Bill Text: TX SB787 | 2015-2016 | 84th Legislature | Introduced
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.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2015-03-02 - Referred to Health & Human Services [SB787 Detail]
Download: Texas-2015-SB787-Introduced.html
84R1424 EES-D | ||
By: Rodríguez, Eltife | S.B. No. 787 |
|
||
|
||
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, [ |
||
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 [ |
||
hygiene therapy to a qualified dental hygiene practitioner, or a | ||
license to practice dental hygiene to a qualified [ |
||
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, [ |
||
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 [ |
||
dental hygiene therapy to any qualified dental hygiene | ||
practitioner, or a temporary license to practice dental hygiene to | ||
any qualified [ |
||
(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, [ |
||
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) [ |
||
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, [ |
||
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. [ |
||
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 [ |
||
examination or diagnosis and treatment planning; | ||
(B) [ |
||
|
||
[ |
||
work authorization; | ||
(C) [ |
||
restoration, appliance, or prosthesis; or | ||
(D) [ |
||
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 | ||
[ |
||
|
||
[ |
||
|
||
[ |
||
[ |
||
|
||
|
||
|
||
[ |
||
|
||
[ |
||
|
||
|
||
|
||
[ |
||
|
||
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; [ |
||
(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) [ |
||
[ |
||
|
||
[ |
||
|
||
|
||
[ |
||
(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[ |
||
|
||
(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 [ |
||
|
||
|
||
(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 [ |
||
procedures with respect to a patient for not more than 12 [ |
||
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 [ |
||
|
||
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, [ |
||
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) 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. |