Maine Scope of Practice Policy: State Profile
Maine scope of practice laws allow for the licensing of dental hygienists, dental therapists, nurse practitioners and physician assistants.
Dental hygienists may provide their services under the general or direct supervision of a licensed dentist depending upon the activity being performed. After attaining certain educational and experience levels, a dental hygienist may become an independent practice dental hygienist and practice without the supervision of a dentist. A public health dental hygienist practices in a public health setting and under a supervision agreement with a dentist. Dental hygienists may prescribe, dispense or administer anti-cavity toothpastes or topical gels with 1.1% or less of sodium fluoride and oral rinses with 0.05%, 0.2%, 0.44% or 0.5% sodium fluoride, as well as chlorhexidine gluconate oral rinse.
Dental therapists are also licensed under Maine scope of practice laws. Dental therapists may practice under a supervising dentist pursuant to a practice agreement that outlines the dental therapist’s authorized services and prescriptive authority. A dental therapist may also supervise up to two dental hygienists and provide dental hygiene services under general supervision.
Nurse practitioners (NPs) in Maine are authorized to practice independently and without physician supervision or a collaborative agreement after practicing for 24 months under the supervision of a licensed physician or NP. NPs are required to practice within their qualifications and the scope of practice as authorized by state law. The state board of nursing is authorized to grant prescriptive authority to qualified NPs for drugs and Schedules II-V controlled substances. NPs are recognized as primary care providers in Maine.
Maine physician assistants (PAs) may provide delegated medical services under the supervision of a licensed physician and pursuant to a written supervisory plan. The PA’s supervision is to be continuous but does not require the supervising physician’s physical presence as long as the PA and physician can be in contact by telecommunication means. A supervising physician may also delegate prescriptive authority to a PA for drugs, devices and Schedules II-V controlled substances.
Maine SOP Legislation
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- Practice Authority
Before independent practice authority is granted, an NP must practice for at least 24 months under the supervision of a licensed physician. 32 M.R.S.A. §2102
- Prescriptive Authority
NPs may prescribe prescription drugs and Schedules II-V controlled substances once registered with the U.S. Drug Enforcement Administration. Me. Code of Regs. §02.380.008 Section 7
- Nurse Practitioner as a Primary Care Provider
NPs are recognized in state policy as primary care providers. Primary care provider means a physician, or a nurse practitioner or physician assistant under the supervision of a physician, under contract with a managed care plan to supervise, coordinate and provide initial and basic care to plan patients, maintain continuity of patient care, and initiate patient referrals for specialist care. Me. Code of Regs. §02.031.850.5(FF)
- Dental Hygienists with Direct Access
A dental hygienist may practice independently without supervision by a dentist after educational and experience requirements are met. Me. Rev. Stat. Ann. tit. 32 §18345 and Me. Rev. Stat. Ann. tit. 32 §18375.
- Dental Hygienists with Prescriptive Authority
Dental hygienists may prescribe, dispense, or administer anti-cavity toothpastes or topical gels with 1.1% of less sodium fluoride and oral rinses with 0.05%, 0.2%, 0.44% or 0.5% sodium fluoride, as well as chlorhexidine gluconate oral rinse. Me. Rev. Stat. Ann. tit. 32 §18374.
- Dental Therapists
Dental therapists must practice under the direct supervision of a dentist in limited practice settings. A written practice agreement must outline the services that the dental hygiene therapist is authorized to perform under direct supervision. The practice agreement must also outline the protocols for administering and dispensing medications. Me. Rev. Stat. Ann. tit. 32 §18377.
- Supervision Requirements
A written supervision agreement is required between the physician and the PA. The agreement must outline the requirements set forth in statute and the physician and the PA may determine how each requirement is accomplished. Maine Rules §02-373 Chap. 2, Sec. 4
- Prescriptive Authority for Physician Assistants
A PA may prescribe drugs, devices and Schedules II-V controlled substances if delegated by the supervising physician and outlined in the written agreement. Maine Rules §02-373 Chap. 2, Section 3
- Scope of Practice Determination
A written supervision agreement outlines the PA’s scope of practice and practice setting. Delegated medical services must be within the scope of practice of the supervising physician. Maine Rules §02-373 Chap. 2, Sec. 3