2015 -- H 5953 SUBSTITUTE A

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LC001789/SUB A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- DENTISTS AND DENTAL

HYGIENISTS

     

     Introduced By: Representatives Azzinaro, Carnevale, Craven, Kennedy, and McNamara

     Date Introduced: March 20, 2015

     Referred To: House Health, Education & Welfare

     (Health)

It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 5-31.1 of the General Laws entitled "Dentists and Dental

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Hygienists" is hereby amended by adding thereto the following section:

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     5-31.1-39. Public health hygienists. – (a) Any public health dental hygienist which for

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purposes of this chapter means any practicing registered dental hygienist who may perform dental

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hygiene procedures in a public health setting subject to conditions adopted by the Rhode Island

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board of examiners in dentistry, may perform in a public health setting, without the immediate or

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direct supervision or direction of a dentist, any procedure or provide any service that is within the

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dental hygiene scope of practice that has been authorized and adopted by the Rhode Island board

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of examiners in dentistry as a delegable procedure for a dental hygienist under general

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supervision in a private practice setting.

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     (b) Public health settings shall for purposes of this section, include, but are not limited to,

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residences of the homebound, schools, nursing home and long-term care facilities, clinics,

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hospitals, medical facilities, community health centers licensed or certified by the department of

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health, mobile and portable dental health programs licensed or certified by the department of

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health and operated by a local or state agency, head start programs and any other facilities or

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programs deemed appropriate by the department of health.

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     (c) Any public health hygienist shall enter into a written collaborative agreement with a

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local or state government agency or institution or with a licensed dentist who states that he or she

 

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shall be able to provide the appropriate level of communication and consultation with the dental

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hygienist to ensure patient health and safety prior to performing any procedure or providing any

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service under this section. The written collaborative agreement will follow the appropriate

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guidelines as determined and established by the Rhode Island board of examiners in dentistry.

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     (d) Any public health dental hygienist shall provide to the patient or to the patient's legal

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guardian a consent form to be signed by the patient or legal guardian. The consent form shall be

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consistent with current department of health policies that describes services to be rendered and

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explains that services rendered are not a substitute for a dental examination by a dentist. The

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consent form shall also inform the patient or legal guardian that the patient should obtain a dental

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examination by a dentist within ninety (90) days after undergoing a procedure authorized

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pursuant to this section. The patient or legal guardian shall also obtain written referral to a dentist

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and an assessment of further dental needs.

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     (e) The public health dental hygienist shall be directly reimbursed for services

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administered in a public health setting by Medicaid or the state health care insurance program

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except as required by federal Medicaid law, but shall not seek reimbursement from any other

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insurance or third-party payor. A public health dental hygienist shall not operate independently of

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a dentist, except for a dental hygienist working for a local or state government agency or

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institution or practicing in a mobile or portable prevention program licensed or certified by the

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department of health. In such cases the local or state government agency or institution or mobile

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or portable prevention program licensed or certified by the department of health may seek

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reimbursement from any other third-party payor.

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     SECTION 2. Section 16-21-9 of the General Laws in Chapter 16-21 entitled "Health and

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Safety of Pupils" is hereby amended to read as follows:

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     16-21-9. Health examinations and dental screenings -- Reports -- Records. -- (a) Each

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community as defined in § 16-7-16 shall provide for the appointment of a physician to make

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examinations of the health of the school children, who shall report any deviation from the normal,

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and for the preservation of records of the examinations of the children. Each community shall

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further provide for dental screenings by a licensed dentist or licensed dental hygienist or a

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licensed public health dental hygienist, with at least three (3) years of clinical experience, who

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shall report any suspected deviation from the normal and for the preservation of records of the

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screenings of the children. Each community shall notify the parents or custodians of children of

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conditions requiring professional or skilled treatment. The state commissioner of elementary and

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secondary education shall provide blank forms and record books that he or she may deem

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necessary for the purposes of this section.

 

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      (b) Each community as defined in § 16-7-16 shall only contract with a licensed dentist,

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and/or a licensed public health dental hygienist, for the provision of the dental screenings services

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required by this section. Dental hygienists performing the dental screenings pursuant to the

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provisions of this section shall do so under the general supervision of the dentist liable and

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responsible under the contract with the community or within the collaborative agreement

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guidelines between a licensed public health hygienist and licensed dentist.

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      (c) Except in emergency circumstances, referral by a dentist, or dental hygienist, and/or

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public health dental hygienist of children screened pursuant to the provisions of this section to a

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dental practice by which the dentist or dental hygienist is employed and/or which the dentist owns

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shall be strictly prohibited. In the event that a referral has been made in violation of this

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provision, the community shall terminate its contract with the dentist. In the case of an egregious

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violation of the referral prohibition contained in this section, that conduct shall be reported to the

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board of dental examiners.

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      (d) Each community shall provide to parents or custodians of children who require

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professional or skilled treatment a list of both dental practices in the community which accept

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patients insured by Medical Assistance and/or RIte Care and dental practices which provide

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services on a sliding scale basis to uninsured individuals. The department of human services shall

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provide each community with a list containing the addresses and telephone numbers of both

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dental practices which accept patients insured by Medical Assistance and/or RIte Care and dental

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practices which provide services on a sliding scale basis to uninsured individuals.

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      (e) Dental screenings for children in kindergarten, third, and ninth grade shall only be

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performed by a licensed dentist.

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      (f) All dentists, or dental hygienists and/or public health dental hygienists, performing

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dental screenings pursuant to the provisions of this section shall meet with the oral health director

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of the department of health on a regular basis, as determined by the chief.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- DENTISTS AND DENTAL

HYGIENISTS

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     This act would allow public health dental hygienists to perform certain dental hygiene

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procedures in a public setting without the immediate supervision of a dentist. This act would also

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allow licensed dental health hygienists in certain circumstances to provide dental screenings to

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school children.

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     This act would take effect upon passage.

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