By Lucio                                               S.B. No. 964
         76R5949 GJH-F                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the regulation of dentists and dental hygienists.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Sections 3(a) and (b), Article 4543a, Revised
 1-5     Statutes, are amended to read as follows:
 1-6           (a)  An officer, employee, or paid consultant of a Texas
 1-7     trade association in the field of health care may not be a member
 1-8     or employee of the Board who is exempt from the state's position
 1-9     classification plan or is compensated at or above the amount
1-10     prescribed by the General Appropriations Act for B9 [step 1, salary
1-11     group 17,] of the position classification salary schedule.
1-12           (b)  A person who is the spouse of an officer, manager, or
1-13     paid consultant of a Texas trade association in the field of health
1-14     care may not be a Board member and may not be a Board employee who
1-15     is exempt from the state's position classification plan or is
1-16     compensated at or above the amount prescribed by the General
1-17     Appropriations Act for B9 [step 1, salary group 17,] of the
1-18     position classification salary schedule.
1-19           SECTION 2.  Section 1, Article 4544, Revised Statutes, is
1-20     amended to read as follows:
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           SECTION 3.  Section 3, Article 4544, Revised Statutes, is
2-25     amended to read as follows:
2-26           Sec. 3.   (a)  Within 30 days after the day on which a
2-27     licensing examination is administered under this article, the Board
 3-1     shall notify each examinee of the results of the examination.
 3-2     However, if an examination is graded or reviewed by a national
 3-3     testing service, the Board shall notify examinees of the results of
 3-4     the examination within two weeks after the day that the Board
 3-5     receives the results from the testing service.  If the notice of
 3-6     the examination results will be delayed for longer than 90 days
 3-7     after the examination date, the Board shall notify the examinee of
 3-8     the reason for the delay before the 90th day.
 3-9           (b)  If the Board contracts with an independent or regional
3-10     testing service, this section does not apply.  The contract with
3-11     the independent or regional testing service shall provide for
3-12     notification of results as provided by Subsection (a) of this
3-13     section.
3-14           SECTION 4.  Section 4, Article 4544, Revised Statutes, is
3-15     amended to read as follows:
3-16           Sec. 4.   (a)  If requested in writing by a person who fails
3-17     the licensing examination administered under this article, the
3-18     Board shall furnish the person with an analysis of the person's
3-19     performance on the examination as prescribed by Board rule.
3-20           (b)  If the Board contracts with an independent or regional
3-21     testing service, this section does not apply.  The contract with
3-22     the independent or regional testing service shall provide for
3-23     notification of results as provided by Subsection (a) of this
3-24     section.
3-25           SECTION 5.  Section 5(b), Article 4544, Revised Statutes, is
3-26     amended to read as follows:
3-27           (b)  The Board by rule shall:
 4-1                 (1)  require a licensee to complete at least 12 [36]
 4-2     hours of continuing education for [in] each annual registration
 4-3     [three-year]  period as a prerequisite to renewal for a subsequent
 4-4     annual period [to maintain licensure];
 4-5                 (2)  identify the key factors that lead to the
 4-6     competent performance of professional duties under this Act;
 4-7                 (3)  develop a process to evaluate and approve
 4-8     continuing education courses; and
 4-9                 (4)  develop a process to assess a licensee's
4-10     participation and performance in continuing education courses that
4-11     will enable the Board to evaluate the overall effectiveness of the
4-12     program.
4-13           SECTION 6.  Article 4545, Revised Statutes, is amended to
4-14     read as follows:
4-15           Art. 4545.  QUALIFICATIONS OF APPLICANTS.  Each applicant for
4-16     a license to practice dentistry in this state shall be not less
4-17     than twenty-one (21) years of age and [shall present evidence] of
4-18     good moral character and shall present:
4-19                 (1)  proof of graduation from a dental school
4-20     accredited by the Commission on Dental Accreditation of the
4-21     American Dental Association; or
4-22                 (2)  proof of:
4-23                       (A)  graduation from a dental school that is not
4-24     accredited by the Commission on Dental Accreditation of the
4-25     American Dental Association; and
4-26                       (B)  successful completion of training in an
4-27     American Dental Association approved specialty in an education
 5-1     program that is accredited by the Commission on Dental
 5-2     Accreditation and that consists of at least two years of training
 5-3     as specified by the Council on Dental Education.
 5-4           SECTION 7.  Section 1(a), Article 4545a, Revised Statutes, is
 5-5     amended to read as follows:
 5-6           (a)  The State Board of Dental Examiners, upon payment by the
 5-7     applicant of a fee set by the Board, shall grant a license to
 5-8     practice dentistry to any reputable dentist or a license to
 5-9     practice dental hygiene to any reputable [dentist or] dental
5-10     hygienist who:
5-11                 (1)  is licensed in good standing as a dentist or
5-12     dental hygienist in another state, the District of Columbia, or a
5-13     territory of the United States that has licensing requirements that
5-14     are substantially equivalent to the requirements of this Act;
5-15                 (2)  has not been the subject of final or pending
5-16     disciplinary action in any jurisdiction in which the dentist or
5-17     dental hygienist is or has been licensed;
5-18                 (3)  has graduated from a dental or dental hygiene
5-19     school accredited by the Commission on Dental Accreditation of the
5-20     American Dental Association and approved by the Board according to
5-21     rules established by the Board;
5-22                 (4)  has passed a national or other examination
5-23     recognized by the Board relating to dentistry or dental hygiene;
5-24                 (5)  has successfully completed the Board's
5-25     jurisprudence examination;
5-26                 (6)  has submitted documentation of current
5-27     cardiopulmonary resuscitation certification;
 6-1                 (7)  has practiced dentistry or dental hygiene:
 6-2                       (A)  for a minimum of five years immediately
 6-3     prior to applying; or
 6-4                       (B)  as a dental educator at a dental school or
 6-5     dental hygiene school accredited by the Commission on Dental
 6-6     Accreditation of the American Dental Association for the five years
 6-7     immediately preceding the date of applying for the license; and
 6-8                 (8)  has met any additional criteria established by
 6-9     Board rule.
6-10           SECTION 8.  Article 4547a, Revised Statutes, is amended to
6-11     read as follows:
6-12           Art. 4547a.  AID TO THE BOARD.  The Texas State Board of
6-13     Dental Examiners shall have power and authority to appoint such
6-14     committees, clerks, advisors, consultants, dentists, hygienists,
6-15     and/or examiners to aid the board to carry out its duties as it
6-16     deems necessary and advisable and may reimburse said persons so
6-17     appointed in such amounts as is reasonable and in conformity with
6-18     the provisions of the general appropriations bill as enacted by the
6-19     Texas Legislature.
6-20           SECTION 9.  Article 4548d, Revised Statutes, is amended to
6-21     read as follows:
6-22           Art. 4548d.  SHALL EXHIBIT ANNUAL REGISTRATION CERTIFICATE
6-23     [LICENSE].  Any person authorized to practice dentistry or dental
6-24     hygiene [surgery] in this State either under this or any former law
6-25     of Texas, shall place the person's current registration certificate
6-26     [his license] on exhibition in each [his] office where said dentist
6-27     or dental hygienist provides dental services.  When a dentist or
 7-1     dental hygienist provides dental services at more than one
 7-2     location, the person may display a duplicate of the original
 7-3     registration certificate obtained from the State Board of Dental
 7-4     Examiners for a duplicate certificate fee set by the Board [license
 7-5     shall be in plain view of patients].  No such person shall do any
 7-6     operation in the mouth of a patient, or treat any lesions of the
 7-7     mouth or teeth, without having said registration certificate
 7-8     [license] so exhibited.
 7-9           SECTION 10.  Article 4548e, Revised Statutes, is amended to
7-10     read as follows:
7-11           Art. 4548e. USE OF TRADE NAME.   Any person, corporation,
7-12     company, or association may use a corporation, company,
7-13     association, or trade name.  Any advertisement by a person, [the]
7-14     corporation, company, or association[, or trade name] must include
7-15     prominently the name of at least one dentist practicing under such
7-16     name, and if the advertisement refers to one or more locations
7-17     where dental services are provided, it must include, for each
7-18     location, the name of at least one dentist who provides services at
7-19     that location.  The person, corporation, company, or association
7-20     shall file with the State Board of Dental Examiners a list of all
7-21     dentists who practice under the name and a list of each trade name
7-22     used if the trade name is different from the corporation, company,
7-23     or association name.  A list required under this section must be
7-24     updated and filed with the Board not later than the 30th day after
7-25     the date of the change.  Each day of violation of this Article
7-26     shall constitute a separate offense.
7-27           SECTION 11.  Article 4548g, Revised Statutes, is amended to
 8-1     read as follows:
 8-2           Art. 4548g. UNPROFESSIONAL CONDUCT.  It shall be unlawful for
 8-3     any person, firm, or corporation to engage in or be guilty of any
 8-4     unprofessional conduct pertaining to dentistry directly or
 8-5     indirectly.  Any unprofessional conduct, as used herein, means and
 8-6     includes any one or more of the following acts:
 8-7                 (1)  obtaining or attempting to collect any fee by
 8-8     fraud or misrepresentation;
 8-9                 (2)  soliciting dental business by means of oral
8-10     [verbal] communication, in person or otherwise, directed to an
8-11     individual or group of less than five individuals, which is
8-12     primarily for the purpose of attracting the patronage of such
8-13     individual or group to a particular practice of dentistry;
8-14                 (3)  employing, directly or indirectly, or permitting
8-15     any unlicensed person to perform dental services upon any person,
8-16     except as otherwise authorized by law or the rules and regulations
8-17     of the State Board of Dental Examiners;
8-18                 (4)  claiming or circulating any statement of
8-19     professional superiority or the performance of professional
8-20     services in a superior manner;
8-21                 (5)  forging, altering, or changing any diploma,
8-22     license, registration certificate, transcript, or any other legal
8-23     document pertaining to the practice of dentistry, being a party
8-24     thereto or beneficiary thereof, or making any false statement about
8-25     or in securing such document, or being guilty of misusing the same;
8-26                 (6)  accepting employment as a dentist under any
8-27     referral scheme which is false, misleading, or deceptive;
 9-1                 (7)  advertising to perform any dental work without
 9-2     pain or discomfort to the patient; or
 9-3                 (8)  advertising predictions of future satisfaction or
 9-4     success of any dental service.
 9-5           SECTION 12.  Article 4549, Revised Statutes, is amended to
 9-6     read as follows:
 9-7           Art. 4549. REFUSAL TO [EXAMINE OR] ISSUE LICENSE;  JUDICIAL
 9-8     SUSPENSIONS AND REVOCATIONS
 9-9           Sec. 1.  The State Board of Dental Examiners shall have
9-10     authority to refuse to issue a license by examination to a dental
9-11     or dental hygiene applicant [examine any person or refuse to issue
9-12     a dental license or a dental hygienist license to any person] for
9-13     any one or more of the following causes:
9-14                 (a)  Proof of presentation to the Board of any
9-15     dishonest or fake evidence of qualification, or being guilty of any
9-16     illegality, fraud, or deception in the process of examination, or
9-17     for the purpose of securing a license or certificate.
9-18                 (b)  Proof of chronic or habitual intoxication or
9-19     addiction to drugs on the part of the applicant.
9-20                 (c)  Proof that the applicant has been guilty of
9-21     dishonest or illegal practices in or connected with the practice of
9-22     dentistry or dental hygiene.
9-23                 (d)  Proof of conviction of the applicant of a felony
9-24     under the laws of this State or any other State or of the United
9-25     States.
9-26                 (e)  Proof that the applicant violated any of the
9-27     provisions of the statutes of the State of Texas relating to the
 10-1    practice of dentistry or any provisions of Chapter 9, Title 71,
 10-2    Revised Statutes, within 12 months before the filing of an
 10-3    application for the license.
 10-4          Sec. 2.   The State Board of Dental Examiners shall have
 10-5    jurisdiction and authority, after notice and hearing, to suspend or
 10-6    revoke a dental license or a dental hygienist license, to impose a
 10-7    fine on a person licensed under this chapter, to place on probation
 10-8    with conditions a person whose license or certificate is suspended,
 10-9    or to reprimand a licensee or certificate holder, and in addition
10-10    to or in lieu of said suspension, revocation, probation, or
10-11    reprimand, to assess an administrative penalty as provided for in
10-12    Article 4548j, Revised Statutes, for any one or more of the
10-13    following causes:
10-14                (a)  Proof of insanity of the holder of a license or
10-15    certificate, as adjudged by the regularly constituted authorities.
10-16                (b)  Proof of conviction of the holder of a license or
10-17    certificate of a misdemeanor involving fraud or any felony [or a
10-18    misdemeanor involving fraud] under the laws of this State or any
10-19    other State or of the United States.
10-20                (c)  That the holder [thereof has been or] is guilty of
10-21    dishonorable conduct[, malpractice, gross incompetency,] or failure
10-22    to treat a patient according to the standard of care in the
10-23    practice of dentistry or dental hygiene.
10-24                (d)  That the holder thereof has been or is guilty of
10-25    any deception or misrepresentation for the purpose of soliciting or
10-26    obtaining patronage.
10-27                (e)  That the holder thereof procured a license or
 11-1    certificate through fraud or misrepresentation.
 11-2                (f)  That the holder thereof is addicted to or is
 11-3    habitually intemperate in [habitual intoxication or] the use of
 11-4    alcoholic beverages or drugs or has improperly obtained, possessed,
 11-5    used, or distributed habit forming drugs or narcotics.
 11-6                (g)  That a dentist employs or permits or has employed
 11-7    or permitted persons to practice dentistry in the office or offices
 11-8    under his control or management, who were not licensed to practice
 11-9    dentistry.
11-10                (h)  That the holder thereof has failed to use proper
11-11    diligence in the conduct of his practice or to safeguard his
11-12    patients against avoidable infections.
11-13                (i)  That the holder thereof has failed or refused to
11-14    comply with any State law relating to the regulation of dentists or
11-15    dental hygienists.
11-16                (j)  That the holder thereof has failed or refused to
11-17    comply with the adopted and promulgated rules and regulations of
11-18    the Board.
11-19                (k)  That the holder thereof is physically or mentally
11-20    incapable of practicing with safety to dental patients.
11-21                (l)  That the holder thereof has been negligent in the
11-22    performance of dental services which injured or damaged dental
11-23    patients.
11-24                (m)  Proof of suspension, revocation, probation,
11-25    reprimand, or other restriction by another State of a license or
11-26    certificate to practice dentistry or dental hygiene based upon acts
11-27    by the licensee or certificate holder enumerated in this section.
 12-1                (n)  That the holder thereof has knowingly provided or
 12-2    agreed to provide dental care in a manner which violates any
 12-3    provision of federal or State law regulating a plan whereby any
 12-4    person undertakes to provide, arrange for, pay for, or reimburse
 12-5    any part of the cost of any dental care services or regulating the
 12-6    business of insurance.
 12-7          Sec. 3.   (a)  If the Board proposes to refuse to issue a
 12-8    license by examination to a dental or dental hygiene applicant or
 12-9    [examine a person,] to suspend or revoke a license, to impose a
12-10    fine, to place on probation a person whose license has been
12-11    suspended, or to reprimand a license holder, the person is entitled
12-12    to a hearing under Chapter 2001, Government Code.
12-13          (b)  The hearing under this section and an appeal from the
12-14    hearing under this section are governed by Chapter 2001, Government
12-15    Code (Administrative Procedure Act).
12-16          SECTION 13.  Article 4549-1.1, Revised Statutes, is amended
12-17    to read as follows:
12-18          Art. 4549-1.1. SUBPOENA POWER.   The State Board of Dental
12-19    Examiners may request and, if necessary, compel by subpoena the
12-20    attendance of witnesses for examination under oath and the
12-21    production for inspection and copying of books, accounts, records,
12-22    papers, correspondence, documents, and other evidence relevant to
12-23    the investigation of alleged violations of the provisions of the
12-24    statutes of the State of Texas relating to the practice of
12-25    dentistry or any provisions of this chapter.  If a person fails to
12-26    comply with a subpoena issued under this article, the board, acting
12-27    through the attorney general, may file suit to enforce the subpoena
 13-1    in a district court in Travis County [or in the county in which a
 13-2    hearing conducted by the board may be held].  The court, if it
 13-3    determines that good cause exists for the issuance of the subpoena,
 13-4    shall order compliance with the requirements of the subpoena.
 13-5    Failure to obey the order of the court may be punished by the court
 13-6    as contempt.
 13-7          SECTION 14.  Article 4549-2, Revised Statutes, is amended to
 13-8    read as follows:
 13-9          Art. 4549-2. RECORDS OF THE DENTIST.             Records of
13-10    the diagnosis made and the treatment performed for and on a dental
13-11    patient shall be the property of the dentist who performs the
13-12    dental service and may not be sold, pledged as collateral, or
13-13    otherwise transferred to any person other than the patient unless
13-14    the other person is a dentist licensed by the Board and the
13-15    transfer is made in compliance with rules relating to the transfer
13-16    of records as may be adopted by the Board.  The owning dentist
13-17    shall furnish to a patient, on request, copies of the patient's
13-18    dental records in accordance with rules relating to patient records
13-19    adopted by the Board.  Nothing herein shall prevent the voluntary
13-20    submission of records to insurance companies for the purpose of
13-21    determining benefits.
13-22          SECTION 15.  Article 4550, Revised Statutes, is amended to
13-23    read as follows:
13-24          Art. 4550. RECORDS OF THE BOARD
13-25          Sec. 1.  The Board shall keep records in which shall be
13-26    registered the name and permanent address [residence] and place of
13-27    business of all persons authorized under this law to practice
 14-1    dentistry, dental hygiene and such other professions or businesses
 14-2    under its jurisdiction as provided by law.  Each dentist, dental
 14-3    hygienist, dental laboratory, and dental technician registered with
 14-4    the Board shall timely notify the Board in writing of:
 14-5                (1)  any change of address of the place of business of
 14-6    such dentist, hygienist, laboratory, or technician; and
 14-7                (2)  any change of employers by such dentist,
 14-8    hygienist, laboratory, or technician, and any change of owners of
 14-9    the laboratory.
14-10          The Board is timely notified if it receives the notice within
14-11    60 days after the date the change occurs.
14-12          Sec. 2.  All of the records and files of the State Board of
14-13    Dental Examiners shall be public records and open to inspection at
14-14    reasonable times, except the investigation files and records which
14-15    shall be confidential and shall be divulged only to persons so
14-16    investigated upon completion of said investigation.  It is not a
14-17    violation of this section for the Board to share investigation
14-18    files and records with another state regulatory agency or a local,
14-19    state, or federal law enforcement agency [during the course of a
14-20    joint investigation or in determining the feasibility of conducting
14-21    an investigation].
14-22          SECTION 16.  Section 1, Article 4550a, Revised Statutes, is
14-23    amended to read as follows:
14-24          Sec. 1.  It shall be the duty of all persons holding a dental
14-25    license or dental hygienist license issued by the State Board of
14-26    Dental Examiners to annually apply and to be registered as such
14-27    practitioners with the State Board of Dental Examiners on or before
 15-1    the expiration date of the license [March 1st of each calendar
 15-2    year].  Each person so registering shall pay in connection with
 15-3    such annual registration for the receipt hereinafter provided for,
 15-4    a fee as determined by said Board according to the needs of said
 15-5    Board, such payment to be made by each person to such Board, and
 15-6    every person so registering shall file with said Board a written
 15-7    application setting forth such facts as the Board may require.  A
 15-8    person holding a dental or dental hygienist license must attach to
 15-9    the application proof that the applicant has successfully completed
15-10    a current course [of current certification] in cardiopulmonary
15-11    resuscitation given or approved by the American Heart Association
15-12    or American Red Cross or, in the event that the applicant [person]
15-13    is not physically capable of successfully completing such training,
15-14    a written statement executed by either a licensed physician or an
15-15    instructor in cardiopulmonary resuscitation approved by the
15-16    American Heart Association or American Red Cross that describes
15-17    such physical incapacity.  In lieu of this requirement for
15-18    completion of a current course in [annual] cardiopulmonary
15-19    resuscitation [certification], a dentist or dental hygienist
15-20    licensed by the  State Board of Dental Examiners and residing in a
15-21    country other than the United States may satisfy this requirement
15-22    by submitting proof of residence upon the annual date of renewal.
15-23    Upon receipt of such applications, accompanied by such fees, said
15-24    Board, after ascertaining either from its records or other sources
15-25    deemed by it to be reliable that the applicant holds a valid
15-26    license or certificate to practice in this State, shall issue to
15-27    the applicant an annual registration certificate or receipt
 16-1    certifying that he has filed such application and has paid the
 16-2    required fee;  provided that the filing of such application, the
 16-3    payment of such fee, and the issuance of such receipt therefor
 16-4    shall not entitle the holder thereof to lawfully practice within
 16-5    the State of Texas unless he in fact holds a license or certificate
 16-6    as such practitioner issued by the State Board of Dental Examiners,
 16-7    as provided by this law, and unless said license or certificate is
 16-8    in full force and effect; and provided further, that in any
 16-9    prosecution for unlawful practice such receipt showing payment of
16-10    the annual registration fee required by this chapter shall not be
16-11    treated as evidence that the holder thereof is lawfully entitled to
16-12    practice.
16-13          SECTION 17.  Sections 2(c), (d), (e), and (h), Article 4550a,
16-14    Revised Statutes, are amended to read as follows:
16-15          (c)  If a person's license or certificate has been expired
16-16    for not longer than ninety (90) days, the person may renew it by
16-17    paying to the Board the required renewal fee and a fee that is
16-18    one-half of the application [examination] fee for the license or
16-19    certificate.
16-20          (d)  If a person's license or certificate has been expired
16-21    for longer than ninety (90) days but less than one year, the person
16-22    may renew it by paying to the Board all unpaid renewal fees and a
16-23    fee that is equal to the application [examination] fee for the
16-24    license or certificate.
16-25          (e)  If a person's license or certificate has been expired
16-26    for one year or longer, the person may not renew it[, except as
16-27    provided by Section 2A of this article].  The person may obtain a
 17-1    new license or certificate by submitting to reexamination and
 17-2    complying with the requirements and procedures for obtaining an
 17-3    original license or certificate.  However, the Board may adopt
 17-4    rules providing for renewal without reexamination of an expired
 17-5    license of a person who was licensed in this state, moved to
 17-6    another state, and is currently licensed and has been in practice
 17-7    in the other state for the two years preceding application.  The
 17-8    person must pay to the Board a fee that is equal to the examination
 17-9    fee for the license.
17-10          (h)  The Board by rule may adopt a system under which
17-11    licenses expire on various dates during the year.  [For the year in
17-12    which the license expiration date is changed, license fees payable
17-13    on March 1 shall be prorated on a monthly basis so that each
17-14    licensee shall pay only that portion of the license fee that is
17-15    allocable to the number of months during which the license is
17-16    valid.  On renewal of the license on the new expiration date, the
17-17    total license renewal fee is payable.]
17-18          SECTION 18.  Section 4(i), Article 4550a, Revised Statutes,
17-19    is amended to read as follows:
17-20          (i)  The Board shall develop and implement policies that
17-21    provide the public with a reasonable opportunity to appear before
17-22    the Board and to speak on any issue under the jurisdiction of the
17-23    Board, except to the extent that that communication would be ex
17-24    parte under any provision of law.
17-25          SECTION 19.  Subsection (a), Article 4550c, Revised Statutes,
17-26    is amended to read as follows:
17-27          (a)  Each dental application [examination] fee and dentist
 18-1    annual renewal fee imposed by or under Subsection (b), Article
 18-2    4551, Revised Statutes, is increased by $200.
 18-3          SECTION 20.  Article 4551a, Revised Statutes, is amended to
 18-4    read as follows:
 18-5          Art. 4551a. PERSONS REGARDED AS PRACTICING DENTISTRY.  Any
 18-6    person shall be regarded as practicing dentistry within the meaning
 18-7    of this Chapter:
 18-8                (1)  Who publicly professes to be a dentist or dental
 18-9    surgeon or who uses or permits to be used for himself or for any
18-10    other person, the title of "Doctor," "Dr.," "Doctor of Dental
18-11    Surgery," "D.D.S.," "Doctor of Dental Medicine," "D.M.D.," or any
18-12    other letters, titles, terms or descriptive matter, including use
18-13    of the terms "denturist" or "denturism," which directly or
18-14    indirectly represents him as being able to diagnose, treat, remove
18-15    stains or concretions from teeth, provide surgical and adjunctive
18-16    treatment for any disease, pain, injury, deficiency, deformity or
18-17    physical condition of the human teeth, oral cavity, alveolar
18-18    process, gums, jaws or directly related and adjacent masticatory
18-19    structures.
18-20                (2)  Who shall offer or undertake by any means or
18-21    methods whatsoever, to clean teeth or to remove stains, concretions
18-22    or deposits from teeth in the human mouth, or who shall undertake
18-23    or offer to diagnose, treat, operate, or prescribe by any means or
18-24    methods for any disease, pain, injury, deficiency, deformity, or
18-25    physical condition of the human teeth, oral cavity, alveolar
18-26    process, gums, or jaws.
18-27                (3)  Any person who shall offer or undertake in any
 19-1    manner to prescribe or make, or cause to be made, an impression of
 19-2    any portion of the human mouth, teeth, gums, or jaws, for the
 19-3    purpose of diagnosing, prescribing, treating, or aiding in the
 19-4    diagnosing, prescribing or treating, any physical condition of the
 19-5    human mouth, teeth, gums or jaws, or for the purpose of
 19-6    constructing or aiding in the construction of any dental appliance,
 19-7    denture, dental bridge, false teeth, dental plate or plates of
 19-8    false teeth, or any other substitute for human teeth.
 19-9                (4)  Any one who owns or manages a dental practice
19-10    or[,] maintains or operates any office or place of business where
19-11    he employs or engages, under any kind of contract whatsoever, any
19-12    other person or persons to practice dentistry as above defined
19-13    shall be deemed to be practicing dentistry himself and shall
19-14    himself be required to be duly licensed to practice dentistry as
19-15    hereinabove defined, and shall be subject to all of the other
19-16    provisions of this Chapter, even though the person or persons so
19-17    employed or engaged by him shall be duly licensed to practice
19-18    dentistry as hereinabove defined, unless otherwise provided by law.
19-19                (5)  Any person, firm, group, association, or
19-20    corporation who shall offer or undertake to fit, adjust, repair, or
19-21    substitute in the human mouth or directly related and adjacent
19-22    masticatory structures any dental appliance, structure, prosthesis,
19-23    or denture, or who shall aid or cause to be fitted, adjusted,
19-24    repaired, or substituted in the human mouth or directly related and
19-25    adjacent masticatory structures any dental appliance, structure,
19-26    prosthesis, or denture.
19-27                (6)  Who makes, fabricates, processes, constructs,
 20-1    produces, reproduces, duplicates, repairs, relines, or fixes any
 20-2    full or partial denture, any fixed or removable dental bridge or
 20-3    appliance, any dental plate or plates of false teeth, any
 20-4    artificial dental restoration, or any substitute or corrective
 20-5    device or appliance for the human teeth, gums, jaws, mouth,
 20-6    alveolar process, or any part thereof for another, or who in any
 20-7    manner offers, undertakes, aids, abets, or causes another person so
 20-8    to do for another, without a written prescription or work-order
 20-9    therefor signed by the dentist legally engaged in the practice of
20-10    dentistry in this state or in the jurisdiction where such dentist
20-11    maintains his dental office and who prescribed and ordered same.
20-12                (7)  Who shall offer or undertake or cause another to
20-13    do, directly or indirectly, for any person any act, service, or
20-14    work in the practice of dentistry or any part thereof as provided
20-15    for in the laws of Texas relating to the practice of dentistry
20-16    including without limitation the inducing, administering,
20-17    prescribing, or dispensing any anesthesia, anesthetic drug,
20-18    medicine, or agent in anywise incidental to or in connection with
20-19    the practice of dentistry; or who permits or allows another to use
20-20    his license or certificate to practice dentistry in this state for
20-21    the purpose of performing any act described in this Article; or who
20-22    shall aid or abet, directly or indirectly, the practice of
20-23    dentistry by any person not duly licensed to practice dentistry by
20-24    the State Board of Dental Examiners.
20-25                (8)  Who shall manage, control, attempt to control,
20-26    influence, attempt to influence, or otherwise interfere with the
20-27    exercise of a dentist's independent professional judgment regarding
 21-1    the diagnosis or treatment of any dental disease, disorder, or
 21-2    physical condition.  Rules adopted by the board addressing the
 21-3    prohibitions in this section shall prohibit a person who is not a
 21-4    dentist from directly or indirectly influencing or interfering with
 21-5    the exercise of a dentist's independent professional judgment.
 21-6    However, nothing herein shall be construed to require any entity to
 21-7    pay for services which are not provided for in a contract or
 21-8    agreement or to exempt any dentist who is a member of a hospital
 21-9    staff from adhering to hospital bylaws, medical staff bylaws, or
21-10    established policies approved by the governing board and the
21-11    medical and dental staff of the hospital.
21-12                (9)  If the person holds the person out to be a
21-13    denturist or uses another title that is intended to convey to the
21-14    public that the services offered by the person are included within
21-15    the practice of dentistry.
21-16          SECTION 21.  Article 4551b, Revised Statutes, is amended to
21-17    read as follows:
21-18          Art. 4551b. EXCEPTION.  The definition of dentistry as
21-19    contained in Chapter 9, Title 71, Revised Statutes, shall not apply
21-20    to:
21-21                (1)  members of the faculty of a reputable dental or
21-22    dental hygiene college or school where such faculty members perform
21-23    their services for the sole benefit of such school or college;
21-24                (2)  students of a reputable dental college who perform
21-25    their operations without pay except for actual cost of materials,
21-26    in the presence of and under the direct personal supervision of a
21-27    demonstrator or teacher who is a member of the faculty of a
 22-1    reputable dental college;
 22-2                (3)  persons doing laboratory work on inert matter
 22-3    only, and who do not solicit or obtain work, by any means, from a
 22-4    person or persons not a licensed dentist actually engaged in the
 22-5    practice of dentistry and who do not act as the agents or
 22-6    solicitors of, or have any interest whatsoever in, any dental
 22-7    office, practice or the receipts therefrom;
 22-8                (4)  physicians and surgeons legally authorized to
 22-9    practice medicine as defined by the law of this state who do not
22-10    hold themselves out to the public as practicing dentistry;
22-11                (5)  dental hygienists legally authorized to practice
22-12    dental hygiene in this state and who practice dental hygiene in
22-13    strict conformity with the laws of Texas regulating the practice of
22-14    dental hygiene;
22-15                (6)  those persons who as members of an established
22-16    church practice healing by prayer only;
22-17                (7)  employees of a dentist who make dental x-rays in
22-18    the dental office and under the supervision of such dentist or
22-19    dentists legally engaged in the practice of dentistry in this
22-20    state;
22-21                (8)  Dental Health Service Corporations legally
22-22    chartered under Section A(1), Article 2.01, Texas Non-Profit
22-23    Corporation Act (Article 1396-2.01, Vernon's Texas Civil Statutes);
22-24                (9)  dental interns and dental residents as defined and
22-25    regulated by the Texas State Board of Dental Examiners in its rules
22-26    and regulations;
22-27                (10)  students of a dental hygiene program accredited
 23-1    by the Commission on Dental Accreditation of the American Dental
 23-2    Association and operated at an accredited institution of higher
 23-3    education, in a clinic operated for the sole benefit of the
 23-4    program's institution of higher education, or in a clinic operated
 23-5    by a government or nonprofit organization that serves underserved
 23-6    populations as determined by rule by the State Board of Dental
 23-7    Examiners, and who practice dental hygiene without pay under the
 23-8    general supervision of a dentist and under the supervision of a
 23-9    demonstrator  or teacher who is a member of the faculty of that
23-10    program in strict conformity with the laws of this state regulating
23-11    the practice of dental hygiene, except that they may practice under
23-12    the supervision of a demonstrator or teacher who is a dentist
23-13    member of the faculty of that program [in a clinic operated for the
23-14    sole benefit of the program's institution of higher education or in
23-15    a clinic operated by a government or nonprofit organization that
23-16    serves underserved populations as determined by rule of the State
23-17    Board of Dental Examiners and in strict conformity with the laws of
23-18    this state regulating the practice of dental hygiene];
23-19                (11)  dental assistants who perform the duties
23-20    permitted by Article 4551e-1, Revised Statutes, in strict
23-21    conformity with the laws of this state; [or]
23-22                (12)  dentists and dental hygienists licensed by
23-23    another state or foreign country who perform clinical procedures
23-24    only for professional and technical education demonstration
23-25    purposes, provided that such dentists and dental hygienists must
23-26    first obtain a temporary license for such purpose from the State
23-27    Board of Dental Examiners;
 24-1                (13)  a dental hygienist who is a faculty member of a
 24-2    dental or dental hygiene school while practicing dental hygiene
 24-3    only, in strict conformity with the laws regulating the practice of
 24-4    dental hygiene;
 24-5                (14)  a dentist enrolled in remedial training programs
 24-6    sponsored by the Commission on Dental Accreditation of the American
 24-7    Dental Association at an accredited dental or dental hygiene school
 24-8    while participating in such a program in this state;
 24-9                (15)  a dental hygienist enrolled in remedial training
24-10    programs sponsored by the Commission on Dental Accreditation of the
24-11    American Dental Association at an accredited dental or dental
24-12    hygiene school while participating in such a program in this state
24-13    in strict conformity with the laws regulating the practice of
24-14    dental hygiene, except that supervision may be provided by a
24-15    demonstrator or teacher who is a dentist member of the program;
24-16                (16)  a dentist who is not licensed in this state and
24-17    who is a candidate enrolled to take the dental clinical examination
24-18    offered by the Western Regional Examining Board in this state while
24-19    taking the examination;
24-20                (17)  a dental hygienist who is not licensed in this
24-21    state and who is a candidate enrolled to take the dental hygiene
24-22    clinical examination offered by the Western Regional Examining
24-23    Board in this state while taking the examination if participation
24-24    is in strict conformity with the laws of this state regulating the
24-25    practice of dental hygiene, except that supervision may be provided
24-26    by a dentist whose services are secured by the Western Regional
24-27    Examining Board;
 25-1                (18)  a dentist whose license is in retired status or
 25-2    who is licensed in another state and is attending a continuing
 25-3    education clinical program offered at a dental or dental hygiene
 25-4    school accredited by the Commission on Dental Accreditation of the
 25-5    American Dental Association while attending the  program; or
 25-6                (19)  a dental hygienist whose dental hygienist license
 25-7    is in  retired status or who is licensed in another state and is
 25-8    attending a continuing education clinical program offered at a
 25-9    dental or dental hygiene school accredited by the Commission on
25-10    Dental Accreditation of the American Dental Association while
25-11    attending the  program if tasks are performed in strict conformity
25-12    with the laws regulating the practice of dental hygiene, except
25-13    that supervision may be provided by a dentist member of the
25-14    program.
25-15          SECTION 22.  Section 2, Chapter 475, Acts of the 52nd
25-16    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
25-17    Civil Statutes), is amended to read as follows:
25-18          Sec. 2.  QUALIFICATIONS.  Each applicant for a license to
25-19    practice [A] dental hygiene in this state [hygienist] shall be:
25-20                (1)  not less than eighteen (18) years of age;
25-21                (2)  of good moral character;
25-22                (3)  [and] a graduate of an accredited high school or
25-23    hold a certificate of high school equivalency (GED); and
25-24                (4)  [be]  a graduate of a recognized school or college
25-25    of [dentistry or] dental hygiene accredited by the Commission on
25-26    Dental Accreditation of the American Dental Association and
25-27    approved by the State Board of Dental Examiners.
 26-1          SECTION 23.  Section 3(b), Chapter 475, Acts of the 52nd
 26-2    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
 26-3    Civil Statutes), is amended to read as follows:
 26-4          (b)  All work performed by a dental hygienist in the practice
 26-5    of dental hygiene, as defined in this Act, shall be performed in
 26-6    the dental office of the supervising dentist or dentists who are
 26-7    legally engaged in the practice of dentistry in this state[, by
 26-8    whom he or she must be employed,] or under the supervision of a
 26-9    supervising dentist in an alternate setting, including, but not
26-10    limited to, a nursing home, [or] the patient's home, a school, a
26-11    hospital, a state institution, a public health clinic, or another
26-12    institution [provided that the hygienist is licensed to perform the
26-13    delegated procedure and the supervising dentist examines the
26-14    patient during the 12 months preceding the performance of the
26-15    procedure by the dental hygienist or at the time the procedure is
26-16    performed, except where employed by schools, hospitals, state
26-17    institutions, public health clinics or other institutions that have
26-18    applied to and been approved by the Texas State Board of Dental
26-19    Examiners as a proper location for the performance of a dental
26-20    procedure].
26-21          SECTION 24.  Section 4A(d), 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          (d)  A member of the advisory committee is entitled to the
26-25    compensatory per diem set by the General Appropriations Act for
26-26    each day that the member engages in committee business.  [Except
26-27    for transportation expenses, a member is not entitled to
 27-1    reimbursement for travel expenses.]  A member may receive [is
 27-2    entitled to] reimbursement for travel [transportation] expenses,
 27-3    including expenses for meals and lodging [as provided by the
 27-4    General Appropriations Act].
 27-5          SECTION 25.  Section 5, Chapter 475, Acts of the 52nd
 27-6    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
 27-7    Civil Statutes), is amended to read as follows:
 27-8          Sec. 5.  EXAMINATION.  (a)  It shall be the duty of the Board
 27-9    to provide for the examination of all qualified applicants for
27-10    licensure as dental hygienists in this State.  All applicants for
27-11    licensure [examination] shall pay an application [a] fee set by the
27-12    Board to said Board as determined by said Board according to its
27-13    needs and shall apply upon forms furnished by the Board and shall
27-14    furnish such other information as the Board may in its discretion
27-15    require to determine any applicant's qualifications.  An applicant
27-16    must attach to the application proof that the applicant has
27-17    successfully completed a current course in cardiopulmonary
27-18    resuscitation given or approved by the American Heart Association
27-19    or American Red Cross before the date on which the applicant
27-20    submits the application or, in the event that the applicant is not
27-21    physically capable of successfully completing such training, a
27-22    written statement executed by either a licensed physician or an
27-23    instructor in cardiopulmonary resuscitation approved by the
27-24    American Heart Association or American Red Cross that describes
27-25    such physical incapacity.
27-26          (b)  The examination shall be taken by all applicants on such
27-27    subjects and operations pertaining to dentistry and dental hygiene
 28-1    which shall include Dental Anatomy, Pharmacology, X-Ray, Ethics,
 28-2    Jurisprudence, and Hygiene, and such other subjects as are
 28-3    regularly taught in reputable schools of dentistry and dental
 28-4    hygiene, as the Board in its discretion may require.
 28-5          (c)  The Board shall contract with an independent or regional
 28-6    testing service for any required clinical examination.
 28-7          (d)  In the event that the Board uses a regional testing
 28-8    service, the Board is authorized to contract for or otherwise use
 28-9    the services of licensed dental hygienists in this State for the
28-10    purpose of providing assistance to the regional testing service.
28-11          (e)  The Board shall have the written portion of the Board's
28-12    jurisprudence examination validated by an independent testing
28-13    professional.
28-14          (f)  The Board shall report such grades to the applicant
28-15    within a reasonable time after such examination.  If the Board
28-16    contracts with an independent or regional testing service, the
28-17    contract with the independent or regional testing service shall
28-18    provide for notification of results.  Each[, and each] applicant
28-19    who has satisfactorily passed all phases of the examination as
28-20    determined by the Board shall be entitled to and shall be issued a
28-21    license permitting such applicant to practice dental hygiene in the
28-22    State of Texas as is defined and regulated by the law of this
28-23    State.
28-24          (g) [(b)]  The Board by rule shall set the number of and
28-25    conditions for examination retakes.  The Board may require an
28-26    applicant who fails the examination to meet additional education
28-27    requirements set by the Board.
 29-1          SECTION 26.  Section 5A(b), Chapter 475, Acts of the 52nd
 29-2    Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
 29-3    Civil Statutes), is amended to read as follows:
 29-4          (b)  The State Board of Dental Examiners by rule shall:
 29-5                (1)  require a licensee to complete at least 12 [36]
 29-6    hours of continuing education for [in] each annual registration
 29-7    [three-year] period as a prerequisite to renewal for a subsequent
 29-8    annual period [to maintain licensure];
 29-9                (2)  identify the key factors that lead to the
29-10    competent performance of professional duties under this Act;
29-11                (3)  develop a process to evaluate and approve
29-12    continuing education courses; and
29-13                (4)  develop a process to assess a licensee's
29-14    participation and performance in continuing education courses that
29-15    will enable the Board to evaluate the overall effectiveness of the
29-16    program.
29-17          SECTION 27.  Subsections (c) and (d), Section (6), Article
29-18    4551f, Revised Statutes, are amended to read as follows:
29-19          (c)  If the owner or manager of a dental laboratory required
29-20    to be registered under this section fails to renew the registration
29-21    and pay the annual renewal fee before the expiration date as set by
29-22    the Board, the Board shall suspend the registration certificate of
29-23    that laboratory.  An owner or manager may renew an unexpired
29-24    certificate by paying the required renewal fee to the Board on or
29-25    before the expiration date.  If the certificate has been expired
29-26    for not more than 90 days, the owner or manager may renew the
29-27    certificate by paying to the Board the required renewal fee and a
 30-1    fee equal to one-half the renewal fee.  If the certificate has been
 30-2    expired for more than 90 days but less than one year [two years],
 30-3    the owner or manager may renew the certificate by paying to the
 30-4    Board all unpaid renewal fees and a fee equal to the amount of the
 30-5    initial registration fee.  If the certificate has been expired for
 30-6    one year [two years] or longer, the owner or manager may not renew
 30-7    the certificate.  To reinstate the certificate, the owner or
 30-8    manager must comply with the requirements for obtaining an original
 30-9    certificate.
30-10          (d)  The owner of a dental laboratory registered with the
30-11    Board on September 1, 1987, is not required to submit proof that
30-12    the laboratory has at least one certified dental technician
30-13    employed by and working on the premises of the laboratory if:
30-14                (1)  the registration of the laboratory has been
30-15    renewed each year [continuous] since that date and all registration
30-16    fees have been paid;
30-17                (2)  the beneficial ownership of at least 51 percent of
30-18    the laboratory has not been transferred; and
30-19                (3)  the owner is employed on the premises of the
30-20    laboratory not less than 30 hours each week.
30-21          SECTION 28.  Article 4551j, Revised Statutes, is amended to
30-22    read as follows:
30-23          Art. 4551j. CIVIL IMMUNITY, OFFICIAL ACTS.       In the
30-24    absence of fraud, conspiracy, or malice, no member of the Texas
30-25    State Board of Dental Examiners, its employees, part-time
30-26    employees, or persons who contract with the Board, nor any witness
30-27    called to testify by said board, nor any consultant or hearing
 31-1    officer appointed by said board shall be liable or subject to suit
 31-2    or suits for damages for alleged injury, wrong, loss, or damage
 31-3    allegedly caused by any of said persons for any investigation,
 31-4    report, recommendation, statement, evaluation, finding, order, or
 31-5    award made in the course of any of said persons performing
 31-6    assigned, designated, official, or statutory duties.  This immunity
 31-7    is enacted to relieve and protect the persons named from being
 31-8    harassed and threatened with legal action while attempting to
 31-9    perform official duties.
31-10          SECTION 29.  The following laws are repealed:
31-11                (1)  Section 2, Article 4544, Revised Statutes; and
31-12                (2)  Section 2, Article 4544a, Revised Statutes.
31-13          SECTION 30.  Section 5(b), Article 4544, Revised Statutes,
31-14    Section 5A(b), Chapter 475, Acts of the 52nd Legislature, Regular
31-15    Session, 1951 (Article 4551e, Vernon's Texas Civil Statutes), and
31-16    Subsection (c), Section (6), Article 4551f, Revised Statutes, as
31-17    amended by this Act, apply only to licenses and registrations that
31-18    expire after the effective date of this Act.  Licenses and
31-19    registrations in effect the day before the effective date of this
31-20    Act continue to be valid and expire according to their own terms.
31-21          SECTION 31.  This Act takes effect September 1, 1999.
31-22          SECTION 32.  The importance of this legislation and the
31-23    crowded condition of the calendars in both houses create an
31-24    emergency and an imperative public necessity that the
31-25    constitutional rule requiring bills to be read on three several
31-26    days in each house be suspended, and this rule is hereby suspended.