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Sub. H. B. No. 190 As Reported by the Senate Health, Human Services and Aging CommitteeAs Reported by the Senate Health, Human Services and Aging 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, Adams, J., Adams, R., Amstutz, Batchelder, Belcher, Blair, Boyd, Bubp, Carney, Chandler, Combs, Daniels, DeBose, Domenick, Driehaus, Dyer, Evans, Foley, Gardner, Garrison, Goyal, Grossman, Heard, Hottinger, Jones, Koziura, Lundy, Maag, Mallory, Mandel, Newcomb, Otterman, Pryor, Schneider, Sears, Snitchler, Stewart, Szollosi, Uecker, Wachtmann, Winburn, Zehringer
Senators Gillmor, Morano
A BILL
To amend sections 3313.713, 4715.14, 4715.141,
4715.21, 4715.22, 4715.231, 4715.24, and 4715.25
and to enact sections 3701.136, 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, to establish the Oral
Health Access Supervision Program for the
provision of dental hygiene services, to allow
certain dental hygienists to administer local
anesthesia based on instruction obtained while
licensed in another state, and to authorize the
Director of Health to establish a school-based
fluoride mouth rinse program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3313.713, 4715.14, 4715.141,
4715.21, 4715.22, 4715.231, 4715.24, and 4715.25 be amended and
sections 3701.136, 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. 3313.713. (A) As used in this section:
(1) "Drug" means a drug, as defined in section 4729.01 of the
Revised Code, that is to be administered pursuant to the
instructions of the prescriber, whether or not required by law to
be sold only upon a prescription.
(2) "Federal law" means the "Individuals with Disabilities
Education Act of 1997," 111 Stat. 37, 20 U.S.C. 1400, as amended.
(3) "Prescriber" has the same meaning as in section 4729.01
of the Revised Code.
(B) The board of education of each city, local, exempted
village, and joint vocational school district shall, not later
than one hundred twenty days after September 20, 1984, adopt a
policy on the authority of its employees, when acting in
situations other than those governed by sections 2305.23,
2305.231, and 3313.712 of the Revised Code, to administer drugs
prescribed to students enrolled in the schools of the district.
The policy shall provide either that:
(1) Except as otherwise required by federal law, no person
employed by the board shall, in the course of such employment,
administer any drug prescribed to any student enrolled in the
schools of the district.
(2) Designated persons employed by the board are authorized
to administer to a student a drug prescribed for the student.
Effective July 1, 2011, only employees of the board who are
licensed health professionals, or who have completed a drug
administration training program conducted by a licensed health
professional and considered appropriate by the board, may
administer to a student a drug prescribed for the student. Except
as otherwise provided by federal law, the board's policy may
provide that certain drugs or types of drugs shall not be
administered or that no employee shall use certain procedures,
such as injection, to administer a drug to a student.
(C) No drug prescribed for a student shall be administered
pursuant to federal law or a policy adopted under division (B) of
this section until the following occur:
(1) The board, or a person designated by the board, receives
a written request, signed by the parent, guardian, or other person
having care or charge of the student, that the drug be
administered to the student.
(2) The board, or a person designated by the board, receives
a statement, signed by the prescriber, that includes all of the
following information:
(a) The name and address of the student;
(b) The school and class in which the student is enrolled;
(c) The name of the drug and the dosage to be administered;
(d) The times or intervals at which each dosage of the drug
is to be administered;
(e) The date the administration of the drug is to begin;
(f) The date the administration of the drug is to cease;
(g) Any severe adverse reactions that should be reported to
the prescriber and one or more phone numbers at which the
prescriber can be reached in an emergency;
(h) Special instructions for administration of the drug,
including sterile conditions and storage.
(3) The parent, guardian, or other person having care or
charge of the student agrees to submit a revised statement signed
by the prescriber to the board or a person designated by the board
if any of the information provided by the prescriber pursuant to
division (C)(2) of this section changes.
(4) The person authorized by the board to administer the drug
receives a copy of the statement required by division (C)(2) or
(3) of this section.
(5) The drug is received by the person authorized to
administer the drug to the student for whom the drug is prescribed
in the container in which it was dispensed by the prescriber or a
licensed pharmacist.
(6) Any other procedures required by the board are followed.
(D) If a drug is administered to a student, the board of
education shall acquire and retain copies of the written requests
required by division (C)(1) and the statements required by
divisions (C)(2) and (3) of this section and shall ensure that by
the next school day following the receipt of any such statement a
copy is given to the person authorized to administer drugs to the
student for whom the statement has been received. The board, or a
person designated by the board, shall establish a location in each
school building for the storage of drugs to be administered under
this section and federal law. All such drugs shall be stored in
that location in a locked storage place, except that drugs that
require refrigeration may be kept in a refrigerator in a place not
commonly used by students.
(E) No person who has been authorized by a board of education
to administer a drug and has a copy of the most recent statement
required by division (C)(2) or (3) of this section given to the
person in accordance with division (D) of this section prior to
administering the drug is liable in civil damages for
administering or failing to administer the drug, unless such
person acts in a manner that constitutes gross negligence or
wanton or reckless misconduct.
(F) A board of education may designate a person or persons to
perform any function or functions in connection with a drug policy
adopted under this section either by name or by position,
training, qualifications, or similar distinguishing factors.
(G) A policy adopted by a board of education pursuant to this
section may be changed, modified, or revised by action of the
board.
(H) Nothing in this section shall be construed to require a
person employed by a board of education to administer a drug to a
student unless the board's policy adopted in compliance with this
section establishes such a requirement. A board shall not require
an employee to administer a drug to a student if the employee
objects, on the basis of religious convictions, to administering
the drug.
A policy adopted by a board of education pursuant to this
section may be changed, modified, or revised by action of the
board.
Nothing in this section affects the application of section
2305.23, 2305.231, or 3313.712 of the Revised Code to the
administration of emergency care or treatment to a student.
Nothing in this section affects the ability of a public or
nonpublic school to participate in a school-based fluoride mouth
rinse program established by the director of health pursuant to
section 3701.136 of the Revised Code. Nothing in this section
affects the ability of a person who is employed by, or who
volunteers for, a school that participates in such a program to
administer fluoride mouth rinse to a student in accordance with
section 3701.136 of the Revised Code and any rules adopted by the
director under that section.
Sec. 3701.136. (A) The director of health may establish a
school-based fluoride mouth rinse program. If the director
establishes the program, divisions (B) to (E) of this section are
applicable.
(B) The director shall conduct a program to educate employees
of the department of health and dental hygienists licensed under
Chapter 4715. of the Revised Code on how to train employees of,
and volunteers for, public and nonpublic schools regarding the
proper means of administering fluoride mouth rinse to students.
(C) Schools that participate in the school-based fluoride
mouth rinse program shall require that their employees and
volunteers who intend to administer fluoride mouth rinse to
students receive training, by either of the following, on the
proper means of administering fluoride mouth rinse to students:
(1) An employee of the department of health or a dental
hygienist who has been trained through the program the director
conducts pursuant to division (B) of this section;
(2) A school employee or volunteer who has been trained by an
individual described in division (C)(1) of this section.
(D)(1) The director shall prescribe a form that the parent,
guardian, or other person having care or charge of a student
enrolled in a public or nonpublic school that participates in the
school-based fluoride mouth rinse program may use to consent to
the administration of fluoride mouth rinse to the student for the
duration of the student's enrollment in that school. School
employees or volunteers shall not administer fluoride mouth rinse
to a student unless the consent form from the student's parent,
guardian, or other person has been received.
(2) The consent form shall include all of the following:
(a) A space designated for the student's name and address;
(b) A space designated for the name of the student's school;
(c) A space designated for the student's grade level and
class;
(d) A space designated for the signature of the parent,
guardian, or other person who authorizes the administration of
fluoride mouth rinse to the student;
(e) Information on the name, dosage, and intervals at which
the fluoride mouth rinse is scheduled to be administered during
each school year;
(f) The dates the administration of fluoride mouth rinse is
to begin and cease, which may, respectively, be the first and last
days of a school year;
(g) Any other information or spaces the director considers
necessary for the proper administration of the program.
(E) The director may adopt rules as necessary to implement
and administer the school-based fluoride mouth rinse program. The
rules shall be adopted in accordance with Chapter 119. of the
Revised Code.
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 oral health access 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. 4715.231. (A) As used in this section, "direct
supervision" means a dentist licensed under this chapter is
present, for purposes of consultation and direction, at the
location where a dental hygienist performs the administration of
local anesthesia to a patient. "Direct supervision" does not mean
that the dentist must observe the administration of local
anesthesia to a patient.
(B) Under the direct supervision of a dentist, a dental
hygienist may administer intraoral block and infiltration local
anesthesia to a patient if the dental hygienist is in compliance
with division (D) of this section and has done both either of the
following is the case:
(1) The dental hygienist has met both of the following
requirements:
(a) Successfully completed a course in the administration of
local anesthesia approved by the state dental board and offered by
a dental or dental hygiene program that is accredited by the
commission on dental accreditation of the American dental
association;
(2)(b) Within eighteen months of completion of the anesthesia
course, successfully passed a state or regional written
examination on local anesthesia approved by the board.
(2) The dental hygienist is authorized to administer local
anesthesia by another state's licensing authority with
jurisdiction over the practice of dental hygiene and both of the
following conditions are met:
(a) The dental hygienist was required by the licensing
authority of the other state to complete, and the dental hygienist
successfully completed, a course or instruction as a requirement
to be authorized to administer local anesthesia.
(b) Either of the following applies:
(i) The required hours and content of the course or
instruction described in division (B)(2)(a) of this section are
substantially equivalent, as determined by the board, to the
required hours and content of the course described in division (C)
of this section.
(ii) The board determines that the required hours and content
of the course or instruction described in division (B)(2)(a) of
this section are not substantially equivalent to the required
hours and content of the course described in division (C) of this
section, but the dental hygienist submits evidence satisfactory to
the board that the dental hygienist obtained, within the
forty-eight months immediately preceding the date that the dental
hygienist applied under section 4715.21 of the Revised Code for a
license to practice as a dental hygienist, twenty-four consecutive
months of experience in the administration of local anesthesia in
the other state where the dental hygienist is authorized to
administer local anesthesia.
(C) To be approved by the board, a the local anesthesia
administration course described in division (B)(1)(a) of this
section must contain not less than fifteen hours of didactic
instruction and not less than fourteen hours of clinical
experience and include instruction on each of the following
subjects:
(1) Theory of pain control;
(2) Selection of pain control modalities;
(5) Pharmacology of local anesthetics;
(6) Pharmacology of vasoconstrictors;
(7) Psychological aspects of pain control;
(8) Systemic complications;
(9) Techniques of maxillary and mandibular anesthesia taught
by a dentist or other qualified instructor;
(11) Local anesthesia medical emergencies.
(D) A dental hygienist may administer local anesthesia only
if the dental hygienist has obtained current certification to
perform basic cardiac life-support procedures as required by
section 4715.251 of the Revised Code.
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 oral health access 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
oral health access supervision program shall apply to the state
dental board for an oral health access 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 an oral health access
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 oral health access supervision program shall
apply to the state dental board for a permit to practice under the
oral health access 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 oral health access 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 oral health access 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 oral health access 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 oral health access supervision of a
dentist.
Sec. 4715.365. (A) A dentist who holds a current, valid oral
health access 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 one or more
procedures that could not be completed during the visit in which
dental hygiene services were commenced. If the patient requires
multiple visits to complete the one or more procedures that could
not be completed during the visit in which dental hygiene services
were commenced, the one or more procedures shall be completed not
later than eight weeks after the visit in which the dental hygiene
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 oral health access
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 oral health access
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) An oral health access 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 an oral health access 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 oral health
access 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 oral health access 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 oral health
access 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 oral health access 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 oral health access supervision program;
(2) For the purpose of section 4715.362 of the Revised Code,
prescribe the application form and requirements for obtaining an
oral health access 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 oral health access 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 oral health access supervision;
(5) For the purpose of section 4715.369 of the Revised Code,
prescribe the form for renewal of an oral health access
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 oral health access supervision of a dentist.
(B) The course in the practice of dental hygiene under oral
health access 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 oral health access 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
oral health access 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 oral health access
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 oral health access 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 oral health
access 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 oral health access 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 oral health access 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 3313.713, 4715.14,
4715.141, 4715.21, 4715.22, 4715.231, 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 expired 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.
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