California Dental Hygiene Regulations: Licensing, Duties, and Ethics, Exams of Dentistry

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Law and Ethics for CA Dental Hygiene

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Direct Supervision - ANSWER-Procedures based on instructions given by dentist who is required to be PHYSICALLY PRESENT General Supervision - ANSWER-Supervision of dental procedures based on instructions given by licensed dentist who is NOT required to be present. Oral prophylaxis - ANSWER-Create environment which patient can maintain healthy tissues Bacterial debris went Removal of supra/sub calculus and plaque What is highest priority of committee? - ANSWER-Protection of the public Licensees must disclose which types of employment statuses? - ANSWER-Full time Part time Inside/outside of California Administrative employment Retirement Other practice When is information on cultural background and language proficiency collected? - ANSWER-Annually Sorted by state or zip code Posted on site by July 1 annually Under what conditions can an RDH from another state teach in a different state? - ANSWER-Have evidence of contract with CA DH college Graduated from DH college approved by committee Certified as diploma or completed advanced educational program

Completed CA law and ethics Paid application fee and renewal fee When can an RDH perform RDA duties? - ANSWER-If licensed AFTER January 1, 2006 - MUST HAVE RDA license to perform RDA duties True or False: If an RDH is licensed BEFORE December 31, 2005, they can perform all RDA duties - ANSWER-True RDH Duties - ANSWER-Treatment plan Education Counseling Health Screenings Can an RDH diagnose and comprehensive provide treatment plan? - ANSWER-NO Can an RDH place, condense, carve, or remove permanent restorations? - ANSWER- NO Can an RDH do surgery or cut hard and soft tissues, including removal of teeth, cutting, and suturing of soft tissue? - ANSWER-NO Can an RDH prescribe medication? - ANSWER-NO Can an RDH administer local or general anesthesia, oral/parenteral conscious sedation? - ANSWER-NO What RDH duties require DIRECT supervision - ANSWER-STC Local Anesthesia Nitrous Oxide Under what supervision can an RDH apply preventative and therapeutic prophylaxis/SRP - ANSWER-General Under what supervision can an RDH apply topical, therapeutic, and subgingival agents for control of caries and perio? - ANSWER-General Under what supervision can an RDH take impression for BLEACHING trays and apply activation agents with NON LASER, light curing devices? - ANSWER-General

Under what supervision can an RDH take impression for bleaching trays and placement of in-office, whitening devices? - ANSWER-General Under what supervision can an RDH provide educational services, oral health training, and health screenings? - ANSWER-NO supervision Under what supervision can an RDH refer any screened pt with abnormalities to a dentist? - ANSWER-NO supervision What additional duties can an RDH do without supervision if it's a public health program created by federal, state, or local government entity? - ANSWER-Fluoride and Sealants What "Authorized Persons" can perform RDH duties that aren't RDHs? - ANSWER-DH Student DA - Can apply topical agents, fluoride, take bleach impressions RDA - +coronal polish, +bleaching agents w/ light, apply sealants RDAEF - +pit and fissure sealants When must you notify the DHCC of an address change? - ANSWER-Within 30 days When must you notify the DHCC of a legal name change? - ANSWER-Within 10 days When does your license expire? - ANSWER-If not renewed, at midnight on the last day of the month of your birthday during the second year of a two-year term. Ex. Birthday is July 20, so it expires July 31, 2018. How much time after expiration can you apply for a license renewal? - ANSWER-Within 5 years by application and fee payment. what is subversion of licensing examination and its consequences? - ANSWER- Cheating on the test - talking, copying, selling/distributing information, paying someone to take exam, taking exam materials, etc. May pay up to $10,000 fine When can the committee revoke a license? - ANSWER-Unprofessional conduct Incompetence Gross negligence

Repeated acts of negligence Receiving a license by mistake If you are convicted of a crime substantially related to license qualification, function, or duties, what can happen to your license? - ANSWER-Revoked Suspended Reprimanded Probation What's considered "Unprofessional Conduct? - ANSWER-Fraud or misrepresentation Aiding/abetting and UNLICENSED person to practice Sexual abuse/misconduct/relations with patient Use of false name Accepting/receiving commission of fees for professional services - X-rays, prescriptions False advertising, advertising professional superiority, advertising/guaranteeing any procedure as painless Soliciting or using solicitors Altering patient records to deceive Misrepresentation about disciplinary action Patient abandonment without written notice to pt What is the fine for excessive administration of drugs or treatment? - ANSWER- Misdemeanor $100- Imprisonment: 60-180 days Or both If a patient dies during/hospitalized for longer than 24 hours/discovery of death after procedure related to DH procedure, how long do you have until it must be reported? - ANSWER-Within 7 days

How should the committee be informed? - ANSWER-In writing within 7 days with a copy sent to the dental board. Dentists will report deaths in writing to dental board with copy to committee. When can the committee undertake proceedings? - ANSWER-Upon receipt of a certified copy of the record of conviction Certified by the clerk of the court or by the judge in whose court the conviction occurred. The committee can suspend, revoke, place on probation, or decline license if any of the following occurs: - ANSWER-Time for appeal has elapsed Judgement of conviction has affirmed on appeal Order granting probation is made suspending the imposition of sentence What are some conditions that the committee can grant a licensee? - ANSWER- Following but not limited to: Additional training or passing examination upon completion of training or both Submit complete diagnostic exam by physician regarding mental/physical health of licensee. Restricting extent of scope or type of practice Requiring restitution of fees or patients or payers of service Comminuted service in lieu of all or part of a suspension period in cases other than quality of care violation How must a patient record be signed by the DH? - ANSWER-Name or identification number and initials Service performed Date Repeated violation = unprofessional conduct Penalty for not releasing pt records after written authorization for release within 15 days

• ANSWER-Civil or administrative penalty Fine up to $250/day after 15th day

Max = $ Multiple acts by licensee in violation of court ordered subpoena mandating release of records - ANSWER-$1000 fine not exceeding $ Imprisonment in county jail no greater than 6 months Or both Consequences of false representation, failing to furnish names of associates, using controlled substances during practice, and the like. - ANSWER-Misdemeanor Imprisonment in county jail - 10 day to 1 year $100-$ Or both Penalties for making false diploma, false affidavit statement, practicing without license, or under false name - ANSWER-1st offense: Misdemeanor, fine $200-$3,000, imprisonment no longer than 6 months 2nd offense: Felony conviction, fine $1,000-$6, Penalty for practicing w/o valid license that cause bodily harm, serious physical/mental illness or death - ANSWER-Guilty for crime punishable for 1 year imprisonment T or F: A licensee that is not the subject of a current investigation may self-refer to a diversion program on a confidential basis - ANSWER-True What occurs if an investigation of a licensee is based on self-administration of controlled substance/drug/alcohol/Rex drug that does not harm public? - ANSWER-Committee shall close investigation without further action if accepted into committee's diversion program and completes it. If incomplete, investigation will be reopened, disciplinary action imposed if warranted. When is a licensee's participation from a diversion program purged and destroyed? - ANSWER-After the diversion evaluation committee has determined licensee is rehabilitated and program is complete. PPE - ANSWER-Hand hygiene GLoves Gown Mask

Eye protection Critical Items - ANSWER-Used to penetrate soft tissue or bone Autoclave, chemiclave vapor, or dry heat Label with date and sterilizer number Semi Critical Items - ANSWER-Contact oral mucous membranes, non-intact skin, or other potentially infections material (OPIM) Autoclave, chemiclave vapor, or dry heat Label with date and sterilizer number Non-Critical Items - ANSWER-Contact soil, debris, saliva, blood, OPIM, intact skin, but NOT oral mucous membranes Low-Level Disinfection - ANSWER-Kills SOME bacteria, viruses and fungi Intermediate-Level Disinfection - ANSWER-Kill M. Tuberculosis, but NOT spores High-level Disinfection - ANSWER-Kills SOME, but not all spores. Kills M. Tuberculosis, bacteria, fungi, and viruses. Germicide - ANSWER-Chemical agent used to disinfect ties and surfaces Sterilization - ANSWER-Free of all forms of viable microorganisms Cleaning - ANSWER-Removal of visible soil (organic and nonorganic) How long do you flush waterline? - ANSWER-2 min at start of day 20 sec between patients How often must spore test be done? - ANSWER-Weekly. Records kept for 12 months CE requirements - ANSWER-2 units infection control 2 units Dental Practice Act Max 4 units of BLS CE Credits for each position - ANSWER-Dentist: 50 units RDH: 25 units

RDA: 25 units RDHAP: 35 units Keep proof for a period of 3 renewal periods What is the limitation of type and amount the licensee can take? - ANSWER-Courses that benefit primarily the licensee will be limited to 20% Ex. Production, communication systems, data management, organization, management, leadership Reporting Child Abuse - ANSWER-ASAP - initial report by telephone to agency immediately or as soon as is practicably possible Then prepare and send, fax, or e-transmit written follow up report Within 36 hour follow up with letter explaining situation What is consequence for failure to report child abuse? - ANSWER-Misdemeanor Up to 6 months in jail $1000 fine or both Where should does a mandated reporter report? - ANSWER-Any police department County probation office County welfare department Different types of reports - ANSWER-Unfounded report - determined by investigator that it's false, improbably, accident, not abuse/neglect Substantiated report- constitutes abuse or neglect Inconclusive - unfounded, inconclusive, insufficient evidence Elder Abuse - ANSWER-Similar to child abuse Abandonment Abduction

Isolation Financial abuse Neglect Probation options - ANSWER-Additional training or pass an exam Submit an exam by physician (physical or mental) Restricting restitution of fees to patients Restricting/limiting scope of practice Community service in lieu of all or part of period of suspension in cases that DO NOT INVOLVE quality of care. Unprofessional conduct of uncontrolled substances - ANSWER-Obtaining/possessing controlled substance Use CS, dangerous drug, alcohol in manner that's unsafe to public Being convicted of more than one misdemeanor, or any felony involving the use or alcohol/drugs if SUBSTANTIALLY RELATED TO THE PRACTICE Committee can suspend or revoke license Identification on Patient Records - ANSWER-Name OR Identification Number and Initials Date Repeated violation: UNPROFESSIONAL CONDUCT Services Beyond Scope of Practice - ANSWER-Do NOT do anything beyond your: -Education -Experience -Training Does NOT apply to:

• Research in accredited dental/DH schools
• Research approved by FDA Discouraging Excessive Treatment - ANSWER-Unprofessional conduct to permit the delivery of excessive, incompetent or unnecessary care

Consequences of Misdemeanor Violations - ANSWER-10 days - 1 year in jail $100 - $1,500 fine What are some common misdemeanor violations? - ANSWER-Assume title without license Practice DH without displaying license Fail to furnish names and addresses of everyone practicing or assisting in practice (when requested by DHCC) - 10 days to do this Under the influence while practicing to extent that impairs ability Unlicensed Activity - ANSWER-Punishable up to 1 year in county jail Program Criteria for Diversion Program - ANSWER-Can be voluntary or required by committee for someone on probation. Can be confidential: If it's for drugs/alcohol and does not involve direct harm to public - committee will close the investigation without further action if accepted into diversion program and completes it. But they can still investigate you Responsibility of Diversion Program Costs - ANSWER-If you sign up for program, you must bear all costs unless waived by the committee If you fail to comply, you will be terminated Ethics - ANSWER-Thoughts and ideas about morality Concerned with human behavior and principles that regulate it In healthcare, ethical behavior is result of perceiving an action as either right or wrong Perception is based on norms, duties, consequences, and character traits Autonomy - ANSWER-Self-determination Individuals should be able to decide for themselves what actions will undertake even if these seem foolish to others Informed Consent - ANSWER-Competent patients can accept or refuse treatment

Pt must have adequate information to make decision (Risks, Benefits, Alternatives, Cost) Tolerance - ANSWER-Accepting of all individuals Culture and background Compassion - ANSWER-Ability to feel for another person and identify with patient's overall well-being Relieving pain and suffering Acts of kindness and sympathetic ear Integrity - ANSWER-Quality of being honest and having strong moral principles Veracity - ANSWER-Telling the truth Do not leave out information or fail to inform of other options Justice - ANSWER-Aka fairness Patients should receive same quality of care regardless of socioeconomic status, ethnicity, education or ability to pay Competence - ANSWER-Ability to perform duties successfully and efficiently Ability to treat patients oral health needs and refer when its in their best interest Maintaining competence requires continual self-assessment and commitment to lifelong learning Just expectation of the patient Professionalism - ANSWER-Community service and volunteering Promoting the profession in a positive way Self-governance Confidentiality - ANSWER-Avoidance of revealing any personal information Beneficence - ANSWER-Doing what will benefit the patient (when non-maleficent is not sufficient) Offering active help (ex. pro bono work)

Non-maleficence - ANSWER-Do no harm Most basic element of morality Provide care that is compatible with safety, dignity, and rights of people. (ex. standard precautions and through debridement) Universality - ANSWER-If one individual judges an action to be right or wrong in a situation, other people in same situation would make same judgement Complementarity - ANSWER-Recognizes existence of an obligation to justice and basic human rights Societal Trust - ANSWER-We value client trust and understand that public trust in our profession is based on our actions and behavior