As Introduced

128th General Assembly Regular Session 2009-2010

H. B. No. 190

Representative Fende 

Cosponsors: Representatives McGregor, Williams, S., Moran, Huffman, Yuko, Phillips, Oelslager, Garland, Jordan, Murray, Gerberry, Brown, Bolon, Slesnick, Okey, Pillich, Letson, Hagan, Luckie, Mecklenborg, Blessing, Harwood 

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A BILL

To amend sections 4715.14, 4715.141, 4715.22,

1

4715.24, and 4715.25 and to enact sections

2

4715.241, 4715.242, 4715.36, 4715.361, 4715.362,

3

4715.363, 4715.364, 4715.365, 4715.366, 4715.367,

4

4715.368, 4715.369, 4715.37, 4715.371, 4715.372,

5

4715.373, 4715.374, and 4715.375 of the Revised

6

Code to modify certain licensing procedures for

7

dentists and dental hygienists and to establish

8

the Public Oral Health Supervision Program for

9

the provision of dental hygiene services.

10

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

Section 1. That sections 4715.14, 4715.141, 4715.22, 4715.24,	11
and 4715.25 be amended and sections 4715.241, 4715.242, 4715.36,	12
4715.361, 4715.362, 4715.363, 4715.364, 4715.365, 4715.366,	13
4715.367, 4715.368, 4715.369, 4715.37, 4715.371, 4715.372,	14
4715.373, 4715.374, and 4715.375 of the Revised Code be enacted to	15
read as follows:	16

Sec. 4715.14.  (A) Each person who is licensed to practice	17
dentistry in Ohio shall, on or before the first day of January of	18
each even-numbered year, register with the state dental board. The	19
registration shall be made on a form prescribed by the board and	20
furnished by the secretary, shall include the licensee's name,	21
address, license number, and such other reasonable information as	22
the board may consider necessary, and shall include payment of a	23
biennial registration fee of two hundred forty-five dollars.	24
Except as provided in division (D)(E) of this section, this fee	25
shall be paid to the treasurer of state. All such registrations	26
shall be in effect for the two-year period beginning on the first	27
day of January of the even-numbered year and ending on the last	28
day of December of the following odd-numbered year, and shall be	29
renewed in accordance with the standard renewal procedure of	30
sections 4745.01 to 4745.03 of the Revised Code. The	31

(B) The failure of a licensee to renew the licensee's	32
registration in accordance with this section shall result in an	33
automatic suspension of the licensee's license to practice	34
dentistry.	35

(B) AnyThe license of any dentist whose license has been	36
suspended under this division for six months or less shall be	37
automatically reinstated on the payment of the biennial	38
registration fee and eighty-one dollars to cover costs of the	39
reinstatement. The reinstated license shall be retroactively	40
effective beginning on the first day of January of the year in	41
which the license was reinstated.	42

The license of any dentist whose license has been suspended	43
under this sectiondivision for more than six months may be	44
reinstated byon the payment of the biennial registration fee and	45
in addition thereto eighty-one dollars to cover costs of the	46
reinstatement; excepting that to any. The reinstated license shall	47
be effective on the day it is reinstated.	48

(C) The board shall grant temporary retirement to any	49
licensed dentist who desires to temporarily retire from practice,	50
and who has given the board notice in writing to that effect, the	51
board shall grant such a retirement, provided only that at the	52
time that timethe board grants the temporary retirement all	53
previous registration fees and additional costs of reinstatement	54
have been paid.	55

(C)(D) Each dentist licensed to practice, whether a resident	56
or not, shall notify the secretary in writing or electronically of	57
any change in the dentist's office address or employment within	58
ten days after such change has taken place. On the first day of	59
July of every even-numbered year, the secretary shall issue a	60
printed roster of the names and addresses so registered.	61

(D)(E) Twenty dollars of each biennial registration fee shall	62
be paid to the dentist loan repayment fund created under section	63
3702.95 of the Revised Code.	64

Sec. 4715.141.  (A) Each licensed dentist shall complete	65
biennially not less than forty hours of continuing dental	66
education, which may include, but is not limited to, attendance at	67
lectures, study clubs, college and postgraduate courses, or	68
scientific sessions of conventions, research, graduate study,	69
teaching, service as a clinician, or correspondence courses.	70
Continuing dental education programs include, but are not limited	71
to, programs that address any of the following:	72

(1) CompentencyCompetency in treating patients who are	73
medically compromised or who experience medical emergencies during	74
the course of dental treatment;	75

(2) Knowledge of pharmaceutical products and the protocol of	76
the proper use of medications;	77

(3) Competency to diagnose oral pathology;

78

(4) Awareness of currently accepted methods of infection	79
control;	80

(5) Basic medical and scientific subjects including, but not	81
limited to, biology, physiology, pathology, biochemistry, and	82
pharmacology;	83

(6) Clinical and technological subjects including, but not	84
limited to, clinical techniques and procedures, materials, and	85
equipment;	86

(7) Subjects pertinent to health and safety.

87

Dentists shall earn continuing education credits at the rate	88
of one-half credit for each twenty-five to thirty contact minutes	89
of instruction and one credit hour for each fifty to sixty contact	90
minutes of instruction.	91

(B) Programs meeting the general requirements of division (A)	92
of this section may be developed and offered to dentists by any of	93
the following agencies or organizations:	94

(1) National, state, district, or local dental associations	95
affiliated with the American dental association or national dental	96
association;	97

(2) Accredited dental colleges or schools;

98

(3) Other organizations, schools, or agencies approved by the	99
state dental board.	100

(C) Each licensed dentist shall submit to the board at the	101
time of biennial registration pursuant to section 4715.14 of the	102
Revised Code a sworn affidavit, on a form acceptable to the state	103
dental board, attesting that hethe dentist has completed	104
continuing education programs in compliance with this section and	105
listing the date, location, sponsor, subject matter, and hours	106
completed of the programs.	107

A licensed dentist shall retain in histhe dentist's records	108
for a period of at least three years such receipts, vouchers, or	109
certificates as may be necessary to document completion of	110
continuing education programs. With cause, the board may request	111
such documentation from licensed dentists, and the board may	112
request such documentation from licensed dentists selected at	113
random without cause.	114

(D) The board may excuse licensed dentists, as a group or as	115
individuals, from all or any part of the requirements of this	116
section because of an unusual circumstance, emergency, or special	117
hardship.	118

(E) Failure to comply with the requirements of this section	119
constitutes a failure to renew registration pursuant to section	120
4715.14 of the Revised Code.	121

Sec. 4715.22.  (A) As(1) This section applies only when a	122
licensed dental hygienist is not practicing under a permit issued	123
pursuant to section 4715.363 of the Revised Code authorizing	124
practice under the public oral health supervision of a dentist.	125

(2) As used in this section, "health care facility" means	126
either of the following:	127

(1)(a) A hospital registered under section 3701.07 of the	128
Revised Code;	129

(2)(b) A "home" as defined in section 3721.01 of the Revised	130
Code.	131

(B) A licensed dental hygienist shall practice under the	132
supervision, order, control, and full responsibility of a dentist	133
licensed under this chapter. A dental hygienist may practice in a	134
dental office, public or private school, health care facility,	135
dispensary, or public institution. Except as provided in division	136
(C) or (D) of this section, a dental hygienist may not provide	137
dental hygiene services to a patient when the supervising dentist	138
is not physically present at the location where the dental	139
hygienist is practicing.	140

(C) A dental hygienist may provide, for not more than fifteen	141
consecutive business days, dental hygiene services to a patient	142
when the supervising dentist is not physically present at the	143
location at which the services are provided if all of the	144
following requirements are met:	145

(1) The dental hygienist has at least two years and a minimum	146
of three thousand hours of experience in the practice of dental	147
hygiene.	148

(2) The dental hygienist has successfully completed a course	149
approved by the state dental board in the identification and	150
prevention of potential medical emergencies.	151

(3) The dental hygienist complies with written protocols for	152
emergencies the supervising dentist establishes.	153

(4) The dental hygienist does not perform, while the	154
supervising dentist is absent from the location, procedures while	155
the patient is anesthetized, definitive root planing, definitive	156
subgingival curettage, or other procedures identified in rules the	157
state dental board adopts.	158

(5) The supervising dentist has evaluated the dental	159
hygienist's skills.	160

(6) The supervising dentist examined the patient not more	161
than seven months prior to the date the dental hygienist provides	162
the dental hygiene services to the patient.	163

(7) The dental hygienist complies with written protocols or	164
written standing orders that the supervising dentist establishes.	165

(8) The supervising dentist completed and evaluated a medical	166
and dental history of the patient not more than one year prior to	167
the date the dental hygienist provides dental hygiene services to	168
the patient and, except when the dental hygiene services are	169
provided in a health care facility, the supervising dentist	170
determines that the patient is in a medically stable condition.	171

(9) If the dental hygiene services are provided in a health	172
care facility, a doctor of medicine and surgery or osteopathic	173
medicine and surgery who holds a current certificate issued under	174
Chapter 4731. of the Revised Code or a registered nurse licensed	175
under Chapter 4723. of the Revised Code is present in the health	176
care facility when the services are provided.	177

(10) In advance of the appointment for dental hygiene	178
services, the patient is notified that the supervising dentist	179
will be absent from the location and that the dental hygienist	180
cannot diagnose the patient's dental health care status.	181

(11) The dental hygienist is employed by, or under contract	182
with, one of the following:	183

(a) The supervising dentist;

184

(b) A dentist licensed under this chapter who is one of the	185
following:	186

(i) The employer of the supervising dentist;

187

(ii) A shareholder in a professional association formed under	188
Chapter 1785. of the Revised Code of which the supervising dentist	189
is a shareholder;	190

(iii) A member or manager of a limited liability company	191
formed under Chapter 1705. of the Revised Code of which the	192
supervising dentist is a member or manager;	193

(iv) A shareholder in a corporation formed under division (B)	194
of section 1701.03 of the Revised Code of which the supervising	195
dentist is a shareholder;	196

(v) A partner or employee of a partnership or a limited	197
liability partnership formed under Chapter 1775. or 1776. of the	198
Revised Code of which the supervising dentist is a partner or	199
employee.	200

(c) A government entity that employs the dental hygienist to	201
provide dental hygiene services in a public school or in	202
connection with other programs the government entity administers.	203

(D) A dental hygienist may provide dental hygiene services	204
to a patient when the supervising dentist is not physically	205
present at the location at which the services are provided if the	206
services are provided as part of a dental hygiene program that is	207
approved by the state dental board and all of the following	208
requirements are met:	209

(1) The program is operated through a school district board	210
of education or the governing board of an educational service	211
center; the board of health of a city or general health district	212
or the authority having the duties of a board of health under	213
section 3709.05 of the Revised Code; a national, state, district,	214
or local dental association; or any other public or private entity	215
recognized by the state dental board.	216

(2) The supervising dentist is employed by or a volunteer	217
for, and the patients are referred by, the entity through which	218
the program is operated.	219

(3) The services are performed after examination and	220
diagnosis by the dentist and in accordance with the dentist's	221
written treatment plan.	222

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

223

(1) Practice dental hygiene in a manner that is separate or	224
otherwise independent from the dental practice of a supervising	225
dentist;	226

(2) Establish or maintain an office or practice that is	227
primarily devoted to the provision of dental hygiene services.	228

(F) The state dental board shall adopt rules under division	229
(C) of section 4715.03 of the Revised Code identifying procedures	230
a dental hygienist may not perform when practicing in the absence	231
of the supervising dentist pursuant to division (C) or (D) of this	232
section.	233

Sec. 4715.24.  (A) Each person who is licensed to practice as	234
a dental hygienist in Ohio shall, on or before the first day of	235
January of each even-numbered year, register with the state dental	236
board, unless the person is temporarily retired pursuant to	237
section 4715.241 of the Revised Code. The registration shall be	238
made on a form prescribed by the board and furnished by the	239
secretary, shall include the licensee's name, address, license	240
number, and such other reasonable information as the board may	241
consider necessary, and shall include payment of a biennial	242
registration fee of one hundred five dollars. This fee shall be	243
paid to the treasurer of state. All such registrations shall be in	244
effect for the two-year period beginning on the first day of	245
January of each even-numbered year and ending on the last day of	246
December of the following odd-numbered year, and shall be renewed	247
in accordance with the standard renewal procedure of sections	248
4745.01 to 4745.03 of the Revised Code. The failure of a licensee	249
to renew registration in accordance with this section shall result	250
in the automatic suspension of the licensee's license to practice	251
as a dental hygienist, unless the licensee is temporarily retired	252
pursuant to section 4715.241 of the Revised Code.	253

(B) Any dental hygienist whose license has been automatically	254
suspended under this section may be reinstated by theon	255
application to the board on a form prescribed by the board for	256
licensure reinstatement and payment of the biennial registration	257
fee and in addition thereto thirty-one dollars to cover the costs	258
of reinstatement.	259

(C) The license of a dental hygienist shall be exhibited in a	260
conspicuous place in the room in which the dental hygienist	261
practices. Each dental hygienist licensed to practice, whether a	262
resident or not, shall notify the secretary in writing or	263
electronically of any change in the dental hygienist's office	264
address or employment within ten days after the change takes	265
place.	266

Sec. 4715.241.  (A) As used in this section and sections	267
4715.242 and 4715.25 of the Revised Code, "registration period"	268
means the two-year period during which a dental hygienist's	269
registration is in effect under section 4715.24 of the Revised	270
Code.	271

(B) A dental hygienist seeking to retire temporarily from the	272
practice of dental hygiene shall provide written notice of that	273
intent to the state dental board. Except as provided in division	274
(C) of this section, the board shall grant temporary retirement	275
if the dental hygienist has paid the registration fee required by	276
section 4715.24 of the Revised Code for the registration period	277
that includes the day immediately before the day that the	278
temporary retirement is to begin. The license of a dental	279
hygienist who is granted temporary retirement shall be inactive.	280

(C) The board may deny temporary retirement to a dental	281
hygienist who is, at the time that the board denies the temporary	282
retirement, the subject of a disciplinary action initiated by the	283
board under section 4715.30 of the Revised Code.	284

Sec. 4715.242.  (A) A dental hygienist who is temporarily	285
retired pursuant to section 4715.241 of the Revised Code may	286
submit a written request to the state dental board at any time for	287
reinstatement of the dental hygienist's license. The board shall	288
reinstate the license if the dental hygienist does both of the	289
following:	290

(1) Pays the biennial registration fee established under	291
section 4715.24 of the Revised Code for the period that includes	292
the day on which the temporary retirement is to cease;	293

(2) Provides the board satisfactory evidence of both of the	294
following:	295

(a) If the dental hygienist's license is to be reinstated in	296
an even-numbered year, that the dental hygienist, during the	297
registration period preceding the current registration period,	298
completed the continuing education requirement established under	299
section 4715.25 of the Revised Code for that registration period;	300

(b) If the dental hygienist's license is to be reinstated in	301
an odd-numbered year, that the dental hygienist, during the	302
current registration period, completed the current registration	303
period's continuing education requirement established by section	304
4715.25 of the Revised Code.	305

(B) The state dental board shall register each dental	306
hygienist whose license is reinstated under this section. The	307
registration expires at the end of the registration period during	308
which the license is reinstated.	309

Sec. 4715.25.  (A) Every person licensed to practice as a	310
dental hygienist and required to register with the state dental	311
board shall certify to the board at the time of applying for a	312
renewal of registration that in the two-year period preceding two	313
yearsthe registration period for which renewal is sought the	314
registrant has completed a minimum of twelvetwenty-four hours of	315
continuing dental hygiene education. Certification shall be made	316
upon the application for registration prescribed by the board	317
pursuant to section 4715.24 of the Revised Code.	318

(B)(1) The board shall apply toward the satisfaction of a	319
registrant's continuing dental hygiene education requirement any	320
course required by statute for registration that the registrant	321
completed, including any of the following:	322

(a) The basic life-support training course required by	323
section 4715.251 of the Revised Code;	324

(b) Any course required by rule of the board as a condition	325
of performing a particular function;	326

(c) Any other course that the board determines acceptable.

327

(2) In the case of a registrant whose license is reinstated	328
in an odd-numbered year under section 4715.242 of the Revised	329
Code, the board shall apply toward the satisfaction of the	330
registrant's continuing dental hygiene education requirement any	331
course that the board applied toward the continuing dental	332
hygiene education requirement for reinstatement of the license.	333

(C) Continuing education programs may be developed and	334
offered to dental hygienists by any of the following agencies or	335
organizations:	336

(1) National, state, district, or local dental hygienists'	337
associations affiliated with the American dental hygienists'	338
association;	339

(2) National, state, district, or local dental associations	340
affiliated with the American dental association or national dental	341
association;	342

(3) Accredited dental hygiene colleges or schools;

343

(4) Accredited dental colleges or schools;

344

(5) Other organizations, schools, paraprofessional programs,	345
or agencies approved by the state dental board.	346

(B)(D) A licensed dental hygienist shall retain in histhe	347
dental hygienist's records for a period of at least threefour	348
years such receipts, vouchers, or certificates as may be necessary	349
to document completion of continuing education programs. With	350
cause, the board may request such documentation from licensed	351
dental hygienists, and the board may request such documentation	352
from licensed dental hygienists at random without cause.	353

(C)(E) The board may excuse licensed dental hygienists, as a	354
group or as individuals, from all or any part of the requirements	355
of this section because of an unusual circumstance, emergency, or	356
special hardship.	357

(D)(F) Failure to comply with the requirements of this	358
section constitutes a failure to renew registration pursuant to	359
section 4715.24 of the Revised Code.	360

Sec. 4715.36. As used in this section and sections 4715.361	361
to 4715.374 of the Revised Code:	362

(A) "Accredited dental hygiene school" means a dental hygiene	363
school accredited by the council on dental education of the	364
American dental association or a dental hygiene school whose	365
educational standards are recognized by the council on dental	366
education of the American dental association and approved by the	367
state dental board.	368

(B) "Authorizing dentist" means a dentist who authorizes a	369
dental hygienist to perform dental hygiene services under section	370
4715.365 of the Revised Code.	371

(C) "Clinical evaluation" means a diagnosis and treatment	372
plan formulated for an individual patient by a dentist.	373

(D) "Dentist" means an individual licensed under this chapter	374
to practice dentistry.	375

(E) "Dental hygienist" means an individual licensed under	376
this chapter to practice as a dental hygienist.	377

(F) "Dental hygiene services" means the prophylactic,	378
preventive, and other procedures that dentists are authorized by	379
this chapter and rules of the state dental board to assign to	380
dental hygienists, except for the procedures described in division	381
(C)(4) of section 4715.22 of the Revised Code.	382

(G) "Facility" means any of the following:

383

(1) A health care facility, as defined in section 4715.22 of	384
the Revised Code;	385

(2) A state correctional institution, as defined in section	386
2967.01 of the Revised Code;	387

(3) A comprehensive child development program that receives	388
funds distributed under the "Head Start Act," 95 Stat. 499 (1981),	389
42 U.S.C. 9831, as amended, and is licensed as a child day-care	390
center;	391

(4) A residential facility licensed under section 5123.19 of	392
the Revised Code;	393

(5) A public school, as defined in section 3701.93 of the	394
Revised Code, located in an area designated as a dental health	395
resource shortage area pursuant to section 3702.87 of the Revised	396
Code;	397

(6) A nonpublic school, as defined in section 3701.93 of the	398
Revised Code, located in an area designated as a dental health	399
resource shortage area pursuant to section 3702.87 of the Revised	400
Code;	401

(7) A federally qualified health center or federally	402
qualified health center look-alike, as defined in section 3701.047	403
of the Revised Code;	404

(8) A shelter for victims of domestic violence, as defined	405
in section 3113.33 of the Revised Code;	406

(9) A facility operated by the department of youth services	407
under Chapter 5139. of the Revised Code;	408

(10) A shelter for runaways, as defined in section 5119.64	409
of the Revised Code;	410

(11) A foster home, as defined in section 5103.02 of the	411
Revised Code;	412

(12) A nonprofit clinic, as defined in section 3715.87 of the	413
Revised Code;	414

(13) The residence of one or more individuals receiving	415
services provided by a home health agency, as defined in section	416
5101.61 of the Revised Code;	417

(14) A dispensary;

418

(15) A health care facility, such as a clinic or hospital, of	419
the United States department of veterans affairs;	420

(16) The residence of one or more individuals enrolled in a	421
home and community-based services medicaid waiver component, as	422
defined in section 5111.851 of the Revised Code;	423

(17) A facility operated by the board of health of a city or	424
general health district or the authority having the duties of a	425
board of health under section 3709.05 of the Revised Code;	426

(18) A women, infants, and children clinic;

427

(19) A mobile dental unit located at any location listed in	428
divisions (G)(1) to (18) of this section;	429

(20) Any other location, as specified by the state dental	430
board in rules adopted under section 4715.372 of the Revised Code,	431
that is in an area designated as a dental health resource shortage	432
area pursuant to section 3702.87 of the Revised Code and provides	433
health care services to individuals who are recipients of medical	434
assistance under the medicaid program established pursuant to	435
Chapter 5111. of the Revised Code and to indigent and uninsured	436
persons, as defined in section 2305.234 of the Revised Code.	437

Sec. 4715.361. The public health oral supervision program is	438
hereby created. The program shall begin six months after the	439
effective date of this section.	440

Sec. 4715.362. A dentist who desires to participate in the	441
public oral health supervision program shall apply to the state	442
dental board for a public oral health supervision permit. The	443
application shall be under oath, on a form prescribed by the board	444
in rules adopted under section 4715.372 of the Revised Code, and	445
accompanied by an application fee of twenty dollars. To be	446
eligible to receive the permit, an applicant shall meet the	447
requirements established by the board in rules adopted under	448
section 4715.372 of the Revised Code.	449

The state dental board shall issue a public oral health	450
supervision permit to a dentist who is in good standing with the	451
board and satisfies all of the requirements of this section.	452

Sec. 4715.363. (A) A dental hygienist who desires to	453
participate in the public oral health supervision program shall	454
apply to the state dental board for a permit to practice under	455
the public oral health supervision of a dentist. The application	456
shall be under oath, on a form prescribed by the board in rules	457
adopted under section 4715.372 of the Revised Code, and	458
accompanied by an application fee of twenty dollars.	459

(B) The applicant shall provide evidence satisfactory to the	460
board that the applicant has done all of the following:	461

(1) Completed at least two years and attained a minimum of	462
three thousand hours of experience in the practice of dental	463
hygiene;	464

(2) Completed at least twenty-four hours of continuing dental	465
hygiene education during the two years prior to submission of the	466
application;	467

(3) Completed a course pertaining to the practice of dental	468
hygiene under the public oral health supervision of a dentist	469
that meets standards established in rules adopted under section	470
4715.372 of the Revised Code;	471

(4) Completed, during the two years prior to submission of	472
the application, a course pertaining to the identification and	473
prevention of potential medical emergencies that meets standards	474
established in rules adopted under section 4715.372 of the	475
Revised Code.	476

(C) The state dental board shall issue a permit to practice	477
under the public oral health supervision of a dentist to a dental	478
hygienist who is in good standing with the board and meets all of	479
the requirements of divisions (A) and (B) of this section.	480

Sec. 4715.364. (A) No person shall authorize a dental	481
hygienist to provide dental hygiene services under section	482
4715.365 of the Revised Code unless the person holds a current,	483
valid public oral health supervision permit issued under section	484
4715.362 of the Revised Code.	485

(B) No person shall provide dental hygiene services under	486
section 4715.365 of the Revised Code unless the person holds a	487
current, valid permit issued under section 4715.363 of the	488
Revised Code to practice under the public oral health supervision	489
of a dentist.	490

Sec. 4715.365. (A) A dentist who holds a current, valid	491
public oral health supervision permit issued under section	492
4715.362 of the Revised Code may authorize a dental hygienist who	493
holds a current, valid permit issued under section 4715.363 of	494
the Revised Code to perform dental hygiene services at a facility	495
when no dentist is physically present if all of the following	496
conditions are met:	497

(1) The authorizing dentist's authorization is in writing and	498
includes, at a minimum, all of the following:	499

(a) The authorizing dentist's name and permit number;

500

(b) The dental hygienist's name and permit number;

501

(c) The patient's name;

502

(d) The name and address of the location where the dental	503
hygiene services are to be provided;	504

(e) The date of authorization;

505

(f) A statement, signed by the dental hygienist, that the	506
hygienist agrees to comply with section 4715.366 of the Revised	507
Code.	508

(2) The authorizing dentist has personally evaluated the	509
dental hygienist's skills prior to authorizing the dental	510
hygienist to provide the dental hygiene services.	511

(3) Prior to authorizing the dental hygienist to perform the	512
dental hygiene services, the patient's medical and dental history	513
is made available to the authorizing dentist and the authorizing	514
dentist reviews and evaluates the history and determines that	515
the patient may safely receive dental hygiene services.	516

(4) Immediately prior to the provision of dental hygiene	517
services, the patient or patient's representative verifies, by the	518
signature or mark of the patient or representative, that no	519
medically significant changes to the patient's medical or dental	520
history have occurred since the authorizing dentist most recently	521
reviewed and evaluated the history and determined that the	522
patient could safely receive dental hygiene services. The	523
signature or mark may be provided through reasonable	524
accommodation, including the use of assistive technology or	525
augmentative devices.	526

(5) Prior to receiving dental hygiene services, the patient	527
and the operator of the facility where the dental hygiene	528
services are to be provided are notified that no dentist will be	529
present at the location and that the dental hygienist is	530
prohibited from doing either of the following:	531

(a) Diagnosing the patient's oral health care status;

532

(b) Providing dental hygiene services to the same patient on	533
a subsequent occasion until the patient has received a clinical	534
evaluation performed by a dentist, except in instances described	535
in division (D)(2) of this section.	536

(6) The dental hygienist is employed by, or under contract	537
with, one of the following:	538

(a) The authorizing dentist;

539

(b) A dentist who is any of the following:

540

(i) The authorizing dentist's employer;

541

(ii) A shareholder in a professional association, formed	542
under Chapter 1785. of the Revised Code, of which the authorizing	543
dentist is a shareholder;	544

(iii) A member or manager of a limited liability company,	545
formed under Chapter 1705. of the Revised Code, of which the	546
authorizing dentist is a member or manager;	547

(iv) A shareholder in a corporation, formed under division	548
(B) of section 1701.03 of the Revised Code, of which the	549
authorizing dentist is a shareholder;	550

(v) A partner or employee of a partnership, formed under	551
Chapter 1775. of the Revised Code, of which the authorizing	552
dentist is a partner or employee;	553

(vi) A partner or employee of a limited liability	554
partnership, formed under Chapter 1775. of the Revised Code, of	555
which the authorizing dentist is a partner or employee.	556

(c) A government entity that employs the dental hygienist to	557
provide dental hygiene services under the public oral health	558
supervision of a dentist.	559

(7) If the patient to whom the services are to be provided	560
previously received dental hygiene services under this section,	561
there is written evidence that the patient received a clinical	562
evaluation after the most recent provision of those services.	563

(B) No dentist shall authorize a dental hygienist to perform,	564
and no dental hygienist shall perform, dental hygiene services on	565
a patient under this section unless all of the conditions in	566
division (A) of this section are met.	567

(C) If a patient or patient's representative indicates, under	568
division (A)(4) of this section, that a medically significant	569
change has occurred in the patient's medical or dental history	570
since the authorizing dentist's most recent review and	571
evaluation of the medical and dental history required by division	572
(A)(3) of this section, no dental hygiene services shall be	573
provided under this section until the authorizing dentist	574
completes another review and evaluation of the patient's medical	575
and dental history. The authorizing dentist may complete the	576
subsequent review and evaluation of the patient's medical and	577
dental history by telephone, facsimile, electronic mail, video,	578
or any other means of electronic communication.	579

(D)(1) Except as provided in division (D)(2) of this section,	580
no dentist shall authorize a dental hygienist to provide, and no	581
dental hygienist shall provide, dental hygiene services under this	582
section to the same patient on a subsequent occasion until the	583
patient has received a clinical evaluation performed by a dentist.	584

(2) Division (D)(1) of this section does not apply if the	585
patient requires multiple visits to complete dental hygiene	586
services that could not be completed during the visit in which the	587
services were commenced. If a patient requires multiple visits to	588
complete dental hygiene services, the services shall be completed	589
not later than eight weeks after the visit in which the services	590
were commenced.	591

(E) No authorizing dentist shall authorize a dental hygienist	592
to diagnose a patient's oral health care status. No dental	593
hygienist practicing under a permit issued under section 4715.363	594
of the Revised Code to practice under the public oral health	595
supervision of a dentist shall diagnose a patient's oral health	596
care status.	597

Sec. 4715.366. (A) A dental hygienist providing dental	598
hygiene services under a permit issued under section 4715.363 of	599
the Revised Code to practice under the public oral health	600
supervision of a dentist shall do both of the following:	601

(1) Comply with written protocols established by the	602
authorizing dentist who authorizes the dental hygienist's	603
provision of services and standing orders established by the	604
authorizing dentist, including protocols and standing orders	605
regarding emergencies and, for the purpose of section 4715.365 of	606
the Revised Code, protocols regarding what constitutes a medically	607
significant change to a patient's medical or dental history;	608

(2) Immediately following the completion of the dental	609
hygiene services and subject to division (B) of this section,	610
direct the patient to the authorizing dentist for a clinical	611
evaluation and schedule or cause to be scheduled an appointment	612
for the patient with the authorizing dentist.	613

(B) For purposes of division (A)(2) of this section, the	614
dental hygienist shall make every attempt to schedule the	615
patient's appointment with the authorizing dentist not later than	616
ninety days after the completion of the dental hygiene services.	617
The dental hygienist shall provide the patient with a written	618
notice of the appointment that includes, at a minimum, the	619
authorizing dentist's name, address, and telephone number; the	620
date and time of the appointment; and a statement of the dental	621
hygiene services performed by the hygienist. The notice shall be	622
given to the patient or the patient's representative and one copy	623
shall be given to the authorizing dentist.	624

Sec. 4715.367. An authorizing dentist shall not at any one	625
time have more than three dental hygienists who hold permits	626
issued under section 4715.363 of the Revised Code working under	627
the dentist's authorization pursuant to section 4715.365 of the	628
Revised Code.	629

Sec. 4715.368. At the request of the state dental board, an	630
authorizing dentist or the dental hygienist who has been	631
authorized to perform dental hygiene services in accordance with	632
section 4715.365 of the Revised Code shall make available to the	633
board a list of all locations where the dental hygienist provided	634
services, the locations where the hygienist plans to provide	635
services in the future, or both, as specified in the board's	636
request.	637

Sec. 4715.369. (A) A public oral health supervision permit	638
issued under section 4715.362 of the Revised Code expires on the	639
thirty-first day of December of the odd-numbered year that occurs	640
after the permit's issuance. A dentist who desires to renew a	641
permit shall apply, under oath, to the state dental board on a	642
form prescribed by the board in rules adopted under section	643
4715.372 of the Revised Code. At the time of application, the	644
dentist shall pay a renewal fee of twenty dollars.	645

(B) The board shall renew a public oral health supervision	646
permit for a two-year period if the dentist submitted a complete	647
application, paid the renewal fee, is in good standing with the	648
board, and verified with the board all of the following:	649

(1) The locations at which dental hygienists have, under the	650
dentist's authorization, provided services during the two years	651
prior to submission of the renewal application;	652

(2) The number of patients treated, during the two years	653
prior to submission of the renewal application, by each dental	654
hygienist providing dental hygiene services under the dentist's	655
authorization;	656

(3) For each number of patients provided under division	657
(B)(2) of this section, the number of patients whom the dentist	658
clinically evaluated following the provision of dental hygiene	659
services by a dental hygienist.	660

Sec. 4715.37. (A) A permit to practice under the public oral	661
health supervision of a dentist issued under section 4715.363 of	662
the Revised Code expires on the thirty-first day of December of	663
the odd-numbered year that occurs after the permit's issuance. A	664
dental hygienist who desires to renew a permit to practice under	665
the public oral health supervision of a dentist shall apply, under	666
oath, to the state dental board on a form prescribed by the board	667
in rules adopted under section 4715.372 of the Revised Code. At	668
the time of application, the dental hygienist shall pay a renewal	669
fee of twenty dollars.	670

(B) The state dental board shall renew a permit for a	671
two-year period if the dental hygienist submitted a complete	672
application, paid the renewal fee, is in good standing with the	673
board, and has verified with the board both of the following:	674

(1) The locations at which the hygienist has provided dental	675
hygiene services under a permit to practice under the public oral	676
health supervision of a dentist;	677

(2) The number of patients that the hygienist has treated	678
under a permit during the two years prior to submission of the	679
renewal application.	680

Sec. 4715.371. The state dental board shall develop and	681
publish on its web site a directory containing the names and	682
contact information of dentists and dental hygienists who hold	683
current, valid permits issued under sections 4715.362 and	684
4715.363 of the Revised Code.	685

Sec. 4715.372. (A) The state dental board shall adopt rules	686
in accordance with Chapter 119. of the Revised Code as necessary	687
to implement the public oral health supervision program,	688
including rules that do all of the following:	689

(1) For the purpose of division (G)(20) of section 4715.36 of	690
the Revised Code, designate additional facilities at which a	691
dental hygienist may be authorized to perform dental hygiene	692
services under the public oral health supervision program;	693

(2) For the purpose of section 4715.362 of the Revised Code,	694
prescribe the application form and requirements for obtaining a	695
public oral health supervision permit;	696

(3) For the purpose of section 4715.363 of the Revised Code,	697
prescribe the application form for a permit to practice as a	698
dental hygienist under the public oral health supervision of a	699
dentist;	700

(4) For the purpose of division (B)(3) of section 4715.363	701
of the Revised Code and subject to division (B) of this section,	702
establish standards for courses in the practice of dental	703
hygiene under public oral health supervision;	704

(5) For the purpose of division (B)(4) of section 4715.363 of	705
the Revised Code, establish standards for courses in the	706
identification and prevention of potential medical emergencies;	707

(6) For the purpose of section 4715.369 of the Revised Code,	708
prescribe the form for renewal of a public oral health	709
supervision permit;	710

(7) For the purpose of section 4715.37 of the Revised Code,	711
prescribe the form for renewal of a permit to practice as a dental	712
hygienist under the public oral health supervision of a dentist.	713

(B) The courses in the practice of dental hygiene under	714
public oral health supervision for which the board establishes	715
standards under division (A)(4) of this section shall each meet	716
all of the following requirements:	717

(1) Be at least eight hours in length;

718

(2) Include, at a minimum, instruction in both of the	719
following:	720

(a) The treatment of geriatric patients, medically	721
compromised patients, developmentally disabled patients, and	722
pediatric patients;	723

(b) Recordkeeping practices.

724

(3) Be developed and offered by an institution accredited by	725
the American dental association commission on dental accreditation	726
or a program provided by a sponsor of continuing education	727
approved by the board;	728

(4) Include content that is separate and independent from the	729
course content required for the completion of dental hygiene	730
education from an accredited dental hygiene school.	731

Sec. 4715.373. Nothing in sections 4715.36 to 4715.372 of the	732
Revised Code authorizes any activity prohibited by this chapter or	733
prohibited by a rule adopted under this chapter by the state	734
dental board.	735

Sec. 4715.374. The state dental board may, in accordance with	736
Chapter 119. of the Revised Code, suspend or revoke a permit	737
issued under section 4715.362 or 4715.363 of the Revised Code if	738
the permit holder fails to comply with sections 4715.361 to	739
4715.373 of the Revised Code.	740

Sec. 4715.375. The state dental board shall annually report	741
the status of the public oral health supervision program. The	742
report shall be submitted to the governor and, in accordance with	743
section 101.68 of the Revised Code, to the general assembly. The	744
report shall specify, for the year covered by the report, at least	745
all of the following:	746

(A) The number of dentists who applied for and were issued	747
public oral health supervision permits under section 4715.362 of	748
the Revised Code;	749

(B) The number of dental hygienists who applied for and were	750
issued permits to practice under the public oral health	751
supervision of a dentist under section 4715.363 of the Revised	752
Code;	753

(C) The number of dentists who applied for and were granted	754
renewal of public oral health supervision permits under section	755
4715.369 of the Revised Code;	756

(D) The number of dental hygienists who applied for and were	757
granted renewal of permits to practice under the public oral	758
health supervision of a dentist under section 4715.37 of the	759
Revised Code;	760

(E) The number and geographic locations of facilities at	761
which dental hygienists provided dental hygiene services under	762
permits to practice under the public oral health supervision of a	763
dentist;	764

(F) The number of patients who received dental hygiene	765
services from dental hygienists providing services under permits	766
to practice under the public oral health supervision of a dentist;	767

(G) The number of patients who received a clinical evaluation	768
from a dentist following the provision of dental hygiene services	769
under section 4715.365 of the Revised Code.	770

Section 2.  That existing sections 4715.14, 5715.141,	771
4715.22, 4715.24, and 4715.25 of the Revised Code are hereby	772
repealed.	773

Section 3. As used in this section, "registration period" has	774
the same meaning as in section 4715.241 of the Revised Code, as	775
enacted by this act.	776

Notwithstanding the provisions of section 4715.25 of the	777
Revised Code, as amended by this act, that increase from twelve to	778
twenty-four the minimum number of hours of continuing education	779
that a dental hygienist must certify to the State Dental Board	780
when applying for a renewal of registration, a dental hygienist	781
whose registration expires on December 31, 2009, remains subject	782
to the requirement to certify completion of a minimum of twelve	783
hours of continuing education when applying for a renewal of	784
registration for the 2010 to 2011 registration period.	785