Yesterday, Governor Ned Lamont issued a document called “Best Practices for Dental Offices Considering Expanding Operations Beyond Emergency Care to Include Non-Urgent and Elective Procedures During the COVID-19 Pandemic.” This document notes that while dental offices were never subject to the mandatory Executive Order to close, they had been strongly advised by the Department of Public Health (DPH) and various statewide organizations to voluntarily limit procedures to those required for emergency care. However, with other businesses starting to reopen on May 20, 2020, some dental practices have begun preparations for expanding their operations beyond emergency procedures to include elective procedures and routine hygiene and health exams. The document, which is over ten pages long and covers topics such as Planning and Preparation, Physical Space Setup, Health Screening, Work Practice Controls, Personal Protective Equipment and Cleaning and Disinfecting, is intended to provide guidance to dental providers as they undertake the expansion process.
At the outset, the document warns dental providers to check with their insurer to fully understand any potential liabilities that may arise from their decision to expand care.
In addition, the document points out that dental practices considering expanding their operations must exercise caution to prevent infection both in their staff and their patients. That caution includes “strict adherence to the controls listed here which are the minimum baseline precautions needed to protect their employees, their patients, and the overall public health in Connecticut.” It goes on to advise that “dental care practices that are not able to meet the guidelines listed here …are strongly advised to delay expansion of their operations beyond urgent care until they are able to meet these guidelines.”
In terms of patients, the document specifically notes that persons with known or suspected COVID-19 infection should not seek or receive dental treatment in a dental office for either routine or emergency care. Dental and medical professionals should work together to determine how best to provide needed emergency dental care to individuals with active COVID-19 symptoms. With respect to other patients, the document makes clear that, “Patients who choose to seek non-emergency dental care during this time should be fully aware of the potential risks.” It goes on to advise that “dental offices are strongly advised to delay, to the extent possible, non-urgent procedures for patients 65 years of age or older or those with underlying health conditions that put them at higher risk for COVID-19 infection.”
In terms of employees, “Employers are also strongly advised to consider these restrictions when deciding which of their staff members will be recalled to work during this early phase. At a minimum, employers should allow temporary modified duty assignments that remove higher-risk employees from potential exposure to aerosols in favor of lower-risk duties. If modified duty is not possible, employers should consider allowing higher-risk individuals who are uncomfortable returning to work during this phase to continue to remain out of the office until such time as increased risk to those individuals is mitigated by a significant decrease in community spread of COVID-19 infection.”
The document specifies that the recommended best practices are in addition to, and do not supplant, any other statutory or regulatory requirement. It warns that pursuant to statute, the State Dental Commission has the authority to discipline licensed dental practitioners for failure to adhere to the most recent version of the Centers for Disease Control and Prevention’s guidelines for infection control in dental care settings. The document also encourages employees and patients “to report violations and/or conditions in their dental offices that they feel are unsafe to the State of Connecticut Department of Public Health for investigation and referral to the Connecticut State Dental Commission” and provides a link to the DPH website for reporting a complaint. It also makes clear that “Employers may not retaliate against workers for raising concerns about COVID-related or other safety and health conditions.”
Clearly, these guidelines present many challenges from every perspective, including legal. For example, there are many potential issues from a licensing and disciplinary standpoint with DPH and the State Dental Commission. Other potential legal issues include, but are not limited to, making sure you have obtained informed consent from your patients, employment rights and workers’ compensation issues, contracts that must be negotiated and signed for various changes to the physical space, and even potential professional liability issues involving your patients. Halloran Sage has experts in each of these areas to guide and represent you at each step of the way. Please do no hesitate to contact us. We are here to help.