EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0306*
SENATE BILL 306
J2 2lr1757
CF HB 219
By: Senator Lam
Introduced and read first time: January 20, 2022
Assigned to: Education, Health, and Environmental Affairs
A BILL ENTITLED
AN ACT concerning 1
Dental Hygienists – Consultation Requirements – Health Care Practitioners 2
FOR the purpose of altering the types of health care practitioners with whom a dental 3
hygienist must consult before providing certain treatment to a dental patient to 4
include a patient’s registered nurse practitioner, certified nurse midwife, or licensed 5
certified midwife; and generally relating to dental hygienists and the provision of 6
dental services. 7
BY repealing and reenacting, with amendments, 8
Article – Health Occupations 9
Section 4–308(k)(4)(vi) and (m)(1) and (5) 10
Annotated Code of Maryland 11
(2021 Replacement Volume) 12
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 13
That the Laws of Maryland read as follows: 14
Article – Health Occupations 15
4–308. 16
(k) (4) A facility in which a dental hygienist is authorized to practice under the 17
general supervision of a licensed dentist in accordance with this subsection shall ensure 18
that: 19
(vi) A dental hygienist consults with the supervising dentist, the 20
patient’s dentist, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, 21
OR LICENSED CERTIFIE D MIDWIFE, or a treating physician before proceeding with 22
treatment if there is a change in the patient’s medical history; 23
2 SENATE BILL 306
(m) (1) (i) In this subsection the following words have the meanings 1
indicated. 2
(ii) “Assisted living program” has the meaning stated in § 19–1801 3
of the Health – General Article. 4
(III) “CLINICAL OFFICE ” MEANS AN OFFICE OF A LICENSED 5
PHYSICIAN, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, OR 6
LICENSED CERTIFIED M IDWIFE WHO PROVIDES PRENATAL, POSTPARTUM , OR 7
PRIMARY CARE AND IN WHICH THE SUPERVISIN G DENTIST AND DENTAL HYGIENIST 8
COMMUNICATE WITH THE LICENSED PHYSICIAN , CERTIFIED REGIST ERED NURSE 9
PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D MIDWIFE IN 10
PROVIDING DENTAL HYG IENE SERVICES TO A P ATIENT. 11
[(iii)] (IV) “Facility” means: 12
1. A nursing home; 13
2. An assisted living program; 14
3. [Medical] CLINICAL offices; or 15
4. A group home or adult day care center. 16
[(iv)] (V) “General supervision” means supervision of a dental 17
hygienist by a dentist, where the dentist may or may not be present when the dental 18
hygienist performs the dental hygiene procedures. 19
[(v)] (VI) “Group home or adult day care center” means a group 20
home or adult day care center where the patient’s medical records are made available to 21
the dentist and the dental hygienist and that obtains the consent of the patient or the 22
patient’s guardian for dental hygiene services to be provided under this subsection. 23
[(vi) “Medical office” means an office of a licensed physician who 24
provides prenatal or primary medical care and in which the physician, supervising dentist, 25
and dental hygienist communicate in providing dental hygiene services to a patient.] 26
(vii) “Nursing home” has the meaning stated in § 19–1401 of the 27
Health – General Article. 28
(5) A dental hygienist practicing under the general supervision of a 29
licensed dentist in a facility and performing an authorized dental hygiene service for a 30
patient’s initial appointment shall: 31
(i) Ensure that, while the dental hygienist is performing the service, 32
the supervising dentist is available for consultation with the dental hygienist: 33 SENATE BILL 306 3
1. In person; 1
2. By telephone; or 2
3. Electronically; 3
(ii) Consult with the supervising dentist or a treating physician OR 4
THE PATIENT’S REGISTERED NURSE P RACTITIONER, CERTIFIED NURSE MIDW IFE, 5
OR LICENSED CERTIFIE D MIDWIFE before proceeding with initial treatment if there is a 6
change in or concerns about a patient’s medical history; 7
(iii) Assess the appropriate recall interval based on the needs of the 8
patient, or as otherwise recommended by the supervising dentist; 9
(iv) Limit dental hygiene tasks and procedures provided during the 10
initial appointment to: 11
1. Toothbrush prophylaxis; 12
2. Application of fluoride; 13
3. Dental hygiene instruction; 14
4. Full mouth debridement; 15
5. Assessing the patient’s apparent need for further 16
evaluation by a dentist in order to diagnose the presence of dental disease; and 17
6. Other duties as may be delegated, verbally or in writing, 18
by the supervising dentist; and 19
(v) Submit findings of the initial assessment to the supervising 20
dentist for a collaborative determination of future treatment based on the patient’s overall 21
health status. 22
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
October 1, 2022. 24