Bill Text: NH SB284 | 2012 | Regular Session | Introduced


Bill Title: Establishing a certified public health dental hygienist in New Hampshire.

Spectrum: Slight Partisan Bill (Republican 7-4)

Status: (Passed) 2012-06-11 - Senate Signed by the Governor on 06/11/2012; Chapter 0183; Effective 06/11/2012 [SB284 Detail]

Download: New_Hampshire-2012-SB284-Introduced.html

SB 284 – AS INTRODUCED

2012 SESSION

12-2829

06/10

SENATE BILL 284

AN ACT establishing pilot projects to improve access to oral health care.

SPONSORS: Sen. Lambert, Dist 13; Sen. Gallus, Dist 1; Sen. Barnes, Jr., Dist 17; Sen. Carson, Dist 14; Sen. D'Allesandro, Dist 20; Sen. Groen, Dist 6; Sen. Larsen, Dist 15; Sen. Luther, Dist 12; Sen. Merrill, Dist 21; Rep. Gorman, Hills 23; Rep. Pilliod, Belk 5

COMMITTEE: Health and Human Services

ANALYSIS

This bill authorizes a pilot program to enable the expansion of mid-level oral health services to underserved areas of the state.

This bill adds a new oral health professional and expands the scope of practice of a public health hygienist.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

12-2829

06/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twelve

AN ACT establishing pilot projects to improve access to oral health care.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Subdivision; Pilot Projects to Improve Access to Oral Heath Care. Amend RSA 317-A by inserting after section 6 the following new subdivision:

Pilot Projects to Improve Access to Oral Health Care

317-A:6-a Oral Health Pilot Projects. The department of health and human services shall approve one or more 5-year pilot projects designed to expand the roles of oral health professionals and develop new categories of oral health professionals.

317-A:6-b Additional Categories of Oral Health Professionals. The commissioner of the department of health and human services shall approve pilot projects under RSA 317-A:6-a developing the following new categories of dental professionals:

I. A dental therapist to perform services under the general supervision of a dentist in accordance with a public health dental hygienist permit issued by the board. A public health dental hygienist practicing under this section may provide an oral assessment, prepare a treatment plan, provide referrals, administer local anesthesia, perform basic restorations, prescribe prophylactic antibiotics and other drugs specified in the practice agreement with the supervising dentist, administer radiographs, and perform other related services and functions authorized by the supervising dentist and for which the expanded public health dental hygienist is trained. Services may be provided to an individual patient without the patient first seeing a dentist for an examination, diagnosis, informed consent, treatment planning, or other dental services if the supervising dentist has provided written general authorization and standing protocols for the public health dental hygienist.

II. An expanded-function dental auxiliary to perform services under the supervision of a dentist in accordance with an expanded function dental auxiliary permit issued by the board. An expanded-function dental auxiliary practicing under this section may place and shape direct restorations, take final impressions, cement restorations for temporary use, apply pit and fissure sealants without mechanical alteration of the tooth, place temporary and sedative restorative material in hand-excavated carious lesions and unprepared tooth fractures, remove orthodontic bracket cement, fit and shape stainless steel crowns to be cemented by a dentist, and perform other related services and functions authorized by the supervising dentist and for which the expanded function dental auxiliary is trained.

III. A dental therapist to perform services under the general supervision of a dentist in accordance with a dental therapist permit issued by the board. A dental therapist practicing under this section may perform an oral assessment, prepare a treatment plan, provide referrals, administer local anesthesia, perform basic restorations, prescribe prophylactic antibiotics and other drugs specified in the practice agreement with the supervising dentist, administer radiographs, and perform other related services and functions authorized by the supervising dentist and for which the dental therapist is trained. Services may be provided to an individual patient without the patient first seeing a dentist for an examination, diagnosis, or treatment plan if the supervising dentist has provided written authorization and standing protocols for the dental therapist.

317-A:6-c When Services Authorized. Services provided pursuant to a pilot project authorized under RSA 317-A:6-a may be provided to patients or residents of the following facilities or programs who, due to age, infirmity, or disability are unable to receive regular dental hygiene treatment:

I. Nursing homes as defined in RSA 151-A:1, IV;

II. Residential care facilities as defined in RSA 151-E:2, VIII;

III. Community residences;

IV. Psychiatric hospitals as defined in RSA 151-C:2, XXXI;

V. Facilities for mentally ill persons;

VI. Correctional facilities and juvenile detention facilities;

VII. The homebound;

VIII. Students or enrollees of nursery schools and day care programs and their siblings under 18 years of age, employment training facilities, primary and secondary schools, including private schools and public charter schools, and persons entitled to benefits under the Women, Infants and Children Program under RSA 132:12-a;

IX. Patients in hospitals, medical clinics, medical offices, or offices operated or staffed by nurse practitioners, physician assistants, or midwives;

X. Other populations that the department of health and human services determines are underserved or lack access to dental hygiene services.

317-A:6-d Dental Insurance. A public health dental hygienist, an expanded function dental auxiliary, or a dental therapist authorized to practice under this subdivision shall enter into a written practice agreement with a supervising dentist that meets standards established by the department of health and human services. Any service performed by a New Hampshire-licensed dentist, dental assistant, or dental hygienist that is covered by insurance, shall be covered when performed by a public health dental hygienist, an expanded-function dental auxiliary, or a dental therapist authorized to practice under this subdivision.

317-A:6-e Temporary License. The department of health and human services shall consult with the board in planning and implementing the pilot projects. The board shall issue a temporary license under RSA 317-A:8 for the duration of the pilot program to a public health dental hygienist, an expanded-function dental auxiliary, and a dental therapist who meets the education and training standards and other requirements established by the department of health and human services and is practicing within a pilot project established under this subdivision.

317-A:6-f Report. The department of health and human services, in consultation with the board, shall report annually to the legislative committees with jurisdiction over health care and dental professional licensing on the status of the projects and final report with findings and conclusions regarding the success of the pilot project in improving access to affordable dental services for underserved patients and communities.

317-A:6-g Rulemaking by Department of Health and Human Services. The commissioner of the department of health and human services shall adopt rules for this subdivision pursuant to RSA 541-A:

I. Establishing an application process and requirements for the pilot project or projects.

II. Requiring an approved pilot project to report to the department on the progress of the project.

2 New Paragraph; Practice of Dental Hygiene; Public Health Dental Hygienist. Amend RSA 317-A:21-c by inserting after paragraph IV the following new paragraph:

V. A dental hygienist licensed under this chapter may obtain a certification to practice as a public health dental hygienist by submitting an application to the board in writing accompanied by a fee established by the board, and satisfactory proof that the applicant is a graduate of an educational program approved by the board providing training in dental services. A public health dental hygienist practicing under this section may perform an oral assessment, prepare a treatment plan, provide referrals, administer local anesthesia, perform basic restorations, prescribe prophylactic antibiotics and other drugs specified in the practice agreement with the supervising dentist, administer radiographs, and perform other related services and functions authorized by the supervising dentist and for which the dental therapist is trained. The dental hygienists committee established under RSA 317-A:2-a shall develop licensing and application requirements, approve education programs, and develop other regulations and requirements relating to public health dental hygienists.

3 Non-Practice; Public Health Dental Hygienist. Amend RSA 317-A:23 to read as follows:

317-A:23 Non-practice.

I. None of the following procedures may be assigned to a dental hygienist or assistant or to any other person not licensed to practice dentistry:

[I.] (a) Diagnosis, treatment planning and prescriptions (including prescriptions for drugs and medicaments or authorization for restorative, prosthodontic, or orthodontic appliances).

[II.] (b) Surgical procedures on hard or soft tissues within the oral cavity; or any other inter-oral procedure that contributes to, or results in, an irremediable alteration of the oral anatomy.

II. Under the general supervision of a dentist and in accordance with a written practice agreement, a public health dental hygienist may provide certain services under paragraph I for which public health dental hygienists have been trained and which have been authorized by a supervising dentist. Services may be provided to an individual patient without the patient first seeing a dentist for an examination, diagnosis, informed consent, and treatment planning if the supervising dentist has provided written general authorization and standing protocols for the public health dental hygienist. The dental hygienists committee established under RSA 317-A:2-a shall develop licensing and application requirements, approve education programs, and develop other regulations and requirements relating to public health dental hygienists.

4 Pilot Projects to Improve Access to Oral Heath Care. No state funds shall be appropriated to implement the pilot projects to improve access to oral health care authorized under RSA 317-A:6-a.

5 Effective Date.

I. Sections 2 and 3 of this act shall take effect January 1, 2015.

II. The remainder of this act shall take effect 60 days after its passage.

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