Update on Rules for Written Dental Records

I wanted to provide our membership with a summary/update regarding proposed rule changes by the Board of Dentistry (BOD) governing the requirements for written dental records (Rule 64B5-17.002, Written Dental Records, Minimum Content, Retention).

As many are aware, a three member BOD Task Force had proposed adding new language, with more detailed requirements, to the existing rule. Several Task Force meetings were held, with discussions of the proposed changes, over a period of many months, since about the summer of 2013.

However, admittedly not until somewhat later in the process, several organized dental groups took notice and developed concerns regarding the proposed rule language.

Although some of the new requirements dealt with issues such as informed consent, record alterations, retention of one’s appointment book, and maintenance of electronic dental records – which were largely non-controversial – the portion of the new Rule language singled out as being the most objectionable or controversial had been limited to language added to Sections 1(a) through 1(e) (please see existing rule language, and the previously proposed new language, denoted by underline, at the end of this update).

Following a January, 2014 Florida Dental Association House of Delegates (FDA HOD) meeting in Tampa, in which BOD Chair, Dr. Joe Thomas, was present for a Q & A regarding the issue, I sent out an email to our executive board and other interested parties with information and concerns expressed. Soon thereafter, our president, Mark Braxton, appointed an ad hoc committee (composed of myself as chair, also Larry Nissen, Tom Bowers, and Mike Huey) to further study and discuss the issue. As a result, we voted to develop a position letter, which we then brought to our board for approval, and forwarded it to the BOD, in which we stated opposition to the addition of new language to the existing rule.

Soon thereafter, however, the BOD passed the new rule language at a May, 16 meeting. Following this, a greater level of concern developed among multiple other dental groups, and among grass roots dentists throughout the state.

The Florida Dental Association (FDA) then jumped on board and, at a
June 13-14 HOD meeting, passed a resolution to “oppose the recent addition of language within Rule 64B5-17.002, Paragraph 1(a) through 1(e), and take such steps as appropriate, up to and including, a challenge of the proposed rule.”

Soon thereafter, FSOMS and FDA sent letters to the BOD requesting an appearance to discuss the Rue language further at a planned “Rule Workshop” scheduled for August 22 in Orlando. Leading up the workshop, I had also communicated with all of the other specialty groups in Florida (excluding oral path, radiology, public health), and all of whom agreed to join us (FSOMS) in appearing before the BOD to express the same/similar message.

The August 22 Rule Workshop began with a brief presentation by the FDA liaison to the BOD, Dr. Don Ilkka. Following that item, Mike Huey and I both spoke before the BOD, and with reps from each of the other dental specialty groups sitting along side us at the table. A rep from AGD then followed us on the agenda.

As a result, the BOD voted to table the entire rule, and send it back to committee. Also, the previous chair of the BOD Records Task Force, Wade Winker, declined to continue his previous well-intended effort. Upon asking for another volunteer from within the BOD, the newest BOD member, and our own, TJ Tejera, agreed to be the new chair.

In search of a new direction, TJ decided to:
(1) do away with Section 1(a) through 1(e) which had caused so much consternation, and
(2) replace it with a paragraph of language, with some minor changes in wording, which had withstood the test of time, and had already been in place and in use since 1992 – by the Board of Medicine.

(Please see new language at the end of this update)

Upon seeing the new language – it appeared to help the BOD in terms of providing items which no doubt should be included within a dental or medical record, but yet with language which few, if any, could argue with or feel threatened by.

And for now – it appears to be a problem solved.

A meeting/teleconference of the BOD Dental Records Task Force was held last evening in which the new language appeared well appreciated and well liked by virtually everyone on the call. The rule would next need to pass through a vote of the Rules Committee (November 6), and then by the BOD at the next general meeting (November 21).

Anyone familiar with the rulemaking process would tell you that nothing is “final” at this point, as unforeseen changes may still occur. But in any case, this appears to be headed in the right direction, and we will continue to make every effort to keep you, our members, informed.

Respectfully,

Richard Mufson, DDS, Chair
FSOMS Task Force on Dental Records