AB367,14,1712 447.06 (4) Practice circumstances without a dentist present and without a
13prescription; additional education and experience.
(a) A dental hygienist may
14perform any of the following practices without a dentist present in the facility in
15which the practices are performed and without a written or oral prescription if the
16requirements of pars. (am), (b), and (c) are met and if the dental hygienist first
17reviews the patient's medical history and performs an oral risk assessment:
AB367,14,2118 1. Conduct an oral screening and have a plan of what dental hygiene
19procedures will be performed on the patient. Oral screening that is performed solely
20for the purpose of data collection does not require an oral risk assessment and does
21not require certification under par. (c).
AB367,15,2
12. Apply dental sealants. Sealants may be applied under this subdivision
2without a diagnosis or treatment plan by a dentist.
AB367,15,33 3. Provide fluoride therapies.
AB367,15,44 4. Provide patient education services.
AB367,15,65 5. Expose radiographs if a dentist will be available to read and diagnose the
6radiographs.
AB367,15,127 6. Perform oral prophylaxis, if a dentist, nurse practitioner, physician or
8physician assistant has reviewed a current medical history for the patient and has
9indicated in writing that the patient may receive the service. The dental hygienist
10may use topical anesthesia under this subdivision only if the anesthesia has been
11prescribed by a dentist, nurse practitioner, physician, or physician assistant. Local
12anesthesia may not be administered by a dental hygienist under this subdivision.
AB367,15,2113 7. Remove supragingival or subgingival calcareous deposits, subgingival
14cement, or extrinsic stains from a natural or restored surface of a human tooth or a
15fixed replacement for a human tooth, perform debridement or deep scaling or root
16planing of teeth, if a dentist, nurse practitioner, physician, or physician assistant has
17reviewed a current medical history of the patient and has indicated in writing that
18the patient may receive the service for the patient. The dental hygienist may use
19topical anesthesia under this subdivision only if prescribed by a dentist, nurse
20practitioner, physician, or physician assistant. Local anesthesia may not be
21administered by a dental hygienist under this subdivision.
AB367,15,2422 (am) A dental hygienist shall maintain a written record of and oral risk
23assessment performed under par. (a) and make appropriate referrals based on the
24assessment.
AB367,15,2525 (b) The practices under par. (a) may be performed only as follows:
AB367,16,1
11. For a school board or a governing body of a private school.
AB367,16,32 2. For a facility, as defined in s. 50.01 (1m), a hospital, as defined in s. 50.33 (2),
3or a facility established to provide care for terminally ill patients.
AB367,16,44 3. For a local health department, as defined in s. 250.01 (4).
AB367,16,65 4. For a charitable institution open to the general public or to members of a
6religious sect or order.
AB367,16,77 5. For a nonprofit home health care agency.
AB367,16,98 6. For a nonprofit dental care program serving primarily indigent,
9economically disadvantaged, or migrant worker populations.
AB367,16,1510 (c) A dental hygienist may perform the practices under par. (a) only if certified
11by the examining board in dental hygiene practice circumstances without a dentist
12present and without a prescription. The examining board shall issue a certificate in
13dental hygiene practice circumstances without a dentist present and without a
14presciption to an individual who documents to the board that he or she has 2 years
15of experience as a dental hygienist and meets any of the following:
AB367,16,2016 1. Has submitted to the examining board proof of course completion issued by
17an accredited dental school or an accredited dental hygiene school in dental hygiene
18circumstances without a dentist present and without a prescription. This course
19may be offered in conjunction with a national or state dental or dental hygiene
20association.
AB367,16,2321 2. Has been certified in community dental health, public health, or public
22health education from an accredited dental school or an accredited dental hygiene
23program.
AB367,16,2524 3. Has worked for at least 1,000 hours in a public health or community health
25setting.
AB367,17,1
14. 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 2Section 27. 447.06 (5) (title) of the statutes is created to read:
AB367,17,33 447.06 (5) (title) Prohibited practices.
Note: This Section creates a new subsection title to reflect a restructuring of s.
447.06, stats.
AB367, s. 28 4Section 28. 447.06 (6) (title), (d) and (e) of the statutes are created to read:
AB367,17,55 447.06 (6) (title) Delegation by a dentist to a dental hygienist.
AB367,17,76 (d) Any dentistry practice not included in dental hygiene, except as provided
7in sub. (5), if all of the following conditions are met:
AB367,17,108 1. The delegated practices are ones that, in the opinion of the dentist and the
9dental hygienist, the dental hygienist is competent to perform based on his or her
10education, training, or experience.
AB367,17,1111 2. The dental hygienist's performance of the practice is inspected by a dentist.
AB367,17,1412 (e) A remediable procedure, except that a dentist need not be present on the
13premises in which the procedure is performed if it is performed pursuant to a
14prescription 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 15Section 29 . 447.06 (7) of the statutes is created to read:
AB367,18,216 447.06 (7) Dentist responsible for delegation. A dentist who delegates to a
17dental hygienist the performance of any practice or remediable procedure under sub.

1(6) is responsible for that dental hygienist's performance of that delegated practice
2or procedure.
AB367, s. 30 3Section 30 . 447.065 (title) of the statutes is amended to read:
AB367,18,5 4447.065 (title) Delegation of remediable procedures and dental
5dentistry 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 6Section 31 . 447.065 (1) of the statutes is amended to read:
AB367,18,107 447.065 (1) A dentist who is licensed to practice dentistry under this chapter
8may delegate to an individual who is not licensed under this chapter only the
9performance of remediable procedures, and only or other dentistry practices subject
10to sub. (2),
if all of the following conditions are met:
AB367,18,1211 (a) The unlicensed individual performs the remediable procedure or dentistry
12practices
in accordance with a treatment plan approved by the dentist.
AB367,18,1413 (b) The dentist is on the premises when the unlicensed individual performs the
14remediable procedures or dentistry practices.
AB367,18,1615 (c) The unlicensed individual's performance of the remediable procedures or
16dentistry practices
is subject to inspection inspected by the dentist.
AB367, s. 32 17Section 32 . 447.065 (2) of the statutes is repealed and recreated to read:
AB367,18,2018 447.065 (2) A dentist may make a delegation under sub. (1) of dentistry
19practices that are not remediable procedures if all of the following requirements are
20met:
AB367,19,321 (a) The practice does not involve a practice under s. 447.01 (3) (a), (b), (e), (f),
22or (g), diagnosis of a dental disease or ailment, determination of any treatment or any
23regimen of treatment, prescription or ordering of medication, performance of any

1procedure that involves the intentional cutting of soft or hard tissue of the mouth by
2any means, or administration of local anesthesia or subgingival sustained release
3chemotherapeutic agents.
AB367,19,64 (b) The individual has graduated from an accredited dental assisting program
5or has worked at least 1,000 hours during the preceding 12 months in a clinical
6dentistry setting.
AB367,19,117 (c) The dentist making the delegation documents in his or her records that the
8individual has been trained or educated to do the delegated practice by a dental
9school; dental hygiene program; dental assisting program; a program offered or
10approved by a national or state dental, dental hygiene, or dental assisting
11association; or a program approved by the examining board.
AB367,19,1412 (d) The delegated practices are ones that, in the opinion of the dentist and the
13individual to whom the practices are delegated, the individual is competent to
14perform 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 15Section 33. 447.065 (3) of the statutes is amended to read:
AB367,19,1816 447.065 (3) A dentist who delegates to another an unlicensed individual the
17performance of any practice or remediable procedure is responsible for that
18individual'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 19Section 34 . 560.183 (title) of the statutes is amended to read:
AB367,19,20 20560.183 (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 1Section 35. 560.183 (1) (ad) of the statutes is created to read:
AB367,20,42 560.183 (1) (ad) "Dental health professional shortage area" means an area that
3is designated by the federal department of health and human services under 42 CFR
4part 5
, appendix B, as having a shortage of dental professionals.
AB367, s. 36 5Section 36. 560.183 (1) (ae) of the statutes is created to read:
AB367,20,66 560.183 (1) (ae) "Dentist" means an individual licensed under s. 447.04 (1).
AB367, s. 37 7Section 37. 560.183 (2) (a) and (b) of the statutes are amended to read:
AB367,20,118 560.183 (2) (a) The department may repay, on behalf of a physician or dentist,
9up to $50,000 in educational loans obtained by the physician or dentist from a public
10or private lending institution for education in an accredited school of medicine or
11dentistry
or for postgraduate medical training.
AB367,20,1512 (b) A physician or dentist who is a participant in the national health service
13corps scholarship program under 42 USC 254n, or a physician or dentist who was a
14participant in that program and who failed to carry out his or her obligations under
15that program, is not eligible for loan repayment under this section.
AB367, s. 38 16Section 38. 560.183 (3) (a) of the statutes is amended to read:
AB367,21,317 560.183 (3) (a) The department shall enter into a written agreement with the
18physician. In the agreement, the physician shall agree , in which the physician
19agrees
to practice at least 32 clinic hours per week for 3 years in one or more eligible
20practice areas in this state, except that a physician specializing in psychiatry may
21only agree to practice psychiatry in a mental health shortage area and a physician
22in the expanded loan assistance program under sub. (9) may only agree to practice
23at a public or private nonprofit entity in a health professional shortage area. The

1physician shall also agree to care for patients who are insured or for whom health
2benefits are payable under medicare, medical assistance, or any other governmental
3program.
AB367, s. 39 4Section 39. 560.183 (3) (am) of the statutes is created to read:
AB367,21,95 560.183 (3) (am) The department shall enter into a written agreement with the
6dentist, in which the dentist agrees to practice at least 32 clinic hours per week for
73 years in one or more dental health professional shortage areas in this state. The
8dentist shall also agree to care for patients for whom health benefits are payable
9under medical assistance.
AB367, s. 40 10Section 40. 560.183 (5) (b) 1., 2., 3., 4. and 5. and (d) of the statutes are
11amended to read:
AB367,21,1612 560.183 (5) (b) 1. The degree to which there is an extremely high need for
13medical care in the eligible practice area or health professional shortage area in
14which the a physician desires to practice and the degree to which there is an
15extremely high need for dental care in the dental health professional shortage area
16in which a dentist desires to practice
.
AB367,21,2017 2. The likelihood that a physician will remain in the eligible practice area or
18health professional shortage area, and that a dentist will remain in the dental health
19professional shortage area,
in which he or she desires to practice after the loan
20repayment period.
AB367,21,2321 3. The per capita income of the eligible practice area or health professional
22shortage area in which a physician desires to practice and of the dental health
23professional shortage area in which a dentist desires to practice
.
AB367,22,424 4. The financial or other support for physician recruitment and retention
25provided by individuals, organizations, or local governments in the eligible practice

1area or health professional shortage area in which a physician desires to practice and
2for dentist recruitment and retention provided by individuals, organizations, or local
3governments in the dental health professional shortage area in which a dentist
4desires to practice
.
AB367,22,85 5. The geographic distribution of the physicians and dentists who have entered
6into loan repayment agreements under this section and the geographic distribution
7of the eligible practice areas or, health professional shortage areas, and dental health
8professional shortage areas
in which the eligible applicants desire to practice.
AB367,22,119 (d) An agreement under sub. (3) does not create a right of action against the
10state on the part of the physician or the, dentist, or lending institution for failure to
11make the payments specified in the agreement.
AB367, s. 41 12Section 41. 560.183 (6m) (a) (intro.) of the statutes is amended to read:
AB367,22,1613 560.183 (6m) (a) (intro.) The department shall, by rule, establish penalties to
14be assessed by the department against physicians or dentists who breach an
15agreement
agreements entered into under sub. (3) (a). The rules shall do all of the
16following:
AB367, s. 42 17Section 42. 560.183 (8) (b), (d), (e) and (f) of the statutes are amended to read:
AB367,22,2118 560.183 (8) (b) Advise the department and rural health development council
19on the identification of eligible practice areas with an extremely high need for
20medical care and dental health professional shortage areas with an extremely high
21need for dental care
.
AB367,22,2322 (d) Assist the department to publicize the program under this section to
23physicians, dentists, and eligible communities.
AB367,22,2524 (e) Assist physicians and dentists who are interested in applying for the
25program under this section.
AB367,23,2
1(f) Assist communities in obtaining physicians' and dentists' services through
2the program under this section.
AB367, s. 43 3Section 43 . 560.183 (9) of the statutes is amended to read:
AB367,23,104 560.183 (9) Expanded loan assistance program. The department may agree
5to repay loans as provided under this section on behalf of a physician or dentist under
6an expanded physician and dentist loan assistance program that is funded through
7federal funds in addition to state matching funds. To be eligible for loan repayment
8under the expanded physician and dentist loan assistance program, a physician or
9dentist
must fulfill all of the requirements for loan repayment under this section, as
10well as all of the following:
AB367,23,1111 (a) The physician or dentist must be a U.S. citizen.
AB367,23,1312 (b) The physician or dentist may not have a judgment lien against his or her
13property for a debt to the United States.
AB367,23,1414 (c) The physician or dentist must agree to do all of the following:
AB367,23,1615 1. Accept If the provider is a physician, accept medicare assignment as
16payment in full for services or articles provided.
AB367,23,1917 2. Use a sliding fee scale or a comparable method of determining payment
18arrangements for patients who are not eligible for medicare or medical assistance
19and who are unable to pay the customary fee for the physician's or dentist's services.
AB367,23,2220 3. Practice at a public or private nonprofit entity in a health professional
21shortage area, if the provider is a physician, or in a dental health professional
22shortage area, if the provider is a dentist
.
AB367, s. 44 23Section 44 . 560.184 (1) (ag) of the statutes is created to read:
Loading...
Loading...