SB167,16,32
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.
SB167,16,44
3. For a local health department, as defined in s. 250.01 (4).
SB167,16,65
4. For a charitable institution open to the general public or to members of a
6religious sect or order.
SB167,16,77
5. For a nonprofit home health care agency.
SB167,16,98
6. For a nonprofit dental care program serving primarily indigent,
9economically disadvantaged, or migrant worker populations.
SB167,16,1510
(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:
SB167,16,2016
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.
SB167,16,2321
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.
SB167,16,2524
3. Has worked for at least 1,000 hours in a public health or community health
25setting.
SB167,17,1
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.
SB167, s. 27
2Section
27. 447.06 (5) (title) of the statutes is created to read:
SB167,17,33
447.06
(5) (title)
Prohibited practices.
Note: This Section creates a new subsection title to reflect a restructuring of s.
447.06, stats.
SB167, s. 28
4Section
28. 447.06 (6) (title), (d) and (e) of the statutes are created to read:
SB167,17,55
447.06
(6) (title)
Delegation by a dentist to a dental hygienist.
SB167,17,76
(d) Any dentistry practice not included in dental hygiene, except as provided
7in sub. (5), if all of the following conditions are met:
SB167,17,108
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.
SB167,17,1111
2. The dental hygienist's performance of the practice is inspected by a dentist.
SB167,17,1412
(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.
SB167, s. 29
15Section
29
. 447.06 (7) of the statutes is created to read:
SB167,18,216
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.
SB167, s. 30
3Section
30
. 447.065 (title) of the statutes is amended to read:
SB167,18,5
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.
SB167, s. 31
6Section
31
. 447.065 (1) of the statutes is amended to read:
SB167,18,107
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:
SB167,18,1211
(a) The unlicensed individual performs the remediable procedure
or dentistry
12practices in accordance with a treatment plan approved by the dentist.
SB167,18,1413
(b) The dentist is on the premises when the unlicensed individual performs the
14remediable procedures
or dentistry practices.
SB167,18,1615
(c) The unlicensed individual's performance of the remediable procedures
or
16dentistry practices is
subject to inspection
inspected by the dentist.
SB167, s. 32
17Section
32
. 447.065 (2) of the statutes is repealed and recreated to read:
SB167,18,2018
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:
SB167,19,321
(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.
SB167,19,64
(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.
SB167,19,117
(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.
SB167,19,1412
(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.
SB167, s. 33
15Section
33. 447.065 (3) of the statutes is amended to read:
SB167,19,1816
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.
SB167, s. 34
19Section
34
. 560.183 (title) of the statutes is amended to read:
SB167,19,20
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."
SB167, s. 35
1Section
35. 560.183 (1) (ad) of the statutes is created to read:
SB167,20,42
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.
SB167, s. 36
5Section
36. 560.183 (1) (ae) of the statutes is created to read:
SB167,20,66
560.183
(1) (ae) "Dentist" means an individual licensed under s. 447.04 (1).
SB167, s. 37
7Section
37. 560.183 (2) (a) and (b) of the statutes are amended to read:
SB167,20,118
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.
SB167,20,1512
(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.
SB167, s. 38
16Section
38. 560.183 (3) (a) of the statutes is amended to read:
SB167,21,317
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.
SB167, s. 39
4Section
39. 560.183 (3) (am) of the statutes is created to read:
SB167,21,95
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.
SB167, s. 40
10Section
40. 560.183 (5) (b) 1., 2., 3., 4. and 5. and (d) of the statutes are
11amended to read:
SB167,21,1612
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.
SB167,21,2017
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.
SB167,21,2321
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.
SB167,22,424
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.
SB167,22,85
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.
SB167,22,119
(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.
SB167, s. 41
12Section
41. 560.183 (6m) (a) (intro.) of the statutes is amended to read:
SB167,22,1613
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:
SB167, s. 42
17Section
42. 560.183 (8) (b), (d), (e) and (f) of the statutes are amended to read:
SB167,22,2118
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.
SB167,22,2322
(d) Assist the department to publicize the program under this section to
23physicians
, dentists, and eligible communities.
SB167,22,2524
(e) Assist physicians
and dentists who are interested in applying for the
25program under this section.
SB167,23,2
1(f) Assist communities in obtaining physicians'
and dentists' services through
2the program under this section.
SB167, s. 43
3Section
43
. 560.183 (9) of the statutes is amended to read:
SB167,23,104
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:
SB167,23,1111
(a) The physician
or dentist must be a U.S. citizen.
SB167,23,1312
(b) The physician
or dentist may not have a judgment lien against his or her
13property for a debt to the United States.
SB167,23,1414
(c) The physician
or dentist must agree to do all of the following:
SB167,23,1615
1.
Accept If the provider is a physician, accept medicare assignment as
16payment in full for services or articles provided.
SB167,23,1917
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.
SB167,23,2220
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.
SB167, s. 44
23Section
44
. 560.184 (1) (ag) of the statutes is created to read:
SB167,23,2524
560.184
(1) (ag) "Dental health professional shortage area" has the meaning
25given in s. 560.183 (1) (ad).
Note: Sections 44 to 50 include dental hygienists in the health care provider loan
assistance program by including dental hygienists in the definition of "health care
provider."
SB167, s. 45
1Section
45. 560.184 (1) (aj) of the statutes is created to read:
SB167,24,32
560.184
(1) (aj) "Dental hygienist" means an individual licensed under s.
3447.04 (2).
SB167, s. 46
4Section
46. 560.184 (1) (am) and (b) of the statutes are amended to read:
SB167,24,85
560.184
(1) (am) "Eligible practice area" means a primary care shortage area,
6an American Indian reservation
, or trust lands of an American Indian tribe
, except
7that with respect to a dental hygienist "eligible practice area" means a dental health
8professional shortage area.
SB167,24,109
(b) "Health care provider" means a
dental hygienist, physician assistant,
10nurse-midwife
, or nurse practitioner.
SB167, s. 47
11Section
47
. 560.184 (3) (a) of the statutes is amended to read:
SB167,24,1712
560.184
(3) (a) The department shall enter into a written agreement with the
13health care provider. In the agreement, the health care provider shall agree to
14practice at least 32 clinic hours per week for 3 years in one or more eligible practice
15areas in this state, except that a health care provider in the expanded loan assistance
16program under sub. (8)
who is not a dental hygienist may only agree to practice at
17a public or private nonprofit entity in a health professional shortage area.
SB167, s. 48
18Section
48. 560.184 (5) (b) 1. of the statutes is amended to read:
SB167,25,219
560.184
(5) (b) 1. The degree to which there is an extremely high need for
20medical care in the eligible practice area or health professional shortage area in
21which an eligible applicant
who is not a dental hygienist desires to practice
and the
22degree to which there is an extremely high need for dental care in the dental health
1professional shortage area in which an eligible applicant who is a dental hygienist
2desires to practice.