HF 3847

as introduced - 92nd Legislature (2021 - 2022) Posted on 02/28/2022 02:12pm

A bill for an act
relating to health; modifying requirements for dental hygienist collaborative
agreements; amending Minnesota Statutes 2020, sections 150A.10, subdivision
1a; 150A.105, subdivision 8.

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

Section 1.

Minnesota Statutes 2020, section 150A.10, subdivision 1a, is amended to read:

Subd. 1a.

Collaborative practice authorization for dental hygienists in community
settings.

(a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter
may be employed or retained by a health care facility, program, or nonprofit organization
to perform the dental hygiene services listed in Minnesota Rules, part 3100.8700, subpart
1, without the patient first being examined by a licensed dentist if the dental hygienist:

(1) has entered into a collaborative agreement with a licensed dentist that designates
authorization for the services provided by the dental hygienist; and

(2) has documented completion of a course on medical emergencies within each
continuing education cycle.

(b) A collaborating dentist must be licensed under this chapter and may enter into a
collaborative agreement with no more than four dental hygienists unless otherwise authorized
by the board. The board shall develop parameters and a process for obtaining authorization
to collaborate with more than four dental hygienists. The collaborative agreement must
include:

(1) consideration for medically compromised patients and medical conditions for which
a dental evaluation and treatment plan must occur prior to the provision of dental hygiene
services;

(2) age- and procedure-specific standard collaborative practice protocols, including
recommended intervals for the performance of dental hygiene services and a period of time
in which an examination by a dentist should occur;

(3) copies of consent to treatment form provided to the patient by the dental hygienist;

(4) specific protocols for the placement of pit and fissure sealants new text begin and medicaments or
other materials new text end and requirements for follow-up care to deleted text begin assure the deleted text end new text begin ensure new text end efficacy deleted text begin of the
sealants after application deleted text end ; deleted text begin and
deleted text end

(5) the procedure for creating and maintaining dental records for patients who are treated
by the dental hygienist under Minnesota Rules, part 3100.9600, including specifying where
records will be located deleted text begin . deleted text end new text begin ; and
new text end

deleted text begin The collaborative agreement must be signed and maintained by the dentist, the dental
hygienist, and the facility, program, or organization; must be reviewed annually by the
collaborating dentist and dental hygienist and must be made available to the board upon
request.
deleted text end

new text begin (6) the enrollment of the dental hygienist as a provider in medical assistance and
MinnesotaCare and the procedure for submitting claims for services provided.
new text end

new text begin (c) The collaborative agreement must be:
new text end

new text begin (1) signed and maintained by the dentist; the dental hygienist; and the facility, program,
or organization;
new text end

new text begin (2) reviewed annually by the collaborating dentist and the dental hygienist; and
new text end

new text begin (3) made available to the board upon request.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end Before performing any services authorized under this subdivision, a dental
hygienist must provide the patient with a consent to treatment form which must include a
statement advising the patient that the dental hygiene services provided are not a substitute
for a dental examination by a licensed dentist. When the patient requires a referral for
additional dental services, the dental hygienist shall complete a referral form and provide
a copy to the patient, the facility, if applicable, the dentist to whom the patient is being
referred, and the collaborating dentist, if specified in the collaborative agreement. A copy
of the referral form shall be maintained in the patient's health care record. The patient does
not become a new patient of record of the dentist to whom the patient was referred until the
dentist accepts the patient for follow-up services after referral from the dental hygienist.

deleted text begin (d) deleted text end new text begin (e) new text end For the purposes of this subdivision, a "health care facility, program, or nonprofit
organization" includes a hospital; nursing home; home health agency; group home serving
the elderly, disabled, or juveniles; state-operated facility licensed by the commissioner of
human services or the commissioner of corrections; and federal, state, or local public health
facility, community clinic, tribal clinic, school authority, Head Start program, or nonprofit
organization that serves individuals who are uninsured or who are Minnesota health care
public program recipients.

deleted text begin (e) deleted text end new text begin (f) new text end For purposes of this subdivision, a "collaborative agreement" means a written
agreement with a licensed dentist who authorizes and accepts responsibility for the services
performed by the dental hygienist.

new text begin (g) A collaborative practice dental hygienist must be reimbursed for all services
performed:
new text end

new text begin (1) through a health care facility, program, or nonprofit organization; or
new text end

new text begin (2) directly by medical assistance or MinnesotaCare as a pay-to provider without having
to form a nonprofit organization or a separate entity.
new text end

new text begin (h) The commissioner of human services shall report annually, beginning January 15,
2023, and each January 15 thereafter, to the Board of Dentistry on the services provided by
collaborative practice dental hygienists. The information reported must include, at a
minimum, the geographic location and type of setting at which care was delivered, the
number of patients served, and the characteristics of the patient population.
new text end

Sec. 2.

Minnesota Statutes 2020, section 150A.105, subdivision 8, is amended to read:

Subd. 8.

Definitions.

(a) For the purposes of this section, the following definitions apply.

(b) "Practice settings that serve the low-income and underserved" mean:

(1) critical access dental provider settings as designated by the commissioner of human
services under section 256B.76, subdivision 4;

(2) dental hygiene collaborative practice settings identified in section 150A.10,
subdivision 1a, paragraph deleted text begin (d) deleted text end new text begin (e) new text end , and including medical facilities, assisted living facilities,
federally qualified health centers, and organizations eligible to receive a community clinic
grant under section 145.9268, subdivision 1;

(3) military and veterans administration hospitals, clinics, and care settings;

(4) a patient's residence or home when the patient is home-bound or receiving or eligible
to receive home care services or home and community-based waivered services, regardless
of the patient's income;

(5) oral health educational institutions; or

(6) any other clinic or practice setting, including mobile dental units, in which at least
50 percent of the total patient base of the dental therapist or advanced dental therapist
consists of patients who:

(i) are enrolled in a Minnesota health care program;

(ii) have a medical disability or chronic condition that creates a significant barrier to
receiving dental care;

(iii) do not have dental health coverage, either through a public health care program or
private insurance, and have an annual gross family income equal to or less than 200 percent
of the federal poverty guidelines; or

(iv) do not have dental health coverage, either through a state public health care program
or private insurance, and whose family gross income is equal to or less than 200 percent of
the federal poverty guidelines.

(c) "Dental health professional shortage area" means an area that meets the criteria
established by the secretary of the United States Department of Health and Human Services
and is designated as such under United States Code, title 42, section 254e.