A Missouri Telehealth Bill Passes on April 26, 2016. The Governor may sign or veto the bill but it still needs to be signed by the Governor to actually become law.
SB 579, sponsored by Senator Rob Schaff, was originally intended to modify provisions relating to reporting infections in health care facilities and telehealth services. The bill was amended to include more provisions on telehealth, including definitions of telehealth, telemedicine and asynchronous store and forward technology. “Ansynchronous store and forward” is defined as the transfer of a clinically important digital samples, such as still images, videos, audio, and text files, (dental radiographs, electronic records, oral photos) and relevant data from an originating site through the use of a camera or similar recording device that stores digital samples that are forwarded via telecommunication to a distant site for consultation by a consulting provider (such as a dentist) without requiring the simultaneous presence of the patient and the patient's treating provider. The bill also defines the relationship required between providers and patients, where telehealth services may originated and where they may be performed and who can be reimbursed. Teledentistry is the name related to telehealth in the area of dentistry.
The language states: 208.675. For purposes of the provision of telehealth services in the MO HealthNet program, the following individuals, licensed in Missouri, shall be considered eligible health care providers: (1) Physicians, assistant physicians, and physician assistants; (2) Advanced practice registered nurses; (3) Dentists, oral surgeons, and dental hygienists under the supervision of a currently registered and licensed dentist...........
Note that others are included as providers. Having dental hygienists being able to work under a teledentistry arrangement with a dentist will increase access to oral health care and will increase jobs for dental hygienists. There will also be a dentist on the Telehealth Services Advisory Board which will advise the Missouri Department of Health and Senior Services in regard to rules made about telehealth in consultation with the Departments of Mental Health and Health and Senior Services.
This act establishes a statewide home telemonitoring program for the MO HealthNet program. Home telemonitoring services are health care services that require scheduled remote monitoring of data related to a patient's health. The act specifies the individuals for whom home telemonitoring services may be made available. If the Department of Social Services determines that home telemonitoring is not cost effective, the Department may discontinue the program and stop providing reimbursement through MO HealthNet for such services.
At the January 16, 2015 Missouri Dental Board meeting, the board vote to promulgate thefollowing rule. This is just a first step in making this a rule that must be followed in all Missouri dental facilities. MDHA wanted to make you aware of this. MDHA is on record supporting it.
Missouri Dental Board Rule Proposal on Infection Control
1. All health care professionals and facilities where dental services are offered shall adhere to all current recommendations for preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings as defined by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services and the Occupational Safety and Health Administration (OSHA) of the U.S. Department of Labor.
2. The supervising dentist shall be responsible for ensuring that all dental assistants, dental hygienists and other personnel under his/her supervision adhere to all current recommendations for preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings as defined by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services and the Occupational Safety and Health Administration (OSHA) of the U.S. Department of Labor.
3. The board may conduct inspections of facilities where dental services are provided to verify compliance with infection control guidelines.
Missouri Dental Board (MDB) rule change now allows hygienists to apply fluoride without a dentist being present.
2OCSR 2110 - 2.130 Dental Hygienists (#7): "A hygienist may provide oral hygiene instructions, conduct oral screenings and apply fluoride with out a dentist being present. The hygienist shall refer the individual screened to a dentist for diagnosis."
The MDHA Board of Trustees voted to send these proposed resolutions to the general membership. They will be voted on at the MDHA Annual Session. There is also one proposed bylaws change. It is required that these be published for the membership to review ahead of time.