Bill Text: CT HB05355 | 2010 | General Assembly | Comm Sub

Bill Title: An Act Concerning An Advanced Dental Hygiene Practice Pilot Program.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2010-04-07 - File Number 368 [HB05355 Detail]

Download: Connecticut-2010-HB05355-Comm_Sub.html

General Assembly


Substitute Bill No. 5355

    February Session, 2010




Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (Effective from passage) (a) For purposes of this section: (1) "Advanced dental hygiene practitioner" means a licensed dental hygienist who (A) is authorized to perform all services set forth in section 20-126l of the general statutes, pursuant to a collaborative management agreement, and (B) has presented documentation to the Commissioner of Public Health establishing that the licensed dental hygienist has graduated from a master's degree program in advanced dental hygiene practice from an institution of higher learning accredited by the Board of Governors of Higher Education in accordance with the provisions of section 10a-34 of the general statutes. Any such master's degree program accredited by the Board of Governors of Higher Education shall include a curriculum that incorporates advanced dental hygiene practice competencies as adopted by the American Dental Hygienists' Association; (2) "collaborative management agreement" means a written agreement between an advanced dental hygiene practitioner and a dentist, licensed in accordance with the provisions of chapter 379 of the general statutes, that outlines a mutually agreed upon relationship in which the advanced dental hygiene practitioner and the dentist agree to the parameters of practice provided by such advanced dental hygiene practitioner; and (3) "public health facility" means an institution, as defined in section 19a-490 of the general statutes, a community health center, group home, school, preschool operated by a local or regional board of education, or a head start program.

(b) The Commissioner of Social Services, in consultation with the Commissioner of Public Health, shall establish an advanced dental hygiene practice pilot program. Under such program, an advanced dental hygiene practitioner may provide services as described in this subsection, in public health facilities located in the city of Bridgeport. The advanced dental hygiene practitioner may:

(1) Formulate an individualized care plan based on scientific rationale, evidence-based standards of care and practice guidelines in collaboration with the patient and a multidisciplinary health care team;

(2) Administer local anesthesia;

(3) Diagnose and treat oral diseases and conditions within the advanced dental hygiene practitioner scope of practice;

(4) Provide diagnostic, educational, palliative, therapeutic, prescriptive and minimally invasive restorative oral health services including: (A) Preparation and restoration of primary and permanent teeth using direct placement of appropriate dental materials; (B) temporary placement of crowns and restorations; (C) placement of preformed crowns; (D) pulpotomies on primary teeth; (E) direct and indirect pulp capping in primary and permanent teeth; and (F) placement of atraumatic temporary restorations;

(5) Prescribe, dispense and administer the following drugs within the parameters of the collaborative management agreement and within the scope of practice of the advanced dental hygiene practitioner: (A) Analgesics, (B) anti-inflammatories, and (C) antibiotics;

(6) Perform nonsurgical extractions on primary and permanent teeth that are mobile or exfoliating;

(7) Place and remove sutures;

(8) Prevent or intercept potential orthodontic problems and parafunctional habits by early identification of such problems, space maintenance services and appropriate referral to other health care professionals;

(9) Provide temporary reparative services to patients with defective prosthetic appliances;

(10) Consult, collaborate and coordinate care with other health care professionals;

(11) Provide referrals to patients as needed for further dental procedures or other health care needs;

(12) Utilize emerging technologies in assessment, evaluation, diagnosis, prognosis, intervention and prevention of disease or conditions that impair oral or systemic health and wellness; and

(13) Use electronic technology to transfer digital radiography, photography, clinical assessment data and fiber optic imaging in collaboration with other health care professionals when warranted for the health of the patient.

(c) The Commissioner of Social Services, or the commissioner's designee, shall (1) coordinate the provision of advanced dental hygienist practitioner services in public health facilities that participate in the pilot program in the city of Bridgeport; and (2) establish rates of payment for the provision of such services.

(d) A collaborative management agreement entered into in accordance with the provisions of this section shall be in writing, signed by the parties to the agreement and maintained by the advanced dental hygiene practitioner at the public health facility where such practitioner is providing services and shall be available for inspection upon the request of the Department of Public Health and the Department of Social Services. A collaborative management agreement shall minimally include: (1) A description of the supervisory relationship between the advanced dental hygiene practitioner and the licensed dentist; (2) specific protocols for prescribing, administering and dispensing medications, including, the types of medications to be prescribed, administered and dispensed and the conditions and circumstances under which such medications are to be prescribed, dispensed and administered; and (3) an emergency protocol that addresses situations under which the following shall occur: (A) Consultation with a licensed dentist or other health care provider; (B) transfer of patient care to a licensed dentist or other licensed health care provider; (C) the provision of emergency care; (D) methods for disclosing the relationship covered by such agreement to the patient; and (E) methods for reviewing patient outcomes.

(e) Nothing in this act shall be construed to: (1) Allow an advanced dental hygiene practitioner to practice beyond the parameters of the collaborative management agreement with the collaborating licensed dentist; or (2) prevent a licensed dentist from providing advanced dental hygiene practice services.

(f) Each advanced dental hygiene practitioner, who provides direct patient care services as part of the pilot program shall maintain professional liability insurance or other indemnity against liability for professional malpractice. The amount of insurance that each such person shall carry as insurance or indemnity against claims for injury or death for professional malpractice shall not be less than five hundred thousand dollars for one person, per occurrence, with an aggregate of not less than one million five hundred thousand dollars.

(g) Each insurance company that issues professional liability insurance, as defined in subsection (b) of section 38a-393 of the general statutes, shall, on and after January 1, 2013, render to the Commissioner of Social Services a true record of the names of persons issued professional liability insurance for the practice of advanced dental hygiene, of cancellations of and refusals to renew such professional liability insurance policies and the reasons for such cancellations or refusal to renew said policies for the year ending on the thirty-first day of December next preceding.

(h) The pilot program shall commence on or before January 1, 2013, and shall terminate not later than January 1, 2014.

(i) The Commissioner of Social Services, in consultation with the Commissioner of Public Health, shall report, in accordance with section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and human services not later than July 1, 2014, concerning the results of such pilot program. The report shall include, but not be limited to: (1) Recommendations to expand the pilot program to other geographic areas of the state; (2) a timeline for expansion of the pilot program; and (3) recommendations for policies and procedures to permit advanced dental hygiene practitioners to provide the services described in subsection (b) of this section on a state-wide basis.

This act shall take effect as follows and shall amend the following sections:

Section 1

from passage

New section


Joint Favorable Subst.