.04 Qualification for Practice Under General Supervision by Report to the Board.

A. With the exception of those facilities identified in Regulations .09A and .10 of this chapter, a facility is qualified to permit a dental hygienist to practice under general supervision if the facility has filed a report with the Board and the facility is owned or operated by:

(1) The federal government;

(2) The State government;

(3) A county or local government; or

(4) A public health department of the federal, State, or local government.

B. A facility shall include in the report to the Board:

(1) The name of the federal, State, or local government agency which owns or operates the facility;

(2) The location of the facility and all other sites where dental hygiene services will be provided;

(3) The name of the supervising dentist affiliated with the facility who will be responsible for carrying out the requirements necessary for the facility to operate under general supervision; and

(4) The names of the dental hygienists who will provide dental hygiene services under general supervision.

C. A facility which is qualified for practice under general supervision by report to the Board may do so on receipt of the report by the Board.