| Chapter 192 |
| 2015 -- S 0683 SUBSTITUTE A Enacted 07/09/2015 |
| A N A C T |
| RELATING TO BUSINESSES AND PROFESSIONS -- DENTISTS AND DENTAL HYGIENISTS |
| Introduced By: Senators Nesselbush, Crowley, Pichardo, Miller, and P Fogarty |
| Date Introduced: March 12, 2015 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Chapter 5-31.1 of the General Laws entitled "Dentists and Dental |
| Hygienists" is hereby amended by adding thereto the following section: |
| 5-31.1-39. Public health hygienists. – (a) Any public health dental hygienist, which for |
| purposes of this chapter means any practicing registered dental hygienist who may perform dental |
| hygiene procedures in a public health setting subject to conditions adopted by the Rhode Island |
| board of examiners in dentistry, may perform in a public health setting, without the immediate or |
| direct supervision or direction of a dentist, any procedure or provide any service that is within the |
| dental hygiene scope of practice that has been authorized and adopted by the Rhode Island board |
| of examiners in dentistry as a delegable procedure for a dental hygienist under general |
| supervision in a private practice setting. |
| (b) Public health settings shall, for purposes of this section, include, but are not limited |
| to, residences of the homebound, schools, nursing home and long-term care facilities, clinics, |
| hospitals, medical facilities, community health centers licensed or certified by the department of |
| health, mobile and portable dental health programs licensed or certified by the department of |
| health and operated by a local or state agency, head start programs and any other facilities or |
| programs deemed appropriate by the department of health. |
| (c) Any public health hygienist shall enter into a written, collaborative agreement with a |
| local or state government agency or institution or with a licensed dentist who states that he or she |
| shall be able to provide the appropriate level of communication and consultation with the dental |
| hygienist to ensure patient health and safety prior to performing any procedure or providing any |
| service under this section. The written, collaborative agreement will follow the appropriate |
| guidelines as determined and established by the Rhode Island board of examiners in dentistry. |
| (d) Any public health dental hygienist shall provide to the patient, or to the patient's legal |
| guardian, a consent form to be signed by the patient or legal guardian. The consent form shall be |
| consistent with current department of health policies that describes services to be rendered and |
| explains that services rendered are not a substitute for a dental examination by a dentist. The |
| consent form shall also inform the patient or legal guardian that the patient should obtain a dental |
| examination by a dentist within ninety (90) days after undergoing a procedure authorized |
| pursuant to this section. The patient or legal guardian shall also obtain written referral to a dentist |
| and an assessment of further dental needs. |
| (e) The public health dental hygienist shall be directly reimbursed for services |
| administered in a public health setting by Medicaid or the state health care insurance program |
| except as required by federal Medicaid law, but shall not seek reimbursement from any other |
| insurance or third-party payor. A public health dental hygienist shall not operate independently of |
| a dentist, except for a dental hygienist working for a local or state government agency or |
| institution or practicing in a mobile or portable prevention program licensed or certified by the |
| department of health. In such cases, the local or state government agency or institution or mobile |
| or portable prevention program licensed or certified by the department of health may seek |
| reimbursement from any other third-party payor. |
| SECTION 2. Section 16-21-9 of the General Laws in Chapter 16-21 entitled "Health and |
| Safety of Pupils" is hereby amended to read as follows: |
| 16-21-9. Health examinations and dental screenings -- Reports -- Records. -- (a) Each |
| community as defined in § 16-7-16 shall provide for the appointment of a physician to make |
| examinations of the health of the school children, who shall report any deviation from the normal, |
| and for the preservation of records of the examinations of the children. Each community shall |
| further provide for dental screenings by a licensed dentist or licensed dental hygienist or a |
| licensed public health dental hygienist, with at least three (3) years of clinical experience, who |
| shall report any suspected deviation from the normal normal, and for the preservation of records |
| of the screenings of the children. Each community shall notify the parents or custodians of |
| children of conditions requiring professional or skilled treatment. The state commissioner of |
| elementary and secondary education shall provide blank forms and record books that he or she |
| may deem necessary for the purposes of this section. |
| (b) Each community as defined in § 16-7-16 shall only contract with a licensed dentist, |
| dentist and/or a licensed public health dental hygienist, for the provision of the dental screenings |
| services required by this section. Dental hygienists performing the dental screenings pursuant to |
| the provisions of this section shall do so under the general supervision of the dentist liable and |
| responsible under the contract with the community or within the collaborative agreement |
| guidelines between a licensed public health hygienist and licensed dentist. |
| (c) Except in emergency circumstances, referral by a dentist, or dental hygienist, and/or |
| public health dental hygienist of children screened pursuant to the provisions of this section to a |
| dental practice by which the dentist or dental hygienist is employed and/or which the dentist owns |
| shall be strictly prohibited. In the event that a referral has been made in violation of this |
| provision, the community shall terminate its contract with the dentist. In the case of an egregious |
| violation of the referral prohibition contained in this section, that conduct shall be reported to the |
| board of dental examiners. |
| (d) Each community shall provide to parents or custodians of children who require |
| professional or skilled treatment a list of both dental practices in the community which that |
| accept patients insured by Medical Assistance medical assistance and/or RIte Care and dental |
| practices which that provide services on a sliding scale basis to uninsured individuals. The |
| department of human services shall provide each community with a list containing the addresses |
| and telephone numbers of both dental practices which that accept patients insured by Medical |
| Assistance medical assistance and/or RIte Care and dental practices which that provide services |
| on a sliding scale basis to uninsured individuals. |
| (e) Dental screenings for children in kindergarten, third, and ninth grade shall only be |
| performed by a licensed dentist. |
| (f) All dentists, or dental hygienists, and/or public health dental hygienists, performing |
| dental screenings pursuant to the provisions of this section, shall meet with the oral health |
| director of the department of health on a regular basis, as determined by the chief. |
| SECTION 3. This act shall take effect upon passage. |
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| LC001791/SUB A/2 |
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