Sen. William R. Haine

Filed: 5/18/2016

 

 


 

 


 
09900HB5948sam003LRB099 20560 SMS 48805 a

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7    (Section scheduled to be repealed on January 1, 2026)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 at least 42 clock 72
21hours of additional structured courses in dental education
22approved by rule by the Department course work in advanced
23areas specific to public health dentistry, including, but not
24limited to, emergency procedures for medically compromised
25patients, pharmacology, medical recordkeeping procedures,
26geriatric dentistry, pediatric dentistry, and pathology, and

 

 

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1other areas of study as determined by the Department, and works
2in a public health setting pursuant to a written public health
3supervision agreement as defined by rule by the Department with
4a dentist working in or contracted with a local or State
5government agency or institution or who is providing services
6as part of a certified school-based program or school-based
7oral health program.
8    "Public health setting" means a federally qualified health
9center; a federal, State, or local public health facility; Head
10Start; a special supplemental nutrition program for Women,
11Infants, and Children (WIC) facility; or a certified
12school-based health center or school-based oral health
13program.
14    "Public health supervision" means the supervision of a
15public health dental hygienist by a licensed dentist who has a
16written public health supervision agreement with that public
17health dental hygienist while working in an approved facility
18or program that allows the public health dental hygienist to
19treat patients, without a dentist first examining the patient
20and being present in the facility during treatment, (1) who are
21eligible for Medicaid or (2) who are uninsured and whose
22household income is not greater than 200% of the federal
23poverty level.
24(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15.)
 
25    (225 ILCS 25/17)  (from Ch. 111, par. 2317)

 

 

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1    (Section scheduled to be repealed on January 1, 2026)
2    Sec. 17. Acts constituting the practice of dentistry. A
3person practices dentistry, within the meaning of this Act:
4        (1) Who represents himself or herself as being able to
5    diagnose or diagnoses, treats, prescribes, or operates for
6    any disease, pain, deformity, deficiency, injury, or
7    physical condition of the human tooth, teeth, alveolar
8    process, gums or jaw; or
9        (2) Who is a manager, proprietor, operator or conductor
10    of a business where dental operations are performed; or
11        (3) Who performs dental operations of any kind; or
12        (4) Who uses an X-Ray machine or X-Ray films for dental
13    diagnostic purposes; or
14        (5) Who extracts a human tooth or teeth, or corrects or
15    attempts to correct malpositions of the human teeth or
16    jaws; or
17        (6) Who offers or undertakes, by any means or method,
18    to diagnose, treat or remove stains, calculus, and bonding
19    materials from human teeth or jaws; or
20        (7) Who uses or administers local or general
21    anesthetics in the treatment of dental or oral diseases or
22    in any preparation incident to a dental operation of any
23    kind or character; or
24        (8) Who takes impressions of the human tooth, teeth, or
25    jaws or performs any phase of any operation incident to the
26    replacement of a part of a tooth, a tooth, teeth or

 

 

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1    associated tissues by means of a filling, crown, a bridge,
2    a denture or other appliance; or
3        (9) Who offers to furnish, supply, construct,
4    reproduce or repair, or who furnishes, supplies,
5    constructs, reproduces or repairs, prosthetic dentures,
6    bridges or other substitutes for natural teeth, to the user
7    or prospective user thereof; or
8        (10) Who instructs students on clinical matters or
9    performs any clinical operation included in the curricula
10    of recognized dental schools and colleges; or
11        (11) Who takes impressions of human teeth or places his
12    or her hands in the mouth of any person for the purpose of
13    applying teeth whitening materials, or who takes
14    impressions of human teeth or places his or her hands in
15    the mouth of any person for the purpose of assisting in the
16    application of teeth whitening materials. A person does not
17    practice dentistry when he or she discloses to the consumer
18    that he or she is not licensed as a dentist under this Act
19    and (i) discusses the use of teeth whitening materials with
20    a consumer purchasing these materials; (ii) provides
21    instruction on the use of teeth whitening materials with a
22    consumer purchasing these materials; or (iii) provides
23    appropriate equipment on-site to the consumer for the
24    consumer to self-apply teeth whitening materials.
25    The fact that any person engages in or performs, or offers
26to engage in or perform, any of the practices, acts, or

 

 

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1operations set forth in this Section, shall be prima facie
2evidence that such person is engaged in the practice of
3dentistry.
4    The following practices, acts, and operations, however,
5are exempt from the operation of this Act:
6        (a) The rendering of dental relief in emergency cases
7    in the practice of his or her profession by a physician or
8    surgeon, licensed as such under the laws of this State,
9    unless he or she undertakes to reproduce or reproduces lost
10    parts of the human teeth in the mouth or to restore or
11    replace lost or missing teeth in the mouth; or
12        (b) The practice of dentistry in the discharge of their
13    official duties by dentists in any branch of the Armed
14    Services of the United States, the United States Public
15    Health Service, or the United States Veterans
16    Administration; or
17        (c) The practice of dentistry by students in their
18    course of study in dental schools or colleges approved by
19    the Department, when acting under the direction and
20    supervision of dentists acting as instructors; or
21        (d) The practice of dentistry by clinical instructors
22    in the course of their teaching duties in dental schools or
23    colleges approved by the Department:
24            (i) when acting under the direction and
25        supervision of dentists, provided that such clinical
26        instructors have instructed continuously in this State

 

 

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1        since January 1, 1986; or
2            (ii) when holding the rank of full professor at
3        such approved dental school or college and possessing a
4        current valid license or authorization to practice
5        dentistry in another country; or
6        (e) The practice of dentistry by licensed dentists of
7    other states or countries at meetings of the Illinois State
8    Dental Society or component parts thereof, alumni meetings
9    of dental colleges, or any other like dental organizations,
10    while appearing as clinicians; or
11        (f) The use of X-Ray machines for exposing X-Ray films
12    of dental or oral tissues by dental hygienists or dental
13    assistants; or
14        (g) The performance of any dental service by a dental
15    assistant, if such service is performed under the
16    supervision and full responsibility of a dentist.
17        For purposes of this paragraph (g), "dental service" is
18    defined to mean any intraoral procedure or act which shall
19    be prescribed by rule or regulation of the Department.
20    Dental service, however, shall not include:
21            (1) Any and all diagnosis of or prescription for
22        treatment of disease, pain, deformity, deficiency,
23        injury or physical condition of the human teeth or
24        jaws, or adjacent structures.
25            (2) Removal of, or restoration of, or addition to
26        the hard or soft tissues of the oral cavity, except for

 

 

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1        the placing, carving, and finishing of amalgam
2        restorations by dental assistants who have had
3        additional formal education and certification as
4        determined by the Department. A dentist utilizing
5        dental assistants shall not supervise more than 4
6        dental assistants at any one time for placing, carving,
7        and finishing of amalgam restorations.
8            (3) Any and all correction of malformation of teeth
9        or of the jaws.
10            (4) Administration of anesthetics, except for
11        monitoring of nitrous oxide, conscious sedation, deep
12        sedation, and general anesthetic as provided in
13        Section 8.1 of this Act, that may be performed only
14        after successful completion of a training program
15        approved by the Department. A dentist utilizing dental
16        assistants shall not supervise more than 4 dental
17        assistants at any one time for the monitoring of
18        nitrous oxide.
19            (5) Removal of calculus from human teeth.
20            (6) Taking of impressions for the fabrication of
21        prosthetic appliances, crowns, bridges, inlays,
22        onlays, or other restorative or replacement dentistry.
23            (7) The operative procedure of dental hygiene
24        consisting of oral prophylactic procedures, except for
25        coronal polishing and pit and fissure sealants, which
26        may be performed by a dental assistant who has

 

 

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1        successfully completed a training program approved by
2        the Department. Dental assistants may perform coronal
3        polishing under the following circumstances: (i) the
4        coronal polishing shall be limited to polishing the
5        clinical crown of the tooth and existing restorations,
6        supragingivally; (ii) the dental assistant performing
7        the coronal polishing shall be limited to the use of
8        rotary instruments using a rubber cup or brush
9        polishing method (air polishing is not permitted); and
10        (iii) the supervising dentist shall not supervise more
11        than 4 dental assistants at any one time for the task
12        of coronal polishing or pit and fissure sealants.
13            In addition to coronal polishing and pit and
14        fissure sealants as described in this item (7), a
15        dental assistant who has at least 2,000 hours of direct
16        clinical patient care experience and who has
17        successfully completed a structured training program
18        provided by (1) an educational institution such as a
19        dental school or dental hygiene or dental assistant
20        program, or (2) by a statewide dental or dental
21        hygienist association, approved by the Division on or
22        before the effective date of this amendatory Act of the
23        99th General Assembly, that has developed and
24        conducted a training program for expanded functions
25        for dental assistants or hygienists approved by rule by
26        the Department may perform: (A) coronal scaling above

 

 

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1        the gum line, supragingivally, on the clinical crown of
2        the tooth only on patients 12 years of age or younger
3        who have an absence of periodontal disease and who are
4        not medically compromised or individuals with special
5        needs and (B) intracoronal temporization of a tooth.
6        The training program approved by the Department must:
7        (I) include a minimum of 16 hours of instruction in
8        both didactic and clinical manikin or human subject
9        instruction; all training programs shall include areas
10        of study courses in dental anatomy, public health
11        dentistry, medical history, dental emergencies, and
12        managing the pediatric patient; (II) include an
13        outcome assessment examination that demonstrates
14        competency; (III) require the supervising dentist to
15        observe and approve the completion of 6 full mouth
16        supragingival scaling procedures; and (IV) issue a
17        certificate of completion of the training program,
18        which must be kept on file at the dental office and be
19        made available to the Division upon request. A dental
20        assistant must have successfully completed an approved
21        coronal polishing course prior to taking the coronal
22        scaling course. A dental assistant performing these
23        functions shall be limited to the use of hand
24        instruments only. In addition, coronal scaling as
25        described in this paragraph shall only be utilized on
26        patients who are eligible for Medicaid or who are

 

 

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

 

 

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1        training in an approved dental program situated in this
2        State; or
3            (v) has been accepted or appointed for specialty
4        training in a dental public health agency situated in
5        this State.
6        The applicant shall be permitted to practice dentistry
7    for a period of 3 months from the starting date of the
8    program, unless authorized in writing by the Department to
9    continue such practice for a period specified in writing by
10    the Department.
11        The applicant shall only be entitled to perform such
12    acts as may be prescribed by and incidental to his or her
13    program of residency or specialty training and shall not
14    otherwise engage in the practice of dentistry in this
15    State.
16        The authority to practice shall terminate immediately
17    upon:
18            (1) the decision of the Department that the
19        applicant has failed the examination; or
20            (2) denial of licensure by the Department; or
21            (3) withdrawal of the application.
22(Source: P.A. 98-147, eff. 1-1-14; 98-463, eff. 8-16-13;
2398-756, eff. 7-16-14; 99-492, eff. 12-31-15.)
 
24    (225 ILCS 25/18.1)
25    (Section scheduled to be repealed on January 1, 2021)

 

 

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1    Sec. 18.1. Public health dental supervision
2responsibilities.
3    (a) When working together in a public health supervision
4relationship, dentists and public health dental hygienists
5shall enter into a public health supervision agreement. The
6dentist providing public health supervision must:
7        (1) be available to provide an appropriate level of
8    contact, communication, collaboration, and consultation
9    with the public health dental hygienist and must meet
10    in-person with the public health dental hygienist at least
11    quarterly for review and consultation;
12        (2) have specific standing orders or policy guidelines
13    for procedures that are to be carried out for each location
14    or program, although the dentist need not be present when
15    the procedures are being performed;
16        (3) provide for the patient's additional necessary
17    care in consultation with the public health dental
18    hygienist;
19        (4) file agreements and notifications as required; and
20        (5) include procedures for creating and maintaining
21    dental records, including protocols for transmission of
22    all records between the public health dental hygienist and
23    the dentist following each treatment, which shall include a
24    notation regarding procedures authorized by the dentist
25    and performed by the public health dental hygienist and the
26    location where those records are to be kept.

 

 

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

 

 

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1    prophylactic cleanings, application of fluoride, and
2    placement of sealants;
3        (2) the exposure and processing of x-ray films of the
4    teeth and surrounding structures; and
5        (3) such other procedures and acts as shall be
6    prescribed by rule of the Department.
7    Any patient treated under this subsection (b) must be
8examined by a dentist before additional services can be
9provided by a public health dental hygienist. However, if the
10supervising dentist, after consultation with the public health
11hygienist, determines that time is needed to complete an
12approved treatment plan on a patient eligible under this
13Section, then the dentist may instruct the hygienist to
14complete the remaining services prior to an oral examination by
15the dentist. Such instruction by the dentist to the hygienist
16shall be noted in the patient's records. Any services performed
17under this exception must be scheduled in a timely manner and
18shall not occur more than 30 days after the first appointment
19date.
20    (c) A public health dental hygienist providing services
21under public health supervision must:
22        (1) provide to the patient, parent, or guardian a
23    written plan for referral or an agreement for follow-up
24    that records all conditions observed that should be called
25    to the attention of a dentist for proper diagnosis;
26        (2) have each patient sign a permission slip or consent

 

 

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1    form that informs them that the service to be received does
2    not take the place of regular dental checkups at a dental
3    office and is meant for people who otherwise would not have
4    access to the service;
5        (3) inform each patient who may require further dental
6    services of that need;
7        (4) maintain an appropriate level of contact and
8    communication with the dentist providing public health
9    supervision; and
10        (5) complete an additional 4 hours of continuing
11    education in areas specific to public health dentistry
12    yearly.
13    (d) Each public health dental hygienist who has rendered
14services under subsections (c), (d), and (e) of this Section
15must complete a summary report at the completion of a program
16or, in the case of an ongoing program, at least annually. The
17report must be completed in the manner specified by the
18Division of Oral Health in the Department of Public Health
19including information about each location where the public
20health dental hygienist has rendered these services. The public
21health dental hygienist must submit the form to the dentist
22providing supervision for his or her signature before sending
23it to the Division.
24    (e) Public health dental hygienists providing services
25under public health supervision may be compensated for their
26work by salary, honoraria, and other mechanisms by the

 

 

09900HB5948sam003- 20 -LRB099 20560 SMS 48805 a

1employing or sponsoring entity. Nothing in this Act shall
2preclude the entity that employs or sponsors a public health
3dental hygienist from seeking payment, reimbursement, or other
4source of funding for the services provided.
5    (f) This Section is repealed on January 1, 2021.
6(Source: P.A. 99-492, eff. 12-31-15.)".