By Maxey H.B. No. 411
77R2793 MXM-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to delegation of certain acts by dentists.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 258.001, Occupations Code, is amended to
1-5 read as follows:
1-6 Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not
1-7 delegate:
1-8 (1) an act to an individual who, by board order, is
1-9 prohibited from performing the act;
1-10 (2) any of the following acts to a person not licensed
1-11 as a dentist or dental hygienist:
1-12 (A) the removal of calculus, deposits, or
1-13 accretions from the natural and restored surfaces of exposed human
1-14 teeth and restorations in the human mouth;
1-15 (B) root planing or the smoothing and polishing
1-16 of roughened root surfaces [or exposed human teeth]; or
1-17 (C) any other act the delegation of which is
1-18 prohibited by board rule;
1-19 (3) any of the following acts to a person not licensed
1-20 as a dentist:
1-21 (A) comprehensive examination or diagnosis and
1-22 treatment planning;
1-23 (B) a surgical or cutting procedure on hard or
1-24 soft tissue;
2-1 (C) the prescription of a drug, medication, or
2-2 work authorization;
2-3 (D) the taking of an impression for a final
2-4 restoration, appliance, or prosthesis;
2-5 (E) the making of an intraoral occlusal
2-6 adjustment;
2-7 (F) direct pulp capping, pulpotomy, or any other
2-8 endodontic procedure;
2-9 (G) the final placement and intraoral adjustment
2-10 of a fixed or removable appliance; or
2-11 (H) the placement of any final restoration; or
2-12 (4) the authority to an individual to administer a
2-13 local anesthetic agent, inhalation sedative agent, parenteral
2-14 sedative agent, or general anesthetic agent if the individual is
2-15 not licensed as:
2-16 (A) a dentist with a permit issued by the board
2-17 for the procedure being performed, if a permit is required;
2-18 (B) a certified registered nurse anesthetist
2-19 licensed by the Board of Nurse Examiners, only if the delegating
2-20 dentist holds a permit issued by the board for the procedure being
2-21 performed, if a permit is required; or
2-22 (C) a physician anesthesiologist licensed by the
2-23 Texas State Board of Medical Examiners.
2-24 SECTION 2. Section 258.002, Occupations Code, is amended by
2-25 amending Subsection (b) and adding Subsection (c) to read as
2-26 follows:
2-27 (b) A licensed dentist who is a Medicaid provider may
3-1 delegate, under Subsection (a), the application of a pit and
3-2 fissure sealant.
3-3 (c) The board by rule shall establish guidelines regarding
3-4 the types of dental acts that may be properly or safely delegated
3-5 by a dentist, including a determination of which delegated dental
3-6 acts, if any, require competency testing before a person may
3-7 perform the act.
3-8 SECTION 3. Subchapter D, Chapter 262, Occupations Code, is
3-9 amended by adding Section 262.1515 to read as follows:
3-10 Sec. 262.1515. DELEGATION OF DUTIES TO DENTAL HYGIENIST
3-11 PRACTICING IN FACILITY SERVING UNDERSERVED POPULATION. (a) In
3-12 this section, "facility serving an underserved population" means:
3-13 (1) a health center as defined by 42 U.S.C. Section
3-14 254b;
3-15 (2) a group home as defined by Section 591.003, Health
3-16 and Safety Code;
3-17 (3) a public school as defined by Section 821.001,
3-18 Government Code; or
3-19 (4) a nursing facility as defined by Section 242.301,
3-20 Health and Safety Code.
3-21 (b) A licensed dentist may delegate a service, task, or
3-22 procedure, including the application of a pit and fissure sealant,
3-23 to a dental hygienist without complying with Section 262.151(a)(2)
3-24 if:
3-25 (1) the dental hygienist has at least two years'
3-26 experience in the practice of dental hygiene; and
3-27 (2) the service, task, or procedure is performed in a
4-1 facility serving an underserved population.
4-2 (c) The patient must be referred to a licensed dentist after
4-3 the completion of a service, task, or procedure perfomed under
4-4 Subsection (b).
4-5 SECTION 4. Section 265.003, Occupations Code, is amended to
4-6 read as follows:
4-7 Sec. 265.003. PERMITTED DUTIES. (a) A dental assistant who
4-8 is not professionally licensed may:
4-9 (1) be employed by and work in the office of a
4-10 licensed and practicing dentist; and
4-11 (2) perform one or more delegated dental acts under
4-12 the direct supervision, direction, and responsibility of the
4-13 dentist, including the application of a pit and fissure sealant.
4-14 (b) A dental assistant may apply a pit and fissure sealant
4-15 under Subsection (a) only if the assistant:
4-16 (1) has at least two years' experience as an
4-17 assistant;
4-18 (2) has completed any training required by the board
4-19 for application of a sealant under this section; and
4-20 (3) is certified by the board to perform the act.
4-21 SECTION 5. This Act takes effect September 1, 2001.