As Passed by the House

128th General Assembly Regular Session 2009-2010

Sub. 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, Williams, B., Hackett, Lehner, Patten, Harris, Adams, J., Adams, R., Amstutz, Batchelder, Belcher, Blair, Boyd, Bubp, Carney, Chandler, Combs, Daniels, DeBose, Domenick, Driehaus, Dyer, Evans, Foley, Gardner, Garrison, Goyal, Grossman, Heard, Hottinger, Jones, Koziura, Lundy, Maag, Mallory, Mandel, Newcomb, Otterman, Pryor, Schneider, Sears, Snitchler, Stewart, Szollosi, Uecker, Wachtmann, Winburn, Zehringer 

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A BILL

To amend sections 4715.14, 4715.141, 4715.21,

1

4715.22, 4715.24, and 4715.25 and to enact

2

sections 4715.241, 4715.242, 4715.36, 4715.361,

3

4715.362, 4715.363, 4715.364, 4715.365,

4

4715.366, 4715.367, 4715.368, 4715.369, 4715.37,

5

4715.371, 4715.372, 4715.373, 4715.374, and

6

4715.375 of the Revised Code to modify certain

7

licensing procedures for dentists and dental

8

hygienists and to establish the Public Oral

9

Health Supervision Program for the provision of

10

dental hygiene services.

11

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

Section 1. That sections 4715.14, 4715.141, 4715.21, 4715.22,	12
4715.24, and 4715.25 be amended and sections 4715.241, 4715.242,	13
4715.36, 4715.361, 4715.362, 4715.363, 4715.364, 4715.365,	14
4715.366, 4715.367, 4715.368, 4715.369, 4715.37, 4715.371,	15
4715.372, 4715.373, 4715.374, and 4715.375 of the Revised Code be	16
enacted to read as follows:	17

Sec. 4715.14.  (A) Each person who is licensed to practice	18
dentistry in Ohio shall, on or before the first day of January of	19
each even-numbered year, register with the state dental board. The	20
registration shall be made on a form prescribed by the board and	21
furnished by the secretary, shall include the licensee's name,	22
address, license number, and such other reasonable information as	23
the board may consider necessary, and shall include payment of a	24
biennial registration fee of two hundred forty-five dollars.	25
Except as provided in division (D)(E) of this section, this fee	26
shall be paid to the treasurer of state. All such registrations	27
shall be in effect for the two-year period beginning on the first	28
day of January of the even-numbered year and ending on the last	29
day of December of the following odd-numbered year, and shall be	30
renewed in accordance with the standard renewal procedure of	31
sections 4745.01 to 4745.03 of the Revised Code. The failure ofIf	32
a licensee fails to renew the licensee's registration in	33
accordance with this section shall result in an automatic	34
suspension of the licensee's license to practice dentistry, the	35
board may take any of the disciplinary actions described in	36
division (C) of section 4715.30 of the Revised Code with respect	37
to the licensee or licensee's license.	38

(B) AnyThe license of any dentist whose license has been	39
suspended under this section may be reinstated byon the payment	40
of the biennial registration fee and in addition thereto	41
eighty-one dollars to cover costs of the reinstatement; excepting	42
that to any.	43

(C) The board shall grant temporary retirement to any	44
licensed dentist who desires to temporarily retire from practice,	45
and who has given the board notice in writing to that effect, the	46
board shall grant such a retirement, provided only that at the	47
time that timethe board grants the temporary retirement all	48
previous registration fees and additional costs of reinstatement	49
have been paid.	50

(C)(D) Each dentist licensed to practice, whether a resident	51
or not, shall notify the secretary in writing or electronically of	52
any change in the dentist's office address or employment within	53
ten days after such change has taken place. On the first day of	54
July of every even-numbered year, the secretary shall issue a	55
printed roster of the names and addresses so registered.	56

(D)(E) Twenty dollars of each biennial registration fee shall	57
be paid to the dentist loan repayment fund created under section	58
3702.95 of the Revised Code.	59

Sec. 4715.141.  (A) Each licensed dentist shall complete	60
biennially not less than forty hours of continuing dental	61
education, which may include, but is not limited to, attendance at	62
lectures, study clubs, college and postgraduate courses, or	63
scientific sessions of conventions, research, graduate study,	64
teaching, service as a clinician, or correspondence courses.	65
Continuing dental education programs include, but are not limited	66
to, programs that address any of the following:	67

(1) CompentencyCompetency in treating patients who are	68
medically compromised or who experience medical emergencies during	69
the course of dental treatment;	70

(2) Knowledge of pharmaceutical products and the protocol of	71
the proper use of medications;	72

(3) Competency to diagnose oral pathology;

73

(4) Awareness of currently accepted methods of infection	74
control;	75

(5) Basic medical and scientific subjects including, but not	76
limited to, biology, physiology, pathology, biochemistry, and	77
pharmacology;	78

(6) Clinical and technological subjects including, but not	79
limited to, clinical techniques and procedures, materials, and	80
equipment;	81

(7) Subjects pertinent to health and safety.

82

Dentists shall earn continuing education credits at the rate	83
of one-half credit for each twenty-five to thirty contact minutes	84
of instruction and one credit hour for each fifty to sixty contact	85
minutes of instruction.	86

(B) Programs meeting the general requirements of division (A)	87
of this section may be developed and offered to dentists by any of	88
the following agencies or organizations:	89

(1) National, state, district, or local dental associations	90
affiliated with the American dental association or national dental	91
association;	92

(2) Accredited dental colleges or schools;

93

(3) Other organizations, schools, or agencies approved by the	94
state dental board.	95

(C) Each licensed dentist shall submit to the board at the	96
time of biennial registration pursuant to section 4715.14 of the	97
Revised Code a sworn affidavit, on a form acceptable to the state	98
dental board, attesting that hethe dentist has completed	99
continuing education programs in compliance with this section and	100
listing the date, location, sponsor, subject matter, and hours	101
completed of the programs.	102

A licensed dentist shall retain in histhe dentist's records	103
for a period of at least three years such receipts, vouchers, or	104
certificates as may be necessary to document completion of	105
continuing education programs. With cause, the board may request	106
such documentation from licensed dentists, and the board may	107
request such documentation from licensed dentists selected at	108
random without cause.	109

(D) The board may excuse licensed dentists, as a group or as	110
individuals, from all or any part of the requirements of this	111
section because of an unusual circumstance, emergency, or special	112
hardship.	113

(E) Failure to comply with the requirements of this section	114
constitutes a failure to renew registration pursuant to section	115
4715.14 of the Revised Code.	116

Sec. 4715.21.  Each person who desires to practice as a	117
dental hygienist shall file with the secretary of the state dental	118
board a written application for a license, under oath, upon the	119
form prescribed. Such applicant shall furnish satisfactory proof	120
of being at least eighteen years of age and of good moral	121
character. An applicant shall present a diploma or certificate of	122
graduation from an accredited dental hygiene school and shall pay	123
the examination fee of ninety-six dollars if the license is issued	124
in an odd-numbered year or one hundred forty-seven dollars if	125
issued in an even-numbered year. Those passing such examination as	126
the board prescribes relating to dental hygiene shall receive a	127
certificate of registration entitling them to practice. If an	128
applicant fails to pass the first examination the applicant may	129
apply for a re-examination at the next regular or special	130
examination meeting of the board.	131

No applicant shall be admitted to more than two examinations	132
without first presenting satisfactory proof that the applicant has	133
successfully completed such refresher courses in an accredited	134
dental hygiene school as the state dental board may prescribe.	135

An accredited dental hygiene school shall be one accredited	136
by the council on dental education of the American dental	137
association commission on dental accreditation or whose	138
educational standards are recognized by the council on dental	139
education of the American dental association commission on dental	140
accreditation and approved by the state dental board.	141

Sec. 4715.22.  (A) As(1) This section applies only when a	142
licensed dental hygienist is not practicing under a permit issued	143
pursuant to section 4715.363 of the Revised Code authorizing	144
practice under the public oral health supervision of a dentist.	145

(2) As used in this section, "health care facility" means	146
either of the following:	147

(1)(a) A hospital registered under section 3701.07 of the	148
Revised Code;	149

(2)(b) A "home" as defined in section 3721.01 of the Revised	150
Code.	151

(B) A licensed dental hygienist shall practice under the	152
supervision, order, control, and full responsibility of a dentist	153
licensed under this chapter. A dental hygienist may practice in a	154
dental office, public or private school, health care facility,	155
dispensary, or public institution. Except as provided in division	156
(C) or (D) of this section, a dental hygienist may not provide	157
dental hygiene services to a patient when the supervising dentist	158
is not physically present at the location where the dental	159
hygienist is practicing.	160

(C) A dental hygienist may provide, for not more than fifteen	161
consecutive business days, dental hygiene services to a patient	162
when the supervising dentist is not physically present at the	163
location at which the services are provided if all of the	164
following requirements are met:	165

(1) The dental hygienist has at least two years and a minimum	166
of three thousand hours of experience in the practice of dental	167
hygiene.	168

(2) The dental hygienist has successfully completed a course	169
approved by the state dental board in the identification and	170
prevention of potential medical emergencies.	171

(3) The dental hygienist complies with written protocols for	172
emergencies the supervising dentist establishes.	173

(4) The dental hygienist does not perform, while the	174
supervising dentist is absent from the location, procedures while	175
the patient is anesthetized, definitive root planing, definitive	176
subgingival curettage, or other procedures identified in rules the	177
state dental board adopts.	178

(5) The supervising dentist has evaluated the dental	179
hygienist's skills.	180

(6) The supervising dentist examined the patient not more	181
than seven months prior to the date the dental hygienist provides	182
the dental hygiene services to the patient.	183

(7) The dental hygienist complies with written protocols or	184
written standing orders that the supervising dentist establishes.	185

(8) The supervising dentist completed and evaluated a medical	186
and dental history of the patient not more than one year prior to	187
the date the dental hygienist provides dental hygiene services to	188
the patient and, except when the dental hygiene services are	189
provided in a health care facility, the supervising dentist	190
determines that the patient is in a medically stable condition.	191

(9) If the dental hygiene services are provided in a health	192
care facility, a doctor of medicine and surgery or osteopathic	193
medicine and surgery who holds a current certificate issued under	194
Chapter 4731. of the Revised Code or a registered nurse licensed	195
under Chapter 4723. of the Revised Code is present in the health	196
care facility when the services are provided.	197

(10) In advance of the appointment for dental hygiene	198
services, the patient is notified that the supervising dentist	199
will be absent from the location and that the dental hygienist	200
cannot diagnose the patient's dental health care status.	201

(11) The dental hygienist is employed by, or under contract	202
with, one of the following:	203

(a) The supervising dentist;

204

(b) A dentist licensed under this chapter who is one of the	205
following:	206

(i) The employer of the supervising dentist;

207

(ii) A shareholder in a professional association formed under	208
Chapter 1785. of the Revised Code of which the supervising dentist	209
is a shareholder;	210

(iii) A member or manager of a limited liability company	211
formed under Chapter 1705. of the Revised Code of which the	212
supervising dentist is a member or manager;	213

(iv) A shareholder in a corporation formed under division (B)	214
of section 1701.03 of the Revised Code of which the supervising	215
dentist is a shareholder;	216

(v) A partner or employee of a partnership or a limited	217
liability partnership formed under Chapter 1775. or 1776. of the	218
Revised Code of which the supervising dentist is a partner or	219
employee.	220

(c) A government entity that employs the dental hygienist to	221
provide dental hygiene services in a public school or in	222
connection with other programs the government entity administers.	223

(D) A dental hygienist may provide dental hygiene services	224
to a patient when the supervising dentist is not physically	225
present at the location at which the services are provided if the	226
services are provided as part of a dental hygiene program that is	227
approved by the state dental board and all of the following	228
requirements are met:	229

(1) The program is operated through a school district board	230
of education or the governing board of an educational service	231
center; the board of health of a city or general health district	232
or the authority having the duties of a board of health under	233
section 3709.05 of the Revised Code; a national, state, district,	234
or local dental association; or any other public or private entity	235
recognized by the state dental board.	236

(2) The supervising dentist is employed by or a volunteer	237
for, and the patients are referred by, the entity through which	238
the program is operated.	239

(3) The services are performed after examination and	240
diagnosis by the dentist and in accordance with the dentist's	241
written treatment plan.	242

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

243

(1) Practice dental hygiene in a manner that is separate or	244
otherwise independent from the dental practice of a supervising	245
dentist;	246

(2) Establish or maintain an office or practice that is	247
primarily devoted to the provision of dental hygiene services.	248

(F) The state dental board shall adopt rules under division	249
(C) of section 4715.03 of the Revised Code identifying procedures	250
a dental hygienist may not perform when practicing in the absence	251
of the supervising dentist pursuant to division (C) or (D) of this	252
section.	253

Sec. 4715.24.  (A) Each person who is licensed to practice as	254
a dental hygienist in Ohio shall, on or before the first day of	255
January of each even-numbered year, register with the state dental	256
board, unless the person is temporarily retired pursuant to	257
section 4715.241 of the Revised Code. The registration shall be	258
made on a form prescribed by the board and furnished by the	259
secretary, shall include the licensee's name, address, license	260
number, and such other reasonable information as the board may	261
consider necessary, and shall include payment of a biennial	262
registration fee of one hundred five dollars. This fee shall be	263
paid to the treasurer of state. All such registrations shall be in	264
effect for the two-year period beginning on the first day of	265
January of each even-numbered year and ending on the last day of	266
December of the following odd-numbered year, and shall be renewed	267
in accordance with the standard renewal procedure of sections	268
4745.01 to 4745.03 of the Revised Code. The failure of a licensee	269
to renew registration in accordance with this section shall result	270
in the automatic suspension of the licensee's license to practice	271
as a dental hygienist, unless the licensee is temporarily retired	272
pursuant to section 4715.241 of the Revised Code.	273

(B) Any dental hygienist whose license has been automatically	274
suspended under this section may be reinstated by theon	275
application to the board on a form prescribed by the board for	276
licensure reinstatement and payment of the biennial registration	277
fee and in addition thereto thirty-one dollars to cover the costs	278
of reinstatement.	279

(C) The license of a dental hygienist shall be exhibited in a	280
conspicuous place in the room in which the dental hygienist	281
practices. Each dental hygienist licensed to practice, whether a	282
resident or not, shall notify the secretary in writing or	283
electronically of any change in the dental hygienist's office	284
address or employment within ten days after the change takes	285
place.	286

Sec. 4715.241.  (A) As used in this section and sections	287
4715.242 and 4715.25 of the Revised Code, "registration period"	288
means the two-year period during which a dental hygienist's	289
registration is in effect under section 4715.24 of the Revised	290
Code.	291

(B) A dental hygienist seeking to retire temporarily from the	292
practice of dental hygiene shall provide written notice of that	293
intent to the state dental board. Except as provided in division	294
(C) of this section, the board shall grant temporary retirement	295
if the dental hygienist has paid the registration fee required by	296
section 4715.24 of the Revised Code for the registration period	297
that includes the day immediately before the day that the	298
temporary retirement is to begin. The license of a dental	299
hygienist who is granted temporary retirement shall be inactive.	300

(C) The board may deny temporary retirement to a dental	301
hygienist who is, at the time that the board denies the temporary	302
retirement, the subject of a disciplinary action initiated by the	303
board under section 4715.30 of the Revised Code.	304

Sec. 4715.242.  (A) A dental hygienist who is temporarily	305
retired pursuant to section 4715.241 of the Revised Code may	306
submit a written request to the state dental board at any time for	307
reinstatement of the dental hygienist's license. The board shall	308
reinstate the license if the dental hygienist does both of the	309
following:	310

(1) Pays the biennial registration fee established under	311
section 4715.24 of the Revised Code for the period that includes	312
the day on which the temporary retirement is to cease;	313

(2) Provides the board satisfactory evidence that the dental	314
hygienist, during the two-year period immediately preceding the	315
date that the dental hygienist submitted the written request for	316
license reinstatement, completed a minimum of twenty-four hours	317
of continuing dental hygiene education in accordance with division	318
(B) of this section.	319

(B) The completion of continuing dental hygiene education	320
required under division (A)(2) of this section is subject to	321
division (D) of section 4715.25 of the Revised Code. The	322
continuing education programs may be developed and offered to	323
dental hygienists by any of the agencies or organizations	324
described in division (C) of section 4715.25 of the Revised Code.	325
The board may excuse dental hygienists, as a group or as	326
individuals, from all or any part of the requirements of division	327
(A)(2) of this section because of an unusual circumstance,	328
emergency, or special hardship.	329

(C) The state dental board shall register each dental	330
hygienist whose license is reinstated under this section. The	331
registration expires at the end of the registration period during	332
which the license is reinstated.	333

Sec. 4715.25.  (A) Every person licensed to practice as a	334
dental hygienist and required to register with the state dental	335
board shall certify to the board at the time of applying for a	336
renewal of registration that in the two-year period preceding two	337
yearsthe registration period for which renewal is sought the	338
registrant has completed a minimum of twelvetwenty-four hours of	339
continuing dental hygiene education. Certification shall be made	340
upon the application for registration prescribed by the board	341
pursuant to section 4715.24 of the Revised Code.	342

(B)(1) The board shall apply toward the satisfaction of a	343
registrant's continuing dental hygiene education requirement any	344
of the following courses that the registrant completed:	345

(a) The basic life-support training course required by	346
section 4715.251 of the Revised Code;	347

(b) Any course required by statute or rule of the board for	348
registration;	349

(c) Any course required by statute or rule of the board as a	350
condition of performing a particular function;	351

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

352

(2) In the case of a registrant whose license was reinstated	353
under section 4715.242 of the Revised Code, the board shall	354
apply toward the satisfaction of the registrant's continuing	355
dental hygiene education requirement any course that the board	356
applied toward the continuing dental hygiene education	357
requirement for reinstatement of the license if the course was	358
completed during the two-year period immediately preceding the	359
registration period for which renewal is sought.	360

(C) Continuing education programs may be developed and	361
offered to dental hygienists by any of the following agencies or	362
organizations:	363

(1) National, state, district, or local dental hygienists'	364
associations affiliated with the American dental hygienists'	365
association;	366

(2) National, state, district, or local dental associations	367
affiliated with the American dental association or national dental	368
association;	369

(3) Accredited dental hygiene colleges or schools;

370

(4) Accredited dental colleges or schools;

371

(5) Other organizations, schools, paraprofessional programs,	372
or agencies approved by the state dental board.	373

(B)(D) A licensed dental hygienist shall retain in histhe	374
dental hygienist's records for a period of at least threefour	375
years such receipts, vouchers, or certificates as may be necessary	376
to document completion of continuing education programs. With	377
cause, the board may request such documentation from licensed	378
dental hygienists, and the board may request such documentation	379
from licensed dental hygienists at random without cause.	380

(C)(E) The board may excuse licensed dental hygienists, as a	381
group or as individuals, from all or any part of the requirements	382
of this section because of an unusual circumstance, emergency, or	383
special hardship.	384

(D)(F) Failure to comply with the requirements of this	385
section constitutes a failure to renew registration pursuant to	386
section 4715.24 of the Revised Code.	387

Sec. 4715.36. As used in this section and sections 4715.361	388
to 4715.374 of the Revised Code:	389

(A) "Accredited dental hygiene school" means a dental hygiene	390
school accredited by the American dental association commission on	391
dental accreditation or a dental hygiene school whose educational	392
standards are recognized by the American dental association	393
commission on dental accreditation and approved by the state	394
dental board.	395

(B) "Authorizing dentist" means a dentist who authorizes a	396
dental hygienist to perform dental hygiene services under section	397
4715.365 of the Revised Code.	398

(C) "Clinical evaluation" means a diagnosis and treatment	399
plan formulated for an individual patient by a dentist.	400

(D) "Dentist" means an individual licensed under this chapter	401
to practice dentistry.	402

(E) "Dental hygienist" means an individual licensed under	403
this chapter to practice as a dental hygienist.	404

(F) "Dental hygiene services" means the prophylactic,	405
preventive, and other procedures that dentists are authorized by	406
this chapter and rules of the state dental board to assign to	407
dental hygienists, except for procedures while a patient is	408
anesthetized, definitive root planing, definitive subgingival	409
curettage, the administration of local anesthesia, and the	410
procedures specified in rules adopted by the board as described in	411
division (C)(4) of section 4715.22 of the Revised Code.	412

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

413

(1) A health care facility, as defined in section 4715.22 of	414
the Revised Code;	415

(2) A state correctional institution, as defined in section	416
2967.01 of the Revised Code;	417

(3) A comprehensive child development program that receives	418
funds distributed under the "Head Start Act," 95 Stat. 499 (1981),	419
42 U.S.C. 9831, as amended, and is licensed as a child day-care	420
center;	421

(4) A residential facility licensed under section 5123.19 of	422
the Revised Code;	423

(5) A public school, as defined in section 3701.93 of the	424
Revised Code, located in an area designated as a dental health	425
resource shortage area pursuant to section 3702.87 of the Revised	426
Code;	427

(6) A nonpublic school, as defined in section 3701.93 of the	428
Revised Code, located in an area designated as a dental health	429
resource shortage area pursuant to section 3702.87 of the Revised	430
Code;	431

(7) A federally qualified health center or federally	432
qualified health center look-alike, as defined in section 3701.047	433
of the Revised Code;	434

(8) A shelter for victims of domestic violence, as defined	435
in section 3113.33 of the Revised Code;	436

(9) A facility operated by the department of youth services	437
under Chapter 5139. of the Revised Code;	438

(10) A shelter for runaways, as defined in section 5119.64	439
of the Revised Code;	440

(11) A foster home, as defined in section 5103.02 of the	441
Revised Code;	442

(12) A nonprofit clinic, as defined in section 3715.87 of the	443
Revised Code;	444

(13) The residence of one or more individuals receiving	445
services provided by a home health agency, as defined in section	446
5101.61 of the Revised Code;	447

(14) A dispensary;

448

(15) A health care facility, such as a clinic or hospital, of	449
the United States department of veterans affairs;	450

(16) The residence of one or more individuals enrolled in a	451
home and community-based services medicaid waiver component, as	452
defined in section 5111.851 of the Revised Code;	453

(17) A facility operated by the board of health of a city or	454
general health district or the authority having the duties of a	455
board of health under section 3709.05 of the Revised Code;	456

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

457

(19) A mobile dental unit located at any location listed in	458
divisions (G)(1) to (18) of this section;	459

(20) Any other location, as specified by the state dental	460
board in rules adopted under section 4715.372 of the Revised Code,	461
that is in an area designated as a dental health resource shortage	462
area pursuant to section 3702.87 of the Revised Code and provides	463
health care services to individuals who are recipients of medical	464
assistance under the medicaid program established pursuant to	465
Chapter 5111. of the Revised Code and to indigent and uninsured	466
persons, as defined in section 2305.234 of the Revised Code.	467

Sec. 4715.361. The public health oral supervision program is	468
hereby created. The program shall begin six months after the	469
effective date of this section.	470

Sec. 4715.362. A dentist who desires to participate in the	471
public oral health supervision program shall apply to the state	472
dental board for a public oral health supervision permit. The	473
application shall be under oath, on a form prescribed by the board	474
in rules adopted under section 4715.372 of the Revised Code, and	475
accompanied by an application fee of twenty dollars. To be	476
eligible to receive the permit, an applicant shall meet the	477
requirements established by the board in rules adopted under	478
section 4715.372 of the Revised Code.	479

The state dental board shall issue a public oral health	480
supervision permit to a dentist who is in good standing with the	481
board and satisfies all of the requirements of this section.	482

Sec. 4715.363. (A) A dental hygienist who desires to	483
participate in the public oral health supervision program shall	484
apply to the state dental board for a permit to practice under	485
the public oral health supervision of a dentist. The application	486
shall be under oath, on a form prescribed by the board in rules	487
adopted under section 4715.372 of the Revised Code, and	488
accompanied by an application fee of twenty dollars.	489

(B) The applicant shall provide evidence satisfactory to the	490
board that the applicant has done all of the following:	491

(1) Completed at least two years and attained a minimum of	492
three thousand hours of experience in the practice of dental	493
hygiene;	494

(2) Completed at least twenty-four hours of continuing dental	495
hygiene education during the two years prior to submission of the	496
application;	497

(3) Completed a course pertaining to the practice of dental	498
hygiene under the public oral health supervision of a dentist	499
that meets standards established in rules adopted under section	500
4715.372 of the Revised Code;	501

(4) Completed, during the two years prior to submission of	502
the application, a course pertaining to the identification and	503
prevention of potential medical emergencies that is the same as	504
the course described in division (C)(2) of section 4715.22 of the	505
Revised Code.	506

(C) The state dental board shall issue a permit to practice	507
under the public oral health supervision of a dentist to a dental	508
hygienist who is in good standing with the board and meets all of	509
the requirements of divisions (A) and (B) of this section.	510

Sec. 4715.364. (A) No person shall authorize a dental	511
hygienist to provide dental hygiene services under section	512
4715.365 of the Revised Code unless the person holds a current,	513
valid public oral health supervision permit issued under section	514
4715.362 of the Revised Code.	515

(B) No person shall provide dental hygiene services under	516
section 4715.365 of the Revised Code unless the person holds a	517
current, valid permit issued under section 4715.363 of the	518
Revised Code to practice under the public oral health supervision	519
of a dentist.	520

Sec. 4715.365. (A) A dentist who holds a current, valid	521
public oral health supervision permit issued under section	522
4715.362 of the Revised Code may authorize a dental hygienist who	523
holds a current, valid permit issued under section 4715.363 of	524
the Revised Code to perform dental hygiene services at a facility	525
when no dentist is physically present if all of the following	526
conditions are met:	527

(1) The authorizing dentist's authorization is in writing and	528
includes, at a minimum, all of the following:	529

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

530

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

531

(c) The patient's name;

532

(d) The name and address of the location where the dental	533
hygiene services are to be provided;	534

(e) The date of authorization;

535

(f) A statement, signed by the dental hygienist, that the	536
hygienist agrees to comply with section 4715.366 of the Revised	537
Code.	538

(2) The authorizing dentist has personally evaluated the	539
dental hygienist's skills prior to authorizing the dental	540
hygienist to provide the dental hygiene services.	541

(3) Prior to authorizing the dental hygienist to perform the	542
dental hygiene services, the patient's medical and dental history	543
is made available to the authorizing dentist and the authorizing	544
dentist reviews and evaluates the history and determines that	545
the patient may safely receive dental hygiene services.	546

(4) Immediately prior to the provision of dental hygiene	547
services, the patient or patient's representative verifies, by the	548
signature or mark of the patient or representative, that no	549
medically significant changes to the patient's medical or dental	550
history have occurred since the authorizing dentist most recently	551
reviewed and evaluated the history and determined that the	552
patient could safely receive dental hygiene services. The	553
signature or mark may be provided through reasonable	554
accommodation, including the use of assistive technology or	555
augmentative devices.	556

(5) Prior to receiving dental hygiene services, the patient	557
and the operator of the facility where the dental hygiene	558
services are to be provided are notified that no dentist will be	559
present at the location and that the dental hygienist is	560
prohibited from doing either of the following:	561

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

562

(b) Providing dental hygiene services to the same patient on	563
a subsequent occasion until the patient has received a clinical	564
evaluation performed by a dentist, except in instances described	565
in division (D)(2) of this section.	566

(6) The dental hygienist is employed by, or under contract	567
with, one of the following:	568

(a) The authorizing dentist;

569

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

570

(i) The authorizing dentist's employer;

571

(ii) A shareholder in a professional association, formed	572
under Chapter 1785. of the Revised Code, of which the authorizing	573
dentist is a shareholder;	574

(iii) A member or manager of a limited liability company,	575
formed under Chapter 1705. of the Revised Code, of which the	576
authorizing dentist is a member or manager;	577

(iv) A shareholder in a corporation, formed under division	578
(B) of section 1701.03 of the Revised Code, of which the	579
authorizing dentist is a shareholder;	580

(v) A partner or employee of a partnership, formed under	581
Chapter 1775. of the Revised Code, of which the authorizing	582
dentist is a partner or employee;	583

(vi) A partner or employee of a limited liability	584
partnership, formed under Chapter 1775. of the Revised Code, of	585
which the authorizing dentist is a partner or employee.	586

(c) A government entity that employs the dental hygienist to	587
provide dental hygiene services.	588

(7) If the patient to whom the services are to be provided	589
previously received dental hygiene services under this section,	590
there is written evidence that the patient received a clinical	591
evaluation after the most recent provision of those services.	592

(B) No dentist shall authorize a dental hygienist to perform,	593
and no dental hygienist shall perform, dental hygiene services on	594
a patient under this section unless all of the conditions in	595
division (A) of this section are met.	596

(C) If a patient or patient's representative indicates, under	597
division (A)(4) of this section, that a medically significant	598
change has occurred in the patient's medical or dental history	599
since the authorizing dentist's most recent review and	600
evaluation of the medical and dental history required by division	601
(A)(3) of this section, no dental hygiene services shall be	602
provided under this section until the authorizing dentist	603
completes another review and evaluation of the patient's medical	604
and dental history. The authorizing dentist may complete the	605
subsequent review and evaluation of the patient's medical and	606
dental history by telephone, facsimile, electronic mail, video,	607
or any other means of electronic communication.	608

(D)(1) Except as provided in division (D)(2) of this section,	609
no dentist shall authorize a dental hygienist to provide, and no	610
dental hygienist shall provide, dental hygiene services under this	611
section to the same patient on a subsequent occasion until the	612
patient has received a clinical evaluation performed by a dentist.	613

(2) Division (D)(1) of this section does not apply if the	614
patient requires multiple visits to complete a procedure that	615
could not be completed during the visit in which dental hygiene	616
services were commenced. If the patient requires multiple visits	617
to complete the procedure that could not be completed during the	618
visit in which dental hygiene services were commenced, the	619
procedure shall be completed not later than eight weeks after the	620
visit in which the services were commenced.	621

(E) No authorizing dentist shall authorize a dental hygienist	622
to diagnose a patient's oral health care status. No dental	623
hygienist practicing under a permit issued under section 4715.363	624
of the Revised Code to practice under the public oral health	625
supervision of a dentist shall diagnose a patient's oral health	626
care status.	627

Sec. 4715.366. (A) A dental hygienist providing dental	628
hygiene services under a permit issued under section 4715.363 of	629
the Revised Code to practice under the public oral health	630
supervision of a dentist shall do both of the following:	631

(1) Comply with written protocols established by the	632
authorizing dentist who authorizes the dental hygienist's	633
provision of services and standing orders established by the	634
authorizing dentist, including protocols and standing orders	635
regarding emergencies and, for the purpose of section 4715.365 of	636
the Revised Code, protocols regarding what constitutes a medically	637
significant change to a patient's medical or dental history;	638

(2) Immediately following the completion of the dental	639
hygiene services and subject to division (B) of this section,	640
direct the patient to the authorizing dentist for a clinical	641
evaluation and schedule or cause to be scheduled an appointment	642
for the patient with the authorizing dentist.	643

(B) For purposes of division (A)(2) of this section, the	644
dental hygienist shall make every attempt to schedule the	645
patient's appointment with the authorizing dentist not later than	646
ninety days after the completion of the dental hygiene services.	647
The dental hygienist shall provide the patient with a written	648
notice of the appointment that includes, at a minimum, the	649
authorizing dentist's name, address, and telephone number; the	650
date and time of the appointment; and a statement of the dental	651
hygiene services performed by the hygienist. The notice shall be	652
given to the patient or the patient's representative and one copy	653
shall be given to the authorizing dentist.	654

Sec. 4715.367. An authorizing dentist shall not at any one	655
time have more than three dental hygienists who hold permits	656
issued under section 4715.363 of the Revised Code working under	657
the dentist's authorization pursuant to section 4715.365 of the	658
Revised Code.	659

Sec. 4715.368. At the request of the state dental board, an	660
authorizing dentist or the dental hygienist who has been	661
authorized to perform dental hygiene services in accordance with	662
section 4715.365 of the Revised Code shall make available to the	663
board a list of all locations where the dental hygienist provided	664
services, the locations where the hygienist plans to provide	665
services in the future, or both, as specified in the board's	666
request.	667

Sec. 4715.369. (A) A public oral health supervision permit	668
issued under section 4715.362 of the Revised Code expires on the	669
thirty-first day of December of the odd-numbered year that occurs	670
after the permit's issuance. A dentist who desires to renew a	671
permit shall apply, under oath, to the state dental board on a	672
form prescribed by the board in rules adopted under section	673
4715.372 of the Revised Code. At the time of application, the	674
dentist shall pay a renewal fee of twenty dollars.	675

(B) The board shall renew a public oral health supervision	676
permit for a two-year period if the dentist submitted a complete	677
application, paid the renewal fee, is in good standing with the	678
board, and verified with the board all of the following:	679

(1) The locations at which dental hygienists have, under the	680
dentist's authorization, provided services during the two years	681
prior to submission of the renewal application;	682

(2) The number of patients treated, during the two years	683
prior to submission of the renewal application, by each dental	684
hygienist providing dental hygiene services under the dentist's	685
authorization;	686

(3) For each number of patients provided under division	687
(B)(2) of this section, the number of patients whom the dentist	688
clinically evaluated following the provision of dental hygiene	689
services by a dental hygienist.	690

Sec. 4715.37. (A) A permit to practice under the public oral	691
health supervision of a dentist issued under section 4715.363 of	692
the Revised Code expires on the thirty-first day of December of	693
the odd-numbered year that occurs after the permit's issuance. A	694
dental hygienist who desires to renew a permit to practice under	695
the public oral health supervision of a dentist shall apply, under	696
oath, to the state dental board on a form prescribed by the board	697
in rules adopted under section 4715.372 of the Revised Code. At	698
the time of application, the dental hygienist shall pay a renewal	699
fee of twenty dollars.	700

(B) The state dental board shall renew a permit for a	701
two-year period if the dental hygienist submitted a complete	702
application, paid the renewal fee, is in good standing with the	703
board, and has verified with the board both of the following:	704

(1) The locations at which the hygienist has provided dental	705
hygiene services under a permit to practice under the public oral	706
health supervision of a dentist;	707

(2) The number of patients that the hygienist has treated	708
under a permit during the two years prior to submission of the	709
renewal application.	710

Sec. 4715.371. The state dental board shall develop and	711
publish on its web site a directory containing the names and	712
contact information of dentists and dental hygienists who hold	713
current, valid permits issued under sections 4715.362 and	714
4715.363 of the Revised Code.	715

Sec. 4715.372. (A) The state dental board shall adopt rules	716
in accordance with Chapter 119. of the Revised Code as necessary	717
to implement the public oral health supervision program,	718
including rules that do all of the following:	719

(1) For the purpose of division (G)(20) of section 4715.36 of	720
the Revised Code, designate additional facilities at which a	721
dental hygienist may be authorized to perform dental hygiene	722
services under the public oral health supervision program;	723

(2) For the purpose of section 4715.362 of the Revised Code,	724
prescribe the application form and requirements for obtaining a	725
public oral health supervision permit;	726

(3) For the purpose of section 4715.363 of the Revised Code,	727
prescribe the application form for a permit to practice as a	728
dental hygienist under the public oral health supervision of a	729
dentist;	730

(4) For the purpose of division (B)(3) of section 4715.363	731
of the Revised Code and subject to division (B) of this section,	732
establish standards for the course in the practice of dental	733
hygiene under public oral health supervision;	734

(5) For the purpose of section 4715.369 of the Revised Code,	735
prescribe the form for renewal of a public oral health	736
supervision permit;	737

(6) For the purpose of section 4715.37 of the Revised Code,	738
prescribe the form for renewal of a permit to practice as a dental	739
hygienist under the public oral health supervision of a dentist.	740

(B) The course in the practice of dental hygiene under	741
public oral health supervision for which the board establishes	742
standards under division (A)(4) of this section shall meet all	743
of the following requirements:	744

(1) Be eight hours in length;

745

(2) Include, at a minimum, instruction in both of the	746
following:	747

(a) The treatment of geriatric patients, medically	748
compromised patients, developmentally disabled patients, and	749
pediatric patients;	750

(b) Recordkeeping practices.

751

(3) Be developed and offered by an institution accredited by	752
the American dental association commission on dental accreditation	753
or a program provided by a sponsor of continuing education	754
approved by the board;	755

(4) Include content that is separate and independent from the	756
course content required for the completion of dental hygiene	757
education from an accredited dental hygiene school.	758

Sec. 4715.373. Nothing in sections 4715.36 to 4715.372 of the	759
Revised Code authorizes any activity prohibited by this chapter or	760
prohibited by a rule adopted under this chapter by the state	761
dental board, including the activities prohibited by division (E)	762
of section 4715.22 of the Revised Code and the activities	763
prohibited or not authorized by section 4715.23 of the Revised	764
Code.	765

Sec. 4715.374. The state dental board may, in accordance with	766
Chapter 119. of the Revised Code, suspend or revoke a permit	767
issued under section 4715.362 or 4715.363 of the Revised Code if	768
the permit holder fails to comply with sections 4715.361 to	769
4715.373 of the Revised Code.	770

Sec. 4715.375. The state dental board shall annually report	771
the status of the public oral health supervision program. The	772
report shall be submitted to the governor and, in accordance with	773
section 101.68 of the Revised Code, to the general assembly. The	774
report shall specify, for the year covered by the report, at least	775
all of the following:	776

(A) The number of dentists who applied for and were issued	777
public oral health supervision permits under section 4715.362 of	778
the Revised Code;	779

(B) The number of dental hygienists who applied for and were	780
issued permits to practice under the public oral health	781
supervision of a dentist under section 4715.363 of the Revised	782
Code;	783

(C) The number of dentists who applied for and were granted	784
renewal of public oral health supervision permits under section	785
4715.369 of the Revised Code;	786

(D) The number of dental hygienists who applied for and were	787
granted renewal of permits to practice under the public oral	788
health supervision of a dentist under section 4715.37 of the	789
Revised Code;	790

(E) The number and geographic locations of facilities at	791
which dental hygienists provided dental hygiene services under	792
permits to practice under the public oral health supervision of a	793
dentist;	794

(F) The number of patients who received dental hygiene	795
services from dental hygienists providing services under permits	796
to practice under the public oral health supervision of a dentist;	797

(G) The number of patients who received a clinical evaluation	798
from a dentist following the provision of dental hygiene services	799
under section 4715.365 of the Revised Code.	800

Section 2.  That existing sections 4715.14, 4715.141,	801
4715.21, 4715.22, 4715.24, and 4715.25 of the Revised Code are	802
hereby repealed.	803

Section 3. (A) As used in this section, "registration period"	804
has the same meaning as in section 4715.241 of the Revised Code,	805
as enacted by this act.	806

(B) Notwithstanding the provisions of section 4715.25 of the	807
Revised Code, as amended by this act, that increase from twelve to	808
twenty-four the minimum number of hours of continuing education	809
that a dental hygienist must certify to the State Dental Board	810
when applying for a renewal of registration, a dental hygienist	811
whose registration expires on December 31, 2009, remains subject	812
to the requirement to certify completion of a minimum of twelve	813
hours of continuing education when applying for a renewal of	814
registration for the 2010 to 2011 registration period.	815

(C) Notwithstanding the provisions of section 4715.242 of	816
the Revised Code, as enacted by this act, that require the	817
completion of a minimum of twenty-four hours of continuing dental	818
hygiene education for the reinstatement of a dental hygienist's	819
license, a dental hygienist who submits a written request to the	820
Board for reinstatement of the dental hygienist's license on or	821
before December 31, 2009, must provide the Board with satisfactory	822
evidence that the dental hygienist, during the two-year period	823
immediately preceding the date that the dental hygienist submitted	824
the written request, completed a minimum of twelve hours of	825
continuing dental hygiene education. The completion of continuing	826
dental hygiene education required under this division is subject	827
to division (D) of section 4715.25 of the Revised Code, as amended	828
by this act. The continuing education programs may be developed	829
and offered to dental hygienists by any of the agencies or	830
organizations described in division (C) of section 4715.25 of the	831
Revised Code, as amended by this act. The Board may excuse dental	832
hygienists, as a group or as individuals, from all or any part of	833
the requirements of this division because of an unusual	834
circumstance, emergency, or special hardship.	835