79R7312 MSE-F
By:  Rodriguez                                                    H.B. No. 3027
A BILL TO BE ENTITLED
AN ACT
relating to the authority of a dental hygienist to provide services 
in certain facilities and schools.
	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.  Except as 
provided by Section 262.1515, a [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)  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.  The heading to Section 262.1515, Occupations 
Code, is amended to read as follows:
	Sec. 262.1515.  [DELEGATION OF DUTIES TO] DENTAL HYGIENIST 
PRACTICING IN CERTAIN [LONG-TERM CARE] FACILITIES AND SCHOOLS
[SCHOOL-BASED HEALTH CENTERS].
	SECTION 3.  Sections 262.1515(a)-(c), Occupations Code, are 
amended to read as follows:
	(a)  A licensed [dentist may delegate a service, task, or 
procedure, pursuant to this section, to a] dental hygienist may 
provide unsupervised preventive and therapeutic dental hygiene 
services in a long-term care facility, school, Head Start Center, 
day-care facility, and other institution approved by board rule[, 
without complying with Section 262.151(a)(2)] if:
		(1)  the dental hygienist is a graduate of a dental 
hygiene program accredited by the American Dental Association's 
Commission on Dental Accreditation [has at least two years' 
experience in the practice of dental hygiene]; [and]
		(2)  the dental hygienist has at least two years' 
experience practicing dental hygiene;
		(3)  the service, task, or procedure is included in the 
American Dental Association's Commission on Dental Accreditation 
standards for dental hygiene education programs patient care 
competencies; and
		(4)  the dental hygienist has established a 
collaborative agreement with a licensed dentist for purposes of 
consultation [the service, task, or procedure is performed in one 
of the following locations:
			[(A)  a nursing facility as defined in Section 
242.301, Health and Safety Code;  or
			[(B)  a school-based health center established 
under Section 38.011, Education Code, as added by Chapter 1418, 
Acts of the 76th Legislature, Regular Session, 1999].
	(b)  A dental hygienist providing services under this 
section shall:  
		(1)  follow appropriate documentation protocols 
established by board rule;
		(2)  ensure that the patient or the patient's parent, 
legal guardian, or custodian does not construe the services 
provided by the dental hygienist to be a replacement for a 
comprehensive dental evaluation by a licensed dentist; and
		(3)  refer the patient to a licensed dentist to 
establish a dentist and patient relationship.  [The patient must be 
referred to a licensed dentist after the completion of a service, 
task, or procedure performed under Subsection (a).]
	(c)  A dental hygienist providing services under this 
section is exempt from a requirement in this subtitle that the 
dental hygienist be supervised by a licensed dentist [may not 
perform a second set of delegated tasks or procedures until the 
patient has been examined by a dentist in compliance with Section 
262.151(a)(2)].
	SECTION 4.  Section 262.152, Occupations Code, is amended to 
read as follows:
	Sec. 262.152.  PERFORMANCE OF DELEGATED DUTIES.  Except as 
provided by Section 262.1515, 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 5.  (a)  The State Board of Dental Examiners shall 
adopt rules as required by Section 262.1515, Occupations Code, as 
amended by this Act, not later than November 1, 2005.
	(b)  To the extent of any conflict, this Act prevails over 
another Act of the 79th Legislature, Regular Session, 2005, 
relating to nonsubstantive additions to and corrections in enacted 
codes.
	SECTION 6.  This Act takes effect September 1, 2005.