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Connecticut State Dental Association

Regulations (State & Federal)

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State Regulations

Dental Practice Act
Connecticut General Statutes: Chapter 379 - Dentistry

    Dental Hygiene Practice Act
    Connecticut General Statues: Chapter 379a - Dental Hygienists

    Dental Assistants 2017 Legislation

    Highlights of this legislation include:

    • After July 1, 2018 no dental assistant in Connecticut may perform any type of dental procedure unless the dental assistant has taken and provides records to a licensed dentist demonstrating successful completion of the Infection Control exam administered by the Dental Assistant National Board. All dental assistants who have earned the CDA certification before 6/1/93 or the COA certification before 6/1/94 and have not taken the ICE exam in the interim, will need to take the ICE exam before July 1, 2018.
    • After July 1, 2018 a dental assistant may have no more than 9 months of on-the-job training by a licensed dentist before taking this exam.
    • After July 1, 2018, all dental assistants will then be required to complete no less than one hour of training or education in infection control in a dental setting every two years.

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    Mercury Amalgam 
    Best management practices (BMP’s) replace the October 23, 2003 BMP’s for mercury amalgam and are intended to help dental practitioners comply with the requirements of Sections 22a-616(d) and 22a-622 of the Connecticut General Statutes (CGS) concerning the management of amalgam. 

    DEEP has also developed a Certification Form on which dental practitioners certify that their practice(s) or clinic(s) is in compliance with the state adopted BMPs.

    Amalgam Separator Inspection Form - Dentists in Connecticut, and now across the country, are required to perform inspections and keep records of such inspections for their amalgam separators. There is no prescribed form, you can make up their own, or you can use the sample form below one, or modify it if they choose. At some point in the future, the Department of Energy and Environmental Protection may randomly ask dental practices to submit inspection records as evidence of compliance with best management practices, specifically having and maintaining an amalgam separator. Please Note: This specific form doesn’t ensure compliance with all best management practices and you should become familiar with the DEEP standards.


    Opioid Prevention
    Public Act 17-131 requires various changes to prevent and treat opioid drug abuse.  Several of these items can impact dental practices that write prescriptions for opioids, including:

    • Requires prescribing practitioners to electronically transmit the controlled substance prescription to a pharmacy (effective January 1, 2018);
    • Requires practitioners, when prescribing opioids, to discuss with all patients, rather than only minors, the risks associated with opioid drug use;
      • All Schedule II, III, IV, and V controlled substance medications must be electronically prescribed
      • Electronically prescribed means to use a software system that is compliant with the Drug Enforcement Administration to electronically transmit prescription to a pharmacy. (It does NOT mean facsimile or email)
      • Exemptions exist to this regulation, including “lack of technological capacity”
      • The Department of Consumer Protection has sent out a brief questionnaire to each prescriber with an Active Control Substance Registration. Answers to the questionnaire will serve as the exemption.
      • Prescribers will have the ability to change/update their questionnaire (meaning if prescriber gets software after filling out the questionnaire, they will be allowed to update their information).
      • A pharmacist has a duty to determine if a prescription is valid whether it was transmitted electronically or otherwise permitted by law.
      • Prescribers are encouraged to document the reason for the written prescription on the prescription.
      • A pharmacist will be able to check if a prescriber has applied for the exemption from the EPCS requirement at www.elicense.ct.gov.
    • Anyone who does not wish to be issued a prescription for an opioid drug may file a “voluntary non-opioid directive”   form with a prescribing practitioner. Upon reviewing the form, the prescribing practitioner must document it in the patient’s medical record;
    • A prescribing practitioner shall not issue a prescription of an opioid drug to a minor for more than a five-day supply of such drug; and
    • By October 1, 2017, the Alcohol and Drug Policy Council (ADPC) is required to develop a one-page fact sheet on opioid drugs. The ADPC must make the fact sheet available on the Department of Mental Health and Addiction Services website. Health care providers are encouraged to disseminate the fact sheet to anyone they provide an opioid drug prescription to.
    Water Fluoridation in Connecticut 
    Fluoridation became a law in Connecticut on May 18, 1965, initiated by Public Act 156. Public Water Systems (PWSs) serving 50,000 or more were required to begin fluoridation on January 1, 1967, and PWSs serving 20,000 to 49,999 people were required to begin fluoridation on October 1, 1967. The amount of fluoride in many drinking water supplies is changed to a level to help reduce tooth decay and promote good oral health. Research studies have shown that water fluoridation is safe, effective and the best way to improve oral health in a community.

    HHS Fluoride Announcement


    Infection Control in Dental Practice and Regulatory Response
    The Department of Public Health is authorized under Connecticut General Statutes, 19a‐14(10)(11) to investigate complaints against health care practitioners. The Dental Practice Act which is defined in Chapter 379 of the Connecticut General Statutes allows the Department and the Board to seek disciplinary action under Section 20‐114 for “incompetence or negligent conduct toward a patient”.

    2016 Legislation Passed: An Act Concerning Various Revisions to the Public Health Statute includes language about Infection Control.

    • "Failure to adhere to the most recent version of the National Centers for Disease Control and Prevention guidelines for infection control in dental care settings."
    • Of particular interest is the addition of the sterilization of hand pieces in-between patients. This and other requirements can be found in the National Centers for Disease Control and Prevention guidelines, which was updated in September 2016.

    Checklists from the "CDC Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care": 


    Patient Access to Medical Records
    (PDF)
    Frequently Asked Questions on Patient Access to Medical Records according to the provisions of the Connecticut General Statutes. 


    State Inspections of Dental Facilities and X-ray Machines
    The CT Department of Energy and Environmental Protection (DEEP) has shared this information regarding their state inspection process of dental x-ray operations. The information is provided in hopes that the DEEP, in tandem with the CSDA, can enhance mutual effectiveness, communicate regulatory requirements, and maintain low dose and high quality dental imaging. If you have any additional questions, please feel free to contact the CT DEEP Radiation Division at 860.424.3029.


    Permit to Administer Dental Anesthesia and Conscious Sedation
    Connecticut Department of Public Health guidelines for obtaining dental anesthesia and conscious sedation permit.

    http://www.ct.gov/dph/cwp/view.asp?a=3121&q=389278


    Prescription Monitoring Program
    The prescription monitoring program collects prescription data for Schedule II through Schedule V drugs into a central database, the Connecticut Prescription Monitoring and Reporting System (CPMRS), which can then be used by providers and pharmacists in the active treatment of their patients.


    Backflow Prevention and the Connecticut Dental Office
     (PDF Version)
    The Connecticut Department of Public Health (DPH) requires all Connecticut dental offices to have backflow prevention devices installed. Furthermore, those devices can (and have been) the subject of inspections by local water utility companies. It is important for you as a Connecticut dentist to understand what is required prior to being inspected.

    What is a backflow prevention device? Quite simply, a backflow prevention device is used to use to prevent back-siphon age of contaminated fluids into the public water supply. 

    What specifically does Connecticut require? The CT DPH Fact Sheet on Backflow Prevention at Dental offices (link below) provides information on State requirements. However, it is important to note that a local water utility always has the option of having policies that are more stringent than the State's requirements.

    How can I find out what's required in my area? If you are unsure about the backflow prevention device requirements in your area, please contact your local water utility company. The links to some of the larger water utilities in the State are listed below. 

    Useful references:


    Various CT Water Utility Companies (yours may not be listed):


    Mobile Dental Providers
     
    In response to questions regarding the credentials of mobile dental programs offering to provide oral health services to children in school settings, the CSDA and the Department of Public Health have reissued a letter to school administrators highlighting questions to be asked in order to assess the appropriateness of protocols in place by the mobile dental program. Click here to review the letter sent to school superintendents, principles, and school nurses in Connecticut. 


    Non-Covered Services 
    In 2011, the Connecticut General Assembly passed a non-covered services legislation that prohibits most insurance providers from dictating the rates that dentists can charge to their patients for any services or procedures that are not covered under their dental plans. While self-funded and collectively bargained (i.e. union) insurance plans were not covered under this new law, it does apply to all other dental provider contracts that are signed, renewed or amended after January 1, 2012.   

    The law also requires that dentists post a notice in their office to inform patients that not all dental services may be covered under their insurance plans. Click on the links below to access and print the notice for your practice. 

    Federal Regulations

    Section 1557 of the Patient Protection and Affordable Care Act
    The Office for Civil Rights has issued a final rule that prohibits health care entities that receive certain federal financial assistance, including Medicaid and CHIP, from discriminating based on race, color, national origin, sex, age or disability. According to ADA’s Health Policy Institute, 42% of dentists across the country were enrolled in Medicaid programs in 2014, and will therefore be subject to this rule. 

    The rule, went into effect July 18, 2016 and implements Section 1557 of the Affordable Care Act, required the affected parties by October 16, 2016 to post taglines in multiple languages and nondiscrimination notices in their offices, on their websites and in significant publications and communications. The ADA provides a number of resources, including a checklist, Q&A and sample documents for dental practices, free of charge only to ADA members to help them comply with this rule at success.ada.org. Read more in ADA News.


    Recommended Infection Control Practices for Dentistry
    Developed by CDC staff in collaboration with a working group of infection control experts, the document contains a review of the scientific evidence regarding dental infection control issues as well as consensus, evidence-based recommendations.

    Checklists from the "CDC Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care": 

    Click here for State of Connecticut Infection Control in a Dental Practice Regulations. 


    OSHA Guide for Medical & Dental Offices
    State plans establish guidelines and standards to promote worker safety and health that apply to every workplace in the United States, including medical and dental offices. A glimpse of the most frequently found hazards in medical and dental offices.

    The Americans with Disabilities Act
    The Americans with Disabilities Act of 1990 is a wide-ranging civil rights law that prohibits, under certain circumstances, discrimination based on disability. This link will take you to the American Dental Association's Americans with Disabilities Act Q&A. It is important to note that ALL practicing dentists are affected by this law, since dental offices are considered public accommodations under the Act

    Electronic Health Records 
    An electronic health record (EHR) is a digital version of a paper chart that contains all of a patient’s medical history from one practice. An EHR is mostly used by providers for diagnosis and treatment.

    HIPAA

    The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; the HIPAA Breach Notification Rule, which requires covered entities and business associates to provide notification following a breach of unsecured protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.