July

July 2012

State Board of Dentistry Report July 27, 2012

Michael Kaner DMD JD FAGD

Attended by Shawn Casey DMD and Michael Kaner, DMD

Report of Prosecutors

1) A consent agreement with an oral surgeon for record keeping violations form 2001-2007.  A civil penalty of $2000 was imposed and he was given a public reprimand as well as being required to attend 6 hours of Continuing Education on record keeping for failure to document anesthesia used.

2)  A general dentist who was impaired was suspended for violating a prior consent agreement due to a relapse of  his drug problem.  A 3 year active suspension was imposed retroactive to December 2010 and 5 years of probation  was imposed afterwards. That probation period will include monitoring and random urine testing for drugs.

3) A consent agreement involved as dentist who provided a false license to the practice that employed them. The employee dentist was immediately fired when the practice learned that he did not have a valid Pennsylvania dental license. The employee dentist had no prior disciplinary history and was imposed a civil penalty of $1000, a suspension of 2 years but they could apply for reinstatement after 90 days and a requirement that they have liability insurance in order to practice in PA.  The Board imposed 200 hours of public service dentistry over the next 21 months after the suspension is lifted.

4) A dentist convicted in Federal court for the crime of failure to file tax returns agreed to a revocation of his dental license.

5) A consent agreement for a dentist involved in a case in which another dentist and an EFDA were previously disciplined for allowing the EFDA to practice beyond her allowed scope. The dentist previously disciplined was the partner of the dentist in this case who was present and aware of his partner’s action. While the dentist in this case had no direct supervision of the EFDA, he was aware of her actions. The EFDA did endodontic procedures as well as permanently cementing crowns and taking final impressions.

Her supervising dentist previously received a $4000 civil penalty and a suspension stayed for probation for what the SBOD classified as an act of commission. 

  In this case, the non-supervising dentist received a public reprimand and $2000 civil penalty  for an act of omission of not reporting the actions of the EFDA immediately, though he eventually did report the violations.

6) A dental hygienist was disciplined for failure to meet the 20 hours of CE. She had nine hours but was missing the other eleven required hours.  She was imposed a $550 penalty and given a public reprimand.

7)Probable Cause case- In this case, he respondent dentist had criminal and SBOD disciplinary imposed from 1994-2008. He had a history of drug decency and two convictions in 1997 and 2006 after which the SBOD imposed three years of probation. In 2012, that dentist was charged with possession of Xanax and marijuana blunt ( small cigar hollowed out and refilled with marijuana),. The SBOD imposed an immediate temporary suspension and required him to see a physician for screening. The physician’s report concluded that the dentist had a cocaine dependency as well as being an abuser of marijuana with a high risk of relapse.  The recommendation was that the dentist was safe to practice dentistry only if in a structured program. The criminal charges was reduced to a summary offense. The Board recommended a civil penalty of $2500 for the costs of the investigation and a period of 5 years  Disciplinary Monitoring Unit (DMU) probation.

REPORT OF BOARD COUNSEL

1) Volunteer License- All of the State Boards with  licenses for those practitioners rendering treatment gratuitously are working to making requirements uniform across the board.

2) Mandatory reporting of suspected child abuse- There is an effort ongoing to amend it for all seven of the health care boards.

3) EFDA Scope of Practice- The codified rules at being reviewed by the Independent Regulatory Review Commission. After that step, it is sent to the Attorney General for final review . The AG’s office will have 30 days to review. If there are no actions taken, they are deemed to have been accepted and the final regulations will then be published in the PA Bulletin which is expected by late August.

4) Policy Statements- The board is working on statements  for tooth whitening and Botox.

Legislation

House bill 2492- This legislation involves the license and scope of practice of foreign trained dentists.  While allowed to practice under certain circumstances in a dental schools if not holding a full PA dental license, it would prevent them from practicing in satellite facilities. It would limit their practice to the main building of the dental school and not off campus. In addition, it details the time limit to receive a dental degree from a CODA approved school.

Implementation of a Temporary License

Dr. Siegel discussed how the SBOD was trying to emulate other states such as Wisconsin and Connecticut  that have addressed the issue of volunteer licenses.. He recommended the medical model in which dentists license in Pennsylvania as well as those from out of state, licensed elsewhere  can participate in emergencies and special events . It is more efficient that mid-level providers and can aid both the adult and child population and will help to establish access to care for adults. Dr. Siegel discussed the crafted of legislation that is in preliminary stages because the Board Counsel noted that the Board does not have statutory authority to create a new class of license and needs a legislative initiative.

  He mentioned a provisional license valid for 10 days if certain requirements are met;

  A) Licensee is in good standing 

  B) It is valid for volunteer services only

  C) It is for a specific site or a specific event

  D) 120 days prior to the event, the applicant for a volunteer license must file paperwork with the SBOD detailing their licensure state as well as having liability coverage. This is not to be a “ rubber stamping” approval but a full vetting process. There was discussion as to the feasibility of such a long vetting process and how that might negatively impact the ability to get volunteers who often decide to participate soon before an event;

Additional requirements proposed would require the site of the donated dental services to be approved by the Board and ensure that all volunteers have

1) a valid dental license

2) valid current liability coverage at Pennsylvania statutory minimums ( $ 1 million/per occurrence $3 million total)

3) Agree to provide services gratuitously with no payment of any kind. 

Further concerns were t ensure that follow-up care was provided.

State Board Budget

For the past several meetings, the SBOD has been working on devising a revision in licensing fees that will ensure that the Board is able to maintain a balanced budget, in the coming year and well into the future. They have given their accountants various scenarios for increases and asked for reports on how it impacts the overall long term fiscal health.

The options were

a) Increasing application fee from $20 to $200 for dentists ( comparable to other states) and for hygienists from $20 to $75. This would keep it in positive numbers until 2018.

b) A 2.5% increase in renewal fees for dentists from $250 to $258 and for hygienists from $40 to $41. This stabilizes the budget until 2018-19.

c)  Increase renewal fees 5% from $250 to $275 for DMDs and $40 to $44 for RDHs. 

One Board member asked that they project numbers for a 10% increase to evaluate its impact.

At the next Board meeting, they will discuss it further.

                                             Submitted,

                                             Michael Kaner DMD JD FAGD