1. Dental Hygiene Collaborative Practice
Mary Ellen Yankosky, B.S., R.D.H. Director of Policy and Advocacy, DHASNY
New York State Oral Health Coalition
November 13, 2014

2. Session Outcomes By the end of the session, you will have heard about:
Statutory Changes in the Practice of Dental Hygiene
Regulatory Process Promulgating Rules to Implement the Law
Role of DHASNY in preparing RDHs for collaborative practice

3. Dental Hygiene: 11th oldest profession in NYS
Photo compliments of U of Rochester Library

4. Changes in Practice…………..
General Supervision 1970’s
New York Codes, Rules and Regulations, Title 10 – Nursing Homes Practice 1990’s
Increased Dental Hygiene Representation, State Board for Dentistry 1990’s
Mandatory Continuing Education 1995
Local Anesthesia and Nitrous Oxide Administration and Monitoring 2005
Expanded Scope of Practice to include any/all duties allowed by law for NY Licensed Dental Assistants 1995
Limited License 2000’s
Limited Permit 2000’s
Children’s Dental Health Certificate 2009
Elimination of Citizenship for Licensure 2013
Collaborative Practice 2013

5. A bill becomes law………….. A7866/S5757 – Glick/Hannon
This amendment to the Education Law allows dental hygienists to provide dental services in facilities organized under Article 28 of PHL, pursuant to a collaborative agreement with a licensed and registered dentist who has a formal agreement with facility
Passed both Houses June 2013
Signed into law August 1, 2013

6. 1. The Dental Hygiene Practice Act states that "[the] practice of dental hygiene ... must be done under supervision of a licensed dentist” or effective January 1, 2015, pursuant to a collaborative arrangement as defined in regulations of the Commissioner of Education approved by the Board of Regents.
2. Personal supervision shall mean that the dentist in the dental office
or facility, personally diagnoses the condition to be treated, personally authorizes the procedure and, before dismissal of the patient, personally examines the condition after treatment is completed.
3. General supervision shall mean that a supervising dentist is available for consultation, diagnosis and evaluation, has authorized the dental hygienist to perform the services, and exercises that degree of supervision appropriate to the circumstances.
§ Definition of practice of dental hygiene
§61.9 Practice of dental hygiene
Supervision.

7. The Law:
The practice of dental hygiene, in accordance with section 6606 of the Education Law, shall be performed either under the supervision of a licensed dentist or pursuant to a collaborative arrangement as defined in subdivision (f) of this section.
Instruct patients to visit a license dentist for comprehensive examination or treatment
Requires certified in CPR and maintain certification as part of mandatory continuing education hours

8. Scope of Practice
Dental Hygiene procedures allowable within Collaborative Practice includes those currently provided under general supervision

9. The Regulations – Key Updates
Taking and assessing medical history including the measuring and recording of vital signs as an aid to diagnosis by the dentist and to assist the dental hygienist in providing dental hygiene services;
Charting caries and periodontal conditions as an aid to diagnosis by the dentist Performing dental and/or periodontal assessments as an aid to diagnosis by the dentist and to assist the dental hygienist in providing dental hygiene services;
Assessments of the oral and maxillofacial area as an aid to diagnosis by the dentist;

10. Key Updates con’t………….
Providing dental health care case management and care coordination services, which shall include, but not be limited to:
(i) Community outreach;
(ii) Improving oral outcomes;
(iii)Improving access to dental care by assisting people in establishing an ongoing relationship with a dentist, in order to promote the comprehensive, continuous and coordinated delivery of all aspects of oral health care; and
(iv) Assisting people to obtain dental health care.

11. Who made this happen? NYS Medicaid Redesign Team
New York State Dental Association
NYSDOH, Bureau of Dental Health
NYS Assembly and Senate
NYS Governor
NYS Education Department, State Board for Dentistry
Dental Hygienists’ Association of the State of NY

12. Collaborative Practice
“The fundamental feature of collaborative practice is always the commitment by the collaborating providers to work in concert to provide the best comprehensive care for their patients while respecting, recognizing, and building on each other’s strengths and talents.”
Elizabeth Mertz, PhD, MA; Vanessa Lindler, MA; and Catherine Dower, JD. January, “Collaborative Practice in American Dentistry: Practice and Potential.” UCSF Center for the Health Professions