Sen. William R. Haine

Filed: 5/25/2015

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 500

2    AMENDMENT NO. ______. Amend House Bill 500 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 17 and 18 as follows:
 
6    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
7    (Section scheduled to be repealed on January 1, 2016)
8    Sec. 17. Acts Constituting the Practice of Dentistry. A
9person practices dentistry, within the meaning of this Act:
10        (1) Who represents himself or herself as being able to
11    diagnose or diagnoses, treats, prescribes, or operates for
12    any disease, pain, deformity, deficiency, injury, or
13    physical condition of the human tooth, teeth, alveolar
14    process, gums or jaw; or
15        (2) Who is a manager, proprietor, operator or conductor
16    of a business where dental operations are performed; or

 

 

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1        (3) Who performs dental operations of any kind; or
2        (4) Who uses an X-Ray machine or X-Ray films for dental
3    diagnostic purposes; or
4        (5) Who extracts a human tooth or teeth, or corrects or
5    attempts to correct malpositions of the human teeth or
6    jaws; or
7        (6) Who offers or undertakes, by any means or method,
8    to diagnose, treat or remove stains, calculus, and bonding
9    materials from human teeth or jaws; or
10        (7) Who uses or administers local or general
11    anesthetics in the treatment of dental or oral diseases or
12    in any preparation incident to a dental operation of any
13    kind or character; or
14        (8) Who takes impressions of the human tooth, teeth, or
15    jaws or performs any phase of any operation incident to the
16    replacement of a part of a tooth, a tooth, teeth or
17    associated tissues by means of a filling, crown, a bridge,
18    a denture or other appliance; or
19        (9) Who offers to furnish, supply, construct,
20    reproduce or repair, or who furnishes, supplies,
21    constructs, reproduces or repairs, prosthetic dentures,
22    bridges or other substitutes for natural teeth, to the user
23    or prospective user thereof; or
24        (10) Who instructs students on clinical matters or
25    performs any clinical operation included in the curricula
26    of recognized dental schools and colleges; or

 

 

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1        (11) Who takes impressions of human teeth or places his
2    or her hands in the mouth of any person for the purpose of
3    applying teeth whitening materials, or who takes
4    impressions of human teeth or places his or her hands in
5    the mouth of any person for the purpose of assisting in the
6    application of teeth whitening materials. A person does not
7    practice dentistry when he or she discloses to the consumer
8    that he or she is not licensed as a dentist under this Act
9    and (i) discusses the use of teeth whitening materials with
10    a consumer purchasing these materials; (ii) provides
11    instruction on the use of teeth whitening materials with a
12    consumer purchasing these materials; or (iii) provides
13    appropriate equipment on-site to the consumer for the
14    consumer to self-apply teeth whitening materials.
15    The fact that any person engages in or performs, or offers
16to engage in or perform, any of the practices, acts, or
17operations set forth in this Section, shall be prima facie
18evidence that such person is engaged in the practice of
19dentistry.
20    The following practices, acts, and operations, however,
21are exempt from the operation of this Act:
22        (a) The rendering of dental relief in emergency cases
23    in the practice of his or her profession by a physician or
24    surgeon, licensed as such under the laws of this State,
25    unless he or she undertakes to reproduce or reproduces lost
26    parts of the human teeth in the mouth or to restore or

 

 

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1    replace lost or missing teeth in the mouth; or
2        (b) The practice of dentistry in the discharge of their
3    official duties by dentists in any branch of the Armed
4    Services of the United States, the United States Public
5    Health Service, or the United States Veterans
6    Administration; or
7        (c) The practice of dentistry by students in their
8    course of study in dental schools or colleges approved by
9    the Department, when acting under the direction and
10    supervision of dentists acting as instructors; or
11        (d) The practice of dentistry by clinical instructors
12    in the course of their teaching duties in dental schools or
13    colleges approved by the Department:
14            (i) when acting under the direction and
15        supervision of dentists, provided that such clinical
16        instructors have instructed continuously in this State
17        since January 1, 1986; or
18            (ii) when holding the rank of full professor at
19        such approved dental school or college and possessing a
20        current valid license or authorization to practice
21        dentistry in another country; or
22        (e) The practice of dentistry by licensed dentists of
23    other states or countries at meetings of the Illinois State
24    Dental Society or component parts thereof, alumni meetings
25    of dental colleges, or any other like dental organizations,
26    while appearing as clinicians; or

 

 

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1        (f) The use of X-Ray machines for exposing X-Ray films
2    of dental or oral tissues by dental hygienists or dental
3    assistants; or
4        (g) The performance of any dental service by a dental
5    assistant, if such service is performed under the
6    supervision and full responsibility of a dentist.
7        For purposes of this paragraph (g), "dental service" is
8    defined to mean any intraoral procedure or act which shall
9    be prescribed by rule or regulation of the Department.
10    Dental service, however, shall not include:
11            (1) Any and all diagnosis of or prescription for
12        treatment of disease, pain, deformity, deficiency,
13        injury or physical condition of the human teeth or
14        jaws, or adjacent structures.
15            (2) Removal of, or restoration of, or addition to
16        the hard or soft tissues of the oral cavity, except for
17        the placing, carving, and finishing of amalgam
18        restorations by dental assistants who have had
19        additional formal education and certification as
20        determined by the Department. A dentist utilizing
21        dental assistants shall not supervise more than 4
22        dental assistants at any one time for placing, carving,
23        and finishing of amalgam restorations.
24            (3) Any and all correction of malformation of teeth
25        or of the jaws.
26            (4) Administration of anesthetics, except for

 

 

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1        monitoring of nitrous oxide, conscious sedation, deep
2        sedation, and general anesthetic as provided in
3        Section 8.1 of this Act, that may be performed only
4        after successful completion of a training program
5        approved by the Department. A dentist utilizing dental
6        assistants shall not supervise more than 4 dental
7        assistants at any one time for the monitoring of
8        nitrous oxide.
9            (5) Removal of calculus from human teeth.
10            (6) Taking of impressions for the fabrication of
11        prosthetic appliances, crowns, bridges, inlays,
12        onlays, or other restorative or replacement dentistry.
13            (7) The operative procedure of dental hygiene
14        consisting of oral prophylactic procedures, except for
15        coronal polishing and pit and fissure sealants, which
16        may be performed by a dental assistant who has
17        successfully completed a training program approved by
18        the Department. Dental assistants may perform coronal
19        polishing under the following circumstances: (i) the
20        coronal polishing shall be limited to polishing the
21        clinical crown of the tooth and existing restorations,
22        supragingivally; (ii) the dental assistant performing
23        the coronal polishing shall be limited to the use of
24        rotary instruments using a rubber cup or brush
25        polishing method (air polishing is not permitted); and
26        (iii) the supervising dentist shall not supervise more

 

 

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1        than 4 dental assistants at any one time for the task
2        of coronal polishing or pit and fissure sealants.
3            In addition to coronal polishing and pit and
4        fissure sealants as described in this paragraph (7), a
5        dental assistant who has successfully completed a
6        training program approved by the Department may
7        perform light scaling on patients 12 years and younger
8        in the absence of periodontal disease and intracoronal
9        temporization of a tooth. A dental assistant
10        performing these functions shall be limited to the use
11        of hand instruments only.
12        The limitations on the number of dental assistants a
13    dentist may supervise contained in items (2), (4), and (7)
14    of this paragraph (g) mean a limit of 4 total dental
15    assistants or dental hygienists doing expanded functions
16    covered by these Sections being supervised by one dentist.
17        (h) The practice of dentistry by an individual who:
18            (i) has applied in writing to the Department, in
19        form and substance satisfactory to the Department, for
20        a general dental license and has complied with all
21        provisions of Section 9 of this Act, except for the
22        passage of the examination specified in subsection (e)
23        of Section 9 of this Act; or
24            (ii) has applied in writing to the Department, in
25        form and substance satisfactory to the Department, for
26        a temporary dental license and has complied with all

 

 

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1        provisions of subsection (c) of Section 11 of this Act;
2        and
3            (iii) has been accepted or appointed for specialty
4        or residency training by a hospital situated in this
5        State; or
6            (iv) has been accepted or appointed for specialty
7        training in an approved dental program situated in this
8        State; or
9            (v) has been accepted or appointed for specialty
10        training in a dental public health agency situated in
11        this State.
12        The applicant shall be permitted to practice dentistry
13    for a period of 3 months from the starting date of the
14    program, unless authorized in writing by the Department to
15    continue such practice for a period specified in writing by
16    the Department.
17        The applicant shall only be entitled to perform such
18    acts as may be prescribed by and incidental to his or her
19    program of residency or specialty training and shall not
20    otherwise engage in the practice of dentistry in this
21    State.
22        The authority to practice shall terminate immediately
23    upon:
24            (1) the decision of the Department that the
25        applicant has failed the examination; or
26            (2) denial of licensure by the Department; or

 

 

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1            (3) withdrawal of the application.
2(Source: P.A. 97-526, eff. 1-1-12; 97-886, eff. 8-2-12;
397-1013, eff. 8-17-12; 98-147, eff. 1-1-14; 98-463, eff.
48-16-13; 98-756, eff. 7-16-14.)
 
5    (225 ILCS 25/18)   (from Ch. 111, par. 2318)
6    (Section scheduled to be repealed on January 1, 2016)
7    Sec. 18. Acts constituting the practice of dental hygiene;
8limitations.
9    (a) A person practices dental hygiene within the meaning of
10this Act when he or she performs the following acts under the
11supervision of a dentist:
12            (i) the operative procedure of dental hygiene,
13        consisting of oral prophylactic procedures;
14            (ii) the exposure and processing of X-Ray films of
15        the teeth and surrounding structures;
16            (iii) the application to the surfaces of the teeth
17        or gums of chemical compounds designed to be
18        desensitizing agents or effective agents in the
19        prevention of dental caries or periodontal disease;
20            (iv) all services which may be performed by a
21        dental assistant as specified by rule pursuant to
22        Section 17, and a dental hygienist may engage in the
23        placing, carving, and finishing of amalgam
24        restorations only after obtaining formal education and
25        certification as determined by the Department;

 

 

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1            (v) administration and monitoring of nitrous oxide
2        upon successful completion of a training program
3        approved by the Department;
4            (vi) administration of local anesthetics upon
5        successful completion of a training program approved
6        by the Department; and
7            (vii) such other procedures and acts as shall be
8        prescribed by rule or regulation of the Department.
9    (b) A dental hygienist may be employed or engaged only:
10        (1) by a dentist;
11        (2) by a federal, State, county, or municipal agency or
12    institution;
13        (3) by a public or private school; or
14        (4) by a public clinic operating under the direction of
15    a hospital or federal, State, county, municipal, or other
16    public agency or institution.
17    (c) When employed or engaged in the office of a dentist, a
18dental hygienist may perform, under general supervision, those
19procedures found in items (i) through (iv) of subsection (a) of
20this Section, provided the patient has been examined by the
21dentist within one year of the provision of dental hygiene
22services, the dentist has approved the dental hygiene services
23by a notation in the patient's record and the patient has been
24notified that the dentist may be out of the office during the
25provision of dental hygiene services.
26    (d) If a patient of record is unable to travel to a dental

 

 

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1office because of illness, or infirmity, or imprisonment, a
2dental hygienist with 2 years of full-time clinical experience
3or its equivalent of 4,000 clinical hours may perform, under
4the general supervision of a dentist, those procedures found in
5items (i) through (iv) of subsection (a) of this Section,
6provided the patient is located in a long-term care facility
7licensed by the State of Illinois, a mental health or
8developmental disability facility, or a State or federal
9prison. The dentist shall personally examine and diagnose the
10patient and determine which services are necessary to be
11performed, which shall be contained in an order to the
12hygienist and a notation in the patient's record. Such order
13must be implemented within 180 120 days of its issuance, and an
14updated medical history and observation of oral conditions must
15be performed by the hygienist immediately prior to beginning
16the procedures to ensure that the patient's health has not
17changed in any manner to warrant a reexamination by the
18dentist.
19    This subsection (d) is inoperative on and after January 1,
202020.
21    (e) School-based oral health care, consisting of and
22limited to oral prophylactic procedures, sealants, and
23fluoride treatments, may be provided by a dental hygienist with
242 years of full-time clinical experience or its equivalent of
254,000 clinical hours under the general supervision of a
26dentist. A dental hygienist may not provide other dental

 

 

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1hygiene treatment in a school-based setting, including but not
2limited to administration or monitoring of nitrous oxide or
3administration of local anesthetics. The school-based
4procedures may be performed provided the patient is located at
5a public or private school and the program is being conducted
6by a State, county or local public health department initiative
7or in conjunction with a dental school or dental hygiene
8program. The dentist shall personally examine and diagnose the
9patient and determine which services are necessary to be
10performed, which shall be contained in an order to the
11hygienist and a notation in the patient's record. Any such
12order for sealants must be implemented within 180 120 days
13after its issuance. Any such order for oral prophylactic
14procedures or fluoride treatments must be implemented within
15180 days after its issuance. An updated medical history and
16observation of oral conditions must be performed by the
17hygienist immediately prior to beginning the procedures to
18ensure that the patient's health has not changed in any manner
19to warrant a reexamination by the dentist.
20    This subsection (e) is inoperative on and after January 1,
212020.
22    (e-5) When employed by a county public health clinic or
23federally qualified health center, a dental hygienist with 3
24years of full-time clinical experience or its equivalent of
256,000 clinical hours and has completed 32 hours of additional
26course work in areas specific to public health dentistry,

 

 

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1including, but not limited to, emergency procedures for
2medically compromised patients, pharmacology, medical
3recordkeeping procedures, geriatric dentistry, pediatric
4dentistry, and pathology, as defined by the Department, may
5perform under general supervision those procedures found in
6items (i) through (iv) of subsection (a) of this Section,
7provided that the dentist has personally examined and diagnosed
8the patient and determined which services are necessary to be
9performed, which shall be contained in an order to the
10hygienist and a notation in the patient's record, or has
11conducted a limited oral evaluation that is problem-focused on
12a patient who has been treated at the facility for an emergency
13or critical oral condition and, in the opinion of the dentist,
14is eligible for additional routine preventative services, as
15provided in items (i) through (iv) of subsection (a) of this
16Section,` which is noted in the patient's record. Any order
17issued under this subsection (e-5) must be implemented within
18one year after its issuance. An updated medical history and
19observation of oral conditions must be performed by the
20hygienist immediately prior to beginning the procedures to
21ensure that the patient's health has not changed in any manner
22to warrant a reexamination by the dentist. The dental hygienist
23must provide to the patient and have them sign a permission
24slip or consent form that informs them that the services to be
25received do not take the place of a regular dental checkup and
26is meant for people who otherwise would not have access to the

 

 

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1services.
2    Each dental hygienist who has rendered services under
3subsections (d) or (e) of this Section or this subsection (e-5)
4must complete a summary report at the completion of each
5program or, in the case of an ongoing program, at least
6annually. The report must be completed in the manner specified
7by the Division of Oral Health in the Department of Public
8Health, including information about each location where the
9dental hygienist has rendered these services and how many
10patients were treated and the type of treatment performed. The
11dental hygienist must submit the form to the dentist providing
12supervision for his or her signature before sending it to the
13Department. The Department shall compile a report on an annual
14basis to summarize these requirements.
15    This subsection (e-5) is inoperative on and after January
161, 2020.
17    (f) Without the supervision of a dentist, a dental
18hygienist may perform dental health education functions and may
19record case histories and oral conditions observed.
20    (g) The number of dental hygienists practicing in a dental
21office shall not exceed, at any one time, 4 times the number of
22dentists practicing in the office at the time.
23(Source: P.A. 97-526, eff. 1-1-12.)".