H. B. No. 131 As Introduced

As Introduced

127th General Assembly

Regular Session

2007-2008

H. B. No. 131

Representative McGregor, R.

Cosponsors: Representatives Stewart, J., Chandler, Seitz, McGregor, J., Bubp, Oelslager, Miller, Harwood, Wagoner, Peterson, Fessler, Bacon

A BILL

To amend section 4715.22 of the Revised Code to 1
permit dental hygienists to practice in certain 2
places and to make appropriations to the 3
Departments of Development and Health. 4

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That section 4715.22 of the Revised Code be 5
amended to read as follows: 6

       Sec. 4715.22. (A) As used in this section, "health care 7
facility" means either of the following: 8

       (1) A hospital registered under section 3701.07 of the 9
Revised Code; 10

       (2) A "home" as defined in section 3721.01 of the Revised 11
Code. 12

       (B) A licensed dental hygienist shall practice under the 13
supervision, order, control, and full responsibility of a dentist 14
licensed under this chapter. A dental hygienist may practice in a 15
dental office, public or private school, health care facility, 16
dispensary, or public institution, nursing home, public or private 17
clinic, mobile dental unit, headstart program or facility, patient 18
home, or other location approved by the state dental board. Except 19
as provided in division (C) or (D) of this section, a dental 20
hygienist may not provide dental hygiene services to a patient 21
when the supervising dentist is not physically present at the 22
location where the dental hygienist is practicing. 23

       (C) A dental hygienist may provide, for not more than fifteen 24
consecutive business days, dental hygiene services to a patient 25
when the supervising dentist is not physically present at the 26
location at which the services are provided if all of the 27
following requirements are met: 28

       (1) The dental hygienist has at least two years and a minimum 29
of three thousand hours of experience in the practice of dental 30
hygiene. 31

       (2) The dental hygienist has successfully completed a course 32
approved by the state dental board in the identification and 33
prevention of potential medical emergencies. 34

       (3) The dental hygienist complies with written protocols for 35
emergencies the supervising dentist establishes. 36

       (4) The dental hygienist does not perform, while the 37
supervising dentist is absent from the location, procedures while 38
the patient is anesthetized, definitive root planing, definitive 39
subgingival curettage, or other procedures identified in rules the 40
state dental board adopts. 41

       (5) The supervising dentist has evaluated the dental 42
hygienist's skills. 43

       (6) The supervising dentist examined the patient not more 44
than seven months prior to the date the dental hygienist provides 45
the dental hygiene services to the patient. 46

       (7) The dental hygienist complies with written protocols or 47
written standing orders that the supervising dentist establishes. 48

       (8) The supervising dentist completed and evaluated a medical 49
and dental history of the patient not more than one year prior to 50
the date the dental hygienist provides dental hygiene services to 51
the patient and, except when the dental hygiene services are 52
provided in a health care facility, the supervising dentist 53
determines that the patient is in a medically stable condition. 54

       (9) If the dental hygiene services are provided in a health 55
care facility, a doctor of medicine and surgery or osteopathic 56
medicine and surgery who holds a current certificate issued under 57
Chapter 4731. of the Revised Code or a registered nurse licensed 58
under Chapter 4723. of the Revised Code is present in the health 59
care facility when the services are provided. 60

       (10) In advance of the appointment for dental hygiene 61
services, the patient is notified that the supervising dentist 62
will be absent from the location and that the dental hygienist 63
cannot diagnose the patient's dental health care status. 64

       (11) The dental hygienist is employed by, or under contract 65
with, one of the following: 66

       (a) The supervising dentist; 67

       (b) A dentist licensed under this chapter who is one of the 68
following: 69

       (i) The employer of the supervising dentist; 70

       (ii) A shareholder in a professional association formed under 71
Chapter 1785. of the Revised Code of which the supervising dentist 72
is a shareholder; 73

       (iii) A member or manager of a limited liability company 74
formed under Chapter 1705. of the Revised Code of which the 75
supervising dentist is a member or manager; 76

       (iv) A shareholder in a corporation formed under division (B) 77
of section 1701.03 of the Revised Code of which the supervising 78
dentist is a shareholder; 79

       (v) A partner or employee of a partnership or a limited 80
liability partnership formed under Chapter 1775. of the Revised 81
Code of which the supervising dentist is a partner or employee. 82

       (c) A government entity that employs the dental hygienist to 83
provide dental hygiene services in a public school or in 84
connection with other programs the government entity administers. 85

       (D) A dental hygienist may provide dental hygiene services to 86
a patient when the supervising dentist is not physically present 87
at the location at which the services are provided if the services 88
are provided as part of a dental hygiene program that is approved 89
by the state dental board and all of the following requirements 90
are met: 91

       (1) The program is operated through a school district board 92
of education or the governing board of an educational service 93
center; the board of health of a city or general health district 94
or the authority having the duties of a board of health under 95
section 3709.05 of the Revised Code; a national, state, district, 96
or local dental association; or any other public or private entity 97
recognized by the state dental board. 98

       (2) The supervising dentist is employed by or a volunteer 99
for, and the patients are referred by, the entity through which 100
the program is operated. 101

       (3) The services are performed after examination and 102
diagnosis by the dentist and in accordance with the dentist's 103
written treatment plan. 104

       (E) No person shall do either of the following: 105

       (1) Practice dental hygiene in a manner that is separate or 106
otherwise independent from the dental practice of a supervising 107
dentist; 108

       (2) Establish or maintain an office or practice that is 109
primarily devoted to the provision of dental hygiene services. 110

       (F) The state dental board shall adopt rules under division 111
(C) of section 4715.03 of the Revised Code identifying procedures 112
a dental hygienist may not perform when practicing in the absence 113
of the supervising dentist pursuant to division (C) or (D) of this 114
section. 115

       Section 2. That existing section 4715.22 of the Revised Code 116
is hereby repealed. 117

       Section 3. All items in this section are hereby appropriated 118
as designated out of any moneys in the state treasury to the 119
credit of the General Revenue Fund. For all appropriations made in 120
this act, those in the first column are for fiscal year 2008 and 121
those in the second column are for fiscal year 2009. The 122
appropriations made in this act are in addition to any other 123
appropriations made for the FY 2008-2009 biennium. 124

DOD Department of Development 125

Appropriations

General Revenue Fund 126

GRF 195-442 Dental Equipment Loans $ 1,000,000 $ 1,000,000 127

TOTAL GRF General Revenue Fund $ 1,000,000 $ 1,000,000 128

TOTAL ALL BUDGET FUND GROUPS $ 1,000,000 $ 1,000,000 129

       DENTAL EQUIPMENT LOANS 130

        The foregoing appropriation item 195-442, Dental Equipment 131
Loans, shall be used by the Department of Development to provide 132
no-interest loans for the purchase of dental equipment to be used 133
in state defined Dental Professional Shortage Areas to treat 134
underserved populations. 135

DOH Department of Health 136

Appropriations

General Revenue Fund 137

GRF 440-433 Dental Program $ 1,250,000 $ 1,000,000 138

TOTAL GRF General Revenue Fund $ 1,250,000 $ 1,000,000 139

TOTAL ALL BUDGET FUND GROUPS $ 1,250,000 $ 1,000,000 140

       DENTAL PROGRAM 141

       Of the foregoing appropriation item 440-433, Dental Program, 142
$500,000 shall be allocated in fiscal year 2008 and $250,000 shall 143
be allocated in fiscal year 2009 for the purchase of portable 144
dental equipment by county and city health departments that agree 145
to make the portable equipment available to local dental 146
professionals providing basic dental services in facilities such 147
as nursing homes, clinics, hospitals, schools, or other locations; 148
$250,000 shall be allocated in each fiscal year for use in 149
providing financial support for the creation or expansion of 150
accredited dental residency programs that provide dental services 151
to underserved populations; $300,000 shall be granted in each 152
fiscal year to the Ohio State University College of Dentistry for 153
the support of the Ohio Project mobile dental unit; $100,000 shall 154
be granted in each fiscal year to the Ohio State University 155
College of Dentistry for the support of mobile outreach programs 156
designed to provide dental services to underserved populations, 157
including geriatric and indigent patients; $40,000 shall be 158
granted in each fiscal year to the Case School of Dental Medicine 159
for the creation or expansion of mobile outreach programs designed 160
to provide dental services to underserved populations, including 161
geriatric and indigent patients; and $60,000 shall be used in each 162
fiscal year to expand the Dentist Loan Repayment Program operated 163
by the Department of Health. 164

       Within the limits set forth in this act, the Director of 165
Budget and Management shall establish accounts indicating the 166
source and amount of funds for each appropriation made in this 167
act, and shall determine the form and manner in which 168
appropriation accounts shall be maintained. Expenditures from 169
appropriations contained in this act shall be accounted for as 170
though made in the main operating appropriations act of the 127th 171
General Assembly. 172

       The appropriations made in this act are subject to all 173
provisions of the main operating appropriations act of the 127th 174
General Assembly that are generally applicable to such 175
appropriations. 176

       Section 4. This section and Section 3 of this act are not 177
subject to the referendum. Therefore, under Ohio Constitution, 178
Article II, Section 1d and section 1.471 of the Revised Code, the 179
sections go into immediate effect when this act becomes law. 180

Section 1. That section 4715.22 of the Revised Code be	5
amended to read as follows:	6

Sec. 4715.22. (A) As used in this section, "health care	7
facility" means either of the following:	8

(1) A hospital registered under section 3701.07 of the	9
Revised Code;	10

(2) A "home" as defined in section 3721.01 of the Revised	11
Code.	12

(B) A licensed dental hygienist shall practice under the	13
supervision, order, control, and full responsibility of a dentist	14
licensed under this chapter. A dental hygienist may practice in a	15
dental office, public or private school, health care facility,	16
dispensary, or public institution, nursing home, public or private	17
clinic, mobile dental unit, headstart program or facility, patient	18
home, or other location approved by the state dental board. Except	19
as provided in division (C) or (D) of this section, a dental	20
hygienist may not provide dental hygiene services to a patient	21
when the supervising dentist is not physically present at the	22
location where the dental hygienist is practicing.	23

(C) A dental hygienist may provide, for not more than fifteen	24
consecutive business days, dental hygiene services to a patient	25
when the supervising dentist is not physically present at the	26
location at which the services are provided if all of the	27
following requirements are met:	28

(1) The dental hygienist has at least two years and a minimum	29
of three thousand hours of experience in the practice of dental	30
hygiene.	31

(2) The dental hygienist has successfully completed a course	32
approved by the state dental board in the identification and	33
prevention of potential medical emergencies.	34

(3) The dental hygienist complies with written protocols for	35
emergencies the supervising dentist establishes.	36

(4) The dental hygienist does not perform, while the	37
supervising dentist is absent from the location, procedures while	38
the patient is anesthetized, definitive root planing, definitive	39
subgingival curettage, or other procedures identified in rules the	40
state dental board adopts.	41

(5) The supervising dentist has evaluated the dental	42
hygienist's skills.	43

(6) The supervising dentist examined the patient not more	44
than seven months prior to the date the dental hygienist provides	45
the dental hygiene services to the patient.	46

(7) The dental hygienist complies with written protocols or	47
written standing orders that the supervising dentist establishes.	48

(8) The supervising dentist completed and evaluated a medical	49
and dental history of the patient not more than one year prior to	50
the date the dental hygienist provides dental hygiene services to	51
the patient and, except when the dental hygiene services are	52
provided in a health care facility, the supervising dentist	53
determines that the patient is in a medically stable condition.	54

(9) If the dental hygiene services are provided in a health	55
care facility, a doctor of medicine and surgery or osteopathic	56
medicine and surgery who holds a current certificate issued under	57
Chapter 4731. of the Revised Code or a registered nurse licensed	58
under Chapter 4723. of the Revised Code is present in the health	59
care facility when the services are provided.	60

(10) In advance of the appointment for dental hygiene	61
services, the patient is notified that the supervising dentist	62
will be absent from the location and that the dental hygienist	63
cannot diagnose the patient's dental health care status.	64

(11) The dental hygienist is employed by, or under contract	65
with, one of the following:	66

(b) A dentist licensed under this chapter who is one of the	68
following:	69

(ii) A shareholder in a professional association formed under	71
Chapter 1785. of the Revised Code of which the supervising dentist	72
is a shareholder;	73

(iii) A member or manager of a limited liability company	74
formed under Chapter 1705. of the Revised Code of which the	75
supervising dentist is a member or manager;	76

(iv) A shareholder in a corporation formed under division (B)	77
of section 1701.03 of the Revised Code of which the supervising	78
dentist is a shareholder;	79

(v) A partner or employee of a partnership or a limited	80
liability partnership formed under Chapter 1775. of the Revised	81
Code of which the supervising dentist is a partner or employee.	82

(c) A government entity that employs the dental hygienist to	83
provide dental hygiene services in a public school or in	84
connection with other programs the government entity administers.	85

(D) A dental hygienist may provide dental hygiene services to	86
a patient when the supervising dentist is not physically present	87
at the location at which the services are provided if the services	88
are provided as part of a dental hygiene program that is approved	89
by the state dental board and all of the following requirements	90
are met:	91

(1) The program is operated through a school district board	92
of education or the governing board of an educational service	93
center; the board of health of a city or general health district	94
or the authority having the duties of a board of health under	95
section 3709.05 of the Revised Code; a national, state, district,	96
or local dental association; or any other public or private entity	97
recognized by the state dental board.	98

(2) The supervising dentist is employed by or a volunteer	99
for, and the patients are referred by, the entity through which	100
the program is operated.	101

(3) The services are performed after examination and	102
diagnosis by the dentist and in accordance with the dentist's	103
written treatment plan.	104

(1) Practice dental hygiene in a manner that is separate or	106
otherwise independent from the dental practice of a supervising	107
dentist;	108

(2) Establish or maintain an office or practice that is	109
primarily devoted to the provision of dental hygiene services.	110

(F) The state dental board shall adopt rules under division	111
(C) of section 4715.03 of the Revised Code identifying procedures	112
a dental hygienist may not perform when practicing in the absence	113
of the supervising dentist pursuant to division (C) or (D) of this	114
section.	115