General Assembly		Raised Bill No. 6814
January Session, 2015		LCO No. 3537
		*03537_______PH_*
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)

AN ACT CONCERNING DENTAL ASSISTANTS AND EXPANDED FUNCTION DENTAL AUXILIARY.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 20-112a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2015):

(a) As used in this section:

(1) "Direct supervision" means a licensed dentist has authorized certain procedures to be performed on a patient by a dental assistant with such dentist remaining on-site in the dental office or treatment facility while such procedures are performed and that, prior to the patient's departure from the dental office, such dentist reviews and approves the treatment performed by the dental assistant;

(2) "Indirect supervision" means a licensed dentist is in the dental office or treatment facility, has personally diagnosed the condition, planned the treatment, authorized the procedures to be performed and remains in the dental office or treatment facility while the procedures are being performed by the dental assistant and evaluates the performance of the dental assistant;

(3) "Dental assistant" means a noncredentialed dental assistant, a credentialed dental assistant or an expanded function dental auxiliary;

(4) "Noncredentialed dental assistant" means a person who (A) has completed on-the-job training in dental assisting under the direct supervision, control and responsibility of an employing, licensed dentist, or (B) has successfully completed a dental assistant education program accredited by the American Dental Association's Commission on Dental Accreditation, or (C) has successfully completed a dental assistant program that is accredited or recognized by the New England Association of Schools and Colleges, and (D) has met any requirements established by the Commissioner of Public Health;

(5) "Credentialed dental assistant" means a person who successfully completed the Dental Assisting National Board's certified dental assistant or certified orthodontic assistant examination and maintains current certification by the Dental Assisting National Board; and

(6) "Expanded function dental auxiliary" means a credentialed dental assistant, dental hygienist licensed under chapter 379a, a person who has served as an expanded function dental auxiliary for a period of not less than three years in the United States armed forces or the United States Department of Health and Human Services' United States Public Health Service Commissioned Corps or Indian Health Service, or a person holding a diploma from a foreign dental school who has successfully completed (A) an expanded function dental auxiliary program at an institution of higher education that is accredited by the Commission on Dental Accreditation of the American Dental Association and that includes: (i) A curriculum with courses relating to didactic and laboratory preclinical objectives for skills used by an expanded function dental auxiliary and that requires demonstration of such skills prior to advancing to clinical practice; (ii) not less than four hours of education in the areas of law and ethics applicable to the dental profession; and (iii) a comprehensive clinical examination, and (B) a comprehensive written examination in expanded functions administered by the Dental Assisting National Board.

(b) A licensed dentist may delegate to dental assistants such dental procedures as the dentist may deem advisable, including the taking of dental x-rays if the dental assistant can demonstrate successful completion of the dental [radiography portion of an examination prescribed] radiation health and safety examination administered by the Dental Assisting National Board and the taking of impressions of the teeth for study models and fabrication of orthodontic appliances, but such procedures shall be performed under the dentist's supervision and control and the dentist shall assume responsibility for such procedures; provided such assistants may not engage in: (1) Diagnosis for dental procedures or dental treatment; (2) the cutting or removal of any hard or soft tissue or suturing; (3) the prescribing of drugs or medications that require the written or oral order of a licensed dentist or physician; (4) the administration of local, parenteral, inhalation or general anesthetic agents in connection with any dental operative procedure; (5) the taking of any final impression of the teeth or jaws or the relationship of the teeth or jaws for the purpose of fabricating any appliance or prosthesis; (6) the placing, finishing and adjustment of [temporary or final restorations] temporary restorations and long-term individual fillings, capping materials and cement bases [or] unless the dental assistant is an expanded function dental auxiliary; (7) the practice of dental hygiene as defined in section 20-126l; or (8) coronal polishing, unless such dental assistant is an expanded function dental auxiliary and the procedure is not represented or billed as prophylaxis.

(c) An expanded function dental auxiliary shall: (1) Maintain dental assistant or orthodontic assistant certification by the Dental Assisting National Board or dental hygiene licensure in accordance with chapter 379a; (2) conspicuously display such certificate or license in the place of employment where such expanded function dental auxiliary services are performed; (3) maintain professional liability insurance or other indemnity against liability for professional malpractice while employed in such capacity in an amount that is not less than five hundred thousand dollars for one person, per occurrence, with an aggregate liability of not less than one million five hundred thousand dollars; and (4) limit his or her practice to providing services under the indirect supervision or direct supervision of a licensed dentist.

(d) Each dentist employing or engaging the services of an expanded function dental auxiliary shall: (1) Before hiring or otherwise engaging the services of an expanded function dental auxiliary, verify that the expanded function dental auxiliary has successfully completed the requirements for an expanded function dental auxiliary, as described in this section; (2) maintain documentation of the expanded function dental auxiliary's completion of such requirements on the premises where the expanded function dental auxiliary provides services; (3) make such documentation available to the Department of Public Health upon request; and (4) provide indirect supervision or direct supervision to not more than two expanded function dental auxiliaries who are providing services at one time or, if the dentist's practice is limited to orthodontics, provide indirect supervision or direct supervision to not more than four expanded function dental auxiliaries who are providing services at one time.

(e) An expanded function dental auxiliary may practice in settings that include, but are not limited to, (1) a public health facility, as defined in section 20-126l; or (2) a dental health professional shortage area as designated by the federal Health Resources and Services Administration.

(f) The Commissioner of Public Health, in consultation with the State Dental Commission, established under section 20-103a, shall adopt regulations, in accordance with chapter 54, to implement the provisions of this section. Such regulations shall include, but shall not be limited to: (1) Identification of the types of procedures that may be performed by a noncredentialed dental assistant, credentialed dental assistant and an expanded function dental auxiliary; (2) identification of the appropriate number of didactic, preclinical and clinical hours or number of procedures to be evaluated for clinical competency for each skill employed by an expanded function dental auxiliary; and (3) identification of the level of supervision, including direct supervision, indirect supervision or a description of another level of supervision that is required for each procedure to be performed by an expanded function dental auxiliary.

(g) The State Dental Commission shall publish on its Internet web site a list of the types of procedures that may be performed by a noncredentialed dental assistant, credentialed dental assistant or expanded function dental auxiliary. Said commission shall update the list not less than once every three years.

This act shall take effect as follows and shall amend the following sections:
Section 1	October 1, 2015	20-112a

Statement of Purpose:

To modernize dental assisting in the state by defining services that may be performed by certain dental professionals.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]