STATE OF WISCONSIN
Dentistry Examining Board
IN THE MATTER OF RULE-MAKING PROCEEDINGS BEFORE THE
DENTISTRY EXAMINING BOARD
PROPOSED ORDER OF THE DENTISTRY EXAMINING BOARD
ADOPTING RULES
(CLEARINGHOUSE RULE )
PROPOSED ORDER
An order of the
Dentistry Examining Board
to
create DE 10 relating to mobile dentistry.
Analysis prepared by the Department of
Safety and Professional Services
.
---------------------------------------------------------------------------------------------------------------------
ANALYSIS
Explanation of agency authority:
Each examining board shall promulgate rules for its own guidance and for the guidance of the profession to which it pertains, and define and enforce professional conduct and unethical practices not inconsistent with the law relating to the particular profession. s.
15.08
(5)
(b)
The examining board shall promulgate rules specifying
: a requirement that a mobile dentistry program registrant establish procedures for a patient treated in the mobile dentistry program to
access
his or her patient records; standards of conduct for the operation of a mobile dentistry program in this state, the provision of dental services through a mobile dentistry program and the use of portable dental equipment; and
a definition of “mobile dentistry program: and the activities that constitute the operation of a mobile dentistry program for purposes of the registration requirement under s.
447.058
.
ss.
447.02
(2)
(f)
,
(g)
and
(h)
, Stats.
Related statute or rule:
Plain language analysis:
Chapter
DE
10.01 defines mobile dentistry program as a program which uses portable equipment or supplies
in a
location that is not a dental or hospital facility or is a self-contained facility that moves. The definition excludes
the following:
dental or den
tal
hygiene
care provided within a 30 mile radius of a main or satellite facility provided the care is billed by that facility and necessary follow-up care is being provided by the dentist or dental hygienist; the care is being provided to no more than 2 per day to a new or established patient of record of a main or satellite dental facility; and the Department of Health conducting screenings as part of the Centers for Disease
Control and Prevention surveys. The first two exceptions allow for a dentist or dental hygienist to make “house calls” and the last recognizes the unique nature of the survey screenings.
Chapter
DE
10.02
creates the registration requirements. An applicant would be required to fill out an application, pay a fee, and provide a list of all employees or contractors who are providing dental or dental hygiene care and their Wisconsin dentist or dental hygienist license number. A renew fee requires a renewal form and fee and a current list of their employees or contractors. If a person owns or operates more than one mobile dentistry program, a registration is required for each program.
Chapter
DE
10.03 requires access to patient records. Each patient is to be provided with the name and contact information of the program and the registration number. At the time of providing services, the program is required to provide the patient with a written description of the services provided, the provider’s name and license number and the findings and recommendations. Mobile dentistry records are subject to the same rules governing a dentist or dental hygienist working in a dental facility. A mobile dentistry program is required to provide access to patient records.
Chapter
DE
10.04 requires a mobile dentistry program to have a written protocol
for follow-up care in a dental facility that is permanently established within a 60 mile radius of where the mobile dentistry services were provided. The protocol must include a written agreement with at least one provider for emergency treatment.
Chapter
DE
10.05 lists unprofessional conduct as a violation of the standards of conduct all licensed dentists and dental hygienists are required to maintain or the specific mobile dentistry access to patient records or written protocols. In addition, it is unprofessional conduct for a mobile dentistry program registrant to fail to update the department within 30 days of new employees or contractors providing dental or dental hygienist services in Wisconsin.
Summary of, and comparison with, existing or proposed federal regulation:
None
Comparison with rules in adjacent states:
Illinois
:
Illinois defines mobile dental vans and
portable
dental units as any self-contained or portable dental unit in which dentistry is practiced that can be moved, towed, or transported from
one location to another in order to establish a location where dental services can be provided. A dentist providing services through a mobile dental van or portable dental unit is to provide to the patient or the patient’s parent or guardian, in writing, the dentist’s name, license number, address, and information on how the patient or the patient’s parent or guardian may obtain the patient’s dental records.
Iowa
:
Iowa does not require the registration of mobile dentist
ry
programs.
Michigan
:
Michigan defines mobile dentistry as a self-contained, intact facility in which dentistry or dental
hygiene
is practiced that may be transported from one location to another or a site used on a temporary basis to provide dental services using portable equipment.
An application shall include: a list of each dentist, dental hygienist and dental assistant who will provide care including each individual’s name, address, telephone number and license number; a written plan and procedure for providing emergency follow-up care to each patient; a signed memorandum of agreement between the operator and at least one dentist who can arrange for or provide follow-up services at a site within a reasonable distance for the patient; if provides only preventative services, a signed memorandum of agreement for referral for comprehensive dental services between the operator and at least 1 dentist; and proof of general liability insurance covering the mobile dental facility. If an operator has a memorandum of agreement due to its status as a state of Michigan designated or funded oral health prevention program with oversight from the department of community health, the operator is exempt from any requirement concerning a memorandum of agreement.
The patient shall be provided a copy of a written treatment plan which shall address comprehensive services to be provided either at the mobile dental facility or through a dentist under a memorandum of agreement with the operator of the mobile dental facility. If the operator is unable to make arrangements for continued treatment, he or she shall place written documentation of the attempts in the patient record and make the documentation available to the department upon request. The operator shall provide access to records upon request.
Minnesota:
Minnesota does not require the registration of mobile dentistry programs.
Summary of factual data and analytical methodologies:
The Board formed a committee which looked at the proposals from stakeholders as well as reviewing other states’ laws. The committee and Board spent considerable time discussing issues relating to the definition of mobile dentistry programs and protocols for follow-up care balancing the accessibility of the programs to operate in the state with the safety of the public.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact
analysis
:
The rules were posted for economic comments for 14 days. One comment was received requesting an exemption from the rule for mobile dentistry programs receiving partial funding from the state. The Board invited Matt Crespin of Children’s Health Alliance of Wisconsin to a meeting to discuss his economic concerns.
Mr. Crespin focused on exempting his programs and
not on the economic impact on mobile dentistry programs in general.
The Board decided not to make changes to the rule to mitigate the economic impact to programs receiving state funds.
Throughout the rule promulgation process, the Board solicited comments from stakeholders. A main concern of all stakeholders is for patients
treated by a
mobile dentistry program
to obtain follow-up care
. The Board considered many alternatives to reach
this objective with a goal for the rule to not be a burden on small businesses. Requiring a mobile dentistry program to have protocols for follow-up care, including a written agreement for
emergency care meets the objective of protecting public health but not burdening businesses.
Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis is attached.
Effect on small business
:
These proposed rules may have an economic impact on small businesses, as defined in s.
227.114 (1)
, Stats.
and
are submitted to the Small Business Regulatory Review Board for a determination on whether the rules will have a significant economic impact on a substantial number of small businesses. The Department’s Regulatory Review Coordinator may be contacted by email at
Eric.Esser@wisonsin.gov
, or by calling (608) 267-2435
Agency contact person
:
Sharon Henes, Administrative Rules Coordinator
, Department of
Safety and Professional Services
, Division of Board Services, 1400 East Washington Avenue, Room 151, P.O. Box
8366
, Madison, Wisconsin 53708; telephone 608-
261-2377
; email at
Sharon.Henes
@wisconsin.gov
.
Place where comments are to be submitted and deadline for submission
:
Comments may be submitted to
Sharon Henes, Administrative Rules Coordinator,
Department of
Safety and Professional Services
, Division of Board Services, 1400 East Washington Avenue, Room 151, P.O. Box 8
366
, Madison, WI 53708-
8366
, or by email to
Sharon.Henes
@wisco
ns
in.gov
. Comment
s must be received at or before the public hearing to
held
on January 6, 2015
to be included in the record of rule-making proceedings.
---------------------------------------------------------------------------------------------------------------------
TEXT OF RULE
Section
1. Chapter
DE 10
is created to read:
MOBILE DENTISTRY
DE 1
0
.01 Definitions
.
In this chapter:
(1)
“Mobile dentistry program”
(a) Mobile dentistry program means a program delivering dental or dental hygiene care in one of the following:
1. Using portable equipment or supplies that are transported to any location that is not an intact dental or hospital facility.
2. In a self-contained, intact facility that can be moved.
(b) A program providing dental or dental hygienist care is not a mobile dentistry program if it meets one of the following requirements:
1. The dental or dental hygiene care is provided within a 30 mile radius of their main or satellite facility and all of the following:
a. The care is billed by the main or satellite dental facility.
b. The dentist or dental hygienist provides any necessary follow-up care to the patient.
2. The
dental or dental hygiene
care is being provided to
a new or established patient of record of the main or satellite dental facility and
no more
than
2
patients
per day
are being treated using portable equipment or a self-contained, intact facility that can be moved
.
3. Department of health conducting surveillance screenings as part of the state oral disease prevention program cooperative agreement with the Centers for Disease Control and Prevention, Division of Oral Health.
(2)
“Mobile dentistry program registrant” means a person registered under s.
447.058
, Stats.
DE 1
0
.02 Mobile dentistry program registration.
(1)
Registration required.
(a)
No person may own or operate a mobile dentistry program in this state unless the person is registered under this section. A person that wishes to own or operate more than one mobile dentistry program in this state shall apply for a separate registration under this section for each mobile dentistry program the person owns or operates.
(b) A mobile dentistry program providing dental hygiene as defined by s.
447.01
(3)
, Stats.
or
dentistry as defined by s.
447.01
(8)
, Stats. constitutes the operation of a mobile dentistry program and requires registration.
(2)
Registration.
An applicant for registration to own or operate a mobile dentistry program shall submit all of the following:
(a) An application for registration on a form provided by the department.
(c) A list of all employees or contractors who are providing
dental or dental hygiene
care in Wisconsin. The list shall include the Wisconsin license number for each person providing
dental or dental hygiene
care.
(3)
Renewal.
A mobile dentistry program registrant renewing a registration shall submit all of the following:
(a) A renewal form provided by the department.
(b) The renewal fee as determined by the department under s.
440.03
(9)
(a)
.
(c) A list of all employees or contractors who are providing
dental or dental hygiene
care in Wisconsin. The list shall include the Wisconsin license number for each person providing dental care.
DE 1
0
.03 Access to patient records.
The mobile dentistry program registrant shall do all of the following:
(1)
Provide each patient with the name and contact information of the mobile dentistry program and registration number providing services.
(2)
At the time of providing services, give each patient a written description of the dental services provided for that patient, any provider’s name and license number, and the findings and recommendations.
(3)
Maintain patient dental records in accordance with ch.
DE 8
, Wis. Admin. Code.
(4)
Provide access to dental records in accordance with s.
146.83
, Stats.
DE 10.04
Pro
tocol
for follow-up care.
There is a written pr
otocol
for follow-up care for patients treated in the mobile dental
program
in a dental facility that is permanently established within 60
mile radius
of where services
were provided. The protocol shall include a written agreement with at least one provider for emergency treatment.
DE 1
0
.0
5
Standards of
c
onduct
. Unprofessional conduct by a mobile dentistry program registrant includes any of the following:
(1)
Failure to update the Department within 30 days of new employees or contractors providing dental or dental hygienist services in Wisconsin.
(3)
Engaging in unprofessional conduct under s.
DE 5.02
.
Section
2. EFFECTIVE DATE.
The rules adopted in this order shall take effect on the first day of the
third
month following publication in the
Wisconsin
administrative register, pursuant to s.
227.22 (2) (intro.)
, Stats.
---------------------------------------------------------------------------------------------------------------------
(END OF TEXT OF RULE)
---------------------------------------------------------------------------------------------------------------------
