Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S1379 Compare Versions

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

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 747 FILED ON: 1/18/2023
3	3	SENATE . . . . . . . . . . . . . . No. 1379
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Adam Gomez
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 :Adam GomezHampdenJason M. LewisFifth Middlesex1/18/2023Sal N. DiDomenicoMiddlesex and Suffolk2/23/2023James B. EldridgeMiddlesex and Worcester3/6/2023 1 of 16
16	16	SENATE DOCKET, NO. 747 FILED ON: 1/18/2023
17	17	SENATE . . . . . . . . . . . . . . No. 1379
18	18	By Mr. Gomez, a petition (accompanied by bill, Senate, No. 1379) of Adam Gomez, Jason M.
19	19	Lewis, Sal N. DiDomenico and James B. Eldridge for legislation to improve oral health for all
20	20	Massachusetts residents. Public Health.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE SENATE, NO. 743 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act to improve oral health for all Massachusetts residents.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Chapter 71 of the General Laws, as appearing in the 2020 Official Edition,
32	32	2is hereby amended by inserting after Section 34H the following new section:-
33	33	3 Section 34I. A public school shall notify the parent or legal guardian of a pupil described
34	34	4in the second paragraph of section 57 of chapter 71 concerning the importance of oral health
35	35	5screenings. The department of public health in, consultation with the board of registration in
36	36	6dentistry, shall develop a standard form of notice containing at minimum the following: 1)
37	37	7information on the importance of primary teeth; 2) information on the importance of oral health
38	38	8to overall health as it relates to learning; 3) contact information for local public health
39	39	9departments; 4) information about programs and services to access affordable dental care. 2 of 16
40	40	10 SECTION 2. Section 7 of chapter 94C of the General Laws, as so appearing, is hereby
41	41	11amended by striking out, in lines 80 and 81, the words "practical nurse or a licensed dental
42	42	12hygienist", and inserting in place thereof the following words:- practical nurse, or a licensed
43	43	13dental therapist under the supervision of a practitioner as defined in section 1 for the purposes of
44	44	14administering analgesics, anti-inflammatories and antibiotics only, or a licensed dental hygienist.
45	45	15 SECTION 3. Paragraph (a) of section 9 of said chapter 94C, as so appearing, is hereby
46	46	16amended by adding the following paragraph:-
47	47	17 A practitioner, as defined in section 1, may cause controlled substances to be
48	48	18administered under his direction by a licensed dental therapist, for the purposes of administering
49	49	19non-narcotic analgesics, anti-inflammatories and antibiotics only.
50	50	20 SECTION 4. Paragraph (c) of said section 9 of said chapter 94C, as so appearing, is
51	51	21hereby amended by adding the following paragraph:-
52	52	22 A licensed dental therapist who has obtained a controlled substance from a practitioner,
53	53	23as defined in section 1, for dispensing to an ultimate user pursuant to paragraph (a) shall return to
54	54	24such practitioner any unused portion of the substance which is no longer required by the patient.
55	55	25 SECTION 5. Subsection (a) of section 4O of chapter 111 of the General Laws, as so
56	56	26appearing, is hereby amended by inserting after the word "disparities", in line 9, the following:-
57	57	27 The dental director shall be responsible for recruiting, monitoring progress of, and
58	58	28supporting dental health providers. The dental director shall aim to increase the delivery of
59	59	29preventative dental services to underserved and vulnerable populations, including but not limited 3 of 16
60	60	30to, those residing in dental health provider shortage communities and pediatric and geriatric
61	61	31patients.
62	62	32 SECTION 6. Said section 4O of said chapter 111 is hereby further amended by inserting
63	63	33after the word "to", in line 32, the following word:- “annual”.
64	64	34 SECTION 7. Section 43A of chapter 112, as so appearing, is hereby amended by
65	65	35inserting after the definition of "Appropriate supervision" the following 2 definitions:-
66	66	36 "Board", the board of registration in dentistry or a committee or subcommittee thereof
67	67	37established in the department of public health pursuant to sections 9 and 19 of chapter 13,
68	68	38chapter 30A and sections 43 to 53, inclusive.
69	69	39 "Collaborative management agreement", a written agreement that complies with section
70	70	40B between a dental therapist and a supervising dentist, as defined in section 43A, who holds a
71	71	41valid license issued pursuant to section 45, who agrees to provide the appropriate level of
72	72	42communication and consultation with a licensed dental therapist to ensure patient health and
73	73	43safety.
74	74	44 SECTION 8. Said section 43A of said chapter 112, as so appearing, is hereby further
75	75	45amended by inserting after the definition of "Dental hygienist" the following definition:-
76	76	46 "Dental therapist", a person who has been licensed by the board to practice dental therapy
77	77	47under section 51B, and who has the appropriate training and works pursuant to a collaborative
78	78	48management agreement as provided in section 51B.
79	79	49 SECTION 9. Said section 43A of said chapter 112, as so appearing, is hereby further
80	80	50amended by adding the following definition:- 4 of 16
81	81	51 "Supervising dentist", a dentist licensed in Massachusetts who is a provider enrolled in
82	82	52the division of medical assistance, or who works for an entity that is a provider enrolled in
83	83	53division of medical assistance, who maintains an active patient list and routinely provides care,
84	84	54and who enters into a collaborative management agreement with a licensed dental therapist.
85	85	55 SECTION 10. Said chapter 112, as so appearing, is hereby further amended by inserting
86	86	56after section 51A the following section:-
87	87	57 Section 51B. (a) Any person of good moral character, who: (i) is a graduate of a master's
88	88	58level dental therapist education program that includes both dental therapy and dental hygiene
89	89	59education, or an equivalent combination of both dental therapy education and dental hygiene
90	90	60education, if all education programs are accredited by the Commission on Dental Accreditation
91	91	61and provided by a post-secondary institution accredited by the New England Association of
92	92	62Schools and Colleges, Inc.; (ii) passes a comprehensive, competency-based clinical examination
93	93	63that is approved by the board and administered by a recognized national or regional dental
94	94	64testing service that administers testing for dentists and other dental professionals or equivalent
95	95	65examination administered by another entity approved by the board; and (iii) obtains a policy of
96	96	66professional liability insurance and shows proof of such insurance as required by rules and
97	97	67regulations shall, upon payment of a fee to be determined annually by the commissioner of
98	98	68administration under the provision of section 3B of chapter 7, be licensed as a dental therapist
99	99	69and be given a certificate to practice in this capacity. A licensed dental therapist shall have
100	100	70practiced under the direct supervision of a supervising dentist for a minimum of 2 years or 2,500
101	101	71hours, whichever is longer, before practicing under general supervision pursuant to a
102	102	72collaborative management agreement. 5 of 16
103	103	73 For the purposes of this section, "general supervision" shall mean supervision of
104	104	74procedures and services based on a written collaborative management agreement between a
105	105	75licensed dentist and a licensed dental therapist but not requiring a prior exam or diagnosis by a
106	106	76supervising dentist or the physical presence of a supervising dentist during the performance of
107	107	77those procedures and services unless required by the supervising dentist in the collaborative
108	108	78management agreement.
109	109	79 (b) Any person licensed as a dental therapist under this section may also be registered as
110	110	80a dental hygienist and be given a certificate to practice in this capacity.
111	111	81 (c) An applicant for licensure as a dental therapist educated in the commonwealth must
112	112	82graduate from a master's level dental therapy education program that is accredited by the
113	113	83Commission on Dental Accreditation provided by a post-secondary institution accredited by the
114	114	84New England Association of Schools and Colleges, Inc. All dental therapy educational programs
115	115	85in the commonwealth must include at least one licensed dentist as an instructor. The board shall
116	116	86provide guidance for any educational entity or institution that may operate all or some portion of
117	117	87a master's level program, or may collaborate with other educational entities, including but not
118	118	88limited to universities, colleges, community colleges, and technical colleges, to operate all or
119	119	89some portion of a master's level program. The board may also provide guidance to develop
120	120	90mechanisms to award advanced standing to students who have completed coursework at other
121	121	91educational programs accredited by the Commission on Dental Accreditation. All education
122	122	92programs must prepare students to perform all procedures and services within the dental therapy
123	123	93scope of practice as set forth in this section. 6 of 16
124	124	94 The educational curriculum for a dental therapist educated in the commonwealth shall
125	125	95include training on serving patients with special needs including, but not limited to, people with
126	126	96developmental disabilities including autism spectrum disorders, mental illness, cognitive
127	127	97impairment, complex medical problems, significant physical limitations and the vulnerable
128	128	98elderly.
129	129	99 Not later than January 1, 2020, the board shall approve a comprehensive, competency-
130	130	100based clinical dental therapy examination that includes assessment of technical competency in
131	131	101performing the procedures and services within the scope of practice as set forth in this section, to
132	132	102be administered by a recognized national or regional dental testing service that administers
133	133	103testing for dentists and other dental professionals. The examination shall be comparable to the
134	134	104examination given to applicants for a dental license but only for the limited scope of dental
135	135	105services in the dental therapy scope of practice as set forth in this section.
136	136	106 (d) The board shall grant a dental therapy license by examination to an applicant, upon
137	137	107payment of a fee as determined annually by the secretary of administration and finance under
138	138	108section 3B of chapter 7, provided the applicant is of good moral character and has: (i) met the
139	139	109eligibility requirements as defined by the board; (ii) submitted documentation to the board of a
140	140	110passing score on a comprehensive, competency-based clinical examination, or combination of
141	141	111examinations, that includes both dental therapy and dental hygiene components and is approved
142	142	112by the board and administered by a recognized national or regional dental testing service that
143	143	113administers testing for dentists and other dental professionals; and (iii) submitted to the board
144	144	114documentation of a passing score on the Massachusetts Dental Ethics and Jurisprudence
145	145	115Examination or any other successor examination. An applicant failing to pass the examination
146	146	116shall be entitled to re-examination pursuant to the rules and guidelines established by the 7 of 16
147	147	117Commission on Dental Competency Assessments, for which the applicant shall pay a fee as
148	148	118determined annually by the secretary of administration and finance under section 3B of chapter
149	149	1197.
150	150	120 The board shall require as a condition of granting or renewing a license under this
151	151	121section, that the dental therapist apply to participate in the medical assistance program
152	152	122administered by the secretary of health and human services in accordance with chapter 118E and
153	153	123Title XIX of the Social Security Act and any federal demonstration or waiver relating to such
154	154	124medical assistance program for the limited purposes of ordering and referring services covered
155	155	125under such program, provided that regulations governing such limited participation are
156	156	126promulgated under said chapter 118E. A dental therapist practicing in a dental therapist role who
157	157	127chooses to participate in such medical assistance program as a provider of services shall be
158	158	128deemed to have fulfilled this requirement.
159	159	129 The board shall grant a license by credentials, without further professional examination,
160	160	130to a dental therapist licensed in another jurisdiction, upon payment of a fee as determined
161	161	131annually by the secretary of administration and finance under section 3B of chapter 7, provided
162	162	132the applicant is of good moral character and has: (i) met the eligibility requirements as defined
163	163	133by the board; (ii) furnished the board with satisfactory proof of graduation from an education
164	164	134program, or combination of education programs, providing both dental therapy and dental
165	165	135hygiene education that meets the standards of the Commission on Dental Accreditation,
166	166	136provided, however, that an applicant who graduated from a dental therapy education program
167	167	137established before the Commission on Dental Accreditation established a dental therapy
168	168	138accreditation program is eligible notwithstanding the lack of accreditation of the program at the
169	169	139time the education was received; (iii) submitted documentation of a passing score on a dental 8 of 16
170	170	140therapy examination administered by another state or testing agency that is substantially
171	171	141equivalent to the board-approved dental therapy examination for dental therapists as defined in
172	172	142this section; (iv) submitted documentation of a passing score on the Massachusetts Dental Ethics
173	173	143and Jurisprudence Examination or any other successor examination; and (v) submitted
174	174	144documentation of completion of 2 years or 2,500 hours, whichever is longer, of practice. If such
175	175	145practice requirement is not met, a dental therapist shall be required to complete the remaining
176	176	146hours or years, whichever is longer, under direct supervision in the Commonwealth prior to
177	177	147practicing under general supervision.
178	178	148 (e) Pursuant to a collaborative management agreement, a dental therapist licensed by the
179	179	149board may perform: (i) all acts of a public health dental hygienist as set forth in regulations of the
180	180	150board and (ii) all acts in the Commission on Dental Accreditation's dental therapy standards.
181	181	151Dental therapists shall have the authority to perform an oral evaluation and assessment of dental
182	182	152disease and formulate an individualized treatment plan as authorized by the supervising dentist in
183	183	153the collaborative management agreement. A dental therapist may dispense and administer the
184	184	154following medications within the parameters of the collaborative management agreement and
185	185	155with the authorization of the supervising dentist: non-narcotic analgesics, anti- inflammatories
186	186	156and antibiotics. The authority to dispense and administer shall extend only to the categories of
187	187	157drugs identified in this paragraph and may be further limited by the collaborative management
188	188	158agreement. A dental therapist is prohibited from dispensing or administering narcotic analgesics.
189	189	159A dental therapist may oversee not more than 2 dental hygienists and 2 dental assistants, but
190	190	160shall not oversee public health dental hygienists.
191	191	161 After entering into a collaborative management agreement with a supervising dentist,
192	192	162dental therapists shall practice under direct supervision for not less than 2,500 clinical hours or 9 of 16
193	193	163two years, whichever is longer. After completing 2,500 clinical hours or two years, whichever is
194	194	164longer, of practice under direct supervision, dental therapists are authorized to perform all
195	195	165procedures and services listed in the Commission on Dental Accreditation's dental therapy
196	196	166standards and all procedures and services within the scope of a public health dental hygienist, as
197	197	167set forth in regulations by the board, under general supervision if authorized by a supervising
198	198	168dentist pursuant to a written collaborative agreement. In addition, the following procedures,
199	199	169referred to in this section as advanced procedures, may be performed under direct supervision: (i)
200	200	170preparation and placement of direct restoration in primary and permanent teeth; (ii) fabrication
201	201	171and placement of single-tooth temporary crowns; (iii) preparation and placement of preformed
202	202	172crowns on primary teeth; (iv) indirect and direct pulp capping on permanent teeth; (v) indirect
203	203	173pulp capping on primary teeth; and (vi) simple extractions of erupted primary teeth, provided
204	204	174however that the advanced procedures may be performed under general supervision if authorized
205	205	175by the board pursuant to subsection (f) of this section.
206	206	176 Pursuant to a collaborative management agreement, a dental therapist may provide
207	207	177procedures and services permitted under general supervision when the supervising dentist is not
208	208	178on-site and has not previously examined or diagnosed the patient provided the supervising
209	209	179dentist is available for consultation and supervision if needed through telemedicine or by other
210	210	180means of communication. If the supervising dentist will not be available, arrangements shall be
211	211	181made for another licensed dentist to be available to provide timely consultation and supervision.
212	212	182 A dental therapist may not operate independently of, and may not practice or treat any
213	213	183patients without, a supervising dentist. A dental therapist is prohibited from practicing without
214	214	184entering into a collaborative management agreement with a supervising dentist. 10 of 16
215	215	185 (f) By January 1, 2020, the department of public health, in consultation with the board
216	216	186and any other entity they deem appropriate, shall begin an evaluation assessing the impact of
217	217	187dental therapists practicing under general supervision in Massachusetts and the rest of the United
218	218	188States, specifically on: (i) dental therapists' progress in expanding access to safe and effective
219	219	189dental services for vulnerable populations including, at a minimum, Medicaid beneficiaries and
220	220	190individuals who are underserved as defined in this section; (ii) an appropriate geographic
221	221	191distance limitation between the dental therapist and supervising dentist that permits the dental
222	222	192therapist to expand access to vulnerable populations including, at a minimum, Medicaid
223	223	193beneficiaries and individuals who are underserved as defined in this section; and (iii) the number
224	224	194of dental hygienists and dental assistants a dental therapist may oversee.
225	225	195 Not before January 1, 2021 and no later than December 1, 2022, the department of public
226	226	196health, in consultation with the board and any other entity they deem appropriate, shall make a
227	227	197recommendation, based on its assessment of whether dental therapists should be authorized to
228	228	198perform one or more of the advanced procedures, as defined in subsection (e) under general
229	229	199supervision pursuant to a collaborative management agreement. The department shall also make
230	230	200a recommendation on an appropriate geographic distance limitation between the dental therapist
231	231	201and supervising dentist that permits the dental therapist to expand access to vulnerable
232	232	202populations including, at a minimum, individuals receiving benefits through the division of
233	233	203medical assistance and individuals who are underserved as defined in this section. After the
234	234	204department completes its assessment and submits its recommendations to the board, the board
235	235	205shall make a determination, with consideration to how authorizing general supervision will
236	236	206expand access to safe and effective dental services for vulnerable populations including, at a
237	237	207minimum, individuals receiving benefits through the division of medical assistance and 11 of 16
238	238	208individuals who are underserved as defined in this section, whether to authorize performance of
239	239	209one or more of the procedures as identified in subsection (e), under general supervision pursuant
240	240	210to a collaborative management agreement.
241	241	211 Should the board, in consultation with the department and any other appropriate entity,
242	242	212determine that dental therapists shall have the authority to perform one or more of the procedures
243	243	213and services as identified in subsection (e) in their scope of practice under general supervision,
244	244	214then the board shall establish regulations no later than six months following the recommendation,
245	245	215authorizing dental therapists to perform one or more procedures as identified in subsection (e)
246	246	216under general supervision pursuant to a collaborative management agreement after receiving
247	247	217advanced practice certification.
248	248	218 The board shall grant advanced practice certification for a dental therapist licensed by the
249	249	219board to perform all services under general supervision pursuant to a collaborative management
250	250	220agreement if the dental therapist provides documentation of completion of at least two years or
251	251	2212,500 hours, whichever is longer, of direct supervision pursuant to subsection (a) of this section,
252	252	222and satisfying any other criteria established by regulation adopted by the board as authorized in
253	253	223this section.
254	254	224 Should the board determine that dental therapists shall continue to perform one or more
255	255	225of the advanced procedures under direct supervision, the department, in consultation with the
256	256	226board, shall re-evaluate annually the impact of dental therapists practicing under general
257	257	227supervision in Massachusetts and the rest of the United States, and the board shall annually
258	258	228reassess whether to authorize general supervision for the advanced procedures in order to
259	259	229improve dental therapists' progress in expanding access to safe and effective dental services for 12 of 16
260	260	230vulnerable populations including, at a minimum, individuals receiving benefits through the
261	261	231division of medical assistance and individuals who are underserved as defined in this section.
262	262	232 (g) The board shall establish appropriate guidelines for a written collaborative
263	263	233management agreement. A collaborative management agreement shall be signed and maintained
264	264	234by the supervising dentist and the dental therapist and shall be submitted annually to the board.
265	265	235 The agreement may be updated as necessary. The agreement shall serve as standing
266	266	236orders from the supervising dentist and shall address: (i) practice settings; (ii) any limitation on
267	267	237services established by the supervising dentist; (iii) the level of supervision required for various
268	268	238services or treatment settings; (iv) patient populations that may be served; (v) practice protocols;
269	269	239(vi) record keeping; (vii) managing medical emergencies; (viii) quality assurance; (ix)
270	270	240administering and dispensing medications; (x) geographic distance limitations; (xi) oversight of
271	271	241dental hygienists and dental assistants; and (xii) referrals for services outside of the dental
272	272	242therapy scope of practice. The collaborative management agreement shall include specific
273	273	243protocols to govern situations in which the dental therapist encounters a patient who requires
274	274	244treatment that exceeds the authorized scope of practice of the dental therapist. The supervising
275	275	245dentist is responsible for directly providing, or arranging for another dentist or specialist within
276	276	246an accessible geographic distance to provide, any necessary additional services outside of the
277	277	247dental therapy scope of practice needed by the patient. A supervising dentist may have a
278	278	248collaborative management agreement with not more than 3 dental therapists at the same time.
279	279	249Not more than 2 of the dental therapists may practice under general supervision with certification
280	280	250to perform one or more of the advanced procedures. A practice or organization with more than
281	281	251one practice location listed under the same business name may not employ more than six dental
282	282	252therapists, provided, however, that this requirement shall not apply if such an organization or 13 of 16
283	283	253practice is a federally qualified health center or look-alike, a community health center, a non-
284	284	254profit practice or organization, public health setting as defined by 234 CMR 2.02, or as otherwise
285	285	255permitted by the board.
286	286	256 (h) No medical malpractice insurer shall refuse primary medical malpractice insurance
287	287	257coverage to a licensed dentist on the basis of whether they entered into a collaborative
288	288	258management agreement with a dental therapist or public health dental hygienist. A dental
289	289	259therapist may not bill separately for services rendered; the services of the dental therapist are the
290	290	260services of the supervising dentist and shall be billed as such.
291	291	261 (i) Not less than 50% of the patient panel of a dental therapist, as determined in each
292	292	262calendar year, shall consist of patients who receive coverage through the division of medical
293	293	263assistanceor are considered underserved provided, however, that this requirement shall not apply
294	294	264if the dental therapist is operating in a federally qualified health center or look-alike, community-
295	295	265health center, non-profit practice or organization, or other public health setting as defined by 234
296	296	266CMR 2.02, or as otherwise permitted by the board. As used in this section, "underserved" means
297	297	267individuals who: (i) receive, or are eligible to receive, benefits through the division of medical
298	298	268assistance; (ii) receive, or are eligible to receive, social security disability benefits, supplemental
299	299	269security income, and/or Massachusetts state supplement program; (iii) live in a dental health
300	300	270professional shortage area as designated by the federal department of health and human services;
301	301	271(iv) reside in a long-term care facility licensed under section 71 of chapter 111; (v) receive dental
302	302	272services at a public health setting as defined by 234 CMR 2.02; (vi) receive benefits, or are
303	303	273eligible to receive subsidized insurance through the commonwealth health insurance connector
304	304	274authority;; (viii) receive benefits, or are eligible to receive benefits, through the Indian Health
305	305	275Service, tribal or urban Indian organizations, or through the contract health service program; (ix) 14 of 16
306	306	276receive benefits, or are eligible to receive benefits, through the federal department of veterans
307	307	277affairs or other organization serving veterans; (x) are elderly and have trouble accessing dental
308	308	278care due to mobility or transportation challenges; (xi) meet the Commission on Dental
309	309	279Accreditation's definition of people with special needs; (xii) are uninsured have an annual
310	310	280income at or below 305% of the federal poverty level; or (xiii) as otherwise permitted by the
311	311	281board.
312	312	282 An employer of a dental therapist shall submit quarterly reports to the board that provide
313	313	283information concerning the makeup of the dental therapist's patient panel, including the
314	314	284percentage of underserved in the patient panel. No later than January 1, 2020, the secretary of
315	315	285health and human services may establish by regulation penalties for employers who fail to meet
316	316	286the requirements pertaining to the percentage of underserved in the dental therapist's patient
317	317	287panel.
318	318	288 (j) Not later than January 1, 2020, the board, in consultation with the department shall
319	319	289establish regulations to implement the provisions of this section for the practice of dental therapy
320	320	290to protect the public health, safety and welfare, including, but not limited to: requirements for
321	321	291approval of educational programs; guidelines for collaborative management agreements,
322	322	292continuing education requirements, license renewal, standards of conduct, and the investigation
323	323	293of complaints, conduct of disciplinary proceedings and grounds for discipline.
324	324	294 SECTION 11. Section 259 of chapter 112 of the General Laws, as so appearing, is hereby
325	325	295amended by inserting after the word "skills", in line 51, the following:
326	326	296 (j) Oral health education; 15 of 16
327	327	297 SECTION 12. Section 260 of chapter 112 of the General Laws, as so appear, is hereby
328	328	298amended by inserting after the number 7, in line 21, the following:- As a condition for licensure
329	329	299or renewal of licensure, the board shall require community health workers to receive education
330	330	300or training in oral health.
331	331	301 SECTION 13. Section 79L of chapter 233, as so appearing, is hereby amended by
332	332	302inserting after the word "dentist," the following words:- dental therapist.
333	333	303 SECTION 14. The department of public health, in consultation with the executive office
334	334	304of health and human services, shall perform a 5-year evaluation of the impact of dental
335	335	305therapists, as established under section 51B of chapter 112 of the General Laws, on patient
336	336	306safety, cost-effectiveness and access to dental services. The department may enter into an inter-
337	337	307agency agreement with the health policy commission, established under chapter 6D of the
338	338	308General Laws, to provide assistance to the department in conducting such evaluation, as it deems
339	339	309necessary. The department shall ensure effective measurements of the following outcomes and
340	340	310file a report of its findings, which shall include the:
341	341	311 (i) Number of dental therapists in the commonwealth each year;
342	342	312 (ii) Number of licensed dental therapists in the commonwealth each year;
343	343	313 (iii) Number of new and total patients served each year;
344	344	314 (iv) Impact on wait times for needed services;
345	345	315 (v) Impact on travel time for patients;
346	346	316 (vi) Impact on emergency room usage for dental care; and 16 of 16
347	347	317 (vii) Costs to the public health care system.
348	348	318 The report shall be submitted not later than five years after the date of graduation of the
349	349	319first graduating class of dental therapists educated in the commonwealth to the joint committee
350	350	320on public heath, the joint committee on health care financing and the senate and house
351	351	321committees on ways and means.
352	352	322 The center for health information and analysis shall, by the first day of January of each
353	353	323year, submit a report including information on:
354	354	324 (i) Number of dental therapists in the commonwealth;
355	355	325 (ii) Number of licensed dental therapists practicing in the commonwealth;
356	356	326 (iii) Number of new and total patients served;
357	357	327 (iv) Number of new and total pediatric patients served, including geographic location and
358	358	328insurance type;
359	359	329 (v) Practice settings; and
360	360	330 (vi) Commonly performed procedures and services
361	361	331 The first annual report shall be submitted not later than three years after the date of
362	362	332graduation of the first graduating class of dental therapists educated in the commonwealth to the
363	363	333joint committee on public heath, the joint committee on health care financing and the senate and
364	364	334house committees on ways and means.