BILL NO A00111A
SAME AS SAME AS S07353
SPONSOR Paulin (MS)
MLTSPNSR Gabryszak, Ortiz, Reilly, Titone
Add S6607-a, Ed L
Authorizes dental hygienists to provide such services without supervision in
collaboration with a licensed dentist under a collaborative practice agreement.
TITLE OF BILL: An act to amend the education law, in relation to regis-
tered dental hygienists working without supervision but within a colla-
borative practice agreement with a licensed dentist
PURPOSE: To create the category of registered dental hygienist, colla-
borative practice, which authorizes dental hygienists to practice with-
out supervision but within a collaborative practice agreement with a
SUMMARY OF PROVISIONS:
Section one adds a new section 6607-a to the education law which creates
and defines the practice of collaborative practice dental hygiene. This
section provides that the practice of dental hygiene may be performed in
collaboration with a licensed dentist provided such services are
performed in accordance with a written practice agreement and written
This section also establishes the required content and procedures
pertaining to the written collaborative practice agreement and collabo-
rative practice arrangements.
Section one of this bill also requires dental hygienists to provide a
patient with a written statement advising the patient that dental
hygiene services are not a substitute for a dental examination by a
licensed dentist, and to make referrals for further dental procedures as
Section two Provides for the immediate enactment of this bill.
JUSTIFICATION: According to the Department of Health's Oral Health Plan
for New York State (2005), approximately 50% of children in New York
experience tooth decay by the third grade and about 18% of New Yorkers
65 years and older have lost all their teeth. Because of current dispar-
ities that exist in oral health, these numbers are even higher among
low-income and minority populations. Increasing access to dental hygiene
services will help to ensure that all New Yorkers are able to receive
quality oral healthcare.
Dental hygienists fulfill a critical role in the provision of dental
care, both in private-practice and public health settings. In fact, a
2010 report issued by the Pew Center on the States found that adding
dental hygienists to a practice enables most private-practice dentists
to serve more patients while increasing profitability and productivity.
With the enactment of the federal health care reform law in 2010, which
will extend dental insurance to an estimated 5,3 million more children
nationally by 2014, patient demand for dental care will continue to
increase. Thus, it is imperative that dental hygienists' skills and
training are fully utilized freeing up dentists to treat more patients.
Medicaid Redesign Team (MRT) supports this action as one of its top five
priorities of their twelve final recommendations. According to the 2011
published recommendations from MRT, this bill will allow for the maximum
utilization of the dental hygienists in New York State, in keeping with
their education, training, and expertise as oral health prevention
specialists. Collaborative Practice will serve to improve the oral
health status of New Yorkers and promote the prevention of disease and
Collaborative practice is another way to increase access to dental
hygiene care and disease prevention. Collaborative practice dental
hygienists would be able to practice, pursuant to the terms of the
collaborative practice agreement, without the supervision of the
dentist. This makes it much easier for dental hygienists to practice in
under served communities, where there is a great need for prophylactic
treatments and oral health counseling. Collaborative practice dental
hygienists would also screen patients for disease and refer them to the
collaborating dentist for dental examinations and other treatments. This
creates more opportunities for New Yorkers to receive dental hygiene
care, and decreases their risk of developing oral disease and tooth
Moreover this bill requires registered dental hygienist to apply for a
new certification with the New York State Education Department for
Collaborative Practice (RDH-CP). As a prerequisite, three years experi-
ence and continuing education requirements are provided for.
LEGISLATIVE HISTORY: New Bill.
FISCAL IMPLICATIONS:; None.
EFFECTIVE DATE: This act shall take effect immediately.
S T A T E O F N E W Y O R K
2011-2012 Regular Sessions
I N A S S E M B L Y
January 5, 2011
Introduced by M. of A. PAULIN, CAHILL -- Multi-Sponsored by -- M. of A.
GABRYSZAK, ORTIZ, REILLY, TITONE -- read once and referred to the
Committee on Higher Education -- recommitted to the Committee on High-
er Education in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the education law, in relation to registered dental
hygienists working without supervision but within a collaborative
practice agreement with a licensed dentist
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. The education law is amended by adding a new section 6607-a
2 to read as follows:
3 S 6607-A. PRACTICE OF COLLABORATIVE PRACTICE DENTAL HYGIENE AND USE OF
4 TITLE "REGISTERED DENTAL HYGIENIST, COLLABORATIVE PRACTICE" (RDH-CP). 1.
5 THE PRACTICE OF THE PROFESSION OF DENTAL HYGIENE, AS DEFINED UNDER THIS
6 ARTICLE, MAY BE PERFORMED IN COLLABORATION WITH A LICENSED DENTIST
7 PROVIDED SUCH SERVICES ARE PERFORMED IN ACCORDANCE WITH A WRITTEN PRAC-
8 TICE AGREEMENT AND WRITTEN PRACTICE PROTOCOLS TO BE KNOWN AS A COLLABO-
9 RATIVE PRACTICE AGREEMENT. UNDER A COLLABORATIVE PRACTICE AGREEMENT,
10 DENTAL HYGIENISTS MAY PERFORM ALL SERVICES WHICH ARE DESIGNATED IN REGU-
11 LATION WITHOUT PRIOR EVALUATION OF A DENTIST OR MEDICAL PROFESSIONAL AND
12 MAY BE PERFORMED WITHOUT SUPERVISION IN A COLLABORATIVE PRACTICE
14 2. (A) THE COLLABORATIVE PRACTICE AGREEMENT SHALL INCLUDE CONSIDER-
15 ATION FOR MEDICALLY COMPROMISED PATIENTS, SPECIFIC MEDICAL CONDITIONS,
16 AND AGE- AND PROCEDURE-SPECIFIC PRACTICE PROTOCOLS, INCLUDING, BUT NOT
17 LIMITED TO RECOMMENDED INTERVALS FOR THE PERFORMANCE OF DENTAL HYGIENE
18 SERVICES AND A PERIODICITY IN WHICH AN EXAMINATION BY A DENTIST SHOULD
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
A. 111--A 2
1 (B) THE COLLABORATIVE AGREEMENT SHALL BE:
2 (I) SIGNED AND MAINTAINED BY THE DENTIST, THE DENTAL HYGIENIST, AND
3 THE FACILITY, PROGRAM, OR ORGANIZATION;
4 (II) REVIEWED ANNUALLY BY THE COLLABORATING DENTIST AND DENTAL HYGIEN-
5 IST; AND
6 (III) MADE AVAILABLE TO THE DEPARTMENT AND OTHER INTERESTED PARTIES
7 UPON REQUEST.
8 (C) ONLY ONE AGREEMENT BETWEEN A COLLABORATING DENTIST AND REGISTERED
9 DENTAL HYGIENIST, COLLABORATIVE PRACTICE (RDH-CP) MAY BE IN FORCE AT A
11 3. BEFORE PERFORMING ANY SERVICES AUTHORIZED UNDER THIS SECTION, A
12 DENTAL HYGIENIST MUST PROVIDE THE PATIENT WITH A WRITTEN STATEMENT
13 ADVISING THE PATIENT THAT THE DENTAL HYGIENE SERVICES PROVIDED ARE NOT A
14 SUBSTITUTE FOR A DENTAL EXAMINATION BY A LICENSED DENTIST. IF THE DENTAL
15 HYGIENIST MAKES ANY REFERRALS TO THE PATIENT FOR FURTHER DENTAL PROCE-
16 DURES, THE DENTAL HYGIENIST MUST FILL OUT A REFERRAL FORM AND PROVIDE A
17 COPY OF THE FORM TO THE COLLABORATING DENTIST.
18 4. THE COLLABORATIVE PRACTICE DENTAL HYGIENIST MAY ENTER INTO A
19 CONTRACTUAL ARRANGEMENT WITH ANY NEW YORK STATE LICENSED AND REGISTERED
20 DENTIST, HEALTH CARE FACILITY, PROGRAM, AND/OR NON-PROFIT ORGANIZATION
21 TO PERFORM DENTAL HYGIENE SERVICES IN THE FOLLOWING SETTINGS: DENTAL
22 OFFICES; LONGTERM CARE FACILITIES/SKILLED NURSING FACILITIES; PUBLIC OR
23 PRIVATE SCHOOLS; PUBLIC HEALTH AGENCIES/FEDERALLY QUALIFIED HEALTH
24 CENTERS; CORRECTIONAL FACILITIES; PUBLIC INSTITUTIONS/MENTAL HEALTH
25 FACILITIES; AND PRIVATE SETTINGS IN WHICH HOMEBOUND RESIDENTS ARE UNABLE
26 TO BE RELOCATED FOR NECESSARY TREATMENT.
27 5. A COLLABORATING DENTIST SHALL HAVE COLLABORATIVE AGREEMENTS WITH NO
28 MORE THAN SIX COLLABORATIVE PRACTICE DENTAL HYGIENISTS. THE DEPARTMENT
29 MAY GRANT EXCEPTIONS TO THESE LIMITATIONS FOR PUBLIC HEALTH SETTINGS ON
30 A CASE-BY-CASE BASIS.
31 6. A DENTAL HYGIENIST MUST MAKE APPLICATION TO THE NEW YORK STATE
32 EDUCATION DEPARTMENT TO PRACTICE AS A REGISTERED DENTAL HYGIENIST,
33 COLLABORATIVE PRACTICE (RDH-CP) AND PAY A FEE SET BY THE DEPARTMENT. AS
34 A CONDITION OF COLLABORATIVE PRACTICE, THE DENTAL HYGIENIST MUST HAVE
35 BEEN ENGAGED IN PRACTICE FOR THREE YEARS WITH A MINIMUM OF FOUR THOUSAND
36 FIVE HUNDRED PRACTICE HOURS AND MUST COMPLETE AN EIGHT HOUR CONTINUING
37 EDUCATION PROGRAM THAT INCLUDES INSTRUCTION IN MEDICAL EMERGENCY PROCE-
38 DURES, RISK MANAGEMENT, DENTAL HYGIENE JURISPRUDENCE AND PROFESSIONAL
40 S 2. This act shall take effect immediately.