75R13369 MCK-D
By Sibley S.B. No. 877
Substitute the following for S.B. No. 877:
By Berlanga C.S.S.B. No. 877
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of the practice of dentistry.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Subsection (a), Section 1, Article 4544, Revised
1-5 Statutes, is amended to read as follows:
1-6 (a) It shall be the duty of the Board to provide for the
1-7 examination of all applicants for license to practice dentistry in
1-8 this State. Each person applying for an examination shall pay to
1-9 said Board a fee set by the Board and shall be granted a license to
1-10 practice dentistry in this State upon his satisfactorily passing an
1-11 examination provided for by said Board on subjects and operations
1-12 pertaining to dentistry which shall include Anatomy, Physiology,
1-13 Anaesthesia, Biochemistry, Dental Materials, Diagnosis, Treatment
1-14 Planning, Ethics, Jurisprudence, Hygiene, Pharmacology, Operative
1-15 Dentistry, Oral Surgery, Orthodontia, Periodontia, Prosthetic
1-16 Dentistry, Pathology, Microbiology, and such other subjects as are
1-17 regularly taught in reputable Dental Schools as the Board may in
1-18 its discretion require. [The examination shall be given either
1-19 orally or in writing, or by giving a practical demonstration of the
1-20 applicant's skill, or by any combination of such methods or
1-21 subjects as the Board may in its discretion require.] The Board
1-22 shall contract with an independent or regional testing service for
1-23 any required clinical examination. In the event that the Board
1-24 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
2-26 dental colleges of the United States, and whose course of
2-27 instruction shall be the equivalent of not less than four (4) terms
3-1 of eight (8) months each].
3-2 SECTION 3. Article 4545a, Revised Statutes, is amended to
3-3 read as follows:
3-4 Art. 4545a. LICENSING BY CREDENTIALS[; LICENSING OF
3-5 FOREIGN-TRAINED DENTISTS].
3-6 [Sec. 1.] (a) The State Board of Dental Examiners, upon
3-7 payment by the applicant of a fee set by the Board, shall grant a
3-8 license to practice dentistry or dental hygiene to any reputable
3-9 dentist or dental hygienist who:
3-10 (1) is licensed in good standing as a dentist or
3-11 dental hygienist in another state, the District of Columbia, or a
3-12 territory of the United States that has licensing requirements that
3-13 are substantially equivalent to the requirements of this Act;
3-14 (2) has not been the subject of final or pending
3-15 disciplinary action in any jurisdiction in which the dentist or
3-16 dental hygienist is or has been licensed;
3-17 (3) has graduated from a dental or dental hygiene
3-18 school accredited by the Commission on Dental Accreditation of the
3-19 American Dental Association and approved by the Board according to
3-20 rules established by the Board;
3-21 (4) has passed a national or other examination
3-22 recognized by the Board relating to dentistry or dental hygiene;
3-23 (5) has successfully completed the Board's
3-24 jurisprudence examination;
3-25 (6) has submitted documentation of current
3-26 cardiopulmonary resuscitation certification; [and]
3-27 (7) has practiced dentistry or dental hygiene:
4-1 (A) for a minimum of five years immediately
4-2 prior to applying; or
4-3 (B) as a dental educator at a dental school or
4-4 dental hygiene school accredited by the Commission on Dental
4-5 Accreditation of the American Dental Association for the [a minimum
4-6 of] five years immediately preceding the date of applying for the
4-7 license; and
4-8 (8) has met any additional criteria established by
4-9 Board rule [or]
4-10 [(C) for two years of obligated service in the
4-11 state under the National Health Service Corps or other federal
4-12 scholarship or loan repayment program].
4-13 (b) In addition to the qualifications of Subsection (a) of
4-14 this article, a dentist applicant must be endorsed by the board of
4-15 dentistry of the jurisdiction of current practice.
4-16 (c) The Board must complete the processing of an application
4-17 for a license not later than the 180th day after all documentation
4-18 and examination results required by this section have been received
4-19 by the Board or grant a license to the applicant.
4-20 [Sec. 2. (a) The Board, upon payment by the applicant of a
4-21 fee set by the Board, shall grant a license to a dentist or dental
4-22 hygienist who has not graduated from a dental or dental hygiene
4-23 school accredited by the Commission on Dental Accreditation of the
4-24 American Dental Association if:]
4-25 [(1) the dentist or dental hygienist has practiced for
4-26 a minimum of five years immediately prior to applying;]
4-27 [(2) the dentist or dental hygienist has not been the
5-1 subject of final or pending disciplinary action in any jurisdiction
5-2 in which the dentist or dental hygienist is or has been licensed;]
5-3 [(3) the Board, through a procedure adopted by rule,
5-4 has determined that the educational qualifications are equivalent
5-5 to those required to practice dentistry or dental hygiene in the
5-6 state; and]
5-7 [(4) the dentist or dental hygienist has completed all
5-8 examinations required by the Board for licensure.]
5-9 [(b) The Board must complete the processing of an
5-10 application for a license not later than the 180th day after all
5-11 documentation, the determination of educational equivalency, and
5-12 examination results required by this section have been received by
5-13 the Board or grant a license to the applicant.]
5-14 [(c) An applicant for a license to practice dentistry
5-15 applying under this section who fails the qualifying clinical
5-16 examination required by the Board under its rules three times shall
5-17 be required to attend a two-year program at a dental school
5-18 accredited by the Commission on Dental Accreditation of the
5-19 American Dental Association. The Board shall review two-year
5-20 programs offered to fulfill the requirements of this subsection for
5-21 educational sufficiency.]
5-22 SECTION 4. Article 4548c, Revised Statutes, is amended to
5-23 read as follows:
5-24 Art. 4548c. PRACTICE AFTER LICENSE HAS BEEN REVOKED. No
5-25 person whose license to practice dentistry in this State has been
5-26 [shall be] revoked by any district court of this State or by the
5-27 State Board of Dental Examiners may [shall] practice or attempt to
6-1 practice dentistry or dental surgery in this State after such
6-2 license has been so revoked.
6-3 SECTION 5. Article 4548e, Revised Statutes, is amended to
6-4 read as follows:
6-5 Art. 4548e. USE OF TRADE NAME. Any person, corporation [It
6-6 shall be unlawful for any person or persons to practice dentistry
6-7 in this State under the name of a corporation, company,
6-8 association, or trade name unless included as a prominent portion
6-9 of such name is the proper name used on the license, as issued by
6-10 the State Board of Dental Examiners, of the dentist or dentists
6-11 practicing under such corporate, company, association, or trade
6-12 name. Provided, however, any corporate], company, or association
6-13 may use a corporation, company, association, or trade name. Any
6-14 advertisement by the corporation, company, association, or trade
6-15 name must [used by a group of dentists in a nonprint medium shall
6-16 only be required to] include prominently the name of at least one
6-17 dentist practicing under such name. The person, corporation,
6-18 company, or association shall file with the State Board of Dental
6-19 Examiners a list of all dentists who practice under the name and a
6-20 list of each trade name used if the trade name is different from
6-21 the corporation, company, or association name. A list required
6-22 under this section must be updated and filed with the Board not
6-23 later than the 30th day after the date of the change. Each day of
6-24 violation of this Article shall constitute a separate offense.
6-25 SECTION 6. Section 1, Chapter 501, Acts of the 45th
6-26 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
6-27 Civil Statutes), is amended by amending Subsections (f) through (j)
7-1 and adding Subsections (k) and (l) to read as follows:
7-2 (f) A complaint received under this article must be filed
7-3 with the Board and reviewed to determine jurisdiction. If the
7-4 Board has jurisdiction, the Board shall require an investigation of
7-5 the complaint to determine the facts concerning the complaint.
7-6 (g) The Board shall dispose of all complaints in a timely
7-7 manner. The Board shall establish a schedule for conducting each
7-8 phase of a complaint that is under the control of the Board. The
7-9 schedule shall be kept in the information file for the complaint.
7-10 A change in the schedule must be noted in the complaint information
7-11 file.
7-12 (h) [(g)] The Executive Director of the Board shall notify
7-13 the Board of the number of complaints that extend beyond a two-year
7-14 time frame for resolution. The Executive Director shall provide
7-15 the Board with an explanation of the reasons that the complaints
7-16 have not been resolved. The notice and explanation required shall
7-17 be provided to the Board periodically at regularly scheduled Board
7-18 meetings.
7-19 (i) [(h)] The Board by rule shall adopt procedures
7-20 governing:
7-21 (1) informal disposition of a contested case under
7-22 Section 2001.056, Government Code; and
7-23 (2) informal proceedings held in compliance with
7-24 Section 2001.054(c), Government Code.
7-25 (j) [(i)] Rules adopted under this section must provide the
7-26 complainant, where applicable and permitted by law, an opportunity
7-27 to be heard, must provide the licensee an opportunity to be heard,
8-1 and must require the presence of an attorney to advise the Board or
8-2 the Board's employees. The attorney must be a member of the
8-3 Board's legal staff, if the Board has a legal staff. If the Board
8-4 does not have a legal staff, the attorney must be an employee of
8-5 the office of the attorney general.
8-6 (k) [(j)] The Board by rule shall develop a system for
8-7 monitoring license holders' compliance with the requirements of
8-8 this Act. Rules adopted under this section shall include
8-9 procedures for monitoring a license holder who is ordered by the
8-10 Board to perform certain acts to ascertain that the license holder
8-11 performs the required acts and to identify and monitor license
8-12 holders who represent a risk to the public.
8-13 (l) The Board may only consider a complaint that is filed
8-14 with the Board not later than the fourth anniversary of the date
8-15 the complained-of act occurred or of the date the complainant
8-16 discovered, or in the exercise of reasonable diligence should have
8-17 discovered, the occurrence of the complained-of act.
8-18 SECTION 7. Sections 2 and 3, Chapter 501, Acts of the 45th
8-19 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
8-20 Civil Statutes), are amended to read as follows:
8-21 Sec. 2. (a) The Board shall revoke[, cancel,] or suspend
8-22 any license or licenses that may have been issued by such Board,
8-23 impose a fine on a license holder, place on probation with
8-24 conditions a person whose license has been suspended, or reprimand
8-25 a licensee if in the opinion of a majority of such Board any person
8-26 or persons to whom a license has been issued by said Board to
8-27 practice dentistry or dental hygiene in this State shall have,
9-1 after the issuance of such license, violated any of the provisions
9-2 of the Statutes of the State of Texas relating to the practice of
9-3 dentistry or dental hygiene in this State, or any of the provisions
9-4 of Chapter 9, Title 71, Revised Statutes, or any amendments that
9-5 may hereafter be made thereto, or a rule of the Board. All
9-6 revocations[, cancellations,] or suspensions of licenses by the
9-7 Board shall be made in the manner provided by Chapter 2001,
9-8 Government Code (Administrative Procedure Act).
9-9 (b) Notice of a hearing issued [All complaints to be
9-10 considered] by the Board under this article shall be made in
9-11 writing and shall set out the alleged violations of such Statutes
9-12 or rules.
9-13 (c) [All complaints under this article as received shall be
9-14 filed with the Secretary of the Board or an authorized employee of
9-15 the Board. All complaints filed with the Board shall be reviewed
9-16 to determine jurisdiction, and if jurisdiction exists, the
9-17 Secretary of the Board or designee shall cause an investigation of
9-18 such complaint to be made to determine the facts in such case. If
9-19 the facts as determined by such investigation justify further
9-20 action, the disposition of the complaint shall comply with this
9-21 article.]
9-22 [(d)] If a licensee suspension is probated, the Board may
9-23 require the practitioner:
9-24 (1) to report regularly to the Board on matters that
9-25 are the basis of the probation;
9-26 (2) to limit practice to the areas prescribed by the
9-27 Board; or
10-1 (3) to continue or review professional education until
10-2 the practitioner attains a degree of skill satisfactory to the
10-3 Board in those areas that are the basis of the probation.
10-4 (d) [(e)] If the Board or an executive committee of the
10-5 Board determines from the evidence or information presented to it
10-6 that a person licensed under this Act by continuation in practice
10-7 would constitute a clear, imminent, or continuing threat to a
10-8 person's physical health or well-being, the Board or the executive
10-9 committee of the Board shall temporarily suspend the license of
10-10 that person. The license may be suspended under this section
10-11 without notice or hearing on the complaint, provided the Board or
10-12 the executive committee of the Board simultaneously with the
10-13 temporary suspension requests the State Office of Administrative
10-14 Hearings to set a date for a hearing on the temporary suspension.
10-15 A hearing shall be held not later than fourteen (14) days after the
10-16 date of the suspension unless a continuance is requested by the
10-17 licensee. A second hearing on the suspension shall be held by the
10-18 State Office of Administrative Hearings within sixty (60) days
10-19 after the date the suspension was ordered or after the date
10-20 specified in the continuance requested by the licensee. The time
10-21 requirements in this subsection must be adhered to or the
10-22 suspension is lifted without further order or action.
10-23 (e) [(f)] All proceedings under this section are subject to
10-24 Chapter 2001, Government Code [complaints considered by the Board
10-25 must be filed with the Board within four (4) years after the date
10-26 on which the act occurred or within four (4) years after a
10-27 complainant discovered, or in the exercise of reasonable diligence
11-1 should have discovered, the occurrence of the act].
11-2 Sec. 3. (a) A person aggrieved by a ruling, order, or
11-3 decision of the Board under this article has the right to appeal as
11-4 provided by Chapter 2001, Government Code [to a district court in
11-5 the county of his residence or in the county where the alleged
11-6 offense occurred within thirty (30) days from the service of notice
11-7 of the action of the Board].
11-8 (b) [The appeal having been properly filed, the court may
11-9 request of the Board and the Board on receiving the request shall
11-10 within thirty (30) days prepare and transmit to the court a
11-11 certified copy of its entire record in the matter in which the
11-12 appeal has been taken. The appeal shall be tried in accordance
11-13 with the Texas Rules of Civil Procedure.]
11-14 [(c)] If an aggrieved person fails to perfect an appeal as
11-15 provided in this section, the Board's ruling shall become final.
11-16 (c) [(d)] Review by the court shall be by the substantial
11-17 evidence rule and not de novo.
11-18 [(e) The court may, in its discretion, permit a person who
11-19 files an appeal under this section to stay enforcement of penalty
11-20 or punishment by giving to the court a supersedeas bond that is
11-21 approved by the court, unless there is a finding of clear,
11-22 imminent, or continuing harm to a person's physical health or
11-23 well-being by the State Office of Administrative Hearings in a
11-24 hearing held under Section 2(e) of this article. If the court
11-25 sustains the occurrence of the violation, the court may uphold the
11-26 amount of penalty or punishment assessed or may reduce the amount
11-27 of penalty or punishment assessed. If the court does not sustain
12-1 the occurrence of the violation, the court shall order that no
12-2 penalty or punishment is assessed.]
12-3 SECTION 8. Subsection (b), Article 4548i, Revised Statutes,
12-4 is amended to read as follows:
12-5 (b) Any person who shall violate a provision of Chapter 9,
12-6 Title 71, Revised Statutes, is liable to the state for a civil
12-7 penalty in an amount not to exceed $5,000 [$2,500]. Each day a
12-8 violation continues or occurs is a separate violation for the
12-9 purpose of imposing a penalty. On request of the Board, the
12-10 attorney general or the county attorney or district attorney of the
12-11 county in which the violation is alleged to have occurred shall
12-12 file suit to collect the penalty. A civil penalty collected under
12-13 this subsection shall be deposited in the state treasury to the
12-14 credit of the general revenue fund.
12-15 SECTION 9. Chapter 9, Title 71, Revised Statutes, is amended
12-16 by adding Article 4548k to read as follows:
12-17 Art. 4548k. CONTRACTUAL AND ORGANIZATIONAL AGREEMENTS
12-18 Sec. 1. (a) A person or organization providing dental
12-19 services in this state under an agreement or contract that allows
12-20 another person or organization to control or influence any aspect,
12-21 including business and professional aspects, of the provision of
12-22 dental services by the person or organization on request shall
12-23 report to the Board, under rules adopted by the Board:
12-24 (1) information concerning the contract or agreement;
12-25 (2) the manner in which fees are billed to a patient;
12-26 (3) the manner in which the dental service provider is
12-27 paid and information, if any, provided to a patient concerning that
13-1 payment agreement or contract; and
13-2 (4) information concerning the nature of the
13-3 arrangement provided to shareholders of organizations contracting
13-4 with a dental service provider.
13-5 (b) A person or organization practicing dentistry that has
13-6 one or more dentists practicing with or under the person or
13-7 organization, regardless of whether the dentist has an ownership
13-8 interest or an employment or contractual relationship, is
13-9 responsible for all professional acts done under the name of the
13-10 person or organization. This article does not affect an individual
13-11 license holder's responsibilities and rights under this chapter.
13-12 Sec. 2. A statute relating to the practice of dentistry in
13-13 this state may not be construed to prohibit a licensed dentist from
13-14 maintaining any number of offices in this state if the dentist:
13-15 (1) assumes full legal responsibility and liability
13-16 for the dental services rendered in each of the dentist's offices;
13-17 and
13-18 (2) complies with the requirements prescribed by Board
13-19 rule.
13-20 SECTION 10. Section 1, Article 4549, Revised Statutes, is
13-21 amended to read as follows:
13-22 Sec. 1. The State Board of Dental Examiners shall have
13-23 authority to refuse to examine any person or refuse to issue a
13-24 dental license or a dental hygienist license to any person for any
13-25 one or more of the following causes:
13-26 (a) Proof of presentation to the Board of any
13-27 dishonest or fake evidence of qualification, or being guilty of any
14-1 illegality, fraud, or deception in the process of examination, or
14-2 for the purpose of securing a license or certificate.
14-3 (b) Proof of chronic or habitual intoxication or
14-4 addiction to drugs on the part of the applicant.
14-5 (c) Proof that the applicant has been guilty of
14-6 dishonest or illegal practices in or connected with the practice of
14-7 dentistry or dental hygiene.
14-8 (d) Proof of conviction of the applicant of a felony
14-9 [involving moral turpitude] under the laws of this State or any
14-10 other State or of the United States.
14-11 (e) Proof that the applicant violated any of the
14-12 provisions of the statutes of the State of Texas relating to the
14-13 practice of dentistry or any provisions of Chapter 9, Title 71,
14-14 Revised Statutes, within 12 months before the filing of an
14-15 application for the license.
14-16 SECTION 11. Section 2, Article 4549, Revised Statutes, is
14-17 amended to read as follows:
14-18 Sec. 2. The State Board of Dental Examiners shall have
14-19 jurisdiction and authority, after notice and hearing, to suspend or
14-20 revoke a dental license or a dental hygienist license, to impose a
14-21 fine on a person licensed under this chapter, to place on probation
14-22 with conditions a person whose license or certificate is suspended,
14-23 or to reprimand a licensee or certificate holder, and in addition
14-24 to or in lieu of said suspension, revocation, probation, or
14-25 reprimand, to assess an administrative penalty as provided for in
14-26 Article 4548j, Revised Statutes, for any one or more of the
14-27 following causes:
15-1 (a) Proof of insanity of the holder of a license or
15-2 certificate, as adjudged by the regularly constituted authorities.
15-3 (b) Proof of conviction of the holder of a license or
15-4 certificate of any felony or a misdemeanor involving fraud under
15-5 the laws of this State or any other State or of the United States.
15-6 (c) That the holder thereof has been or is guilty of
15-7 dishonorable conduct, malpractice, [or] gross incompetency, or
15-8 failure to treat a patient according to the standard of care in the
15-9 practice of dentistry or dental hygiene.
15-10 (d) That the holder thereof has been or is guilty of
15-11 any deception or misrepresentation for the purpose of soliciting or
15-12 obtaining patronage.
15-13 (e) That the holder thereof procured a license or
15-14 certificate through fraud or misrepresentation.
15-15 (f) That the holder thereof is addicted to habitual
15-16 intoxication or the use of drugs.
15-17 (g) That a dentist employs or permits or has employed
15-18 or permitted persons to practice dentistry in the office or offices
15-19 under his control or management, who were not licensed to practice
15-20 dentistry.
15-21 (h) That the holder thereof has failed to use proper
15-22 diligence in the conduct of his practice or to safeguard his
15-23 patients against avoidable infections.
15-24 (i) That the holder thereof has failed or refused to
15-25 comply with any State law relating to the regulation of dentists or
15-26 dental hygienists.
15-27 (j) That the holder thereof has failed or refused to
16-1 comply with the adopted and promulgated rules and regulations of
16-2 the Board.
16-3 (k) That the holder thereof is physically or mentally
16-4 incapable of practicing with safety to dental patients.
16-5 (l) That the holder thereof has been negligent in the
16-6 performance of dental services which injured or damaged dental
16-7 patients.
16-8 (m) Proof of suspension, revocation, probation,
16-9 reprimand, or other restriction by another State of a license or
16-10 certificate to practice dentistry or dental hygiene based upon acts
16-11 by the licensee or certificate holder enumerated in this section.
16-12 (n) That the holder thereof has knowingly provided or
16-13 agreed to provide dental care in a manner which violates any
16-14 provision of federal or State law regulating a plan whereby any
16-15 person undertakes to provide, arrange for, pay for, or reimburse
16-16 any part of the cost of any dental care services or regulating the
16-17 business of insurance.
16-18 SECTION 12. Subsection (a), Section 3, Article 4549, Revised
16-19 Statutes, is amended to read as follows:
16-20 (a) If the Board proposes to refuse to examine a person, to
16-21 suspend or revoke a license, to impose a fine, to place on
16-22 probation a person whose license has been suspended, or to
16-23 reprimand a license holder, the person is entitled to a hearing
16-24 under Chapter 2001, Government Code [before the Board].
16-25 SECTION 13. Article 4549-1, Revised Statutes, is amended to
16-26 read as follows:
16-27 Art. 4549-1. REVOCATION AND SUSPENSION OF LICENSE FOR
17-1 DRUG-RELATED FELONY CONVICTION. On conviction of a person licensed
17-2 by the board of a felony under Chapter 481, Health and Safety Code,
17-3 Section 485.033, Health and Safety Code, or Chapter 483, Health and
17-4 Safety Code, the board shall, after an administrative hearing
17-5 conducted in accordance with Chapter 2001, Government Code [the
17-6 Administrative Procedure and Texas Register Act, as amended
17-7 (Article 6252-13a, Vernon's Texas Civil Statutes)], in which the
17-8 fact of conviction is determined, suspend the person's license. On
17-9 the person's final conviction, the board shall revoke the person's
17-10 license. The board may not reinstate or reissue a license to a
17-11 person whose license is suspended or revoked under this article
17-12 except on an express determination based on substantial evidence
17-13 contained in an investigative report indicating that the
17-14 reinstatement or reissue of the license is in the best interests of
17-15 the public and of the person whose license has been suspended or
17-16 revoked.
17-17 SECTION 14. Article 4550, Revised Statutes, is amended to
17-18 read as follows:
17-19 Art. 4550. Records of the Board
17-20 Sec. 1. The Board shall keep records in which shall be
17-21 registered the name and residence and [or] place of business of all
17-22 persons authorized under this law to practice dentistry, dental
17-23 hygiene and such other professions or businesses under its
17-24 jurisdiction as provided by law. Each dentist, dental hygienist,
17-25 dental laboratory, and dental technician registered with the Board
17-26 shall timely notify the Board of:
17-27 (1) any change of address of the place of business of
18-1 such [the] dentist, hygienist, laboratory, or technician; and
18-2 (2) any change of employers by such [the] dentist,
18-3 hygienist, laboratory, or technician, and any change of owners of
18-4 the laboratory.
18-5 The Board is timely notified if it receives the notice within
18-6 60 days after the date the change occurs.
18-7 Sec. 2. All of the records and files of the [Texas] State
18-8 Board of Dental Examiners shall be public records and open to
18-9 inspection at reasonable times, except the investigation files and
18-10 records which shall be confidential and shall be divulged only to
18-11 persons so investigated upon completion of said investigation. It
18-12 is not a violation of this section for the Board to share
18-13 investigation files and records with another state regulatory
18-14 agency or federal law enforcement agency during the course of a
18-15 joint investigation or in determining the feasibility of conducting
18-16 an investigation.
18-17 SECTION 15. Subsection (b), Article 4551, Revised Statutes,
18-18 is amended to read as follows:
18-19 (b) The Board shall establish reasonable and necessary fees
18-20 so that the fees, in the aggregate, produce sufficient revenue to
18-21 cover the cost of administering this Act.
18-22 [The Board may not set a fee at an amount less than the
18-23 amount of that fee on September 1, 1993.]
18-24 SECTION 16. Article 4551a, Revised Statutes, is amended to
18-25 read as follows:
18-26 Art. 4551a. PERSONS REGARDED AS PRACTICING DENTISTRY. Any
18-27 person shall be regarded as practicing dentistry within the meaning
19-1 of this Chapter:
19-2 (1) Who publicly professes to be a dentist or dental
19-3 surgeon or who uses or permits to be used for himself or for any
19-4 other person, the title of "Doctor," "Dr.," "Doctor of Dental
19-5 Surgery," "D.D.S.," "Doctor of Dental Medicine," "D.M.D.," or any
19-6 other letters, titles, terms or descriptive matter, including use
19-7 of the terms "denturist" or "denturism," which directly or
19-8 indirectly represents him as being able to diagnose, treat, remove
19-9 stains or concretions from teeth, provide surgical and adjunctive
19-10 treatment for any disease, pain, injury, deficiency, deformity or
19-11 physical condition of the human teeth, oral cavity, alveolar
19-12 process, gums, jaws or directly related and adjacent masticatory
19-13 structures.
19-14 (2) Who shall offer or undertake by any means or
19-15 methods whatsoever, to clean teeth or to remove stains, concretions
19-16 or deposits from teeth in the human mouth, or who shall undertake
19-17 or offer to diagnose, treat, operate, or prescribe by any means or
19-18 methods for any disease, pain, injury, deficiency, deformity, or
19-19 physical condition of the human teeth, oral cavity, alveolar
19-20 process, gums, or jaws.
19-21 (3) Any person who shall offer or undertake in any
19-22 manner to prescribe or make, or cause to be made, an impression of
19-23 any portion of the human mouth, teeth, gums, or jaws, for the
19-24 purpose of diagnosing, prescribing, treating, or aiding in the
19-25 diagnosing, prescribing or treating, any physical condition of the
19-26 human mouth, teeth, gums or jaws, or for the purpose of
19-27 constructing or aiding in the construction of any dental appliance,
20-1 denture, dental bridge, false teeth, dental plate or plates of
20-2 false teeth, or any other substitute for human teeth.
20-3 (4) Any one who owns, maintains or operates any office
20-4 or place of business where he employs or engages, under any kind of
20-5 contract whatsoever, any other person or persons to practice
20-6 dentistry as above defined shall be deemed to be practicing
20-7 dentistry himself and shall himself be required to be duly licensed
20-8 to practice dentistry as hereinabove defined, and shall be subject
20-9 to all of the other provisions of this Chapter, even though the
20-10 person or persons so employed or engaged by him shall be duly
20-11 licensed to practice dentistry as hereinabove defined, unless
20-12 otherwise provided by law.
20-13 (5) Any person, firm, group, association, or
20-14 corporation who shall offer or undertake to fit, adjust, repair, or
20-15 substitute in the human mouth or directly related and adjacent
20-16 masticatory structures any dental appliance, structure, prosthesis,
20-17 or denture, or who shall aid or cause to be fitted, adjusted,
20-18 repaired, or substituted in the human mouth or directly related and
20-19 adjacent masticatory structures any dental appliance, structure,
20-20 prosthesis, or denture.
20-21 (6) Who makes, fabricates, processes, constructs,
20-22 produces, reproduces, duplicates, repairs, relines, or fixes any
20-23 full or partial denture, any fixed or removable dental bridge or
20-24 appliance, any dental plate or plates of false teeth, any
20-25 artificial dental restoration, or any substitute or corrective
20-26 device or appliance for the human teeth, gums, jaws, mouth,
20-27 alveolar process, or any part thereof for another, or who in any
21-1 manner offers, undertakes, aids, abets, or causes another person so
21-2 to do for another, without a written prescription or work-order
21-3 therefor signed by the dentist legally engaged in the practice of
21-4 dentistry in this state or in the jurisdiction where such dentist
21-5 maintains his dental office and who prescribed and ordered same.
21-6 (7) Who shall offer or undertake or cause another to
21-7 do, directly or indirectly, for any person any act, service, or
21-8 work in the practice of dentistry or any part thereof as provided
21-9 for in the laws of Texas relating to the practice of dentistry
21-10 including without limitation the inducing, administering,
21-11 prescribing, or dispensing any anesthesia, anesthetic drug,
21-12 medicine, or agent in anywise incidental to or in connection with
21-13 the practice of dentistry; or who permits or allows another to use
21-14 his license or certificate to practice dentistry in this state for
21-15 the purpose of performing any act described in this Article; or who
21-16 shall aid or abet, directly or indirectly, the practice of
21-17 dentistry by any person not duly licensed to practice dentistry by
21-18 the [Texas] State Board of Dental Examiners.
21-19 (8) Who shall control, attempt to control, influence,
21-20 attempt to influence, or otherwise interfere with the exercise of a
21-21 dentist's independent professional judgment regarding the diagnosis
21-22 or treatment of any dental disease, disorder, or physical
21-23 condition. However, nothing herein shall be construed to require
21-24 any entity to pay for services which are not provided for in a
21-25 contract or agreement or to exempt any dentist who is a member of a
21-26 hospital staff from adhering to hospital bylaws, medical staff
21-27 bylaws, or established policies approved by the governing board and
22-1 the medical and dental staff of the hospital.
22-2 (9) If the person holds the person out to be a
22-3 denturist or uses another title that is intended to convey to the
22-4 public that the services offered by the person are included within
22-5 the practice of dentistry.
22-6 SECTION 17. Section 11, Chapter 244, General Laws, Acts of
22-7 the 44th Legislature, Regular Session, 1935 (Article 4551b,
22-8 Vernon's Texas Civil Statutes), is amended to read as follows:
22-9 Sec. 11. The definition of dentistry as contained in Chapter
22-10 9 of Title 71, of the Revised Civil Statutes of Texas as amended,
22-11 shall not apply to:
22-12 (1) members of the faculty of a reputable dental or
22-13 dental hygiene college or school where such faculty members perform
22-14 their services for the sole benefit of such school or college; or
22-15 (2) students of a reputable dental college who perform
22-16 their operations without pay except for actual cost of materials,
22-17 in the presence of and under the direct personal supervision of a
22-18 demonstrator or teacher who is a member of the faculty of a
22-19 reputable dental college; or
22-20 (3) persons doing laboratory work on inert matter
22-21 only, and who do not solicit or obtain work, by any means, from a
22-22 person or persons not a licensed dentist actually engaged in the
22-23 practice of dentistry and who do not act as the agents or
22-24 solicitors of, or have any interest whatsoever in, any dental
22-25 office, practice or the receipts therefrom; or
22-26 (4) physicians and surgeons legally authorized to
22-27 practice medicine as defined by the law of this state who do not
23-1 hold themselves out to the public as practicing dentistry; or
23-2 (5) dental hygienists legally authorized to practice
23-3 dental hygiene in this state and who practice dental hygiene in
23-4 strict conformity with the laws of Texas regulating the practice of
23-5 dental hygiene; or
23-6 (6) those persons who as members of an established
23-7 church practice healing by prayer only; or
23-8 (7) employees of a dentist who make dental x-rays in
23-9 the dental office and under the supervision of such dentist or
23-10 dentists legally engaged in the practice of dentistry in this
23-11 state; or
23-12 (8) Dental Health Service Corporations legally
23-13 chartered under Section A(1), [Subsection (1) of] Article 2.01, [of
23-14 the] Texas Non-Profit [Nonprofit] Corporation Act (Article
23-15 1396-2.01, Vernon's Texas Civil Statutes); or
23-16 (9) dental interns and dental residents as defined and
23-17 regulated by the [Texas] State Board of Dental Examiners in its
23-18 rules and regulations; or
23-19 (10) students of a reputable dental hygiene school who
23-20 practice dental hygiene without pay in strict conformity with the
23-21 laws of this state regulating the practice of dental hygiene; or
23-22 (11) dental assistants who perform the duties
23-23 permitted by Article 4551e-1, Revised Statutes, in strict
23-24 conformity with the laws of this state; or
23-25 (12) dentists licensed by another state or foreign
23-26 country who perform clinical procedures only for professional and
23-27 technical education demonstration purposes, provided that such
24-1 dentists must first obtain a temporary license for such purpose
24-2 from the State Board of Dental Examiners.
24-3 SECTION 18. Section 2, Chapter 475, Acts of the 52nd
24-4 Legislature, 1951 (Article 4551e, Vernon's Texas Civil Statutes),
24-5 is amended to read as follows:
24-6 Sec. 2. QUALIFICATIONS. A dental hygienist shall be not
24-7 less than eighteen (18) years of age and a graduate of an
24-8 accredited high school or hold a certificate of high school
24-9 equivalency (GED) and be a graduate of a recognized [and
24-10 accredited] school or college of dentistry or dental hygiene
24-11 accredited by the Commission on Dental Accreditation of the
24-12 American Dental Association and approved by the [Texas] State Board
24-13 of Dental Examiners [in which the course of instruction shall be
24-14 the equivalent of not less than two (2) terms of eight (8) months
24-15 each and who shall have thereafter passed an examination given by
24-16 and before the Texas State Board of Dental Examiners on subjects
24-17 pertaining to dental hygiene, and who shall have complied with all
24-18 of the provisions of this Act and the rules and regulations
24-19 promulgated by the Texas State Board of Dental Examiners].
24-20 SECTION 19. Subsection (a), Section 5, Chapter 475, Acts of
24-21 the 52nd Legislature, 1951 (Article 4551e, Vernon's Texas Civil
24-22 Statutes), is amended to read as follows:
24-23 (a) It shall be the duty of the Board to provide for the
24-24 examination of all qualified applicants for licensure as dental
24-25 hygienists in this State. All applicants for examination shall pay
24-26 a fee set by the Board to said Board as determined by said Board
24-27 according to its needs and shall apply upon forms furnished by the
25-1 Board and shall furnish such other information as the Board may in
25-2 its discretion require to determine any applicant's qualifications.
25-3 An applicant must attach to the application proof that the
25-4 applicant has successfully completed a current course in
25-5 cardiopulmonary resuscitation given or approved by the American
25-6 Heart Association or American Red Cross before the date on which
25-7 the applicant submits the application or, in the event that the
25-8 applicant is not physically capable of successfully completing such
25-9 training, a written statement executed by either a licensed
25-10 physician or an instructor in cardiopulmonary resuscitation
25-11 approved by the American Heart Association or American Red Cross
25-12 that describes such physical incapacity. The examination shall be
25-13 taken by all applicants on such subjects and operations pertaining
25-14 to dentistry and dental hygiene which shall include Dental Anatomy,
25-15 Pharmacology, X-Ray, Ethics, Jurisprudence, and Hygiene, and such
25-16 other subjects as are regularly taught in reputable schools of
25-17 dentistry and dental hygiene, as the Board in its discretion may
25-18 require. [The examination shall be given orally or in writing, or
25-19 by giving a practical demonstration of the applicant's skill or by
25-20 any combination of such methods or subjects as the Board may in its
25-21 discretion require.] The Board shall contract with an independent
25-22 or regional testing service for any required clinical examination.
25-23 In the event that the Board uses a regional testing service, the
25-24 Board is authorized to contract for or otherwise use the services
25-25 of licensed dental hygienists in this State for the purpose of
25-26 providing assistance to the regional testing service. The Board
25-27 shall have the written portion of the examination validated by an
26-1 independent testing professional. The Board shall report such
26-2 grades to the applicant within a reasonable time after such
26-3 examination, and each applicant who has satisfactorily passed all
26-4 phases of the examination as determined by the Board shall be
26-5 entitled to and shall be issued a license permitting such applicant
26-6 to practice dental hygiene in the State of Texas as is defined and
26-7 regulated by the law of this State.
26-8 SECTION 20. Subsections (a) and (b), Article 4551e-1,
26-9 Revised Statutes, are amended to read as follows:
26-10 (a) A dental assistant who is not professionally licensed
26-11 may be [is one who is] employed by and work [works] in the office
26-12 of a licensed[, registered,] and practicing dentist and perform
26-13 [who performs] one or more delegated dental acts under the direct
26-14 supervision, direction, and responsibility of such dentist. Direct
26-15 supervision, direction, and responsibility, as used in this
26-16 article, means that the dentist employing a dental assistant or
26-17 dentist in charge of a dental assistant is physically present in
26-18 the dental office when a dental assistant performs a delegated
26-19 dental act.
26-20 (b) A person licensed to practice dentistry may delegate to
26-21 any qualified and properly trained dental assistant acting under
26-22 the dentist's direct supervision any dental act that a reasonable
26-23 and prudent dentist would find is within the scope of sound dental
26-24 judgment to delegate if, in the opinion of the delegating dentist,
26-25 the act can be properly and safely performed by the person to whom
26-26 the dental act is delegated and the act is performed in its
26-27 customary manner, not in violation of this Act or any other
27-1 statute, and the person to whom the dental act is delegated does
27-2 not hold himself out to the public as being authorized to practice
27-3 dentistry. However, a dentist may not:
27-4 (1) delegate an act to an individual who, by order of
27-5 the Board, is prohibited from performing the act;
27-6 (2) delegate the performance of any of the following
27-7 acts to a person not licensed as a dentist or dental hygienist:
27-8 (A) the removal of calculus, deposits, or
27-9 accretions from the natural and restored surfaces of exposed human
27-10 teeth and restorations in the human mouth;
27-11 (B) root planing or the smoothing and polishing
27-12 of roughened root surfaces or exposed human teeth; or
27-13 (C) any other act the delegation of which is
27-14 prohibited by the rules of the Board; [or]
27-15 (3) delegate the performance of any of the following
27-16 acts to a person not licensed as a dentist:
27-17 (A) comprehensive examination or diagnosis and
27-18 treatment planning;
27-19 (B) a surgical or cutting procedure on hard or
27-20 soft tissue;
27-21 (C) the prescription of a drug, medication, or
27-22 work authorization;
27-23 (D) the taking of an impression for a final
27-24 restoration, appliance, or prosthesis;
27-25 (E) the making of an intraoral occlusal
27-26 adjustment;
27-27 (F) the performance of direct pulp capping,
28-1 pulpotomy, or any other endodontic procedure;
28-2 (G) the final placement and intraoral adjustment
28-3 of a fixed or removable appliance; or
28-4 (H) the placement of any final restoration; or
28-5 (4) delegate the authority to administer a local
28-6 anesthetic agent, inhalation sedative agent, parenteral sedative
28-7 agent, or general anesthetic agent to an individual not licensed
28-8 as:
28-9 (A) a dentist with a permit issued by the State
28-10 Board of Dental Examiners for the procedure being performed, if a
28-11 permit is required;
28-12 (B) a certified registered nurse anesthetist
28-13 licensed by the Board of Nurse Examiners, only if the delegating
28-14 dentist holds a permit issued by the State Board of Dental
28-15 Examiners for the procedure being performed, if a permit is
28-16 required; or
28-17 (C) a physician anesthesiologist licensed by the
28-18 Texas State Board of Medical Examiners [(I) the administration of a
28-19 local anesthetic, parenteral or inhalational sedative agent, or
28-20 general anesthetic agent].
28-21 SECTION 21. Subsection (b), Section (6), Article 4551f,
28-22 Revised Statutes, is amended to read as follows:
28-23 (b) As a condition for the renewal of a dental laboratory
28-24 registration, the applicant must also provide evidence satisfactory
28-25 to the Board that at least one employee working on the premises of
28-26 the dental laboratory:
28-27 (1) has completed at least 12 [10] hours of continuing
29-1 education during the registration period; or
29-2 (2) is a certified dental technician.
29-3 SECTION 22. Section (8), Article 4551f, Revised Statutes, is
29-4 amended by amending Subsection (a) and adding Subsection (g) to
29-5 read as follows:
29-6 (a) The Board may refuse to issue a certificate of
29-7 registration, [or] may suspend or revoke a certificate, may impose
29-8 a fine, or may probate all or part of a suspension if after a
29-9 hearing the Board finds that the person applying for or holding a
29-10 certificate of registration has violated or aided another person in
29-11 violating any law regulating the practice of dentistry or has
29-12 required or allowed a person under the direction or control of the
29-13 applicant or certificate holder to violate any law regulating the
29-14 practice of dentistry [has violated this article]. In any
29-15 complaint or disciplinary action under this article, the Board
29-16 shall follow the procedures prescribed for dentists and dental
29-17 hygienists under Article 4549, Revised Statutes.
29-18 (g) For purposes of Subsection (a) of this section, a person
29-19 applying for or holding a certificate of registration includes a
29-20 person who has a 20 percent or greater ownership interest in or is
29-21 the general partner or managing partner in a dental laboratory that
29-22 is registered or for which an application for registration has been
29-23 filed.
29-24 SECTION 23. Article 4551n, Revised Statutes, is amended to
29-25 read as follows:
29-26 Art. 4551n. EMPLOYMENT OF DENTISTS
29-27 Sec. 1. (a) The Board shall, on a form and under rules
30-1 adopted by the Board, approve and certify any health organization
30-2 to contract with or employ dentists licensed by the Board on
30-3 application by the organization and presentation of satisfactory
30-4 proof to the Board that the organization:
30-5 (1) is a nonprofit corporation under the Texas
30-6 Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's
30-7 Texas Civil Statutes) and Section 501(c)(3), Internal Revenue Code
30-8 of 1986 (26 U.S.C. Section 501); and
30-9 (2) is organized and operated as a migrant, community,
30-10 or homeless health center under the authority of and in compliance
30-11 with 42 U.S.C. Section 254b or[,] 254c[, or 256] or as a federally
30-12 qualified health center under 42 U.S.C. Section 1396d(l)(2)(B).
30-13 (b) Any dentist providing dental services under Subsection
30-14 (a) of this section [article] shall provide those services free of
30-15 charge or at a reduced fee commensurate with the patient's ability
30-16 to pay in strict compliance with the applicable provisions of 42
30-17 U.S.C. Section 254b or[,] 254c[, or 256].
30-18 (c) The Board may, at its discretion, refuse to approve or
30-19 certify any such health organization making application to the
30-20 Board if in the Board's determination the applying nonprofit
30-21 corporation is established or organized or operated in
30-22 contravention of or with the intent to circumvent any provision of
30-23 this Act.
30-24 Sec. 2. A dentist licensed by the Board may be employed by
30-25 or contract with a governmental entity providing dental services
30-26 under federal or state law.
30-27 Sec. 3. A dentist licensed by the Board may be employed by
31-1 or contract with an organization if:
31-2 (1) the organization is a nonprofit corporation under
31-3 the Texas Non-Profit Corporation Act (Article 1396-1.01 et seq.,
31-4 Vernon's Texas Civil Statutes) and Section 501(c)(3), Internal
31-5 Revenue Code of 1986 (26 U.S.C. Section 501); and
31-6 (2) the organization is:
31-7 (A) approved by the Board as an organization
31-8 that provides services to underserved populations for no fee or a
31-9 reduced fee; or
31-10 (B) a clinic that provides dental services
31-11 primarily to individuals who have AIDS or the human
31-12 immunodeficiency virus.
31-13 SECTION 24. Subsection (a), Section 467.004, Health and
31-14 Safety Code, is amended to read as follows:
31-15 (a) A licensing or disciplinary authority may add a
31-16 surcharge of not more than $10 [$5] to its license or license
31-17 renewal fee to fund an approved peer assistance program. The
31-18 authority must adopt the surcharge in accordance with the procedure
31-19 that the authority uses to initiate and adopt an increase in its
31-20 license or license renewal fee.
31-21 SECTION 25. Subsection (b), Section 467.0041, Health and
31-22 Safety Code, is amended to read as follows:
31-23 (b) The board may add a surcharge of not more than $10 [$5]
31-24 to its license or license renewal fee to fund an approved peer
31-25 assistance program.
31-26 SECTION 26. The following are repealed:
31-27 (1) Section 4, Chapter 501, Acts of the 45th
32-1 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
32-2 Civil Statutes); and
32-3 (2) Subsection (f), Section 2A, Article 4550a, Revised
32-4 Statutes.
32-5 SECTION 27. (a) This Act takes effect September 1, 1997.
32-6 (b) The State Board of Dental Examiners shall adopt rules
32-7 required under this Act not later than December 1, 1997.
32-8 (c) The change in law made by this Act regarding a
32-9 disciplinary proceeding or contested case applies only to a
32-10 proceeding for a violation that occurs on or after the effective
32-11 date of this Act. A violation that occurs before the effective
32-12 date of this Act is governed by the law in effect on the date the
32-13 violation occurred, and the former law is continued in effect for
32-14 that purpose.
32-15 SECTION 28. The importance of this legislation and the
32-16 crowded condition of the calendars in both houses create an
32-17 emergency and an imperative public necessity that the
32-18 constitutional rule requiring bills to be read on three several
32-19 days in each house be suspended, and this rule is hereby suspended.