Section 12 AAC 28.956 - Collaborative agreement requirements(a) The board may approve a collaborative agreement between a dental hygienist licensed under AS 08.32 and a dentist licensed under AS 08.36 and who is affiliated with an active dental practice in this state, if the collaborative agreement meets the requirements of AS 08.32.115 and that the dental hygiene and the dental licenses are in good standing. The applicant must submit (1) a completed, notarized application on the form provided by the department, which includes the names and license numbers of the collaborating dentist and dental hygienist, and the name and location of the dentist's affiliated practice;(2) the applicable fees required in 12 AAC 02.190;(3) an affidavit stating that the applicant has a minimum of 4,000 hours of clinical experience within the five years preceding the date of application;(4) a copy of current certification in cardiopulmonary resuscitation (CPR) techniques for the applicant that meets the requirements of 12 AAC 28.920;(5) a copy of the applicant's and the collaborating dentist's current professional liability policy or declaration page that includes the policy number and expiration date;(6) an evidence of continuing educational courses meeting the requirements of the collaborative agreement;(7) a written agreement including (A) identification of each affiliated practice setting in which the dental hygienist may engage in dental hygiene practice under the collaborative agreement relationship;(B) identification of the procedures that can be performed in accordance with AS 08.32.115 and standing orders that the dental hygienist must follow;(C) a requirement that the dental hygienist refer patients who have been assessed by the dental hygienist to the affiliated dentist for treatment or planning that is outside of the dental hygienist's scope of practice;(D) starting and ending dates of the collaboration;(E) patient record location;(F) patient billing location.(b) The dental hygienist and the affiliated dentist must notify the board of any amendments to the agreement.(c) The board may not approve a collaborative agreement to a dental hygienist if (1) the affiliated dentist has five current collaborative agreements under this section;(2) the applicant or affiliated dentist is under unresolved investigation under AS 08.32 - 08.36 or this chapter or a similar provision of another jurisdiction;(3) during the five years immediately preceding the date of application, the applicant or affiliated dentist is the subject of adverse disciplinary action under AS 08.32 - 08.36 or this chapter, or a similar provision of another jurisdiction.(d) In addition to the continuing education requirements in 12 AAC 28.400 - 12 AAC 28.420, a dental hygienist who wishes to practice under a collaborative agreement must complete an additional four contact hours of continuing education per biennial license renewal period in one or more of the following subject areas: (2) pediatric and other special health care needs;(5) public health or other eleemosynary facility, relating to, or supporting charity;(7) general medicine and physical diagnosis;(8) jurisprudence relating to unsupervised practice.(e) An affiliated dentist in a collaborative agreement must(1) be available to provide contact, communication, and consultation with the affiliated dental hygienist;(2) adopt standing orders applicable to dental hygiene procedures that may be performed by the dental hygienist.(f) A dental hygienist authorized in a collaborative agreement (1) may perform any dental operations or other services the dental hygienist is authorized to perform under AS 08.32.110 and this chapter, and those dental operations and other services authorized under the collaborative agreement, if approved by the board;(2) must maintain contact, communication, and consultation with the affiliated dentist; and(3) before performing any dental hygiene services, shall assess the patient, gather data, interpret the data, determine the patient's dental hygiene treatment needs, and formulate a patient care plan.(g) A dental hygienist authorized in a collaborative agreement shall (1) maintain dental charts and other records for the patients who are treated by the dental hygienist; the collaborative agreement must specify where these records are to be secured;(2) document in the patient's official chart the name of the affiliated dentist;(3) document all referrals.(h) A collaborative agreement (1) expires immediately on the date agreed upon by the collaborating dental hygienist and dentist and approved by the board;(2) may not have a term exceeding two years.(i) If a dental hygienist and affiliated dentist in a collaborative agreement end their affiliation before the expiration date of the collaborative agreement, each shall notify the board within 30 days of the end of the affiliation.(j) Before or upon the expiration of the collaborative agreement, the board may renew a collaborative agreement if the applicant submits a new completed application under this section.(k) The board shall maintain a registry of all current collaborative agreements.Eff. 12/5/2009, Register 192; am 6/24/2012, Register 202; am 3/11/2016, Register 217, April 2016Authority:AS 08.32.115
AS 08.32.187
AS 08.36.070