69 Blo St E, Suite 300, Tonto, ON M4W 1A9 t: 416-961-6234 tf: 1-800-268-2346 f: 416-961-6028 www.cdho.g Self-Initiation Package Rev: July 2013 Effective Aug. 1, 2013 1
This Standard of Practice will apply to CDHO registrants who plan to self-initiate the controlled act of scaling teeth and root planing, including curetting surrounding tissue under the Dental Hygiene Act, 1991 as amended by the Health System Improvements Act, 2007. This standard applies regardless of the health care setting in which self-initiation occurs. This Standard of Practice must be applied in the context of the Dental Hygiene Act as amended and the CDHO s Contraindications Regulation (Ontario Regulation 501/07). The objective of the Standard of Practice f Authization to Self-Initiate is to provide assurance to Ontarians who choose to have a dental hygienist clean their teeth without an der from a dentist, that the dental hygienist is fully competent to do so as safely and effectively as if the procedure were perfmed under an der. This Standard of Practice f Authization to Self-Initiate describes three streams scenarios designed to provide this assurance. This Standard of Practice also articulates the professional expectation that dental hygienists will not self-initiate the controlled act of scaling teeth and root planing, including curetting surrounding tissue unless they have been authized to do so by the CDHO through one of the three streams as explained herein. CDHO registrants who plan to self-initiate are expected to apply, pay the required application fee ($75), and provide proof that they meet the requirements of the stream that they are applying under. The College will issue a new wall certificate with a foil-stamped seal that signifies authization to self-initiate. A notation will also be placed beside the approved registrant s name on the public register. Registrants who have been granted authization with conditions will have that notation recded on their certificate and on the register. /2
Standard f Authization to Self-Initiate Profession-Specific Acts Stream Eligibility Requirements Authization Term Level One Currently holds a general specialty certificate of registration with the CDHO, is in good standing and who: Application & Fee Good standing with relevant regulaty body Full No limitation a) has practised clinically under a standing der protocol in Ontario f at least the two (2) years (3200 hours) previous to application b) has practised clinically f at least two (2) years (3200 hours) and completed either a clinical refresher course the CDHA selfinitiation course within the previous 24 months c) has practised in Alberta British Columbia f at least two (2) years (3200 hours) previous to application d) is currently authized to self-initiate in Nova Scotia e) Has held a certificate of conditional authization f at least six (6) months and has successfully completed the mentship and any other requirements of Stream Two Three. proof of clinical practice with, and evidence of, a standing der protocol f at least the two (2) previous years proof of clinical practice f at least two (2) years and proof of successful course completion proof of clinical practice in Alberta BC 1 in the previous two (2) years Proof of authization to self-initiate in Nova Scotia 2 Proof of completed mentship and Proof of conditional authization under Stream Two Three. 1 Dental hygienists in the Provinces of Alberta and British Columbia are authized under provincial legislation to self-initiate upon registration. 2 Nova Scotia dental hygienists must meet the following criteria to be authized to self-initiate in that province. Regulation Section 8 (1) (h) f an applicant who intends to engage in self-directed clinical practice and f an applicant applying f a practising licence two (2) years after being issued an initial licence under the Act, they must (i) have successfully completed the self-initiation module.
Stream Eligibility Requirements Authization Term Level Two Currently holds a general specialty certificate with the CDHO, is in good standing, graduated from a dental hygiene program but does not meet the eligibility requirements of Stream One and who: Application 4 (fee waived) Good standing Conditional 6 Minimum six (6) months, expires in 12 months (renewable) a) has completed either a clinical refresher course the CDHA selfinitiation course within the previous 24 months and b) is being mented by a ment 3 Certificate of successful completion of the refresher 5 course the CDHA selfinitiation course Mentship contract with a CDHOapproved ment f a minimum 6-month term 3 To qualify as a ment, applicants must be registered with the College, have a minimum five (5) years clinical experience including a minimum of two (2) years with authization to self initiate and be in good standing. They must also successfully complete the CDHO mentship course (under development). 4 The application fee f a conditional authization under Streams Two and Three would be waived but would apply when the registrant applies f full authization under Stream One. 5 CDHO maintains a list of approved clinical refresher courses. The course outline matches that of the CDHA Self-initiation Course. 6 Authization to self-initiate with conditions permits a registrant to decide, based on a comprehensive health assessment, to proceed with the controlled act of scaling teeth, root planing and curettage of the surrounding tissue without the der requirement, while under the mentship of a ment. Removes the current requirement of a standing der.
Stream Eligibility Requirements Authization Term Level Three Currently holds a general specialty certificate with the CDHO, is in good standing, but does not meet the eligibility requirements of Stream One and graduated from an accredited 7 dental hygiene program after January 1, 2013 8 who: Application (fee waived) Good standing with relevant regulaty body Conditional 10 Minimum six (6) months, expires in 12 months (renewable) a) is being mented by a ment 9 Mentship contract with a CDHOapproved ment f a minimum 6-month term 7 Currently, all dental hygiene programs with graduates after this date are accredited. Should an institution lose its accreditation status, the graduates would no longer be eligible to apply under Stream Three. They would be required to apply under Stream Two which includes an additional requirement to successfully complete a refresher course the CDHA Self-initiation Course. 8 Eligibility date f consideration as a graduate of the expanded dental hygiene curriculum. 9 Recognizes that the expanded dental hygiene curriculum provides me opptunity f students to be evaluated on their knowledge of, and ability to, self-initiate their authized acts. 10 Suppts new graduates by giving them authization to self-initiate with condition that the registrant is mented by a CDHOapproved ment. Revision: February 12, 2013 Effective: August 1, 2013 www.cdho.g 69 Blo Street East, Suite 300, Tonto ON M4W 1A9 416-961-6234 1-800-268-2346
69 Blo St E, Suite 300, Tonto, ON M4W 1A9 t: 416-961-6234 tf: 1-800-268-2346 f: 416-961-6028 www.cdho.g Application f Authization Self-Initiation (effective August 1, 2013) Please refer to the Standard f Authization to Self-Initiate Profession-Specific Acts included in this package befe completing this application. Please print in block letters and/ check the appropriate box. Name:... CDHO Registration No.:... Self-Initiation Streams (Please select the Stream option that you are applying under.) Stream One Registrants who hold a General/Specialty certificate of registration with the CDHO and meet ONE of the following criteria options: Option a) I have practised clinically under a standing der/protocol in Ontario f at least two (2) years (minimum 3200 hours) immediately preceding this application; AND I can provide a copy of a standing der/protocol that authizes me to perfm the controlled act of scaling teeth and root planning, including curetting surrounding tissue. Written statement not accepted in lieu of standing der/protocol. Option b) I have practised clinically f at least two (2) years (minimum 3200 hours); AND I have completed a clinical refresher course OR the CDHA Self-Initiation course during the 24 months immediately preceding this application. Option c) I have practised clinically in Alberta British Columbia f at least two (2) years (minimum 3200 hours) immediately preceding this application. Suppting Documents: (to be submitted with application) Declaration of clinical practice f at least two (2) years; AND Copy of standing der/protocol f previous two (2) years (3200-hour equivalent) Declaration of clinical practice f at least two (2) years; AND Proof of successful completion of a CDHOapproved clinical refresher course OR the CDHA Self-Initiation course Declaration of clinical practice f at least two (2) years; AND Certificate of Professional Conduct (Fm B) OR Letter of Standing, to be sent directly from the CRDHA the CDHBC Option d) I have practised clinically in Nova Scotia and I was authized by the CDHNS to self-initiate during that time. Proof of authization to self-initiate in Nova Scotia to be sent directly from the CDHNS; AND I have completed the requirements of Stream Two I have completed the requirements of Stream Three Certificate of Professional Conduct (Fm B) OR Letter of Standing to be sent directly from the CDHNS Proof of successful completion of Mentship Program (Ment s Declaration) FOR OFFICE USE ONLY Date application received: Date self-initiation approval was issued: With condition Rev: October 2015 12
Stream Two / Conditional Authization Registrants who hold a General/Specialty certificate of registration with the CDHO, who do not satisfy any of the criteria in Stream One, and meet ALL of the following criteria: I graduated from an accredited non-accredited Dental Hygiene program befe January 1, 2013, non-accredited program after January 1, 2013; AND I completed a clinical refresher course OR the CDHA Self-Initiation course within the 24 months preceding this application; AND I have entered into a mentship contract with a CDHO peer ment. Suppting Documents: (to be submitted with application) Proof of successful completion of a CDHO approved clinical refresher course OR the CDHA Self-Initiation course; AND Copy of mentship contract Note: This conditional authization is f a minimum of six (6) months to a maximum of twelve (12 months), and can be renewed. Once the mentship period has been completed, the registrant can apply under Stream One. Stream Three / Conditional Authization Registrants who hold a General/Specialty certificate of registration with the CDHO, who do not satisfy any of the criteria in Stream One Two, and meet ALL of the following criteria: I graduated from an accredited Dental Hygiene program after January 1, 2013; AND Suppting Documents: (to be submitted with application) Copy of mentship contract I have entered into a mentship contract with a CDHO peer ment. Note: This conditional authization is f a minimum of six (6) months to a maximum of twelve (12) months, and can be renewed. Once the mentship period has been completed, the registrant can apply under Stream One. I have reviewed the Standard f Authization to Self-Initiate Profession-Specific Acts included in this package. I am applying f authization to self-initiate under the following: Stream One Please see payment instructions below Stream Two / Conditional Authization (fee waived) Payment Instructions: STREAM ONE (CDN $75.00 Processing Fee) Offline Payment: Amount: CAN $75.00 Payment Type: Certified Cheque Money der Stream Three / Conditional Authization (fee waived) Online Payment: An email with payment instructions will be sent to you once your application has been approved. Registrant s Declaration I certify that the statements made by me in this application are complete and crect to the best of my knowledge and belief. I understand that making a false misleading statement on this application is considered professional misconduct and could be subject to disciplinary action. I have enclosed made arrangements to have suppting documentation sent directly to the CDHO. Signature Date Rev: October 2015 23
69 Blo St E, Suite 300, Tonto, ON M4W 1A9 t: 416-961-6234 tf: 1-800-268-2346 f: 416-961-6028 www.cdho.g Declaration of Clinical Practice To be completed if applying under Stream One Please print in block letters. Name:... CDHO Registration No.:... Employment Profile (Please recd your clinical practices over the last two (2) years, starting with the most current.) Start Date (mm/dd/yyyy) End Date (mm/dd/yyyy) Business Name and Address No. of Clinical Hours Comments Total Number of Clinical Hours Registrant s Declaration I declare that I have practised clinically f at least two (2) years (3200 hours) and the above infmation is crect. I understand that making a false misleading statement on this declaration is considered professional misconduct and could be subject to disciplinary action. (Please consult the CDHO s Professional Misconduct Regulations.) Signature Date