BILL ANALYSIS



S.B. 18
By: Moncrief (Counts)
1-19-95
Committee Report (Unamended)


BACKGROUND

The State Board of Dental Examiners was abolished on August 31,
1994, because a bill that would have reauthorized its operations
failed to pass the 73rd Legislature.  Although the board was
subject to sunset in August, the Dental Practice Act remains in
effect, and administrative tasks are being handled by other
agencies.  The Dental Information Resource Center has also
continued to be available to field inquiries and make referrals.

The legislature is under a court order to reinstate the board
within 30 days of reconvening.  The governor must sign the bill by
February 8.  The bill reestablishes the board according to the
agreement reached by the Texas Dental Association and the Texas
Association of Dental Hygienists.

PURPOSE

As proposed, S.B. 18 provides for the continuation, under the
Sunset Act, of the State Board of Dental Examiners and the Dental
Hygiene Advisory Committee and provides for training and continuing
education requirements, a modified complaint process, and
administrative penalties for violations, among other statutory
modifications.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the State Board of Dental Examiners under SECTION 3 (Sections
1(b) and 5, Article 4544, V.T.C.S.), SECTION 4 (Section 2(a),
Article 4545a, V.T.C.S.), SECTION 5 (Section 1(a), Article 4548f,
V.T.C.S.), SECTION 6 (Sections 1(c), (e), (h), and (j), Article
4548h, V.T.C.S.), SECTION 8 (Article 4548i(c), V.T.C.S.), SECTION
10 (Article 4549b(b), V.T.C.S.), SECTION 11 (Sections 2(e) and (h),
Article 4550a, V.T.C.S.), SECTION 14 (Section 5(b), Article 4551e,
V.T.C.S.), SECTION 15 (Section 5A(b), Article 4551e, V.T.C.S.),
SECTION 18 (Article 4551n(a), V.T.C.S.), and to the Dental Hygiene
Advisory Committee under SECTION 27 of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Article 4543a, V.T.C.S. (Dental Practice Act),
as follows:

             Art. 4543a.  APPOINTMENT; QUALIFICATIONS

     Sec. 1. (a)(1) Increases the membership of the State Board of
     Dental Examiners (board) from 15 to 18 and the number of
     public members from 3 to 6.
     
     (2) Provides that a person is not eligible for appointment
         as a public member if the person or the person's spouse
         uses a substantial amount of tangible goods, services or
         funds from the board, other than certain authorized
         compensation.  Makes conforming changes.
       (b) Requires board appointments to be made without regard to
       certain personal characteristics.
     Sec. 2.  Requires the president of the board to be a dentist
     and makes nonsubstantive changes.
     
     Sec. 3.  (a)-(c) Set forth individuals prohibited from serving
     as members, employees, and general counsel of the board.
     
     (d) Sets forth the definition of a Texas trade association. 
       
     Sec. 4.  (a) Adds members who cannot discharge member duties
     for a substantial part of the term for which the member is
     appointed because of illness or disability to the list of
     grounds for removal of members.
     
       (b) Makes no changes.
       
       (c) Requires board members possessing knowledge that a
       potential ground for removal exists to inform the board. 
       Requires the board to notify the governor.  Deletes
       requirements that violations be presented in writing and be
       reviewed at the next meeting.
       
     Sec. 5.  (a) Requires board members to comply with member
     training requirements.
     
     (b) Requires the board to provide information to members and
       employees regarding qualifications for office or employment
       and their responsibilities relating to standards of conduct
       for state employees.
     Sec. 6.  (a) Requires the board to establish a training
     program for board members.
     
     (b) Requires members to complete at least one section of the
       training program before assuming membership duties and
       before senate confirmation.
       
       (c) Sets forth requirements for the training program.
       
       (d) Requires the board to consult with the governor's office
       and the Texas Ethics Commission in developing training
       requirements.
       
       (e) Requires the board to allow another state agency or
       entity given the authority to establish the training
       requirements in lieu of developing its own program.
       
SECTION 2. Amends Article 4543b, V.T.C.S., as follows:

     Art. 4543b.  SUNSET PROVISION.  Updates the board's sunset
     date to September 1, 2005.
SECTION 3. Amends Sections 1 and 5, Article 4544, V.T.C.S., as
follows:

     Sec. 1.  (a) Created from existing text and makes
     nonsubstantive changes.  Requires the board to contract with
     an independent or regional testing service for any required
     clinical examination.  Authorizes the board to use the
     services of Texas licensed dentists to provide assistance if
     the regional testing service is used.  Requires the written
     portion of the examination to be validated by an independent
     testing professional.
     
     (b) Requires the board, by rule, to set the number of and
       conditions for examination retakes.  Authorizes the board to
       require an applicant who fails the examination to meet
       additional education requirements.
     Sec. 5.  Replaces existing text to set forth more specific
     requirements for continuing education programs. Sets forth
     requirements that the board, by rule, must set for continuing
     education programs.
     
     SECTION 4.     Amends Article 4545a, V.T.C.S., as follows:

Art. 4545a.  New title:  LICENSING BY CREDENTIALS; LICENSING OF
                    FOREIGN-TRAINED DENTISTS

     Sec. 1.  (a) Requires the board, rather than authorizes it, to
     grant a dentistry or a dental hygienist license to a person
     who meets certain qualifications.
     
     (b) Requires the applicant to be endorsed by the board of
       dentistry of the jurisdiction of current practice.
       
       (c) Requires the board to complete the processing of an
       application within 180 days of receiving all required
       documentation and results or grant a license to the
       applicant.
     Sec. 2.  (a) Requires the board, upon receipt of payment, to
     grant a license to a dentist or dental hygienist who has not
     graduated from a dental or dental hygiene school accredited by
     the commission on Dental Accreditation of the American Dental
     Association under certain circumstances, including if the
     board, through a procedure adopted by rule, determines that
     the educational qualifications are equivalent to those
     required to practice dentistry or dental hygiene in the state.
     
     (b) Requires the board to complete the processing of an
       application within 180 days of receiving all required
       documentation and results or grant a license to the
       applicant.  Deletes existing requirements for applicants.
SECTION 5. Amends Section 1(a), Article 4548f, V.T.C.S., as
follows:

     (a) Prohibits the board from adopting rules restricting
     competitive bidding or advertising by a person regulated by
     the board, unless it prohibits false advertising practices. 
     Replaces existing prohibitions for the rules governing false
     advertising practices.
SECTION 6. Amends Article 4548h, V.T.C.S., as follows:

    Art. 4548h.  New title:  COMPLAINTS; REFUSING, REVOKING,
              CANCELLING, AND SUSPENDING LICENSES

     Sec. 1. (a)  Requires the board to keep an information file
     about each complaint filed with the board.  Sets forth
     requirements for files.
     
     (b) Requires the board to notify parties to the complaint of
       the status of the complaint at certain intervals, with an
       exception.
       
       (c) Requires the board, by rule, to adopt a form to
       standardize information concerning complaints made to the
       board.  Requires the board to prescribe, by rule,
       information to be provided in filing a complaint.
       
       (d) Requires the board to provide reasonable assistance to
       a person filing a complaint.
       
       (e) Requires the board to adopt rules concerning the
       investigation of a complaint filed with the board.  Sets
       forth requirements for these rules.
       
       (f) Sets forth requirements for disposing of all complaints
       in a timely manner. 
       
       (g) Requires the executive director of the board (director)
       to notify the board of the number of and reasons for
       complaints that extend beyond a two-year time frame for
       resolution at board meetings.
       
       (h) Requires the board, by rule, to adopt procedures
       governing informal disposition or proceedings of contested
       cases.
       
       (i) Requires rules adopted under this section to provide the
       complainant and licensee an opportunity to be heard and
       requires an attorney to be present to advise the board. 
       Requires the attorney to be a member of the board's legal
       staff or of the attorney general's office.
       
       (j) Requires the board, by rule, to develop a system for
       monitoring license holders' compliance with the requirements
       of this Act.  Deletes existing provision authorizing the
       board to refuse to grant a license under certain
       circumstances.  
     Sec. 2.  (a) Requires the board to place on probation a person
     whose license has been suspended, or to reprimand a licensee,
     in addition to revoking or suspending a license, under certain
     circumstances. Makes conforming and nonsubstantive changes.
     
     (b) Makes nonsubstantive changes.
       
       (c) Sets forth required procedure for the board when it
       receives a complaint.  Deletes the distinction between
       complaints filed by members and by non-members.
       
       (d) Sets forth actions which the board is authorized to
       require of a practitioner whose license suspension is
       probated.
       
       (e) Requires the board or the executive committee to
       temporarily suspend a license if it determines that
       continuation in practice would constitute a clear threat to
       a person's well-being.  Sets forth required procedure for
       suspending a license.
       
       (f) Requires all complaints considered by the board to be
       filed within four years of the date on which the act
       occurred or within four years after a complainant
       discovered, or in the exercise of reasonable diligence
       should have discovered, the occurrence of the act.
     Sec. 3. (a)-(b) Make nonsubstantive changes.
     
     (c)-(d) Redesignate existing Subsections (d)-(e).  Delete
       provision requiring an appeal to be considered as a
       supersedeas under certain circumstances.  
       
       (e) Authorizes the court to permit a person who files an
       appeal to stay enforcement of penalty by giving the court a
       supersedeas bond that the court approves, with an exception. 
       Authorizes the court to uphold or reduce a punishment if it
       sustains the occurrence of violation and requires the court
       to assess no punishment if it does not sustain the
       occurrence.
       
       Sec. 4.  Makes a nonsubstantive change.  
SECTION 7. Amends Article 4548i, V.T.C.S., as follows:

     Art. 4548i.  PUNISHMENT (a) Provides that an offense involving
     practicing without an appropriate license issued by the board
     is a third degree felony.
     
       (b) Provides that a penalty for violation of Chapter 9,
       Title 71, V.T.C.S., is liable to the state for a civil
       penalty up to $2,500 and that each day of violation is a
       separate offense.  Sets forth requirements for filing and
       collecting penalties.
SECTION 8. Amends Title 71, Chapter 9, V.T.C.S., by adding Article
4548j, as follows:

     Art. 4548j.  ADMINISTRATIVE PENALTY.  Authorizes the board to
     impose an administrative penalty against a person who violates
     this Act or a rule or order adopted under this Act.
     
     (b) Provides that a penalty for violation may be up to
       $5,000 and that each day of violation is a separate offense.
       
       (c) Requires the director or a board subcommittee, composed
       of at least one public board member, to determine the amount
       of the penalty based on a standardized penalty schedule. 
       Requires the board, by rule, to develop a penalty schedule
       based on certain criteria.
       
       (d) Authorizes the director or subcommittee to issue a
       report and recommended penalty to the board.
       
       (e) Sets forth requirements for notifying the person of the
       board's report.
       
       (f) Authorizes the person receiving the notice to accept the
       determination or to request a hearing within 20 days.
       
       (g) Requires the board, by order, to approve the
       determination and impose the penalty if the person accepts
       the determination.
       
       (h) Sets forth requirements for a hearing on the board's
       determination.
       
       (i) Requires the board's notice to include a statement of
       the right of the person to judicial review of the order.
       
       (j) Sets forth requirements of the person within 30 days of
       the board's final order.
       
       (k) Sets forth authorized actions for a person within 30
       days of receiving the board's notice.
       
       (l) Authorizes a director who receives a copy of an
       affidavit under Subsection (k)(2) to file a contest to the
       affidavit within five days.
       
       (m) Authorizes the director, if a person does not pay the
       penalty and the enforcement is not stayed, to refer the
       matter to the attorney general.
       
       (n) Sets forth requirements for board judicial review
       orders.
       
       (o) Authorizes the court to order, change, or cancel
       penalties.
       
       (p) Sets forth requirements for the court when its judgment
       become final.
       
       (q) Requires penalties collected under this article to be
       remitted to the comptroller for deposit in the dental
       registration account in the state treasury.  Authorizes
       these funds to be used only for an approved peer assistance
       program.
       
       (r) Subjects proceedings under this article to the
       Administrative Procedure Act.
       
       (s) Prohibits anything in this article from being construed
       as preventing the board from assessing an administrative
       penalty using an informal proceeding under Article 4548h,
       V.T.C.S.
SECTION 9. Amends Article 4549, V.T.C.S., as follows:

   Art. 4549.  REFUSAL TO EXAMINE OR ISSUE LICENSE; JUDICIAL
                  SUSPENSIONS AND REVOCATIONS
                                
          Sec. 1.  Adds proof that an applicant violated provisions
     relating to the practice of dentistry or any provision of
     Chapter 9, Title 71, V.T.C.S., within 12 months before filing
     a license application to the list of reasons for which the
     board is authorized to refuse to issue a license.
     
     Sec. 2.  Created from existing Section 3 to make conforming
     changes.  Deletes existing Section 2.
     
     Sec. 3.  Created from existing Section 4 to make conforming
     changes.  Deletes existing Sections 5-7 setting forth
     complaint procedure.
SECTION 10.    Amends Article 4549b, V.T.C.S., as follows:

     Art. 4549b.  CONSUMER INFORMATION. (a) Makes nonsubstantive
     changes.
     
     (b) Requires the board, by rule, to establish methods by
       which consumers and service recipients are notified of the
       board's address and telephone number in order to file
       complaints.  Sets forth authorized methods of notification.
       
       (c) Requires the board to list a toll-free number, if
       applicable. 
SECTION 11.  Amends Sections 1-4, Article 4550a, V.T.C.S., as
follows:

     Sec. 1.  Makes nonsubstantive changes.
     
     Sec. 2.  (a)-(d) Make conforming and nonsubstantive changes.
     
     (e) Provides that a person may renew a license up to one
       year, rather than two years,  after it expires.  Authorizes
       the board to adopt rules for renewal without reexamination
       of an expired license if a person has moved to another state
       and has been in practice in the other state for two years
       preceding application, providing the person pays the
       examination fee.
       
       (f) Requires the board to send written notice at least 30
       days before impending license expiration.  Deletes
       requirement that the board attempt to obtain signed notice
       from the licensee confirming receipt of notification.
       
       (g) Makes no changes.
       
       (h) Requires the board, by rule, to adopt a system under
       which licenses expire throughout the year.  Sets forth
       requirements for determining renewal fees.
     Sec. 3.  Requires the board to file an annual report
     accounting for all funds in the manner provided by the General
     Appropriations Act and makes conforming changes.
     
     Sec. 4.  (a)-(c) Make conforming and nonsubstantive changes.
     
     (d) Requires the director or a designee to prepare a written
       statement for a program of equal employment opportunity
       (statement).  Sets forth requirements for the statement.
       
       (e) Requires the statement to cover an annual period and be
       updated and reviewed annually and filed with the governor's
       office.
       
       (f) Requires the governor's office to deliver a biennial
       report based on the statement. 
       
       (g) Requires the board to clearly define the respective
       responsibilities of the board and board staff.
       
       (h) Requires the board to prepare and maintain a written
       plan that provides a non-English speaker with access to the
       board's programs and to comply with federal and state
       accessibility laws.
       
       (i) Requires the board to provide the public with a
       reasonable opportunity to appear before the board.
SECTION 12.    Amends Article 4551, V.T.C.S., as follows:

     Art. 4551.  FEES AND EXPENSES.  (a) Provides that a member may
     receive reimbursement for expenses incurred in performing
     official duties.
     
     (b) Requires the board to establish fees to cover
       administration costs, rather than setting limits on fees.
SECTION 13.    Amends Section 4A, Article 4551e, V.T.C.S., as
follows:


     Sec. 4A.  DENTAL HYGIENE ADVISORY COMMITTEE.  Sets forth more
     specific requirements for composition of the Dental Hygiene
     Advisory Committee (committee). 
     SECTION 14.    Amends Section 5, Chapter 475, Article 4551e,
V.T.C.S., as follows:

     Sec. 5.  EXAMINATION.  (a) Created from existing text and
     makes nonsubstantive changes.  Requires the board to contract
     with an independent or regional testing service for any
     required clinical examination.  Authorizes the board to use
     the services of Texas licensed dental hygienists to provide
     assistance if the regional testing service is used.  Requires
     the written portion of the examination to be validated by an
     independent testing professional.
     
     (b) Requires the board, by rule, to set the number of and
       conditions for examination retakes.  Authorizes the board to
       require an applicant who fails the examination to meet
       additional education requirements.  Makes conforming
       changes.
SECTION 15.    Amends Article 4551e, V.T.C.S., by adding Section
5A, as follows:

     Sec. 5A.  CONTINUING EDUCATION.  Sets forth requirements for
     continuing education programs and requirements that the board,
     by rule, must set for continuing education programs.
SECTION 16.    Amends Section (6)(a), Article 4551f, V.T.C.S., to
make conforming changes.

SECTION 17.    Amends Section (7), Article 4551f, V.T.C.S., as
follows:

     (a)-(c) Make nonsubstantive changes.
     
     (d) Created from existing text of Subsection (b).
     
     (e) Makes conforming changes.
     
     (f) Provides that a person who violates this section commits
     an offense.  Sets forth degree of offense according to the
     subsection violated.
     
     (g) Makes conforming changes.
     
SECTION 18.    Amends Chapter 9, Title 71, V.T.C.S., by adding
Article 4551n, as follows:

     Art. 4551n.  EMPLOYMENT OF DENTISTS.  (a) Requires the board,
     by rule, to approve and certify health organizations to employ
     dentists upon application by the organization and presentation
     of certain criteria to the board.
     
     (b) Requires dentists providing services under Subsection
       (a) to provide these services commensurate with the
       patient's ability to pay in strict compliance with federal
       codes.
       
       (c) Authorizes the board to refuse to approve or certify
       health organizations the board determines is operated with
       the intent to circumvent this Act.
SECTION 19.    Amends Sections 467.0041 (c) and (d), Health and
Safety Code, to make conforming changes.

SECTION 20.    Repealer:  Article 4551d(b), V.T.C.S. (Rules and
regulations of Board).

SECTION 21.    (a) Provides that the board is reestablished.

     (b) Provides that the board is appropriated $206,168 for the
     fiscal biennium ending August 31, 1995.
     
     (c) Requires funds received under Article 4550a, V.T.C.S., to
     be deposited to the dental registration account.  Requires
     unexpended funds to be deposited to the credit of the dental
     registration account.
SECTION 22.    Provides that personnel, property and record, and
fund transfers that occurred as a result of the abolition of the
board be retransferred to the board.

SECTION 23.    Requires the chief coordinator of the Dental
Information Resource Center of the Health Professions Council on
January 1, 1995, to serve as the interim director.  Sets forth the
term, powers and duties of the interim director.

SECTION 24.    Reactivates board rules in existence August 31,
1994, on the date the board is reestablished under this Act.

SECTION 25.    (a) Requires the governor to appoint the members of
the board within 90 days of the effective date of this Act.  Sets
forth requirements for term limits for initial members.

     (b) Provides that initial members are not required to complete
     the training course before assuming membership duties and
     before senate confirmation, but must do so within 12 months of
     the effective date of this Act.
     
SECTION 26.    Requires the governor and the board to appoint the
members of the Dental Hygiene Advisory Committee (committee) as
soon as possible after the reestablishment of the board.  Sets
forth requirements for term limits for initial members.

SECTION 27.    (a) Requires the committee to develop and recommend
rules to the Board to establish licensure and educational
requirements for dental hygienists.

     (b) Requires the board to approve or reject the proposed
     rules, explain the reasons to the committee for the board's
     decision, and to act as final authority.
     
     (c) Provides that this section expires three years from the
     effective date of this Act.
     
SECTION 28.  Prohibits the board from establishing a date on which
the committee is abolished prior to the expiration of four years
after the effective date of this Act.

SECTION 29.    Makes application of this Act prospective.

SECTION 30.    Emergency clause.
           Effective date:  upon passage.