Special Interest Groups

 

 

 

 3

 

Public Health

Did you know…Current law allows dental hygienists to apply for two separate permits allowing select services to children only or to adults and children in healthcare facilities and public health settings without the supervision of a dentist?

Permit #1: The public health permit to provide services to children only contains the following:

  1. Provide evidence of a current Nebraska dental hygiene license.
  2. Carry professional liability coverage.
  3. Complete and submit to DHHS a completed application form.
  4. Advise the patient or recipient that the services provided are preventive in nature and do not constitute a comprehensive dental diagnosis and care.

Duties allowable:

  1. Oral prophylaxis for healthy children who do not require prophylactic antibiotic coverage.
  2. Pulp vitality testing
  3. Application of fluorides
  4. Application of sealants and other topical agents for the prevention of oral disease.

Permit #2: The public health permit to provide services to children and adults contains the following:

  1. Provide evidence of a current Nebraska dental hygiene license.
  2. Show evidence of obtaining 3,000 clinical hours of practice.
  3. Carry professional liability coverage.
  4. Complete and submit to DHHS a completed application form.
  5. Advise the patient or recipient that the services provided are preventive in nature and do not constitute a comprehensive dental diagnosis and care.

Duties allowable:

  1. Oral prophylaxis
  2. Pulp vitality testing
  3. Application of fluorides
  4. Application of sealants and other topical agents for the prevention of oral disease

Health care or related facility means a hospital, a nursing facility, an assisted living facility, a correctional facility, a tribal clinic or a school based preventive health program.

Public health setting means a federal, state or local public health department or clinic, community health center, or other similar program or agency that serves primarily public health care program recipients.

What options are available to practice as an unsupervised PHRDH?

1. Apply for the public health permit

Two separate application forms are now available, depending on whether you are applying to provide services to only children or to children and adults.  Applications are available by clicking on the links below:

Permit #1 – Children only

Permit #2 – Children & Adults

2. Apply for a National provider identification number

All health care providers across the nation must obtain a National provider identification number. This is a federal requirement.

Required in ’07, Information here

3. Apply for a Medicaid provider number

All public health permit holders are encouraged to obtain a Medicaid provider number as all services allowed under this permit are reimbursed by Medicaid.

*Medicaid Direct Reimbursement to RDH Enrollment Forms are in the process of being updated.  for the time being, you may use these forms to enroll and we will update with the new forms once Medicaid has sent us the newest version.

The enrollment form and instructions can be found at the following website: http://dhhs.ne.gov/medicaid/Pages/med_providerenrollment.aspx

The form that needs to be completed is the MC-19.  Inquiries relating to Provider Enrollment should contact Medicaid’s Contact Center at 877-255-3092 or by email at DHHS.MedicaidProviderEnrollment@Nebraska.gov

DHHS NE OWNERSHIP-CONTROLLING INTEREST

NE SERVICE PROVIDER AGREEMENT INSTRUCTIONS

DHHS SERVICE PROVIDER AGREEMENT

NE ACH-EFT ENROLLMENT FORM

4. Read Nebraska statute 38-1130 and 38-1131 so you fully understand the law as it applies to practicing in public health settings.

Statutes 38-1130 & 38-1131

**As of October 1, 2013, statutes 38-1130 and 38-1131 have not been updated with the current law terminology allowing RDHs to provide select services to children and adults but will be updated soon. Please reference the NDHA website for correct language of this new law until the statutes have been updated.

Annual Reporting Requirements — Annual Reporting to the DHHS is required to maintain a public health authorization permit. DHHS will develop a form that all public health permit holders must complete and submit indicating the services that have been performed by the dental hygienist. We will include a link to this form once it becomes available.

 

Common Questions

What if I currently hold a public health authorization permit? Do I need to reapply?

Answer: The Dept. of Health & Human Services is in the process of creating a letter which will be sent to all current public health permit holders explaining the process. A new form will be included in the letter which must be submitted by the dental hygienist back to DHHS.  So technically, the answer is “NO”, if you currently hold a public health permit, you do not need to reapply. Simply wait to receive the letter from DHHS and comply with their requirements.

What does it cost to apply for either one of the permits?

Answer: There currently is no cost to apply for either permit.

Do I have to obtain a National provider number and a Medicaid provider number?

Answer: Regarding the National Provider Number – YES, all health care professionals who provide health services MUST obtain a national provider number. This is a federal requirement.

Regarding the Medicaid Provider Number – We strongly encourage all public health permit holders to obtain a Medicaid provider number as Medicaid does provide reimbursement for the functions allowed under this new law.

Can I take x-rays or provide root planing or other services under the new law?

Answer: Prophylaxis, pulp vitality testing, fluorides, sealants and preventive agents are the only services currently allowed under the public health permit. All other duties found in Statute 38-1131 are only allowed while working under the supervision of a dentist. These duties are listed below:

When properly authorized, a licensed dental hygienist, under the general supervision of a licensed dentist, may perform the following intra and extra oral procedures:

  1. Scaling of teeth, including subgingival regions and root planing with hand and ultrasonic instruments;
  2. Polish all exposed tooth surfaces with motor-driven and hand instruments in the oral prophylaxis procedure, including polishing amalgam restorations;
  3. Conduct preliminary charting and screening examinations;
  4. Periodontal probing and charting;
  5. Gingival curettage;
  6. Place and remove periodontal dressings;
  7. Remove sutures;
  8. Provide preventive measures, such as the application of fluorides, sealants, and other recognized topical agents for the prevention of oral disease;
  9. Provide impressions for study casts;
  10. Apply topical desensitizing agents;
  11. Provide radiographic exposures;
  12. Provide oral health education for patients including the teaching of appropriate plaque control techniques; and
  13. Perform or provide all of the duties that any dental assistant is authorized to perform.

When properly authorized, a licensed dental hygienist, under indirect supervision, may perform the following procedures:

  1. A licensed dental hygienist may monitor nitrous oxide analgesia under the indirect supervision of a licensed dentist.
  2. A licensed dental hygienist may administer local anesthesia under the indirect supervision of a licensed dentist.

 

 

 

 

Expanded Function RDH

 

Orofacial Myology

Orofacial myology is a specialized professional discipline that evaluates and treats a variety of oral and facial (orofacial) muscle (myo-) postural and functional disorders and habit patterns that may disrupt normal dental development and also create cosmetic problems. The principles involved with the evaluation and treatment of orofacial myofunctional disorders are based upon dental science tenets; however, orofacial myofunctional therapy is not dental treatment.