Bills relating to dental hygiene signed into law, July 2008 through September 2009.

Arizona SB 1400                                         Signed 2/13/09

This bill removes the provision that restricted affiliated
practice care to children. Affiliated practice means the
dental hygienist has an agreement with a consulting dentist
and provides services according to protocols established
in that agreement to patients enrolled in a federal,
state, county or local health program or who have income
below twice the poverty level.

Arkansas HB 1367                                        Signed 2/20/09

This bill allows dental hygienists to provide dental hygiene
services in correctional facilities under general supervision
if the patient has been examined by a dentist.
The physical presence of a dentist is not required, but
the hygienist is required to administer care in accordance
with a protocol developed by a dentist.

Colorado SB 129                                         Signed 4/22/09

This bill adds duties to the list of what constitutes the
practice of unsupervised and supervised dental hygiene.
It adds diagnosis and X-rays to unsupervised practice,
moves local anesthesia to general supervision and defines
the dental hygiene diagnosis.

Iowa HB 380                                             Signed 4/10/09

This bill removes the prohibition against faculty members
serving on the dental board. It includes tooth-whitening
procedures in the practice of dentistry and limits it
to dental professionals.

Kentucky HB 336                                         Signed 3/20/09

This bill adds dental hygiene assessment to the dental
hygiene scope of practice. It removes the three-day
notification to patients for general supervision and allows
for a dental hygienist to perform an unsupervised dental
screening for children before they enter school.

Maine LD 100                                            Signed 5/26/09

This document expands health screening in schools
to include oral health screening. It requires oral health
screening for students prior to entering kindergarten and
for students who are new to a school district entering
grades 1 to 6 and periodically thereafter.

Maryland SB 602                                         Signed 5/19/09

This bill expands the practice of dental hygiene to include
manual curettage and administration of local anesthesia.
Dental hygienists will be permitted to administer
local anesthesia by infiltration under the direct supervision
of a dentist. In addition, the time a dental hygienist
can work under general supervision in a private office
is increased to 60 percent of the dental hygienist's total
time worked in a three-month period.

Massachusetts SB 2819                                   Signed 1/15/09

This bill creates a public health hygienist who works
in public health settings via a collaborative agreement
with a dentist. In order to qualify, a dental hygienist must
have at least three years of full-time clinical experience
practicing in public health settings and receive appropriate
training as determined by the department of public
health. This hygienist also would be allowed to bill
Medicaid directly for services. The Medicaid rules must be
amended to reflect this directive from the legislature.

Minnesota SF 2083                                       Signed 5/18/09

This file creates the dental therapist and advanced
dental therapist mid-level providers. A dental therapist
provides basic preventive and limited restorative services
and extractions of primary teeth and has limited
prescriptive authority. A number of services can be
administered without onsite supervision; however, all
restorative services and extractions require the presence
of a dentist. The advanced dental therapist is a master's-level
educated provider licensed to practice as a dental
therapist. The advanced dental therapist scope of practice
includes evaluation, assessment and treatment planning,
and nonsurgical extractions of permanent teeth as well
as all services administered by a dental therapist without
the requirement for onsite supervision. Both providers
work via a collaborative management agreement in settings
that serve low-income, uninsured and underserved
patients.

Missouri SB 296                                   Sent to the governor
                                                               5/29/09

This bill initiates a volunteer license for retired dentists
and dental hygienist who have practiced in any state for
10 years and retired less than four years ago. It includes
tooth-whitening procedures in the practice of dentistry,
and limits them to dental professionals.

Montana SB 226                                       Chaptered 4/20/09

61st Legislature SB0226: This bill allows for the temporary
volunteer licensure of nonresident dentists and
dental hygienists.

New Hampshire HB301                               Sent to the governor
                                                                5/6/09

This bill establishes a task force to study access to
dental care. The task force will study the problem of
access to dental care for low-income, uninsured and
underinsured persons and shall make recommendations
for improving the delivery of services to this population.
Areas of focus shall include, but not be limited to, education;
Medicaid and other reimbursement for children and
adults; promoting a "dental home" to lessen the reliance
on emergency rooms for dental care; geographical disparities
in available dental services; barriers to care such
as transportation, language and other health problems;
and provider models from other states. In addition, the
task force shall create a detailed action plan for improving
access to dental care. The 15-member taskforce will
be composed of various stakeholder organizations including
the New Hampshire Dental Hygienists' Association,
the New Hampshire Dental Society, state legislators and
other issue stakeholders.

New Mexico HB 286                                       Signed 4/07/09

This bill reinstates the Board of Dental Health Care until
July 1, 2016, following a "sunset review" in 2008 with
no changes to the practice act.

North Dakota HB 1091                                    Signed 4/09/09

This bill authorizes a registered dental hygienist to
orally transmit a prescription to a pharmacist if the supervising
dentist has authorized the hygienist to do so.

North Dakota HB 1176                                    Signed 4/08/09

This bill redefines the conditions in which a dental hygienist
may practice under general supervision. General supervision
may be used if the procedures are authorized in advance by the
supervising dentist, except for procedures that may be performed
only under direct supervision as established by the board
by rule.

Oklahoma HB 1059                                        Signed 5/14/09

This bill creates a special volunteer license for Oklahoma dental
hygienists and temporary volunteer license for out-of-state
hygienists.

Oregon HB 3204                                          Signed 6/25/09

Oregon became the first state to specifically authorize unsupervised
dental hygienists holding a limited access permit (LAP)
to practice in medical offices or offices operated or staffed by
nurse practitioners, physician assistants or midwives. Hospitals
were also added as an LAP setting.

Texas S97/H456                                 Effective after 9/01/09

This bill adds community health centers to settings where
a dental hygienist may provide delegated services before the
dentist examines the patient, and extends the length of time for
performing services to six months.

Utah HB 121                                             Signed 3/25/09

The Retired Volunteer Health Care Practitioner Act, covering
most health professions, includes dentists and dental hygienists.
It provides for a license that will allow practice at "charity
locations." Individual boards will make additional rules.

Virginia SB 1202                                        Signed 3/27/09

This bill establishes a pilot project where dental hygienists
employed by the Virginia Department of Health may provide
dental hygiene services in Virginia Dental Health Professional
Shortage Areas. The dental hygienist shall practice pursuant to
a protocol developed jointly by the medical directors of each of
the districts, dental hygienists employed by the Department of
Health, the Director of the Dental Health Division of the Department
of Health and representatives from the Virginia Dental and
Dental Hygienists' Associations.

Vermont HB 86                                           Signed 5/23/09

This bill directs the director of the Office of Professional Regulation
to file a report with the general assembly by January 1,
2010, recommending whether to restructure the Board of Dental
Examiners to improve the regulation of dental hygienists. If the
board determines that restructuring is necessary, it shall make
appropriate recommendations.

Washington HB 1309                                      Signed 5/04/09

This bill makes permanent a provision allowing dental hygienists
direct access to patients in "senior centers."

West Virginia HB 2191 Signed 3/27/09

This bill authorizes dental hygienists who meet specific
requirements to provide dental hygiene services without the
supervision of a dentist in hospitals, schools, correctional facilities,
jails, community clinics, long-term care facilities, nursing
homes, home health agencies, group homes, state institutions
under the Department of Health and Human Resources, public
health facilities, homebound settings and accredited dental hygiene
education programs. In order to qualify, a dental hygienist
is required to have two years and 3,000 hours of clinical dental
hygiene experience; and six additional continuing education
hours that include three hours in medical emergencies and three
hours in general public health content. The dental hygienist and
supervising dentist must submit an annual report to the West
Virginia Board of Dental Examiners of services rendered.

The bill also authorizes dental hygienists who meet specific
requirements to work under general supervision in a dental office
or treatment facilities. The hygienist cannot work when the
supervising dentist is not physically at the location for more than
15 consecutive days.

Wisconsin AB 103                                        Signed 5/13/09

This bill authorizes the board to issue a permit to practice
dental hygiene, without compensation, for a period of not more
than 10 days in a year and in a specified area, to a person who
is licensed to practice dental hygiene in another state. The board
must determine that the person's services will improve the
welfare of Wisconsin residents and that the person is qualified
to obtain and satisfies current criteria for obtaining a permanent
license in Wisconsin based on licensure in another state.
The board may not require an examination on state statutes
and rules relating to dental hygiene. Under the bill, the board
may renew a permit but may not charge a fee for issuance or
renewal.

Stateline is prepared by the ADHA Division of Governmental Affairs.