In 1980, the Healing Arts Radiation Protection (HARP) Act (the “Harp Act”) was introduced by the Ministry of Health and Long-Term Care for the purpose of ensuring safe use of X-Ray machines in medical practices of Ontario. Five years later, another regulation called the X-Ray Safety Code was implemented, which rendered the act applicable to Dental Professionals as well. It was developed by the Dental Advisory Committee to the HARP Commission, which was constituted of practicing dentists and dental educators. The HARP Act was an instrumental step in X-Ray safety as it stipulated operator qualification requirements and technical performance standards. Furthermore, it established the criteria for determining the necessity of procedures and tests, as well as their frequency, in order to attain the highest degree of safety for both patients and operators.
Operator Qualifications For X-Ray Equipment
Generally, dentists are qualified to be the radiation protection officer in a dental office. Dental assistants who have taken appropriate training in x-ray safety in order to take radiographs may also be qualified but should present proof of successful completion of such a program to the dentist and will be required to present proof when requested to do so by X-ray Inspection Service inspectors.
Registration Of X-Ray Machines Under The HARP Act
There are also several requirements regarding the registration of X-Ray machines. All dental X-Ray machines must be registered by the dentist and new installations must be approved by the X-ray Inspection Service (“XRIS”) of the Ministry of Health and Long-Term Care. Written approval to install and operate any X-Ray machine must be made by the provincial Director of X-ray Safety. The following should be noted:
1. All new or renovated dental offices must be approved by the Director of X-Ray Safety with the XRIS to ensure staff and patient safety from unnecessary radiation exposure. You will have to provide plans of your office layout and you will have to obtain approval of such plans. If you are selling your office you should have the approval available for the Purchaser and if you have lost the approval you should reapply to obtain a copy – this may take 4 to 6 weeks.
2. Any changes to the plan of a Dental office must be reported to the XRIS. If you purchase a practice from another dentist and do not renovate the pre-existing plans, if already approved, will suffice. However, you should inform the College and the XRIS about the change in ownership.
3. As inspectors may inspect the premises you should ensure that you have all necessary paperwork including forms and plans associated with the installation of the X-Ray machines. If you do not have the proper paperwork available when the inspector visits he/she can issue an order that you are in violation of the HARP Act which may result in a stop use order preventing further use of the X-Ray equipment. The dentist/owner of the practice will therefore have to submit a new plan or redesign the office to match the approved plans.
Shielding
All dental offices will have to install proper shielding to protect staff and patients. Although, this will normally include lead shielding the HARP Act does provide for lead equivalent. This will have to be approved when submitting plans.
Annual HARP Reports
It is a requirement that you obtain annual HARP reports which are performed by independent private companies and are to be available to proposed purchasers of your practice.
Due Diligence
As part of your due diligence when looking to purchase a dental practice the dentist should be asking the seller for at least the last three (3) years of HARP Reports, the radiation shielding plan approval, radiation shielding quality test results, x-ray equipment registration and proof of staff qualifications. In many cases older practices cannot located the plans when the unit was originally built out or purchased. It then becomes the purchaser’s decision as to whether they are comfortable closing without those plans and relying on representations, warranties and indemnities contained in the purchase agreement.
The foregoing is a summary of the requirements imposed on dentists and does not cover all the HARP requirements. This blog post should not be construed as legal advice. If you have any questions please do not hesitate to contact Kutner Law LLP.