On September 20, 2017, the Michigan Senate Committee on Health Policy recommended Senate Bill 541 (2017) (the “Bill”), which would authorize licensure for dental therapists in Michigan. The Bill would allow licensed dental therapists to perform certain dental services under the supervision of a dentist pursuant to a written practice agreement. Specifically, the Bill would accomplish the following.
- Establish qualifications for dental therapist licensure, including education, examination and completion of 500 hours of directly supervised clinical practice. “Direct supervision” means that the supervising dentist must: (i) designate a patient for procedures and describe such procedures; (ii) examine the patient before prescribing the procedures and after completion; and (iii) be physically present in the office when the procedures are being performed.
- Prescribe the scope of practice for a dental therapist, including charting, x-rays, nonsurgical extractions and crown preparation and placement.
- Prescribe the health setting in which a dental therapist may practice. A dental therapist would be permitted to practice in any of the following health settings.
- Federally Qualified Health Centers
- Outpatient health programs or facilities operated by tribal organizations
- School-based health centers
- Dental shortage areas designated by the Department of Health and Human Services
- Mobile dental units serving a primarily underserved patient population.
- Allow a dental therapist to practice only under a written practice agreement with a supervising dentist and prescribe the elements that must be contained in the practice agreement.
- Permit a dental therapist to supervise up to three dental assistants and two dental hygienists if authorized in the practice agreement.
- Specify that a dental therapist who provided services or procedures beyond those specified in the practice agreement would be considered to have engaged in unprofessional conduct and subject to disciplinary action.
- Require a supervising dentist to arrange for, and require a dental therapist to provide a referral for, any necessary services that exceeded that dental therapist’s scope of practice.
- Include a dental therapist among the health care professionals who may use a dental assistant as a “second pair of hands.”
- Establish a continuing education requirement for renewal of a dental therapist license.
- Require the Michigan Board of Dentistry (the “Board”), in consultation with the Department of Health and Human Services, to complete a study on the impact of dental therapist licensure and report to certain entities.
- Include two dental therapists on the Board, beginning five years after the effective date of the Bill.
Dental therapy is a fairly new profession and the practice of dental therapy is currently only authorized in Maine, Minnesota, Oregon, Vermont and Washington. Sen. Mike Shirkey said that integration of dental therapists “could improve overall access to oral health care for underserved patients while allowing dentists to increase their revenues and modernize and expand their practices.”
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