1-1 By: Sibley S.B. No. 877
1-2 (In the Senate - Filed March 3, 1997; March 5, 1997, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 14, 1997, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 11, Nays 0; April 14, 1997,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 877 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of the practice of dentistry.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Subsection (a), Section 1, Article 4544, Revised
1-13 Statutes, is amended to read as follows:
1-14 (a) It shall be the duty of the Board to provide for the
1-15 examination of all applicants for license to practice dentistry in
1-16 this State. Each person applying for an examination shall pay to
1-17 said Board a fee set by the Board and shall be granted a license to
1-18 practice dentistry in this State upon his satisfactorily passing an
1-19 examination provided for by said Board on subjects and operations
1-20 pertaining to dentistry which shall include Anatomy, Physiology,
1-21 Anaesthesia, Biochemistry, Dental Materials, Diagnosis, Treatment
1-22 Planning, Ethics, Jurisprudence, Hygiene, Pharmacology, Operative
1-23 Dentistry, Oral Surgery, Orthodontia, Periodontia, Prosthetic
1-24 Dentistry, Pathology, Microbiology, and such other subjects as are
1-25 regularly taught in reputable Dental Schools as the Board may in
1-26 its discretion require. [The examination shall be given either
1-27 orally or in writing, or by giving a practical demonstration of the
1-28 applicant's skill, or by any combination of such methods or
1-29 subjects as the Board may in its discretion require.] The Board
1-30 shall contract with an independent or regional testing service for
1-31 any required clinical examination. In the event that the Board
1-32 uses a regional testing service, the Board is authorized to
1-33 contract for or otherwise use the services of licensed dentists in
1-34 this state for the purpose of providing assistance to the regional
1-35 testing service. The Board shall have the written portion of the
1-36 examination validated by an independent testing professional.
1-37 SECTION 2. Article 4545, Revised Statutes, is amended to
1-38 read as follows:
1-39 Art. 4545. QUALIFICATIONS OF APPLICANTS. Each applicant for
1-40 a license to practice dentistry in this state shall be not less
1-41 than twenty-one (21) years of age and shall present evidence of
1-42 good moral character and:
1-43 (1) proof of graduation from a dental school
1-44 accredited by the Commission on Dental Accreditation of the
1-45 American Dental Association; or
1-46 (2) proof of:
1-47 (A) graduation from a dental school that is not
1-48 accredited by the Commission on Dental Accreditation of the
1-49 American Dental Association; and
1-50 (B) successful completion of training in an
1-51 American Dental Association approved specialty in an education
1-52 program accredited by the Commission on Dental Accreditation and
1-53 that consists of at least two years of training as specified by the
1-54 Council on Dental Education [reputable dental college and evidence
1-55 of good moral character. A dental college shall be held reputable
1-56 whose entrance requirements and course of instruction are as high
1-57 as those adopted by the better class of dental colleges of the
1-58 United States, and whose course of instruction shall be the
1-59 equivalent of not less than four (4) terms of eight (8) months
1-60 each].
1-61 SECTION 3. Article 4545a, Revised Statutes, is amended to
1-62 read as follows:
1-63 Art. 4545a. LICENSING BY CREDENTIALS[; LICENSING OF
1-64 FOREIGN-TRAINED DENTISTS].
2-1 [Sec. 1.] (a) The State Board of Dental Examiners, upon
2-2 payment by the applicant of a fee set by the Board, shall grant a
2-3 license to practice dentistry or dental hygiene to any reputable
2-4 dentist or dental hygienist who:
2-5 (1) is licensed in good standing as a dentist or
2-6 dental hygienist in another state, the District of Columbia, or a
2-7 territory of the United States that has licensing requirements that
2-8 are substantially equivalent to the requirements of this Act;
2-9 (2) has not been the subject of final or pending
2-10 disciplinary action in any jurisdiction in which the dentist or
2-11 dental hygienist is or has been licensed;
2-12 (3) has graduated from a dental or dental hygiene
2-13 school accredited by the Commission on Dental Accreditation of the
2-14 American Dental Association and approved by the Board according to
2-15 rules established by the Board;
2-16 (4) has passed a national or other examination
2-17 recognized by the Board relating to dentistry or dental hygiene;
2-18 (5) has successfully completed the Board's
2-19 jurisprudence examination;
2-20 (6) has submitted documentation of current
2-21 cardiopulmonary resuscitation certification; [and]
2-22 (7) has practiced dentistry or dental hygiene:
2-23 (A) for a minimum of five years immediately
2-24 prior to applying; or
2-25 (B) as a dental educator at a dental school or
2-26 dental hygiene school accredited by the Commission on Dental
2-27 Accreditation of the American Dental Association for the [a minimum
2-28 of] five years immediately preceding the date of applying for the
2-29 license; and
2-30 (8) has met any additional criteria established by
2-31 Board rule [or]
2-32 [(C) for two years of obligated service in the
2-33 state under the National Health Service Corps or other federal
2-34 scholarship or loan repayment program].
2-35 (b) In addition to the qualifications of Subsection (a) of
2-36 this article, a dentist applicant must be endorsed by the board of
2-37 dentistry of the jurisdiction of current practice.
2-38 (c) The Board must complete the processing of an application
2-39 for a license not later than the 180th day after all documentation
2-40 and examination results required by this section have been received
2-41 by the Board or grant a license to the applicant.
2-42 [Sec. 2. (a) The Board, upon payment by the applicant of a
2-43 fee set by the Board, shall grant a license to a dentist or dental
2-44 hygienist who has not graduated from a dental or dental hygiene
2-45 school accredited by the Commission on Dental Accreditation of the
2-46 American Dental Association if:]
2-47 [(1) the dentist or dental hygienist has practiced for
2-48 a minimum of five years immediately prior to applying;]
2-49 [(2) the dentist or dental hygienist has not been the
2-50 subject of final or pending disciplinary action in any jurisdiction
2-51 in which the dentist or dental hygienist is or has been licensed;]
2-52 [(3) the Board, through a procedure adopted by rule,
2-53 has determined that the educational qualifications are equivalent
2-54 to those required to practice dentistry or dental hygiene in the
2-55 state; and]
2-56 [(4) the dentist or dental hygienist has completed all
2-57 examinations required by the Board for licensure.]
2-58 [(b) The Board must complete the processing of an
2-59 application for a license not later than the 180th day after all
2-60 documentation, the determination of educational equivalency, and
2-61 examination results required by this section have been received by
2-62 the Board or grant a license to the applicant.]
2-63 [(c) An applicant for a license to practice dentistry
2-64 applying under this section who fails the qualifying clinical
2-65 examination required by the Board under its rules three times shall
2-66 be required to attend a two-year program at a dental school
2-67 accredited by the Commission on Dental Accreditation of the
2-68 American Dental Association. The Board shall review two-year
2-69 programs offered to fulfill the requirements of this subsection for
3-1 educational sufficiency.]
3-2 SECTION 4. Article 4548c, Revised Statutes, is amended to
3-3 read as follows:
3-4 Art. 4548c. PRACTICE AFTER LICENSE HAS BEEN REVOKED. No
3-5 person whose license to practice dentistry in this State has been
3-6 [shall be] revoked by any district court of this State or by the
3-7 State Board of Dental Examiners may [shall] practice or attempt to
3-8 practice dentistry or dental surgery in this State after such
3-9 license has been so revoked.
3-10 SECTION 5. Article 4548e, Revised Statutes, is amended to
3-11 read as follows:
3-12 Art. 4548e. USE OF TRADE NAME. Any person, corporation,
3-13 [It shall be unlawful for any person or persons to practice
3-14 dentistry in this State under the name of a corporation, company,
3-15 association, or trade name unless included as a prominent portion
3-16 of such name is the proper name used on the license, as issued by
3-17 the State Board of Dental Examiners, of the dentist or dentists
3-18 practicing under such corporate, company, association, or trade
3-19 name. Provided, however, any corporate,] company, or association,
3-20 may use a corporation, company, association, or trade name. Any
3-21 advertisement by the corporation, company, association, or trade
3-22 name must [used by a group of dentists in a nonprint medium shall
3-23 only be required to] include prominently the name of at least one
3-24 dentist practicing under such name. The person, corporation,
3-25 company, or association shall file with the State Board of Dental
3-26 Examiners a list of all dentists who practice under the name and a
3-27 list of each trade name used if the trade name is different from
3-28 the corporation, company, or association name. A list required
3-29 under this section must be updated and filed with the Board not
3-30 later than the 30th day after the date of the change. Each day of
3-31 violation of this Article shall constitute a separate offense.
3-32 SECTION 6. Section 1, Chapter 501, Acts of the 45th
3-33 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
3-34 Civil Statutes), is amended by amending Subsections (f) through (j)
3-35 and adding Subsections (k) and (l) to read as follows:
3-36 (f) A complaint received under this article must be filed
3-37 with the Board and reviewed to determine jurisdiction. If the
3-38 Board has jurisdiction, the Board shall require an investigation of
3-39 the complaint to determine the facts concerning the complaint.
3-40 (g) The Board shall dispose of all complaints in a timely
3-41 manner. The Board shall establish a schedule for conducting each
3-42 phase of a complaint that is under the control of the Board. The
3-43 schedule shall be kept in the information file for the complaint.
3-44 A change in the schedule must be noted in the complaint information
3-45 file.
3-46 (h) [(g)] The Executive Director of the Board shall notify
3-47 the Board of the number of complaints that extend beyond a two-year
3-48 time frame for resolution. The Executive Director shall provide
3-49 the Board with an explanation of the reasons that the complaints
3-50 have not been resolved. The notice and explanation required shall
3-51 be provided to the Board periodically at regularly scheduled Board
3-52 meetings.
3-53 (i) [(h)] The Board by rule shall adopt procedures
3-54 governing:
3-55 (1) informal disposition of a contested case under
3-56 Section 2001.056, Government Code; and
3-57 (2) informal proceedings held in compliance with
3-58 Section 2001.054(c), Government Code.
3-59 (j) [(i)] Rules adopted under this section must provide the
3-60 complainant, where applicable and permitted by law, an opportunity
3-61 to be heard, must provide the licensee an opportunity to be heard,
3-62 and must require the presence of an attorney to advise the Board or
3-63 the Board's employees. The attorney must be a member of the
3-64 Board's legal staff, if the Board has a legal staff. If the Board
3-65 does not have a legal staff, the attorney must be an employee of
3-66 the office of the attorney general.
3-67 (k) [(j)] The Board by rule shall develop a system for
3-68 monitoring license holders' compliance with the requirements of
3-69 this Act. Rules adopted under this section shall include
4-1 procedures for monitoring a license holder who is ordered by the
4-2 Board to perform certain acts to ascertain that the license holder
4-3 performs the required acts and to identify and monitor license
4-4 holders who represent a risk to the public.
4-5 (l) The Board may only consider a complaint that is filed
4-6 with the Board not later than the fourth anniversary of the date
4-7 the complained-of act occurred or of the date the complainant
4-8 discovered, or in the exercise of reasonable diligence should have
4-9 discovered, the occurrence of the complained-of act.
4-10 SECTION 7. Sections 2 and 3, Chapter 501, Acts of the 45th
4-11 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
4-12 Civil Statutes), are amended to read as follows:
4-13 Sec. 2. (a) The Board shall revoke[, cancel,] or suspend
4-14 any license or licenses that may have been issued by such Board,
4-15 impose a fine on a license holder, place on probation with
4-16 conditions a person whose license has been suspended, or reprimand
4-17 a licensee if in the opinion of a majority of such Board any person
4-18 or persons to whom a license has been issued by said Board to
4-19 practice dentistry or dental hygiene in this State shall have,
4-20 after the issuance of such license, violated any of the provisions
4-21 of the Statutes of the State of Texas relating to the practice of
4-22 dentistry or dental hygiene in this State, or any of the provisions
4-23 of Chapter 9, Title 71, Revised Statutes, or any amendments that
4-24 may hereafter be made thereto, or a rule of the Board. All
4-25 revocations[, cancellations,] or suspensions of licenses by the
4-26 Board shall be made in the manner provided by Chapter 2001,
4-27 Government Code (Administrative Procedure Act).
4-28 (b) Notice of a hearing issued [All complaints to be
4-29 considered] by the Board under this article shall be made in
4-30 writing and shall set out the alleged violations of such Statutes
4-31 or rules.
4-32 (c) [All complaints under this article as received shall be
4-33 filed with the Secretary of the Board or an authorized employee of
4-34 the Board. All complaints filed with the Board shall be reviewed
4-35 to determine jurisdiction, and if jurisdiction exists, the
4-36 Secretary of the Board or designee shall cause an investigation of
4-37 such complaint to be made to determine the facts in such case. If
4-38 the facts as determined by such investigation justify further
4-39 action, the disposition of the complaint shall comply with this
4-40 article.]
4-41 [(d)] If a licensee suspension is probated, the Board may
4-42 require the practitioner:
4-43 (1) to report regularly to the Board on matters that
4-44 are the basis of the probation;
4-45 (2) to limit practice to the areas prescribed by the
4-46 Board; or
4-47 (3) to continue or review professional education until
4-48 the practitioner attains a degree of skill satisfactory to the
4-49 Board in those areas that are the basis of the probation.
4-50 (d) [(e)] If the Board or an executive committee of the
4-51 Board determines from the evidence or information presented to it
4-52 that a person licensed under this Act by continuation in practice
4-53 would constitute a clear, imminent, or continuing threat to a
4-54 person's physical health or well-being, the Board or the executive
4-55 committee of the Board shall temporarily suspend the license of
4-56 that person. The license may be suspended under this section
4-57 without notice or hearing on the complaint, provided the Board or
4-58 the executive committee of the Board simultaneously with the
4-59 temporary suspension requests the State Office of Administrative
4-60 Hearings to set a date for a hearing on the temporary suspension.
4-61 A hearing shall be held not later than fourteen (14) days after the
4-62 date of the suspension unless a continuance is requested by the
4-63 licensee. A second hearing on the suspension shall be held by the
4-64 State Office of Administrative Hearings within sixty (60) days
4-65 after the date the suspension was ordered or after the date
4-66 specified in the continuance requested by the licensee. The time
4-67 requirements in this subsection must be adhered to or the
4-68 suspension is lifted without further order or action.
4-69 (e) [(f)] All proceedings under this section are subject to
5-1 Chapter 2001, Government Code [complaints considered by the Board
5-2 must be filed with the Board within four (4) years after the date
5-3 on which the act occurred or within four (4) years after a
5-4 complainant discovered, or in the exercise of reasonable diligence
5-5 should have discovered, the occurrence of the act].
5-6 Sec. 3. (a) A person aggrieved by a ruling, order, or
5-7 decision of the Board under this article has the right to appeal as
5-8 provided by Chapter 2001, Government Code [to a district court in
5-9 the county of his residence or in the county where the alleged
5-10 offense occurred within thirty (30) days from the service of notice
5-11 of the action of the Board].
5-12 (b) [The appeal having been properly filed, the court may
5-13 request of the Board and the Board on receiving the request shall
5-14 within thirty (30) days prepare and transmit to the court a
5-15 certified copy of its entire record in the matter in which the
5-16 appeal has been taken. The appeal shall be tried in accordance
5-17 with the Texas Rules of Civil Procedure.]
5-18 [(c)] If an aggrieved person fails to perfect an appeal as
5-19 provided in this section, the Board's ruling shall become final.
5-20 (c) [(d)] Review by the court shall be by the substantial
5-21 evidence rule and not de novo.
5-22 [(e) The court may, in its discretion, permit a person who
5-23 files an appeal under this section to stay enforcement of penalty
5-24 or punishment by giving to the court a supersedeas bond that is
5-25 approved by the court, unless there is a finding of clear,
5-26 imminent, or continuing harm to a person's physical health or
5-27 well-being by the State Office of Administrative Hearings in a
5-28 hearing held under Section 2(e) of this article. If the court
5-29 sustains the occurrence of the violation, the court may uphold the
5-30 amount of penalty or punishment assessed or may reduce the amount
5-31 of penalty or punishment assessed. If the court does not sustain
5-32 the occurrence of the violation, the court shall order that no
5-33 penalty or punishment is assessed.]
5-34 SECTION 8. Subsection (b), Article 4548i, Revised Statutes,
5-35 is amended to read as follows:
5-36 (b) Any person who shall violate a provision of Chapter 9,
5-37 Title 71, Revised Statutes, is liable to the state for a civil
5-38 penalty in an amount not to exceed $5,000 [$2,500]. Each day a
5-39 violation continues or occurs is a separate violation for the
5-40 purpose of imposing a penalty. On request of the Board, the
5-41 attorney general or the county attorney or district attorney of the
5-42 county in which the violation is alleged to have occurred shall
5-43 file suit to collect the penalty. A civil penalty collected under
5-44 this subsection shall be deposited in the state treasury to the
5-45 credit of the general revenue fund.
5-46 SECTION 9. Chapter 9, Title 71, Revised Statutes, is amended
5-47 by adding Article 4548k to read as follows:
5-48 Art. 4548k. CONTRACTUAL AND ORGANIZATIONAL AGREEMENTS
5-49 Sec. 1. (a) A person or organization providing dental
5-50 services in this state under an agreement or contract that allows
5-51 another person or organization to control or influence any aspect,
5-52 including business and professional aspects, of the provision of
5-53 dental services by the person or organization on request shall
5-54 report to the Board, under rules adopted by the Board:
5-55 (1) information concerning the contract or agreement;
5-56 (2) the manner in which fees are billed to a patient;
5-57 (3) the manner in which the dental service provider is
5-58 paid and information, if any, provided to a patient concerning that
5-59 payment agreement or contract; and
5-60 (4) information concerning the nature of the
5-61 arrangement provided to shareholders of organizations contracting
5-62 with a dental service provider.
5-63 (b) A person or organization practicing dentistry that has
5-64 one or more dentists practicing with or under the person or
5-65 organization, regardless of whether the dentist has an ownership
5-66 interest or an employment or contractual relationship, is
5-67 responsible for all professional acts done under the name of the
5-68 person or organization. This article does not affect an individual
5-69 license holder's responsibilities and rights under this chapter.
6-1 Sec. 2. A statute relating to the practice of dentistry in
6-2 this state may not be construed to prohibit a licensed dentist from
6-3 maintaining any number of offices in this state if the dentist:
6-4 (1) assumes full legal responsibility and liability
6-5 for the dental services rendered in each of the dentist's offices;
6-6 and
6-7 (2) complies with the requirements prescribed by Board
6-8 rule.
6-9 SECTION 10. Section 1, Article 4549, Revised Statutes, is
6-10 amended to read as follows:
6-11 Sec. 1. The State Board of Dental Examiners shall have
6-12 authority to refuse to examine any person or refuse to issue a
6-13 dental license or a dental hygienist license to any person for any
6-14 one or more of the following causes:
6-15 (a) Proof of presentation to the Board of any
6-16 dishonest or fake evidence of qualification, or being guilty of any
6-17 illegality, fraud, or deception in the process of examination, or
6-18 for the purpose of securing a license or certificate.
6-19 (b) Proof of chronic or habitual intoxication or
6-20 addiction to drugs on the part of the applicant.
6-21 (c) Proof that the applicant has been guilty of
6-22 dishonest or illegal practices in or connected with the practice of
6-23 dentistry or dental hygiene.
6-24 (d) Proof of conviction of the applicant of a felony
6-25 [involving moral turpitude] under the laws of this State or any
6-26 other State or of the United States.
6-27 (e) Proof that the applicant violated any of the
6-28 provisions of the statutes of the State of Texas relating to the
6-29 practice of dentistry or any provisions of Chapter 9, Title 71,
6-30 Revised Statutes, within 12 months before the filing of an
6-31 application for the license.
6-32 SECTION 11. Section 2, Article 4549, Revised Statutes, is
6-33 amended to read as follows:
6-34 Sec. 2. The State Board of Dental Examiners shall have
6-35 jurisdiction and authority, after notice and hearing, to suspend or
6-36 revoke a dental license or a dental hygienist license, to impose a
6-37 fine on a person licensed under this chapter, to place on probation
6-38 with conditions a person whose license or certificate is suspended,
6-39 or to reprimand a licensee or certificate holder, and in addition
6-40 to or in lieu of said suspension, revocation, probation, or
6-41 reprimand, to assess an administrative penalty as provided for in
6-42 Article 4548j, Revised Statutes, for any one or more of the
6-43 following causes:
6-44 (a) Proof of insanity of the holder of a license or
6-45 certificate, as adjudged by the regularly constituted authorities.
6-46 (b) Proof of conviction of the holder of a license or
6-47 certificate of any felony or a misdemeanor involving fraud under
6-48 the laws of this State or any other State or of the United States.
6-49 (c) That the holder thereof has been or is guilty of
6-50 dishonorable conduct, malpractice, [or] gross incompetency, or
6-51 failure to treat a patient according to the standard of care in the
6-52 practice of dentistry or dental hygiene.
6-53 (d) That the holder thereof has been or is guilty of
6-54 any deception or misrepresentation for the purpose of soliciting or
6-55 obtaining patronage.
6-56 (e) That the holder thereof procured a license or
6-57 certificate through fraud or misrepresentation.
6-58 (f) That the holder thereof is addicted to habitual
6-59 intoxication or the use of drugs.
6-60 (g) That a dentist employs or permits or has employed
6-61 or permitted persons to practice dentistry in the office or offices
6-62 under his control or management, who were not licensed to practice
6-63 dentistry.
6-64 (h) That the holder thereof has failed to use proper
6-65 diligence in the conduct of his practice or to safeguard his
6-66 patients against avoidable infections.
6-67 (i) That the holder thereof has failed or refused to
6-68 comply with any State law relating to the regulation of dentists or
6-69 dental hygienists.
7-1 (j) That the holder thereof has failed or refused to
7-2 comply with the adopted and promulgated rules and regulations of
7-3 the Board.
7-4 (k) That the holder thereof is physically or mentally
7-5 incapable of practicing with safety to dental patients.
7-6 (l) That the holder thereof has been negligent in the
7-7 performance of dental services which injured or damaged dental
7-8 patients.
7-9 (m) Proof of suspension, revocation, probation,
7-10 reprimand, or other restriction by another State of a license or
7-11 certificate to practice dentistry or dental hygiene based upon acts
7-12 by the licensee or certificate holder enumerated in this section.
7-13 (n) That the holder thereof has knowingly provided or
7-14 agreed to provide dental care in a manner which violates any
7-15 provision of federal or State law regulating a plan whereby any
7-16 person undertakes to provide, arrange for, pay for, or reimburse
7-17 any part of the cost of any dental care services or regulating the
7-18 business of insurance.
7-19 SECTION 12. Subsection (a), Section 3, Article 4549, Revised
7-20 Statutes, is amended to read as follows:
7-21 (a) If the Board proposes to refuse to examine a person, to
7-22 suspend or revoke a license, to impose a fine, to place on
7-23 probation a person whose license has been suspended, or to
7-24 reprimand a license holder, the person is entitled to a hearing
7-25 under Chapter 2001, Government Code [before the Board].
7-26 SECTION 13. Article 4549-1, Revised Statutes, is amended to
7-27 read as follows:
7-28 Art. 4549-1. REVOCATION AND SUSPENSION OF LICENSE FOR
7-29 DRUG-RELATED FELONY CONVICTION. On conviction of a person licensed
7-30 by the board of a felony under Chapter 481, Health and Safety Code,
7-31 Section 485.033, Health and Safety Code, or Chapter 483, Health and
7-32 Safety Code, the board shall, after an administrative hearing
7-33 conducted in accordance with Chapter 2001, Government Code [the
7-34 Administrative Procedure and Texas Register Act, as amended
7-35 (Article 6252-13a, Vernon's Texas Civil Statutes)], in which the
7-36 fact of conviction is determined, suspend the person's license. On
7-37 the person's final conviction, the board shall revoke the person's
7-38 license. The board may not reinstate or reissue a license to a
7-39 person whose license is suspended or revoked under this article
7-40 except on an express determination based on substantial evidence
7-41 contained in an investigative report indicating that the
7-42 reinstatement or reissue of the license is in the best interests of
7-43 the public and of the person whose license has been suspended or
7-44 revoked.
7-45 SECTION 14. Article 4550, Revised Statutes, is amended to
7-46 read as follows:
7-47 Art. 4550. Records of the Board
7-48 Sec. 1. The Board shall keep records in which shall be
7-49 registered the name and residence and [or] place of business of all
7-50 persons authorized under this law to practice dentistry, dental
7-51 hygiene and such other professions or businesses under its
7-52 jurisdiction as provided by law. Each dentist, dental hygienist,
7-53 dental laboratory, and dental technician registered with the Board
7-54 shall timely notify the Board of:
7-55 (1) any change of address of the place of business of
7-56 such [the] dentist, hygienist, laboratory, or technician; and
7-57 (2) any change of employers by such [the] dentist,
7-58 hygienist, the laboratory, or technician, and any change of owners
7-59 of the laboratory.
7-60 The Board is timely notified if it receives the notice within
7-61 60 days after the date the change occurs.
7-62 Sec. 2. All of the records and files of the Texas State
7-63 Board of Dental Examiners shall be public records and open to
7-64 inspection at reasonable times, except the investigation files and
7-65 records which shall be confidential and shall be divulged only to
7-66 persons so investigated upon completion of said investigation. It
7-67 is not a violation of this section for the Board to share
7-68 investigation files and records with another state regulatory
7-69 agency or federal law enforcement agency during the course of a
8-1 joint investigation or in determining the feasibility of conducting
8-2 an investigation.
8-3 SECTION 15. Subsection (b), Article 4551, Revised Statutes,
8-4 is amended to read as follows:
8-5 (b) The Board shall establish reasonable and necessary fees
8-6 so that the fees, in the aggregate, produce sufficient revenue to
8-7 cover the cost of administering this Act.
8-8 [The Board may not set a fee at an amount less than the
8-9 amount of that fee on September 1, 1993.]
8-10 SECTION 16. Article 4551a, Revised Statutes, is amended to
8-11 read as follows:
8-12 Art. 4551a. PERSONS REGARDED AS PRACTICING DENTISTRY. Any
8-13 person shall be regarded as practicing dentistry within the meaning
8-14 of this Chapter:
8-15 (1) Who publicly professes to be a dentist or dental
8-16 surgeon or who uses or permits to be used for himself or for any
8-17 other person, the title of "Doctor," "Dr.," "Doctor of Dental
8-18 Surgery," "D.D.S.," "Doctor of Dental Medicine," "D.M.D.," or any
8-19 other letters, titles, terms or descriptive matter, including use
8-20 of the terms "denturist" or "denturism," which directly or
8-21 indirectly represents him as being able to diagnose, treat, remove
8-22 stains or concretions from teeth, provide surgical and adjunctive
8-23 treatment for any disease, pain, injury, deficiency, deformity or
8-24 physical condition of the human teeth, oral cavity, alveolar
8-25 process, gums, jaws or directly related and adjacent masticatory
8-26 structures.
8-27 (2) Who shall offer or undertake by any means or
8-28 methods whatsoever, to clean teeth or to remove stains, concretions
8-29 or deposits from teeth in the human mouth, or who shall undertake
8-30 or offer to diagnose, treat, operate, or prescribe by any means or
8-31 methods for any disease, pain, injury, deficiency, deformity, or
8-32 physical condition of the human teeth, oral cavity, alveolar
8-33 process, gums, or jaws.
8-34 (3) Any person who shall offer or undertake in any
8-35 manner to prescribe or make, or cause to be made, an impression of
8-36 any portion of the human mouth, teeth, gums, or jaws, for the
8-37 purpose of diagnosing, prescribing, treating, or aiding in the
8-38 diagnosing, prescribing or treating, any physical condition of the
8-39 human mouth, teeth, gums or jaws, or for the purpose of
8-40 constructing or aiding in the construction of any dental appliance,
8-41 denture, dental bridge, false teeth, dental plate or plates of
8-42 false teeth, or any other substitute for human teeth.
8-43 (4) Any one who owns, maintains or operates any office
8-44 or place of business where he employs or engages, under any kind of
8-45 contract whatsoever, any other person or persons to practice
8-46 dentistry as above defined shall be deemed to be practicing
8-47 dentistry himself and shall himself be required to be duly licensed
8-48 to practice dentistry as hereinabove defined, and shall be subject
8-49 to all of the other provisions of this Chapter, even though the
8-50 person or persons so employed or engaged by him shall be duly
8-51 licensed to practice dentistry as hereinabove defined, unless
8-52 otherwise provided by law.
8-53 (5) Any person, firm, group, association, or
8-54 corporation who shall offer or undertake to fit, adjust, repair, or
8-55 substitute in the human mouth or directly related and adjacent
8-56 masticatory structures any dental appliance, structure, prosthesis,
8-57 or denture, or who shall aid or cause to be fitted, adjusted,
8-58 repaired, or substituted in the human mouth or directly related and
8-59 adjacent masticatory structures any dental appliance, structure,
8-60 prosthesis, or denture.
8-61 (6) Who makes, fabricates, processes, constructs,
8-62 produces, reproduces, duplicates, repairs, relines, or fixes any
8-63 full or partial denture, any fixed or removable dental bridge or
8-64 appliance, any dental plate or plates of false teeth, any
8-65 artificial dental restoration, or any substitute or corrective
8-66 device or appliance for the human teeth, gums, jaws, mouth,
8-67 alveolar process, or any part thereof for another, or who in any
8-68 manner offers, undertakes, aids, abets, or causes another person so
8-69 to do for another, without a written prescription or work-order
9-1 therefor signed by the dentist legally engaged in the practice of
9-2 dentistry in this state or in the jurisdiction where such dentist
9-3 maintains his dental office and who prescribed and ordered same.
9-4 (7) Who shall offer or undertake or cause another to
9-5 do, directly or indirectly, for any person any act, service, or
9-6 work in the practice of dentistry or any part thereof as provided
9-7 for in the laws of Texas relating to the practice of dentistry
9-8 including without limitation the inducing, administering,
9-9 prescribing, or dispensing any anesthesia, anesthetic drug,
9-10 medicine, or agent in anywise incidental to or in connection with
9-11 the practice of dentistry; or who permits or allows another to use
9-12 his license or certificate to practice dentistry in this state for
9-13 the purpose of performing any act described in this Article; or who
9-14 shall aid or abet, directly or indirectly, the practice of
9-15 dentistry by any person not duly licensed to practice dentistry by
9-16 the Texas State Board of Dental Examiners.
9-17 (8) Who shall control, attempt to control, influence,
9-18 attempt to influence, or otherwise interfere with the exercise of a
9-19 dentist's independent professional judgment regarding the diagnosis
9-20 or treatment of any dental disease, disorder, or physical
9-21 condition. However, nothing herein shall be construed to require
9-22 any entity to pay for services which are not provided for in a
9-23 contract or agreement or to exempt any dentist who is a member of a
9-24 hospital staff from adhering to hospital bylaws, medical staff
9-25 bylaws, or established policies approved by the governing board and
9-26 the medical and dental staff of the hospital.
9-27 (9) If the person holds himself or herself out to be a
9-28 denturist or uses another title that is intended to convey to the
9-29 public that the services offered by the person are included within
9-30 the practice of dentistry.
9-31 SECTION 17. Section 11, Chapter 244, General Laws, Acts of
9-32 the 44th Legislature, Regular Session, 1935 (Article 4551b,
9-33 Vernon's Texas Civil Statutes), is amended to read as follows:
9-34 Sec. 11. The definition of dentistry as contained in Chapter
9-35 9 of Title 71, of the Revised Civil Statutes of Texas as amended,
9-36 shall not apply to:
9-37 (1) members of the faculty of a reputable dental or
9-38 dental hygiene college or school where such faculty members perform
9-39 their services for the sole benefit of such school or college; or
9-40 (2) students of a reputable dental college who perform
9-41 their operations without pay except for actual cost of materials,
9-42 in the presence of and under the direct personal supervision of a
9-43 demonstrator or teacher who is a member of the faculty of a
9-44 reputable dental college; or
9-45 (3) persons doing laboratory work on inert matter
9-46 only, and who do not solicit or obtain work, by any means, from a
9-47 person or persons not a licensed dentist actually engaged in the
9-48 practice of dentistry and who do not act as the agents or
9-49 solicitors of, or have any interest whatsoever in, any dental
9-50 office, practice or the receipts therefrom; or
9-51 (4) physicians and surgeons legally authorized to
9-52 practice medicine as defined by the law of this state who do not
9-53 hold themselves out to the public as practicing dentistry; or
9-54 (5) dental hygienists legally authorized to practice
9-55 dental hygiene in this state and who practice dental hygiene in
9-56 strict conformity with the laws of Texas regulating the practice of
9-57 dental hygiene; or
9-58 (6) those persons who as members of an established
9-59 church practice healing by prayer only; or
9-60 (7) employees of a dentist who make dental x-rays in
9-61 the dental office and under the supervision of such dentist or
9-62 dentists legally engaged in the practice of dentistry in this
9-63 state; or
9-64 (8) Dental Health Service Corporations legally
9-65 chartered under Subsection (1) of Article 2.01, of the Texas
9-66 Nonprofit Corporation Act; or
9-67 (9) dental interns and dental residents as defined and
9-68 regulated by the Texas State Board of Dental Examiners in its rules
9-69 and regulations; or
10-1 (10) students of a reputable dental hygiene school who
10-2 practice dental hygiene without pay in strict conformity with the
10-3 laws of this state regulating the practice of dental hygiene; or
10-4 (11) dental assistants who perform the duties
10-5 permitted by Article 4551e-1, Revised Statutes, in strict
10-6 conformity with the laws of this state; or
10-7 (12) dentists licensed by another state or foreign
10-8 country who perform clinical procedures only for professional and
10-9 technical education demonstration purposes, provided that such
10-10 dentists must first obtain a temporary license for such purpose
10-11 from the State Board of Dental Examiners.
10-12 SECTION 18. Section 2, Chapter 475, Acts of the 52nd
10-13 Legislature, 1951 (Article 4551e, Vernon's Texas Civil Statutes),
10-14 is amended to read as follows:
10-15 Sec. 2. QUALIFICATIONS. A dental hygienist shall be not
10-16 less than eighteen (18) years of age and a graduate of an
10-17 accredited high school or hold a certificate of high school
10-18 equivalency (GED) and be a graduate of a recognized [and
10-19 accredited] school or college of dentistry or dental hygiene
10-20 accredited by the Commission on Dental Accreditation of the
10-21 American Dental Association and approved by the Texas State Board
10-22 of Dental Examiners [in which the course of instruction shall be
10-23 the equivalent of not less than two (2) terms of eight (8) months
10-24 each and who shall have thereafter passed an examination given by
10-25 and before the Texas State Board of Dental Examiners on subjects
10-26 pertaining to dental hygiene, and who shall have complied with all
10-27 of the provisions of this Act and the rules and regulations
10-28 promulgated by the Texas State Board of Dental Examiners].
10-29 SECTION 19. Subsection (a), Section 5, Chapter 475, Acts of
10-30 the 52nd Legislature, 1951 (Article 4551e, Vernon's Texas Civil
10-31 Statutes), is amended to read as follows:
10-32 (a) It shall be the duty of the Board to provide for the
10-33 examination of all qualified applicants for licensure as dental
10-34 hygienists in this State. All applicants for examination shall pay
10-35 a fee set by the Board to said Board as determined by said Board
10-36 according to its needs and shall apply upon forms furnished by the
10-37 Board and shall furnish such other information as the Board may in
10-38 its discretion require to determine any applicant's qualifications.
10-39 An applicant must attach to the application proof that the
10-40 applicant has successfully completed a current course in
10-41 cardiopulmonary resuscitation given or approved by the American
10-42 Heart Association or American Red Cross before the date on which
10-43 the applicant submits the application or, in the event that the
10-44 applicant is not physically capable of successfully completing such
10-45 training, a written statement executed by either a licensed
10-46 physician or an instructor in cardiopulmonary resuscitation
10-47 approved by the American Heart Association or American Red Cross
10-48 that describes such physical incapacity. The examination shall be
10-49 taken by all applicants on such subjects and operations pertaining
10-50 to dentistry and dental hygiene which shall include Dental Anatomy,
10-51 Pharmacology, X-Ray, Ethics, Jurisprudence, and Hygiene, and such
10-52 other subjects as are regularly taught in reputable schools of
10-53 dentistry and dental hygiene, as the Board in its discretion may
10-54 require. [The examination shall be given orally or in writing, or
10-55 by giving a practical demonstration of the applicant's skill or by
10-56 any combination of such methods or subjects as the Board may in its
10-57 discretion require.] The Board shall contract with an independent
10-58 or regional testing service for any required clinical examination.
10-59 In the event that the Board uses a regional testing service, the
10-60 Board is authorized to contract for or otherwise use the services
10-61 of licensed dental hygienists in this State for the purpose of
10-62 providing assistance to the regional testing service. The Board
10-63 shall have the written portion of the examination validated by an
10-64 independent testing professional. The Board shall report such
10-65 grades to the applicant within a reasonable time after such
10-66 examination, and each applicant who has satisfactorily passed all
10-67 phases of the examination as determined by the Board shall be
10-68 entitled to and shall be issued a license permitting such applicant
10-69 to practice dental hygiene in the State of Texas as is defined and
11-1 regulated by the law of this State.
11-2 SECTION 20. Subsections (a) and (b), Article 4551e-1,
11-3 Revised Statutes, are amended to read as follows:
11-4 (a) A dental assistant who is not professionally licensed
11-5 may be [is one who is] employed by and work [works] in the office
11-6 of a licensed[, registered,] and practicing dentist and perform
11-7 [who performs] one or more delegated dental acts under the direct
11-8 supervision, direction, and responsibility of such dentist. Direct
11-9 supervision, direction, and responsibility, as used in this
11-10 article, means that the dentist employing a dental assistant or
11-11 dentist in charge of a dental assistant is physically present in
11-12 the dental office when a dental assistant performs a delegated
11-13 dental act.
11-14 (b) A person licensed to practice dentistry may delegate to
11-15 any qualified and properly trained dental assistant acting under
11-16 the dentist's direct supervision any dental act that a reasonable
11-17 and prudent dentist would find is within the scope of sound dental
11-18 judgment to delegate if, in the opinion of the delegating dentist,
11-19 the act can be properly and safely performed by the person to whom
11-20 the dental act is delegated and the act is performed in its
11-21 customary manner, not in violation of this Act or any other
11-22 statute, and the person to whom the dental act is delegated does
11-23 not hold himself out to the public as being authorized to practice
11-24 dentistry. However, a dentist may not:
11-25 (1) delegate an act to an individual who, by order of
11-26 the Board, is prohibited from performing the act;
11-27 (2) delegate the performance of any of the following
11-28 acts to a person not licensed as a dentist or dental hygienist:
11-29 (A) the removal of calculus, deposits, or
11-30 accretions from the natural and restored surfaces of exposed human
11-31 teeth and restorations in the human mouth;
11-32 (B) root planing or the smoothing and polishing
11-33 of roughened root surfaces or exposed human teeth; or
11-34 (C) any other act the delegation of which is
11-35 prohibited by the rules of the Board; [or]
11-36 (3) delegate the performance of any of the following
11-37 acts to a person not licensed as a dentist:
11-38 (A) comprehensive examination or diagnosis and
11-39 treatment planning;
11-40 (B) a surgical or cutting procedure on hard or
11-41 soft tissue;
11-42 (C) the prescription of a drug, medication, or
11-43 work authorization;
11-44 (D) the taking of an impression for a final
11-45 restoration, appliance, or prosthesis;
11-46 (E) the making of an intraoral occlusal
11-47 adjustment;
11-48 (F) the performance of direct pulp capping,
11-49 pulpotomy, or any other endodontic procedure;
11-50 (G) the final placement and intraoral adjustment
11-51 of a fixed or removable appliance; or
11-52 (H) the placement of any final restoration; or
11-53 (4) delegate the authority to administer a local
11-54 anesthetic agent, inhalation sedative agent, parenteral sedative
11-55 agent, or general anesthetic agent to an individual not licensed
11-56 as:
11-57 (A) a dentist with a permit issued by the Texas
11-58 State Board of Dental Examiners for the procedure being performed,
11-59 if a permit is required;
11-60 (B) a certified registered nurse anesthetist
11-61 licensed by the Texas Board of Nurse Examiners, only if the
11-62 delegating dentist holds a permit issued by the Texas State Board
11-63 of Dental Examiners for the procedure being performed, if a permit
11-64 is required; or
11-65 (C) a physician anesthesiologist licensed by the
11-66 Texas State Board of Medical Examiners [(I) the administration of a
11-67 local anesthetic, parenteral or inhalational sedative agent, or
11-68 general anesthetic agent].
11-69 SECTION 21. Subsection (b), Section (6), Article 4551f,
12-1 Revised Statutes, is amended to read as follows:
12-2 (b) As a condition for the renewal of a dental laboratory
12-3 registration, the applicant must also provide evidence satisfactory
12-4 to the Board that at least one employee working on the premises of
12-5 the dental laboratory:
12-6 (1) has completed at least 12 [10] hours of continuing
12-7 education during the registration period; or
12-8 (2) is a certified dental technician.
12-9 SECTION 22. Section (8), Article 4551f, Revised Statutes, is
12-10 amended by amending Subsection (a) and adding Subsection (g) to
12-11 read as follows:
12-12 (a) The Board may refuse to issue a certificate of
12-13 registration, [or] may suspend or revoke a certificate, may impose
12-14 a fine, or may probate all or part of a suspension if after a
12-15 hearing the Board finds that the person applying for or holding a
12-16 certificate of registration has violated or aided another person in
12-17 violating any law regulating the practice of dentistry or has
12-18 required or allowed a person under the direction or control of the
12-19 applicant or certificate holder to violate any law regulating the
12-20 practice of dentistry [has violated this article]. In any
12-21 complaint or disciplinary action under this article, the Board
12-22 shall follow the procedures prescribed for dentists and dental
12-23 hygienists under Article 4549, Revised Statutes.
12-24 (g) For purposes of Subsection (a) of this section, a person
12-25 applying for or holding a certificate of registration includes a
12-26 person who has a 20 percent or greater ownership interest in or is
12-27 the general partner or managing partner in a dental laboratory that
12-28 is registered or for which an application for registration has been
12-29 filed.
12-30 SECTION 23. Article 4551n, Revised Statutes, is amended to
12-31 read as follows:
12-32 Art. 4551n. EMPLOYMENT OF DENTISTS
12-33 Sec. 1. (a) The Board shall, on a form and under rules
12-34 adopted by the Board, approve and certify any health organization
12-35 to contract with or employ dentists licensed by the Board on
12-36 application by the organization and presentation of satisfactory
12-37 proof to the Board that the organization:
12-38 (1) is a nonprofit corporation under the Texas
12-39 Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's
12-40 Texas Civil Statutes) and Section 501(c)(3), Internal Revenue Code
12-41 of 1986 (26 U.S.C. Section 501); and
12-42 (2) is organized and operated as a migrant, community,
12-43 or homeless health center under the authority of and in compliance
12-44 with 42 U.S.C. Section 254b, 254c, or 256 or as a federally
12-45 qualified health center under 42 U.S.C. Section 1396d(l)(2)(B).
12-46 (b) Any dentist providing dental services under Subsection
12-47 (a) of this section [article] shall provide those services free of
12-48 charge or at a reduced fee commensurate with the patient's ability
12-49 to pay in strict compliance with the applicable provisions of 42
12-50 U.S.C. Section 254b, 254c, or 256.
12-51 (c) The Board may, at its discretion, refuse to approve or
12-52 certify any such health organization making application to the
12-53 Board if in the Board's determination the applying nonprofit
12-54 corporation is established or organized or operated in
12-55 contravention of or with the intent to circumvent any provision of
12-56 this Act.
12-57 Sec. 2. A dentist licensed by the Board may be employed by
12-58 or contract with a governmental entity providing dental services
12-59 under federal or state law.
12-60 Sec. 3. A dentist licensed by the Board may be employed by
12-61 or contract with an organization that meets the requirements of
12-62 Section 1(a)(1) of this article if the organization is approved by
12-63 the Board as an organization that provides services to underserved
12-64 populations for no fee or a reduced fee.
12-65 SECTION 24. Subsection (a), Section 467.004, Health and
12-66 Safety Code, is amended to read as follows:
12-67 (a) A licensing or disciplinary authority may add a
12-68 surcharge of not more than $10 [$5] to its license or license
12-69 renewal fee to fund an approved peer assistance program. The
13-1 authority must adopt the surcharge in accordance with the procedure
13-2 that the authority uses to initiate and adopt an increase in its
13-3 license or license renewal fee.
13-4 SECTION 25. Subsection (b), Section 467.0041, Health and
13-5 Safety Code, is amended to read as follows:
13-6 (b) The board may add a surcharge of not more than $10 [$5]
13-7 to its license or license renewal fee to fund an approved peer
13-8 assistance program.
13-9 SECTION 26. The following are repealed:
13-10 (1) Section 4, Chapter 501, Acts of the 45th
13-11 Legislature, Regular Session, 1937 (Article 4548h, Vernon's Texas
13-12 Civil Statutes); and
13-13 (2) Subsection (f), Section 2A, Article 4550a, Revised
13-14 Statutes.
13-15 SECTION 27. (a) This Act takes effect September 1, 1997.
13-16 (b) The State Board of Dental Examiners shall adopt rules
13-17 required under this Act not later than December 1, 1997.
13-18 (c) The change in law made by this Act regarding a
13-19 disciplinary proceeding or contested case applies only to a
13-20 proceeding for a violation that occurs on or after the effective
13-21 date of this Act. A violation that occurs before the effective
13-22 date of this Act is governed by the law in effect on the date the
13-23 violation occurred, and the former law is continued in effect for
13-24 that purpose.
13-25 SECTION 28. The importance of this legislation and the
13-26 crowded condition of the calendars in both houses create an
13-27 emergency and an imperative public necessity that the
13-28 constitutional rule requiring bills to be read on three several
13-29 days in each house be suspended, and this rule is hereby suspended.
13-30 * * * * *