PROPOSED RULEMAKING
STATE BOARD OF DENTISTRY
[49 PA. CODE CH. 33]
Expanded Function Dental Assistants
[32 Pa.B. 5283] The State Board of Dentistry (Board) proposes to amend § 33.103 (relating to examinations) to read as set forth in Annex A.
A. Effective Date
The proposed rulemaking will be effective upon final-form publication in the Pennsylvania Bulletin.
B. Statutory Authority
The Board is authorized to adopt regulations concerning certification requirements for expanded function dental assistants under section 3(o) of the Dental Law (act) (63 P. S. § 122(o)).
C. Background and Purpose
The act of December 27, 1994 (P. L. 1361, No. 160) (Act 160) amended the act to require the certification and regulation of expanded function dental assistants (EFDA). Act 160 required that EFDAs desiring to be certified by the Board must have completed an education program and passed an examination approved by the Board.
The Board, through a final-form rulemaking published at 30 Pa.B. 2359 (May 13, 2000), determined that the examination would include both written and clinical (performance) components to ensure that certificate holders possess the requisite knowledge and skill to properly and safely perform their job functions. In part, the Board included a clinical component at the request of many EFDAs who believed that this was a necessary requirement. The public, including individuals, dentists, dental hygienists, EFDAs and numerous professional associations, participated in the lengthy rulemaking process. Both written and clinical components to an examination were seen as necessary to insure protection of public heath and safety.
Efforts to develop an examination for EFDAs had been underway for several years. Numerous attempts were made to contract with vendors, either through the use of Requests for Proposals (RFP) or through sole source contracting. However, despite these efforts, the Department of State was only able to enter into contract negotiations with one potential bidder for the development of an EFDA examination.
The Board had concerns regarding the cost of the examination. Those concerns were also expressed by anticipated certificate holders and professional associations. A performance component greatly increases the cost of the examination due the need to rent a facility and to hire additional proctors for necessary manual grading. Additionally, the examination must be initially administered to approximately 1,800 temporary permit holders. Because no National examination for EFDAs exists, the costs of developing and administering a Commonwealth examination must be included in the costs for candidates from this Commonwealth. After the first examination is given, approximately 100 candidates will be tested each year. When an examination is developed for a small candidate population, the costs will be higher because those costs cannot be distributed over a large continuous population of candidates.
Due in some part to the prospect of an examination fee between $700-900, permit holders and members of the Legislature sought input after the RFP process had been completed. After examining these concerns, the Board decided to take some additional time to address the issue of the necessity of a clinical examination.
Accordingly, the Board held a public hearing on July 20, 2001, to receive testimony from interested parties concerning the EFDA examination. Based upon the testimony received, as well as written comment, the Board was persuaded that the clinical portion of the examination requirement should be deleted. The Board believes that the public can be adequately protected with a written examination and that supervising dentists and EFDA programs requiring clinical experience can ensure capability.
The quality of a dental restoration is ultimately determined by the competency of the supervising dentist. If a restoration is below standard, it can be redone without harm to the patient and with minimal inconvenience. In addition, competency testing for other comparable occupations indicates that a written examination can adequately test for clinical competency.
D. Description of Proposed Rulemaking
The proposed rulemaking deletes the clinical examination requirement for expanded function dental assistants in § 33.103(c) (relating to examination).
E. Compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation''
The Board reviewed this proposed rulemaking and considered its purpose and likely impact upon the public and the regulated population under the directives of Executive Order 1996-1. The proposed rulemaking addresses a compelling public interest as described in this Preamble and otherwise complies with Executive Order 1996-1.
In accordance with Executive Order 1996-1, the Board sent a draft of this proposed rulemaking on April 6, 2001, to 138 dental associations, schools and interested persons for predraft comment and held a public hearing on July 20, 2001. The list of these entities is available upon request from the contact person listed. Thirty-three EFDAs commented in the predraft stage supporting the elimination of the clinical examination. At the public hearing, six persons testified in support of the elimination of the clinical examination, two persons supported eliminating the clinical examination for temporary permit holders only and two persons supported retention of both the clinical and written examinations.
F. Fiscal Impact and Paperwork Requirements
This proposed rulemaking will have a beneficial fiscal impact upon EFDA certification applicants as the cost of the certification examination should be considerably reduced. At this stage, it is not possible to estimate the fiscal impact with precision. Cost data will be available when a contract is finalized for the administration of the written examination.
G. Sunset Date
The Board continuously monitors its regulations. Therefore, no sunset date has been assigned.
H. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on October 10, 2002, the Board submitted a copy of this proposed rulemaking to the Independent Regulatory Review Commission (IRRC) and the Chairpersons of the House Professional Licensure Committee and the Senate Consumer Protection and Professional Licensure Committee. In addition to submitting the proposed rulemaking, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, if IRRC has objections to any portion of the proposed rulemaking, it will notify the Board within 10 days of the close of the Committees' review period. The notification shall specify the regulatory review criteria that have not been met by the portion of the proposed rulemaking to which an objection is made. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Board, the General Assembly and the Governor of objections raised.
I. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed rulemaking to Deborah B. Eskin, Counsel, State Board of Dentistry, P. O. Box 2649, Harrisburg, PA 17105-2649 within 30 days following publication of this proposed rulemaking in the Pennsylvania Bulletin. Reference No. 16A-4612 (Deletion of Expanded Function Dental Assistants) when submitting comments.
NORBERT O. GANNON, D.D.S.,
ChairpersonFiscal Note: 16A-4612. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 33. STATE BOARD OF DENTISTRY
Subchapter B. LICENSURE OF DENTISTS AND DENTAL HYGIENISTS AND CERTIFICATION OF EXPANDED FUNCTION DENTAL ASSISTANTS § 33.103. Examinations.
* * * * * (c) Expanded function dental assistants. Candidates for certification shall pass an examination [comprised of both a written and a clinical component] acceptable to the Board.
* * * * *
[Pa.B. Doc. No. 02-1883. Filed for public inspection October 25, 2002, 9:00 a.m.]
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