AB367: Bill Text

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 In addition, an educational dentist's license granted under the bill is no longer in effect if the licensee ceases to be a full-time faculty member at a school of dentistry in this state.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 Section 1. 15.157 (8) (intro.) and (g) of the statutes are amended to read:

AB367,5,7 15.157 (8) Rural health development council. (intro.) There is created in the department of commerce a rural health development council consisting of 11 13 members nominated by the governor, and with the advice and consent of the senate appointed, for 5-year terms, and the secretaries of commerce and health and family services, or their designees. The appointed members shall include all of the following:

AB367,6,3 (g) A physician licensed under ch. 448 and, a nurse licensed under ch. 441, both a dentist licensed under ch. 447, and a dental hygienist licensed under ch. 447, all of 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 Section 2. 20.143 (1) (jc) (title), (jm) (title), and (kr) (title) of the statutes are amended to read:

AB367,6,7 20.143 (1) (jc) (title) Physician and dentist and health care provider loan assistance programs repayments; penalties.

AB367,6,8 (jm) (title) Physician and dentist loan assistance program; local contributions.

AB367,6,10 (kr) (title) Physician and dentist and health care provider loan assistance programs, repayments and contract.

Note: This Section modifies the name of the physician loan assistance program to be the physician and dentist loan assistance program.

AB367, s. 3 Section 3 . 46.03 (44) of the statutes is created to read:

AB367,6,17 46.03 (44) Dental work force report. By January 1, 2003, and every 5 years thereafter, submit jointly with the dentistry examining board a report to the legislature in the manner provided under s. 13.172 (2) and to the governor on the ability of the dental work force to meet the oral health care needs of individuals in this state. The report shall include findings and any recommendations of the department and the examining board.

Note: Sections 3 and 9 require the department of health and family services and the dentistry examining board to submit a periodic report on the ability of the dental work force to meet the oral health care needs of individuals in Wisconsin. The first report is due January 1, 2003, and subsequent reports would be due every five years thereafter.

AB367, s. 4 Section 4. 447.01 (10) of the statutes is created to read:

AB367,7,3 447.01 (10) "Oral risk assessment" means a review of the patient's caries experience, dental care utilization, use of preventive services, and medical history. "Oral risk assessment" does not include a dental diagnosis.

Note: This Section creates a definition of "oral risk assessment." The term is used in provisions of the bill dealing with the scope of practice of dental hygienists.

AB367, s. 5 Section 5. 447.01 (12) of the statutes is amended to read:

AB367,7,8 447.01 (12) "Remediable procedures" means patient procedures that create changes within the oral cavity or surrounding structures that are reversible without professional intervention and do not involve any increased health risks to the patient.

Note: This Section modifies the current definition of "remediable procedures." The bill specifies that the procedures must be reversible without professional intervention.

AB367, s. 6 Section 6 . 447.02 (1) (c) of the statutes is amended to read:

AB367,7,11 447.02 (1) (c) Subject to ch. 553 and s. 447.06 (1) 447.055, governing dental franchising.

AB367, s. 7 Section 7. 447.02 (2) (d) of the statutes is amended to read:

AB367,7,15 447.02 (2) (d) The oral systemic premedications and subgingival sustained release chemotherapeutic agents that may be administered by a dental hygienist licensed under this chapter under s. 447.06 (2) (e) 1. and 3 (6) (a) and (c).

AB367, s. 8 Section 8 . 447.02 (2) (e) of the statutes is amended to read:

AB367,7,19 447.02 (2) (e) The educational requirements for administration of local anesthesia by a dental hygienist licensed under this chapter under s. 447.06 (2) (e) 2 (6) (b).

Note: Sections 6 to 8 modify current cross-references to reflect changes made by the bill.

AB367, s. 9 Section 9 . 447.02 (3) of the statutes is created to read:

AB367,8,6 447.02 (3) By January 1, 2003, and every 5 years thereafter, the examining board shall submit jointly with the department of health and family services a report to the legislature under s. 13.172 (2) and to the governor on the ability of the dental work force to meet the oral health care needs of individuals in this state. The report shall include findings and any recommendations of the examining board and the department.

AB367, s. 10 Section 10 . 447.03 (2) (intro.), (a) and (b) of the statutes are renumbered 447.03 (2) (a) (intro.), 1. and 2.

AB367, s. 11 Section 11 . 447.03 (2) (b) of the statutes is created to read:

AB367,8,12 447.03 (2) (b) Any individual who is licensed as a dental hygienist under this chapter is not required to be licensed as a dentist to perform acts delegated by a dentist under s. 447.06.

AB367, s. 12 Section 12 . 447.03 (3) (g) of the statutes is amended to read:

AB367,8,15 447.03 (3) (g) Any individual who provides remediable procedures or other dentistry practices that are delegated under s. 447.065 (1) or (2).

Note: Sections 10 to 12 modify current statutes dealing with unauthorized practice of dentistry to allow individuals who are delegated dentistry practices by a dentist under the bill to do so without having to be licensed as a dentist.

AB367, s. 13 Section 13. 447.04 (1) (a) 4. of the statutes is amended to read:

AB367,8,20 447.04 (1) (a) 4. Submits evidence satisfactory to the examining board that he or she has passed the national dental examination and either the examination of a dental testing service approved by the examining board or an examination of a regional dental testing service in the United States.

Note: This Section modifies one of the requirements for licensure as a dentist. Under the current requirement, the applicant must submit evidence satisfactory to the dentistry examining board that he or she has passed the national dental examination and the examination of a dental testing service approved by the examining board. This Section modifies the latter requirement so that the individual would have to pass either the examination of a dental testing service approved by the examining board or an examination of a regional dental testing service in the United States. There are four such regional dental testing services in the United States, two of which are currently recognized by the examining board.

AB367, s. 14 Section 14. 447.04 (1) (b) of the statutes is amended to read:

AB367,9,7 447.04 (1) (b) The Except as provided in pars. (c) and (d), the examining board may grant a license to practice dentistry to an individual who is licensed in good standing to practice dentistry in another state or territory of the United States or in another country if the applicant meets the requirements for licensure established by the examining board by rule and upon presentation of the license and payment of the fee specified under s. 440.05 (2).

Note: This Section amends the current statute allowing the dentistry examining board to grant a license to practice dentistry to an individual who is licensed in another state, territory, or country. The statute is amended to reference the two provisions in the bill under which the examining board would be required to grant a license to practice dentistry, as specified in Sections 15 and 16.

AB367, s. 15 Section 15 . 447.04 (1) (c) of the statutes is created to read:

AB367,9,13 447.04 (1) (c) 1. The examining board shall 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 fee specified under s. 440.05 (2), and submission of evidence satisfactory to the examining board that all of the following conditions are met:

AB367,9,15 a. The applicant has graduated from a school of dentistry accredited by the American Dental Association's commission on dental accreditation.

AB367,9,19 b. The applicant submits a certificate from each jurisdiction in which the applicant is or has ever been licensed stating that no disciplinary action is pending against the applicant or the license, and detailing all discipline, if any, that has ever been imposed against the applicant or the license.

AB367,10,4 c. The applicant has been engaged in the active practice of dentistry, as defined in s. DE 1.02 (2), Wis. Adm. Code, in one or more jurisdictions in which the applicant has a current license in good standing, for at least 48 of the 60 months preceding the application for licensure in this state.

AB367,10,7 d. The applicant has successfully completed a jurisprudence examination on the provisions of Wisconsin statutes and administrative rules relating to dentistry and dental hygiene.

AB367,10,9 e. The applicant possesses a current certificate of proficiency in cardiopulmonary resuscitation.

AB367,10,12 f. The applicant has disclosed all discipline that has ever been taken against the applicant in any jurisdiction shown in reports from the national practitioner data bank and the American association of dental examiners.

AB367,10,16 g. The applicant has presented satisfactory responses during any personal interview with the board that the board may require to resolve conflicts between the licensing standards and the applicant's application or to inquire into any discipline that was imposed against the applicant or the license in another jurisdiction.

AB367,10,20 2. Notwithstanding subd. 1., the examining board may refuse to grant a license to an applicant following an interview under subd. 1. g. 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.

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 of the United States or in Canada upon satisfying conditions specified in the bill. Licensure of persons who have practiced in another jurisdiction is commonly referred to as "licensure by endorsement."

AB367, s. 16 Section 16 . 447.04 (1) (d) of the statutes is created to read:

AB367,11,5 447.04 (1) (d) 1. The examining board shall 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 another country upon presentation of the license, payment of the fee specified under s. 440.05 (2), and submission of evidence satisfactory to the examining board that all of the following conditions are met:

AB367,11,6 a. The applicant is a faculty member at a school of dentistry in this state.

AB367,11,10 b. The applicant submits a certificate from each jurisdiction in which the applicant is or has ever been licensed stating that no disciplinary action is pending against the applicant or the license, and detailing all discipline, if any, that has ever been imposed against the applicant or the license.

AB367,11,13 c. The applicant has successfully completed a jurisprudence examination on the provisions of Wisconsin statutes and administrative rules relating to dentistry and dental hygiene.

AB367,11,15 d. The applicant possesses a current certificate of proficiency in cardiopulmonary resuscitation.

AB367,11,18 e. The applicant has disclosed all discipline that has ever been taken against the applicant in any jurisdiction shown in reports from the national practitioner data bank and the American association of dental examiners.

AB367,11,22 f. The applicant has presented satisfactory responses during any personal interview with the board that the board may require to resolve conflicts between the licensing standards and the applicant's application or to inquire into any discipline that was imposed against the applicant or the license in another jurisdiction.

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.