79R7312 MSE-F

By:  Lucio                                                        S.B. No. 1163


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.