Certification Rules for Local School Dental Sealant Programs
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Establishes certification, training, infection control, quality monitoring, data reporting, and service-delivery requirements for Local School Dental Sealant Programs that operate in Oregon elementary and middle schools; affects entities seeking Program certification and their clinical and administrative staff.
Terminology is clarified by consistently referencing the 'Oregon Health Authority, Public Health Division, Oral Health Program' and replacing 'Authority' with 'Program' throughout the rules.
Certification requirements updated to align IPC requirements with Oregon OSHA, Oregon Board of Dentistry, and CDC guidance and to require a Program-approved Quality Monitoring and Evaluation Plan with specified data submission.
Definitions and training requirements updated and standardized, including certification training, clinical training, and definitions for Program, Local SDSP, and related terms.
Certification and recertification processes clarified, including application procedures, timelines, Program authority, provisional certification, and notification requirements for terminated services.
Verification review requirements revised to clarify administrative and in-person site review processes, prioritization criteria, review intervals, and allowance for unannounced reviews.
Compliance rule strengthened with clarified waiver processes, timelines for corrective action, and Program enforcement authority including suspension and decertification procedures.
Quality Monitoring and Evaluation Plan and reporting requirements specified, including required data elements and twice-per-year QI/QA submissions.
Certification, Operation, and Monitoring Requirements
Certification and program operation criteria
Operational and service-delivery requirements Local SDSPs must meet to be certified and to operate in schools:
ALL of the following
- Local SDSP must be an entity outside of the Program with infrastructure to operate a school-based sealant program; if a business entity, it must be registered with the Oregon Secretary of State.
- Local SDSP must have a written policy to coordinate with schools, districts, or public charter schools to facilitate background checks of Local SDSP staff as required by school policy per ORS 326.607.
- When multiple Local SDSPs request to serve the same school, the Program will determine which Local SDSP will provide services after consulting Local SDSPs, CCOs, and schools to ensure access and minimize duplication.
ALL of the following
- A representative responsible for coordinating and implementing the Local SDSP must attend a one-time certification training provided by the Program prior to applying; if the representative changes, the new representative must attend the one-time training before applying for recertification.
- Local SDSP must provide annual clinical training to all providers rendering care in schools; this may be met by (a) the Local SDSP developing and implementing its own annual training within the certification year, or (b) clinical providers attending an annual Program-provided training that includes application techniques for resin-based and glass ionomer sealants.
ALL of the following
- Sealant services must be primarily provided on school grounds during normal instruction hours.
- Use four-handed technique to apply sealants in elementary schools; the second provider need not be a dental professional but must be trained and proficient and adhere to IPC, equipment operation, confidentiality, and Program policies.
- Use two-handed technique with an Isolite or equivalent Program-approved isolation device or the four-handed technique to apply sealants in middle and high schools.
- Apply resin-based or glass ionomer sealants according to manufacturer instructions.
- Use compressor and suction capabilities at all times except in rare situations as determined by professional judgment or during a declared state of emergency or public health emergency.
ALL of the following
- Local SDSP must comply with all scope of practice laws as determined by the Oregon Board of Dentistry and with Oregon Board of Dentistry oral health screening guidelines for screening and reporting results to parents/guardians.
- Local SDSP must comply with infection prevention and control (IPC) protocols established in OAR 333-019-0061, OAR 818-012-0040, and guidance from the Oregon Board of Dentistry, Oregon OSHA, and CDC; the Program will provide a guidance document.
ALL of the following
- A medical history is required on the parent/guardian permission form.
- Any templates or materials provided by the Program that are modified or used by the Local SDSP must acknowledge the Program on such templates or materials.
- Local SDSP must respect classroom time, limit demands on school staff, deliver services efficiently to minimize time out of class, develop accessible forms consistent with health literacy and plain language, and communicate with assigned schools to engage them using email, telephone, or in-person methods.
- Local SDSP must provide the Program certification logo on all parent/guardian permission forms and written communication to schools or provide schools a Program letter indicating the Local SDSP is certified.
Certification, monitoring, review, and compliance criteria
Quality Monitoring, data collection, clinical and operational standards, and reporting requirements for Local SDSPs:
ALL of the following
- Each Local SDSP must develop and maintain a Quality Monitoring and Evaluation Plan describing how the program will collect, analyze, and report program data; the Plan must be approved by the Program.
- A Local SDSP must submit the self-monitoring Quality Monitoring and Evaluation Plan annually to the Program in the format, method, and timeline specified by the Program and must comply with Program requests for information related to the Plan.
- The Plan must identify, analyze, and address client safety concerns and adverse events, including obtaining consent for services, adherence to manufacturers' instructions and IPC protocols, and compliance with HIPAA and FERPA as applicable.
- A Local SDSP must evaluate its Quality Monitoring and Evaluation Plan at least twice during each school year and make adjustments as needed.
ALL of the following
- A Local SDSP must submit to the Program, twice per certification school year, a Quality Improvement and/or Quality Assurance (QI/QA) assessment reporting progress on implementing the Quality Monitoring and Evaluation Plan; the Program will provide a QI/QA assessment guidance document.
- A Local SDSP must submit a mid-school-year update no later than February 1 and an end-of-school-year update no later than June 15, in the format and aggregate-level definitions determined by the Program.
ALL of the following
- Only an authorized individual may apply via the Program's online Certification Application and Renewal Certification Application; the Program will review the application for completeness (target ~15 business days) and may approve, deny, or grant provisional certification.
- Certified status is effective August 1 through July 31; renewal applications must be submitted by July 15 each year and require submission of the Program-approved data report prior to renewal.
ALL of the following
- The Program will conduct an administrative verification review each school year and in-person on-site verification reviews prioritized for newly certified programs, programs with prior deficiencies, programs with new lead clinician or program director, and at least once every five years for programs in good standing.
- Unannounced reviews: The Program may conduct unannounced reviews when compliance concerns arise.
ALL of the following
- A Local SDSP must notify the Program within 10 business days of any change causing noncompliance and may submit a waiver within 10 business days that includes an explanation of the noncompliant rule(s), a corrective action plan, and a proposed compliance date; the Program will respond to the waiver within 10 business days.
- Services may continue while a waiver is under review; for egregious or unresolved deficiencies the Program may suspend or decertify a Local SDSP and will notify CCOs and schools of suspensions, decertifications, and when suspensions are lifted.
- If rule updates require operational changes, the Program will allow until the next certification year or a minimum of 90 days for Local SDSPs to come into compliance, except during declared emergencies or when immediate compliance is specified.
Coding, Priority Criteria, and Encounter Reporting
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Provider Certification, Training, and Required Actions
Certification, training, and Medicaid encounter reporting
Local SDSPs must be certified by the Program before providing dental sealants in a school setting. During a declared state of emergency or public health emergency, the Program may, in writing, waive certification requirements. A representative responsible for coordinating and implementing the Local SDSP must attend the one-time certification training provided by the Program prior to applying; if that representative changes, the new representative must attend the one-time training before applying for recertification. Local SDSPs must provide an annual clinical training to all providers rendering care in schools. The Program will provide Coordinated Care Organizations (CCOs) with a list of certified Local SDSPs and the schools they serve twice per certification year. Local SDSPs must ensure Medicaid encounters for sealants are entered into the Medicaid system (the Program will provide a CCO contact list).
- Certification required before providing school sealants; Program may waive during declared emergencies (chunk 16).
- One-time certification training for the coordinating representative required before applying; new representative must complete training before recertification (chunk 16).
- Annual clinical training required for all providers; may be Program-provided or locally developed (chunk 16).
- Program provides CCO list of certified Local SDSPs twice per certification year (chunk 26).
Certification application, provisional certification, and service termination notification
Apply and renew only via the Program's online Certification Application and Renewal Certification Application posted on the Program website. The Program will review an application for completeness within approximately 15 business days; incomplete applications will be returned for resubmission. If approved, the Program will notify the applicant by email and schedule virtual administrative and in-person verification reviews. Provisional certification may be granted with an agreed corrective action timeline. A Local SDSP must notify the Program and CCOs if it plans to terminate or cannot provide services to a scheduled school and must consult with the Program and exhaust options before terminating services (notification requirement may be waived during a declared emergency).
- Submit initial Certification Application and Renewal Certification Application online via www.healthoregon.org/sealantcert (chunk 26).
- Program reviews application completeness within ~15 business days; incomplete applications returned (chunk 26).
- If application meets requirements, Program emails approval and schedules virtual and on-site reviews (chunk 26).
- Provisional certification allowed with corrective action plan; applicant must submit waiver including explanation, corrective actions, and compliance date (chunk 27).
- Notify Program and CCOs before terminating services for a scheduled school; must consult and exhaust options prior to termination (chunk 27).
Waiver submission and consequences for noncompliance
If out of compliance, submit a waiver to the Program that includes an explanation of the non-compliant requirement, a corrective action plan, and a proposed date for compliance. The Program will review the waiver and inform the Local SDSP of approval or denial within 10 business days; services may continue until the Program notifies the Local SDSP of the waiver decision. If approved, provisional certification is provided and the Local SDSP must meet the proposed compliance date. If denied, or if compliance is not achieved, the Program may require additional waivers, issue written warnings, or notify the Local SDSP of suspension or decertification; the Program will notify CCOs and affected schools of suspensions or decertifications.
- Waiver must include: explanation of non-compliance, plan for corrective action, and date for compliance (chunk 34).
- Program will respond to waiver within 10 business days; services may continue until notified of result (chunk 34).
- Approved waivers lead to provisional certification with the stated compliance date; denied waivers or unresolved noncompliance may result in additional waivers, written warnings, suspension, or decertification (chunk 34).
- Program will notify CCOs and schools when a Local SDSP is suspended, decertified, or when a suspension is lifted (chunks 34, 35).
Key Terms and Program Definitions
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