Feb. 21, Gov. Jay Inslee (D-WA) signed the first bill of the regular session
5079. The new law allows federally
recognized tribes to use federal funding for dental health aide therapists
(DHATs), who provide preventive care and procedures such as cleanings,
fillings and oral exams.
SB 5079 passed the full House with an 80–18 vote and received unanimous approval
in the Senate.
Indian Health Service (IHS)
is a federal agency responsible for providing federal health services to
American Indians and Alaska Natives. The IHS is authorized under the Indian Health
Care Improvement Act to develop and
operate a community health aide program in Alaska that serves rural native
2001, the IHS established a dental health aide program as a component of the
community health aide program to address the shortage of licensed dentists in
the remote locations where rural Native Alaska communities are located.
the IHS announced
its plan to expand the community health aide program across the country. Such
an expansion expressly excludes DHAT services from any expanded program in a
state unless such services are authorized by the state legislature.
does not have a DHAT license. Under the new law, the DHAT practice is
authorized and exempt from licensing requirements if the DHAT is certified by a
federal community health aide program or a federally recognized tribe that has
adopted similar certification standards. The DHAT services must be performed in
accordance with the certification standards or through a certified DHAT
training program. Additionally, authorized DHAT services must be performed in a
practice setting operated by an Indian health program that is located within
the boundaries of a tribal reservation. The DHAT services are only authorized
to be performed on tribal members or persons otherwise eligible to receive IHS
care. The Washington State Health Care Authority is directed to coordinate with
the Centers for Medicare & Medicaid Services to ensure that DHAT services are
eligible to receive federal funding up to 100%.
 A DHAT is
certified through the dental health aide program to practice without the direct
supervision of a licensed dentist for procedures such as oral exams,
preventative dental services, simple restorations, stainless steel crowns and X-rays.
A DHAT may perform extractions and root canal procedures only after
consultation with a licensed dentist who determines that the procedure is a
medical emergency. The DHAT certification requires a high school diploma,
graduation from a two-year educational program and a 400-hour clinical
preceptorship under the supervision of a dentist.