HF 3020

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health; modifying practice provisions for 
  1.3             licensed dental hygienists; amending Minnesota 
  1.4             Statutes 2002, section 150A.10, subdivision 1; 
  1.5             Minnesota Statutes 2003 Supplement, section 150A.10, 
  1.6             subdivision 1a. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 2002, section 150A.10, 
  1.9   subdivision 1, is amended to read: 
  1.10     Subdivision 1.  [DENTAL HYGIENISTS.] Any licensed dentist, 
  1.11  public institution, or school authority may obtain services from 
  1.12  a licensed dental hygienist.  Such licensed dental hygienist may 
  1.13  provide those services defined in section 150A.05, subdivision 
  1.14  1a.  Such services shall not include the establishment of a 
  1.15  final diagnosis or treatment plan for a dental patient.  Such 
  1.16  services shall be provided under supervision of a licensed 
  1.17  dentist.  Any licensed dentist who shall permit any dental 
  1.18  service by a dental hygienist other than those authorized by the 
  1.19  Board of Dentistry, shall be deemed to be violating the 
  1.20  provisions of sections 150A.01 to 150A.12, and Any such 
  1.21  unauthorized dental service by a dental hygienist shall 
  1.22  constitute a violation of sections 150A.01 to 150A.12.  
  1.23     Sec. 2.  Minnesota Statutes 2003 Supplement, section 
  1.24  150A.10, subdivision 1a, is amended to read: 
  1.25     Subd. 1a.  [LIMITED AUTHORIZATION FOR DENTAL HYGIENISTS.] 
  1.26  (a) Notwithstanding subdivision 1, a dental hygienist licensed 
  2.1   under this chapter may be employed or retained by a health care 
  2.2   facility, program, or nonprofit organization to perform dental 
  2.3   hygiene services described under paragraph (b) without the 
  2.4   patient first being examined by a licensed dentist if the dental 
  2.5   hygienist: 
  2.6      (1) has been engaged in the active practice of clinical 
  2.7   dental hygiene for not less than 2,400 hours in the past 18 
  2.8   months or a career total of 3,000 hours, including a minimum of 
  2.9   200 hours of clinical practice in two of the past three years; 
  2.10     (2) has entered into a collaborative agreement with a 
  2.11  licensed dentist that designates authorization for the services 
  2.12  provided by the dental hygienist; 
  2.13     (3) has documented participation in courses in infection 
  2.14  control and medical emergencies within each continuing education 
  2.15  cycle; and 
  2.16     (4) (3) maintains current certification in advanced or 
  2.17  basic cardiac life support as recognized by the American Heart 
  2.18  Association, the American Red Cross, or another agency that is 
  2.19  equivalent to the American Heart Association or the American Red 
  2.20  Cross. 
  2.21     (b) The dental hygiene services authorized to be performed 
  2.22  by a dental hygienist under this subdivision are limited to: 
  2.23     (1) oral health promotion and disease prevention education; 
  2.24     (2) removal of deposits and stains from the surfaces of the 
  2.25  teeth; 
  2.26     (3) application of topical preventive or prophylactic 
  2.27  agents, including fluoride varnishes and pit and fissure 
  2.28  sealants; 
  2.29     (4) polishing and smoothing restorations; 
  2.30     (5) removal of marginal overhangs; 
  2.31     (6) performance of preliminary charting; 
  2.32     (7) taking of radiographs; and 
  2.33     (8) performance of scaling and root planing.  
  2.34  The dental hygienist shall not perform injections of anesthetic 
  2.35  agents or the administration of nitrous oxide unless under the 
  2.36  indirect supervision of a licensed dentist.  Collaborating 
  3.1   Dental hygienists may work with unregistered and registered 
  3.2   dental assistants who may only perform duties for which 
  3.3   registration is not required.  The performance of dental hygiene 
  3.4   services in a health care facility, program, or nonprofit 
  3.5   organization as authorized under this subdivision is limited to 
  3.6   patients, students, and residents of the facility, program, or 
  3.7   organization. 
  3.8      (c) A collaborating dentist must be licensed under this 
  3.9   chapter and may enter into a collaborative agreement with no 
  3.10  more than four dental hygienists unless otherwise authorized by 
  3.11  the board.  The board shall develop parameters and a process for 
  3.12  obtaining authorization to collaborate with more than four 
  3.13  dental hygienists.  The collaborative agreement must include: 
  3.14     (1) consideration for medically compromised patients and 
  3.15  medical conditions for which a dental evaluation and treatment 
  3.16  plan must occur prior to the provision of dental hygiene 
  3.17  services; 
  3.18     (2) age- and procedure-specific standard collaborative 
  3.19  practice protocols, including recommended intervals for the 
  3.20  performance of dental hygiene services and a period of time in 
  3.21  which an examination by a dentist should occur; 
  3.22     (3) copies of consent to treatment form provided to the 
  3.23  patient by the dental hygienist; 
  3.24     (4) specific protocols for the placement of pit and fissure 
  3.25  sealants and requirements for follow-up care to assure the 
  3.26  efficacy of the sealants after application; and 
  3.27     (5) a procedure for creating and maintaining dental records 
  3.28  for the patients that are treated by the dental hygienist.  This 
  3.29  procedure must specify where these records are to be located. 
  3.30  The collaborative agreement must be signed and maintained by the 
  3.31  dentist, the dental hygienist, and the facility, program, or 
  3.32  organization; must be reviewed annually by the collaborating 
  3.33  dentist and dental hygienist; and must be made available to the 
  3.34  board upon request.  
  3.35     (d) Before performing any services authorized under this 
  3.36  subdivision, a dental hygienist must provide the patient with a 
  4.1   consent to treatment form which must include a statement 
  4.2   advising the patient that the dental hygiene services provided 
  4.3   are not a substitute for a dental examination by a licensed 
  4.4   dentist.  If the dental hygienist makes any referrals to the 
  4.5   patient for further dental procedures, the dental hygienist must 
  4.6   fill out a referral form and provide a copy of the form to the 
  4.7   collaborating a dentist.  
  4.8      (e) (d) For the purposes of this subdivision, a "health 
  4.9   care facility, program, or nonprofit organization" is limited to 
  4.10  a hospital; nursing home; home health agency; group home serving 
  4.11  the elderly, disabled, or juveniles; state-operated facility 
  4.12  licensed by the commissioner of human services or the 
  4.13  commissioner of corrections; and federal, state, or local public 
  4.14  health facility, community clinic, tribal clinic, school 
  4.15  authority, Head Start program, or nonprofit organization that 
  4.16  serves individuals who are uninsured or who are Minnesota health 
  4.17  care public program recipients.  
  4.18     (f) For purposes of this subdivision, a "collaborative 
  4.19  agreement" means a written agreement with a licensed dentist who 
  4.20  authorizes and accepts responsibility for the services performed 
  4.21  by the dental hygienist.  The services authorized under this 
  4.22  subdivision and the collaborative agreement may be performed 
  4.23  without the presence of a licensed dentist and may be performed 
  4.24  at a location other than the usual place of practice of the 
  4.25  dentist or dental hygienist and without a dentist's diagnosis 
  4.26  and treatment plan, unless specified in the collaborative 
  4.27  agreement.