79R5720 MSE-D

By:  Zedler                                                       H.B. No. 3003



A BILL TO BE ENTITLED

AN ACT

relating to the authority of a dental hygienist to prescribe and 
administer fluoride varnish.
	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)  except as provided by Section 262.153, 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)  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.
	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 is licensed to perform the 
service, task, or procedure;
		(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)  except as provided by Section 262.153,
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.  Section 262.152, Occupations Code, is amended to 
read as follows:
	Sec. 262.152.  PERFORMANCE OF DELEGATED DUTIES.  Except as 
provided by Section 262.153, a [A] dental hygienist shall practice 
dental hygiene:
		(1)  in the dental office of a supervising dentist 
licensed by the board; or
		(2)  in an alternate setting, including a nursing home, 
the patient's home, a school, a hospital, a state institution, a 
public health clinic, or another institution, under the supervision 
of a supervising dentist.
	SECTION 4.  Subchapter D, Chapter 262, Occupations Code, is 
amended by adding Section 262.153 to read as follows:
	Sec. 262.153.  LIMITED PRESCRIPTION PERMIT.  (a)  The board 
by rule shall provide for issuance of a permit to a dental hygienist 
to prescribe and administer fluoride varnish.
	(b)  To obtain a permit under this section, a dental 
hygienist must meet the educational qualifications and provide 
proof of competency in the administration of fluoride varnish 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 fluoride varnish 
by a dental hygienist who holds a permit under this section.
	(d)  A dental hygienist with a permit issued under this 
section may prescribe and administer fluoride varnish without 
supervision by a dentist.
	SECTION 5.  The State Board of Dental Examiners shall adopt 
rules as required by Section 262.153, Occupations Code, as added by 
this Act, not later than November 1, 2005.
	SECTION 6.  This Act takes effect September 1, 2005.