78R5492 JMM-F

By:  Reyna                                                        H.B. No. 2597



A BILL TO BE ENTITLED

AN ACT

relating to the authority of a dental hygienist to administer a 
local anesthetic agent.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 258.001, Occupations Code, is amended to 
read as follows:
	Sec. 258.001.  IMPERMISSIBLE DELEGATIONS.  A dentist may not 
delegate:       
		(1)  an act to an individual who, by board order, is 
prohibited from performing the act;
		(2)  any of the following acts to a person not licensed 
as a dentist or dental hygienist:
			(A)  the removal of calculus, deposits, or 
accretions from the natural and restored surfaces of exposed human 
teeth and restorations in the human mouth;
			(B)  root planing or the smoothing and polishing 
of roughened root surfaces or exposed human teeth;  or
			(C)  any other act the delegation of which is 
prohibited by board rule;    
		(3)  any of the following acts to a person not licensed 
as a dentist:       
			(A)  comprehensive examination or diagnosis and 
treatment planning;        
			(B)  a surgical or cutting procedure on hard or 
soft tissue;               
			(C)  the prescription of a drug, medication, or 
work authorization;        
			(D)  the taking of an impression for a final 
restoration, appliance, or prosthesis;
			(E)  the making of an intraoral occlusal 
adjustment;                       
			(F)  direct pulp capping, pulpotomy, or any other 
endodontic procedure;    
			(G)  the final placement and intraoral adjustment 
of a fixed or removable appliance;  or
			(H)  the placement of any final restoration;  [or]          
		(4)  except as provided by Subdivision (5), the 
authority to an individual to administer a local anesthetic agent, 
inhalation sedative agent, parenteral sedative agent, or general 
anesthetic agent if the individual is not licensed as:
			(A)  a dentist with a permit issued by the board 
for the procedure being performed, if a permit is required;
			(B)  a certified registered nurse anesthetist 
licensed by the Board of Nurse Examiners, only if the delegating 
dentist holds a permit issued by the board for the procedure being 
performed, if a permit is required;  or
			(C)  a physician anesthesiologist licensed by the 
Texas State Board of Medical Examiners;  or
		(5)  the authority to a dental hygienist to administer 
a local anesthetic agent unless the dental hygienist is certified 
by the board to administer a local anesthetic agent under the 
supervision of a dentist or a physician licensed in this state.
	SECTION 2.  Section 262.151(a), Occupations Code, is amended 
to read as follows:
	(a)  A licensed dentist may delegate orally or in writing a 
service, task, or procedure to a dental hygienist who is under the 
supervision and responsibility of the dentist, if:
		(1)  the dental hygienist:                                             
			(A) is licensed to perform the service, task, or 
procedure;  and
			(B)  holds any necessary certification issued by 
the board;         
		(2)  the supervising dentist examines the patient:                            
			(A)  at the time the service, task, or procedure 
is performed by the dental hygienist;  or
			(B)  during the 12 calendar months preceding the 
date of performance of the service, task, or procedure by the dental 
hygienist;  and
		(3)  the dental hygienist does not:                                           
			(A)  diagnose a dental disease or ailment;                                   
			(B)  prescribe a treatment or a regimen;                                     
			(C)  prescribe, order, or dispense medication;  or                           
			(D)  perform any procedure that is irreversible or 
involves the intentional cutting of soft or hard tissue by any 
means.
	SECTION 3.  Subchapter D, Chapter 262, Occupations Code, is 
amended by adding Section 262.154 to read as follows:
	Sec. 262.154.  CERTIFICATION TO ADMINISTER LOCAL ANESTHETIC 
AGENT.  (a) The board by rule shall provide for issuance of a 
certificate to a dental hygienist to administer a local anesthetic 
agent.
	(b)  To obtain a certificate under this section, a dental 
hygienist must meet the educational qualifications and provide 
proof of competency in the administration of local anesthetic 
agents as required by the board after consultation with the 
advisory committee.
	(c)  Rules adopted by the board under this section must 
include rules that regulate the administration of a local 
anesthetic agent by a dental hygienist who holds a certificate 
under this section, including rules that provide for supervision of 
the dental hygienist by a dentist or physician licensed in this 
state.
	SECTION 4.  (a) This Act takes effect September 1, 2003.                       
	(b)  The State Board of Dental Examiners shall adopt rules 
required by Section 262.154, Occupations Code, as added by this 
Act, not later than January 1, 2004.