Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H2253 Compare Versions

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

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2	2	HOUSE DOCKET, NO. 111 FILED ON: 1/9/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 2253
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Smitty Pignatelli
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act to improve oral health for all Massachusetts residents.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Smitty Pignatelli3rd Berkshire1/9/2023Christopher Hendricks11th Bristol1/19/2023John Barrett, III1st Berkshire1/20/2023Antonio F. D. Cabral13th Bristol2/2/2023Tricia Farley-Bouvier2nd Berkshire2/8/2023Lindsay N. Sabadosa1st Hampshire2/9/2023Paul McMurtry11th Norfolk2/15/2023Jason M. LewisFifth Middlesex2/17/2023James J. O'Day14th Worcester2/21/2023Bud L. Williams11th Hampden2/23/2023Christine P. Barber34th Middlesex2/24/2023Rodney M. Elliott16th Middlesex2/27/2023Jonathan D. Zlotnik2nd Worcester3/1/2023James B. EldridgeMiddlesex and Worcester3/4/2023 1 of 16
16	16	HOUSE DOCKET, NO. 111 FILED ON: 1/9/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 2253
18	18	By Representative Pignatelli of Lenox, a petition (accompanied by bill, House, No. 2253) of
19	19	Smitty Pignatelli and others for legislation to expand patient access to oral health care. Public
20	20	Health.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act to improve oral health for all Massachusetts residents.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Chapter 71 of the General Laws, as appearing in the 2020 Official Edition,
30	30	2is hereby amended by inserting after Section 34H the following new section:-
31	31	3 Section 34I. A public school shall notify the parent or legal guardian of a pupil described
32	32	4in the second paragraph of section 57 of chapter 71 concerning the importance of oral health
33	33	5screenings. The department of public health in, consultation with the board of registration in
34	34	6dentistry, shall develop a standard form of notice containing at minimum the following: 1)
35	35	7information on the importance of primary teeth; 2) information on the importance of oral health
36	36	8to overall health as it relates to learning; 3) contact information for local public health
37	37	9departments; 4) information about programs and services to access affordable dental care.
38	38	10 SECTION 2. Section 7 of chapter 94C of the General Laws, as appearing in the 2020
39	39	11Official Edition, is hereby amended by striking out, in lines 80 and 81, the words "practical nurse
40	40	12or a licensed dental hygienist", and inserting in place thereof the following words:- practical 2 of 16
41	41	13nurse, or a licensed dental therapist under the supervision of a practitioner as defined in section 1
42	42	14for the purposes of administering analgesics, anti-inflammatories and antibiotics only, or a
43	43	15licensed dental hygienist.
44	44	16 SECTION 3. Paragraph (a) of section 9 of said chapter 94C, as so appearing, is hereby
45	45	17amended by adding the following paragraph:-
46	46	18 A practitioner, as defined in section 1, may cause controlled substances to be
47	47	19administered under his direction by a licensed dental therapist, for the purposes of administering
48	48	20non-narcotic analgesics, anti-inflammatories and antibiotics only.
49	49	21 SECTION 4. Paragraph (c) of said section 9 of said chapter 94C, as so appearing, is
50	50	22hereby amended by adding the following paragraph:-
51	51	23 A licensed dental therapist who has obtained a controlled substance from a practitioner,
52	52	24as defined in section 1, for dispensing to an ultimate user pursuant to paragraph (a) shall return to
53	53	25such practitioner any unused portion of the substance which is no longer required by the patient.
54	54	26 SECTION 5. Subsection (a) of section 4O of chapter 111 of the General Laws, as
55	55	27appearing in the 2020 Official Edition, is hereby amended by inserting after the word
56	56	28"disparities", in line 9, the following:-
57	57	29 The dental director shall be responsible for recruiting, monitoring the progress of, and
58	58	30supporting dental health providers. The dental director shall aim to increase the delivery of
59	59	31preventative dental services to underserved and vulnerable populations, including but not limited
60	60	32to, those residing in dental health provider shortage communities and pediatric and geriatric
61	61	33patients. 3 of 16
62	62	34 SECTION 6. Said section 4O of said chapter 111 is hereby further amended by inserting
63	63	35after the word "to", in line 32, the following word:- “annual”.
64	64	36 SECTION 7. Section 43A of chapter 112, as appearing in the 2020 Official Edition, is
65	65	37hereby amended by inserting after the definition of "Appropriate supervision" the following 2
66	66	38definitions:-
67	67	39 "Board", the board of registration in dentistry or a committee or subcommittee thereof
68	68	40established in the department of public health pursuant to sections 9 and 19 of chapter 13,
69	69	41chapter 30A and sections 43 to 53, inclusive.
70	70	42 "Collaborative management agreement", a written agreement that complies with section
71	71	43B between a dental therapist and a supervising dentist, as defined in section 43A, who holds a
72	72	44valid license issued pursuant to section 45, who agrees to provide the appropriate level of
73	73	45communication and consultation with a licensed dental therapist to ensure patient health and
74	74	46safety.
75	75	47 SECTION 8. Said section 43A of said chapter 112, as so appearing, is hereby further
76	76	48amended by inserting after the definition of "Dental hygienist" the following definition:-
77	77	49 "Dental therapist", a person who has been licensed by the board to practice dental therapy
78	78	50under section 51B, and who has the appropriate training and works pursuant to a collaborative
79	79	51management agreement as provided in section 51B.
80	80	52 SECTION 9. Said section 43A of said chapter 112, as so appearing, is hereby further
81	81	53amended by adding the following definition:- 4 of 16
82	82	54 "Supervising dentist", a dentist licensed in Massachusetts who is a provider enrolled in
83	83	55the division of medical assistance, or who works for an entity that is a provider enrolled in
84	84	56division of medical assistance, who maintains an active patient list and routinely provides care,
85	85	57and who enters into a collaborative management agreement with a licensed dental therapist.
86	86	58 SECTION 10. Said chapter 112, as so appearing, is hereby further amended by inserting
87	87	59after section 51A the following section:-
88	88	60 Section 51B. (a) Any person of good moral character, who: (i) is a graduate of a master's
89	89	61level dental therapist education program that includes both dental therapy and dental hygiene
90	90	62education, or an equivalent combination of both dental therapy education and dental hygiene
91	91	63education, if all education programs are accredited by the Commission on Dental Accreditation
92	92	64and provided by a post-secondary institution accredited by the New England Association of
93	93	65Schools and Colleges, Inc.; (ii) passes a comprehensive, competency-based clinical examination
94	94	66that is approved by the board and administered by a recognized national or regional dental
95	95	67testing service that administers testing for dentists and other dental professionals or equivalent
96	96	68examination administered by another entity approved by the board; and (iii) obtains a policy of
97	97	69professional liability insurance and shows proof of such insurance as required by rules and
98	98	70regulations shall, upon payment of a fee to be determined annually by the commissioner of
99	99	71administration under the provision of section 3B of chapter 7, be licensed as a dental therapist
100	100	72and be given a certificate to practice in this capacity. A licensed dental therapist shall have
101	101	73practiced under the direct supervision of a supervising dentist for a minimum of 2 years or 2,500
102	102	74hours, whichever is longer, before practicing under general supervision pursuant to a
103	103	75collaborative management agreement. 5 of 16
104	104	76 For the purposes of this section, "general supervision" shall mean supervision of
105	105	77procedures and services based on a written collaborative management agreement between a
106	106	78licensed dentist and a licensed dental therapist but not requiring a prior exam or diagnosis by a
107	107	79supervising dentist or the physical presence of a supervising dentist during the performance of
108	108	80those procedures and services unless required by the supervising dentist in the collaborative
109	109	81management agreement.
110	110	82 (b) Any person licensed as a dental therapist under this section may also be registered as
111	111	83a dental hygienist and be given a certificate to practice in this capacity.
112	112	84 (c) An applicant for licensure as a dental therapist educated in the commonwealth must
113	113	85graduate from a master's level dental therapy education program that is accredited by the
114	114	86Commission on Dental Accreditation provided by a post-secondary institution accredited by the
115	115	87New England Association of Schools and Colleges, Inc. All dental therapy educational programs
116	116	88in the commonwealth must include at least one licensed dentist as an instructor. The board shall
117	117	89provide guidance for any educational entity or institution that may operate all or some portion of
118	118	90a master's level program, or may collaborate with other educational entities, including but not
119	119	91limited to universities, colleges, community colleges, and technical colleges, to operate all or
120	120	92some portion of a master's level program. The board may also provide guidance to develop
121	121	93mechanisms to award advanced standing to students who have completed coursework at other
122	122	94educational programs accredited by the Commission on Dental Accreditation. All education
123	123	95programs must prepare students to perform all procedures and services within the dental therapy
124	124	96scope of practice as set forth in this section. 6 of 16
125	125	97 The educational curriculum for a dental therapist educated in the commonwealth shall
126	126	98include training on serving patients with special needs including, but not limited to, people with
127	127	99developmental disabilities including autism spectrum disorders, mental illness, cognitive
128	128	100impairment, complex medical problems, significant physical limitations and the vulnerable
129	129	101elderly.
130	130	102 Not later than January 1, 2023, the board shall approve a comprehensive, competency-
131	131	103based clinical dental therapy examination that includes an assessment of technical competency in
132	132	104performing the procedures and services within the scope of practice as set forth in this section, to
133	133	105be administered by a recognized national or regional dental testing service that administers
134	134	106testing for dentists and other dental professionals. The examination shall be comparable to the
135	135	107examination given to applicants for a dental license but only for the limited scope of dental
136	136	108services in the dental therapy scope of practice as set forth in this section.
137	137	109 (d) The board shall grant a dental therapy license by examination to an applicant, upon
138	138	110payment of a fee as determined annually by the secretary of administration and finance under
139	139	111section 3B of chapter 7, provided the applicant is of good moral character and has: (i) met the
140	140	112eligibility requirements as defined by the board; (ii) submitted documentation to the board of a
141	141	113passing score on a comprehensive, competency-based clinical examination, or combination of
142	142	114examinations, that includes both dental therapy and dental hygiene components and is approved
143	143	115by the board and administered by a recognized national or regional dental testing service that
144	144	116administers testing for dentists and other dental professionals; and (iii) submitted to the board
145	145	117documentation of a passing score on the Massachusetts Dental Ethics and Jurisprudence
146	146	118Examination or any other successor examination. An applicant failing to pass the examination
147	147	119shall be entitled to re-examination pursuant to the rules and guidelines established by the 7 of 16
148	148	120Commission on Dental Competency Assessments, for which the applicant shall pay a fee as
149	149	121determined annually by the secretary of administration and finance under section 3B of chapter
150	150	1227.
151	151	123 The board shall require as a condition of granting or renewing a license under this
152	152	124section, that the dental therapist apply to participate in the medical assistance program
153	153	125administered by the secretary of health and human services in accordance with chapter 118E and
154	154	126Title XIX of the Social Security Act and any federal demonstration or waiver relating to such
155	155	127medical assistance program for the limited purposes of ordering and referring services covered
156	156	128under such program, provided that regulations governing such limited participation are
157	157	129promulgated under said chapter 118E. A dental therapist practicing in a dental therapist role who
158	158	130chooses to participate in such medical assistance program as a provider of services shall be
159	159	131deemed to have fulfilled this requirement.
160	160	132 The board shall grant a license by credentials, without further professional examination,
161	161	133to a dental therapist licensed in another jurisdiction, upon payment of a fee as determined
162	162	134annually by the secretary of administration and finance under section 3B of chapter 7, provided
163	163	135the applicant is of good moral character and has: (i) met the eligibility requirements as defined
164	164	136by the board; (ii) furnished the board with satisfactory proof of graduation from an education
165	165	137program, or combination of education programs, providing both dental therapy and dental
166	166	138hygiene education that meets the standards of the Commission on Dental Accreditation,
167	167	139provided, however, that an applicant who graduated from a dental therapy education program
168	168	140established before the Commission on Dental Accreditation established a dental therapy
169	169	141accreditation program is eligible notwithstanding the lack of accreditation of the program at the
170	170	142time the education was received; (iii) submitted documentation of a passing score on a dental 8 of 16
171	171	143therapy examination administered by another state or testing agency that is substantially
172	172	144equivalent to the board-approved dental therapy examination for dental therapists as defined in
173	173	145this section; (iv) submitted documentation of a passing score on the Massachusetts Dental Ethics
174	174	146and Jurisprudence Examination or any other successor examination; and (v) submitted
175	175	147documentation of completion of 2 years or 2,500 hours, whichever is longer, of practice. If such
176	176	148practice requirement is not met, a dental therapist shall be required to complete the remaining
177	177	149hours or years, whichever is longer, under direct supervision in the Commonwealth prior to
178	178	150practicing under general supervision.
179	179	151 (e) Pursuant to a collaborative management agreement, a dental therapist licensed by the
180	180	152board may perform: (i) all acts of a public health dental hygienist as set forth in regulations of the
181	181	153board and (ii) all acts in the Commission on Dental Accreditation's dental therapy standards.
182	182	154Dental therapists shall have the authority to perform an oral evaluation and assessment of dental
183	183	155disease and formulate an individualized treatment plan as authorized by the supervising dentist in
184	184	156the collaborative management agreement. A dental therapist may dispense and administer the
185	185	157following medications within the parameters of the collaborative management agreement and
186	186	158with the authorization of the supervising dentist: non-narcotic analgesics, anti-inflammatories
187	187	159and antibiotics. The authority to dispense and administer shall extend only to the categories of
188	188	160drugs identified in this paragraph and may be further limited by the collaborative management
189	189	161agreement. A dental therapist is prohibited from dispensing or administering narcotic analgesics.
190	190	162A dental therapist may oversee not more than 2 dental hygienists and 2 dental assistants, but
191	191	163shall not oversee public health dental hygienists.
192	192	164 After entering into a collaborative management agreement with a supervising dentist,
193	193	165dental therapists shall practice under direct supervision for not less than 2,500 clinical hours or 9 of 16
194	194	166two years, whichever is longer. After completing 2,500 clinical hours or two years, whichever is
195	195	167longer, of practice under direct supervision, dental therapists are authorized to perform all
196	196	168procedures and services listed in the Commission on Dental Accreditation's dental therapy
197	197	169standards and all procedures and services within the scope of a public health dental hygienist, as
198	198	170set forth in regulations by the board, under general supervision if authorized by a supervising
199	199	171dentist pursuant to a written collaborative agreement. In addition, the following procedures,
200	200	172referred to in this section as advanced procedures, may be performed under direct supervision: (i)
201	201	173preparation and placement of direct restoration in primary and permanent teeth; (ii) fabrication
202	202	174and placement of single-tooth temporary crowns; (iii) preparation and placement of preformed
203	203	175crowns on primary teeth; (iv) indirect and direct pulp capping on permanent teeth; (v) indirect
204	204	176pulp capping on primary teeth; and (vi) simple extractions of erupted primary teeth, provided
205	205	177however that the advanced procedures may be performed under general supervision if authorized
206	206	178by the board pursuant to subsection (f) of this section.
207	207	179 Pursuant to a collaborative management agreement, a dental therapist may provide
208	208	180procedures and services permitted under general supervision when the supervising dentist is not
209	209	181on-site and has not previously examined or diagnosed the patient provided the supervising
210	210	182dentist is available for consultation and supervision if needed through telemedicine or by other
211	211	183means of communication. If the supervising dentist will not be available, arrangements shall be
212	212	184made for another licensed dentist to be available to provide timely consultation and supervision.
213	213	185 A dental therapist may not operate independently of, and may not practice or treat any
214	214	186patients without, a supervising dentist. A dental therapist is prohibited from practicing without
215	215	187entering into a collaborative management agreement with a supervising dentist. 10 of 16
216	216	188 (f) By January 1, 2020, the department of public health, in consultation with the board
217	217	189and any other entity they deem appropriate, shall begin an evaluation assessing the impact of
218	218	190dental therapists practicing under general supervision in Massachusetts and the rest of the United
219	219	191States, specifically on: (i) dental therapists' progress in expanding access to safe and effective
220	220	192dental services for vulnerable populations including, at a minimum, Medicaid beneficiaries and
221	221	193individuals who are underserved as defined in this section; (ii) an appropriate geographic
222	222	194distance limitation between the dental therapist and supervising dentist that permits the dental
223	223	195therapist to expand access to vulnerable populations including, at a minimum, Medicaid
224	224	196beneficiaries and individuals who are underserved as defined in this section; and (iii) the number
225	225	197of dental hygienists and dental assistants a dental therapist may oversee.
226	226	198 Not before January 1, 2023 and no later than December 1, 2024, the department of public
227	227	199health, in consultation with the board and any other entity they deem appropriate, shall make a
228	228	200recommendation, based on its assessment of whether dental therapists should be authorized to
229	229	201perform one or more of the advanced procedures, as defined in subsection (e) under general
230	230	202supervision pursuant to a collaborative management agreement. The department shall also make
231	231	203a recommendation on an appropriate geographic distance limitation between the dental therapist
232	232	204and supervising dentist that permits the dental therapist to expand access to vulnerable
233	233	205populations including, at a minimum, individuals receiving benefits through the division of
234	234	206medical assistance and individuals who are underserved as defined in this section. After the
235	235	207department completes its assessment and submits its recommendations to the board, the board
236	236	208shall make a determination, with consideration to how authorizing general supervision will
237	237	209expand access to safe and effective dental services for vulnerable populations including, at a
238	238	210minimum, individuals receiving benefits through the division of medical assistance and 11 of 16
239	239	211individuals who are underserved as defined in this section, whether to authorize the performance
240	240	212of one or more of the procedures as identified in subsection (e), under general supervision
241	241	213pursuant to a collaborative management agreement.
242	242	214 Should the board, in consultation with the department and any other appropriate entity,
243	243	215determine that dental therapists shall have the authority to perform one or more of the procedures
244	244	216and services as identified in subsection (e) in their scope of practice under general supervision,
245	245	217then the board shall establish regulations no later than six months following the recommendation,
246	246	218authorizing dental therapists to perform one or more procedures as identified in subsection (e)
247	247	219under general supervision pursuant to a collaborative management agreement after receiving
248	248	220advanced practice certification.
249	249	221 The board shall grant advanced practice certification for a dental therapist licensed by the
250	250	222board to perform all services under general supervision pursuant to a collaborative management
251	251	223agreement if the dental therapist provides documentation of completion of at least two years or
252	252	2242,500 hours, whichever is longer, of direct supervision pursuant to subsection (a) of this section,
253	253	225and satisfying any other criteria established by regulation adopted by the board as authorized in
254	254	226this section.
255	255	227 Should the board determine that dental therapists shall continue to perform one or more
256	256	228of the advanced procedures under direct supervision, the department, in consultation with the
257	257	229board, shall re-evaluate annually the impact of dental therapists practicing under general
258	258	230supervision in Massachusetts and the rest of the United States, and the board shall annually
259	259	231reassess whether to authorize general supervision for the advanced procedures in order to
260	260	232improve dental therapists' progress in expanding access to safe and effective dental services for 12 of 16
261	261	233vulnerable populations including, at a minimum, individuals receiving benefits through the
262	262	234division of medical assistance and individuals who are underserved as defined in this section.
263	263	235 (g) The board shall establish appropriate guidelines for a written collaborative
264	264	236management agreement. A collaborative management agreement shall be signed and maintained
265	265	237by the supervising dentist and the dental therapist and shall be submitted annually to the board.
266	266	238 The agreement may be updated as necessary. The agreement shall serve as standing
267	267	239orders from the supervising dentist and shall address: (i) practice settings; (ii) any limitation on
268	268	240services established by the supervising dentist; (iii) the level of supervision required for various
269	269	241services or treatment settings; (iv) patient populations that may be served; (v) practice protocols;
270	270	242(vi) record keeping; (vii) managing medical emergencies; (viii) quality assurance; (ix)
271	271	243administering and dispensing medications; (x) geographic distance limitations; (xi) oversight of
272	272	244dental hygienists and dental assistants; and (xii) referrals for services outside of the dental
273	273	245therapy scope of practice. The collaborative management agreement shall include specific
274	274	246protocols to govern situations in which the dental therapist encounters a patient who requires
275	275	247treatment that exceeds the authorized scope of practice of the dental therapist. The supervising
276	276	248dentist is responsible for directly providing, or arranging for another dentist or specialist within
277	277	249an accessible geographic distance to provide, any necessary additional services outside of the
278	278	250dental therapy scope of practice needed by the patient. A supervising dentist may have a
279	279	251collaborative management agreement with not more than 3 dental therapists at the same time.
280	280	252Not more than 2 dental therapists may practice under general supervision with certification to
281	281	253perform one or more of the advanced procedures. A practice or organization with more than one
282	282	254practice location listed under the same business name may not employ more than six dental
283	283	255therapists, provided, however, that this requirement shall not apply if such an organization or 13 of 16
284	284	256practice is a federally qualified health center or look-alike, a community health center, a non-
285	285	257profit practice or organization, public health setting as defined by 234 CMR 2.02, or as otherwise
286	286	258permitted by the board.
287	287	259 (h) No medical malpractice insurer shall refuse primary medical malpractice insurance
288	288	260coverage to a licensed dentist on the basis of whether they entered into a collaborative
289	289	261management agreement with a dental therapist or public health dental hygienist. A dental
290	290	262therapist may not bill separately for services rendered; the services of the dental therapist are the
291	291	263services of the supervising dentist and shall be billed as such.
292	292	264 (i) Not less than 50% of the patient panel of a dental therapist, as determined in each
293	293	265calendar year, shall consist of patients who receive coverage through the division of medical
294	294	266assistance or are considered underserved provided, however, that this requirement shall not apply
295	295	267if the dental therapist is operating in a federally qualified health center or look-alike, community-
296	296	268health center, non-profit practice or organization, or other public health settings as defined by
297	297	269234 CMR 2.02, or as otherwise permitted by the board. As used in this section, "underserved"
298	298	270means individuals who: (i) receive, or are eligible to receive, benefits through the division of
299	299	271medical assistance; (ii) receive, or are eligible to receive, social security disability benefits,
300	300	272supplemental security income, and/or Massachusetts state supplement program; (iii) live in a
301	301	273dental health professional shortage area as designated by the federal department of health and
302	302	274human services; (iv) reside in a long-term care facility licensed under section 71 of chapter 111;
303	303	275(v) receive dental services at a public health setting as defined by 234 CMR 2.02; (vi) receive
304	304	276benefits, or are eligible to receive subsidized insurance through the commonwealth health
305	305	277insurance connector authority;; (viii) receive benefits, or are eligible to receive benefits, through
306	306	278the Indian Health Service, tribal or urban Indian organizations, or through the contract health 14 of 16
307	307	279service program; (ix) receive benefits, or are eligible to receive benefits, through the federal
308	308	280department of veterans affairs or other organization serving veterans; (x) are elderly and have
309	309	281trouble accessing dental care due to mobility or transportation challenges; (xi) meet the
310	310	282Commission on Dental Accreditation's definition of people with special needs; (xii) are
311	311	283uninsured have an annual income at or below 305% of the federal poverty level; or (xiii) as
312	312	284otherwise permitted by the board.
313	313	285 An employer of a dental therapist shall submit quarterly reports to the board that provide
314	314	286information concerning the makeup of the dental therapist's patient panel, including the
315	315	287percentage of underserved in the patient panel. No later than January 1, 2023, the secretary of
316	316	288health and human services may establish by regulation penalties for employers who fail to meet
317	317	289the requirements pertaining to the percentage of underserved in the dental therapist's patient
318	318	290panel.
319	319	291 (j) Not later than January 1, 2020, the board, in consultation with the department shall
320	320	292establish regulations to implement the provisions of this section for the practice of dental therapy
321	321	293to protect the public health, safety and welfare, including, but not limited to: requirements for
322	322	294approval of educational programs; guidelines for collaborative management agreements,
323	323	295continuing education requirements, license renewal, standards of conduct, and the investigation
324	324	296of complaints, conduct of disciplinary proceedings and grounds for discipline.
325	325	297 SECTION 11. Section 259 of chapter 112 of the General Laws, as appearing in the 2020
326	326	298Official Edition, is hereby amended by inserting after the word "skills", in line 51, the following:
327	327	299 (j) Oral health education; 15 of 16
328	328	300 SECTION 12. Section 260 of chapter 112 of the General Laws, as appearing in the 2020
329	329	301Official Edition, is hereby amended by inserting after the number 7, in line 21, the following:-
330	330	302As a condition for licensure or renewal of licensure, the board shall require community health
331	331	303workers to receive education or training in oral health.
332	332	304 SECTION 13. Section 79L of chapter 233, as appearing in the 2020 Official Edition, is
333	333	305hereby amended by inserting after the word "dentist," the following words:- dental therapist.
334	334	306 SECTION 14. The department of public health, in consultation with the executive office
335	335	307of health and human services, shall perform a 5-year evaluation of the impact of dental
336	336	308therapists, as established under section 51B of chapter 112 of the General Laws, on patient
337	337	309safety, cost-effectiveness, and access to dental services. The department may enter into an inter-
338	338	310agency agreement with the health policy commission, established under chapter 6D of the
339	339	311General Laws, to provide assistance to the department in conducting such evaluation, as it deems
340	340	312necessary. The department shall ensure effective measurements of the following outcomes and
341	341	313file a report of its findings, which shall include the:
342	342	314 (i) Number of dental therapists in the commonwealth each year;
343	343	315 (ii) Number of licensed dental therapists in the commonwealth each year;
344	344	316 (iii) Number of new and total patients served each year;
345	345	317 (iv) Impact on wait times for needed services;
346	346	318 (v) Impact on travel time for patients;
347	347	319 (vi) Impact on emergency room usage for dental care; and 16 of 16
348	348	320 (vii) Costs to the public health care system.
349	349	321 The report shall be submitted not later than five years after the date of graduation of the
350	350	322first graduating class of dental therapists educated in the commonwealth to the joint committee
351	351	323on public health, the joint committee on health care financing, and the senate and house
352	352	324committees on ways and means.
353	353	325 The center for health information and analysis shall, by the first day of January of each
354	354	326year, submit a report including information on:
355	355	327 (i) Number of dental therapists in the commonwealth;
356	356	328 (ii) Number of licensed dental therapists practicing in the commonwealth;
357	357	329 (iii) Number of new and total patients served;
358	358	330 (iv) Number of new and total pediatric patients served, including geographic location and
359	359	331insurance type;
360	360	332 (v) Practice settings; and
361	361	333 (vi) Commonly performed procedures and services
362	362	334 The first annual report shall be submitted not later than three years after the date of
363	363	335graduation of the first graduating class of dental therapists educated in the commonwealth to the
364	364	336joint committee on public health, the joint committee on health care financing, and the senate
365	365	337and house committees on ways and means.