Bill Text: HI HB221 | 2020 | Regular Session | Amended

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Bill Title: Relating To Dental Assistants.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed - Dead) 2020-06-22 - Received notice of discharge of all House conferees (Hse. Com. No. 363). [HB221 Detail]

Download: Hawaii-2020-HB221-Amended.html

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HOUSE OF REPRESENTATIVES	H.B. NO.	221
THIRTIETH LEGISLATURE, 2019		H.D. 2
STATE OF HAWAII		S.D. 1

A BILL FOR AN ACT

 

 

RELATING TO DENTAL ASSISTANTS.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that the proper standardization and regulation of dental assistants is necessary to ensure the health, safety, and well-being of the State's citizens.  Currently, Hawaii is one of only a handful of states that does not require dental assistants to be certified, and the legislature finds that this exposes patients to unnecessary risks.  The legislature further finds that establishing minimum requirements for dental assistants, including educational requirements, will ensure that dental patients receive the best available care.

     Accordingly, the purpose of this Act is to establish minimum requirements for dental assistants in Hawaii, including:

     (1)  Requiring an individual hired as a dental assistant on or after January 1, 2020, to hold a cardiopulmonary resuscitation certification and complete a two-semester program accredited by the American Dental Association Commission on Dental Accreditation;

     (2)  Requiring all dental assistants employed as of July 1, 2019, to obtain a cardiopulmonary resuscitation certification by January 1, 2020;

     (3)  Requiring an individual employed as a dental assistant for less than five years as of July 1, 2019, to provide proof of enrollment in a two-semester program accredited by the American Dental Association Commission on Dental Accreditation;

     (4)  Exempting an individual employed as a dental assistant for at least five years as of July 1, 2019, from the education requirements for dental assistants; provided that the individual has no history of complaints filed with the board of dentistry; and

     (5)  Clarifying the allowable and prohibited practices of dental assistants.

     SECTION 2.  Chapter 448, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§448-    Dental assistants; requirements; allowed and prohibited practices.  (a)  All individuals hired as dental assistants in this State on or after January 1, 2020, shall:

     (1)  Hold a cardiopulmonary resuscitation certification; and

     (2)  Provide proof to the board that the dental assistant has successfully completed a two-semester program accredited by the American Dental Association Commission on Dental Accreditation.

     (b)  An individual employed as a dental assistant as of July 1, 2019, shall obtain a cardiopulmonary resuscitation certification by January 1, 2020.

     (c)  An individual employed as a dental assistant for less than five years as of July 1, 2019, shall provide proof to the board that the individual has enrolled in a two-semester program accredited by the American Dental Association Commission on Dental Accreditation by January 1, 2020.

     (d)  An individual employed as a dental assistant for at least five years as of July 1, 2019, shall be exempt from the education requirement under subsection (a)(2); provided that the individual has no history of complaints filed with the board.   (e)  A dental assistant may perform the following supportive dental procedures under the direct supervision, direction, evaluation, and responsibility of a licensed dentist:

     (1)  Assisting a licensed dentist who is actually performing a dental procedure on a patient, including:

          (A)  Preparing procedural trays or armamentaria set-ups;

          (B)  Retracting a patient's oral tissues to maintain the field of operation during the dental procedure;

          (C)  Removing debris, as is normally created and accumulated during or after operative procedures by the dentist;

          (D)  Placing and removing the rubber dam;

          (E)  Mixing dental materials; and

          (F)  Transferring dental instruments or any other concept of four-handed dentistry the dentist requires to perform the procedure;

     (2)  Assisting a licensed dental hygienist in the performance of the duties of the dental hygienist; provided that the assistance shall not include procedures included in subsection (f);

     (3)  Collecting medical and dental histories, taking intra-oral and extra-oral photographs, and recording or charting clinical findings as dictated by a licensed dentist or dental hygienist;

     (4)  Completing prescription and authorization forms for drug or restorative, prosthodontic, or orthodontic appliance for the supervising licensed dentist; provided that the licensed dentist signs the forms;

     (5)  Conducting mouth mirror supragingival inspections and reporting observations to the supervising licensed dentist; provided that the inspection and reporting observations shall not be interpreted as an oral cancer screening;

     (6)  Exposing, processing, mounting, and labeling radiographs;

     (7)  Making impressions for study casts; opposing models; occlusal appliances, such as splints and bite guards; mouth guards; orthodontic retainers; and medicament trays;

     (8)  Making intra-oral measurements for orthodontic procedures; performing the preliminary selection and sizing of bands; checking for loose bands and bonded brackets; placing and removing orthodontic separators, ligature ties, and inter-arch elastics, including chain elastics and rubber bands; fitting and removing head appliances; and removing arch wires;

     (9)  Measuring and recording vital signs;

    (10)  Monitoring the nitrous oxide/oxygen unit and reporting to the supervising dentist any adverse observations; provided that the licensed dentist shall evaluate, initiate, and administer the sedation;

    (11)  Placing matrix retainers;

    (12)  Placing non-aerosol topical anesthetics;

    (13)  Relating pre-operative and post-operative instructions and patient education in oral hygiene as instructed by the supervising licensed dentist or licensed dental hygienist;

    (14)  Removing dressing and sutures;

    (15)  Removing excess supragingival cement after a licensed dentist has placed a permanent or temporary prosthetic restoration, appliance, or orthodontic band with hand instruments; and

    (16)  Performing a try-in with any removable prosthetic or orthodontic appliance; provided that the supervising licensed dentist shall make the adjustments.

     (f)  A dental assistant shall not perform any activity deemed to be irreversible so as to cause change in the affected hard or soft tissues and is permanent, may require reconstructive or corrective procedures, or represents the practice of dentistry and dental hygiene or requires the knowledge, skill, and training of a licensed dentist or licensed dental hygienist, including the following procedures and intra-oral functions:

     (1)  Administering local anesthetic, sedation, or general anesthesia;

     (2)  Cementing, bonding, and adjusting any part of a prosthesis or appliance worn in the mouth;

     (3)  Cementing or re-cementing, finishing margins, performing a try-in, and adjusting the occlusion of a temporary or permanent fixed prosthetic restoration, or placing cement bases;

     (4)  Cementing bands and brackets or activating any orthodontic appliance;

     (5)  Establishing occlusal vertical dimension, making bite registrations, or making face-bow transfers;

     (6)  Examining, diagnosing, or prescribing a treatment plan;

     (7)  Making final impressions, which would lead to the fabrication of any appliance or prosthesis that, when worn by the patient, would come in direct contact with hard or soft tissues with the exception of the procedures listed in subsection (e)(7);

     (8)  Performing any endodontic procedure to ream, file, irrigate, medicate, dry, try-in cores, or fill root canals, or establishing the length of the tooth;

     (9)  Performing any surgical or cutting procedures on hard or soft tissues, extracting teeth, or suturing;

    (10)  Placing, condensing, carving, finishing, or adjusting the occlusion of final restorations; or placing cavity liners, medicaments, or pulp cap materials;

    (11)  Placings materials subgingivally including but not limited to prescriptive medicaments, retraction cords, and other devices that are used for tissue displacement;

    (12)  Prescribing medications or authorizing the fabrication of any restorative, prosthodontic, or orthodontic appliances;

    (13)  Performing pulp vitality tests or other non-surgical clinical and laboratory oral diagnostic tests;

    (14)  Using ultrasonic instruments or polishing natural or restored surfaces;

    (15)  Applying pit and fissure sealants;

    (16)  Performing non-surgical periodontal scaling and root planing, and periodontal maintenance;

    (17)  Performing dental prophylaxis, coronal polish natural or restored surfaces, or removing overhangs;

    (18)  Placing periodontal dressing;

    (19)  Collecting, documenting, and assessing comprehensive patient data including but not limited to screenings for oral cancer, periodontal chartings, indices, and risk assessments, which identify dental hygiene needs;

    (20)  Establishing a dental hygiene care plan that reflects dental hygiene goals and strategies; or

    (21)  Providing dental hygiene care including but not limited to pain management, full mouth debridement, care of restorations, behavior modification, or preventative education and nutrition counseling as it relates to oral health."

     SECTION 3.  Section 448-3, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

     "(b)  A duly licensed and registered dentist may employ auxiliary personnel, other than registered dental hygienists, to assist the dentist in the practice of dentistry.  These employees shall be known as dental assistants and shall perform all duties assigned to them under the supervision, direction and responsibility of the dentist[.  Duties of the dental assistant and regulatory directives shall be delineated under rules which the board of dentistry may from time to time adopt.] pursuant to section 448-  ."

     SECTION 4.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect on July 1, 2050.

 

Report Title:

Dental Assistants; Minimum Requirements; Certifications

 

Description:

Establishes minimum requirements for dental assistants.  Clarifies the allowable and prohibited practices by dental assistants.  Effective 7/1/2050.  (SD1)

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.