required for the Dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate. The dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate is a prerequisite to the block anesthesia certif- icate. Currently, 43 states allow dental hygienists to perform local infil- tration and all of those but two - New York and South Carolina also allow for block anesthesia. This legislation will allow dental offices to function more efficiently, thereby benefiting the patient and allow- ing dentists and dental hygienists to provide greater access to care.   LEGISLATIVE HISTORY: A.1046, 2021 and 2022, referred to higher education. Same as 5.6399, committed to rules in 2021 and passed Senate in 2022. A.462, 2019 and 2020, referred to higher education. A.7732, 2017 and 2018, referred to higher education. Same as 5.7200, 2018, referred to higher education.   FISCAL IMPLICATIONS: None.   EFFECTIVE DATE: This bill shall take effect one year after it shall have become law.
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A00284 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         284--B
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                     January 4, 2023
                                       ___________
 
        Introduced  by M. of A. PAULIN, THIELE -- Multi-Sponsored by -- M. of A.
          COOK -- read once and referred to the Committee on Higher Education --
          recommitted to the Committee on Higher Education  in  accordance  with
          Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
          reprinted  as  amended  and  recommitted  to  said  committee -- again
          reported from said committee with  amendments,  ordered  reprinted  as
          amended and recommitted to said committee
 
        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:
 
     1    Section 1. Section 6605-b of the education law, as  added  by  chapter
     2  437  of  the laws of 2001 and subdivision 1 as amended by chapter 198 of
     3  the laws of 2022, is amended to read as follows:
     4    § 6605-b.    Dental    hygiene    restricted    local     infiltration
     5  anesthesia/nitrous  oxide  analgesia certificate.  1. A dental hygienist
     6  shall not administer or monitor nitrous oxide analgesia or local  infil-
     7  tration  anesthesia  in  the practice of dental hygiene without a dental
     8  hygiene restricted local infiltration anesthesia/nitrous oxide analgesia
     9  certificate and except under the personal supervision of a  dentist  and
    10  in accordance with regulations promulgated by the commissioner. Personal
    11  supervision,  for  purposes  of this section, means that the supervising
    12  dentist remains in the dental office where the local infiltration  anes-
    13  thesia   or  nitrous  oxide  analgesia  services  are  being  performed,
    14  personally authorizes and prescribes the use of local infiltration anes-
    15  thesia or nitrous oxide analgesia for the patient and, before  dismissal
    16  of  the  patient, personally examines the condition of the patient after
    17  the use of local infiltration anesthesia or nitrous oxide  analgesia  is
    18  completed.  It  is  professional  misconduct  for  a  dentist to fail to
    19  provide the supervision required by this section, and any dentist  found
    20  guilty  of  such  misconduct  under the procedures prescribed in section

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02127-04-4

        A. 284--B                           2
 
     1  sixty-five hundred ten of this title shall be subject to  the  penalties
     2  prescribed in section sixty-five hundred eleven of this title.
     3    2.    Dental  hygiene block anesthesia certificate. A dental hygienist
     4  shall not administer or monitor block  anesthesia  in  the  practice  of
     5  dental  hygiene  without  a dental hygiene restricted local infiltration
     6  anesthesia/nitrous oxide analgesia  certificate  and  a  dental  hygiene
     7  block  anesthesia  certificate and except under the personal supervision
     8  of a dentist authorized  by  law  and  in  accordance  with  regulations
     9  promulgated  by  the commissioner. Personal supervision, for purposes of
    10  this section, means that the supervising dentist remains in  the  dental
    11  office   where  the  block  anesthesia  services  are  being  performed,
    12  personally authorizes and prescribes the use of block anesthesia for the
    13  patient and, before dismissal of the patient,  personally  examines  the
    14  condition of the patient after the use of block anesthesia is completed.
    15  It  is  professional  misconduct  for  a  dentist to fail to provide the
    16  supervision required by this section, and any dentist  found  guilty  of
    17  such  misconduct  under  the procedures prescribed in section sixty-five
    18  hundred ten of this title shall be subject to the  penalties  prescribed
    19  in section sixty-five hundred eleven of this title.
    20    3.  The  commissioner shall promulgate regulations establishing stand-
    21  ards and procedures for the issuance of such [certificate] certificates.
    22  Such standards shall require completion of an educational program and/or
    23  course of training or experience appropriate  to  each  certificate  and
    24  sufficient  to ensure that a dental hygienist is specifically trained in
    25  the administration and monitoring of nitrous oxide analgesia  and  local
    26  infiltration anesthesia or is specifically trained in the administration
    27  and  monitoring  of  block anesthesia, the possible effects of such use,
    28  and in the recognition of and response to possible emergency situations.
    29    [3.] 4. The fee for a dental  hygiene  restricted  local  infiltration
    30  anesthesia/nitrous  oxide  analgesia  certificate  shall  be twenty-five
    31  dollars and the fee for a dental hygiene  block  anesthesia  certificate
    32  shall be twenty-five dollars and shall be paid on a triennial basis upon
    33  renewal  of  such certificate. A certificate may be suspended or revoked
    34  in the same manner as a license to practice dental hygiene.
    35    § 2. Subdivision 1 of section 6606 of the education law, as amended by
    36  chapter 239 of the laws of 2013, is amended to read as follows:
    37    1. The practice of the profession of dental hygiene is defined as  the
    38  performance  of  dental services which shall include removing calcareous
    39  deposits, accretions and stains from the exposed surfaces of  the  teeth
    40  which  begin  at  the  epithelial attachment and applying topical agents
    41  indicated for a complete dental prophylaxis, removing cement, placing or
    42  removing rubber dam, removing sutures, placing  matrix  band,  providing
    43  patient  education,  applying  topical  medication, placing and exposing
    44  diagnostic dental X-ray films, performing topical fluoride  applications
    45  and  topical  anesthetic  applications,  polishing teeth, taking medical
    46  history, charting caries, taking impressions for  study  casts,  placing
    47  and   removing  temporary  restorations,  administering  and  monitoring
    48  nitrous oxide analgesia and administering and  monitoring  local  infil-
    49  tration  and  administering  and monitoring block anesthesia, subject to
    50  certification in accordance with section  sixty-six  hundred  five-b  of
    51  this  article,  and any other function in the definition of the practice
    52  of dentistry as may be delegated by a  licensed  dentist  in  accordance
    53  with regulations promulgated by the commissioner. The practice of dental
    54  hygiene may be conducted in the office of any licensed dentist or in any
    55  appropriately  equipped  school  or  public institution but must be done
    56  either under the supervision of a licensed dentist or, in the case of  a

        A. 284--B                           3
 
     1  registered dental hygienist working for a hospital as defined in article
     2  twenty-eight  of  the  public  health  law,  pursuant to a collaborative
     3  arrangement with a licensed and registered  dentist  who  has  a  formal
     4  relationship  with  the  same  hospital  in  accordance with regulations
     5  promulgated by the department in consultation  with  the  department  of
     6  health.  Such  collaborative  arrangement shall not obviate or supersede
     7  any law or regulation which requires identified services to be performed
     8  under the  personal  supervision  of  a  dentist.  When  dental  hygiene
     9  services are provided pursuant to a collaborative agreement, such dental
    10  hygienist  shall  instruct  individuals  to visit a licensed dentist for
    11  comprehensive examination or treatment.
    12    § 3. This act shall take effect one year after it shall have become  a
    13  law.
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