OAR 333-010-0760: Dental Pilot Projects: Minimum Standards

An approved dental pilot project must: (1) Provide for patient safety and that the applicable standard of care is met as follows: (a) Comply with informed consent in accordance with OAR 333-010-0770, Informed Consent; (b) Prohibit a trainee from performing procedures the trainee is not capable of performing based on the trainee’s level of education, training and experience, physical or mental disability, or which are outside of the trainee’s approved scope of practice as outlined in the approved application by the Authority; (c) Provide or arrange for emergency treatment for a patient currently receiving treatment and needs emergency care; (d) Not use the behavior management technique of Hand Over Mouth (HOM) or Hand Over Mouth Airway Restriction (HOMAR) on any patient; (e) Comply with ORS 419B.005 to 419B.010 related to the mandatory reporting of child abuse; (f) Comply with ORS 453.605 to 453.755 or rules adopted pursuant thereto relating to the use of X-ray machines; (g) Comply with ORS 679.520 or rules adopted pursuant thereto relating to the treatment of dental waste materials; (h) Comply with ORS 679.535 or rules adopted pursuant thereto relating to the requirement to test heat sterilization devices; and (i) Ensure that project participants involved in direct patient care: (A) Have not been convicted of any crimes, within the last 10 years, that is a crime of violence or crime of dishonesty. (B) Have not been denied or disciplined by a state entity that issues licenses or certificates. (j) Ensure adequate supervision and evaluation of trainees, including but not limited to: (A) Timely review of trainee procedures and addressing any deficiencies; (B) Monitoring for adverse events and addressing any deficiencies; and (C) Monitoring and evaluating trainees and addressing any deficiencies. (2) Ensure that participants in the project, including trainees, do not engage in unprofessional conduct as that is defined in ORS 676.150. (3) Ensure that an accurate patient record is prepared and maintained for each person receiving dental services, regardless of whether any fee is charged. The record shall contain the name of the trainee rendering the service and include, but is not limited to: (a) Name and address and, if a minor, name of guardian; (b) Date and description of examination and diagnosis; (c) An entry that informed consent has been obtained in accordance with OAR 333-010-0770, Informed Consent; (d) Date and description of treatment or services rendered; (e) Date and description of all radiographs, study models, and periodontal charting; (f) Health history; and (g) Date, name of, quantity of, and strength of all drugs dispensed, administered, or prescribed. (4) Have a sufficient number and distribution of qualified clinical and non-clinical instructors to meet project objectives, as identified in the approved application. (5) Provide instruction to trainees following the training program outlined in the approved application by the Authority. (6) Assure that trainees achieve a minimal level of competence before they are permitted to enter the employment/utilization phase. The sponsor must provide notice to the Authority within 14 business days of a trainee entering the employment/utilization phase. The notice shall include, but is not limited to, the following: (a) Name, work address, electronic mail address and telephone number of the trainee; (b) Name, work address, electronic mail address, telephone number and license number of the supervisor; (c) Information regarding the trainee’s responsibilities and limitations under Oregon Laws 2011, chapter 716 and these rules; and (d) A disclaimer that there is no assurance of a future change in law or regulations that will allow them to practice without a license outside an approved dental pilot project. (e) Trainee monitoring records shall be provided to the Authority. (7) Comply with the requirements of the Dental Pilot Projects statute, Oregon Laws 2011, chapter 716; these rules; and the approved application including, but not limited to, the evaluation and monitoring plan. (8) Evaluate quality of care, access, cost, workforce, and efficacy in accordance with the evaluation and monitoring plan approved by the Authority and as described in OAR 333-010-0780, Pilot Project Evaluation and Monitoring by Sponsor. (9) Within 24 hours of any incident involving a patient in the care of a trainee which results in any medical occurrence that is life-threatening, requires hospitalization, results in disability or permanent damage, requires medical or surgical intervention or results in death, the sponsor must ensure that a detailed written report, along with the patient’s complete dental records, is submitted to the Authority by the supervising dentist. (10) Submit detailed quarterly monitoring reports in a format prescribed by the Authority that include but are not limited to the following information for the previous quarter: (a) Accomplishments or highlights. (b) Challenges faced and continuous quality improvement activities. (c) Updated project timeline. (d) Data reports: (A) A comprehensive breakdown of each of the data points the project is capturing in its approved evaluation and monitoring plan including anonymized client level data. (B) Data generated by the clinical evaluator. (C) Number and type of any adverse event or complication that occurred during the reporting period. (D) Underserved population report: Information identifying the percentage of patients served by each of the pilot project’s trainees or employment/utilization sites that are within the underserved population identified in the application. (11) Follow written standard operating policies and procedures approved by the Authority as outlined in OAR 333-010-0750, Provisional Approval; Final Approval. (12) Use templates and follow guidelines for the submission of documents and other reporting requirements as prescribed by the Authority. (13) Provide care only at Authority approved employment/utilization sites. (14) Demonstrate that each of the pilot project’s trainees or employment/utilization sites provides care to the underserved populations identified in the application at a rate of at least 51 percent of the total individuals served by the trainee or employment/utilization site on a quarterly basis. (15) Exemption: (a) Pilot projects may seek an exemption for each employment/utilization site as defined in OAR 333-010-0710 from the requirement to submit quarterly underserved population reports by submitting documentation demonstrating the employment/utilization site falls within an exemption category listed below. The Authority shall respond to the exemption request in writing. (b) The Authority may request additional documentation demonstrating the employment/utilization site currently qualifies for an exemption or the rate described in section (14). (c) A pilot project must immediately notify the Authority if an employment/utilization site no longer qualifies for exemption and begin submitting quarterly underserved population reports for that employment/utilization site. (d) Exemption-eligibility. Employment/utilization sites as defined in OAR 333-010-0710 that only provide services via the following are eligible for an exemption: (A) Community Mental Health Centers (CMHC); (B) Federally-Qualified Health Centers (FQHCs) that are recipients of Public Health Service Act Section 330 grant funds; (C) U.S. Health Resources & Services Administration (HRSA) Designated Health Centers; (D) Indian Health Service Facilities; (E) Tribally-Operated 638 Health Programs as defined by HRSA; (F) Urban Indian Health Programs (ITUs) as defined by the Indian Health Service; (G) State or local health departments; (H) Substance Abuse and Mental Health Services Administration (SAMHSA) certified opioid treatment programs, office-based opioid treatment programs and non-opioid outpatient substance use disorders treatment facilities; and (I) Other designation or criteria as determined by the Authority.