Pennsylvania Dental Assistants Association. Presentation to the House Professional Licensure Committee

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1 Pennsylvania Assistants Association Presentation to the House Professional Licensure Committee Hearing on the Proposed EFDA changes and HB 494 November 7,2007 On behalf of the Pennsylvania Assistants Association I would like to thank the Professional Licensure Committee for the opportunity for all the state dental organizations to present their thoughts and concerns on the proposed changes and legislation effecting our dental assisting profession. I would like to begin with HB494. This bill is the result of legislation initiated at the request of the Pennsylvania Assistants Association back in June Over 12 years ago the PA State Board of Dentistry issued temporary permits to dental s who met certain requirements to perform function dental assisting duties. This was to be a temporary measure until an Expanded Function Assistant exam was established by the Board then allowing for permanent, renewable permits. We were met with years of delay and had no one to formally voice our concerns. It was not until HB2690 (the 2006 version of HB494) was introduced did we see formal action taken by the State Board of Dentistry to establish this exam. We feel that if not for the persistence of the Pennsylvania Assistants Association and this proposed legislation, we would not be getting any closer to our permanent EFDA permits. This new representative will be a voice on the Board for ALL dental s. Having a dental on a state dental board is not unusual. Linda Boyum, a Registered Assistant from Minnesota, served as the President of the Minnesota State Board. We strongly feel, that if the PA State Board of Dentistry is going to be making decisions and regulations involving our dental s then we should have a voice and representation in that decision making process. The only amendment we would like to propose to HB494 is on page 2 lines 11-12: We would like it to read: One member shall be an Expanded Function Assistant permitted to practice in this Commonwealth and shall have been ennaned in the practice of function dental assisting for a period of at least three vears immediatelv preceding appointment. This is to be consistent with the practice requirements for the dentists and hygienist already on the Board. In regards to the "Expanded Function Assistant" scope of practice; we would like to see this rewritten to include the duties we are already allowed to perform: 1) placing and removing rubber dams, matrices and wedges

2 2) apply cavity liners and bases, 3) place, condense, carve and contour amalgams, 4) place and finish composite/resin restorations 5) placement of sealants and temporary restorations The Pennsylvania Assistants Association is in support of allowing EFDA's to perform limited dental hygiene duties with some additional requirements. It is our general consensus that in order for an EFDA to perform coronal polishing and supragingival scaling for patients age 17 and under and give fluoride treatments they must have additional training. The prerequisites we recommend are: 1) Hold a current EFDA permit in Pennsylvania 2) Hold current Assisting National Board credentials as a Certified Assistant 3) Enroll and successfully complete a hygiene course at an ADA approved dental hygiene school 4) Upon meeting these requirements an additional "Hygiene Assistant" permit would be attached to their EDFA permit 5) We would also recommend additional continuing education requirements be added to the "Hygiene Assistant" permit to include dental hygiene courses Our rationale: s being allowed to perform limited dental hygiene duties is not a new concept. According to the Assisting National Board's 2006 State Career Ladder Templates for Assistants, there are currently 25 states that allow dental s to perform coronal polishing and 27 states allow dental s to give fluoride treatments. Kansas allows " Assistants with duties training" to perform "coronal scaling". Most of these states do require additional training and certification. Our recommendation for additional credentialing and education is in concern for public safety. We want only highly trained and skilled dental assisting professionals to perform these hygiene duties. Assisting National Board will not even consider an to sit for the Certified Assistant exam until they meet education or experience requirements. DANB requires CDA's to take 12 hours of approved continuing education every year plus be current in CPR. Currently Pennsylvania EFDAfs are only required to take 10 hours of continuing education every two years. We recommend additional continuing education requirements be added to the EFDA hygiene permit to include hygiene courses. These hours would be included in, not in addition to, the DANB approved certificate requirements. We understand that "certified dental " and "hygiene " would need to be added to the definitions recognized in Pennsylvania and would support the legislative steps

3 necessary. Please be advised that the Pennsylvania Assistants Association is firm in the stand that additional hygiene duties are given only to a DANB CDA's with EFDA permits after the additional hygiene training. This is solely in concern for public safety. Our thoughts were to follow the lead of the Pennsylvania Hygiene Association regarding allowing dental hygienists to give local anesthesia. Local anesthesia was originally considered outside the hygiene scope of practice. In order for a dental hygienist to give local anesthesia they must complete an anesthesia course at a dental school, pass an exam then receive an additional permit to their current hygiene license. Additional continuing education might also be required every two years. We propose the same for our EFDA's. In order for an EFDA to perform the additional hygiene duties they must have additional training and certification. The Pennsylvania Assistants Association would like to do our part in addressing the access to care problem by asking the Professional Licensure Committee to allow our dentists to delegate limited, supervised dental hygiene duties to trained Expanded Function Assistants while our dental hygienists care for the more dentally compromised patients. I personally spoke with several dentists who treat Medical Assistance patients and utilize EFDA's. They feel this would be a great advantage in the treatment of their dentally underserved population. We need to address the access to care problem as a team approach with patient safety being a key concern. We realize that there will be stumbling blocks with every proposed plan however we believe that all our dental professionals truly care for their patients and together we can arrive at a common ground to do what is in the best interest of our patients. In closing, I now ask the Professional Licensure Committee to work with the Pennsylvania State Board of Dentistry, the Pennsylvania Association, the Pennsylvania Academy of General Dentistry, the Pennsylvania Hygiene Association and the Pennsylvania Assistants Association to create legislation that will help our team of dental professionals provide the highest quality of care to the citizens of Pennsylvania. Thank you. Colette Jesikiewicz CDPMA Pennsylvania Assistants Association President

4 State Alabama Arizona Arizona Arkansas California California Colorado Florida Georgia Georgia Coronal fluoride Job title Requirements/certifications polishing None Pass Arizona Coronal Polishing exam qualified in (administered by coronal DANB)AND submit an polishing Arizona Coronal Polishing procedures Clinical Skills Affidavit to DANB AND receive the Arizona Coronal Polishing Certificate None Registered DANB CDA or graduate from an ADA accredited Assistant (RDA) RDA Unlicensed dental EFDA Expanded Dutv dental assisting school AND apply to the Arkansas State Board of examiners Graduate from a Board - approved RDA educational program or complete 12 months of work experience as a dental AND successfully Board approved courses in radiation safety and coronal polishing AND pass a state written and hands on RDA exam AND apply for licensure as a RDA to the California Board None None Graduate form an ADA program OR successfully complete a Board approved duties training program None High school diploma or eauivalent AND current

5 Idaho Idaho Illinois Kansas Assistant (EDDA) CPR AND successfully complete Board approved course in duties OR DANB CDA EFDA DANB CDA or successfully complete a Board approved course in the fundamentals of dental assisting AND successfully complete a Board approved competency exam None 18 years of age AND 1,000 qualified in hours of clinical dental assisting or complete ADA program or DANB CDA AND complete an approved course in Coronal Coronal polishingpolishing approved training by a AND with licensed dentist coronal Coronal scaling- complete scaling duty a Board approved course training of instruction Kentucky Complete an 8 hour course developed by the qualified in Kentucky Board of coronal Dentistry polishing Kentucky Louisiana Maryland complete 35 hour training program approved by the qualified in Maryland State Board of Examiners and duties pass the Maryland General Assisting Expanded Functions exam administered by DANB OR DANB CDA AND apply to Maryland State Board of Examiners for the

6 .-- Massachusetts Michigan Minnesota Missouri Montana Formally trained dental OR DANB CDA RDA RDA qualified in OR DANB CDA auxiliary Qualified in General Duties SuccessfuHy complete an ADA accredited dental assisting program OR hold current DANB CDA Degree or certificate of dental assisting from a school AND pass the board comprehensive and clinical exam AND apply for a license to the Michigan Board of Dentistry Graduate from an ADA program or DANB CDA AND complete a Board approved course in in Minnesota AND pass the Minnesota Registration exam within 5 years prior to application for registration AND pass the Minnesota Jurisprudence Exam AND apply for registration to the Minnesota Board of Dentistry Pass the Missouri Basic Assisting Skills exam [administered by DANB] AND complete Board approved courses AND pass a Board approved competency exam and provide proof of competence to the Missouri Board Graduate from an ADA program OR receive instruction and training by a licensed dentist OR receive instruction and

7 Nebraska Nebraska Nevada New Hampshire qualified in coronal polishing qualified to perform training in a board approved continuing education course Graduate from an ADA program which includes a coronal polishing course OR complete 1 year (1500 hours minimum) of clinical work experience as a dental and a Board approved course in polishing procedures NONE NONE Be a Graduate dental Assistant [GDA) or have at least 2000 hours of dental assisting work experience AND successfully complete a coronal polishing course approved by the New Hampshire Board of dental Examiners AND apply to the New Hampshire Board of Examiners for state certification New Hampshire New Mexico DANB CDA and GDA with state certification in DANB CDA s in New Hampshire can earn Graduate Assistant status by graduating from an accredited school of dental assisting Successfully complete a Board approved training program and/or assist with/observe 5 cases of rubber cup polishing AND pass DANB's written exam on rubber cup coronal polishing AND THEN perform rubber cup coronal polishing (under Board approved supervision] in 5 cases

8 New Mexico New York with state certification in NY certified dental or DANB CDA AND pass the state take home jurisprudence exam AND apply for state certification in coronal polishing to the New Mexico Board of Health Care Successfully complete a Board approved training program AND assist/observe 5 cases of application of topical fluoride AND pass DANB's written exam on topical fluoride AND THEN apply topical fluoride [under Board approved supervision) in 5 cases AND pass the state take home jurisprudence exam AND apply for the state certification in topical fluoride to the New Mexico Board of Health Care B e 17 years old, high school graduate or equivalent, successfully complete 1 of 2 educational options: approved 1 year course of study in dental assisting in a degree granting institution or board of cooperative educational services program of at least 200 hours of clinical experience OR alternate course of study in dental assisting acceptable to NY State Education Department that includes at least 1000 hours of relevant work experience in accordance with the Commissioner's regulations AND pass all three components of the DANB CDA exam OR pass the 3 part NY State

9 North Carolina North Carolina North Dakota licensed certified dental exam which includes 2 parts of the DANB CDA exam and the NY Professional Assisting component exam AND apply licensure from the NY State Education Department Current CPR AND Assistant 11 successfully complete ADA accredited dental assisting program or 1 academic year or longer in an ADA accredited dental hygiene program OR complete 2 years (3000 hours) of full time employment and experience as a chairside, radiography training as required by law and a 3 hour course in dental office emergencies and a 3 hour course in sterilization and infection control OR pass the DANB CDA exam AND successfully complete a Board approved 3 hour didactic and 4 hour clinical course in coronal polishing May perform basic I supportive dental procedures under the direct control and supervision of a licensed dentist RDA DANB CDA or complete a course in dental assisting from an ADA accredited school or complete a course in dental assisting approved by the North Dakota State Board of Examiners AND current CPR AND apply for registration to the North Dakota State Board

10 Ohio Ohio Oklahoma Oregon Rhode Island Tennessee DANB CDA or Ohio certified dental EFDA EDDA EFDA DANB CDA RDA qualified to perform of Examiners DANB CDA or pass the exam administered by the Ohio Commission on Assistant Certification and apply for a certificate from the Ohio State Board Complete a state Board approved EFDA training course (course may require DANB CDA Certification for entry) AND pass the EFDA exam administered by the Ohio Commission on Testing AND current CPR Expanded duty training at an ADA accredited dental assisting program AND successful~y complete Board approved course of study including a clinical component consisting of a minimum 14 hours Oregon Certificate of Radiological Proficiency AND complete a course of instruction in an ADA accredited program or complete All the following: pass the Oregon Basic Assisting exam or DANB CDA AND Oregon EFDA exam (all administered by DANB) and provide certification from a licensed dentist stating that the applicant has completed clinical requirements DANB CDA exam Successfully complete a Board approved coronal polishing course (to qualify and individual must be a RDA for at least 1 year or be a current DANB CDA) AND current CPR AND pass written and

11 Tennessee Washington West Virginia Wyoming RDA clinical exams AND receive a certificate in coronal polishing from the Tennessee Board of Dentistry Current DANB CDA or graduate from a TN Board approved, ADA accredited dental assisting program or from Board approved equivalent AND pass the TN RDA exam administered by DANB AND apply for registration to the TN Board of Dentistry NONE Course approved by the qualified in duties NONE West Virginia Board of dentai Examiners There are states, like Wisconsin, that list dental duties as "any delegated procedure or function for which the dental has been trained by the dentist or by another verifiable source". Could dental s in these states also be performing coronal polishing, scaling and fluorides? All information was obtained from the Assisting National Board's 2006 State Career Ladder Templates for Assistants. Please refer to this book for more detailed information. Prepared by: Colette Jesikiewicz CDPMA

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