By: Hirschi H.B. No. 2168
73R5277 JMM-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to dental care pilot programs for certain underserved
1-3 areas.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 9, Title 71, Revised Statutes, is amended
1-6 by adding Article 4551n to read as follows:
1-7 Art. 4551n. DENTAL CARE FOR UNDERSERVED AREAS
1-8 Sec. 1. DESIGNATION OF UNDERSERVED COUNTIES. The State
1-9 Board of Dental Examiners shall designate counties that are
1-10 underserved with regard to dental care by compiling
1-11 county-by-county statistics on the per capita number of dentists in
1-12 each county. The board shall designate a county as underserved if:
1-13 (1) the county does not have a dentist practicing in
1-14 the county;
1-15 (2) the ratio of dentists to the county population is
1-16 50 percent below the statewide norm based on the statistics
1-17 compiled under this section; or
1-18 (3) special circumstances determined by the board
1-19 exist for designating the county as underserved.
1-20 Sec. 2. PILOT PROGRAM. (a) An accredited dental hygiene or
1-21 dental education program that applies to the board and meets the
1-22 requirements of this article may establish a five-year oral health
1-23 access pilot program for an area not to exceed 15 underserved
1-24 counties. The board by rule may adopt standards for the extension
2-1 of a program under this section beyond five years.
2-2 (b) A school that establishes a pilot program under this
2-3 section shall adopt strategic goals for the program, describe the
2-4 activities necessary to accomplish these goals, and specify the
2-5 quantitative methods for measuring the effectiveness of the
2-6 program. The information required under this subsection shall be
2-7 provided to the board.
2-8 (c) A school that establishes a pilot program under this
2-9 section shall attempt to earn the support and participation of
2-10 dentists and dental hygienists who are already practicing in the
2-11 program area.
2-12 Sec. 3. PRACTICE REQUIREMENTS FOR PILOT PROGRAM. (a) The
2-13 board by rule shall ease the practice restrictions for license
2-14 holders who participate in a pilot program under this article. The
2-15 board shall also ease practice restrictions on participating
2-16 students at a school that establishes a pilot program.
2-17 (b) A dentist or dental hygienist practicing in a designated
2-18 underserved county who participates in a pilot program under this
2-19 article shall comply with the reporting requirements adopted by the
2-20 board for program participants and shall be subject to evaluation
2-21 by the coordinators of the pilot program.
2-22 (c) A dentist who participates in a pilot program under this
2-23 article may use mobile vans or satellite clinics without
2-24 restrictions imposed by the board or elsewhere under law. A mobile
2-25 van or satellite clinic is subject to the same requirements as the
2-26 dentist's main office practice setting.
2-27 (d) The board shall permit the ownership and operation of
3-1 for-profit and nonprofit dental practices in an area served by a
3-2 pilot program under this article. A dental practice under this
3-3 subsection that is owned by an entity other than a licensed dentist
3-4 shall register with the board and pay a business license fee of
3-5 $500.
3-6 (e) A licensed dentist who practices under a trade name may
3-7 not be required to include the dentist's name on all signs or
3-8 advertising that uses the trade name to the extent of the dentist's
3-9 participation in a pilot program.
3-10 Sec. 4. PRACTICE BY DENTAL HYGIENIST IN PILOT PROGRAM. (a)
3-11 A licensed dental hygienist who participates in a pilot program
3-12 under this article may provide limited services outside of the
3-13 hygienist's dental office if the hygienist acts with the authority
3-14 and permission of the hygienist's employing dentist.
3-15 (b) A dental hygienist participating in a pilot program
3-16 under this section may provide a patient the following services,
3-17 without the requirement that the patient first be seen by a dentist
3-18 or without having the patient being a patient of record of the
3-19 hygienist's practice before the treatment is provided:
3-20 (1) individual nondiagnostic referral screenings;
3-21 (2) fluoride treatments;
3-22 (3) sealant applications; and
3-23 (4) patient education.
3-24 (c) A dental hygienist who participates in a pilot program
3-25 under this section shall establish the required patient records but
3-26 may not perform any diagnostic activities.
3-27 (d) A person who receives a fluoride treatment or a sealant
4-1 treatment from a hygienist under Subsection (b) of this section
4-2 shall be referred for a follow-up examination with the hygienist's
4-3 authorizing dentist.
4-4 (e) A dental hygienist who participates in a pilot program
4-5 under this section may provide prophylaxis treatments with the
4-6 permission of the hygienist's employing dentist for homebound
4-7 patients, disabled patients, elderly patients, mobility impaired
4-8 patients, and nursing home patients without the requirement that
4-9 these patients first be seen by a dentist.
4-10 Sec. 5. ADDITIONAL DENTAL CARE PROGRAMS. (a) A pilot
4-11 program under this section may provide for additional dental care
4-12 to be provided in the area served by the program through
4-13 internships, special care programs provided by dental and dental
4-14 hygienist students, patient education programs, and sealant,
4-15 fluoridation, and referral screening projects.
4-16 (b) Quantitative records for additional programs offered by
4-17 a pilot program under this section shall be maintained separately
4-18 from other records for services provided by practicing dentists and
4-19 dental hygienists in the pilot program.
4-20 Sec. 6. ANNUAL REPORT. (a) A school operating a pilot
4-21 program shall file an annual report providing information required
4-22 by the board.
4-23 (b) A report required under this section shall be filed with
4-24 the board, any advisory committee that advises the Texas Department
4-25 of Health about technical dental issues, the Texas Department of
4-26 Human Services, the senate health and human services committee, the
4-27 house of representatives public health committee, and members of
5-1 the legislature who represent a county that is served by the pilot
5-2 program.
5-3 SECTION 2. This Act takes effect September 1, 1993.
5-4 SECTION 3. The importance of this legislation and the
5-5 crowded condition of the calendars in both houses create an
5-6 emergency and an imperative public necessity that the
5-7 constitutional rule requiring bills to be read on three several
5-8 days in each house be suspended, and this rule is hereby suspended.