Sunset Review – Part III
The latest info to come out of the Sunset Advisory Commission regarding our state Dental Board is the “Sunset Staff Report with Commission Decisions.” This report contains the final decisions of the Commission which will form the basis of the agency’s Sunset Bill during Legislative Session, which begins January 10, 2017.
Issue 1 – The Unusually Large Dental Board Inappropriately Focuses on Issues Unrelated to Its Public Safety Mission.
The original recommendations were for a reduction in the total size of the board from 15 to nine, with a reduction in the number of dentist board members from eight to four. The final recommendation was somewhat of a compromise, recommending a reduction to a total size of 11 members, including six dentists, three hygienists, and two public members.
The Board will also be directed to create a more detailed system for stakeholder input as well as informal settlement hearings, both of which aim at increasing the Boards concentration on public safety
Issue 2 – State Regulation of Dental Assistants Is Unnecessary to Ensure Public Protection and Is an Inefficient Use of Resources.
Again a compromise between current regulation and the original recommendation. The final decision, in lieu of the original recommendation to discontinue the licensure of dental assistants, is to combine the board’s four dental assistant certificate programs into one registration for dental assistants. This one registration will cover radiology, nitrous monitoring, sealants, and coronal polishing. Whether or not current dental assisting licensees with be grandfathered in or will be required to show proof of CE or take a new examination remains unclear. Dental assistant registrations will be renewed biennially.
Issue 3 – The Board Lacks Key Enforcement Tools to Ensure Dentists Are Prepared to Respond to Increasing Anesthesia Concerns.
The Board will be authorized to conduct inspections of dentists administering parenteral sedation in office settings. The Board will also establish four levels of sedation permits, with appropriate education and standards for each, with an additional limitation to be placed on pediatric and high-risk patients.
Dentists with one or more anesthesia permits will also be required to maintain adequate written emergency plans, and will have requirements for necessary equipment and drugs prior to administering sedation/anesthesia.
A nine-member board-appointed standing Advisory Committee on Dental Anesthesia will be created to advise the Board on the development and revision of rules related to dental sedation and anesthesia. The board will track and report anesthesia-related data and to make publicly available on its website aggregate enforcement data by fiscal year and type of license.
The Board is directed to define portability, methods to obtain a portability permit, and establish advanced didactic and clinical training requirements for the permit.
Issue 4 – Key Elements of the State Board of Dental Examiners’ Licensing and Regulatory Functions Do Not Conform to Common Licensing Standards.
The Board will be required to monitor licensees for adverse licensure actions, and be allowed (i.e. encouraged) to deny applications to renew a license if an applicant is not compliant with a board order, be allowed to require evaluations of licensees suspected of being impaired, and be allowed to remove unnecessary qualifications required of applicants for licensure or registration.
There is also a recommendation to stagger registration renewals, but the details have not been given yet. Maybe every two years?
Previous recommendation didn’t address any prescription drug issues, but the final decisions do contain a Prescription Monitoring Program.
As of September 1, 2018, dentists will be required to search the Prescription Monitoring Program and review a patient’s prescription history before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. A dentist who does not check the program before prescribing these drugs will be subject to disciplinary action by the Dental Board.
The Board will be required to query the Prescription Monitoring Program on a periodic basis for potentially harmful prescribing patterns among its licensees. The Board will work with the Pharmacy Board to establish potentially harmful prescribing patterns that the Board should monitor by querying the database for dentists who meet those prescribing patterns. Based on the information obtained from the Prescription Monitoring Program, the Board will be authorized to open a complaint for possible non-therapeutic prescribing.
By Jonathon R. Kimes, DDS