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Sub. H. B. No. 190 As Reported by the House Healthcare Access and Affordability CommitteeAs Reported by the House Healthcare Access and Affordability Committee
128th General Assembly | Regular Session | 2009-2010 |
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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
A BILL
To amend sections 4715.14, 4715.141, 4715.21,
4715.22,
4715.24, and
4715.25 and to enact
sections
4715.241, 4715.242,
4715.36, 4715.361,
4715.362,
4715.363, 4715.364,
4715.365,
4715.366, 4715.367,
4715.368, 4715.369,
4715.37,
4715.371, 4715.372,
4715.373, 4715.374,
and
4715.375 of the Revised
Code to modify certain
licensing procedures for
dentists and dental
hygienists and to establish
the Public Oral
Health
Supervision Program for
the provision of
dental
hygiene services.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4715.14, 4715.141, 4715.21, 4715.22,
4715.24,
and
4715.25 be amended and sections 4715.241, 4715.242,
4715.36,
4715.361, 4715.362, 4715.363, 4715.364, 4715.365,
4715.366,
4715.367, 4715.368, 4715.369, 4715.37, 4715.371,
4715.372,
4715.373, 4715.374, and 4715.375 of the Revised Code be
enacted to
read as follows:
Sec. 4715.14. (A) Each person who is licensed to practice
dentistry in Ohio shall, on or before the first day of January of
each even-numbered year, register with the state dental board.
The
registration shall be made on a form prescribed by the board
and
furnished by the secretary, shall include the licensee's
name,
address, license number, and such other reasonable
information as
the board may consider necessary, and shall
include payment of a
biennial registration fee of
two hundred
forty-five dollars.
Except as provided in division (D)(E) of this section, this fee
shall be paid to the
treasurer of
state. All
such
registrations
shall be in effect for the
two-year period
beginning
on the first
day of January of the
even-numbered year
and ending
on the last
day of December of the
following
odd-numbered year,
and shall be
renewed in accordance
with the
standard renewal
procedure of
sections 4745.01 to
4745.03 of the
Revised Code. The failure of If
a licensee fails to renew
the licensee's
registration in
accordance with this section
shall result in an
automatic
suspension of the licensee's license to
practice
dentistry, the
board may take any of the disciplinary actions described in
division (C) of section 4715.30 of the Revised Code with respect
to the licensee or licensee's license.
(B) Any The license of any dentist whose license has been
suspended
under
this
section may be
reinstated by on the payment
of the
biennial
registration fee and
in addition thereto
eighty-one dollars
to
cover
costs of the
reinstatement; excepting
that to any.
(C) The board shall grant temporary retirement to any
licensed
dentist who desires to temporarily retire from practice,
and who
has given the board notice in writing to that effect, the
board
shall grant such a retirement, provided only that at the
time that
time
the board grants the temporary retirement all
previous registration fees and additional costs of
reinstatement
have been paid.
(C)(D) Each dentist licensed to practice, whether a resident
or
not, shall notify the secretary in writing or electronically of
any change in
the
dentist's office address or employment within
ten days
after such
change has taken place. On the first day of
July of every
even-numbered year, the secretary shall issue a
printed roster of
the names and addresses so registered.
(D)(E) Twenty dollars of each biennial registration fee shall
be paid to the dentist loan repayment fund created under section
3702.95 of the Revised Code.
Sec. 4715.141. (A) Each licensed dentist shall complete
biennially not less than forty hours of continuing dental
education, which may include, but is not limited to, attendance
at
lectures, study clubs, college and postgraduate courses, or
scientific sessions of conventions, research, graduate study,
teaching, service as a clinician, or correspondence courses.
Continuing dental education programs include, but are not limited
to, programs that address any of the following:
(1) Compentency Competency in treating patients who are
medically compromised or who experience medical emergencies
during
the course of dental treatment;
(2) Knowledge of pharmaceutical products and the protocol
of
the proper use of medications;
(3) Competency to diagnose oral pathology;
(4) Awareness of currently accepted methods of infection
control;
(5) Basic medical and scientific subjects including, but
not
limited to, biology, physiology, pathology, biochemistry, and
pharmacology;
(6) Clinical and technological subjects including, but not
limited to, clinical techniques and procedures, materials, and
equipment;
(7) Subjects pertinent to health and safety.
Dentists shall earn continuing education credits at the
rate
of one-half credit for each twenty-five to thirty contact
minutes
of instruction and one credit hour for each fifty to
sixty contact
minutes of instruction.
(B) Programs meeting the general requirements of division
(A)
of this section may be developed and offered to dentists by
any of
the following agencies or organizations:
(1) National, state, district, or local dental
associations
affiliated with the American dental association or
national dental
association;
(2) Accredited dental colleges or schools;
(3) Other organizations, schools, or agencies approved by
the
state dental board.
(C) Each licensed dentist shall submit to the board at the
time of biennial registration pursuant to section 4715.14 of the
Revised Code a sworn affidavit, on a form acceptable to the state
dental board, attesting that he the dentist has completed
continuing
education programs in compliance with this section and
listing
the date, location, sponsor, subject matter, and hours
completed
of the programs.
A licensed dentist shall retain in his the dentist's records
for a period
of at least three years such receipts, vouchers, or
certificates
as may be necessary to document completion of
continuing
education programs. With cause, the board may request
such
documentation from licensed dentists, and the board may
request
such documentation from licensed dentists selected at
random
without cause.
(D) The board may excuse licensed dentists, as a group or
as
individuals, from all or any part of the requirements of this
section because of an unusual circumstance, emergency, or special
hardship.
(E) Failure to comply with the requirements of this
section
constitutes a failure to renew registration pursuant to
section
4715.14 of the Revised Code.
Sec. 4715.21. Each person who desires to practice as a
dental hygienist shall file with the secretary of the state
dental
board a written application for a license, under oath,
upon the
form prescribed. Such applicant shall furnish
satisfactory proof
of being at least eighteen years of age and of
good moral
character. An applicant shall present a diploma or
certificate of
graduation from an accredited dental hygiene
school and shall pay
the examination fee of
ninety-six dollars
if the
license is
issued
in an odd-numbered year or one
hundred
forty-seven
dollars
if
issued in an even-numbered year. Those
passing such
examination as
the board prescribes relating to
dental hygiene
shall receive a
certificate of registration
entitling them to
practice. If an
applicant fails to pass the
first examination
the
applicant
may
apply for a re-examination at
the next regular or
special
examination meeting of the board.
No applicant shall be admitted to more than two
examinations
without first presenting satisfactory proof that the
applicant
has
successfully completed such refresher courses in an
accredited
dental hygiene school as the state dental board may
prescribe.
An accredited dental hygiene school shall be one accredited
by the council on dental education of the American dental
association commission on dental accreditation or whose
educational standards are recognized by the
council on dental
education of the American dental association
commission on dental
accreditation and
approved by the state dental board.
Sec. 4715.22. (A) As (1) This section applies only when a
licensed dental hygienist is not practicing under a permit issued
pursuant to section 4715.363 of the Revised Code authorizing
practice under the public oral health supervision of a
dentist.
(2) As used in this section, "health
care
facility" means
either of the following:
(1)(a) A hospital registered under section 3701.07 of the
Revised
Code;
(2)(b) A "home" as defined in section 3721.01 of the Revised
Code.
(B) A licensed dental hygienist shall
practice under the
supervision, order, control, and full responsibility of
a dentist
licensed under this chapter. A dental hygienist may practice in
a
dental office, public or private school, health care
facility,
dispensary, or public institution. Except as provided in
division
(C) or (D) of this section, a dental
hygienist may not provide
dental hygiene services to a patient
when the supervising dentist
is not physically present at the
location where the dental
hygienist is practicing.
(C) A dental hygienist
may provide, for not more than fifteen
consecutive business
days, dental hygiene services to a patient
when the supervising
dentist is not physically present at the
location
at which the services are provided if all of the
following
requirements are met:
(1) The dental hygienist has at least two years and a minimum
of three
thousand hours of experience in the practice of
dental
hygiene.
(2) The dental hygienist has successfully completed a
course
approved by the
state dental board in the
identification and
prevention of potential medical
emergencies.
(3) The dental hygienist complies with written protocols
for
emergencies the supervising dentist establishes.
(4) The dental hygienist does not perform, while the
supervising dentist is absent from the location, procedures while
the patient
is anesthetized, definitive root planing, definitive
subgingival curettage, or other procedures identified in rules
the
state dental board adopts.
(5) The supervising dentist has evaluated the dental
hygienist's skills.
(6) The supervising dentist examined the patient not more
than seven months prior to the date the dental hygienist
provides
the dental hygiene services to the patient.
(7) The dental hygienist complies with written protocols or
written
standing orders that the supervising dentist establishes.
(8) The supervising dentist completed and evaluated a
medical
and dental history of the patient not more than one year
prior to
the date the dental hygienist provides dental hygiene
services to
the patient and, except when the dental hygiene services
are
provided in a health care facility, the supervising dentist
determines that the patient is in a medically stable
condition.
(9) If the dental hygiene services are provided in a
health
care facility, a doctor of medicine and
surgery or osteopathic
medicine and surgery who holds a current
certificate issued under
Chapter 4731. of the
Revised
Code or a registered nurse
licensed
under Chapter 4723. of
the Revised
Code is present in the health
care facility when the services are
provided.
(10) In advance of the
appointment for dental hygiene
services, the patient is notified that the
supervising dentist
will be absent from the
location and that the dental hygienist
cannot diagnose the patient's
dental health care status.
(11) The dental hygienist is employed by, or under
contract
with, one of the following:
(a) The supervising dentist;
(b) A dentist licensed under this chapter who is
one of the
following:
(i) The employer of the supervising
dentist;
(ii) A shareholder in a professional association
formed under
Chapter
1785. of the Revised
Code of which the supervising
dentist
is a shareholder;
(iii) A member or manager of a limited liability
company
formed under
Chapter 1705. of the
Revised
Code of which the
supervising
dentist is a member or manager;
(iv) A shareholder in a corporation formed
under division (B)
of
section 1701.03 of the Revised
Code of which the supervising
dentist is a shareholder;
(v) A partner or employee of a partnership or a
limited
liability partnership formed under
Chapter 1775. or 1776. of the
Revised
Code of which the supervising
dentist is a partner or
employee.
(c) A government entity that employs the dental hygienist
to
provide dental hygiene services in a public school or in
connection with other programs the government entity
administers.
(D) A dental hygienist may provide dental hygiene services
to
a
patient
when the supervising dentist is not physically
present
at the location at
which
the services are provided if
the
services
are provided as part of a dental hygiene program that is
approved
by the state dental board and all of the following
requirements
are
met:
(1) The program is operated through a school district
board
of education or the governing board of an educational service
center; the
board
of health of a city or general health district
or the authority having the
duties of a board of health under
section 3709.05 of the Revised
Code; a national, state, district,
or local dental association; or
any
other public or private entity
recognized by the state dental board.
(2) The supervising dentist is employed by or a volunteer
for, and the
patients
are referred by, the entity through which
the program is operated.
(3) The services are performed after examination and
diagnosis by the dentist
and in accordance with the dentist's
written treatment plan.
(E) No person shall do
either of the following:
(1) Practice dental hygiene in a manner that is separate
or
otherwise independent from the dental practice of a
supervising
dentist;
(2) Establish or maintain an office or practice that is
primarily devoted to the provision of dental hygiene services.
(F) The state dental
board shall adopt rules under division
(C) of section 4715.03 of the
Revised
Code identifying procedures
a
dental hygienist may not perform when practicing in the absence
of the supervising dentist pursuant to division
(C) or (D) of this
section.
Sec. 4715.24. (A) Each person who is licensed to practice
as
a dental hygienist in Ohio shall, on or before the first day
of
January of each even-numbered year, register with the state
dental
board, unless the person is temporarily retired pursuant to
section 4715.241 of the Revised Code. The registration shall be
made on a form
prescribed by the
board and furnished by the
secretary, shall
include the licensee's
name, address, license
number, and such
other reasonable
information as the board may
consider necessary,
and shall include
payment of a biennial
registration fee of
one hundred
five
dollars. This fee shall be
paid to the treasurer of state.
All
such registrations shall be in
effect for the two-year period
beginning on the first day of
January of each even-numbered year
and ending on the last day of
December of the following
odd-numbered year, and shall be renewed
in accordance with the
standard renewal procedure of sections
4745.01 to 4745.03 of the
Revised Code. The failure of a licensee
to renew
registration in
accordance with this section shall result
in the
automatic
suspension of the licensee's license to practice
as a dental
hygienist, unless the licensee is temporarily retired
pursuant to section 4715.241 of the Revised Code.
(B) Any dental hygienist whose license has been automatically
suspended
under this section may be reinstated by the on
application to the board on a form prescribed by the board for
licensure reinstatement and payment of the
biennial registration
fee and in addition thereto
thirty-one
dollars to cover the costs
of reinstatement.
(C) The license of a dental hygienist shall be exhibited
in
a
conspicuous place in the room in which the dental hygienist
practices. Each dental hygienist licensed to practice, whether a
resident or not, shall notify the secretary in writing or
electronically of any
change in the dental hygienist's office
address or
employment
within ten days after
the change takes
place.
Sec. 4715.241. (A) As used in this section and sections
4715.242
and 4715.25 of the Revised Code, "registration period"
means the
two-year period during which a dental hygienist's
registration is
in effect
under section 4715.24 of the Revised
Code.
(B) A dental hygienist seeking to retire temporarily from the
practice of dental hygiene shall provide written notice of that
intent to the state dental board. Except as provided in division
(C) of this section, the board shall grant temporary
retirement
if the dental hygienist has paid the registration fee
required by
section 4715.24 of the Revised Code for the
registration period
that includes the day immediately before the
day that the
temporary retirement is to begin. The license of a
dental
hygienist who is granted temporary retirement shall be
inactive.
(C) The board may deny temporary retirement to a dental
hygienist who is, at the time that the board denies the temporary
retirement, the subject of a disciplinary action initiated by the
board under section 4715.30 of the Revised Code.
Sec. 4715.242. (A) A dental hygienist who is temporarily
retired pursuant to section 4715.241 of the Revised Code may
submit a written request to the state dental board at any time for
reinstatement of the dental hygienist's license. The board shall
reinstate the license if the dental hygienist does both of the
following:
(1) Pays the biennial registration fee established under
section 4715.24 of the Revised Code for the period that includes
the day on which the temporary retirement is to cease;
(2) Provides the board satisfactory evidence that the dental
hygienist, during
the
two-year period immediately preceding the
date that the dental hygienist submitted the
written request for
license reinstatement,
completed a minimum of twenty-four hours
of
continuing dental hygiene education in accordance with division
(B) of this
section.
(B) The completion of continuing
dental hygiene education
required under division (A)(2) of this
section is subject to
division (D) of section 4715.25 of the
Revised Code. The
continuing education programs may be developed
and offered to
dental hygienists by any of the agencies or
organizations
described in division (C) of section 4715.25 of the
Revised Code.
The board may excuse dental hygienists, as a group
or as
individuals, from all or any part of the requirements of
division
(A)(2) of this section because of an unusual
circumstance,
emergency, or special hardship.
(C) The state dental board shall register each dental
hygienist whose license is reinstated under this section. The
registration expires at the end of the registration period during
which the license is reinstated.
Sec. 4715.25. (A) Every person licensed to practice as a
dental hygienist and required to register with the state dental
board shall certify to the board at the time of applying for a
renewal of registration that in the two-year period preceding two
years the registration period for which renewal is sought the
registrant has completed a minimum
of twelve twenty-four hours of
continuing
dental hygiene education. Certification
shall be made
upon the
application for registration
prescribed by the board
pursuant to
section 4715.24 of the Revised Code.
(B)(1) The board shall apply toward the satisfaction of a
registrant's continuing dental hygiene education requirement any
of the following courses that the registrant completed:
(a) The basic life-support training course
required by
section 4715.251 of the Revised Code;
(b) Any course required by
statute or rule of the board for
registration;
(c) Any course
required by statute or rule of the board as a
condition
of performing a
particular function;
(d) Any other course that the board determines acceptable.
(2) In the case of a registrant whose license was reinstated
under section 4715.242 of the Revised
Code, the
board shall
apply toward the satisfaction of the
registrant's
continuing
dental hygiene education requirement any
course that the
board
applied toward the continuing dental
hygiene education
requirement for reinstatement of the license if the course was
completed during the two-year period immediately preceding the
registration period for which renewal is sought.
(C) Continuing education programs may be developed and
offered
to dental hygienists by any of the following agencies or
organizations:
(1) National, state, district, or local dental hygienists'
associations affiliated with the American dental hygienists'
association;
(2) National, state, district, or local dental
associations
affiliated with the American dental association or
national dental
association;
(3) Accredited dental hygiene colleges or schools;
(4) Accredited dental colleges or schools;
(5) Other organizations, schools, paraprofessional
programs,
or agencies approved by the state dental board.
(B)(D) A licensed dental hygienist shall retain in his the
dental hygienist's records for a period of at least three four
years such receipts,
vouchers, or certificates as may be necessary
to document
completion of continuing education programs. With
cause, the
board
may request such documentation from licensed
dental
hygienists,
and the board may request such documentation
from
licensed dental
hygienists at random without cause.
(C)(E) The board may excuse licensed dental hygienists, as a
group or as individuals, from all or any part of the requirements
of this section because of an unusual circumstance, emergency, or
special hardship.
(D)(F) Failure to comply with the requirements of this
section constitutes a failure to renew registration pursuant to
section 4715.24 of the Revised Code.
Sec. 4715.36. As used in this section and sections 4715.361
to 4715.374 of the Revised Code:
(A) "Accredited dental hygiene school" means a dental hygiene
school accredited
by the American dental
association commission on
dental accreditation or a dental hygiene school whose
educational
standards are recognized by the
American dental association
commission on dental accreditation and
approved by the
state
dental board.
(B) "Authorizing dentist" means a dentist who authorizes a
dental hygienist to perform dental hygiene services under section
4715.365 of the Revised Code.
(C) "Clinical evaluation" means a diagnosis and treatment
plan formulated for an individual patient by a dentist.
(D) "Dentist" means an individual licensed under this chapter
to practice dentistry.
(E) "Dental hygienist" means an individual licensed under
this chapter to practice as a dental hygienist.
(F) "Dental hygiene services" means the prophylactic,
preventive, and other procedures that dentists are authorized by
this chapter and rules of the state dental board to assign to
dental hygienists, except for procedures while a
patient is
anesthetized, definitive root planing, definitive
subgingival
curettage, the administration of local anesthesia, and
the
procedures specified in rules adopted by the board as described in
division
(C)(4) of section 4715.22 of the Revised Code.
(G) "Facility" means any of the following:
(1) A health care facility, as defined in section 4715.22 of
the Revised Code;
(2) A state correctional institution, as defined in section
2967.01 of the Revised Code;
(3) A comprehensive child development program that receives
funds distributed under the "Head Start Act," 95 Stat. 499 (1981),
42 U.S.C. 9831, as amended, and is licensed as a child day-care
center;
(4) A residential facility licensed under section 5123.19 of
the Revised Code;
(5) A public school, as defined in
section 3701.93 of the
Revised Code, located in an area designated as a dental health
resource shortage area pursuant to section 3702.87 of the Revised
Code;
(6) A nonpublic school, as defined in
section 3701.93 of the
Revised Code, located in an area designated as a dental health
resource shortage area pursuant to section 3702.87 of the Revised
Code;
(7) A federally qualified health center or federally
qualified health center look-alike, as defined in section 3701.047
of the Revised Code;
(8) A shelter for victims of domestic violence, as defined
in section 3113.33 of the Revised Code;
(9) A facility operated by the department of youth services
under Chapter 5139. of the Revised Code;
(10) A shelter for runaways, as defined in section 5119.64
of the Revised Code;
(11) A foster home, as defined in section 5103.02 of the
Revised Code;
(12) A nonprofit clinic, as defined in section 3715.87 of the
Revised Code;
(13) The residence of one or more individuals receiving
services provided by a home health agency, as defined in section
5101.61 of the Revised Code;
(15) A health care facility, such as a clinic or hospital, of
the United States department of veterans affairs;
(16) The residence of one or more individuals enrolled in a
home and community-based services medicaid waiver component, as
defined in section 5111.851 of the Revised Code;
(17) A facility operated by the board of health of a city or
general health district or the authority having the duties of a
board of health under section 3709.05 of the Revised Code;
(18) A women, infants, and children clinic;
(19) A mobile dental unit located at any location listed in
divisions (G)(1) to (18) of this section;
(20) Any other location, as specified by the state dental
board in rules adopted under section 4715.372 of the Revised Code,
that is in an area designated as a dental health resource shortage
area pursuant to section 3702.87 of the Revised Code and provides
health care services to individuals who are recipients of medical
assistance under the medicaid program established pursuant to
Chapter 5111. of the Revised Code and to indigent and uninsured
persons, as defined in section 2305.234 of the Revised Code.
Sec. 4715.361. The public health oral supervision
program is
hereby created. The program shall begin six months after the
effective
date of this section.
Sec. 4715.362. A dentist who desires to participate in the
public oral health supervision program shall apply
to the state
dental board for a public oral health
supervision
permit. The
application shall be under oath, on a form prescribed by the board
in
rules adopted under
section 4715.372 of the Revised Code, and
accompanied by an application fee of twenty dollars. To
be
eligible to receive the permit, an applicant shall meet the
requirements established by the board in rules adopted under
section 4715.372 of the Revised Code.
The state dental board shall issue a public oral health
supervision permit to a dentist who is in good standing with the
board and satisfies all of the requirements of this section.
Sec. 4715.363. (A) A dental hygienist who desires to
participate in the public oral health supervision program
shall
apply to the state dental board for a permit to
practice under
the public oral health supervision of a dentist.
The
application
shall be under oath, on a form prescribed by the board in rules
adopted under
section 4715.372 of the Revised Code, and
accompanied by an application fee of twenty dollars.
(B) The applicant shall provide evidence satisfactory to the
board that the applicant has done all of the following:
(1) Completed at least two years and attained a minimum of
three thousand hours of experience in the practice of dental
hygiene;
(2) Completed at least twenty-four hours of continuing dental
hygiene education during the two years prior to submission of the
application;
(3) Completed a course pertaining to the practice of dental
hygiene
under the public oral health supervision of a dentist
that meets standards established in rules adopted under section
4715.372 of the
Revised Code;
(4) Completed, during the two years prior to submission of
the application, a course pertaining to the identification and
prevention
of potential medical emergencies that is the same as
the course described in division (C)(2) of section 4715.22
of the
Revised Code.
(C) The state dental board shall issue a permit to practice
under the public oral health supervision of a dentist to a dental
hygienist who is in good standing with the board and meets all of
the requirements of divisions (A) and (B) of this section.
Sec. 4715.364. (A) No person shall authorize a dental
hygienist to provide dental hygiene services under section
4715.365 of the Revised Code unless the person holds a current,
valid
public oral health supervision permit issued under section
4715.362 of
the Revised Code.
(B) No person shall provide dental hygiene services under
section 4715.365 of the Revised Code unless the person holds a
current, valid permit issued
under section 4715.363 of the
Revised Code to practice under the public oral health supervision
of a dentist.
Sec. 4715.365. (A) A dentist who holds a current, valid
public oral health supervision permit issued
under section
4715.362 of the Revised Code may authorize a dental
hygienist who
holds a current, valid permit issued under section 4715.363
of
the Revised Code to perform dental hygiene services at a
facility
when no dentist is physically present if all of the
following
conditions are met:
(1) The authorizing dentist's authorization is in writing and
includes, at a minimum, all of the following:
(a) The authorizing dentist's name and permit number;
(b) The dental hygienist's name and permit number;
(d) The name and address of the location where the dental
hygiene services are to be provided;
(e) The date of authorization;
(f) A statement, signed by the dental hygienist, that the
hygienist agrees to comply with section 4715.366 of the Revised
Code.
(2) The authorizing dentist has personally evaluated the
dental hygienist's
skills prior to authorizing the dental
hygienist to provide the dental hygiene services.
(3) Prior to authorizing the dental hygienist to perform the
dental hygiene services, the patient's medical and dental history
is made
available to the authorizing dentist and the authorizing
dentist
reviews and evaluates
the history and determines that
the patient
may safely receive dental hygiene services.
(4) Immediately prior to the provision of dental hygiene
services, the patient or patient's representative verifies, by the
signature or mark of the patient or representative, that no
medically significant changes to the patient's medical or
dental
history have occurred since the authorizing dentist most recently
reviewed and
evaluated the history and determined that the
patient could safely receive dental hygiene services. The
signature or mark may be provided through reasonable
accommodation, including the use of assistive technology or
augmentative devices.
(5) Prior to receiving dental hygiene services, the
patient
and the operator of the
facility where the dental hygiene
services are to be provided are notified that
no dentist will be
present at the location and that the dental
hygienist is
prohibited from doing either of the following:
(a) Diagnosing the patient's oral health care status;
(b) Providing dental hygiene services to the same patient on
a subsequent
occasion until the patient has received a clinical
evaluation
performed by a dentist, except in instances described
in division (D)(2) of this section.
(6) The dental hygienist is employed by, or under contract
with, one of the following:
(a) The authorizing dentist;
(b) A dentist who is any of the following:
(i) The authorizing dentist's employer;
(ii) A shareholder in a professional association, formed
under
Chapter 1785. of the Revised Code, of which the authorizing
dentist is a shareholder;
(iii) A member or manager of a limited liability company,
formed under Chapter 1705. of the Revised Code, of which the
authorizing dentist is a member or manager;
(iv) A shareholder in a corporation, formed under division
(B)
of section 1701.03 of the Revised Code, of which the
authorizing
dentist is a shareholder;
(v) A partner or employee of a partnership, formed under
Chapter 1775. of the Revised
Code, of which the authorizing
dentist is a partner or employee;
(vi) A partner or employee of a limited liability
partnership, formed under Chapter 1775. of the Revised Code, of
which the authorizing dentist is a partner or employee.
(c) A government entity that employs the dental hygienist to
provide dental hygiene services.
(7) If the patient to whom the services are to be provided
previously received dental hygiene
services under this section,
there is written evidence that
the
patient received a clinical
evaluation after the most recent
provision of those services.
(B) No dentist shall authorize a dental hygienist to perform,
and no dental hygienist shall perform, dental hygiene services on
a patient under this section unless all of the conditions in
division (A) of this section are met.
(C) If a patient or patient's representative indicates, under
division (A)(4) of this section, that a
medically significant
change has occurred in the patient's
medical or
dental history
since the authorizing dentist's most recent review
and
evaluation of the medical and dental history required by division
(A)(3) of this section, no
dental
hygiene services shall be
provided under this section
until the
authorizing dentist
completes another review and evaluation of the
patient's medical
and
dental history. The authorizing dentist may complete
the
subsequent review and evaluation of the patient's medical and
dental
history by telephone, facsimile, electronic mail, video,
or any other means of electronic communication.
(D)(1) Except as provided in division (D)(2) of this section,
no dentist shall authorize a dental hygienist to provide, and no
dental hygienist shall provide, dental hygiene services under this
section to the same patient on a subsequent occasion until the
patient has received a clinical evaluation performed by a dentist.
(2) Division (D)(1) of this section does not apply if the
patient requires multiple visits to complete a procedure that
could not be completed during the visit in which dental hygiene
services were commenced. If the patient requires multiple visits
to
complete the procedure that could not be completed during the
visit in which dental hygiene services were commenced, the
procedure shall be completed
not later than eight weeks after the
visit in which the services
were commenced.
(E) No authorizing dentist shall authorize a dental hygienist
to diagnose a patient's oral health care status. No dental
hygienist practicing under a permit issued under section 4715.363
of the Revised Code to practice under the public oral health
supervision of a dentist shall diagnose a patient's oral health
care status.
Sec. 4715.366. (A) A dental hygienist providing dental
hygiene services under a permit
issued under section 4715.363 of
the Revised Code to practice under the public oral health
supervision of a dentist shall do both of
the following:
(1) Comply with written protocols established by the
authorizing dentist who authorizes the dental hygienist's
provision of services and standing orders established by the
authorizing dentist, including protocols
and standing orders
regarding emergencies and, for the purpose of section 4715.365 of
the Revised Code, protocols regarding what constitutes a medically
significant change to a patient's medical or dental history;
(2) Immediately following the completion of the dental
hygiene
services and subject to division (B) of this section,
direct the
patient to the authorizing dentist for a clinical
evaluation and
schedule or cause to be scheduled an appointment
for the patient
with the authorizing dentist.
(B) For purposes of division (A)(2) of this section, the
dental hygienist shall make every attempt to schedule the
patient's appointment with the authorizing dentist not later than
ninety days after the completion of the dental hygiene services.
The dental hygienist shall provide the patient with a written
notice of the appointment that includes, at a
minimum, the
authorizing dentist's name, address, and telephone number; the
date and time of the appointment; and a statement of the dental
hygiene services performed by the hygienist. The notice shall be
given to
the patient or the patient's representative and one copy
shall be
given to the authorizing dentist.
Sec. 4715.367. An authorizing dentist shall not at any one
time have more
than three dental hygienists who hold permits
issued under section
4715.363
of the Revised Code working under
the dentist's
authorization pursuant
to section 4715.365 of the
Revised Code.
Sec. 4715.368. At the request of the state dental board, an
authorizing dentist or the dental hygienist
who has been
authorized to perform dental hygiene services in
accordance with
section 4715.365 of the Revised Code shall make
available to the
board a
list of all locations where the dental hygienist provided
services, the
locations where the hygienist plans to provide
services in the
future, or both, as specified in the board's
request.
Sec. 4715.369. (A) A public oral health supervision permit
issued under section 4715.362 of the Revised Code expires on the
thirty-first day of December of the odd-numbered year that occurs
after the permit's issuance. A dentist who desires to renew a
permit shall apply, under oath,
to the state dental board on a
form prescribed by the board in
rules adopted under section
4715.372 of the Revised Code. At the time of application, the
dentist shall pay a renewal fee of twenty dollars.
(B) The board shall renew a public oral health supervision
permit for a two-year period if the dentist submitted a complete
application, paid the renewal fee, is
in good standing with the
board, and verified with the board all of the following:
(1) The locations at which dental hygienists have, under the
dentist's authorization, provided services during the two years
prior to
submission of the renewal application;
(2) The number of patients treated, during the two years
prior to submission of the
renewal application, by each dental
hygienist providing dental hygiene services under the dentist's
authorization;
(3) For each number of patients provided under division
(B)(2) of this
section, the number of patients whom the dentist
clinically evaluated following the provision of dental hygiene
services by a dental hygienist.
Sec. 4715.37. (A) A permit to practice under the public oral
health
supervision of a dentist issued under section 4715.363 of
the
Revised Code expires on the thirty-first day of December of
the
odd-numbered year that occurs after the permit's issuance. A
dental hygienist who desires to renew a permit to practice under
the public oral health supervision of a dentist shall apply, under
oath, to the state dental board
on a form prescribed by the board
in rules adopted under section
4715.372 of the Revised Code. At
the time of application, the dental hygienist shall pay a renewal
fee of twenty dollars.
(B) The state dental board shall renew a permit for a
two-year period if the dental hygienist submitted a complete
application, paid the renewal fee, is in good standing with the
board, and has verified with the board both of the following:
(1) The locations at which the hygienist has provided dental
hygiene services under a permit to practice under the public oral
health
supervision of a dentist;
(2) The number of patients that the hygienist has treated
under a
permit during the two years prior to submission of the
renewal
application.
Sec. 4715.371. The state dental board shall develop and
publish on its web site a directory containing the names and
contact information of dentists and dental hygienists who hold
current,
valid permits issued under sections 4715.362 and
4715.363 of the
Revised Code.
Sec. 4715.372. (A) The state dental board shall adopt rules
in accordance with Chapter 119. of the Revised Code as necessary
to implement the public oral health supervision program,
including rules that do all of the following:
(1) For the purpose of division (G)(20) of section 4715.36 of
the Revised Code, designate additional facilities at which a
dental hygienist may be authorized to perform dental hygiene
services under the public oral health supervision program;
(2) For the purpose of section 4715.362 of the Revised Code,
prescribe the application form and requirements for obtaining a
public oral
health supervision permit;
(3) For the purpose of section 4715.363 of
the Revised Code,
prescribe the application form for a permit to
practice as a
dental hygienist under the public oral health
supervision
of a
dentist;
(4) For the purpose of division (B)(3) of section 4715.363
of the Revised Code and subject to division (B) of this
section,
establish standards for the course in the practice of
dental
hygiene
under public oral health supervision;
(5) For the purpose of section 4715.369 of the Revised Code,
prescribe the form for renewal of a public oral health
supervision permit;
(6) For the purpose of section 4715.37 of the Revised Code,
prescribe the form for renewal of a permit to practice as a dental
hygienist under the public oral health supervision of a dentist.
(B) The course in the practice of dental hygiene under
public oral health supervision for which the board establishes
standards under
division (A)(4) of this section shall meet
all
of the following requirements:
(1) Be eight hours in length;
(2) Include, at a minimum, instruction in both of the
following:
(a) The treatment of geriatric patients, medically
compromised patients, developmentally disabled patients, and
pediatric patients;
(b) Recordkeeping practices.
(3) Be developed and offered by an institution accredited by
the American dental association commission on dental accreditation
or a program provided by a sponsor of continuing education
approved by the board;
(4) Include content that is separate and independent from the
course content required for the completion of dental hygiene
education from an accredited dental hygiene school.
Sec. 4715.373. Nothing in sections 4715.36 to 4715.372 of the
Revised Code authorizes any activity prohibited by this chapter or
prohibited by a rule adopted under this chapter by the state
dental board, including the activities
prohibited by division (E)
of section 4715.22 of the Revised Code
and the activities
prohibited or not authorized by section 4715.23
of the Revised
Code.
Sec. 4715.374. The state dental board may, in accordance with
Chapter 119. of the Revised Code, suspend or revoke a permit
issued under section 4715.362 or 4715.363 of the Revised Code if
the permit holder fails to comply with sections 4715.361 to
4715.373 of the Revised Code.
Sec. 4715.375. The state dental board shall annually report
the status of the public oral health supervision program. The
report shall be submitted to the governor and, in accordance with
section 101.68 of the Revised Code, to the general assembly. The
report shall specify, for the year covered by the report, at least
all of the following:
(A) The number of dentists who applied for and were issued
public oral health supervision permits under section 4715.362 of
the Revised Code;
(B) The number of dental hygienists who applied for and were
issued permits to practice under the public oral health
supervision of a dentist under section 4715.363 of the Revised
Code;
(C) The number of dentists who applied for and were granted
renewal of public oral health supervision permits under section
4715.369 of the Revised Code;
(D) The number of dental hygienists who applied for and were
granted renewal of permits to practice under the public oral
health supervision of a dentist under section 4715.37 of the
Revised Code;
(E) The number and geographic locations of facilities at
which dental hygienists provided dental hygiene services under
permits to practice under the public oral health supervision of a
dentist;
(F) The number of patients who received dental hygiene
services from dental hygienists providing services under permits
to practice under the public oral health supervision of a dentist;
(G) The number of patients who received a clinical evaluation
from a dentist following the provision of dental hygiene services
under section 4715.365 of the Revised Code.
Section 2. That existing sections 4715.14, 4715.141,
4715.21,
4715.22, 4715.24,
and 4715.25 of the Revised Code are
hereby
repealed.
Section 3. (A) As used in this section, "registration period"
has
the same meaning as in section 4715.241 of the Revised Code,
as
enacted by this act.
(B) Notwithstanding the provisions of section 4715.25 of the
Revised Code, as amended by this act, that increase from twelve to
twenty-four the minimum number of hours of continuing education
that a
dental hygienist must certify to the State Dental Board
when
applying for a renewal of registration, a dental hygienist
whose
registration expires on December 31, 2009, remains subject
to the
requirement to certify completion of a minimum of twelve
hours of
continuing education when applying for a renewal of
registration
for the 2010 to 2011 registration period.
(C) Notwithstanding the provisions of section 4715.242 of
the Revised Code, as enacted by this act, that require the
completion of a minimum of twenty-four hours of continuing dental
hygiene education for the reinstatement of a dental hygienist's
license, a dental hygienist who submits a written request to the
Board for reinstatement of the dental hygienist's license on or
before December 31, 2009, must provide the Board with satisfactory
evidence that the dental hygienist, during the two-year period
immediately preceding the date that the dental hygienist submitted
the written request, completed a minimum of twelve hours of
continuing dental hygiene education. The completion of continuing
dental hygiene education required under this division is subject
to division (D) of section 4715.25 of the Revised Code, as amended
by this act. The continuing education programs may be developed
and offered to dental hygienists by any of the agencies or
organizations described in division (C) of section 4715.25 of the
Revised Code, as amended by this act. The Board may excuse dental
hygienists, as a group or as individuals, from all or any part of
the requirements of this division because of an unusual
circumstance, emergency, or special hardship.
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