By Jennifer Goodrum, CDA director of Government Relations
From the Spring 2016 Journal of the Colorado Dental Association
Every Colorado dental practice is governed by the Colorado Dental Board’s rules and policies. As shared with CDA members through email and social media, the Colorado Dental Board is currently conducting a comprehensive review of its rules and policies. Nearly all dental board rules along with all dental board policies are being reviewed and revised through this process. Be sure to take time to review and submit any feedback on proposed changes, as they will impact your dental practice!
The Process
Applicable dental board rules and policies were split among four committees for review. Committees met throughout January and February 2016 and their recommendations on rule changes were presented to the full dental board on Feb. 24, 2016, for preliminary public input and review. CDA representatives participated on all dental board committees and at all rulemaking hearings to date.
Proposed Changes
Some of the key rules impacted by changes include:
- Recordkeeping (Rule IX)
- Anesthesia (Rule XIV)
- Protective Stabilization/Medical Immobilization (Rule XV)
- Infection Control (Rule XVI)
- Use of Lasers (Rule XXIV)
- Placement of Interim Therapeutic Restorations by Dental Hygienists (Rule XXV)
In addition to substantive changes, substantial streamlining and consolidation of rules was undertaken, as well as grammatical and formatting cleanups. A full copy of the rule markup is available on the CDA website.
After the rule revisions are finalized, the board will conduct a major rewrite of all board policies.
Your Input
We encourage all CDA members to review the proposed changes and provide comments and feedback. Final feedback may be presented to the full dental board in-person at a meeting April 28, 2016, at 8 a.m. (Conference Room 110D at 1560 Broadway, Denver, CO 80202). Written comments may also be submitted to maulid.miskell@state.co.us. Please send a copy of any written comments to jennifer@cdaonline.org. View additional details.
Colorado Dental Board Proposed 2016 Rule Revisions: Highlights of Substantive Changes
RULE PROPOSED CHANGES
Rule I. Definitions
- Clarify that any payment to the patient that exceeds the costs of original provided services is considered a reportable malpractice settlement.
Rule II. Financial Responsibility Exemptions
- A separate, emergency rulemaking is proposed for Rule II, as Rule II is scheduled to be repealed due to a legal challenge and HB15-1257.
- A 2011 version of this rule is being proposed to replace the current version with edits to provisions on inactive dental licenses and removal of exemptions for dental hygienists (HB15-1327 seeks to allow these exemptions to be restored).
Rule III. Licensure of Dentists and Dental Hygienists
- Add language from policies regarding calculation of work hours for demonstration of clinical competency.
- Add language from policies regarding organizations recognized for BLS training, including clarification that BLS credits do not count toward CE required to renew an anesthesia permit.
Rule IV. License Presentation
- Add language to address a temporary proprietorship by an unlicensed heir.
Rule V. Practice in Education and Research Programs
- No substantive changes.
Rule VI. Treatment Provider Identification
Rule VII. Patient Records Retention
Rule VIII. Patient Records in the Custody of a Dentist or Dental Hygienist
- Repeal.
- Incorporate relevant portions into Rule IX.
Rule IX. Controlled Substance Record Keeping Requirements
- Re-title and combine all recordkeeping rules in this section.
- Give the treating provider access to copies of records with patient consent.
- Limit charges for copies of records (no labor fees may be charged).
- Make adjustments to recognize electronic records.
- Outline detail on what information must be maintained in records (including requiring radiographs, periodontal screening by all specialists billing for a comprehensive exam, and rubber dams for endodontic procedures).
- Add records requirements for general prescription drugs (non controlled substances).
- Clarify controlled substance requirements by creating separate sections for prescribing and dispensing/administering.
- Add legibility and comprehensibility requirements for controlled substance records.
- Add cross references to recordkeeping requirements in other rules (i.e., anesthesia, passive restraint and lasers).
Rule X. Minimum Standards for Qualifications, Training and Education for Unlicensed Personnel Exposing Patients to Ionizing Radiation
- Add cross references to CDPHE regulations.
- Update terminology to “radiographic images” and increase training by .5 hours to ensure new technology (such as CT and portable equipment) is addressed.
- Adjust rule language to account for both digital and film equipment.
Rule XIV. Anesthesia
- Clarify situations that do not require an anesthesia permit – i.e., providing a dose of a single drug (not to exceed the manufacturer’s recommended dose) that can be given for unmonitored home use, and the single drug above plus nitrous oxide.
- Clarify that training hours and cases for permits may be obtained through residency programs in addition to other training pathways.
- Require that a dentist be actively practicing in Colorado in order to renew an anesthesia permit.
- Require an office inspection for a dentist that uses a non-dental board regulated professional (such as an anesthesiologist or CRNA) to administer moderate sedation or deep sedation/general anesthesia in his/her dental office.
- Reformat documentation requirements.
- Add requirements to record temperature and perform an airway assessment for pediatric patients.
- Add ventilator status and temperature monitoring requirements for deep sedation/general anesthesia.
Rule XV. Pediatric Case Management; Medical Immobilization/Protective Stabilization
- Rewrite based on current AAPD guidelines.
- Update to reflect current terminology (protective stabilization) and distinguish between passive and active techniques.
- Require training for dentist use of active and passive techniques.
NEW – Rule XVI. Infection Control
- Reference CDC and OSHA standards.
- Clarify that licensees are responsible for compliance of any unlicensed personnel.
Rule XVII. Advertising
- Changes to Rule XVII were tabled for now for further review by the attorney general’s office.
- Will revisit after initial rulemaking is complete.
Rule XVIII. Protocol for Termination of Practice Upon Revocation, Relinquishment, or Suspension for More Than 90 Days of Dental License
- Retitle and add protocols for termination and suspension from Rule XIX.
- Remove requirements to relinquish a physical copy of the license.
- Clarify timelines for cessation of practice and allowable roles in the practice.
- Extend the rule to dental hygienists in unsupervised practice.
Rule XIX. Protocol for Suspension of Dental License for Less Than 90 Days (Summary Suspension and Suspension of Less Than 90 Days)
- Repeal.
- Combined with Rule XVIII.
Rule XX. Compliance with Board Subpoena
- Clarify records that must be provided to the dental board in disciplinary cases.
Rule XXI. Declaratory Order
- No substantive changes.
Rule XXII. Practice Monitor Consultant Guidelines
- Repeal.
- Move relevant portions to Policy 1G.
Rule XXIII. Fining Schedule for Violations of the Dental Practice Act and Board Rules
- Adjust fining schedules for practicing on a lapsed or inactive license to reflect both the number of violations and amount of time elapsed.
Rule XXIV. Use of Lasers
- Remove grandfathering exemption for training requirements.
- Add requirement that laser training be live and interactive.
- Add recordkeeping requirements.
NEW – Rule XXV. Placement of Interim Therapeutic Restorations by Dental Hygienists
- Add new rule on dental hygienist placement of Interim Therapeutic Restorations addressing both requirements from the law and training requirements as recommended by the state ITR advisory committee.