SENATE BILL 22-219
BY SENATOR(S) Moreno and Smallwood, Fields, Jaquez Lewis, Lee;
also REPRESENTATIVE(S) Duran and McLachlan, Bernett, Cutter,
Hooton, Lindsay, Lontine, Ricks, Valdez A., Woodrow.
C
ONCERNING THE REGULATION OF DENTAL THERAPISTS , AND, IN
CONNECTION THEREWITH
, MAKING AN APPROPRIATION.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. Legislative declaration. (1) The general assembly
hereby finds and declares that:
(a) Access to affordable, quality, and equitable dental care and to
dental providers has been demonstrated to have a positive impact on
people's overall health outcomes and overall well-being;
(b) Although great strides have been made toward increasing access
to affordable dental care, not enough has been accomplished to address
oral-health-access issues across Colorado, particularly in the state's rural
areas, and for Coloradans who have historically and systematically faced
barriers to health care, including people of color and Coloradans with low
incomes;
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. (c) According to the "Colorado Health Access Survey" (survey) by
the Colorado Health Institute, roughly one in five Coloradans report poor
oral health;
(d) In the survey, 400,000 Coloradans said that at some point in the
past year, they were unable to participate in regular daily activities like
school or work due to dental pain;
(e) Fifty-three of Colorado's 64 counties are designated as dental
professional shortage areas, with five counties without a single licensed
dentist;
(f) Dentist participation in Medicaid sits at 59.9%, but in 2018, only
28% of Colorado dentists served any Medicaid-enrolled patients;
(g) Adults in rural areas have almost twice the prevalence of tooth
loss when compared to urban adults;
(h) By kindergarten, 40% of children in Colorado already have
dental decay, and this rate increases for children living in low-income
communities. Dental health issues continue to be a leading cause of school
absenteeism for Colorado's kids.
(i) Research has shown that dental therapists practicing in other
states provide safe and high-quality care, assist in improving access to
dental care, and experience high patient acceptability;
(j) A long-term study of dental therapists in the country found that
dental therapists are improving access to care, resulting in both adults and
children getting more preventive care and keeping their natural teeth; and
(k) In order to ensure dental care is accessible for all Coloradans, it
is critical that the state establish a license for dental therapists to help close
the historic gaps and barriers that Coloradans face in accessing dental care.
SECTION 2. In Colorado Revised Statutes, amend 12-220-102 as
follows:
12-220-102. Legislative declaration. The practice of dentistry,
PAGE 2-SENATE BILL 22-219 DENTAL THERAPY, and dental hygiene in this state is declared to affect the
public health, safety, and welfare and to be subject to regulation and control
in the public interest. It is further declared to be a matter of public interest
and concern that the dental profession merit and receive the confidence of
the public and that only qualified dentists,
DENTAL THERAPISTS, and dental
hygienists be permitted to practice dentistry,
DENTAL THERAPY, or dental
hygiene in this state. It is the purpose of this article 220 to promote the
public health, safety, and welfare by regulating the practice of dentistry,
DENTAL THERAPY, and dental hygiene and to ensure that no one shall
practice PRACTICES dentistry, DENTAL THERAPY, or dental hygiene without
qualifying under this article 220. The provisions of this article 220 relating
to licensure by credentials are not intended to reduce competition or restrain
trade with respect to the oral health needs of the public. All provisions of
this article 220 relating to the practice of dentistry,
DENTAL THERAPY, and
dental hygiene shall be liberally construed to carry out these objects and
purposes.
SECTION 3. In Colorado Revised Statutes, 12-220-104, amend
(1), (3), (13), and (15); and add (5.5) as follows:
12-220-104. Definitions - rules. As used in this article 220, unless
the context otherwise requires:
(1) "Accredited" means a program that is nationally recognized for
specialized accrediting for dental,
DENTAL THERAPY, dental hygiene, and
dental auxiliary programs by the United States department of education.
(3) "Dental assistant" means any person, other than a dentist,
DENTAL THERAPIST, or dental hygienist, licensed in Colorado, who may be
assigned or delegated to perform dental tasks or procedures as authorized
by this article 220 or by rules of the board.
(5.5) "D
ENTAL THERAPY" MEANS THE DELIVERY OF DENTAL CARE AS
SPECIFIED IN SECTION
12-220-508 AND IN ACCORDANCE WITH THIS ARTICLE
220 AND RULES PROMULGATED BY THE BOARD .
(13) "Proprietor" includes any person who:
(a) Employs dentists,
DENTAL THERAPISTS, dental hygienists, or
dental assistants in the operation of a dental office, except as provided in
PAGE 3-SENATE BILL 22-219 sections 12-220-305 and 12-220-501;
(b) Places in possession of a dentist,
DENTAL THERAPIST, dental
hygienist, dental assistant, or other agent dental material or equipment that
may be necessary for the management of a dental office on the basis of a
lease or any other agreement for compensation for the use of the material,
equipment, or offices; or
(c) Retains the ownership or control of dental equipment or material
or a dental office and makes the same available in any manner for use by
dentists,
DENTAL THERAPISTS, dental hygienists, dental assistants, or other
agents; except that nothing in this subsection (13)(c) applies to bona fide
sales of dental equipment or material secured by a chattel mortgage or
retain-title agreement or to the loan of articulators.
(15) "Telehealth supervision" means indirect supervision by a
dentist of a
DENTAL THERAPIST OR dental hygienist performing a statutorily
authorized procedure using telecommunications systems.
SECTION 4. In Colorado Revised Statutes, add 12-220-407.2 and
12-220-407.5 as follows:
12-220-407.2. Application for dental therapist license - fee -
rules. (1) E
FFECTIVE MAY 1, 2023, EVERY PERSON WHO DESIRES TO
QUALIFY FOR PRACTICE AS A DENTAL THERAPIST WITHIN THIS STATE MUST
FILE WITH THE BOARD
:
(a) A
WRITTEN APPLICATION FOR A LICENSE, ON WHICH APPLICATION
THE APPLICANT MUST LIST
:
(I) A
NY ACT OR OMISSION OF THE APPLICANT THAT WOULD BE
GROUNDS FOR DISCIPLINARY ACTION UNDER SECTION
12-220-201 AGAINST
A LICENSED DENTAL THERAPIST
; AND
(II) AN EXPLANATION OF THE CIRCUMSTANCES OF THE ACT OR
OMISSION
; AND
(b) SATISFACTORY PROOF THAT THE APPLICANT :
(I) G
RADUATED FROM A SCHOOL OF DENTAL THERAPY THAT , AT THE
PAGE 4-SENATE BILL 22-219 TIME OF THE APPLICANT 'S GRADUATION, WAS ACCREDITED BY THE
AMERICAN DENTAL ASSOCIATION'S COMMISSION ON DENTAL
ACCREDITATION
, OR ITS SUCCESSOR ORGANIZATION; OR
(II) GRADUATED FROM A DENTAL THERAPY EDUCATION PROGRAM
DEVELOPED PRIOR TO
FEBRUARY 6, 2015, THAT, AT THE TIME OF THE
APPLICANT
'S GRADUATION, WAS ACCREDITED BY THE MINNESOTA BOARD OF
DENTISTRY OR CERTIFIED BY THE
ALASKA COMMUNITY HEALTH AIDE
PROGRAM CERTIFICATION BOARD
.
(2) T
HE APPLICANT MUST APPLY FOR A DENTAL THERAPIST LICENSE
ON THE FORM PRESCRIBED AND FURNISHED BY THE BOARD
, MUST CERTIFY
THE APPLICATION UNDER PENALTY OF PERJURY
, AND MUST SUBMIT THE FEE
ESTABLISHED PURSUANT TO SECTION
12-20-105 WITH THE APPLICATION.
(3) A
N APPLICANT FOR LICENSURE WHO HAS NOT GRADUATED FROM
A SCHOOL DESCRIBED IN SUBSECTION
(1)(b) OF THIS SECTION WITHIN THE
TWELVE MONTHS IMMEDIATELY PRECEDING APPLICATION
, OR WHO HAS NOT
ENGAGED EITHER IN THE ACTIVE CLINICAL PRACTICE OF DENTAL THERAPY OR
IN TEACHING DENTAL THERAPY IN AN ACCREDITED PROGRAM FOR AT LEAST
ONE YEAR DURING THE FIVE YEARS IMMEDIATELY PRECEDING THE
APPLICATION
, MUST DEMONSTRATE TO THE BOARD THAT THE APPLICANT HAS
MAINTAINED THE PROFESSIONAL ABILITY AND KNOWLEDGE REQUIRED BY
THIS ARTICLE
220.
12-220-407.5. Dental therapist examinations - license. (1) E
VERY
APPLICANT FOR A DENTAL THERAPY LICENSE MUST SUBMIT TO THE BOARD
PROOF THAT THE APPLICANT SUCCESSFULLY COMPLETED A CLINICAL
EXAMINATION FOR DENTAL THERAPY THAT
:
(a) I
S DESIGNED TO TEST THE APPLICANT 'S CLINICAL DENTAL
THERAPY SKILLS AND KNOWLEDGE
;
(b) I
NCLUDES DENTAL THERAPY RESTORATIVE AND DENTAL HYGIENE
CLINICAL SKILL EVALUATION
; AND
(c) IS ADMINISTERED BY A REGIONAL TESTING AGENCY COMPOSED
OF AT LEAST FOUR STATES OR AN EXAMINATION OF ANOTHER STATE
.
(2) A
LL EXAMINATION RESULTS REQUIRED BY THE BOARD MUST BE
PAGE 5-SENATE BILL 22-219 FILED WITH THE BOARD AND KEPT FOR REFERENCE FOR A PERIOD OF NOT LESS
THAN TWO YEARS
. IF AN APPLICANT SUCCESSFULLY COMPLETES THE
EXAMINATIONS AND IS OTHERWISE QUALIFIED
, THE BOARD SHALL GRANT A
LICENSE TO THE APPLICANT AND SHALL ISSUE A LICENSE CERTIFICATE SIGNED
BY THE OFFICERS OF THE BOARD
.
(3) F
OR THE PURPOSE OF COMPLETING THE EXAMINATION
REQUIREMENT IN SUBSECTION
(1) OF THIS SECTION, IF THE APPLICANT HAS
PREVIOUSLY SUCCESSFULLY COMPLETED A CLINICAL EXAMINATION FOR
DENTAL HYGIENE ADMINISTERED BY A TESTING AGENCY ACCEPTED BY THE
BOARD
, THE APPLICANT MAY BE EXEMPTED FROM THAT PART OF THE DENTAL
THERAPY EXAMINATION
.
SECTION 5. In Colorado Revised Statutes, 12-220-501, amend
(1)(a)(I); and add (2.5) as follows:
12-220-501. Tasks authorized to be performed by dental
therapists, dental hygienists, or dental assistants - rules.
(1) (a) (I) Except as provided in subsection (1)(a)(II) of this section, the
responsibility for dental diagnosis, dental treatment planning, or the
prescription of therapeutic measures in the practice of dentistry remains
with a licensed dentist and may not be assigned to any
DENTAL THERAPIST
OR
dental hygienist.
(2.5) A
DENTAL THERAPIST MAY PERFORM A DENTAL TASK OR
PROCEDURE ASSIGNED TO THE DENTAL THERAPIST BY A LICENSED DENTIST
THAT DOES NOT REQUIRE THE PROFESSIONAL SKILL OF A LICENSED DENTIST
;
EXCEPT THAT THE DENTAL THERAPIST MAY PERFORM THE TASK OR
PROCEDURE ONLY UNDER THE SUPERVISION AUTHORIZED UNDER SECTION
12-220-508.
SECTION 6. In Colorado Revised Statutes, add 12-220-508 as
follows:
12-220-508. Practice of dental therapy supervision requirement
- rules. (1) (a) A
DENTAL THERAPIST MAY PERFORM THE FOLLOWING TASKS
AND PROCEDURES UNDER THE DIRECT SUPERVISION OF A LICENSED DENTIST
:
(I) P
REPARE AND PLACE DIRECT RESTORATIONS IN PRIMARY AND
PERMANENT TEETH
;
PAGE 6-SENATE BILL 22-219 (II) PERFORM BRUSH BIOPSIES;
(III) E
XTRACT PERIODONTALLY DISE ASED PERMANENT TEETH WITH
MOBILITY OF
+3 TO +4, EXCEPT FOR TEETH THAT ARE UNERUPTED ,
IMPACTED, FRACTURED, OR REQUIRE SECTIONING;
(IV) E
XTRACT PRIMARY TEETH THAT ARE ERUPTED OR NOT
IMPACTED WITH RADIOLOGICAL EVIDENCE OF ROOTS
;
(V) O
RAL EXAMINATION AND EVALUATION FOR CONDITIONS AND
SERVICES THAT ARE WITHIN THE DENTAL THERAPIST
'S SCOPE OF PRACTICE
AND EDUCATION
;
(VI) P
LACE TEMPORARY CROWNS ;
(VII) P
REPARE AND PLACE PREFORMED CROWNS ; AND
(VIII) REPAIR DEFECTIVE PROSTHETIC DEVICES.
(b) A
DENTAL THERAPIST LICENSED PURSUANT TO THIS ARTICLE 220
WHO HAS COMPLETED ONE THOUS AND HOURS OR MORE UNDER DIRECT
SUPERVISION
, OR WHO HAS COMPLETED THE DIRECT SUPERVISION HOURS
REQUIRED UNDER THE WAIVER DESCRIBED IN SUBSECTION
(1)(e) OF THIS
SECTION
, MAY PRACTICE THE TASKS AND PROCEDURES IDENTIFIED IN
SUBSECTION
(1)(a) OF THIS SECTION UNDER THE INDIRECT SUPERVISION OF
A LICENSED DENTIST PURSUANT TO A WRITTEN ARTICULATED PLAN WITH THE
DENTIST THAT MEETS THE REQUIREMENTS OF SUBSECTION
(2) OF THIS
SECTION
.
(c) A
DENTAL THERAPIST LICENSED PURSUANT TO THIS ARTICLE 220
MAY PERFORM THE FOLLOWING TASKS UNDER THE INDIRECT SUPERVISION OF
A LICENSED DENTIST
, REGARDLESS OF THE NUMBER OF HOURS THE DENTAL
THERAPIST HAS PRACTICED
:
(I) R
EIMPLANTING TEETH;
(II) S
TABILIZING REIMPLANTED TEETH;
(III) E
XTRACTING PRIMARY TEETH THAT ARE ERUPTED OR NOT
IMPACTED WITHOUT RADIOLOGICAL EVIDENCE OF ROOTS
;
PAGE 7-SENATE BILL 22-219 (IV) REMOVING SUTURES;
(V) P
REPARING DENTAL STUDY CASTS ;
(VI) A
DMINISTERING LOCAL ANESTHESIA IN ACCORDANCE WITH
SECTION
12-220-411;
(VII) D
ISPENSING AND ADMINISTERING THE FOLLOWING DRUGS
WITHIN THE PARAMETERS OF A WRI TTEN ARTICULATED PLAN AND WITH THE
AUTHORIZATION OF THE SUPERVISING DENTIST
: NONNARCOTIC ANALGESICS ,
ANTI-INFLAMMATORIES, AND ANTIBIOTICS; AND
(VIII) ANY TASK OR PROCEDURE AUTHORIZED TO BE PERFORMED BY
A LICENSED DENTAL HYGIENIST AS SPECIFIED IN RULES ADOPTED PURSUANT
TO SECTIONS
12-220-106 (1)(a)(I), 12-220-501, 12-220-503 (1), 12-220-504
(1),
AND 12-220-505.
(d) A
DENTAL THERAPIST SHALL COMPLETE AT LEAST A MAJORITY OF
THE DIRECT SUPERVISION HOURS REQUIRED UNDER SUBSECTION
(1)(b) OR
(1)(e) OF THIS SECTION PERFORMING THE TASKS AND PROCEDURES
IDENTIFIED IN SUBSECTION
(1)(a) OF THIS SECTION.
(e) F
OR THE PURPOSES OF SATISFYING THE PRACTICE HOURS
REQUIREMENT SPECIFIED IN SUBSECTION
(1)(a) OF THIS SECTION, THE BOARD,
BY RULE, MAY WAIVE UP TO SIX HUNDRED HOURS OF THE REQUIRED
PRACTICE HOURS
. IN PROMULGATING THESE RULES , THE BOARD SHALL, AT
A MINIMUM
, CONSIDER THE NUMBER OF YEARS THE DENTAL THERAPIST HAS
PRACTICED AS
:
(I) A
LICENSED DENTAL HYGIENIST IN COLORADO;
(II) A
LICENSED DENTAL HYGIENIST IN ANOTHER STATE ; OR
(III) A LICENSED DENTAL THERAPIST IN ANOTHER STATE .
(2) (a) A
N ARTICULATED PLAN BETWEEN A DENTAL THERAPIST AND
A DENTIST MUST INCLUDE
:
(I) M
ETHODS OF DENTIST SUPERVISION , CONSULTATION, AND
APPROVAL
;
PAGE 8-SENATE BILL 22-219 (II) PROTOCOLS FOR INFORMED CONSENT , RECORD KEEPING, QUALITY
ASSURANCE
, AND DISPENSING OR ADMINISTERING MEDICATIONS ;
(III) P
OLICIES FOR HANDLING REFERRALS WHEN A PATIENT NEEDS
SERVICES THE DENTAL THERAPIST IS NOT AUTHORIZED OR QUALIFIED TO
PROVIDE
;
(IV) P
ROTOCOLS FOR ASSESSMENT OF DENTAL DISEASE AND THE
FORMULATION OF AN INDIVIDUALIZED TREATMENT PLAN AUTHORIZED BY
THE SUPERVISING DENTIST
;
(V) P
OLICIES FOR HANDLING MEDICAL EMERGENCIES ; AND
(VI) POLICIES FOR SUPERVISING DENTAL ASSISTANTS AND WORKING
WITH DENTAL HYGIENISTS AND OTHER DENTAL PRACTITIONERS AND STAFF
.
(b) (I) A
DENTIST WHO ENTERS INTO A WRITTEN ARTICULATED PLAN
WITH A DENTAL THERAPIST SHALL ENSURE THAT THE DENTIST
, OR ANOTHER
DENTIST
, IS AVAILABLE TO THE DENTAL THERAPIST FOR TIMELY
COMMUNICATION DURING THE DENTAL THERAPIST
'S PROVISION OF CARE TO
A PATIENT
.
(II) A
DENTAL THERAPIST AND A DENTIST WHO ENTER INTO A
WRITTEN ARTICULATED PLAN SHALL EACH MAINTAIN A PHYSICAL OR DIGITAL
COPY OF THE PLAN
.
(III) A
DENTAL THERAPIST MAY ENTER INTO WRITTEN ARTICULATED
PLANS WITH MORE THAN ONE DENTIST IF EACH ARTICULATED PLAN INCLUDES
THE SAME SUPERVISION REQUIREMENTS AND SCOPE OF PRACTICE
.
(c) A
WRITTEN ARTICULATED PLAN MUST BE SIGNED BY THE DENTIST
AND THE DENTAL THERAPIST
.
(d) F
OR PURPOSES OF THIS SECTION, A WRITTEN ARTICULATED PLAN
SATISFIES THE REQUIREMENT OF PRIOR KNOWLEDGE AND CONSENT FOR
INDIRECT SUPERVISION
.
(3) (a) E
XCEPT AS PROVIDED IN SUBSECTION (3)(b) OR (3)(c) OF THIS
SECTION
, A DENTIST MAY NOT SIMULTANEOUSLY SUPERVISE MORE THAN
THREE FULL
-TIME OR FULL-TIME EQUIVALENT DENTAL THERAPISTS .
PAGE 9-SENATE BILL 22-219 (b) A DENTIST MAY SUPERVISE AN ADDITIONAL TWO FULL -TIME OR
FULL
-TIME EQUIVALENT DENTAL THERAPISTS WHO PRACTICE IN A
FEDERALLY QUALIFIED HEALTH CENTER PURSUANT TO
42 U.S.C. SEC. 1395x
(aa)(4)
OR A RURAL HEALTH CLINIC PURSUANT TO 42 U.S.C. SEC. 1395x
(aa)(4).
(c) T
HE BOARD SHALL PROMULGATE RULES CREATING A PROCESS FOR
A DENTIST TO SEEK A WAIVER FROM THE SUPERVISION LIMIT SPECIFIED IN
SUBSECTION
(3)(a) OF THIS SECTION. AT A MINIMUM, THE RULES MUST
SPECIFY THE APPLICATION PROCESS AND WAIVER REQUIREMENTS
.
SECTION 7. In Colorado Revised Statutes, 12-220-105, amend
(1)(a) and (1)(c); and amend as amended by Senate Bill 22-013 (1)(b) as
follows:
12-220-105. Colorado dental board - qualifications of board
members - quorum - panel - rules - review of functions - repeal of
article - repeal. (1) (a) The Colorado dental board is hereby created as the
agency of this state for the regulation of the practice of dentistry,
DENTAL
THERAPY
, AND DENTAL HYGIENE in this state and to carry out the purposes
of this article 220. The board is subject to the supervision and control of the
division as provided by section 12-20-103 (2).
(b) (I) E
XCEPT AS PROVIDED IN SUBSECTION (1)(b)(II) OF THIS
SECTION
, the board consists of seven dentist members, three dental hygienist
members, and three members from the public at large. The governor shall
appoint each member for a term of four years, and each member must have
the qualifications provided in this article 220. A member shall not serve
more than two consecutive terms of four years. Each board member holds
office until the member's term expires or until the governor appoints a
successor. T
HIS SUBSECTION (1)(b)(I) IS REPEALED, EFFECTIVE DECEMBER
1, 2031.
(II) (A) E
FFECTIVE JULY 1, 2031, THE BOARD CONSISTS OF SEVEN
DENTIST MEMBERS
, TWO DENTAL THERAPIST MEMBERS , TWO DENTAL
HYGIENIST MEMBERS
, AND TWO MEMBERS FROM THE PUBLIC AT LARGE . THE
GOVERNOR SHALL APPOINT EACH MEMBER FOR A TERM OF FOUR YEARS
, AND
EACH MEMBER MUST HAVE THE QUALIFICATIONS PROVIDED IN THIS ARTICLE
220. A MEMBER SHALL NOT SERVE MORE THAN TWO CONSECUTIVE TERMS OF
FOUR YEARS
. EACH BOARD MEMBER HOLDS OFFICE UNTIL THE MEMBER 'S
PAGE 10-SENATE BILL 22-219 TERM EXPIRES OR UNTIL THE GOVERNOR APPOINTS A SUCCESSOR .
(B) A
MEMBER SERVING ON THE BOARD AS OF JUNE 30, 2031, MAY
SERVE THE MEMBER
'S FULL TERM.
(II)
(III) A person is qualified to be appointed to the board if the
person:
(A) Is a legal resident of Colorado;
(B) Is currently licensed as a dentist,
DENTAL THERAPIST, or dental
hygienist, if fulfilling that position on the board; and
(C) Has been actively engaged in a clinical practice in this state for
at least five years immediately preceding the appointment, if fulfilling the
position of dentist,
DENTAL THERAPIST, or dental hygienist on the board.
(c) (I) In making appointments to the board, the governor shall
attempt to create geographical, political, urban, and rural balance among the
board members. If a vacancy occurs in any board membership before the
expiration of the member's term, the governor shall fill the vacancy by
appointment for the remainder of the term in the same manner as in the case
of original appointments.
(II) (A) I
N MAKING APPOINTMENTS OF DENTAL THERAPISTS TO THE
BOARD
, THE GOVERNOR SHALL APPOINT INDIVIDUALS WHO ARE DIVERSE
WITH REGARD TO RACE
, ETHNICITY, IMMIGRATION STATUS , INCOME,
WEALTH, AGE, ABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, AND
GEOGRAPHY
.
(B) I
N CONSIDERING THE RACIAL AND ETHNIC DIVERSITY OF THE
DENTAL THERAPISTS APPOINTED TO THE BOARD
, THE GOVERNOR SHALL
ATTEMPT TO ENSURE THAT AT LEAST ONE MEMBER IS A PERSON OF COLOR
.
(C) I
N CONSIDERING THE GEOGRAPHIC DIVERSITY OF THE DENTAL
THERAPISTS APPOINTED TO THE BOARD
, THE GOVERNOR SHALL ATTEMPT TO
APPOINT MEMBERS FROM BOTH RURAL AND URBAN AREAS OF THE STATE
.
SECTION 8. In Colorado Revised Statutes, 12-220-106, amend
(1)(a)(I) and (1)(f) as follows:
PAGE 11-SENATE BILL 22-219 12-220-106. Powers and duties of board - rules - limitation on
authority. (1) The board shall exercise, in accordance with this article 220,
the following powers and duties:
(a) Make, publish, declare, and periodically review reasonable rules
pursuant to section 12-20-204, including rules regarding:
(I) The use of lasers for dental,
DENTAL THERAPY, and dental
hygiene purposes within defined scopes of practice, subject to appropriate
education and training, and with appropriate supervision, as applicable;
(f) In accordance with section 12-220-411, issue anesthesia and
sedation permits to licensed dentists,
DENTAL THERAPISTS, and dental
hygienists and set and collect fees for permit issuance. except that the board
shall only collect fees for local anesthesia permits issued to dental
hygienists on or after July 1, 2014.
SECTION 9. In Colorado Revised Statutes, 12-220-201, amend
(1)(a), (1)(g), (1)(h), (1)(j)(I), (1)(j)(II), (1)(k), (1)(o), (1)(q), (1)(r), (1)(v)
introductory portion, (1)(v)(II), (1)(x), (1)(y)(IV), (1)(ee), (1)(ff), and
(1)(gg) as follows:
12-220-201. Grounds for disciplinary action - definition. (1) The
board may take disciplinary action against an applicant or licensee in
accordance with sections 12-20-404 and 12-220-202 for any of the
following causes:
(a) Engaging in fraud, misrepresentation, or deception in applying
for, securing, renewing, or seeking reinstatement of a license to practice
dentistry,
DENTAL THERAPY, or dental hygiene in this state, in applying for
professional liability coverage required pursuant to section 12-220-307, or
in taking the examinations provided for in this article 220;
(g) Aiding or abetting, in the practice of dentistry,
DENTAL THERAPY,
or dental hygiene, a person who is not licensed to practice dentistry,
DENTAL
THERAPY
, or dental hygiene under this article 220 or whose license to
practice dentistry,
DENTAL THERAPY, or dental hygiene is suspended;
(h) Except as otherwise provided in sections 12-220-304,
12-220-503 (4), and 25-3-103.7, practicing dentistry,
DENTAL THERAPY, or
PAGE 12-SENATE BILL 22-219 dental hygiene as a partner, agent, or employee of or in joint venture with
any person who does not hold a license to practice dentistry,
DENTAL
THERAPY
, or dental hygiene within this state or practicing dentistry, DENTAL
THERAPY
, or dental hygiene as an employee of or in joint venture with any
partnership, association, or corporation. A licensee holding a license to
practice dentistry,
DENTAL THERAPY, or dental hygiene in this state may
accept employment from any person, partnership, association, or
corporation to examine, prescribe, and treat the employees of the person,
partnership, association, or corporation.
(j) (I) Failing to notify the board, as required by section 12-30-108
(1), of a physical illness, physical condition, or behavioral health, mental
health, or substance use disorder that renders the licensee unable, or limits
the licensee's ability, to perform dental,
DENTAL THERAPY, or dental hygiene
services with reasonable skill and with safety to the patient;
(II) Failing to act within the limitations created by a physical illness,
physical condition, or behavioral health, mental health, or substance use
disorder that renders the licensee unable to practice
PERFORM dental,
DENTAL THERAPY, or dental hygiene services with reasonable skill and
safety or that may endanger the health or safety of persons under his or her
THE LICENSEE'S care; or
(k) Committing an act or omission that constitutes grossly negligent
dental,
DENTAL THERAPY, or dental hygiene practice or that fails to meet
generally accepted standards of dental,
DENTAL THERAPY, or dental hygiene
practice;
(o) False billing in the delivery of dental,
DENTAL THERAPY, or
dental hygiene services, including but not limited to,
performing one service
and billing for another, billing for any service not rendered, or committing
a fraudulent insurance act, as defined in section 10-1-128;
(q) Failing to notify the board, in writing and within ninety days
after a judgment is entered, of a final judgment by a court of competent
jurisdiction in favor of any party and against the licensee involving
negligent malpractice of dentistry,
DENTAL THERAPY, or dental hygiene,
which notice must contain the name of the court, the case number, and the
names of all parties to the action;
PAGE 13-SENATE BILL 22-219 (r) Failing to report a dental, DENTAL THERAPY, or dental hygiene
malpractice judgment or malpractice settlement to the board by the licensee
within ninety days;
(v) Sharing any professional fees with anyone except those with
whom the dentist,
DENTAL THERAPIST, or dental hygienist is lawfully
associated in the practice of dentistry,
DENTAL THERAPY, or dental hygiene;
except that:
(II) Nothing in this section prohibits a dentist,
DENTAL THERAPIST,
or dental hygienist practice owned or operated by a proprietor authorized
under section 12-220-303 from contracting with any person or entity for
business management services or paying a royalty in accordance with a
franchise agreement if the terms of the contract or franchise agreement do
not affect the exercise of the independent professional judgment of the
dentist,
DENTAL THERAPIST, or dental hygienist.
(x) Failure of a
DENTAL THERAPIST OR dental hygienist to
recommend that a patient be examined by a dentist or to refer a patient to
a dentist when the
DENTAL THERAPIST OR dental hygienist detects a
condition that requires care beyond the scope of practicing
DENTAL
THERAPY OR
supervised or unsupervised dental hygiene;
(y) Engaging in any of the following activities and practices:
(IV) Ordering or performing, without clinical justification, any
service, X ray, or treatment that is contrary to recognized standards of the
practice of dentistry,
DENTAL THERAPY, or dental hygiene, as interpreted by
the board;
(ee) Failing to provide adequate or proper supervision when
employing unlicensed persons in a dental or dental hygiene practice OF
UNLICENSED PERSONS IN DENTAL
, DENTAL THERAPY, OR DENTAL HYGIENE
PRACTICE
;
(ff) Engaging in any conduct that constitutes a crime as defined in
title 18, which conduct relates to the licensee's practice as a dentist,
DENTAL
THERAPIST
, or dental hygienist;
(gg) Practicing outside the scope of dental,
DENTAL THERAPY, or
PAGE 14-SENATE BILL 22-219 dental hygiene practice;
SECTION 10. In Colorado Revised Statutes, 12-220-202, amend
(1)(a)(II), (3) introductory portion, (4), and (5)(a) as follows:
12-220-202. Disciplinary actions - rules. (1) (a) If, after notice and
hearing conducted in accordance with article 4 of title 24 and section
12-20-403, the board determines that an applicant or licensee has engaged
in an act specified in section 12-220-201, the board may:
(II) Reprimand, censure, or, in accordance with section 12-20-404
(1)(b), place on probation any licensed dentist,
DENTAL THERAPIST, or dental
hygienist;
(3) The board may include, in any disciplinary order that allows a
dentist,
DENTAL THERAPIST, or dental hygienist to continue to practice,
conditions the board deems appropriate to assure that the dentist,
DENTAL
THERAPIST
, or dental hygienist is physically, mentally, and otherwise
qualified to practice dentistry,
DENTAL THERAPY, or dental hygiene in
accordance with generally accepted professional standards of practice. The
order may include any or all of the following:
(4) The board may suspend the license of a dentist,
DENTAL
THERAPIST
, or dental hygienist who fails to comply with an order of the
board issued in accordance with this section. The board may impose the
license suspension until the licensee complies with the board's order.
(5) (a) In addition to any other penalty permitted under this article
220, when a licensed dentist,
DENTAL THERAPIST, or dental hygienist
violates a provision of this article 220 or of any rule promulgated pursuant
to this article 220, the board may impose a fine on the licensee. If the
licensee is a dentist, the fine must not exceed five thousand dollars. I
F THE
LICENSEE IS A DENTAL THERAPIST
, THE FINE MUST NOT EXCEED FOUR
THOUSAND DOLLARS
. If the licensee is a dental hygienist, the fine must not
exceed three thousand dollars.
SECTION 11. In Colorado Revised Statutes, 12-220-203, amend
(1)(a) as follows:
12-220-203. Disciplinary proceedings. (1) (a) Any person may
PAGE 15-SENATE BILL 22-219 submit a complaint relating to the conduct of a dentist, DENTAL THERAPIST,
or dental hygienist, which complaint must be in writing and signed by the
person. The board, on its own motion, may initiate a complaint. The board
shall notify the dentist,
DENTAL THERAPIST, or dental hygienist of the
complaint against the dentist,
DENTAL THERAPIST, or dental hygienist.
SECTION 12. In Colorado Revised Statutes, 12-220-206, amend
(1) and (2) introductory portion as follows:
12-220-206. Mental and physical examinations. (1) (a) If the
board has reasonable cause to believe that a person licensed to practice
dentistry,
DENTAL THERAPY, or dental hygiene in this state is unable to
practice dentistry,
DENTAL THERAPY, or dental hygiene with reasonable skill
and safety to patients because of a physical or mental disability or because
of excessive use of alcohol, a habit-forming drug or substance, or a
controlled substance, as defined in section 18-18-102 (5), the board may
require the licensed dentist,
DENTAL THERAPIST, or dental hygienist to
submit to a mental or physical examination by a qualified professional
designated by the board.
(b) Upon the failure of the licensed dentist,
DENTAL THERAPIST, or
dental hygienist to submit to a mental or physical examination required by
the board, unless the failure is due to circumstances beyond the dentist's,
DENTAL THERAPIST'S, or dental hygienist's control, the board may suspend
the dentist's,
DENTAL THERAPIST'S, or dental hygienist's license to practice
dentistry,
DENTAL THERAPY, or dental hygiene in this state until the dentist,
DENTAL THERAPIST, or dental hygienist submits to the examination.
(2) Every person licensed to practice dentistry,
DENTAL THERAPY,
or dental hygiene in this state is deemed, by so practicing or by applying for
a renewal of the person's license to practice dentistry,
DENTAL THERAPY, or
dental hygiene in this state, to have:
SECTION 13. In Colorado Revised Statutes, 12-220-208, amend
(2) as follows:
12-220-208. Review of board action. (2) The provisions of this
section apply to a license issued to a dentist,
DENTAL THERAPIST, or dental
hygienist.
PAGE 16-SENATE BILL 22-219 SECTION 14. In Colorado Revised Statutes, 12-220-210, amend
(1)(a)(I), (2) introductory portion, and (2)(a) as follows:
12-220-210. Use or sale of forged or invalid diploma, license,
license renewal certificate, or identification. (1) (a) It is unlawful for any
person to use or attempt to use:
(I) As the person's own, a diploma from a dental college or school
or school of
DENTAL THERAPY OR dental hygiene, or a license or license
renewal certificate, that was issued or granted to another person; or
(2) It is unlawful to sell or offer to sell a diploma conferring a
dental,
DENTAL THERAPY, or dental hygiene degree or a license or license
renewal certificate granted pursuant to this article 220 or prior dental
practice laws, or to procure such diploma or license or license renewal
certificate:
(a) With the intent that it be used as evidence of the right to practice
dentistry,
DENTAL THERAPY, or dental hygiene by a person other than the
one upon whom it was conferred or to whom the license or license renewal
certificate was granted; or
SECTION 15. In Colorado Revised Statutes, amend 12-220-211
as follows:
12-220-211. Unauthorized practice - penalties. Any person who
practices or offers or attempts to practice dentistry,
DENTAL THERAPY, or
dental hygiene without an active license issued under this article 220 is
subject to penalties pursuant to section 12-20-407 (1)(a).
SECTION 16. In Colorado Revised Statutes, 12-220-301, amend
(1) introductory portion and (1)(a) as follows:
12-220-301. Persons entitled to practice dentistry, dental
therapy, or dental hygiene. (1) It is unlawful for any person to practice
dentistry,
DENTAL THERAPY, or dental hygiene in this state except those:
(a) Who are duly licensed as dentists,
DENTAL THERAPISTS, or dental
hygienists pursuant to this article 220;
PAGE 17-SENATE BILL 22-219 SECTION 17. In Colorado Revised Statutes, 12-220-302, amend
(1)(c), (1)(e), (1)(f), (1)(i), and (1)(j) as follows:
12-220-302. Persons exempt from operation of this article.
(1) This article 220 does not apply to the following practices, acts, and
operations:
(c) The practice of dentistry,
DENTAL THERAPY, or dental hygiene in
the discharge of their official duties by graduate dentists, or
dental surgeons,
DENTAL THERAPISTS, or dental hygienists in the United States armed forces,
public health service, Coast Guard, or veterans administration;
(e) The practice of
DENTAL THERAPY OR dental hygiene by
instructors and students or the practice of dentistry by students or residents
in schools or colleges of dentistry, schools of
DENTAL THERAPY, SCHOOLS
OF
dental hygiene, or schools of dental assistant education while the
instructors, students, or residents are participating in accredited programs
of the schools or colleges;
(f) The practice of dentistry,
DENTAL THERAPY, or dental hygiene by
dentists,
DENTAL THERAPISTS, or dental hygienists licensed in good standing
by other states or countries while appearing in programs of dental education
or research at the invitation of any group of licensed dentists,
DENTAL
THERAPISTS
, or dental hygienists in this state who are in good standing, so
long as the practice is limited to five consecutive days in a twelve-month
period and the name of each person engaging in the practice is submitted to
the board, in writing and on a form approved by the board, at least ten days
before the person performs the practice;
(i) The practicing of dentistry,
DENTAL THERAPY, or dental hygiene
by an examiner representing a testing agency approved by the board, during
the administration of an examination; or
(j) The practice of dentistry,
DENTAL THERAPY, or dental hygiene by
dentists,
DENTAL THERAPISTS, or dental hygienists licensed in good standing
by other states while providing care as a volunteer, at the invitation of any
group of licensed dentists,
DENTAL THERAPISTS, or dental hygienists in this
state who are in good standing, so long as the practice is limited to five
consecutive days in a twelve-month period and the name of each person
engaging in the practice is submitted to the board, in writing and on a form
PAGE 18-SENATE BILL 22-219 approved by the board, at least ten days before the person performs the
practice.
SECTION 18. In Colorado Revised Statutes, amend 12-220-304
as follows:
12-220-304. Names and status under which dental practice may
be conducted. (1) The conduct of the practice of dentistry,
DENTAL
THERAPY
, or dental hygiene in a corporate capacity is prohibited, but the
prohibition shall not be construed to prevent the practice of dentistry,
DENTAL THERAPY, or dental hygiene by a professional service corporation
of licensees so constituted that they may be treated under the federal
internal revenue laws as a corporation for tax purposes only. Any such
A
professional service corporation may exercise such THE powers and shall be
subject to such limitations and requirements, insofar as applicable, as are
provided in section 12-240-138, relating to professional service
corporations for the practice of medicine.
(2) The group practice of dentistry,
DENTAL THERAPY, or dental
hygiene is permitted.
(3) The practice of dentistry,
DENTAL THERAPY, or dental hygiene
by a limited liability company of licensees or by a limited liability
partnership of licensees is permitted subject to the limitations and
requirements, insofar as are applicable, set forth in section 12-240-138,
relating to a limited liability company or limited liability partnership for the
practice of medicine.
SECTION 19. In Colorado Revised Statutes, 12-220-305, amend
(1)(a), (1)(b), (1)(c), (1)(j), (1)(k), (1)(m), (1)(n), (1)(p), and (1)(r) as
follows:
12-220-305. What constitutes practicing dentistry - authority to
electronically prescribe. (1) A person is practicing dentistry if the person:
(a) Performs, or attempts or professes to perform, any dental
operation, oral surgery, or dental diagnostic or therapeutic services of any
kind; except that nothing in this subsection (1)(a) prohibits a
DENTAL
THERAPIST
, dental hygienist, or dental assistant from providing preventive
dental or nutritional counseling, education, or instruction services;
PAGE 19-SENATE BILL 22-219 (b) Is a proprietor of a place where dental operation, oral surgery,
or dental diagnostic or therapeutic services are performed; except that
nothing in this subsection (1)(b) prohibits a
DENTAL THERAPIST, dental
hygienist, or dental assistant from performing those tasks and procedures
consistent with section 12-220-501;
(c) Directly or indirectly, by any means or method, takes impression
of the human tooth, teeth, jaws, maxillofacial area, or adjacent and
associated structures; performs any phase of any operation incident to the
replacement of a part of a tooth; or supplies artificial substitutes for the
natural teeth, jaws, or adjacent and associated structures; except that
nothing in this subsection (1)(c) prohibits a
DENTAL THERAPIST, dental
hygienist, or dental assistant from performing tasks and procedures
consistent with sections 12-220-501 (3)(b)(III), and
12-220-503 (1)(d), AND
12-220-508;
(j) Extracts, or attempts to extract, human teeth or corrects, or
attempts to correct, malformations of human teeth or jaws;
EXCEPT THAT
THIS SUBSECTION
(1)(j) DOES NOT PROHIBIT A DENTAL THERAPIST FROM
PERFORMING TASKS AND PROCEDURES CONSISTENT WITH SECTION
12-220-508;
(k) Repairs or fills cavities in human teeth;
EXCEPT THAT THIS
SUBSECTION
(1)(k) DOES NOT PROHIBIT A DENTAL THERAPIST FROM
PERFORMING TASKS AND PROCEDURES CONSISTENT WITH SECTION
12-220-508;
(m) Gives, or professes to give, interpretations or readings of dental
X rays or roentgenograms, CT scans, or other diagnostic methodologies;
except that nothing in this subsection (1)(m) prohibits a dental hygienist
from performing tasks and procedures consistent with sections 12-220-503
and 12-220-504
OR A DENTAL THERAPIST FROM PERFORMING TASKS
CONSISTENT WITH SECTION
12-220-508;
(n) Represents himself or herself to an individual or the general
public as practicing dentistry, by using the words "dentist" or "dental
surgeon", or by using the letters "D.D.S.", "D.M.D.", "D.D.S./M.D.", or
"D.M.D./M.D." Nothing in this subsection (1)(n) prohibits a
DENTAL
THERAPIST
, dental hygienist, or dental assistant from performing tasks and
procedures consistent with section 12-220-501 (2), (2.5), or (3)(b).
PAGE 20-SENATE BILL 22-219 (p) Prescribes drugs or medications and administers local anesthesia,
analgesia including nitrous oxide/oxygen inhalation, medication prescribed
or administered for the relief of anxiety or apprehension, minimal sedation,
moderate sedation, deep sedation, or general anesthesia as necessary for the
proper practice of dentistry; except that nothing in this subsection (1)(p)
prohibits:
(I) A dental hygienist from performing those tasks and procedures
consistent with sections 12-220-501, 12-220-503 (1)(e) and (1)(g), and
12-220-504 (1)(c), and in accordance with rules promulgated by the board;
OR
(II) A DENTAL THERAPIST FROM PERFORMING THOSE TASKS AND
PROCEDURES CONSISTENT WITH SECTIONS
12-220-501 (2.5) AND 12-220-508,
AND IN ACCORDANCE WITH RULES PROMULGATED BY THE BOARD .
(r) Gives or professes to give interpretations or readings of dental
charts or records or gives treatment plans or interpretations of treatment
plans derived from examinations, patient records, dental X rays, or
roentgenograms; except that nothing in this subsection (1)(r) prohibits a
DENTAL THERAPIST, dental hygienist, or dental assistant from performing
tasks and procedures consistent with sections 12-220-501 (2), (2.5), and (3),
12-220-503, and
12-220-504, AND 12-220-508.
SECTION 20. In Colorado Revised Statutes, amend 12-220-307
as follows:
12-220-307. Professional liability insurance required - rules.
(1) A licensed dentist,
A LICENSED DENTAL THERAPIST , and a licensed
dental hygienist must meet the financial responsibility requirements
established by the board pursuant to section 13-64-301 (1)(a).
(2) Upon request of the board, a licensed dentist,
LICENSED DENTAL
THERAPIST
, or licensed dental hygienist shall provide proof of professional
liability insurance to the board.
(3) The board may, by rule, exempt from or establish lesser financial
responsibility standards for licensed dentists,
LICENSED DENTAL
THERAPISTS
, and licensed dental hygienists who meet the criteria in section
13-64-301 (1)(a)(II).
PAGE 21-SENATE BILL 22-219 SECTION 21. In Colorado Revised Statutes, amend 12-220-308
as follows:
12-220-308. Continuing education requirements - rules. (1) As
a condition of renewing, reactivating, or reinstating a license issued under
this article 220, every dentist,
DENTAL THERAPIST, and dental hygienist must
obtain at least thirty hours of continuing education every two years to ensure
patient safety and professional competency.
(2) The board may adopt rules establishing the basic requirements
for continuing education, including the types of programs that qualify,
exemptions for persons holding an inactive or retired license, requirements
for courses designed to enhance clinical skills for certain licenses, and the
manner by which dentists,
DENTAL THERAPISTS, and dental hygienists are
to report compliance with the continuing education requirements.
SECTION 22. In Colorado Revised Statutes, 12-220-409, amend
(1), (2)(a), and (5) as follows:
12-220-409. Inactive dental, dental therapist, or dental hygienist
license. (1) Any person licensed to practice dentistry,
DENTAL THERAPY, or
dental hygiene pursuant to this article 220 may apply to the board to be
transferred to an inactive status. The licensee must submit an application in
the form and manner designated by the board. The board may grant inactive
status by issuing an inactive license or deny the application for any of the
causes set forth in section 12-220-201.
(2) Any person applying for a license under this section must:
(a) Provide an affidavit to the board that the applicant, after a date
certain, will not practice dentistry,
DENTAL THERAPY, or dental hygiene in
this state unless the applicant is issued a license to practice dentistry,
DENTAL THERAPY, or dental hygiene pursuant to subsection (5) of this
section;
(5) Any person licensed under this section who wishes to resume the
practice of dentistry,
DENTAL THERAPY, or dental hygiene must file an
application in the form and manner the board designates, pay the license fee
promulgated by the board pursuant to section 12-20-105, and meet the
financial responsibility requirements or the professional liability insurance
PAGE 22-SENATE BILL 22-219 requirements established by the board pursuant to sections 12-220-307 and
13-64-301 (1)(a), as applicable. The board may approve the application and
issue a license to practice dentistry,
DENTAL THERAPY, or dental hygiene or
may deny the application for any of the causes set forth in section
12-220-201.
SECTION 23. In Colorado Revised Statutes, 12-220-410, amend
(1), (2)(a), (5), and (6) as follows:
12-220-410. Retired dental, dental therapist, and dental
hygienist licenses. (1) Any person licensed to practice dentistry,
DENTAL
THERAPY
, or dental hygiene pursuant to this article 220 may apply to the
board for retired licensure status. The application must be in the form and
manner designated by the board. The board may grant retired licensure
status by issuing a retired license, or it may deny the application if the
licensee has been disciplined for any of the causes set forth in section
12-220-201.
(2) Any person applying for a license under this section must:
(a) Provide an affidavit to the board stating that, after a date certain,
the applicant will not practice dentistry,
DENTAL THERAPY, or dental
hygiene; will no longer earn income as a dentist,
DENTAL THERAPIST, or
dental hygiene administrator or consultant; and will not perform any activity
that constitutes practicing dentistry,
DENTAL THERAPY, or dental hygiene
pursuant to sections 12-220-305, 12-220-501, 12-220-503, and
12-220-504,
AND 12-220-508 unless the applicant is issued a license to practice dentistry,
DENTAL THERAPY, or dental hygiene pursuant to subsection (5) of this
section; and
(5) Any person licensed under this section may apply to the board
for a return to active licensure status by filing an application in the form and
manner the board designates, paying the appropriate license fee established
pursuant to section 12-20-105, and meeting the financial responsibility
requirements or the professional liability insurance requirements established
by the board pursuant to sections 12-220-307 and 13-64-301 (1)(a), as
applicable. The board may approve the application and issue a license to
practice dentistry,
DENTAL THERAPY, or dental hygiene or may deny the
application if the licensee has been disciplined for any of the causes set
forth in section 12-220-201.
PAGE 23-SENATE BILL 22-219 (6) A dentist, DENTAL THERAPIST, or dental hygienist on retired
status may provide dental,
DENTAL THERAPY, or dental hygiene services on
a voluntary basis to the
PEOPLE WHO ARE indigent if the retired dentist,
DENTAL THERAPIST, or dental hygienist provides the services on a limited
basis and does not charge a fee for the services. A retired dentist,
DENTAL
THERAPIST
, or dental hygienist providing voluntary care pursuant to this
subsection (6) is immune from any liability resulting from the voluntary
care the retired dentist,
DENTAL THERAPIST, or dental hygienist provided.
SECTION 24. In Colorado Revised Statutes, 12-220-411, amend
(1), (3), and (4)(a); and add (6) as follows:
12-220-411. Anesthesia and sedation permits - dentists, dental
therapists, and dental hygienists - training and experience
requirements - office inspections - rules. (1) Upon application in a form
and manner determined by the board and payment of the applicable fees
established by the board, the board may issue an anesthesia or sedation
permit to a licensed dentist or a local anesthesia permit to a
DENTAL
THERAPIST OR
dental hygienist in accordance with this section.
(3) (a) A licensed
DENTAL THERAPIST OR dental hygienist who
obtains a local anesthesia permit pursuant to this section may administer
local anesthesia.
(b) A local anesthesia permit issued to a
DENTAL THERAPIST OR
dental hygienist is valid as long as the DENTAL THERAPIST'S OR dental
hygienist's license is active.
(4) (a) The board shall establish, by rule, minimum training,
experience, and equipment requirements for the administration of local
anesthesia, analgesia including nitrous oxide/oxygen inhalation, and
medication prescribed or administered for the relief of anxiety or
apprehension, minimal sedation, moderate sedation, deep sedation, or
general anesthesia, including procedures that may be used by and minimum
training requirements for dentists,
DENTAL THERAPISTS, dental hygienists,
and dental assistants.
(6) F
OR THE PURPOSES OF THIS SECTION, A DENTAL THERAPIST WHO
PERFORMS A TASK PURSUANT TO A WRITTEN ARTICULATED PLAN THAT
MEETS THE REQUIREMENTS OF SECTION
12-220-508 (2) IS CONSIDERED TO
PAGE 24-SENATE BILL 22-219 HAVE PERFORMED THE TASK WITH THE PRIOR KNOWLEDGE AND CONSENT OF
THE DENTIST
.
SECTION 25. In Colorado Revised Statutes, 12-220-601, amend
(1) and (2) as follows:
12-220-601. Legislative declaration. (1) The general assembly
hereby finds, determines, and declares that public exposure to the hazards
of ionizing radiation used for diagnostic purposes should be minimized
wherever possible. Accordingly, the general assembly finds, determines,
and declares that for any dentist,
DENTAL THERAPIST, or dental hygienist to
allow an untrained person to operate a machine source of ionizing radiation,
including without limitation a device commonly known as an "X-ray
machine", or to administer radiation to a patient for diagnostic purposes is
a threat to the public health and safety.
(2) It is the intent of the general assembly that dentists,
DENTAL
THERAPISTS
, and dental hygienists utilizing unlicensed persons in their
practices provide those persons with a minimum level of education and
training before allowing them to operate machine sources of ionizing
radiation; however, it is not the general assembly's intent to discourage
education and training beyond this minimum. It is further the intent of the
general assembly that established minimum training and education
requirements correspond as closely as possible to the requirements of each
particular work setting as determined by the board pursuant to this part 6.
SECTION 26. In Colorado Revised Statutes, 12-220-602, amend
(1) and (2) as follows:
12-220-602. Minimum standards - rules - definition. (1) (a) The
board shall adopt rules prescribing minimum standards for the
qualifications, education, and training of unlicensed persons operating
machine sources of ionizing radiation and administering radiation to
patients for diagnostic medical use. A licensed dentist,
DENTAL THERAPIST,
or dental hygienist shall not allow an unlicensed person to operate a
machine source of ionizing radiation or to administer radiation to any
patient unless the person meets standards then in effect under rules adopted
pursuant to this section. The board may adopt rules allowing a grace period
in which newly hired operators of machine sources of ionizing radiation are
to receive the training required by this section.
PAGE 25-SENATE BILL 22-219 (b) For purposes of AS USED IN this part 6, "unlicensed person"
means a person who does not hold a current and active license entitling the
person to practice dentistry,
DENTAL THERAPY, or dental hygiene under this
article 220.
(2) The board shall seek the assistance of licensed dentists,
DENTAL
THERAPISTS
, or licensed
dental hygienists in developing and formulating the
rules promulgated pursuant to this section.
SECTION 27. In Colorado Revised Statutes, 12-20-202, add
(3)(e)(IX.5) as follows:
12-20-202. Licenses, certifications, and registrations - renewal
- reinstatement - fees - occupational credential portability program -
temporary authority for military spouses - exceptions for military
personnel - rules - consideration of criminal convictions or driver's
history - executive director authority - definitions. (3) Occupational
credential portability program. (e) Subsections (3)(a) to (3)(d) of this
section do not apply to the following professions or occupations:
(IX.5) D
ENTAL THERAPISTS, REGULATED PURSUANT TO ARTICLE 220
OF THIS TITLE 12;
SECTION 28. In Colorado Revised Statutes, 12-20-406, amend
(3)(f) as follows:
12-20-406. Injunctive relief. (3) This section does not apply to the
following:
(f) Article 220 of this title 12 concerning dentists,
DENTAL
THERAPISTS
, and dental hygienists;
SECTION 29. In Colorado Revised Statutes, 12-20-407, amend
(1)(a)(V)(J) as follows:
12-20-407. Unauthorized practice of profession or occupation -
penalties - exclusions. (1) (a) A person commits a class 2 misdemeanor
and shall be punished as provided in section 18-1.3-501 if the person:
(V) Practices or offers or attempts to practice any of the following
PAGE 26-SENATE BILL 22-219 professions or occupations without an active license, certification, or
registration issued under the part or article of this title 12 governing the
particular profession or occupation:
(J) Dentistry,
DENTAL THERAPY, or dental hygiene, as regulated
under article 220 of this title 12;
SECTION 30. In Colorado Revised Statutes, 12-30-102, amend
(3)(a)(VII) as follows:
12-30-102. Medical transparency act of 2010 - disclosure of
information about health-care providers - fines - rules - short title -
legislative declaration - review of functions - repeal. (3) (a) As used in
this section, "applicant" means a person applying for a new, active license,
certification, or registration or to renew, reinstate, or reactivate an active
license, certification, or registration to practice:
(VII) Dental
THERAPY OR DENTAL hygiene pursuant to article 220
of this title 12;
SECTION 31. In Colorado Revised Statutes, 12-30-103, amend
(4)(a)(IV) as follows:
12-30-103. Solicitation of accident victims - waiting period -
definitions. (4) As used in this section:
(a) "Health-care practitioner" means:
(IV) A dentist,
DENTAL THERAPIST, or dental hygienist licensed
under article 220 of this title 12;
SECTION 32. In Colorado Revised Statutes, 13-4-102, amend
(1)(g) and (2)(g) as follows:
13-4-102. Jurisdiction. (1) Any provision of law to the contrary
notwithstanding, the court of appeals shall have initial jurisdiction over
appeals from final judgments of, and interlocutory appeals of certified
questions of law in civil cases pursuant to section 13-4-102.1 from, the
district courts, the probate court of the city and county of Denver, and the
juvenile court of the city and county of Denver, except in:
PAGE 27-SENATE BILL 22-219 (g) Review actions of the Colorado dental board in refusing to issue
or renew or in suspending or revoking a license to practice dentistry,
DENTAL THERAPY, or dental hygiene, as provided in section 12-220-208;
(2) The court of appeals has initial jurisdiction to:
(g) Review actions of the Colorado dental board in refusing to issue
or renew or in suspending or revoking a license to practice dentistry,
DENTAL THERAPY, or dental hygiene, as provided in section 12-220-137
SECTION 12-220-208;
SECTION 33. In Colorado Revised Statutes, 13-21-115.5, amend
(3)(c)(II)(R) as follows:
13-21-115.5. Volunteer service act - immunity - exception for
operation of motor vehicles - short title - legislative declaration -
definitions. (3) As used in this section, unless the context otherwise
requires:
(c) (II) "Volunteer" includes:
(R) A licensed dentist,
DENTAL THERAPIST, or dental hygienist
governed by article 220 of title 12 performing the practice of dentistry,
DENTAL THERAPY, or dental hygiene, as defined in section 12-220-104 and
as described in section
SECTIONS 12-220-305, 12-220-402, 12-220-403, AND
12-220-508; as a volunteer for a nonprofit organization, nonprofit
corporation, governmental entity, or hospital; or a dentist,
DENTAL
THERAPIST
, or dental hygienist who holds a license in good standing from
another state performing the practice of dentistry,
DENTAL THERAPY, or
dental hygiene, as defined in section 12-220-104 and as described in section
SECTIONS 12-220-305, 12-220-402, 12-220-403, AND 12-220-508, as a
volunteer for a nonprofit organization, nonprofit corporation, governmental
entity, or hospital pursuant to section 12-220-302 (1)(j); and
SECTION 34. In Colorado Revised Statutes, 13-64-301, amend (1)
introductory portion, (1)(a)(I), (1)(a)(II) introductory portion, (1)(a)(III),
and (1)(a)(IV) as follows:
13-64-301. Financial responsibility. (1) As a condition of active
licensure or authority to practice in this state, every physician, dentist,
PAGE 28-SENATE BILL 22-219 DENTAL THERAPIST, or dental hygienist; every physician assistant who has
been practicing for at least three years; and every health-care institution as
defined in section 13-64-202, except as provided in section 13-64-303.5,
that provides health-care services shall establish financial responsibility, as
follows:
(a) (I) (A) If a dentist, by maintaining commercial professional
liability insurance coverage with an insurance company authorized to do
business in this state or an eligible nonadmitted insurer allowed to insure in
Colorado pursuant to article 5 of title 10, C.R.S.,
in a minimum indemnity
amount of five hundred thousand dollars per incident and one million five
hundred thousand dollars annual aggregate per year; except that this
requirement is not applicable to a dentist who is a public employee under
the "Colorado Governmental Immunity Act", article 10 of title 24. C.R.S.
(B) A licensed dental hygienist must have MAINTAIN professional
liability insurance in an amount not less than fifty thousand dollars per
claim and with an aggregate liability limit for all claims during a calendar
year of not less than three hundred thousand dollars; except that this
requirement does not apply to a licensed dental hygienist who is a public
employee under the "Colorado Governmental Immunity Act", article 10 of
title 24. C.R.S.
(C) A LICENSED DENTAL THERAPIST MUST MAINTAIN PROFESSIONAL
LIABILITY INSURANCE IN AN AMOUNT NOT LESS THAN FIVE HUNDRED
THOUSAND DOLLARS PER INCIDENT AND ONE MILLION FIVE HUNDRED
THOUSAND DOLLARS ANNUAL AGGREGATE PER YEAR
; EXCEPT THAT THIS
REQUIREMENT IS NOT APPLICABLE TO A DENTAL THERAPIST WHO IS A PUBLIC
EMPLOYEE UNDER THE
"COLORADO GOVERNMENTAL IMMUNITY ACT",
ARTICLE 10 OF TITLE 24.
(II) The Colorado dental board, by rule, may exempt from or
establish lesser financial responsibility standards than those prescribed in
this section for classes of
LICENSED dentists, and licensed
DENTAL
THERAPISTS
, AND dental hygienists who:
(III) The Colorado dental board may exempt from or establish lesser
financial responsibility standards for a
LICENSED dentist, DENTAL
THERAPIST
, or licensed
dental hygienist for reasons other than those
described in subparagraph (II) of this paragraph (a) SUBSECTION (1)(a)(II)
PAGE 29-SENATE BILL 22-219 OF THIS SECTION that render the limits provided in subparagraph (I) of this
paragraph (a) SUBSECTION (1)(a)(I) OF THIS SECTION unreasonable or
unattainable.
(IV) Nothing in this paragraph (a) SUBSECTION (1)(a) shall preclude
or otherwise prohibit a licensed dentist,
DENTAL THERAPIST, or licenseddental hygienist from rendering appropriate patient care on an occasional basis when the circumstances surrounding the need for care so warrant.
SECTION 35. In Colorado Revised Statutes, 19-3-304, amend
(2)(o) as follows:
19-3-304. Persons required to report child abuse or neglect.
(2) Persons required to report such abuse or neglect or circumstances or
conditions include any:
(o) Dental
THERAPIST OR DENTAL hygienist;
SECTION 36. In Colorado Revised Statutes, add 23-5-148 as
follows:
23-5-148. Dental therapy training programs - authorization to
grant advanced standing - definition. (1) A
S USED IN THIS SECTION,
"
STATE INSTITUTION OF HIGHER EDUCATION" HAS THE SAME MEANING AS SET
FORTH IN SECTION
23-18-102 (10)(a).
(2) A
STATE INSTITUTION OF HIGHER EDUCATION OFFERING AN
ACCREDITED DENTAL THERAPY TRAINING PROGRAM MAY GRANT ADVANCED
STANDING TOWARD COMPLETION OF AN ACCREDITED DENTAL THERAPY
PROGRAM IF A STUDENT DEMONSTRATES PAST COMPLETION OF CURRICULUM
THAT MEETS OR EXCEEDS THE CONTENT STANDARDS FOR ONE OR MORE
COURSES THAT COMPRISE THE DENTAL THERAPY CURRICULUM ACCREDITED
BY THE
AMERICAN DENTAL ASSOCIATION'S COMMISSION ON DENTAL
ACCREDITATION
, OR ITS SUCCESSOR ORGANIZATION.
SECTION 37. In Colorado Revised Statutes, 25-1-108.7, amend
(3)(f) as follows:
25-1-108.7. Health care credentials uniform application act -
legislative declaration - definitions - state board of health rules. (3) As
PAGE 30-SENATE BILL 22-219 used in this section, unless the context otherwise requires:
(f) "Health-care professional" means a physician, dentist,
DENTAL
THERAPIST
, dental hygienist, chiropractor, podiatrist, psychologist,
advanced practice
REGISTERED nurse, optometrist, physician assistant,
licensed clinical social worker, child health associate, marriage and family
therapist, or other health-care professional who is registered, certified, or
licensed pursuant to title 12; C.R.S.; who is subject to credentialing; and
who practices, or intends to practice, in Colorado.
SECTION 38. In Colorado Revised Statutes, 25-1-1202, amend
(1)(k) as follows:
25-1-1202. Index of statutory sections regarding medical record
confidentiality and health information. (1) Statutory provisions
concerning policies, procedures, and references to the release, sharing, and
use of medical records and health information include the following:
(k) Section 12-220-201, concerning disciplinary actions against
dentists,
DENTAL THERAPISTS, and dental hygienists;
SECTION 39. In Colorado Revised Statutes, amend 25.5-4-411
as follows:
25.5-4-411. Authorization of services provided by dental
hygienists. (1) When dental hygiene services are provided to children by
a licensed dental hygienist
OR DENTAL THERAPIST who is providing dental
hygiene services pursuant to section 12-220-503 without the supervision of
a licensed dentist, the executive director of the state department shall
authorize reimbursement for said services, subject to the requirements of
this section. Payment for the services shall be made directly to the licensed
dental hygienist
OR DENTAL THERAPIST, if requested by the licensed dental
hygienist
OR DENTAL THERAPIST; except that this section shall
DOES not
apply to licensed dental hygienists
OR DENTAL THERAPISTS when acting
within the scope of their employment as salaried employees of public or
private institutions, physicians, or dentists.
(2) For each child provided dental hygiene services pursuant to this
section, the dental hygienist
OR DENTAL THERAPIST shall attempt to identify
a dentist participating in medicaid for the child.
PAGE 31-SENATE BILL 22-219 SECTION 40. Appropriation. (1) For the 2022-23 state fiscal
year, $14,786 is appropriated to the department of regulatory agencies. This
appropriation is from the division of professions and occupations cash fund
created in section 12-20-105 (3), C.R.S. To implement this act, the
department may use this appropriation for the purchase of legal services.
(2) For the 2022-23 state fiscal year, $14,786 is appropriated to the
department of law. This appropriation is from reappropriated funds received
from the department of regulatory agencies under subsection (1) of this
section and is based on an assumption that the department of law will
require an additional 0.1 FTE. To implement this act, the department of law
may use this appropriation to provide legal services for the department of
regulatory agencies.
SECTION 41. Act subject to petition - effective date -
applicability. (1) This act takes effect January 1, 2023; except that, if a
referendum petition is filed pursuant to section 1 (3) of article V of the state
constitution against this act or an item, section, or part of this act within the
ninety-day period after final adjournment of the general assembly, then the
act, item, section, or part will not take effect unless approved by the people
at the general election to be held in November 2022 and, in such case, will
take effect January 1, 2023, or on the date of the official declaration of the
vote thereon by the governor, whichever is later.
PAGE 32-SENATE BILL 22-219 (2) This act applies to the practice of dental therapy on or after the
applicable effective date of this act.
____________________________ ____________________________
Steve Fenberg Alec Garnett
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Cindi L. Markwell Robin Jones
SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 33-SENATE BILL 22-219