NYSDA Achieves Major Priority with Passage of Article 28 Dental Hygiene Collaborative Practice Legislation

ALBANY, NY (08/02/2013)(readMedia)-- The New York State Dental Association (NYSDA) is pleased that Governor Cuomo has signed a bill into law that will allow dental hygienists working in facilities licensed under Article 28 of the New York State Public Health Law to work under collaborative agreements with dentists having a formal relationship with the same Article 28 facility.

With the passage of this law, NYSDA has answered the call for improving access to dental care while maintaining important patient safety concerns.

The New York State Dental Association (NYSDA) led the way in achieving this important piece of oral health legislation. After many months of lobbying and negotiating with the Legislature, the governor's office, the New York State Department of Health, and the New York State Education Department, NYSDA finally achieved passage of its priority legislation. Article 28 facilities are primarily hospitals, but also include nursing homes and school based health clinics. The legislation, A.7866, sponsored by Assemblywoman Deborah Glick, and S.5757, sponsored by Senator Kemp Hannon, passed overwhelmingly in both the New York State Assembly (138-2) and in the Senate (60-3).

What the collaborative agreement system will do in these Article 28 facilities is free the dentist from the current requirement that they must be readily physically available to the location in order to be considered as providing proper general supervision for dental hygienists. It substitutes a collaborative practice agreement arrangement that will allow the dentist and the dental hygienist to work out the supervision protocol most effective for the particular Article 28 setting. Only a dentist who already has a formal relationship, such as hospital privileges, will be allowed to enter into a collaborative practice agreement with a dental hygienist at the same hospital.

As far back as 2008, NYSDA had been introducing legislation for collaborative practice arrangements with dental hygienists. Issues concerning scope of practice kept the bill from advancing through the legislature at that time. In the intervening years, NYSDA has been working with Dr. Jayanth Kumar, Director of the State Health Department Bureau of Dental Health, and the Medicaid Redesign Team led by Jason Helgerson from the DOH to fashion some type of acceptable collaborative practice arrangement that would be targeted to areas that made the most sense and would help improve access to dental care for underserved populations in the state. That effort culminated this year with the governor's introduction of a collaborative practice proposal as part of his 2013-2014 State Budget. Nevertheless, Assemblywoman Glick had concerns that the governor's budget proposal left too much to chance in the regulations that were to be developed by the DOH and failed to adequately protect against the fact that dental hygienists do not have adequate diagnostic training for conducting actual dental examinations.

Assemblywoman Glick offered to sponsor her own bill to address the issue of eliminating the "readily physically available" general supervision requirement in Article 28 settings through a collaborative practice arrangement between a dentist and a dental hygienist as advocated by NYSDA. The Education Department was brought into the discussions and, ultimately, given the primary task of creating the new regulations to implement the law in consultation with the Department of Health. After many months of fine tuning the language, the bill was introduced and moved towards passage in both houses of the Legislature.

Much credit is due Assemblywoman Glick for guiding this process forward to a favorable conclusion by bringing all parties to the table and to Senator Hannon for collegially agreeing to move this bill forward in the Senate. The bill was strongly opposed by dental hygienists.

"This is a great legislative victory for dentistry," said NYSDA President Dr. Joel M. Friedman. "We have advanced a proposal to make a real difference in creating better access to dental care, while at the same time, preserving the critical role of the dentist in delivering such care."

"I am very proud of our entire NYSDA governmental affairs team," said NYSDA Executive Director Dr. Mark Feldman. "They worked tirelessly over many months to craft legislation that did the job NYSDA members wanted and, most importantly, included patient safety precautions. At times it seemed like everything would fall through, but their efforts helped make this priority become a reality."

The New York State Dental Association, founded in 1868, is one of the largest constituents of the American Dental Association and represents more than 13,000 dentists practicing in New York State.