LRB-3155/1
MDK/DAK/PJK:wlj:km
2001 - 2002 LEGISLATURE
May 1, 2001 - Introduced by Joint Legislative Council. Referred to Committee
on Health.
AB367,2,14 1An Act to renumber 447.03 (2) (intro.), (a) and (b), 447.06 (2) (d) and 447.06 (2)
2(e); to renumber and amend 447.06 (1), 447.06 (2) (a), 447.06 (2) (b) and
3447.06 (2) (c); to amend 15.157 (8) (intro.) and (g), 20.143 (1) (jc) (title), (jm)
4(title), and (kr) (title), 447.01 (12), 447.02 (1) (c), 447.02 (2) (d), 447.02 (2) (e),
5447.03 (3) (g), 447.04 (1) (a) 4., 447.04 (1) (b), 447.06 (title), 447.065 (title),
6447.065 (1), 447.065 (3), 560.183 (title), 560.183 (2) (a) and (b), 560.183 (3) (a),
7560.183 (5) (b) 1., 2., 3., 4. and 5. and (d), 560.183 (6m) (a) (intro.), 560.183 (8)
8(b), (d), (e) and (f), 560.183 (9), 560.184 (1) (am) and (b), 560.184 (3) (a), 560.184
9(5) (b) 1., 560.184 (7) (a), 560.184 (8) (c) 1., 2. and 3. and 560.185 (1); to repeal
10and recreate
447.065 (2); and to create 46.03 (44), 447.01 (10), 447.02 (3),
11447.03 (2) (b), 447.04 (1) (c), 447.04 (1) (d), 447.06 (2m) (title), 447.06 (3), 447.06
12(4), 447.06 (5) (title), 447.06 (6) (title), (d) and (e), 447.06 (7), 560.183 (1) (ad),
13560.183 (1) (ae), 560.183 (3) (am), 560.184 (1) (ag) and 560.184 (1) (aj) of the
14statutes; relating to: regional dental testing service examinations; dentist

1licenses for individuals licensed in another jurisdiction; the scope of practice of
2dental hygienists; delegation of dentistry practices to dental hygienists and
3unlicensed individuals; providing loan assistance to dentists and dental
4hygienists who practice in underserved areas; requiring the technical college
5system board to report on community dental health education; requiring the
6dentistry examining board and the department of health and family services to
7prepare a joint report on the ability of the dental work force to meet dental
8needs; requiring the department of health and family services to prepare a plan
9for a comprehensive oral health data collection system; requiring the
10department of health and family services to report on prior authorization for
11dental services under medical assistance; and requiring the department of
12health and family services and the department of regulation and licensing to
13prepare joint reports on improved access to dental services and dental hygiene
14services.
Analysis by the Legislative Reference Bureau
This bill is explained in the Notes provided by the joint legislative council in
the bill.
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:
Prefatory note: This bill was prepared for the joint legislative council's special
committee on dental care access. The bill contains the following provisions:
Regional Dental Examinations
Under current law, the dentistry examining board is required to grant a dentist
license to a person who does all of the following: (1) submits an application for licensure;
(2) pays the specified fee; (3) submits evidence of graduation from an accredited dental
school; (4) submits evidence that he or she has passed the national dental examination
and the examination of a dental testing service approved by the board; (5) passes an

examination administered by the board on the statutes and rules relating to dentistry;
and (6) completes any other requirements established by the board by rule.
The bill modifies the fourth requirement above. Under the bill, the applicant will
have to submit evidence that he or she has passed the national dental examination, as
required under current law. However, the bill provides that the applicant may pass an
examination of either a dental testing service approved by the board or a regional dental
testing service in the United States.
Licensure of Dentists from Other Jurisdictions
Current law specifies that the board may grant a license to practice dentistry to a
person who is licensed in good standing in another state or U.S. territory or another
country if the applicant meets the requirements for licensure established by the board by
rule and presents the license and pays the specified fee.
The bill requires the 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 of the
United States or in Canada upon presentation of the license, payment of the required fee,
and submission of evidence satisfactory to the board that he or she has met the seven
conditions specified in the bill. The board would be permitted to refuse to grant a license
to an applicant following an interview if the board determines that discipline that was
imposed against the applicant in another jurisdiction demonstrates that the applicant is
unfit to practice dentistry.
Educational Dentist's License
The bill requires the board to grant a license to practice dentistry to an applicant
who is a faculty member at a school of dentistry in Wisconsin if specified conditions are
met. Marquette University School of Dentistry is the only school of dentistry in this state.
The person must present his or her license to the board, pay the required fee and submit
evidence satisfactory to the board that he or she has met the seven conditions specified
in the bill, one of which is that he or she is a faculty member at a school of dentistry in
this state. The board would be permitted to refuse to grant a license to an applicant
following an interview if the board determines that discipline that was imposed against
the applicant in another jurisdiction demonstrates that the applicant is unfit to practice
dentistry. In addition, an educational dentist's license granted under the bill is no longer
in effect if the licensee ceases to be a full-time faculty member at a school of dentistry in
this state.
Dental Hygienist's Scope of Practice
Current law allows a dental hygienist to practice dental hygiene or perform
remediable procedures only as an employee or as an independent contractor and only in
one of eight specified settings or circumstances. In five of those settings or circumstances,
the dental hygienist may practice only if there is a dentist present in the facility or if the
practice is being performed pursuant to a dentist's written or oral prescription that meets
specified requirements.
The bill retains the eight settings and circumstances in which a dental hygienist
may practice. The bill specifies that a dental hygienist may practice dental hygiene only
if a dentist is present in the facility or pursuant to a dentist's oral or written prescription
that meets the requirements set forth in current law, with two exceptions.
The first exception is that a dental hygienist may practice at a school for the
education of dental hygienists without a dentist present in the facility 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 the dental hygienist has performed an oral risk assessment, as defined by the
bill.

The second exception to the requirement that a dentist be present in the facility
or an oral or written prescription be used is set forth in the bill for dental hygienists who
meet specified education and experience requirements and practice specified procedures.
The dental hygienist will be allowed to perform those practices only in the following
settings or circumstances: (1) for a school board or a governing body of a private school;
(2) for a facility, as defined in current law, a hospital, or a facility established to provide
care for terminally ill patients; (3) for a local health department; (4) for a charitable
institution open to the general public or to members of a religious sect or order; (5) for a
nonprofit home health care agency; and (6) for a nonprofit dental care program serving
primarily indigent, economically disadvantaged, or migrant worker populations.
Under this second exception, the dental hygienist would be permitted to practice
as specified in the bill if he or she meets the education and experience requirements under
the bill to obtain a separate certificate. To obtain such a certificate, the person must have
two years experience as a dental hygienist and meet one of four educational
requirements.
Delegation of Dentistry Practices
Current law allows a dentist to delegate to an unlicensed person the performance
of remediable procedures if certain conditions are met. In addition, a dentist may
delegate to a dental hygienist the performance of remediable procedures and the
administration of oral systemic premedications, local anesthesia, and subgingival
sustained release chemotherapeutic agents if certain requirements are met.
The bill modifies the statute on delegation of practices by a dentist to a dental
hygienist. The bill allows any dentistry practice not included in dental hygiene to be
delegated to a dental hygienist, except for those practices that are prohibited practices
by a dental hygienist under current law. In order for the delegation to occur, the delegated
acts 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.
In addition, the dental hygienist's performance of the practice must be inspected by a
dentist.
The bill also modifies the statute dealing with delegation of remediable procedures
to unlicensed persons. In addition to delegation of remediable procedures, the bill
permits a dentist to delegate dentistry practices if certain requirements are met. First,
the practice must be one that is not one of several prohibitions on delegation enumerated
in the bill. Second, the person must have graduated from an accredited dental assisting
program or have worked at least 1,000 hours during the preceding 12 months in a clinical
dentistry setting. Third, the dentist making the delegation must document in his or her
records that the person has been trained or educated to do the dental practice by one of
several specified entities. Fourth, the delegated practices must be 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.
Loan Assistance Programs
Under current law, the department of commerce administers a physician loan
assistance program and a health care provider loan assistance program. Current law also
has established a rural health development council, which advises the department on
operation of the two programs. The physician loan assistance program provides loan
assistance to physicians who practice in specified eligible practice areas, and the health
care provider loan assistance program provides such assistance to physician assistants,
nurse-midwives, and nurse practitioners who practice in specified eligible practice areas.
The amount of the assistance is $50,000 under the physician loan assistance program and
$25,000 under the health care provider loan assistance program, both repaid by the
department over a three-year period.

The bill expands the physician loan assistance program to include dentists and
renames it the physician and dentist loan assistance program. In addition, the bill
expands the health care provider loan assistance program to include dental hygienists.
Finally, the bill adds a dentist and a dental hygienist to the rural health development
council.
Community Dental Health Education Report
The bill requires the Wisconsin technical college system board to report on the
feasibility and cost of increasing the number of sites in the system that offer community
dental health education for dentists and dental hygienists. The report must be submitted
to the governor and the legislature by the first day of the sixth month after publication
of the act.
Dental Work Force Report
The bill requires the dentistry examining board and the department of health and
family services to prepare a joint report every five years on the ability of the dental work
force to meet the oral health care needs of individuals in Wisconsin. The report must be
submitted to the governor and the legislature. The first report is due January 1, 2003.
Oral Health Data Collection Plan
The bill requires the department of health and family services to prepare a plan
for development of a comprehensive oral health data collection system. The plan must
be submitted to the governor and the legislature by September 1, 2002.
Prior Authorization Report
The bill requires the department of health and family services to prepare a report
on its efforts to reduce the requirement for prior authorization for dental services under
medical assistance and to simplify the prior authorization process for those services. The
report must be submitted to the governor and the legislature by the first day of the sixth
month beginning after publication of the act.
Access to Services Report
The bill requires the department of health and family services and the department
of regulation and licensing jointly to prepare reports on whether the provisions of the bill
relating to a dental hygienist's scope of practice and delegation of dentistry practices have
improved access to dental services and dental hygiene services. The reports, which would
be submitted to the governor and the legislature, would be done two years and four years
after enactment of the bill.
AB367, s. 1 1Section 1. 15.157 (8) (intro.) and (g) of the statutes are amended to read:
AB367,5,72 15.157 (8) Rural health development council. (intro.) There is created in the
3department of commerce a rural health development council consisting of 11 13
4members nominated by the governor, and with the advice and consent of the senate
5appointed, for 5-year terms, and the secretaries of commerce and health and family
6services, or their designees. The appointed members shall include all of the
7following:
AB367,6,3
1(g) A physician licensed under ch. 448 and, a nurse licensed under ch. 441, both
2a dentist licensed under ch. 447, and a dental hygienist licensed under ch. 447, all
3of whom practice in a rural area, and a representative of public health services.
Note: This Section adds a dentist and a dental hygienist to the rural health
development council. The council is advisory to the department of commerce, which
administers the current physician loan assistance program and the health care provider
loan assistance program. The first program is being expanded to include dentists and the
second program is being expanded to include dental hygienists.
AB367, s. 2 4Section 2. 20.143 (1) (jc) (title), (jm) (title), and (kr) (title) of the statutes are
5amended to read:
AB367,6,76 20.143 (1) (jc) (title) Physician and dentist and health care provider loan
7assistance programs
repayments; penalties.
AB367,6,88 (jm) (title) Physician and dentist loan assistance program; local contributions.
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