AN ACT
1-1 relating to the regulation of the practice of dentistry.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 SECTION 1. Subsection (a), Section 1, Article 4544, Revised
1-4 Statutes, is amended to read as follows:
1-5 (a) It shall be the duty of the Board to provide for the
1-6 examination of all applicants for license to practice dentistry in
1-7 this State. Each person applying for an examination shall pay to
1-8 said Board a fee set by the Board and shall be granted a license to
1-9 practice dentistry in this State upon his satisfactorily passing an
1-10 examination provided for by said Board on subjects and operations
1-11 pertaining to dentistry which shall include Anatomy, Physiology,
1-12 Anaesthesia, Biochemistry, Dental Materials, Diagnosis, Treatment
1-13 Planning, Ethics, Jurisprudence, Hygiene, Pharmacology, Operative
1-14 Dentistry, Oral Surgery, Orthodontia, Periodontia, Prosthetic
1-15 Dentistry, Pathology, Microbiology, and such other subjects as are
1-16 regularly taught in reputable Dental Schools as the Board may in
1-17 its discretion require. [The examination shall be given either
1-18 orally or in writing, or by giving a practical demonstration of the
1-19 applicant's skill, or by any combination of such methods or
1-20 subjects as the Board may in its discretion require.] The Board
1-21 shall contract with an independent or regional testing service for
1-22 any required clinical examination. In the event that the Board
1-23 uses a regional testing service, the Board is authorized to
2-1 contract for or otherwise use the services of licensed dentists in
2-2 this state for the purpose of providing assistance to the regional
2-3 testing service. The Board shall have the written portion of the
2-4 examination validated by an independent testing professional.
2-5 SECTION 2. Article 4545, Revised Statutes, is amended to
2-6 read as follows:
2-7 Art. 4545. QUALIFICATIONS OF APPLICANTS. Each applicant for
2-8 a license to practice dentistry in this state shall be not less
2-9 than twenty-one (21) years of age and shall present evidence of
2-10 good moral character and:
2-11 (1) proof of graduation from a dental school
2-12 accredited by the Commission on Dental Accreditation of the
2-13 American Dental Association; or
2-14 (2) proof of:
2-15 (A) graduation from a dental school that is not
2-16 accredited by the Commission on Dental Accreditation of the
2-17 American Dental Association; and
2-18 (B) successful completion of training in an
2-19 American Dental Association approved specialty in an education
2-20 program that is accredited by the Commission on Dental
2-21 Accreditation and that consists of at least two years of training
2-22 as specified by the Council on Dental Education [reputable dental
2-23 college and evidence of good moral character. A dental college
2-24 shall be held reputable whose entrance requirements and course of
2-25 instruction are as high as those adopted by the better class of
3-1 dental colleges of the United States, and whose course of
3-2 instruction shall be the equivalent of not less than four (4) terms
3-3 of eight (8) months each].
3-4 SECTION 3. Article 4545a, Revised Statutes, is amended to
3-5 read as follows:
3-6 Art. 4545a. LICENSING BY CREDENTIALS[; LICENSING OF
3-7 FOREIGN-TRAINED DENTISTS].
3-8 [Sec. 1.] (a) The State Board of Dental Examiners, upon
3-9 payment by the applicant of a fee set by the Board, shall grant a
3-10 license to practice dentistry or dental hygiene to any reputable
3-11 dentist or dental hygienist who:
3-12 (1) is licensed in good standing as a dentist or
3-13 dental hygienist in another state, the District of Columbia, or a
3-14 territory of the United States that has licensing requirements that
3-15 are substantially equivalent to the requirements of this Act;
3-16 (2) has not been the subject of final or pending
3-17 disciplinary action in any jurisdiction in which the dentist or
3-18 dental hygienist is or has been licensed;
3-19 (3) has graduated from a dental or dental hygiene
3-20 school accredited by the Commission on Dental Accreditation of the
3-21 American Dental Association and approved by the Board according to
3-22 rules established by the Board;
3-23 (4) has passed a national or other examination
3-24 recognized by the Board relating to dentistry or dental hygiene;
3-25 (5) has successfully completed the Board's
4-1 jurisprudence examination;
4-2 (6) has submitted documentation of current
4-3 cardiopulmonary resuscitation certification; [and]
4-4 (7) has practiced dentistry or dental hygiene:
4-5 (A) for a minimum of five years immediately
4-6 prior to applying; or
4-7 (B) as a dental educator at a dental school or
4-8 dental hygiene school accredited by the Commission on Dental
4-9 Accreditation of the American Dental Association for the [a minimum
4-10 of] five years immediately preceding the date of applying for the
4-11 license; and
4-12 (8) has met any additional criteria established by
4-13 Board rule [or]
4-14 [(C) for two years of obligated service in the
4-15 state under the National Health Service Corps or other federal
4-16 scholarship or loan repayment program].
4-17 (b) In addition to the qualifications of Subsection (a) of
4-18 this article, a dentist applicant must be endorsed by the board of
4-19 dentistry of the jurisdiction of current practice.
4-20 (c) The Board must complete the processing of an application
4-21 for a license not later than the 180th day after all documentation
4-22 and examination results required by this section have been received
4-23 by the Board or grant a license to the applicant.
4-24 [Sec. 2. (a) The Board, upon payment by the applicant of a
4-25 fee set by the Board, shall grant a license to a dentist or dental
5-1 hygienist who has not graduated from a dental or dental hygiene
5-2 school accredited by the Commission on Dental Accreditation of the
5-3 American Dental Association if:]
5-4 [(1) the dentist or dental hygienist has practiced for
5-5 a minimum of five years immediately prior to applying;]
5-6 [(2) the dentist or dental hygienist has not been the
5-7 subject of final or pending disciplinary action in any jurisdiction
5-8 in which the dentist or dental hygienist is or has been licensed;]
5-9 [(3) the Board, through a procedure adopted by rule,
5-10 has determined that the educational qualifications are equivalent
5-11 to those required to practice dentistry or dental hygiene in the
5-12 state; and]
5-13 [(4) the dentist or dental hygienist has completed all
5-14 examinations required by the Board for licensure.]
5-15 [(b) The Board must complete the processing of an
5-16 application for a license not later than the 180th day after all
5-17 documentation, the determination of educational equivalency, and
5-18 examination results required by this section have been received by
5-19 the Board or grant a license to the applicant.]
5-20 [(c) An applicant for a license to practice dentistry
5-21 applying under this section who fails the qualifying clinical
5-22 examination required by the Board under its rules three times shall
5-23 be required to attend a two-year program at a dental school
5-24 accredited by the Commission on Dental Accreditation of the
5-25 American Dental Association. The Board shall review two-year
6-1 programs offered to fulfill the requirements of this subsection for
6-2 educational sufficiency.]
6-3 SECTION 4. Article 4548c, Revised Statutes, is amended to
6-4 read as follows:
6-5 Art. 4548c. PRACTICE AFTER LICENSE HAS BEEN REVOKED. No
6-6 person whose license to practice dentistry in this State has been
6-7 [shall be] revoked by any district court of this State or by the
6-8 State Board of Dental Examiners may [shall] practice or attempt to
6-9 practice dentistry or dental surgery in this State after such
6-10 license has been so revoked.
6-11 SECTION 5. Article 4548e, Revised Statutes, is amended to
6-12 read as follows:
6-13 Art. 4548e. USE OF TRADE NAME. Any person, corporation [It
6-14 shall be unlawful for any person or persons to practice dentistry
6-15 in this State under the name of a corporation, company,
6-16 association, or trade name unless included as a prominent portion
6-17 of such name is the proper name used on the license, as issued by
6-18 the State Board of Dental Examiners, of the dentist or dentists
6-19 practicing under such corporate, company, association, or trade
6-20 name. Provided, however, any corporate], company, or association
6-21 may use a corporation, company, association, or trade name. Any
6-22 advertisement by the corporation, company, association, or trade
6-23 name must [used by a group of dentists in a nonprint medium shall
6-24 only be required to] include prominently the name of at least one
6-25 dentist practicing under such name. The person, corporation,
7-1 company, or association shall file with the State Board of Dental
7-2 Examiners a list of all dentists who practice under the name and a
7-3 list of each trade name used if the trade name is different from
7-4 the corporation, company, or association name. A list required
7-5 under this section must be updated and filed with the Board not
7-6 later than the 30th day after the date of the change. Each day of
7-7 violation of this Article shall constitute a separate offense.
7-8 SECTION 6. Section 1, Chapter 501, Acts of the 45th
7-9 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
7-10 Civil Statutes), is amended by amending Subsections (f) through (j)
7-11 and adding Subsections (k) and (l) to read as follows:
7-12 (f) A complaint received under this article must be filed
7-13 with the Board and reviewed to determine jurisdiction. If the
7-14 Board has jurisdiction, the Board shall require an investigation of
7-15 the complaint to determine the facts concerning the complaint.
7-16 (g) The Board shall dispose of all complaints in a timely
7-17 manner. The Board shall establish a schedule for conducting each
7-18 phase of a complaint that is under the control of the Board. The
7-19 schedule shall be kept in the information file for the complaint.
7-20 A change in the schedule must be noted in the complaint information
7-21 file.
7-22 (h) [(g)] The Executive Director of the Board shall notify
7-23 the Board of the number of complaints that extend beyond a two-year
7-24 time frame for resolution. The Executive Director shall provide
7-25 the Board with an explanation of the reasons that the complaints
8-1 have not been resolved. The notice and explanation required shall
8-2 be provided to the Board periodically at regularly scheduled Board
8-3 meetings.
8-4 (i) [(h)] The Board by rule shall adopt procedures
8-5 governing:
8-6 (1) informal disposition of a contested case under
8-7 Section 2001.056, Government Code; and
8-8 (2) informal proceedings held in compliance with
8-9 Section 2001.054(c), Government Code.
8-10 (j) [(i)] Rules adopted under this section must provide the
8-11 complainant, where applicable and permitted by law, an opportunity
8-12 to be heard, must provide the licensee an opportunity to be heard,
8-13 and must require the presence of an attorney to advise the Board or
8-14 the Board's employees. The attorney must be a member of the
8-15 Board's legal staff, if the Board has a legal staff. If the Board
8-16 does not have a legal staff, the attorney must be an employee of
8-17 the office of the attorney general.
8-18 (k) [(j)] The Board by rule shall develop a system for
8-19 monitoring license holders' compliance with the requirements of
8-20 this Act. Rules adopted under this section shall include
8-21 procedures for monitoring a license holder who is ordered by the
8-22 Board to perform certain acts to ascertain that the license holder
8-23 performs the required acts and to identify and monitor license
8-24 holders who represent a risk to the public.
8-25 (l) The Board may only consider a complaint that is filed
9-1 with the Board not later than the fourth anniversary of the date
9-2 the complained-of act occurred or of the date the complainant
9-3 discovered, or in the exercise of reasonable diligence should have
9-4 discovered, the occurrence of the complained-of act.
9-5 SECTION 7. Sections 2 and 3, Chapter 501, Acts of the 45th
9-6 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
9-7 Civil Statutes), are amended to read as follows:
9-8 Sec. 2. (a) The Board shall revoke[, cancel,] or suspend
9-9 any license or licenses that may have been issued by such Board,
9-10 impose a fine on a license holder, place on probation with
9-11 conditions a person whose license has been suspended, or reprimand
9-12 a licensee if in the opinion of a majority of such Board any person
9-13 or persons to whom a license has been issued by said Board to
9-14 practice dentistry or dental hygiene in this State shall have,
9-15 after the issuance of such license, violated any of the provisions
9-16 of the Statutes of the State of Texas relating to the practice of
9-17 dentistry or dental hygiene in this State, or any of the provisions
9-18 of Chapter 9, Title 71, Revised Statutes, or any amendments that
9-19 may hereafter be made thereto, or a rule of the Board. All
9-20 revocations[, cancellations,] or suspensions of licenses by the
9-21 Board shall be made in the manner provided by Chapter 2001,
9-22 Government Code (Administrative Procedure Act).
9-23 (b) Notice of a hearing issued [All complaints to be
9-24 considered] by the Board under this article shall be made in
9-25 writing and shall set out the alleged violations of such Statutes
10-1 or rules.
10-2 (c) [All complaints under this article as received shall be
10-3 filed with the Secretary of the Board or an authorized employee of
10-4 the Board. All complaints filed with the Board shall be reviewed
10-5 to determine jurisdiction, and if jurisdiction exists, the
10-6 Secretary of the Board or designee shall cause an investigation of
10-7 such complaint to be made to determine the facts in such case. If
10-8 the facts as determined by such investigation justify further
10-9 action, the disposition of the complaint shall comply with this
10-10 article.]
10-11 [(d)] If a licensee suspension is probated, the Board may
10-12 require the practitioner:
10-13 (1) to report regularly to the Board on matters that
10-14 are the basis of the probation;
10-15 (2) to limit practice to the areas prescribed by the
10-16 Board; or
10-17 (3) to continue or review professional education until
10-18 the practitioner attains a degree of skill satisfactory to the
10-19 Board in those areas that are the basis of the probation.
10-20 (d) [(e)] If the Board or an executive committee of the
10-21 Board determines from the evidence or information presented to it
10-22 that a person licensed under this Act by continuation in practice
10-23 would constitute a clear, imminent, or continuing threat to a
10-24 person's physical health or well-being, the Board or the executive
10-25 committee of the Board shall temporarily suspend the license of
11-1 that person. The license may be suspended under this section
11-2 without notice or hearing on the complaint, provided the Board or
11-3 the executive committee of the Board simultaneously with the
11-4 temporary suspension requests the State Office of Administrative
11-5 Hearings to set a date for a hearing on the temporary suspension.
11-6 A hearing shall be held not later than fourteen (14) days after the
11-7 date of the suspension unless a continuance is requested by the
11-8 licensee. A second hearing on the suspension shall be held by the
11-9 State Office of Administrative Hearings within sixty (60) days
11-10 after the date the suspension was ordered or after the date
11-11 specified in the continuance requested by the licensee. The time
11-12 requirements in this subsection must be adhered to or the
11-13 suspension is lifted without further order or action.
11-14 (e) [(f)] All proceedings under this section are subject to
11-15 Chapter 2001, Government Code [complaints considered by the Board
11-16 must be filed with the Board within four (4) years after the date
11-17 on which the act occurred or within four (4) years after a
11-18 complainant discovered, or in the exercise of reasonable diligence
11-19 should have discovered, the occurrence of the act].
11-20 Sec. 3. (a) A person aggrieved by a ruling, order, or
11-21 decision of the Board under this article has the right to appeal as
11-22 provided by Chapter 2001, Government Code [to a district court in
11-23 the county of his residence or in the county where the alleged
11-24 offense occurred within thirty (30) days from the service of notice
11-25 of the action of the Board].
12-1 (b) [The appeal having been properly filed, the court may
12-2 request of the Board and the Board on receiving the request shall
12-3 within thirty (30) days prepare and transmit to the court a
12-4 certified copy of its entire record in the matter in which the
12-5 appeal has been taken. The appeal shall be tried in accordance
12-6 with the Texas Rules of Civil Procedure.]
12-7 [(c)] If an aggrieved person fails to perfect an appeal as
12-8 provided in this section, the Board's ruling shall become final.
12-9 (c) [(d)] Review by the court shall be by the substantial
12-10 evidence rule and not de novo.
12-11 [(e) The court may, in its discretion, permit a person who
12-12 files an appeal under this section to stay enforcement of penalty
12-13 or punishment by giving to the court a supersedeas bond that is
12-14 approved by the court, unless there is a finding of clear,
12-15 imminent, or continuing harm to a person's physical health or
12-16 well-being by the State Office of Administrative Hearings in a
12-17 hearing held under Section 2(e) of this article. If the court
12-18 sustains the occurrence of the violation, the court may uphold the
12-19 amount of penalty or punishment assessed or may reduce the amount
12-20 of penalty or punishment assessed. If the court does not sustain
12-21 the occurrence of the violation, the court shall order that no
12-22 penalty or punishment is assessed.]
12-23 SECTION 8. Subsection (b), Article 4548i, Revised Statutes,
12-24 is amended to read as follows:
12-25 (b) Any person who shall violate a provision of Chapter 9,
13-1 Title 71, Revised Statutes, is liable to the state for a civil
13-2 penalty in an amount not to exceed $5,000 [$2,500]. Each day a
13-3 violation continues or occurs is a separate violation for the
13-4 purpose of imposing a penalty. On request of the Board, the
13-5 attorney general or the county attorney or district attorney of the
13-6 county in which the violation is alleged to have occurred shall
13-7 file suit to collect the penalty. A civil penalty collected under
13-8 this subsection shall be deposited in the state treasury to the
13-9 credit of the general revenue fund.
13-10 SECTION 9. Chapter 9, Title 71, Revised Statutes, is amended
13-11 by adding Article 4548k to read as follows:
13-12 Art. 4548k. CONTRACTUAL AND ORGANIZATIONAL AGREEMENTS
13-13 Sec. 1. (a) A person or organization providing dental
13-14 services in this state under an agreement or contract that allows
13-15 another person or organization to control or influence any aspect,
13-16 including business and professional aspects, of the provision of
13-17 dental services by the person or organization on request shall
13-18 report to the Board, under rules adopted by the Board:
13-19 (1) information concerning the contract or agreement;
13-20 (2) the manner in which fees are billed to a patient;
13-21 (3) the manner in which the dental service provider is
13-22 paid and information, if any, provided to a patient concerning that
13-23 payment agreement or contract; and
13-24 (4) information concerning the nature of the
13-25 arrangement provided to shareholders of organizations contracting
14-1 with a dental service provider.
14-2 (b) A person or organization practicing dentistry that has
14-3 one or more dentists practicing with or under the person or
14-4 organization, regardless of whether the dentist has an ownership
14-5 interest or an employment or contractual relationship, is
14-6 responsible for all professional acts done under the name of the
14-7 person or organization. This article does not affect an individual
14-8 license holder's responsibilities and rights under this chapter.
14-9 Sec. 2. A statute relating to the practice of dentistry in
14-10 this state may not be construed to prohibit a licensed dentist from
14-11 maintaining any number of offices in this state if the dentist:
14-12 (1) assumes full legal responsibility and liability
14-13 for the dental services rendered in each of the dentist's offices;
14-14 and
14-15 (2) complies with the requirements prescribed by Board
14-16 rule.
14-17 SECTION 10. Section 1, Article 4549, Revised Statutes, is
14-18 amended to read as follows:
14-19 Sec. 1. The State Board of Dental Examiners shall have
14-20 authority to refuse to examine any person or refuse to issue a
14-21 dental license or a dental hygienist license to any person for any
14-22 one or more of the following causes:
14-23 (a) Proof of presentation to the Board of any
14-24 dishonest or fake evidence of qualification, or being guilty of any
14-25 illegality, fraud, or deception in the process of examination, or
15-1 for the purpose of securing a license or certificate.
15-2 (b) Proof of chronic or habitual intoxication or
15-3 addiction to drugs on the part of the applicant.
15-4 (c) Proof that the applicant has been guilty of
15-5 dishonest or illegal practices in or connected with the practice of
15-6 dentistry or dental hygiene.
15-7 (d) Proof of conviction of the applicant of a felony
15-8 [involving moral turpitude] under the laws of this State or any
15-9 other State or of the United States.
15-10 (e) Proof that the applicant violated any of the
15-11 provisions of the statutes of the State of Texas relating to the
15-12 practice of dentistry or any provisions of Chapter 9, Title 71,
15-13 Revised Statutes, within 12 months before the filing of an
15-14 application for the license.
15-15 SECTION 11. Section 2, Article 4549, Revised Statutes, is
15-16 amended to read as follows:
15-17 Sec. 2. The State Board of Dental Examiners shall have
15-18 jurisdiction and authority, after notice and hearing, to suspend or
15-19 revoke a dental license or a dental hygienist license, to impose a
15-20 fine on a person licensed under this chapter, to place on probation
15-21 with conditions a person whose license or certificate is suspended,
15-22 or to reprimand a licensee or certificate holder, and in addition
15-23 to or in lieu of said suspension, revocation, probation, or
15-24 reprimand, to assess an administrative penalty as provided for in
15-25 Article 4548j, Revised Statutes, for any one or more of the
16-1 following causes:
16-2 (a) Proof of insanity of the holder of a license or
16-3 certificate, as adjudged by the regularly constituted authorities.
16-4 (b) Proof of conviction of the holder of a license or
16-5 certificate of any felony or a misdemeanor involving fraud under
16-6 the laws of this State or any other State or of the United States.
16-7 (c) That the holder thereof has been or is guilty of
16-8 dishonorable conduct, malpractice, [or] gross incompetency, or
16-9 failure to treat a patient according to the standard of care in the
16-10 practice of dentistry or dental hygiene.
16-11 (d) That the holder thereof has been or is guilty of
16-12 any deception or misrepresentation for the purpose of soliciting or
16-13 obtaining patronage.
16-14 (e) That the holder thereof procured a license or
16-15 certificate through fraud or misrepresentation.
16-16 (f) That the holder thereof is addicted to habitual
16-17 intoxication or the use of drugs.
16-18 (g) That a dentist employs or permits or has employed
16-19 or permitted persons to practice dentistry in the office or offices
16-20 under his control or management, who were not licensed to practice
16-21 dentistry.
16-22 (h) That the holder thereof has failed to use proper
16-23 diligence in the conduct of his practice or to safeguard his
16-24 patients against avoidable infections.
16-25 (i) That the holder thereof has failed or refused to
17-1 comply with any State law relating to the regulation of dentists or
17-2 dental hygienists.
17-3 (j) That the holder thereof has failed or refused to
17-4 comply with the adopted and promulgated rules and regulations of
17-5 the Board.
17-6 (k) That the holder thereof is physically or mentally
17-7 incapable of practicing with safety to dental patients.
17-8 (l) That the holder thereof has been negligent in the
17-9 performance of dental services which injured or damaged dental
17-10 patients.
17-11 (m) Proof of suspension, revocation, probation,
17-12 reprimand, or other restriction by another State of a license or
17-13 certificate to practice dentistry or dental hygiene based upon acts
17-14 by the licensee or certificate holder enumerated in this section.
17-15 (n) That the holder thereof has knowingly provided or
17-16 agreed to provide dental care in a manner which violates any
17-17 provision of federal or State law regulating a plan whereby any
17-18 person undertakes to provide, arrange for, pay for, or reimburse
17-19 any part of the cost of any dental care services or regulating the
17-20 business of insurance.
17-21 SECTION 12. Subsection (a), Section 3, Article 4549, Revised
17-22 Statutes, is amended to read as follows:
17-23 (a) If the Board proposes to refuse to examine a person, to
17-24 suspend or revoke a license, to impose a fine, to place on
17-25 probation a person whose license has been suspended, or to
18-1 reprimand a license holder, the person is entitled to a hearing
18-2 under Chapter 2001, Government Code [before the Board].
18-3 SECTION 13. Article 4549-1, Revised Statutes, is amended to
18-4 read as follows:
18-5 Art. 4549-1. REVOCATION AND SUSPENSION OF LICENSE FOR
18-6 DRUG-RELATED FELONY CONVICTION. On conviction of a person licensed
18-7 by the board of a felony under Chapter 481, Health and Safety Code,
18-8 Section 485.033, Health and Safety Code, or Chapter 483, Health and
18-9 Safety Code, the board shall, after an administrative hearing
18-10 conducted in accordance with Chapter 2001, Government Code [the
18-11 Administrative Procedure and Texas Register Act, as amended
18-12 (Article 6252-13a, Vernon's Texas Civil Statutes)], in which the
18-13 fact of conviction is determined, suspend the person's license. On
18-14 the person's final conviction, the board shall revoke the person's
18-15 license. The board may not reinstate or reissue a license to a
18-16 person whose license is suspended or revoked under this article
18-17 except on an express determination based on substantial evidence
18-18 contained in an investigative report indicating that the
18-19 reinstatement or reissue of the license is in the best interests of
18-20 the public and of the person whose license has been suspended or
18-21 revoked.
18-22 SECTION 14. Article 4550, Revised Statutes, is amended to
18-23 read as follows:
18-24 Art. 4550. Records of the Board
18-25 Sec. 1. The Board shall keep records in which shall be
19-1 registered the name and residence and [or] place of business of all
19-2 persons authorized under this law to practice dentistry, dental
19-3 hygiene and such other professions or businesses under its
19-4 jurisdiction as provided by law. Each dentist, dental hygienist,
19-5 dental laboratory, and dental technician registered with the Board
19-6 shall timely notify the Board of:
19-7 (1) any change of address of the place of business of
19-8 such [the] dentist, hygienist, laboratory, or technician; and
19-9 (2) any change of employers by such [the] dentist,
19-10 hygienist, laboratory, or technician, and any change of owners of
19-11 the laboratory.
19-12 The Board is timely notified if it receives the notice within
19-13 60 days after the date the change occurs.
19-14 Sec. 2. All of the records and files of the [Texas] State
19-15 Board of Dental Examiners shall be public records and open to
19-16 inspection at reasonable times, except the investigation files and
19-17 records which shall be confidential and shall be divulged only to
19-18 persons so investigated upon completion of said investigation. It
19-19 is not a violation of this section for the Board to share
19-20 investigation files and records with another state regulatory
19-21 agency or federal law enforcement agency during the course of a
19-22 joint investigation or in determining the feasibility of conducting
19-23 an investigation.
19-24 SECTION 15. Subsection (b), Article 4551, Revised Statutes,
19-25 is amended to read as follows:
20-1 (b) The Board shall establish reasonable and necessary fees
20-2 so that the fees, in the aggregate, produce sufficient revenue to
20-3 cover the cost of administering this Act.
20-4 [The Board may not set a fee at an amount less than the
20-5 amount of that fee on September 1, 1993.]
20-6 SECTION 16. Article 4551a, Revised Statutes, is amended to
20-7 read as follows:
20-8 Art. 4551a. PERSONS REGARDED AS PRACTICING DENTISTRY. Any
20-9 person shall be regarded as practicing dentistry within the meaning
20-10 of this Chapter:
20-11 (1) Who publicly professes to be a dentist or dental
20-12 surgeon or who uses or permits to be used for himself or for any
20-13 other person, the title of "Doctor," "Dr.," "Doctor of Dental
20-14 Surgery," "D.D.S.," "Doctor of Dental Medicine," "D.M.D.," or any
20-15 other letters, titles, terms or descriptive matter, including use
20-16 of the terms "denturist" or "denturism," which directly or
20-17 indirectly represents him as being able to diagnose, treat, remove
20-18 stains or concretions from teeth, provide surgical and adjunctive
20-19 treatment for any disease, pain, injury, deficiency, deformity or
20-20 physical condition of the human teeth, oral cavity, alveolar
20-21 process, gums, jaws or directly related and adjacent masticatory
20-22 structures.
20-23 (2) Who shall offer or undertake by any means or
20-24 methods whatsoever, to clean teeth or to remove stains, concretions
20-25 or deposits from teeth in the human mouth, or who shall undertake
21-1 or offer to diagnose, treat, operate, or prescribe by any means or
21-2 methods for any disease, pain, injury, deficiency, deformity, or
21-3 physical condition of the human teeth, oral cavity, alveolar
21-4 process, gums, or jaws.
21-5 (3) Any person who shall offer or undertake in any
21-6 manner to prescribe or make, or cause to be made, an impression of
21-7 any portion of the human mouth, teeth, gums, or jaws, for the
21-8 purpose of diagnosing, prescribing, treating, or aiding in the
21-9 diagnosing, prescribing or treating, any physical condition of the
21-10 human mouth, teeth, gums or jaws, or for the purpose of
21-11 constructing or aiding in the construction of any dental appliance,
21-12 denture, dental bridge, false teeth, dental plate or plates of
21-13 false teeth, or any other substitute for human teeth.
21-14 (4) Any one who owns, maintains or operates any office
21-15 or place of business where he employs or engages, under any kind of
21-16 contract whatsoever, any other person or persons to practice
21-17 dentistry as above defined shall be deemed to be practicing
21-18 dentistry himself and shall himself be required to be duly licensed
21-19 to practice dentistry as hereinabove defined, and shall be subject
21-20 to all of the other provisions of this Chapter, even though the
21-21 person or persons so employed or engaged by him shall be duly
21-22 licensed to practice dentistry as hereinabove defined, unless
21-23 otherwise provided by law.
21-24 (5) Any person, firm, group, association, or
21-25 corporation who shall offer or undertake to fit, adjust, repair, or
22-1 substitute in the human mouth or directly related and adjacent
22-2 masticatory structures any dental appliance, structure, prosthesis,
22-3 or denture, or who shall aid or cause to be fitted, adjusted,
22-4 repaired, or substituted in the human mouth or directly related and
22-5 adjacent masticatory structures any dental appliance, structure,
22-6 prosthesis, or denture.
22-7 (6) Who makes, fabricates, processes, constructs,
22-8 produces, reproduces, duplicates, repairs, relines, or fixes any
22-9 full or partial denture, any fixed or removable dental bridge or
22-10 appliance, any dental plate or plates of false teeth, any
22-11 artificial dental restoration, or any substitute or corrective
22-12 device or appliance for the human teeth, gums, jaws, mouth,
22-13 alveolar process, or any part thereof for another, or who in any
22-14 manner offers, undertakes, aids, abets, or causes another person so
22-15 to do for another, without a written prescription or work-order
22-16 therefor signed by the dentist legally engaged in the practice of
22-17 dentistry in this state or in the jurisdiction where such dentist
22-18 maintains his dental office and who prescribed and ordered same.
22-19 (7) Who shall offer or undertake or cause another to
22-20 do, directly or indirectly, for any person any act, service, or
22-21 work in the practice of dentistry or any part thereof as provided
22-22 for in the laws of Texas relating to the practice of dentistry
22-23 including without limitation the inducing, administering,
22-24 prescribing, or dispensing any anesthesia, anesthetic drug,
22-25 medicine, or agent in anywise incidental to or in connection with
23-1 the practice of dentistry; or who permits or allows another to use
23-2 his license or certificate to practice dentistry in this state for
23-3 the purpose of performing any act described in this Article; or who
23-4 shall aid or abet, directly or indirectly, the practice of
23-5 dentistry by any person not duly licensed to practice dentistry by
23-6 the [Texas] State Board of Dental Examiners.
23-7 (8) Who shall control, attempt to control, influence,
23-8 attempt to influence, or otherwise interfere with the exercise of a
23-9 dentist's independent professional judgment regarding the diagnosis
23-10 or treatment of any dental disease, disorder, or physical
23-11 condition. However, nothing herein shall be construed to require
23-12 any entity to pay for services which are not provided for in a
23-13 contract or agreement or to exempt any dentist who is a member of a
23-14 hospital staff from adhering to hospital bylaws, medical staff
23-15 bylaws, or established policies approved by the governing board and
23-16 the medical and dental staff of the hospital.
23-17 (9) If the person holds the person out to be a
23-18 denturist or uses another title that is intended to convey to the
23-19 public that the services offered by the person are included within
23-20 the practice of dentistry.
23-21 SECTION 17. Section 11, Chapter 244, General Laws, Acts of
23-22 the 44th Legislature, Regular Session, 1935 (Article 4551b,
23-23 Vernon's Texas Civil Statutes), is amended to read as follows:
23-24 Sec. 11. The definition of dentistry as contained in Chapter
23-25 9 of Title 71, of the Revised Civil Statutes of Texas as amended,
24-1 shall not apply to:
24-2 (1) members of the faculty of a reputable dental or
24-3 dental hygiene college or school where such faculty members perform
24-4 their services for the sole benefit of such school or college; or
24-5 (2) students of a reputable dental college who perform
24-6 their operations without pay except for actual cost of materials,
24-7 in the presence of and under the direct personal supervision of a
24-8 demonstrator or teacher who is a member of the faculty of a
24-9 reputable dental college; or
24-10 (3) persons doing laboratory work on inert matter
24-11 only, and who do not solicit or obtain work, by any means, from a
24-12 person or persons not a licensed dentist actually engaged in the
24-13 practice of dentistry and who do not act as the agents or
24-14 solicitors of, or have any interest whatsoever in, any dental
24-15 office, practice or the receipts therefrom; or
24-16 (4) physicians and surgeons legally authorized to
24-17 practice medicine as defined by the law of this state who do not
24-18 hold themselves out to the public as practicing dentistry; or
24-19 (5) dental hygienists legally authorized to practice
24-20 dental hygiene in this state and who practice dental hygiene in
24-21 strict conformity with the laws of Texas regulating the practice of
24-22 dental hygiene; or
24-23 (6) those persons who as members of an established
24-24 church practice healing by prayer only; or
24-25 (7) employees of a dentist who make dental x-rays in
25-1 the dental office and under the supervision of such dentist or
25-2 dentists legally engaged in the practice of dentistry in this
25-3 state; or
25-4 (8) Dental Health Service Corporations legally
25-5 chartered under Section A(1), [Subsection (1) of] Article 2.01, [of
25-6 the] Texas Non-Profit [Nonprofit] Corporation Act (Article
25-7 1396-2.01, Vernon's Texas Civil Statutes); or
25-8 (9) dental interns and dental residents as defined and
25-9 regulated by the [Texas] State Board of Dental Examiners in its
25-10 rules and regulations; or
25-11 (10) students of a reputable dental hygiene school who
25-12 practice dental hygiene without pay in strict conformity with the
25-13 laws of this state regulating the practice of dental hygiene; or
25-14 (11) dental assistants who perform the duties
25-15 permitted by Article 4551e-1, Revised Statutes, in strict
25-16 conformity with the laws of this state; or
25-17 (12) dentists licensed by another state or foreign
25-18 country who perform clinical procedures only for professional and
25-19 technical education demonstration purposes, provided that such
25-20 dentists must first obtain a temporary license for such purpose
25-21 from the State Board of Dental Examiners.
25-22 SECTION 18. Section 2, Chapter 475, Acts of the 52nd
25-23 Legislature, 1951 (Article 4551e, Vernon's Texas Civil Statutes),
25-24 is amended to read as follows:
25-25 Sec. 2. QUALIFICATIONS. A dental hygienist shall be not
26-1 less than eighteen (18) years of age and a graduate of an
26-2 accredited high school or hold a certificate of high school
26-3 equivalency (GED) and be a graduate of a recognized [and
26-4 accredited] school or college of dentistry or dental hygiene
26-5 accredited by the Commission on Dental Accreditation of the
26-6 American Dental Association and approved by the [Texas] State Board
26-7 of Dental Examiners [in which the course of instruction shall be
26-8 the equivalent of not less than two (2) terms of eight (8) months
26-9 each and who shall have thereafter passed an examination given by
26-10 and before the Texas State Board of Dental Examiners on subjects
26-11 pertaining to dental hygiene, and who shall have complied with all
26-12 of the provisions of this Act and the rules and regulations
26-13 promulgated by the Texas State Board of Dental Examiners].
26-14 SECTION 19. Subsection (a), Section 5, Chapter 475, Acts of
26-15 the 52nd Legislature, 1951 (Article 4551e, Vernon's Texas Civil
26-16 Statutes), is amended to read as follows:
26-17 (a) It shall be the duty of the Board to provide for the
26-18 examination of all qualified applicants for licensure as dental
26-19 hygienists in this State. All applicants for examination shall pay
26-20 a fee set by the Board to said Board as determined by said Board
26-21 according to its needs and shall apply upon forms furnished by the
26-22 Board and shall furnish such other information as the Board may in
26-23 its discretion require to determine any applicant's qualifications.
26-24 An applicant must attach to the application proof that the
26-25 applicant has successfully completed a current course in
27-1 cardiopulmonary resuscitation given or approved by the American
27-2 Heart Association or American Red Cross before the date on which
27-3 the applicant submits the application or, in the event that the
27-4 applicant is not physically capable of successfully completing such
27-5 training, a written statement executed by either a licensed
27-6 physician or an instructor in cardiopulmonary resuscitation
27-7 approved by the American Heart Association or American Red Cross
27-8 that describes such physical incapacity. The examination shall be
27-9 taken by all applicants on such subjects and operations pertaining
27-10 to dentistry and dental hygiene which shall include Dental Anatomy,
27-11 Pharmacology, X-Ray, Ethics, Jurisprudence, and Hygiene, and such
27-12 other subjects as are regularly taught in reputable schools of
27-13 dentistry and dental hygiene, as the Board in its discretion may
27-14 require. [The examination shall be given orally or in writing, or
27-15 by giving a practical demonstration of the applicant's skill or by
27-16 any combination of such methods or subjects as the Board may in its
27-17 discretion require.] The Board shall contract with an independent
27-18 or regional testing service for any required clinical examination.
27-19 In the event that the Board uses a regional testing service, the
27-20 Board is authorized to contract for or otherwise use the services
27-21 of licensed dental hygienists in this State for the purpose of
27-22 providing assistance to the regional testing service. The Board
27-23 shall have the written portion of the examination validated by an
27-24 independent testing professional. The Board shall report such
27-25 grades to the applicant within a reasonable time after such
28-1 examination, and each applicant who has satisfactorily passed all
28-2 phases of the examination as determined by the Board shall be
28-3 entitled to and shall be issued a license permitting such applicant
28-4 to practice dental hygiene in the State of Texas as is defined and
28-5 regulated by the law of this State.
28-6 SECTION 20. Subsections (a) and (b), Article 4551e-1,
28-7 Revised Statutes, are amended to read as follows:
28-8 (a) A dental assistant who is not professionally licensed
28-9 may be [is one who is] employed by and work [works] in the office
28-10 of a licensed[, registered,] and practicing dentist and perform
28-11 [who performs] one or more delegated dental acts under the direct
28-12 supervision, direction, and responsibility of such dentist. Direct
28-13 supervision, direction, and responsibility, as used in this
28-14 article, means that the dentist employing a dental assistant or
28-15 dentist in charge of a dental assistant is physically present in
28-16 the dental office when a dental assistant performs a delegated
28-17 dental act.
28-18 (b) A person licensed to practice dentistry may delegate to
28-19 any qualified and properly trained dental assistant acting under
28-20 the dentist's direct supervision any dental act that a reasonable
28-21 and prudent dentist would find is within the scope of sound dental
28-22 judgment to delegate if, in the opinion of the delegating dentist,
28-23 the act can be properly and safely performed by the person to whom
28-24 the dental act is delegated and the act is performed in its
28-25 customary manner, not in violation of this Act or any other
29-1 statute, and the person to whom the dental act is delegated does
29-2 not hold himself out to the public as being authorized to practice
29-3 dentistry. However, a dentist may not:
29-4 (1) delegate an act to an individual who, by order of
29-5 the Board, is prohibited from performing the act;
29-6 (2) delegate the performance of any of the following
29-7 acts to a person not licensed as a dentist or dental hygienist:
29-8 (A) the removal of calculus, deposits, or
29-9 accretions from the natural and restored surfaces of exposed human
29-10 teeth and restorations in the human mouth;
29-11 (B) root planing or the smoothing and polishing
29-12 of roughened root surfaces or exposed human teeth; or
29-13 (C) any other act the delegation of which is
29-14 prohibited by the rules of the Board; [or]
29-15 (3) delegate the performance of any of the following
29-16 acts to a person not licensed as a dentist:
29-17 (A) comprehensive examination or diagnosis and
29-18 treatment planning;
29-19 (B) a surgical or cutting procedure on hard or
29-20 soft tissue;
29-21 (C) the prescription of a drug, medication, or
29-22 work authorization;
29-23 (D) the taking of an impression for a final
29-24 restoration, appliance, or prosthesis;
29-25 (E) the making of an intraoral occlusal
30-1 adjustment;
30-2 (F) the performance of direct pulp capping,
30-3 pulpotomy, or any other endodontic procedure;
30-4 (G) the final placement and intraoral adjustment
30-5 of a fixed or removable appliance; or
30-6 (H) the placement of any final restoration; or
30-7 (4) delegate the authority to administer a local
30-8 anesthetic agent, inhalation sedative agent, parenteral sedative
30-9 agent, or general anesthetic agent to an individual not licensed
30-10 as:
30-11 (A) a dentist with a permit issued by the State
30-12 Board of Dental Examiners for the procedure being performed, if a
30-13 permit is required;
30-14 (B) a certified registered nurse anesthetist
30-15 licensed by the Board of Nurse Examiners, only if the delegating
30-16 dentist holds a permit issued by the State Board of Dental
30-17 Examiners for the procedure being performed, if a permit is
30-18 required; or
30-19 (C) a physician anesthesiologist licensed by the
30-20 Texas State Board of Medical Examiners [(I) the administration of a
30-21 local anesthetic, parenteral or inhalational sedative agent, or
30-22 general anesthetic agent].
30-23 SECTION 21. Subsection (b), Section (6), Article 4551f,
30-24 Revised Statutes, is amended to read as follows:
30-25 (b) As a condition for the renewal of a dental laboratory
31-1 registration, the applicant must also provide evidence satisfactory
31-2 to the Board that at least one employee working on the premises of
31-3 the dental laboratory:
31-4 (1) has completed at least 12 [10] hours of continuing
31-5 education during the registration period; or
31-6 (2) is a certified dental technician.
31-7 SECTION 22. Section (8), Article 4551f, Revised Statutes, is
31-8 amended by amending Subsection (a) and adding Subsection (g) to
31-9 read as follows:
31-10 (a) The Board may refuse to issue a certificate of
31-11 registration, [or] may suspend or revoke a certificate, may impose
31-12 a fine, or may probate all or part of a suspension if after a
31-13 hearing the Board finds that the person applying for or holding a
31-14 certificate of registration has violated or aided another person in
31-15 violating any law regulating the practice of dentistry or has
31-16 required or allowed a person under the direction or control of the
31-17 applicant or certificate holder to violate any law regulating the
31-18 practice of dentistry [this article]. In any complaint or
31-19 disciplinary action under this article, the Board shall follow the
31-20 procedures prescribed for dentists and dental hygienists under
31-21 Article 4549, Revised Statutes.
31-22 (g) For purposes of Subsection (a) of this section, a person
31-23 applying for or holding a certificate of registration includes a
31-24 person who has a 20 percent or greater ownership interest in or is
31-25 the general partner or managing partner in a dental laboratory that
32-1 is registered or for which an application for registration has been
32-2 filed.
32-3 SECTION 23. Article 4551n, Revised Statutes, is amended to
32-4 read as follows:
32-5 Art. 4551n. EMPLOYMENT OF DENTISTS
32-6 Sec. 1. (a) The Board shall, on a form and under rules
32-7 adopted by the Board, approve and certify any health organization
32-8 to contract with or employ dentists licensed by the Board on
32-9 application by the organization and presentation of satisfactory
32-10 proof to the Board that the organization:
32-11 (1) is a nonprofit corporation under the Texas
32-12 Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's
32-13 Texas Civil Statutes) and Section 501(c)(3), Internal Revenue Code
32-14 of 1986 (26 U.S.C. Section 501); and
32-15 (2) is organized and operated as a migrant, community,
32-16 or homeless health center under the authority of and in compliance
32-17 with 42 U.S.C. Section 254b or[,] 254c[, or 256] or as a federally
32-18 qualified health center under 42 U.S.C. Section 1396d(l)(2)(B).
32-19 (b) Any dentist providing dental services under Subsection
32-20 (a) of this section [article] shall provide those services free of
32-21 charge or at a reduced fee commensurate with the patient's ability
32-22 to pay in strict compliance with the applicable provisions of 42
32-23 U.S.C. Section 254b or[,] 254c[, or 256].
32-24 (c) The Board may, at its discretion, refuse to approve or
32-25 certify any such health organization making application to the
33-1 Board if in the Board's determination the applying nonprofit
33-2 corporation is established or organized or operated in
33-3 contravention of or with the intent to circumvent any provision of
33-4 this Act.
33-5 Sec. 2. A dentist licensed by the Board may be employed by
33-6 or contract with a governmental entity providing dental services
33-7 under federal or state law.
33-8 Sec. 3. A dentist licensed by the Board may be employed by
33-9 or contract with an organization if:
33-10 (1) the organization is a nonprofit corporation under
33-11 the Texas Non-Profit Corporation Act (Article 1396-1.01 et seq.,
33-12 Vernon's Texas Civil Statutes) and Section 501(c)(3), Internal
33-13 Revenue Code of 1986 (26 U.S.C. Section 501); and
33-14 (2) the organization is:
33-15 (A) approved by the Board as an organization
33-16 that provides services to underserved populations for no fee or a
33-17 reduced fee; or
33-18 (B) a clinic that provides dental services
33-19 primarily to individuals who have AIDS or the human
33-20 immunodeficiency virus.
33-21 SECTION 24. Subsection (a), Section 467.004, Health and
33-22 Safety Code, is amended to read as follows:
33-23 (a) A licensing or disciplinary authority may add a
33-24 surcharge of not more than $10 [$5] to its license or license
33-25 renewal fee to fund an approved peer assistance program. The
34-1 authority must adopt the surcharge in accordance with the procedure
34-2 that the authority uses to initiate and adopt an increase in its
34-3 license or license renewal fee.
34-4 SECTION 25. Subsection (b), Section 467.0041, Health and
34-5 Safety Code, is amended to read as follows:
34-6 (b) The board may add a surcharge of not more than $10 [$5]
34-7 to its license or license renewal fee to fund an approved peer
34-8 assistance program.
34-9 SECTION 26. The following are repealed:
34-10 (1) Section 4, Chapter 501, Acts of the 45th
34-11 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
34-12 Civil Statutes); and
34-13 (2) Subsection (f), Section 2A, Article 4550a, Revised
34-14 Statutes.
34-15 SECTION 27. (a) This Act takes effect September 1, 1997.
34-16 (b) The State Board of Dental Examiners shall adopt rules
34-17 required under this Act not later than December 1, 1997.
34-18 (c) The change in law made by this Act regarding a
34-19 disciplinary proceeding or contested case applies only to a
34-20 proceeding for a violation that occurs on or after the effective
34-21 date of this Act. A violation that occurs before the effective
34-22 date of this Act is governed by the law in effect on the date the
34-23 violation occurred, and the former law is continued in effect for
34-24 that purpose.
34-25 SECTION 28. The importance of this legislation and the
35-1 crowded condition of the calendars in both houses create an
35-2 emergency and an imperative public necessity that the
35-3 constitutional rule requiring bills to be read on three several
35-4 days in each house be suspended, and this rule is hereby suspended.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 877 passed the Senate on
April 17, 1997, by a viva-voce vote; and that the Senate concurred
in House amendment on May 28, 1997, by a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 877 passed the House, with
amendment, on May 23, 1997, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor