W. Va. Code R. § 5-14-7 - Informed Consent; Post Care Information

Current through Register Vol. XXXIX, No. 11, March 18, 2022

7.1. A licensee providing dental care at a mobile dental facility or through a portable dental unit shall not perform services on a minor or incapacitated person without the signed informed consent of a parent or guardian. The informed consent form must be obtained prior to any dental service in a mobile dental facility or through a portable dental unit. The informed consent form is required for the initial visit for diagnostic and preventative services. Consent for subsequent treatment may be written or verbal provided that the verbal consent is documented in the patient record.

7.2. The informed consent form shall include, at a minimum, the following information:

(a) Name of the operator of the mobile dental facility or portable dental unit;

(b) Permanent office address of the mobile dental facility or portable dental unit that is not a PO Box;

(c) Telephone number and/or other emergency contact number where calls will be returned within 24 hours of being received;

(d) Services to be provided;

(e) Whether the prospective minor or incapacitated patient received dental care from a licensed dentist during the previous twelve months: Provided, That if the dental care was received from a mobile dental facility or though a portable dental unit, the name, address and telephone number of the mobile dental facility or portable dental unit's dental home shall be documented: Provided further, the licensee shall contact such dental home to notify the dental home of the minor or incapacitated person's interest in receiving the dental care at the mobile dental facility or through the portable dental unit. If the dental home confirms that an appointment for the minor or incapacitated individual is scheduled with the dental home, the licensee shall encourage the parent or guardian of the minor or incapacitated individual to seek care from the dental home; and

(f) The informed consent form must be signed by the parent or legal guardian of the minor or incapacitated individual and shall document that the parent or legal guardian understands that the prospective patient may choose at any time to receive care from their dental home rather than from the mobile dental facility or portable dental unit.

7.3. A licensee providing dental care at a mobile dental facility or through a portable dental unit shall not perform services on an adult without first obtaining a signed informed consent form the prospective patient. The informed consent form shall document that the prospective patient understands that he or she may choose at any time to receive care from his or her dental home rather than at the mobile dental facility or through the portable dental unit, that the patient has elected to receive care at the mobile dental facility or through the portable dental unit, and that the mobile dental facility or portable dental unit is now the prospective patient's dental home and will be responsible for post-op complications and general dental care.

7.4. Each person receiving dental care in a mobile dental facility or through a portable dental unit shall receive a copy of the informed consent form and an information sheet at the end of the visit.

7.5. The information sheet provided to the patient after dental care is rendered at a mobile dental facility or through a portable dental imit shall contain:

(a) Name of the licensee(s) who provided service;

(b) Telephone number and/or other emergency contact number where calls will be returned within 24 hours of being received;

(c) Listing of treatment rendered including, when applicable, billing codes, fees and tooth numbers;

(d) Description of treatment that is needed or recommended;

(e) Referrals to specialists or other dentist if mobile facility or portable dental unit is unable to provide the necessary treatment; and

(f) Consent form or a documented, verbal consent for additional treatment or altered treatment plan when applicable.

7.6. Any operator of a mobile dental facility or portable dental unit, or any licensee providing dental care at a mobile dental facility or through a portable dental unit, that accepts or treats a patient but does not refer patients for follow-up care when such follow-up care is clearly necessary, shall be considered to have abandoned the patient and will subject the operator, licensee, or both to disciplinary action by the Board.

Notes

W. Va. Code R. § 5-14-7