3. Department of health services screening assessments conducted as part of the Wisconsin Oral Health surveillance program.
(2) Registration. An applicant for registration to own or operate a mobile dentistry program shall submit all of the following:
(a) An application for registration on a form provided by the department. The application shall include the person’s name and tax identification number, the person’s business address and telephone and any other information the department or the examining board requires.
(b) The fee specified in s. 440.05 (1), Stats. (c) A list of all employees, contractors, or volunteers who are providing dental or dental hygiene care in Wisconsin. The list shall include the Wisconsin license number for each person providing dental or dental hygiene care.
(3) Renewal. A mobile dentistry program registrant renewing a registration shall submit all of the following:
(a) A renewal form provided by the department.
(b) The renewal fee as determined by the department under s. 440.03 (9) (a), Stats. (c) A list of all employees, contractors or volunteers who are providing dental or dental hygiene care in Wisconsin. The list shall include the Wisconsin license number for each person providing dental care.
DE 10.03 Access to patient records. The mobile dentistry program registrant shall do all of the following:
(1) Provide each patient with the name and contact information of the mobile dentistry program and mobile dentistry program’s registration number providing services.
(2) At the time of providing services, give each patient a written description of the dental services provided for that patient, any provider’s name and license number, and the findings and recommendations.
(3) Maintain patient dental records in accordance with ch. DE 8. (4) Provide access to dental records in accordance with s. 146.83, Stats. DE 10.04 Protocol for follow-up care. (1) There shall be a written protocol for follow-up care, for patients treated in the mobile dental program, in a dental facility that is permanently established within 60 mile radius of where services were provided.
(2) There shall be an agreement with at least one provider for emergency treatment.
DE 10.045 Notification to department. The mobile dentistry program shall notify the department within 30 days of new employees, contractors or volunteers providing dental or dental hygiene services in Wisconsin.
DE 10.05 Standards of conduct. Unprofessional conduct by a mobile dentistry program registrant includes any of the following:
(2) Engaging in unprofessional conduct under s. DE 5.02. Section 2. EFFECTIVE DATE. The rules adopted in this order shall take effect on the first day of the third month following publication in the Wisconsin Administrative Register, pursuant to s. 227.22 (2) (intro.), Stats. ---------------------------------------------------------------------------------------------------------------------
(END OF TEXT OF RULE)
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