OHIO ORAL HEATH ACCESS SUPERVISION PROGRAM
The Ohio Oral Health Access Supervision Program (OHASP) was created in 2010 by the legislature with the intent to give clinical providers the opportunity to increase access to care in Ohio. House Bill 190 established the program in ORC 4715.361 and gave the dental board the authority to write administrative rules to establish the program. In this article I would like to summarize the requirements to be part of this program for a dentist and a hygienist and demonstrate the areas in which this program could be used.
In order for a dentist to take part in the program they need to apply and be granted a permit under ORC 4715.362. The dentist applying for the permit must be in good standing with the board and fill out a form prescribed by and provided by the board including the dentist’s name, Ohio license number and current practice address. Along with the form the dentist must pay a $20 application fee. The permit, once granted by the board, will expire Dec. 31 of odd numbered years and the dentist must renew the permit at that time. To renew the permit a dentist must, under oath, fill out a form provided by the board and pay a $20 renewal fee. The renewal form requires the dentist to verify the locations at which dental hygienists provided services during the previous two years, the number of patients treated and the number of patients who received a clinical evaluation from a dentist following the provision of dental hygiene services by the dental hygienist.
Along with the dentist’s permit, each dental hygienist that wants to work under the oral health access supervision of a dentist must also receive a permit. For the hygienist to receive a permit they must fill out an application provided by the board which includes the hygienist’s name, license number and any other information requested by the board along with a $20 application fee. They must also provide evidence to show that they have: completed at least one year and attained a minimum of 1,500 hours of clinical dental hygiene experience; completed at least 24 hours of continuing education during the two years preceding submission of the application; completed a course pertaining to the practice of dental hygiene under the oral health access supervision of a dentist that meets requirements laid out in rule 4715-9-06.1; and completed a course pertaining to the identification and prevention of potential medical emergencies in the preceding two years. The course described in 4715-9-06.1 shall include basic concepts that allow a dental hygienist to provide dental hygiene services to a patient when the oral health access supervising dentist is not present at the location at which the services are provided, be eight hours in length, and include treatment of geriatric patients, medically compromised patients, developmentally disabled patients and pediatric patients. Further the course must include infection control and ethical and legal considerations. The ODA has offered this course for the past two years as a part of Annual Session, and this can still be taken online through the end of 2023. To take the course, click here.
Now that we understand how one is authorized to participate in OHASP it is important to understand how the program works. A permit holding dentist may authorize not more than three permit holding dental hygienists to perform dental hygiene services at a facility when no dentist is physically present. The facilities that qualify for this program are defined in ORC 4715.36, and some examples include health care facilities, correctional institutions, school head start programs, residential facilities, public and private schools, federally qualified health centers, shelters and mobile dental units. To perform dental hygiene services the following requirements must be met 1.) The authorizing dentist must make a written document including authorization date, the dentist and hygienist’s name and permit number, the patient’s name, the name and address where the services are to be provided and a statement signed by the hygienist agreeing to comply with the OHASP regulations. 2.) The authorizing dentist has personally evaluated the hygienist’s skills and the patient’s medical and dental history have been made available, reviewed and evaluated by the authorizing dentist and determined to be safe to receive hygiene services. 3.) Immediately prior to the treatment the patient or their representative verifies by signature that there has been no change to medical or dental history since the authorization date. 4.) Prior to treatment the patient and the operator of the facility are notified that no dentist will be present at the location and the limitations of the treatment. 5.) The dental hygienist is employed by the authorizing dentist or the authorizing dentist’s employer. 6.) The patient cannot have received previous hygiene services through OHASP unless in the intervening time they have received a clinical evaluation from a dentist. Further, the dental hygienist must comply with written protocols from the authorizing dentist regarding medical emergencies and immediately after treatment direct the patient to a dentist for a clinical evaluation and schedule or cause to be scheduled an appointment for the patient with a dentist.
The creation of the program added another avenue to increase access to care in Ohio. Each year the dental board is required by law to create a report based off of the information provided by permit holders on the number of patients treated and patients who had a clinical evaluation by a dentist after the hygiene treatment. These reports can be found on the dental board’s website.
I hope after reading all of the legal information you are able to glean that the creation of this program struck the right balance of patient safety and access to hygiene care. The main idea being that patients will be able to receive treatment and ultimately be seen by a dentist for a clinical evaluation. The entire legal section can be found in ORC 4715.36-4715.375 and the corresponding Ohio administrative code sections. Please contact the ODA at 614-486-2700 if you have questions regarding OHASP.
