AB367: Bill Text

AB367,12,2 2. Notwithstanding subd. 1., the examining board may refuse to grant a license to an applicant following an interview under subd. 1. f. if the examining board determines that discipline that was imposed against the applicant or the license in another jurisdiction demonstrates that the applicant is unfit to practice dentistry.

AB367,12,4 3. A license under this paragraph is no longer in effect if the licensee ceases to be a faculty member at a school of dentistry in this state.

Note: This Section requires the dentistry examining board to grant a license to practice dentistry to an applicant who is licensed in good standing to practice dentistry in another state or territory in the United States or in another country if the applicant is a faculty member at a school of dentistry in this state and satisfies other conditions specified in this Section. A license granted under this provision is no longer in effect if the licensee ceases to be a faculty member at a school of dentistry in this state.

AB367, s. 17 Section 17 . 447.06 (title) of the statutes is amended to read:

AB367,12,6 447.06 (title) Practice Dental hygienist practice limitations.

AB367, s. 18 Section 18 . 447.06 (1) of the statutes is renumbered 447.055 and amended to read:

AB367,12,15 447.055 Contract provisions. No contract of employment entered into between a dentist and any other party under which the dentist renders dental services may require the dentist to act in a manner which violates the professional standards for dentistry set forth in this chapter. Nothing in this subsection section 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 set forth in this chapter.

Note: Sections 17 and 18 remove from a statutory section dealing primarily with dental hygienists a provision that relates to dentists. Titles are modified to accommodate this change.

AB367, s. 19 Section 19 . 447.06 (2) (a) of the statutes is renumbered 447.06 (1m) and 447.06 (1m) (intro.), as renumbered, is amended to read:

AB367,12,20 447.06 (1m) Practice circumstances. A dental hygienist may practice dental hygiene or perform remediable procedures or other delegated procedures only as an employee or as an independent contractor and only as follows:

AB367, s. 20 Section 20. 447.06 (2) (b) of the statutes is renumbered 447.06 (2m) (a) and amended to read:

AB367,13,9 447.06 (2m) (a) A Except as provided in subs. (3) and (4), a dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1., 4., 6., 7. or 8. only as only if either authorized by a dentist who is licensed to practice dentistry under this chapter and who is present in the facility in which those practices or procedures are performed, except as provided in par. (c) or if the practices or procedures are performed pursuant to a prescription that meets the requirements of par. (b).

AB367, s. 21 Section 21 . 447.06 (2) (c) of the statutes is renumbered 447.06 (2m) (b) and 447.06 (2m) (b) (intro.), as renumbered, is amended to read:

AB367,13,16 447.06 (2m) (b) (intro.) A dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1., 4., 6., 7. or 8. if a dentist who is licensed to practice dentistry under this chapter is not present in the facility in which those The practices or procedures are under par. (a) may be performed pursuant to a prescription only if all of the following conditions are met:

AB367, s. 22 Section 22. 447.06 (2) (d) of the statutes is renumbered 447.06 (5).

AB367, s. 23 Section 23 . 447.06 (2) (e) of the statutes is renumbered 447.06 (6).

AB367, s. 24 Section 24 . 447.06 (2m) (title) of the statutes is created to read:

AB367,13,21 447.06 (2m) (title) Requirement for a dentist present or a prescription if a dentist is not present.

Note: Sections 19 to 24 restructure s. 447.06, stats. This bill restates from current law the general requirement that a dental hygienist may practice only if a dentist is present in the facility or a dentist has issued an oral or written prescription. Exceptions to this general requirement are set forth in Sections 25 and 26 and are different than the exceptions in current law.

AB367, s. 25 Section 25 . 447.06 (3) of the statutes is created to read:

AB367,14,10 447.06 (3) Practice circumstances without a dentist present and without a prescription; dental hygienist school. A dental hygienist may practice dental hygiene or perform remediable procedures at a school for the education of dental hygienists without a dentist present in the facility in which the practices or procedures are performed and without a written or oral prescription. A dental hygienist may apply sealants on a patient at a school for the education of dental hygienists without a diagnosis or treatment plan by a dentist if a dental hygienist has performed an oral risk assessment of the patient. A dental hygienist shall maintain a written record of the assessment and make appropriate referrals based on the assessment.

Note: This Section permits a dental hygienist to practice at a school for the education of dental hygienists without a dentist present in the facility and without a written or oral prescription. In addition, a dental hygienist may apply sealants on a patient in this setting without a diagnosis or treatment plan by a dentist if a dental hygienist has performed an oral risk assessment of the patient.

AB367, s. 26 Section 26 . 447.06 (4) of the statutes is created to read:

AB367,14,17 447.06 (4) Practice circumstances without a dentist present and without a prescription; additional education and experience. (a) A dental hygienist may perform any of the following practices without a dentist present in the facility in which the practices are performed and without a written or oral prescription if the requirements of pars. (am), (b), and (c) are met and if the dental hygienist first reviews the patient's medical history and performs an oral risk assessment:

AB367,14,21 1. Conduct an oral screening and have a plan of what dental hygiene procedures will be performed on the patient. Oral screening that is performed solely for the purpose of data collection does not require an oral risk assessment and does not require certification under par. (c).

AB367,15,2 2. Apply dental sealants. Sealants may be applied under this subdivision without a diagnosis or treatment plan by a dentist.

AB367,15,3 3. Provide fluoride therapies.

AB367,15,4 4. Provide patient education services.

AB367,15,6 5. Expose radiographs if a dentist will be available to read and diagnose the radiographs.

AB367,15,12 6. Perform oral prophylaxis, if a dentist, nurse practitioner, physician or physician assistant has reviewed a current medical history for the patient and has indicated in writing that the patient may receive the service. The dental hygienist may use topical anesthesia under this subdivision only if the anesthesia has been prescribed by a dentist, nurse practitioner, physician, or physician assistant. Local anesthesia may not be administered by a dental hygienist under this subdivision.

AB367,15,21 7. Remove supragingival or subgingival calcareous deposits, subgingival cement, or extrinsic stains from a natural or restored surface of a human tooth or a fixed replacement for a human tooth, perform debridement or deep scaling or root planing of teeth, if a dentist, nurse practitioner, physician, or physician assistant has reviewed a current medical history of the patient and has indicated in writing that the patient may receive the service for the patient. The dental hygienist may use topical anesthesia under this subdivision only if prescribed by a dentist, nurse practitioner, physician, or physician assistant. Local anesthesia may not be administered by a dental hygienist under this subdivision.

AB367,15,24 (am) A dental hygienist shall maintain a written record of and oral risk assessment performed under par. (a) and make appropriate referrals based on the assessment.

AB367,15,25 (b) The practices under par. (a) may be performed only as follows:

AB367,16,1 1. For a school board or a governing body of a private school.

AB367,16,3 2. For a facility, as defined in s. 50.01 (1m), a hospital, as defined in s. 50.33 (2), or a facility established to provide care for terminally ill patients.

AB367,16,4 3. For a local health department, as defined in s. 250.01 (4).

AB367,16,6 4. For a charitable institution open to the general public or to members of a religious sect or order.

AB367,16,7 5. For a nonprofit home health care agency.

AB367,16,9 6. For a nonprofit dental care program serving primarily indigent, economically disadvantaged, or migrant worker populations.

AB367,16,15 (c) A dental hygienist may perform the practices under par. (a) only if certified by the examining board in dental hygiene practice circumstances without a dentist present and without a prescription. The examining board shall issue a certificate in dental hygiene practice circumstances without a dentist present and without a presciption to an individual who documents to the board that he or she has 2 years of experience as a dental hygienist and meets any of the following:

AB367,16,20 1. Has submitted to the examining board proof of course completion issued by an accredited dental school or an accredited dental hygiene school in dental hygiene circumstances without a dentist present and without a prescription. This course may be offered in conjunction with a national or state dental or dental hygiene association.

AB367,16,23 2. Has been certified in community dental health, public health, or public health education from an accredited dental school or an accredited dental hygiene program.

AB367,16,25 3. Has worked for at least 1,000 hours in a public health or community health setting.

AB367,17,1 4. Has received a bachelor's degree from an accredited college or university.

Note: This Section creates an exception to the general rule that in order for a dental hygienist to practice, there must be a dentist in the facility or the practice must be pursuant to a written or oral prescription by a dentist. A dental hygienist who meets specified education and experience requirements would be allowed to perform specified procedures in the six practice settings or circumstances specified in this Section.

AB367, s. 27 Section 27. 447.06 (5) (title) of the statutes is created to read:

AB367,17,3 447.06 (5) (title) Prohibited practices.

Note: This Section creates a new subsection title to reflect a restructuring of s. 447.06, stats.

AB367, s. 28 Section 28. 447.06 (6) (title), (d) and (e) of the statutes are created to read:

AB367,17,5 447.06 (6) (title) Delegation by a dentist to a dental hygienist.

AB367,17,7 (d) Any dentistry practice not included in dental hygiene, except as provided in sub. (5), if all of the following conditions are met:

AB367,17,10 1. The delegated practices are ones that, in the opinion of the dentist and the dental hygienist, the dental hygienist is competent to perform based on his or her education, training, or experience.

AB367,17,11 2. The dental hygienist's performance of the practice is inspected by a dentist.

AB367,17,14 (e) A remediable procedure, except that a dentist need not be present on the premises in which the procedure is performed if it is performed pursuant to a prescription that meets the requirements of sub. (2m) (b).

Note: This Section allows a dentist to delegate to a dental hygienist any dentistry practice not included in dental hygiene, with certain exceptions specified in current law, if two conditions are met. First, the delegated practices must be ones that, in the opinion of the dentist and the dental hygienist, the dental hygienist is competent to perform based on his or her education, training, or experience. Second, the dental hygienist's performance of the practice must be inspected by a dentist.

AB367, s. 29 Section 29 . 447.06 (7) of the statutes is created to read:

AB367,18,2 447.06 (7) Dentist responsible for delegation. A dentist who delegates to a dental hygienist the performance of any practice or remediable procedure under sub. (6) is responsible for that dental hygienist's performance of that delegated practice or procedure.

AB367, s. 30 Section 30 . 447.065 (title) of the statutes is amended to read:

AB367,18,5 447.065 (title) Delegation of remediable procedures and dental dentistry practices to unlicensed individuals.

Note: Since all provisions dealing with delegation by a dentist to a dental hygienist will be in s. 447.06, stats., Section 29 replicates a current law dealing with dental responsibility for delegation and Section 30 modifies the title of s. 447.065, stats., to reflect that that section applies only to delegation to unlicensed individuals.

AB367, s. 31 Section 31 . 447.065 (1) of the statutes is amended to read:

AB367,18,10 447.065 (1) A dentist 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 or other dentistry practices subject to sub. (2), if all of the following conditions are met:

AB367,18,12 (a) The unlicensed individual performs the remediable procedure or dentistry practices in accordance with a treatment plan approved by the dentist.

AB367,18,14 (b) The dentist is on the premises when the unlicensed individual performs the remediable procedures or dentistry practices.

AB367,18,16 (c) The unlicensed individual's performance of the remediable procedures or dentistry practices is subject to inspection inspected by the dentist.

AB367, s. 32 Section 32 . 447.065 (2) of the statutes is repealed and recreated to read:

AB367,18,20 447.065 (2) A dentist may make a delegation under sub. (1) of dentistry practices that are not remediable procedures if all of the following requirements are met:

AB367,19,3 (a) The practice does not involve a practice under s. 447.01 (3) (a), (b), (e), (f), or (g), diagnosis of a dental disease or ailment, determination of any treatment or any regimen of treatment, prescription or ordering of medication, performance of any procedure that involves the intentional cutting of soft or hard tissue of the mouth by any means, or administration of local anesthesia or subgingival sustained release chemotherapeutic agents.

AB367,19,6 (b) The individual has graduated from an accredited dental assisting program or has worked at least 1,000 hours during the preceding 12 months in a clinical dentistry setting.

AB367,19,11 (c) The dentist making the delegation documents in his or her records that the individual has been trained or educated to do the delegated practice by a dental school; dental hygiene program; dental assisting program; a program offered or approved by a national or state dental, dental hygiene, or dental assisting association; or a program approved by the examining board.

AB367,19,14 (d) The delegated practices are ones that, in the opinion of the dentist and the individual to whom the practices are delegated, the individual is competent to perform based on his or her education, training, or experience.

Note: Section 31 modifies the current law regarding delegation of remediable procedures by a dentist to an unlicensed individual to reflect that a dentist may delegate additional dentistry practices to an unlicensed individual. With regard to those other dentistry practices, the three conditions for delegation in current law must be met as well as the four conditions specified in Section 32.

AB367, s. 33 Section 33. 447.065 (3) of the statutes is amended to read:

AB367,19,18 447.065 (3) A dentist who delegates to another an unlicensed individual the performance of any practice or remediable procedure is responsible for that individual's performance of that delegated practice or procedure.

Note: This Section amends the current law on dental responsibility for delegation to make it applicable to delegation to unlicensed individuals. A separate provision dealing with dental responsibility for delegation to a dental hygienist is created in Section 29.

AB367, s. 34 Section 34 . 560.183 (title) of the statutes is amended to read:

AB367,19,20 560.183 (title) Physician and dentist loan assistance program.

Note: Sections 34 to 43 include dentists in the current physician loan assistance program and rename the program to be the physician and dentist loan assistance program. In addition, the bill defines "dental health professional shortage area."

AB367, s. 35 Section 35. 560.183 (1) (ad) of the statutes is created to read:

AB367,20,4 560.183 (1) (ad) "Dental health professional shortage area" means an area that is designated by the federal department of health and human services under 42 CFR part 5, appendix B, as having a shortage of dental professionals.

AB367, s. 36 Section 36. 560.183 (1) (ae) of the statutes is created to read:

AB367,20,6 560.183 (1) (ae) "Dentist" means an individual licensed under s. 447.04 (1).

AB367, s. 37 Section 37. 560.183 (2) (a) and (b) of the statutes are amended to read:

AB367,20,11 560.183 (2) (a) The department may repay, on behalf of a physician or dentist, up to $50,000 in educational loans obtained by the physician or dentist from a public or private lending institution for education in an accredited school of medicine or dentistry or for postgraduate medical training.

AB367,20,15 (b) A physician or dentist who is a participant in the national health service corps scholarship program under 42 USC 254n, or a physician or dentist who was a participant in that program and who failed to carry out his or her obligations under that program, is not eligible for loan repayment under this section.

AB367, s. 38 Section 38. 560.183 (3) (a) of the statutes is amended to read:

AB367,21,3 560.183 (3) (a) The department shall enter into a written agreement with the physician. In the agreement, the physician shall agree , in which the physician agrees to practice at least 32 clinic hours per week for 3 years in one or more eligible practice areas in this state, except that a physician specializing in psychiatry may only agree to practice psychiatry in a mental health shortage area and a physician in the expanded loan assistance program under sub. (9) may only agree to practice at a public or private nonprofit entity in a health professional shortage area. The physician shall also agree to care for patients who are insured or for whom health benefits are payable under medicare, medical assistance, or any other governmental program.

AB367, s. 39 Section 39. 560.183 (3) (am) of the statutes is created to read:

AB367,21,9 560.183 (3) (am) The department shall enter into a written agreement with the dentist, in which the dentist agrees to practice at least 32 clinic hours per week for 3 years in one or more dental health professional shortage areas in this state. The dentist shall also agree to care for patients for whom health benefits are payable under medical assistance.