AB367: Bill Text

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.

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: