AB367: Bill Text

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.

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.