By:  Lucio, Sibley                                     S.B. No. 964
                                A BILL TO BE ENTITLED
                                       AN ACT
 1-1     relating to the regulation of dentists and dental hygienists.
 1-2           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-3           SECTION 1.  Subsections (a) and (b), Section 3, Article
 1-4     4543a, Revised Statutes, are amended to read as follows:
 1-5           (a)  An officer, employee, or paid consultant of a Texas
 1-6     trade association in the field of health care may not be a member
 1-7     or employee of the Board who is exempt from the state's position
 1-8     classification plan or is compensated at or above the amount
 1-9     prescribed by the General Appropriations Act for B9 [step 1, salary
1-10     group 17,] of the position classification salary schedule.
1-11           (b)  A person who is the spouse of an officer, manager, or
1-12     paid consultant of a Texas trade association in the field of health
1-13     care may not be a Board member and may not be a Board employee who
1-14     is exempt from the state's position classification plan or is
1-15     compensated at or above the amount prescribed by the General
1-16     Appropriations Act for B9 [step 1, salary group 17,] of the
1-17     position classification salary schedule.
1-18           SECTION 2.  Article 4544, Revised Statutes, is amended to
1-19     read as follows:
1-20           Art. 4544.  EXAMINATION FOR LICENSE TO PRACTICE DENTISTRY
1-21           Sec. 1.  (a)  It shall be the duty of the Board to provide
1-22     for the examination of all applicants for license to practice
1-23     dentistry in this State.  Each person applying for a license [an
1-24     examination] shall pay to said Board an application [a] fee set by
 2-1     the Board and shall be granted a license to practice dentistry in
 2-2     this State upon his satisfactorily passing an examination provided
 2-3     for by said Board on subjects and operations pertaining to
 2-4     dentistry which shall include Anatomy, Physiology, Anaesthesia,
 2-5     Biochemistry, Dental Materials, Diagnosis, Treatment Planning,
 2-6     Ethics, Jurisprudence, Hygiene, Pharmacology, Operative Dentistry,
 2-7     Oral Surgery, Orthodontia, Periodontia, Prosthetic Dentistry,
 2-8     Pathology, Microbiology, and such other subjects as are regularly
 2-9     taught in reputable Dental Schools as the Board may in its
2-10     discretion require.
2-11           (b)  The Board shall contract with an independent or regional
2-12     testing service for any required clinical examination.
2-13           (c)  In the event that the Board uses a regional testing
2-14     service, the Board is authorized to contract for or otherwise use
2-15     the services of licensed dentists in this state for the purpose of
2-16     providing assistance to the regional testing service.
2-17           (d)  The Board shall have the written portion of the Board's
2-18     jurisprudence examination validated by an independent testing
2-19     professional.
2-20           (e) [(b)]  The Board by rule shall set the number of and
2-21     conditions for examination retakes.  The Board may require an
2-22     applicant who fails the examination to meet additional education
2-23     requirements set by the Board.
2-24           Sec. 2.  (a)  [The Texas State Board of Dental Examiners may
2-25     provide in its rules and regulations the procedures, fees, and
2-26     requirements for graduates of foreign and/or nonaccredited Dental
 3-1     Schools to become licensed to practice dentistry in Texas.]
 3-2           [Sec. 3.]  Within 30 days after the day on which a licensing
 3-3     examination is administered under this article, the Board shall
 3-4     notify each examinee of the results of the examination.  However,
 3-5     if an examination is graded or reviewed by a national testing
 3-6     service, the Board shall notify examinees of the results of the
 3-7     examination within two weeks after the day that the Board receives
 3-8     the results from the testing service.  If the notice of the
 3-9     examination results will be delayed for longer than 90 days after
3-10     the examination date, the Board shall notify the examinee of the
3-11     reason for the delay before the 90th day.
3-12           (b)  If the Board contracts with an independent or regional
3-13     testing service, this section does not apply.  The contract with
3-14     the independent or regional testing service shall provide for
3-15     notification of results as provided by Subsection (a) of this
3-16     section.
3-17           Sec. 3.  (a)  [Sec. 4.]  If requested in writing by a person
3-18     who fails the licensing examination administered under this
3-19     article, the Board shall furnish the person with an analysis of the
3-20     person's performance on the examination as prescribed by Board
3-21     rule.
3-22           (b)  If the Board contracts with an independent or regional
3-23     testing service, this section does not apply.  The contract with
3-24     the independent or regional testing service shall provide for
3-25     notification of results as provided by Subsection (a) of this
3-26     section.
 4-1           Sec. 4. [Sec. 5.]  (a)  The Board shall develop a mandatory
 4-2     continuing education program.
 4-3           (b)  The Board by rule shall:
 4-4                 (1)  require a licensee to complete at least 12 [36]
 4-5     hours of continuing education for [in] each annual registration
 4-6     [three-year] period as a prerequisite to renewal for a subsequent
 4-7     annual period [to maintain licensure];
 4-8                 (2)  identify the key factors that lead to the
 4-9     competent performance of professional duties under this Act;
4-10                 (3)  develop a process to evaluate and approve
4-11     continuing education courses; and
4-12                 (4)  develop a process to assess a licensee's
4-13     participation and performance in continuing education courses that
4-14     will enable the Board to evaluate the overall effectiveness of the
4-15     program.
4-16           (c)  The Board is authorized to assess the continuing
4-17     education needs of licensees and may require licensees to attend
4-18     continuing education courses specified by the Board.
4-19           SECTION 3.  Article 4545, Revised Statutes, is amended to
4-20     read as follows:
4-21           Art. 4545.  QUALIFICATIONS OF APPLICANTS.  Each applicant for
4-22     a license to practice dentistry in this state shall be not less
4-23     than twenty-one (21) years of age and [shall present evidence] of
4-24     good moral character and shall present:
4-25                 (1)  proof of graduation from a dental school
4-26     accredited by the Commission on Dental Accreditation of the
 5-1     American Dental Association; or
 5-2                 (2)  proof of:
 5-3                       (A)  graduation from a dental school that is not
 5-4     accredited by the Commission on Dental Accreditation of the
 5-5     American Dental Association; and
 5-6                       (B)  successful completion of training in an
 5-7     American Dental Association approved specialty in an education
 5-8     program that is accredited by the Commission on Dental
 5-9     Accreditation and that consists of at least two years of training
5-10     as specified by the Council on Dental Education.
5-11           SECTION 4.  Subsection (a), Section 1, Article 4545a, Revised
5-12     Statutes, is amended to read as follows:
5-13           (a)  The State Board of Dental Examiners, upon payment by the
5-14     applicant of a fee set by the Board, shall grant a license to
5-15     practice dentistry to any reputable dentist or a license to
5-16     practice dental hygiene to any reputable [dentist or] dental
5-17     hygienist who:
5-18                 (1)  is licensed in good standing as a dentist or
5-19     dental hygienist in another state, the District of Columbia, or a
5-20     territory of the United States that has licensing requirements that
5-21     are substantially equivalent to the requirements of this Act;
5-22                 (2)  has not been the subject of final or pending
5-23     disciplinary action in any jurisdiction in which the dentist or
5-24     dental hygienist is or has been licensed;
5-25                 (3)  has graduated from a dental or dental hygiene
5-26     school accredited by the Commission on Dental Accreditation of the
 6-1     American Dental Association and approved by the Board according to
 6-2     rules established by the Board;
 6-3                 (4)  has passed a national or other examination
 6-4     recognized by the Board relating to dentistry or dental hygiene;
 6-5                 (5)  has successfully completed the Board's
 6-6     jurisprudence examination;
 6-7                 (6)  has submitted documentation of current
 6-8     cardiopulmonary resuscitation certification;
 6-9                 (7)  has practiced dentistry or dental hygiene:
6-10                       (A)  for a minimum of five years immediately
6-11     prior to applying; or
6-12                       (B)  as a dental educator at a dental school or
6-13     dental hygiene school accredited by the Commission on Dental
6-14     Accreditation of the American Dental Association for the five years
6-15     immediately preceding the date of applying for the license; and
6-16                 (8)  has met any additional criteria established by
6-17     Board rule.
6-18           SECTION 5.  Article 4547a, Revised Statutes, is amended to
6-19     read as follows:
6-20           Art. 4547a.  AID TO THE BOARD.  The Texas State Board of
6-21     Dental Examiners shall have power and authority to appoint such
6-22     committees, clerks, advisors, consultants, dentists, hygienists,
6-23     and/or examiners to aid the board to carry out its duties as it
6-24     deems necessary and advisable and may reimburse said persons so
6-25     appointed in such amounts as is reasonable and in conformity with
6-26     the provisions of the general appropriations bill as enacted by the
 7-1     Texas Legislature.
 7-2           SECTION 6.  Article 4548d, Revised Statutes, is amended to
 7-3     read as follows:
 7-4           Art. 4548d.  SHALL EXHIBIT ANNUAL REGISTRATION CERTIFICATE
 7-5     [LICENSE].  Any person authorized to practice dentistry or dental
 7-6     hygiene [surgery] in this State either under this or any former law
 7-7     of Texas, shall place the person's current registration certificate
 7-8     [his license] on exhibition in each [his] office where said dentist
 7-9     or dental hygienist provides dental services.  When a dentist or
7-10     dental hygienist provides dental services at more than one
7-11     location, the person may display a duplicate of the original
7-12     registration certificate obtained from the State Board of Dental
7-13     Examiners for a duplicate certificate fee set by the Board [license
7-14     shall be in plain view of patients].  No such person shall do any
7-15     operation in the mouth of a patient, or treat any lesions of the
7-16     mouth or teeth, without having said registration certificate
7-17     [license] so exhibited.
7-18           SECTION 7.  Article 4548e, Revised Statutes, is amended to
7-19     read as follows:
7-20           Art. 4548e.  USE OF TRADE NAME.  Any person, corporation,
7-21     company, or association may use a corporation, company,
7-22     association, or trade name.  Any advertisement by a person, [the]
7-23     corporation, company, or association[, or trade name] must include
7-24     prominently the name of at least one dentist practicing under such
7-25     name, and if the advertisement refers to one or more locations
7-26     where dental services are provided, it must include, for each
 8-1     location, the name of at least one dentist who provides services at
 8-2     that location.  The person, corporation, company, or association
 8-3     shall file with the State Board of Dental Examiners a list of all
 8-4     dentists who practice under the name and a list of each trade name
 8-5     used if the trade name is different from the corporation, company,
 8-6     or association name.  A list required under this section must be
 8-7     updated and filed with the Board not later than the 30th day after
 8-8     the date of the change.  Each day of violation of this Article
 8-9     shall constitute a separate offense.
8-10           SECTION 8.  Article 4548g, Revised Statutes, is amended to
8-11     read as follows:
8-12           Art. 4548g.  UNPROFESSIONAL CONDUCT.  It shall be unlawful
8-13     for any person, firm, or corporation to engage in or be guilty of
8-14     any unprofessional conduct pertaining to dentistry directly or
8-15     indirectly.  Any unprofessional conduct, as used herein, means and
8-16     includes any one or more of the following acts:
8-17                 (1)  obtaining or attempting to collect any fee by
8-18     fraud or misrepresentation;
8-19                 (2)  soliciting dental business by means of oral
8-20     [verbal] communication, in person or otherwise, directed to an
8-21     individual or group of less than five individuals, which is
8-22     primarily for the purpose of attracting the patronage of such
8-23     individual or group to a particular practice of dentistry;
8-24                 (3)  employing, directly or indirectly, or permitting
8-25     any unlicensed person to perform dental services upon any person,
8-26     except as otherwise authorized by law or the rules and regulations
 9-1     of the State Board of Dental Examiners;
 9-2                 (4)  claiming or circulating any statement of
 9-3     professional superiority or the performance of professional
 9-4     services in a superior manner;
 9-5                 (5)  forging, altering, or changing any diploma,
 9-6     license, registration certificate, transcript, or any other legal
 9-7     document pertaining to the practice of dentistry, being a party
 9-8     thereto or beneficiary thereof, or making any false statement about
 9-9     or in securing such document, or being guilty of misusing the same;
9-10                 (6)  accepting employment as a dentist under any
9-11     referral scheme which is false, misleading, or deceptive;
9-12                 (7)  advertising to perform any dental work without
9-13     pain or discomfort to the patient; or
9-14                 (8)  advertising predictions of future satisfaction or
9-15     success of any dental service.
9-16           SECTION 9.  Article 4549, Revised Statutes, is amended to
9-17     read as follows:
9-18           Art. 4549.  REFUSAL TO [EXAMINE OR] ISSUE LICENSE; JUDICIAL
9-19     SUSPENSIONS AND REVOCATIONS
9-20           Sec. 1.  The State Board of Dental Examiners shall have
9-21     authority to refuse to issue a license by examination to a dental
9-22     or dental hygiene applicant [examine any person or refuse to issue
9-23     a dental license or a dental hygienist license to any person] for
9-24     any one or more of the following causes:
9-25                 (a)  Proof of presentation to the Board of any
9-26     dishonest or fake evidence of qualification, or being guilty of any
 10-1    illegality, fraud, or deception in the process of examination, or
 10-2    for the purpose of securing a license or certificate.
 10-3                (b)  Proof of chronic or habitual intoxication or
 10-4    addiction to drugs on the part of the applicant.
 10-5                (c)  Proof that the applicant has been guilty of
 10-6    dishonest or illegal practices in or connected with the practice of
 10-7    dentistry or dental hygiene.
 10-8                (d)  Proof of conviction of the applicant of a felony
 10-9    under the laws of this State or any other State or of the United
10-10    States.
10-11                (e)  Proof that the applicant violated any of the
10-12    provisions of the statutes of the State of Texas relating to the
10-13    practice of dentistry or any provisions of Chapter 9, Title 71,
10-14    Revised Statutes, within 12 months before the filing of an
10-15    application for the license.
10-16          Sec. 2.  The State Board of Dental Examiners shall have
10-17    jurisdiction and authority, after notice and hearing, to suspend or
10-18    revoke a dental license or a dental hygienist license, to impose a
10-19    fine on a person licensed under this chapter, to place on probation
10-20    with conditions a person whose license or certificate is suspended,
10-21    or to reprimand a licensee or certificate holder, and in addition
10-22    to or in lieu of said suspension, revocation, probation, or
10-23    reprimand, to assess an administrative penalty as provided for in
10-24    Article 4548j, Revised Statutes, for any one or more of the
10-25    following causes:
10-26                (a)  Proof of insanity of the holder of a license or
 11-1    certificate, as adjudged by the regularly constituted authorities.
 11-2                (b)  Proof of conviction of the holder of a license or
 11-3    certificate of a misdemeanor involving fraud or any felony [or a
 11-4    misdemeanor involving fraud] under the laws of this State or any
 11-5    other State or of the United States.
 11-6                (c)  That the holder [thereof has been or] is guilty of
 11-7    dishonorable conduct[, malpractice, gross incompetency,] or failure
 11-8    to treat a patient according to the standard of care in the
 11-9    practice of dentistry or dental hygiene.
11-10                (d)  That the holder thereof has been or is guilty of
11-11    any deception or misrepresentation for the purpose of soliciting or
11-12    obtaining patronage.
11-13                (e)  That the holder thereof procured a license or
11-14    certificate through fraud or misrepresentation.
11-15                (f)  That the holder thereof is addicted to or is
11-16    habitually intemperate in [habitual intoxication or] the use of
11-17    alcoholic beverages or drugs or has improperly obtained, possessed,
11-18    used, or distributed habit-forming drugs or narcotics.
11-19                (g)  That a dentist employs or permits or has employed
11-20    or permitted persons to practice dentistry in the office or offices
11-21    under his control or management, who were not licensed to practice
11-22    dentistry.
11-23                (h)  That the holder thereof has failed to use proper
11-24    diligence in the conduct of his practice or to safeguard his
11-25    patients against avoidable infections.
11-26                (i)  That the holder thereof has failed or refused to
 12-1    comply with any State law relating to the regulation of dentists or
 12-2    dental hygienists.
 12-3                (j)  That the holder thereof has failed or refused to
 12-4    comply with the adopted and promulgated rules and regulations of
 12-5    the Board.
 12-6                (k)  That the holder thereof is physically or mentally
 12-7    incapable of practicing with safety to dental patients.
 12-8                (l)  That the holder thereof has been negligent in the
 12-9    performance of dental services which injured or damaged dental
12-10    patients.
12-11                (m)  Proof of suspension, revocation, probation,
12-12    reprimand, or other restriction by another State of a license or
12-13    certificate to practice dentistry or dental hygiene based upon acts
12-14    by the licensee or certificate holder enumerated in this section.
12-15                (n)  That the holder thereof has knowingly provided or
12-16    agreed to provide dental care in a manner which violates any
12-17    provision of federal or State law regulating a plan whereby any
12-18    person undertakes to provide, arrange for, pay for, or reimburse
12-19    any part of the cost of any dental care services or regulating the
12-20    business of insurance.
12-21          Sec. 3.  (a)  If the Board proposes to refuse to issue a
12-22    license by examination to a dental or dental hygiene applicant or
12-23    [examine a person,] to suspend or revoke a license, to impose a
12-24    fine, to place on probation a person whose license has been
12-25    suspended, or to reprimand a license holder, the person is entitled
12-26    to a hearing under Chapter 2001, Government Code.
 13-1          (b)  The hearing under this section and an appeal from the
 13-2    hearing under this section are governed by Chapter 2001, Government
 13-3    Code (Administrative Procedure Act).
 13-4          SECTION 10.  Article 4549-1.1, Revised Statutes, is amended
 13-5    to read as follows:
 13-6          Art. 4549-1.1.  SUBPOENA POWER.  The State Board of Dental
 13-7    Examiners may request and, if necessary, compel by subpoena the
 13-8    attendance of witnesses for examination under oath and the
 13-9    production for inspection and copying of books, accounts, records,
13-10    papers, correspondence, documents, and other evidence relevant to
13-11    the investigation of alleged violations of the provisions of the
13-12    statutes of the State of Texas relating to the practice of
13-13    dentistry or any provisions of this chapter.  If a person fails to
13-14    comply with a subpoena issued under this article, the board, acting
13-15    through the attorney general, may file suit to enforce the subpoena
13-16    in a district court in Travis County [or in the county in which a
13-17    hearing conducted by the board may be held].  The court, if it
13-18    determines that good cause exists for the issuance of the subpoena,
13-19    shall order compliance with the requirements of the subpoena.
13-20    Failure to obey the order of the court may be punished by the court
13-21    as contempt.
13-22          SECTION 11.  Article 4549-2, Revised Statutes, is amended to
13-23    read as follows:
13-24          Art. 4549-2.  RECORDS OF THE DENTIST.  Records of the
13-25    diagnosis made and the treatment performed for and on a dental
13-26    patient shall be the property of the dentist who performs the
 14-1    dental service and may not be sold, pledged as collateral, or
 14-2    otherwise transferred to any person other than the patient unless
 14-3    the other person is a dentist licensed by the Board and the
 14-4    transfer is made in compliance with rules relating to the transfer
 14-5    of records as may be adopted by the Board.  The owning dentist
 14-6    shall furnish to a patient, on request, copies of the patient's
 14-7    dental records in accordance with rules relating to patient records
 14-8    adopted by the Board.  Nothing herein shall prevent the voluntary
 14-9    submission of records to insurance companies for the purpose of
14-10    determining benefits.
14-11          SECTION 12.  Article 4550, Revised Statutes, is amended to
14-12    read as follows:
14-13          Art. 4550.  RECORDS OF THE BOARD
14-14          Sec. 1.  The Board shall keep records in which shall be
14-15    registered the name and permanent address [residence] and place of
14-16    business of all persons authorized under this law to practice
14-17    dentistry, dental hygiene and such other professions or businesses
14-18    under its jurisdiction as provided by law.  Each dentist, dental
14-19    hygienist, dental laboratory, and dental technician registered with
14-20    the Board shall timely notify the Board in writing of:
14-21                (1)  any change of address of the place of business of
14-22    such dentist, hygienist, laboratory, or technician; and
14-23                (2)  any change of employers by such dentist,
14-24    hygienist, laboratory, or technician, and any change of owners of
14-25    the laboratory.
14-26          The Board is timely notified if it receives the notice within
 15-1    60 days after the date the change occurs.
 15-2          Sec. 2.  All of the records and files of the State Board of
 15-3    Dental Examiners shall be public records and open to inspection at
 15-4    reasonable times, except the investigation files and records which
 15-5    shall be confidential and shall be divulged only to persons so
 15-6    investigated upon completion of said investigation.  It is not a
 15-7    violation of this section for the Board to share investigation
 15-8    files and records with another state regulatory agency or a local,
 15-9    state, or federal law enforcement agency [during the course of a
15-10    joint investigation or in determining the feasibility of conducting
15-11    an investigation].
15-12          SECTION 13.  Section 1, Article 4550a, Revised Statutes, is
15-13    amended to read as follows:
15-14          Sec. 1.  It shall be the duty of all persons holding a dental
15-15    license or dental hygienist license issued by the State Board of
15-16    Dental Examiners to annually apply and to be registered as such
15-17    practitioners with the State Board of Dental Examiners on or before
15-18    the expiration date of the license [March 1st of each calendar
15-19    year].  Each person so registering shall pay in connection with
15-20    such annual registration for the receipt hereinafter provided for,
15-21    a fee as determined by said Board according to the needs of said
15-22    Board, such payment to be made by each person to such Board, and
15-23    every person so registering shall file with said Board a written
15-24    application setting forth such facts as the Board may require.  A
15-25    person holding a dental or dental hygienist license must attach to
15-26    the application proof that the applicant has successfully completed
 16-1    a current course [of current certification] in cardiopulmonary
 16-2    resuscitation given or approved by the American Heart Association
 16-3    or American Red Cross or, in the event that the applicant [person]
 16-4    is not physically capable of successfully completing such training,
 16-5    a written statement executed by either a licensed physician or an
 16-6    instructor in cardiopulmonary resuscitation approved by the
 16-7    American Heart Association or American Red Cross that describes
 16-8    such physical incapacity.  In lieu of this requirement for
 16-9    completion of a current course in [annual] cardiopulmonary
16-10    resuscitation [certification], a dentist or dental hygienist
16-11    licensed by the State Board of Dental Examiners and residing in a
16-12    country other than the United States may satisfy this requirement
16-13    by submitting proof of residence upon the annual date of renewal.
16-14    Upon receipt of such applications, accompanied by such fees, said
16-15    Board, after ascertaining either from its records or other sources
16-16    deemed by it to be reliable that the applicant holds a valid
16-17    license or certificate to practice in this State, shall issue to
16-18    the applicant an annual registration certificate or receipt
16-19    certifying that he has filed such application and has paid the
16-20    required fee; provided that the filing of such application, the
16-21    payment of such fee, and the issuance of such receipt therefor
16-22    shall not entitle the holder thereof to lawfully practice within
16-23    the State of Texas unless he in fact holds a license or certificate
16-24    as such practitioner issued by the State Board of Dental Examiners,
16-25    as provided by this law, and unless said license or certificate is
16-26    in full force and effect; and provided further, that in any
 17-1    prosecution for unlawful practice such receipt showing payment of
 17-2    the annual registration fee required by this chapter shall not be
 17-3    treated as evidence that the holder thereof is lawfully entitled to
 17-4    practice.
 17-5          SECTION 14.  Subsections (c), (d), (e), and (h), Section 2,
 17-6    Article 4550a, Revised Statutes, are amended to read as follows:
 17-7          (c)  If a person's license or certificate has been expired
 17-8    for not longer than ninety (90) days, the person may renew it by
 17-9    paying to the Board the required renewal fee and a fee that is
17-10    one-half of the application [examination] fee for the license or
17-11    certificate.
17-12          (d)  If a person's license or certificate has been expired
17-13    for longer than ninety (90) days but less than one year, the person
17-14    may renew it by paying to the Board all unpaid renewal fees and a
17-15    fee that is equal to the application [examination] fee for the
17-16    license or certificate.
17-17          (e)  If a person's license or certificate has been expired
17-18    for one year or longer, the person may not renew it[, except as
17-19    provided by Section 2A of this article].  The person may obtain a
17-20    new license or certificate by submitting to reexamination and
17-21    complying with the requirements and procedures for obtaining an
17-22    original license or certificate.  However, the Board may adopt
17-23    rules providing for renewal without reexamination of an expired
17-24    license of a person who was licensed in this state, moved to
17-25    another state, and is currently licensed and has been in practice
17-26    in the other state for the two years preceding application.  The
 18-1    person must pay to the Board a fee that is equal to the examination
 18-2    fee for the license.
 18-3          (h)  The Board by rule may adopt a system under which
 18-4    licenses expire on various dates during the year.  [For the year in
 18-5    which the license expiration date is changed, license fees payable
 18-6    on March 1 shall be prorated on a monthly basis so that each
 18-7    licensee shall pay only that portion of the license fee that is
 18-8    allocable to the number of months during which the license is
 18-9    valid.  On renewal of the license on the new expiration date, the
18-10    total license renewal fee is payable.]
18-11          SECTION 15.  Subsection (i), Section 4, Article 4550a,
18-12    Revised Statutes, is amended to read as follows:
18-13          (i)  The Board shall develop and implement policies that
18-14    provide the public with a reasonable opportunity to appear before
18-15    the Board and to speak on any issue under the jurisdiction of the
18-16    Board, except to the extent that that communication would be ex
18-17    parte under any provision of law.
18-18          SECTION 16.  Subsection (a), Article 4550c, Revised Statutes,
18-19    is amended to read as follows:
18-20          (a)  Each dental application [examination] fee and dentist
18-21    annual renewal fee imposed by or under Subsection (b), Article
18-22    4551, Revised Statutes, is increased by $200.
18-23          SECTION 17.  Article 4551a, Revised Statutes, is amended to
18-24    read as follows:
18-25          Art. 4551a.  PERSONS REGARDED AS PRACTICING DENTISTRY.  Any
18-26    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
 20-1    constructing or aiding in the construction of any dental appliance,
 20-2    denture, dental bridge, false teeth, dental plate or plates of
 20-3    false teeth, or any other substitute for human teeth.
 20-4                (4)  Any one who owns, manages, maintains, or operates
 20-5    any office or place of business where he employs or engages, under
 20-6    any kind of contract whatsoever, any other person or persons to
 20-7    practice dentistry as above defined shall be deemed to be
 20-8    practicing dentistry himself and shall himself be required to be
 20-9    duly licensed to practice dentistry as hereinabove defined, and
20-10    shall be subject to all of the other provisions of this Chapter,
20-11    even though the person or persons so employed or engaged by him
20-12    shall be duly licensed to practice dentistry as hereinabove
20-13    defined, unless otherwise provided by law.
20-14                (5)  Any person, firm, group, association, or
20-15    corporation who shall offer or undertake to fit, adjust, repair, or
20-16    substitute in the human mouth or directly related and adjacent
20-17    masticatory structures any dental appliance, structure, prosthesis,
20-18    or denture, or who shall aid or cause to be fitted, adjusted,
20-19    repaired, or substituted in the human mouth or directly related and
20-20    adjacent masticatory structures any dental appliance, structure,
20-21    prosthesis, or denture.
20-22                (6)  Who makes, fabricates, processes, constructs,
20-23    produces, reproduces, duplicates, repairs, relines, or fixes any
20-24    full or partial denture, any fixed or removable dental bridge or
20-25    appliance, any dental plate or plates of false teeth, any
20-26    artificial dental restoration, or any substitute or corrective
 21-1    device or appliance for the human teeth, gums, jaws, mouth,
 21-2    alveolar process, or any part thereof for another, or who in any
 21-3    manner offers, undertakes, aids, abets, or causes another person so
 21-4    to do for another, without a written prescription or work-order
 21-5    therefor signed by the dentist legally engaged in the practice of
 21-6    dentistry in this state or in the jurisdiction where such dentist
 21-7    maintains his dental office and who prescribed and ordered same.
 21-8                (7)  Who shall offer or undertake or cause another to
 21-9    do, directly or indirectly, for any person any act, service, or
21-10    work in the practice of dentistry or any part thereof as provided
21-11    for in the laws of Texas relating to the practice of dentistry
21-12    including without limitation the inducing, administering,
21-13    prescribing, or dispensing any anesthesia, anesthetic drug,
21-14    medicine, or agent in anywise incidental to or in connection with
21-15    the practice of dentistry; or who permits or allows another to use
21-16    his license or certificate to practice dentistry in this state for
21-17    the purpose of performing any act described in this Article; or who
21-18    shall aid or abet, directly or indirectly, the practice of
21-19    dentistry by any person not duly licensed to practice dentistry by
21-20    the State Board of Dental Examiners.
21-21                (8)  Who shall control, attempt to control, influence,
21-22    attempt to influence, through a management agreement, or otherwise
21-23    interfere with the exercise of a dentist's independent professional
21-24    judgment regarding the diagnosis or treatment of any dental
21-25    disease, disorder, or physical condition.  Rules adopted by the
21-26    Board addressing the prohibitions in this section may prohibit a
 22-1    person who is not a dentist from directly or indirectly influencing
 22-2    or interfering with the exercise of a dentist's independent
 22-3    professional judgment.  However, nothing herein shall be construed
 22-4    to require any entity to pay for services which are not provided
 22-5    for in a contract or agreement or to exempt any dentist who is a
 22-6    member of a hospital staff from adhering to hospital bylaws,
 22-7    medical staff bylaws, or established policies approved by the
 22-8    governing board and the medical and dental staff of the hospital.
 22-9                (9)  If the person holds the person out to be a
22-10    denturist or uses another title that is intended to convey to the
22-11    public that the services offered by the person are included within
22-12    the practice of dentistry.
22-13          SECTION 18.  Section 11, Chapter 244, General Laws, Acts of
22-14    the 44th Legislature, Regular Session, 1935 (Article 4551b,
22-15    Vernon's Texas Civil Statutes), is amended to read as follows:
22-16          Sec. 11.  The definition of dentistry as contained in Chapter
22-17    9, Title 71, Revised Statutes, shall not apply to:
22-18                (1)  members of the faculty of a reputable dental or
22-19    dental hygiene college or school where such faculty members perform
22-20    their services for the sole benefit of such school or college;
22-21                (2)  students of a reputable dental college who perform
22-22    their operations without pay except for actual cost of materials,
22-23    in the presence of and under the direct personal supervision of a
22-24    demonstrator or teacher who is a member of the faculty of a
22-25    reputable dental college;
22-26                (3)  persons doing laboratory work on inert matter
 23-1    only, and who do not solicit or obtain work, by any means, from a
 23-2    person or persons not a licensed dentist actually engaged in the
 23-3    practice of dentistry and who do not act as the agents or
 23-4    solicitors of, or have any interest whatsoever in, any dental
 23-5    office, practice or the receipts therefrom;
 23-6                (4)  physicians and surgeons legally authorized to
 23-7    practice medicine as defined by the law of this state who do not
 23-8    hold themselves out to the public as practicing dentistry;
 23-9                (5)  dental hygienists legally authorized to practice
23-10    dental hygiene in this state and who practice dental hygiene in
23-11    strict conformity with the laws of Texas regulating the practice of
23-12    dental hygiene;
23-13                (6)  those persons who as members of an established
23-14    church practice healing by prayer only;
23-15                (7)  employees of a dentist who make dental x-rays in
23-16    the dental office and under the supervision of such dentist or
23-17    dentists legally engaged in the practice of dentistry in this
23-18    state;
23-19                (8)  Dental Health Service Corporations legally
23-20    chartered under Section A(1), Article 2.01, Texas Non-Profit
23-21    Corporation Act (Article 1396-2.01, Vernon's Texas Civil Statutes);
23-22                (9)  dental interns and dental residents as defined and
23-23    regulated by the Texas State Board of Dental Examiners in its rules
23-24    and regulations;
23-25                (10)  a student [students] of a dental hygiene program
23-26    accredited by the Commission on Dental Accreditation of the
 24-1    American Dental Association and operated at an accredited
 24-2    institution of higher education who practices [practice] dental
 24-3    hygiene:
 24-4                      (A)  without pay under the general supervision of
 24-5    a dentist and under the supervision of a demonstrator or teacher
 24-6    who is a member of the faculty of that program;
 24-7                      (B)  in strict conformity with the laws of this
 24-8    state regulating the practice of dental hygiene, except that they
 24-9    may practice under the supervision of a demonstrator or teacher who
24-10    is a dentist member of the faculty of that program; and
24-11                      (C)  in a clinic operated:
24-12                            (i)  for the sole benefit of the program's
24-13    institution of higher education; or
24-14                            (ii)  [in a clinic operated] by a
24-15    government or nonprofit organization that serves underserved
24-16    populations, as determined by rule of the State Board of Dental
24-17    Examiners [and in strict conformity with the laws of this state
24-18    regulating the practice of dental hygiene];
24-19                (11)  dental assistants who perform the duties
24-20    permitted by Article 4551e-1, Revised Statutes, in strict
24-21    conformity with the laws of this state; [or]
24-22                (12)  dentists and dental hygienists licensed by
24-23    another state or foreign country who perform clinical procedures
24-24    only for professional and technical education demonstration
24-25    purposes, provided that such dentists and dental hygienists must
24-26    first obtain a temporary license for such purpose from the State
 25-1    Board of Dental Examiners;
 25-2                (13)  a dental hygienist who is a faculty member of a
 25-3    dental or dental hygiene school while practicing dental hygiene
 25-4    only:
 25-5                      (A)  under the supervision of a dentist licensed
 25-6    in Texas or of a teacher or demonstrator who is a dentist faculty
 25-7    member of the school; and
 25-8                      (B)  otherwise, in strict conformity with the
 25-9    laws regulating the practice of dental hygiene;
25-10                (14)  a dentist enrolled in remedial training programs
25-11    sponsored by the Commission on Dental Accreditation of the American
25-12    Dental Association at an accredited dental or dental hygiene school
25-13    while participating in such a program in this state;
25-14                (15)  a dental hygienist enrolled in remedial training
25-15    programs sponsored by the Commission on Dental Accreditation of the
25-16    American Dental Association at an accredited dental or dental
25-17    hygiene school while participating in such a program in this state
25-18    in strict conformity with the laws regulating the practice of
25-19    dental hygiene, except that supervision may be provided by a
25-20    demonstrator or teacher who is a dentist member of the program;
25-21                (16)  a dentist who is not licensed in this state and
25-22    who is a candidate enrolled to take the dental clinical examination
25-23    offered by the Western Regional Examining Board in this state while
25-24    taking the examination;
25-25                (17)  a dental hygienist who is not licensed in this
25-26    state and who is a candidate enrolled to take the dental hygiene
 26-1    clinical examination offered by the Western Regional Examining
 26-2    Board in this state while taking the examination if participation
 26-3    is in strict conformity with the laws of this state regulating the
 26-4    practice of dental hygiene, except that supervision may be provided
 26-5    by a dentist whose services are secured by the Western Regional
 26-6    Examining Board;
 26-7                (18)  a dentist whose license is in retired status or
 26-8    who is licensed in another state and is attending a continuing
 26-9    education clinical program offered at a dental or dental hygiene
26-10    school accredited by the Commission on Dental Accreditation of the
26-11    American Dental Association while attending the program; or
26-12                (19)  a dental hygienist whose dental hygienist license
26-13    is in  retired status or who is licensed in another state and is
26-14    attending a continuing education clinical program offered at a
26-15    dental or dental hygiene school accredited by the Commission on
26-16    Dental Accreditation of the American Dental Association while
26-17    attending the program if tasks are performed in strict conformity
26-18    with the laws regulating the practice of dental hygiene, except
26-19    that supervision may be provided by a dentist member of the
26-20    program.
26-21          SECTION 19.  Section 2, Chapter 475, Acts of the 52nd
26-22    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
26-23    Civil Statutes), is amended to read as follows:
26-24          Sec. 2.  QUALIFICATIONS.  Each applicant for a license to
26-25    practice [A] dental hygiene in this state [hygienist] shall be:
26-26                (1)  not less than eighteen (18) years of age;
 27-1                (2)  of good moral character;
 27-2                (3)  [and] a graduate of an accredited high school or
 27-3    hold a certificate of high school equivalency (GED); and
 27-4                (4)  [be]  a graduate of a recognized school or college
 27-5    of dentistry or dental hygiene accredited by the Commission on
 27-6    Dental Accreditation of the American Dental Association and
 27-7    approved by the State Board of Dental Examiners that includes at
 27-8    least two full academic years of instruction or its equivalent at
 27-9    the postsecondary level.
27-10          SECTION 20.  Subsection (b), Section 3, Chapter 475, Acts of
27-11    the 52nd Legislature, Regular Session, 1951 (Article 4551e,
27-12    Vernon's Texas Civil Statutes), is amended to read as follows:
27-13          (b)  All work performed by a dental hygienist in the practice
27-14    of dental hygiene, as defined in this Act, shall be performed in
27-15    the dental office of the supervising dentist or dentists who are
27-16    legally engaged in the practice of dentistry in this state[, by
27-17    whom he or she must be employed,] or under the supervision of a
27-18    supervising dentist in an alternate setting, including, but not
27-19    limited to, a nursing home, [or] the patient's home, a school, a
27-20    hospital, a state institution, a public health clinic, or another
27-21    institution [provided that the hygienist is licensed to perform the
27-22    delegated procedure and the supervising dentist examines the
27-23    patient during the 12 months preceding the performance of the
27-24    procedure by the dental hygienist or at the time the procedure is
27-25    performed, except where employed by schools, hospitals, state
27-26    institutions, public health clinics or other institutions that have
 28-1    applied to and been approved by the Texas State Board of Dental
 28-2    Examiners as a proper location for the performance of a dental
 28-3    procedure].
 28-4          SECTION 21.  Subsection (d), Section 4A, Chapter 475, Acts of
 28-5    the 52nd Legislature, Regular Session, 1951 (Article 4551e,
 28-6    Vernon's Texas Civil Statutes), is amended to read as follows:
 28-7          (d)  A member of the advisory committee is entitled to the
 28-8    compensatory per diem set by the General Appropriations Act for
 28-9    each day that the member engages in committee business.  [Except
28-10    for transportation expenses, a member is not entitled to
28-11    reimbursement for travel expenses.]  A member may receive [is
28-12    entitled to] reimbursement for travel [transportation] expenses,
28-13    including expenses for meals and lodging [as provided by the
28-14    General Appropriations Act].
28-15          SECTION 22.  Section 5, Chapter 475, Acts of the 52nd
28-16    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
28-17    Civil Statutes), is amended to read as follows:
28-18          Sec. 5.  EXAMINATION.  (a)  It shall be the duty of the Board
28-19    to provide for the examination of all qualified applicants for
28-20    licensure as dental hygienists in this State.  All applicants for
28-21    licensure [examination] shall pay an application [a] fee set by the
28-22    Board to said Board as determined by said Board according to its
28-23    needs and shall apply upon forms furnished by the Board and shall
28-24    furnish such other information as the Board may in its discretion
28-25    require to determine any applicant's qualifications.  An applicant
28-26    must attach to the application proof that the applicant has
 29-1    successfully completed a current course in cardiopulmonary
 29-2    resuscitation given or approved by the American Heart Association
 29-3    or American Red Cross before the date on which the applicant
 29-4    submits the application or, in the event that the applicant is not
 29-5    physically capable of successfully completing such training, a
 29-6    written statement executed by either a licensed physician or an
 29-7    instructor in cardiopulmonary resuscitation approved by the
 29-8    American Heart Association or American Red Cross that describes
 29-9    such physical incapacity.
29-10          (b)  The examination shall be taken by all applicants on such
29-11    subjects and operations pertaining to dentistry and dental hygiene
29-12    which shall include Dental Anatomy, Pharmacology, X-Ray, Ethics,
29-13    Jurisprudence, and Hygiene, and such other subjects as are
29-14    regularly taught in reputable schools of dentistry and dental
29-15    hygiene, as the Board in its discretion may require.
29-16          (c)  The Board shall contract with an independent or regional
29-17    testing service for any required clinical examination.
29-18          (d)  In the event that the Board uses a regional testing
29-19    service, the Board is authorized to contract for or otherwise use
29-20    the services of licensed dental hygienists in this State for the
29-21    purpose of providing assistance to the regional testing service.
29-22          (e)  The Board shall have the written portion of the Board's
29-23    jurisprudence examination validated by an independent testing
29-24    professional.
29-25          (f)  The Board shall report such grades to the applicant
29-26    within a reasonable time after such examination.  If the Board
 30-1    contracts with an independent or regional testing service, the
 30-2    contract with the independent or regional testing service shall
 30-3    provide for notification of results.  Each[, and each] applicant
 30-4    who has satisfactorily passed all phases of the examination as
 30-5    determined by the Board shall be entitled to and shall be issued a
 30-6    license permitting such applicant to practice dental hygiene in the
 30-7    State of Texas as is defined and regulated by the law of this
 30-8    State.
 30-9          (g) [(b)]  The Board by rule shall set the number of and
30-10    conditions for examination retakes.  The Board may require an
30-11    applicant who fails the examination to meet additional education
30-12    requirements set by the Board.
30-13          SECTION 23.  Subsection (b), Section 5A, Chapter 475, Acts of
30-14    the 52nd Legislature, Regular Session, 1951 (Article 4551e,
30-15    Vernon's Texas Civil Statutes), is amended to read as follows:
30-16          (b)  The State Board of Dental Examiners by rule shall:
30-17                (1)  require a licensee to complete at least 12 [36]
30-18    hours of continuing education for [in] each annual registration
30-19    [three-year] period as a prerequisite to renewal for a subsequent
30-20    annual period [to maintain licensure];
30-21                (2)  identify the key factors that lead to the
30-22    competent performance of professional duties under this Act;
30-23                (3)  develop a process to evaluate and approve
30-24    continuing education courses; and
30-25                (4)  develop a process to assess a licensee's
30-26    participation and performance in continuing education courses that
 31-1    will enable the Board to evaluate the overall effectiveness of the
 31-2    program.
 31-3          SECTION 24.  Subsections (c) and (d), Section (6), Article
 31-4    4551f, Revised Statutes, are amended to read as follows:
 31-5          (c)  If the owner or manager of a dental laboratory required
 31-6    to be registered under this section fails to renew the registration
 31-7    and pay the annual renewal fee before the expiration date as set by
 31-8    the Board, the Board shall suspend the registration certificate of
 31-9    that laboratory.  An owner or manager may renew an unexpired
31-10    certificate by paying the required renewal fee to the Board on or
31-11    before the expiration date.  If the certificate has been expired
31-12    for not more than 90 days, the owner or manager may renew the
31-13    certificate by paying to the Board the required renewal fee and a
31-14    fee equal to one-half the renewal fee.  If the certificate has been
31-15    expired for more than 90 days but less than one year [two years],
31-16    the owner or manager may renew the certificate by paying to the
31-17    Board all unpaid renewal fees and a fee equal to the amount of the
31-18    initial registration fee.  If the certificate has been expired for
31-19    one year [two years] or longer, the owner or manager may not renew
31-20    the certificate.  To reinstate the certificate, the owner or
31-21    manager must comply with the requirements for obtaining an original
31-22    certificate.
31-23          (d)  The owner of a dental laboratory registered with the
31-24    Board on September 1, 1987, is not required to submit proof that
31-25    the laboratory has at least one certified dental technician
31-26    employed by and working on the premises of the laboratory if:
 32-1                (1)  the registration of the laboratory has been
 32-2    renewed each year [continuous] since that date and all registration
 32-3    fees have been paid;
 32-4                (2)  the beneficial ownership of at least 51 percent of
 32-5    the laboratory has not been transferred; and
 32-6                (3)  the owner is employed on the premises of the
 32-7    laboratory not less than 30 hours each week.
 32-8          SECTION 25.  Article 4551j, Revised Statutes, is amended to
 32-9    read as follows:
32-10          Art. 4551j.  CIVIL IMMUNITY, OFFICIAL ACTS.  In the absence
32-11    of fraud, conspiracy, or malice, no member of the Texas State Board
32-12    of Dental Examiners, its employees, part-time employees, or persons
32-13    who contract with the board, nor any witness called to testify by
32-14    said board, nor any consultant or hearing officer appointed by said
32-15    board shall be liable or subject to suit or suits for damages for
32-16    alleged injury, wrong, loss, or damage allegedly caused by any of
32-17    said persons for any investigation, report, recommendation,
32-18    statement, evaluation, finding, order, or award made in the course
32-19    of any of said persons performing assigned, designated, official,
32-20    or statutory duties.  This immunity is enacted to relieve and
32-21    protect the persons named from being harassed and threatened with
32-22    legal action while attempting to perform official duties.
32-23          SECTION 26.  Section 2, Article 4544a, Revised Statutes, is
32-24    repealed.
32-25          SECTION 27.  Subsection (b), Section 5, Article 4544, Revised
32-26    Statutes, Subsection (b), Section 5A, Chapter 475, Acts of the 52nd
 33-1    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
 33-2    Civil Statutes), and Subsection (c), Section (6), Article 4551f,
 33-3    Revised Statutes, as amended by this Act, apply only to licenses
 33-4    and registrations that expire after the effective date of this Act.
 33-5    Licenses and registrations in effect the day before the effective
 33-6    date of this Act continue to be valid and expire according to their
 33-7    own terms.
 33-8          SECTION 28.  This Act takes effect September 1, 1999.
 33-9          SECTION 29.  The importance of this legislation and the
33-10    crowded condition of the calendars in both houses create an
33-11    emergency and an imperative public necessity that the
33-12    constitutional rule requiring bills to be read on three several
33-13    days in each house be suspended, and this rule is hereby suspended.