Sen. William R. Haine

Filed: 4/28/2016

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 5948

2    AMENDMENT NO. ______. Amend House Bill 5948 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4, 17, and 18.1 as follows:
 
6    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 4. Definitions. As used in this Act:
9    "Address of record" means the designated address recorded
10by the Department in the applicant's or licensee's application
11file or license file as maintained by the Department's
12licensure maintenance unit. It is the duty of the applicant or
13licensee to inform the Department of any change of address and
14those changes must be made either through the Department's
15website or by contacting the Department.
16    "Department" means the Department of Financial and

 

 

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1Professional Regulation.
2    "Secretary" means the Secretary of Financial and
3Professional Regulation.
4    "Board" means the Board of Dentistry.
5    "Dentist" means a person who has received a general license
6pursuant to paragraph (a) of Section 11 of this Act and who may
7perform any intraoral and extraoral procedure required in the
8practice of dentistry and to whom is reserved the
9responsibilities specified in Section 17.
10    "Dental hygienist" means a person who holds a license under
11this Act to perform dental services as authorized by Section
1218.
13    "Dental assistant" means an appropriately trained person
14who, under the supervision of a dentist, provides dental
15services as authorized by Section 17.
16    "Dental laboratory" means a person, firm or corporation
17which:
18        (i) engages in making, providing, repairing or
19    altering dental prosthetic appliances and other artificial
20    materials and devices which are returned to a dentist for
21    insertion into the human oral cavity or which come in
22    contact with its adjacent structures and tissues; and
23        (ii) utilizes or employs a dental technician to provide
24    such services; and
25        (iii) performs such functions only for a dentist or
26    dentists.

 

 

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1    "Supervision" means supervision of a dental hygienist or a
2dental assistant requiring that a dentist authorize the
3procedure, remain in the dental facility while the procedure is
4performed, and approve the work performed by the dental
5hygienist or dental assistant before dismissal of the patient,
6but does not mean that the dentist must be present at all times
7in the treatment room.
8    "General supervision" means supervision of a dental
9hygienist requiring that the patient be a patient of record,
10that the dentist examine the patient in accordance with Section
1118 prior to treatment by the dental hygienist, and that the
12dentist authorize the procedures which are being carried out by
13a notation in the patient's record, but not requiring that a
14dentist be present when the authorized procedures are being
15performed. The issuance of a prescription to a dental
16laboratory by a dentist does not constitute general
17supervision.
18    "Public member" means a person who is not a health
19professional. For purposes of board membership, any person with
20a significant financial interest in a health service or
21profession is not a public member.
22    "Dentistry" means the healing art which is concerned with
23the examination, diagnosis, treatment planning and care of
24conditions within the human oral cavity and its adjacent
25tissues and structures, as further specified in Section 17.
26    "Branches of dentistry" means the various specialties of

 

 

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1dentistry which, for purposes of this Act, shall be limited to
2the following: endodontics, oral and maxillofacial surgery,
3orthodontics and dentofacial orthopedics, pediatric dentistry,
4periodontics, prosthodontics, and oral and maxillofacial
5radiology.
6    "Specialist" means a dentist who has received a specialty
7license pursuant to Section 11(b).
8    "Dental technician" means a person who owns, operates or is
9employed by a dental laboratory and engages in making,
10providing, repairing or altering dental prosthetic appliances
11and other artificial materials and devices which are returned
12to a dentist for insertion into the human oral cavity or which
13come in contact with its adjacent structures and tissues.
14    "Impaired dentist" or "impaired dental hygienist" means a
15dentist or dental hygienist who is unable to practice with
16reasonable skill and safety because of a physical or mental
17disability as evidenced by a written determination or written
18consent based on clinical evidence, including deterioration
19through the aging process, loss of motor skills, abuse of drugs
20or alcohol, or a psychiatric disorder, of sufficient degree to
21diminish the person's ability to deliver competent patient
22care.
23    "Nurse" means a registered professional nurse, a certified
24registered nurse anesthetist licensed as an advanced practice
25nurse, or a licensed practical nurse licensed under the Nurse
26Practice Act.

 

 

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1    "Patient of record" means a patient for whom the patient's
2most recent dentist has obtained a relevant medical and dental
3history and on whom the dentist has performed an examination
4and evaluated the condition to be treated.
5    "Dental responder" means a dentist or dental hygienist who
6is appropriately certified in disaster preparedness,
7immunizations, and dental humanitarian medical response
8consistent with the Society of Disaster Medicine and Public
9Health and training certified by the National Incident
10Management System or the National Disaster Life Support
11Foundation.
12    "Mobile dental van or portable dental unit" means any
13self-contained or portable dental unit in which dentistry is
14practiced that can be moved, towed, or transported from one
15location to another in order to establish a location where
16dental services can be provided.
17    "Public health dental hygienist" means a hygienist who
18holds a valid license to practice in the State, has 2 years of
19full-time clinical experience or an equivalent of 4,000 hours
20of clinical experience and has completed 42 72 hours of
21additional online and classroom instruction course work in
22areas specific to public health dentistry provided by an
23educational institution, such as a dental school or dental
24hygiene program, or by an approved continuing education
25sponsor. No more than one-half of the required course work may
26be taken online. Courses being offered by continuing education

 

 

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1sponsors must meet the requirements set forth in items (A) and
2(B) of paragraph (2) of subsection (b) of Section 1220.440 in
3Title 68 of the Illinois Administrative Code and the
4requirements set forth in this Section and include areas in
5public health dentistry, including, but not limited to,
6emergency procedures for medically compromised patients,
7pharmacology, medical recordkeeping procedures, geriatric
8dentistry, pediatric dentistry, and pathology, and works in a
9public health setting pursuant to a written public health
10supervision agreement as defined by rule by the Department with
11a dentist working in or contracted with a local or State
12government agency or institution or who is providing services
13as part of a certified school-based program or school-based
14oral health program.
15    "Public health setting" means a federally qualified health
16center; a federal, State, or local public health facility; Head
17Start; a special supplemental nutrition program for Women,
18Infants, and Children (WIC) facility; or a certified
19school-based health center or school-based oral health
20program.
21    "Public health supervision" means the supervision of a
22public health dental hygienist by a licensed dentist who has a
23written public health supervision agreement with that public
24health dental hygienist while working in an approved facility
25or program that allows the public health dental hygienist to
26treat patients, without a dentist first examining the patient

 

 

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1and being present in the facility during treatment, (1) who are
2eligible for Medicaid or (2) who are uninsured and whose
3household income is not greater than 200% of the federal
4poverty level.
5(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15.)
 
6    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
7    (Section scheduled to be repealed on January 1, 2026)
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
17        (3) Who performs dental operations of any kind; or
18        (4) Who uses an X-Ray machine or X-Ray films for dental
19    diagnostic purposes; or
20        (5) Who extracts a human tooth or teeth, or corrects or
21    attempts to correct malpositions of the human teeth or
22    jaws; or
23        (6) Who offers or undertakes, by any means or method,
24    to diagnose, treat or remove stains, calculus, and bonding
25    materials from human teeth or jaws; or

 

 

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1        (7) Who uses or administers local or general
2    anesthetics in the treatment of dental or oral diseases or
3    in any preparation incident to a dental operation of any
4    kind or character; or
5        (8) Who takes impressions of the human tooth, teeth, or
6    jaws or performs any phase of any operation incident to the
7    replacement of a part of a tooth, a tooth, teeth or
8    associated tissues by means of a filling, crown, a bridge,
9    a denture or other appliance; or
10        (9) Who offers to furnish, supply, construct,
11    reproduce or repair, or who furnishes, supplies,
12    constructs, reproduces or repairs, prosthetic dentures,
13    bridges or other substitutes for natural teeth, to the user
14    or prospective user thereof; or
15        (10) Who instructs students on clinical matters or
16    performs any clinical operation included in the curricula
17    of recognized dental schools and colleges; or
18        (11) Who takes impressions of human teeth or places his
19    or her hands in the mouth of any person for the purpose of
20    applying teeth whitening materials, or who takes
21    impressions of human teeth or places his or her hands in
22    the mouth of any person for the purpose of assisting in the
23    application of teeth whitening materials. A person does not
24    practice dentistry when he or she discloses to the consumer
25    that he or she is not licensed as a dentist under this Act
26    and (i) discusses the use of teeth whitening materials with

 

 

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1    a consumer purchasing these materials; (ii) provides
2    instruction on the use of teeth whitening materials with a
3    consumer purchasing these materials; or (iii) provides
4    appropriate equipment on-site to the consumer for the
5    consumer to self-apply teeth whitening materials.
6    The fact that any person engages in or performs, or offers
7to engage in or perform, any of the practices, acts, or
8operations set forth in this Section, shall be prima facie
9evidence that such person is engaged in the practice of
10dentistry.
11    The following practices, acts, and operations, however,
12are exempt from the operation of this Act:
13        (a) The rendering of dental relief in emergency cases
14    in the practice of his or her profession by a physician or
15    surgeon, licensed as such under the laws of this State,
16    unless he or she undertakes to reproduce or reproduces lost
17    parts of the human teeth in the mouth or to restore or
18    replace lost or missing teeth in the mouth; or
19        (b) The practice of dentistry in the discharge of their
20    official duties by dentists in any branch of the Armed
21    Services of the United States, the United States Public
22    Health Service, or the United States Veterans
23    Administration; or
24        (c) The practice of dentistry by students in their
25    course of study in dental schools or colleges approved by
26    the Department, when acting under the direction and

 

 

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1    supervision of dentists acting as instructors; or
2        (d) The practice of dentistry by clinical instructors
3    in the course of their teaching duties in dental schools or
4    colleges approved by the Department:
5            (i) when acting under the direction and
6        supervision of dentists, provided that such clinical
7        instructors have instructed continuously in this State
8        since January 1, 1986; or
9            (ii) when holding the rank of full professor at
10        such approved dental school or college and possessing a
11        current valid license or authorization to practice
12        dentistry in another country; or
13        (e) The practice of dentistry by licensed dentists of
14    other states or countries at meetings of the Illinois State
15    Dental Society or component parts thereof, alumni meetings
16    of dental colleges, or any other like dental organizations,
17    while appearing as clinicians; or
18        (f) The use of X-Ray machines for exposing X-Ray films
19    of dental or oral tissues by dental hygienists or dental
20    assistants; or
21        (g) The performance of any dental service by a dental
22    assistant, if such service is performed under the
23    supervision and full responsibility of a dentist.
24        For purposes of this paragraph (g), "dental service" is
25    defined to mean any intraoral procedure or act which shall
26    be prescribed by rule or regulation of the Department.

 

 

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1    Dental service, however, shall not include:
2            (1) Any and all diagnosis of or prescription for
3        treatment of disease, pain, deformity, deficiency,
4        injury or physical condition of the human teeth or
5        jaws, or adjacent structures.
6            (2) Removal of, or restoration of, or addition to
7        the hard or soft tissues of the oral cavity, except for
8        the placing, carving, and finishing of amalgam
9        restorations by dental assistants who have had
10        additional formal education and certification as
11        determined by the Department. A dentist utilizing
12        dental assistants shall not supervise more than 4
13        dental assistants at any one time for placing, carving,
14        and finishing of amalgam restorations.
15            (3) Any and all correction of malformation of teeth
16        or of the jaws.
17            (4) Administration of anesthetics, except for
18        monitoring of nitrous oxide, conscious sedation, deep
19        sedation, and general anesthetic as provided in
20        Section 8.1 of this Act, that may be performed only
21        after successful completion of a training program
22        approved by the Department. A dentist utilizing dental
23        assistants shall not supervise more than 4 dental
24        assistants at any one time for the monitoring of
25        nitrous oxide.
26            (5) Removal of calculus from human teeth.

 

 

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1            (6) Taking of impressions for the fabrication of
2        prosthetic appliances, crowns, bridges, inlays,
3        onlays, or other restorative or replacement dentistry.
4            (7) The operative procedure of dental hygiene
5        consisting of oral prophylactic procedures, except for
6        coronal polishing and pit and fissure sealants, which
7        may be performed by a dental assistant who has
8        successfully completed a training program approved by
9        the Department. Dental assistants may perform coronal
10        polishing under the following circumstances: (i) the
11        coronal polishing shall be limited to polishing the
12        clinical crown of the tooth and existing restorations,
13        supragingivally; (ii) the dental assistant performing
14        the coronal polishing shall be limited to the use of
15        rotary instruments using a rubber cup or brush
16        polishing method (air polishing is not permitted); and
17        (iii) the supervising dentist shall not supervise more
18        than 4 dental assistants at any one time for the task
19        of coronal polishing or pit and fissure sealants.
20            In addition to coronal polishing and pit and
21        fissure sealants as described in this item (7), a
22        dental assistant who has at least 2,000 hours of direct
23        clinical patient care experience and who has
24        successfully completed a training program provided by
25        an educational institution, such as a dental school or
26        dental hygiene or dental assistant program, or by an

 

 

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1        approved continuing education sponsor that meets the
2        requirements set forth in items (A) and (B) of
3        paragraph (2) of subsection (b) of Section 1220.440 in
4        Title 68 of the Illinois Administrative Code and the
5        requirements set forth in this Section approved by rule
6        by the Department may perform: (A) coronal scaling
7        above the gum line, supragingivally, on the clinical
8        crown of the tooth only on patients 12 years of age or
9        younger who have an absence of periodontal disease and
10        who are not medically compromised or individuals with
11        special needs and (B) intracoronal temporization of a
12        tooth. The training program approved by the Department
13        must: (I) include a minimum of 16 hours of instruction
14        in both didactic and clinical manikin or human subject
15        instruction; all training programs shall include areas
16        of study courses in dental anatomy, public health
17        dentistry, medical history, dental emergencies, and
18        managing the pediatric patient; (II) include an
19        outcome assessment examination that demonstrates
20        competency; (III) require the supervising dentist to
21        observe and approve the completion of 6 full mouth
22        supragingival scaling procedures; and (IV) issue a
23        certificate of completion of the training program,
24        which must be kept on file at the dental office. A
25        dental assistant must have successfully completed an
26        approved coronal polishing course prior to taking the

 

 

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1        coronal scaling course. A dental assistant performing
2        these functions shall be limited to the use of hand
3        instruments only. In addition, coronal scaling as
4        described in this paragraph shall only be utilized on
5        patients who are eligible for Medicaid or who are
6        uninsured and whose household income is not greater
7        than 200% of the federal poverty level. A dentist may
8        not supervise more than 2 dental assistants at any one
9        time for the task of coronal scaling. This paragraph is
10        inoperative on and after January 1, 2021.
11        The limitations on the number of dental assistants a
12    dentist may supervise contained in items (2), (4), and (7)
13    of this paragraph (g) mean a limit of 4 total dental
14    assistants or dental hygienists doing expanded functions
15    covered by these Sections being supervised by one dentist.
16        (h) The practice of dentistry by an individual who:
17            (i) has applied in writing to the Department, in
18        form and substance satisfactory to the Department, for
19        a general dental license and has complied with all
20        provisions of Section 9 of this Act, except for the
21        passage of the examination specified in subsection (e)
22        of Section 9 of this Act; or
23            (ii) has applied in writing to the Department, in
24        form and substance satisfactory to the Department, for
25        a temporary dental license and has complied with all
26        provisions of subsection (c) of Section 11 of this Act;

 

 

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

 

 

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1(Source: P.A. 98-147, eff. 1-1-14; 98-463, eff. 8-16-13;
298-756, eff. 7-16-14; 99-492, eff. 12-31-15.)
 
3    (225 ILCS 25/18.1)
4    (Section scheduled to be repealed on January 1, 2021)
5    Sec. 18.1. Public health dental supervision
6responsibilities.
7    (a) When working together in a public health supervision
8relationship, dentists and public health dental hygienists
9shall enter into a public health supervision agreement. The
10dentist providing public health supervision must:
11        (1) be available to provide an appropriate level of
12    contact, communication, collaboration, and consultation
13    with the public health dental hygienist and must meet
14    in-person with the public health dental hygienist at least
15    quarterly for review and consultation;
16        (2) have specific standing orders or policy guidelines
17    for procedures that are to be carried out for each location
18    or program, although the dentist need not be present when
19    the procedures are being performed;
20        (3) provide for the patient's additional necessary
21    care in consultation with the public health dental
22    hygienist;
23        (4) file agreements and notifications as required; and
24        (5) include procedures for creating and maintaining
25    dental records, including protocols for transmission of

 

 

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1    all records between the public health dental hygienist and
2    the dentist following each treatment, which shall include a
3    notation regarding procedures authorized by the dentist
4    and performed by the public health dental hygienist and the
5    location where those records are to be kept.
6    Each dentist and hygienist who enters into a public health
7supervision agreement must document and maintain a copy of any
8change or termination of that agreement.
9    Dental records shall be owned and maintained by the
10supervising dentist for all patients treated under public
11health supervision, unless the supervising dentist is an
12employee of a public health clinic or federally qualified
13health center, in which case the public health clinic or
14federally qualified health center shall maintain the records.
15    If a dentist ceases to be employed or contracted by the
16facility, the dentist shall notify the facility administrator
17that the public health supervision agreement is no longer in
18effect. A new public health supervision agreement is required
19for the public health dental hygienist to continue treating
20patients under public health supervision.
21    A dentist entering into an agreement under this Section may
22supervise and enter into agreements for public health
23supervision with 2 public health dental hygienists. This shall
24be in addition to the limit of 4 dental hygienists per dentist
25set forth in subsection (g) of Section 18 of this Act.
26    (b) A public health dental hygienist providing services

 

 

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1under public health supervision may perform only those duties
2within the accepted scope of practice of dental hygiene, as
3follows:
4        (1) the operative procedures of dental hygiene,
5    consisting of oral prophylactic procedures, including
6    prophylactic cleanings, application of fluoride, and
7    placement of sealants;
8        (2) the exposure and processing of x-ray films of the
9    teeth and surrounding structures; and
10        (3) such other procedures and acts as shall be
11    prescribed by rule of the Department.
12    Any patient treated under this subsection (b) must be
13examined by a dentist before additional services can be
14provided by a public health dental hygienist. However, if the
15supervising dentist, after consultation with the public health
16hygienist, determines that time is needed to complete an
17approved treatment plan on a patient eligible under this
18Section, then the dentist may instruct the hygienist to
19complete the remaining services prior to an oral examination by
20the dentist. Such instruction by the dentist to the hygienist
21shall be noted in the patient's records. Any services performed
22under this exception must be scheduled in a timely manner and
23shall not exceed 30 days after the first appointment has taken
24place.
25    (c) A public health dental hygienist providing services
26under public health supervision must:

 

 

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1        (1) provide to the patient, parent, or guardian a
2    written plan for referral or an agreement for follow-up
3    that records all conditions observed that should be called
4    to the attention of a dentist for proper diagnosis;
5        (2) have each patient sign a permission slip or consent
6    form that informs them that the service to be received does
7    not take the place of regular dental checkups at a dental
8    office and is meant for people who otherwise would not have
9    access to the service;
10        (3) inform each patient who may require further dental
11    services of that need;
12        (4) maintain an appropriate level of contact and
13    communication with the dentist providing public health
14    supervision; and
15        (5) complete an additional 4 hours of continuing
16    education in areas specific to public health dentistry
17    yearly.
18    (d) Each public health dental hygienist who has rendered
19services under subsections (c), (d), and (e) of this Section
20must complete a summary report at the completion of a program
21or, in the case of an ongoing program, at least annually. The
22report must be completed in the manner specified by the
23Division of Oral Health in the Department of Public Health
24including information about each location where the public
25health dental hygienist has rendered these services. The public
26health dental hygienist must submit the form to the dentist

 

 

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1providing supervision for his or her signature before sending
2it to the Division.
3    (e) Public health dental hygienists providing services
4under public health supervision may be compensated for their
5work by salary, honoraria, and other mechanisms by the
6employing or sponsoring entity. Nothing in this Act shall
7preclude the entity that employs or sponsors a public health
8dental hygienist from seeking payment, reimbursement, or other
9source of funding for the services provided.
10    (f) This Section is repealed on January 1, 2021.
11(Source: P.A. 99-492, eff. 12-31-15.)
 
12    Section 99. Effective date. This Act takes effect upon
13becoming law.".