As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 463

Representative Johnson 

Cosponsors: Representatives Duffey, Roegner, Scherer, Milkovich, Blessing, Schuring, Bishoff, Young, Hackett, Stinziano, Smith, Stebelton, Rosenberger, Adams, R., Grossman, Celebrezze, Sears, Barnes, Hill, Amstutz, Perales, Terhar, Thompson, Retherford, Lundy, Barborak 

---

A BILL

To amend sections 3333.61, 4715.10, 4715.13, 4715.22,

1

4715.23, 4715.363, 4715.366, 4715.371, 4715.39,

2

4715.64, and 4715.66 and to enact section 4715.421

3

of the Revised Code to make changes to the laws

4

governing dental professionals.

5

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

Section 1. That sections 3333.61, 4715.10, 4715.13, 4715.22,	6
4715.23, 4715.363, 4715.366, 4715.371, 4715.39, 4715.64, and	7
4715.66 be amended and section 4715.421 of the Revised Code be	8
enacted to read as follows:	9

Sec. 3333.61.  The chancellor of the Ohio board of regents	10
shall establish and administer the Ohio innovation partnership,	11
which shall consist of the choose Ohio first scholarship program	12
and the Ohio research scholars program. Under the programs, the	13
chancellor, subject to approval by the controlling board, shall	14
make awards to state universities or colleges for programs and	15
initiatives that recruit students and scientists in the fields of	16
science, technology, engineering, mathematics, and medicine, and	17
dentistry to state universities or colleges, in order to enhance	18
regional educational and economic strengths and meet the needs of	19
the state's regional economies. Awards may be granted for programs	20
and initiatives to be implemented by a state university or college	21
alone or in collaboration with other state institutions of higher	22
education, nonpublic Ohio universities and colleges, or other	23
public or private Ohio entities. If the chancellor makes an award	24
to a program or initiative that is intended to be implemented by a	25
state university or college in collaboration with other state	26
institutions of higher education or nonpublic Ohio universities or	27
colleges, the chancellor may provide that some portion of the	28
award be received directly by the collaborating universities or	29
colleges consistent with all terms of the Ohio innovation	30
partnership.	31

The choose Ohio first scholarship program shall assign a	32
number of scholarships to state universities and colleges to	33
recruit Ohio residents as undergraduate, or as provided in section	34
3333.66 of the Revised Code graduate, students in the fields of	35
science, technology, engineering, mathematics, and medicine, and	36
dentistry, or in science, technology, engineering, mathematics, or	37
medical, or dental education. Choose Ohio first scholarships shall	38
be awarded to each participating eligible student as a grant to	39
the state university or college the student is attending and shall	40
be reflected on the student's tuition bill. Choose Ohio first	41
scholarships are student-centered grants from the state to	42
students to use to attend a university or college and are not	43
grants from the state to universities or colleges.	44

Notwithstanding any other provision of this section or	45
sections 3333.62 to 3333.69 of the Revised Code, a nonpublic	46
four-year Ohio institution of higher education may submit a	47
proposal for choose Ohio first scholarships or Ohio research	48
scholars grants. If the chancellor awards a nonpublic institution	49
scholarships or grants, the nonpublic institution shall comply	50
with all requirements of this section, sections 3333.62 to 3333.69	51
of the Revised Code, and the rules adopted under this section that	52
apply to state universities or colleges awarded choose Ohio first	53
scholarships or Ohio research scholars grants.	54

The Ohio research scholars program shall award grants to use	55
in recruiting scientists to the faculties of state universities or	56
colleges.	57

The chancellor shall adopt rules in accordance with Chapter	58
119. of the Revised Code to administer the programs.	59

Sec. 4715.10. (A) As used in this section, "accredited dental	60
college" means a dental college accredited by the commission on	61
dental accreditation or a dental college that has educational	62
standards recognized by the commission on dental accreditation and	63
is approved by the state dental board.	64

(B) Each person who desires to practice dentistry in this	65
state shall file a written application for a license with the	66
secretary of the state dental board. The application shall be on a	67
form prescribed by the board and verified by oath. Each applicant	68
shall furnish satisfactory proof to the board that the applicant	69
has met the requirements of divisions (C) and (D) of this section,	70
and if the applicant is a graduate of an unaccredited dental	71
college located outside the United States, division (E) of this	72
section.	73

(C) To be granted a license to practice dentistry, an	74
applicant must meet all of the following requirements:	75

(1) Be at least eighteen years of age;

76

(2) Be of good moral character;

77

(3) Be a graduate of an accredited dental college or of a	78
dental college located outside the United States who meets the	79
standards adopted under section 4715.11 of the Revised Code;	80

(4) Have passed parts I and II of the examination given by	81
the national board of dental examiners;	82

(5) Have passed a written jurisprudence examination	83
administered by the state dental board under division (E)(2) of	84
section 4715.03 of the Revised Code;	85

(6) Pay the fee required by division (A)(1) of section	86
4715.13 of the Revised Code.	87

(D) To be granted a license to practice dentistry, an	88
applicant must meet any one of the following requirements:	89

(1) Have taken an examination administered by any of the	90
following regional testing agencies and received on each component	91
of the examination a passing score as specified in division (A) of	92
section 4715.11 of the Revised Code: the central regional dental	93
testing service, inc., northeast regional board of dental	94
examiners, inc., the southern regional dental testing agency,	95
inc., or the western regional examining board;	96

(2) Have taken an examination administered by the state	97
dental board and received a passing score as established by the	98
board;	99

(3) Possess a license in good standing from another state and	100
have actively engaged in the legal and reputable practice of	101
dentistry in another state or in the armed forces of the United	102
States, the United States public health service, or the United	103
States department of veterans' affairs for five years immediately	104
preceding application;	105

(4) Have completed a dental residency program accredited or	106
approved by the commission on dental accreditation and	107
administered by an accredited dental college or hospital.	108

(E) To be granted a license to practice dentistry, a graduate	109
of an unaccredited dental college located outside the United	110
States must meet both of the following requirements:	111

(1) Have taken a basic science and laboratory examination	112
consistent with rules adopted under section 4715.11 of the Revised	113
Code and received a passing score as established by the board;	114

(2) Have had sufficient clinical training in an accredited	115
institution to reasonably assure a level of competency equal to	116
that of graduates of accredited dental colleges, as determined by	117
the board.	118

Sec. 4715.13. (A) Applicants for licenses to practice	119
dentistry or for a general anesthesia permit or a conscious	120
intravenous sedation permit shall pay to the secretary of the	121
state dental board the following fees:	122

(1) For license to practice dentistry, two hundred dollars if	123
issued in an odd-numbered year or three hundred thirty-seven	124
dollars if issued in an even-numbered year;	125

(2) For duplicate license, to be granted upon proof of loss	126
of the original, twenty dollars;	127

(3) For a general anesthesia permit, one hundred twenty-seven	128
dollars;	129

(4) For a conscious intravenous sedation permit, one hundred	130
twenty-seven dollars.	131

(B) TwentyForty dollars of each fee collected under division	132
(A)(1) of this section for a license issued in an even-numbered	133
year and tentwenty dollars of each fee collected under division	134
(A)(1) of this section in an odd-numbered year shall be paid to	135
the dentist loan repayment fund established under section 3702.95	136
of the Revised Code.	137

(C) In the case of a person who applies for a license to	138
practice dentistry by taking an examination administered by the	139
state dental board, both of the following apply:	140

(1) The fee in division (A)(1) of this section may be	141
refunded to an applicant who is unavoidably prevented from	142
attending the examination, or the applicant may be examined at the	143
next regular or special meeting of the board without an additional	144
fee.	145

(2) An applicant who fails the first examination may be	146
re-examined at the next regular or special meeting of the board	147
without an additional fee.	148

Sec. 4715.22.  (A)(1) This section applies only when a	149
licensed dental hygienist is not practicing under a permit issued	150
pursuant to section 4715.363 of the Revised Code authorizing	151
practice under the oral health access supervision of a dentist.	152

(2) As used in this section, "health care facility" means	153
either of the following:	154

(a) A hospital registered under section 3701.07 of the	155
Revised Code;	156

(b) A "home" as defined in section 3721.01 of the Revised	157
Code.	158

(B) A licensed dental hygienist shall practice under the	159
supervision, order, control, and full responsibility of a dentist	160
licensed under this chapter. A dental hygienist may practice in a	161
dental office, public or private school, health care facility,	162
dispensary, or public institution. Except as provided in division	163
(C) or (D) of this section, a dental hygienist may not provide	164
dental hygiene services to a patient when the supervising dentist	165
is not physically present at the location where the dental	166
hygienist is practicing.	167

(C) A dental hygienist may provide, for not more than fifteen	168
consecutive business days, dental hygiene services to a patient	169
when the supervising dentist is not physically present at the	170
location at which the services are provided if all of the	171
following requirements are met:	172

(1) The dental hygienist has at least two years and a minimum	173
of three thousand hours of experience in the practice of dental	174
hygiene.	175

(2) The dental hygienist has successfully completed a course	176
approved by the state dental board in the identification and	177
prevention of potential medical emergencies.	178

(3) The dental hygienist complies with written protocols for	179
emergencies the supervising dentist establishes for emergencies.	180

(4) The dental hygienist does not perform, while the	181
supervising dentist is absent from the location, procedures while	182
the patient is anesthetized, definitive root planing, definitive	183
subgingival curettage, or other procedures identified in rules the	184
state dental board adopts.	185

(5) The supervising dentist has evaluated the dental	186
hygienist's skills.	187

(6) The supervising dentist examined the patient not more	188
than seven monthsone year prior to the date the dental hygienist	189
provides the dental hygiene services to the patient.	190

(7) The dental hygienist complies with written protocols or	191
written standing orders that the supervising dentist establishes.	192

(8) The supervising dentist completed and evaluated a medical	193
and dental history of the patient not more than one year prior to	194
the date the dental hygienist provides dental hygiene services to	195
the patient and, except when the dental hygiene services are	196
provided in a health care facility, the supervising dentist	197
determines that the patient is in a medically stable condition.	198

(9) If the dental hygiene services are provided in a health	199
care facility, a doctor of medicine and surgery or osteopathic	200
medicine and surgery who holds a current certificate issued under	201
Chapter 4731. of the Revised Code or a registered nurse licensed	202
under Chapter 4723. of the Revised Code is present in the health	203
care facility when the services are provided.	204

(10) In advance of the appointment for dental hygiene	205
services, the patient is notified that the supervising dentist	206
will be absent from the location and that the dental hygienist	207
cannot diagnose the patient's dental health care status.	208

(11) The dental hygienist is employed by, or under contract	209
with, one of the following:	210

(a) The supervising dentist;

211

(b) A dentist licensed under this chapter who is one of the	212
following:	213

(i) The employer of the supervising dentist;

214

(ii) A shareholder in a professional association formed under	215
Chapter 1785. of the Revised Code of which the supervising dentist	216
is a shareholder;	217

(iii) A member or manager of a limited liability company	218
formed under Chapter 1705. of the Revised Code of which the	219
supervising dentist is a member or manager;	220

(iv) A shareholder in a corporation formed under division (B)	221
of section 1701.03 of the Revised Code of which the supervising	222
dentist is a shareholder;	223

(v) A partner or employee of a partnership or a limited	224
liability partnership formed under Chapter 1775. or 1776. of the	225
Revised Code of which the supervising dentist is a partner or	226
employee.	227

(c) A government entity that employs the dental hygienist to	228
provide dental hygiene services in a public school or in	229
connection with other programs the government entity administers.	230

(D) A dental hygienist may provide dental hygiene services to	231
a patient when the supervising dentist is not physically present	232
at the location at which the services are provided if the services	233
are provided as part of a dental hygiene program that is approved	234
by the state dental board and all of the following requirements	235
are met:	236

(1) The program is operated through a school district board	237
of education or the governing board of an educational service	238
center; the board of health of a city or general health district	239
or the authority having the duties of a board of health under	240
section 3709.05 of the Revised Code; a national, state, district,	241
or local dental association; or any other public or private entity	242
recognized by the state dental board.	243

(2) The supervising dentist is employed by or a volunteer	244
for, and the patients are referred by, the entity through which	245
the program is operated.	246

(3)(a) Except as provided in division (D)(3)(b) of this	247
section, the services are performed after examination and	248
diagnosis by the dentist and in accordance with the dentist's	249
written treatment plan.	250

(b) The requirement in division (D)(3)(a) of this section	251
does not apply when the only service to be provided by the dental	252
hygienist is the placement of pit and fissure sealants.	253

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

254

(1) Practice dental hygiene in a manner that is separate or	255
otherwise independent from the dental practice of a supervising	256
dentist;	257

(2) Establish or maintain an office or practice that is	258
primarily devoted to the provision of dental hygiene services.	259

(F) The state dental board shall adopt rules under division	260
(C) of section 4715.03 of the Revised Code identifying procedures	261
a dental hygienist may not perform when practicing in the absence	262
of the supervising dentist pursuant to division (C) or (D) of this	263
section. The board shall not identify the re-cementation of	264
temporary crowns as one of those procedures.	265

Sec. 4715.23.  The practice of a dental hygienist shall	266
consist of those prophylactic, preventive, and other procedures	267
that licensed dentists are authorized by this chapter and rules of	268
the dental board to assign only to licensed dental hygienists or	269
to qualified personnel under section 4715.39 of the Revised Code.	270

Licensed dentists may assign to dental hygienists intraoral	271
tasks that do not require the professional competence or skill of	272
the licensed dentist and that are authorized by board rule. Such	273
performance of intraoral tasks by dental hygienists shall be under	274
supervision and full responsibility of the licensed dentist, and	275
at no time shall more than threefour dental hygienists be	276
practicing clinical hygiene under the supervision of the same	277
dentist. The foregoing shall not be construed as authorizing the	278
assignment of diagnosis, treatment planning and prescription	279
(including prescriptions for drugs and medicaments or	280
authorizations for restorative, prosthodontic, or orthodontic	281
appliances); or, except when done in conjunction with the removal	282
of calcarious deposits, dental cement, or accretions on the crowns	283
and roots of teeth, surgical procedures on hard and soft tissues	284
within the oral cavity or any other intraoral procedure that	285
contributes to or results in an irremediable alteration of the	286
oral anatomy; or the making of final impressions from which casts	287
are made to construct any dental restoration.	288

The state dental board shall issue rules defining the	289
procedures that may be performed by licensed dental hygienists	290
engaged in school health activities or employed by public	291
agencies.	292

Sec. 4715.363. (A) A dental hygienist who desires to	293
participate in the oral health access supervision program shall	294
apply to the state dental board for a permit to practice under the	295
oral health access supervision of a dentist. The application shall	296
be under oath, on a form prescribed by the board in rules adopted	297
under section 4715.372 of the Revised Code, and accompanied by an	298
application fee of twenty dollars, which may be paid by personal	299
check.	300

(B) The applicant shall provide evidence satisfactory to the	301
board that the applicant has done all of the following:	302

(1) Completed at least two years and attained a minimum of	303
three thousand hours of experience in the practice of dental	304
hygiene;	305

(2) Completed at least twenty-four hours of continuing dental	306
hygiene education during the two years prior to submission of the	307
application;	308

(3) Completed a course pertaining to the practice of dental	309
hygiene under the oral health access supervision of a dentist that	310
meets standards established in rules adopted under section	311
4715.372 of the Revised Code;	312

(4) Completed, during the two years prior to submission of	313
the application, a course pertaining to the identification and	314
prevention of potential medical emergencies that is the same as	315
the course described in division (C)(2) of section 4715.22 of the	316
Revised Code.	317

(C) The state dental board shall issue a permit to practice	318
under the oral health access supervision of a dentist to a dental	319
hygienist who is in good standing with the board and meets all of	320
the requirements of divisions (A) and (B) of this section.	321

Sec. 4715.366. (A) A dental hygienist providing dental	322
hygiene services under a permit issued under section 4715.363 of	323
the Revised Code to practice under the oral health access	324
supervision of a dentist shall do both of the following:	325

(1) Comply with written protocols established by the	326
authorizing dentist who authorizes the dental hygienist's	327
provision of services and standing orders established by the	328
authorizing dentist, including protocols and standing orders	329
regarding emergencies and, for the purpose of section 4715.365 of	330
the Revised Code, protocols regarding what constitutes a medically	331
significant change to a patient's medical or dental history;	332

(2) Immediately following the completion of the dental	333
hygiene services and subject to division (B) of this section,	334
direct the patient to the authorizinga dentist for a clinical	335
evaluation and schedule or cause to be scheduled an appointment	336
for the patient with the authorizing dentist.	337

(B) For purposes of division (A)(2) of this section, the	338
dental hygienist shall make every attempt to schedule the	339
patient's appointment with the authorizing dentist not later than	340
ninety dayssix months after the completion of the dental hygiene	341
services. The dental hygienist shall provide the patient with a	342
written notice of the appointment that includes, at a minimum, the	343
authorizing dentist's name, address, and telephone number; the	344
date and time of the appointment; and a statement of the dental	345
hygiene services performed by the hygienist. The notice shall be	346
given to the patient or the patient's representative and one copy	347
shall be given to the authorizing dentist.	348

Sec. 4715.371. The state dental board shall develop and	349
publish on its internet web site a directory containing the names	350
and contact information, including electronic mail addresses, of	351
dentists and dental hygienists who hold current, valid permits	352
issued under sections 4715.362 and 4715.363 of the Revised Code.	353

Sec. 4715.39.  (A) The state dental board may define the	354
duties that may be performed by dental assistants and other	355
individuals designated by the board as qualified personnel. If	356
defined, the duties shall be defined in rules adopted in	357
accordance with Chapter 119. of the Revised Code. The rules may	358
include training and practice standards for dental assistants and	359
other qualified personnel. The standards may include examination	360
and issuance of a certificate. If the board issues a certificate,	361
the recipient shall display the certificate in a conspicuous	362
location in any office in which the recipient is employed to	363
perform the duties authorized by the certificate.	364

(B) A dental assistant may polish the clinical crowns of	365
teeth if all of the following requirements are met:	366

(1) The dental assistant's polishing activities are limited	367
to the use of a rubber cup attached to a slow-speed rotary dental	368
hand piece to remove soft deposits that build up over time on the	369
crowns of teeth.	370

(2) The polishing is performed only after a dentist has	371
evaluated the patient and any calculus detected on the teeth to be	372
polished has been removed by a dentist or dental hygienist.	373

(3) The dentist supervising the assistant supervises not more	374
than two dental assistants engaging in polishing activities at any	375
given time.	376

(4) The dental assistant is certified by the dental assisting	377
national board or the Ohio commission on dental assistant	378
certification.	379

(5) The dental assistant receives a certificate from the	380
board authorizing the assistant to engage in the polishing	381
activities. The board shall issue the certificate if the	382
individual has successfully completed training in the polishing of	383
clinical crowns through a program accredited by the American	384
dental association commission on dental accreditation or	385
equivalent training approved by the board. The training shall	386
include courses in basic dental anatomy and infection control,	387
followed by a course in coronal polishing that includes didactic,	388
preclinical, and clinical training; any other training required by	389
the board; and a skills assessment that includes successful	390
completion of standardized testing. The board shall adopt rules	391
pursuant to division (A) of this section establishing standards	392
for approval of this training.	393

(C) A dental assistant may apply pit and fissure sealants if	394
all of the following requirements are met:	395

(1) A dentist evaluates the patient and designates the teeth	396
and surfaces that will benefit from the application of sealant on	397
the day the application is to be performed.	398

(2) The dental assistant is certified by the dental assisting	399
national board or the Ohio commission on dental assistant	400
certification.	401

(3) The dental assistant has successfully completed a course	402
in the application of sealants consisting of at least two hours of	403
didactic instruction and six hours of clinical instruction through	404
a program provided by an institution accredited by the American	405
dental association commission on dental accreditation or a program	406
provided by a sponsor of continuing education approved by the	407
board.	408

(4) The dentist supervising the assistant has observed the	409
assistant successfully apply at least six sealants.	410

(5) TheExcept as provided in division (D) of this section,	411
the dentist supervising the assistant checks and approves the	412
application of all sealants placed by the assistant before the	413
patient leaves the location where the sealant application	414
procedure is performed.	415

(D)(1) A dental assistant who is certified by the dental	416
assisting national board or the Ohio commission on dental	417
assistant certification may provide, for not more than fifteen	418
consecutive business days, the services specified in division	419
(D)(2) of this section to a patient when the supervising dentist	420
is not physically present at the location where the services are	421
provided if all of the following conditions are met:	422

(a) The dental assistant has at least two years and a minimum	423
of three thousand hours of experience practicing as a dental	424
assistant.	425

(b) The dental assistant has successfully completed a course	426
approved by the state dental board in the identification and	427
prevention of potential medical emergencies.	428

(c) The dental assistant complies with written protocols the	429
supervising dentist establishes for emergencies.	430

(d) The supervising dentist has evaluated the dental	431
assistant's skills.	432

(e) The supervising dentist examined the patient not more	433
than one year prior to the date the dental assistant provides the	434
services to the patient.	435

(f) The dental assistant complies with written protocols or	436
written standing orders that the supervising dentist establishes.	437

(g) The supervising dentist completed and evaluated a medical	438
and dental history of the patient not more than one year prior to	439
the date the dental assistant provides services to the patient	440
and, except when the services are provided in a health care	441
facility, the supervising dentist determines that the patient is	442
in a medically stable condition.	443

(h) If the services are provided in a health care facility, a	444
doctor of medicine and surgery or osteopathic medicine and surgery	445
who holds a current certificate issued under Chapter 4731. of the	446
Revised Code or a registered nurse licensed under Chapter 4723. of	447
the Revised Code is present in the health care facility when the	448
services are provided.	449

(i) In advance of the appointment for services, the patient	450
is notified that the supervising dentist will be absent from the	451
location and that the dental assistant cannot diagnose the	452
patient's dental health care status.	453

(j) The dental assistant is employed by, or under contract	454
with, the supervising dentist, a dentist licensed under this	455
chapter who meets one of the criteria specified in division	456
(C)(11)(b) of section 4715.22 of the Revised Code, or a government	457
entity that employs the dental assistant to provide services in a	458
public school or in connection with other programs the government	459
entity administers.	460

(2) The services that a dental assistant may provide under	461
the conditions specified in division (A)(1) of this section are	462
all of the following:	463

(a) The re-cementation of temporary crowns;

464

(b) The application of topical fluoride;

465

(c) The application of fluoride varnish;

466

(d) The application of disclosing solutions;

467

(e) The application of desensitizing agents;

468

(f) Carries susceptibility testing;

469

(g) The demonstration of oral hygiene procedures, including	470
the use of toothbrushes and dental floss;	471

(h) The discussion of proper nutrition.

472

(3) A dental assistant who is certified by the dental	473
assisting national board or the Ohio commission on dental	474
assistant certification and meets the conditions specified in	475
divisions (D)(1)(a) and (b) of this section may apply pit and	476
fissure sealants prior to a dentist examining the patient and	477
rendering a diagnosis, and when a dentist is not physically	478
present at the location where the service is provided, subject to	479
all of the following:	480

(a) The dental assistant must be providing the service as	481
part of a program operated through any of the following: a school	482
district board of education or the governing board of an	483
educational service center; the board of health of a city or	484
general health district or the authority having the duties of a	485
board of health under section 3709.05 of the Revised Code; a	486
national, state, district, or local dental association; or any	487
other public or private entity recognized by the state dental	488
board.	489

(b) A supervising dentist for the program described in	490
division (D)(3)(a) of this section must meet both of the following	491
conditions:	492

(i) Be employed by or a volunteer for, and the patients are	493
referred by, the entity through which the program is operated;	494

(ii) Be available for consultation by telephone,	495
videoconferencing, or other means of electronic communication.	496

(c) The application of pit and fissure sealants must be	497
limited to erupted permanent posterior teeth without suspicion of	498
cavitation.	499

(d) If the patient is a minor, a parent, guardian, or other	500
person responsible for the patient must be notified that a dentist	501
will not be present at the location and that the dental assistant	502
is not trained to diagnose or treat other serious dental concerns	503
that could exist.	504

(E) Subject to this section and the applicable rules of the	505
board, licensed dentists may assign to dental assistants and other	506
qualified personnel dental procedures that do not require the	507
professional competence or skill of the licensed dentist, a dental	508
hygienist, or an expanded function dental auxiliary as this	509
section or the board by rule authorizes dental assistants and	510
other qualified personnel to perform. TheExcept as provided in	511
division (D) of this section, the performance of dental procedures	512
by dental assistants and other qualified personnel shall be under	513
direct supervision and full responsibility of the licensed	514
dentist.	515

(E)(F) Nothing in this section shall be construed by rule of	516
the state dental board or otherwise to do the following:	517

(1) Authorize dental assistants or other qualified personnel	518
to engage in the practice of dental hygiene as defined by sections	519
4715.22 and 4715.23 of the Revised Code or to perform the duties	520
of a dental hygienist, including the removal of calcarious	521
deposits, dental cement, or accretions on the crowns and roots of	522
teeth other than as authorized pursuant to this section;	523

(2) Authorize dental assistants or other qualified personnel	524
to engage in the practice of an expanded function dental auxiliary	525
as specified in section 4715.64 of the Revised Code or to perform	526
the duties of an expanded function dental auxiliary other than as	527
authorized pursuant to this section.	528

(3) Authorize the assignment of any of the following:

529

(a) Diagnosis;

530

(b) Treatment planning and prescription, including	531
prescription for drugs and medicaments or authorization for	532
restorative, prosthodontic, or orthodontic appliances;	533

(c) Surgical procedures on hard or soft tissue of the oral	534
cavity, or any other intraoral procedure that contributes to or	535
results in an irremediable alteration of the oral anatomy;	536

(d) The making of final impressions from which casts are made	537
to construct any dental restoration.	538

(F)(G) No dentist shall assign any dental assistant or other	539
individual acting in the capacity of qualified personnel to	540
perform any dental procedure that the assistant or other	541
individual is not authorized by this section or by board rule to	542
perform. No dental assistant or other individual acting in the	543
capacity of qualified personnel shall perform any dental procedure	544
other than in accordance with this section and any applicable	545
board rule or any dental procedure that the assistant or other	546
individual is not authorized by this section or by board rule to	547
perform.	548

Sec. 4715.421. (A) As used in this section, "operation" has	549
the same meaning as in section 2305.234 of the Revised Code.	550

(B) Within thirty days after receiving an application for a	551
temporary volunteer's certificate that includes all of the items	552
listed in divisions (C)(1) and (2) of this section, the state	553
dental board shall issue, without examination, a temporary	554
volunteer's certificate to a person not licensed under this	555
chapter so that the person may provide dental services in this	556
state as a volunteer.	557

(C) An application for a temporary volunteer's certificate	558
shall include both of the following:	559

(1) A copy of the applicant's degree from a dental college or	560
dental hygiene school;	561

(2) One of the following, as applicable:

562

(a) Evidence satisfactory to the board that the applicant	563
holds a valid, unrestricted license to practice dentistry or	564
dental hygiene issued by a jurisdiction in the United States that	565
licenses persons to practice dentistry or dental hygiene;	566

(b) Evidence satisfactory to the board that the applicant is	567
practicing dentistry or dental hygiene in one or more branches of	568
the United States armed services.	569

(D) The holder of a temporary volunteer's certificate shall	570
not accept any form of remuneration for providing dental services	571
pursuant to the certificate. Except in a dental emergency, the	572
holder shall not perform any operation. The board may revoke a	573
temporary volunteer's certificate on receiving proof satisfactory	574
to the board that the holder has engaged in practice in this state	575
outside the scope of the holder's certificate or that there are	576
grounds for action against the person under section 4715.30 of the	577
Revised Code.	578

(E)(1) A temporary volunteer's certificate shall be valid for	579
a period of seven days, and may be renewed upon the application of	580
the holder, unless the certificate was previously revoked under	581
division (D) of this section. The board shall maintain a register	582
of all persons who hold a temporary volunteer's certificate. The	583
board may charge a fee not to exceed twenty-five dollars for	584
issuing or renewing a certificate pursuant to this section.	585

(2) The board shall issue to each person who qualifies under	586
this section for a temporary volunteer's certificate a wallet	587
certificate that states that the certificate holder is authorized	588
to provide dental services pursuant to the laws of this state. The	589
holder shall keep the wallet certificate on the holder's person	590
while providing dental services.	591

(3) The holder of a temporary volunteer's certificate issued	592
pursuant to this section is subject to the immunity provisions in	593
section 2305.234 of the Revised Code.	594

(F) The board shall adopt rules in accordance with Chapter	595
119. of the Revised Code to administer and enforce this section.	596

(G) Not later than ninety days after the effective date of	597
this section, the state dental board shall make available through	598
the board's internet web site the application form for a temporary	599
volunteer's certificate under this section, a description of the	600
application process, and a list of all items that are required by	601
division (C) of this section to be submitted with the application.	602

Sec. 4715.64. (A) TheSubject to divisions (B), (C), and (D)	603
of this section, the practice of an expanded function dental	604
auxiliary shall consist of the following:	605

(1) The procedures involved in the placement of restorative	606
materials limited to amalgam restorative materials and	607
non-metallicnonmetallic restorative materials, including	608
direct-bonded restorative materials;	609

(2) The procedures involved in the placement ofapplication	610
of pit and fissure sealants;	611

(3) The re-cementation of temporary crowns;

612

(4) The application of topical fluoride;

613

(5) The application of fluoride varnish;

614

(6) The application of disclosing solutions;

615

(7) The application of desensitizing agents;

616

(8) Carries susceptibility testing;

617

(9) The demonstration of oral hygiene procedures, including	618
the use of toothbrushes and dental floss;	619

(10) The discussion of proper nutrition;

620

(11) Any additional procedures authorized by the state dental	621
board in rules adopted under section 4715.66 of the Revised Code.	622

(B) An expanded function dental auxiliary shall practice	623
perform the services specified in divisions (A)(1) and (11) of	624
this section only under the direct supervision, order, control,	625
and full responsibility of a dentist licensed under this chapter.	626
At no time shall more than two expanded function dental	627
auxiliaries be practicing as expanded function dental auxiliaries	628
under the direct supervision of the same dentist. AnExcept as	629
provided in divisions (C) and (D) of this section, an expanded	630
function dental auxiliary shall not practice as an expanded	631
function dental auxiliary when the supervising dentist is not	632
physically present at the location where the expanded function	633
dental auxiliary is practicing.	634

(C) An expanded function dental auxiliary may perform, for	635
not more than fifteen consecutive days, the services specified in	636
divisions (A)(3) to (10) of this section when the supervising	637
dentist is not physically present at the location where the	638
expanded function dental auxiliary is practicing if all of the	639
following conditions are met:	640

(1) The expanded function dental auxiliary has at least two	641
years and a minimum of three thousand hours of experience	642
practicing as an expanded function dental auxiliary.	643

(2) The expanded function dental auxiliary has successfully	644
completed a course approved by the board in the identification and	645
prevention of potential medical emergencies.	646

(3) The expanded function dental auxiliary complies with	647
written protocols the supervising dentist establishes for	648
emergencies.	649

(4) The supervising dentist has evaluated the expanded	650
function dental auxiliary's skills.	651

(5) The supervising dentist examined the patient not more	652
than one year prior to the date the expanded function dental	653
auxiliary provides services to the patient.	654

(6) The expanded function dental auxiliary complies with	655
written protocols or written standing orders that the supervising	656
dentist establishes.	657

(7) The supervising dentist completed and evaluated a medical	658
and dental history of the patient not more than one year prior to	659
the date the expanded function dental auxiliary provides services	660
to the patient and, except when the services are provided in a	661
health care facility, the supervising dentist determines that the	662
patient is in a medically stable condition.	663

(8) If the services are provided in a health care facility, a	664
doctor of medicine and surgery or osteopathic medicine and surgery	665
who holds a current certificate issued under Chapter 4731. of the	666
Revised Code or a registered nurse licensed under Chapter 4723. of	667
the Revised Code ispresent in the health care facility when the	668
services are provided.	669

(9) In advance of the appointment for services, the patient	670
is notified that the supervising dentist will be absent from the	671
location and that the expanded function dental auxiliary cannot	672
diagnose the patient's dental health care status.	673

(10) The expanded function dental auxiliary is employed by,	674
or under contract with, the supervising dentist, a dentist	675
licensed under this chapter who meets one of the criteria	676
specified in division (C)(11)(b) of section 4715.22 of the Revised	677
Code, or a government entity that employs the expanded function	678
dental auxiliary to provide services in a public school or in	679
connection with other programs the government entity administers.	680

(D) An expanded function dental auxiliary who meets the	681
conditions specified in divisions (C)(1) and (2) of this section	682
may apply pit and fissure sealants prior to a dentist examining	683
the patient and rendering a diagnosis, and when a dentist is not	684
physically present at the location where the service is provided,	685
subject to all of the following:	686

(1) The expanded function dental auxiliary must be providing	687
the service as part of a program operated through any of the	688
following: a school district board of education or the governing	689
board of an educational service center; the board of health of a	690
city or general health district or the authority having the duties	691
of a board of health under section 3709.05 of the Revised Code; a	692
national, state, district, or local dental association; or any	693
other public or private entity recognized by the state dental	694
board.	695

(2) A supervising dentist for the program described in	696
division (D)(3) of this section must meet both of the following	697
conditions:	698

(a) Be employed by or a volunteer for, and the patients are	699
referred by, the entity through which the program is operated;	700

(b) Be available for consultation by telephone,	701
videoconferencing, or other means of electronic communication.	702

(3) The application of pit and fissure sealants must be	703
limited to erupted permanent posterior teeth without suspicion of	704
cavitation.	705

(4) If the patient is a minor, a parent, guardian, or other	706
person responsible for the patient must be notified that a dentist	707
will not be present at the location and that the expanded function	708
dental auxiliary is not trained to diagnose or treat other serious	709
dental concerns that could exist.	710

(E) Nothing in this section shall be construed by rule of the	711
board or otherwise to authorize an expanded function dental	712
auxiliary to engage in the practice of dental hygiene as defined	713
by sections 4715.22 and 4715.23 of the Revised Code.	714

Sec. 4715.66. (A) The state dental board shall adopt rules as	715
the board considers necessary to implement and administer sections	716
4715.61 to 4715.64 of the Revised Code. The rules shall be adopted	717
in accordance with Chapter 119. of the Revised Code.	718

(B) In adopting rules under this section, all of the	719
following apply:	720

(1) The board shall adopt rules specifying the education or	721
training necessary for an individual to register as an expanded	722
function dental auxiliary under this chapter.	723

(2) The board shall adopt rules specifying the standards that	724
must be met for an examination to be accepted by the board as an	725
examination of competency to practice as an expanded function	726
dental auxiliary. In specifying the standards, the board shall	727
provide that an examination will be accepted only if the entity	728
that administered the examination required an individual to be one	729
of the following as a condition of admission to the examination:	730

(a) An unlicensed dentist who has graduated from an	731
accredited dental college, as specified in section 4715.10 of the	732
Revised Code, and does not have a dental license under suspension	733
or revocation by the board;	734

(b) A dental student who is enrolled in an accredited dental	735
college, as specified in section 4715.10 of the Revised Code, and	736
is considered by the dean of the college to be in good standing as	737
a dental student;	738

(c) A graduate of a dental college located outside of the	739
United States;	740

(d) A dental assistant who is certified by the dental	741
assisting national board or the Ohio commission on dental	742
assistant certification;	743

(e) A dental hygienist licensed under this chapter whose	744
license is in good standing;	745

(f) An unlicensed dental hygienist who has graduated from an	746
accredited dental hygiene school, as specified in section 4715.21	747
of the Revised Code, and does not have a dental hygienist license	748
under suspension or revocation by the board.	749

(3) The board may adopt rules specifying procedures an	750
expanded function dental auxiliary may perform that are in	751
addition to the procedures specified in divisions (A)(1) and (2)	752
to (10) of section 4715.64 of the Revised Code.	753

Section 2.  That existing sections 3333.61, 4715.10, 4715.13,	754
4715.22, 4715.23, 4715.363, 4715.366, 4715.371, 4715.39, 4715.64,	755
and 4715.66 of the Revised Code are hereby repealed.	756

Section 3. (A) There is hereby created the Medicaid Payment	757
Rates for Dental Services Workgroup. The Workgroup shall consist	758
of all of the following:	759

(1) The Medicaid Director or the Director's designee;

760

(2) The Director of Health or the Director's designee;

761

(3) Two members of the Senate, one from the majority party	762
and the other from the minority party, appointed by the President	763
of the Senate;	764

(4) Two members of the House of Representatives, one from the	765
majority party and the other from the minority party, appointed by	766
the Speaker of the House of Representatives;	767

(5) Four dentists who have valid Medicaid provider agreements	768
and practice in different geographic areas of the state, appointed	769
by the executive director of the Ohio Dental Association.	770

(B) Appointments to the Workgroup shall be made not later	771
than thirty days after the effective date of this section. Except	772
to the extent that serving on the Workgroup is part of a member's	773
regular employment duties, a member of the Workgroup shall not be	774
paid for the member's service on the Workgroup. Members of the	775
Workgroup shall not be reimbursed for their expenses incurred in	776
serving on the Workgroup.	777

(C) The Medicaid Director or Director's designee shall serve	778
as the Workgroup's chairperson. The Workgroup shall meet at the	779
call of the chairperson.	780

(D) The Department of Medicaid shall provide staff and other	781
support services for the Workgroup.	782

(E) The Workgroup shall study the issue of Medicaid payment	783
rates for dental services. Not later than December 31, 2014, the	784
Workgroup shall submit a report of its study to the Governor and,	785
in accordance with section 101.68 of the Revised Code, the General	786
Assembly. The report shall include recommendations regarding	787
Medicaid payment rates for dental services. The Workgroup shall	788
cease to exist on submission of its report.	789

Section 4. Not later than July 1, 2015, the Development	790
Services Agency shall enter into a contract with JobsOhio. This	791
contract shall specify that JobsOhio shall use $250,000 in the	792
fiscal year ending June 30, 2016, to provide no-interest loans for	793
the purchase of dental equipment to be used for the treatment of	794
underserved populations in dental health resource shortage areas	795
designated by the Director of Health under section 3702.87 of the	796
Revised Code. The Development Services Agency shall coordinate	797
duties with JobsOhio through this contract.	798