Find below helpful answers to a compilation of frequently asked questions by our members.
Last updated 19 September 2021.
This information is intended to be general in nature and is current as at the date of issue. It is not intended to be a substitute for legal advice and should not be relied upon as such. You should seek legal advice or other professional advice in relation to any particular matters you or your organisation may have. Public Health Orders and information frequently change.
- Public Health Orders are made under various state/territory Public Health Acts. A breach of a Public Health Orders is a criminal offence. Penalties (fines and imprisonment) may vary from state to state.
- State and federal discrimination laws make it unlawful to treat someone less favourably on set grounds, for example their age, sex, disability, pregnancy, race, religion. Discrimination laws apply both in the provision of services and in employment.
- Workplace health and safety laws trump discrimination laws. Work health and safety laws do not just apply to employers and employees, they apply to everyone at a workplace (e.g. the employer, workers and diners at a restaurant).
- Privacy laws regulate the collection and storage of details about a person. They do not prevent a service provider/employer from asking private questions.
- Workplace relations laws govern the employment relationship and impact on what an employer can direct an employee to do and the actions an employer can take if the employee fails to comply, and in some circumstances give employees an ability to commence legal action if they consider the employer has breached the legal obligations.
- Professional standards/regulations requirements continue to apply and may deal with specific COVID-19 protocols or require the provision of services in certain circumstances (i.e. the provision of medical care in an emergency, subject to it being safe).
Can I ask someone to prove their COVID-19 vaccination status?
Yes, but unless it is mandated by a Public Health Order or other law, they are not required to produce it.
Can I refuse to treat an unvaccinated patient?
Yes, as long as the refusal is not based on any ground of discrimination (i.e. age, gender, race, religion, disability, sexual preference, physical appearance, etc) and is not inconsistent with any obligations, professional standards or code of conduct relevant to your profession.
The Ahpra Code of Conduct says the following:
2.4 Decisions about access to care
Practitioner decisions about access to care need to be free from bias and discrimination. Good practice involves:
- treating patients or clients with respect at all times
- not prejudicing the care of a patient or client because a practitioner believes that the behaviour of the patient or client has contributed to their condition
- upholding the duty to the patient or client and not discriminating on grounds irrelevant to healthcare, including race, religion, sex, disability or other grounds specified in anti-discrimination legislation
- investigating and treating patients or clients on the basis of clinical need and the effectiveness of the proposed investigations or treatment, and not providing unnecessary services or encouraging the indiscriminate or unnecessary use of health services
- keeping practitioners and their staff safe when caring for patients or clients; while action should be taken to protect practitioners and their staff if a patient or client poses a risk to health or safety, the patient or client should not be denied care, if reasonable steps can be taken to keep practitioners and their staff safe
- being aware of a practitioner’s right to not provide or participate directly in treatments to which the practitioner objects conscientiously, informing patients or clients and, if relevant, colleagues of the objection, and not using that objection to impede access to treatments that are legal, and
- not allowing moral or religious views to deny patients or clients access to healthcare, recognising that practitioners are free to decline to provide or participate in that care personally.
Ultimately it is up to practitioners to decide how they want to approach this. We recommend that if you do decide not to provide dental care to unvaccinated patients that you have a practice policy in place, and that this is communicated to patients at the time of booking so that they are aware of the policy before turning up to the practice.
Can I refuse service to someone that is not wearing a mask?
Generally, yes. A business can set its own rules about to whom, or in what circumstances, it provides services as long as they are not inconsistent with any obligations, professional standards or code of conduct relevant to the profession.
There may be circumstances where a client/visitor cannot wear a mask due to their personal health circumstances or religious beliefs. In that case, it may be unlawful discrimination not to provide them with services and consideration should be given to whether the service can be provided with other safety measures in place.
According to the Victorian Government:
Businesses should not refuse service to patrons who may have a lawful reason for not wearing a face mask at venues that require mandatory face masks. For more information on face masks and human rights, visit the website of the Victorian Equal Opportunity and Human Rights Commission.
You do not need a medical certificate stating that you have a lawful reason for not wearing a face mask. If you have a lawful reason for not wearing a face mask, you do not need to apply for an exemption or permit.
What should I do if a patient asks the vaccination status of me or my dental team?
Information about vaccination status is sensitive information and is afforded a higher degree of protection under the Privacy Act, including Australian Privacy Principle 3. Staff would need to provide their consent in order for a dental practice to disclose their vaccination status. We would recommend that if asked this question practices respond along the lines of:
‘We take all of the necessary precautions to ensure that safety of our staff and patients. We support vaccination as an important measure to minimize the risk of COVID-19 transmission. For privacy reasons, we are not allowed to disclose the private health information of our staff members.’
Can I ask someone to prove that they are COVID-19 negative before providing service to them?
A person with COVID-19 could not comply with the request to provide a negative test. It is generally unlawful to discriminate against a person, including treating them less favourably by refusing services, because they have a medical condition/disability, including COVID-19.
However, the safety of everyone at the premises is paramount. There may be circumstances where it will not be unlawful to mandate a negative test result if it is reasonably and practicably necessary to protect the safety of others.
Consideration must be given to whether other safety measures might be sufficient to allow for the services to be provided safely and in compliance with any professional standards or code of conduct relevant to the profession.
Can I ask my employees to prove that they are COVID-19 negative?
Public Health Orders may require employees in some regions or occupations to undertake regular testing. Where testing is required by a Public Health Order an employer can ask an employee to provide evidence of the test and the negative result.
If there is no Public Health Order or other law in that industry mandating testing, an employer may only direct an employee to provide evidence of a negative test if the direction is ‘lawful and reasonable’.
Whether a direction is lawful and reasonable will depend on the circumstances. However, relevant factors for consideration include; whether the employee is displaying symptoms, the level of vulnerability of clients (particularly those that cannot be vaccinated), the level of COVID risk in the region/setting, the employee’s personal circumstance and the terms of workplace policies and the contract of employment.
Medical information provided by employees, such as COVID test results, is sensitive personal information and must be securely stored and not used for any purpose other than the purpose for which it was obtained.
What treatment can I provide under current restrictions?
Updated 3 October 2021
The current restrictions state:
Dental practitioners continue to be authorised workers and are permitted to provide management of patients with urgent needs or care where failure to do so in a clinically appropriate timeframe will lead to adverse outcomes.
There are two main drivers for these restrictions - to minimise the movement of people in the community to prevent virus transmission, and the perceived risk of aerosol generating procedures. It seems likely that the Government will not want industries to return to 100 per cent normal activity over the short term until vaccination rates increase.
Nonetheless, the restrictions currently allow clinicians to make a risk assessment based on the circumstances of the patient to determine whether the treatment required should be deferred (based on the current risk of COVID-19 and the duration of the lockdown) or whether deferring treatment would lead to adverse outcomes for the patient.
Things to consider when determining whether dental treatment meets the 'adverse outcomes' requirement:
- Melbourne has been in and out of lockdown since late May 2021, with the current lockdown in place since early August. Regional Victoria was in lockdown for slightly less time (except Greater Shepparton).
- There is no projected end date for the Melbourne lockdown, and it has been extended from 1 week to 2 weeks to 4 weeks and is now likely to continue until the end of October 2021.
- If you defer treatment now, how long until you will be able to provide care?
- What is the current backlog of patients that you are currently experiencing, and what impact will that have on your ability to provide timely care when the restrictions are lifted?
- Will deferring treatment result in significant complications such as pain, infection, loss of the tooth or function, or significant progression of disease?
- Can the condition be temporarily managed with minimal intervention eg. pharmacologically?
- If you defer treatment now will it be possible to provide the same treatment later with no expected deterioration or complication?
- What is the risk status of the patient and their previous dental history?
- Dental caries can progress rapidly in young children, medically compromised or older patients.
- Patients with chronic periodontitis may need regular maintenance care to prevent further deterioration and potential loss of teeth.
- Orthodontic treatment that is dependent on growth (ie. to avoid surgery or tooth impaction)
- Orthodontic patients who are significantly over the expected completion time where there is risk of further disease without debanding
- The time since the last dental examination (in the context of overall patient risk for disease)?
- Can you use teledentistry to screen patients prior to coming in to determine some level of patient risk for dental disease and treatment need?
- All diagnostic findings, treatment and consent should be recorded as per Dental Board of Australia requirements to demonstrate why treatment was provided at that point and not deferred.
Dentists should not use this guidance to return to normal practice activity.
How do I assess risk?
It is important to also consider the COVID-19 risk in your geographic area and use that to guide your decision making. Areas where there are high levels of community transmission will pose a greater risk and dentists in these areas should exercise more caution and be vigilant with screening patients.
The Dental Board of Australia advises that 'all dental practitioners should consider the current risk environment and public safety when making decisions about whether to defer non-urgent or elective dental services'. Dental practitioners must consider the current risk environment, public safety and importantly the duty of care for patients when making decisions about the provision of services.
Clinicians take a risk-based approach as they apply their knowledge, skills, and experience to judge whether the risks to a patient from movement in the community outweigh delaying care and when deferring immediate care will have an adverse outcome for that person. Only when it is safe are patients accepted and treated. Knowledge of specific patients and teledentistry consultation help when making these judgements.
Can I treat a patient who has recovered from COVID-19?
Yes. Individuals that have tested positive to COVID 19 are required to meet a criterion to be released from isolation. Once released from isolation, they may resume routine activities, in accordance with the current public health directives. The release from isolation criteria is dependent on several factors and is outlined in the SoNG Coronavirus Disease 2019 (COVID 19).
Can I use Rapid Antigen Testing?
Updated 22 October 2021
The Therapeutic Goods Administration has approved rapid antigen testing (RAT) for use by dentists, and they are an option for screening patients prior to treatment, or staff in higher risk areas. Everyone who will perform the test needs to be trained in the correct use of the device (including specimen collection) and interpretation of results. This training needs to be undertaken prior to commencement of any testing. As a minimum, the supplier of the test needs to provide training to the health practitioners or paramedics performing or overseeing testing. Once trained, a health practitioner or paramedic can train persons under their supervision to conduct the test. There is more information available in the ADA webinar.
If a patient or staff member tests positive to COVID-19, their results are provided to the Department of Health via an online form. For all positive RAT COVID-19 result notifications please fill out the Rapid Antigen Test (RAT) Form.
If a worker tests positive to COVID-19 using a rapid antigen test, the department will follow up to ensure a confirmatory PCR test is performed and matched against the positive rapid antigen test.
How can I take part in the Vaccination Emergency Surge Workforce
Updated 8 September 2021
The Victorian Government has authorised a number of additional emergency surge workforces to support the expanded Victoria’s COVID-19 vaccination program via Public Health Emergency Orders. This surge workforce includes dentists, oral health therapists, dental hygienists and dental therapists, and some dentist and oral health therapy students.
The Victorian COVID-19 Vaccination Guidelines have now been updated and provide detailed information about the newly authorised workforces including training and supervision requirements.
The Victorian COVID-19 eLearning Competency training, which is the initial step in the required training for emergency authorised workforce, has also been updated and can now be accessed by eligible workforces wishing to participate in the program.
Additional information regarding the new workforces including fact sheets, position descriptions and how to register interest to participate can be found at COVID-19 vaccine program workforce | Coronavirus Victoria.
We have confirmed that the new emergency authorised surge workforces will be covered under the Victorian Managed Insurance Authority (VMIA) medical indemnity policy for any claims arising out of the actions of individuals employed or engaged by state-run vaccination clinics (health care services) to perform work on behalf of the health care service, subject to the terms, exclusions and conditions of the policy. Any members wishing to participate in the surge workforce should review the contract of employment/engagement and clarify cover with their respective employers.
Dentists and dental students will be engaged as part of the state run COVID-19 Vaccination Program and will be supervised by a suitably qualified medical practitioner, nurse practitioner (within scope), nurse immuniser or a pharmacist immuniser who have additional knowledge and experience in the technical aspects of vaccination which enables them to respond to clinical questions and issues escalated to them by the emergency-authorised immunisers, including the management of an AEFI and the administration of adrenaline, if required. Pay rates for each workforce will be determined by the employing health service and will depend on qualifications, experience and job roles within the program. You will need to have a current Working With Children check and a police check.
Are vaccinations mandatory for treating patients in aged care?
Updated 8 September 2021
The Victorian Chief Health Officer has issued a directive that requires that all dental practitioners and dental assistants who provide dental care at public, private and non-for-profit residential aged care facilities must:
- Have received at least their first dose of a COVID-19 vaccine by 17 September 2021, OR
- Provide evidence that they have an appointment to be vaccinated before 1 October 2021, AND
- Provide evidence of making a booking for their second dose of a COVID-19 vaccine before 15 November 2021.
Workers who have a booking for their first dose between 17 and 30 September 2021 will be able to continue working until 30 September provided they meet the following additional safety obligations:
- Wear additional personal protective equipment (PPE) when working, AND
- Continue to be restricted to working at a single facility.
Additional PPE includes at a minimum, a surgical mask and face shield, at all times that they are present at the work premises. Workers who are unable to be vaccinated due to medical issues will be required to provide evidence from an authorised medical practitioner to their employer.
This directive applies to dental practitioners in both the public and private sector. If you provide dental services in any residential aged care facilities in Victoria, you will have to comply with this requirement to continue to treat these patients.