May 12, 2004, Meeting of COMDA
Agenda
Agenda
Item Information
Minutes
Agenda
Notice
of PUBLIC MEETING - Notice is hereby given that
a public meeting of the Committee on Dental Auxiliaries
will be held as follows
May 12,
2004 – 1:30 p.m.
Embassy
Suites, San Francisco Airport,150 Anza Blvd, Burlingame,
650-342-4600
Agenda
1. Call to Order/Roll
Call/Establishment of Quorum
2. Approval of January 29, 2004, Meeting Minutes
3. Report of the Chair
4. Report of the Executive Officer
5. Legislation of Interest to COMDA
a. AB539 – 3rd and 4th year dental students applying
for RDH licensure
b. SB 1546 – Dental assisting scopes of practice
RDA Program
6. Review of RDA Educational Programs and Courses/Recommendations to Board
7. RDA Practical Examination Testable Procedures – Recommendation of
Subcommittee
8. Required Coronal Polishing and Radiation Safety Courses for RDAs – Affidavit
in Lieu of Certificate
9. Proposed Changes to Regulations 1014 and 1014.1 – Approval of Radiation
Safety Programs
10. Appointment of New RDA Examiners
11. Appointment of Chief and Assistant Chief Examiners
EF Program
12. Proposed Restructuring of EF Subcommittee
RDH Program
13. Recommendation: Board Appointment of Subcommittee to Review RDH Law and
Ethics Examination and RDHAP Law and Ethics Examination
14. Appointment of New RDH Examiners
15. Review of Necessity/Desirability of RDHAP Prescription Requirement
All Programs
16. Review of Last COMDA Strategic Plan
17. Agenda Items for Future Meetings
18. Public Comment
19. Adjournment
The Committee may take
action on any item listed on the agenda unless
listed as information only. All times are approximate
and subject to change. Public comments will be
taken on agenda items at the time the specific
item is raised. Items may be taken out of order
to accommodate speakers and to maintain a quorum.
The meeting may be cancelled without notice. For
meeting verification, call (916) 263-2595 or access
the Committee’s website at www. comda. ca.gov.
The meeting is accessible to the physically disabled.
A person who needs disability-related accommodations
or modifications in order to participate in the
meeting shall make a request to the Committee by
contacting Karen Wyant at (916) 263-2300 or sending
a written request to the person at the Committee
on Dental Auxiliaries, 1428 Howe Avenue, Suite
58, Sacramento, CA 95825, one week prior to the
day of the meeting. Contact: Karen Wyant, (916)
263-2595 or email Karen_Wyant@dca.ca.gov.
AGENDA
ITEM INFORMATION
5. Legislation
of Interest to COMDA
a. AB539 - 3rd and 4th
year dental students applying for RDH licensure
AB539 would allow 3rd
and 4th year California dental school students
in good standing to apply for a Registered Dental
Hygienist license, which would require completion
of the National written examination and the State
clinical examination.
The bill was amended
before leaving the Assembly to provide that a successful
applicant may only practice in a dental practice
that serves patients who are insured under Denti-Cal,
the Healthy Families Program, or other governmental
programs, or a dental practice that has a sliding
scale fee system based on income. However, the
language is unclear as to whether the practice,
for example, need only serve one person in one
of the designated classes per year, or a majority
of time, or exclusively. In the Senate, the bill
was amended to require that the examination fee
for such applicants not exceed the actual cost
of the examination.
The bill has passed
the Assembly and the Senate, and has been enrolled,
but as of April 16, 2004, had not been sent to
the Governor.
b. SB1546 (Figueroa)
- Dental assisting scopes of practice
SB1546 was amended April
12th to define, in statute, the scope of practice
of dental assisting. Attached, along with a copy
of the bill, is a fact sheet prepared by the Alliance
which outlines all of the provisions of the bill.
Staff has provided the sponsors and the author
with suggestions and recommendations on certain
portions of the proposal from an administrative
point of view.
6. Review
of RDA Educational Programs and Courses
Staff and consultants
have reviewed the curriculum and conducted an on-site
evaluation of the following proposed full RDA educational
program, and it is recommended that COMDA recommend
provisional approval to the Board. COMDA staff
and consultants then perform another on-site inspection
of the program at a later date to assure that it
is operating appropriately, and then make a recommendation
as to whether the program should be granted full
approval.
a. Silicon Valley College,
Fremont
Any other programs or
courses that are ready for consideration by the
meeting date will be presented at the meeting.
7. RDA Practical
Examination Testable Procedures - Recommendation
of Subcommittee
At COMDA's last meeting,
it decided to ask that the RDA Practical Examination
Subcommittee review the proposed new duties for
RDAs (proposed changes to regulation Section 1086)
and determine which, if any, duties it might be
desirable/feasible to actually include on the RDA
practical examination. The additional duties include:
1. Pre-positioning and
curing in dentist-approved position of orthodontic
brackets. 2. Taking facebow transfers and bite
registrations. 3. Taking impressions for space
maintaining appliances, orthodontic appliances
and occlusal guards. 4. Other reversible dental
procedures, not listed in regulation.
The Subcommittee recommends
that none of the new duties be added to the list
of testable duties, as they are impractical to
test. (Note: The pass rate on the RDA practical
examination has been relatively stable for some
time.)
8. Required
Coronal Polishing and Radiation Safety Courses
for RDAs - Affidavit In Lieu of Certificate
A law enacted several
years ago as part of the Legislative Sunset Review
process at that time requires that all RDAs provide
evidence of having completed both a radiation safety
course and a coronal polishing course by January
1, 2005. Unless such evidence is received, the
license of the RDA is automatically suspended.
(Note: It is anticipated that legislation will
be introduced this session to extend that deadline
to January 1, 2006.)
COMDA has notified all
RDAs of this requirement, but has heard from many
that they have lost or misplaced their certificates.
If they completed a course many years ago, the
course provider may no longer be in business, or
if they are, they may not have kept records for
such a long period of time.
Members of the public
have asked that COMDA consider allowing an RDA
whose radiation certificate and/or coronal polishing
certificate has been destroyed, lost, or misplaced,
to file an affidavit of completion under penalty
of perjury.
Following is the text
of the law in question:
1645.1. Required completion
of radiation safety and coronal polishing courses
By January 1, 2005, each person who holds a registered
dental assistant license shall provide evidence
of having successfully completed board-approved
courses in radiation safety and coronal polishing.
The length and content of the courses shall be
governed by applicable board regulations. Failure
to comply with this section shall result in automatic
suspension of the license which shall be reinstated
upon the receipt of evidence that the licensee
has successfully completed the required courses.
Completion of the courses may be counted toward
fulfillment of the continuing education requirements
governed by Section 1645.
9. Proposed
Changes to Regulations 1014 and 1014.1 - Approval
of Radidation Safety Programs
Regulation sections
1014 and 1014.1 define the requirements that providers
must meet to obtain and maintain Board approval
to offer radiation safety courses.
Attached are proposed
amendments that will be presented by Vice Chair
Drury-Klein. Also attached are comments on a prior
version of the proposed changes received from CDA
and the Alliance, as well as a 2-page sheet indicating
why certain changes proposed by CDA and the Alliance
were not included in the revised proposed changes.
10. Appointment
of New RDA Examiners
The RDA Practical Examination
Subcommittee recommends that COMDA recommend that
the Board appoint the following new RDA examiners:
Kristie Nunes - North
- Chico Mary Holm - North - Orland Mary Jenkins
- North - Corning Sheronda Walton - South - Palmdale
11. Appointment
of Chief and Assistant Chief Examiners
COMDA's RDA Practical
Examination Subcommittee has appointed Charlene
Flowers as Chief Examiner, and Cassandra Elston
as Assistant Chief Examiner.
Pursuant to COMDA policy,
the appointments are valid unless COMDA chooses
to revoke the Subcommittee's decision.
12. Proposed
Restructuring of EF Examination Subcommittee
The EF Examination Subcommittee,
as defined by COMDA in the past, consists of a
Chair, who is An EF COMDA member or other EF appointed
by COMDA, a DDS COMDA member, an EF Dental Board
member (if one exists), and the two Chief Examiners.
The Chair also serves as the "EF Coordinator",
overseeing the administration of the examination
including oversight of examiner training.
Several years ago, the
constitution of the Subcommittee was changed as
indicated above in order to allow COMDA to appoint
an EF to the Chair and Coordinator positions who
is not a member of COMDA, because of the possibility
that future appointments to COMDA would not include
an EF licensee, which is currently the case.
Rhona Lee, RDHEF, was
the immediate past Chair of COMDA, and served as
such for more than two terms, and was also the
EF Subcommittee Chair and EF Coordinator. The past
COMDA appreciated her efforts to such an extent
that they expressed their belief that it would
be extremely beneficial if she were appointed by
a future COMDA as the EF Subcommittee Chair and
EF Coordinator (if no other EF was appointed to
COMDA in the future) once she had completed the
one-year mandatory period as a non-member of COMDA.
The EF Subcommittee
would benefit a great deal by the guidance of an
EF who has experience as a COMDA member. Rhona
Lee commanded a huge amount of respect from all
of the examiners and the two Chiefs, not to mention
the other COMDA members and the various people
with whom COMDA interacts. COMDA may want to consider
appointing her as the EF Subcommittee Chair and
Coordinator, with certain reporting requirements
to COMDA.
13. Recommendation:
Board Appointment of Subcommittee to Review
RDH Law and Ethics Examinations and RDHAP Law
and Ethics Examinations
Two regulatory change
proposals have been approved by the Board and are
under review either within the Department of Consumer
Affairs or OAL: one would require that RDH applicants
complete examinations in law and ethics as a condition
of licensure, and the other would replace the current
examination for RDHAPs with examinations in law
and ethics only.
The examinations are
currently being developed by COMDA staff. Staff
recommends that a subcommittee, perhaps of two
of the COMDA RDH members, review the final products.
It is proposed that the examinations not be reviewed
by the entire COMDA to assure exam security.
Staff also recommends
that COMDA recommend to the Board that it also
appoint a subcommittee of two Board members, one
of them the RDH member, to review the examinations
approved by COMDA's subcommittee, and make appropriate
recommendations to the Board's Examination Committee,
again, without actual review by the Examination
Committee to assure the security of the examination.
14. Appointment
of New RDH Examiners
The RDH Examination
Subcommittee recommends that COMDA recommend that
the Board appoint the following new RDH examiners:
Christine Dawson - South
- La Habra Ann Havlik - North - San Luis Obispo
Lisa Galasso - South - Huntington Beach Paulina
Jo Attebery - South - South Pasadena
15. Review
of Necessity/Desirability of RDHAP Prescription
Requirement
In COMDA's October,
2002, Supplemental Report to the Joint Legislative
Sunset Review Committee, COMDA recommended that
the existing requirement that an RDHAP may only
perform services independently upon the receipt
of a prescription from a licensed dentist be eliminated.
While that recommendation was not implemented by
the Legislature, this newly-constituted COMDA may
want to consider what position it wishes to take
on the issue.
Following are excerpts
from the October, 2002, Supplemental Report. References
to the "report" are to the report issued
on September 1, 2002, by Sjoberg & Evashenk
Consulting, LLC, titled "Review of the Regulatory
Structure and Scope of Practice for California's
Dental Auxiliaries". Sjoberg & Evashenk
were hired by the Dental Board to complete the
report, which was mandated by legislation that
resulted from the 2000 sunset review process.
The following is quoted
from COMDA's Supplement Report, which makes reference
to the "report" issued by Sjoberg & Evashenk:
The report notes: "In
the existing RDHAP environment, patients must be
'of record' or first examined and diagnosed by
a physician or dentist before any procedures can
be delegated to a dental auxiliary….However,
this requirement can present a considerable barrier
in the path to providing basic preventive services
to underserved populations. By definition, these
are the very patients that are least likely to
have access to a dentist or physician. In settings
such as "dental health professionals shortage
areas" or in programs seeking to provide preventive
services to school children or rural farm workers,
first obtaining an examination and prescription
from a physician or dentist may effectively prevent
an individual from obtaining dental care." {p.
35}
B&P Section 1770(h)
states:
"(h) A registered
dental hygienist in alternative practice may perform
dental hygiene services for a patient who presents
to the registered hygienist in alternative practice
a written prescription for dental hygiene services
issued by a dentist or physician and surgeon licensed
to practice in this state who has performed a physical
examination and a diagnosis of the patient prior
to a prescription being provided. The prescription
shall be valid for a time period based on the dentist's
or physician and surgeon's professional judgment,
but not to exceed 15 months from the date that
it was issued."
Current law also provides
that "A registered dental hygienist in alternative
practice shall provide to the board documentation
of an existing relationship with at least one dentist
for referral, consultation, and emergency services."
Section 1090(c) of the
Board's regulations also provides as follows:
"1090…(c)
Independently and without the supervision of a
licensed dentist, an RDHAP may, upon the prescription
of a dentist or a physician and surgeon licensed
in California, perform the duties assigned to a
registered dental hygienist by Section 1088(c)."
COMDA concurs with the
report's conclusion that "the state should
consider alternatives for the prescription and
patient of record requirements." {p. 35}
The report presents
two different alternative models: the Physician
Assistant in California, and Public Health Supervision
Status for RDHs in the State of Maine. Both examples
call for some type of "standing orders" or
other types of supervisorial oversight by a licensed
dentist.
The report also examined
the State of New Mexico, which provides for a "collaborative
practice dental hygienist", allowing experienced
dental hygienists form an agreement with a dentist
whereby standing orders are issued and all records
must be forwarded to that dentist. The report notes "{New
Mexico} Board officials believe that dental hygienists
have found it difficult to arrange a collaborative
agreement with a consulting dentist." {p.
64}
Adoption of a model
similar to those described above would seem to
be even more restrictive than the current requirement
that a physician or dentist first examine and diagnose
a patient before referring the patient to a RDHAP
via a prescription.
Those models seem to
focus on oversight of the practitioner's ability
to provide appropriate and competent hygiene care,
which is not the assumption underlying the current
prescription requirement.
Rather, the current
model seems to rest on the assumption that examination
by a physician or dentist will identify, and address,
oral health conditions that would not be recognized
by the RDHAP.
However, the effectiveness
of this assumption seems to be questioned by the
report's previously cited finding that "first
obtaining an examination and prescription from
a physician or dentist may effectively prevent
an individual from obtaining dental care" {p.
35} in under-served areas and for certain populations.
In fact, dental hygienists
were allowed to practice independently for 16 years
under two Health Manpower Pilot Projects prior
to the establishment of the RDHAP license category.
During those 16 years, there was no prescription
requirement and there is no evidence that any public
harm occurred.
COMDA received written
and oral comments from 12 of the existing 21 licensed
RDHAPs, all of whom indicated that the prescription
requirement has been a considerable barrier to
providing services to those who need them most.
No evidence was presented to COMDA indicating that
harm would occur if the prescription requirement
were eliminated.
COMDA therefore recommends
that the prescription requirement be eliminated,
as proposed in Section 1775.
COMMITTEE
ON DENTAL AUXILIARIES
Draft
Meeting Minutes - May 12, 2004
Members Present:
LaDonna Drury-Klein, RDA, Vice Chair; Linda Gipson,
RDH, Secretary; Teresita Churchill, RDA; Darla
Dale, RDH; Coragene Savio, DDS
Members Absent:
Shanda Wallace, RDH, Kevin Biggers, public member;
Marlyn Hiroto, RDA; Sonia Molina, DDS
Staff Present: Karen
R. Wyant, Executive Officer; Dyna Leonard, Associate
Analyst; Lori Hubble, Staff Analyst; Norine Marks,
DCA Legal Counsel; Donna Kantner, Staff
1. Call to
Order/ Roll Call/ Establishment of Quorum
Acting Chair Drury-Klein
called the meeting to order at 1:35 p.m.; roll
was called by Secretary Gipson and a quorum established.
2. Approval
of January 29, 2004 Meeting Minutes
Minutes of the January
29, 2004 COMDA meeting were accepted with the following
changes: Page 2, next to last paragraph should
read "JoAnn Galliano, CDHA". Page 4,
Item 10, Chair Drury-Klein noted that there was
public comment regarding those regulations that
were heard and recorded at that time and asked
that those statements be referred to staff to add
as appropriate. Page 4, Final paragraph, should
read "Drury-Klein noted that CDAA and others
would also be asked for their input", not
CDHA.
Page 5, Item #14 should
read " JoAnn Galliano, CDHA, noted that COMDA's
meetings have taken place on Wednesdays and sometimes
the Board has Subcommittee meetings on Wednesday
as well, so this may or may not resolve those conflicts.
She asked that the Board recognize and acknowledge
the move of the meeting to ensure that there would
be no conflict. Drury-Klein offered to apprise
the Board and Board's staff of the change."
3. Report
of the Chair
The Chair's report was
deferred by Acting Chair Drury-Klein due to the
absence of Chair Wallace.
4. Report
of the Executive Officer
Executive Officer Wyant
reported that she had met with new Department of
Consumer Affairs Director Charlene Zettel, who
is an RDH, and Agency Secretary Fred Aguiar noting
that there seemed to be support for specially funded
agencies such as COMDA being treated differently
than general fund agencies as far as funding and
staffing.
Wyant reported that
Director Zettel would be recusing herself from
reviewing any dental-related matters, due to her
background in the field, noting that while Boards
are autonomous, certain powers still lie within
the Department through the regulatory and budget
process.
She reported that the
EF and RDHAP examinations were being held this
weekend. She noted that in the future, the RDHAP
will be a Law and Ethics examination only, as a
regulation change will become effective sometime
in June. She noted that there had been 58 RDHs
licensed through licensure by credential, with
15 pending.
She also reported that
the budget will be very tight, as COMDA will come
within $1,000 of expending its entire $1.3 million
budget, noting that the budget had been reduced
by $60,000 as the result of a mandatory statewide
budget reduction. She reported that there is currently
a bill by Senator Figueroa to codify that special
funds be treated differently than general funds.
Wyant further reported
that regulation 1079.3 has been approved, and all
other regulations are in the Department awaiting
approval. She noted that she continues to receive
calls, so they are being actively reviewed, adding
that 1072.1, the regulation regarding RDH Educational
programs, will be heard by the Board on Friday.
Wyant noted that updated
Examination statistics are in the packet for COMDA's
review. Member Savio asked what is the expense
of reviewing the RDH Licensure by Credential candidates.
Wyant indicated that staff member Lori Hubble performs
in-house review of all LBC applications, so there
is no additional cost associated with that program.
JoAnn Galliano asked if the Law and Ethics examination
that will be given to RDHAPs will be the same one
given to RDHs, and Wyant noted that it would not.
5. Legislation
of Interest to COMDA
a. AB539 - 3rd and 4th
Year Dental Students applying for RDH licensure
Executive Officer Wyant
reported that AB539 has been enrolled, but has
not yet been sent to the Governor for consideration.
b. SB136 (Figueroa)
- Delays Requirement for Radiation Safety and Coronal
Polishing Certification for RDA licensure for one
year
Wyant noted that this
is an omnibus bill, and the item of interest to
COMDA is that it will delay the requirement that
all currently licensed RDAs show proof of completion
of Radiation Safety and Coronal Polishing certification
for one year, as well as only require inactive
RDAs to show proof of certification when they reactivate
their licenses. She indicated that this is an urgency
bill which will be effective upon signature by
the Governor, rather than January 1st as is true
of most bills.
c. SB1546 (Figueroa)
- Scope of Practice for Dental Assisting
Wyant drew COMDA's attention
to the Amendments Summary provided by The Alliance
included in the packet, noting that a recent amendment
of the bill has entirely stricken Sections 24 and
27. She explained that essentially the bill would
create three areas of certification - Restorative,
Orthodontic or Surgical. She explained that applicants
would be required to take Dental Board approved
courses to become certified in each of these areas,
and that the RDA practical and written examinations
would be eliminated. The bill would also require
dental assistants to complete Board approved courses
in Infection Control and California law.
Tim Hart, CDA, noted
that Wyant had proposed some changes to the legislation
that they were reviewing, but he foresaw no problems
since the issues were mostly technical. In response
to a question from Chair Drury-Klein regarding
the effective date of the legislation, Hart advised
that it would take effect as of January 1, 2007,
with the exception of RDAs being allowed to do
pit and fissure sealants in public health settings,
which would be effective January 1, 2005.
Executive Officer Wyant
reported that for future discussion, it came out
of the meeting with the Director that some other
agencies find it more cost-effective to renew licenses
every four years. Wyant noted that with the low
cost of the renewal fee, $35 for the two-year renewal,
perhaps COMDA would wish to explore this option
in the future.
Linda Madden, Dental
Board, reported that after discussion this morning
in the Business and Professions Committee, SB 1239,
which extended the sunset dates for COMDA and the
Dental Board appears dead, so the extension of
sunset dates will be addressed in SB 1546.
6. Review
of RDA Educational Programs and Courses/ Recommendations
to the Board
It was M/S/P(Savio/Gipson)
to recommend provisional approval to the Dental
Board for the Dental Assisting program at Silicon
Valley College in Fremont.
7. RDA Practical
Exam Testable Procedures - Recommendation of
Subcommittee
Executive Officer Wyant
noted that the Subcommittee had reviewed all of
the potential new RDA duties contained in the pending
regulatory changes, and recommended that they not
be tested at it is not feasible or practical for
these particular procedures.
It was M/S/P (Gipson/Savio)
to accept the Subcommittee's recommendation.
8. Required
Coronal Polishing and Radiation Safety Courses
for RDAs - Affidavit in Lieu of Certificate
Executive Officer Wyant
noted that the statute requires "proof of
completion", however many licensees have lost
their documents or they have been destroyed, and
they are unable to obtain duplicates because their
school has closed. She reported that she had been
approached regarding an affidavit being sworn under
penalty of perjury and asked if COMDA would wish
to pursue something along that line.
Lana Wright, educator,
noted that she had taught at a school who is no
longer in business, so if a person can prove graduation
from a program that required Coronal Polishing
and Radiation Safety as a component, then that
should be considered. Tim Hart felt that CDA would
most likely support an affidavit in hardship circumstances,
with penalties for falsification.
Wyant noted that staff
could delineate some recommendations to bring back
to the next meeting. Drury-Klein offered to assist
staff in this matter. Wyant noted that if the deadline
is extended to January 1, 2006 by legislation,
there will not be such urgency to the issue. It
was M/S/P (Savio/Gipson) to defer to next meeting,
when staff will present recommendations.
9. Proposed
Changes to Regulations 1014 and 1014.1 - Approval
of Radiation Safety Programs
Executive Officer Wyant
noted that included in the packet were proposed
changes developed by Chair Drury-Klein, along with
The Alliance's and CDA's proposed changes. Tim
Hart, CDA, supported adoption of the proposed regulations,
noting one of the changes suggests using a term
more flexible than "darkroom". He reported
that of 47 internship sites, 46 have digital equipment
and the 47th is upgrading. He encouraged COMDA
to adopt the proposed changes. It was M/S/P(Churchill/Dale)
to accept the proposal with the changes and recommend
that the proposed changes be set for hearing by
the Dental Board.
10. Appointment
of New RDA Examiners
Drury-Klein noted that
the Subcommittee recommends approval of Kristie
Nunes, Mary Holm, and Mary Jenkins (North) and
Sheronda Walton (South) as new RDA Examiners. It
was M/S/P(Savio/Gipson) to approve, and recommend
approval by the Dental Board.
11. Appointment
of Chief and Assistant Chief Examiners
Wyant noted that the
RDH Subcommittee has made the selection of Chief
and Assistant Chief, which only requires action
if COMDA wishes to revoke the Subcommittee's action.
COMDA approved the Subcommittee's action.
12. Proposed
Restructuring of EF Examination Committee
Chair Drury-Klein noted
that Executive Officer Wyant had given an excellent
history and reasons for the proposal. Member Savio
asked if Rhona Lee's proposed appointment as Chairperson
would continue indefinitely with no term imposed.
She asked if COMDA wants the coordinator to be
an EF or a Dentist , believing that this is a stopgap
measure. She asked who has been performing these
duties during the past year. Wyant noted that staff
and the EF Examiners have been handling the functions
in the interim that there were no COMDA EF members,
explaining that expertise in the process is required.
It was M/S/P(Savio/Gipson)
that Ms. Lee be appointed for a four-year term,
with the specification that training of a subsequent
Committee Chair be directed.
13. Recommendation:
Board Appointment of Subcommittee to Review
RDH Law and Ethics Examinations and RDHAP Law
and Ethics Examinations
Executive Officer Wyant
felt that a two-member Subcommittee could be established
to review the proposed Law and Ethics Examination
developed by staff and that their recommendation
be reviewed by a two-member committee appointed
by the Board's Examination Committee Chair. JoAnn
Galliano, CDHA, asked if an RDH COMDA Member appointed
to this review Subcommittee becomes an RDHAP, would
that compromise exam security. Wyant noted that
there will be a bank of items that will be rotated,
but the intent of the exam is not necessarily to
test knowledge, but also for the candidate to gain
knowledge and be aware of the law and ethical practice.
She indicated that there are not the usual exam
security issues.
It was M/S/P(Savio/Dale)
that the Chair appoint a two-person Subcommittee
to review the examination, and that it be recommended
to the Board that its Examination Committee Chair
appoint a two-person committee to review their
recommendation. .
14. Appointment
of New RDH Examiners
The RDH Examination
Subcommittee recommended that Christine Dawson,
Lisa Galasso, and Paulina Jo Attebery (South) and
Ann Havlik (North) be appointed as new RDH Examiners.
It was M/S/P(Churchill/Savio) to approve and to
refer the matter to the Dental Board for approval..
15. Review
of Necessity/Desirability of RDHAP Prescription
Requirement
Executive Officer Wyant
asked if the new COMDA wished to review this issue,
as during the review of duties and Sunset Review
process it was recommended by the COMDA that existed
at that time that this requirement be eliminated.
Wyant continued that the Consultant stated in their
report to the Legislature that the prescription
requirement should be changed, however COMDA at
that time disagreed with the Consultant's proposed
options, considering them to be even more restrictive
than a prescription requirement. Wyant noted that
this issue is before COMDA for its consideration.
Member Savio saw no
need for change. Member Dale disagreed, noting
that she lives in a rural area where it is a very
large barrier to care, and felt that the entire
oral health condition is evaluated by the hygienist.
Member Savio felt that the prescription was necessary,
as a dentist would also evaluate the patient and
that way the patient would be informed twice of
any conditions that should be addressed.
JoAnn Galliano, CDHA,
noted that the initial Health Manpower Projects
leading up to the legislation did not require a
prescription, adding that studies showed that rather
than seeing less dental care, more dental care
was sought by patients seen by RDHAPs. She stated
that the prescription requirement was something
that simply had to be agreed to at the time for
the bill to be enacted. She noted that RDHAPs working
in nursing homes have difficulty getting a prescription,
and liability insurance is sometimes an issue.
She felt that the requirement definitely restricted
access for some and was simply unnecessary, since
there is no proven harm to the consumer.
Member Savio noted that
physicians are on staff at all nursing homes, so
it should be easy to obtain a prescription. JoAnn
Galliano agreed that some facilities have an on-site
physician, but not all do, and some have no dentist
on staff at all. Tim Hart, CDA, noted that other
policy issues are at play here. He stated that
this change would require legislative action, and
a better goal would be to improve access to care.
He offered CDA's collaboration on any evidence
that the prescription requirement is a barrier
to care.
Chair Drury-Klein asked
to defer this issue until the next COMDA meeting,
and asked that any information on this item be
sent to Executive Officer Wyant by the end of June.
Wyant noted that she would bring the information
from the Health Manpower Pilot Projects and the
Sunset Review process to the next meeting.
Member Dale noted that
she is in an extremely rural area where clinics
have a waiting list of 6 to 8 months to see a physician.
She stated that in such areas where care is the
most needed, it is the least available, and this
is where the prescription requirement is a noticeable
barrier to care.
16. Review
of Last COMDA Strategic Plan
Executive Officer Wyant
noted that the Plan is outdated, as it was coming
up for review when a quorum of COMDA was lost,
then the new board was appointed. She indicated
that this is an important working document, since
funding requests are always predicated with "Where
is this in your Strategic Plan?". She noted
that this item is informational, no motion is necessary,
but asked that members seriously read and consider
what changes should be made during the August or
November COMDA meeting.
17. Agenda
Items for Future Meetings
Chair Drury-Klein asked
that the course approval requirements be reviewed
for Coronal Polishing and Ultrasonic Scaling along
the same vein as was done for pit and fissure sealants.
Executive Officer Wyant
noted that the changes in duties that have been
held up in the regulation moratorium will have
major impacts to the EF programs and examination,
and these should be discussed at COMDA's next meeting.
18. Public
Comment
None.
19. Adjournment
The meeting adjourned
at 2:45 p.m. |
