1-1 By: Lucio S.B. No. 964
1-2 (In the Senate - Filed March 5, 1999; March 9, 1999, read
1-3 first time and referred to Committee on Health Services;
1-4 April 8, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; April 8, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 964 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of dentists and dental hygienists.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Subsections (a) and (b), Section 3, Article
1-13 4543a, Revised Statutes, are amended to read as follows:
1-14 (a) An officer, employee, or paid consultant of a Texas
1-15 trade association in the field of health care may not be a member
1-16 or employee of the Board who is exempt from the state's position
1-17 classification plan or is compensated at or above the amount
1-18 prescribed by the General Appropriations Act for B9 [step 1, salary
1-19 group 17,] of the position classification salary schedule.
1-20 (b) A person who is the spouse of an officer, manager, or
1-21 paid consultant of a Texas trade association in the field of health
1-22 care may not be a Board member and may not be a Board employee who
1-23 is exempt from the state's position classification plan or is
1-24 compensated at or above the amount prescribed by the General
1-25 Appropriations Act for B9 [step 1, salary group 17,] of the
1-26 position classification salary schedule.
1-27 SECTION 2. Article 4544, Revised Statutes, is amended to
1-28 read as follows:
1-29 Art. 4544. EXAMINATION FOR LICENSE TO PRACTICE DENTISTRY
1-30 Sec. 1. (a) It shall be the duty of the Board to provide
1-31 for the examination of all applicants for license to practice
1-32 dentistry in this State. Each person applying for a license [an
1-33 examination] shall pay to said Board an application [a] fee set by
1-34 the Board and shall be granted a license to practice dentistry in
1-35 this State upon his satisfactorily passing an examination provided
1-36 for by said Board on subjects and operations pertaining to
1-37 dentistry which shall include Anatomy, Physiology, Anaesthesia,
1-38 Biochemistry, Dental Materials, Diagnosis, Treatment Planning,
1-39 Ethics, Jurisprudence, Hygiene, Pharmacology, Operative Dentistry,
1-40 Oral Surgery, Orthodontia, Periodontia, Prosthetic Dentistry,
1-41 Pathology, Microbiology, and such other subjects as are regularly
1-42 taught in reputable Dental Schools as the Board may in its
1-43 discretion require.
1-44 (b) The Board shall contract with an independent or regional
1-45 testing service for any required clinical examination.
1-46 (c) In the event that the Board uses a regional testing
1-47 service, the Board is authorized to contract for or otherwise use
1-48 the services of licensed dentists in this state for the purpose of
1-49 providing assistance to the regional testing service.
1-50 (d) The Board shall have the written portion of the Board's
1-51 jurisprudence examination validated by an independent testing
1-52 professional.
1-53 (e) [(b)] The Board by rule shall set the number of and
1-54 conditions for examination retakes. The Board may require an
1-55 applicant who fails the examination to meet additional education
1-56 requirements set by the Board.
1-57 Sec. 2. (a) [The Texas State Board of Dental Examiners may
1-58 provide in its rules and regulations the procedures, fees, and
1-59 requirements for graduates of foreign and/or nonaccredited Dental
1-60 Schools to become licensed to practice dentistry in Texas.]
1-61 [Sec. 3.] Within 30 days after the day on which a licensing
1-62 examination is administered under this article, the Board shall
1-63 notify each examinee of the results of the examination. However,
1-64 if an examination is graded or reviewed by a national testing
2-1 service, the Board shall notify examinees of the results of the
2-2 examination within two weeks after the day that the Board receives
2-3 the results from the testing service. If the notice of the
2-4 examination results will be delayed for longer than 90 days after
2-5 the examination date, the Board shall notify the examinee of the
2-6 reason for the delay before the 90th day.
2-7 (b) If the Board contracts with an independent or regional
2-8 testing service, this section does not apply. The contract with
2-9 the independent or regional testing service shall provide for
2-10 notification of results as provided by Subsection (a) of this
2-11 section.
2-12 Sec. 3. (a) [Sec. 4.] If requested in writing by a person
2-13 who fails the licensing examination administered under this
2-14 article, the Board shall furnish the person with an analysis of the
2-15 person's performance on the examination as prescribed by Board
2-16 rule.
2-17 (b) If the Board contracts with an independent or regional
2-18 testing service, this section does not apply. The contract with
2-19 the independent or regional testing service shall provide for
2-20 notification of results as provided by Subsection (a) of this
2-21 section.
2-22 Sec. 4. [Sec. 5.] (a) The Board shall develop a mandatory
2-23 continuing education program.
2-24 (b) The Board by rule shall:
2-25 (1) require a licensee to complete at least 12 [36]
2-26 hours of continuing education for [in] each annual registration
2-27 [three-year] period as a prerequisite to renewal for a subsequent
2-28 annual period [to maintain licensure];
2-29 (2) identify the key factors that lead to the
2-30 competent performance of professional duties under this Act;
2-31 (3) develop a process to evaluate and approve
2-32 continuing education courses; and
2-33 (4) develop a process to assess a licensee's
2-34 participation and performance in continuing education courses that
2-35 will enable the Board to evaluate the overall effectiveness of the
2-36 program.
2-37 (c) The Board is authorized to assess the continuing
2-38 education needs of licensees and may require licensees to attend
2-39 continuing education courses specified by the Board.
2-40 SECTION 3. Article 4545, Revised Statutes, is amended to
2-41 read as follows:
2-42 Art. 4545. QUALIFICATIONS OF APPLICANTS. Each applicant for
2-43 a license to practice dentistry in this state shall be not less
2-44 than twenty-one (21) years of age and [shall present evidence] of
2-45 good moral character and shall present:
2-46 (1) proof of graduation from a dental school
2-47 accredited by the Commission on Dental Accreditation of the
2-48 American Dental Association; or
2-49 (2) proof of:
2-50 (A) graduation from a dental school that is not
2-51 accredited by the Commission on Dental Accreditation of the
2-52 American Dental Association; and
2-53 (B) successful completion of training in an
2-54 American Dental Association approved specialty in an education
2-55 program that is accredited by the Commission on Dental
2-56 Accreditation and that consists of at least two years of training
2-57 as specified by the Council on Dental Education.
2-58 SECTION 4. Subsection (a), Section 1, Article 4545a, Revised
2-59 Statutes, is amended to read as follows:
2-60 (a) The State Board of Dental Examiners, upon payment by the
2-61 applicant of a fee set by the Board, shall grant a license to
2-62 practice dentistry to any reputable dentist or a license to
2-63 practice dental hygiene to any reputable [dentist or] dental
2-64 hygienist who:
2-65 (1) is licensed in good standing as a dentist or
2-66 dental hygienist in another state, the District of Columbia, or a
2-67 territory of the United States that has licensing requirements that
2-68 are substantially equivalent to the requirements of this Act;
2-69 (2) has not been the subject of final or pending
3-1 disciplinary action in any jurisdiction in which the dentist or
3-2 dental hygienist is or has been licensed;
3-3 (3) has graduated from a dental or dental hygiene
3-4 school accredited by the Commission on Dental Accreditation of the
3-5 American Dental Association and approved by the Board according to
3-6 rules established by the Board;
3-7 (4) has passed a national or other examination
3-8 recognized by the Board relating to dentistry or dental hygiene;
3-9 (5) has successfully completed the Board's
3-10 jurisprudence examination;
3-11 (6) has submitted documentation of current
3-12 cardiopulmonary resuscitation certification;
3-13 (7) has practiced dentistry or dental hygiene:
3-14 (A) for a minimum of five years immediately
3-15 prior to applying; or
3-16 (B) as a dental educator at a dental school or
3-17 dental hygiene school accredited by the Commission on Dental
3-18 Accreditation of the American Dental Association for the five years
3-19 immediately preceding the date of applying for the license; and
3-20 (8) has met any additional criteria established by
3-21 Board rule.
3-22 SECTION 5. Article 4547a, Revised Statutes, is amended to
3-23 read as follows:
3-24 Art. 4547a. AID TO THE BOARD. The Texas State Board of
3-25 Dental Examiners shall have power and authority to appoint such
3-26 committees, clerks, advisors, consultants, dentists, hygienists,
3-27 and/or examiners to aid the board to carry out its duties as it
3-28 deems necessary and advisable and may reimburse said persons so
3-29 appointed in such amounts as is reasonable and in conformity with
3-30 the provisions of the general appropriations bill as enacted by the
3-31 Texas Legislature.
3-32 SECTION 6. Article 4548d, Revised Statutes, is amended to
3-33 read as follows:
3-34 Art. 4548d. SHALL EXHIBIT ANNUAL REGISTRATION CERTIFICATE
3-35 [LICENSE]. Any person authorized to practice dentistry or dental
3-36 hygiene [surgery] in this State either under this or any former law
3-37 of Texas, shall place the person's current registration certificate
3-38 [his license] on exhibition in each [his] office where said dentist
3-39 or dental hygienist provides dental services. When a dentist or
3-40 dental hygienist provides dental services at more than one
3-41 location, the person may display a duplicate of the original
3-42 registration certificate obtained from the State Board of Dental
3-43 Examiners for a duplicate certificate fee set by the Board [license
3-44 shall be in plain view of patients]. No such person shall do any
3-45 operation in the mouth of a patient, or treat any lesions of the
3-46 mouth or teeth, without having said registration certificate
3-47 [license] so exhibited.
3-48 SECTION 7. Article 4548e, Revised Statutes, is amended to
3-49 read as follows:
3-50 Art. 4548e. USE OF TRADE NAME. Any person, corporation,
3-51 company, or association may use a corporation, company,
3-52 association, or trade name. Any advertisement by a person, [the]
3-53 corporation, company, or association[, or trade name] must include
3-54 prominently the name of at least one dentist practicing under such
3-55 name, and if the advertisement refers to one or more locations
3-56 where dental services are provided, it must include, for each
3-57 location, the name of at least one dentist who provides services at
3-58 that location. The person, corporation, company, or association
3-59 shall file with the State Board of Dental Examiners a list of all
3-60 dentists who practice under the name and a list of each trade name
3-61 used if the trade name is different from the corporation, company,
3-62 or association name. A list required under this section must be
3-63 updated and filed with the Board not later than the 30th day after
3-64 the date of the change. Each day of violation of this Article
3-65 shall constitute a separate offense.
3-66 SECTION 8. Article 4548g, Revised Statutes, is amended to
3-67 read as follows:
3-68 Art. 4548g. UNPROFESSIONAL CONDUCT. It shall be unlawful
3-69 for any person, firm, or corporation to engage in or be guilty of
4-1 any unprofessional conduct pertaining to dentistry directly or
4-2 indirectly. Any unprofessional conduct, as used herein, means and
4-3 includes any one or more of the following acts:
4-4 (1) obtaining or attempting to collect any fee by
4-5 fraud or misrepresentation;
4-6 (2) soliciting dental business by means of oral
4-7 [verbal] communication, in person or otherwise, directed to an
4-8 individual or group of less than five individuals, which is
4-9 primarily for the purpose of attracting the patronage of such
4-10 individual or group to a particular practice of dentistry;
4-11 (3) employing, directly or indirectly, or permitting
4-12 any unlicensed person to perform dental services upon any person,
4-13 except as otherwise authorized by law or the rules and regulations
4-14 of the State Board of Dental Examiners;
4-15 (4) claiming or circulating any statement of
4-16 professional superiority or the performance of professional
4-17 services in a superior manner;
4-18 (5) forging, altering, or changing any diploma,
4-19 license, registration certificate, transcript, or any other legal
4-20 document pertaining to the practice of dentistry, being a party
4-21 thereto or beneficiary thereof, or making any false statement about
4-22 or in securing such document, or being guilty of misusing the same;
4-23 (6) accepting employment as a dentist under any
4-24 referral scheme which is false, misleading, or deceptive;
4-25 (7) advertising to perform any dental work without
4-26 pain or discomfort to the patient; or
4-27 (8) advertising predictions of future satisfaction or
4-28 success of any dental service.
4-29 SECTION 9. Article 4549, Revised Statutes, is amended to
4-30 read as follows:
4-31 Art. 4549. REFUSAL TO [EXAMINE OR] ISSUE LICENSE; JUDICIAL
4-32 SUSPENSIONS AND REVOCATIONS
4-33 Sec. 1. The State Board of Dental Examiners shall have
4-34 authority to refuse to issue a license by examination to a dental
4-35 or dental hygiene applicant [examine any person or refuse to issue
4-36 a dental license or a dental hygienist license to any person] for
4-37 any one or more of the following causes:
4-38 (a) Proof of presentation to the Board of any
4-39 dishonest or fake evidence of qualification, or being guilty of any
4-40 illegality, fraud, or deception in the process of examination, or
4-41 for the purpose of securing a license or certificate.
4-42 (b) Proof of chronic or habitual intoxication or
4-43 addiction to drugs on the part of the applicant.
4-44 (c) Proof that the applicant has been guilty of
4-45 dishonest or illegal practices in or connected with the practice of
4-46 dentistry or dental hygiene.
4-47 (d) Proof of conviction of the applicant of a felony
4-48 under the laws of this State or any other State or of the United
4-49 States.
4-50 (e) Proof that the applicant violated any of the
4-51 provisions of the statutes of the State of Texas relating to the
4-52 practice of dentistry or any provisions of Chapter 9, Title 71,
4-53 Revised Statutes, within 12 months before the filing of an
4-54 application for the license.
4-55 Sec. 2. The State Board of Dental Examiners shall have
4-56 jurisdiction and authority, after notice and hearing, to suspend or
4-57 revoke a dental license or a dental hygienist license, to impose a
4-58 fine on a person licensed under this chapter, to place on probation
4-59 with conditions a person whose license or certificate is suspended,
4-60 or to reprimand a licensee or certificate holder, and in addition
4-61 to or in lieu of said suspension, revocation, probation, or
4-62 reprimand, to assess an administrative penalty as provided for in
4-63 Article 4548j, Revised Statutes, for any one or more of the
4-64 following causes:
4-65 (a) Proof of insanity of the holder of a license or
4-66 certificate, as adjudged by the regularly constituted authorities.
4-67 (b) Proof of conviction of the holder of a license or
4-68 certificate of a misdemeanor involving fraud or any felony [or a
4-69 misdemeanor involving fraud] under the laws of this State or any
5-1 other State or of the United States.
5-2 (c) That the holder [thereof has been or] is guilty of
5-3 dishonorable conduct[, malpractice, gross incompetency,] or failure
5-4 to treat a patient according to the standard of care in the
5-5 practice of dentistry or dental hygiene.
5-6 (d) That the holder thereof has been or is guilty of
5-7 any deception or misrepresentation for the purpose of soliciting or
5-8 obtaining patronage.
5-9 (e) That the holder thereof procured a license or
5-10 certificate through fraud or misrepresentation.
5-11 (f) That the holder thereof is addicted to or is
5-12 habitually intemperate in [habitual intoxication or] the use of
5-13 alcoholic beverages or drugs or has improperly obtained, possessed,
5-14 used, or distributed habit-forming drugs or narcotics.
5-15 (g) That a dentist employs or permits or has employed
5-16 or permitted persons to practice dentistry in the office or offices
5-17 under his control or management, who were not licensed to practice
5-18 dentistry.
5-19 (h) That the holder thereof has failed to use proper
5-20 diligence in the conduct of his practice or to safeguard his
5-21 patients against avoidable infections.
5-22 (i) That the holder thereof has failed or refused to
5-23 comply with any State law relating to the regulation of dentists or
5-24 dental hygienists.
5-25 (j) That the holder thereof has failed or refused to
5-26 comply with the adopted and promulgated rules and regulations of
5-27 the Board.
5-28 (k) That the holder thereof is physically or mentally
5-29 incapable of practicing with safety to dental patients.
5-30 (l) That the holder thereof has been negligent in the
5-31 performance of dental services which injured or damaged dental
5-32 patients.
5-33 (m) Proof of suspension, revocation, probation,
5-34 reprimand, or other restriction by another State of a license or
5-35 certificate to practice dentistry or dental hygiene based upon acts
5-36 by the licensee or certificate holder enumerated in this section.
5-37 (n) That the holder thereof has knowingly provided or
5-38 agreed to provide dental care in a manner which violates any
5-39 provision of federal or State law regulating a plan whereby any
5-40 person undertakes to provide, arrange for, pay for, or reimburse
5-41 any part of the cost of any dental care services or regulating the
5-42 business of insurance.
5-43 Sec. 3. (a) If the Board proposes to refuse to issue a
5-44 license by examination to a dental or dental hygiene applicant or
5-45 [examine a person,] to suspend or revoke a license, to impose a
5-46 fine, to place on probation a person whose license has been
5-47 suspended, or to reprimand a license holder, the person is entitled
5-48 to a hearing under Chapter 2001, Government Code.
5-49 (b) The hearing under this section and an appeal from the
5-50 hearing under this section are governed by Chapter 2001, Government
5-51 Code (Administrative Procedure Act).
5-52 SECTION 10. Article 4549-1.1, Revised Statutes, is amended
5-53 to read as follows:
5-54 Art. 4549-1.1. SUBPOENA POWER. The State Board of Dental
5-55 Examiners may request and, if necessary, compel by subpoena the
5-56 attendance of witnesses for examination under oath and the
5-57 production for inspection and copying of books, accounts, records,
5-58 papers, correspondence, documents, and other evidence relevant to
5-59 the investigation of alleged violations of the provisions of the
5-60 statutes of the State of Texas relating to the practice of
5-61 dentistry or any provisions of this chapter. If a person fails to
5-62 comply with a subpoena issued under this article, the board, acting
5-63 through the attorney general, may file suit to enforce the subpoena
5-64 in a district court in Travis County [or in the county in which a
5-65 hearing conducted by the board may be held]. The court, if it
5-66 determines that good cause exists for the issuance of the subpoena,
5-67 shall order compliance with the requirements of the subpoena.
5-68 Failure to obey the order of the court may be punished by the court
5-69 as contempt.
6-1 SECTION 11. Article 4549-2, Revised Statutes, is amended to
6-2 read as follows:
6-3 Art. 4549-2. RECORDS OF THE DENTIST. Records of the
6-4 diagnosis made and the treatment performed for and on a dental
6-5 patient shall be the property of the dentist who performs the
6-6 dental service and may not be sold, pledged as collateral, or
6-7 otherwise transferred to any person other than the patient unless
6-8 the other person is a dentist licensed by the Board and the
6-9 transfer is made in compliance with rules relating to the transfer
6-10 of records as may be adopted by the Board. The owning dentist
6-11 shall furnish to a patient, on request, copies of the patient's
6-12 dental records in accordance with rules relating to patient records
6-13 adopted by the Board. Nothing herein shall prevent the voluntary
6-14 submission of records to insurance companies for the purpose of
6-15 determining benefits.
6-16 SECTION 12. Article 4550, Revised Statutes, is amended to
6-17 read as follows:
6-18 Art. 4550. RECORDS OF THE BOARD
6-19 Sec. 1. The Board shall keep records in which shall be
6-20 registered the name and permanent address [residence] and place of
6-21 business of all persons authorized under this law to practice
6-22 dentistry, dental hygiene and such other professions or businesses
6-23 under its jurisdiction as provided by law. Each dentist, dental
6-24 hygienist, dental laboratory, and dental technician registered with
6-25 the Board shall timely notify the Board in writing of:
6-26 (1) any change of address of the place of business of
6-27 such dentist, hygienist, laboratory, or technician; and
6-28 (2) any change of employers by such dentist,
6-29 hygienist, laboratory, or technician, and any change of owners of
6-30 the laboratory.
6-31 The Board is timely notified if it receives the notice within
6-32 60 days after the date the change occurs.
6-33 Sec. 2. All of the records and files of the State Board of
6-34 Dental Examiners shall be public records and open to inspection at
6-35 reasonable times, except the investigation files and records which
6-36 shall be confidential and shall be divulged only to persons so
6-37 investigated upon completion of said investigation. It is not a
6-38 violation of this section for the Board to share investigation
6-39 files and records with another state regulatory agency or a local,
6-40 state, or federal law enforcement agency [during the course of a
6-41 joint investigation or in determining the feasibility of conducting
6-42 an investigation].
6-43 SECTION 13. Section 1, Article 4550a, Revised Statutes, is
6-44 amended to read as follows:
6-45 Sec. 1. It shall be the duty of all persons holding a dental
6-46 license or dental hygienist license issued by the State Board of
6-47 Dental Examiners to annually apply and to be registered as such
6-48 practitioners with the State Board of Dental Examiners on or before
6-49 the expiration date of the license [March 1st of each calendar
6-50 year]. Each person so registering shall pay in connection with
6-51 such annual registration for the receipt hereinafter provided for,
6-52 a fee as determined by said Board according to the needs of said
6-53 Board, such payment to be made by each person to such Board, and
6-54 every person so registering shall file with said Board a written
6-55 application setting forth such facts as the Board may require. A
6-56 person holding a dental or dental hygienist license must attach to
6-57 the application proof that the applicant has successfully completed
6-58 a current course [of current certification] in cardiopulmonary
6-59 resuscitation given or approved by the American Heart Association
6-60 or American Red Cross or, in the event that the applicant [person]
6-61 is not physically capable of successfully completing such training,
6-62 a written statement executed by either a licensed physician or an
6-63 instructor in cardiopulmonary resuscitation approved by the
6-64 American Heart Association or American Red Cross that describes
6-65 such physical incapacity. In lieu of this requirement for
6-66 completion of a current course in [annual] cardiopulmonary
6-67 resuscitation [certification], a dentist or dental hygienist
6-68 licensed by the State Board of Dental Examiners and residing in a
6-69 country other than the United States may satisfy this requirement
7-1 by submitting proof of residence upon the annual date of renewal.
7-2 Upon receipt of such applications, accompanied by such fees, said
7-3 Board, after ascertaining either from its records or other sources
7-4 deemed by it to be reliable that the applicant holds a valid
7-5 license or certificate to practice in this State, shall issue to
7-6 the applicant an annual registration certificate or receipt
7-7 certifying that he has filed such application and has paid the
7-8 required fee; provided that the filing of such application, the
7-9 payment of such fee, and the issuance of such receipt therefor
7-10 shall not entitle the holder thereof to lawfully practice within
7-11 the State of Texas unless he in fact holds a license or certificate
7-12 as such practitioner issued by the State Board of Dental Examiners,
7-13 as provided by this law, and unless said license or certificate is
7-14 in full force and effect; and provided further, that in any
7-15 prosecution for unlawful practice such receipt showing payment of
7-16 the annual registration fee required by this chapter shall not be
7-17 treated as evidence that the holder thereof is lawfully entitled to
7-18 practice.
7-19 SECTION 14. Subsections (c), (d), (e), and (h), Section 2,
7-20 Article 4550a, Revised Statutes, are amended to read as follows:
7-21 (c) If a person's license or certificate has been expired
7-22 for not longer than ninety (90) days, the person may renew it by
7-23 paying to the Board the required renewal fee and a fee that is
7-24 one-half of the application [examination] fee for the license or
7-25 certificate.
7-26 (d) If a person's license or certificate has been expired
7-27 for longer than ninety (90) days but less than one year, the person
7-28 may renew it by paying to the Board all unpaid renewal fees and a
7-29 fee that is equal to the application [examination] fee for the
7-30 license or certificate.
7-31 (e) If a person's license or certificate has been expired
7-32 for one year or longer, the person may not renew it[, except as
7-33 provided by Section 2A of this article]. The person may obtain a
7-34 new license or certificate by submitting to reexamination and
7-35 complying with the requirements and procedures for obtaining an
7-36 original license or certificate. However, the Board may adopt
7-37 rules providing for renewal without reexamination of an expired
7-38 license of a person who was licensed in this state, moved to
7-39 another state, and is currently licensed and has been in practice
7-40 in the other state for the two years preceding application. The
7-41 person must pay to the Board a fee that is equal to the examination
7-42 fee for the license.
7-43 (h) The Board by rule may adopt a system under which
7-44 licenses expire on various dates during the year. [For the year in
7-45 which the license expiration date is changed, license fees payable
7-46 on March 1 shall be prorated on a monthly basis so that each
7-47 licensee shall pay only that portion of the license fee that is
7-48 allocable to the number of months during which the license is
7-49 valid. On renewal of the license on the new expiration date, the
7-50 total license renewal fee is payable.]
7-51 SECTION 15. Subsection (i), Section 4, Article 4550a,
7-52 Revised Statutes, is amended to read as follows:
7-53 (i) The Board shall develop and implement policies that
7-54 provide the public with a reasonable opportunity to appear before
7-55 the Board and to speak on any issue under the jurisdiction of the
7-56 Board, except to the extent that that communication would be ex
7-57 parte under any provision of law.
7-58 SECTION 16. Subsection (a), Article 4550c, Revised Statutes,
7-59 is amended to read as follows:
7-60 (a) Each dental application [examination] fee and dentist
7-61 annual renewal fee imposed by or under Subsection (b), Article
7-62 4551, Revised Statutes, is increased by $200.
7-63 SECTION 17. Article 4551a, Revised Statutes, is amended to
7-64 read as follows:
7-65 Art. 4551a. PERSONS REGARDED AS PRACTICING DENTISTRY. Any
7-66 person shall be regarded as practicing dentistry within the meaning
7-67 of this Chapter:
7-68 (1) Who publicly professes to be a dentist or dental
7-69 surgeon or who uses or permits to be used for himself or for any
8-1 other person, the title of "Doctor," "Dr.," "Doctor of Dental
8-2 Surgery," "D.D.S.," "Doctor of Dental Medicine," "D.M.D.," or any
8-3 other letters, titles, terms or descriptive matter, including use
8-4 of the terms "denturist" or "denturism," which directly or
8-5 indirectly represents him as being able to diagnose, treat, remove
8-6 stains or concretions from teeth, provide surgical and adjunctive
8-7 treatment for any disease, pain, injury, deficiency, deformity or
8-8 physical condition of the human teeth, oral cavity, alveolar
8-9 process, gums, jaws or directly related and adjacent masticatory
8-10 structures.
8-11 (2) Who shall offer or undertake by any means or
8-12 methods whatsoever, to clean teeth or to remove stains, concretions
8-13 or deposits from teeth in the human mouth, or who shall undertake
8-14 or offer to diagnose, treat, operate, or prescribe by any means or
8-15 methods for any disease, pain, injury, deficiency, deformity, or
8-16 physical condition of the human teeth, oral cavity, alveolar
8-17 process, gums, or jaws.
8-18 (3) Any person who shall offer or undertake in any
8-19 manner to prescribe or make, or cause to be made, an impression of
8-20 any portion of the human mouth, teeth, gums, or jaws, for the
8-21 purpose of diagnosing, prescribing, treating, or aiding in the
8-22 diagnosing, prescribing or treating, any physical condition of the
8-23 human mouth, teeth, gums or jaws, or for the purpose of
8-24 constructing or aiding in the construction of any dental appliance,
8-25 denture, dental bridge, false teeth, dental plate or plates of
8-26 false teeth, or any other substitute for human teeth.
8-27 (4) Any one who owns, manages, maintains, or operates
8-28 any office or place of business where he employs or engages, under
8-29 any kind of contract whatsoever, any other person or persons to
8-30 practice dentistry as above defined shall be deemed to be
8-31 practicing dentistry himself and shall himself be required to be
8-32 duly licensed to practice dentistry as hereinabove defined, and
8-33 shall be subject to all of the other provisions of this Chapter,
8-34 even though the person or persons so employed or engaged by him
8-35 shall be duly licensed to practice dentistry as hereinabove
8-36 defined, unless otherwise provided by law.
8-37 (5) Any person, firm, group, association, or
8-38 corporation who shall offer or undertake to fit, adjust, repair, or
8-39 substitute in the human mouth or directly related and adjacent
8-40 masticatory structures any dental appliance, structure, prosthesis,
8-41 or denture, or who shall aid or cause to be fitted, adjusted,
8-42 repaired, or substituted in the human mouth or directly related and
8-43 adjacent masticatory structures any dental appliance, structure,
8-44 prosthesis, or denture.
8-45 (6) Who makes, fabricates, processes, constructs,
8-46 produces, reproduces, duplicates, repairs, relines, or fixes any
8-47 full or partial denture, any fixed or removable dental bridge or
8-48 appliance, any dental plate or plates of false teeth, any
8-49 artificial dental restoration, or any substitute or corrective
8-50 device or appliance for the human teeth, gums, jaws, mouth,
8-51 alveolar process, or any part thereof for another, or who in any
8-52 manner offers, undertakes, aids, abets, or causes another person so
8-53 to do for another, without a written prescription or work-order
8-54 therefor signed by the dentist legally engaged in the practice of
8-55 dentistry in this state or in the jurisdiction where such dentist
8-56 maintains his dental office and who prescribed and ordered same.
8-57 (7) Who shall offer or undertake or cause another to
8-58 do, directly or indirectly, for any person any act, service, or
8-59 work in the practice of dentistry or any part thereof as provided
8-60 for in the laws of Texas relating to the practice of dentistry
8-61 including without limitation the inducing, administering,
8-62 prescribing, or dispensing any anesthesia, anesthetic drug,
8-63 medicine, or agent in anywise incidental to or in connection with
8-64 the practice of dentistry; or who permits or allows another to use
8-65 his license or certificate to practice dentistry in this state for
8-66 the purpose of performing any act described in this Article; or who
8-67 shall aid or abet, directly or indirectly, the practice of
8-68 dentistry by any person not duly licensed to practice dentistry by
8-69 the State Board of Dental Examiners.
9-1 (8) Who shall control, attempt to control, influence,
9-2 attempt to influence, through a management agreement, or otherwise
9-3 interfere with the exercise of a dentist's independent professional
9-4 judgment regarding the diagnosis or treatment of any dental
9-5 disease, disorder, or physical condition. Rules adopted by the
9-6 Board addressing the prohibitions in this section may prohibit a
9-7 person who is not a dentist from directly or indirectly influencing
9-8 or interfering with the exercise of a dentist's independent
9-9 professional judgment. However, nothing herein shall be construed
9-10 to require any entity to pay for services which are not provided
9-11 for in a contract or agreement or to exempt any dentist who is a
9-12 member of a hospital staff from adhering to hospital bylaws,
9-13 medical staff bylaws, or established policies approved by the
9-14 governing board and the medical and dental staff of the hospital.
9-15 (9) If the person holds the person out to be a
9-16 denturist or uses another title that is intended to convey to the
9-17 public that the services offered by the person are included within
9-18 the practice of dentistry.
9-19 SECTION 18. Section 11, Chapter 244, General Laws, Acts of
9-20 the 44th Legislature, Regular Session, 1935 (Article 4551b,
9-21 Vernon's Texas Civil Statutes), is amended to read as follows:
9-22 Sec. 11. The definition of dentistry as contained in Chapter
9-23 9, Title 71, Revised Statutes, shall not apply to:
9-24 (1) members of the faculty of a reputable dental or
9-25 dental hygiene college or school where such faculty members perform
9-26 their services for the sole benefit of such school or college;
9-27 (2) students of a reputable dental college who perform
9-28 their operations without pay except for actual cost of materials,
9-29 in the presence of and under the direct personal supervision of a
9-30 demonstrator or teacher who is a member of the faculty of a
9-31 reputable dental college;
9-32 (3) persons doing laboratory work on inert matter
9-33 only, and who do not solicit or obtain work, by any means, from a
9-34 person or persons not a licensed dentist actually engaged in the
9-35 practice of dentistry and who do not act as the agents or
9-36 solicitors of, or have any interest whatsoever in, any dental
9-37 office, practice or the receipts therefrom;
9-38 (4) physicians and surgeons legally authorized to
9-39 practice medicine as defined by the law of this state who do not
9-40 hold themselves out to the public as practicing dentistry;
9-41 (5) dental hygienists legally authorized to practice
9-42 dental hygiene in this state and who practice dental hygiene in
9-43 strict conformity with the laws of Texas regulating the practice of
9-44 dental hygiene;
9-45 (6) those persons who as members of an established
9-46 church practice healing by prayer only;
9-47 (7) employees of a dentist who make dental x-rays in
9-48 the dental office and under the supervision of such dentist or
9-49 dentists legally engaged in the practice of dentistry in this
9-50 state;
9-51 (8) Dental Health Service Corporations legally
9-52 chartered under Section A(1), Article 2.01, Texas Non-Profit
9-53 Corporation Act (Article 1396-2.01, Vernon's Texas Civil Statutes);
9-54 (9) dental interns and dental residents as defined and
9-55 regulated by the Texas State Board of Dental Examiners in its rules
9-56 and regulations;
9-57 (10) a student [students] of a dental hygiene program
9-58 accredited by the Commission on Dental Accreditation of the
9-59 American Dental Association and operated at an accredited
9-60 institution of higher education who practices [practice] dental
9-61 hygiene:
9-62 (A) without pay under the general supervision of
9-63 a dentist and under the supervision of a demonstrator or teacher
9-64 who is a member of the faculty of that program;
9-65 (B) in strict conformity with the laws of this
9-66 state regulating the practice of dental hygiene, except that they
9-67 may practice under the supervision of a demonstrator or teacher who
9-68 is a dentist member of the faculty of that program; and
9-69 (C) in a clinic operated:
10-1 (i) for the sole benefit of the program's
10-2 institution of higher education; or
10-3 (ii) [in a clinic operated] by a
10-4 government or nonprofit organization that serves underserved
10-5 populations, as determined by rule of the State Board of Dental
10-6 Examiners [and in strict conformity with the laws of this state
10-7 regulating the practice of dental hygiene];
10-8 (11) dental assistants who perform the duties
10-9 permitted by Article 4551e-1, Revised Statutes, in strict
10-10 conformity with the laws of this state; [or]
10-11 (12) dentists and dental hygienists licensed by
10-12 another state or foreign country who perform clinical procedures
10-13 only for professional and technical education demonstration
10-14 purposes, provided that such dentists and dental hygienists must
10-15 first obtain a temporary license for such purpose from the State
10-16 Board of Dental Examiners;
10-17 (13) a dental hygienist who is a faculty member of a
10-18 dental or dental hygiene school while practicing dental hygiene
10-19 only:
10-20 (A) under the supervision of a dentist member of
10-21 the faculty; and
10-22 (B) otherwise, in strict conformity with the
10-23 laws regulating the practice of dental hygiene;
10-24 (14) a dentist enrolled in remedial training programs
10-25 sponsored by the Commission on Dental Accreditation of the American
10-26 Dental Association at an accredited dental or dental hygiene school
10-27 while participating in such a program in this state;
10-28 (15) a dental hygienist enrolled in remedial training
10-29 programs sponsored by the Commission on Dental Accreditation of the
10-30 American Dental Association at an accredited dental or dental
10-31 hygiene school while participating in such a program in this state
10-32 in strict conformity with the laws regulating the practice of
10-33 dental hygiene, except that supervision may be provided by a
10-34 demonstrator or teacher who is a dentist member of the program;
10-35 (16) a dentist who is not licensed in this state and
10-36 who is a candidate enrolled to take the dental clinical examination
10-37 offered by the Western Regional Examining Board in this state while
10-38 taking the examination;
10-39 (17) a dental hygienist who is not licensed in this
10-40 state and who is a candidate enrolled to take the dental hygiene
10-41 clinical examination offered by the Western Regional Examining
10-42 Board in this state while taking the examination if participation
10-43 is in strict conformity with the laws of this state regulating the
10-44 practice of dental hygiene, except that supervision may be provided
10-45 by a dentist whose services are secured by the Western Regional
10-46 Examining Board;
10-47 (18) a dentist whose license is in retired status or
10-48 who is licensed in another state and is attending a continuing
10-49 education clinical program offered at a dental or dental hygiene
10-50 school accredited by the Commission on Dental Accreditation of the
10-51 American Dental Association while attending the program; or
10-52 (19) a dental hygienist whose dental hygienist license
10-53 is in retired status or who is licensed in another state and is
10-54 attending a continuing education clinical program offered at a
10-55 dental or dental hygiene school accredited by the Commission on
10-56 Dental Accreditation of the American Dental Association while
10-57 attending the program if tasks are performed in strict conformity
10-58 with the laws regulating the practice of dental hygiene, except
10-59 that supervision may be provided by a dentist member of the
10-60 program.
10-61 SECTION 19. Section 2, Chapter 475, Acts of the 52nd
10-62 Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
10-63 Civil Statutes), is amended to read as follows:
10-64 Sec. 2. QUALIFICATIONS. Each applicant for a license to
10-65 practice [A] dental hygiene in this state [hygienist] shall be:
10-66 (1) not less than eighteen (18) years of age;
10-67 (2) of good moral character;
10-68 (3) [and] a graduate of an accredited high school or
10-69 hold a certificate of high school equivalency (GED); and
11-1 (4) [be] a graduate of a recognized school or college
11-2 of dentistry or dental hygiene accredited by the Commission on
11-3 Dental Accreditation of the American Dental Association and
11-4 approved by the State Board of Dental Examiners that includes at
11-5 least two full academic years of instruction or its equivalent at
11-6 the postsecondary level.
11-7 SECTION 20. Subsection (b), Section 3, Chapter 475, Acts of
11-8 the 52nd Legislature, Regular Session, 1951 (Article 4551e,
11-9 Vernon's Texas Civil Statutes), is amended to read as follows:
11-10 (b) All work performed by a dental hygienist in the practice
11-11 of dental hygiene, as defined in this Act, shall be performed in
11-12 the dental office of the supervising dentist or dentists who are
11-13 legally engaged in the practice of dentistry in this state[, by
11-14 whom he or she must be employed,] or under the supervision of a
11-15 supervising dentist in an alternate setting, including, but not
11-16 limited to, a nursing home, [or] the patient's home, a school, a
11-17 hospital, a state institution, a public health clinic, or another
11-18 institution [provided that the hygienist is licensed to perform the
11-19 delegated procedure and the supervising dentist examines the
11-20 patient during the 12 months preceding the performance of the
11-21 procedure by the dental hygienist or at the time the procedure is
11-22 performed, except where employed by schools, hospitals, state
11-23 institutions, public health clinics or other institutions that have
11-24 applied to and been approved by the Texas State Board of Dental
11-25 Examiners as a proper location for the performance of a dental
11-26 procedure].
11-27 SECTION 21. Subsection (d), Section 4A, Chapter 475, Acts of
11-28 the 52nd Legislature, Regular Session, 1951 (Article 4551e,
11-29 Vernon's Texas Civil Statutes), is amended to read as follows:
11-30 (d) A member of the advisory committee is entitled to the
11-31 compensatory per diem set by the General Appropriations Act for
11-32 each day that the member engages in committee business. [Except
11-33 for transportation expenses, a member is not entitled to
11-34 reimbursement for travel expenses.] A member may receive [is
11-35 entitled to] reimbursement for travel [transportation] expenses,
11-36 including expenses for meals and lodging [as provided by the
11-37 General Appropriations Act].
11-38 SECTION 22. Section 5, Chapter 475, Acts of the 52nd
11-39 Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
11-40 Civil Statutes), is amended to read as follows:
11-41 Sec. 5. EXAMINATION. (a) It shall be the duty of the Board
11-42 to provide for the examination of all qualified applicants for
11-43 licensure as dental hygienists in this State. All applicants for
11-44 licensure [examination] shall pay an application [a] fee set by the
11-45 Board to said Board as determined by said Board according to its
11-46 needs and shall apply upon forms furnished by the Board and shall
11-47 furnish such other information as the Board may in its discretion
11-48 require to determine any applicant's qualifications. An applicant
11-49 must attach to the application proof that the applicant has
11-50 successfully completed a current course in cardiopulmonary
11-51 resuscitation given or approved by the American Heart Association
11-52 or American Red Cross before the date on which the applicant
11-53 submits the application or, in the event that the applicant is not
11-54 physically capable of successfully completing such training, a
11-55 written statement executed by either a licensed physician or an
11-56 instructor in cardiopulmonary resuscitation approved by the
11-57 American Heart Association or American Red Cross that describes
11-58 such physical incapacity.
11-59 (b) The examination shall be taken by all applicants on such
11-60 subjects and operations pertaining to dentistry and dental hygiene
11-61 which shall include Dental Anatomy, Pharmacology, X-Ray, Ethics,
11-62 Jurisprudence, and Hygiene, and such other subjects as are
11-63 regularly taught in reputable schools of dentistry and dental
11-64 hygiene, as the Board in its discretion may require.
11-65 (c) The Board shall contract with an independent or regional
11-66 testing service for any required clinical examination.
11-67 (d) In the event that the Board uses a regional testing
11-68 service, the Board is authorized to contract for or otherwise use
11-69 the services of licensed dental hygienists in this State for the
12-1 purpose of providing assistance to the regional testing service.
12-2 (e) The Board shall have the written portion of the Board's
12-3 jurisprudence examination validated by an independent testing
12-4 professional.
12-5 (f) The Board shall report such grades to the applicant
12-6 within a reasonable time after such examination. If the Board
12-7 contracts with an independent or regional testing service, the
12-8 contract with the independent or regional testing service shall
12-9 provide for notification of results. Each[, and each] applicant
12-10 who has satisfactorily passed all phases of the examination as
12-11 determined by the Board shall be entitled to and shall be issued a
12-12 license permitting such applicant to practice dental hygiene in the
12-13 State of Texas as is defined and regulated by the law of this
12-14 State.
12-15 (g) [(b)] The Board by rule shall set the number of and
12-16 conditions for examination retakes. The Board may require an
12-17 applicant who fails the examination to meet additional education
12-18 requirements set by the Board.
12-19 SECTION 23. Subsection (b), Section 5A, Chapter 475, Acts of
12-20 the 52nd Legislature, Regular Session, 1951 (Article 4551e,
12-21 Vernon's Texas Civil Statutes), is amended to read as follows:
12-22 (b) The State Board of Dental Examiners by rule shall:
12-23 (1) require a licensee to complete at least 12 [36]
12-24 hours of continuing education for [in] each annual registration
12-25 [three-year] period as a prerequisite to renewal for a subsequent
12-26 annual period [to maintain licensure];
12-27 (2) identify the key factors that lead to the
12-28 competent performance of professional duties under this Act;
12-29 (3) develop a process to evaluate and approve
12-30 continuing education courses; and
12-31 (4) develop a process to assess a licensee's
12-32 participation and performance in continuing education courses that
12-33 will enable the Board to evaluate the overall effectiveness of the
12-34 program.
12-35 SECTION 24. Subsections (c) and (d), Section (6), Article
12-36 4551f, Revised Statutes, are amended to read as follows:
12-37 (c) If the owner or manager of a dental laboratory required
12-38 to be registered under this section fails to renew the registration
12-39 and pay the annual renewal fee before the expiration date as set by
12-40 the Board, the Board shall suspend the registration certificate of
12-41 that laboratory. An owner or manager may renew an unexpired
12-42 certificate by paying the required renewal fee to the Board on or
12-43 before the expiration date. If the certificate has been expired
12-44 for not more than 90 days, the owner or manager may renew the
12-45 certificate by paying to the Board the required renewal fee and a
12-46 fee equal to one-half the renewal fee. If the certificate has been
12-47 expired for more than 90 days but less than one year [two years],
12-48 the owner or manager may renew the certificate by paying to the
12-49 Board all unpaid renewal fees and a fee equal to the amount of the
12-50 initial registration fee. If the certificate has been expired for
12-51 one year [two years] or longer, the owner or manager may not renew
12-52 the certificate. To reinstate the certificate, the owner or
12-53 manager must comply with the requirements for obtaining an original
12-54 certificate.
12-55 (d) The owner of a dental laboratory registered with the
12-56 Board on September 1, 1987, is not required to submit proof that
12-57 the laboratory has at least one certified dental technician
12-58 employed by and working on the premises of the laboratory if:
12-59 (1) the registration of the laboratory has been
12-60 renewed each year [continuous] since that date and all registration
12-61 fees have been paid;
12-62 (2) the beneficial ownership of at least 51 percent of
12-63 the laboratory has not been transferred; and
12-64 (3) the owner is employed on the premises of the
12-65 laboratory not less than 30 hours each week.
12-66 SECTION 25. Article 4551j, Revised Statutes, is amended to
12-67 read as follows:
12-68 Art. 4551j. CIVIL IMMUNITY, OFFICIAL ACTS. In the absence
12-69 of fraud, conspiracy, or malice, no member of the Texas State Board
13-1 of Dental Examiners, its employees, part-time employees, or persons
13-2 who contract with the board, nor any witness called to testify by
13-3 said board, nor any consultant or hearing officer appointed by said
13-4 board shall be liable or subject to suit or suits for damages for
13-5 alleged injury, wrong, loss, or damage allegedly caused by any of
13-6 said persons for any investigation, report, recommendation,
13-7 statement, evaluation, finding, order, or award made in the course
13-8 of any of said persons performing assigned, designated, official,
13-9 or statutory duties. This immunity is enacted to relieve and
13-10 protect the persons named from being harassed and threatened with
13-11 legal action while attempting to perform official duties.
13-12 SECTION 26. Section 2, Article 4544a, Revised Statutes, is
13-13 repealed.
13-14 SECTION 27. Subsection (b), Section 5, Article 4544, Revised
13-15 Statutes, Subsection (b), Section 5A, Chapter 475, Acts of the 52nd
13-16 Legislature, Regular Session, 1951 (Article 4551e, Vernon's Texas
13-17 Civil Statutes), and Subsection (c), Section (6), Article 4551f,
13-18 Revised Statutes, as amended by this Act, apply only to licenses
13-19 and registrations that expire after the effective date of this Act.
13-20 Licenses and registrations in effect the day before the effective
13-21 date of this Act continue to be valid and expire according to their
13-22 own terms.
13-23 SECTION 28. This Act takes effect September 1, 1999.
13-24 SECTION 29. The importance of this legislation and the
13-25 crowded condition of the calendars in both houses create an
13-26 emergency and an imperative public necessity that the
13-27 constitutional rule requiring bills to be read on three several
13-28 days in each house be suspended, and this rule is hereby suspended.
13-29 * * * * *