District Of Columbia 2023-2024 Regular Session

District Of Columbia Council Bill B25-0347 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	MURIEL BOWSER
2	2	MAYOR
3	3	June 26, 2023
4	4	The Honorable Phil Mendelson
5	5	Chairman
6	6	Council
7	7	of the District of Columbia
8	8	John A. Wilson Building
9	9	1350 Pennsylvania Avenue, NW, Suite 504
10	10	Washington, D.C. 20004
11	11	Dear Chairman Mendelson:
12	12	Enclosed for consideration and enactment by the Council
13	13	of the District of Columbia is the "Dental
14	14	Hygiene and Dental Assistants Scope
15	15	of Practice Amendment Act of 2023." This legislation will modify
16	16	the scope
17	17	of practice of dental hygiene to authorize dental hygienists to perform additional functions. It
18	18	will also modify the scope of practice of dental assistants to include assisting a licensed dental hygienist;
19	19	authorize dental assistants to perform specified duties under general or indirect supervision; and clarify
20	20	who
21	21	is required to be registered as a dental assistant.
22	22	As a whole, the legislation will help increase access to care for District residents in need
23	23	of oral
24	24	healthcare treatment and services. Also, by clarifying who
25	25	is required to register as a dental assistant, the
26	26	legislation will help prevent individuals from circumventing training and registration requirements.
27	27	I urge the Council to take prompt and favorable action on the enclosed legislation.
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66	66	~~
67	67	Chairman Phil Mendelson
68	68	at the request
69	69	of the Mayor
70	70	A BILL
71	71	IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
72	72	To amend the Health Occupations Revision Act of 1985 to modify the scope of practice
73	73	of dental hygiene to authorize dental hygienists to apply pit and fissure sealants,
74	74	place and remove periodontal dressings, administer vaccinations
75	75	under the direct
76	76	supervision
77	77	of a dentist licensed under the act, when certified by the Board to do
78	78	so, prescribe topical prescription
79	79	or over-the-counter fluoride preparations and
80	80	topical antimicrobial oral rinses,
81	81	under the supervision of a dentist licensed under
82	82	the act,
83	83	perfonn blood glucose testing, place or remove temporary restorations
84	84	and crowns, take study cast impressions, and remove sutures; to clarify that dental
85	85	hygienists can practice
86	86	under the supervision of a dentist in long-term care
87	87	facilities; to define the
88	88	term "dental hygiene diagnosis"; to amend the scope of
89	89	practice of dental assistants to include assisting a licensed dental hygienist; to
90	90	authorize dental assistants to perform specified duties
91	91	under general or indirect
92	92	supervision pursuant to the required level
93	93	of supervision set forth through
94	94	rulemaking; and to clarify
95	95	who is required to be registered as a dental assistant.
96	96	BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA,
97	97	That this act may be cited as the "Dental Hygiene and Dental Assistants Scope of
98	98	Practice Amendment Act of 2023 ".
99	99	Sec.
100	100	2. The District of Columbia Health Occupations Revision Act of 1985,
101	101	effective
102	102	March 25, 1986 (D.C. Law 6-99; D.C. Official Code§ 3-1201.01 et seq.), is
103	103	amended as follows:
104	104	(a) Section 102(4) (D.C. Official
105	105	Code§ 3-1201.02(4)) is amended as follows:
106	106	(1) Subparagraph (A) is
107	107	amended to read as follows:
108	108	1 39 "(A) "Practice of dental hygiene" means the performance of any of
109	109	40 the following activities in accordance with the provisions of subparagraph (B) of this
110	110	41 paragraph:
111	111	42 "(i) A preliminary dental examination, including charting
112	112	43 of cavities, soft tissue examination, periodontal examination, and oral cancer screening; a
113	113	44 complete prophylaxis, including the removal
114	114	of any deposit, accretion, or stain from the
115	115	45 surface of a tooth or a restoration; scaling and root planing; soft tissue curettage;
116	116	46 application
117	117	of topical fluoride and fluoride varnish; and the polishing of a tooth or a
118	118	47 restoration;
119	119	48 "(ii) Applying a medicinal agent to a tooth for a
120	120	49 prophylactic purpose;
121	121	50 "(iii) Taking dental radiographs;
122	122	51 "(iv) Instructing individuals or groups of individuals in oral
123	123	52 health care;
124	124	53 "(v) Administering local anesthesia and nitrous oxide,
125	125	54 when certified
126	126	by the Board to do so;"
127	127	55 "(vi) Applying pit and fissure sealants;
128	128	56 "(vii) Placing and removing periodontal dressings;
129	129	57 "(viii) Administering vaccinations under the direct
130	130	58 supervision of a dentist licensed under this act, when certified by the Board to do so;
131	131	59 "(ix) Prescribing topical prescription or over-the-counter
132	132	60 fluoride preparations and topical antimicrobial oral rinses, under the general supervision
133	133	61 of a dentist licensed under this act;
134	134	2 62
135	135	63
136	136	64 crowns;
137	137	"(x) Performing blood glucose testing;
138	138	"(xi) Placing or removing temporary restorations and
139	139	65 "(xii) Taking study cast impressions;
140	140	66 "(xiii) Removing sutures; and
141	141	67 "(xiv) Any other functions included in the curricula
142	142	of
143	143	68 approved educational programs in dental hygiene, including dental hygiene diagnosis.".
144	144	69 (2) Subparagraph (B)
145	145	is amended by:
146	146	70 (A) Striking the phrase
147	147	"A dental hygienist may perform" and
148	148	71 inserting the phrase "Except for administering vaccinations, a dental hygienist may
149	149	72 perform" in its place;
150	150	73 (B) Striking the phrase "in his or her office or any public school or
151	151	74 institution rendering dental services" and inserting the phrase "in his or her office, any
152	152	75 public school or institution rendering dental services, or a long-term care facility as
153	153	76 defined in section 101(7)
154	154	of the District of Columbia Long-Tenn Care Ombudsman
155	155	77 Program Act of 1988, effective March 16, 1989 (D.C. Law 7-218; D.C. Official Code§
156	156	78 7-701.01(7))"; and
157	157	79
158	158	(C) Striking the phrase "subparagraph (A)(vi)" and inserting the
159	159	80 phrase "subparagraph (A)(xiv)" in its place.
160	160	81 (3) A new subparagraph (D) is added to read as follows:
161	161	82 "(D) For the purposes of subparagraph (A) of this paragraph, the
162	162	83 term "dental hygiene diagnosis" means the identification of an existing oral health
163	163	84 problem that a dental hygienist
164	164	is qualified and licensed to treat within the scope of dental
165	165	3 85 hygiene practice. The dental hygiene diagnosis focuses on behavioral risks and physical
166	166	86 conditions that are related to oral health. "
167	167	87 (b) Section 905 (D.
168	168	C. Official Code§ 3-1209.05) is amended as follows:
169	169	88 (1) Subsection (a) is amended as follows:
170	170	89 (A) Paragraph (1)
171	171	is amended by:
172	172	90 (i) Striking the phrase "assist a licensed dentist" and
173	173	91 inserting the phrase "assist a licensed dentist or a licensed dental hygienist" in its place;
174	174	92 and
175	175	93 (ii) Striking the phrase "direct supervision" and inserting
176	176	94 the word "supervision" in its place.
177	177	95 (B) Paragraph (2)
178	178	is repealed.
179	179	96 (2) Subsection (b) is amended to read as follows:
180	180	97
181	181	"(b) A person who is engaged as a dental assistant to assist a dentist in the
182	182	98 performance
183	183	of dental procedures, or to assist a dental hygienist in the performance of
184	184	99 dental hygiene procedures, in any area of or specialty area of dentistry, including oral and
185	185	100 maxillofacial surgery, or who performs the duties
186	186	of a dental assistant in any area of or
187	187	101 specialty area of dentistry, including oral and maxillofacial surgery, in the District shall
188	188	102 be registered with the Board, renew the registration as required by rule, and pay the
189	189	103 required registration fee established by the Board.".
190	190	104 (3) Subsection (d) is amended by:
191	191	105 (A) Striking the phrase "A person shall not engage in the practice,
192	192	106 or use the title,
193	193	of dental assistant" and inserting after the phrase "A person shall not
194	194	4 107 engage in the practice of dental assisting or use the title of dental assistant" in its place;
195	195	108 and
196	196	109 (B) Striking the phrase "direct supervision" and inserting the word
197	197	110 "supervision" in its place.
198	198	111 ( 4) Subsection ( e) is repealed.
199	199	112 ( 5) Subsection (g) is amended
200	200	by striking the phrase "and the duties that
201	201	113 may be performed by a dental assistant" and inserting the
202	202	phrase", the duties that may be
203	203	114 performed by a dental assistant, and the required level
204	204	of supervision" in its place.
205	205	115 Sec.
206	206	3. Fiscal impact statement.
207	207	116 The Council adopts the fiscal impact statement in the committee report as the
208	208	117 fiscal impact statement required by section 602( c )(3)
209	209	of the District of Columbia Home
210	210	118 Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official
211	211	Code§ 1-
212	212	119 206.02(c)(3)).
213	213	120 Sec. 4. Effective date.
214	214	121 This act shall take effect following approval by the Mayor ( or in the event of veto
215	215	122 by the Mayor, action by the Council to override the veto), a 30-day period
216	216	of
217	217	123 Congressional review as provided in section 602( c )(1) of the District of Columbia Home
218	218	124 Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official
219	219	Code§ 1-
220	220	125 206.02( c
221	221	)(1 )), and publication in the District of Columbia Register.
222	222	5 GOVERNMENT OF THE DISTRICT OF COLUMBIA
223	223	OFFICE OF THE ATTORNEY GENERAL
224	224	BRIAN L. SCHWALB
225	225	ATTORNEY GENERAL
226	226	Legal Counsel Division
227	227	MEMORANDUM
228	228	TO: Phillip Husband
229	229	General Counsel
230	230	*** --
231	231	District of Columbia Department of Health
232	232	FROM: Megan D. Browder
233	233	Deputy Attorney General
234	234	Legal Counsel Division
235	235	DATE: March 23, 2023
236	236	SUBJECT: Legal Sufficiency Review of Draft Bill, the "Dental Hygiene and
237	237	Dental Assistance Scope of Practice Amendment Act of 2023"
238	238	(AD-23-229)
239	239	This is to Certify that this Office has reviewed the above-referenced
240	240	legislation and has found it to be legally sufficient. If you have any questions
241	241	regarding this certification, please do not hesitate to contact me at (202) 724-5524.
242	242	1Y!_o/~lPJjre!3
243	243	Megan D. Browder
244	244	1350 Pennsylvania Avenue, N.W., Suite 409, Washington, D.C. 20004 Phone: (202) 724-5524 Email: megan.browder@dc.gov Glen Lee
245	245	Chief Financial Officer
246	246	MEMORANDUM
247	247	TO:
248	248	FROM:
249	249	DATE:
250	250	SUBJECT:
251	251	REFERENCE:
252	252	Conclusion
253	253	Government of the District of Columbia
254	254	Office
255	255	of the Chief Financial Officer
256	256	* * *
257	257	The Honorable Phil Mendelson
258	258	Chairman, Council of the District of Columbia
259	259	Glen Lee
260	260	;)
261	261	Chief Financial Officer /J /] /) IA f,:::_
262	262	April 4, 2023 p-
263	263	Fiscal Impact Statement -Dental Hygiene and Dental Assistants Scope
264	264	of Practice Amendment Act of 2023
265	265	Draft Introduction as provided to the Office of Revenue Analysis on
266	266	March 23, 2023
267	267	Funds are sufficient in the fiscal year 2023 budget and proposed fiscal year 2024 through fiscal year
268	268	2027 budget and financial plan to implement the bill.
269	269	Background
270	270	The bill expands
271	271	1 the scope of practice for dental hygiene in the District of Columbia to increase
272	272	access to care for residents. Specifically,
273	273	the bill allows dental hygienists to:
274	274	• Apply pit
275	275	and fissure sealants;
276	276	• Place
277	277	and remove periodontal dressings;
278	278	• Administer vaccinations
279	279	under the direct supervision of a licensed dentist;
280	280	• Prescribe topical prescription
281	281	or over-the-counter fluoride preparations and topical
282	282	antimicrobial oral rinses,
283	283	under the supervision of a licensed dentist;
284	284	• Perform blood glucose testing;
285	285	• Place
286	286	or remove temporary restorations and crowns;
287	287	• Take
288	288	study cast impressions;
289	289	• Remove
290	290	sutures; and
291	291	• Practice under the supervision of a dentist in long-term care facilities.
292	292	1 By amending The District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986
293	293	(D.C. Law 6-99; D.C. Official Code§ 3-1201.01 et seq.).
294	294	1350 Pennsylvania Avenue, NW, Suite 203, Washington, DC 20004 (202)727-2476
295	295	www.cfo.dc.gov The Honorable Phil Mendelson
296	296	FIS: "Dental Hygiene and Dental Assistants Scope of Practice Amendment Act of 2023," Draft Introduction as
297	297	provided to the Office of Revenue Analysis on March 23, 2023
298	298	The bill also expands the scope of practice for dental assistants in the District of Columbia by allowing
299	299	assistants to assist licensed dental hygienists and
300	300	perform specified duties under general or indirect
301	301	supervision.
302	302	Financial Plan Impact
303	303	Funds are sufficient in the fiscal year 2023 budget and proposed fiscal year 2024 through fiscal year
304	304	2027 budget and financial plan to implement the bill. The Board of Dentistry already regulates the
305	305	practice of dentistry and dental hygiene in the District. No additional resources are required to
306	306	regulate the expanded practice of dental hygienists and dental assistants.
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