RD30 - Report on Services Provided by Virginia Department of Health Dental Hygienists Pursuant to a “Remote Supervision” Practice Protocol 2013

Executive Summary:
In 2009, the Virginia General Assembly passed legislation to revise § 54.1-2722 “License; application; qualifications; practice of dental hygiene” in Chapter 27 of Title 54.1 of the Code of Virginia. The changes to the practice of dental hygiene pertained specifically to those hygienists employed by the Virginia Department of Health (VDH) who work in the Cumberland Plateau, Lenowisco, and Southside Health Districts, all dentally underserved areas. The practice changes were in effect through July 1, 2012, due to additional legislation in the 2011 Session. As of July 1, 2012, Virginia Code, as amended by Senate Bill146 and passed in 2012 (Appendix A,B), permits any VDH dental hygienist throughout the Commonwealth to practice under the “remote supervision” protocol previously created by a committee of dental advisors and approved by the VDH Commissioner of Health (Appendix C).

This legislative action has enabled VDH dental hygienists to provide preventive dental services without the general or direct supervision of a dentist. This effort has improved access to preventive dental services for those at highest risk of dental disease, as well as reduced barriers and costs for dental care for low-income individuals. This report documents the services provided in FY13 by the hygienists and assistants employed by VDH.

Over 3,000 children returned a permission form and were screened by a dental hygienist in a school-based setting; 831 received sealants and 1794 received a fluoride varnish application. A total of 1,094 children were identified as having other oral health needs and referred to providers. In clinic settings through the VDH “Bright Smiles for Babies” program 5,828 infants and children were screened. School and clinic programs combined to provide 7,476 fluoride varnish applications.

As this and previous reports indicate, the remote supervision model offers an alternative method of delivery for safety net dental program services with increased access for underserved populations. The remote supervision protocol has also proven successful in increasing the ability of VDH to successfully compete for federal grant funding for staff to work under this model.