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LRB-0543/P3
MED:amn
2019 - 2020 LEGISLATURE
DOA:......Ames, BB0022 - Dental therapist licensure
For 2019-2021 Budget -- Not Ready For Introduction
An Act ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
safety and professional services
Professional licensure
1. Licensure of dental therapists
Under current law, dentists and dental hygienists are licensed by the Dentistry Examining Board to practice dentistry and dental hygiene, respectively. This bill provides for the licensure of a third type of dental practitioner, dental therapists. Under the bill, the board must grant a dental therapist license to an individual who satisfies certain criteria, including completion of a dental therapy program and passage of required examinations.
Dental therapists may provide dental therapy services only under the general supervision of a dentist with whom the dental therapist has a collaborative management agreement that addresses various aspects of the dental therapist's practice. Supervision by a dentist requires the dentist's prior knowledge and consent, but does not require the presence of the dentist at the time a task or procedure is being performed or prior examination or diagnosis of a patient by a dentist prior to the provision of dental therapy services by a dental therapist. Dental therapists are, subject to the terms of a collaborative management agreement, limited to providing services, treatments, and procedures that are specified in the bill, as well as additional services, treatments, or procedures specified by the board by rule. Dental therapists must complete 12 hours of continuing education each biennium.
The bill subjects dental therapists to, or covers dental therapists under, various other laws, including the health care records law, the volunteer health care provider program, the health care worker protection law, and the emergency volunteer health care practitioner law. The bill also provides for loan forgiveness for dental therapists under the health care provider loan assistance program.
Finally, the bill requires, effective when the first individual becomes licensed as a dental therapist in this state, that two dental therapists be added to the board.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
Section 1 . 15.405 (6) (am) of the statutes is created to read:
15.405 (6) (am) Two dental therapists who are licensed under ch. 447.
Section 2 . 36.61 (1) (ak) of the statutes is created to read:
36.61 (1) (ak) “Dental therapist” means an individual licensed under s. 447.04 (1m).
Section 3 . 36.61 (1) (b) of the statutes is amended to read:
36.61 (1) (b) “Health care provider" means a dental therapist, dental hygienist, physician assistant, nurse-midwife, or nurse practitioner.
Section 4 . 36.61 (3) (a) of the statutes is amended to read:
36.61 (3) (a) The board shall enter into a written agreement with the health care provider. In the agreement, the health care provider shall agree to practice at least 32 clinic hours per week for 3 years in one or more eligible practice areas in this state or in a rural area, except that a health care provider in the expanded loan assistance program under sub. (8) who is not a dental therapist or dental hygienist may only agree to practice at a public or private nonprofit entity in a health professional shortage area.
Section 5. 36.61 (5) (b) 1. of the statutes is amended to read:
36.61 (5) (b) 1. The degree to which there is an extremely high need for medical care in the eligible practice area, health professional shortage area, or rural area in which an eligible applicant who is not a dental therapist or dental hygienist desires to practice and the degree to which there is an extremely high need for dental care in the dental health shortage area or rural area in which an eligible applicant who is a dental therapist or dental hygienist desires to practice.
Section 6 . 36.61 (8) (c) 3. of the statutes is amended to read:
36.61 (8) (c) 3. Practice at a public or private nonprofit entity in a health professional shortage area, if the health care provider is not a dental therapist or dental hygienist, or in a dental health shortage area, if the health care provider is a dental therapist or dental hygienist.
Section 7 . 146.81 (1) (c) of the statutes is amended to read:
146.81 (1) (c) A dentist or dental therapist licensed under ch. 447.
Section 8 . 146.89 (1) (r) 1. of the statutes is amended to read:
146.89 (1) (r) 1. Licensed as a physician under ch. 448, a dentist, dental therapist, or dental hygienist under ch. 447, a registered nurse, practical nurse, or nurse-midwife under ch. 441, an optometrist under ch. 449, a physician assistant under ch. 448, a pharmacist under ch. 450, a chiropractor under ch. 446, a podiatrist under subch. IV of ch. 448, or a physical therapist under subch. III of ch. 448.
Section 9 . 146.89 (1) (r) 5. of the statutes is amended to read:
146.89 (1) (r) 5. An individual who holds a valid, unexpired license, certification, or registration issued by another state or territory that authorizes or qualifies the individual to perform acts that are substantially the same as those acts that an individual who is described in subds. 1. to 4., except a dentist , dental therapist, or dental hygienist, is licensed or certified to perform and who performs acts that are within the scope of that license, certification, or registration.
Section 10 . 146.89 (3) (b) 8. of the statutes is amended to read:
146.89 (3) (b) 8. Dental services, including tooth extractions and other procedures done under local anesthesia only and any necessary suturing related to the extractions, performed by a dentist or dental therapist who is a volunteer health provider; and dental hygiene services, performed by a dental hygienist who is a volunteer health provider.
Section 11 . 146.89 (3m) (intro.) of the statutes is amended to read:
146.89 (3m) (intro.) A volunteer health care provider who is a dentist or dental therapist may provide dental services or a volunteer health care provider who is a dental hygienist may provide dental hygiene services, to persons who are recipients of Medical Assistance, if all of the following apply:
Section 12 . 146.997 (1) (d) 3. of the statutes is amended to read:
146.997 (1) (d) 3. A dentist or dental therapist licensed under ch. 447.
Section 13 . 155.01 (7) of the statutes is amended to read:
155.01 (7) “Health care provider" means a nurse licensed or permitted under ch. 441, a chiropractor licensed under ch. 446, a dentist or dental therapist licensed under ch. 447, a physician, physician assistant, perfusionist, podiatrist, physical therapist, physical therapist assistant, occupational therapist, or occupational therapy assistant licensed under ch. 448, a person practicing Christian Science treatment, an optometrist licensed under ch. 449, a psychologist licensed under ch. 455, a partnership thereof, a corporation or limited liability company thereof that provides health care services, a cooperative health care association organized under s. 185.981 that directly provides services through salaried employees in its own facility, or a home health agency, as defined in s. 50.49 (1) (a).
Section 14 . 252.14 (1) (ar) 3. of the statutes is amended to read:
252.14 (1) (ar) 3. A dentist or dental therapist licensed under ch. 447.
Section 15 . 257.01 (5) (a) of the statutes is amended to read:
257.01 (5) (a) An individual who is licensed as a physician, a physician assistant, or a podiatrist under ch. 448, licensed as a registered nurse, licensed practical nurse, or nurse-midwife under ch. 441, licensed as a dentist or dental therapist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448.
Section 16 . 257.01 (5) (b) of the statutes is amended to read:
257.01 (5) (b) An individual who was at any time within the previous 10 years, but is not currently, licensed as a physician, a physician assistant, or a podiatrist under ch. 448, licensed as a registered nurse, licensed practical nurse or nurse-midwife, under ch. 441, licensed as a dentist or dental therapist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a veterinary technician under ch. 89, or certified as a respiratory care practitioner under ch. 448, if the individual's license or certification was never revoked, limited, suspended, or denied renewal.
Section 17 . 440.03 (13) (b) 20m. of the statutes is created to read:
440.03 (13) (b) 20m. Dental therapist.
Section 18 . 440.08 (2) (a) 25m. of the statutes is created to read:
440.08 (2) (a) 25m. Dental therapist: October 1 of each odd-numbered year.
Section 19 . 447.01 (6g) of the statutes is created to read:
447.01 (6g) “Dental therapist” means an individual who practices dental therapy.
Section 20 . 447.01 (6r) of the statutes is created to read:
447.01 (6r) “Dental therapy” means the limited practice of dentistry, consisting of the services, treatments, and procedures specified in s. 447.06 (3) (b).
Section 21 . 447.02 (1) (a) of the statutes is amended to read:
447.02 (1) (a) Governing the reexamination of an applicant who fails an examination specified in s. 447.04 (1) (a) 5., (1m) (a) 5., or (2) (a) 5. The rules may specify additional educational requirements for those applicants and may specify the number of times an applicant may be examined.
Section 22 . 447.02 (1) (b) of the statutes is amended to read:
447.02 (1) (b) Governing the standards and conditions for the use of radiation and ionizing equipment in the practice of dentistry or dental therapy.
Section 23 . 447.02 (1) (g) of the statutes is created to read:
447.02 (1) (g) Specifying services, treatments, or procedures, in addition to those specified under s. 447.06 (3) (b) 1. to 28., that are included within the practice of dental therapy.
Section 24 . 447.02 (2) (a) of the statutes is amended to read:
447.02 (2) (a) The conditions for supervision and the degree of supervision required under ss. 447.03 (3) (a), (am), (b) and (d) 2. and 447.065.
Section 25 . 447.02 (3) (a) (intro.) of the statutes is amended to read:
447.02 (3) (a) (intro.) The examining board may issue a permit authorizing the practice in this state, without compensation, of dentistry, dental therapy, or dental hygiene to an applicant who is licensed to practice dentistry, dental therapy, or dental hygiene in another state, if all of the following apply:
Section 26. 447.02 (3) (a) 2. of the statutes is amended to read:
447.02 (3) (a) 2. The examining board determines that the applicant is qualified and satisfies the criteria specified under s. 447.04 (1) (b) 1. to 3., except that the examining board may not require the applicant to pass an examination of state statutes and rules relating to dentistry, dental therapy, or dental hygiene.
Section 27 . 447.02 (3) (b) of the statutes is amended to read:
447.02 (3) (b) A permit under this subsection shall authorize the practice of dentistry, dental therapy, or dental hygiene in a specified area of the state for a period of time not more than 10 days in a year and may be renewed by the examining board. The examining board may not require an applicant to pay a fee for the issuance or renewal of a permit under this subsection.
Section 28 . 447.02 (5) of the statutes is amended to read:
447.02 (5) Except as provided in ss. 447.058 and 447.063, nothing in this chapter may be construed as authorizing the examining board to regulate business or administrative support functions or services, that do not constitute the practice of dentistry, dental therapy, or dental hygiene, provided to a business that provides dental or dental hygiene services.
Section 29 . 447.03 (1m) of the statutes is created to read:
447.03 (1m) Dental therapists. Except as provided under sub. (3) and s. 447.02 (3), no person may do any of the following unless he or she is licensed to practice dental therapy under this chapter:
(a) Practice or offer to practice dental therapy.
(b) Represent himself or herself to the public as a dental therapist or use, in connection with his or her name, any title or description that may convey the impression that he or she is a dental therapist.
Section 30. 447.03 (3) (am) of the statutes is created to read:
447.03 (3) (am) A dental therapy student who practices dental therapy under the supervision of a dentist in an infirmary, clinic, hospital or other institution connected or associated for training purposes with an accredited dental therapy school.
Section 31 . 447.03 (3) (c) of the statutes is amended to read:
447.03 (3) (c) An individual licensed to practice dentistry, dental therapy, or dental hygiene in another state or country who practices dentistry , dental therapy, or dental hygiene in a program of dental education or research at the invitation of a group of dentists or practices dentistry, dental therapy, or dental hygiene under the jurisdiction of the army, navy, air force, U.S. public health service , or veterans bureau.
Section 32 . 447.04 (1m) of the statutes is created to read:
447.04 (1m) Dental therapists. (a) The examining board shall grant a license to practice dental therapy to an individual who does all of the following:
1. Submits an application for the license to the department on a form provided by the department.
2. Pays the fee specified in s. 440.05 (1).
3. Submits evidence satisfactory to the examining board that he or she has done one of the following:
a. Graduated from an accredited dental therapy education program.
b. Graduated from a dental therapy education program that was not accredited at the time of graduation, but was accredited or approved by a state dental licensing board, was certified as a community health aide program dental therapy education program under U.S. Indian health service standards, or is otherwise approved by the examining board as being substantially comparable to an accredited program.
4. Submits evidence satisfactory to the examining board that he or she has passed a national board dental therapy examination and a dental therapy clinical examination administered by a regional testing service that has been approved by the examining board to administer clinical examinations for dental professionals. If a national board examination or a regional testing service examination for dental therapy does not exist, the examining board shall accept evidence of passing an alternative examination administered by another entity or testing service that is approved by the examining board.
5. Passes an examination administered by the examining board on the statutes and rules relating to dental therapy.
5m. Submits evidence satisfactory to the examining board that he or she has current proficiency in cardiopulmonary resuscitation, including the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.
6. Completes any other requirements established by the examining board by rule that are comparable to and no more restrictive than the requirements established by the board for dentists under sub. (1) (a) 6. and dental hygienists under sub. (2) (a) 6.
(b) The examining board may grant a license to practice dental therapy to an individual who is licensed or certified in good standing to practice dental therapy in another state or territory of the United States or in another country, or by the U.S. Indian health service community health aide program, if the applicant complies with all of the following requirements:
1. Meets the requirements for licensure established by the examining board by rule. The board shall establish requirements under this subdivision that are comparable to and no more restrictive than the requirements established by the board for dentists under sub. (1) (b) 1. and dental hygienists under sub. (2) (b) 1.
2. Submits evidence satisfactory to the examining board that the person has current proficiency in cardiopulmonary resuscitation, including the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education qualified to provide such instruction. The examining board shall consult with the department of health services to determine whether an individual, organization, or institution of higher education is qualified to provide instruction under this subdivision.
3. Presents the license or certification to the examining board and pays the fee specified under s. 440.05 (2).
Section 33 . 447.05 of the statutes is amended to read:
447.05 Expiration and renewal. Renewal applications shall be submitted to the department on a form provided by the department on or before the applicable renewal date specified under s. 440.08 (2) (a) and shall include the applicable renewal fee determined by the department under s. 440.03 (9) (a). The examining board may not renew a license to practice dentistry unless the applicant for renewal attests that he or she has complied with s. 447.056, that he or she has current proficiency in cardiopulmonary resuscitation, including and that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. The examining board may not renew a license to practice dental therapy unless the applicant for renewal attests that he or she has complied with s. 447.057 and any rules promulgated under s. 447.057, that he or she has current proficiency in cardiopulmonary resuscitation, and that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. The examining board may not renew a license to practice dental hygiene unless the applicant for renewal attests that he or she has complied with s. 447.055 and any rules promulgated by the examining board under s. 447.055, that he or she has a current certification in cardiopulmonary resuscitation, and that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.
Section 34 . 447.057 of the statutes is created to read:
447.057 Continuing education; dental therapists. (1) (a) Except as provided in subs. (3) and (4), a person is not eligible for renewal of a license to practice dental therapy, other than a permit issued under s. 447.02 (3), unless the person has taught, prepared, attended, or otherwise completed, during the 2-year period immediately preceding the renewal date specified under s. 440.08 (2) (a), 12 credit hours of continuing education relating to the clinical practice of dental therapy that is sponsored or recognized by a local, state, regional, national, or international dental, dental therapy, dental hygiene, dental assisting, or medical-related professional organization.
(b) Continuing education required under par. (a) may include training in all of the following:
1. Basic life support or cardiopulmonary resuscitation. Not more than 2 of the credit hours required under par. (a) may be satisfied by such training.
2. Infection control. Not less than 2 of the credit hours required under par. (a) must be satisfied by such training.
(d) After consultation with the department of health services, the examining board may promulgate rules requiring that continuing education credit hours under par. (a) include courses in specific clinical subjects.
(2) The credit hours required under sub. (1) (a) may be satisfied by independent study, correspondence, or Internet programs or courses.
(3) Subsection (1) (a) does not apply to an applicant for renewal of a license that expires on the first renewal date after the date on which the examining board initially granted the license.
(4) A person may substitute credit hours of college level courses related to the practice of dental therapy for the credit hours required under sub. (1) (a). For purposes of this subsection, one credit hour of a college level course is equivalent to 6 credit hours of continuing education.
(5) For purposes of sub. (1) (a), one hour of teaching or preparing a continuing education program is equivalent to one credit hour of continuing education, but a person who teaches or prepares a continuing education program may obtain credit for the program only once.
(6) The examining board may require applicants for renewal of a license to practice dental therapy to submit proof of compliance with the requirements of this section.
Section 35. 447.06 (1) of the statutes is amended to read:
447.06 (1) No contract of employment entered into between a dentist or dental therapist and any other party under which the dentist or dental therapist renders dental services may require the dentist or dental therapist to act in a manner which that violates the professional standards for dentistry or dental therapy set forth in this chapter. Nothing in this subsection limits the ability of the other party to control the operation of the dental practice in a manner in accordance with the professional standards for dentistry or dental therapy set forth in this chapter.
Section 36 . 447.06 (1m) of the statutes is created to read:
447.06 (1m) No contract of employment entered into between a dental therapist and any other party under which the dental therapist is employed to practice dental therapy may require a dental therapist to meet a minimum quota for the number of patients seen or the number of procedures performed.
Section 37 . 447.06 (2) (a) 3. of the statutes is amended to read:
447.06 (2) (a) 3. For a school for the education of dentists, dental therapists, or dental hygienists.
Section 38 . 447.06 (2) (b) of the statutes is amended to read:
447.06 (2) (b) A dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1. only as authorized by a dentist or dental therapist who is licensed to practice dentistry or dental therapy under this chapter and who is present in the facility in which those practices or procedures are performed, except as provided in par. (c).
Section 39 . 447.06 (2) (c) (intro.) of the statutes is amended to read:
447.06 (2) (c) (intro.) A dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1. if a dentist or dental therapist who is licensed to practice dentistry or dental therapy under this chapter is not present in the facility in which those practices or procedures are performed only if all of the following conditions are met:
Section 40 . 447.06 (2) (c) 2. (intro.) of the statutes is amended to read:
447.06 (2) (c) 2. (intro.) The dentist or dental therapist who made the written or oral prescription has examined the patient at least once during the 12-month period immediately preceding:
Section 41 . 447.06 (3) of the statutes is created to read:
447.06 (3) (a) In this subsection:
1. “Collaborative management agreement” means an agreement under par. (d).
2. “Qualifying dentist” means a dentist who is licensed in this state and who is actively practicing in this state.
(b) The scope of practice of a dental therapist shall, subject to the terms of a collaborative management agreement, be limited to providing the following services, treatments, and procedures:
1. Oral evaluation and assessment of dental disease and formulation of an individualized treatment plan.
2. Identification of oral and systemic conditions requiring evaluation or treatment by dentists, physicians, or other health care providers and managing referrals.
3. Comprehensive charting of the oral cavity.
4. Oral health instruction and disease prevention education, including nutritional counseling and dietary analysis.
5. Exposure and evaluation of radiographic images.
6. Dental prophylaxis, including subgingival scaling and polishing procedures.
7. Dispensing and administration via the oral or topical route of nonnarcotic analgesic, anti-inflammatory, and antibiotic medications as prescribed by a licensed health care provider.
8. Application of topical preventive or prophylactic agents, including fluoride varnish, antimicrobial agents, caries arresting medicaments, and pit and fissure sealants.
9. Pulp vitality testing.
10. Application of desensitizing medications or resins.
11. Fabrication of athletic mouth guards and soft occlusal guards.
12. Changing of periodontal dressings.
13. Administration of local anesthetic and nitrous oxide.
14. Simple extraction of erupted primary teeth.
15. Nonsurgical extraction of periodontally diseased permanent teeth with tooth mobility of +3 to +4 to the extent authorized in the dental therapist's collaborative management agreement, except that “dental therapy” does not include the extraction of a tooth that is unerupted, impacted, or fractured or that needs to be sectioned for removal.
16. Emergency palliative treatment of dental pain limited to the procedures in this paragraph.
17. Preparation and placement of direct restoration in primary and permanent teeth.
18. Fabrication and placement of single-tooth temporary crowns.
19. Preparation and placement of preformed crowns on primary teeth.
20. Indirect and direct pulp capping on permanent teeth.
21. Indirect pulp capping on primary teeth.
22. Intraoral suture placement and removal.
23. Minor adjustment and repair of removable prostheses.
24. Placement and removal of space maintainers.
25. Pulpotomy on primary teeth.
26. Tooth reimplantation and stabilization.
27. Recementing of a permanent crown.
28. Any additional services, treatments, or procedures specified in the rules promulgated under s. 447.02 (1) (g).
(c) 1. A dental therapist licensed under this chapter may provide dental therapy services only under the general supervision of a qualifying dentist with whom the dental therapist has entered into a collaborative management agreement. For purposes of this subdivision, general supervision of a dental therapist by a dentist requires that a task or procedure be performed by a dental therapist with the prior knowledge and consent of the dentist, but does not require the presence of the dentist in the office or on the premises at the time a task or procedure is being performed by the dental therapist and does not require prior examination or diagnosis of a patient by the dentist before the dental therapist provides dental therapy services to the patient.
2. A supervising dentist shall accept responsibility for all services performed by a dental therapist pursuant to a collaborative management agreement. If services needed by a patient are beyond the dental therapist's scope of practice or authorization under the collaborative management agreement, the dental therapist shall, to the extent required under the collaborative management agreement, consult with the supervising dentist as needed to arrange for those services to be provided by a dentist or another qualified health care professional.
(d) 1. Prior to providing any dental therapy services, a dental therapist shall enter into a written collaborative management agreement with a qualifying dentist who will serve as a supervising dentist under par. (c). The agreement must be signed by the dental therapist and the qualifying dentist and address all of the following:
a. The practice settings where services may be provided and the patient populations that may be served.
b. Any conditions or limitations on the services that may be provided by the dental therapist, the level of supervision required, and any circumstances requiring consultation prior to performing services.
c. Age-specific and procedure-specific practice protocols.
d. Dental record-keeping procedures.
e. Plans for managing dental or medical emergencies.
f. A quality assurance plan for monitoring care provided by the dental therapist.
g. Protocols for administering and dispensing medications.
h. Criteria or protocols relating to the provision of care to patients with specific medical conditions, treatments, or medications.
i. Policies relating to supervision of dental hygienists and other staff.
j. A plan for the referral of patients to other dental or health care professionals or clinics when services needed are beyond the scope of practice or authorization of the dental therapist.
k. Whether and to what extent the dental therapist may perform services described in par. (b) 15.
2. a. A collaborative management agreement shall be limited to covering one qualifying dentist and one dental therapist.
b. A dental therapist may enter into multiple collaborative management agreements.
c. No dentist may have collaborative management agreements with more than 5 dental therapists at any time.
Section 42 . 447.065 of the statutes is amended to read:
447.065 Delegation of remediable procedures and dental practices. (1) A dentist or dental therapist who is licensed to practice dentistry under this chapter may delegate to an individual who is not licensed under this chapter only the performance of remediable procedures, and only if all of the following conditions are met:
(a) The unlicensed individual performs the remediable procedures in accordance with a treatment plan approved by the dentist or dental therapist.
(b) The dentist or dental therapist is on the premises when the unlicensed individual performs the remediable procedures.
(c) The unlicensed individual's performance of the remediable procedures is subject to inspection by the dentist or dental therapist.
(2) Subject to the requirements under s. 447.06 (2), a dentist or dental therapist who is licensed to practice dentistry under this chapter may delegate to a dental hygienist who is licensed to practice dental hygiene under this chapter the performance of remediable procedures and the administration of oral systemic premedications, local anesthesia, nitrous oxide inhalation analgesia, and subgingival sustained release chemotherapeutic agents, to the extent the dentist or dental therapist has the authority to perform the activity personally.
(3) A dentist or dental therapist who delegates to another individual the performance of any practice or remediable procedure is responsible for that individual's performance of that delegated practice or procedure.
Section 43 . 447.07 (1) of the statutes is amended to read:
447.07 (1) The examining board may, without further notice or process, limit, suspend, or revoke the license or certificate of any dentist, dental therapist, or dental hygienist, or the registration of a mobile dentistry program registrant, who fails, within 60 days after the mailing of written notice to the dentist's, dental therapist's, dental hygienist's, or registrant's last-known address, to renew the license, certificate, or registration.
Section 44 . 447.07 (3) (intro.) of the statutes is amended to read:
447.07 (3) (intro.) Subject to the rules promulgated under s. 440.03 (1), the examining board may make investigations and conduct hearings in regard to any alleged action of any dentist, dental therapist, or dental hygienist, of a mobile dentistry program registrant, or of any other person it has reason to believe is engaged in or has engaged in the practice of dentistry, dental therapy, or dental hygiene, or the operation of a mobile dentistry program, in this state, and may, on its own motion, or upon complaint in writing, reprimand any dentist , dental therapist, or dental hygienist who is licensed or certified under this chapter, or any mobile dentistry program registrant, or deny, limit, suspend, or revoke his or her license or certificate, or the registration of the mobile dentistry program registrant, if it finds that the dentist, dental therapist, dental hygienist, or mobile dentistry program registrant has done any of the following:
Section 45 . 447.07 (3) (e) to (h) of the statutes are amended to read:
447.07 (3) (e) Subject to ss. 111.321, 111.322, and 111.335, been convicted of a crime, the circumstances of which substantially relate to the practice of dentistry, dental therapy, or dental hygiene or the operation of a mobile dentistry program.
(f) Violated this chapter or any federal or state statute or rule that relates to the practice of dentistry, dental therapy, or dental hygiene, or the operation of a mobile dentistry program.
(g) Subject to ss. 111.321, 111.322 and 111.34, practiced dentistry , dental therapy, or dental hygiene while his or her ability was impaired by alcohol or other drugs.
(h) Engaged in conduct that indicates a lack of knowledge of, an inability to apply or the negligent application of, principles or skills of dentistry , dental therapy, or dental hygiene.
Section 46 . 447.40 (intro.) of the statutes is amended to read:
447.40 Informed consent. (intro.) Any dentist or dental therapist who treats a patient shall inform the patient about the availability of reasonable alternate modes of treatment and about the benefits and risks of these treatments. The reasonable dentist standard is the standard for informing a patient under this section. The reasonable dentist standard requires disclosure only of information that a reasonable dentist would know and disclose under the circumstances. The dentist's or dental therapist's duty to inform the patient under this section does not require disclosure of any of the following:
Section 47 . 447.40 (6) of the statutes is amended to read:
447.40 (6) Information about alternate modes of treatment for any condition the dentist or dental therapist has not included in his or her diagnosis, assessment, or treatment plan at the time the dentist or dental therapist informs the patient.
Section 48. 448.03 (2) (a) of the statutes is amended to read:
448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry, dental therapy, or dental hygiene under ch. 447, to practice optometry under ch. 449, to practice acupuncture under ch. 451 or under any other statutory provision, or as otherwise provided by statute.
Section 49 . 448.21 (1) (a) of the statutes is amended to read:
448.21 (1) (a) The practice of dentistry, dental therapy, or dental hygiene within the meaning of ch. 447.
Section 50 . 450.03 (1) (e) of the statutes is amended to read:
450.03 (1) (e) Any person lawfully practicing within the scope of a license, permit, registration, certificate, or certification granted to provide home medical oxygen under s. 450.076, to practice professional or practical nursing or nurse-midwifery under ch. 441, to practice dentistry, dental therapy, or dental hygiene under ch. 447, to practice medicine and surgery under ch. 448, to practice optometry under ch. 449 or to practice veterinary medicine under ch. 89, or as otherwise provided by statute.
Section 51 . 450.10 (3) (a) 4. of the statutes is amended to read:
450.10 (3) (a) 4. A dentist or dental therapist licensed under ch. 447.
Section 52 . 462.02 (2) (d) of the statutes is amended to read:
462.02 (2) (d) A dentist licensed under s. 447.04 (1), a dental therapist licensed under s. 447.04 (1m), a dental hygienist licensed under s. 447.04 (2), or a person under the direct supervision of a dentist.
Section 53. 462.04 of the statutes is amended to read:
462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed under s. 447.04 (1), a dental therapist licensed under s. 447.04 (1m), a podiatrist licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced practice nurse certified under s. 441.16 (2), a physician assistant licensed under s. 448.04 (1) (f), or, subject to s. 448.56 (7) (a), a physical therapist licensed under s. 448.53.
Section 54 . 463.10 (5) of the statutes is amended to read:
463.10 (5) Exception. Subsections (2) to (4m) do not apply to a dentist who is licensed under s. 447.03 (1) or to a , dental therapist, or physician who tattoos or offers to tattoo a person in the course of the dentist's, dental therapist's, or physician's professional practice.
Section 55 . 463.12 (5) of the statutes is amended to read:
463.12 (5) Exception. Subsections (2) to (4m) do not apply to a dentist who is licensed under s. 447.03 (1) or to a , dental therapist, or physician who pierces the body of or offers to pierce the body of a person in the course of the dentist's, dental therapist's, or physician's professional practice.
Section 56 . 632.87 (4) of the statutes is amended to read:
632.87 (4) No policy, plan or contract may exclude coverage for diagnosis and treatment of a condition or complaint by a licensed dentist or dental therapist within the scope of the dentist's or dental therapist's license, if the policy, plan or contract covers diagnosis and treatment of the condition or complaint by another health care provider, as defined in s. 146.81 (1) (a) to (p).
Section 57 . 895.48 (1m) (a) (intro.) of the statutes is amended to read:
895.48 (1m) (a) (intro.) Except as provided in par. (b), any physician, physician assistant, podiatrist, or athletic trainer licensed under ch. 448, chiropractor licensed under ch. 446, dentist or dental therapist licensed under ch. 447, emergency medical services practitioner licensed under s. 256.15, emergency medical responder certified under s. 256.15 (8), registered nurse licensed under ch. 441, or a massage therapist or bodywork therapist licensed under ch. 460 who renders voluntary health care to a participant in an athletic event or contest sponsored by a nonprofit corporation, as defined in s. 66.0129 (6) (b), a private school, as defined in s. 115.001 (3r), a tribal school, as defined in s. 115.001 (15m), a public agency, as defined in s. 46.856 (1) (b), or a school, as defined in s. 609.655 (1) (c), is immune from civil liability for his or her acts or omissions in rendering that care if all of the following conditions exist:
Section 58 . 895.48 (1m) (a) 2. of the statutes is amended to read:
895.48 (1m) (a) 2. The physician, podiatrist, athletic trainer, chiropractor, dentist, dental therapist, emergency medical services practitioner, as defined in s. 256.01 (5), emergency medical responder, as defined in s. 256.01 (4p), physician assistant, registered nurse, massage therapist or bodywork therapist does not receive compensation for the health care, other than reimbursement for expenses.
Section 59 . 941.315 (5) of the statutes is amended to read:
941.315 (5) (a) Subsection (2) does not apply to a person to whom nitrous oxide is administered for the purpose of providing medical or dental care, if the nitrous oxide is administered by a physician or, dentist, or dental therapist or at the direction or under the supervision of a physician or, dentist, or dental therapist.
(b) Subsection (3) does not apply to the administration of nitrous oxide by a physician or, dentist, or dental therapist, or by another person at the direction or under the supervision of a physician or, dentist, or dental therapist, for the purpose of providing medical or dental care.
(c) Subsection (3) (c) does not apply to the sale to a hospital, health care clinic or other health care organization or to a physician or , dentist, or dental therapist of any object used, designed for use or primarily intended for use in administering nitrous oxide for the purpose of providing medical or dental care.
Section 9138. Nonstatutory provisions; Safety and Professional Services.
(1) Dental therapist licensure.
(a) When the first individual becomes licensed as a dental therapist in this state under s. 447.04 (1m), the dentistry examining board shall send a notice to the legislative reference bureau for publication in the Wisconsin Administrative Register.
(b) 1. The dentistry examining board shall promulgate emergency rules under s. 227.24 that are necessary to implement the licensure of dental therapist under this act. Notwithstanding s. 227.24 (1) (c) and (2), emergency rules promulgated under this subdivision remain in effect for 2 years, or until the date on which permanent rules take effect, whichever is sooner. Notwithstanding s. 227.24 (1) (a) and (3), the board is not required to provide evidence that promulgating a rule under this subdivision as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subdivision.
2. The dentistry examining board shall present a statement of scope for permanent and emergency rules required to implement the licensure of dental therapist under this act to the department of administration under s. 227.135 (2) no later than the 30th day after the effective date of this subdivision. Notwithstanding s. 227.135 (2), if the governor does not disapprove the statement of scope by the 30th day after the statement is presented to the department of administration, the statement is considered to be approved by the governor.
3. The dentistry examining board shall submit a proposed emergency rule required to implement the licensure of dental therapist under this act to the governor for approval under s. 227.24 (1) (e) 1g. no later than the 150th day after the effective date of this subdivision. Notwithstanding s. 227.24 (1) (e) 1g., if the governor does not reject the proposed emergency rule by the 14th day after the rule is submitted to the governor in final draft form, the rule is considered to be approved by the governor.
4. The dentistry examining board shall submit a proposed permanent rule required to implement the licensure of dental therapist under this act to the governor for approval under s. 227.185 no later than the 365th day after the effective date of this subdivision. Notwithstanding s. 227.185, if the governor does not reject that proposed permanent rule by the 30th day after the rule is submitted to the governor in final draft form, the rule is considered to be approved by the governor.
Section 9438. Effective dates; Safety and Professional Services.
(1) Dental therapist licensure. The treatment of s. 15.405 (6) (am) takes effect on the date the notice under Section 9138 (1) (a ) of this act is published in the Wisconsin Administrative Register.
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