CDA objects to dental hygiene committee policy proposals in sunset review

The Dental Hygiene Committee of California is undergoing its 2017–18 “sunset review” — an evaluation by the Legislature to assess the DHCC’s performance and determine whether it should continue to exist and, if so, whether it should be modified.

As part of this process, the DHCC in November 2017 submitted its sunset report, outlining actions it has taken since its prior review in 2013-14 and making more than a dozen policy recommendations to address what it has identified as unresolved issues or problem areas.

In a letter to Sen. Jerry Hill, Senate Business, Professions and Economic Development Committee chair, CDA recognized the DHCC’s substantial work on its 2018 sunset review package before moving on to outline its objections to five policy recommendations.

With regard to the committee’s recommendation to remove the direct supervision requirement for the administration of local anesthesia and nitrous oxide analgesia, CDA stated that “direct supervision of hygienists during local anesthesia and nitrous oxide analgesia procedures is a matter of patient safety and the highest level of care.” Should an emergency arise, the “direct supervision requirement ensures that a depth of experienced professionals and emergency equipment are immediately available. This arrangement is supported when both dentists and dental hygienists work collaboratively together in a dental office setting.” 

On the recommendation to remove the 18-month prescription requirement for registered dental hygienists in alternative practice  to continue to provide care, CDA expressed concern that the DHCC’s recommendation is “not consistent with the standards of care.”

“It is important that a patient receives a full diagnosis and treatment plan that comes only from an examination with a dentist,” CDA commented. If a patient receives only hygiene care over an extended period of time, patients are at risk for undiagnosed oral disease and the RDHAP is potentially at risk for unprofessional conduct.

As mandated by state law, the Legislature periodically conducts a formal evaluation of each state licensing body. This sunset review occurs every four years for the DHCC, which was established in 2009 as a separate committee under the jurisdiction of the Dental Board of California to regulate licensure, enforcement and education of dental hygienists.

The DHCC had its first sunset review in 2013-14, and CDA also engaged in that review, objecting to some of the same policy recommendations under consideration in the 2017-18 review. One of these is the DHCC’s request for a change of status from a committee under jurisdiction of the dental board to an independent board — a recommendation the legislature declined to entertain in 2014.

CDA maintains its objection to this recommendation, stating, “CDA appreciates the regulatory authority invested in the DHCC and believes that the regulatory structure that exists between the DHCC and the dental board appropriately reflects the interconnected working relationship of dental team members who together ensure the delivery of comprehensive, high-quality dental care to Californians.” CDA went on to note that the sunset review is designed to identify and address deficiencies in a licensing body’s performance, not to resolve larger jurisdictional and scope-of-practice issues.

The DHCC's current sunset date is Jan. 1, 2019, which must be extended by legislation in order for the committee’s existence to continue. CDA is engaging with legislators as the DHCC sunset review bill, SB 1482, moves through the legislative process.

CDA will update members on the bill’s status in the Update and on cda.org.

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On May 24, 2018, the Registered Dental Assistant Written and Registered Dental Assistant Law and Ethics examinations are expected to launch as a single combined exam. The Dental Board of California and the Dental Assisting Council in a December 2016 meeting agreed to take this action to “ensure that the combined examination is legally defensible and meets the requirements of Business and Professions Code Section 139.”

The Dental Hygiene Committee of California (DHCC) faced its first legislative "sunset review" hearing last week. Based on that hearing, all indications are that the legislature will continue the committee for another four years but will not support expanding the committee's authority or the hygiene profession's scope of practice as proposed by the DHCC and the California Dental Hygienists Association.