Bill Text: TX SB787 | 2015-2016 | 84th Legislature | Introduced

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Bill Title: Relating to the improvement of oral health care access through the regulation of dental hygiene practitioners, dental hygienists, and dentists in this state.

Sponsorship: Bipartisan Bill

Status: (Introduced - Dead) 2015-03-02 - Referred to Health & Human Services [SB787 Detail]

Download: Texas-2015-SB787-Introduced.html

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84R1424 EES-D
By: Rodríguez, Eltife S.B. No. 787

A BILL TO BE ENTITLED
AN ACT
relating to the improvement of oral health care access through the
regulation of dental hygiene practitioners, dental hygienists, and
dentists in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Chapter 256, Occupations Code, is
amended to read as follows:
CHAPTER 256. LICENSING OF DENTISTS, [AND] DENTAL HYGIENISTS, AND
DENTAL HYGIENE PRACTITIONERS
SECTION 2. Chapter 256, Occupations Code, is amended by
adding Subchapter B-1 to read as follows:
SUBCHAPTER B-1. ISSUANCE OF LICENSE TO DENTAL HYGIENE PRACTITIONER
Sec. 256.081. DEFINITION. In this chapter, "dental hygiene
practitioner" means a person who practices dental hygiene therapy
under a license issued under this chapter.
Sec. 256.082. LICENSE REQUIRED. A person may not practice
or offer to practice dental hygiene therapy in this state unless the
person is licensed under this chapter.
Sec. 256.083. ELIGIBILITY FOR LICENSE. An applicant for a
license to practice dental hygiene therapy in this state must:
(1) be at least 18 years of age;
(2) be of good moral character;
(3) be a licensed dental hygienist;
(4) have obtained an associate's or bachelor's degree
in dental hygiene from a public or private institution of higher
education or other postsecondary institution accredited by:
(A) an accrediting agency recognized by the Texas
Higher Education Coordinating Board; and
(B) the Commission on Dental Accreditation of the
American Dental Association or a successor organization;
(5) after having obtained an associate's degree in
dental hygiene or having completed coursework equivalent to an
associate's degree in dental hygiene as part of a bachelor's degree
in dental hygiene, have successfully completed a dental hygiene
practitioner program that:
(A) is accredited by the Commission on Dental
Accreditation of the American Dental Association or a successor
organization;
(B) consists of a minimum of four semesters;
(C) has a curriculum that:
(i) is consistent with the model curriculum
for dental hygiene practitioner programs adopted by the American
Association of Public Health Dentistry or a successor organization;
(ii) is consistent with the curriculum
followed by dental hygiene practitioner programs in other states;
and
(iii) has been approved by the board; and
(D) meets the requirements for dental hygiene
practitioner programs adopted by the board; and
(6) have passed the examination required by Section
256.085.
Sec. 256.084. APPLICATION FOR EXAMINATION. To take the
examination under Section 256.085, an applicant for a license must:
(1) submit an application on a form prescribed by the
board;
(2) pay the application fee set by the board;
(3) include with the application:
(A) proof of current certification in
cardiopulmonary resuscitation approved by the American Heart
Association or American Red Cross; or
(B) if the applicant is not physically able to
comply with the certification requirement of Paragraph (A), a
written statement describing the person's physical incapacity
executed by a physician or an instructor in cardiopulmonary
resuscitation approved by the American Heart Association or
American Red Cross; and
(4) provide any other information the board requires
to determine the applicant's qualifications.
Sec. 256.085. LICENSE EXAMINATION. (a) The board shall
provide for the examination of an applicant for a dental hygiene
practitioner license.
(b) The examination must include subjects and operations
relating to dentistry and dental hygiene therapy, including
subjects regularly taught in schools of dentistry and in dental
hygiene practitioner programs accredited by an accrediting agency
recognized by the Texas Higher Education Coordinating Board.
(c) The board shall contract with one or more independent or
regional testing services for any required clinical examination. If
the board uses one or more regional testing services, the board may
contract for or otherwise use licensed dental hygiene practitioners
to provide assistance to the regional testing service or services.
(d) The board shall have the written portion of the board's
jurisprudence examination validated by an independent testing
professional.
Sec. 256.086. EXAMINATION RESULTS. (a) The board shall
notify each examinee of the results of the examination within a
reasonable time after the date of the examination.
(b) If the board contracts with an independent or regional
testing service, the contract with the service must provide for the
notification of results.
Sec. 256.087. REEXAMINATION. (a) The board by rule shall
establish the conditions under which and the number of times an
applicant may retake an examination.
(b) The board may require an applicant who fails the
examination to meet additional education requirements set by the
board.
Sec. 256.088. ISSUANCE OF LICENSE. The board shall issue a
license to practice dental hygiene therapy to an applicant who
meets the eligibility requirements of Section 256.083.
Sec. 256.089. MAINTENANCE OF DENTAL HYGIENE LICENSE NOT
REQUIRED. A dental hygiene practitioner is not required to
maintain an active license to practice dental hygiene.
SECTION 3. Sections 256.101(a) and (a-1), Occupations Code,
are amended to read as follows:
(a) The board shall issue a license to practice dentistry to
a qualified [reputable] dentist, a license to practice dental
hygiene therapy to a qualified dental hygiene practitioner, or a
license to practice dental hygiene to a qualified [reputable]
dental hygienist who:
(1) pays the fee set by the board;
(2) is licensed in good standing as a dentist, dental
hygiene practitioner, or dental hygienist in another state that has
licensing requirements substantially equivalent to the
requirements of this subtitle;
(3) has not been the subject of a final disciplinary
action and is not the subject of a pending disciplinary action in
any jurisdiction in which the dentist, dental hygiene practitioner,
or dental hygienist is or has been licensed;
(4) has graduated from a dental or dental hygiene
school or a dental hygiene practitioner program accredited by the
Commission on Dental Accreditation of the American Dental
Association and approved by the board under board rule;
(5) has passed a national or other examination
relating to dentistry, dental hygiene therapy, or dental hygiene
and recognized by the board;
(6) has passed the board's jurisprudence examination;
(7) has submitted documentation of current
cardiopulmonary resuscitation certification;
(8) has practiced dentistry, dental hygiene therapy,
or dental hygiene:
(A) for at least the three years preceding the
date of application for a license under this section; or
(B) as a dental educator at a dental school or
dental hygiene school or in a dental hygiene practitioner program
accredited by the Commission on Dental Accreditation of the
American Dental Association for at least the five years preceding
the date of application for a license under this section;
(9) has been endorsed by the board of dentistry in the
jurisdiction in which the applicant practices at the time of
application; and
(10) meets any additional criteria established by
board rule.
(a-1) The board by rule shall specify the circumstances
under which the board may waive the requirement under Subsection
(a)(8) that an applicant for a license under this section has been
continuously engaged in the practice of dentistry, dental hygiene
therapy, or dental hygiene during the period required by that
subsection if the applicant has engaged in the practice of
dentistry, dental hygiene therapy, or dental hygiene for a
cumulative total of at least three years before the date of
application for a license under this section.
SECTION 4. Sections 256.1013(a) and (c), Occupations Code,
are amended to read as follows:
(a) The board may issue a provisional license to an
applicant currently licensed in another jurisdiction who seeks a
license in this state and who:
(1) has been licensed in good standing as a dentist,
dental hygiene practitioner, or dental hygienist for at least two
years in another jurisdiction that has licensing requirements
substantially equivalent to the requirements of this subtitle;
(2) is a graduate of a recognized school of dentistry
or dental hygiene or a dental hygiene practitioner program
accredited by the Commission on Dental Accreditation of the
American Dental Association and approved by the board;
(3) has passed a national or other examination
recognized by the board relating to the practice of dentistry,
dental hygiene therapy, or dental hygiene, as appropriate; and
(4) is sponsored by a person who holds an appropriate
license under this subtitle and with whom the provisional license
holder will practice during the time the person holds a provisional
license.
(c) A provisional license is valid until the date the board
approves or denies the provisional license holder's application for
a license. The board shall issue a license under this subtitle to
the provisional license holder if:
(1) the provisional license holder is eligible to be
licensed under Section 256.101; or
(2) the provisional license holder passes the part of
the examination under Section 256.003, [or] 256.055, or 256.085
that relates to the applicant's knowledge and understanding of the
laws and rules relating to the practice of dentistry, dental
hygiene therapy, or dental hygiene, as appropriate, in this state
and:
(A) the board verifies that the provisional
license holder meets the academic and experience requirements for a
license under this subtitle; and
(B) the provisional license holder satisfies any
other licensing requirements under this subtitle.
SECTION 5. Section 256.1015(a), Occupations Code, is
amended to read as follows:
(a) The board, upon payment by the applicant of a fee set by
the board, shall grant a temporary license to practice dentistry to
any qualified [reputable] dentist, a temporary license to practice
dental hygiene therapy to any qualified dental hygiene
practitioner, or a temporary license to practice dental hygiene to
any qualified [reputable] dental hygienist who:
(1) meets all requirements of Section 256.101 except
those of Subsection (a)(8); and
(2) is employed by a nonprofit corporation that
accepts Medicaid reimbursement.
SECTION 6. Section 256.103(a), Occupations Code, is amended
to read as follows:
(a) A licensed dentist, dental hygiene practitioner, or
dental hygienist shall display the person's current registration
certificate in each office in which the person provides dental
services. If the dentist, dental hygiene practitioner, or dental
hygienist provides dental services at more than one location, the
person may display a duplicate of the original registration
certificate obtained from the board on payment of a duplicate
certificate fee set by the board.
SECTION 7. Section 256.105(a), Occupations Code, is amended
to read as follows:
(a) Each dentist, dental hygiene practitioner, dental
hygienist, and owner or manager of a dental laboratory licensed or
registered with the board shall timely notify the board of:
(1) any change of address of the person's place of
business;
(2) any change of employers for the dentist, dental
hygiene practitioner, or dental hygienist and any change of owners
or managers for the dental laboratory; and
(3) any change of the person's mailing address.
SECTION 8. Section 257.004, Occupations Code, is amended to
read as follows:
Sec. 257.004. CARDIOPULMONARY RESUSCITATION REQUIREMENTS.
(a) A person holding a dental, [or] dental hygienist, or dental
hygiene practitioner license must submit at the time the person
applies for renewal of the license:
(1) a written statement executed by the person stating
that the person has successfully completed a current program or
course in cardiopulmonary resuscitation that includes a
demonstration of skills and a written evaluation; or
(2) if the person is not physically able to comply with
the requirements of Subdivision (1), a written statement describing
the person's physical incapacity executed by a licensed physician.
(b) [(c)] A dentist, [or] dental hygienist, or dental
hygiene practitioner licensed by the board who resides in a country
other than the United States on the renewal date of the person's
license and has not practiced dentistry, [or] dental hygiene, or
dental hygiene therapy in the United States during the year
preceding the renewal date is exempt from the requirements of
Subsection (a) if the person submits proof of foreign residence
with the person's renewal application.
SECTION 9. The heading to Section 257.005, Occupations
Code, is amended to read as follows:
Sec. 257.005. CONTINUING EDUCATION FOR DENTIST, DENTAL
HYGIENE PRACTITIONER, AND DENTAL HYGIENIST.
SECTION 10. Section 257.005(a), Occupations Code, is
amended to read as follows:
(a) The board shall develop a mandatory continuing
education program for licensed dentists, dental hygiene
practitioners, and dental hygienists. The board by rule shall
require a license holder to complete at least 12 hours of continuing
education for each annual registration period to renew the license
for a subsequent annual period.
SECTION 11. Section 258.001, Occupations Code, is amended
to read as follows:
Sec. 258.001. [IMPERMISSIBLE] DELEGATIONS. A dentist may
not delegate:
(1) an act to an individual who, by board order, is
prohibited from performing the act;
(2) any of the following acts to a person not licensed
as a dentist, dental hygiene practitioner, or dental hygienist:
(A) the removal of calculus, deposits, or
accretions from the natural and restored surfaces of exposed human
teeth and restorations in the human mouth;
(B) root planing or the smoothing and polishing
of roughened root surfaces or exposed human teeth; or
(C) any other act the delegation of which is
prohibited by board rule;
(3) any of the following acts to a person not licensed
as a dentist or dental hygiene practitioner:
(A) initial assessment or [comprehensive]
examination or diagnosis and treatment planning;
(B) [a surgical or cutting procedure on hard or
soft tissue;
[(C)] the prescription of a drug, medication, or
work authorization;
(C) [(D)] the taking of an impression for a final
restoration, appliance, or prosthesis; or
(D) [(E)] the making of an intraoral occlusal
adjustment; or
(4) any of the following acts to a person not licensed
as a dentist:
(A) a surgical or cutting procedure on hard or
soft tissue;
(B) direct pulp capping, pulpotomy, or any other
endodontic procedure;
(C) the final placement and intraoral adjustment
of a fixed or removable appliance; or
(D) the placement of any final restoration
[(F) direct pulp capping, pulpotomy, or any other
endodontic procedure;
[(G) the final placement and intraoral
adjustment of a fixed or removable appliance; or
[(H) the placement of any final restoration; or
[(4) the authority to an individual to administer a
local anesthetic agent, inhalation sedative agent, parenteral
sedative agent, or general anesthetic agent if the individual is
not licensed as:
[(A) a dentist with a permit issued by the board
for the procedure being performed, if a permit is required;
[(B) a certified registered nurse anesthetist
licensed by the Texas Board of Nursing, only if the delegating
dentist holds a permit issued by the board for the procedure being
performed, if a permit is required; or
[(C) a physician anesthesiologist licensed by
the Texas Medical Board].
SECTION 12. Subchapter A, Chapter 258, Occupations Code, is
amended by adding Section 258.004 to read as follows:
Sec. 258.004. COLLABORATIVE PRACTICE WITH DENTAL HYGIENIST
OR DENTAL HYGIENE PRACTITIONER. (a) In this section,
"collaborative practice agreement" means a written practice
agreement and protocols for the practice of dental hygiene or
dental hygiene therapy.
(b) A dental hygienist may practice dental hygiene or a
dental hygiene practitioner may practice dental hygiene therapy
under a collaborative practice agreement with a dentist if the
dental hygienist or dental hygiene practitioner:
(1) has been engaged in the practice of dental hygiene
or dental hygiene therapy, as applicable, for at least one year with
a minimum of 2,000 practice hours;
(2) completes annually an eight-hour continuing
education program that includes instruction in medical emergency
procedures, risk management, and professional ethics;
(3) completes a jurisprudence class every three years;
and
(4) pays the required fee.
(c) A dental hygienist may enter into a collaborative
practice agreement to practice dental hygiene in any setting
authorized by law for the practice of dental hygiene. A dental
hygiene practitioner may enter into a collaborative practice
agreement to practice dental hygiene therapy in any setting
authorized by law for the practice of dental hygiene therapy.
(d) A collaborative practice agreement must include
protocols:
(1) describing the practice of dental hygiene or
dental hygiene therapy for:
(A) medically compromised patients;
(B) specific medical conditions;
(C) patients with needs related to age; and
(D) patients with complex medical histories;
(2) prescribing standards for specific dental hygiene
or dental hygiene therapy procedures, including intervals for the
performance of those procedures;
(3) prescribing intervals at which a supervising
dentist must examine a patient;
(4) describing the services that the dental hygienist
or dental hygiene practitioner may provide, the procedures that the
dental hygienist or dental hygiene practitioner may perform, the
practice settings in which the services may be provided and the
procedures may be performed, and any limitations on the services
and procedures;
(5) describing case selection criteria, assessment
guidelines, and imaging frequency guidelines for patients by age
and in relation to specific procedures;
(6) prescribing procedures for obtaining informed
consent from patients and for creating and maintaining patient
records;
(7) establishing a plan for the dentist to review
patient records created and maintained by the dental hygienist or
dental hygiene practitioner;
(8) establishing a plan for the management of medical
emergencies in each setting in which the dental hygienist or dental
hygiene practitioner practices;
(9) establishing a quality assurance plan for the
dentist to monitor care provided by the dental hygienist or dental
hygiene practitioner, including review of patient care, referrals,
and charts;
(10) describing the medications that may be
administered and dispensed by the dental hygienist or dental
hygiene practitioner and the specific circumstances under which the
medications may be administered and dispensed;
(11) describing any requirements for consultation
with the dentist before providing care to patients with specific
medical conditions or complex medical histories; and
(12) establishing a plan, which includes clinical
resources and referrals, for situations in which a patient requires
treatment that exceeds the capabilities or scope of practice of the
dental hygienist or dental hygiene practitioner.
(e) A collaborative practice agreement may include
provisions to allow the practice of dental hygiene or dental
hygiene therapy without:
(1) prior examination of the patient by a dentist; and
(2) the presence of a supervising dentist.
(f) A collaborative practice agreement must be:
(1) signed by the dentist, the dental hygienist or the
dental hygiene practitioner, and, if applicable, a representative
of the facility, program, or organization in which the practice of
dental hygiene or dental hygiene therapy takes place;
(2) reviewed annually by the dentist and the dental
hygienist or the dental hygiene practitioner who are parties to the
collaborative practice agreement; and
(3) made available to the board and other interested
parties on request.
(g) Not more than two collaborative practice agreements
between a dentist and a dental hygienist or a dental hygiene
practitioner may be in effect at a time.
(h) A dentist may have a collaborative practice agreement
with not more than six dental hygienists or dental hygiene
practitioners at the same time. The board may grant an exception to
the requirements of this subsection for the practice of dental
hygiene or dental hygiene therapy in a public health setting.
(i) Before providing any service authorized by a
collaborative practice agreement, the dental hygienist or dental
hygiene practitioner must provide the patient with a written
statement advising the patient that the dental hygiene or dental
hygiene therapy services performed are not a substitute for
examination by a dentist.
(j) If a dental hygienist or dental hygiene practitioner
operating under a collaborative practice agreement makes a referral
for further dental procedures, the dental hygienist or dental
hygiene practitioner must complete a referral form approved by the
board and provide a copy of the form to the dentist who is a party to
the collaborative practice agreement.
SECTION 13. Section 262.002, Occupations Code, is amended
by amending Subsection (a) and adding Subsection (c) to read as
follows:
(a) A person practices dental hygiene if the person:
(1) removes accumulated matter, tartar, deposits,
accretions, or stains, other than mottled enamel stains, from the
natural and restored surface of exposed human teeth and
restorations in the human mouth;
(2) smoothes roughened root surfaces;
(3) polishes exposed human teeth, restorations in the
human mouth, or roughened root surfaces;
(4) topically applies drugs to the surface tissues of
the human mouth or the exposed surface of human teeth;
(5) makes dental x-rays; [and]
(6) administers intraoral, block, or infiltration
anesthesia or inhalation sedations in the form of nitrous oxide
under the authorization and supervision of a dentist; and
(7) performs any other service, task, or procedure
prescribed by board rule.
(c) A dental hygienist may not establish an independent
practice to provide services authorized by this subtitle.
SECTION 14. Section 262.151(a), Occupations Code, is
amended to read as follows:
(a) A licensed dentist may delegate orally or in writing a
service, task, or procedure to a dental hygienist who is under the
supervision and responsibility of the dentist, if:
(1) the dental hygienist is licensed to perform the
service, task, or procedure;
(2) [the supervising dentist examines the patient:
[(A) at the time the service, task, or procedure
is performed by the dental hygienist; or
[(B) during the 12 calendar months preceding the
date of performance of the service, task, or procedure by the dental
hygienist; and
[(3)] the dental hygienist does not:
(A) diagnose a dental disease or ailment;
(B) prescribe a treatment or a regimen;
(C) prescribe, order, or dispense medication; or
(D) perform any procedure that is irreversible or
involves the intentional cutting of soft or hard tissue by any
means; and
(3) the supervising dentist has determined that the
patient presents no evidence of tooth decay.
SECTION 15. Sections 262.1515(a) and (c), Occupations Code,
are amended to read as follows:
(a) A licensed dentist may delegate a service, task, or
procedure, pursuant to this section, to a dental hygienist[,
without complying with Section 262.151(a)(2)] if:
(1) the dental hygienist has at least two years'
experience in the practice of dental hygiene; and
(2) the service, task, or procedure is performed in
one of the following locations:
(A) a nursing facility as defined in Section
242.301, Health and Safety Code;
(B) a primary or secondary school [school-based
health center established under Subchapter B, Chapter 38, Education
Code]; [or]
(C) a community health center as defined by
Section 136.002, Human Resources Code;
(D) a Head Start program facility;
(E) a hospital;
(F) a charitable clinic;
(G) a correctional facility;
(H) a state-operated facility;
(I) a military or veterans clinic;
(J) an adult day care facility licensed under
Chapter 103, Human Resources Code;
(K) a clinic located on land recognized as tribal
land by the federal government and maintained or operated by a
federally recognized Indian tribe or tribal organization as listed
by the United States secretary of the interior under 25 U.S.C.
Section 479a-1 or as listed under a successor federal statute or
regulation; or
(L) the residence of a patient who is homebound
or who is receiving or is eligible to receive:
(i) home and community-based waiver
services under the Medicaid program;
(ii) hospice services; or
(iii) other home care services.
(c) A dental hygienist may [only] perform delegated tasks or
procedures with respect to a patient for not more than 12 [six]
months unless:
(1) the patient has been examined by a dentist;
(2) a dentist has reviewed the patient's dental
records and determined that the dental hygienist may continue to
provide services to the patient; or
(3) a dentist has used telemedicine as defined by
Section 262.154(a) to determine that the dental hygienist may
continue to provide services to the patient [in compliance with
Section 262.151(a)(2)].
SECTION 16. Subchapter D, Chapter 262, Occupations Code, is
amended by adding Section 262.154 to read as follows:
Sec. 262.154. TELEMEDICINE. (a) In this section,
"telemedicine" means the use of technology that allows a health
care service provider located at a site other than the site where
the patient is located to deliver health care services and
information, either in real time or after a delay.
(b) To the extent otherwise provided by law, a dental
hygienist may use telemedicine to practice dental hygiene in any
setting authorized by law for the practice of dental hygiene.
SECTION 17. Subtitle D, Title 3, Occupations Code, is
amended by adding Chapter 268 to read as follows:
CHAPTER 268. REGULATION OF DENTAL HYGIENE PRACTITIONERS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 268.001. DEFINITIONS. In this chapter, "dental
hygiene practitioner" means a person who practices dental hygiene
therapy under a license issued by the board under Chapter 256.
Sec. 268.002. PRACTICE OF DENTAL HYGIENE THERAPY. (a) A
person practices dental hygiene therapy if the person:
(1) provides:
(A) oral health and nutrition education; and
(B) assessment and treatment planning as
authorized by a dentist;
(2) places sealant on exposed human teeth;
(3) places or removes:
(A) preformed or temporary crowns on exposed
human teeth; and
(B) space maintainers in the human mouth;
(4) applies coronal polishing of exposed human teeth;
(5) performs:
(A) oral cancer screening;
(B) tooth decay risk assessment;
(C) provisional restorations of primary and
permanent teeth;
(D) nonsurgical removal of primary teeth;
(E) nonsurgical removal of periodontally
diseased permanent teeth, if authorized in advance by the
supervising dentist;
(F) atraumatic restorative therapy; and
(G) stabilization of reimplanted teeth;
(6) makes and assesses dental radiographs;
(7) administers and monitors inhalation sedations in
the form of nitrous oxide;
(8) administers intraoral, block, or infiltration
anesthesia under the authorization and supervision of a dentist;
(9) prescribes, dispenses, and administers, with the
authorization of the supervising dentist, analgesics,
anti-inflammatories, antibiotics, antimicrobials, and anticaries;
(10) repairs defective prosthetic devices for the
human mouth; and
(11) performs other related services and functions
authorized by the supervising dentist and for which the dental
hygiene practitioner is trained.
(b) A person legally practicing dental hygiene therapy does
not violate state law regulating the practice of dentistry.
(c) A dental hygiene practitioner may not establish an
independent practice to provide services authorized by this
subtitle.
(d) A dental hygiene practitioner may supervise dental
hygienists and dental assistants but may not supervise more than
two dental hygienists and three dental assistants in a practice
setting.
Sec. 268.003. EXEMPTIONS. This chapter does not apply to:
(1) a dentist practicing dentistry in this state,
except as provided by Subchapter C;
(2) a physician authorized to practice medicine in
this state; or
(3) an employee of a dentist practicing dentistry in
this state who makes dental x-rays in the office of and under the
supervision of the dentist.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD RELATING TO DENTAL HYGIENE
PRACTITIONERS
Sec. 268.051. BOARD POWERS AND DUTIES. The board shall:
(1) administer this chapter; and
(2) regulate all matters concerning dental hygiene
practitioners and the practice of dental hygiene therapy.
Sec. 268.052. RULEMAKING AUTHORITY OF BOARD. (a) The board
shall adopt and enforce rules that are necessary and advisable to
carry out the purposes of and to enforce this chapter, including
rules relating to professional conduct for dental hygiene
practitioners.
(b) As necessary to protect public health and safety, the
board may adopt and enforce a rule to establish the number of dental
hygiene practitioners a dentist may employ.
SUBCHAPTER C. PRACTICE BY LICENSE HOLDER
Sec. 268.101. DELEGATION OF DUTIES BY DENTIST. (a) A
dentist may delegate orally or in writing a service, task, or
procedure to a dental hygiene practitioner who is under the
supervision and responsibility of the dentist, if:
(1) the dental hygiene practitioner is licensed to
perform the service, task, or procedure; and
(2) the dental hygiene practitioner does not:
(A) diagnose a dental disease or ailment without
consulting with the supervising dentist;
(B) prescribe a treatment or a regimen without
consulting with the supervising dentist; or
(C) prescribe, order, or dispense medication,
other than as authorized by the dentist.
(b) A dentist may delegate to a dental hygiene practitioner
any act that a dentist may delegate to a dental hygienist or a
dental assistant.
(c) A dentist is not required to be on the premises when the
dental hygiene practitioner performs a delegated act.
(d) This chapter does not prevent a dentist from authorizing
a dental hygiene practitioner employed by the dentist to:
(1) instruct and educate a patient in proper oral
hygiene; or
(2) provide to a patient a medication ordered by the
dentist.
Sec. 268.102. PERFORMANCE OF DELEGATED DUTIES. A dental
hygiene practitioner shall practice dental hygiene therapy:
(1) in the dental office of a supervising dentist; or
(2) in an alternate setting, including a location
described by Section 268.103(2).
Sec. 268.103. DELEGATION OF DUTIES TO DENTAL HYGIENE
PRACTITIONER PRACTICING IN CERTAIN FACILITIES. A licensed dentist
may delegate a service, task, or procedure, pursuant to this
section, to a dental hygiene practitioner if:
(1) the dental hygiene practitioner has at least two
years' experience in the practice of dental hygiene therapy; and
(2) the service, task, or procedure is performed in
one of the following locations:
(A) a nursing facility as defined in Section
242.301, Health and Safety Code;
(B) a primary or secondary school;
(C) a community health center as defined by
Section 136.002, Human Resources Code;
(D) a Head Start program facility;
(E) a hospital;
(F) a charitable clinic;
(G) a correctional facility;
(H) a state-operated facility;
(I) a military or veterans clinic;
(J) an adult day care facility licensed under
Chapter 103, Human Resources Code;
(K) a clinic located on land recognized as tribal
land by the federal government and maintained or operated by a
federally recognized Indian tribe or tribal organization as listed
by the United States secretary of the interior under 25 U.S.C.
Section 479a-1 or as listed under a successor federal statute or
regulation; or
(L) the residence of a patient who is homebound
or who is receiving or is eligible to receive:
(i) home and community-based waiver
services under the Medicaid program;
(ii) hospice services; or
(iii) other home care services.
Sec. 268.104. TELEMEDICINE. (a) In this section,
"telemedicine" means the use of technology that allows a health
care service provider located at a site other than the site where
the patient is located to deliver health care services and
information, either in real time or after a delay.
(b) To the extent otherwise provided by law, a dental
hygiene practitioner may use telemedicine to practice dental
hygiene therapy in any setting authorized by law for the practice of
dental hygiene therapy.
SUBCHAPTER D. PROHIBITED PRACTICES; CIVIL LIABILITIES
Sec. 268.151. PROHIBITED PRACTICE. A dental hygiene
practitioner may not practice or offer to practice dental hygiene
therapy under a name other than the name appearing on the person's
license.
Sec. 268.152. CIVIL LIABILITY. A dental hygiene
practitioner who administers to a person cardiopulmonary
resuscitation or other emergency care in an emergency situation is
not liable to the person for damages unless the emergency care is
performed in a wilfully or wantonly negligent manner.
SECTION 18. Section 32.024, Human Resources Code, is
amended by adding Subsection (ll) to read as follows:
(ll) The department shall establish separate provider types
for dental hygienists and dental hygiene practitioners for purposes
of enrollment as providers of and reimbursement under the medical
assistance program.
SECTION 19. Section 843.002(24), Insurance Code, is amended
to read as follows:
(24) "Provider" means:
(A) a person, other than a physician, who is
licensed or otherwise authorized to provide a health care service
in this state, including:
(i) a chiropractor, registered nurse,
pharmacist, optometrist, registered optician, [or] acupuncturist,
dental hygienist, or dental hygiene practitioner; or
(ii) a pharmacy, hospital, or other
institution or organization;
(B) a person who is wholly owned or controlled by
a provider or by a group of providers who are licensed or otherwise
authorized to provide the same health care service; or
(C) a person who is wholly owned or controlled by
one or more hospitals and physicians, including a
physician-hospital organization.
SECTION 20. Section 1301.001(1-a), Insurance Code, is
amended to read as follows:
(1-a) "Health care provider" means a practitioner,
institutional provider, or other person or organization that
furnishes health care services and that is licensed or otherwise
authorized to practice in this state. [The term includes a
pharmacist and a pharmacy.] The term does not include a physician.
The term includes:
(A) a pharmacist;
(B) a pharmacy;
(C) a dental hygienist; and
(D) a dental hygiene practitioner.
SECTION 21. Section 1451.101, Insurance Code, is amended by
amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
read as follows:
(1) "Dental hygiene practitioner" has the meaning
assigned by Section 256.081, Occupations Code.
(1-a) "Dental hygienist" has the meaning assigned by
Section 256.051, Occupations Code.
(1-b) "Health insurance policy" means a policy,
contract, or agreement described by Section 1451.102.
SECTION 22. Subchapter C, Chapter 1451, Insurance Code, is
amended by adding Sections 1451.128 and 1451.129 to read as
follows:
Sec. 1451.128. SELECTION OF DENTAL HYGIENIST. An insured
may select a dental hygienist to provide the services scheduled in
the health insurance policy that are within the scope of the dental
hygienist's license.
Sec. 1451.129. SELECTION OF DENTAL HYGIENE PRACTITIONER.
An insured may select a dental hygiene practitioner to provide the
services scheduled in the health insurance policy that are within
the scope of the dental hygiene practitioner's license.
SECTION 23. The State Board of Dental Examiners shall, not
later than June 30, 2016, adopt rules under Chapter 256,
Occupations Code, as amended by this Act, and Chapter 268,
Occupations Code, as added by this Act.
SECTION 24. As soon as practicable after the effective date
of this Act, the Health and Human Services Commission shall
establish and implement separate provider types for dental
hygienists and dental hygiene practitioners as required by Section
32.024(ll), Human Resources Code, as added by this Act.
SECTION 25. If before implementing any provision of this
Act a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 26. This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2015.