MD
Maryland Senate Bill SB306

Maryland 2022 Regular Session

Maryland Senate Bill SB306 Compare Versions

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1- LAWRENCE J. HOGAN, JR., Governor Ch. 678
21
3-– 1 –
4-Chapter 678
5-(Senate Bill 306)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *sb0306*
89
9-Dental Hygienists – Consultation Requirements – Health Care Practitioners
10+SENATE BILL 306
11+J2 2lr1757
12+ CF HB 219
13+By: Senator Lam
14+Introduced and read first time: January 20, 2022
15+Assigned to: Education, Health, and Environmental Affairs
16+Committee Report: Favorable with amendments
17+Senate action: Adopted
18+Read second time: February 26, 2022
1019
11-FOR the purpose of altering the types of health care practitioners with whom a dental
12-hygienist must consult before providing certain treatment to a dental patient to
13-include a patient’s registered nurse practitioner, certified nurse midwife, or licensed
14-certified midwife; requiring that certain consultations by a dental hygienist be made
15-if there is a change in the patient’s medical condition; and generally relating to
16-dental hygienists and the provision of dental services.
20+CHAPTER ______
1721
18-BY repealing and reenacting, with amendments,
19- Article – Health Occupations
20-Section 4–308(k)(4)(vi) and (m)(1) and (5)
21- Annotated Code of Maryland
22- (2021 Replacement Volume)
22+AN ACT concerning 1
2323
24- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
25-That the Laws of Maryland read as follows:
24+Dental Hygienists – Consultation Requirements – Health Care Practitioners 2
2625
27-Article – Health Occupations
26+FOR the purpose of altering the types of health care practitioners with whom a dental 3
27+hygienist must consult before providing certain treatment to a dental patient to 4
28+include a patient’s registered nurse practitioner, certified nurse midwife, or licensed 5
29+certified midwife; requiring that certain consultations by a dental hygienist be made 6
30+if there is a change in the patient’s medical condition; and generally relating to 7
31+dental hygienists and the provision of dental services. 8
2832
29-4–308.
33+BY repealing and reenacting, with amendments, 9
34+ Article – Health Occupations 10
35+Section 4–308(k)(4)(vi) and (m)(1) and (5) 11
36+ Annotated Code of Maryland 12
37+ (2021 Replacement Volume) 13
3038
31- (k) (4) A facility in which a dental hygienist is authorized to practice under the
32-general supervision of a licensed dentist in accordance with this subsection shall ensure
33-that:
39+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
40+That the Laws of Maryland read as follows: 15
3441
35- (vi) A dental hygienist consults with the supervising dentist, OR the
36-patient’s dentist, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE,
37-OR LICENSED CERTIFIE D MIDWIFE, or a AND THE treating physician, REGISTERED
38-NURSE PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D
39-MIDWIFE before proceeding with treatment if there is a change in the patient’s medical
40-history CONDITION;
42+Article – Health Occupations 16
4143
42- (m) (1) (i) In this subsection the following words have the meanings
43-indicated.
44+4–308. 17
4445
45- (ii) “Assisted living program” has the meaning stated in § 19–1801
46-of the Health – General Article.
47- Ch. 678 2022 LAWS OF MARYLAND
46+ (k) (4) A facility in which a dental hygienist is authorized to practice under the 18
47+general supervision of a licensed dentist in accordance with this subsection shall ensure 19
48+that: 20 2 SENATE BILL 306
4849
49-– 2 –
50- (III) “CLINICAL OFFICE ” MEANS AN OFFICE OF A LICENSED
51-PHYSICIAN, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, OR
52-LICENSED CERTIFIED M IDWIFE WHO PROVIDES PRENATAL, POSTPARTUM , OR
53-PRIMARY CARE AND IN WHICH THE SUPERVISING DENTIST AND DENTAL HYGIENIST
54-COMMUNICATE WITH THE LICENSED PHYSICIAN , CERTIFIED REGISTERED NURSE
55-PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D MIDWIFE IN
56-PROVIDING DENTAL HYG IENE SERVICES TO A P ATIENT.
5750
58- [(iii)] (IV) “Facility” means:
5951
60- 1. A nursing home;
52+ (vi) A dental hygienist consults with the supervising dentist, OR the 1
53+patient’s dentist, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, 2
54+OR LICENSED CERTIFIE D MIDWIFE, or a AND THE treating physician, REGISTERED 3
55+NURSE PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D 4
56+MIDWIFE before proceeding with treatment if there is a change in the patient’s medical 5
57+history CONDITION; 6
6158
62- 2. An assisted living program;
59+ (m) (1) (i) In this subsection the following words have the meanings 7
60+indicated. 8
6361
64- 3. [Medical] CLINICAL offices; or
62+ (ii) “Assisted living program” has the meaning stated in § 19–1801 9
63+of the Health – General Article. 10
6564
66- 4. A group home or adult day care center.
65+ (III) “CLINICAL OFFICE ” MEANS AN OFFICE OF A LICENSED 11
66+PHYSICIAN, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, OR 12
67+LICENSED CERTIFIED M IDWIFE WHO PROVIDES PRENATAL, POSTPARTUM , OR 13
68+PRIMARY CARE AND IN WHICH THE SUPERVISING DENTIST AND DENTAL HYGIENIST 14
69+COMMUNICATE WITH THE LICENSED PHYSICIAN , CERTIFIED REGISTERED NURSE 15
70+PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D MIDWIFE IN 16
71+PROVIDING DENTAL HYG IENE SERVICES TO A P ATIENT. 17
6772
68- [(iv)] (V) “General supervision” means supervision of a dental
69-hygienist by a dentist, where the dentist may or may not be present when the dental
70-hygienist performs the dental hygiene procedures.
73+ [(iii)] (IV) “Facility” means: 18
7174
72- [(v)] (VI) “Group home or adult day care center” means a group
73-home or adult day care center where the patient’s medical records are made available to
74-the dentist and the dental hygienist and that obtains the consent of the patient or the
75-patient’s guardian for dental hygiene services to be provided under this subsection.
75+ 1. A nursing home; 19
7676
77- [(vi) “Medical office” means an office of a licensed physician who
78-provides prenatal or primary medical care and in which the physician, supervising dentist,
79-and dental hygienist communicate in providing dental hygiene services to a patient.]
77+ 2. An assisted living program; 20
8078
81- (vii) “Nursing home” has the meaning stated in § 19–1401 of the
82-Health – General Article.
79+ 3. [Medical] CLINICAL offices; or 21
8380
84- (5) A dental hygienist practicing under the general supervision of a
85-licensed dentist in a facility and performing an authorized dental hygiene service for a
86-patient’s initial appointment shall:
81+ 4. A group home or adult day care center. 22
8782
88- (i) Ensure that, while the dental hygienist is performing the service,
89-the supervising dentist is available for consultation with the dental hygienist:
83+ [(iv)] (V) “General supervision” means supervision of a dental 23
84+hygienist by a dentist, where the dentist may or may not be present when the dental 24
85+hygienist performs the dental hygiene procedures. 25
9086
91- 1. In person;
87+ [(v)] (VI) “Group home or adult day care center” means a group 26
88+home or adult day care center where the patient’s medical records are made available to 27
89+the dentist and the dental hygienist and that obtains the consent of the patient or the 28
90+patient’s guardian for dental hygiene services to be provided under this subsection. 29
9291
93- 2. By telephone; or
94- LAWRENCE J. HOGAN, JR., Governor Ch. 678
92+ [(vi) “Medical office” means an office of a licensed physician who 30
93+provides prenatal or primary medical care and in which the physician, supervising dentist, 31
94+and dental hygienist communicate in providing dental hygiene services to a patient.] 32
95+ SENATE BILL 306 3
9596
96-– 3 –
97- 3. Electronically;
9897
99- (ii) Consult with the supervising dentist or a AND THE treating
100-physician OR THE PATIENT’S, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE
101-MIDWIFE, OR LICENSED CERTIFIE D MIDWIFE before proceeding with initial treatment
102-if there is a change in or concerns about a patient’s medical history CONDITION;
98+ (vii) “Nursing home” has the meaning stated in § 19–1401 of the 1
99+Health – General Article. 2
103100
104- (iii) Assess the appropriate recall interval based on the needs of the
105-patient, or as otherwise recommended by the supervising dentist;
101+ (5) A dental hygienist practicing under the general supervision of a 3
102+licensed dentist in a facility and performing an authorized dental hygiene service for a 4
103+patient’s initial appointment shall: 5
106104
107- (iv) Limit dental hygiene tasks and procedures provided during the
108-initial appointment to:
105+ (i) Ensure that, while the dental hygienist is performing the service, 6
106+the supervising dentist is available for consultation with the dental hygienist: 7
109107
110- 1. Toothbrush prophylaxis;
108+ 1. In person; 8
111109
112- 2. Application of fluoride;
110+ 2. By telephone; or 9
113111
114- 3. Dental hygiene instruction;
112+ 3. Electronically; 10
115113
116- 4. Full mouth debridement;
114+ (ii) Consult with the supervising dentist or a AND THE treating 11
115+physician OR THE PATIENT’S, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE 12
116+MIDWIFE, OR LICENSED CERTIFIE D MIDWIFE before proceeding with initial treatment 13
117+if there is a change in or concerns about a patient’s medical history CONDITION; 14
117118
118- 5. Assessing the patient’s apparent need for further
119-evaluation by a dentist in order to diagnose the presence of dental disease; and
119+ (iii) Assess the appropriate recall interval based on the needs of the 15
120+patient, or as otherwise recommended by the supervising dentist; 16
120121
121- 6. Other duties as may be delegated, verbally or in writing,
122-by the supervising dentist; and
122+ (iv) Limit dental hygiene tasks and procedures provided during the 17
123+initial appointment to: 18
123124
124- (v) Submit findings of the initial assessment to the supervising
125-dentist for a collaborative determination of future treatment based on the patient’s overall
126-health status.
125+ 1. Toothbrush prophylaxis; 19
127126
128- SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
129-October 1, 2022.
127+ 2. Application of fluoride; 20
130128
131-Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.
129+ 3. Dental hygiene instruction; 21
130+
131+ 4. Full mouth debridement; 22
132+
133+ 5. Assessing the patient’s apparent need for further 23
134+evaluation by a dentist in order to diagnose the presence of dental disease; and 24
135+
136+ 6. Other duties as may be delegated, verbally or in writing, 25
137+by the supervising dentist; and 26
138+
139+ (v) Submit findings of the initial assessment to the supervising 27
140+dentist for a collaborative determination of future treatment based on the patient’s overall 28
141+health status. 29
142+
143+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 30
144+October 1, 2022. 31