By: Hirschi H.B. No. 2689 73R3510 CAG-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the regulation of dental hygienists and to the 1-3 creation, powers, and duties of the State Dental Hygiene Examiners 1-4 Board; providing a penalty. 1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-6 SECTION 1. Chapter 9, Title 71, Revised Statutes, is 1-7 amended by adding Article 4551e-2 to read as follows: 1-8 Art. 4551e-2. STATE DENTAL HYGIENE EXAMINERS BOARD 1-9 Sec. 1. STATE DENTAL HYGIENE EXAMINERS BOARD. (a) The 1-10 State Dental Hygiene Examiners Board consists of: 1-11 (1) three members licensed as dental hygienists; and 1-12 (2) three members who are not licensed dental 1-13 hygienists to represent the public. 1-14 (b) Each member of the board is appointed by the governor. 1-15 To qualify for appointment as a dental hygienist member of the 1-16 board, an individual must have been licensed for at least five 1-17 years before the date of appointment to the board. 1-18 (c) Appointments to the board shall be made without regard 1-19 to the race, color, disability, sex, religion, age, or national 1-20 origin of the appointees. 1-21 (d) In this article, "board" means the State Dental Hygiene 1-22 Examiners Board. 1-23 Sec. 2. OFFICERS; MEETINGS; COMPENSATION. (a) The board 1-24 annually shall select a presiding officer, assistant presiding 2-1 officer, and secretary-treasurer. 2-2 (b) The board shall hold at least two regular meetings each 2-3 year at which time an examination for a license under a law 2-4 administered by the board shall be administered. Additional 2-5 meetings may be held on the call of the presiding officer or at the 2-6 written request of four members of the board. 2-7 (c) A member of the board is entitled to a per diem as set 2-8 by the General Appropriations Act for each day that the member 2-9 engages in the business of the board. A member may not receive any 2-10 compensation for travel expenses, including expenses for meals and 2-11 lodging, other than transportation expenses as provided by the 2-12 General Appropriations Act. 2-13 Sec. 3. TERMS. Members of the board serve staggered terms 2-14 of six years, with three members' terms expiring on February 1 of 2-15 each odd-numbered year. A board member may not serve more than one 2-16 term. 2-17 Sec. 4. PUBLIC MEMBERSHIP RESTRICTION. A person is not 2-18 eligible for appointment as a public member of the board if the 2-19 person or the person's spouse: 2-20 (1) is registered, certified, or licensed by an 2-21 occupational regulatory agency in the field of health care; 2-22 (2) is employed by or participates in the management 2-23 of a business entity or other organization regulated by the board 2-24 or receiving funds from the board; 2-25 (3) owns or controls, directly or indirectly, more 2-26 than 10 percent interest in a business entity or other organization 2-27 regulated by the board or receiving funds from the board; or 3-1 (4) uses or receives a substantial amount of tangible 3-2 goods, services, or funds from the board, other than compensation 3-3 or reimbursement authorized by law for board membership, 3-4 attendance, or expenses. 3-5 Sec. 5. CONFLICT OF INTEREST RESTRICTIONS. (a) An officer, 3-6 employee, or paid consultant of a Texas trade association in the 3-7 field of health care may not be a member or employee of the board 3-8 who is exempt from the state's position classification plan or is 3-9 compensated at or above the amount prescribed by the General 3-10 Appropriations Act for step 1, salary group 17, of the position 3-11 classification salary schedule. 3-12 (b) A person who is the spouse of an officer, manager, or 3-13 paid consultant of a Texas trade association in the field of health 3-14 care may not be a board member and may not be an employee of the 3-15 board who is exempt from the state's position classification plan 3-16 or is compensated at or above the amount prescribed by the General 3-17 Appropriations Act for step 1, salary group 17, of the position 3-18 classification salary schedule. 3-19 (c) For the purposes of this section, a Texas trade 3-20 association is a nonprofit, cooperative, and voluntarily joined 3-21 association of business or professional competitors in this state 3-22 designed to assist its members and its industry or profession in 3-23 dealing with mutual business or professional problems and in 3-24 promoting their common interest. 3-25 Sec. 6. EFFECT OF LOBBYING ACTIVITY. A person may not serve 3-26 as a member of the board or act as the general counsel to the board 3-27 if the person is required to register as a lobbyist under Chapter 4-1 305, Government Code, and its subsequent amendments, because of the 4-2 person's activities for compensation on behalf of a profession 4-3 related to the operation of the board. 4-4 Sec. 7. GROUNDS FOR REMOVAL FROM BOARD. (a) It is a ground 4-5 for removal from the board if a member: 4-6 (1) does not have at the time of appointment the 4-7 qualifications required by Section 1 of this article; 4-8 (2) does not maintain during service on the board the 4-9 qualifications required by Section 1 of this article; 4-10 (3) violates a prohibition established by Section 4, 4-11 5, or 6 of this article; 4-12 (4) cannot discharge the member's term for a 4-13 substantial part of the term for which the member is appointed 4-14 because of illness or disability; or 4-15 (5) is absent from more than half of the regularly 4-16 scheduled board meetings that the member is eligible to attend 4-17 during a calendar year unless the absence is excused by majority 4-18 vote of the board. 4-19 (b) The validity of an action of the board is not affected 4-20 by the fact that it is taken when a ground for removal of a board 4-21 member exists. 4-22 (c) If the director has knowledge that a potential ground 4-23 for removal exists, the director shall notify the presiding officer 4-24 of the board of the ground. The presiding officer shall then 4-25 notify the governor that a potential ground for removal exists. 4-26 Sec. 8. STAFF. (a) The board shall employ a director and 4-27 administrative and clerical employees as necessary to carry out the 5-1 board's functions. 5-2 (b) The board shall develop and implement policies that 5-3 clearly define the respective responsibilities of the board and the 5-4 staff of the board. 5-5 Sec. 9. EXPENDITURES; AUDIT. (a) The board may authorize, 5-6 from funds appropriated to it, all necessary disbursements to 5-7 implement this article. 5-8 (b) The financial transactions of the board are subject to 5-9 audit by the state auditor in accordance with Chapter 321, 5-10 Government Code, and its subsequent amendments. 5-11 Sec. 10. ANNUAL FINANCIAL REPORT. The board shall file 5-12 annually with the governor and the presiding officer of each house 5-13 of the legislature a complete and detailed written report 5-14 accounting for all funds received and disbursed by the board during 5-15 the preceding fiscal year. The annual report must be in the form 5-16 and reported in the time provided by the General Appropriations 5-17 Act. 5-18 Sec. 11. PERSONNEL POLICIES. (a) The director or the 5-19 director's designee shall develop an intra-agency career ladder 5-20 program. The program shall require intra-agency posting of all 5-21 nonentry level positions concurrently with any public posting. 5-22 (b) The director or the director's designee shall develop a 5-23 system of annual performance evaluations based on measurable job 5-24 tasks. All merit pay for board employees must be based on the 5-25 system established under this subsection. 5-26 Sec. 12. EQUAL EMPLOYMENT OPPORTUNITY POLICIES. (a) The 5-27 director or the director's designee shall prepare and maintain a 6-1 written policy statement to ensure implementation of a program of 6-2 equal employment opportunity under which all personnel transactions 6-3 are made without regard to race, color, disability, sex, religion, 6-4 age, or national origin. The policy statement must include: 6-5 (1) personnel policies, including policies relating to 6-6 recruitment, evaluation, selection, application, training, and 6-7 promotion of personnel that are in compliance with the Commission 6-8 on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes) 6-9 and its subsequent amendments; 6-10 (2) a comprehensive analysis of the board workforce 6-11 that meets federal and state guidelines; 6-12 (3) procedures by which a determination can be made of 6-13 significant underuse in the board workforce of all persons for whom 6-14 federal or state guidelines encourage a more equitable balance; and 6-15 (4) reasonable methods to appropriately address those 6-16 areas of underuse. 6-17 (b) A policy statement prepared under Subsection (a) of this 6-18 section must cover an annual period, be updated annually, be 6-19 reviewed by the Commission on Human Rights for compliance with 6-20 Subsection (a)(1) of this section, and be filed with the governor's 6-21 office. 6-22 (c) The governor's office shall deliver a biennial report to 6-23 the legislature based on the information received under Subsection 6-24 (b) of this section. The report may be made separately or as part 6-25 of other biennial reports to the legislature. 6-26 Sec. 13. PUBLIC INTEREST INFORMATION. (a) The board shall 6-27 prepare information of public interest describing the functions of 7-1 the board and the board's procedures by which complaints are filed 7-2 with and resolved by the board. The board shall make the 7-3 information available to the public and appropriate state agencies. 7-4 (b) The board by rule shall establish methods by which 7-5 consumers and service recipients are notified of the name, mailing 7-6 address, and telephone number of the board for the purpose of 7-7 directing complaints to the board. The board may provide for that 7-8 notification: 7-9 (1) on each registration form, application, or written 7-10 contract for services of an individual or entity regulated by the 7-11 board; 7-12 (2) on a sign prominently displayed in the place of 7-13 business of each individual or entity regulated by the board; or 7-14 (3) in a bill for service provided by an individual or 7-15 entity regulated by the board. 7-16 (c) The board shall list along with its regular telephone 7-17 number the toll-free telephone number that may be called to present 7-18 a complaint about a health professional if the toll-free number is 7-19 established under other state law. 7-20 Sec. 14. PUBLIC PARTICIPATION IN BOARD HEARINGS. The board 7-21 shall develop and implement policies that provide the public with a 7-22 reasonable opportunity to appear before the board and to speak on 7-23 any issue under the jurisdiction of the board. 7-24 Sec. 15. PROGRAM ACCESSIBILITY. The board shall prepare and 7-25 maintain a written plan that describes how a person who does not 7-26 speak English can be provided reasonable access to the board's 7-27 programs. The board shall also comply with federal and state laws 8-1 for program and facility accessibility. 8-2 Sec. 16. TRAINING; STANDARDS OF CONDUCT INFORMATION. (a) 8-3 Each board member shall comply with the board member training 8-4 requirements established by any other state agency that is given 8-5 authority to establish the requirements for the board. 8-6 (b) The board shall provide to its members and employees, as 8-7 often as necessary, information regarding their qualifications for 8-8 office or employment under this article and their responsibilities 8-9 under applicable laws relating to standards of conduct for state 8-10 officers or employees. 8-11 Sec. 17. OPEN MEETINGS AND ADMINISTRATIVE PROCEDURE. The 8-12 board is subject to: 8-13 (1) the open meetings law, Chapter 271, Acts of the 8-14 60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's 8-15 Texas Civil Statutes), and its subsequent amendments; and 8-16 (2) the Administrative Procedure and Texas Register 8-17 Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its 8-18 subsequent amendments. 8-19 Sec. 18. SUNSET PROVISION. The State Dental Hygiene 8-20 Examiners Board is subject to Chapter 325, Government Code (Texas 8-21 Sunset Act), and its subsequent amendments. Unless continued in 8-22 existence as provided by that chapter, the board is abolished and 8-23 this article expires September 1, 2005. 8-24 Sec. 19. LICENSE REQUIRED. Except as otherwise provided by 8-25 this article, a person may not act as a dental hygienist as 8-26 described by Sections 29 and 30 of this article unless the person 8-27 is licensed as a dental hygienist by the board. 9-1 Sec. 20. GENERAL POWERS AND DUTIES OF BOARD. (a) The board 9-2 may adopt and enforce rules as necessary for the performance of the 9-3 board's duties and to ensure compliance with laws relating to the 9-4 practice of dental hygiene to protect the public health and safety. 9-5 (b) The board by rule may define additional duties that are 9-6 logical extensions of duties specified in this article to be 9-7 performed by dental hygienists. Duties prohibited by this article 9-8 may not be included. The board shall determine by rule the level 9-9 of supervision required for each additional duty and may require 9-10 successful completion of a specific educational requirement or 9-11 competence test before a dental hygienist may perform the 9-12 additional duty. 9-13 (c) The board shall prepare a plan to remedy the issue of 9-14 underserved populations for dental hygiene care, including those 9-15 populations underserved for reasons of economics, geography, or 9-16 institutionalization. The board may adopt rules relating to the 9-17 duties and supervision of a dental hygienist serving underserved 9-18 populations. 9-19 (d) The board shall administer this article. 9-20 (e) The board shall adopt rules, including rules of 9-21 professional conduct for dental hygienists. 9-22 Sec. 21. RECORDS. The board shall keep a record of the 9-23 name, residence, and place of business of each person licensed to 9-24 practice dental hygiene. Each dental hygienist registered with the 9-25 board shall notify the board not later than the 60th day after the 9-26 date of: 9-27 (1) a change of address of the place of business of 10-1 the dental hygienist; or 10-2 (2) a change of employers by the dental hygienist. 10-3 Sec. 22. FEES AND EXPENSES. (a) The board shall establish 10-4 reasonable and necessary fees so that the fees, in the aggregate, 10-5 produce sufficient revenue to cover the cost of administering this 10-6 article. 10-7 (b) The board may authorize an additional annual fee of $1 10-8 from each license holder to establish a peer assistance program and 10-9 may authorize an additional annual fee of $1 from each license 10-10 holder to establish a scholarship program to forgive the 10-11 educational loans of license holders who practice in an underserved 10-12 area. 10-13 Sec. 23. FUNDS. (a) All funds collected by the board shall 10-14 be deposited in the state treasury to the credit of a fund known 10-15 as the dental hygiene registration fund to be used for the 10-16 administration of this article. 10-17 (b) Funds specifically collected for either a peer 10-18 assistance program or a dental hygiene scholarship program shall be 10-19 segregated and may be used only for the purpose for which the funds 10-20 were collected. 10-21 Sec. 24. QUALIFICATIONS OF APPLICANTS. An applicant for a 10-22 dental hygiene license must be at least 18 years of age, a graduate 10-23 of an accredited high school or holder of a certificate of high 10-24 school equivalency, and a graduate of a dental hygiene program that 10-25 is accredited by a national accrediting agency recognized by the 10-26 board. The dental hygiene program must include a course of 10-27 instruction that is the equivalent of at least two terms of eight 11-1 months of dental hygiene instruction provided by an institution of 11-2 higher education. An applicant must also pass an examination given 11-3 by the board and shall comply with the provisions of this article 11-4 and the rules of the board. 11-5 Sec. 25. EXAMINATION AND OTHER TESTING REQUIREMENTS. (a) 11-6 The board shall designate the time and place for examining 11-7 qualified applicants for licensing as dental hygienists. Each 11-8 applicant for examination shall pay a fee set by the board and 11-9 shall apply to the board, furnishing information the board may 11-10 require to determine the applicant's qualifications. 11-11 (b) An applicant must attach to the application proof that 11-12 the applicant has successfully completed a course in 11-13 cardiopulmonary resuscitation approved by the American Heart 11-14 Association or American Red Cross less than one year before the 11-15 date the applicant submits the application or, in the event that 11-16 the applicant is not physically capable of successfully completing 11-17 that training, a written statement executed by a licensed physician 11-18 or an instructor in cardiopulmonary resuscitation approved by the 11-19 American Heart Association or American Red Cross that describes the 11-20 incapacity. 11-21 (c) The examination shall be taken by applicants on subjects 11-22 and operations pertaining to dental hygiene that are regularly 11-23 taught in accredited schools of dental hygiene. 11-24 (d) The examination shall be given orally, in writing, or by 11-25 a practical demonstration of the applicant's skill or a combination 11-26 of testing methods. The board shall grade each applicant on the 11-27 various phases of the examination and shall report the grades to 12-1 the applicant within a reasonable time after examination. The 12-2 board may adopt a standardized test, including the national written 12-3 dental hygiene examination administered by the Joint Commission on 12-4 Dental Examinations as all or part of the written examination and 12-5 may enter into agreements with a regional agency to provide for the 12-6 practical testing of applicants or accept completion of a regional 12-7 practical examination as all or part of the practical examination. 12-8 Sec. 26. LICENSE RENEWAL. (a) To renew a license issued 12-9 under this article, a license holder must submit to the board 12-10 before the expiration of the license: 12-11 (1) the license renewal fee; 12-12 (2) proof of completion of continuing education 12-13 requirements under Section 28 of this article; 12-14 (3) proof of successful completion of a course in 12-15 cardiopulmonary resuscitation given or approved by the American 12-16 Heart Association or American Red Cross less than two years before 12-17 the date of submitting the proof to the board; and 12-18 (4) other information required by the board. 12-19 (b) A license holder residing in a country other than the 12-20 United States may satisfy the requirement under Subsection (a)(3) 12-21 of this section by submitting proof of residence in the foreign 12-22 country on the date of application for renewal. 12-23 (c) On application by a license holder, the board may waive 12-24 requirements for a license renewal for good cause. 12-25 (d) If a person's license has been expired for 90 days or 12-26 less, the person may renew the license by paying to the board the 12-27 required renewal fee and a fee that is one-half of the examination 13-1 fee for the license. 13-2 (e) If a person's license has been expired for longer than 13-3 90 days but less than two years, the person may renew the license 13-4 by paying to the board all unpaid renewal fees and a fee that is 13-5 equal to the examination fee for the license. 13-6 (f) If a person's license has been expired for two years or 13-7 longer, the person may not renew the license. The person may 13-8 obtain a new license by submitting to reexamination and complying 13-9 with the requirements and procedures for obtaining an original 13-10 license. 13-11 (g) At least 30 days before the expiration of a person's 13-12 license, the board shall send written notice of the impending 13-13 license expiration to the person at the person's last known address 13-14 according to the records of the board. 13-15 (h) Subsections (e)-(g) of this section do not apply to a 13-16 license holder who is on active duty with the armed forces of the 13-17 United States and is not engaged in private or civilian practice. 13-18 Sec. 27. STAGGERED RENEWAL OF LICENSE. The board by rule 13-19 may adopt a system under which licenses expire on various dates 13-20 during the year. For the year in which the license expiration date 13-21 is changed, license fees payable on February 1 shall be prorated so 13-22 that each license holder pays only that portion of the license fee 13-23 that is allocable to the number of months during which the license 13-24 is valid. On renewal of the license on the new expiration date, 13-25 the total license renewal fee is payable. 13-26 Sec. 28. CONTINUING EDUCATION. The board shall require a 13-27 license holder to complete 20 hours of professional continuing 14-1 education during each licensing period. The board by rule shall 14-2 adopt a process to evaluate and approve continuing education 14-3 courses. 14-4 Sec. 29. PERSONS PRACTICING DENTAL HYGIENE. (a) A person 14-5 practicing dental hygiene may: 14-6 (1) use the title of "dental hygienist," or "RDH," or 14-7 any other letters, titles, terms, or descriptive matter that 14-8 represents the person as being able to practice dental hygiene; or 14-9 (2) perform: 14-10 (A) prophylaxis, or the removal of accumulated 14-11 matter, calculus, deposits, accretions, or stains from the natural 14-12 and restored surfaces of the human teeth and restorations of human 14-13 teeth in the human mouth and the polishing of those surfaces; 14-14 (B) root planing, or the smoothing of roughened 14-15 root surfaces; 14-16 (C) the application of therapeutic or preventive 14-17 agents to the surfaces of the teeth; or 14-18 (D) a preliminary examination and evaluation of 14-19 a person's periodontal condition. 14-20 (b) A person is not considered to be practicing dental 14-21 hygiene as described by Subsection (a) of this section if the 14-22 person is: 14-23 (1) a student enrolled in a nationally accredited 14-24 dental or dental hygiene school or program who performs an activity 14-25 without compensation, except for actual cost of materials, and 14-26 under the direct personal supervision of a demonstrator or teacher 14-27 who is a member of the faculty of the school or program; 15-1 (2) a dentist authorized to practice dentistry in this 15-2 state; 15-3 (3) a person who is a member of an established church 15-4 and practices healing by prayer only; 15-5 (4) a dental hygienist licensed by another state or 15-6 foreign country who performs clinical procedures only for 15-7 professional and technical education demonstration purposes, if the 15-8 dental hygienist first obtains a temporary license from the board; 15-9 (5) a physician or surgeon authorized to practice 15-10 medicine; or 15-11 (6) an employee of a dentist who makes dental X-rays 15-12 in the dental office and under the supervision of a dentist. 15-13 Sec. 30. ADDITIONAL SERVICES DENTAL HYGIENISTS MAY PERFORM; 15-14 REQUIRED SUPERVISION; PRACTICE SETTINGS. (a) In addition to 15-15 performing dental hygiene as described in Section 29 of this 15-16 article, a dental hygienist may make dental X-rays and perform a 15-17 dental hygiene service prescribed by the board or a dental service 15-18 prescribed by the State Board of Dental Examiners, except that a 15-19 dental hygienist may not perform: 15-20 (1) comprehensive examination or final diagnosis and 15-21 treatment planning; 15-22 (2) a surgical or cutting procedure on hard or soft 15-23 tissue other than incidental curettage during a root planing 15-24 procedure; 15-25 (3) the prescription of a drug, medication, or work 15-26 authorization; 15-27 (4) the taking of an impression for a final 16-1 restoration, appliance, or prosthesis; 16-2 (5) the making of an intraoral occlusal adjustment; 16-3 (6) the performance of direct pulpcapping, pulpotomy, 16-4 or any other endodontic procedure; 16-5 (7) the placement of any final restoration; or 16-6 (8) the administration of a parenteral or inhalational 16-7 sedative agent or general anesthetic agent. 16-8 (b) A dental hygienist may perform a service, task, or 16-9 procedure only on the verbal or written authorization and under the 16-10 supervision of a licensed dentist if: 16-11 (1) the dental hygienist is licensed to perform the 16-12 function; and 16-13 (2) the supervising dentist examines the patient at 16-14 the time the dental hygiene procedure is performed or not longer 16-15 than 12 months before the date of the performance of the procedure. 16-16 (c) A dentist is not required to be on the premises when a 16-17 hygienist performs a function authorized under this article. 16-18 (d) This article does not prevent: 16-19 (1) a dentist from authorizing a dental hygienist to 16-20 instruct and educate a patient in good oral hygiene technique; 16-21 (2) a dental hygienist from providing a medication 16-22 ordered by a dentist; or 16-23 (3) a dentist from authorizing the incidental removal 16-24 of cementum by a dental hygienist during root planing. 16-25 (e) Work performed by a dental hygienist in the practice of 16-26 dental hygiene shall be performed: 16-27 (1) in the office of a dentist who employs the dental 17-1 hygienist; 17-2 (2) under the supervision of a supervising dentist in 17-3 an alternate setting, including a nursing home or the patient's 17-4 home; or 17-5 (3) a school, hospital, state institution, public 17-6 health clinic, or other institution approved by the board as a 17-7 proper location for the performance of a dental hygiene procedure. 17-8 Sec. 31. EMERGENCY CARE. A dental hygienist who administers 17-9 cardiopulmonary resuscitation or other emergency care in an 17-10 emergency is not liable for damages arising from providing that 17-11 care unless the emergency care is performed in a wilfully or 17-12 wantonly negligent manner. 17-13 Sec. 32. PRACTICE NOT IN VIOLATION OF DENTAL LAWS. A person 17-14 engaged in the practice of dental hygiene as described by and in 17-15 compliance with this article is not in violation of the laws of 17-16 this state regulating the practice of dentistry. 17-17 Sec. 33. DISPLAY OF LICENSE; DUPLICATE LICENSE. (a) A 17-18 dental hygienist shall place the license issued by the board in 17-19 plain view of patients at a location at which the dental hygienist 17-20 practices. 17-21 (b) If a license issued by the board is lost or destroyed, 17-22 the holder of the license is entitled to a duplicate license on 17-23 payment of a fee to and the filing of an application and affidavit 17-24 describing the loss of the license with the board. If the records 17-25 of the board fail to show that the applicant is licensed by the 17-26 board, the board may deny the request for a duplicate license. 17-27 Sec. 34. EMPLOYMENT RESTRICTIONS. (a) It is unlawful for a 18-1 person to practice or offer to practice dental hygiene or use the 18-2 title "RDH" without having first obtained a license from the board. 18-3 (b) It is unlawful to practice dental hygiene under a name 18-4 other than the name appearing on the license holder's license. 18-5 (c) A person may not be employed as a dental hygienist until 18-6 the person shows proof of having obtained a license. A person 18-7 whose license to practice dental hygiene or dentistry has been 18-8 revoked by a district court may not practice dental hygiene after 18-9 the revocation of the license. 18-10 Sec. 35. DISCIPLINARY ACTIONS. The board and the district 18-11 courts shall have concurrent jurisdiction and authority, after 18-12 notice and hearing, to suspend or revoke a dental hygiene license, 18-13 to place conditions or restrictions on a license, to place on 18-14 probation a person whose license is suspended, or to reprimand or 18-15 require community service of a license holder. A license may be 18-16 suspended or revoked for the following: 18-17 (1) the insanity of the holder of a license, as 18-18 adjudged by the regularly constituted authorities; 18-19 (2) the conviction of the holder of a license of any 18-20 felony or a misdemeanor involving fraud under the laws of this 18-21 state, any other state, or the United States; 18-22 (3) the holder has been or is guilty of dishonorable 18-23 conduct, malpractice, or gross incompetency in the practice of 18-24 dental hygiene; 18-25 (4) the holder has been or is guilty of any deception 18-26 or misrepresentation for the purpose of soliciting or obtaining 18-27 patronage; 19-1 (5) the holder obtained a license through fraud or 19-2 misrepresentation; 19-3 (6) the holder is addicted to alcohol or drugs; 19-4 (7) the holder aided or abetted a person not permitted 19-5 to do so under this article to practice dental hygiene; 19-6 (8) the holder failed to use proper diligence in the 19-7 conduct of the holder's practice or to safeguard patients against 19-8 avoidable infections or knowingly failed to comply with commonly 19-9 accepted national infection control standards such as those 19-10 established by the federal Centers for Disease Control, the 19-11 Occupational Safety and Health Administration, or the board; 19-12 (9) the holder has failed or refuses to comply with 19-13 the law relating to the regulation of dental hygienists; 19-14 (10) the holder has failed or refuses to comply with 19-15 rules of the board; 19-16 (11) the holder is physically or mentally incapable of 19-17 safely practicing; 19-18 (12) the holder has been negligent in the performance 19-19 of dental hygiene services that injured or damaged a patient; 19-20 (13) proof of suspension, revocation, probation, 19-21 reprimand, or other restriction by another state of a license to 19-22 practice dentistry or dental hygiene if the sanction is for conduct 19-23 similar to the conduct described by this section; or 19-24 (14) the holder has knowingly provided or agreed to 19-25 provide dental hygiene care in a manner that violates federal or 19-26 state law regulating a plan to provide, arrange for, pay for, or 19-27 reimburse the cost of dental hygiene care services or regulating 20-1 the business of insurance. 20-2 Sec. 36. UNPROFESSIONAL CONDUCT. (a) A person, firm, or 20-3 corporation that engages directly or indirectly in unprofessional 20-4 conduct pertaining to dental hygiene violates this article. 20-5 (b) "Unprofessional conduct" means: 20-6 (1) obtaining a fee by fraud or misrepresentation; 20-7 (2) aiding or permitting any unlicensed person to 20-8 perform dental hygiene services, except as authorized by this 20-9 article or the rules and regulations of the board; 20-10 (3) claiming or circulating any statement of 20-11 professional superiority or the performance of professional 20-12 services in a superior manner; 20-13 (4) forging, altering, or changing any diploma, 20-14 license, registration certificate, transcript, or other legal 20-15 document relating to the practice of dental hygiene, supplying or 20-16 using a false document, or making a false statement about the use 20-17 or possession of a false document; 20-18 (5) accepting employment as a dental hygienist under a 20-19 false, misleading, or deceptive referral scheme; 20-20 (6) advertising to perform dental hygiene work without 20-21 pain or discomfort to the patient; or 20-22 (7) advertising predictions of future satisfaction or 20-23 success of a dental hygiene service. 20-24 Sec. 37. REFUSAL TO ISSUE OR RENEW A LICENSE. The board may 20-25 refuse to examine or refuse to issue a dental hygiene license to a 20-26 person if the person: 20-27 (1) presents to the board a dishonest or fake evidence 21-1 of qualification or is guilty of any illegality, fraud, or 21-2 deception in the process of examination or for the purpose of 21-3 securing a license; 21-4 (2) is addicted to alcohol or drugs; 21-5 (3) is guilty of dishonest or illegal practices 21-6 connected with the practice of dental hygiene; or 21-7 (4) has been convicted of a felony under the laws of 21-8 this state, another state, or the United States. 21-9 Sec. 38. HEARING BEFORE THE BOARD. If the board proposes to 21-10 refuse to examine a person, to suspend or revoke a license, to 21-11 place on probation a person whose license has been suspended, or to 21-12 reprimand a license holder, the person is entitled to a hearing 21-13 before the board. 21-14 Sec. 39. REVOCATION AND SUSPENSION OF LICENSE FOR 21-15 DRUG-RELATED FELONY CONVICTION. On the finding of guilty in a 21-16 trial court of a person licensed by the board of a felony under 21-17 Chapter 481, Health and Safety Code, or Chapter 483, Health and 21-18 Safety Code, and their subsequent amendments, the board shall, 21-19 after a hearing in which the fact of the finding is determined, 21-20 suspend the person's license. On the person's final conviction, 21-21 the board shall revoke the person's license. The board may not 21-22 reinstate or reissue a license to a person whose license is 21-23 suspended or revoked under this section unless the board determines 21-24 from substantial evidence contained in an investigative report that 21-25 the issuance of a license is in the best interests of the public 21-26 and of the person whose license has been suspended or revoked. 21-27 Sec. 40. COMPLAINT INVESTIGATION AND DISPOSITION. (a) The 22-1 board shall adopt rules concerning the investigation of a complaint 22-2 filed with the board. The rules adopted under this subsection 22-3 shall: 22-4 (1) distinguish between categories of complaints; 22-5 (2) ensure that complaints are not dismissed without 22-6 appropriate consideration; 22-7 (3) require that the board be advised of a complaint 22-8 that is dismissed and that a letter be sent to the person who filed 22-9 the complaint explaining the action taken on the dismissed 22-10 complaint; 22-11 (4) ensure that the person who filed the complaint has 22-12 an opportunity to explain the allegations made in the complaint; 22-13 and 22-14 (5) prescribe guidelines concerning the categories of 22-15 complaints that require the use of a private investigator and the 22-16 procedures for the board to obtain the services of a private 22-17 investigator. 22-18 (b) The board shall dispose of all complaints in a timely 22-19 manner. The board shall establish a time for completing each phase 22-20 of the complaint procedure that is under the control of the board. 22-21 The process must be completed not later than the 30th day after the 22-22 date the complaint is received by the board. The schedule shall be 22-23 kept in the information file for the complaint and all parties 22-24 shall be notified of the projected time requirements for pursuing 22-25 the complaint. A change in the schedule must be noted in the 22-26 complaint information file and all parties to the complaint shall 22-27 be notified not later than the seventh day after the date the 23-1 change is made. 23-2 (c) The director shall notify the board of a complaint the 23-3 process for which extends beyond the time prescribed by the board 23-4 for resolving the complaint so that the board may take necessary 23-5 action on the complaint. 23-6 Sec. 41. JUDICIAL REVIEW. Judicial review of the order or 23-7 decision of the board assessing a penalty or disciplinary action is 23-8 as provided by Section 19, Administrative Procedure and Texas 23-9 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), and 23-10 its subsequent amendments. 23-11 Sec. 42. RESTRAINING PRACTICE IN VIOLATION OF LAW. (a) In 23-12 addition to any other action, proceeding, or remedy authorized by 23-13 law, the board may institute an action in its own name to obtain an 23-14 injunction prohibiting a violation of this article or a rule of the 23-15 board. For the board to sustain the action, alleging or proving 23-16 that an adequate remedy at law does not exist or that substantial 23-17 or irreparable damage would result from the continued violation is 23-18 unnecessary. 23-19 (b) In any proceeding for an injunction the defendant may 23-20 prove as a defense to the action that the actions or proceedings of 23-21 the board were: 23-22 (1) arbitrary or capricious; 23-23 (2) contrary to legal requirements; or 23-24 (3) conducted without due process of law. 23-25 (c) The board is not required to give any appeal bond in any 23-26 cause arising under this law. 23-27 Sec. 43. BOARD TO AID IN ENFORCING STATUTES. The board 24-1 shall aid in the enforcement of this article. A member of the 24-2 board may present to a prosecuting officer complaints relating to 24-3 violations of this article and the board may, through the board's 24-4 members, officers, and employees, assist in the trial of a case 24-5 involving alleged violations of this article, subject to the 24-6 control of the prosecuting officers. 24-7 Sec. 44. OFFENSE; PENALTY. (a) A person who violates any 24-8 provision of this article commits an offense. 24-9 (b) Except as provided by this section, an offense under 24-10 this section is a Class A misdemeanor. 24-11 (c) If it is shown in the trial of a person allegedly in 24-12 violation of this article that the person has once before been 24-13 convicted of a violation of this article, on conviction the person 24-14 shall be punished for a felony of the third degree. 24-15 (d) Each day that a violation continues is a separate 24-16 offense. 24-17 SECTION 2. (a) As soon as possible after the effective date 24-18 of this Act, the governor shall appoint the initial members of the 24-19 State Dental Hygiene Examiners Board in accordance with Article 24-20 4551e-2, Revised Statutes, as added by this Act. In making the 24-21 initial appointments, the governor shall designate members to serve 24-22 terms as follows: 24-23 (1) one public member and one member licensed as a 24-24 dental hygienist serve for terms expiring February 1, 1995; 24-25 (2) one member licensed as a dental hygienist and one 24-26 public member serve for terms expiring February 1, 1997; and 24-27 (3) one member licensed as a dental hygienist and one 25-1 public member serve for terms expiring February 1, 1999. 25-2 (b) The State Dental Hygiene Examiners Board may not take 25-3 any action and is not created until the day after the date that the 25-4 last appointee to the initial board takes office. On the date of 25-5 its creation, the board assumes its functions and: 25-6 (1) the Dental Hygiene Advisory Committee is 25-7 abolished; 25-8 (2) the obligations, rights, contracts, records and 25-9 other property, and personnel of, and unspent money appropriated to 25-10 or for, the abolished committee is transferred to the State Dental 25-11 Hygiene Examiners Board; 25-12 (3) the rules of the abolished committee are continued 25-13 in effect as rules of the State Dental Hygiene Examiners Board 25-14 until superseded by rule of the new board; 25-15 (4) the licenses in effect that were issued by the 25-16 abolished committee are continued in effect as licenses of the 25-17 State Dental Hygiene Examiners Board; 25-18 (5) a complaint or investigation pending before the 25-19 abolished committee is transferred without change in status to the 25-20 State Dental Hygiene Examiners Board; and 25-21 (6) any reference in a law to the abolished committee 25-22 means the State Dental Hygiene Examiners Board. 25-23 (c) Regardless of the changes in law made by this Act, until 25-24 the date that the Dental Hygiene Advisory Committee is abolished as 25-25 provided by this section, the committee continues in existence and 25-26 shall administer its functions under the law that governed the 25-27 committee before the effective date of this Act, and the prior law 26-1 is continued in effect for that purpose. 26-2 (d) The State Dental Hygiene Examiners Board shall adopt 26-3 rules under this Act not later than December 1, 1993. 26-4 SECTION 3. Chapter 475, Acts of the 52nd Legislature, 26-5 Regular Session, 1951 (Article 455le, Vernon's Texas Civil 26-6 Statutes), is repealed. 26-7 SECTION 4. This Act takes effect September 1, 1993. 26-8 SECTION 5. The importance of this legislation and the 26-9 crowded condition of the calendars in both houses create an 26-10 emergency and an imperative public necessity that the 26-11 constitutional rule requiring bills to be read on three several 26-12 days in each house be suspended, and this rule is hereby suspended.