AzDA 2015 Legislative Accomplishments

Senate Bill 1282 (Ward)
Signed by the Governor, April 2/2015.
Effective July 3, 2015

Principal Provisions:

  • Creates Expanded Function Dental Assistants (EFDA) – Under direct supervision, EFDAs may place and carve dental fillings following preparation by a dentist; place and cement pre-fabricated crowns. Under general supervision: apply sealants and fluoride varnish; place interim therapeutic restorations after a consultation with a dentist via teledentistry. A licensed dental hygienist may perform expanded function duties with equivalent training. Training shall occur in a CODA accredited dental assisting program and completion of an exam approved by BODEX.
  • Removes regulatory barrier that required a dentist’s exam before a sealant could be placed. The old provision was seen as an impediment to the efficient operation of school sealant programs.
  • Moves definitions of “unprofessional conduct” to its own new subchapter.
  • Clarifies those definitions to state that “dividing a professional fee or offering, providing or receiving any consideration for patient referrals among or between dental care institutions or entities…” is considered unprofessional conduct. (Bold language reflects the changes)
  • Defines “teledentistry” as “the use of data transmitted through interactive audio, video or data communication for the purposes of diagnosis, treatment planing, consultation and directing the delivery of treatment by dentists and dental providers…”.
  • Makes changes in the scope of practice of a dental hygienist, including:
    • Removes language permitting the placement of periodontal sutures
    • Removes language referring to “examinations” since an examination is not recognized in the CDT code as a billable procedure for dental hygienist. New language now reads :
      • Inspecting the oral cavity and surrounding structures for the purposes of gathering clinical data to facilitate a diagnosis.
      • Periodontal screening or assessment. (which are recognized in the CDT)
  • A dental hygienist may perform those restorative functions permissible for an expanded function dental assistant if qualified pursuant to section 32‑1291.01.
  • Makes several changes to the law on Affiliated Practice Dental Hygienists, including:
    • A dental hygienist may qualify as an AP hygienist if: (a.) held an active license for at least five years and a have actively practices for at least 500 hours in each of the two years immediately preceding the application; OR, (b.) Hold a bachelor’s degree in dental hygiene, hold an active license for at least three years and engaged in active practice for at least 500 hours in each of the two years preceding the application.
    • Strengthens the relationship between the AP Dentist and the AP Dental Hygienist. Requires patients who have been assessed by the dental hygienist to be referred to the AP dentist for diagnosis, treatment planning that is outside the AP hygienist’s scope of practice. Requires consultation with the AP dentist if: any proposed treatment is outside the scope of the AP hygienist agreement; before initiating treatment on a patients that has not been seen by a dentist within 12 months of initial treatment by the dental hygienist; before initiating treatment on patients presenting with a complex medical history or medication regimen. Patients are to be informed in writing that the dental hygiene treatment does not take the place of a diagnosis or treatment plan by a dentist.
    • The AP dentist needs to be available to maintain an appropriate level of contact whenever AP hygiene services are offered. AP hygiene agreement shall include standing orders applicable to what services maybe offered, to what populations and in what settings. Procedures are required to be adopted for timely referral to the AP dentist or a designee. Once a referral is made, timely treatment shall be provided.
    • An AP Dentist may not have more than 3 (three) AP hygienists working at any one time.
    • Contracts for AP dental hygiene services may be entered into by:
      • A healthcare organization or facility.
      • A long term care facility
      • A public health agency or institution
      • A public or private school authority
      • A government sponsored program
      • A private non-profit or charitable organization
      • A social service organization or program
  • The Dental Practice Act now recognized teledentistry in a manner consistent with previous legislative enactments on telemedicine in Arizona. Requires written consent from the patient or the patient’s health care decision maker. Requires AHCCCS to implement teledentistry services. Currently, AHCCCS has put together a work group and will develop standards for the implementation.

House Bill 2496 (Carter) - Dental Board Omnibus Bill
Signed by the Governor, 4/2/2015.
Effective July 3, 2015

Makes several changes to the Dental Practice Act as follows:

  • Requires Board to post audio recordings of its proceedings on the BODEX website
  • Applicants for a license (dentist, dental hygienist or denturist) are now required to obtain a valid fingerprint clearance card.
  • Requires Board to establish by rule the minimum number of active practice hours in another jurisdiction for dentist and dental hygiene applicants for licensure by credential.
  • Requires the Board to post non disciplinary actions and letters of concern on the BODEX website. (NOTE: Other provisions of the Dental Practice Act limit these postings to five years)
  • Makes several changes to the Board’s substance abuse and monitoring program addressing options for licensees who relapse after completing a second monitoring program.
  • Clarifies that the expenses associated with licensees referred for a physical, psychological, psychiatric and competency evaluation are the responsibility of the individual (not the Board).

House Bill 2492 (Carter) – No Action – Adult Dental Services

This legislation would have reinstated the Adult Emergency Dental Benefit under AHCCCS and would have restored preventative and emergency services for the Intellectually and Developmentally Disabled (IDD) as well as the Elderly Disabled (ED) population served by ALTCS. Despite a do pass recommendation from the House Health committee, no action was taken on this bill that was also assigned to the House Appropriation Committee (where it died).

New efforts are underway to restore these benefits in the 2016 Legislative session, supported by new data compiled by the University of Arizona demonstrating that AHCCCS and ALTCS patients are currently being seen in hospitals ERs and admissions, without resolving their underlying dental issue.

On the ALTCS population, a letter is currently being circulated among Republican legislators asking the Governor to restore dental coverage in his budget request this coming January.