MURIEL BOWSER
MAYOR
June 26, 2023
The Honorable Phil Mendelson
Chairman
Council
of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, NW, Suite 504
Washington, D.C. 20004
Dear Chairman Mendelson:
Enclosed for consideration and enactment by the Council
of the District of Columbia is the "Dental
Hygiene and Dental Assistants Scope
of Practice Amendment Act of 2023." This legislation will modify
the scope
of practice of dental hygiene to authorize dental hygienists to perform additional functions. It
will also modify the scope of practice of dental assistants to include assisting a licensed dental hygienist;
authorize dental assistants to perform specified duties under general or indirect supervision; and clarify
who
is required to be registered as a dental assistant.
As a whole, the legislation will help increase access to care for District residents in need
of oral
healthcare treatment and services. Also, by clarifying who
is required to register as a dental assistant, the
legislation will help prevent individuals from circumventing training and registration requirements.
I urge the Council to take prompt and favorable action on the enclosed legislation.
Sincerely, 1
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~~
Chairman Phil Mendelson
at the request
of the Mayor
A BILL
IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
To amend the Health Occupations Revision Act of 1985 to modify the scope of practice
of dental hygiene to authorize dental hygienists to apply pit and fissure sealants,
place and remove periodontal dressings, administer vaccinations
under the direct
supervision
of a dentist licensed under the act, when certified by the Board to do
so, prescribe topical prescription
or over-the-counter fluoride preparations and
topical antimicrobial oral rinses,
under the supervision of a dentist licensed under
the act,
perfonn blood glucose testing, place or remove temporary restorations
and crowns, take study cast impressions, and remove sutures; to clarify that dental
hygienists can practice
under the supervision of a dentist in long-term care
facilities; to define the
term "dental hygiene diagnosis"; to amend the scope of
practice of dental assistants to include assisting a licensed dental hygienist; to
authorize dental assistants to perform specified duties
under general or indirect
supervision pursuant to the required level
of supervision set forth through
rulemaking; and to clarify
who is required to be registered as a dental assistant.
BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA,
That this act may be cited as the "Dental Hygiene and Dental Assistants Scope of
Practice Amendment Act of 2023 ".
Sec.
2. The District of Columbia Health Occupations Revision Act of 1985,
effective
March 25, 1986 (D.C. Law 6-99; D.C. Official Code§ 3-1201.01 et seq.), is
amended as follows:
(a) Section 102(4) (D.C. Official
Code§ 3-1201.02(4)) is amended as follows:
(1) Subparagraph (A) is
amended to read as follows:
1 39 "(A) "Practice of dental hygiene" means the performance of any of
40 the following activities in accordance with the provisions of subparagraph (B) of this
41 paragraph:
42 "(i) A preliminary dental examination, including charting
43 of cavities, soft tissue examination, periodontal examination, and oral cancer screening; a
44 complete prophylaxis, including the removal
of any deposit, accretion, or stain from the
45 surface of a tooth or a restoration; scaling and root planing; soft tissue curettage;
46 application
of topical fluoride and fluoride varnish; and the polishing of a tooth or a
47 restoration;
48 "(ii) Applying a medicinal agent to a tooth for a
49 prophylactic purpose;
50 "(iii) Taking dental radiographs;
51 "(iv) Instructing individuals or groups of individuals in oral
52 health care;
53 "(v) Administering local anesthesia and nitrous oxide,
54 when certified
by the Board to do so;"
55 "(vi) Applying pit and fissure sealants;
56 "(vii) Placing and removing periodontal dressings;
57 "(viii) Administering vaccinations under the direct
58 supervision of a dentist licensed under this act, when certified by the Board to do so;
59 "(ix) Prescribing topical prescription or over-the-counter
60 fluoride preparations and topical antimicrobial oral rinses, under the general supervision
61 of a dentist licensed under this act;
2 62
63
64 crowns;
"(x) Performing blood glucose testing;
"(xi) Placing or removing temporary restorations and
65 "(xii) Taking study cast impressions;
66 "(xiii) Removing sutures; and
67 "(xiv) Any other functions included in the curricula
of
68 approved educational programs in dental hygiene, including dental hygiene diagnosis.".
69 (2) Subparagraph (B)
is amended by:
70 (A) Striking the phrase
"A dental hygienist may perform" and
71 inserting the phrase "Except for administering vaccinations, a dental hygienist may
72 perform" in its place;
73 (B) Striking the phrase "in his or her office or any public school or
74 institution rendering dental services" and inserting the phrase "in his or her office, any
75 public school or institution rendering dental services, or a long-term care facility as
76 defined in section 101(7)
of the District of Columbia Long-Tenn Care Ombudsman
77 Program Act of 1988, effective March 16, 1989 (D.C. Law 7-218; D.C. Official Code§
78 7-701.01(7))"; and
79
(C) Striking the phrase "subparagraph (A)(vi)" and inserting the
80 phrase "subparagraph (A)(xiv)" in its place.
81 (3) A new subparagraph (D) is added to read as follows:
82 "(D) For the purposes of subparagraph (A) of this paragraph, the
83 term "dental hygiene diagnosis" means the identification of an existing oral health
84 problem that a dental hygienist
is qualified and licensed to treat within the scope of dental
3 85 hygiene practice. The dental hygiene diagnosis focuses on behavioral risks and physical
86 conditions that are related to oral health. "
87 (b) Section 905 (D.
C. Official Code§ 3-1209.05) is amended as follows:
88 (1) Subsection (a) is amended as follows:
89 (A) Paragraph (1)
is amended by:
90 (i) Striking the phrase "assist a licensed dentist" and
91 inserting the phrase "assist a licensed dentist or a licensed dental hygienist" in its place;
92 and
93 (ii) Striking the phrase "direct supervision" and inserting
94 the word "supervision" in its place.
95 (B) Paragraph (2)
is repealed.
96 (2) Subsection (b) is amended to read as follows:
97
"(b) A person who is engaged as a dental assistant to assist a dentist in the
98 performance
of dental procedures, or to assist a dental hygienist in the performance of
99 dental hygiene procedures, in any area of or specialty area of dentistry, including oral and
100 maxillofacial surgery, or who performs the duties
of a dental assistant in any area of or
101 specialty area of dentistry, including oral and maxillofacial surgery, in the District shall
102 be registered with the Board, renew the registration as required by rule, and pay the
103 required registration fee established by the Board.".
104 (3) Subsection (d) is amended by:
105 (A) Striking the phrase "A person shall not engage in the practice,
106 or use the title,
of dental assistant" and inserting after the phrase "A person shall not
4 107 engage in the practice of dental assisting or use the title of dental assistant" in its place;
108 and
109 (B) Striking the phrase "direct supervision" and inserting the word
110 "supervision" in its place.
111 ( 4) Subsection ( e) is repealed.
112 ( 5) Subsection (g) is amended
by striking the phrase "and the duties that
113 may be performed by a dental assistant" and inserting the
phrase", the duties that may be
114 performed by a dental assistant, and the required level
of supervision" in its place.
115 Sec.
3. Fiscal impact statement.
116 The Council adopts the fiscal impact statement in the committee report as the
117 fiscal impact statement required by section 602( c )(3)
of the District of Columbia Home
118 Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official
Code§ 1-
119 206.02(c)(3)).
120 Sec. 4. Effective date.
121 This act shall take effect following approval by the Mayor ( or in the event of veto
122 by the Mayor, action by the Council to override the veto), a 30-day period
of
123 Congressional review as provided in section 602( c )(1) of the District of Columbia Home
124 Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official
Code§ 1-
125 206.02( c
)(1 )), and publication in the District of Columbia Register.
5 GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE ATTORNEY GENERAL
BRIAN L. SCHWALB
ATTORNEY GENERAL
Legal Counsel Division
MEMORANDUM
TO: Phillip Husband
General Counsel
*** --
District of Columbia Department of Health
FROM: Megan D. Browder
Deputy Attorney General
Legal Counsel Division
DATE: March 23, 2023
SUBJECT: Legal Sufficiency Review of Draft Bill, the "Dental Hygiene and
Dental Assistance Scope of Practice Amendment Act of 2023"
(AD-23-229)
This is to Certify that this Office has reviewed the above-referenced
legislation and has found it to be legally sufficient. If you have any questions
regarding this certification, please do not hesitate to contact me at (202) 724-5524.
1Y!_o/~lPJjre!3
Megan D. Browder
1350 Pennsylvania Avenue, N.W., Suite 409, Washington, D.C. 20004 Phone: (202) 724-5524 Email: megan.browder@dc.gov Glen Lee
Chief Financial Officer
MEMORANDUM
TO:
FROM:
DATE:
SUBJECT:
REFERENCE:
Conclusion
Government of the District of Columbia
Office
of the Chief Financial Officer
* * *
The Honorable Phil Mendelson
Chairman, Council of the District of Columbia
Glen Lee
;)
Chief Financial Officer /J /] /) IA f,:::_
April 4, 2023 p-
Fiscal Impact Statement -Dental Hygiene and Dental Assistants Scope
of Practice Amendment Act of 2023
Draft Introduction as provided to the Office of Revenue Analysis on
March 23, 2023
Funds are sufficient in the fiscal year 2023 budget and proposed fiscal year 2024 through fiscal year
2027 budget and financial plan to implement the bill.
Background
The bill expands
1 the scope of practice for dental hygiene in the District of Columbia to increase
access to care for residents. Specifically,
the bill allows dental hygienists to:
• Apply pit
and fissure sealants;
• Place
and remove periodontal dressings;
• Administer vaccinations
under the direct supervision of a licensed dentist;
• Prescribe topical prescription
or over-the-counter fluoride preparations and topical
antimicrobial oral rinses,
under the supervision of a licensed dentist;
• Perform blood glucose testing;
• Place
or remove temporary restorations and crowns;
• Take
study cast impressions;
• Remove
sutures; and
• Practice under the supervision of a dentist in long-term care facilities.
1 By amending The District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986
(D.C. Law 6-99; D.C. Official Code§ 3-1201.01 et seq.).
1350 Pennsylvania Avenue, NW, Suite 203, Washington, DC 20004 (202)727-2476
www.cfo.dc.gov The Honorable Phil Mendelson
FIS: "Dental Hygiene and Dental Assistants Scope of Practice Amendment Act of 2023," Draft Introduction as
provided to the Office of Revenue Analysis on March 23, 2023
The bill also expands the scope of practice for dental assistants in the District of Columbia by allowing
assistants to assist licensed dental hygienists and
perform specified duties under general or indirect
supervision.
Financial Plan Impact
Funds are sufficient in the fiscal year 2023 budget and proposed fiscal year 2024 through fiscal year
2027 budget and financial plan to implement the bill. The Board of Dentistry already regulates the
practice of dentistry and dental hygiene in the District. No additional resources are required to
regulate the expanded practice of dental hygienists and dental assistants.
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