Rule-Making Notices (Hearing Notices)

Section 227.11 (2) (a), Stats., authorizes all agencies to promulgate rules interpreting the statutes it enforces or administers, when deemed necessary to effectuate the purpose of such statutes.

Related statute or rule

Section 146.81 (1) and (4), Stats.

Plain language analysis

The proposed rule is to outline the minimum requirements for patient dental records. The rule considers ss. 146.81 (1) and (4), Stats., whereby dentist is defined as a healthcare provider and consequently required to maintain patient health records as specified in s. 146.81 (4), Stats. No additional requirements are proposed in this newly created chapter.

SECTION 1. This section creates a new chapter, DE 8 patient dental records and substantially mirrors the patient health records as specified in ch. Med 21, Wisc. Admin. Code. Specific areas of compliance include: retention, confidentiality, destruction and falsification of records.

SECTION 2. This section identifies when in the rule-making process the rule shall become effective.

Summary of, and comparison with, existing or proposed federal regulation

An Internet-based search of the U.S. Code and Federal Register did not reveal any laws or proposals related to patient dental records, with the exception of the move to electronic records for Medicaid patients in 2016.

Comparison with rules in adjacent states

An Internet-based search of the four adjacent states revealed the following:

Illinois: In Illinois Department of Financial and Professional Regulation oversees dentists; no rules requiring patient dental records were found.

Iowa: In Iowa, chapter 27 of the Iowa code, 650—27.11 (153,272C), relates to record keeping. Patient dental records must be maintained for a minimum of six years after the date of last examination, prescription, or treatment and for a minor for 6 years after the age of majority. . Similar to other states, when electronic records are kept, a duplicate hard copy record or use of an unalterable electronic record must be maintained.

Michigan: In Michigan the Board of Dentistry rule, 1120 (R 338.11101 - 338.11821), requires records to be maintained for 10 years after the last treatment. In addition charting of dental procedures and a listing of medications administered are two additional requirements unlike proposed in this rule.

Minnesota: In Minnesota, the related rule is 3100.9600, record keeping. This rule requires records to be maintained for 7 years after the last treatment. In the case of a minor patient, the records must be maintained for 7 years beyond the age of majority. In addition an emergency contact, information related to any insurance coverage, and providing an electronic backup are three additional requirements unlike proposed in this rule.

Summary of factual data and analytical methodologies

No factual data and analytical methodologies were used to draft these rules.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis

The issue of patient dental records was raised in the context of not having a retention policy and the impact on associated costs related to the amount of storage dentist and firms are currently are maintaining. Section 146.81 (4), Stats., provides a period for destruction of records 5 years after the date of the last entry, or for such longer period as may be otherwise required by law.

Pursuant to s. IV, 3. a., EO # 50, the rules herein were posted on both the state's and the department's administrative rules websites for 14 days in order to solicit comments regarding the rule's potential economic impact on businesses, business sectors, professional associations, local government units, or potentially interested parties.

It is expected that this proposed rule will result in a decrease expense at least in the cost of hard-copy record storage. No specific data was collected or analyzed to come to this conclusion.

Fiscal Estimate and Economic Impact Analysis

The Fiscal Estimate and Economic Impact Analysis is attached.

Initial Regulatory Flexibility Analysis or Summary

These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Environmental Assessment/Statement [if required]:

N/A

Agency Contact Person

Jean MacCubbin, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, 1400 East Washington Avenue, Room 151, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone [phone] or telecommunications rely at 711; email at [e-mail].

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (R03/2012)	Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: [phone]
ADMINISTRATIVE RULES Fiscal Estimate & Economic Impact Analysis

1. Type of Estimate and Analysis
X Original   ⍽ Updated   ⍽ Corrected
2. Administrative Rule Chapter, Title and Number
Ch. DE 8, Patient Dental Records
3. Subject
Dental Patient Records; record Retention, Record Guidelines
4. Fund Sources Affected			5. Chapter 20, Stats. Appropriations Affected
⍽ GPR   ⍽ FED   X PRO   ⍽ PRS   ⍽ SEG   ⍽ SEG-S			20.165(1)(g)
6. Fiscal Effect of Implementing the Rule
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues		⍽ Increase Costs ⍽ Could Absorb Within Agency's Budget ⍽ Decrease Cost
7. The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy ⍽ Local Government Units		⍽ Specific Businesses/Sectors ⍽ Public Utility Rate Payers ⍽ Small Businesses (if checked, complete Attachment A)
8. Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes   X No
9. Policy Problem Addressed by the Rule
Currently there are no guidelines or policies on patient dental records retention in chs. DE 1 to 13. Licensees report that hard copy retention of records requires storage and in some cases, off-site storage. Electronic record storage is an option and hard-copy storage could be reduced depending on retention policies. In both cases, a reduction in cost is evitable in the long-term.
10. Summary of the businesses, business sectors, associations representing business, local governmental units, and individuals that may be affected by the proposed rule that were contacted for comments.
Licensed dentists and dental firms.
11. Identify the local governmental units that participated in the development of this EIA.
None known.
12. Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
There are no known adverse economic impacts on these specific businesses.
13. Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
The rule considers s. 146.81 (4), Stats., patient health records, making the rules under the authority of the Dentistry Examining Board in compliance with state Statutes. An option would be to continue without guidelines on patient records.
14. Long Range Implications of Implementing the Rule
The overhead cost of hard copy record storage is expected to be reduced over time.
15. Compare With Approaches Being Used by Federal Government
None found.
16. Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
With the exception of the state of Illinois, the three adjacent states require dental records retained for periods of 5, 7 or 10 years.
17. Contact Name				18. Contact Phone Number
Jean MacCubbin				608.266.0955

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