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Oregon and California   Message List  
Reply | Forward Message #17 of 23 |
Re: [ORLAPAlliance] Re: Oregon and California

(Below is a delayed response to Jan's post ~ something must have interfered my message going through a few days ago.  I'm resending now.  Thanks for sharing your thoughts, Karen and Jan.)  If anyone else would like to comment on this issue, I'd sure love to hear it.  -Christa
 
Thank you, Jan.  You've just provided me some important feedback.  This is great!
The experience you've shared brings to mind a couple of questions.  
 
1)  Why is reimbursement slow?  Is it slower than a traditional general practice's reimbursement?
2)  Which hygiene services can be performed and billed?  Prophy, perio maint, RPC/SRP?
3)  Can you comment more on the local anesthesia?  I was looking at the 2007 Oregon regulations and it says general anesthesia can be performed under "General" supervision, not "direct".  I think this is a long-standing rule. 
 
As for anesthesia  (see below ~ highlighted yellow).  It seems they're saying local anesthesia is okay for a LAP hygienist IF done within certain LAP circumstances.  By this kind of 'general' supervision I wonder if it might be possible to have the patient's dentist 'ok' the use of local anesthesia.  Seems like this would qualify as general.  Any thoughts?
 
Frankly, the local anesthesia issue is kind of a deal maker or breaker for me.  If I'm going to treat adults who haven't had regular access to care, I want to make sure their first cleanings are not torture, and that they get the kind of care they need.  I don't want that kind of experience.  Neither do they, generally.
 
Thank you so much!!
 
-Christa
 
680.205 Services rendered under permit. (1) A dental hygienist issued a permit to act as a limited access permit dental hygienist under ORS 680.200 shall be authorized to render all services within the scope of practice of dental hygiene, as defined in ORS 679.010, without the supervision of a dentist and as authorized by the limited access permit to:

      (a) Patients or residents of the following facilities or programs who, due to age, infirmity or disability, are unable to receive regular dental hygiene treatment:

      (A) Nursing homes as defined in ORS 678.710;

      (B) Adult foster homes as defined in ORS 443.705;

      (C) Residential care facilities as defined in ORS 443.400;

      (D) Adult congregate living facilities as defined in ORS 441.525;

      (E) Mental health residential programs administered by the Department of Human Services;

      (F) Facilities for mentally ill persons, as those terms are defined in ORS 426.005;

      (G) Facilities for persons with mental retardation, as those terms are defined in ORS 427.005;

      (H) Local correctional facilities and juvenile detention facilities as those terms are defined in ORS 169.005, regional correctional facilities as defined in ORS 169.620, youth correction facilities as defined in ORS 420.005, youth care centers as defined in ORS 420.855, and Department of Corrections institutions as defined in ORS 421.005; or

      (I) Public and nonprofit community health clinics.

      (b) Adults who are homebound.

      (c) Students or enrollees of nursery schools and day care programs and their siblings under 18 years of age, Job Corps and other similar employment training facilities, primary and secondary schools, including private schools and public charter schools, and persons entitled to benefits under the Women, Infants and Children Program.

      (2) The Oregon Board of Dentistry may authorize the provision of dental hygiene services by a limited access permit dental hygienist at locations or to populations that are underserved or lack access to dental hygiene services.

      (3) At least once each calendar year, a dental hygienist issued a permit to act as a limited access permit dental hygienist shall refer each patient or resident to a dentist who is available to treat the patient or resident.

      (4) This section does not authorize a limited access permit dental hygienist to administer local anesthesia, denture soft lines, temporary restorations and radiographs except under the general supervision of a dentist licensed under ORS chapter 679, or to administer nitrous oxide except under the indirect supervision of a dentist licensed under ORS chapter 679.

      (5) A limited access permit dental hygienist may assess the need for and appropriateness of sealants, apply sealants and write prescriptions for all applications of fluoride in which fluoride is applied or supplied to patients.

      (6) A person granted a limited access permit under ORS 680.200 shall also procure all other permits or certificates required by the board under ORS 679.250. [1997 c.251 §3; 2001 c.592 §1; 2005 c.52 §1; 2007 c.70 §306; 2007 c.379 §3]

 


----- Original Message ----
From: "aljanyoung@..." <aljanyoung@...>
To: ORLAPAlliance@yahoogroups.com
Sent: Thursday, June 19, 2008 4:37:36 PM
Subject: Re: [ORLAPAlliance] Re: Oregon and California

Christa,
  You can not use anesthetic because it is under direct supervision.
  We have been able to get reinbursement from the insurance companies.  Some times it is slow.  You are to make referrals to a dentist.  Most have a dentist of record.  I is hard to get a referral on the Oregon Health Plan.  I have done a few with my LAP but still work pretty much full time in a regular dental setting.  Many are making it their full time work.  We are needed in the Care facilities.
Jan Young




----- Original Message ----
From: "aljanyoung@..." <aljanyoung@...>
To: ORLAPAlliance@yahoogroups.com
Sent: Thursday, June 19, 2008 4:37:36 PM
Subject: Re: [ORLAPAlliance] Re: Oregon and California

Christa,
  You can not use anesthetic because it is under direct supervision.
  We have been able to get reinbursement from the insurance companies.  Some times it is slow.  You are to make referrals to a dentist.  Most have a dentist of record.  I is hard to get a referral on the Oregon Health Plan.  I have done a few with my LAP but still work pretty much full time in a regular dental setting.  Many are making it their full time work.  We are needed in the Care facilities.
Jan Young



************ **
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(http://autos. aol.com/used? ncid=aolaut00050 000000007)



Sun Jun 22, 2008 11:46 pm

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Message #17 of 23 |
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Hello everyone! I'm graduating from my DH educational program this year and planning to take National Boards in March 2007 and State Boards in July 2007 in...
Cori Ann
corirdh2007
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Jan 6, 2007
7:01 pm

Hello! Hmm, not a lot of chatter on this site ~ but that's okay. However, I do hope to fluff up a bit of critical information about practicing with an LAP...
Christa
wreckless_x2
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Jun 9, 2008
10:32 pm

Christa, You can not use anesthetic because it is under direct supervision. We have been able to get reinbursement from the insurance companies. Some times it...
aljanyoung@...
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Jun 19, 2008
11:37 pm

Are you sure anesthetic is under direct supervision? That means a dentist needs to be in the room with you as you give anesthetic. I would check the dental...
Karen Hall
karenhall_lap
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Jun 22, 2008
2:54 pm

(Below is a delayed response to Jan's post ~ something must have interfered my message going through a few days ago.  I'm resending now.  Thanks for sharing...
Christa Olsson
wreckless_x2
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Jun 22, 2008
11:46 pm

Karen, You are correct it is General supervision. Jan ************** Gas prices getting you down? Search AOL Autos for fuel-efficient used cars. ...
aljanyoung@...
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Jun 23, 2008
6:42 pm
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