ARC 4948C
DENTAL BOARD[650]
Adopted and Filed
Rule making related to dental assistant remediation requirements
The Dental Board hereby amends Chapter 20, “Dental Assistants,” and Chapter 22, “Dental Assistant Radiography Qualification,” Iowa Administrative Code.
Legal Authority for Rule Making
This rule making is adopted under the authority provided in Iowa Code section 147.76.
State or Federal Law Implemented
This rule making implements, in whole or in part, Iowa Code section 153.39.
Purpose and Summary
These amendments update examination requirements to better reflect the needs of applicants for dental assistant registration in the state of Iowa and to reduce barriers of entry to the job market. Current rules require prospective dental assistants who twice fail required examinations in the areas of jurisprudence, infection control and radiography to submit proof of formal education in the area of examination failure through a program approved by the Board or a school accredited by the Commission on Dental Accreditation. This remedial education is required before the applicant can test a third time. Remediation can be difficult for some dental assistant applicants to complete due to a lack of local options available or due to cost of the training.
The Board wants to be responsive to this issue by eliminating formal remediation requirements. Prospective dental assistants who fail the exam have the ability to review study materials issued by the Board, which provides the opportunity for self-remediation. Further, dental assistant trainees work under the personal supervision of a dentist, which provides safeguards to the public. 
Public Comment and Changes to Rule Making
Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 6, 2019, as ARC 4741C. One written comment was received. Lisa Swett, R.D.H., with Impact Dental Training, expressed concern and believes that formal remediation is beneficial and establishes a basic level of competency for those entering the profession. Ms.	Swett believes that it is counterproductive to allow individuals to retest without formal remediation. Ms.	Swett stated that Impact Dental Training would be happy to consider alternative platforms if access is a problem. No changes from the Notice have been made.
Adoption of Rule Making
This rule making was adopted by the Board on January 24, 2020.
Fiscal Impact
This rule making has no fiscal impact to the State of Iowa.
Jobs Impact
After analysis and review of this rule making, there is a positive impact on jobs, as the remediation requirement delays entry into the job market.
Waivers
Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any.
Review by Administrative Rules Review Committee
The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).
Effective Date
This rule making will become effective on April 1, 2020.
The following rule-making actions are adopted:
	Item 1. Amend rule 650—20.2(153), definition of “Public health supervision,” as follows:
“Public health supervision” means all of the following:
	1.	The dentist authorizes and delegates the services provided by a registered dental assistant to a patient in a public health setting, with the exception that services may be rendered without the patient’s first being examined by a licensed dentist;
	2.	The dentist is not required to provide future dental treatment to patients served under public health supervision;
	3.	The dentist and the registered dental assistant have entered into a written supervision agreement that details the responsibilities of each licensee/registrant, as specified in subrule 20.16(2) 20.15(2); and
	4.	The registered dental assistant has an active Iowa registration and a minimum of one year of clinical practice experience.
	Item 2. Amend subrule 20.5(2) as follows:
	20.5(2) Dental assistant trainee. Dental assistant trainees are all individuals who are engaging in on-the-job training to meet the requirements for registration and who are learning the necessary skills under the personal supervision of a licensed dentist. Trainees may also engage in on-the-job training in dental radiography pursuant to rule 650—22.3(136C,153).
	a. 	General requirements. The dental assistant trainee shall meet the following requirements:
	(1)	Successfully complete a course of study and examination in the areas of infection control, hazardous materials, and jurisprudence. The course of study shall be prior approved by the board and sponsored by a board-approved postsecondary school.
	(2)	If a trainee fails to become registered by the trainee status expiration date, the trainee must stop work as a dental assistant trainee. If the trainee has not yet met the requirements for registration, the trainee may reapply for trainee status but may not work until a new dental assistant trainee status certificate has been issued by the board.
	b. 	Trainee restart.
	(1)	Reapplying for trainee status. A trainee may “start over” as a dental assistant trainee provided the trainee submits an application in compliance with subrule 20.6(1).
	(2)	Examination scores valid for three years. A “repeat” trainee is not required to retake an examination (jurisprudence, infection control/hazardous materials, radiography) if the trainee has successfully passed the examination within three years of the date of application. If a trainee has failed two or more examinations, the trainee must satisfy the remedial education requirements in subrule 20.11(1). The trainee status application will not be approved until the trainee successfully completes any required remedial education.
	(3)	New trainee status expiration date issued. If the repeat trainee application is approved, the board office will establish a new trainee status expiration date by which registration must be completed.
	(4)	Maximum of two “start over” periods allowed. In addition to the initial 12-month trainee status period, a dental assistant is permitted up to two start over periods as a trainee. If a trainee seeks an additional start over period beyond two, the trainee shall submit a petition for rule waiver under 650—Chapter 7.
	c. 	Trainees enrolled in cooperative education or work study programs. The requirements stated in this subrule apply to all dental assistant trainees, including a person enrolled in a cooperative education or work-study program through an Iowa high school. In addition, a trainee under 18 years of age shall not participate in dental radiography.
	Item 3. Rescind rule 650—20.11(153).
	Item 4. Renumber rules 650—20.12(153) to 650—20.17(153) as 650—20.11(153) to 650—20.16(153).
	Item 5. Amend rule 650—22.5(136C,153) as follows:
650—22.5(136C,153) Examination requirements. An applicant for dental assistant radiography qualification shall successfully pass a board-approved examination in dental radiography.
	22.5(1) Examinations must be prior approved by the board and must be administered in a proctored setting. All board-approved examinations must have a minimum of 50 questions. The Dental Assisting National Board Radiation Health and Safety Examination is an approved examination.
	22.5(2) A score of 75 percent or better on a board-approved examination shall be considered successful completion of the examination. The board accepts the passing standard established by the Dental Assisting National Board for applicants who take the Dental Assisting National Board Radiation Health and Safety Examination.
	22.5(3) Information on taking a board-approved examination may be obtained by contacting the board office at 400 SW 8th Street, Suite D, Des Moines, Iowa 50309-4687.
	22.5(4) A dental assistant must meet such other requirements as may be imposed by the board’s approved dental assistant testing centers.
	22.5(5) A dental assistant who fails to successfully complete a board-approved examination after two attempts will be required to submit, prior to each subsequent examination attempt, proof of additional formal education in dental radiography in a program approved by the board or sponsored by a school accredited by the Commission on Dental Accreditation of the American Dental Association.
[Filed 2/6/20, effective 4/1/20]
[Published 2/26/20]
Editor’s Note: For replacement pages for IAC, see IAC Supplement 2/26/20.